37 results on '"Ramin, Susan M"'
Search Results
2. Vitamins C and E to prevent complications of pregnancy-associated hypertension
- Author
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Roberts, James M., Myatt, Leslie, Spong, Catherine Y., Thom, Elizabeth A., Hauth, John C., Leveno, Kenneth J., Pearson, Gail D., Wapner, Ronald J., Varner, Michael W., Thorp, John M. Jr., Mercer, Brian M., Peaceman, Alan M., Ramin, Susan M., Carpenter, Marshall W., Samuels, Philip, Sciscione, Anthony, Harper, Margaret, Smith, Wendy J., Saade, George, Sorokin, Yoram, and Anderson, Garland B.
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Hypertension in pregnancy -- Diet therapy ,Vitamin C -- Health aspects ,Vitamin E -- Health aspects ,Drugs -- Adverse and side effects ,Drugs -- Prevention - Abstract
A study was conducted to evaluate the benefits of antioxidation supplementation with vitamins C and E in helping prevent adverse events during pregnancy due to hypertension. Results indicated that the intake of the vitamins did not reduce the incidence of complications during pregnancy.
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- 2010
3. A multicenter, randomized trial of treatment for mild gestation diabetes
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Landon, Mark B., Spong, Catherine Y., Thom, Elizabeth, Carpenter, Marshall W., Ramin, Susan M., Casey, Brian, Wapner, Ronald J., Varner, Michael W., Rouse, Dwight J., Thorp, John M., Jr., Sciscione, Anthony, Catalano, Patrick, Harper, Margaret, Saade, George, Lain, Kristine Y., Sorokin, Yoram, Peaceman, Alan M., Tolosa, Jorge E., and Anderson, Garland B.
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Diabetes in pregnancy -- Care and treatment ,Hypertension -- Prevention ,Infants (Newborn) -- Diseases ,Infants (Newborn) -- Care and treatment - Abstract
The study aims to evaluate whether treatment for mild, gestational diabetes helps improve the outcomes during pregnancy. The results indicate that treatment of gestational diabetes did not significantly improve stillbirth or perinatal death or several neonatal complications, it did reduce risks of fetal overgrowth, cesarean delivery and hypertensive disorders.
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- 2009
4. Timing of elective repeat cesarean delivery at term and neonatal outcomes
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Tita, Alan T.N., Landon, Mark B., Spong, Catherine Y., Yinglei Lai, Leveno, Kenneth J., Varner, Michael W., Moawad, Atef H., Caritis, Steve N., Meis, Paul J., Wapner, Ronald J., Sorokin, Yoram, Miodovnik, Menachem, Carpenter, Marshall, Peaceman, Alan M., O'Sullivan, Mary J., Sibai, Baha M., Lander, Oded, Thorp, John M., Ramin, Susan M., and Mercer, Brian M.
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Cesarean section -- Health aspects ,Pregnant women -- Health aspects ,Pregnant women -- Care and treatment ,Infants (Newborn) -- Diseases ,Infants (Newborn) -- Risk factors - Abstract
The study examined a cohort of women in the U.S. to describe the timing of elective repeat cesarean deliveries and assess the link between delivery before 39 weeks of gestation and the risk of adverse neonatal outcomes. Findings suggest that elective repeat cesarean delivery before term is common and is associated with adverse neonatal outcomes.
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- 2009
5. Angiotensin receptor agonistic autoantibodies induce pre-eclampsia in pregnant mice
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Zhou, Cissy C., Zhang, Yujin, Irani, Roxanna A., Zhang, Hong, Mi, Tiejuan, Popek, Edwina J., Hicks, M. John, Ramin, Susan M., Kellems, Rodney E., and Xia, Yang
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Autoantibodies -- Research -- Health aspects ,Preeclampsia -- Research -- Risk factors -- Health aspects ,Oxidative stress -- Health aspects -- Research -- Risk factors ,Hypertension in pregnancy -- Research -- Risk factors ,Immunoglobulin G -- Research -- Health aspects ,Angiotensin -- Receptors ,Biological sciences ,Health - Abstract
Pre-eclampsia affects approximately 5% of pregnancies and remains a leading cause of maternal and neonatal mortality and morbidity in the United States and the world (1,2). The clinical hallmarks of this maternal disorder include hypertension, proteinuria, endothelial dysfunction and placental defects. Advanced-stage clinical symptoms include cerebral hemorrhage, renal failure and the HELLP (hemolysis, elevated liver enzymes and low platelets) syndrome. An effective treatment of pre-eclampsia is unavailable owing to the poor understanding of the pathogenesis of the disease. Numerous recent studies (3-5) have shown that women with pre-eclampsia possess autoantibodies, termed A[T.sub.1]-AAs, that bind and activate the angiotensin II receptor type la (A[T.sub.1] receptor). We show here that key features of pre-eclampsia, including hypertension, proteinuria, glomerular endotheliosis (a classical renal lesion of pre-eclampsia), placental abnormalities and small fetus size appeared in pregnant mice after injection with either total IgG or affinity-purified A[T.sub.1]-AAs from women with pre-eclampsia. These features were prevented by co-injection with losartan, an A[T.sub.1] receptor antagonist, or by an antibody neutralizing seven-amino-acid ~epitope peptide. Thus, our studies indicate that pre-eclampsia may be a pregnancy-induced autoimmune disease in which key features of the disease result from autoantibody- induced angiotensin receptor activation. This hypothesis has obvious implications regarding pre-eclampsia screening, diagnosis and therapy., The pathophysiology of pre-eclampsia remains largely unknown. A widely held view is that placental ischemia, stemming from shallow trophoblast invasion and improper spiral artery remodeling, is a crucial initiating event [...]
