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Biomedical subjects

G R Meeks

Publications and source records attributed to G R Meeks.

At least 55 records · Page 3Linked to original sources
PubMed1990

Postpartum eclampsia: a recurring perinatal dilemma.

Because identification of patients at risk and preventive therapies are imperfect, eclamptic seizures continue to occur occasionally during the puerperium. During an 18-year span in a single tertiary medical center, 36 of 254 patients with eclampsia (14.2%) experienced postpartum seizures at a mean gestational age of 35.6 weeks. Early (before 48 hours) postpartum eclampsia was experienced by 72% of patients, and 28% had late (after 48 hours) postpartum eclampsia. Prospectively only 67% of patients were correctly diagnosed, and retrospectively only 83% could be considered to have had preeclampsia before seizure. Hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome was present in 30% of the affected patients. Seven patients were receiving magnesium sulfate by controlled infusion when an eclamptic seizure occurred. The presence or absence of diuresis was unrelated to seizure occurrence. Preeclampsia recurred in 38.5% of subsequent gestations. It appears that HELLP syndrome may be a predisposing factor for eclampsia.

Blood Pressure↗
PubMed1989

Perinatal aspects of abdominal surgery for nonobstetric disease.

Surgical interventions for nonobstetric reasons during pregnancy are reported to occur in 0.2% to 2.2% of all gestations with obvious perinatal implications. In this retrospective study, 57 parturients were identified who underwent nonobstetric abdominal surgery. Thirty-one patients underwent exploratory celiotomy for suspected appendicitis, 16 for adnexal disease other than ectopic pregnancy, six for cholecystectomy, three for intestinal disorders, and one with a pheochromocytoma. Alterations in disease expression are related to the severity of the disease and advancing gestational age, being more important in cases of appendicitis. Preterm labor reflecting fetal morbidity relates to the presence of peritonitis and then only during the third trimester. In this retrospective study, tocolysis with intravenous magnesium sulfate had an uncertain effect on the incidence of preterm delivery. Prospective studies will be required to assess the indications and limitations of tocolysis for nonobstetric abdominal surgical conditions.

Abdomen↗
PubMed1989

Detection of glucose intolerance in pregnancy.

Between 6 and 28 weeks of gestation, 2-hour postprandial blood glucose determinations were performed on 66 pregnant patients who had no history of diabetes. Each patient received two methods of carbohydrate loading on separate occasions in a random, crossover fashion. One group received a 100-g carbohydrate meal and then a 50-g glucose load (Glucola). The order of the test regimens was reversed for the second group. The average 2-hour postprandial glucose value following a meal was 103.1 +/- 3.7 mg/dL, and the mean value for the 2-hour postprandial glucose following Glucola was 102.5 +/- 3.8 mg/dL. The difference in glucose values obtained with the two methods was not statistically significant. A 12% incidence of emesis was encountered after Glucola but none was encountered after the meal. The 100-g carbohydrate meal is recommended as the method of testing for glucose intolerance.

Adolescent↗
PubMed1989

Transcervical resection of submucous uterine fibroids: an alternative approach to management.

Transcervical resection of submucous uterine fibroids can be an effective alternative to laparotomy and transuterine myomectomy in selected women. To date the authors have performed this procedure in three patients in an ambulatory environment. In two patients, transcervical resection was performed for giant intrauterine myomas which caused pathologic uterine bleeding and infertility. In a third patient the procedure was performed to resect multiple small submucous myomas causing infertility.

Adult↗
PubMed1986

External cephalic version of the breech presentation under tocolysis.

External cephalic version with tocolysis at or near term has been advocated to avoid cesarean birth for breech presentation. In our institution this maneuver was successfully performed in 207 of 304 parturients without major complications, and all but six had vertex presentation at delivery. The success of version was inversely correlated with gestational age but was not correlated with ease of version, number of attempts, or placental location. When this 3-year period was compared with the previous three years (1979 to 1981), there was a significant reduction in the number of breech presentations during labor, whereas the total delivery rate remained relatively constant over the 6-year period. It appears that in a carefully selected population, external version near term can be used safely to reduce the need for abdominal birth because of breech presentation.

Breech Presentation↗
PubMed1986

Correlation of neonatal acid-base status with Apgar scores and fetal heart rate tracings.

In this study the immediate neonatal acid-base status, obtained via a double-clamped segment of umbilical cord, in 75 term, singleton vaginal deliveries was compared to electronic fetal heart rate recordings and Apgar scores. Of 75 neonates, 59 had 1-minute Apgar scores greater than or equal to 7 and 52 had an initial pH greater than 7.20. Six of the 16 neonates with a 1-minute Apgar score less than 7 demonstrated a low pH (less than 7.20). At 5 minutes only eight of 75 neonates had Apgar scores less than 7 with six of the eight having pH values less than 7.20. Of those neonates with Apgar scores greater than or equal to 7 and pH less than 7.20 (seven neonates at 1 minute, two at 5 minutes), none had metabolic acidosis. Eighteen fetal heart rate tracings were considered abnormal; acidosis was confirmed in eight (44%) by pH criteria, yet only three of the eight neonates had low Apgar scores. Our investigations suggest that the combination of fetal heart rate monitoring, cord blood pH, and Apgar assessment is better than any one parameter alone as an evaluation of fetal status just after delivery.

Apgar Score↗
PubMed1986

Insemination with fresh donor semen.

Factors influencing the probability of conception after artificial insemination with donor semen were investigated in a series of 80 infertile couples. Overall, 46 pregnancies were achieved for a crude pregnancy rate of 58%. Life table analysis showed a cumulative probability of conception of 97.1% at the end of 12 cycles and an average fecundability of 15.1%. These results were achieved using a single insemination per cycle and individualizing the day of insemination based on the woman's basal body temperature. Women who had been pregnant previously had a significantly better fecundability than nulligravid women (P less than .05). The overall rates of conception in those women who required therapy for ovulatory dysfunction were the same as normal women although the fecundability was somewhat lower. Women who had abdominal pathology had an overall conception rate of 23%.

Cervix Mucus↗