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S J Kilpatrick

Publications and source records attributed to S J Kilpatrick.

58 records · Page 4Linked to original sources
PubMedDate not supplied

Maternal fertility is not affected by fetal surgery.

The purpose of this report is to assess the impact of fetal surgery on future maternal fertility, subsequent pregnancy outcome, and the incidence of pregnancy complications. Retrospective data were collected on 70 mothers who underwent fetal surgery between April 1981 and June 1996. Indications for open hysterotomy fetal surgery included congenital diaphragmatic hernia (n = 44), congenital cystic adenomatoid malformation of the lung (n = 11), urinary obstruction (n = 9), sacrococcygeal teratoma (n = 4), heart block (n = 1), and acardiac-acephalic twin reduction (n = 1). The following data were obtained: number of pregnancy attempts, number of successful pregnancies, pregnancy outcome including obstetrical and neonatal complications, and infertility after fetal surgery. There were 45 respondents, of whom 35 attempted subsequent pregnancies. Thirty-two were successful, resulting in 31 livebirths. Two women had a strong prefetal surgery history of infertility, 1 has only attempted to conceive for 3 months. We report this experience because the effect of open fetal surgery on futrue fertility is such an important question for our patients and referring physicians. This analysis suggests that hysterotomy and open fetal surgery has a negligible impact on maternal fertility.

Adolescent↗
PubMedDate not supplied

The epidemiology of environmental tobacco smoke (ETS) and the weight of evidence argument.

This paper demonstrates that Wald's meta-analysis is an unadjusted combination of unadjusted estimates. There are many differences among the design and implementation of the original studies combined here. One consequence of these differences is that studies of spousal smoking and lung cancer mortality conducted in the United States have a lower combined RR than those done elsewhere. Here it is shown that adjustment for this stratification results is a non significant finding as to the association of ETS with lung cancer. Likewise, the addition, for illustration, of Varela's Ph.D. thesis that is the largest case-control study to date, changes the overall results from a significant to a non-significant result. This paper does not attempt to update Wald's meta-analysis with more recent studies. This is being done, I believe by the Environmental Protection Agency. I have given here my reasons for suspecting the conclusions of meta-analysis of non-randomized studies and the illustrations provided here of the effect of publication bias and covariate adjustment support this view.

Bias↗