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Biomedical subjects

L E Mehl

Publications and source records attributed to L E Mehl.

16 recordsLinked to original sources
PubMed1994

Hypnosis and conversion of the breech to the vertex presentation.

OBJECTIVE: To evaluate the effectiveness of hypnosis to convert a breech presentation to a vertex presentation. DESIGN: Prospective case series compared with historical, matched comparison group. SUBJECTS: One hundred pregnant women whose fetuses were in breech position at 37 to 40 weeks' gestation and a matched comparison group of women with similar obstetrical and sociodemographic parameters derived from databases for other studies from the same time period and geographical areas. INTERVENTION: The intervention group received hypnosis with suggestions for general relaxation with release of fear and anxiety. While in the hypnotic state women were asked for the reasons why their baby was in the breech presentation. As much hypnosis was provided as was convenient and possible for the women until they were delivered of the baby or the baby converted to the vertex position. MAIN OUTCOME VARIABLES: A successful conversion for the intervention group was scored when the baby spontaneously converted to the vertex position before delivery or successful external cephalic version. The conversion rate of the intervention group was compared with the comparison group who received standard obstetrical care without the opportunity for hypnosis. DATA ANALYSIS: Parametric testing of statistically significant differences in the rate of conversion between the two groups. RESULTS: Eighty-one percent of the fetuses in the intervention group converted to vertex presentation compared with 48% of those in the comparison group. This difference was statistically significant. CONCLUSIONS: Motivated subjects can be influenced by a skilled hypnotherapist in such a manner that their fetuses have a higher incidence of conversion from breech to vertex presentation. Psychophysiological factors may influence the breech presentation and may explain this increased frequency of conversion to vertex presentation.

Adult↗
PubMed1993

Use of chaos theory and complex systems modeling to study alcohol effects on fetal condition.

A systems dynamics computer model to predict birth complications for individual pregnant woman was developed from prospectively conducted data on a database of 125 pregnant women. The model is based upon nonlinear mathematics derived from the study of chaos and complex systems. The model was then tested prospectively on 27 additional pregnant women, making predictions on their level of obstetrical risk. The model was refined until it correctly predicted the outcomes of all 125 cases in the development database. Prediction was made with an accuracy of 25/27 cases for the prospective test cases. Predictions were made for fetal condition at birth, presence or absence of operative delivery, and presence or absence of uterine dysfunction. Then the model was used to explore alcohol use during pregnancy. A reasonable spread of alcohol use existed among subjects, allowing consideration of alcohol effects. Alcohol was found to have differential effects on fetal condition at birth depending upon the presence or absence of high levels of psychosocial stress and the use of other substances. In all cases, the effect of alcohol was only evident after the 10 drinks per week level was reached. For the high-stress/one other substance group, there could be an 18-fold effect on fetal condition at birth. For the low-stress/one other substance group, the effect was only 3-fold, and for the alcohol alone group, the effect was negligible.

Alcohol Drinking↗
PubMed1992

Electrical injury from Tasering and miscarriage.

A case report is presented of a woman who was "Tasered" by law enforcement personnel while 12 weeks pregnant. The Taser (Thomas A. Swift's Electric Rifle) is an electronic immobilization and defense weapon that has been commercially available since 1974. The Taser was developed as an alternative to the .38 special handgun. The patient was hit with Taser probes in the abdomen and the leg. She began to spontaneously miscarry 7 days later and received a dilatation and currettage procedure 14 days later for incomplete abortion. The world's literature on electrical and lightning injury to pregnant women is reviewed, and the mechanism of action of Taser injury is discussed. As use of the Taser becomes more common, obstetrical clinicians may encounter complications from the Taser more often.

Abortion, Spontaneous↗
PubMed1991

A mathematical computer stimulation model for the development of colonic polyps and colon cancer.

Currently known information about the development and progression of colon polyps and cancer is summarized and organized into a mathematical computer simulation model that successfully predicts the natural history of colon polyp and cancer development for an average patient with (1) familial polyposis coli (2) genetic susceptibility as measured by a positive family history, and (3) negative family history with a high fat diet. The mathematical model uses four distinct types of cells (normal, transformed, polypoid, and cancerous) and two kinetic processes (mutation and promotion). Arachidonic acid metabolites play a role in the model in the promotion of cancer from polyps, and account for that promotion through: (1) their effect on encouraging more polypoid cells in mitosis to move toward cancer; and (2) their immunosuppressive effect over time. The model also shows that one defect in allowing more cells to mutate to the transformed state is sufficient to account for the chain of events leading to the clinical sequelae of familial polyposis coli. A second genetic effect at another point in the process is unnecessary. The mechanism of action of Sulindac on colon polyps is explained by the model through inhibition of production of arachidonic acid metabolites, most notably prostaglandin E.

