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Jennifer R Niebyl

2013

Humans

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Letter: Pneumoperitoneum Secondary To Cunnilingus., S. Ashai, D. Lipton, A. Colon, Jennifer Niebyl Jun 2013

Letter: Pneumoperitoneum Secondary To Cunnilingus., S. Ashai, D. Lipton, A. Colon, Jennifer Niebyl

Jennifer R Niebyl

No abstract provided.


Clinical Evaluation Of Two Direct Procedures For Free Thyroxin, And Of Free Thyroxin Index Determined Nonisotopically And By Measuring Thyroxin-Binding Globulin., J. Waud, D. Chan, H. Drew, M. Oropeza, M Sucupira, B. Scheinin, G. Garrison, M Mayo, E. Taylor, J. Stem, Jennifer Niebyl Jun 2013

Clinical Evaluation Of Two Direct Procedures For Free Thyroxin, And Of Free Thyroxin Index Determined Nonisotopically And By Measuring Thyroxin-Binding Globulin., J. Waud, D. Chan, H. Drew, M. Oropeza, M Sucupira, B. Scheinin, G. Garrison, M Mayo, E. Taylor, J. Stem, Jennifer Niebyl

Jennifer R Niebyl

We have investigated the clinical utility of two direct radioimmunoassays for free thyroxin, an enzyme-inhibition immunoassay, and a direct measurement of thyroxin-binding globulin (TBG) by radioassay. All assay methods correctly identified greater than or equal to 90% of euthyroid, hyperthyroid, and hypothyroid patients who had normal TBG concentrations. In patients with altered TBG concentrations, none of the assays correctly classified all categories of patients. However, the direct assays of free thyroxin concentrations were able to classify correctly more patients with altered TBG concentrations than did the free thyroxin index methods. The free thyroxin index methods evaluated may be acceptable for …


Gonococcal Salpingitis In Pregnancy, R. R. Genadry, B. H. Thompson, Jennifer Niebyl May 2013

Gonococcal Salpingitis In Pregnancy, R. R. Genadry, B. H. Thompson, Jennifer Niebyl

Jennifer R Niebyl

No abstract provided.


The Effect Of Magnesium Sulfate On Fetal Heart Rate Baseline Variability, A. Babaknia, Jennifer Niebyl May 2013

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 May 2013

Folic Acid And Prevention Of Birth Defects, D. Van Dyke, P. Stumbo, J. Mary, Jennifer Niebyl

Jennifer R Niebyl

No abstract provided.


Efficacy Of Screening For Gestational Diabetes, G. Marquette, V. Klein, Jennifer Niebyl May 2013

Efficacy Of Screening For Gestational Diabetes, G. Marquette, V. Klein, Jennifer Niebyl

Jennifer R Niebyl

A cost analysis of glucose screening was studied prospectively in 434 patients. All patients underwent a 50-gm oral glucose load followed by a 1-hour plasma glucose screen test at 28 weeks (+/- 2 weeks). Patients with a screen test greater than or equal to 130 mg/dl plasma glucose were further tested with an oral glucose tolerance test. Also, previously described clinical risk factors for diabetes were documented on all patients. A 3.3% prevalence of gestational diabetes was found in 178 patients with risk factors, compared with 2.4% of 256 patients without risk factors, not a significant difference. Ten of the …


Neonatal Outcome After Indomethacin Treatment For Preterm Labor, Jennifer Niebyl, F. Witter May 2013

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 …


Penile Nerve Block For Newborn Circumcision, L. Maxwell, M. Yaster, R. Wetzel, Jennifer Niebyl May 2013

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 …


The Validity Of The Leukocyte Esterase Reagent Test Strip In Detecting Significant Leukocyturia, G. Marquette, T. Dillard, S. Bietla, Jennifer Niebyl May 2013

The Validity Of The Leukocyte Esterase Reagent Test Strip In Detecting Significant Leukocyturia, G. Marquette, T. Dillard, S. Bietla, Jennifer Niebyl

Jennifer R Niebyl

This prospective trial demonstrated that the best possible definition for a positive leukocyte esterase test (Chemstrip 9) is + or ++. With use of this definition, the sensitivity in detecting significant leukocyturia is 83% and the specificity is 70%. The use of this test strip could reduce screening costs in registering obstetric patients.


Inhibition Of Arachidonic Acid Metabolism In The Perinatal Period: Pharmacology, Clinical Application, And Potential Adverse Effects, F. Witter, Jennifer Niebyl May 2013

Inhibition Of Arachidonic Acid Metabolism In The Perinatal Period: Pharmacology, Clinical Application, And Potential Adverse Effects, F. Witter, Jennifer Niebyl

Jennifer R Niebyl

No abstract provided.


