Robert F Porges, M.D.

Safe maternal positioning during labor and delivery
Porges, Robert F
2011 Dec;118(6):1418-1418, Obstetrics & gynecology
— id: 141714, year: 2011, vol: 118, page: 1418, stat: Journal Article,

Factors affecting the introduction of new vaccines to poor nations: a comparative study of the Haemophilus influenzae type B and hepatitis B vaccines
Glatman-Freedman, Aharona; Cohen, Mary-Louise; Nichols, Katherine A; Porges, Robert F; Saludes, Ivy Rayos; Steffens, Kevin; Rodwin, Victor G; Britt, David W
2010 ;5(11):e13802-e13802, PLoS ONE
BACKGROUND: A major effort to introduce new vaccines into poor nations of the world was initiated in recent years with the help of the GAVI alliance. The first vaccines introduced have been the Haemophilus influenzae type B (Hib) and the hepatitis B (Hep B) vaccines. The introduction of these vaccines during the first phase of GAVI's operations demonstrated considerable variability. We set out to study the factors affecting the introduction of these vaccines. The African Region (AFRO), where new vaccines were introduced to a substantial number of countries during the first phase of GAVI's funding, was selected for this study. METHODOLOGY/PRINCIPAL FINDINGS: GAVI-eligible AFRO countries with a population of 0.5 million or more were included in the study. Countries were analyzed and compared for new vaccine introduction, healthcare indicators, financial indicators related to healthcare and country-level Governance Indicators, using One Way ANOVA, correlation analysis and Qualitative Comparative Analysis (QCA). Introduction of new vaccines into AFRO nations was associated primarily with high country-level Governance Indicator scores. The use of individual Governance Indicator scores, as well as a combined Governance Indicator score we developed, demonstrated similar results. CONCLUSIONS/SIGNIFICANCE: Our study results indicate that good country-level governance is an imperative pre-requisite for the successful early introduction of new vaccines into poor African nations. Enhanced support measures may be required to effectively introduce new vaccines to countries with low governance scores. The combined governance score we developed may thus constitute a useful tool for helping philanthropic organizations make decisions regarding the type of support needed by different countries to achieve success
— id: 135203, year: 2010, vol: 5, page: e13802, stat: Journal Article,

Vaginal delivery and serum markers of ischemia/reperfusion injury
Conner, E; Margulies, R; Liu, Mengling; Smilen, S W; Porges, R F; Kwon, C
2006 Aug;94(2):96-102, International journal of gynaecology & obstetrics
Objective: Vaginal deliveries have been associated with pelvic organ prolapse and incontinence. The objective was to show whether markers of ischemia/reperfusion injury are dependent upon the mode of delivery and length of labor. Method: Complete venipuncture sets were obtained on 62 subjects. All samples collected were analyzed for serum creatine phosphokinase (CPK) and lactate dehydrogenase (LDH). Lipid peroxidation was analyzed, using thiobarbituric acid reactive substances (TBARS), on a subset of 37 patients. Results: There was a significant increase in CPK from admission to 1 h postpartum and postpartum day 1 in vaginal delivery versus cesarean delivery. Longer second stages were associated with significant increases in CPK. There were no significant changes in either LDH or TBARS from admission to any other time point regardless of mode of delivery. Conclusion: Vaginal delivery and longer second stages were associated with a much greater increase in one of these injury markers
— id: 67432, year: 2006, vol: 94, page: 96, stat: Journal Article,

The use of a 15-7-MHz 'small parts' linear transducer to evaluate the anal sphincter in female patients
Timor-Tritsch, I E; Monteagudo, A; Porges, R F; Santos, R
2005 Feb;25(2):206-209, Ultrasound in obstetrics & gynecology
— id: 56339, year: 2005, vol: 25, page: 206, stat: Journal Article,

