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Biomedical subjects

L B Curet

Publications and source records attributed to L B Curet.

At least 19 recordsLinked to original sources
PubMed1992

Diagnosis of cervical change in pregnancy by means of transvaginal ultrasonography.

There are no absolute objective diagnostic criteria for cervical incompetence. Abdominal and endovaginal ultrasonographic assessment of endocervical length, both of which have been associated with technical problems, have been used to establish the diagnosis. Cervical cerclage may be useful in preventing silent cervical dilatation; however, no prospective trials with and without cerclage have been performed when endocervical shortening has been demonstrated by ultrasonography.

Cervix Uteri↗
PubMed1992

Short-acting beta-adrenergic blockade and the fetus. A case report.

An infant was born to a woman who received intravenous esmolol for intrapartum supraventricular tachyarrhythmia. Despite the very short acting and cardio-selective beta-1 adrenergic blockade induced by that agent, neonatal effects can occur up to 48 hours after delivery.

Adrenergic beta-Antagonists↗
PubMed1992

Does closure of Camper fascia reduce the incidence of post-cesarean superficial wound disruption?

OBJECTIVE: To determine whether closure of Camper fascia prevents the development of superficial wound disruption after cesarean delivery. METHODS: During a 1-year period, 438 women undergoing cesarean delivery were randomized into groups with and without approximation of Camper fascia with absorbable suture during closure of the abdominal incision. All women received routine postoperative care following our departmental guidelines. We reviewed charts after the puerperium to identify women with postoperative superficial wound disruption and to obtain demographic and delivery information for analysis. RESULTS: We found a significantly higher incidence of wound disruption in the group without the suture than in those in whom the tissue was approximated (P = .03). Four or more vaginal examinations and higher body mass index were also associated with a higher incidence of wound disruption (P = .05 and P = .04, respectively). Logistic regression correction for covariables that might influence the results of our main analysis revealed no effect of maternal age, parity, indications for cesarean delivery, duration of labor, duration of ruptured membranes, duration of surgery, use of internal monitoring, type of incision, use of antibiotic prophylaxis, surgeon's level of training, or maternal diabetes mellitus and/or hypertension. CONCLUSION: Approximation of Camper fascia with absorbable suture at closure of the abdominal incision during cesarean delivery appears to protect against postoperative superficial wound disruption and is therefore recommended.

Abdomen↗
PubMed1992

The biophysical profile and the nonstress test: poor predictors of chorioamnionitis and fetal infection in prolonged preterm premature rupture of membranes.

Sixty-eight women admitted with the diagnosis of preterm premature rupture of membranes (PROM) and a latency period of at least 48 hours were followed expectantly. Fetal surveillance consisted of daily kick counts, daily nonstress test (NST), and fetal biophysical profile every 48-72 hours. Patients were delivered as a result of spontaneous labor, clinical chorioamnionitis, fetal distress, or attainment of 37 weeks' gestation. No corticosteroids, tocolytics, or prophylactic antibiotics were used. The last biophysical profile and the last NST before delivery were evaluated for each patient. There was no statistically significant association between chorioamnionitis or fetal infection and the following: 1) a low biophysical profile (score of 6 or lower), 2) a low biophysical profile that included a nonreactive NST and absent fetal breathing movements, or 3) a nonreactive NST. We conclude that the biophysical profile and the NST are poor predictors of perinatal infectious complications.

Adolescent↗
PubMed1991

Recombinant 8 syndrome: the pool of Hispanic pericentric inversion 8 carriers expands numerically and geographically.

Recombinant 8 syndrome is a well-established syndrome with mental and developmental retardation and usually severe cardiac anomalies. A carrier parent will produce affected offspring in 6% of pregnancies and carrier offspring in 53% of such pregnancies. Four New Mexican kindres ascertained by the discovery of four apparently unrelated probands with cytogenetically confirmed recombinant 8 syndrome were studied. We found that (1) recombinant 8 syndrome will soon no longer be confined to New Mexico and southern Colorado, (2) the number of persons at risk may be higher than previously considered, and (3) through proper pedigree techniques and increased professional education, most carriers can be identified.

