Search PubMed⌕ Search

Biomedical subjects

A Huch

Publications and source records attributed to A Huch.

At least 163 records · Page 9Linked to original sources
PubMed1985

Influence of different prostaglandin applications on cervical rheology.

The softening effect of prostaglandin (PG) on cervical tissue prior to elective pregnancy termination is quantified by a new technique for the measurement of the elastance and relaxation of the cervix. The method is based on the pressure-volume relation of a compliant balloon placed in the cervical canal. These properties have been measured before and after different applications of prostaglandins in 58 patients electively terminating pregnancy. Application techniques used included high pressure jet application of PGE2 into the tissue of the portio uteri and the internal cervical os (120 micrograms), PGE2 and PGF2 alpha in Tylose gel (100 micrograms/0.5 ml); PGE2 as an intracervical tablet (150 micrograms) and PGE2 oral tablets placed into the posterior fornix of the vagina. Significant changes in cervical elastance were seen with the intracervically applied PGE2 in Tylose gel and the vaginally applied PGE2 tablets. The intracervically applied PGE2 gel also gave significant changes in cervical relaxation. No side effects other than mild cramping (2 patients) were seen with any of the applications in this study.

Abortion, Induced↗
PubMed1985

Premature contractions: are they caused by maternal standing?

In 33 out of 51 women studied in late gestation, the uterus was found to phasically compress the pelvic vessels and impede the venous blood flow during quiet standing. This caused a reduction of the cardiac stroke volume with resultant reduction of systemic blood pressure and a compensatory increased heart rate (range of increases 9-51 beats/min). In all cases uterine contractions (mostly subclinical) coincided with the phase of circulatory readjustment. Apparently, the contracting uterus, by changing its position and/or shape, relieves the venous obstruction and prevents decompensation. In the women displaying the uterine compression syndrome (UCS), uterine activity was markedly increased in standing compared to the left recumbent position. It was also investigated whether the UCS appeared more often and earlier in gestation in women with twins. In all 9 women with twin pregnancies (mean gestational age 28 5/7 weeks) the UCS associated with uterine contractions was apparent in the standing posture. Although at present no definite conclusions can be reached on the effect on the cervix of these contractions, quiet standing especially in twin pregnancies seems to provoke an increased uterine activity and should therefore be avoided.

Female↗
PubMed1985

Acute polyhydramnios complicating twin pregnancies.

Acute polyhydramnios in the second trimester is a typical complication in monozygous twin pregnancies. It is caused by a feto-fetal transfusion with anemia on the donor and polycythemia on the recipient twin. Contrary to the chronic hydramnios, there is no increase in malformations. In view of the high mortality rate (100%, according to most authors), the clinical management has to be reconsidered. During the years 1979 to 1983, 10 cases of acute polyhydramnios have been observed at the University Hospital in Zurich. This corresponds to an incidence of 9% in our twin population. All cases investigated were MZ twin pregnancies. With the exception of one patient, who underwent an abortion, all women were hospitalized, had bed rest and received recurrent removals of amniotic fluid and prophylactic tocolysis. The mean gestational age at the time of diagnosis was 23 4/7 weeks and at delivery 30 3/7 weeks. In two cases--one of which is presented in detail--with an unintentional puncture of a placental vessel, the recurrence of the hydramnios did not appear. Eight of 18 newborns survived. No malformations were found. Bed rest, tocolysis and recurrent amniocenteses seem to have a positive influence on the prolongation and outcome of the gestation in acute polyhydramnios.

Acute Disease↗
PubMed1985

[Accuracy of prenatal weight estimation using ultrasound in the case of birth weights less than 2000 grams].

In this study foetal weight as estimated by ultrasound was compared with the true birth weight of children having a birth weight of less than 2000 g (n = 105). The estimation of foetal weight was achieved using the authors' own diagram containing a curve for the biparietal and the thoracal diameter as well as for the foetal weight. The data for the weight curve were taken from two European populations (Bonn and Winterthur). There was a highly significant correlation between the ultrasonically estimated foetal weight and the true birth weight. Only in the group less than 1200 g a significant overestimation of foetal weight could be shown by using the weight curve of the population of Bonn, whereas the percentage deviation of both weight curves was comparable: when using the curve of Bonn 68% of readings had a deviation of less than 10%, whereas with the curve of Winterthur this was the case for 65% of the readings.

Embryonic and Fetal Development↗
PubMed1985

[Reaction of mother and fetus to physical stress at high altitude].

The objective of the study reported here was to investigate the reactions of mother and fetus to high-altitude hypoxia combined with physical exercise. The climb was passive, by means of scheduled journeys of the Grap Sogn Gion AG aerial cableway in Laax (Switzerland). The valley station is at an altitude of 1100 m, the mountain station at 2200 m. The mother exercised on a bicycle ergometer set to 25 watts for 3 minutes. The following were measured continuously and noninvasively: heart rate, respiratory rate, systolic and diastolic blood pressure, Po2 and Co2, uterus activity, and fetal heart rate. Twelve pregnant women with an average gestational age of 36 weeks (30th-39th week) took part in the study. Ten of the women were primiparae and two multiparae. During the trip up the mountain the barometric pressure dropped on average from 668 to 583 mmHg. This resulted in a maximum difference in Po2 between the valley and mountain stations of 18 mmHg. There were no systematic changes in Po2. Respiratory rate, heart rate, systolic and diastolic blood pressure remained unchanged during the trip up the mountain. The physical exercise at the mountain station led to an increase in respiratory rate from 12 to 20 min-1, while heart rate rose from 103 to 128 min-1, systolic blood pressure from 117 to 144 mmHg, and diastolic blood pressure from 70 to 90 mmHg. Six of the 12 women had regular contractions even during the trip up the mountain; these either remained unchanged or became less frequent in the course of the study. The mean fetal heart rate only changed slightly.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[Premature detachment of an at the uterine septum implanted placenta. Case report].