Simple ultrasound evaluation of the anal sphincter in female patients using a transvaginal transducer
Timor-Tritsch, I E; Monteagudo, A; Smilen, S W; Porges, R F; Avizova, E
2005 Feb;25(2):177-183, Ultrasound in obstetrics & gynecology
OBJECTIVE: Fecal incontinence affects 0.2% of women aged 15-64 years and about 1.3% of women over 64 years. Most cases are related to instrumental deliveries affecting the anal sphincter complex. We propose a simple technique using the generally available transvaginal transducer to evaluate the anal sphincter complex. METHODS: Ninety-two patients underwent ultrasound examination. Group I consisted of 53 nulliparous patients. In Group II there were six patients with normal spontaneous vaginal deliveries without episiotomies. In Group III there were 14 patients with vaginal deliveries and one to three episiotomies but no lacerations. In Group IV there were nine postpartum patients with recently repaired (48 h to 3 weeks) third- and fourth-degree lacerations. All women in Groups I-IV were asymptomatic. Group V consisted of 10 patients symptomatic for fecal incontinence. We used a vaginal probe (5-9-MHz) with the footprint placed in the fourchette pointing towards the anus in a transverse and then in a median (sagittal) plane. If seen, the combined internal and external anal sphincter thickness at the 12 o'clock location was measured. We visualized normal star-shaped mucosal folds on the transverse section and described the sonographic anatomy in both planes. RESULTS: The mean sphincter thickness measured at 12 o'clock in Group I was 2.3 (range, 1.0-4.7) mm, in Group II it was 2.9 (range, 2.4-3.4) mm, and in Group III it was 2.3 (range, 1.0-3.7) mm. The differences between these three groups were not significant. Patients from Group IV showed thinning or discontinuous sphincter anatomy at the 12 o'clock position. All symptomatic patients from Group V showed abnormal sphincter anatomy, and the normal star-like appearance of the anal mucosa on the transverse section was deformed, radiating from the point of the sphincter damage. Four of the 10 patients in this group underwent surgical repair. In these patients the sonographic findings were confirmed. CONCLUSIONS: The images obtained using this imaging modality show the sphincter muscle anatomy as well as the possible pathology. Due to its simplicity the technique can be applied in any place where a vaginal transducer is available
— id: 56338, year: 2005, vol: 25, page: 177, stat: Journal Article,

Use of medroxyprogesterone acetate in the treatment of Mullerian adenosarcoma: a case report
Hines, Brian J; Porges, Robert F; Mittal, Kush; Muggia, Franco M; Curtin, John P
2002 Apr;85(1):192-195, Gynecologic oncology
BACKGROUND: Mullerianadenosarcoma is a rare pelvic malignancy that most commonly arises from the endometrium. These tumors are relatively insensitive to chemotherapy and radiation and are primarily treated by surgical resection. We report a case of mullerian adenosarcoma arising outside of the uterus from a background of endometriosis treated with a combination of surgical resection and medroxyprogesterone acetate. CASE: A 43-year-old woman with a history of endometriosis was diagnosed with advanced extrauterine mullerian adenosarcoma. After suboptimal tumor dubulking surgery she was treated with medroxyprogesterone acetate. Ten months postoperatively she remains without evidence of disease. CONCLUSION: Medroxyprogesterone acetate may be a useful drug in the treatment of advanced mullerian adenosarcoma
— id: 36624, year: 2002, vol: 85, page: 192, stat: Journal Article,

