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Biomedical subjects

C Redman

Publications and source records attributed to C Redman.

67 records · Page 4Linked to original sources
PubMed1987

Pre-eclampsia and trisomy 13: a possible association.

Pregnancies of fourteen women who gave birth to babies with trisomy 13 were studied retrospectively for evidence of pre-eclampsia, with twenty-eight controls matched for age and parity. Of the five nulliparous women who subsequently gave birth to a baby with trisomy 13 all had had severe pre-eclampsia, compared with none of the control group. The records of eleven women whose first babies had had trisomy 18 (four) or trisomy 21 (seven) were also studied with appropriate controls and none of these pregnancies had been complicated by pre-eclampsia. Development of pre-eclampsia may be influenced by a gene or genes on fetal chromosome 13.

Adult↗
PubMed1987

Endogenous forms of fibrinogen in Hep G2 cells.

The three polypeptide chains of fibrinogen, A alpha, B beta and gamma chain, are synthesized on separate polysomes. Fully formed fibrinogen is a six chain, disulfide-linked, dimeric molecule with a molecular weight of 340kDa. Previous pulse-chase studies with L-35 S methionine using the human hepatocellular carcinoma cell line, Hep-G2, showed that the three chains are not immediately disulfide-linked and that there exist intermediate precursors as well as pools of A alpha and gamma chains (J. Biol. Chem. 259, 10574-10581, 1984). In this study the endogenous levels of fibrinogen and its precursors are measured by two different methods; pulse and steady-state labelling with L-35 S-methionine and immunoblotting. In Hep-G2 cells intracellular fibrinogen-related antigen is primarily (30-53%) composed of an A alpha-gamma complex and, to a smaller degree, of fully-formed fibrinogen (13-33%). Furthermore, the Hep G2 cell also contains endogenous pools of free gamma chain (11-26%). Other fibrinogen precursors (namely, the B beta-A alpha, B beta-gamma complexes as well as the fibrinogen half-molecule) do not appear to accumulate intracellularly. Most, if not all, of these precursors occur as isoforms but this heterogeneity is not due to varying degrees of glycosylation. In all the intracellular fibrinogen forms identified thus far, free sulfhydryl groups, detected by 14C-iodoacetamide incorporation, occur only in the A alpha-gamma complex and the free gamma chains.

Carcinoma, Hepatocellular↗
PubMed1984

Adverse outcome of pregnancy and the quality of obstetric care.

The case-control method was used to study the relation between four possibly preventable adverse outcomes of pregnancy and suboptimal antepartum and intrapartum obstetric care defined by clinical consensus. Fetuses whose deaths were ascribed to asphyxia or trauma, and babies born at term who had seizures within 48 h of delivery, were significantly more likely than controls to have received suboptimal care during pregnancy. Babies with seizures, as well as those with terminal apnoea, were also substantially more likely than controls to have been born after a failure to react appropriately to signs of severe fetal distress during labour. Most of the babies who received suboptimal obstetric care, however, did not have any of these adverse outcomes. In addition, most babies with these adverse outcomes had apparently received satisfactory obstetric care. No relation was detected between cerebral palsy and suboptimal obstetric care.

Adolescent↗
PubMed1984

Analysis of fetal heart rate on-line at 32 weeks gestation.

Antenatal fetal heart rate (FHR) patterns were screened in 634 women with singleton pregnancies at 32 weeks gestation using a microprocessor on-line. The duration of the record was adjusted according to its character, varying from 10 min with high FHR variation (39% of records) to 45 min with low variation (4.7%). The average duration was 16.7 min. Of the 30 fetuses with the lowest FHR variation (less than 5th centile), 19 (63%) had a normal outcome. Of the 11 with an abnormal outcome five were born greater than or equal to 38 weeks; six were born by caesarean section at 32-34 weeks, resulting in an increased incidence in the group. Analysis of the numbers of accelerations, of decelerations, of episodes of high FHR variation or of fetal movements did not improve long-term prediction. It was concluded first, that antenatal FHR monitoring for up to 45 min at 32 weeks gestation had no long-term predictive value; and second, that 3% of our obstetric population have unreactive FHR traces at this age, with a normal outcome. This does not imply that consecutive antenatal records on the same high-risk patient at short intervals are not valuable clinically.

Birth Weight↗
PubMed1983

A comparison of low-risk pregnant women booked for delivery in two systems of care: shared-care (consultant) and integrated general practice unit. I. Obstetrical procedures and neonatal outcome.

