American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Aug 1981
Endotoxic shock in the primate: effects of aspirin and dipyridamole administration.
A primate model was utilized to study the cardiovascular and coagulation effects of endotoxic shock. The therapeutic effectiveness of drugs such as aspirin and dipyridamole, which diminish platelet aggregation and adherence, were evaluated. From the data, it appears that the kidney is a target organ in endotoxic shock, at least when a bolus injection of endotoxin is administered. ⋯ The changes in the coagulation profile were of less magnitude, and the fibrin degradation products appeared late in the group pretreated with aspirin as compared to the other groups. The combination of dipyridamole and aspirin was not as effective as aspirin alone in achieving the apparently protective effect. The study suggests that the administration of aspirin to patients with gram-negative infections may be beneficial.
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Am. J. Obstet. Gynecol. · Aug 1981
Bradycardia in the fetal baboon following paracervical block anesthesia.
In order to define the causal relationship between the use of local anesthetics and fetal bradycardia, paracervical block anesthesia (PCB) with lidocaine of 2-chloroprocaine was induced on 52 occasions to 27 pregnant baboons. The dosages were comparable to those used clinically on the basis of maternal body weight. On 40 occasions, PCB was induced with nonasphyxiated (normal) fetuses, 33% of which developed fetal bradycardia after PCB. ⋯ These levels were far below those associated with myocardial toxicity. The conclusion is that the fetal bradycardia subsequent to PCB is, in part, caused by a decrease in the oxygen available to the fetus secondary to an increase in uterine activity and a reduction in uteroplacental perfusion. This manifestation may occur at drug concentrations in both the mother and fetus that are far below toxic levels.
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Few reliable data exist on the risk of maternal death from cesarean section. To identify more deaths after cesarean section than reported by vital records alone, we linked data from Georgia resident live-birth certificates to those from death certificates of Georgia women aged 10 to 44 years. We found 16 maternal deaths after cesarean section in Georgia during 1975 and 1976, five more (45%) than the 11 reported through vital records alone. ⋯ We than calculated a total death-to-case rate of 105.3 deaths per 100,000 cesarean sections and a rate attributable to cesarean section of 59.3 deaths per 100,000 procedures. Pulmonary embolism and cardiopulmonary arrest during general anesthesia were the leading causes of death in this series. Preventive measures aimed at reducing these complications may reduce deaths after cesarean section.
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Am. J. Obstet. Gynecol. · Feb 1981
Comparative StudyControl of mineral homeostasis during lactation: interrelationships of 25-hydroxyvitamin D, 24,25-dihydroxyvitamin D, 1,25-dihydroxyvitamin D, parathyroid hormone, calcitonin, prolactin, and estradiol.
To further define control of mineral homeostasis during lactation, 28 lactating (L) and 20 nonlactating (NL) women were studied at 6 weeks post partum. Serum and urine calcium, magnesium, and phosphorus were normal and the same in both groups. 25-Hydroxyvitamin D (25-OHD) was the same (L, 18.6 +/- 4.8; NL, 17.0 +/- 5 ng/ml) in spite of a twofold higher intake of vitamin D in the lactating group. The serum fractions containing 24,25-dihydroxyvitamin D (24,25(OH)2D) were lower than in nonpregnant adults in both groups but significantly lower (P less than 0.05) in lactating than in nonlactating women (L, 1.67 +/- 1.7; NL, 2.46 +/- 1.3 ng/ml). 1,25-Hydroxyvitamin D (1,25-(OH)2D) was normal in both groups (L, 25.8 +/- 8.6, NL, 31.8 +/- 8.1 pg/ml). ⋯ Serum prolactin levels had no correlation with serum 1,25(OH)2D. Estradiol was significantly (P less than 0.02) lower in lactating women (L, 78 +/- 23; NL, 105 +/- 28 pg/ml). One could speculate that the lower levels of estradiol in the presence of low 24,25(OH)2D and normal HCT allow bone resorption to occur at a rate adequate to supply the mineral needs of lactation without elevations of either PTH or 1,25(OH)2D.
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We studied 500 unselected young women who consulted a gynecologist in a student health service. Most participants were symptom-free and had normal physical examinations. Few sexually transmitted infections were encountered. ⋯ Mycoplasma hominis and Ureaplasma urealyticum, respectively, were recovered from 17.6 and 56.8% of the subjects. Prevalent vaginal bacteria included lactobacilli, streptococci, Staphylococcus epidermidis, and diphtheroids. Gardnerella vaginalis was isolated from the vaginal specimens of about one third of the participants.