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Full-Text Articles in Medicine and Health Sciences
The Inhibition Of Premature Labor With Indomethacin, Jennifer Niebyl, D. Blake, R. White, K. Kumor, N. Dubin, J. Robinson, P. Egner
The Inhibition Of Premature Labor With Indomethacin, Jennifer Niebyl, D. Blake, R. White, K. Kumor, N. Dubin, J. Robinson, P. Egner
Jennifer R Niebyl
We administered indomethacin orally for the treatment of premature labor in a prospective, randomized, double-blind fashion, and all infants were followed up. Indomethacin was significantly more effective than placebo in inhibition of premature labor during a 24-hour course of therapy, with treatment failure during therapy occurring in only one of 15 indomethacin-treated patients compared to nine of 15 placebo-treated patients (p less than 0.01). Mean plasma concentrations of indomethacin were approximately 0.8 micrograms/ml at both 4 and 12 hours after administration. Mean plasma levels of 15-oxo-13,14-dihydroprostaglandin F2 alpha (PGFM) were similar in the two groups before treatment, decreased markedly in …
Drugs And Related Areas In Pregnancy, Jennifer Niebyl
Drugs And Related Areas In Pregnancy, Jennifer Niebyl
Jennifer R Niebyl
No abstract provided.
The Influence Of Aspirin On The Course Of Induced Midtrimester Abortion, Jennifer Niebyl, D. Blake, L. Burnett, T. King
The Influence Of Aspirin On The Course Of Induced Midtrimester Abortion, Jennifer Niebyl, D. Blake, L. Burnett, T. King
Jennifer R Niebyl
Prostaglandins appear to mediate the uterine contractions of abortion and labor, and aspirin has been shown to be an inhibitor of prostaglandin synthesis. In this double-blind, placebo-controlled, prospective, and randomized study, aspirin was administered orally in doses of 600 mg. every 6 hours to patients undergoing induced midtrimester abortions with hyperosmolar urea and oxytocin augmentation. The mean injection-abortion interval was significantly prolonged by aspirin in nulliparous patients (aspirin 32.3 +/- 3.3 hr. vs. placebo 21.5 +/- 3.5 hr.) and no aspirin-treated nullipara aborted in less than 18 hours. There was no significant difference between treatment groups in the mean injection-abortion …
Effect Of Hydrogen Peroxide On Prostaglandin Production And Contractions Of The Pregnant Rat Uterus, P. Cherouny, R. Ghodgaonkar, Jennifer Niebyl, N. Dubin
Effect Of Hydrogen Peroxide On Prostaglandin Production And Contractions Of The Pregnant Rat Uterus, P. Cherouny, R. Ghodgaonkar, Jennifer Niebyl, N. Dubin
Jennifer R Niebyl
Although evidence for a role for prostaglandins in parturition is abundant, less is known about how prostaglandin levels are regulated at term. Conditions occurring peripartum in the uteroplacental unit can result in reactive oxygen production. We investigated the effect of one reactive oxygen product, hydrogen peroxide, on in vitro activity of uterine segments from the 18-day-pregnant rat. H2O2 (0.3 mmol/L) was found to elicit rhythmic contractions and increase prostaglandins F2 alpha and E2 release by uterine tissue. Indomethacin blocked both of these effects. We conclude that H2O2 stimulates uterine contractions through a prostaglandin release mechanism. A speculative hypothesis of peripartum …
Cardiac And Respiratory Drugs In Pregnancy, P. Gazaway, Jennifer Niebyl, J. Repke, S. Yaffe, M. Yerby
Cardiac And Respiratory Drugs In Pregnancy, P. Gazaway, Jennifer Niebyl, J. Repke, S. Yaffe, M. Yerby
Jennifer R Niebyl
Medical advances have led to safer pregnancies, but fetal toxicity of drugs remains enigmatic. For many, the jury is still out. Use these guidelines to treat pregnant patients safely. First of three articles.
