Jeffrey J. Pomerance

Acceleration of fetal lung maturation following prolonged rupture of the membranes

Abstract Prolonged rupture of the membranes exerts an accelerating effect on fetal lung maturation independent of gestational age or birth weight and resulting in absence of the respiratory distress syndrome (RDS). Sixty-four true-premature infants born of mothers with no complications of pregnancy other than prolonged rupture of the membranes were evaluated for the presence of RDS. In 42 of these infants, membranes were ruptured 24 hours or less prior to delivery, and RDS occurred in 64 per cent. In 22 infants with membranes ruptured more than 24 hours prior to delivery, 31 per cent developed RDS. Lecithin/sphingomyelin ratios showed marked acceleration following membrane rupture, irrespective of gestational age.

Physical fitness in pregnancy: Its effect on pregnancy outcome

Abstract Does a high degree of maternal physical fitness benefit the fetus? Fifty-four women, 35 to 37 weeks pregnant, were tested on a bicycle ergometer and given a physical fitness score (PFS). Forty-one women completed the study. None of the following had a significant correlation with the maternal PFS: Length of gestation, complications of pregnancy, length of labor in primiparas, one-minute Apgar score, infant birth weight, infant length, and infant head circumference. The PFS varied inversely with the length of labor in multiparas (p

Mesenchyman hamartoma of the liver responsive to cyclophosphamide therapy: Therapeutic approach

A newborn infant is described with a highly vascular hepatic mesenchymal hamartoma causing hydrops fetalis, congestive heart failure, and consumption coagulopathy. There was a remarkable response of this life-threatening condition to cyclophosphamide therapy. A review of the various alternative therapeutic modalities is presented.

EFFECT OF TEMPERATURE ON SURVIVAL OF INFANTS WITH RDS

In 1900 Budin reported on the marked effect body temperature had on survival of premature infants. Despite this observation and many similar ones, some institutions still do not adequately prevent cooling of the newborn following delivery. The effect of temperature on survival of infants with RDS was evaluated in a collaborative prospective study of RDS in 9 selected California hospitals with intensive care nurseries. The 470 babies in the sample represent intramural infants only. Two hundred sixty-four survived (56%). Infants were divided into 3 groups according to their temperature on arrival in the ICU. Group I had deep body temperatures of <34.5°C; Group II 34.5-35.4°C; and Group III >35.4°C. The crude survival rates for the 3 groups were 22,47, and 61% respectively. Indirect standardization for birth weight (BW) and gestational age (GA) produced adjusted survival rates of 32, 53, and 61% respectively (p<0.001). It is of interest to speculate how many infants might have lived had none of the newborns been allowed to become chilled. By applying BW-GA specific survival rates of Group III to Groups I and II, it is projected that an additional 33 infants would have survived.Supported by Maternal & Child Health Grant from California Dept. of Public HealthIn 1900 Budin reported on the marked effect body temperature had on survival of premature infants. Despite this observation and many similar ones, some institutions still do not adequately prevent cooling of the newborn following delivery. The effect of temperature on survival of infants with RDS was evaluated in a collaborative prospective study of RDS in 9 selected California hospitals with intensive care nurseries. The 470 babies in the sample represent intramural infants only. Two hundred sixty-four survived (56%). Infants were divided into 3 groups according to their temperature on arrival in the ICU. Group I had deep body temperatures of 35.4°C. The crude survival rates for the 3 groups were 22,47, and 61% respectively. Indirect standardization for birth weight (BW) and gestational age (GA) produced adjusted survival rates of 32, 53, and 61% respectively (p<0.001). It is of interest to speculate how many infants might have lived had none of the newborns been allowed to become chilled. By applying BW-GA specific survival rates of Group III to Groups I and II, it is projected that an additional 33 infants would have survived. Supported by Maternal & Child Health Grant from California Dept. of Public Health

Pneumopericardium complicating respiratory distress syndrome: role of conservative management.

This report describes three infants with RDS who survived the occurrence of pneumopericardium. Two of them required only conservative management without pericardiocentesis. It is recommended that infants with RDS who develop pneumopericardium but have not progressed to the point of cardiac decompensation be managed conservatively. An effort should be made to minimize those forces (IPPV, PEEP, INPV, CPAP, CNCP) which may cause and perpetuate air leak into the pericardial sac.

Weight Gain in Pregnancy: How Much Is Enough?

positive linear association between weight gain of the mother during pregnancy and the birth weight of her child. There is also a positive linear association between prepregnancy weight of the mother and the birth weight of her infant. Increasing prepregnancy weight of the mother, however, diminishes the impact of her weight gain during pregnancy on the infant’s birth weight.9 It has not yet been adequately demonstrated whether the increase in infant birth weight is a function of

Comparison of arterial and capillary bilirubin values in neonates with arterial lines.

To determine whether arterial and capillary values for bilirubin agree in neonates, we analyzed 35 simultaneously sampled capillary and arterial specimens from 13 infants. We found a high correlation between arterial and capillary bilirubin values (r = 0.993). We conclude that arterial bilirubin samples may be substituted for capillary samples in newborn infants.

THE COST OF LIVING FOR INFANTS ≤1000 GMS. AT BIRTH

In the 2½ year period between Jan. 1973 and June 1975, 75 infants weighing ≤1000 gms. at birth were cared for at CSMC. Thirty infants (40%) survived. Nineteen of 27 Infants tested (70%) appear to be neurologically and developmentally (Gesell) “normal” at 1-2½ years of age.Records of hospital charges were available for analysis on 59 of 75 infants (79%). All charges were adjusted to Sept. 1976 rates and corrected for a 94% collection rate. Physician charges represented <5% of the total bill and were not included. Average length of survival for the 45 infants who died was 17 days (range 1-165). Average daily cost for these infants was

338 EFFECT OF ISOXSUPRINE ON |[beta]|-ADRENERGIC RECEPTORS AND ADENYLATE CYCLASE IN FETAL RABBIT CARDIAC MEMBRANES

879; average total cost

1020 HYPERAMMONEMIA IN LOW BIRTH WEIGHT INFANTS

15,145 (range