Chromosome Aberrations↗
PubMed1991

Evaluation of fetal sonographic measurements in the first trimester by transvaginal sonography.

To assess the reliability of early biometric measurements in pregnancy, transvaginal sonography was performed in 92 pregnancies in the first trimester in a cross-sectional fashion. Measurements included crown-to-rump length (CRL), biparietal diameter (BPD), head and abdominal circumference (HC and AC), and femur length (FL). Stepwise regression analysis of the gestational age was performed. CRL maintained the highest correlation with gestational age (r = 0.99, p less than 0.001). BPD, HC, AC also correlated well. FL showed a less strong correlation with gestational age (r = 0.76, p less than 0.001). CRL remains the standard for early sonography measurements.

Embryonic and Fetal Development↗
PubMed1991

Comparative efficacy of intravaginal prostaglandin E2 in the gel and suppository forms for cervical ripening.

Thirty-seven patients admitted for labor induction and presenting with unfavorable cervical features were randomized in a single-blind fashion to receive either 3 mg of prostaglandin E2 in an intravaginal gel or a 2-mg dose in a vaginal suppository. With the aid of previously reported placebo data, the intent was to compare the two dosage forms in terms of their ability to promote cervical ripening, and to see which dosage form was more effective in terms of influencing the overall incidence of cesarean section. The two groups showed a comparable improvement (alpha = 0.05) in cervical condition over that of the placebo group, with the mean Bishop score increasing by 2.0 points in the gel group, 2.5 points in the suppository group, and 0.7 points in the placebo group. As the suppository contained a lower dose of drug than the gel, the data support the concept that the type of drug vehicle and dosage form are important variables affecting product performance. No statistically significant difference in the incidence of cesarean section was noted between the two groups or between either group and placebo. This may be attributable to the small sample size and the relatively high proportion of women diagnosed as having cephalopelvic disproportion/failure to progress. Additional studies are warranted.

Administration, Intravaginal↗
PubMed1990

Effect of mitral valve prosthetic surgery on the outcome of a growth-retarded fetus. A case report.

Mitral valve prosthetic surgery was performed at 29 weeks' gestation in a woman who had reoperation for a thrombotic mitral valve prosthesis and pulmonary edema. Concomitant severe preeclampsia was also present. During operation fetal bradycardia developed and the fetus died. Because the findings differ from those previously reported with regard to normal pregnancies, their implications are discussed.

Adult↗
PubMed1990

Vaginal ultrasonographic assessment of cervical length changes during normal pregnancy.

We measured the cervical length of 166 normal, gravid patients between 8 and 37 weeks' gestation by vaginal ultrasonography. Patients were assigned to one of five groups according to gestational age at the time of the measurements. Cervical length was longest (48 mm) in group 3 (20 to 25 weeks) and significantly longer than that of groups 1 (8 to 13 weeks), 2 (14 to 19 weeks), and 5 (32 to 37 weeks). The use of vaginal ultrasonography to assess cervical length eliminates some technical problems encountered with abdominal ultrasonography. Nomogram of cervical length throughout pregnancy was established. This may aid in early diagnosis and management of preterm labor and cervical incompetence.

Cervix Uteri↗
PubMed1989

Effects of fetal sex and dexamethasone on preterm maternal serum concentrations of human chorionic gonadotropin, progesterone, estrone, estradiol, and estriol.

