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Biomedical subjects

C H Rodeck

Publications and source records attributed to C H Rodeck.

At least 217 records · Page 12Linked to original sources
PubMed1986

Effect of gestational age on fetal and intervillous blood gas and acid-base values in human pregnancy.

Intervillous, umbilical venous and umbilical arterial blood samples were obtained by cordocentesis or fetoscopically from 200 pregnancies at 16-38 weeks gestation. The fetuses were either not affected by the condition under investigation or it was one which would not affect blood gas and acid-base status. Blood pH, pO2, pCO2, bicarbonate, base excess and plasma lactate concentration were determined and ranges for each parameter are presented. Samples obtained fetoscopically were more acidotic, hypercapnic and had a greater base deficit than those obtained by cordocentesis. In the umbilical venous samples, the pO2 decreased, while the bicarbonate, base excess and lactate increased with gestation. In the umbilical arterial samples the pO2 decreased and pCO2 increased; there were no other significant changes with gestation. Similarly, in the intervillous samples the only significant change with gestation was that of a decrease in pO2.

Acid-Base Equilibrium↗
PubMed1986

Rh disease: intravascular fetal blood transfusion by cordocentesis.

A total of 130 cordocenteses, including 96 intravascular fetal blood transfusions, were performed in 21 pregnancies complicated by red cell isoimmunization. Transfusions were commended at 18-34 weeks' gestation and repeated up to 7 times, at 1- to 4-week intervals. The volumes of transfused blood were 5-150 ml, the haematocrits 62-88% and the rate of transfusions 1-15 ml/min. The pretransfusion fetal haematocrits were 5-34% and the posttransfusion ones 28-60%. Final transfusions were given at 32-36 weeks' gestation. Of the 21 pregnancies, 18 delivered at 31-39 weeks and 3 are continuing; 1 baby was stillborn and 17 are alive and well.

Blood Transfusion, Intrauterine↗
PubMed1986

Survival of transfused adult cells in the fetus.

The survival of adult erythrocytes transfused into the circulation of a severely isoimmunised fetus was assessed. The survival time in the fetus was found to be considerably shorter than in adults.

Adult↗
PubMed1986

Fetal blood velocities in Rh isoimmunization: relationship to gestational age and to fetal hematocrit.

Doppler blood cell velocities were measured in the aortas, inferior vena cavas, and umbilical veins of fetuses from isoimmunized pregnancies and related to the hematocrit levels of the fetal blood determined at fetoscopy. Pourcelot Index of flow in the umbilical artery was similarly studied. The mean velocities in the descending aortas and the Pourcelot Indexes of the umbilical arteries of both normal and affected fetuses correlated with fetal age. These velocities and indexes of affected fetuses also correlated inversely with the fetal hematocrit levels independently of the correlation with fetal age. The affected fetuses had higher mean velocities in the aorta and in the inferior vena cava than did normal fetuses. A simple model of multiple regression predicted the fetal hematocrit levels with a mean error of 3.8 hematocrit units (volume %).

Blood Flow Velocity↗
PubMed1986

Blood gases and acid-base status of the human second-trimester fetus.

Maternal arterial, umbilical venous, and umbilical arterial blood were obtained at fetoscopy in the second trimester and analyzed for blood gases and acid-base indexes. In comparing umbilical venous (N = 31) with maternal arterial (N = 39) samples, the mean (+/- SD) PO2 was lower (55 +/- 7 versus 100 +/- 15 mmHg, P less than .001) and PCO2 (37 +/- 4 versus 34 +/- 4 mmHg), bicarbonate (20 +/- 2.0 versus 18.5 +/- 1.5 mmol/L), lactate (1.10 +/- 0.25 versus 0.80 +/- 0.30 mmol/L), and base excess (-4.2 +/- 2.3 versus -6.0 +/- 1.5 mmol/L) were higher (P less than .001). The mean umbilical venous pH did not differ significantly from the maternal arterial (7.358 +/- 0.040 versus 7.373 +/- 0.035). Comparing umbilical arterial (N = 21) with umbilical venous (N = 31) samples, the PO2 level was lower (34 +/- 4 versus 55 +/- 7 mmHg, P less than .001) and PCO2 higher (42 +/- 4 verus 37 +/- 4 mmHg, (P less than .001); the pH was marginally lower (7.339 +/- 0.03 versus 7.358 +/- 0.040; P less than .05) and bicarbonate higher (22 +/- 1.5 versus 20 +/- 2.0 mmol/L, P less than .001). Umbilical arterial and umbilical venous values were similar in the case of lactate and base excess.

