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Biomedical subjects

P C Leppert

Publications and source records attributed to P C Leppert.

At least 37 records · Page 2Linked to original sources
PubMed1986

Pregnancy outcomes among adolescent and older women receiving comprehensive prenatal care.

This study compares three birth outcomes, gestational age, birthweight, and type of delivery, among adolescent and older mothers. Data were collected from 911 women who attended a comprehensive prenatal-care program in a large urban teaching hospital. Women aged 13-19 years were at increased risk for low-birth-weight babies (less than 2500 g) and for preterm infants of fewer than 38 weeks gestation, even with antenatal care, ethnicity, and other factors controlled. Results of bivariate analyses suggested that women aged 20-36 years are more likely than adolescent mothers to have a cesarean section; however, multivariate analyses suggested that maternal age was not an important factor in relation to type of delivery. Thus, even with similar comprehensive care, pregnant adolescents were at an increased risk of some adverse outcomes. However, the amount of antenatal care is a more important predictor of pregnancy outcome than is maternal age.

Adolescent↗
PubMed1986

Neonatal alloimmune thrombocytopenic purpura.

We reviewed 58 literature reports of neonatal alloimmune thrombocytopenic purpura (NAITP). The mortality rate was 9%. The total incidence of suspected intracranial hemorrhage was 28%. We reviewed 17 sibship cases for the relation of birth order to treatment and outcome. Among firstborn affected infants (n = 17) the mortality rate and incidence of central nervous system sequelae were 24 and 47%, respectively, compared to rates of 5 and 15%, respectively, in their younger affected siblings (n = 20). The improved outcome in the latter group appeared to be related to more frequent cesarean section delivery and more frequent and earlier use of corticosteroids and maternal platelet transfusions in the neonate. Sensitive assays of maternal platelet alloantibody are now available, but they lack specificity for NAITP affecting the current gestation. There are two reports in which sensitive assays revealed rising titers of maternal platelet alloantibody during advancing gestation. We propose further study to determine if this is specific for the antepartum diagnosis of NAITP.

Adrenal Cortex Hormones↗
PubMed1985

Cesarean section deliveries among adolescent mothers enrolled in a comprehensive prenatal care program.

A comparison was made of the incidences of cesarean section deliveries between mothers 18 years of age or younger and those 19 to 21 years of age, all of whom were enrolled in a comprehensive program of prenatal care. Also compared were the indications for surgical delivery between the two groups. The rate of cesarean section deliveries was 8.7% among mothers 18 years of age or younger, compared to 14.5% among mothers 19 to 21 years of age. The general-ward cesarean section rate at the same hospital was 19.4%. Since maternal height and weight, and infant's birth weight may affect the diagnosis of cephalopelvic disproportion, these parameters were also evaluated. However, these did not differ significantly between mothers 18 years of age or younger and those 19 to 21 years of age or between vaginal and surgical births in mothers 18 years of age or younger. Thus, cephalopelvic disproportion did not contribute importantly to the cesarean section rate.

Adolescent↗
PubMed1985

The tendency to IUGR in preterm infants born to young women enrolled in a comprehensive prenatal program.

Low-birthweight infants born to young women in an urban poor and multiethnic community who attended an intensive comprehensive prenatal program were studied. Of the 801 young women followed, 69 (8.6%) delivered infants weighing less than or equal to 2500 gm. Despite comprehensive care, there was a high prevalence of maternal anemia though other obstetric factors were not significantly increased. Of the 69 low-birthweight infants, 82.6% were below the 50th percentile for weight. There was a tendency toward intrauterine growth retardation (IUGR) among preterm infants which was pronounced after 33 weeks gestation. Further studies are needed to determine what developmental insult could arrest growth and lead in some instances to preterm birth and in others to IUGR.

Adolescent↗
PubMed1984

Spontaneous regression of fetal ascites in utero in an adolescent.

Fetal ascites has been documented by ultrasound to progressively disappear prior to birth. This report describes a case in a nineteen-year-old in which fetal ascites was documented in the midtrimester of pregnancy and in which subsequent regression was shown by ultrasound. Although nonimmune fetal hydrops commonly has a poor prognosis, it is possible to adopt an observant attitude while a carefully evaluating for an etiology of fetal ascites.

Adult↗
PubMed1984

Grieving characteristics after spontaneous abortion: a management approach.

Twenty-two women who experienced a spontaneous abortion were treated during a 15-month period. All patients were seen for counseling sessions immediately after the spontaneous abortion. The initial counseling was followed by patient contacts and by a second counseling session four to six weeks later. All 22 women demonstrated intense emotional reactions to their pregnancy loss, characterized by the seven stages of grief. Guilt was the state that appeared to be the most difficult for the women and their spouses to resolve without help. Counseling sessions are considered an essential part of the total obstetric care for patients who experience a pregnancy loss.

Abortion, Spontaneous↗
PubMed1983

The content of elastin in the uterine cervix.

Mature, crosslinked elastin has been isolated from 4 human and 12 monkey uterine cervices. A modification of previous methods for determination of elastin content was devised to quantitate the low amounts of elastin in the crude connective tissue of uterine cervices. The percentage of elastin was found to range between 0.9 and 2.4% and did not appear to change at various stages of gestation.

Amino Acids↗
PubMed1979

Fetus papyraceus causing dystocia: inability to detect blighted twin antenatally.

A case is reported of fetus papyraceus diagnosed intrapartum. There was no clinical evidence in early and midpregnancy to suggest such a diagnosis. Ultrasound examination performed 1 week prior to delivery was nondiagnostic, but an x-ray taken intrapartum revealed dystocia caused by fetus papyraceus, thus necessitating cesarean section. It is suggested that the clinician consider x-ray as well as ultrasound in the diagnosis of fetus papyraceus. In addition to the obstetric morbidity, there is considerable neonatal morbidity which further increases the importance of antenatal diagnosis of fetus papyraceus.

Abortion, Missed↗
PubMed1973

Toxemia.

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Biopsy↗