Search PubMed⌕ Search

Biomedical subjects

A Huch

Publications and source records attributed to A Huch.

At least 73 records · Page 4Linked to original sources
PubMed1995

rhEPO treatment of postpartum anemia.

Postpartum hemorrhage is a continuing problem occurring in 5-10% of all deliveries. Due to recent problems with blood transfusion, heterologous blood is nowadays restricted to life-threatening indications. As a consequence the clinician is faced with many patients suffering from overt symptoms of anemia. We therefore investigated the effect of recombinant human erythropoietin (rhEPO) in combination with adequate iron supplementation as an alternative for blood transfusion in postpartum anemia. In a pilot study we could show that rhEPO can enhance the effect of endogenous erythropoietin on erythropoiesis. These data could be confirmed in a larger randomized trial. In another study we could show that rhEPO given s.c. is as effective as i.v. Measurement of the iron stores, however, demonstrated low values at the end of pregnancy indicating that iron is a limiting factor for erythropoiesis in postpartum anemia. In a next study i.v. iron combined with rhEPO showed a greater increase in Hb compared to i.v. iron alone. The chosen dose of i.v. iron, however, was too small as shown by the low ferritin levels. We concluded from these previous studies that rhEPO enhances endogenous erythropoiesis, but so far the effect was only slight (ca 1 g/dl within 14 days); all treated patients developed overt iron deficiency in terms of low ferritin levels despite oral and i.v. iron supplementation; no major side-effects were seen. A further study in healthy non pregnant volunteers demonstrated an effect on erythropoiesis lasting for 3-4 days after a single dose of 300 U/kg rhEPO.(ABSTRACT TRUNCATED AT 250 WORDS)

Anemia↗
PubMed1995

Erythropoiesis in the postpartum period.

The puerperium is a time of immense physiological changes for the female organism. Erythropoiesis plays one of the central roles in these processes. The aim of this investigation was to describe physiological erythropoiesis in healthy women during the puerperium. Blood samples were taken just before delivery and on days 1, 2, 3, 4 and 14 postpartum. In addition to the usual parameters such as hemoglobin, hematocrit, platelets, leucocytes, ferritin, CRP, endogenous erythropoietin, etc., the absolute and the percentage reticulocyte counts-both the total and for the subpopulations-were determined by flow cytometry. The mean Hb values decreased in the first 24 hours postpartum by 0.8 g/dl and then rose to 0.2 g/dl more than the initial value on day 14. The reticulocytes reflected erythropoietic stimulation with an increase from day 0 to day 1 of 2.1% (79.1 x 10(9)/1) and a continual decrease thereafter. The hematological parameters followed a characteristic course in the puerperium. For the reticulocytes and the subpopulations, a definite erythropoietic stimulation was evident even before delivery, as was an increase in the erythropoietic activity in the early puerperium.

Adult↗
PubMed1995

Recombinant human erythropoietin and parenteral iron in the treatment of pregnancy anemia: a pilot study.

Our aim was to correct severe iron deficiency anemia during pregnancy by using a combination therapy of recombinant human erythropoietin and parenteral iron. Eleven anemic pregnant women were treated once weekly until a hemoglobin value of 11.0 g/dl was reached. Red blood cell production was monitored by reticulocyte flow cytometry and hemoglobin increase. Iron status was assessed by serum ferritin values and transferrin saturation values. 8/11 patients showed an immediate response, noted by a continuous increase of reticulocytes, high fluorescent reticulocyte ratio and hemoglobin levels. Three patients who had lower serum ferritin values, low transferrin saturation and a lower reticulocyte count before treatment showed little response. The combination of rhEPO and parenteral iron is effective in stimulating erythropoiesis and in treating certain pregnancy anemias. This therapy could be an alternative for patients refusing blood transfusions or who are resistant to iron alone. Poor response to the treatment can be due to insufficient iron supplementation during therapy with rhEPO or due to factors that inhibit erythropoiesis during pregnancy, such as undetected infections.

Anemia↗
PubMed1995

Does recombinant human erythropoietin not only treat anemia but reduce postpartum (emotional) distress as well?