The use of transvaginal ultrasound and saline infusion sonohysterography for the evaluation of asymptomatic postmenopausal breast cancer patients on tamoxifen
Schwartz LB; Snyder J; Horan C; Porges RF; Nachtigall LE; Goldstein SR
1998 Jan;11(1):48-53, Ultrasound in obstetrics & gynecology
Tamoxifen has been shown to decrease the recurrence rate of breast cancer. Evidence that tamoxifen use may be associated with an increased risk of endometrial cancer has caused investigators to recommend routine invasive sampling. We have assessed a minimally invasive alternative for endometrial surveillance of tamoxifen-treated patients utilizing transvaginal ultrasound and saline infusion sonohysterography. Asymptomatic women (n = 44) with breast cancer on postoperative tamoxifen treatment were referred to our gynecological ultrasound unit. Initially, the endometrial echo was measured with unenhanced transvaginal ultrasound. If a distinct echo measured < or = 5 mm, no further procedure was performed. For thickened or inadequately visualized echoes, sonohysterography was performed. If a thin echo was noted on sonohysterography, no further procedure was performed. If focal changes were detected, hysteroscopy/dilatation and curettage (D&C) was performed. For generalized symmetrically thickened echoes, a blind biopsy was done. If sonohysterography was unsuccessful, hysteroscopy/D&C was performed. Eleven (25%) patients had thin unenhanced echoes of < or = 5 mm. Twenty-five (57%) patients had thickened endometrial echoes. Three (7%) had naturally occurring endometrial fluid outlining a polyp. An endometrial echo could not be visualized in five (11%) patients. Sonohysterography was successfully performed in 21 out of 30 (70%) patients with either thickened or non-visualized unenhanced echoes. Of these, two patients had thin endometria with coexisting myomas; seven had thin endometria with typical tamoxifen-induced subendometrial changes: and seven had focal polypoid thickening confirmed by hysteroscopy/D&C. Histology revealed carcinoma associated with two, proliferation in one and four polyps. Five patients had thickened unenhanced echoes with symmetrically thickened single-layer measurements on sonohysterography. Histology revealed that three were proliferative, one was inactive and one was hyperplastic. In the nine patients with unsuccessful sonohysterography, hysteroscopy/D&C revealed inactive endometria in six, and three polyps. Our paradigm of evaluating the endometrial response to tamoxifen is concluded to overcome the shortcomings of either unenhanced transvaginal ultrasound or blind biopsy alone while it kept the number of invasive sampling procedures to 55% (24 out of 44)
— id: 7783, year: 1998, vol: 11, page: 48, stat: Journal Article,

The risk of cystocele after sacrospinous ligament fixation
Smilen SW; Saini J; Wallach SJ; Porges RF
1998 Dec;179(6 Pt 1):1465-1471, American journal of obstetrics & gynecology
OBJECTIVE: The aim of this study was to determine whether sacrospinous ligament fixation independently increases the risk of anterior vaginal wall defect. STUDY DESIGN: A retrospective cohort study was conducted on patients undergoing pelvic reconstructive surgical operations by a single surgeon from 1970 through 1997. Two groups were examined and divided into subgroups to evaluate the effects of exposure to sacrospinous ligament fixation: patients with anterior wall defects undergoing standard anterior colporrhaphy with (group 1A) or without (group 1B) concomitant sacrospinous ligament fixation, and patients without anterior wall defects undergoing other pelvic reconstructive procedures (but not anterior colporrhaphy) with (group 2A) or without (group 2B) sacrospinous ligament fixation. Recurrence rates were calculated for each group according to evidence of any degree of anatomic defect. RESULTS: Among 322 patients in group 1, 9 of 77 in group 1A and 23 of 245 in group 1B (11.7% vs 9.4%, P >.05) had anterior wall recurrences. Among 73 patients in group 2, 8 of 45 in group 2A and 5 of 28 in group 2B (17.8% vs 17.9%, P >.05) had subsequent anterior wall defects. CONCLUSION: The occurrence of anterior vaginal wall defects was not found to be altered by the performance of sacrospinous ligament fixation. These findings may be attributable to surgical technique emphasizing maintenance of anterior vaginal wall length during sacrospinous ligament fixation
— id: 7450, year: 1998, vol: 179, page: 1465, stat: Journal Article,

