American journal of obstetrics and gynecology
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An excess of physicians ranging from 21,000 to 70,000 has been predicted for 1990, including a "surplus" of 10,450 obstetrician-gynecologists. Published supply figures have been overestimated. In 1990, the supply of and the demand for obstetrician-gynecologists should be essentially in balance. The classic law of supply and demand is beginning to operate in medical care.
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Am. J. Obstet. Gynecol. · Sep 1983
Case ReportsListeriosis as a cause of maternal death: an obstetric complication of the acquired immunodeficiency syndrome (AIDS).
A case of maternal death due to Listeria monocytogenes bacteremia, with survival of the prematurely delivered infant, is presented. Lymphopenia and a Haitian origin suggest that the fatal outcome was related to the acquired immunodeficiency syndrome (AIDS). To our knowledge, this is the first recorded instance of a maternal death due to listeriosis.
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Am. J. Obstet. Gynecol. · Aug 1983
Comparative StudyEffects of induction of general and regional anesthesia for cesarean section on maternal plasma beta-endorphin levels.
Plasma beta-endorphin was measured in 40 healthy pregnant women undergoing cesarean section. Group 1 patients (N = 14) received general anesthesia by rapid-sequence induction and endotracheal intubation with curare, thiopental, and succinylcholine. Anesthesia was maintained with nitrous oxide, oxygen, and muscle relaxant until delivery. ⋯ In the 14 patients who underwent general anesthesia, the mean (+/- SEM) plasma beta-endorphin increased significantly (p less than 0.025) from 46 +/- 7.4 to 111.6 +/- 8.9 fmol/ml. There was no significant change in plasma beta-endorphin level of the 26 patients who underwent regional anesthesia; beta-endorphin levels averaged 44.5 +/- 5.1 and 47.6 +/- 4.8 fmol/ml prior to and after induction of anesthesia, respectively. These data demonstrate that plasma beta-endorphin concentrations are elevated following induction of general anesthesia but not with induction of regional anesthesia, which suggests that less stress is associated with regional than with general anesthesia induction in patients undergoing cesarean section.
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Am. J. Obstet. Gynecol. · Apr 1983
Comparative StudyThe predictive significance of biologic risk factors for deficits in children of a high-risk population.
Two hundred forty-two high-risk children and 47 low-risk children were prospectively studied to assess the relationship between biologic risk factors that occurred during the perinatal period and the motor and cognitive deficits that were identified during the first year of life. Multiple risk factors were present in 80% of the children of the high-risk group. ⋯ High-risk children had a significantly greater incidence of provisional deficits, particularly in respect to positive deficits. In high-risk children, the probability of a deficit was 17% in those without infection or encephalopathy, 30% in those with infection, and 40% in those with encephalopathy.