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Biomedical subjects

S G Gabbe

Publications and source records attributed to S G Gabbe.

At least 127 records · Page 7Linked to original sources
PubMed1980

Maternal outcome in class H diabetes mellitus.

The term class H diabetes mellitus has recently been used to describe pregnant diabetic women with ischemic heart disease. In such patients, the risks of abortion may approach those of continuing the gestation. Because significant cardiac disease can occur with diabetes of even recent onset, a baseline electrocardiogram is thus recommended for all pregnant diabetic women. Review of the literature reveals 11 cases, 8 of which resulted in maternal death. The authors have successfully treated a class H diabetic woman who delivered a healthy infant at 36 weeks' gestation.

Adult↗
PubMed1979

Significance of phosphatidylglycerol in amniotic fluid in complicated pregnancies.

In normal pregnancy lecithin/sphingomyelin ratios correlate with gestational age. In complicated pregnancies biochemical maturation of fetal lung may be accelerated or delayed, depending upon maternal, fetal, or placental conditions. Surfactant contains other phospholipids besides lecithin, including phosphatidylglycerol (PG), the second major component of mature surfactant. Ninety phospholipid patterns in amniotic fluid were studied by two-dimensional thin-layer chromatography. In uncomplicated pregnancies PG was absent until 37 weeks' gestation, then increased there after. In complicated pregnancies (pre-eclampsia, diabetes Classes D, F, and R, premature rupture of membranes) PG was identified before 35 (as early as 29 weeks' gestation. These results verify accelerated lung maturation in certain complicated pregnancies. No newborn infant developed respiratory distress syndrome in the presence of PG.

Amniocentesis↗
PubMed1979

Evaluation of the FELMA microviscosimeter in predicting fetal lung maturity.

A new, rapid technique for determining fetal lung maturity, the FELMA, was tested against the standard lecithin/sphingomyelin (L/S) ratio in predicting hyaline membrane disease (HMD). The FELMA was tested on 236 samples, 154 of which were compared with the L/S ratio; 102 neonates were delivered within 48 hours. There was a significant correlation between methods ( r = 0.47). No neonate with a mature FELMA score developed HMD. Of 5 neonates with HMD, 2 had mature L/S ratio in predicting lung immaturity, providing a rapid result without the necessity of thin-layer chromatography.

Amniotic Fluid↗
PubMed1979

Influence of progestin upon hemodynamics in castrated male pygmy goats.

Effects of progestin administration for 5 to 6 weeks upon hemodynamics were studied in two separate experiments, using trained, adult castrated male Pygmy goats. Measurements of cardiac output, blood pressure, plasma volume, and oxygen content of arterial and mixed venous blood were made before, during, and after treatment. In experiment 1, four animals were used. Progesterone was implanted subcutaneously in silicone envelopes which released an average of 44 mg of progesterone/day/goat. A 20% decrease in cardiac output occurred by the 5th week of treatment. Blood pressure was maintained by an increased peripheral vascular resistance. The five animals in experiment 2 were given (IM) 6 mg of 17-alpha-hydroxyprogesterone/kg of body weight/day. Cardiac output decreased 17% in the 2nd and 3rd weeks of hormone treatment. 17-alpha-Hydroxyprogesterone caused a transient natriuresis followed by sodium retention. Urinary aldosterone excretion increased after 9 days of treatment, but returned to normal by the 15th day.

Animals↗
PubMed1978

Shoulder dystocia. A complication of fetal macrosomia and prolonged second stage of labor with midpelvic delivery.