The Bland-White-Garland Syndrome In Pregnancy, V. Klein, J. Repke, G. Marquette, Jennifer Niebyl May 2013

The Bland-White-Garland Syndrome In Pregnancy, V. Klein, J. Repke, G. Marquette, Jennifer Niebyl

Jennifer R Niebyl

No abstract provided.


Inhibition Of Preterm Labor, Jennifer Niebyl, J. Johnson May 2013

Inhibition Of Preterm Labor, Jennifer Niebyl, J. Johnson

Jennifer R Niebyl

No abstract provided.


The Glycosphingolipid Composition Of The Placenta Of A Blood Group P Fetus Delivered By A Blood Group Pk1 Woman And Analysis Of The Anti-Globoside Antibodies Found In Maternal Serum, G. Hansson, K. Wazniowska, J. Rock, P. Ness, T. Kickler, R. Shirey, Jennifer Niebyl, D. Zopf May 2013

The Glycosphingolipid Composition Of The Placenta Of A Blood Group P Fetus Delivered By A Blood Group Pk1 Woman And Analysis Of The Anti-Globoside Antibodies Found In Maternal Serum, G. Hansson, K. Wazniowska, J. Rock, P. Ness, T. Kickler, R. Shirey, Jennifer Niebyl, D. Zopf

Jennifer R Niebyl

To further define the molecules that may mediate spontaneous abortion due to maternal-fetal blood group incompatibility within the P blood group system, we have examined the fine specificities of maternal antibodies and the glycolipid antigens from the placenta of a P infant born to a Pk1 mother. Maternal antibodies obtained during therapeutic plasmapheresis were analyzed to determine their reactivities with placental glycolipid extracts on thin-layer plates. Second antibodies specific for IgM, IgG, and IgA revealed immunoglobulins of all of these classes strongly reactive with one major placental glycolipid that comigrates with globoside. GC/MS analysis confirmed that the major P-active pentaglycosylceramide …


Folate, Carotene, And Smoking, F. Witter, D. Blake, R. Baumgardner, E. Mellits, Jennifer Niebyl May 2013

Folate, Carotene, And Smoking, F. Witter, D. Blake, R. Baumgardner, E. Mellits, Jennifer Niebyl

Jennifer R Niebyl

No abstract provided.


Metastatic Adenocarcinoma Of The Lung Complicating Pregnancy. A Case Report, R. Suda, J. Repke, R. Steer, Jennifer Niebyl May 2013

Metastatic Adenocarcinoma Of The Lung Complicating Pregnancy. A Case Report, R. Suda, J. Repke, R. Steer, Jennifer Niebyl

Jennifer R Niebyl

A case of large cell undifferentiated adenocarcinoma of the lung was complicated by an aggressive clinical course and documented placental metastases. The management of these neoplasms is complex, requiring one to pay attention to the maternal, as well as fetal and neonatal, prognosis.


Folate, Zinc, And Vitamin B-12 Intake During Pregnancy And Postpartum, M. Berg, D. Van Dyke, C. Chenard, Jennifer Niebyl, S. Hirankarn, A. Bendich, P. Stumbo May 2013

Folate, Zinc, And Vitamin B-12 Intake During Pregnancy And Postpartum, M. Berg, D. Van Dyke, C. Chenard, Jennifer Niebyl, S. Hirankarn, A. Bendich, P. Stumbo

Jennifer R Niebyl

No abstract provided.


Fetal Distress During A Maternal Systemic Allergic Reaction, V. Klein, A. Harris, R. Abraham, Jennifer Niebyl May 2013

Fetal Distress During A Maternal Systemic Allergic Reaction, V. Klein, A. Harris, R. Abraham, Jennifer Niebyl

Jennifer R Niebyl

Systemic allergic reactions to food ingestion rarely result in life-threatening situations. When these reactions occur during pregnancy, however, the accompanying physiologic changes may result in fetal distress. A case of repetitive late decelerations in the fetal heart rate during a maternal allergic reaction is presented. Prompt and aggressive medical management brought about total resolution of maternal and fetal compromise.


The Inhibition Of Premature Labor With Indomethacin, Jennifer Niebyl, D. Blake, R. White, K. Kumor, N. Dubin, J. Robinson, P. Egner May 2013

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 May 2013

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 May 2013

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 …


Cost-Effective Criteria For Glucose Screening, G. Marquette, V. Klein, J. Repke, Jennifer Niebyl May 2013

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 …


Pharmacogenetic Screening For Susceptibility To Fetal Malformations In Women, D. Van Dyke, V. Ellingrod, M. Berg, Jennifer Niebyl, A. Sherbondy, D. Trembath May 2013

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 May 2013

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.


The Effect Of Maternal Age On Primary Cesarean Section Rate, F. Witter, J. Repke, Jennifer Niebyl May 2013

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 May 2013

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 May 2013

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 May 2013

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 May 2013

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 May 2013

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 May 2013

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 …