James E Sumners

• Doctor of Medicine
• MFM Subspecialist at Sumners Maternal-Fetal Medicine

The transabdominal cerclage procedure was first introduced 50 years ago as an approach in those patients who had failed transvaginal cerclage. We review the history, indications, surgical technique, complications, and reported outcomes of the procedure. The procedure has evolved over time in its application and risks appear to be less than previous...

The object of this study was to describe pregnancy outcomes in women who had a transabdominal cerclage (TAC) placed after a prior uterine incision due to caesarean section or hysterotomy. This is a retrospective observational study of 57 women referred to a maternal-fetal medicine specialist (JES) for TAC placement after a previous uterine incision...

The use of cerclage, either through vaginal or abdominal routes, to assist in delaying pre-term delivery among select women with cervical insufficiency may be beneficial, but can also carry significant morbidity. Robotic-assisted transabdominal cervical cerclage (RoboTAC) in the non-pregnant patient has the ability to not only reduce associated mor...

This retrospective cohort study identifies complications associated with transabdominal cerclage (TAC). In 300 procedures performed over a 24 year time span, 11 (3.7%) surgical complications were encountered. Fetal loss (prior to 20 weeks) occurred in 4.1% of pregnancies. The median estimated blood loss among patients was 100 ml, with blood loss su...

The purpose of this study was to determine if functional lung maturity (FtLM) of triplets was affected by differentiating factors within the triplet set. This was a retrospective cohort study of triplets. Data were collected on maternal, pregnancy and neonatal characteristics and FtLM was determined, based on selected neonatal outcomes. Functional...

There are no reports indicating the effect of prophylactic transabdominal cerclage (TAC) on the prolongation of multifetal pregnancies. We report the use of TAC in triplets, which evolved over 20 years in one practice. A retrospective cohort study of triplet pregnancies was conducted. Obstetric and neonatal outcomes were compared among women who un...

A 33-year-old G4P0 white female presented for a pregnancy ultrasound at 9 weeks gestation and was found to have a complete hydatidiform mole coexisting with a live twin fetus (CHTF). The beta-hCG level was 600,000 mIU/ml and the chest X ray was negative. The pregnancy was uneventfully terminated by suction curettage and oral contraceptives were pre...

Urogynecology deals with anatomic and physiologic defects of the female pelvic floor, including urinary and anal incontinence. Ultrasonographic investigation of the female pelvic floor may be helpful in diagnosis and management of both symptom complexes. To interpret pelvic floor ultrasound studies, normal parameters are necessary. Ten asymptomatic...

Pelvic floor physiology is a complex area of clinical study. Continence and voiding functions are not completely understood. Incontinence is an especially underrated problem. With the use of manometry and ultrasound, anorectal physiology is evaluated and correlated with clinical dysfunction. A description of a previously undescribed ultrasound tech...

Pelvic floor physiology is a complex area of clinical study. Continence and voiding functions are not completely understood. Incontinence is an especially underrated problem. With the use of manometry and ultrasound, anorectal physiology is evaluated and correlated with clinical dysfunction. A description of a previously undescribed ultrasound tech...

Thirty women, 25 with incontinence and five asymptomatic volunteer control subjects, were evaluated urodynamically by a variety of techniques, including ultrasound cystourethrography. The ultrasound evaluation was found to be a helpful adjunct in diagnosis. In comparison with radiologic techniques it offers more safety, more comfort, more privacy,...

Neonatal anthropometry, including timed skinfold measurements, was performed on 55 products of selected pregnancies. These skinfold measurements were compared with published standards of measurements obtained by similar techniques. Values outside the 3rd percentile to 97th percentile range were overlaid on the birth weight/menstrual age relationshi...

A method was developed for assessing indirectly the fecal excretion of carbohydrate-derived energy. Then, eight healthy premature infants (28 to 32 wk gestation, postnatal age 12 to 30 days) were randomly assigned to receive one of two formulas that differed only in the carbohydrate source: 100% lactose or 50% lactose: 50% glucose polymer (lactose...