Estrogen and progesterone receptors in the uterosacral ligament
Mokrzycki ML; Mittal K; Smilen SW; Blechman AN; Porges RF; Demopolous RI
1997 Sep;90(3):402-404, Obstetrics & gynecology
OBJECTIVE: To evaluate steroid hormone receptor status in the uterosacral ligament, a structure that contributes to pelvic support. METHODS: A descriptive study was conducted by sampling the uterosacral ligaments from 25 consecutive women undergoing hysterectomy by the primary author for nonmalignant conditions. Using immunohistochemical staining techniques, uterosacral ligaments were assessed for the presence and location of estrogen and progesterone receptors. Positive and negative controls were used. Confirmation of the uterosacral ligament was performed histologically. RESULTS: Using commercially available monoclonal antibodies, estrogen and progesterone receptors were detected in the nuclei of smooth muscle cells of the uterosacral ligament in all patients, regardless of variations in age, race, menopausal status, parity, body mass index, and medications affecting serum steroid hormone levels. Hormone receptors were not found in the collagen, vascular, or neuronal components. CONCLUSION: The presence of estrogen and progesterone receptors in the uterosacral ligaments means that this structure may be a target for estrogen and progesterone. This finding might suggest a possible role for steroid hormones in pelvic support
— id: 56972, year: 1997, vol: 90, page: 402, stat: Journal Article,

Estrogen and progesterone receptors in the uterosacral ligament
Mokrzycki, M; Mittal, K; Smilen, S; Blechman, A; Porges, R; Demopoulos, R
1997 ;76(Suppl 1):610-610, Laboratory investigation
— id: 53324, year: 1997, vol: 76, page: 610, stat: Journal Article,

Alternative techniques of hysterectomy
Porges RF
1997 Jan 23;336(4):290-290, New England journal of medicine
— id: 36952, year: 1997, vol: 336, page: 290, stat: Journal Article,

A user-friendly, time-efficient form for eliciting pertinent information from perimenopausal and menopausal women
Schwartz LB; Mark M; DeCresce M; Porges R; Nachtigall LE
1995 ;2(3):104-106, Primary care update for ob/gyns
— id: 8108, year: 1995, vol: 2, page: 104, stat: Journal Article,

Long-term analysis of the surgical management of pelvic support defects
Porges RF; Smilen SW
1994 Dec;171(6):1518-1526, American journal of obstetrics & gynecology
OBJECTIVE: The aim of this study was to determine the success of various procedures to correct defects of pelvic support and to elucidate the role of sacrospinous ligament fixation in primary versus nonprimary vaginal operations. STUDY DESIGN: This study was a retrospective analysis, covering 23 years, of 486 patients treated for pelvic support defects, grouped according to the location and severity of the defect, type of repair, and outcome. RESULTS: For primary repairs the recurrences were more frequent the more severe the defect, but this relationship did not hold for repeat surgery. Sacrospinous ligament fixation, when performed concurrently with vaginal hysterectomy for patients with third-degree prolapse in primary cases reduced the rate of recurrence from 15.8% to 6.7%. CONCLUSION: The original degree and type of pelvic support defect is important in selecting the appropriate operative procedure for the highest likelihood of cure. There may be a wider role for sacrospinous ligament fixation in primary operations for patients with severe defects
— id: 11476, year: 1994, vol: 171, page: 1518, stat: Journal Article,

Primary cervical choriocarcinoma: case report and review of the literature
Herts BR; Yee JM; Porges RF
1993 Jan;12(1):59-62, Journal of ultrasound in medicine
— id: 13289, year: 1993, vol: 12, page: 59, stat: Journal Article,

Incarcerated uterine prolapse associated with a cul-de-sac abscess
Molinelli EA; Porges RF
1993 Oct;82(4 Pt 2 Suppl):664-666, Obstetrics & gynecology
BACKGROUND: Incarceration is a rare complication of uterine prolapse and is usually associated with bladder calculi. We report a case of uterine incarceration associated with an abscess in the cul-de-sac. CASE: A 64-year-old woman presented with complaints of vaginal prolapse. Pelvic examination on admission revealed an edematous, prolapsed uterus and eversion of the vagina. The bladder was catheterized, and subsequent attempts to reduce the prolapse were unsuccessful. Conservative treatments were initiated including Trendelenburg positioning, estrogen cream, and moist soaks. Failure to reduce the prolapse under general anesthesia necessitated a vaginal hysterectomy and anteroposterior repair. When the cul-de-sac was entered, there was purulent material draining from an abscess behind the uterus. Postoperatively, the patient received antibiotics for 3 days and was sent home on day 4. CONCLUSIONS: Irreducible uterine prolapse is a rare condition and may be attributed to a narrowed introitus, bladder calculi, or pelvic abscesses. Historically, conservative management has attempted to alleviate the edema and restore the prolapse, to allow definitive surgery at a later date. We believe that the pelvic abscess in our case exemplifies a danger of delaying surgery. We recommended that when the patient is in stable condition, a hysterectomy and plastic repair be performed promptly
— id: 13064, year: 1993, vol: 82, page: 664, stat: Journal Article,

