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J S Seiler

Publications and source records attributed to J S Seiler.

7 recordsLinked to original sources
PubMed1990

The demise of vaginal operative obstetrics: a suggested plan for its revival.

Predictions made more than a quarter of a century ago regarding excessive use of cesarean delivery for cases of dystocia have been realized. Breech presentation, correctable dystocia, and twin gestation are increasingly being delivered by the abdominal route. Recent studies have shown that neonatal morbidity is not inherently improved by cesarean birth, and in fact have reported comparable results with vaginal operative procedures in properly selected and managed cases. Pressure to control the cesarean birth rate is now being exerted by consumer groups, professional groups, and governmental agencies. The reintroduction of vaginal operative procedures to modern obstetrics would help reduce the cesarean birth rate. However, major changes in the medical liability system, medical education and training, and the method of certifying obstetricians will be required before vaginal operative obstetrics becomes a serious alternative to cesarean delivery. Without these changes, I believe there is little hope of reversing the trend toward cesarean birth.

Cesarean Section↗
PubMed1986

Laparoscopic tubal sterilization combined with removal of an intrauterine contraceptive device. A report of 49 cases.

A retrospective study was done on 49 patients who underwent removal of an intrauterine device (IUD) and laparoscopic sterilization as a combined procedure during a 13-year period at Booth Memorial Medical Center, Flushing, New York. Five patients were given prophylactic antibiotic therapy, one was treated with postoperative antibiotic therapy for an asymptomatic actinomycosis infection of the endometrium, diagnosed on the curettings, and two patients developed postoperative infections requiring antibiotic therapy. Twenty-one patients had endometritis of various degrees diagnosed on the endometrial curettings, but only two developed clinical infections postoperatively. Elimination of those patients receiving prophylactic antibiotics from the study group left 43, of whom 41 (95%) had an uncomplicated postoperative course and did not develop clinical pelvic inflammatory disease even though 15 of them had endometritis diagnosed on curettage. It appears that removal of an IUD at the time of laparoscopic sterilization does not significantly affect the safety or postoperative morbidity of the sterilization procedure.

Adult↗
PubMed1981

Tubal sterilization by bipolar laparoscopy: report of 232 cases.

Two hundred thirty-two interval bipolar laparoscopic tubal sterilizations were performed in a university-affiliated community teaching hospital over a 3-year period. Advanced laparoscopy equipment, properly trained laparoscopists, and a system of delineated operating privileges were used; the complication rate was 0.8%. There was 1 intraoperative complication, and 1 postoperative complication that manifested itself on postoperative day 3. Neither complication was related to the electrocauterization. The cauterized segments of fallopian tube were intentionally transected in 195 (84%) of the patients. The equipment and methodology employed are discussed with comparison of bipolar electrocautery to mechanical nonelectric methods of laparoscopic sterilization, ie, bands and clips. The authors' preference for bipolar electrocautery tubal sterilization, using single-segment cauterization with tubal transection, is discussed.

Adult↗
PubMed1975

Routine electronic monitoring of fetal heart rate and uterine activity during labor.

Routine electronic monitoring has been performed on 2411 labor patients at Booth Memorial Medical Center. Most recently, 88% of all patients delivered were monitored. As a direct result of this program, intrapartum stillbirths have been dramatically reduced from 1.2/1000 livebirths to 0.5/1000 livebirths. Perinatal mortality for fetuses over 1000 g has fallen to 8.8/1000 deliveries. Apgar scores below 6 at 5 minutes have decreased from a rate of 24/1000 to 14/1000 livebirths. No increase in cesarean sections for fetal distress has occurred although the primary cesarean section rate has increased over the past 10 years, apparently unrelated to fetal monitoring. It is strongly recommended that all patients in labor be monitored by currently available technics.

Apgar Score↗