Cost-Effective Criteria For Glucose Screening, G. Marquette, V. Klein, J. Repke, Jennifer Niebyl
Cost-Effective Criteria For Glucose Screening, G. Marquette, V. Klein, J. Repke, Jennifer Niebyl
Jennifer R Niebyl
To study cost-effective screening criteria for gestational diabetes, a prospective study of 1012 patients was completed. All patients underwent a glucose screen between 26 and 30 weeks of gestation, consisting of a 50-g oral glucose load followed by a one-hour plasma glucose determination. Patients with a glucose screen greater than or equal to 130 mg/dL were studied with a standard three-hour oral glucose tolerance test. The incidence of gestational diabetes was 2.4% (24 of 1012). Only one gestational diabetic was identified with a glucose screen below 150 mg/dL. Twenty-two of the 24 cases were at least 24 years old. Twenty-one …
Letter: Pneumoperitoneum Secondary To Cunnilingus, S. Ashai, D. Lipton, A. Colon, Jennifer Niebyl
Letter: Pneumoperitoneum Secondary To Cunnilingus, S. Ashai, D. Lipton, A. Colon, Jennifer Niebyl
Jennifer R Niebyl
No abstract provided.
Methotrexate And Misoprostol To Terminate Early Pregnancy, J. Yankowitz, Jennifer Niebyl
Methotrexate And Misoprostol To Terminate Early Pregnancy, J. Yankowitz, Jennifer Niebyl
Jennifer R Niebyl
No abstract provided.
Pharmacogenetic Screening For Susceptibility To Fetal Malformations In Women, D. Van Dyke, V. Ellingrod, M. Berg, Jennifer Niebyl, A. Sherbondy, D. Trembath
Pharmacogenetic Screening For Susceptibility To Fetal Malformations In Women, D. Van Dyke, V. Ellingrod, M. Berg, Jennifer Niebyl, A. Sherbondy, D. Trembath
Jennifer R Niebyl
OBJECTIVE: To present a review of the literature and research on the pharmacogenetics of congenital defects, with a focus on the need for predictive maternal genotype assays. DATA SOURCE: MEDLINE searches (January 1985-January 1999), past reference reviews, and unpublished research. STUDY SELECTION: Review of relevant human, animal, and basic science studies. DATA EXTRACTION: Data on research on polymorphisms, genotyping, cytochrome P450 enzyme systems, epoxide hydrolase, folate metabolism, metabolism of anticonvulsant medications, molecular genetics of neural tube defects, variations in drug metabolism, and environmental exposures were evaluated. DATA SYNTHESIS: Data synthesis includes not only a review of the literature but suggests …
Human Plasma Prekallikrein And High Molecular Weight Kininogen Decrease During Parturition, B. Alving, Jennifer Niebyl, D. Proud, B. Mason, J. Pisano
Human Plasma Prekallikrein And High Molecular Weight Kininogen Decrease During Parturition, B. Alving, Jennifer Niebyl, D. Proud, B. Mason, J. Pisano
Jennifer R Niebyl
Prekallikrein and high molecular weight kininogen were measured in plasma taken from nine women during parturition. Prekallikrein decreased significantly (p less than 0.01) from 1.49 +/- 0.15 S-2302 U/ml (mean +/- SEM) in early labor to 1.26 +/- 0.13 S-2302 U/ml in the immediate postpartum period. Immunoreactive high molecular weight kininogen also significantly decreased from 76 +/- 5 micrograms/ml to 68 +/- 5 micrograms/ml one day postpartum (p less than 0.01). Both proteins rose to normal levels within two days. The data suggest that the kallikrein-kinin system is utilized during parturition.
Drugs In Pregnancy, Jennifer Niebyl
The Effect Of Maternal Age On Primary Cesarean Section Rate, F. Witter, J. Repke, Jennifer Niebyl
The Effect Of Maternal Age On Primary Cesarean Section Rate, F. Witter, J. Repke, Jennifer Niebyl
Jennifer R Niebyl
A retrospective analysis of computerized data from 11,815 patients with no history of previous cesarean section revealed an increasing primary cesarean section rate with increasing maternal age. This increase occurred over the entire reproductive age span. Fetal distress as an indication for primary cesarean section may account for this increase.
