Biomedical subjects

J Shuber

Publications and source records attributed to J Shuber.

5 recordsLinked to original sources

PubMed1989

Transcervical sterilization with use of methyl 2-cyanoacrylate and a newer delivery system (the FEMCEPT device).

The increasing use of sterilization as a means of permanent contraception prompts the search for simpler, safer methods. Methyl 2-cyanoacrylate 0.6 ml was administered to the uterocornual tubal junction with the use of the FEMCEPT transcervical delivery system in 35 healthy parous women aged 30 to 44 years. Hysterosalpingography 4 months after the procedure showed bilateral tubal occlusion in 88.2% of the study participants. There were no complications in the study group, and there were no pregnancies among those who demonstrated bilateral tubal occlusion. The technique, which is safe, effective, and simple, could consideraly reduce anesthetic and operative risk in sterilization.

Adult↗

PubMed1987

Prevalence of antibody to Chlamydia trachomatis in spontaneous abortion and infertility.

A higher prevalence of Chlamydia trachomatis antibody occurred in 57.6% of women with recurrent abortion, but not in their male partners, compared to 33.7% of normal pregnant women (p less than 0.01) and 44.2% of infertile women (NS). The mean titer for the recurrent abortion group was not significantly elevated, compared to controls. Women with blocked fallopian tubes had the highest prevalence of elevated titers (p less than 0.01) and the highest mean titer (p less than 0.001). Despite multiple testing, no women or men were chlamydia culture-positive. The lack of isolation among patients with antibody could be due to cryptic infection at a site not amenable to culture or to inhibition by secretory IgA. There could also be nonspecific stimulation of chlamydial antibody caused by other infections such as mycoplasma. The presence, though at a low level, of antibody in culture-negative patients suggests chlamydia may not be directly associated with recurrent abortion but reflect previous exposure to chlamydia or an altered immune system.

Abortion, Habitual↗

PubMed1986

Psychological patterns in donor insemination couples.

One hundred and twenty couples applying for DI or involved in the procedure were seen in consultation or therapy at various stages. The clinical findings provide evidence that both partners experience conflict in two areas. The discovery of infertility generates transient impotence, loss of self-esteem and withdrawal in husbands, and anger, guilt and a wish to make reparations in wives. The DI procedure itself evokes oedipal conflicts. Clinical vignettes have been presented to illustrate these patterns and to provide evidence for the view that couples should recognize, discuss and come to terms with the conflicts generated by the discovery of infertility before tackling DI and the conflicts this procedure evokes. Although secrecy is advocated by most DI couples and physicians, a questionnaire study of 76 couples in our unit disclosed that many individuals consider it psychologically useful to discuss their infertility problems with others. Although secrecy may be useful, it may also, through the indirect sanction of denial and negation, interfere with the couple's acknowledging and discussing their problems. One useful purpose of a psychiatric assessment is that it can promote such acknowledgement and discussion. Conflict needs to be distinguished from psychopathology which may be the outcome of unresolved conflict.

Attitude↗

PubMed1983

Efficacy of antibiotic therapy in preventing spontaneous pregnancy loss among couples colonized with genital mycoplasmas.

Evidence suggests that genital mycoplasmas play a role in spontaneous abortion, prematurity, and perinatal morbidity and mortality rate. Since these organisms are sensitive to antibiotics, three treatment regimens were assessed for efficacy in preventing spontaneous pregnancy loss. The pregnancy loss rate was significantly reduced from 96% to 47.4% among those treated with doxycycline prior to conception and to less than 20% among those treated with erythromycin stearate only during pregnancy or with both regimens. The reduction in pregnancy loss rate was independent of maternal age, the number of previous abortions, gestational age at abortion, or other minor abnormalities. Diagnosis and treatment of mycoplasma infection following a first or later pregnancy loss equally prevented spontaneous loss in the next pregnancy. These observations suggest that appropriate treatment of mycoplasma infection could also prevent recurrent spontaneous abortion syndrome in couples with positive cultures.

Abortion, Habitual↗

PubMed1983

Serologic evidence of ureaplasma urealyticum infection in women with spontaneous pregnancy loss.

Among 71 couples with histories of pregnancy wastage, 84.5% were colonized with Ureaplasma urealyticum and/or Mycoplasma hominis; whereas in couples with successful deliveries the incidence was 25.4%. The distribution of U. urealyticum and M. hominis was comparable in the fertile and infertile populations. Of women with positive cultures, 96% aborted, compared with an expected rate of 19% to 45%. Serologic studies revealed that, at delivery, 42.9% of infants of mothers with pregnancy losses had fourfold elevations in titers above the mothers' level compared with 15% of normal infants. Mothers with pregnancy wastage histories had elevated titers above their infants in 42.9% of cases compared with 10% of normal mothers. Thus, both mothers and fetuses had responded immunologically to the presence of U. urealyticum. When the mean antibody titers in the normal and pregnancy wastage groups were calculated for each ureaplasma serotype, the infants of mothers with pregnancy losses exhibited significantly elevated mean titers to serotypes 6 and 8, while the mothers had elevated mean titers to serotypes 4 and 8. These observations suggest that U. urealyticum causes infection in mothers and fetuses and that certain ureaplasma serotypes may be more pathogenic than others.

Abortion, Spontaneous↗