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Biomedical subjects

R D Eden

Publications and source records attributed to R D Eden.

29 records · Page 2Linked to original sources
PubMed1985

Peripartum hysterectomy: a review of cesarean and postpartum hysterectomy.

A retrospective review of 117 women who underwent peripartum hysterectomy at Duke University Medical Center during the past 21 years was conducted. Seventy-three cesarean hysterectomies were performed electively; 44 cesarean or postpartum hysterectomies were performed as emergencies. Statistically significant differences were noted between these groups in surgical technique, operative time, estimated blood loss, intraoperative hypotension, and intraoperative and total blood replacement. Additional significant differences were noted in postoperative febrile morbidity, use of therapeutic antibiotics, incidence of thromboembolic phenomena, and length of postoperative hospital stay. Separate analysis of elective cesarean hysterectomy patients revealed statistically significant decreases in operative time, estimated blood loss, intraoperative and total blood replacement, and postoperative hospital stay in the group having an experienced surgeon when compared with the group with less experienced surgeons.

Adolescent↗
PubMed1984

Serial nephelometric urine IgG measurement and the management of pregnancy-induced hypertension.

Serial IgG analysis was performed on the urine and serum of 16 patients with pregnancy-induced hypertension. Significant immunoglobulinuria developed prior to the development of azotemia, significantly decreased creatinine clearance, significant proteinuria (greater than or equal to 3+ dipstick or greater than or equal to 5 gm per 24-hour urine collection), or oliguria. Nephelometric measurement of urine IgG concentrations appears to be a rapid and accurate method for confirming the severity of clinical disease, the degree of renal involvement, the benefit of treatment modalities on renal function, and the likelihood of postpartum maternal morbidity.

Adolescent↗
PubMed1984

Intra-amniotic bacterial colonization in premature labor.

Bacterial culturing was performed on amniotic fluid obtained by transabdominal amniocentesis from 33 patients with singleton pregnancies who were in idiopathic premature labor with intact membranes prior to the thirty-fifth week of gestation. Bacteria were isolated in seven patients (21.2%). The patients who were at highest risk for intra-amniotic colonization were those who had two or more clinical parameters suspicious for intra-amniotic infection in a pregnancy prior to the thirtieth week. Anaerobic bacteria were isolated from all seven patients. Only one patient had mixed aerotolerance isolates. Anaerobic that were classified as significant pathogens were isolated in four patients. Three patients had isolates that grew on primary plates, and the rest were recovered only from broth. The greatest impact of intra-amniotic bacterial colonization in premature labor with intact membranes on perinatal outcome is expressed in extreme prematurity and appears to be a function of the pathogenicity and concentration of the offending organism(s).

Amniotic Fluid↗
PubMed1983

Nephelometric urinary protein profile as an index of renal involvement in hypertensive disorders of pregnancy.

Protein analysis was performed on the urine of 62 pregnant women with the use of a nephelometric technique. Thirty-seven women were classified as having mild or severe pregnancy-induced hypertension and/or chronic hypertension. The protein analysis was performed on urine samples obtained prior to delivery and was compared to the degree of proteinuria as determined by the dipstick technique. The degree of immunoglobulinuria increases with increasing severity of pregnancy-induced hypertension while the urine concentration of albumin and transferrin becomes nondetectable. The urinary protein profile appears to be extremely sensitive and accurate in predicting severity of disease.

Adult↗
PubMed1983

Accuracy of ultrasonic fetal weight prediction in preterm infants.

We analyzed the accuracy of four previously reported ultrasound formulas by means of abdominal circumference and/or biparietal diameter measurement for the prediction of fetal weight in the preterm infant (less than 2,000 gm). The birth weights of 25 preterm infants delivered within 72 hours of ultrasound measurement were compared to the weights calculated by formulas derived from the ultrasound measurements, and the accuracy of each formula was determined. A high degree of correlation was found or the logarithmic formulas with the use of both biparietal diameter and abdominal circumference measurement. Our data suggest that the present ultrasound methodology is of sufficient accuracy to warrant the use of ultrasonic measurement to predict fetal weight prospectively before delivery of the very low-birth weight infant. We also retrospectively reviewed the previous 4-year neonatal mortality rate for infant weighing between 500 and 2,000 gm at birth at Duke University.

Abdomen↗
PubMed1983

Myasthenia gravis and pregnancy: a reappraisal of thymectomy.

A retrospective review of pregnancy in patients with myasthenia gravis at Duke University was conducted. Twelve new cases of pregnancy in eight myasthenic mothers are reported. In general, thymectomy was the primary treatment modality in these patients and preceded the gestational period in all cases. The clinical course of myasthenia gravis in these pregnancies prompted a literature review of previous case reports. Comparison of clinical symptomatology, course of disease, and maternal and perinatal morbidity and mortality revealed that the incidence of clinical exacerbation was less in the thymectomy than in the nonthymectomy group. The role of the thymus in the pathogenesis of myasthenia gravis is reviewed. The rationale for the use and timing of thymectomy in the treatment of the myasthenic patient is presented. This review supports the continued use of thymectomy for the initial treatment of the young, nonpregnant myasthenic female patient.

Adolescent↗
PubMed1982

Comparison of antepartum testing schemes for the management of the postdate pregnancy.

We analyzed the outcome results of 583 postdate pregnancies managed prospectively by one of three antepartum testing schemes, each predicated on the nonstress test. In scheme 1, we relied upon the contraction stress test for evaluation of the nonreactive nonstress test. In scheme 2, we used a modified biophysical profile to evaluate the nonreactive nonstress test. In addition, patients were tested semiweekly. In scheme 3, we added routine weekly ultrasound evaluation of amniotic fluid volume to scheme 2. Only in scheme 3 did we induce labor for decreased amniotic fluid volume or fetal cardiac decelerations irrespective of reactivity. The incidence of fetal distress, perinatal mortality, and perinatal morbidity was increased in babies with decelerations or decreased amniotic fluid volume. Nevertheless, outcome results in scheme 2 were improved over those with scheme 1 and were best with scheme 3. These results suggest a benefit to both semiweekly testing and liberalized criteria for intervention in postdate pregnancies. We also compared the outcome results of scheme 3 with those reported for schemes in which the weekly contraction stress test was used as the primary form of surveillance. We found the outcome results comparable in that both schemes showed minimal mortality and morbidity statistics but high intervention rates (25% to 30%). Differences in methodology and test criteria, however, make such comparisons less than ideal.

Amniotic Fluid↗
PubMedDate not supplied

Comparison of intrapartum fetal monitor tracings of karyotypically abnormal and control infants.

To determine if there are any specific monitoring patterns associated with chromosomal abnormalities the intrapartum tracings of 17 postnatally diagnosed karyotypically abnormal infants were obtained. Controls were randomly selected from infants born on the same day at the same gestational age. The tracings from these two groups were independently evaluated. Comparison of the monitor interpretations showed: (1) the karyotypically abnormal group was more likely to have decreased or absent short- (p < 0.001) and long-term (p < 0.01) variability; (2) accelerations were more likely to be represented in the control group (p < 0.001); (3) no significant differences were found in the baseline heart rates or in the presence or frequency of mild, moderate, or severe variable or late decelerations. These findings may reflect underlying central nervous system abnormalities as opposed to uteroplacental insufficiency, but are not specific to karyotypically abnormal infants.

Chromosome Aberrations↗