Acute Bacterial Endocarditis With Postpartum Aortic Valve Replacement, R. Cavalieri, L. Watkins, R. Abraham, H. Berkay, Jennifer Niebyl
Acute Bacterial Endocarditis With Postpartum Aortic Valve Replacement, R. Cavalieri, L. Watkins, R. Abraham, H. Berkay, Jennifer Niebyl
Jennifer R Niebyl
A case of acute bacterial endocarditis with aortic valve abscess, aortic insufficiency, and congestive heart failure at 32 weeks' gestation is described. Prompt valve replacement is indicated due to the risks of embolism to the coronary arteries and brain, and to the high mortality of such patients with medical management only. The infant was delivered prematurely to avoid the intraoperative risks to the fetus of cardiac surgery. General rather than regional anesthesia was chosen because venous pooling from a regional block would necessitate preoperative fluid loading and vasopressor therapy, which would be stressful for an already failing heart. In the …
Reproducibility Of The Diagnosis Of Cervicitis In Pregnancy, J. Repke, L. Berlin, M. Spence, J. Horn, Jennifer Niebyl, S. Kanchanaraksa, E. Mackenzie, R. Nugent, B. Polk
Reproducibility Of The Diagnosis Of Cervicitis In Pregnancy, J. Repke, L. Berlin, M. Spence, J. Horn, Jennifer Niebyl, S. Kanchanaraksa, E. Mackenzie, R. Nugent, B. Polk
Jennifer R Niebyl
Cervicitis has been associated with several infections of the female genital tract. Criteria have been established for making the diagnosis of cervicitis in gynecologic populations but there are no well-established criteria for diagnosing cervicitis in obstetrical populations. Because of the association of the cervicitis and sexually transmitted diseases, and because of the association of sexually transmitted diseases and adverse pregnancy outcome, the present study was undertaken in an attempt to establish criteria for the diagnosis of cervicitis in pregnancy. We also attempted to determine the reproducibility of that diagnosis with respect to intra- and interobserver variability. We concluded that intraobserver …
Therapeutic Drugs In Pregnancy. Caution Is The Watchword, Jennifer Niebyl
Therapeutic Drugs In Pregnancy. Caution Is The Watchword, Jennifer Niebyl
Jennifer R Niebyl
Many medical conditions during pregnancy are best treated initially with nonpharmacologic remedies. Before a drug is used during pregnancy, the indications should be clear and the risk-benefit ratio should justify its use. Then, the minimum effective dose should be employed. If possible, therapy should be postponed until after the first trimester.
Lack Of Maternal Metabolic, Endocrine, And Environmental Influences In The Etiology Of Cleft Lip With Or Without Cleft Palate, Jennifer Niebyl, D. Blake, L. Rocco, R. Baumgardner, E. Mellits
Lack Of Maternal Metabolic, Endocrine, And Environmental Influences In The Etiology Of Cleft Lip With Or Without Cleft Palate, Jennifer Niebyl, D. Blake, L. Rocco, R. Baumgardner, E. Mellits
Jennifer R Niebyl
We studied metabolic, endocrine, and environmental factors in 59 women who had delivered a child with cleft lip with or without cleft palate (CL +/- CP) and compared these values with those of 56 mothers of unaffected children. There was no significant difference between the two groups with respect to race, age, weight, height, education, parity, menstrual history, medical illnesses, or the use of contraceptives, tobacco, alcohol, or caffeine. All patients had a normal XX karyotype confirmed by the fluorescent banding technique. The two groups demonstrated no significant difference in test results of serum chemistries, glucose tolerance, serum or erythrocyte …
Situational And Financial Barriers To Prenatal Care In A Sample Of Low-Income, Inner-City Women, P. St Clair, V. Smeriglio, C. Alexander, F. Connell, Jennifer Niebyl
Situational And Financial Barriers To Prenatal Care In A Sample Of Low-Income, Inner-City Women, P. St Clair, V. Smeriglio, C. Alexander, F. Connell, Jennifer Niebyl
Jennifer R Niebyl