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- 2008
6. Fetal pulse oximetry and cesarean delivery
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Bloom, Steven L.; Spong, Catherine Y.; Thorn, Elizabeth, Varner, Michael W.; Rouse, Dwight J., Weininger, Sandy; Ramin, Susan M.; Caritis, Steve N., Peaceman, Alan; Sorokin, Yoram, and Harper, Margaret; Iarns, Jay; Anderson, Garland
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Cesarean section -- Health aspects ,Oximetry -- Usage ,Infants (Newborn) -- Health aspects - Abstract
A randomized trial was designed to evaluate the effectiveness and safety of fetal oximetry with primary objective to determine whether fetal oximetry as a conventional electronic fetal monitoring would result in a reduction in the overall rate of cesarean deliveries and potential side effects to both mother and the neonate. The knowledge of the fetal oxygen saturation is not associated with a reduction in the rate of cesarean delivery or with improvement in the condition of the newborn.
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- 2006
7. Maternal and perinatal outcomes associated with a trial of labor after prior cesarean delivery
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Landon, Mark B., Leindecker, Sharon, Harper, Margaret, Carpenter, Marshall, Langer, Oded, Gabbe, Steven G., Mercer, Brian M., Ramin, Susan M., Thorp, John M., Sibai, Baha, O'Sullivan, Mary Jo, Peaceman, Alan M., Miodovnik, Minachem, Sorokin, Yoram, Wapner, Ronald J., Caritis, Steve N., Moawad, Atef H., Varner, Michael W., Spong, Catherine Y., Leveno, Kenneth J., and Hauth, John C.
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Vaginal birth after cesarean -- Risk factors ,Vaginal birth after cesarean -- Patient outcomes ,Pregnant women -- Health aspects ,Cesarean section -- Risk factors ,Cesarean section -- Patient outcomes - Abstract
Comparison of maternal and perinatal outcomes between women who underwent a trial of labor and women who had an elective repeated cesarean delivery without labor is presented. Although there are low absolute risks, a trial of labor after prior cesarean delivery is associated with a greater perinatal risk than is elective repeated cesarean delivery without labor.
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- 2004
8. Prevention of recurrent preterm delivery by 17 alpha-hydroxyprogesterone caproate
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Meis, Paul J., Klebanoff, Mark, Thom, Elizabeth, Dombrowski, Mitchell P., Sibai, Baha, Moawad, Atef H., Spong, Catherine Y., Hauth, John C., Miodovnik, Menachem, Varner, Michael W., Levano, Kenneth J., Caritis, Steve N., Iams, Jay D., Wapner, Ronald J., Conway, Deborah, O'Sullivan, Mary J., Carpenter, Marshall, Mercer, Brian, Ramin, Susan M., Thorp, John M., and Peaceman, Alan M.
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Premature birth -- Prevention ,Hydroxyprogesterone -- Evaluation - Abstract
Weekly injections of a hormone called 17 alpha-hydroxyprogesterone caproate can lower the risk of premature birth in pregnant women with a previous premature birth. This was the conclusion of a study of 463 pregnant women. The newborn babies of women who received the injections were also less likely to have necrotizing enterocolitis, brain hemorrhage, or the need for oxygen at birth.
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- 2003
9. Peripartum cocaine use and adverse pregnancy outcome
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Little, Bertis B., Snell, Laura M., Trimmer, Kenneth J., Ramin, Susan M., Ghali, Fred, Blakely, Craig A., and Garret, Andrea
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Cocaine -- Physiological aspects ,Obstetrical research -- Methods ,Drug abuse in pregnancy -- Research ,Birth defects -- Causes of ,Biological sciences - Abstract
Scientists were able to isolate children suffering from the result of cocaine, specifically, by testing for the presence of non-medically administered drugs of abuse and for alcohol in blood samples taken from the umbilical cord. Patients positive from any other drug use were excluded from the study. This allowed researchers to study the direct effects of cocaine on babies which included low birth weight and congenital anomalies.
