A faculty development course in obstetrics and gynecology.

Sponsored by the nonprofit Berlex Foundation, this 6-day Faculty Development Course introduces small groups of new faculty to research design, critical appraisal of the literature, scientific writing, and evidence-based medicine. The course includes didactic presentations, small group discussions, and individual protocol development. Its influence on academic careers is impossible to determine, because defining an appropriate comparison group is not feasible.

Cervical dilation from multiple laminaria tents used for abortion.

Objective: To quantify the cervical dilation achieved from multiple medium-thick laminaria tents used for 16-26 hours in single applications before abortion.

Methods: In a practice setting, cervical dilation was studied from all abortions done at greater than 8 weeks in which one or more medium-thick laminaria tents were used in a single application for 16-26 hours. Multiple regression analysis was used to quantify results.

Cervical dilation from laminaria tents and synthetic osmotic dilators used for 6 hours before abortion.

Objective: To compare thick laminaria tents with two synthetic osmotic devices for softening and dilating the cervix before abortions.

Methods: This was a randomized clinical trial comparing cervical dilation by thick laminaria tents with two commercially made devices, 3-mm Hypan and 3-mm anhydrous magnesium sulfate-impregnated plastic tents, used for 6 hours. Subjects were 7-14 weeks pregnant, and all 93 were assigned to devices in permuted randomized groups of three.

Fetomaternal hemorrhage in threatened abortion.

In this study, we compared the incidence of fetomaternal hemorrhage between patients with threatened abortion and a control population of similar gestational age. The study population comprised pregnant patients at less than 20 weeks' gestation who presented to our emergency room with a history of vaginal bleeding without cervical dilatation or passage of tissue. The control population consisted of women presenting for elective pregnancy termination; they were excluded from the study if they gave a history of any antepartum bleeding.

Similarities of Negro and Caucasian fetal extremity lengths in the interval from 9 to 20 weeks of pregnancy.

Foot, leg, and arm measurements were compared from 599 electively aborted fetuses of Negro and Caucasian women who had reliable menstrual dates and agreement between dates and uterine size. When compared by week, no significant racial differences were detected in the means of any of these measurements between 9 and 20 menstrual weeks of pregnancy. The combined, corrected data provided smoother curves than those previously published.

Distribution of catecholamines between fetal and maternal compartments during human pregnancy with emphasis on L-dopa and dopamine.

This study was undertaken to determine the differential distribution of catecholamines, in particular L-dihydroxyphenylalanine (L-dopa) and dopamine, between the fetal and maternal compartments during human pregnancy. Amniotic fluid and fetal and maternal blood were obtained from two groups of pregnant women with uncomplicated pregnancies. One group was at 15-20 weeks of gestation and the second group was in labor after 36-41 weeks of gestation.

Rh0(D) and Du cord blood typing during elective abortion operations.

During dilatation and suction or evacuation abortion operations, the umbilical cord can be delivered and sufficient fetal blood can be sampled to type for the Rho(D) and Du factors in about 30% of cases at 14 menstrual weeks of pregnancy. By 16 weeks, more than 75% can be sampled successfully. When cord blood can be Rh typed, about 40% of the fetuses of Rh negative women were found also to be Rh negative.

Pancreatic amylase expression in human pancreatic development.

Enzymatic and immunologic methods were used to study amylase expression in amniotic fluid and human pancreatic tissue from fetuses of various gestational ages. A starch-coated slide assay was used to quantitate amylase activity in amniotic fluids, and samples with activity were studied by electrophoresis to determine the presence of salivary amylase (Amy1) and pancreatic amylase (Amy2) isozymes. Immunohistochemical studies were performed with both a rabbit anti-human Amy1 antibody and a murine anti-human Amy2 antibody (Amy2/SP2/1).

Dickinson's sign: focal uterine softening in early pregnancy and its correlation with the placental site.

Focal uterine softening, characteristic of early pregnancy, is usually known as Piskacek's or von Braun-Fernwald's sign but should be attributed to Robert Latou Dickinson, who first described it in 1982. The presence or absence of Dickinson's sign was carefully noted in 1040 pregnant patients seeking abortions. The weeks of gestation, location of uterine softening, and correlation with placental site were also studied.

Brief clinical report: neural tube defects in dup(11q).

We describe clinically and cytogenetically a fetus with multiple congenital anomalies and partial dup(11q) born to a phenotypically normal mother with a 3:1 translocation. Fetal anomalies included complete cleft of lip and palate, small penis, myelomenigocele, and abnormal palmar creases. We think chromosome analysis should be performed when neural tube defects are observed in otherwise dysmorphic neonates, stillbirths, and abortuses.

Human fetal extremity lengths in the interval from 9 to 21 menstrual weeks of pregnancy.

Fetal arm, leg, and foot lengths were freshly measured with vernier calipers on all fetuses aborted by me from 1975 to 1983. With the use of these measurements from the 575 patients with reliable menstrual or conception dates and uterine size in agreement (+/- 2 weeks) with dates, statistical analyses were performed to determine the polynomial regressions of menstrual weeks of pregnancy for each extremity length. The data best fit the following formulas, where W represents weeks and F, L, and A are foot, leg, and arm lengths in centimeters: W = 3.

Five recent urinary tests for early pregnancy evaluated.

We evaluate five tests developed for the earlier detection of pregnancy, either in the clinical laboratory or by the patient in her home. These tests offer no advantage over other urinary pregnancy tests, and the results are distinctly inferior to those reported (Clin. Chem.

An evaluation of four serum tests for pregnancy.

We evaluated four pregnancy tests (Biocept-G, Beta-CG, Preg/Stat, and HCG-Beta Screen), using sera from 59 nonpregnant subjects and 77 patients with serum human choriogonadotropin beta-subunit (beta-hCG) concentrations ranging from 4 to 100 000 int. units/L. The results obtained for each test were compared with the results predicted on the basis of the sample's beta-hCG concentration and the beta-hCG concentration the manufacturer claimed necessary for a positive result (the test's analytical sensitivity).

Clinical test for placenta in 300 consecutive menstrual aspirations.

Results of menstrual aspirations in 300 consecutive patients were analyzed. The infection rate (1.4%) and incomplete abortion rate (1.

Estimation of fetal or neonatal weight from the biperietal diameter.

This paper contains a table of predicted fetal or neonatal weight on the basis of the biparietal diameter. The tabulated values are derived under the assumption that the relationship between biparietal diameter and weight is nonlinear and that weight is best predicted by means of a third degree least square polynominal spline. We believe that our study overcomes the shortcomings inherent in a linear prediction formula, commonly employed in the literature.

Topical anesthesia of the uterine cervix or corpus.

A potent topical anesthetic drug, 1% tetracaine, and a placebo were evaluated in a "double-blind" study to determine whether or not topical anesthesia could be achieved on the exocervix, endocervix, and endometrial cavity. No anesthetic effect of tetracaine was demonstrated.

Educational methodology in an obstetric and gynecologic medical school curriculum: a comparison of self-instructional with traditional methods.

Five successive groups of third-year medical students were identically tested on the subject "diagnosis of early pregnancy" at the end of their course in obstetrics and gynecology. The first group served as control, receiving no specific instruction on the subject. The next four groups did receive instruction on the subject and in the following ways: tape-slide program, lecture, instructional objectives alone, and instructional objectives plus the same tape-slide program.