A method was developed for assessing indirectly the fecal excretion of carbohydrate-derived energy. Then, eight healthy premature infants (28 to 32 wk gestation, postnatal age 12 to 30 days) were randomly assigned to receive one of two formulas that differed only in the carbohydrate source: 100% lactose or 50% lactose: 50% glucose polymer (lactose...

We appreciate the critical eyes of Swyer and associates for the detection of our error in units of measurement. On review of our original data (Pediatrics 68:82, 1981), we found that rate of change in skinfold thickness should have been expressed in millimeters per week instead of millimeters per day. This change of units does not, of course, chang...

Fourteen growing, healthy premature infants were moved from heated incubators to cribs at different points in their growth. Group A (six babies) was moved when babies reached a weight of 1,600 to 1,700 gm; group B (eight babies) when babies reached a weight of 1,800 to 1,900 gm. All other conditions of rearing were kept the same. The effect on thei...

In the face of increasing neonatal referrals from a large geographic region, community hospital resources was recruited and coordinated with regional center resources to facilitate "community-based" neonatal transport. All transport requests were first "triaged" by an attending neonatologist. Discriminant analysis was used to assess the impact of r...

The relation between directly measured arterial blood pressure and blood volume was studied in 61 sick preterm infants. Mean blood volume (derived from plasma volume [T1824 ten-minute albumin space] and hematocrit value) of 26 hypotensive infants (89.1 ± 17.26 ml/kg) was not significantly different from that of 35 normotensive, but otherwise compar...

Although indwelling arterial catheterization in the neonate is usually accomplished through an umbilical artery, this site may be precluded under certain circumstances. An umbilical artery cannot be catheterized in an estimated 5% to 10% of infants.1 Need for an indwelling arterial catheter may arise at a postnatal age when catheterization of an um...

During the latter half of 1974, changes in the neonatal transport system serving mid- and northern Alabama were made in response to increasing demands of transport on NICU personnel and equipment. One major change was from NICU-based ground transport to a combination of NICU-based and community-based transport. Com-commitant with the change in mode...

Amniotic fluid glucose (AF glu) was studied in 92 pregnancies complicated by maternal diabetes. An inverse relation between AF glu and gestational age was found: [AF glu (mg. per diciliter) = 160.9 -- 3.51 (weeks gestation); r = -0.47]. A direct relation between AF glu and severity of maternal diabetes was observed: mean AF glu (mg. per deciliter)...

Previously published data suggested that the faster rate of weight gain observed in parenterally supplemented neonates compared to their orally fed peers might be attributable to water retention rather than to more rapid tissue accretion. The present study was designed to test that hypothesis by observing changes in extracellular water, estimated a...

In the past decade, basic physiologic research and major advances in technology have provided both knowlege and capability to care for the sick or premature newborns faced with nearly insurmountable odds against survival. For the few who survived, permanent neurologic disability was almost inevitable. Physicians were hampered by lack of knowledge o...

Development of a Perinatal Center delivering Level 3 intensive care in a community hospital is described. The inborn neonatal mortality at the hospital in which the Center is located, as well as that of the 13 surrounding counties, has diminished more rapidly than the state neonatal mortality. This has coincided with an almost constant delivery rat...

Extract: Midtricipital (MT) and subscapular (SS) skinfolds were measured within 24 hr of birth in 23 normally grown mature (NG-M); 23 normally grown premature (NG-P); 6 intrauterine growth-retarded mature (IGR-M); and 7 intrauterine growth-retarded premature (IGR-P) infants. A rapid initial decrease in measured skinfold thickness (SFT) occurred aft...

61 intravenous glucose tolerance tests (GTT) were performed within 24 h of birth in 50 infants of birth weights 500–1,380 g. Glucose exposure prior to the test in 33 of the GTT resulted in higher mean plasma glucoses, more frequent preinfusion hyperglycemia (glucose > 125 mg/100 ml), and a greater proportion of slower glucose disappearance rates (K...

One hundred sixteen hearts of children dying with leukemia during the 5-year period of 1962 to 1967 were examined at necropsy. Forty-four per cent of the patients had at least one focus of leukemic infiltration, a slightly higher incidence than previously reported. The evidence suggests that peripheral leukocyte count, type of leukemia, and length...