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- 1999
10. The MFMU Cesarean Registry: Impact of fetal size on trial of labor success for patients with previous cesarean for dystocia
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Peaceman, Alan M., Gersnoviez, Rebecca, Landon, Mark B., Spong, Catherine Y., Leveno, Kenneth J., Varner, Michael W., Rouse, Dwight J., Moawad, Atef H., Caritis, Steve N., Harper, Margaret, Wapner, Ronald J., Sorokin, Yoram, Miodovnik, Menachem, Carpenter, Marshall, O'Sullivan, Mary J., Sibai, Baha M., Langer, Oded, Thorp, John M., Ramin, Susan M., and Mercer, Brian M.
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Birth size -- Health aspects ,Birth weight -- Health aspects ,Dystocia -- Care and treatment ,Cesarean section -- Methods ,Health - Abstract
The rate of successful trial of labor after previous cesarean delivery for dystocia is assessed in a large cohort based on the relative birth weights of the two pregnancies. It is likely that increased fetal size relative to previous birth weight plays a significant role in the outcome of a subsequent trial of labor for patients with previous cesarean delivery for dystocia, reducing chances of vaginal delivery.
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- 2006
11. The Maternal-Fetal Medicine Units Cesarean Registry: Safety and efficacy of a trial of labor in preterm pregnancy after a prior cesarean delivery
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Durnwald, Celeste P., Rouse, Dwight J., Leveno, Kenneth J., Spong, Catherine Y., MacPherson, Cora, Varner, Michael W., Moawad, Atef H., Caritis, Steve N., Harper, Margaret, Wapner, Ronald J., Sorokin, Yoram, Miodovnik, Menachem, Carpenter, Marshall, Peaceman, Alan M., O'Sullivan, Mary Jo, Sibai, Baha, Langer, Oded, Thorp, John M., Ramin, Susan M., Mercer, Brian M., and Gabbe, Steven G.
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Vaginal birth after cesarean -- Research ,Vaginal birth after cesarean -- Physiological aspects ,Premature labor -- Prognosis ,Uterus -- Rupture ,Uterus -- Risk factors ,Health - Abstract
The success rates of vaginal birth after cesarean (VBAC) delivery, uterine rupture and major maternal/perinatal outcomes are compared between women, with previous cesarean deliveries undergoing trial of labor (TOL) with preterm and term pregnancies, and also maternal and neonatal morbidities in women with preterm pregnancies undergoing a TOL versus repeat cesarean delivery without labor (RCD). The likelihood of VBAC success after TOL in preterm pregnancies is comparable to term gestations, with a lower risk of uterine rupture, and perinatal outcomes are similar with preterm TOL and RCD.
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- 2006
12. Don't undertreat asthma in pregnancy: doing so can lead to serious--even fatal--complications. To protect mother and fetus alike, manage these patients just as aggressively as your nonpregnant asthmatics
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Davidson, Christina M., Doyle, Nora M., and Ramin, Susan M.
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Pregnant women -- Health aspects -- Drug therapy -- Care and treatment ,Antiasthmatic agents -- Complications and side effects -- Health aspects ,Asthma -- Care and treatment -- Risk factors -- Drug therapy -- Complications and side effects -- Health aspects - Abstract
Could the fear of adverse fetal outcomes from asthma drugs be keeping you from managing pregnant patients with asthma as aggressively as nonpregnant patients? You'll be less tempted to hold [...]
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- 2005
13. The Maternal-Fetal Medicine Unit cesarean registry: Trial of labor with a twin gestation
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Varner, Michael W., Leindecker, Sharon, Spong, Catherine Y., Moawad, Atef H., Hauth, John C., Landon, Mark B., Leveno, Kenneth J., Caritis, Steve N., Harper, Margaret, Wapner, Ronald J., Sorokin, Yoram, Miodovnik, Menachem, Carpenter, Marshall, Peaceman, Alan, O'Sullivan, Mary J., Sibai, Baha M., Langer, Oded, Thorp, John M., Ramin, Susan M., Mercer, Brian M., and Gabbe, Steven G.
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Pregnancy, Multiple -- Research ,Vaginal birth after cesarean -- Patient outcomes ,Mothers -- Patient outcomes ,Mothers -- Risk factors ,Health - Abstract
The success rates and risks in women with a twin pregnancy who attempt a trial of labor after cesarean delivery are identified. A trial of labor with twins after previous cesarean delivery does not appear to increase maternal morbidity.
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- 2005
14. Characterization of corticosteroid redosing in an in vitro cell line model
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Vidaeff, Alex C., Ramin, Susan M., Gilstrap, Larry C., and Alcorn, Joseph L.
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Dexamethasone ,Health - Abstract
To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ajog.2004.06.049 Byline: Alex C. Vidaeff (a), Susan M. Ramin (a), Larry C. Gilstrap (a), Joseph L. Alcorn (b) Abstract: The purpose of this study was to investigate dexamethasone redosing as function of time and dose. Author Affiliation: (a) Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences (b) and the Department of Pediatrics, University of Texas Medical School at Houston, Houston, Tex Article History: Received 23 February 2004; Revised 25 May 2004; Accepted 11 June 2004 Article Note: (footnote) Presented at the Twenty-Fourth Annual Meeting of the Society for Maternal-Fetal Medicine, February 2-7, 2004, New Orleans, La.