Neonatal genital prolapse
Porges RF
1993 Apr;91(4):853-854, Pediatrics
— id: 36953, year: 1993, vol: 91, page: 853, stat: Journal Article,

Consolidation with intraperitoneal cisplatin in first-line therapy of advanced ovarian cancer
Beller U; Speyer J; Colombo N; Sorich J; Wernz J; Hochster H; Zeleniuch-Jacquotte A; Porges R; Beckman EM
1991 May;9(5):809-817, Journal of clinical oncology
Seventy-five patients with advanced epithelial ovarian cancer were treated with a combined modality regimen of systemic, induction chemotherapy followed by intraperitoneal therapy (IPT). All patients underwent initial surgery for staging and/or cytoreduction followed by cisplatin 20 mg/m2 intravenously (IV) for 5 days and cyclophosphamide 600 mg/m2 on day 4 every 3 to 4 weeks for two to four cycles. Patients were then evaluated for IPT and, if eligible, had an intraperitoneal (IP) catheter placed. IPT consisted of cisplatin 60 mg/m2 in 2 L on day 1 and IV cyclophosphamide 600 mg/m2 on day 2 every 3 weeks for three to six cycles. Patients who demonstrated a clinical complete response (CCR) were then referred for second-look laparotomy (SLL). Of 71 patients who completed the induction phase, 53 (75%) were eligible for IPT, and 49 patients entered the therapy phase. Toxicity of the combined modality approach was acceptable and did not differ from our previous experience using the same drugs systemically. Thirty-two of the 49 patients who completed IPT achieved a CCR, which was confirmed by SLL in 20 patients. Twenty recurrences were documented in the 32 CCR patients, 13 occurred in patients after SLL. Projected median survival of all patients is 38 months. Median survival correlated with amount of residual disease following initial surgery (23 months for bulky v 45 months for minimal residual; P less than .001) and with performance status ([PS]; 24 months for PS 2, 3 v greater than 46 months for PS O; P less than .001). Patients who presented with bulky tumors were less likely to reach the consolidation IPT phase. Incorporation of IP cisplatin into the first-line regimen for treatment of ovarian cancer does not appear to have major impact on the survival of all treated patients when compared with our historical control series. Combined IV and IPT cisplatin and cyclophosphamide is feasible with acceptable toxicity. Its impact on response and survival may be limited to only 'good-prognosis' patients
— id: 14031, year: 1991, vol: 9, page: 809, stat: Journal Article,

Recurrent ovarian theca granulosa cell tumor presenting as bladder neoplasm
Gluck R; Porges R; Brown J
1991 May;37(5):473-474, Urology
— id: 14050, year: 1991, vol: 37, page: 473, stat: Journal Article,

Intraperitoneal carboplatin: favorable results in women with minimal residual ovarian cancer after cisplatin therapy
Speyer JL; Beller U; Colombo N; Sorich J; Wernz JC; Hochster H; Green M; Porges R; Muggia FM; Canetta R; et al
1990 Aug;8(8):1335-1341, Journal of clinical oncology
From August 1985 to November 1989 we conducted a trial of intraperitoneal (IP) carboplatin including a dose-escalation design in 25 women with advanced gynecologic malignancies. All had extensive prior therapy with cisplatin (median cumulative dose, 525 mg/m2). Carboplatin was administered IP in 2 L of 1.5% dextrose with a 4-hour dwell time every 4 weeks for six cycles at a starting dose of 200 mg/m2. Patients with reduced creatinine clearance (30 to 60 cc/min) were escalated more slowly than those with high (greater than 60 cc/min) clearance. Thrombocytopenia was dose-limiting and often more severe in patients with compromised renal function; there was no local drug toxicity. The median time of follow-up is 25 months. Complete responses (CRs) were documented in six of 23 assessable patients (26%) by repeat laparotomy, and an additional 11 patients (48%) had no disease evident by noninvasive restaging. Five of the CRs and six of the patients with no clinically evident disease have relapsed from 3 to 40 months after therapy. Six patients (26%) are alive and free of disease 8 to 47 (median, 20) months after therapy. IP carboplatin is effective against relapsed ovarian cancer, even after prior cisplatin therapy
— id: 15691, year: 1990, vol: 8, page: 1335, stat: Journal Article,