Adenomatous Polyposis Coli↗
PubMed1980

Evaluation of outcomes of non-nurse midwives: matched comparisons with physicians.

The purpose of this study was to assess the practice of a group of non-nurse midwives by comparing the outcomes of their deliveries to the standard of hospital-based physicians. This was done by means of a matching procedure designed to equate the populations on major medical risk factors. The first phase of the study used all physicians and found major differences favoring the midwives. The second phase of the study used the least interventionist half of the physician group and found minimal differences between midwives at home and physicians in the hospital. It is suggested that excessive intervention is not without risk regardless of who does it.

California↗
PubMed1978

Home births.

Explore the source record for details and available documents.

Delivery, Obstetric↗
PubMed1978

Some determinants of maternal attachment.

The authors conducted prenatal interviews and behavior observation sessions with 46 families in which the woman was pregnant. These families were again interviewed and observed 7 days, 1 month, 2 months, and 6 months after the child was born. The authors found that the most significant variable predicting the variance of maternal attachment was the length of separation of mother and infant: less separation was associated with greater attachment. The next most significant variable was birth experience, followed in importance by the length of labor and prenatal attitudes and expectations.

Adult↗
PubMed1977

Children at birth: effects and implications.

The sexual attitudes and beliefs of 20 children who have been present at the labor and delivery of sibs and have observed the birth process are compared with 20 children who have not been present at delivery. The ages of these children ranged from 2 years to 14 years. Several of these children were observed at the actual delivery where naturalistic observations of delivery were carried out. Naturalistic observations of these processes were also carried out as well as observations of play of children who had witnessed the delivery with children who had not. The attitudes of the parents of children present at delivery were characterized and consisted of a feeling that birth was a normal family event of a positive nature that should involve other children of the family. Their children tended to have very accurate notions regarding the proverbial "Where do babies come from?" question and tended to view the birth in a positive, happy manner. Children not present found the idea of birth puzzling or inconceivable and did not seem to understand the concept or be able to relate it to their family. They tended to develop theories about birth that were inaccurate and sometimes fantastic, much as those described earlier by Freud. The results seem to suggest that children's presence at delivery permits an open attitude toward birth as a normal process in families in which this ideology is held and for girls aids in the development of their self-image as women. Preliminary data suggests less sibling rivalry among the children present at the delivery. These results are discussed in regard to current American birth practices.

Age Factors↗
PubMed1977

Outcomes of elective home births: a series of 1,146 cases.

Medical records of 1,146 elective home births from five home delivery services in northern California were reviewed. Three of the services consisted of family physicians and nurses, whereas two consisted of lay midwives without immediate physician supervision. Rates of medical complications in both groups were low. Perinatal morbidity and mortality were lower than California averages. Fifteen premature infants (1.3%) were delivered successfully. Apgar scores were high. Four infants (0.3%) were neurologically abnormal at follow-up. The perinatal mortality rate was 9.5 per 1,000 total births. There were no maternal deaths. These figures demonstrate that in a self-selected, medically screened, low-risk population, home delivery with medical facility back-up can be a reasonable alternative to hospital delivery. Possible reasons for the good results obtained are cited.

Adult↗
PubMed1976

Importance of obstetrics in a comprehensive family practice.

Four family practices in the San Francisco Bay Area, two of which did not include obstetrics and two of which did, were examined with reference to their patient populations and to the number of families for which they provided comprehensive, continuous family care. The groups practicing without obstetrics were found to do acute care primarily and, to a lesser extent, long-term care internal medicine, with very little pediatrics or gynecology. The groups practicing with obstetrics did significantly more minor surgery, gynecology, pediatrics, and psychotherapy. During the six-week study, the group practicing with obstetrics saw five times as many patients who were members of families receiving continuous, comprehensive care from the practice under observation. Psychotherapy done by the group including obstetrics was primarily family therapy; for the other group, individual therapy. If larger studies support these findings, then important implications are suggested for training programs in family practice and for the resident deciding to enter practice.

Adult↗