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J R Bobitt

Publications and source records attributed to J R Bobitt.

6 recordsLinked to original sources
PubMed1979

Abnormal antepartum fetal heart rate tracings, failure to intervene, and fetal death: review of five cases reveals potential pitfalls of antepartum monitoring programs.

The goal of antepartum fetal heart rate monitoring is to identify which infants among high-risk obstetric patients are at risk for intrauterine death and which are not. Effective programs, by appropriately selecting cases for intervention and nonintervention, should contribute to lowering of perinatal morbidity and mortality rates. A review of five fetal deaths preceded by abnormal antepartum FHR tracings suggests effective programs require strict control. Individuals performing the testing should be experienced and knowledgeable in regard to instrumentation characteristics and recognition of normal and abnormal fetal heart rates. Dual responsibility of antepartum testing and providing primary patient care to labor and delivery patients is undesirable. Test interpretation should be based on strict criteria.

Adult↗
PubMed1978

Amniotic fluid analysis. Its role in maternal neonatal infection.

Indirect evidence suggests that amnionitis, in the absence of maternal symptoms, contributes to neonatal morbidity. The incidence is unknown because diagnostic techniques are not available. A quantitative amniotic fluid analysis of bacteria, white blood cells, and lactic dehydrogenase levels was performed during labor among 28 patients considered to be a risk for infection. Thirteen of 16 patients with bacterial colony counts greater than 10(3)/ml subsequently developed maternal infection had a premature delivery, neonatal sepsis, or a combination of these factors. Maternal fever was a late sign in clinical infection and was frequently absent in cases of premature delivery associated with microbiologic evidence of amnionitis. Amniotic fluid analysis may be of value in diagnosing unrecognized amnionitis among patients delivering prematurely and those requiring nonelective cesarean section.

Amnion↗
PubMed1977

Comparison of clindamycin and chloramphenicol in treatment of serious infections of the female genital tract.

A study was performed of 102 obstetric-gynecologic patients who were thought to have sepsis or a pelvic abscess. Fifty-three of these women received chloramphenicol and 49 received clindamycin. In addition, all patients received penicillin or a similar antibiotic and an aminoglycoside. Similar clinical results were observed with the two treatment regimens. In eight of the 49 patients who received clindamycin and in three of 52 patients who received chloramphenicol, use of the drug was discontinued because of side effects. These combinations of antibiotics did not eliminate the necessity for major operative drainage, which was required in 40 patients. Resistant organisms were recovered from only two patients. Although sepsis and shock were most frequently associated with gram-negative aerobic bacteremia, they occurred in two patients in whom only anaerobes were recovered from blood cultures. Because the clinical results with the two regimens were equivalent, a decision to use either clindamycin or chloramphenicol should be based on the individual physician's assessment of the toxicity of these agents.

Abscess↗
PubMed1977

Unrecognized amnionitis and prematurity: a preliminary report.

Quantitative amniotic fluid cultures were performed on 12 patients delivered of premature infants (10-premature labor, 2-premature rupture of membranes). Specimens from patients in premature labor were obtained at the time of amniotomy via transcervical needle aspiration or intrauterine catheter. Of the seven patients with colony counts greater than 1,000 per ml, two mothers and four neonates had clinical evidence of infection. Blood cultures from two infants and one mother and cerebrospinal fluid cultures from one newborn infant were positive for the same organism isolated from amniotic fluid. Anearobic bacteria were the predominant isolates in four specimens and included Bacteriodes species in two. In contrast, the five mothers and infants associated with counts of less than 1,000 per ml exhibited no infectious morbidity. Three had no bacterial growth from amniotic fluid, and factors commonly associated with prematurity were recognized in four. These clinical and microbiologic observations suggest that current methods of evaluating patients with premature labor and delivery are incomplete, and the role of unrecognized amnionitis should be reevaluated.

Amnion↗
PubMed1976

Obstetric observations in eleven cases of neonatal sepsis due to the group B beta hemolytic streptococcus.

Neonatal sepsis due to Group B streptococcus is reported to be increasing, but the reasons are unclear. Eleven cases from a single hospital were reviewed for common obstetric factors. Frequent observations associated with 8 surviving infants were maternal infection, early evaluation and treatment of the newborn, and 4+ or 5+ growth on maternal cultures. In contrast, mothers of the 3 infants who died had no clinical signs of infection, and cultures were not obtained. All 11 infants had direct monitoring during labor but the frequency of infection, 1/1600 live births, was lower than usually reported. Three surviving infants and 3 nonsurvivors were premature. Semiquantitative culture technics suggest that the predominance of Group B streptococcus in the vagina may be a more important etiologic factor than the frequency of its presence.

Female↗