THROMBOCYTOPENIA DURING PREGNANCY
Hart, D; Nardi, M; Porges, RF; Karpatkin, M
1988 Dec 1;319(22):1483-1483, New England journal of medicine
— id: 31432, year: 1988, vol: 319, page: 1483, stat: Journal Article,

Neonatal recognition of familial dysautonomia
Axelrod FB; Porges RF; Sein ME
1987 Jun;110(6):946-948, Journal of pediatrics
— id: 36954, year: 1987, vol: 110, page: 946, stat: Journal Article,

An epidemic of maternal thrombocytopenia associated with elevated antiplatelet antibody. Platelet count and antiplatelet antibody in 116 consecutive pregnancies: relationship to neonatal platelet count
Hart D; Dunetz C; Nardi M; Porges RF; Weiss A; Karpatkin M
1986 Apr;154(4):878-883, American journal of obstetrics & gynecology
Twenty-eight (24%) of 116 pregnant women studied prospectively during an 8-month period in 1983 had platelet counts of less than 150,000/mm3 at least once during pregnancy. Thirteen of these were thrombocytopenic in both the prenatal and the peripartum period. Eighteen were restudied 3 to 12 months after delivery. One woman, who was pregnant again, had a platelet count of 140,000/mm3. In the others, platelet counts were in the normal range. Platelet-associated immunoglobulin G and serum antiplatelet antibody levels were elevated in 79% and 61%, respectively, of these 28 women on at least one occasion. However, 59% of 73 pregnant nonthrombocytopenic women had increased platelet-associated immunoglobulin G levels and 59% had positive serum antiplatelet antibody test results. Twenty women who had increased platelet-associated immunoglobulin G levels and positive serum antiplatelet antibody test results were normal 6 to 10 months after delivery. Of 105 infants studied, 10 were thrombocytopenic. Neonatal thrombocytopenia was not predicted by maternal platelet count, platelet-associated immunoglobulin G, or serum antiplatelet antibody. By the fall of 1984, the incidence of thrombocytopenia had dropped to two in 280 consecutive pregnancies. We conclude that (1) epidemics of thrombocytopenia can occur in pregnant women and (2) if a women is found to be thrombocytopenic for the first time during pregnancy, she should not be subjected to the measures advocated for the management of pregnancy in women with autoimmune thrombocytopenic purpura
— id: 34976, year: 1986, vol: 154, page: 878, stat: Journal Article,

The response of the New York Obstetrical Society to the report by the New York Academy of Medicine on maternal mortality, 1933-1934
Porges RF
1985 Jul 15;152(6 Pt 1):642-649, American journal of obstetrics & gynecology
— id: 36955, year: 1985, vol: 152, page: 642, stat: Journal Article,

STEROID-ADMINISTRATION IN PREGNANT-WOMEN WITH AUTOIMMUNE THROMBOCYTOPENIA - REPLY
Karpatkin, M; Porges, RF; Karpatkin, S
1982 ;306(12):745-745, New England journal of medicine
— id: 30487, year: 1982, vol: 306, page: 745, stat: Journal Article,

Platelet counts in infants of women with autoimmune thrombocytopenia: effects of steroid administration to the mother
Karpatkin M; Porges RF; Karpatkin S
1981 Oct 15;305(16):936-939, New England journal of medicine
— id: 14948, year: 1981, vol: 305, page: 936, stat: Journal Article,