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- 2004
15. Characterization of corticosteroid redosing in an vitro cell line model
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Vidaeff, Alex C., Ramin, Susan M., Gilstrap, Larry C., III, and Alcorn, Joseph L.
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Pregnancy, Complications of -- Drug therapy ,Corticosteroids -- Dosage and administration ,Corticosteroids -- Complications and side effects ,Health - Abstract
Dexamethasone redosing as a function of time and dose was investigated. Results suggest a residual effect of initial exposure that potentiates redosing allowing significant dose reductions.
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- 2004
16. The effects of dexamethasone and betamethasone on surfactant protein-B messenger RNA expression in human type II pnemocytes and human lung adenocarcinoma cells
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Ramin, Susan M., Gilstrap III Larry C., Bishop, Karen D., Jenkins, Gaye N., Alcorn, Joseph L., and Vidaeff, Alex C.
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Dexamethasone -- Case studies ,Betamethasone -- Case studies ,Health - Abstract
A study comparing the effect of a single 48-hour exposure to betamethasone or dexamethasone in the cell line and in human type II pneumocytes is presented. The result reveals that dexamethasone and betamethasone achieved similar dose response patterns of surfactant protein-B expression in vitro.
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- 2004
17. Onset and persistence of postpartum depression in an inner-city maternal health clinic system. (Article)
- Author
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Yonkers, Kimberly A., Ramin, Susan M., Rush, A. John, Navarrete, Carlos A., Carmody, Thomas, March, Dana, Heartwell, Stephen F., and Leveno, Kenneth J.
- Subjects
Postpartum depression -- Risk factors ,Mothers -- Health aspects ,Mother and infant -- Management ,Health ,Psychology and mental health - Abstract
Objective: Postpartum depressive disorders lead to maternal disability and disturbed mother-infant relationships, but information regarding the rates of major depressive disorder in minority women is noticeably lacking. The goal of this study was to determine whether the risk factors for and rate of postpartum major depressive disorder in a predominantly African American and Hispanic clinic population would be similar to those reported for Caucasian women. Method: Investigators systematically screened all women scheduled for their first postpartum visit on selected days at four publicly funded inner-city community maternal health clinics in Dallas County (N=802). A multistage screening process included the Edinburgh Postnatal Depression Scale, the Inventory of Depressive Symptomatology, and the Structured Clinical Interview for DSM-IV for a maximum of three assessments during the initial 3-5-week postpartum period. Results: The estimated rate of major depressive disorder during the postpartum period among women in this setting was between 6.5% and 8.5%. Only 50% of the depressed women reported onset following birth. Bottle-feeding and not living with one's spouse or significant other were associated with depression at the first evaluation; persistent depressive symptoms were linked with the presence of other young children at home. Greater severity of depressive symptoms at first contact predicted major depressive disorder several weeks later. Conclusions: Rates of postpartum depression among Latina and African American postpartum women are similar to epidemiologic rates for Caucasian postpartum and nonpostpartum women. As previously shown for Caucasian women, major depressive disorder in many Latina and African American postpartum women begins before delivery, revealing the need to screen pregnant women for depression. (Am J Psychiatry 2001; 158:1856-1863)
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- 2001
18. A randomized trial of labor analgesia in women with pregnancy-induced hypertension
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Lucas, Michael J., Sharma, Shiv K., McIntire, Donald D., Wiley, Jackie, Sidawi, J. Elaine, Ramin, Susan M., Leveno, Kenneth J., and Cunningham, F. Gary
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Peridural anesthesia -- Evaluation ,Hypertension in pregnancy -- Care and treatment ,Health - Abstract
Epidural analgesia is more effective than intravenous analgesia in relieving labor pain in pregnant women with hypertension but it has more side effects. It prolongs the second stage of labor and increases the risk of a forceps delivery and an infection called chorioamnionitis.
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- 2001
19. An appraisal of treatment guidelines for antepartum community-acquired pneumonia
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Yost, Nicole P., Bloom, Steven L., Richey, Sherrie D., Ramin, Susan M., and Cunningham, F. Gary
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Pneumonia -- Care and treatment ,Pregnant women -- Diseases ,Nosocomial infections -- Care and treatment ,Health - Abstract
Most pregnant women with pneumonia can be treated with erythromycin and about one-fourth can be treated as outpatients. This was the conclusion of a study of 133 pregnant women with community-acquired pneumonia.
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- 2000
20. Maternal cardiac troponin I levels during normal labor and delivery
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Shivvers, Stephan A., Wians, Frank H., Jr., Keffer, Joseph H., and Ramin, Susan M.
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Enzymes -- Measurement ,Heart attack -- Diagnosis ,Pregnancy -- Physiological aspects ,Pregnant women -- Physiological aspects ,Health - Abstract
A protein called cardiac troponin I may be the best indicator of a heart attack in pregnant women. Diagnosing heart attack in pregnant women is a challenge, because many of the proteins that are increased during a heart attack are also increased during pregnancy. This was confirmed in a study of 51 healthy pregnant women in whom blood levels of several proteins were measured before, during and after delivery. Levels of myoglobin, creatine kinase and creatine kinase MB increased two-fold within 30 minutes after delivery. However, levels of cardiac troponin I did not.
