- Email: [email protected]
Heparin versus normal saline as a peripheral line flush in maintenance of intermittent intravenous lines in obstetric patients
Citations from the literature/International
Journal of Gynecology & Obstetrics 51 (1995) 189-197
color Doppler ultrasound examination of the fetus is an alternative for the identification of trisomy 21 for patients who may decline genetic amniocentesis based on their age-related risk. Heparin versus normal saline as a peripheral line flush in maintenance of intermittent intravenous lines in obstetric patients
Meyer B.A.; Little C.J.; Thorp J.A.; Cohen G.R.; Yeast J.D.
191
of low birth weight and pretetm delivery. This phenomenon is seenin all ethnic groups. Some ethnic groups have higher rates of low birth weight and preterm delivery than white women, and they also have higher rates of low hemoglobin concentrations. This increased rate of ‘anemia,’ however, does not account for their higher rates of low birth weight, which occurs at all hemoglobin concentrations.
USA
OBSTET GYNECOL 1995 85/3 (433-436) Objective: To compare heparin sodium (100 United States Pharmacopeia U/ml) with 0.9% sodium chloride for use in the maintenance of intermittent intravenous (IV) devices during pregnancy. Methods: Women at 26-34 weeks’ gestation who required serial phlebotomy were assignedrandomly to heparin or normal saline flush, administered in a double-blind fashion. Catheter sites were examined and flushed with the study solution! at least once every 6 h. Partial thromboplastin times (PITS) were measured at catheter insertion and 48 h later. Statistical analysis was performed with Student r test, MannWhitney U test, Fisher exact test; log-rank, and chi* analysis, as appropriate. Results: There was a significant increase in catheter patency rate at 48 and 72 h in the heparin group (26 of 31 vs. 17 of 33, and 21 of 31 vs. nine of 33, respectively; P c 0.01). In addition, there was a significantly lower rate of catheter complications in the heparin group (four of 31 vs. 13 of 33; P c 0.01). There were no differences in P’ITs. Conclusion: During pregnancy, dilute heparin flush to maintain patency of intermittent IV site devices results in the following: a greater catheter patency rate at 48 and 72 h after insertion of the catheter, a lower rate of catheter complications requiring therapy, and no alteration in PTI’. Relation between materoal bemoglobia concentration sod birth weight in different ethnic groups
Steer P.; Alam M.A.; Wadsworth J.; Welch A. GBR
BR MED J 1995 310/6978(489-4910) Objective: To assessthe relation of the lowest hemoglobin concentration in pregnancy with birth weight and the rates of low birth weight and pretenn delivery in different ethnic groups. DesignRetrospective analysis of 153 602 pregnancies with ethnic group and birth weight recorded on a regional pregnancy database during 1988-1991. The hemoglobin measurement used was the lowest recorded during pregnancy. Setting-North West Thames region. Subjects:115 262 white women, 22 206 Indo-Pakistanis, 4570 Afro-Caribbeans, 2642 mediterraneans, 3905 black Africans, 2351 orientals, and 2666 others. Main outcome measures-Birth weight and rates of low birth weight (< 2500g) and preterm delivery (< 37 completed weeks). Results: Maximum mean birth weight in white women was achieved with a lowest hemoglobin concentration in pregnancy of 85-95 gil; the lowest incidence of low birth weight and preterm labor occurred with a lowest hemoglobin of 95-105 g/l. A similar pattern occurred in all ethnic groups. Conclusions:The magnitude of the fall in hemoglobin concentration in pregnancy is related to birth weight; failure of the hemoglobin concentration to fall below 105 gil indicates an increased risk