SURGICAL CLIPS IN ABDOMINAL HYSTERECTOMY
PORGES, RF; DUNETZ, C
1981 ;246(10):1131-1132, JAMA
— id: 40195, year: 1981, vol: 246, page: 1131, stat: Journal Article,

Accessory cervix: an unusual congenital malformation
Quagliarello, J; Porges, R; Weiss, G
1981 Oct;19(5):389-393, International journal of gynaecology & obstetrics
A woman with a septate vagina and two cervices was observed. One of the cervices ended blindly. The other cervix communicated with a normal corpus and two normally positioned patent fallopian tubes. Two explanations for the origin of this accessory cervix are offered: (1) that it originated from a fusion failure of the lower portions of the mullerian ducts, and (2) that it arose from the urogenital sinus
— id: 105263, year: 1981, vol: 19, page: 389, stat: Journal Article,

Changing indications for vaginal hysterectomy
Porges RF
1980 Jan 15;136(2):153-158, American journal of obstetrics & gynecology
The recent history of vaginal hysterectomy in America is summarized to bring current trends into focus. A series of 252 vaginal hysterectomies is analyzed. The discussion deals with factors contributing to morbidity, the relative advantages of various techniques, and the recognition and management of complications
— id: 36956, year: 1980, vol: 136, page: 153, stat: Journal Article,

Use of Kegel perineometer to measure levator muscle tone
Porges RF
1979 Sep 1;135(1):164-164, American journal of obstetrics & gynecology
— id: 36957, year: 1979, vol: 135, page: 164, stat: Journal Article,

Pregnancy in familial dysautonomia
Porges RF; Axelrod FB; Richards M
1978 Nov 1;132(5):485-488, American journal of obstetrics & gynecology
This report describes the first two known instances of viable pregnancies in two patients with familial dysautonomia (Riley-Day syndrome). The offspring were apparently normal. Several conditions, specifically related to autonomic and sensory dysfunction in pregnancy, are discussed
— id: 36958, year: 1978, vol: 132, page: 485, stat: Journal Article,

DIAGNOSTIC VACUUM ASPIRATION CURETTAGE - EVALUATION IN OFFICE PRACTICE
WEINSTEIN, H; SHENKER, L; PORGES, RF
1977 ;77(3):373-376, New York state journal of medicine
— id: 39992, year: 1977, vol: 77, page: 373, stat: Journal Article,

Breech presentation among infants with familial dysautonomia
Axelrod FB; Leistner HL; Porges RF
1974 Jan;84(1):107-109, Journal of pediatrics
— id: 36951, year: 1974, vol: 84, page: 107, stat: Journal Article,

Indications for hysterectomy and for oophorectomy in various adult age groups - in audit
Porges RF
1974 February 4;227(5):568-569, JAMA
PIP: Hysterectomy is indicated for specific diseases of the uterus and for sterilization. Now that modern methods of contraception are available and abortion laws have been liberalized it should be possible in many instances to avoid sterilization procedures. Oophorectomy is indicated in the presence of ovarian disease, for castration in selected patients with carcinoma of the breast, and as prophylaxis against the potential development of carcinoma of the ovary. Incidental oophorectomy at the time of pelvic surgery generally should be reserved for women in their 40s in whom the anticipated functional lifetime of the ovary is less than 5-10 years and who may receive supplemental exogenous hormones. The operative risk of hysterectomy is greater than for tubal ligations, but comparisons usually fail to consider the risk of the disease for which the hysterectomy is performed. Generally, women in their 20s who wish only sterilization should be able to retain their uteri. A careful history should be taken and a physical examination given in order to eliminate the possibility of pelvic abnorm alities such as fibroids, adenomyosis, endometriosis, and dysplasia that may necessitate a future hysterectomy. O
— id: 36950, year: 1974, vol: 227, page: 568, stat: Journal Article,

Letter: Ectopic pregnancy and the intrauterine contraceptive device
Porges RF
1974 Apr 15;118(8):1115-1115, American journal of obstetrics & gynecology
— id: 36959, year: 1974, vol: 118, page: 1115, stat: Journal Article,