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- 1999
21. Maternal cardiac troponin I levels during normal labor and delivery
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Shivvers, Stephan A., Wians, Frank H., Keffer, Joseph H., and Ramin, Susan M.
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Pregnant women ,Creatine ,Myoglobin ,Creatine kinase ,Health - Abstract
Byline: Stephan A. Shivvers, Frank H. Wians, Joseph H. Keffer, Susan M. Ramin Keywords: Pregnant women; myocardial injury; troponin I Abstract: Objective: Diagnosis of myocardial infarction in pregnant women on the basis of changes in biochemical markers is complicated by the release of some of these markers from noncardiac tissue sources. We compared troponin I levels with those of other markers in normal pregnant women. Study Design: In 51 healthy women at term in labor, cardiac troponin I, myoglobin, creatine kinase, and creatine kinase MB levels were determined at admission, during the second stage of labor, and within 30 minutes, 12 hours, and 24 hours after delivery. Results: Mean admission levels for all markers were below the upper limit of normal. Mean concentrations of myoglobin, creatine kinase, and creatine kinase MB mass were increased nearly twofold within 30 minutes after delivery. The highest level of troponin I (0.134 ng/mL) at all time points was below the cutoff value (0.15 ng/mL) for discriminating myocardial infarction. Conclusions: Because only troponin I levels remained undetectable during and after delivery, it is potentially the most useful biochemical marker for monitoring pregnant women for myocardial injury. (Am J Obstet Gynecol 1999;180:122-7.) Author Affiliation: Dallas, Texas From the Department of Obstetrics and Gynecology.sup.a and the Department of Pathology,.sup.b University of Texas Southwestern Medical Center Article History: Received 16 April 1998; Revised 30 June 1998; Accepted 14 July 1998 Article Note: (footnote) [star] Reprint requests: Stephan A. Shivvers, MD, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75235-9032., [star][star] 0002-9378/99 $8.00 + 0 6/1/93219
- Published
- 1999
22. The course of labor with and without epidural analgesia
- Author
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Alexander, James M., Lucas, Michael J., Ramin, Susan M., McIntire, Donald D., and Leveno, Kenneth J.
- Subjects
Peridural anesthesia -- Physiological aspects ,Labor (Obstetrics) ,Health - Abstract
Epidural analgesia may prolong labor in childbirth. Researchers compared 199 women treated with epidural analgesia or intravenous meperidine for pain control during delivery. Women treated with the spinal analgesia technique were in active labor an average of 8 hours, compared to 6 hours in women given intravenous pain medication. Oxytocin was used to induce uterine contractions more frequently in women given epidural analgesia.
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- 1998
23. The course of labor with and without epidural analgesia
- Author
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Alexander, James M., Lucas, Michael J., Ramin, Susan M., McIntire, Donald D., and Leveno, Kenneth J.
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Pituitary hormones -- Analysis ,Analgesia -- Analysis ,Health - Abstract
Byline: James M. Alexander, Michael J. Lucas, Susan M. Ramin, Donald D. McIntire, Kenneth J. Leveno Keywords: Epidural; labor; anesthesia Abstract: Objective: Our purpose was to measure effects of epidural analgesia on labor compared with boluses of meperidine in a cohort of women with similar clinical circumstances. Study Design: One hundred ninety-nine nulliparous women who were delivered spontaneously at term and who received oxytocin for labor augmentation before the initiation of analgesia were identified for analysis. All these women were managed in a low-risk labor unit according to a standardized protocol. This management protocol encouraged early amniotomy and the use of oxytocin when ineffective labor was diagnosed. Results: The demographic characteristics of the two study groups were similar with respect to age, height, weight, and maternal age. The two groups had the same cervical dilatation on admission (3.3 cm) and at the time of analgesia administration (4.1 vs 4.2 cm), indicating similar progress of labor before oxytocin administration. The length of the active phase of labor was longer in the epidural group (7.9 vs 6.3 hours, p = 0.005), as was the second stage (60 vs 48 minutes, p = 0.03). The mean and maximal rates of oxytocin infusion were similar between the two study groups; however, the amount of oxytocin required for each centimeter of cervical change was more in the epidural group (22 vs 16 mU per cm of cervical change, p = 0.009). Neonatal outcomes were unaffected by the type of labor analgesia. Conclusion: Epidural analgesia decreases uterine performance during oxytocin-stimulated labor, resulting in an increase in the length of the first and second stages of labor. (Am J Obstet Gynecol 1998;178:516-20.) Author Affiliation: Dallas, Texas Article History: Received 22 May 1997; Revised 18 September 1997; Accepted 30 September 1997 Article Note: (footnote) [star] From the Departments of Obstetrics and Gynecologya and Academic Computing,b University of Texas Southwestern Medical Center., [star][star] Reprint requests: James M. Alexander, MD, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75235-9032., a 6/1/86552
- Published
- 1998
24. The relationship of infection to method of delivery in twin pregnancy
- Author
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Alexander, James M., Gilstrap, Larry C., III, Cox, Susan M., and Ramin, Susan M.
