The role of obstetric factors in perinatal mortality trends.

In the Perinatal Unit of the New Jersey Medical School, Newark the combined neonatal mortality and stillbirth rates declined from more than 51 per 1000 to less than 17 per 1000 between 1971 and 1983. This change is comparable to the reduction of perinatal mortality rates nationwide since the Second World War. Because the improvement in the fetal and neonatal survival rates occurred in a static population and against well identifiable changes in the structure, equipment, policies and management patterns of the obstetric unit, it was possible to assess the impact of various factors upon perinatal outcome.

Comparative clinical evaluation of ceftizoxime with clindamycin and gentamicin and cefoxitin in the treatment of postcesarean endomyometritis.

New third generation cephalosporins have been recommended as single agent antibiotic therapy in the treatment of postoperative infections. This study compares the new third generation cephalosporin ceftizoxime with cefoxitin, clindamycin and gentamicin in the treatment of postcesarean section endomyometritis. The results indicate that the clindamycin and gentamicin regimen is more efficacious in the treatment of severe infection after cesarean section than either ceftizoxime or cefoxitin regimens.

Fetal tissue pH-continuous intrapartum monitoring.

The glass tissue pH electrode was evaluated in 42 parturients. The results and technical difficulties are discussed. The fiberoptic tissue pH probe designed like an internal scalp electrode was evaluated in vitro and the results were found to be encouraging.

The rate of early intrauterine growth in twin gestation.

With the use of specimens obtained by induced abortion, the relationships between crown-rump length on the one hand and body weight and menstrual age on the other were investigated in 43 twin fetuses with menstrual ages between 8 1/2 and 21 weeks. This study indicates that the body weight of twins in comparison with length is the same as that of singletons, an indication of the fact that they are not growth retarded. On the other hand, the average crown-rump length when compared with menstrual age is somewhat less than that of singleton fetuses.

Role of placenta in maternal-fetal vitamin transfer in humans.

Vitamins B12, B6, biotin, folate, thiamine, riboflavin, pantothenate, and nicotinate were determined in maternal and fetal blood and placental tissue of normovitaminemic and hypovitaminemic mothers who disclaimed supplemental vitamin intake during pregnancy. No biotin or pantothenate deficits were observed in the gravidas. Hypovitaminemic mothers transferred less B12, folate, and B6 to the fetus and placenta than normovitaminemic mothers.

Control of perinatal infection by traditional preventive measures.

A 9-year review of nosocomial infections occurring in the department of obstetrics and gynecology of a major teaching hospital demonstrated the dramatic effect of strict asepsis and isolation on postoperative infection rates. With rigidly enforced preventive measures and without the use of prophylactic antibiotics, the rates of wound infection and endometritis and the relative prevalence of gram-negative aerobic organisms cultured from these infections could be reduced substantially. The role of anerobes in these infections was not established, since adequate techniques for the accurate diagnosis of anaerobic infection were not available at the time of this study.

The effect of antibody against a purified sperm-coating antigen on human sperm.

A purified fraction of human seminal plasma containing a sperm-coating antigen and two minor contaminants was used to immunize rabbits by intravenous route. An antiserum containing only the antibody against the sperm-coating antigen as examined by immunoelectrophoresis was obtained from one rabbit. The effect of this antiserum on human sperm was examined by sperm-immobilization and sperm-agglutination tests.

Purification and characterization of a sperm-coating antigen from human seminal plasma.

A sperm-coating antigen has been purified from human seminal plasma by a combination of fractionation methods including ammonium sulfate precipitation, Sephadex G-100 gel filtration, and diethylaminoethyl cellulose ion-exchange chromatography. The purified antigen was demonstrated to be immunologically identical sperm-coating antigen, not derived from blood serum but having immunologically cross-relating antigens in milk and saliva, and a glycoprotein with a molecular weight of approximately 33,000. The purpose of purifying this antigen was discussed.

Changing attendance patterns to sex therapy programs as a function of location and personnel.

This paper explores innovative treatment modalities that may encourage the participation of lower socioeconomic minority clients in sex therapy programs. It suggests the consideration of informal therapeutic settings, flexible hours, and an immediate contact with the therapist. It lends support to the concept that equal time be given to education and communication skills in counseling.

Vitamin profile of 174 mothers and newborns at parturition.

Thiamin, biotin, B12, folate, pantothenate, riboflavin, nicotinate, B6, vitamins A, E, C, and beta-cartene was estimated in the blood of 174 mothers and in the cord blood of their neonates at parturition. A vitamin profile of normal preganancy was established for mother and neonate. This was based on values obtained from 95 percent confidence limits in 74 mothers not taking oral vitamins and 133 mothers ingesting various vitamin supllements.