Streptococcal peritonitis in a patient with Hodgkin's disease and an intrauterine contraceptive device
Culliford AT; Harris MN; Porges RF; Berczeller PH; Amorosi EL; Grier WR
1973 Sep 15;117(2):288-290, American journal of obstetrics & gynecology
— id: 28953, year: 1973, vol: 117, page: 288, stat: Journal Article,

Complications associated with the unsuspected presence of intrauterine contraceptive devices
Porges RF
1973 Jun 15;116(4):579-580, American journal of obstetrics & gynecology
PIP: This paper presents three case reports of women whose gynecologic difficulties centered around the unsuspected presence of an IUD. A 42-year-old black woman complained of menorrhagia of 1-year duration following IUD insertion at the local Planned Parenthood Clinic. She also had fibroid tumors of 10-years duration. Examination revealed no loop thread. A uterine sound detected an IUD in place. X-ray showed both a plastic and a metallic IUD in the uterus. Under general anesthesia a Saf-T-coil and Majzlin spring were removed. Her menarrhagia continued and back pain developed. X-ray showed another IUD present. A Lippes loop, size D, was removed and symptoms subsided. Review of her history revealed that she had returned to the Planned Parenthood clinic on 2 occasions where it was assumed the previously inserted IUD had been expelled and without x-ray confirmation another and different device was inserted. A 35-year-old woman, para 1-0- 3-1, complained of infertility of 18 months. She had become pregnant 5 years previously while using a Birnberg bow. After abortion she had used oral contraceptives until 18 months previously. Hysterosalpingogram revealed a Birnberg bow in the uterus. After removal, pregnancy promptly followed. It is believed the Birnberg loop had not been removed at the time of abortion or had been replaced while the patient was under general anesthesia without informing her. A 26-year-old woman complained of infertility for 8-9 months. An abortion had been performed 4 years previously. Later she had used an IUD and then foam contraceptives. A metallic IUD in the uterine cavity was shown by hysterosalpingography, A Hall-Stone ring was deeply imbedded in the uterine wall and removed with difficulty. Her physician stated he had inserted a Hall-Stone ring after the abortion 4 years previously and later was unable to confirm its presence with a uterine probe. He therefore inserted another similar device. No x-rays were taken. He removed 1 device later. It is thought a communication gap may accur between the patient and the physician after an IUD is inserted during general anesthesia or while the patient has amnesia from analgesics. The hysician may assume an IUD has been expelled when no thread is visible at the cervix. Insertion of a probe into the uterus is an unreliable method of detecting an IUD. X-ray confirmation is needed. A hysterogram may be required for exact localization. O
— id: 36960, year: 1973, vol: 116, page: 579, stat: Journal Article,

Carcinoma of the urachus. A case report and review
Rubell D; Porges RF
1972 May;39(5):753-755, Obstetrics & gynecology
— id: 36961, year: 1972, vol: 39, page: 753, stat: Journal Article,

Acute retrograde menstruation: report of a case
Porges RF
1970 Apr;35(4):524-526, Obstetrics & gynecology
— id: 36962, year: 1970, vol: 35, page: 524, stat: Journal Article,

Vaginal hysterectomy at Bellevue Hospital. An experience in teaching residents, 1963-67
Porges RF
1970 Feb;35(2):300-313, Obstetrics & gynecology
— id: 36963, year: 1970, vol: 35, page: 300, stat: Journal Article,

SCIPP line: levator ani
Porges RF
1969 Dec;34(6):898-899, Obstetrics & gynecology
— id: 36964, year: 1969, vol: 34, page: 898, stat: Journal Article,

Blood coagulation and fibrinolytic enzyme studies during cyclic and continuous application of progestational agents
Beller FK; Porges RF
1967 Feb 15;97(4):448-459, American journal of obstetrics & gynecology
— id: 36966, year: 1967, vol: 97, page: 448, stat: Journal Article,

Theoretical and practical aspects of the surgical correction of pelvic relaxation
Porges RF; Porges JC
1967 Mar;29(3):450-455, Obstetrics & gynecology
— id: 36965, year: 1967, vol: 29, page: 450, stat: Journal Article,