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Biomedical subjects

N N Sehgal

Publications and source records attributed to N N Sehgal.

9 recordsLinked to original sources
PubMed1981

Changing rates and indications for cesarean sections at a community hospital from 1972 to 1979.

The indications for all cesarean sections done at Charleston Area Medical Center from 1972 to 1979 were reviewed. The cesarean section rate rose from 4.4% in 1972 to 8.8% in 1975, to 17.2% in 1979. Repeat cesarean sections accounted for 30.3% of all cesarean sections. The increase in the rate of primary cesarean sections was due to more cesarean sections being done for old indications as well as for the additional indications. From 1972 to 1979, cesarean sections performed for indication of dystocia increased threefold, for fetal distress ninefold, and for breech presentation elevenfold. Dystocia, however, remained the leading indication for primary cesarean section. Even though more cesarean sections and fetal surveillance tests were done from 1976 to 1979 than from 1972 to 1975, the perinatal mortality rate during the two four-year periods was not significantly different. Recommendations are made to a more objective and rational evaluation of the need to perform cesarean sections and for a periodic audit of both the operation and cost-effectiveness of the newer technology.

Cesarean Section↗
PubMed1980

Plasma volume expansion in the treatment of pre-eclampsia.

The effects of plasma volume expansion with hyperosmolar solutions with the use of dextran 40 and plasmanate were studied in a controlled manner in 32 primiparous pre-eclamptic patients. The patients who were being studied received either dextran 40 (Rheomacrodex) or plasmanate in addition to the routine treatment with sedatives, bed rest, and magnesium sulfate when indicated. The patients were randomly assigned by blind draw to control (13), dextran (10), and plasmanate (nine) groups. The renal status of all patients was evaluated prior to volume expansion therapy. Patients were monitored for blood pressure, proteinuria, output of urine, hematocrit, and creatinine clearance. There was significant improvement in hemoconcentration and output of urine, and a trend toward a lowering of the mean arterial blood pressure in patients who were receiving plasmanate or dextran for volume expansion.

Adolescent↗
PubMed1980

Early detection of abnormal labor using the Friedman labor graph.

Early recognition and appropriate management of abnormal labor can reduce perinatal mortality and morbidity and lower the cesarean section rate. A simple labor graph devised over 25 years ago and later modified makes labor abnormalities easy to detect; the two main divisions of labor, the latent and active phases, are easily recognized. A prolonged latent phase has no serious effects on mother or fetus, but protraction and arrest disorders of the active phase--eg, protracted cervical dilatation, arrest or failure of descent of the presenting part--may have a deleterious effect. Common causes of a prolonged latent phase include false labor and inappropriate use of analgesia and anesthesia. Fetopelvic disproportion and fetal malposition are common causes of disorders of the active phase.

Adolescent↗
PubMed1980

Perinatal mortality in twin pregnancies: implications for clinical management.

Perinatal deaths were studied among 374 consecutive twin births at a large medical center. The perinatal death rate per 1,000 births was 112.3 for twins compared with 15 for singletons. Neonatal deaths were twice as frequent as fetal deaths and were most often the result of prematurity. Recommendations to improve twin survival include early recognition of twin pregnancy, bed rest and a nutritious diet for the mother, and prompt recognition and management of complications, especially premature labor.

Female↗
PubMed1980

Prognostic value of a prepartum and intrapartum risk-scoring method.

A simple prepartum and intrapartum scoring technic for the identification of high-risk patients was applied to 1,224 patients managed at the Charleston Area Medical Center, Memorial Division. The patients were classified as being at low, moderate, or high risk, according to the total risk score. Perinatal mortality worsened as the risk category increased. Seventy percent of all perinatal deaths occurred in 25% of patients who were identified as moderate- and high-risk patients. The simple one-page scoring form that we used seems to be practical and effective in identifying patients at risk. Such information can be very useful in providing appropriate levels of obstetric care.

Female↗