Martin L Gimovsky

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OBJECTIVE To examine the obstetric and perinatal outcome of pregnancies with singleton breech presentation at term when selection for vaginal delivery was based on clear prelabor and intrapartum criteria. METHODS The outcomes of all pregnancies with a breech presentation after 37 weeks of gestation were retrospectively reviewed from January 1997 to June(More)
Systemic lupus erythematosus has a predilection for women of childbearing age and may potentially complicate pregnancy. Poor pregnancy outcome in women with systemic lupus erythematosus has been principally ascribed to the presence of renal involvement. Maternal risks have been more difficult to evaluate because of the unpredictable nature of the disease(More)
OBJECTIVE To evaluate the utility of the prenatal three-generation pedigree in assessment of the obstetric patient's primary medical risks. STUDY DESIGN In a case series, 250 charts of patients referred for amniocentesis on the basis of advanced maternal age were reviewed for a significant genetic risk of a primary care disorder. RESULTS A total of 40(More)
X-ray evaluation of the pelvis plays a pivotal role in selecting term breech presentation for a possible trial of labor. Even minimal degrees of disproportion may have disastrous consequences for the aftercoming head. Our evaluation of x-ray pelvimetry by computerized tomography scanning suggests it is probably more accurate than conventional methods, with(More)
Intrapartum fetal heart rate response to various scalp stimuli and its correlation with scalp pH was studied in a prospective manner. One hundred fetuses with heart rate tracings judged by the resident responsible for the patient to be suggestive of fetal asphyxia were entered into the study. Each fetus was subjected to firm digital pressure on the head(More)
Cesarean section has become the standard management used by many clinicians for breech presentation in labor. Proof of the superiority of routine cesarean section has been largely circumstantial. Concern over rising cesarean section rates has led to renewed interest in possible alternatives. Protocols have been developed to select which patients may be(More)
Fetal heart rate acceleration in response to various stimuli has long been considered to be a reliable sign of fetal well-being in both the intrapartum and antepartum periods. In an effort to define the correlation between fetal heart rate response and fetal blood pH, we analyzed 200 fetal heart rate tracings of fetuses who had undergone scalp blood(More)
BACKGROUND Late postpartum eclampsia is more frequently recognized than past reports indicate. This report describes the association of a reversible encephalopathy in a woman with late postpartum eclampsia. CASE A woman with lupus nephritis presented 7 days postpartum with eclampsia. Postseizure findings included dramatic short-term memory loss. Although(More)
At 38 weeks of gestation, a woman with a previously unremarkable pregnancy was noted to have fetal tachycardia without obvious cause. Fetal echocardiography resulted in a presumptive diagnosis of fetal atrial flutter with a 2:1 block. The newborn resumed the same rhythm. The neonate underwent transesophageal incremental overdrive pacing. A normal sinus(More)
Autonomic hyperreflexia is a serious peripartum complication associated with spinal cord lesions. Although the majority of reported cases have occurred with lesions at T-5 or higher, we report a case occurring in a patient with a lesion at T-10. Management may be by regional anesthesia or primarily medical.