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Biomedical subjects

G C Starks

Publications and source records attributed to G C Starks.

12 recordsLinked to original sources
PubMed1988

CO2 laser myomectomy in an infertile population.

Thirty-two infertility patients with uterine myomas underwent laser myomectomy with the CO2 laser. Twenty-four patients (75%) had persistent primary infertility, with 8 (25%) experiencing recurrent abortions. Twenty (63%) of the 32 conceived (14/24 [58%] with primary infertility and 6/8 [75%] with secondary infertility); 17 (59%) ultimately had a viable term pregnancy. The mean interval from surgery to pregnancy was 8.5 months. The risk factors of age, duration of infertility, size and number of fibroids, and menorrhagia did not appear to influence the success rate or increase the complication rate. The advantages of the CO2 laser for myoma surgery are decreased adhesion formation, improved hemostasis, precision of application and improved reproductive performance.

Adult↗
PubMed1985

Clinical significance of focal pelvic endometriosis.

Clinical findings in a group of infertile patients with endometriosis were reviewed to determine if minimal (focal) disease exerted an effect on reproductive outcome. Focal disease, defined as isolated implants less than or equal to 5 mm without pelvic adhesions or anatomic distortion, was found in 69 patients, with 35% manifesting menstrual dysfunction/anovulation. Patients with focal disease were divided into two groups: those treated with danazol (400-800 mg) daily for six months and those not treated. Conception occurred in 71% of the danazol-treated patients and 30% of the untreated ones. These results suggest that focal endometriosis does influence reproductive performance and that infertile patients with focal disease should be treated more aggressively with the available medical regimens, particularly when the infertility is of significant duration or when routine therapy has failed.

Danazol↗
PubMed1984

Herpes gestationis. A report of two cases.

Herpes gestationis is a pruritic, blistering disease of pregnancy and the puerperium. The clinical presentation consists of intense itching with widespread erythematous, edematous papules and plaques, grouped vesicles and tense bullae. Through recent advances in the immunopathology of blistering diseases, increased accuracy in the diagnosis of herpes gestationis is now possible.

Adult↗
PubMed1984

Therapeutic uses of contraceptive steroids.

During the past 20 years, contraceptive steroids have undergone significant changes as the result of an increased understanding of their metabolic, pharmacologic, and hormonal activities. During this time, prospective and retrospective epidemiologic studies have elucidated several noncontraceptive health benefits of oral contraceptive steroids, including their therapeutic effects for endometriosis, dysmenorrhea, polycystic ovarian disease, and benign breast disease. From this review it appears that the benefits of oral contraceptive steroids in young, healthy, nonsmoking women far outweigh their more publicized, infrequent risks.

Breast Diseases↗
PubMed1980

Unilateral twin interstitial ectopic pregnancy. A case report.

An unusual case of twin unilateral interstitial pregnancy with premature rupture of membranes and leiomyomata uteri is described. A review of the literature reveals only two previous cases of this type. On admission, the patient was diagnosed as having an intrauterine pregnancy of 27 weeks' gestation, with documented premature rupture of the membranes having occurred. An ultrasound was performed revealing a fibroid uterus, an anterior placenta and an gestation. Septicemia ensued, and antibiotics plus pitocin was begun; however, no uterine response occurred. A culdocentesis revealed free intraabdominal blood. Laparotomy followed, revealing a ruptured twin interstitial pregnancy with placenta accreta and leiomyomata of the uterus.

Adult↗
PubMed1980

Correlation of meconium-stained amniotic fluid, early intrapartum fetal pH, and Apgar scores as predictors of perinatal outcome.

A prospective study was undertaken to determine if the passage of meconium during the early intrapartum period (cervical dilatation 3 cm or less), the type of meconium passed (thick versus thin), and fetal pH values could be correlated with Apgar scores as a predictor of neonatal outcome. One hundred seventy-seven patients had meconium-stained amniotic fluid and a cervical dilatation of 3 cm or less at admission. Group 2 (thick meconium) had significantly lower 1- and 5-minute Apgar scores, lower scalp pH values, and increased risk factors, such as prolonged pregnancy, small-for-gestational-age fetus, and fetal heart rate abnormalities. Group 2 (thin meconium) and the control group (nonmeconium) appeared to have no increased associated risks. Thick meconium as a single variable appeared to be the most significant factor influencing fetal outcome; however, if an associated fetal heart rate abnormality was present, perinatal morbidity was greatly increased as indicated by fetal acidosis and lower 1- and 5-minute Apgar scores. It thus appears that early passage of thick meconium does correlate with fetal outcome and increased perinatal morbidity. The significance of meconium passage is discussed and a modern obstetric management scheme for these high-risk patients is presented.

Acidosis↗
PubMed1979

Role of dextran 70 in microtubal surgery.

Pelvic adhesion formation represents a major problem following fallopian tube surgery for infertility. Intraperitoneal dextran may prevent pelvic adhesions. Extensive personal clinical experience (W. H. U.) with intraperitoneal dextran organ-flotation on completion of tubal and ovarian surgery has appeared to limit adhesions. A specific study was designed to test the validity of this theory. Four randomized groups of rabbits were subjected to bilateral tubocornual division and microsurgical reanastomosis with total hemostasis and pelvic lavage. Routine peritoneal closure was performed on one group, but followed instillation of 30 to 50 ml of normal saline into the peritoneal cavities of the second group, and 30 to 50 ml of 6% dextran 70 into those of the third. Study of fourth group, which received 32% dextran 70 in the peritoneal cavity, was discontinued because of complications. A second laparotomy was performed 4 weeks later for precise assessment and photography of adhesion formation. Each animal was mated 4 weeks after the second operation in order to determine fertility rates. Reduced adhesion formation and increased fertility rates following the instillation of dextran are reported. A role for dextran 70 in infertility surgery is recommended.

Animals↗