Based on the established rhEPO treatment of anemia in endstage renal failure, which results in improved quality of life, and on the clinical observation that patients with postpartum anemia treated with rhEPO seemed to gain a more stable mood, we inferred that there is a beneficial side-effect of rhEPO on postpartum blues. The aim of this study was to test the hypotheses 1) that postpartum anemia aggravates, and 2) that treatment of postpartum anemia with rhEPO reduces maternity blues. The results show that on the fifth day postpartum anemic patients score consistently worse than nonanemic women on the Symptom Checklist SCL-90-R, indicating more symptoms and distress in general, and also more symptoms characteristic of maternity blues (p < 0.05). On a "Blues Questionnaire," postpartum anemia expresses itself with a reduced "well-being" (p < 0.001). Thus, our first hypothesis was verified. There were no differences by the fifth day postpartum between anemic patients receiving either rhEPO or placebo. Our second hypothesis was thus not confirmed within this limited time. We conclude as clinicians that postpartum anemia should be treated effectively to reduce distress and hence the risk for postpartum affective disorders. Follow-up studies after rhEPO treatment beyond the first week post partum are needed. In addition, in investigations on postpartum affective disorders, the hemoglobin concentration should be considered.

Anemia↗
PubMed1995

Pharmacokinetics of fenoterol in pregnant women.

The beta 2-sympathomimetic drug fenoterol (fenoterol hydrobromide, CAS 1944-12-3, Partusisten) is routinely used to inhibit uterine contractions (tocolysis). Investigations of plasma concentrations of those receiving i.v. or oral tocolysis often show different results, both within particular groups of pregnant women and in comparison with non-pregnant persons. The aim of this study was to determine the pharmacokinetics of fenoterol in pregnant women, an important factor which so far had not been known. Four healthy pregnant women with similar weight and gestational age and all with premature labor were administered a continuous intravenous infusion of 4 micrograms fenoterol/min. During and up to 24 hours after the end of the infusion, venous blood samples were taken in order to determine the fenoterol plasma concentrations by radioimmunoassay. From a steady state concentration (css) of 2242 +/- 391 pg/ml (x +/- S.E.), a non-linear two-phased plasma elimination was seen with half-lives t1/2 of 11.40 min and 4.87 h. The area under the plasma concentration-time curve (AUC0-12h) was 6.27 ng/ml x h. The total clearance (Cltot) was 114.8 l/h. These data are nearly the same as the data already known for healthy non-pregnant (male) volunteers. The deviations which are seen in the plasma concentrations in pregnant women in comparison to non-pregnant persons during or after continuous i.v. infusion can therefore not be caused by differences in the pharmacokinetics. Other factors, however, such as body weight and/or gestational age, might influence the results.

Adult↗
PubMed1994

Guidelines for blood sampling and measurement of pH and blood gas values in obstetrics. Based upon a workshop held in Zurich, Switzerland, March 19, 1993 by an Ad Hoc Committee.

Guidelines for the clinical indications for measuring pH and blood gas values in fetal blood, the procedures of blood sampling and measurement and some reference values for the evaluation of the data are given. They cover: prenatal sampling of blood from the umbilical vessels in conjunction with cordocentesis, intra partum sampling of fetal capillary blood by skin puncture of the presenting part, post partum sampling of blood from a clamped section of the umbilical cord and general analytical techniques.

Blood Gas Analysis↗
PubMed1994

[Comparative study of the lower uterine segment after Cesarean section using ultrasound and magnetic resonance tomography].

To determine whether ultrasound (US) or magnetic resonance imaging (MRI) gave more accurate and objective information about the thickness and continuity of scarred isthmical myometrium following previous Caesarean section (CS), US and MRI assessments of the scarred myometrium in 10 pregnant women (37-41 weeks gestation) after 1-8 CS were compared with each other and with findings at subsequent elective CS. Vaginal ultrasound gave more accurate information about the condition of the scarred isthmical myometrium than MRI, since US always allowed precise differentiation of isthmical myometrium from the urinary bladder wall and thus measurements of the scar thickness; there was a good correlation to intraoperative observations. MRI achieved better contrast resolution with T2- than T1-weighted and proton density-weighted spin-echo sequences. However, differentiation of the various tissues was either impossible (T1- and protondensity-weighted sequences) or less informative than with US. Image quality of body and posterior wall of the uterus was better with MRI (T2-weighted sequence) than with US.

