American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Sep 1987
Pregnancy outcome in medically complicated and uncomplicated patients aged 40 years or older.
Patients (183) who were delivered at age greater than or equal to 40 years were studied to ascertain the nature and frequency of maternal and fetal complications at a single institution in a recent time period. These patients were further grouped into those of low parity, those who began pregnancy without underlying disease, and those who began pregnancy with underlying medical disorders. ⋯ The incidence of stillbirth, perinatal mortality, and abnormal birth weight was significantly increased. There were some differences in the nature and frequency of complications encountered among the subgroups, but no subgroup had a complication rate comparable to our general obstetric population.
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Am. J. Obstet. Gynecol. · Aug 1987
Comparative StudyRed blood cell zinc protoporphyrin testing for iron-deficiency anemia in pregnancy.
The diagnostic value of ferritin, transferrin saturation, and red blood cell zinc protoporphyrin for detecting iron depletion and predicting third-trimester anemia was studied in 87 women attending a private obstetrics clinic. A decline in ferritin and transferrin saturation and an increase in red blood cell zinc protoporphyrin levels were observed in third-trimester measurements when compared with those of the first trimester. ⋯ The diagnostic sensitivity and predictive value of red blood cell zinc protoporphyrin for evaluating iron depletion and risk of anemia in pregnancy compared favorably to those of ferritin and transferrin saturation measurements. The operational simplicity and low cost of red blood cell zinc protoporphyrin measurements are additional characteristics that favor this procedure for office testing.
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Am. J. Obstet. Gynecol. · Apr 1987
Case ReportsDeclining serum concentrations of the beta-subunit of human chorionic gonadotropin and ruptured ectopic pregnancy.
Declining values of the beta-subunit of human chorionic gonadotropin may be associated with ectopic pregnancy or missed abortion. Sonography may not always establish a definitive diagnosis. A case is presented where expectant management of declining levels resulted in rupture of an ectopic pregnancy. Declining values of the beta-subunit of human chorionic gonadotropin should not give the clinician a false sense of security in managing first-trimester pregnancy disorders.
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Am. J. Obstet. Gynecol. · Mar 1987
Case ReportsSuccessful pregnancy outcome after cervical dilation with multiple laminaria tents in preparation for second-trimester elective abortion: a report of two cases.
Two patients at 22 weeks' gestation underwent extensive cervical dilation with laminaria tents for elective abortion but continued their pregnancies instead. Both had normal deliveries. For the unusual patient who chooses not to carry out an abortion initiated with cervical dilation, successful pregnancy is possible and therapeutic intervention such as cervical cerclage seems inadvisable.
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Am. J. Obstet. Gynecol. · Mar 1987
Reassessment of White's classification and Pedersen's prognostically bad signs of diabetic pregnancies in insulin-dependent diabetic pregnancies.
The classification systems developed over 20 years ago by White and Pedersen identified diabetic pregnancies at increased risk for perinatal mortality. To assess whether these same criteria would currently be valid, 199 diabetic pregnancies with deliveries from 1977 to 1983 were reviewed. Perinatal mortality rates for White's Classes B gestational (n = 72), B (n = 27), C (n = 67), and D + F + R (n = 33) were 2.9%, 11.1%, 14.9%, and 21.1%, respectively (p less than 0.05). ⋯ The presence of one or more of the prognostically bad signs of pregnancy (n = 76) increased the perinatal mortality rate to 17.1% versus 7.3% among insulin-dependent diabetic pregnancies without prognostically bad signs (p less than 0.05). The presence of any prognostically bad signs of pregnancy was also predictive of pulmonary morbidity in general (31.6% versus 16.3%, respectively) and hyaline membrane disease in particular (13.2% versus 4.1%, respectively). Thus with use of modern obstetric management and medical care of the pregnant diabetic patient, both White's classification and Pedersen's prognostically bad signs of pregnancy continue to be predictive of perinatal mortality.