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Biomedical subjects

B J Trudinger

Publications and source records attributed to B J Trudinger.

At least 73 records · Page 4Linked to original sources
PubMed1985

Umbilical and uterine artery flow velocity waveforms in pregnancy associated with major fetal abnormality.

Flow velocity waveforms from the umbilical artery and branches of the uterine artery in the placental bed were recorded using continuous wave Doppler ultrasound. The records of 26 patients with pregnancy complicated by major fetal abnormality were reviewed to determine the changes of a primary fetal disturbance. The systolic/diastolic (A/B) ratio was used as an index of blood flow resistance. In 13 of the 26 patients the umbilical artery waveform systolic/diastolic ratio was high. It is postulated that in these patients there is a process of obliteration of small arteries in the placenta that is triggered by the abnormal fetus. In all patients the uterine artery waveform was normal. In seven of these 13 patients the infant had a birthweight greater than 10th centile. Placental weights were examined. A small placenta expressed as either low weight for gestational age or low placental/fetal weight ratio was associated with a normal umbilical artery waveform. It is suggested that fetuses in these groups have a low growth potential. In contrast a high placental/fetal weight ratio was associated with an abnormal umbilical artery waveform pattern.

Arteries↗
PubMed1984

Antenatal diagnosis of urinary tract abnormalities: correlation of ultrasound appearance with postnatal diagnosis.

A review was made of the natural history of the urinary tract abnormalities diagnosed antenatally in 18 fetuses in order to correlate the ultrasound appearance with subsequent postnatal diagnosis and prognosis. Unilateral disease, both obstruction and multicystic renal disease, was associated with a good prognosis. Bilateral dysplastic kidneys had a very poor prognosis. The antenatal ultrasound demonstration of bladder distention and/or hydronephrosis, however, does not always signify true obstruction of the urinary tract. This is important in view of the recent introduction of in utero interventions to preserve renal function and prevent pulmonary hypoplasia.

Dilatation, Pathologic↗
PubMed1982

Attitudes to the management of hypertension in pregnancy: a survey of Australian fellows.

Fellows of The Royal Australian College of Obstetricians and Gynaecologists were surveyed to determine current practice in the management of hypertensive disease of pregnancy. Eight hundred and seventy Fellows were sent a questionnaire and there was a 74.1% response. There was in the majority of clinical situations a uniformity of response. This was especially so with the more serious clinical situations. Variations in response were particularly evident in choice of drug therapy. The year of obtaining specialist qualification and the State of practice accounted for most variation in survey results. There was uncertainty about the value of antihypertensive therapy to the fetus.

Antihypertensive Agents↗
PubMed1981

Fetal umbilical venous flow measured in utero by pulsed Doppler and B-mode ultrasound. I. Normal pregnancies.

Umbilical venous blood flow was measured with a pulsed Doppler unit, which was used in combination with a B-mode ultrasonic imaging system to permit location of the umbilical vein and measurement of its cross-sectional area. The accuracy and limitations of the method are discussed. Forty-seven normal fetuses with gestational ages ranging from 22 weeks to term were studied on a total of 61 occasions. Flow increased with gestational age until 36 weeks, was maximal between 37 and 38 weeks, then decreased during the last 2 weeks of pregnancy. Flow per unit of fetal weight was constant during pregnancy until 36 to 37 weeks, when a reduction occurred.

Blood Flow Velocity↗
PubMed1980

Fetal age and patterns of human fetal breathing movements.

Human fetal breathing movements have been studied serially from 20 weeks to the onset of labor in eight normal primigravid patients. Real-time ultrasound was used and the events of the study period were analyzed visually and by computer processing of a punched paper tape record. Studies were performed before and after a maternal glucose load. The pattern of fetal breathing movements changed with increasing fetal age. The breathing rate decreased and became more regular toward term. The form of each breath altered with gestational age. Prior to 32 weeks the breath time was short. Between 32 and 36 weeks a breath characterized by a long inspiratory phase with multiple augmenting movements was seen. After 36 weeks the breath was more uniform. A definite periodicity was seen in the last 2 weeks of pregnancy, with episodes of shallow, more regular breathing and a more variable pattern. Glucose intake did not alter these patterns.

Fetus↗
PubMed1980

Maternal hypertension and intrauterine fetal death in mid-pregnancy.

An analysis of the 156 pregnancies which terminated spontaneously between 16 and 27 weeks gestation, inclusive, indicated that in 41 patients where fetal death was the primary event, maternal arterial pressure was raised in early pregnancy when compared with matched groups of women whose pregnancies had a successful outcome. Blood pressure in the 14th week of pregnancy in women with fetal death was significantly higher than in women with other types of mid-trimester abortion. It is suggested that maternal hypertension predisposes to intrauterine fetal death in the mid-trimester of pregnancy as it does in the third trimester.

Abortion, Spontaneous↗
PubMed1980

Intrapartum and postpartum pyrexia and infection after induction with extra-amniotic prostaglandin E2 in tylose.

One hundred and twenty-four women, bearing 127 children, in whom labour was induced with extra-amniotic prostaglandin E2 in tylose were studied. High vaginal swabs taken from 111 patients immediately before insertion of prostaglandin E2 were examined, specific identification of microbes being restricted to those present in the amniotic fluid, to haemolytic streptococci, and to other specific microbes. Lancefield group B streptococci were isolated from nine patients, and in eight of these the microbes were isolated from the amniotic fluid. Amniotic fluid was examined from 86 patients and was shown to be contaminated with microbes potentially pathogenic for mother or baby in 11 out of 86 (13 per cent) of the patients examined; in eight patients, the contaminating pathogen was the group B streptococcus. All 127 blood cultures taken during or just after delivery were negative. Six out of nine patients with a group B streptococcus in the vagina developed fever and proven streptococcal endometritis; one child developed fever and another streptococcal septicaemia.

