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Biomedical subjects

Samuel Lurie

Publications and source records attributed to Samuel Lurie.

At least 19 recordsLinked to original sources
PubMed2006

Cord around the neck: should it be severed at delivery? A randomized controlled study.

Umbilical cords often become encircled around portions of the fetus, usually the neck. The incidence ranges from 21% in one loop to 0.2% in three loops. In the present study, we assessed the practice of severing the cord, which was encircled once around the neck of the fetus, after delivery of the anterior shoulder and prior to extraction of the body. This was a prospective, randomized, controlled study. The study and the control groups included 30 women each. Cord around the neck was diagnosed during labor by ultrasound. It was cut intentionally in the study group and left intact in the control group. Demographic data were obtained. The course of labor was assessed. Neonatal outcomes measured were cord pH, Apgar scores at 5 minutes, and need for resuscitation. Length of maternal and neonatal hospitalization was determined. No differences were found between the study and the control group before, during, and after labor regarding perinatal variables such as meconium-stained amniotic fluid, fetal heart rate patterns, Apgar scores at 5 minutes, and umbilical cord pH after delivery (7.29 +/- 0.07 [SD] in the study group and 7.32 +/- 0.06 [SD] in the controls; p=0.1). Single nuchal encirclement by the umbilical cord during labor, after delivery of the anterior shoulder, can be severed or left intact. We could not detect any adverse perinatal outcome in such deliveries.

Adult↗
PubMed2006

Re-laparotomy after cesarean section.

OBJECTIVE: To assess the rate, indications, and outcome of re-laparotomy after cesarean section in the early postoperative period. DESIGN: A retrospective observational study during a 121-month period. SETTING: A tertiary care university center. POPULATION: A cohort of 3380 women who underwent cesarean section out of 18,609 parturients. MAIN OUTCOME MEASURES: Incidence of re-laparotomy after cesarean section in the early postoperative period. RESULTS: The incidence of re-laparotomy after cesarean section was 0.53% (18/3380). Of these 18 women, 12 (66%) were operated for hemorrhage, 3 (17%) for eventration, and 3 (17%) for formation of intra-abdominal abscess. Hysterectomy was required in one case (5.5%). We had no maternal mortalities. CONCLUSION: Although the incidence of re-laparotomy after cesarean in the early postoperative period is low and the outcome is favorable, several measures must be undertaken to reduce the need for re-laparotomy.

Adult↗
PubMed2006

Pregnancy-associated rhinitis.

Previous studies overestimated the incidence of pregnancy-associated rhinitis because it is a poorly defined clinical condition. The objective of this study was to assess the incidence of this unique type of rhinitis using up-to-date strict criteria. This prospective study included 109 primigravida parturients who were interviewed using a structured questionnaire and underwent detailed rhinoscopy. Pregnancy-associated rhinitis was defined as nasal obstruction symptom and rhinorrhea appearing during pregnancy, lasting for at least 2 months, and disappearing postpartum. The incidence of rhinitis associated with pregnancy at the time of delivery was 9%. No correlation was found between symptoms and signs. Pregnancy-associated rhinitis is an infrequent clinical entity. It may be related to hormonal changes and possibly altered sensation of nasal airflow.

Adolescent↗
PubMed2006

Treatment of high-grade squamous intraepithelial lesions: a "see and treat" versus a three-step approach.

OBJECTIVE: The study's subject was to examine the correlation between histologic findings in patients with high-grade squamous intraepithelial lesion (HGSIL) who have undergone loop electrosurgical excisional procedure (LEEP) with and without prior colposcopically directed biopsy. STUDY DESIGN: This retrospective study included 144 patients with cytologic HGSIL, of which 62 were treated by a three-step protocol, in which LEEP was performed only if the colposcopically directed cervical biopsies were positive (CIN II-III), and 82 women who were treated by "see and treat" protocol, in which LEEP was immediately performed if colposcopy was suggestive of CIN II or III lesions. RESULTS: There were no differences in the final histological findings between the groups. CONCLUSIONS: The colposcopically directed LEEP after a HGSIL on PAP-smear may reduce the time interval between diagnosis and treatment with a similar accuracy of diagnosis compared to the standard three-step protocol.

Adult↗
PubMed2006

Decision-to-delivery interval for instrumental vaginal deliveries: vacuum extraction versus forceps.

OBJECTIVE: The aim of this study was to assess the decision-to-delivery interval for forceps delivery and vacuum extraction. STUDY DESIGN: A retrospective analysis of all instrumental deliveries over a 1-year period in a delivery ward of a university tertiary health care facility was performed. The decision-to-delivery interval was compared between forceps delivery and vacuum extraction. RESULTS: The decision-to-delivery interval was 8.6+/-5.4 and 13.8+/-6.2 min for forceps and vacuum deliveries, respectively (P=0.0001). CONCLUSION: It appears that it is quicker to accomplish forceps delivery than vacuum extraction.

Decision Making↗
PubMed2006

Vaginal delivery after caesarean delivery in the days of the Talmud (2nd century BCE -6th century CE).