Predictors of ratio of placental weight to fetal weight in multiethnic commuoity
Perry I.J.; Beevers D.G.; Whincup P.H.; Bareford D. GBR
BR MED J 1995310/6977(436-4390) Objective: To determine whether placental ratio is influenced by maternal ethnic origin, obesity, hypertension, and hematological indices of iron deficiency anemia. Design: Observational study. Setting: District general hospital in Birmingham. Subjects:692healthy nulliparous pregnant women, of whom 367 were European, 213 Asian, 99 Afro-Caribbean, and 13 of other or undocumented ethnic origin. Main outcome measures-Placental ratio and maternal body massindex, blood pressure, and hematological indices. Results: Though birth weight and placental weight were lower in Asian women than in other groups, mean placental ratio was similar in Asian (19.5% (S.D.3.3%)), European (20.0% (4.00/o)),and AfroCaribbean women (20.4%(5.3%)). Gestational age at birth was the main predictor of placental ratio in the univariate analysis (r = -0.34, P < 0.001) and multivariate analysis. The only other significant predictor of placental ratio in multivariate analysis was maternal body mass index, which was positively associatedwith placental ratio (r = 0.1, P = 0.01). Mean (SD. placental ratio was not significantly higher in women who developed gestational hypertension (20.4%) (4.5%)) and preeclampsia (23.3% (7.3%)) than in normal women (19.8% (3.8%)). No evidence 6f a relation between placental ratio and first antenatal visit hemoglobin concentration or mean cell volume was detected, and placental ratio was not associated with change in mean cell volume during pregnancy or with third trimester serum ferritin concentration. Conclusions:These data do not support the proposed association between poor maternal nutrition and increased placental ratio. The association between high placental ratio and adult hypertension may be confounded by genetic and environmental factors associated with maternal obesity (and possibly maternal hypertension). A coatrolled trial of povidonehline opbtbalmia m!onatorum
as prophylaxis
against
Isenberg S.J.; Apt L.; Wood M. USA
NEW ENGL J MED 1995 332/9 (562-5660) Background. Neonatal conjunctivitis (ophthalmia neotorum) continues to cause blindness, because the agents used prophylactically to prevent this condition are not completely effective and are not widely available in many parts of the world. Povidone-iodine ophthalmic solution is an effective antibacterial agent with broad antibacterial and antiviral activity to which no bacteria are known to be resistant, and it is far less
Journal of Gynecology & Obstetrics 51 (1995) 189-197
color Doppler ultrasound examination of the fetus is an alternative for the identification of trisomy 21 for patients who may decline genetic amniocentesis based on their age-related risk. Heparin versus normal saline as a peripheral line flush in maintenance of intermittent intravenous lines in obstetric patients
Meyer B.A.; Little C.J.; Thorp J.A.; Cohen G.R.; Yeast J.D.
191
of low birth weight and pretetm delivery. This phenomenon is seenin all ethnic groups. Some ethnic groups have higher rates of low birth weight and preterm delivery than white women, and they also have higher rates of low hemoglobin concentrations. This increased rate of ‘anemia,’ however, does not account for their higher rates of low birth weight, which occurs at all hemoglobin concentrations.