Acid-Base Equilibrium↗
PubMed1985

First trimester diagnosis of hypophosphatasia with a monoclonal antibody to the liver/bone/kidney isoenzyme of alkaline phosphatase.

Prenatal diagnosis of hypophosphatasia was made by alkaline phosphatase (ALP) assay on a chorionic villus sample taken in the first trimester. Monoclonal antibodies against the liver/bone/kidney (LBK) and placental isoenzymes of ALP were used, and the bound isoenzymes were quantified by an amplification system. Very low activities of the LBK isoenzyme indicated an affected fetus. Diagnosis was confirmed by ultrasound scan at 15 weeks' gestation, and by ALP measurement in amniotic fluid supernatant and fetal serum.

Adult↗
PubMed1985

First trimester prenatal diagnosis and detection of carriers of haemophilia A using the linked DNA probe DX13.

Although the use of a gene specific deoxyribonucleic acid (DNA) probe is the method of choice for detecting carriers of genes for rare genetic disorders, there will always be families in which such probes cannot be used because key subjects are not informative for restriction fragment length polymorphisms in or around the gene. In these cases closely linked DNA markers have to be used. An X chromosome specific DNA probe, DX13, which is closely linked to the haemophilia A locus on the X chromosome, was used for early prenatal diagnosis in two cases and to detect carriers in a series of nine possible heterozygote women. The first reported crossover between DX13 and the factor VIII:C locus was observed in this study. There are complexities inherent in using any linked DNA probe for assignment of genes, but such techniques are clinically important.

Female↗
PubMed1985

The relationship of fetal plasma protein concentration and hemoglobin level to the development of hydrops in rhesus isoimmunization.

Fetoscopic samples of pure fetal blood were obtained at 18 to 25 weeks' gestation from seven hydropic and 10 nonhydropic fetuses affected by rhesus isoimmunization, and the fetal plasma albumin, plasma total protein, and hemoglobin concentrations were determined. All fetuses with sonographic evidence of hydrops had a hemoglobin of 3.8 gm/dl or less, whereas all but one of those without hydrops had a hemoglobin greater than 4.0 gm/dl. The plasma total protein was less than 2 standard deviations below the mean of the normal range in all hydropic fetuses and in six of 10 of those without hydrops. Hypoalbuminemia was found in six of the seven hydropic fetuses and in two of the nonhydropic fetuses. Ascitic fluid total protein and albumin concentrations were also determined in four hydropic fetuses, and the values in three were found to be more than 50% of the corresponding plasma levels.

Albumins↗
PubMed1985

Fetal haematology in rhesus isoimmunisation.

Haematological studies were carried out in pure fetal blood samples obtained fetoscopically in 29 rhesus isoimmunised pregnancies at 18-24 weeks' gestation, and the values were compared with those obtained in 62 normal control pregnancies. Fetal reticulocytosis or erythroblastaemia was seen only in association with a haemoglobin concentration of 4 g/dl or less. Ten of the 14 fetuses with a haemoglobin concentration below 4 g/dl showed ultrasonographic evidence of hydrops.

Erythroblasts↗
PubMed1985

Fetal plasma renin and renin substrate in mid-trimester pregnancy.