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Twins -- Health aspects ,Breech delivery -- Methods ,Puerperal fever -- Risk factors ,Health - Abstract
Uterine manipulation to accomplish a vaginal breech delivery of a second twin may decrease the need for a cesarean section and pose no higher risk of maternal infection or poor infant outcome. Of 718 twin births, patients with cesarean delivery had a 17.7% rate of infection. Vaginal delivery with, and without, uterine manipulation resulted in significantly lower rates of 4.6% and 6.1%, respectively. Infant outcome was comparable between groups. Breech extraction possibly avoided cesarean section in 20% of these cases, without increases in maternal or infant complications.
- Published
- 1997
25. The relationship of infection to method of delivery in twin pregnancy
- Author
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Alexander, James M., Gilstrap, Larry C., Cox, Susan M., and Ramin, Susan M.
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Childbirth -- Methods ,Childbirth -- Analysis ,Childbirth -- Health aspects ,Pregnant women -- Methods ,Pregnant women -- Analysis ,Pregnant women -- Health aspects ,Twins -- Methods ,Twins -- Analysis ,Twins -- Health aspects ,Health - Abstract
Byline: James M. Alexander, Larry C. Gilstrap, Susan M. Cox, Susan M. Ramin Keywords: Twins; infection; breech extraction Abstract: Objective: Our purpose was to determine whether manipulation of the second twin increases the risk of postpartum infection. Study Design: Medical records of all twin deliveries between January 1991 and December 1994 were reviewed. The route of delivery (vaginal vs cesarean section) was examined. The vaginal group was further divided into those delivered in the vertex/vertex position (i.e., no uterine manipulation) versus those delivered vertex/breech extraction (i.e., manipulation). The I.sup.2 and Student t test were used where appropriate. Results: A total of 718 twins were identified, and maternal age, parity, gestational age at delivery (36 weeks), and birth weight (2278 gm) were similar among groups. The metritis rate was higher in the cesarean group (74/447 or 18%) than in the vaginal group (17/299 or 5.7%, p < 0.001). In comparing the vaginal group delivered without uterine manipulation with the vaginal group delivered with manipulation (i.e., breech extraction), there was no difference in the incidence of metritis (10/147 or 6.8% vs 7/152 or 4.6%, not significant). The length of time between delivery of twin A and twin B did not affect the metritis rate. Neonatal outcomes including sepsis, neonatal death, and length of hospitalization were similar among groups (not significant). Conclusion: Uterine manipulation of the second twin does not increase the risk of postpartum metritis or neonatal sepsis. In addition, the time interval between delivery of twins A and B has no effect on the rate of metritis. Although the rate of endometritis has been reported to be higher with twins delivered by cesarean section compared to singletons, the 18% rate of endometritis in twins delivered by cesarean section in this study is slightly lower than in our general population of cesarean deliveries (22%). Author Affiliation: Dallas, Texas Article Note: (footnote) [star] From the Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center., [star][star] Reprint requests: James M. Alexander, MD, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75235-9032., a 0002-9378/97 $5.00 + 0 6/6/84357
- Published
- 1997
26. Asthma treatment in pregnancy: A randomized controlled study
- Author
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Wendel, Paul J., Ramin, Susan M., Barnett-Hamm, Cathy, Rowe, Thomas F., and Cunningham, F.Gary
- Subjects
Asthma -- Drug therapy ,Pregnant women -- Drug therapy ,Hypertension -- Drug therapy ,Women -- Health aspects ,Corticosteroids ,Aminophylline ,Methylprednisolone ,Health - Abstract
Byline: Paul J. Wendel, Susan M. Ramin, Cathy Barnett-Hamm, Thomas F. Rowe, F.Gary Cunningham Keywords: Asthma; aminophylline; inhaled corticosteroids Abstract: OBJECTIVE: Our purpose was to study the effect of inhaled corticosteroids on asthma exacerbations in pregnancy. STUDY DESIGN: We prospectively studied 84 pregnant women with 105 asthma exacerbations. Women were hospitalized if the forced expiratory volume in 1 second was Author Affiliation: Dallas, Texas Article History: Received 26 October 1995; Revised 26 January 1995; Accepted 30 January 1996 Article Note: (footnote) [star] From the Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center., [star][star] Reprint requests: Paul J. Wendel, MD, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Arkansas for Medical Sciences, 4301 West Markham St., Slot #518, Little Rock, AR 72205-7199., a 0002-9378/96 $5.00 + 0 6/1/72466
- Published
- 1996
27. Asthma treatment in pregnancy: a randomized controlled study
- Author
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Wendel, Paul J., Ramin, Susan M., Barnett-Hamm, Cathy, Rowe, Thomas F., and Cunningham, F. Gary
- Subjects
Asthma -- Drug therapy ,Pregnant women -- Care and treatment ,Corticosteroids -- Evaluation ,Aminophylline -- Evaluation ,Health - Abstract
Treating pregnant women having severe asthma attacks with intravenous aminophylline does not appear to improve their outcome. In addition to treating with inhaled beta2-adrenergic receptor agonist, 65 pregnant women requiring hospital admission for an asthma attack were randomly assigned to intravenous aminophylline during their hospital stay and then randomly assigned to inhaled corticosteroids at hospital discharge. Women given aminophylline did not respond faster nor did they have shorter hospital stays. However, women assigned to inhaled corticosteroids had fewer readmissions for subsequent attacks.
