Kathryn Reed

Kathryn Reed
The University of Arizona | UA · Department of Obstetrics and Gynecology

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75
Publications
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2,262
Citations

Publications

Publications (75)
Article
Perinatal asphyxia remains one of the major causes of morbidity and mortality for term newborns. Though access to health care and birth attendants have decreased the rate, Neonatal encephalopathy (NE) has not been eliminated. Worldwide, women at socioeconomic disadvantage have the highest risk of delivering a neonate with NE. Neonates that will exp...
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Full-text available
Objective When delivery of a breech fetus is required at a preterm gestational age, Cesarean delivery is often recommended. We performed a prospective patient series to assess the success rate and safety of performing external cephalic version (ECV) procedures on preterm fetuses as an alternative to Cesarean delivery. Study Design We performed a pr...
Article
Objective This article aims to evaluate whether the use of a double-balloon catheter with oral misoprostol results in a lower rate of cesarean and shorter times to delivery than the use of the double-balloon catheter with oral placebo. Study Design In a double-blind randomized controlled trial, a double-balloon catheter was used for induction of la...
Article
Objectives: The purpose of this study was to investigate the relationship between the maternal body mass index (BMI) and the accuracy of ultrasound-derived birth weight. Methods: A retrospective chart review was performed on women who had an ultrasound examination between 36 and 43 weeks' gestation and had complete delivery data available throug...
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Objectives: The purpose of this study was to determine whether the inferior vena caval (IVC) diameter is influenced by intravascular volume changes in pregnancy. Methods: A prospective observational study was done on 2 groups of normal term gravidas. In 24 patients, we measured the IVC diameter, blood pressure, and heart rate (HR) before and aft...
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Full-text available
There is no clear consensus on optimal management of fetuses affected by familial hypertrophic cardiomyopathy (HCM). Intrauterine treatment of the condition has not been attempted in any standardized fashion. We report the case of a fetus treated by maternal propranolol during the third trimester after septal hypertrophy and diastolic dysfunction w...
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Abstract To determine if oxytocin dosage used for labor induction differed in obese and lean women, we analyzed records of patients who underwent term labor induction and delivered vaginally. Each of a cohort of 27 patients with a body mass index (BMI) >40 kg/m2 was matched with a patient with a BMI <28 kg/m2 for gestational age, for birth weight,...
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By applying the strengths of corporate models for effective teamwork, academic scientists can drive transdisciplinary research and accelerate biomedical translation.
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Background: Community physicians are becoming increasingly involved in clinical medical education. Some obstetrician/gynecologists have expressed reluctance to participate as clinical preceptors for medical students due to the sensitive nature of many of their patient encounters and concern for diminished patient satisfaction. Purposes: The purp...
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Marijuana is a commonly used drug. At present, it remains an illegal substance in most areas of the United States. Recent controversy regarding the perceived harms of this drug has resulted in debate in both legal and medical circles. This review examines evidence regarding the effects of marijuana exposure during pregnancy and breast-feeding. We e...
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Full-text available
Academic medical centers (AMCs) are pillars of the community; they provide health care, create jobs, educate biomedical professionals, and engage in research and innovation. To sustain their impact on human health, AMCs must improve the professional satisfaction of their faculty. Here, we describe ways to enhance recruitment, retention, creativity,...
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Studies have documented substantial salary disparities between women and men in academic medicine. While various strategies have been proposed to increase equity, to our knowledge, no interventions have been evaluated. This paper aims to assess the effect of an identity-conscious intervention on salary equity. This study shows comparison of adjuste...
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Full-text available
The influx of women into academic medicine has not been accompanied by equality for male and female faculty. Women earn less than men in comparable positions, progress more slowly through academic ranks, and have not attained important leadership roles. This study tested hypotheses about why gender disparities exist in salary, rank, track, leadersh...
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Women participating in focus groups were asked how they define health and well-being, and what strategies they would suggest for health optimization. Women defined health and well-being largely in terms of relationships. Their strategies for improving health involved enhancement of the quality of relationships with families, partners, and community...
