摘要:

In 13 patients, episodes of transient fetal cardiac arrest were observed in a group of 594 extensively monitored labors during a given 3-year period. The number of episodes per patient ranged from one to six, with a maximal duration of cardiac arrest (R-R interval) being 5.2 seconds. All of the patients responded to changing maternal position or termination of pregnancy except 1. This patient received Atropine as a premedication for cesarean section. The parasympatholytic properties of Atropine minimized the severity of cardiac arrest. The effect of cardiac arrest on fetuses is not clearly shown in these preliminary observations. The prompt elimination of cardiac arrest is thought to be imperative in reducing perinatal loss. Cardiac arrest is thought to be an extensive form of severe variable deceleration. The hypothesis is made that these fetuses had an unbalanced autonomic nervous system and/or an overwhelming vagal tone. If these signs are detected early by fetal monitoring, attention should be paid to the possibility of cardiac arrest.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

An analysis of fetal heart rate patterns preceding death is presented in 7 patients. The intrapartum deaths were not predictable on the basis of clinical evaluation. Predeath recording time varied from 11 minutes to 7.75 hours. An atypical deceleration pattern was observed in 3 patients terminally with associated loss of beat-to-beat variability. These occurred with uterine contractions, hut had the characteristic appearance of variable decelerations (CC). This pattern was characterized by short contraction to deceleration intervals, and by large drops in the rate (62-102 beats/min). In 6 of the 7 patients, there was either absent (0-5 beats/min) or diminished (5-10 beats/min) beat-to-beat variability. In 1 the terminal recording showed an absolutely fixed rate with a progressive loss of beats and an increased amount of electrical noise.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

The pathogenesis of perinatal death due to placental infarction was analyzed in a large prospective study that included more than 1000 medical, demographic, hereditary, and postmortem variables. The disorder was the fifth most frequent cause of death in the study with a perinatal mortality of 2.26/1000 births. Its frequency was directly correlated with the gravidas' blood pressures, an effect augmented by albuminuria and work during pregnancy. Fatal infarcts were increased 20-fold with glomerulonephritis, fivefold with abruptio placentae, and twofold when the gravidas' hemoglobins were over 12 g/100 ml. Maternal weight gains were suboptimal and the involved neonates had a pattern of growth retardation characteristic of undernutrition. The disorder was more frequent when the gravida had made few prenatal visits for medical care and had had prior unsuccessful pregnancies.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

In a prospective study, a small team of obstetricians concurrently performed midtrimester amniocentesis for prenatal genetic diagnosis on 32 patients after ultrasonic placental localization and on SO patients without prior ultrasound. The use of ultrasound did not affect the red cell count in the fluid samples. Furthermore, the 2 patient groups had similar rates of grossly bloody taps. The average number of viable clones after culture was lower both after bloody taps and when ultrasound had been used, hut in neither case was the difference significant. There were no postamniocentesis complications in the entire patient population. These results suggest that ultrasonic placental localization is not helpful in avoiding bloody taps, and that bloody taps may not necessarily be dangerous. Therefore, since the long-range hazards ofin uteroexposure to ultrasound may not yet be known, it would seem judicious to use preamniocentesis ultrasound selectively and on specific indication, rather than routinely.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

An 11-year study from January 1, 1965, through December 31, 1975, was undertaken to study maternal death associated with cesarean section in Rhode Island. The risk of maternal death associated with cesarean section and that for vaginal delivery was calculated, and it was found that the risk of death from cesarean section was 26 times greater than with vaginal delivery. The expanding indications for cesarean section, factors associated with excess risk of death from cesarean section, and suggestions to prevent such catastrophe are discussed.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

During phenylephrine-induced hypertension in 6 near-term pregnant ewes, nitroprusside rapidly lowered the blood pressure to control values with no accompanying change in uterine blood flow. Hydralazine slowly lowered the blood pressure to control values. This change was accompanied by a statistically significant (15%) increase in uterine blood flow. Hydralazine also had a more pronounced effect than nitroprusside on cardiac output (?), heart rate (?), and total peripheral resistance (?). There were no significant acid-base changes in mother or fetus throughout the study.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

The cardiovascular and uterine hemodynamic effects of terbutaline, a beta-adrenergic receptor stimulant and labor inhibiting agent, were evaluated in the chronically instrumented, near-term pregnant ewe. The administration of terbutaline in the dose range required for labor inhibition in this species resulted in a mild maternal tachycardia and increase in pulse pressure without significant changes in uterine blood flow; uterine vascular resistance; or systolic, diastolic, or mean blood pressures. With infusion rates of terbutaline in excess of those required for labor inhibition, significant increases in maternal heart rate, pulse pressure, and systolic blood pressure were observed. Diastolic blood pressure decreased significantly during the higher infusion rates; however, uterine blood flow was unaffected. The minimal cardiovascular and uterine hemodynamic effects noted with the administration of terbutaline in the dose range. necessary for labor inhibition indicate that this agent may possess advantages over several others currently in use for the treatment of premature labor.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

In an attempt to improve the success of a previous study of the prevention of neonatal hyperbilirubinemia employing phenobarbital in a single 30-mg nightly dose from 32 weeks' gestation until delivery, 246 patients were tested against 270 control subjects. A 39% reduction in significant hyperbilirubinemia was realized but this fell far short of previous findings with a larger dose. Premature infants received no apparent protection against jaundice. Mature infants had no severe jaundice (more than 16 mg/100 ml) and the resolution of hyperbilirubinemia was more rapid. No apparent difference in drowsiness or daytime sedation from previous experience was found. Female newborns responded much better (3:1) to prophylaxis. These disappointing results favor a return to the 1-g daily divided dose.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

In experiments performed in anesthetized monkeys in the third trimester of pregnancy, mean maternal arterial blood pressure was continuously monitored, the uterine artery blood flow was measured with an electromagnetic flow probe, and prostaglandin levels were assayed in the uterine venous effluent. After inhibition of prostaglandin synthesis with indomethacin, the mean arterial blood pressure in response to angiotensin II was greater than the response prior to indomethacin treatment, and an increase in uterine artery blood flow was prevented. These findings are consistent with the suggestion that prostaglandins mediate the uterine artery blood flow response to angiotensin II, as well as modifying the maternal systemic blood pressure response.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

One hundred thirty-one nulliparous patients between 28 to 34 weeks' gestation with no known history of renal disease or hypertension were placed in the left lateral recumbent position, and their blood pressures were taken once and recorded. They then turned to the supine position where another blood pressure was taken within 2 minutes and also recorded. All these patients were then followed routinely through their pregnancy, labor, delivery, and postpartum period. Of those patients whose diastolic blood pressure during the modified “roll-over” test rose less than IS mmHg, only 2 of 99 developed pregnancy-induced hypertension (PIH). Of those whose roll-over test showed an increase of more than 15 mmHg, 23 of 32 developed PIH (P<.000000001). Of those whose blood pressure during the roll-over test increased greater than or equal to 20 mmHg, 19 of 25 developed PIH (P<.00000001). Also, 10 of 11 patients whose diastolic blood pressure increased more than 25 mmHg during the roll-over test developed PIH (P<.000000001).

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID