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Full-Text Articles in Medicine and Health Sciences
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.
Treatment Of Premature Labor With Indomethacin., D. Blake, Jennifer Niebyl, R. White, K. Kumor, N. Dubin, J. Robinson, P. Egner
Treatment Of Premature Labor With Indomethacin., D. Blake, Jennifer Niebyl, R. White, K. Kumor, N. Dubin, J. Robinson, P. Egner
Jennifer R Niebyl
No abstract provided.
The Effect Of Magnesium Sulfate On Fetal Heart Rate Baseline Variability, A. Babaknia, Jennifer Niebyl
The Effect Of Magnesium Sulfate On Fetal Heart Rate Baseline Variability, A. Babaknia, Jennifer Niebyl
Jennifer R Niebyl
Variability of the baseline fetal heart rate is correlated with good fetal outcome, and loss of baseline variability has been observed as a sign of fetal distress. Central nervous system depressing drugs may also decrease fetal heart rate variability, and thus recognition of the effect of medication on the baseline fetal heart rate is important for accurate interpretation of fetal monitor tracings. In the cases reported, marked decrease in fetal heart rate variability was observed within 4 minutes of intravenous administration of magnesium sulfate, and fetal outcome was good in all cases.
Folic Acid And Prevention Of Birth Defects, D. Van Dyke, P. Stumbo, J. Mary, Jennifer Niebyl
Folic Acid And Prevention Of Birth Defects, D. Van Dyke, P. Stumbo, J. Mary, Jennifer Niebyl
Jennifer R Niebyl
No abstract provided.
Prevention Of Perinatal Transmission Of Hepatitis B Virus: The Sensitivity, Specificity, And Predictive Value Of The Recommended Screening Questions To Detect High-Risk Women In An Obstetric Population, G. Mcquillan, T. Townsend, C. Johannes, T. Dillard, R. Molteni, P. Ness, Jennifer Niebyl
Prevention Of Perinatal Transmission Of Hepatitis B Virus: The Sensitivity, Specificity, And Predictive Value Of The Recommended Screening Questions To Detect High-Risk Women In An Obstetric Population, G. Mcquillan, T. Townsend, C. Johannes, T. Dillard, R. Molteni, P. Ness, Jennifer Niebyl
Jennifer R Niebyl
The Advisory Committee on Immunization Practices recommends that all pregnant women be questioned concerning risk factors for hepatitis B virus infection and that those giving positive responses be serotested. The sensitivity, specificity, and predictive value of those recommended questions among 692 parturient women were determined. A total of 59 currently or previously infected women (hepatitis B surface antigen (HBsAg), antibody to hepatitis B surface antigen (anti-HBs), or antibody to hepatitis B core antigen (anti-HBc) seropositive) were compared with the 633 seronegative women. Among nonwhite women, the sensitivity of a positive response to any one of the recommended questions was 60%. …
Neonatal Outcome After Indomethacin Treatment For Preterm Labor, Jennifer Niebyl, F. Witter
Neonatal Outcome After Indomethacin Treatment For Preterm Labor, Jennifer Niebyl, F. Witter
Jennifer R Niebyl
Forty-six infants exposed to indomethacin in utero for treatment for preterm labor were compared with infants from two control groups. In one control group the next consecutive patient treated with a tocolytic agent was used, and the other control group was formed by picking the next consecutive patient matched by gestational age who did not receive any tocolytic agent. There was no significant difference in Apgar scores, birth weight, or gestational age in the three groups. The incidence of neonatal complications including hypocalcemia, hypoglycemia, respiratory distress syndrome, patient ductus arteriosus, sepsis, and neonatal mortality were not significantly different in the …
A Placebo-Controlled Randomized Trial Of The Terbutaline Pump For Prevention Of Preterm Delivery, K. Wenstrom, C. Weiner, D. Merrill, Jennifer Niebyl
A Placebo-Controlled Randomized Trial Of The Terbutaline Pump For Prevention Of Preterm Delivery, K. Wenstrom, C. Weiner, D. Merrill, Jennifer Niebyl
Jennifer R Niebyl
To determine the efficacy of the terbutaline pump for the prevention of preterm delivery, patients in preterm labor defined by progressive cervical change underwent intravenous magnesium sulfate tocolysis (with or without oral indomethacin, as necessary), and once labor was arrested, were randomized to one of three treatment arms: terbutaline by pump, saline by pump (blinded), or oral terbutaline. If recurrent preterm labor occurred despite maximization of therapy, the treatment arm was determined and therapy was changed; saline pump and oral terbutaline were switched to terbutaline pump, terbutaline pump was switched to oral terbutaline. Patients who continued to labor were readmitted …
Penile Nerve Block For Newborn Circumcision, L. Maxwell, M. Yaster, R. Wetzel, Jennifer Niebyl
Penile Nerve Block For Newborn Circumcision, L. Maxwell, M. Yaster, R. Wetzel, Jennifer Niebyl
Jennifer R Niebyl
Circumcision in neonates is performed, almost universally, without anesthesia or analgesia. It is associated with pain, crying, agitation, and physiologic stress. Twenty infants receiving penile nerve block for circumcision were compared with ten infants having circumcision without anesthesia. Heart rate and blood pressure rose 34 and 15%, respectively, in unblocked infants, and were unchanged in infants receiving local anesthesia. Oxygen saturation declined 16% in unanesthetized infants compared with 6% in blocked infants (P less than .03). Anesthetized infants were less agitated and cried less. Peak plasma concentrations of the local anesthetic lidocaine averaged 0.51 +/- 0.17 microgram/mL (range 0.1-1.6), well …
Inhibition Of Preterm Labor, Jennifer Niebyl, J. Johnson
Inhibition Of Preterm Labor, Jennifer Niebyl, J. Johnson
Jennifer R Niebyl
No abstract provided.