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The purpose of this study was to determine the direction of transmission of umbilical venous Doppler flow velocity changes in human fetuses. Strip chart recordings of simultaneously measured umbilical arterial and venous velocities were examined at two sites in the umbilical cord, one near the fetus (proximal) and one near the placenta (distal). Fe...
Article
To evaluate the maternal serum dehydroepiandrosterone (DHEA) sulfate level as a factor associated with the outcome of labor induction. Venous blood was collected from 161 women at the initiation of labor induction. Pregnancies complicated by maternal corticosteroid use, antepartum chorioamnionitis, or cesarean delivery for indications other than ar...
Article
>Objective: Variability of the fetal heart rate (FHR) is used clinically to assess fetal well being. Approximate entropy (ApEn) is a statistic that quantifies the regularity of a time series. This study was designed to test whether ApEn changed in the FHR of the hypoxic ovine fetus.Methods: Five time-bred ewes at 130 days of gestation were surgical...
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Intrauterine growth restriction is associated with abnormalities in the fetal circulation. These abnormalities are currently best understood in the umbilical arterial and venous systems. Changes in intracardiac velocities are more variable as well as more difficult to detect. Doppler ultrasound, particularly of the umbilical circulation, has been u...
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To identify the source of umbilical venous velocity pulsations, times of transmission from the atrial contraction pressure waveform to velocity waves in the inferior vena cava, ductus venosus, intra-abdominal umbilical vein, and intra-amniotic umbilical vein were examined. Five lamb fetuses at 125-135 days' gestation were instrumented with solid st...
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To evaluate the maternal serum dehydroepiandrosterone (DHEA) sulfate level as a factor influencing labor "efficiency" at term. On admission to the labor and delivery unit, blood was collected from 55 term nulliparous women up to 25 years of age in active labor. Following delivery, umbilical venous cord blood was also collected. Pregnancies complica...
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To examine effects of fluid administration on inferior vena cava pressure and umbilical venous Doppler velocities in the term fetal lamb. With the ewe given inhalation anesthetics, eight chronically instrumented intrauterine fetal lambs at 125-135 days' gestation were given normal saline fluid boluses. Inferior vena cava peak pressures and umbilica...
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To examine the incidence of very low birth weight (VLBW) neonates, defined as those weighing less than 1500 g, delivered by adolescents compared with the general obstetric population. A retrospective observational study of 16,857 women delivering live-born infants from January 1, 1989, to June 30, 1993, was conducted at the University of Arizona He...
Article
A novel formulation of WKB inverse method is conducted and applied in view of index profile reconstruction in diffused waveguides. Systematic and local errors on the effective indices are investigated. The consequences on the index profile shapes are studied.
Article
Adequate amniotic fluid (AF) volume is one of several factors felt to be essential for normal lung development. Renal agenesis and urinary tract obstruction usually result in oligohydramnios and pulmonary hypoplasia. Two sets of monoamiotic twins with discordant urinary tract anomalies were seen. One twin in each set had anomalies that in a singlet...
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To describe ethnic differences in tobacco use during pregnancy in a clinical population of Mexican-American and non-Hispanic white women. Subjects were randomly selected from all patients attending a university-based obstetrics clinic in Tucson, Arizona. Of 555 subjects selected, 367 were interviewed and had their urinary cotinine levels measured....
Article
To compare umbilical arterial and venous Doppler velocity waveforms during labor in fetuses with normal heart rate tracings and fetuses with late decelerations. During labor, umbilical arterial and venous Doppler flow velocity waveforms were obtained between and during contractions in 20 fetuses (ten with normal heart rate tracings and ten with lat...
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We hypothesized that changes in intrathoracic pressure during fetal breathing episodes result in quantifiable variations in umbilical arterial and venous blood flow velocities, and that these variations are related to compliance properties of each system. We further hypothesized that these variations in velocities are different in fetuses with norm...
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The fetal heart is the organ system most commonly affected with congenital disease. Though risk factors exist for congenital heart disease (eg, family history, toxin exposure, maternal illness, abnormal karyotype, and other fetal anomalies), the fetal heart is most often examined as part of a routine evaluation of the fetal anatomy in the fetus wit...