The relationship between the use of prenatal care and factors that may impede access to care was examined in a sample of low-income, inner-city women. Situational and financial barriers to care were not important correlates of utilization. In unadjusted analyses, only insurance status and employment status were associated with utilization. Of the sociodemographic characteristics studied, only parity was strongly associated with the use of prenatal care. When the apparent associations between utilization and insurance status and utilization and employment were analyzed controlling for parity, the estimated strength and statistical significance of these relationships diminished considerably. Multiparous women who were more …
Overview Of Nausea And Vomiting Of Pregnancy With An Emphasis On Vitamins And Ginger, Jennifer Niebyl, T. Goodwin
Overview Of Nausea And Vomiting Of Pregnancy With An Emphasis On Vitamins And Ginger, Jennifer Niebyl, T. Goodwin
Jennifer R Niebyl
Patients suffering from nausea and vomiting of pregnancy (NVP) frequently do not receive therapy, in part because of fears of adverse effects of medications on the fetus. Several vitamin-based and herbal therapies have been shown to be effective and safe. Two randomized trials of vitamin B(6) have shown a benefit in reducing NVP. Women taking periconceptional multivitamins are less likely to have severe NVP. The combination of vitamin B(6) and doxylamine (previously marketed in the United States as Bendectin) has been shown to be safe for the fetus and effective in reducing NVP. Ginger was shown, in 2 studies, to …
Abnormal Glucose Screening In Pregnancy In Patients With Normal Oral Glucose Tolerance Tests As A Screening Test For Fetal Macrosomia, F. Witter, Jennifer Niebyl
Abnormal Glucose Screening In Pregnancy In Patients With Normal Oral Glucose Tolerance Tests As A Screening Test For Fetal Macrosomia, F. Witter, Jennifer Niebyl
Jennifer R Niebyl
Minor abnormalities of carbohydrate metabolism in pregnancy are a risk factor for delivery of a macrosomic infant. However, the 50-g 1-h oral glucose screen at 28 weeks is not a useful screening test for macrosomia in pregnant patients with normal glucose tolerance tests, because a positive screen does not raise the probability of delivering a macrosomic infant sufficiently to warrant intervention.
Iron Therapy In Pregnancy, Jennifer Niebyl
Iron Therapy In Pregnancy, Jennifer Niebyl
Jennifer R Niebyl
Iron is the only nutrient for which requirements during pregnancy cannot be met by diet alone. A supplement is usually recommended so that the patient's iron stores do not become depleted.
Pregnancy Following Total Hysterectomy, Jennifer Niebyl
Pregnancy Following Total Hysterectomy, Jennifer Niebyl
Jennifer R Niebyl
No abstract provided.
Drugs For Acute Infection During Pregnancy Need Careful Selection, Jennifer Niebyl
Drugs For Acute Infection During Pregnancy Need Careful Selection, Jennifer Niebyl
Jennifer R Niebyl
No abstract provided.
Morphologic And Immunologic Characterization Of Human Basophils Developed In Cultures Of Cord Blood Mononuclear Cells, T. Ishizaka, A. Dvorak, D. Conrad, Jennifer Niebyl, J. Marquette, K. Ishizaka
Morphologic And Immunologic Characterization Of Human Basophils Developed In Cultures Of Cord Blood Mononuclear Cells, T. Ishizaka, A. Dvorak, D. Conrad, Jennifer Niebyl, J. Marquette, K. Ishizaka
Jennifer R Niebyl
Selective growth of human basophilic granulocytes was obtained in suspension cultures of mononuclear cells from umbilical cord blood. Approximately 50 to 80% of nonadherent cells recovered from 2- to 3-wk-old cultures contained metachromatic granules, and these cells were identified as human basophilic granulocytes by electron microscopy. Histamine content of cultured human basophils was comparable to that in peripheral blood basophils. Cultured basophils bear 2.7 to 3.7 X 10(5) IgE receptors per cell that bind both human IgE and rodent IgE with comparable affinity. Average equilibrium constants of the receptors for human IgE and mouse IgE were 2.56 +/- 0.88 X …
Cocaine Abuse In A High Risk Obstetrical Population, S. Keller, Jennifer Niebyl
Cocaine Abuse In A High Risk Obstetrical Population, S. Keller, Jennifer Niebyl
Jennifer R Niebyl
No abstract provided.