Consultations & Comments. Ssris And Pregnancy: What Risk To The Fetus?, Jennifer Niebyl
Consultations & Comments. Ssris And Pregnancy: What Risk To The Fetus?, Jennifer Niebyl
Jennifer R Niebyl
No abstract provided.
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 …
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 …
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.
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 …
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.
Management Of Sickle Cell Disease In Pregnant Patients, S. Charache, J. Scott, Jennifer Niebyl, D. Bonds
Management Of Sickle Cell Disease In Pregnant Patients, S. Charache, J. Scott, Jennifer Niebyl, D. Bonds
Jennifer R Niebyl
Data from a total of 74 pregnancies in 42 patients with sickling disorders seen at Johns Hopkins Hospital are compared with similar data from other centers. Although risks are still higher than those for women without sickle cell disease, they have diminished significantly from those reported earlier. Prophylactic transfusion therapy may decrease these risks further, but benefits of transfusion are unproved at present. Patients with sickling disorders should receive meticulous individualized treatment until further data are made available.
Premature Rupture Of The Membranes And Prolonged Latency, J. Johnson, N. Daikoku, Jennifer Niebyl, T. Johnson, V. Khouzami, F. Witter
Premature Rupture Of The Membranes And Prolonged Latency, J. Johnson, N. Daikoku, Jennifer Niebyl, T. Johnson, V. Khouzami, F. Witter
Jennifer R Niebyl
The aim of this retrospective study in 8320 patients with premature rupture of the membranes (PROM) was to determine the consequences of prolongation of the latent period. Among patients with pregnancies of more than 37 weeks' duration, those with PROM and latent periods of more than 1 day demonstrated an increased incidence of intrapartum fever (IPF), whereas those with latent periods of more than 3 days demonstrated a marked increase in fetal (but not neonatal) deaths. Although IPF and perinatal mortality were more common in preterm pregnancies, neither was found to increase or decrease with prolonged latency, provided differences in …
Pregnancy In Sickle Cell Disease, S. Charache, Jennifer Niebyl
Pregnancy In Sickle Cell Disease, S. Charache, Jennifer Niebyl
Jennifer R Niebyl
No abstract provided.
Treatment Of Premature Labor With Indomethacin, D. Blake, Jennifer Niebyl, R. White, K. Kumor, N. Dubin, J. Robinson, P. Egner
Treatment Of Premature Labor With Indomethacin, D. Blake, Jennifer Niebyl, R. White, K. Kumor, N. Dubin, J. Robinson, P. Egner
Jennifer R Niebyl
No abstract provided.
Marijuana Use In Pregnancy And Pregnancy Outcome, F. Witter, Jennifer Niebyl
Marijuana Use In Pregnancy And Pregnancy Outcome, F. Witter, Jennifer Niebyl
Jennifer R Niebyl
A retrospective analysis utilizing historical data collected as part of our computerized data base was performed to assess the impact of marijuana use in pregnancy on pregnancy outcome. Records of 8350 patients were reviewed and 417 patients gave a history of only marijuana use for a prevalence of 5%. There was no association between marijuana use and prematurity or congenital anomalies. Marijuana use was strongly associated with the use of alcoholic beverages and smoking. Previously reported associations may represent the concomitant use of these other drugs.
Drug Therapy During Pregnancy, Jennifer Niebyl
Drug Therapy During Pregnancy, Jennifer Niebyl
Jennifer R Niebyl
A randomized prospective trial has shown that folic acid started before conception and continued for the first trimester reduces the risk of recurrence of neural tube defects by 72% in women with a previously affected child. Carbamazepine exposure in utero is associated with a 1% risk of spina bifida. Long-term follow-up of antenatal exposure to phenobarbital and carbamazepine in two groups of infants shows no neurologic differences between the two groups. Magnesium sulfate is more effective in prevention of recurrent eclamptic seizures than phenytoin. During pregnancy, the need for thyroxine increases in many women. Vitamin B6 and ginger are both …
Preterm Parturition. Prostaglandin Synthetase Inhibitors, Jennifer Niebyl
Preterm Parturition. Prostaglandin Synthetase Inhibitors, Jennifer Niebyl
Jennifer R Niebyl
No abstract provided.