- Published
- 1996
28. Acute pancreatitis in pregnancy
- Author
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Ramin, Kirk D., Ramin, Susan M., Richey, Sherrie D., and Cunningham, F. Gary
- Subjects
Pancreatitis -- Care and treatment ,Pregnancy, Complications of -- Care and treatment ,Health - Abstract
Prompt diagnosis and hospitalization appear to improve the prognosis of women with acute pancreatitis in pregnancy. Pancreatitis is an inflammation of the pancreas. Of 43 pregnant women with pancreatitis admitted to a Texas hospital over a 10-year period, all responded well to antimicrobial therapy, intravenous hydration, and bowel rest. Of 39 of these women who gave birth in the hospital, 32 delivered full-term, healthy infants. Two of the babies were stillborn and one who was born without a functional brain died after one day. The most common cause of pancreatitis in pregnancy appears to be biliary tract disease which advances with gestational age.
- Published
- 1995
29. Markers of acute and chronic asphyxia in infants with meconium-stained amniotic fluid
- Author
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Richey, Sherrie D., Ramin, Susan M., Bawdon, Roger E., Roberts, Scott W., Dax, Jody, Roberts, Jodie, and Gilstrap, Larry C.
- Subjects
Meconium -- Physiological aspects ,Asphyxia neonatorum -- Physiological aspects ,Erythropoietin -- Physiological aspects ,Health - Abstract
The presence of meconium in the amniotic fluid during labor does not appear to be associated with a lack of oxygen called asphyxia. Meconium is a baby's first stool. Umbilical-cord blood was assayed for lactate, hypoxanthine, and erythropoietin, and concentrations were compared between 28 healthy women in labor with meconium-stained amniotic fluid and 28 similar women with clear amniotic fluid. Fetuses with meconium-stained fluid were older than fetuses that did not pass meconium. This supports the theory that meconium passage relates to maturation of the digestive tract. No fetus showed any signs of fetal distress in labor, and Apgar scores and blood pH, a measure of oxygenation, were similar. Lactate levels and hypoxanthine levels, which are indicators of recent asphyxia, were similar. However, erythropoietin levels were higher in cases of meconium staining. Erythropoietin level appears to correlate with chronic stress or stress in the more distant past.
- Published
- 1995
30. Comparison of prophylactic angiotensin II versus ephedrine infusion for prevention of maternal hypotension during spinal anesthesia
- Author
-
Ramin, Susan M., Ramin, Kirk D., Cox, Kay, Magness, Ronald R., Shearer, Vance E., and Gant, Norman F.
- Subjects
Angiotensin -- Physiological aspects ,Peridural anesthesia -- Complications ,Hypotension -- Prevention ,Health - Abstract
Angiotensin II may be more effective than ephedrine at preventing the fall in maternal blood pressure that commonly follows administration of spinal anesthesia without compromising uterine blood flow. A group of 30 women undergoing elective repeat cesarean section at term were randomly assigned to a control group, I.V. administration of ephedrine, or I.V. administration of angiotensin II prior to receiving spinal anesthesia. After anesthetic administration, half the control women experienced a fall in blood pressure that required a corrective injection of ephedrine. None of the ephedrine or angiotensin group became hypotensive. However, the incidence of low blood pH, a sign of oxygen deprivation, in the newborn was 40% in the ephedrine group versus none in the angiotensin group or among controls. Angiotensin II levels in that group increased fourfold in the mother's bloodstream, but were unchanged in the baby, indicating that angiotensin II does not cross the placenta.
- Published
- 1994
31. Early repair of episiotomy dehiscence associated with infection
- Author
-
Ramin, Susan M., Ramus, Ronald M., Little, Bertis B., and Gilstrap, Larry C., III
- Subjects
Episiotomy -- Care and treatment ,Dehiscence -- Physiological aspects ,Surgical wound infections -- Care and treatment ,Health - Published
- 1992
32. Ultrasonographic diagnosis of uterine rent at 33 weeks' gestation with a history of curettage
- Author
-
Markos, Ferenc, Ramin, Kirk D., Twickler, Diane M., Barron, Julian, and Ramin, Susan M.