Clinical High-Risk Designation Does Not Predict Excess Fetal-Maternal Hemorrhage, P. Ness, M. Baldwin, Jennifer Niebyl
Clinical High-Risk Designation Does Not Predict Excess Fetal-Maternal Hemorrhage, P. Ness, M. Baldwin, Jennifer Niebyl
Jennifer R Niebyl
During a 5-year period, an enzyme-linked antiglobulin test was used to screen and quantitate fetal-maternal hemorrhage in 789 consecutive D-negative mothers who were delivered of D-positive babies. Six hundred seventy-two patients (85.2%) had no detectable fetal-maternal hemorrhage, and 117 patients (14.8%) had a detectable fetal-maternal hemorrhage. Eight of the 789 (1%) had a fetal-maternal hemorrhage greater than 30 ml and required more than one vial of Rh immune globulin. Two patients with fetal-maternal hemorrhage of 29 and 30 ml also received additional Rh immune globulin. Each case was reviewed for the presence of high-risk features that are thought to predict …
Unilateral Ovarian Abscess Associated With The Intrauterine Device, Jennifer Niebyl, T. Parmley, M. Spence, J. Woodruff
Unilateral Ovarian Abscess Associated With The Intrauterine Device, Jennifer Niebyl, T. Parmley, M. Spence, J. Woodruff
Jennifer R Niebyl
Four cases of primary ovarian abscess associated with intrauterine contraceptive devices are presented. It is proposed that both their unilaterality and the fact that they were primary in the ovary rather than tuboovarian are due to the fact that bacteria from the intrauterine device are shed continuously through the fallopian tubes, resulting in the inoculation of the corpus luteum, a unilateral structure. Removal of the ovarian abscess without additional surgical therapy is sufficient for a patient with this type of pelvic infection.
Sporadic (Nonepidemic) Puerperal Mastitis, Jennifer Niebyl, M. Spence, T. Parmley
Sporadic (Nonepidemic) Puerperal Mastitis, Jennifer Niebyl, M. Spence, T. Parmley
Jennifer R Niebyl
Sporadic puerperal mastitis is an acute cellulitis, characterized by fever and segmental erythema in the breast. Staphylococcus aureus can be cultured in approximately one-half of the cases. With early antibiotic therapy, the infection can be cleared and abscess formation prevented. Breast engorgement may also contribute to abscess formation, and so nursing should not be discontinued. No ill effects are observed in infants who continue to nurse. Twenty women with acute puerperal mastitis had breast milk cultures, and Staphylococcus aureus was recovered in seven cases. All patients were treated with antibiotics and continued nursing. No abscesses developed, and no ill effects …
Prolactin And Plasma Prostaglandin Metabolite Levels In Patients Undergoing Nipple Stimulation Contraction Stress Tests, Asha Rijhsinghani, N. Dubin, H. Zacur, T. Johnson, Jennifer Niebyl
Prolactin And Plasma Prostaglandin Metabolite Levels In Patients Undergoing Nipple Stimulation Contraction Stress Tests, Asha Rijhsinghani, N. Dubin, H. Zacur, T. Johnson, Jennifer Niebyl
Jennifer R Niebyl
Twenty-five patients undergoing nipple stimulation contraction stress tests were enrolled in this study. Plasma 13,14-dihydro, 15-keto prostaglandin F2 alpha and plasma prolactin concentrations were analyzed before and during the contraction stress tests. Prolactin concentrations were significantly higher (p less than 0.01) in patients who responded with a successful stress test versus those who did not. No significant changes were observed in the mean concentration of plasma 13,14-dihydro, 15-keto prostaglandin F2 alpha levels between the two groups.
Clinical Practice. Nausea And Vomiting In Pregnancy, Jennifer Niebyl
Clinical Practice. Nausea And Vomiting In Pregnancy, Jennifer Niebyl
Jennifer R Niebyl
No abstract provided.
Ultrasonic Aspiration Transducer For Management Of Rh Incompatibility, J. Rampone, R. Sanders, Jennifer Niebyl
Ultrasonic Aspiration Transducer For Management Of Rh Incompatibility, J. Rampone, R. Sanders, Jennifer Niebyl
Jennifer R Niebyl
No abstract provided.