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To assess the validity of Doppler flow sonography for the prediction of malignancy in adnexal masses and to compare the results with two-dimensional ultrasonographic examination and CA 125 levels. In a cross-sectional study, 55 patients with adnexal masses were examined using Doppler sonography to measure the resistance index of tumor-associated bl...
Article
Variability in the fetal heart rate is known to be a sign of fetal well-being, and yet the origins of the variations remain unclear. This study incorporated the nonlinear analytic techniques of phase-space reconstruction and dimensional analysis to 12 normal heart rate tracings obtained from fetal scalp electrodes of fetuses in labor. Phase-space a...
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Fetal compromise has been associated with an umbilical artery waveform pattern of low or absent diastolic velocity relative to systolic velocity. Fetuses with single umbilical arteries have an increased risk of major malformations, mortality, retarded fetal growth, and prematurity. In this study Doppler flow velocities were obtained in 13 fetuses (...
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Oligohydramnios is a serious complication of pregnancy that is associated with a poor perinatal outcome. Eighty pregnancies complicated by oligohydramnios constitute the basis for this retrospective study. Forty patients had premature rupture of the membranes; of these, outcomes were good in 25. Twelve of 14 fetuses with oligohydramnios and intraut...
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The fetal cardiac and placental circulations are interconnected through the umbilical venous and arterial vasculature. We hypothesized that alterations in umbilical venous blood flow velocities are present in fetuses with abnormal umbilical arterial circulation, and further, that changes in inferior vena cava blood flow velocities occur with, and m...
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The echocardiographic studies and clinical course of 27 fetuses (mean gestational age 26.9 weeks) diagnosed in utero with tricuspid valve disease and significant tricuspid regurgitation were reviewed. The diagnosis of Ebstein's anomaly was made in 17 of the fetuses, 7 had tricuspid valve dysplasia with poorly developed but normally attached leaflet...
Article
Doppler velocity waveforms in the human fetal umbilical vein and artery were analyzed during episodes of fetal breathing. Heart rate, systolic and diastolic velocities were measured from the umbilical artery waveform. Diastolic velocity varied the most with a mean (+/- SD) coefficient of variation of 16.0% +/- 5.0%. The coefficient of variation of...
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Studies in instrumented adults have shown an association between Doppler echocardiography-derived atrioventricular valve deceleration times and ventricular function. To determine how gestational age affects deceleration time in the tricuspid and mitral valve, pulsed Doppler ultrasonographic examinations were performed in 54 normal human fetuses. In...
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We examined vena cava Doppler flow velocity tracings from 69 fetuses between 22 and 40 weeks' gestation. Twenty-three fetuses had arrhythmias. Fifteen fetuses had absent end-diastolic Doppler velocities in the umbilical artery, a condition associated with intrauterine growth retardation, and 15 normal fetuses with normal umbilical artery Doppler ve...
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The study of arrhythmias enables the clinician not only to treat and effectively prevent some types of fetal morbidity, but also to understand the normal human fetal physiology. It can be anticipated that the study of arrhythmias in the fetus will expand, if the work currently performed in the child and adult is any indication.
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Forty-four fetuses with pericardial effusions have been identified by ultrasonographic examinations. The clinical histories and courses of these patients were reviewed. At least eight different clinical features accompanied and were probably responsible for the pericardial effusions. The most common cause of a fetal pericardial effusion was heart f...
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Two-dimensional Doppler echocardiography was used to diagnose congestive heart failure in a fetus with a large sacrococcygeal teratoma. Ultrasound performed for size-date inconsistency revealed a 27.5-week fetus with hydrops and a large solid and cystic mass in the sacral region. Fetal echocardiography showed dilated ventricles and a pericardial ef...
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The prenatal diagnosis of fetal cardiac disease has become increasingly accurate as the technology of ultrasound has improved. Although two-dimensional real-time ultrasound remains the primary method of diagnosis, Doppler blood flow velocity estimates can provide valuable pathophysiologic information to support the anatomic diagnosis. We present si...
