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Biomedical subjects

J I Puyenbroek

Publications and source records attributed to J I Puyenbroek.

15 recordsLinked to original sources
PubMed1992

Reproductive history of mothers of children with solitary, nonsyndromic cleft lip and/or palate.

The reproductive history was studied to evaluate if the three types of solitary, nonsyndromic clefts: cleft lip (CL), cleft lip and palate (CLP), and cleft palate (CP) are homogeneous entities. Occurrence of fetal loss, maternal health, and drug consumption of the mother during the pregnancy were compared in cases involving three types of clefts. Data was gathered from 87 children with clefts, 55 males and 32 females. Spontaneous abortions and vaginal bleeding were found to occur significantly more often in the (older) mother of a CLP child. This suggests that the factors involved in the etiology of CLP differ from the factors involved in CL and CP. Therefore, grouping of data of the three types of clefts in studies on the etiology should be avoided.

Abortion, Spontaneous↗
PubMed1990

[Are earlier birth weights different from current ones?].

A sample was taken from non-pathological Caucasian births in Amsterdam from 1972 until 1982. The methods replicated as closely as possible those applied by Kloosterman to births from 1931 until 1967 for the Amsterdam Growth Curves. Birth weight percentiles and confidence intervals were determined non-parametrically in groups distinguished by sex, order of birth and duration of pregnancy. The correlations among the weekly means and the extreme percentiles were tested from the 36th to the 43th pregnancy week. We found a strong correlation (r = 0.983) between our sample and the Amsterdam Growth Curves. The means in the latter sample exceeded ours by 48.5 grammes which equals the estimated clerical error of the birth weights of 50 grammes. There is no strong evidence that the birth weights have changed much in the Caucasian part of the Amsterdam population.

Birth Order↗
PubMed1987

Single- versus three-dose cefoxitin prophylaxis in caesarean section: a randomized clinical trial.

The present study was undertaken to determine the minimal effective antibiotic dosage in caesarean section prophylaxis. The study was conducted at the Academisch Ziekenhuis der Vrije Universiteit in Amsterdam (Amsterdam Free University Hospital) to compare the efficacy of one dose of cefoxitin (2 g) with three administrations of 2, 1 and 1 g respectively. In this prospective and double-blind study, 66 patients were given one dose and 72 patients received three doses. In terms of febrile morbidity, endometritis, wound infection, urinary tract infection and need for postoperative antibiotic therapy, the three-dose group showed fewer postoperative infections: as to wound infections (p less than 0.05) and therapeutic antibiotic use (p less than 0.025) these differences were statistically significant. The numbers of days of hospitalization after the caesarean section also showed differences: 10.6 +/- 2.6 versus 9.8 +/- 1.5 days in the one- and three-dose groups respectively (p less than 0.05). It is concluded that, contrary to several reports in the literature, prophylaxis consisting of three administrations of cefoxitin is to be preferred. No significant allergic or adverse reactions were observed in our patients.

Bacterial Infections↗
PubMed1987

Secretion of cefoxitin in breast milk following short-term prophylactic administration in caesarean section.

In this study we investigated whether cefoxitin administered prophylactically to the mother in caesarean section could be demonstrated in breast milk. For this purpose 25 samples of breast milk were obtained from 18 patients to whom either 2 or a total of 4 g of cefoxitin had been administered during and following caesarean section. Cefoxitin was determined by means of a modified HPLC method and appeared demonstrable in only one case in a concentration of 0.9 micrograms/ml. On these grounds nursing need not be advised against when prophylactic cefoxitin is briefly administered to the mother during and following caesarean section.

Breast Feeding↗
PubMed1987

Measurement and processing of fetal transcutaneous Pco2 levels.

Because asphyxia is not the only factor influencing fetal heart rhythm, a non-optimal cardiotachogram is not necessarily a sign of fetal distress. It makes further evaluation of the fetal condition advisable, especially determination of the acid-base equilibrium. The method of fetal blood sampling, introduced by Saling, has a number of disadvantages for mother and fetus, because of the invasiveness for both. Further, the measured acid-base equilibrium is only representative for a very short period of time and often repeated micro-blood sampling is necessary. A major problem with regard to determination of the acid-base equilibrium in intermittently obtained fetal blood samples is the inclusion of air bubbles in the sample. When they are introduced into the electrode cuvettes, the measured values cannot be considered reliable. The problem was solved in the Department of Obstetrics and Gynecology of the Vrije Universiteit of Amsterdam with a "pipe" shaped special collecting vessel. Similar measuring results were obtained with the formerly used glass capillary method and the special collecting vessel method. Continuous, non-invasive methods have been pursued to avoid the above mentioned problems. Fetal transcutaneous Po2 measurement has been possible for years, but does not provide adequate information during the important second stage of labor because of methodological problems. Continuous fetal tissue pH surveillance is possible, but it also has an invasive character and is technically difficult to perform, leading to many methodological failures. Recently, continuous transcutaneous Pco2 measurement tcPco2 became available. A good correlation was found with simultaneously measured Pco2 levels in fetal blood samples and with those of umbilical artery blood.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Gas Monitoring, Transcutaneous↗
PubMed1986

