Biomedical subjects

K L Safford

Publications and source records attributed to K L Safford.

4 recordsLinked to original sources

PubMed1995

Repeat external cephalic version. Is it worth the effort?

OBJECTIVE: To determine whether repeat external cephalic version subsequent to initial failed version resulted in a decreased cesarean section rate and hospital cost. STUDY DESIGN: All women who underwent repeat external cephalic version after initial failed version were identified and their charts reviewed. Data collected included success of version, mode of delivery, presentation in labor, hospital days, hospital cost, parity and birth weight. RESULTS: Thirty-six women had a repeat external cephalic version attempt from 1987 to 1992. Six, or 17%, of these were successful. All the successful versions were vertex in labor and had a vaginal delivery. Only 6, or 21%, of the failed versions had a vaginal delivery (P < or = .0002). The mean hospital stay was 2.0 and 3.0 days in the successful and failed groups, respectively. The mean hospital cost, expressed in 1992 dollars, was significantly greater in the failed group: $8,042 vs. $5,059 (P < or = .03). CONCLUSION: Repeat version was associated with a decrease in the cesarean section rate and hospital cost and should be considered in the management of nonvertex term presentations.

Cesarean Section↗

PubMed1993

Maternal hydration increases amniotic fluid index in women with normal amniotic fluid.

OBJECTIVE: To test the hypothesis that maternal oral hydration would increase the amniotic fluid (AF) index in pregnancies with normal AF. METHODS: Forty women with a normal AF index (7.0-24.0 cm) were randomized to either the control or hydration group. Women in the hydration group drank 2 L of water and returned for the post-treatment AF index in 4-6 hours, whereas women in the control group drank only 100 mL of water during the same time period. The investigator performing the AF index was blinded to the subject's group. The pre- and post-treatment AF indexes and maternal urine specific gravities were compared between the groups. RESULTS: The mean AF index in the hydration group increased significantly by 3.0 +/- 2.4 cm (P < or = .0001) whereas it declined significantly by 1.5 +/- 2.7 cm in the control group (P < or = .02). The maternal urine specific gravities also changed significantly in the expected direction, with those in the hydration group decreasing and those in the control group increasing (P < or = .0001). There was a regression coefficient of -0.6 (P < or = .0001) between the change in urine specific gravity and the change in AF index. The mean time between the pre- and post-treatment AF indexes was not different between the groups. CONCLUSIONS: Maternal oral hydration increased the AF index by approximately 16%, whereas fluid restriction decreased the AF index by 8% in women with normal AF. These findings support previous data that maternal hydration increased the AF index by 31% in women with decreased AF and suggest that maternal fluid volume or osmolality may have a role in maintaining the AF volume.

Amniotic Fluid↗

PubMed1991

Maternal hydration increases amniotic fluid index.

Although adequate amniotic fluid (AF) volume is considered an important aspect of fetal well-being, the etiology of decreased AF volume is not well understood. A randomized blinded trial was designed to examine our hypothesis that maternal hydration would increase the AF index in women with low AF indexes. Women seen in our testing centers were randomized into control or hydration groups. The control group was instructed to drink their normal amount of fluid; the hydration group was instructed to drink 2 L of water, in addition to their usual amount of fluid, 2-4 hours before the post-treatment AF index. The women returned for the post-treatment AF index the same or following day. The mean post-treatment AF index was significantly greater in the hydration group (6.3 versus 5.1; P less than .01), as was the mean change in AF index (post-treatment AF index--pre-treatment AF index: 1.5 versus 0.31; P less than .01). These findings suggest that maternal oral hydration increases AF volume in women with decreased fluid levels.

Amniotic Fluid↗

PubMed1981

Review of colorectal cancer in patients under age 40 years.

Brooke Army Medical Center Tumor Registry records from 1947 through 1980 were reviewed. One hundred forty of 819 patients with colorectal cancer were aged 40 or less. The 5 year survival rate was 35 percent and the 10 year survival rate 32 percent. The predominant presenting symptoms were bleeding, pain and change of bowel habits. The median duration of symptoms was 3 months. There were no Dukes'A patients. The 5 and 10 year survival rates in 19 Dukes' B patients were 67 percent. Thirty-three Dukes' C patients had 5 and 10 year survival rates of 37 and 30 percent, respectively. In 42 Dukes' D patients, however, there were no 5 year survivors, and the mean length of survival was only 10 months. Our findings support previous surveys which have concluded that stage at the time of diagnosis, rather than symptoms, duration or patient age, is the most accurate prognostic factor.

Adenocarcinoma↗