Caesarean delivery was practised for ages, almost always as a postmortem procedure. It is referred to in the myths and folklore of many ancient societies, for some of the infants so delivered survived, although their mothers did not. A fascinating medical situation of vaginal birth after caesarean delivery that may have occurred in the days of the Talmud is described in Mishna, Bechoroth, chapter 2, page 47. Maimonides (1135-1204) suggested that this passage described a vaginal delivery of a second twin during a caesarean section. This paper discusses which of these two possibilities was more likely to occur in the days of the Talmud (roughly 2nd century B.C.E. to 6th century C.E).

Female↗
PubMed2005

Maternal mean corpuscle volume and oxytocin augmentation during vaginal delivery.

OBJECTIVE: The aim of this study was to assess whether low maternal MCV values are associated with adverse course of vaginal delivery. STUDY DESIGN: A retrospective analysis of 92 consecutive vertex singleton vaginal deliveries in nulliparous women in a university tertiary health care facility. MCV was considered as major outcome variable. RESULTS: 54.1% of Parturients with higher MCV needed oxytocin augmentation during labor as compared to 79.5% of parturients with lower MCV (P<0.05). The need for oxytocin for augmentation of labor was decreased with larger MCV (OR 0.90 per fL, 95% CI 0.82-0.98, P<0.05). No correlation was found between MCV and other parameters of labor course. CONCLUSION: Low maternal MCV values were associated with increased use of oxytocin augmentation during vaginal delivery.

Adult↗
PubMed2005

The changing motives of cesarean section: from the ancient world to the twenty-first century.

BACKGROUND: Cesarean delivery has been practiced for ages, although originally as a universally postmortem procedure. It is referred to in the myths and folklore of many ancient societies, for some of the infants delivered in this way survived, even though their mothers did not. Since the Renaissance, the objective of the procedure has gradually shifted towards saving the lives of both the mother and the child, and this has become ever more possible, as maternal and perinatal mortality and morbidity decreased dramatically during the twentieth century. CURRENT ISSUES: Today (at the beginning of twenty-first century), we are not only concerned with the safety and health of the mother and the child, but also with mother's desires and preferences and the child's rights.

Cesarean Section↗
PubMed2005

Association of nausea and vomiting in pregnancy with lower body mass index.

OBJECTIVE: To assess the effect of body mass index (BMI) on the tendency of pregnant women to vomit and on their general condition during pregnancy. STUDY DESIGN: We included patients in this study who presented to our gynecological emergency room and clinic during their first trimester of pregnancy. All women completed a questionnaire assessing obstetrical and physical characteristics, including gravidity, parity, gestational age, height and weight for BMI calculation. Women were requested to report the number of vomiting episodes per day and their general condition using a 1 to 10 scale (1-good, 10-bad). Patients were allocated to either a low-frequency group (0-1 vomiting episodes per day) or to a high-frequency group (2 and more vomiting episodes per day). RESULTS: Sixty-one consecutive women were included in the study. The low frequency group consisted of 35 women and the high frequency group included the remaining 26 women. The BMI was significantly lower in the high frequency group as compared to the low frequency group (21.8 +/- 3.5 versus 24.4 +/- 4.7, respectively; P <0.05). Patients in the high frequency group also reported a worse general condition than those in the low frequency group (7.6 +/- 2.2 versus 3.5 +/- 2.1, respectively; P <0.05). CONCLUSION: Patients with higher frequency of vomiting episodes during the first trimester of pregnancy tend to have a lower BMI score and a worse general condition than patients with low frequency of vomiting episodes.

Adult↗
PubMed2005

Memory performance in late pregnancy and erythrocyte indices.

OBJECTIVE: A previous study in elderly people observed an association between chronologically younger erythrocyte population and memory impairment. The aim of this study was to assess whether a similar shift in erythrocyte population in pregnant women in late pregnancy is associated with changes in memory performance in healthy pregnant women. METHODS: Thirty healthy pregnant women were included in a prospective cross-sectional study. Explicit memory and autobiographic memory tests were performed in the late third trimester and 4 months postpartum. Mean corpuscular volume (MCV) was considered the primary predictor variable. RESULTS: The mean explicit memory recall scores were significantly higher at post-delivery compared to pre-delivery: 8.3 +/- 1.7 and 7.4 +/- 1.4, respectively (P = .015). The difference in mean autobiographic memory test score pre- and post-delivery did not reach statistical significance. A positive correlation between post-delivery explicit memory recall scores and the difference between pre- and post-delivery MCV was detected (r = 0.458, P = .01). The correlation between delta MCV and delta explicit memory recall scores was r = 0.2, P =.311. Pre-delivery autobiographic memory test scores were positively correlated with MCV (r = 0.50, P = .006), mean corpuscular hemoglobin (r = 0.57, P = .001), and mean corpuscular hemoglobin concentration (r = 0.46, P = .013). CONCLUSION: The change in erythrocyte population that is present in late pregnancy predicted explicit memory performance after delivery, when it was improved. The younger erythrocyte population that exists in late pregnancy is associated with a better autobiographic memory.

Adolescent↗
PubMed2005

Occurrence of cervical intraepithelial neoplasia in generally healthy women with exophytic vulvar condyloma acuminata.