Article
During recent years, Doppler ultrasound has become an instrument with which the fetal and neonatal cardiovascular system can be examined noninvasively. In fetuses with suspected cardiac anomalies, Doppler examinations can be used to complement two-dimensional and M-mode studies. Information derived from human fetal intracardiac studies has establis...
Article
Umbilical artery Doppler blood flow velocity studies were used to identify 14 fetuses with absent flow during diastole to determine the significance of absent umbilical artery diastolic flow. Outcomes of these fetuses were recorded, and the associated intracardiac Doppler changes were identified in 12 of them. Maximal and mean intracardiac flow vel...
Article
The association of congenital heart block with maternal connective tissue disease and autoimmunity has been recently reported. Two cases of heart block were diagnosed in utero at 23 and 24 weeks' gestation. Both mothers had extensive workups for connective tissue disease that were negative. Two-dimensional and Doppler echocardiography were performe...
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Eighty-six fetuses of 21-41 weeks' gestation with arrhythmias were studied with ultrasound and heart rate monitoring. The type of arrhythmia was identified by M-mode studies and was confirmed by postnatal electrocardiogram in 70 infants. The most common arrhythmia was premature atrial contractions (76), followed by premature ventricular contraction...
Article
The effect of maternal magnesium sulfate treatment on fetal heart rate variability (FHRV) was evaluated by comparing the maternal serum magnesium level drawn during labor to the degree of FHRV seen concurrently on fetal rate heart monitor strips. The records of 57 patients treated with intravenous magnesium sulfate for hypertensive disorders of pre...
Article
To evaluate the qualitative and quantitative changes in Doppler velocities in the normal fetus and newborn, 61 echo Doppler studies were performed in 18 neonates, nine of whom were also studied as fetuses. Four studies were inadequate in fetuses (one pulmonary artery, two mitral, and one tricuspid) and some post natal studies were inadequate due to...
Article
Two-dimensional and pulsed Doppler ultrasound techniques were used to examine 87 fetuses between 17 and 41 weeks' gestation in order to compare pulmonary artery and aortic outflow diameters, mean and maximal flow velocities, and transvalve flows. For purposes of analysis, fetuses were divided into two groups: those less than 31 weeks, and those of...
Article
With the combined use of two-dimensional ultrasound and Doppler echocardiography, noninvasive examination of the human fetal heart and circulation has recently become possible. These techniques were employed to investigate diastolic atrioventricular valve flow in the fetal heart in 120 fetuses studied between 17 and 42 weeks of gestation. Two-dimen...
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Previous studies of normal human embryonic heart rates showed an increase in the rates between the 7th and 9th gestational weeks; the rates gradually declined thereafter until the 15th week. The present study added new information about embryonic heart rates before the seventh week. The heart rates are slower than those reported to occur after the...
Article
Cardiac Doppler flow velocity studies were performed in normal human fetuses between 18 and 40 weeks of gestation. Two-dimensional linear array and sector scanning techniques were used for the initial evaluation of the fetuses, which included a standard ultrasound examination to determine normal anatomy and estimated gestational age and weight. Fet...
Article
Premature labor and delivery complicated 18% of the pregnancies treated at Arizona Health Sciences Center between January 1981 and June 1984. In the diabetic population in this study, a significantly lower incidence of premature labor and delivery occurred (11%), representing what may be interpreted as a shift in the gestational period toward a mor...
Article
Two siblings with Pena-Shokeir syndrome are described. This syndrome consists of polyhydramnios, intrauterine growth retardation, short umbilical cord, perinatal death, facial abnormalities, limb abnormalities including arthrogryposis, and lethal pulmonary hypoplasia. The mode of inheritance is most likely autosomal recessive. Prenatal diagnosis wa...
Article
Based on the points presented above, we recommend the following referral and flow pattern for the study of fetal heart disease: Identify a high risk group by history. Add patients identified during gestation because of an abnormal pregnancy or abnormal fetus, including arrhythmia.
Article
Ultrasound is widely used in obstetrics as a screening technique for fetal size and maturity, placental structure and function, and for detection of fetal congenital malformations in complicated pregnancies.1-3 Our own work on qualitative and quantitative fetal echocardiography4,5 and the work of others6 has suggested that high resolution ultrasoun...

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