A randomized clinical trial of antibiotic prophylaxis in cesarean section: maternal morbidity, risk factors and bacteriological changes.

In the United States, several well-designed studies have demonstrated the efficacy of short-course antibiotic prophylaxis in cesarean sections. The present prospective study was conducted on 150 patients in a Dutch university hospital in a randomized double-blind fashion. Cefoxitin was administered according to a three-dose, 12 h regimen, the first injection given immediately after clamping of the umbilical cord. The rate of infection among the patients was significantly reduced by prophylaxis, judging from febrile morbidity, endometritis, wound infections, urinary tract infections and need for postoperative antibiotic therapy. The prophylactic use of the cefoxitin was especially effective in the secondary cesarean section population. Three risk factors significantly correlated with increased risk of infection: labor, rupture of membranes and pelvic examination. Postoperative cervical cultures showed a significant reduction of bacteria in the cefoxitin group. No shift towards resistant pathogens was demonstrable.

Adult↗
PubMed1986

'Idiopathic' second-trimester abortion--a reproductive failure.

The results of the investigation of all 238 immature deliveries (second-trimester abortions) that occurred in the period 1973 to 1985 in the Academic Hospital of the Vrije Universiteit in Amsterdam are presented. The incidence after 1979 was found to be increasing. Excluding all deliveries with a known cause, 126 'idiopathic' cases remained. In these, the obstetrical history of the women revealed a tendency to recurrent pregnancy wastage. The pregnancies frequently showed growth retardation of both fetus and placenta. Therefore, an extensive search for possible causes and an accurate evaluation of fetal development during a following pregnancy is advocated.

Abortion, Spontaneous↗
PubMed1986

[Incidence of cheilognathopalatoschisis in the Netherlands].

Until now, data on the incidence of cleft lip and/or palate in the Netherlands are scarcely available. For this study data were used from the National Medical Registration (NMR) and the National Obstetric Registration (NOR) over the years 1982 and 1983. Only children born in a general hospital have been registered. In the years 1982 and 1983 the NMR registered 295 children with the malformation just mentioned. The incidence calculated from these figures is between 1,38 and 1,77. The age distribution of mothers with a child with a cleft lip and/or palate (CLP) was compared to the total group of mothers. No correlations were found between the age of the mother and the birth of a CLP-child. The necessity of an accurate registration of congenital malformations in general in the Netherlands is emphasized.

Adult↗
PubMed1983

[Chyloperitoneum in newborn infants].

The authors describe a newborn, in which a diagnosis of ascites was made before birth by ultrasound. Ascites without other signs of hydrops may be caused by meconium-peritonitis, perforation of the bile ducts, disorders of the portal or systemic circulation, flow disturbances in the lymphatic vessels, urinary obstruction or a ruptured ovarian cyst. In this case there was a chylous ascites in a child with Down's syndrome. Diagnosis, pathogenesis and treatment are discussed. With conservative treatment the child was free of symptoms at the age of 6 months.

Chylous Ascites↗
PubMed1982

Clinical significance of 45XX, t(13q14Q) Robertsonian translocation: unexpected triploidy in third abortion of female carrier.

A case report is described of a female t(13q14q) Robertsonian translocation carrier. Her firstborn daughter appeared to be a carrier of the same translocation. Chromosomal investigation of the third of three subsequent spontaneous abortions revealed a triploidy (69XXX). Literature shows discrepancies in the reported abortion rate in the reproductive performance of t(13q14q) carriers. It is concluded that these could in part be explained by heterogenicity of the study groups due to variable presence of other factors known to influence the abortion risk. In our case report treatment for epilepsy, a luteal phase defect and high numbers of spermatozoa in the sperm count of the husband must be considered as contributory factors. It is recommended to perform systematic investigations in all cases of recurrent abortion even when a chromosomal anomaly is found in one of the partners.

Abortion, Habitual↗