AIM: To disclose possible association between exophytic vulvar condyloma acuminata and cervical intraepithelial neoplasia in generally healthy, sexually active women. METHODS: This retrospective study included 74 patients (study group) who were referred for laser vaporization therapy of exophytic vulvar condyloma acuminata, and 88 asymptomatic volunteers without evidence of exophytic vulvar condyloma acuminata (control group) who were referred for screening Papanicolaou (Pap) test cervical evaluation including colposcopy. The diagnosis of cervical intraepithelial neoplasia was based on Pap smear, colposcopy and/or biopsy. RESULTS: On Pap smear, atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesions were found in 10 (13.5%) women with exophytic vulvar condyloma acuminata and in 2 (2.3%) asymptomatic volunteers (p < 0.05). Cervical intraepithelial neoplasia was found in 8 women with exophytic vulvar condyloma acuminata and in none of the asymptomatic volunteers (p < 0.05). CONCLUSION: An association was found between exophytic vulvar condyloma acuminata and abnormal Pap smear or positive cervical biopsy, in generally healthy women.

Adult↗
PubMed2005

Using anovaginal distance at the beginning of labor to predict the likelihood of instrumental delivery.

OBJECTIVE: To investigate whether anovaginal distance in parturients has an impact on the instrumental delivery rate. STUDY DESIGN: In this study with prospective data collection and a convenience sample, 400 parturients planning for vaginal delivery at term with a singleton fetus in vertex presentation were enrolled. Anovaginal distance was measured in the lithotomy position during the latent phase of labor or early first stage. This distance is thought to reflect the angle of inclination of the birth canal axis. RESULTS: At the cutoff point of 25 mm for anovaginal distance, the odds ratio for instrumental delivery was 2.5 (95% CI 1.48-6.6, p<0.05). A final model of instrumental delivery, controlling for various confounding variables, correctly predicted 91.38% of the instrumental deliveries (p<0.0001). The variables anovaginal distance >25 mm (OR 2.9, 95% CI 1.2-6.7, p=0.01), parity (OR 0.54, 95% CI 0.29-0.99, p=0.046) and duration of second stage of labor (OR 1.01, 95% CI 1.004-1.01, p=0.001) significantly contributed to the prediction of instrumental delivery after controlling for the other parameters. CONCLUSION: Women with an anovaginal distance of >25 mm at the beginning of labor was 2.5 more likely to undergo instrumental delivery than were women with an anovaginal distance of <25 mm.

Adult↗
PubMed2004

The decision to delivery interval in emergency and non-urgent cesarean sections.

OBJECTIVE: The aim of this study was to assess the decision to delivery interval (DDI) in our obstetric unit in comparison to current recommendations. STUDY DESIGN: A retrospective analysis of all non-elective cesarean sections during a 10 months period in a delivery ward of a university tertiary health care facility was performed. The DDI was compared between emergency and non-urgent cesarean sections. RESULTS: The DDI was 25.8 +/- 10.8 +/- and 46.2 +/- 19.9 min in the emergency and non-urgent cesareans, respectively (P < 0.01). In the emergency group, 71% delivered within 30 min compared to 35% in the non-urgent group (P < 0.05) and in the emergent-crash group 100% delivered within 30 min compared to 59% in the emergent-non-crash group (P < 0.05). No correlation was found between the DDI and umbilical artery pH or Apgar score at 1 or 5 min in infants of each cesarean group. CONCLUSION: The proposed 30 min DDI standard was achieved in 100, 71, 47 and 35% of emergent-crash, emergent, emergent-non-crash and non-urgent cesareans sections, respectively.

Adult↗
PubMed2004

Vaginal removal of prolapsed pedunculated submucous myoma: a short, simple, and definitive procedure with minimal morbidity.

OBJECTIVE: Our objective was to evaluate the outcome of vaginal removal of prolapsed pedunculated submucous myomas over a 10-year period. STUDY DESIGN: Retrospective observational study. Fifty-two patients were admitted with the diagnosis of prolapsed pedunculated submucous myoma. Six patients were excluded because of an a priori decision for abdominal hysterectomy. In 46 patients an attempt for vaginal myomectomy under general anesthesia was done. RESULTS: Vaginal myomectomy was successful in 44 patients (95.6%). There were no immediate complications. Histological diagnosis of leiomyoma was confirmed in 34 cases (73.9%) and in the remainders intrauterine pathology was endometrial polyp. Total abdominal hysterectomy was performed in additional 6 patients (13.7%) 3 months to 5 years following vaginal myomectomy. CONCLUSIONS: Vaginal myomectomy is the treatment of choice for prolapsed pedunculated submucous myoma. The associated morbidity is minimal.

Adult↗
PubMed2004

Pseudocholinesterase deficiency associated with HELLP syndrome.

We report a case of decreased plasma pseudocholinesterase activity in a patient with hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome. The pseudocholinesterase activity returned to normal with concomitant recovery of HELLP syndrome. This possible association is significant when general anesthesia is provided to patients with HELLP syndrome.

Adult↗