Martin L Gimovsky

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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)
Excessive perinatal loss is associated with breech presentation, and, in large measure, this loss is accounted for by prematurity, congenital anomalies, and birth trauma. In the endeavor to exert an effect on two of these problems, cesarean section has been resorted to increasingly. Three hundred thirty singleton breech pregnancies were reviewed, and(More)
A vital component of selective protocols in term breech presentation management is exclusion of the gravida with borderline pelvic dimensions. Computed tomographic (CT) pelvimetry was employed to evaluate potential candidates for a trial of labor with a breech fetus at term. Thirty-seven of 39 women who underwent labor after this selection had a successful(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.
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 determine the adequacy of genetic risk assessment among primary care providers and to evaluate the efficacy of genetic counseling before "routine" genetic amniocentesis. STUDY DESIGN A retrospective cohort study was undertaken. Charts of 275 consecutive patients referred for genetic counseling and amniocentesis on the basis of advanced(More)