Blood samples were obtained by fetoscopy from 30 fetuses in the middle trimester of pregnancy. The results indicate that high concentrations of renin and relatively low levels of renin substrate are present in the fetus early in pregnancy. These values are similar to those previously demonstrated in the full-term fetus.

Angiotensinogen↗
PubMed1985

Fetoscopy in the assessment of unexplained fetal hydrops.

Pure fetal blood samples, obtained fetoscopically from 30 patients with unexplained fetal hydrops at 16 to 32 weeks gestation were investigated for cytogenetic, haematological, biochemical and virological properties. In two patients with oligohydramnios, the fetoscope was introduced transabdominally into the fetal peritoneal cavity and sampling was undertaken from the intra-abdominal portion of the umbilical vein; in all the other patients an umbilical cord vessel was sampled. Ten (33%) of the fetuses had chromosomal abnormalities, one an erythroblastic process, possibly erythroleukaemia, one alpha-thalassaemia and one cytomegalovirus infection. Blood-film abnormalities were seen in 23 (88%) of 26 fetuses that had this examination. Biochemical analysis of fetal plasma was undertaken in 18 fetuses and hypoproteinaemia was found in all cases. One fetus was subsequently found to have a paroxysmal tachyarrhythmia that responded to digitilization. Three (10%) of the fetuses survived.

Adolescent↗
PubMed1985

Fetal blood chromosome analysis: some new indications for prenatal karyotyping.

Prenatal karyotyping using stimulated fetal blood lymphocytes was undertaken in 170 pregnancies between 16 and 36 weeks gestation for the following reasons--mosaicism or marker chromosomes found in amniotic fluid culture; a family history of X-linked mental retardation with fragile Xq28; fetal abnormalities detected ultrasonographically; late booking or amniotic fluid culture failure in patients with advanced age or balanced translocations; and twin pregnancies discordant for a chromosomal anomaly. Forty-one karyotypic abnormalities were detected (24%). These were: 45,X (7 cases), trisomy 13 (5 cases), trisomy 18 (6 cases), trisomy 21 (4 cases), twin pregnancy where one twin had trisomy 21 (1 case), supernumerary marker chromosome (3 cases, one of which occurred in a twin pregnancy), triploidy (3 cases), X-linked mental retardation with fragile site at Xq28 in males (6 cases), fetal erythroleukaemia (3 cases including 2 cases with Turner's), Fanconi's anaemia (1 case), unbalanced chromosome translocation 47,XY+der22,t(11;22) mat (1 case), mos 46,XX18p-/46,XX,-18+i(18q) (1 case), 46,XXdel(2q) (1 case), and 46,XYt(5;17) de novo (1 case). In fetuses at high risk of a chromosome aberration, a rapidly obtained karyotype is helpful and fetoscopy and fetal blood sampling are justified in the second or third trimester.

Amniotic Fluid↗
PubMed1985

Normal reference ranges for biochemical substances relating to renal, hepatic, and bone function in fetal and maternal plasma throughout pregnancy.

Normal reference ranges for sodium, potassium, urea, creatinine, calcium, phosphate, total protein, albumin, bilirubin, alkaline phosphatase, and aspartate transaminase were determined from 344 fetal and maternal plasma samples between 15 and 38 weeks' gestation. Pure fetal blood was obtained by fetoscopy in the second trimester and in the third trimester by umbilical cord puncture at delivery. All biochemical substances were measured by continuous flow (SMAC, Technicon) except albumin, which was measured by turbidimetry (CobasBio, Roche). The resulting data were analysed on an AMDAHL 470A computer and reference ranges covering 2.5 to 97.5 percentiles were defined. Analysis of variance was performed to examine the overall effect of gestational age on the analytes measured and on the changes in the fetal compartment relative to the mothers'. A paired t test was performed to examine how these biochemical substances in fetal plasma related to maternal plasma from the same pregnancy.

Alkaline Phosphatase↗