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J Seitchik

Publications and source records attributed to J Seitchik.

11 recordsLinked to original sources
PubMed1987

Spontaneous rupture of the membranes, functional dystocia, oxytocin treatment, and the route of delivery.

The details of clinical management were examined in 96 nulliparous patients with functional dystocia who had spontaneous rupture of the membranes before admission and were treated with oxytocin in the first stage of labor. It was our hypothesis that if the allegedly "high" rate of cesarean sections was the result of mediocre or flawed practices, these should be most evident in patients delivered abdominally. A group of 59 patients delivered vaginally were compared with 37 patients delivered by cesarean section. The means of many variables were not statistically different. The cesarean section group was characterized by smaller stature, a lesser cervical dilatation rate both before and after oxytocin administration, a larger maximum oxytocin dose, a longer period of oxytocin administration, more frequent cessation of oxytocin administration or dose reduction because of hypercontractility or an abnormal fetal heart rate or both, and a higher incidence of intra-amniotic infection. We conclude that the decision to perform cesarean section in nulliparous women with functional dystocia arises from disabilities of the patient and not from differences in the application of our management principles, services, or treatments.

Cesarean Section↗
PubMed1987

The management of functional dystocia in the first stage of labor.

To summarize: Functional dystocia is easily diagnosed in laboring patients by lack of cervical dilatation for 2 hours in association with weak uterine contractions. If the membranes are intact, amniotomy should be performed. If cervical dilatation at a rate of at least 1 cm/h does not occur promptly, oxytocin should be begun. Efficient and safe use of oxytocin requires knowledge of its clinical pharmacologic characteristics: that the maximum level of a dose is not reached for approximately 40 minutes, that the blood level needed is a reflection of the sensitivity of the myometrium, and the blood level produced by a specific dose is a manifestation of the plasma clearance rate. While it has never been demonstrated that continuous electronic monitoring of the uterus and fetus with intermittent visits from professional personnel is better than palpation and auscultation performed by an educated attendant present continuously, the former practice is more common in the United States than the latter. If maximum use is to be made of the information provided by the uterine monitor, the data must be quantitated. When the patient's inadequate contractility fails to improve in response to the initial dose of 1 mU/m, the dose must be increased until some improvement is noted. Geometric incrementation should be limited to nulliparas in whom each dose of oxytocin is evaluated after a 40-minute infusion period.(ABSTRACT TRUNCATED AT 250 WORDS)

Amnion↗
PubMed1986

Amniotomy and oxytocin treatment of functional dystocia and route of delivery.

The details of clinical management were examined in 101 nulliparous patients with functional dystocia who underwent amniotomy and were treated with oxytocin in the first stage of labor. It was our hypothesis that if the alleged "high" rate of cesarean sections was the result of mediocre or flawed practices, these should be most evident in patients delivered abdominally. A group of 68 patients delivered vaginally are compared with 33 patients delivered by cesarean section. The means of many variables were statistically similar. The cesarean group was characterized by less cervical dilatation at admission, greater birth weights, larger maximum doses of oxytocin, and longer durations of oxytocin therapy. We conclude from our analysis that the decision to perform cesarean section in nulliparous women with functional dystocia arises from disabilities of the patient and not from differences in the application of our management principles, services, or treatments.

Adult↗
PubMed1986

Oxytocin and prolactin responses associated with nipple stimulation contraction stress tests.

Levels of oxytocin in plasma of pregnant women in the third trimester undergoing nipple stimulation-contraction stress tests were found, by parametric (paired t test) statistical analysis to be elevated. No differences in the plasma increases in oxytocin levels were found between those patients undergoing successful and those undergoing unsuccessful nipple stimulation-contraction stress tests. No significant differences in plasma levels of prolactin were associated with nipple stimulation in these patients.

Breast↗
PubMed1979

A computer-based obstetric data retrieval system.

A computer-based obstetric patient data retrieval system is described which permits physicians with no prior computer knowledge or experience to access a patient data base. The advantages are minimal physician instruction, opportunity to examine maternal and neonatal outcome of defined diagnostic or therapeutic subsets of the data base, and rapid recall of individual patients' data, without need for continuous assistance from computer specialists. Disadvantages are the costs and our inability to interface our medical information with hospital business office data. Two brief examples of use of the system are provided.

Computers↗
PubMed1977

Intrauterine pressure wave form characteristics of successful and failed first stage labor.

A retrospective study was designed to contrast the intrauterine pressure wave form characteristics of hypocontractile labor in patients with and without obstruction and before and after oxytocin therapy. No differences were observed between the patient groups (vaginal delivery vs. cesarean section), either before or after oxytocin. Problems in defining adequate contractility in patients with possible obstructed labors are discussed, and new parameters of potential value are identified.

Cesarean Section↗
PubMed1976

Oxytocin-induced uterine hypercontractility pressure wave forms.

To identify similarities and differences between uterine contractions in patients with spontaneous labor, oxytocin-corrected hypocontractility, and oxytocin-induced hypercontractility, measurements were made of specific characteristics of the intrauterine wave form, including pressure, rate of change of pressure, and duration. Contractions from oxytocin-treated patients differed from contractions of those with spontaneous labor in their disproportionately high rates of rise of the pressure. The time to reach the maximum rate of the pressure--the start-up time--was reduced in oxytocin-induced hypercontractility. The data demonstrate that the contractions of spontaneous labor and oxytocin-augmented labor are not identical, and the physiologic implications are discussed.

Female↗
PubMed1975

Intrauterine pressure wave form characteristics in hypocontractile labor before and after oxytocin administration.

The data demonstrate that the contractions of hypocontractile active labor and normal spontaneous labor are different in several measures in addition to maximal amplitude. Furthermore, when the pathophysiology is corrected by the use of oxytocin, the contractions resemble those of normal spontaneous labor except in the maximal rate of tension development. Our data tend to support the subcellular model of uterine contractility, although the incompleteness of these models limits interpretation.

Adrenocorticotropic Hormone↗
PubMed1975

Intrauterine pressure wave-form characteristics of spontaneous first stage labor.

Intrauterine pressure wave-form parameters were measured in 827 contractions obtained from 26 patients in spontaneous labor. The coefficients of correlation between the maximal and minimal rates of pressure change and the maximal pressure amplitude were 0.78 and 0.63, respectively, and greater than or equal to 0.70 in 22/26 patients. Contractions partitioned into decile statistical groups of the pressure amplitude and both maximal and minimal rates. A linear relationship between these parameters has therefore been established. Contractions of greater amplitude tend to be longer, but the relationship between duration and amplitude is nonlinear with a limiting maximum contraction time. The duration of the midportion of the pressure wave appears invariate with respect to wave amplitude and only start-up and termination times increase with increasing amplitude. Mean values and standard deviations of the maximal amplitude (40.4 +/- 16.9mmHg). the maximal (2.4 +/- 0.9 mmHg/s) and minimal (-2.1+/- 0.9 mmHg/s)rates of pressure change, and the total duration of contractions (68.6 +/- 17.8s) were determined.

Female↗