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Biomedical subjects

A S Thavarasah

Publications and source records attributed to A S Thavarasah.

15 recordsLinked to original sources
PubMed1990

Fetal ECG waveform analysis should improve fetal surveillance in labour.

Fetal heart rate (FHR) and fetal electrocardiogram (ECG) recordings were obtained from a scalp electrode with maternal thigh as reference and used for ST waveform analysis in 201 patients in labour. Nearly 45% had suspicious or abnormal FHR traces whilst only 27% had T/QRS ratio greater than 0.25 (mean +/- 2 SD). A normal T/QRS ratio identified 99.3% of fetuses with normal buffering capacity in cord artery blood. Of 13 infants with a cord artery blood pH less than 7.15, standard bicarbonate was less than 15.0 mmol/l in five who had an average T/QRS ratio less than 0.25 throughout labour. Of the eight with respiratory acidosis, five had an increase in T/QRS ratio greater than 0.25 for longer than 20 minutes prior to delivery, in two the ratio increased during the last few minutes and one had no change (pH 7.14). Persistent elevation of T/QRS in the first stage of labour identified those with decrease in buffer capacity in cord arterial blood (sensitivity of 94.1%). Acute hypoxia was recognized by the rapid rise in T/QRS. The specificity of T/QRS to identify fetuses at risk increased by combining the ST waveform analysis with FHR changes.

Electrocardiography↗
PubMed1989

An alternative approach to assisted vaginal breech delivery.

The immediate neonatal outcome by 2 different methods of assisted vaginal breech delivery was studied. In group A, spontaneous expulsion only up to the hip was allowed with one contraction and bearing down efforts; the rest of the baby was delivered with assistance with the next contraction and bearing down efforts. In group B the mother was allowed to expel the fetus up to the shoulders (with assistance) during one contraction and bearing down efforts, followed by assisted delivery of the head with the next uterine contraction and bearing down efforts. A decline in fetal blood pH (greater than 0.10) from the onset of delivery to cord arterial blood pH was more common in group B compared to group A; the difference being almost statistically significant (p = 0.54). Newborns with 1 min Apgar score less than 4 and with a need for assisted ventilation were significantly more common in group B (p less than 0.05). Exposure, stretching and compression of the umbilical cord for a longer time and possible separation of the placenta in group B may be the reason for such an outcome. Further studies are needed to establish the possible advantage of the method of delivery adapted in group A.

Adult↗
PubMed1989

Internal iliac and ovarian artery ligation in the control of pelvic haemorrhage.

Bilateral ligation of the internal iliac artery with or without ligation of the ovarian arteries was carried out in 17 patients who had life-threatening pelvic haemorrhage; 14 were due to obstetric haemorrhage, 2 followed abdominal hysterectomy and 1 intractable haemorrhage associated with carcinoma of the cervix. The procedure was successful in arresting the haemorrhage in 13 patients but 4 needed hysterectomy in spite of the ligation; 1 patient died from disseminated intravascular coagulation following surgery and 1 had cardiac arrest due to extensive blood loss during surgery and died 12 hours later. A review of the literature, a brief description of the procedure and its indications are discussed.

Adult↗
PubMed1988

Recurrent hydatidiform mole: a report of a patient with 7 consecutive moles.

A rare case of hydatidiform mole occurring 7 consecutive times in a Chinese woman is presented. She was first seen in 1979 at the age of 23 years, with a molar pregnancy and subsequently had 6 consecutive moles, the last being in July, 1986; at this visit the patient and her husband were very depressed, and convinced that a normal pregnancy was unlikely and requested a hysterectomy. They were warned earlier several times, of the possible long-term consequences of a recurrent mole and that their chance of having a normal baby was very remote. A total hysterectomy was performed at her last presentation as the patient requested one, instead of dilatation and curettage for a persistently high HCG and bulky uterus following suction evacuation. Histology revealed an invasive mole. The beta HCG level was less than 4IU/l by the end of September, 1986 and she is still being followed-up.

Female↗
PubMed1987

The value of maternal and fetal blood gas analysis in cesarean sections under general anesthesia.

Maternal and fetal blood gas values were studied in 90 selected mothers of comparable age, weight, duration of pregnancy and hematocrit values undergoing cesarean section under balanced general anesthesia in four differing clinical situations: elective with and without placental dysfunction, and emergency with and without fetal distress in apparently normal mothers. Pre-induction (Fi O2 0.21) and pre-delivery (Fi O2 0.60) maternal blood gas analysis, along with umbilical cord blood gas analysis were performed in all cases. Apgar scoring was carried out at one minute and three minutes and correlated with the blood gas values. Out of the 90 cases studied, 36 neonates (40%) showed good apgar scores of greater than seven at one minute and three minutes and correlated well with maternal blood gas values which were within normal ranges. Of the remaining 54 cases (60%) with similar mean maternal gas values the neonates showed an apgar score of less than seven in the first minute. The score improved in three minutes in 35 of them (66%), and umbilical cord blood gas values showed a low pH (umbilical vein 7.22 +/- 0.02 units, umbilical arterial 7.21 +/- 0.01 units) but satisfactory pO2 (umbilical vein 39.4 +/- 1.9 torr, umbilical arterial 2.5 +/- 1.3 torr).(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, General↗
PubMed1986

Prostaglandin (F2 alpha) in missed abortion. Intravenous, extra-amniotic and intramuscular administration--a randomized study.

Prostaglandin F2-alpha was administered by the intravenous, extra-amniotic and intramuscular routes in three comparable groups of patients with missed abortion, during a randomized study. Out of 45 patients (15 in each group), nine patients (60%) of the intravenous group aborted within a mean time of 16.2 hours, whereas 14 patients (93.4%) of the extra-amniotic group and 12 patients (80%) of the intramuscular group aborted in averaged times of 8.2 and 10.6 hours, respectively. The percentage of complete abortions was highest in the intravenous group 88.8%, followed by the intramuscular group (50%), and the extra-amniotic group (35.7%). Side effects of nausea, vomiting, diarrhoea and shivering were observed in all groups studied, but were marginally higher in the intravenous group.

Abortion, Missed↗