Faculty Bibliography

Patterns of postpartum contraceptive choice are analyzed in a middle class private practice population between the years 1966 and 1981. The effect of age, parity, difficulty in conceiving, future pregnancy plans, and type of delivery are noted. A general decline in the use of oral contraceptives and intrauterine devices with a corresponding increase in the use of barrier methods is documented. Although very few changes among contraceptive techniques occurred between six weeks and six months post partum, an appreciable number of patients, more than half the sample, did change contraceptive techniques between pregnancies. Thus, women perceive different needs at different times during their reproductive lives. To serve patients effectively, a wide range of contraceptives must be available to accommodate changing demands

The correlation of maternal and paternal physical characteristics to the weight of the newborn infant was investigated. It was found that a different anthropomorphic variable best explained the outcome in each group when mothers were divided by weight for height. In women of low weight for height, weight gain was most significantly associated with birth weight (P less than .01); and in women of intermediate weight for height, the significant variable was maternal prepregnancy weight (P less than .01); in women of high weight for height the outcome was best explained by maternal height (P less than .05). The model accounted for 17, 21, and 32% of the variance in birth weight in the 3 weight-for-height groups, respectively. It appears that the relative value of genetic and environmental factors may be different depending on the body type of the mother. It is postulated that other genetic and environmental factors, including smoking, alcohol ingestion, and exact gestation age, may be of significance. The conclusions of this study differ from those of previously reported studies. Possible explanations include variable population homogeneity and different socioeconomic groups studied as well as the obscuring of biologically significant variables if outcomes in subjects with different body types are not analyzed separately

PIP: A combination of Decadreon (dexamethasone) and Phenergan (promethazine) was tested in this collaborative study of 240 infertility patients as a means of preventing postoperative adhesion formation after simple pelvic surgery. 24 patients were lost to follow-up. The overall pregnancy rate among the 240 patients was 51.7% (124): 49% with primary infertility and 58% with secondary infertility conceived after surgery. 90 full-term deliveries were recorded, 27 spontaneous abortions occurred, and 7 ectopic gestations were conceived. In all, 31 cases were reinspected for various reasons after the drug treatment postsurgery; 42% showed no adhesions, 23% showed minimal adhesions, and 35% had significant adhesions. Complications coincident with use of the combined medication were seen in 2.2% (11 of 240) patients. Though this study lacked controls, the authors feel thta the use of corticosteroids postoperatively after pelvic intervention may control the numbers of adhesions which form postoperatively.