The serum human chorionic gonadotropin concentration for the 43 female-bearing gestations was significantly higher (geometric mean 15,603 mIU/ml; 95% confidence interval 12,337 to 19,733) than that for 26 male-bearing pregnancies (geometric mean 8902 mIU/ml; 95% confidence interval 6288 to 12,596), p = 0.0087. The mean gestational age was 32 +/- 2.4 weeks (mean +/- SD). There was no significant difference between male- and female-bearing pregnancies for progesterone, cortisol, estrone, estradiol, estriol, or gestational age. In 19 placebo-treated pregnancies and 14 dexamethasone-treated pregnancies with a mean gestational age of 31.5 +/- 2.7 weeks, there was no significant change from the baseline value observed for either maternal serum human chorionic gonadotropin level or maternal serum progesterone level at 42 hours after institution of treatment. In the dexamethasone-treated subjects the geometric mean was reduced to 20% of baseline for cortisol; 42% of baseline for estrone; 30% of baseline for estradiol; and 41% of baseline for estriol (all p less than 0.001).

Chorionic Gonadotropin↗
PubMed1989

Phosphatidylglycerol, lecithin/sphingomyelin ratio and respiratory distress syndrome in diabetic and non-diabetic pregnancies.

Samples of amniotic fluid from 514 non-diabetic and 69 diabetic patients were analyzed for phospholipid content. Results were correlated with incidence of respiratory distress syndrome (RDS) in the neonate. The incidence of RDS was 4.5% among diabetics and 5.3% among non-diabetics. In the presence of phosphatidylglycerol (PG), no infant developed RDS while in the absence of PG the incidence of RDS was 16.7% and 14.4%, respectively. In the presence of a mature lecithin/sphingomyelin (L/S) ratio the respective incidence of RDS was 1.6 and 1.8, while with an immature L/S ratio the incidence of RDS was 28.6% and 29%. The incidence of RDS after 37 weeks gestation was 0% among diabetics and 0.6% among non-diabetics. We conclude that amniotic fluid phospholipids are equally predictive of risk for RDS in diabetics as among non-diabetic patients. We suggest that in patients with accurate gestational dating, amniotic fluid analysis for phospholipids might not be necessary to establish fetal lung maturity.

Amniotic Fluid↗
PubMed1989

Cervical ripening with intravaginal prostaglandin E2 gel.

Fifty-four patients were randomized in a double blind fashion into either a placebo group or a group treated with a 3 mg dose of an intravaginal prostaglandin E2 gel. The group receiving the prostaglandin E2 gel had a mean change in cervical score of 2.7 while the patients in the placebo group had no significant change. Even though a significantly higher number of patients in the prostaglandin group went into spontaneous labor, the incidence of cesarean section was not different between the two groups. Upon comparing the conflicting reports of various studies on the subject, it is concluded that the method of product preparation, particularly the source of prostaglandin E2 utilized and the choice of drug vehicle, may be important variables in determining treatment success, as measured in terms of decreased cesarean section rate.

Administration, Intravaginal↗
PubMed1989

Lecithin:sphingomyelin ratio in the amniotic fluid of male and female fetuses.

The effect of fetal sex on the amniotic fluid lecithin:sphingomyelin (L:S) ratio was determined with a prospective, randomized, double-blind study designed to evaluate the effect of antenatal steroid administration on the incidence of neonatal respiratory distress syndrome. The immature L:S ratios of 183 single births to nondiabetic women were analyzed. L:S ratios increased with increasing gestational age. Regression lines of L:S versus gestational age suggested that male infants' L:S ratios were lower than females', although the differences were not statistically significant.

Amniotic Fluid↗
PubMed1988

Effect of mode of delivery on incidence of respiratory distress syndrome.

The effect of route of delivery on incidence of respiratory distress syndrome (RDS) has been controversial. While some investigators have reported no difference in RDS rates in infants born by cesarean section as compared to vaginal delivery, others have shown a significant increase in risk for RDS among infants born by cesarean section. Data from the 297 patients comprising the placebo group in the recently completed collaborative study of antenatal steroid therapy in the prevention of neonatal RDS, were analyzed to determine the effect of mode of delivery on RDS. The results indicate that infants born by cesarean section without labor have a higher risk for neonatal RDS than infants born vaginally or by cesarean section after a trial of labor.

Cesarean Section↗