Shoulder dystocia is an infrequently encountered obstetric emergency varying in incidence from 0.15 to 0.60% of all deliveries. Previously identified risk factors include maternal obesity, previous infants weighing greater than 4 kg, maternal diabetes, and fetal macrosomia (greater than 4 kg). To evaluate the role of prolonged second stage of labor (PSS) as a warning sign for shoulder dystocia, 9864 deliveries at LAC-USC Women's Hospital were retrospectively reviewed. Ninety percent delivered vaginally and 4.89% had PSS with midpelvic delivery. Shoulder dystocia occurred in 0.37% of all vertex vaginal deliveries. In the absence of PSS and midpelvic delivery, the incidence of shoulder dystocia was 0.16%. However, with PSS and midpelvic delivery, the incidence of shoulder dystocia was 4.57% (P less than 0.01). Infants weighing in excess of 4 kg were at increased risk of shoulder dystocia compared with infants weighing less than 4 kg. When PSS occurred and midpelvic delivery was attempted, the incidence of shoulder dystocia was 21% in infants weighing in excess of 4 kg; 8% had had failed vaginal delivery. All shoulder dystocias and failed vaginal deliveries occurred after use of the vacuum extractor. Immediate neonatal injury was apparent in 47% of infants with shoulder dystocia after PSS with midpelvic delivery. There were no maternal or fetal deaths related to shoulder dystocia during the study period.

Birth Weight↗
PubMed1978

Evaluation of the contraction stress test before 33 weeks' gestation.

The value of the contraction stress test (CST), although well documented in late pregnancy, has been questioned earlier in gestation. We have evaluated the reliability of the CST in 102 patients tested before 33 weeks' gestation. Eighteen patients with a positive CST had a significantly higher incidence of abnormal urinary estriol excretion (60% of patients), low Apgar scores (44%), growth retardation (39%), and perinatal mortality (277/1000) than did 84 women without a positive CST. Two stillbirths and 3 neonatal deaths occurred in the positive CST group. None of the neonatal losses was due to unnecessary premature intervention. Four patients with a positive CST showed no signs of fetal compromise, a false positive rate of 22%. Delivery was safely delayed an average of 6.1 weeks in patients without a positive CST. These findings demonstrate the predictive value of the CST and support its clinical application early in the third trimester.

Apgar Score↗
PubMed1977

Management and outcome of pregnancy in diabetes mellitus, classes B to R.

During the period 1971 to 1975, 260 women with diabetes mellitus, Classes B through R, were delivered of their infants at Los Angeles County Women's Hospital. The plan of patient management included frequent clinic visits and hospitalization to assure good control. A program of intensive antepartum fetal surveillance was begun at 34 weeks' gestation, with the use of daily 24 hour urinary estriol determinations and a weekly contraction stress test (CST). A lecithin/sphingomyelin ratio was evaluated for all patients before elective delivery. The perinatal mortality rate in these diabetic pregnant women was 46 per 1,000 as compared to 24 per 1,000 in the general population. Only three stillbirths occurred in the diabetic group, none within one week of a negative CST. Congenital malformations were responsible for almost half of the neonatal deaths. There were no deaths due to iatrogenic prematurity or trauma. Mean gestational age at delivery was 37.9 weeks and vaginal delivery was the mode for approximately half of the women. Two thirds of the infants did experience some morbidity.

Delivery, Obstetric↗
PubMed1977

Lecithin/sphingomyelin ratio in pregnancies complicated by diabetes mellitus.

The amniotic fluid lecithin/sphingomyelin (L/S) ratio was determined in 182 pregnancies complicated by Classes B and C diabetes and in 28 patients with Classes D, F, and R diabetes. These data were retrospectively correlated with the occurrence of the respiratory distress syndrome (RDS) or hyaline membrane disease (HMD). Only four cases of RDS and two cases of HMD were observed in 200 patients with an L/S ratio of 2.0 or greater prior to delivery. This 3 per cent incidence of complications is no higher than that of the nondiabetic population in our institution. Seven of 10 neonates with an antenatal L/S ratio of 1.5 to 1.9 developed RDS. An L/S ratio of 2.0 or more appears to be reliable predictor of fetal pulmonary maturity even in pregnancies complicated by diabetes mellitus.

Amniotic Fluid↗