Adult↗
PubMed1994

[Plasma and myometrium electrolyte changes in the last trimester of pregnancy].

It is well known, that magnesium can positively influence preterm labour and that the magnesium level in the plasma is significantly lowered whereby magnesium excretion increases during pregnancy. These results lead to the question, whether the magnesium content in the myometrium is also reduced during pregnancy and whether blood parameters correlate with the concentration of magnesium in the myometrium. Myometrial tissues and blood samples from 127 patients, who underwent a Caesarean section, were analysed for magnesium, calcium, sodium and potassium. Erythrocytes, haemoglobin, haematocrit and the hormones oestradiol, oestriol and progesterone were analysed in the serum. We found a decrease in magnesium in the myometrium (p < 0.01) and in the plasma (p < 0.05) during pregnancy. Magnesium in the plasma correlates with magnesium in the myometrium (p < 0.001). These results indicate, that hypomagnesinaemia during pregnancy decreases the magnesium level in the myometrium.

Cesarean Section↗
PubMed1994

Changes in sleep and sleep electroencephalogram during pregnancy.

The impairment of sleep quality is a common complaint during pregnancy. To investigate the changes in sleep in the course of pregnancy, the sleep electroencephalogram (EEG) was recorded and analyzed in nine healthy women on 2 consecutive nights during each trimester of pregnancy. Waking after sleep onset increased from the second (TR2) to the third (TR3) trimester, whereas rapid eye movement (REM) sleep decreased from the first trimester (TR1) to TR2. Spectral analysis of the EEG in nonrapid eye movement (NREM) sleep revealed a progressive reduction of power density in the course of pregnancy. In comparison to TR1, the values in TR2 were significantly lower in the 10.25-11.0-Hz and 14.25-17.0-Hz bands. In TR3, the significant reduction extended over the ranges of 1.25-12.0 Hz and 13.25-16.0 Hz. The largest decrease (30%) occurred in the 14.25-15.0-Hz band. In REM sleep, the spindle frequency range was not affected, and a minor reduction of power density in some frequency bins below 12 Hz was present only in TR3. The study documents major alterations of the sleep EEG that are not evident from the sleep scores and that may be associated with the characteristic hormonal changes occurring during pregnancy.

Adult↗
PubMed1994

rh-erythropoietin stimulates immature reticulocyte release in man.

The pharmacodynamics of single intravenous dosing with recombinant human erthropoietin (rhEPO) was investigated in eight healthy volunteers (150 U/kg, n = 2; 300 U/kg, n = 6) with respect to reticulocyte subdivisions (by fluorescence flow cytometry) and serum ferritin over 6.5 d. The present study shows that bolus rhEPO injection produces an immediate release of high and middle fluorescence (immature) reticulocytes with a high RNA content from the marrow into the circulation, whereas the low fluorescence (more mature) reticulocytes were at first not affected. Serum ferritin decreased markedly within 24 h, reaching a nadir 50% of baseline after 120 h (5 d), with no increase in haemoglobin. Our data suggests that rhEPO triggers premature expulsion of immature reticulocytes from the bone marrow into the circulation independent of its effect in stimulating erythropoiesis and that rhEPO has an effect on serum ferritin concentration which in this dynamic situation is dependent not only on the iron stores.

Bone Marrow↗
PubMed1994

Control of skin blood flow in pre- and full-term infants.

The response of skin blood flow to local ischemia, heating and cooling was investigated at different intervals after birth in 10 healthy full-term babies and 10 preterm postincubator infants using 2 noninvasive and locally neutral methods of microcirculatory measurement: laser Doppler flowmetry and cutaneous oxygen partial pressure (cPO2) estimation with a probe temperature of 37 degrees C. Both groups of infants were capable of myogenic and neural control of skin blood flow. Higher cPO2 values under basal conditions and during reactive hyperemia suggest a raised nutritive capillary blood flow in the preterm group. The increase in cutaneous blood flow during local warming and reactive hyperemia shows that even in neonates on the first day of life no maximal skin vasodilatation is present. An increase in the periodic flow waves attributed to arteriolar vasomotion in 19- to 22-day-old infants, compared to the preterm group and younger babies, indicates that myogenic activity in skin arterioles increases with advancing age.

Blood Flow Velocity↗