American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Apr 1978
Manpower for obstetrics-gynecology. I. Demographic considerations and practice work load.
A cooperative study between the University of Southern California Division of Research in Medical Education and the American College of Obstetricians and Gynecologists represents one subset of a large-scale study of manpower supply in obstetrics-gynecology. A stratified random sample of all obstetrician-gynecologists was obtained from the AMerican Medical Association's "Master File of Physicians." A total of 879 respondents (56 per cent of the sample) completed a detailed, one-week log of practice activities and self-descriptive questionnaire. ⋯ Practice work load is identified by encounter time per patient, work hours per day and week, and variations related to geographic location and population served. The descriptive findings may have important implications for manpower planning.
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Adverse reactions to paracervical block, including death, are believed to be dose related. By using a modified jet injector instead of the standard syringe-and-needle technique, we obtained equal analgesia with one fifth of the standard milligram dosage of lidocaine in patients undergoing therapeutic abortion. Blood lidocaine levels as determined by gas chromatography were reduced by two thirds with jet injection. These results led us to conclude that jet injection for paracervical block is safer than the syringe-and-needle technique.
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Am. J. Obstet. Gynecol. · Oct 1977
Epidural analgesia and its effects on the "normal" progress of labor.
The effects of epidural analgesia on the duration of labor have been a controversal subject since its increased use in recent years. A total of 598 patients receiving this form of analgesia were studied as to progress in labor and eventual outcome. ⋯ The labor curves are characterized by constant acceleration in dilatation without deceleration at approximately the same rate for nulliparous and multiparous patients after dilatation of 5 cm. has been reached. Examination of maternal and fetal profiles failed to demonstrate any consistent variables that produce abnormal labor.
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Am. J. Obstet. Gynecol. · Sep 1977
Prolonged rupture of fetal membranes and decreased frequency of respiratory distress syndrome and patent ductus arteriosus in preterm infants.
Observations were made on 153 preterm infants (25 to 34 weeks' gestation) in an attempt to answer the following questions: dose prolonged rupture of the fetal membranes (ROM) correlate with a decreased frequency of respiratory distress syndrome (RDS) and patent ductus arteriosus, and, if so, what is the duration of ROM required? An analysis of the data indicates that as the duration of ROM is lengthened the incidence of RDS and patent ductus arteriosus decreases. In fact, after 48 hours of prolonged ROM (PROM), there is a virtual absence of RDS. In addition, after 72 hours of PROM, the frequency of patient ductus arteriosus was markedly reduced to only 12 per cent (three of 25 infants). ⋯ These findings support the hypothesis put forth by the others 1-5 that PROM is indeed associated with a decreased frequenct of RDS in preterm infants. Moreover, our findings suggest that PROM greater than 72 hours is associated with a relatively low frequency of patent ductus arteriosus. The question is then raised that perhaps pregnancies less than or equal to 34 weeks' gestation with PROM should be allowed to continue for 72 hours in the absence of amnionitis.