USA
OBSTET GYNECOL 1995 85/3 (433-436) Objective: To compare heparin sodium (100 United States Pharmacopeia U/ml) with 0.9% sodium chloride for use in the maintenance of intermittent intravenous (IV) devices during pregnancy. Methods: Women at 26-34 weeks’ gestation who required serial phlebotomy were assignedrandomly to heparin or normal saline flush, administered in a double-blind fashion. Catheter sites were examined and flushed with the study solution! at least once every 6 h. Partial thromboplastin times (PITS) were measured at catheter insertion and 48 h later. Statistical analysis was performed with Student r test, MannWhitney U test, Fisher exact test; log-rank, and chi* analysis, as appropriate. Results: There was a significant increase in catheter patency rate at 48 and 72 h in the heparin group (26 of 31 vs. 17 of 33, and 21 of 31 vs. nine of 33, respectively; P c 0.01). In addition, there was a significantly lower rate of catheter complications in the heparin group (four of 31 vs. 13 of 33; P c 0.01). There were no differences in P’ITs. Conclusion: During pregnancy, dilute heparin flush to maintain patency of intermittent IV site devices results in the following: a greater catheter patency rate at 48 and 72 h after insertion of the catheter, a lower rate of catheter complications requiring therapy, and no alteration in PTI’. Relation between materoal bemoglobia concentration sod birth weight in different ethnic groups
Steer P.; Alam M.A.; Wadsworth J.; Welch A. GBR
BR MED J 1995 310/6978(489-4910) Objective: To assessthe relation of the lowest hemoglobin concentration in pregnancy with birth weight and the rates of low birth weight and pretenn delivery in different ethnic groups. DesignRetrospective analysis of 153 602 pregnancies with ethnic group and birth weight recorded on a regional pregnancy database during 1988-1991. The hemoglobin measurement used was the lowest recorded during pregnancy. Setting-North West Thames region. Subjects:115 262 white women, 22 206 Indo-Pakistanis, 4570 Afro-Caribbeans, 2642 mediterraneans, 3905 black Africans, 2351 orientals, and 2666 others. Main outcome measures-Birth weight and rates of low birth weight (< 2500g) and preterm delivery (< 37 completed weeks). Results: Maximum mean birth weight in white women was achieved with a lowest hemoglobin concentration in pregnancy of 85-95 gil; the lowest incidence of low birth weight and preterm labor occurred with a lowest hemoglobin of 95-105 g/l. A similar pattern occurred in all ethnic groups. Conclusions:The magnitude of the fall in hemoglobin concentration in pregnancy is related to birth weight; failure of the hemoglobin concentration to fall below 105 gil indicates an increased risk
Predictors of ratio of placental weight to fetal weight in multiethnic commuoity
Perry I.J.; Beevers D.G.; Whincup P.H.; Bareford D. GBR
BR MED J 1995310/6977(436-4390) Objective: To determine whether placental ratio is influenced by maternal ethnic origin, obesity, hypertension, and hematological indices of iron deficiency anemia. Design: Observational study. Setting: District general hospital in Birmingham. Subjects:692healthy nulliparous pregnant women, of whom 367 were European, 213 Asian, 99 Afro-Caribbean, and 13 of other or undocumented ethnic origin. Main outcome measures-Placental ratio and maternal body massindex, blood pressure, and hematological indices. Results: Though birth weight and placental weight were lower in Asian women than in other groups, mean placental ratio was similar in Asian (19.5% (S.D.3.3%)), European (20.0% (4.00/o)),and AfroCaribbean women (20.4%(5.3%)). Gestational age at birth was the main predictor of placental ratio in the univariate analysis (r = -0.34, P < 0.001) and multivariate analysis. The only other significant predictor of placental ratio in multivariate analysis was maternal body mass index, which was positively associatedwith placental ratio (r = 0.1, P = 0.01). Mean (SD. placental ratio was not significantly higher in women who developed gestational hypertension (20.4%) (4.5%)) and preeclampsia (23.3% (7.3%)) than in normal women (19.8% (3.8%)). No evidence 6f a relation between placental ratio and first antenatal visit hemoglobin concentration or mean cell volume was detected, and placental ratio was not associated with change in mean cell volume during pregnancy or with third trimester serum ferritin concentration. Conclusions:These data do not support the proposed association between poor maternal nutrition and increased placental ratio. The association between high placental ratio and adult hypertension may be confounded by genetic and environmental factors associated with maternal obesity (and possibly maternal hypertension). A coatrolled trial of povidonehline opbtbalmia m!onatorum
as prophylaxis
against
Isenberg S.J.; Apt L.; Wood M. USA
NEW ENGL J MED 1995 332/9 (562-5660) Background. Neonatal conjunctivitis (ophthalmia neotorum) continues to cause blindness, because the agents used prophylactically to prevent this condition are not completely effective and are not widely available in many parts of the world. Povidone-iodine ophthalmic solution is an effective antibacterial agent with broad antibacterial and antiviral activity to which no bacteria are known to be resistant, and it is far less