In the context of a report on a case in which the placenta was implanted at the uterine septum, the diagnosis, course of pregnancy, and obstetric management are described and discussed. In the case reported here this extremely rare nidation site led to premature detachment of the placenta during the last expulsive pain in a delivery with a vaginal breech presentation (43-year-old patient with four previous unproblematic term births).

Adult↗
PubMed1985

Neonatal oxygen-cardiorespirograms.

To those used to intermittent blood sampling, intermittent viewing of ECG, or intermittent counting of heart and respiratory rates, the rapid changes in these variables, as revealed when monitored continuously, must come as a surprise. These rapid changes are found even in quiet, healthy infants. Because of this variability and the diagnostic significance of each single variable, the potential of these variables can be utilized only if they are continuously recorded. It is like studying movement from a videorecording instead of from a couple of photographs taken at different intervals. Knowing normal levels and the trend of changes in all the variables, it becomes easier and more accurate to predict significant clinical changes than before. Or, in M. E. Avery's words, "Those of us who have used continuous monitors would not like to return to the era of sporadic sampling of information."

Electrocardiography↗
PubMed1984

[Incidence of HBsAG in symptom-free pregnant women. Results of screening at the University of Zurich Gynecology Clinic].

Passive and active immunization prevent materno-fetal and postnatal hepatitis B-virus infection. Precondition for interruption of perinatal transmission is knowledge of the mothers' hepatitis B markers before delivery. In switzerland the prevalence of chronic asymptomatic pregnant HBsAG carriers is not known. From February to December 1983 all pregnant women at the Obstetric Clinic, University Hospital of Zurich were screened for HBsAG. 30 out of 2550 women were HBsAG positive (1.2%); the prevalence among Swiss women is 0.5%, and among immigrants 1.9%. It is suggested that screening for HBsAG be confined to pregnant women who belong to a risk group and to immigrants, and that all children born of HBsAG positive mothers be immunized actively and passively regardless of the presence of HBeAG and/or anti-HBe.

Female↗
PubMed1984

Homeostasis of fetal lactate metabolism in late pregnancy and the changes during labor and delivery.

Electrochemical enzymatic measurements of whole blood lactate concentrations were performed in 110 deliveries. In the majority of uncomplicated vaginal deliveries and of elective cesarean sections cord blood levels were higher than maternal concentrations and, as indicated by a positive arterio-venous difference for the cord vessels, lactate is originating in the fetus. In cases with clinical signs of fetal distress production of lactate due to anaerobic glycolysis is markedly increased. Differently from some other studies with uncomplicated vaginal deliveries, maternal lactate concentrations remained below fetal levels in almost 80%, which is explained by a conservative management of the second stage of labor with active pushing being restricted to the final phase of expulsion. The question whether also in late pregnancy the undisturbed human fetus in utero produces lactate or makes use of placental lactate as a substrate for its oxidative metabolism - as has been shown for some animal species - cannot be answered from the presently available evidence.

Energy Metabolism↗
PubMed1984

[Late primiparity: what has changed in the last 25 years?].

The case reports of late primiparae greater than 35 years of age were analysed in respect of the change of anamnestic risks, of the course of pregnancy, birth and puerperium, as well as of infant data. The incidence of late primiparae rose in our clinic from A 1.8% (n = 292, infants n = 294), via B 2.6% (n = 210, infants n = 213) to C 3.7% (n = 222, infants n = 225.) Previous history of internistic diseases was rare during all periods. In period C, the anamnestic risk "Status after sterility treatment" attains increasing importance (17%). The incidence of pre-eclamptic toxaemia (toxaemia associated with oedema, proteinuria and hypertension) with blood pressure levels greater than 140/90 mgHg and proteinuria greater than 1 0/00 is 5-7% for all periods. Preeclampsia and eclampsia are rare. During the C period, almost every tenth late primigravida received tocolytics. In 1979, 31% of the late primiparae were subjected to genetic amniocentesis, whereas in 1982 the percentage was 51% of the late primiparae. Spontaneous deliveries decreased from 81% (A) to 50% (C). The rates of Caesarean sections increased from 11% (A) via 21% (B) to 35% (C); hence, they were twice as high during all periods than among the entirety of hospital patients included in this study. The increase in the quota of Caesarean sections is due to the indications "foetal distress ante partum", "breech presentation" and the liberal use of Caesarean section in underweight infants. For example, the category of newborn with a bodyweight below 2500 g, the rate of Caesarean sections increased from 7% (A) to 56% (C).(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1984

The oscillating 'vena cava syndrome' during quiet standing--an unexpected observation in late pregnancy.

While studying the lung function of pregnant women at term in four different postures, we were surprised to note marked cyclic accelerations in the heart rate in two-thirds of the women when in a standing position. The mean cycle length was 105 s (range: 1-4 min) and the amplitude had a mean of 27 beats/min (range: 9-51). Blood flow velocity measurements with ultrasound Doppler over the femoral vein showed that there was an intermittent reduction of flow during quiet standing. When the venous return ceased, maternal heart rate increased, cardiac output decreased and blood pressure fell. After the venous blood flow was restored, maternal heart rate, cardiac output and blood pressure returned to normal until the cycle started again. Concomitant with these maternal heart rate changes, different patterns of fetal heart rate were observed. About 70% of the fetuses showed reduction in the long-term variability, increase in fetal heart rate or periodic accelerations. Although no woman fainted during quiet standing, the maternal circulatory changes were consistent with those seen in the classical vena cava syndrome.

Blood Flow Velocity↗