- Subjects
Uterus, Pregnant ,Uterus -- Rupture ,Ultrasonics in obstetrics -- Evaluation ,Health - Abstract
An ultrasound scan diagnosed the extrusion of the amniotic sac through a uterine tear. A woman who had had curettage for an incomplete miscarriage two years previously presented 33 weeks gestation with decreased fetal movements and intermittent abdominal pain. A routine scan performed 11 weeks earlier had found everything to be normal. Now, however, sonography revealed a tear in the top of the uterus through which protruded a fluid filled sac. There was virtually no amniotic fluid surrounding the fetus. Surgery revealed that the amniotic sac had ballooned through the rent. A healthy baby was delivered, and the rent was closed. Tubal ligation was also performed. An event such as this is exceedingly rare. Uterine perforation occurs less than 1% of the time during curettage. Uterine rents rarely occur in the absence of a uterine scar, and most have no consequences.
- Published
- 1995
33. The prevalence of sexual assault: a survey of 2404 puerperal women
- Author
-
Satin, Andrew J., Ramin, Susan M., Paicurich, Jean, Millman, Shara, and Wendel, George D., Jr.
- Subjects
Rape -- Surveys ,Pregnant women -- Beliefs, opinions and attitudes ,Pregnancy -- Surveys ,Health - Published
- 1992
34. Late preterm birth: how often is it avoidable?
- Author
-
Holland, Marium G., Refuerzo, Jerrie S., Ramin, Susan M., Saade, George R., and Blackwell, Sean C.
- Subjects
Childbirth ,Infants (Premature) ,Health - Abstract
To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ajog.2009.06.066 Byline: Marium G. Holland (a), Jerrie S. Refuerzo (a), Susan M. Ramin (a), George R. Saade (b), Sean C. Blackwell (a) Keywords: elective delivery; late preterm birth; practice patterns; prematurity; preterm birth Abstract: Our objective was to describe indications for late preterm birth (LPTB) and estimate the frequency of potentially avoidable LPTB deliveries. Author Affiliation: (a) Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, The University of Texas Medical School at Houston, Houston, TX (b) Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The University of Texas Medical Branch, Galveston, TX Article History: Received 27 February 2009; Revised 31 May 2009; Accepted 30 June 2009 Article Note: (footnote) Reprints not available from the authors., Cite this article as: Holland MG, Refuerzo JS, Ramin SM, et al. Late preterm birth: how often is it avoidable? Am J Obstet Gynecol 2009;201:404.e1-4.
- Published
- 2009
35. Randomized trial of preinduction cervical ripening: misoprostol vs oxytocin
- Author
-
Fonseca, Linda, Wood, Hilaire C., Lucas, Michael J., Ramin, Susan M., Phatak, Deepali, Gilstrap, Larry C., and Yeomans, Edward R.
- Subjects
Pituitary hormones ,Neuropeptides ,Misoprostol ,Health - Abstract
To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ajog.2008.07.014 Byline: Linda Fonseca, Hilaire C. Wood, Michael J. Lucas, Susan M. Ramin, Deepali Phatak, Larry C. Gilstrap, Edward R. Yeomans Keywords: cervical ripening; induction; misoprostol; oxytocin Abstract: The purpose of this study was to compare the vaginal delivery rate in women who undergo labor induction with preinduction misoprostol or oxytocin alone. Author Affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, The University of Texas Medical School at Houston, Houston, TX Article History: Received 1 March 2008; Revised 12 May 2008; Accepted 7 July 2008 Article Note: (footnote) Cite this article as: Fonseca L, Wood HC, Lucas MJ, et al. Randomized trial of preinduction cervical ripening: misoprostol vs oxytocin. Am J Obstet Gynecol 2008;199:305.e1-305.e5. , (Dr Fonseca is currently in the Department of Obstetrics, Gynecology, and Reproductive Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL.), Reprints not available from the authors.
- Published
- 2008
36. Diagnosing and treating pulmonary embolism in pregnancy
- Author
-
Miles, Annette M., Pschirrer, E. Rebecca, Gilstrap, Larry C., and Ramin, Susan M.
- Subjects
Heart diseases -- Diagnosis -- Patient outcomes ,Pregnancy -- Diagnosis ,Mothers -- Patient outcomes ,Mortality -- United States ,Pulmonary embolism -- Diagnosis -- Patient outcomes ,Heart diseases in pregnancy -- Diagnosis -- Patient outcomes - Abstract
Dr. Miles is Maternal-Fetal Medicine Clinical Fellow; Dr. Pschirrer is Maternal-Fetal Medicine Clinical Fellow; Dr. Gilstrap is Professor and Chairman; and Dr. Ramin is Associate Professor and Director, Division of [...]
- Published
- 1999
37. Fooled twice by an acute abdomen
- Author
-
Vidaeff, Alex C. and Ramin, Susan M.
- Subjects
Acute abdomen -- Diagnosis ,Pregnancy, Ectopic -- Diagnosis ,Pregnancy, Ectopic -- Case studies ,Ultrasound imaging -- Analysis ,Health - Published
- 2008
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