Adult↗
PubMed1980

Antepartum fetal heart rate monitoring: value of sound stimulation.

The fetal heart rate (FHR) response to sound stimulation has been studied. The normal fetus exhibits an acceleration of at least 15 beats/min sustained for at least 2 minutes. This response was studied in 116 pregnancies in which the fetus was considered to be at high risk. The response was impaired in the 3 cases of perinatal death, in 14 of 19 cases of perinatal morbidity, and in 17 of 27 fetuses whose subsequent birth weight was below the fifth percentile. An impaired response was of greater predictive value than the nonreactive pattern of nonstressed FHR monitoring.

Female↗
PubMed1979

Fetal breathing movements and other tests of fetal wellbeing: a comparative evaluation.

Sixty pregnant women whose fetuses were considered to be at high risk were intensively studied with fetal and placental function tests. Fetal breathing movements were studied with real-time ultrasound and the amount of time spent breathing and the variability of the breath-to-breath interval were measured. A reduction in the amount of time the fetus spent making breathing movements and decreased variability were indicative of fetal compromise. When these results were compared with those of other tests of fetal wellbeing measurement of fetal breathing movements and ultrasound assessment of growth were more sensitive tests of fetal wellbeing than the biochemical measures (urinary oestrogen, human placental lactogen, pregnancy-specific beta-1-glycoprotein, and unconjugated oestriol concentrations) or fetal heart rate. The predictive value was highest with serum unconjugated oestriol but the results of other tests were similar. Study of fetal breathing movements or an ultrasonic assessment of growth may provide a better screening test for fetal compromise than biochemical estimations.

Estriol↗
PubMed1979

Fetal breathing patterns in intrauterine growth retardation.

Fetal breathing movements were studied with real time ultrasound in 21 normal fetuses and 30 fetuses born small-for-dates (less than the 5th centile). The events of the study period were recorded on punched paper tape which was subjected to computer analysis. In the normal group the percentage time of breathing was 54 +/- 12.7 (mean +/- SD). The breath to breath interval was 1.34 +/- 0.25 seconds and the coefficient of variation of this interval was 49.6 +/- 7.7 per cent. In 17 of the small-for-dates group amount of breathing was reduced with short breathing episodes and long apnoea intervals. In the other 13 patients in the small-for-dates group the coefficient of variation for the breath to breath interval was significantly reduced (39.6 +/- 7.9 per cent, p less than 0.01).

Female↗
PubMed1978

Effect of maternal glucose ingestion on fetal breathing and body movements in late pregnancy.

Fetal breathing movements and fetal whole body movements were observed over 2 hours in 22 normal singleton pregnancies between 34 and 38 weeks gestation using a real time ultrasonic B scan method. The proportion of time fetuses spent making breathing movements increased from 9.9 per cent to 48.3 per cent within one hour of their fasting mothers taking a 50 g glucose drink. Fetal whole body movements were not increased after maternal glucose ingestion. Arousal of the fetal central nervous system seems dependent on the level of fetal blood glucose.

Blood Glucose↗
PubMed1978

Fetal hazards of the intrauterine pressure catheter: five case reports.

Five patients with fetal complications associated with the use of an intrauterine pressure catheter in labour are described. In four, a fetal vessel was punctured either by the catheter or its introducing sheath. In the remaining patient, cord compression resulted from entanglement with the catheter. These problems may be minimized by a careful catheter introduction technique.

Adult↗
PubMed1978

Fetal breathing movements in high risk pregnancy.

In 12 normal and 50 high risk pregnancies fetal breathing and fetal trunk movements were measured by real time ultrasound after the mothers had been given oral glucose. Fetal breathing was significantly reduced in the two fetuses which subsequently died and in five of six fetuses developing fetal distress in labour. Two patterns of breathing were noted in 23 fetuses with cessation of Intrauterine growth: either reduced fetal breathing or almost continuous breathing. Fetal trunk movements were more variable than breathing movements and a reduction in trunk movements had less predictive value.

Female↗
PubMed1976

Maternal and neonatal elimination of amobarbital after treatment of the mother with barbiturates during late pregnancy.

Plasma half-lives of amobarbital were determined in newborn children of 10 mothers who had been treated with barbiturates for hypertension in pregnancy for 6 to 42 days prior to delivery. Five mothers had received amobarbital, 200 mg daily, and 5, phenobarbital, 60 to 180 mg daily. Half-lives in 7 of the babies ranged from 16.6 to 49.4 hr, comparable to those previously reported in babies of mothers who had received only a single dose of amobarbital. Thus there was no evidence of induction of amobarbital hydroxylation in these children. Two babies who had a greater than normal rise in serum bilirubin had longer half-lives (86.1 and 117.7 hr). In 1 baby whose mother had membranous glomerulonephritis, plasma amobarbital concentration did not significantly change over the period of the study.

Adult↗
PubMed1976

Platelets and intrauterine growth retardation in pre-eclampsia.

In pre-eclampsia, but not essential hypertension of pregnancy, reduced maternal levels of circulating platelets were found to correlate with intrauterine growth retardation. This suggests that disseminated intravascular coagulation and fibrin deposition contribute to the placental damage of pre-eclampsia.

Birth Weight↗