Samples of records of comparable low-risk pregnant women booked for delivery in an integrated general practice unit (GPU) and a consultant (or shared-care) system were derived from a computer tape of all 5005 births which occurred at the John Radcliffe Hospital in 1978. Induction of labour, epidural analgesia and forceps delivery were all less frequently carried out in women booked for delivery in the GPU. Infants of multiparous women were more often intubated in the shared-care system (3%) than in the GPU (0%); rates in infants of nulliparous women were similar (approx. 7%) in the two systems. These data suggest that short-term outcomes are as good for GPU-booked low-risk women and their infants as for comparable women booked in consultant or shared-care.

Adolescent↗
PubMed1983

A comparison of low-risk pregnant women booked for delivery in two systems of care: shared-care (consultant) and integrated general practice unit. II. Labour and delivery management and neonatal outcome.

A random sample of low-risk pregnant women were equally divided into four groups of 63 nulliparae and multiparae each booked for care in a integrated general practice unit (GPU) and a shared-care (consultant) system. Selection criteria included only women who were admitted because they were in spontaneous labour or thought they were. Nulliparous women booked for shared-care came into hospital at a less advanced state of cervical dilatation than those booked for the GPU and spent longer (11 compared with 8 h) in hospital before delivery; the comparable durations in multiparae were 6 and 4 h. Both the first and second stages of labour were longer in the GPU-booked women but they received less pethidine and fewer had epidural analgesia; they received less electronic fetal monitoring, augmentation and forceps delivery, and fetal distress was diagnosed less often. The 1-min Apgar score was less than or equal to 6 in 17.5% of infants of nulliparae booked for the shared-care system compared with 1.6% of those booked for the GPU. The intubation rate of infants of nulliparae was 11% in the shared-care system compared with no intubations in the GPU. These comparisons demonstrate the simplicity and safety of delivery of low-risk women in the GPU as compared with deliveries of similar women in a shared-care (consultant) unit.

Adolescent↗
PubMed1981

The effect of maternal weight on maternal serum alpha-fetoprotein levels.

In 902 singleton pregnancies, maternal serum alpha-fetoprotein (AFP) levels between 15 and 20 weeks of pregnancy were significantly related to maternal weight (r = 0.24, p less than 0.0001). Lighter women had on average higher AFP levels than heavier women, perhaps on account of the greater concentration of AFP in their relatively smaller volume of blood. The mean AFP level for women weighing less than 45 kg was 68% higher than the mean level for women weighing 85 kg or more. Maternal weight was found to be an important factor which could account for false positive AFP results in antenatal screening for open neural tube defects. A policy of adjusting maternal serum AFP values according to maternal weight among women with borderline positive results could reduce the number having a diagnostic amniocentesis with only a negligible loss of detection for open spina bifida. With such a policy, using a cut-off level of 2.5 x normal median, the false positive rate in the 902 women screened would have been reduced fom 2.8% to 2.0%.

Body Weight↗
PubMedDate not supplied

Recurrent acquired sideroblastic anemia in a twin pregnancy.

A woman whose sideroblastic anemia had relapsed with progestogen and combined oral contraceptive therapy suffered further relapses in a (twin) pregnancy. Previous reports exist of relapses both from progestogens and in pregnancy, and we postulate a shared etiology. Affected women considering pregnancy or sex hormone usage should be advised accordingly.

Adult↗
PubMedDate not supplied

Update on the "sick placenta syndrome". Pre-eclampsia: still a difficult disease.

Pre-eclampsia (PE) and eclampsia is the leading cause of maternal death in the UK and a major cause of perinatal morbidity and mortality. PE is predominantly a disorder of first pregnancy. There is a genetic component. PE is a syndrome without a defined cause. The variability with which it presents, and the speed with which it progresses, make it hard to diagnose. High blood pressure and proteinuria, with or without oedema, are classic symptoms but it may also present in an unusual way, eg as jaundice; as proteinuria with normal blood pressure; as intra-uterine growth retardation; as abdominal pain. The placenta becomes "sick" because of restricted blood flow from the mother; an unknown factor causes disturbances to spread throughout the mother's circulation which may lead to blindness, strokes, liver rupture and death. Delivery of the placenta is the only effective treatment, but preventive options being explored include aspirin and calcium supplements.

Female↗