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Biomedical subjects

C W Redman

Publications and source records attributed to C W Redman.

At least 217 records · Page 12Linked to original sources
PubMed1985

Factors associated with the blood pressures of children born to women who were hypertensive during pregnancy.

At age 7.5 years the supine blood pressures of 216 children born to women who had been hypertensive during pregnancy were recorded. No associations were found between the blood pressures of the children and their mothers. The blood pressures of children whose mothers received methyldopa during pregnancy did not differ from those of children whose mothers had no specific treatment. Four boys whose mothers had taken methyldopa for more than 150 days had significantly lower systolic and diastolic pressures than those in whom the treatment had been of shorter duration. Significant findings from multiple regression analyses were: positive associations between boys' systolic and diastolic pressures and current weight, and diastolic pressure and maternal weight; negative associations between boys' systolic and diastolic pressures and birthweight; and a positive association between girls' systolic pressure and current weight.

Birth Weight↗
PubMed1985

Antihypertensive drugs in pregnancy.

When mean arterial pressure exceeds 140 mmHg (equivalent to 180/120), there is a significant risk of maternal cerebral vascular damage. Therefore it is recommended that blood pressures greater than 170/110 should be treated with urgency, aiming to maintain the blood pressure at all times at less than 170/110 but not lower than 130/90. Parenteral hydralazine is effective and safe therapy. Labetalol (intravenously or orally) appears to be as effective and as safe, and causes fewer troublesome side effects; however, clinical experience of its use is more limited, particularly in relation to its safety for the fetus and neonate. Delivery of the fetus is usually the definitive management of severe hypertension in pregnancy. However, this action may not reduce the blood pressure immediately. After initial treatment with rapid-acting agents, it is often advantageous to maintain control of arterial pressure with ongoing oral therapy (methyldopa, labetalol). In addition to the protective effect on the mother, such therapy may allow delivery of the fetus to be deferred; this should be considered only if the fetus is significantly premature (e.g., less than 34 weeks), there is no other evidence of maternal or fetal distress, and there can be meticulous monitoring of the maternal and fetal state proceeding to prompt delivery if deterioration occurs. The indications for treatment of mild or moderate hypertension in pregnancy are less clear. Severe hypertensive episodes can be reduced by several drugs (methyldopa, labetalol, beta-blockers). Methyldopa appears to reduce the small risk of mid-trimester abortions seen in association with early hypertension. Other benefits may be possible with other individual drugs; however, none of these have been found consistently in controlled studies to date. There seems, therefore, to be no definite indication for treatment of mild hypertension in pregnancy; treatment of moderate hypertension may be reasonable but its value is unproved at present. Antihypertensive drugs are valuable in pregnancy to reduce the risks directly due to elevated blood pressure. These drugs are not expected to affect the evolution of preeclampsia nor to treat the other complications of this condition.

Adrenergic beta-Antagonists↗
PubMed1984

Erythrocytic cation transport receptor numbers and activity in pregnancies complicated by essential hypertension and pre-eclampsia.

Various functions of erythrocytic cation transport were studied in normotensive and hypertensive pregnancy (women with pre-eclampsia and essential hypertension). The results showed that in pregnancy there is an increase in the number of erythrocytic glycoside binding sites accompanied by a proportional increase in the active inward transport of rubidium (used as a substitute for potassium). There was no evidence of an effect of pregnancy on intraerythrocytic sodium concentrations. These changes were apparently entirely attributable to pregnancy and not affected by pre-eclampsia or essential hypertension. It is suggested that these alterations indicate an adaptive increase in sodium pump numbers and activity secondary to a tendency for the intraerythrocytic sodium concentration to rise during pregnancy and compensating for that tendency.

Adolescent↗
PubMed1984

Factors associated with the intellectual ability of children born to women with high risk pregnancies.

The intellectual abilities of 242 children born to women who had been hypertensive during pregnancy were assessed at the age of 7 1/2 years. Associations between 15 maternal, fetal, perinatal, postnatal and environmental factors, and test scores were investigated. After adjustment for confounding variables children in the upper social classes, born to non-smokers, who were first born, breast fed, and with birth weights above the 10th centile had significantly higher scores in some aspects of ability than the rest. Children whose mothers had developed superimposed pre-eclampsia had higher scores than those whose mothers had not suffered preeclampsia; and children delivered by elective caesarean section had lower scores than those delivered spontaneously. In a small subgroup of women with particularly high risk pregnancies perinatal mortality had been 10 times greater than in the rest of the sample. At 7 1/2 years the intellectual ability of the survivors in this subgroup did not differ from that of the rest. These findings do not support the notion that there is a quantitative continuum of "reproductive casualty" from mortality to morbidity.

Birth Weight↗
PubMed1984

Fall in blood pressure in response to volume expansion in pregnancy-associated hypertension (pre-eclampsia): why does it occur?

The infusion of 500 ml of a volume expanding solution caused a significant fall in blood pressure for up to 72 h in 35 women with pregnancy-associated hypertension of varying grades of severity. The response to the infusion was not obviously related to the clinical severity of the underlying disorder, nor to the extent of plasma volume expansion produced. The plasma volume of oedematous women increased, while there was no significant change in non-oedematous women in response to the infusion. Changes in other measurements were similar in oedematous and non-oedematous women. There was no evidence for prostacyclin release into the circulation in response to the infusion as a mediator of the blood pressure response. Both 6-keto-prostaglandin F1 alpha levels and 13,14-dihydro-15-keto-prostaglandin F (PGFM) levels fell significantly, suggesting suppression of prostaglandin release by the infusion. The antihypertensive effect of volume expanders in pregnancy-associated hypertension is mediated by a factor other than simple volume expansion.

Adult↗
PubMed1984

Characterization of the reduced heart rate variation in growth-retarded fetuses.

Fetal heart rate (FHR) variation has been studied by computerized numerical analysis in 20 growth-retarded fetuses and 20 normal fetuses matched for gestational age. FHR variation was significantly reduced in the 14 growth-retarded fetuses where there was clinical evidence of associated pathology. Rest-activity cycles were assessed by changes in FHR variation and fetal movements. The growth-retarded fetuses with reduced FHR variation showed the same pattern of rest and activity as normal fetuses but the changes in FHR variation were of lower amplitude. This was observed even in the subgroup of six fetuses with the lowest FHR variation. Thus the unreactive FHR patterns associated with growth retardation do not arise because the fetus spends less time in activity.

Female↗
PubMed1984

Treatment of severe pregnancy-associated hypertension with the calcium antagonist nifedipine.

The calcium antagonist, nifedipine, was given orally to 21 women with acute episodes of severe hypertension during pregnancy or in the puerperium. A rapid and significant fall in blood pressure by an average of 26/20 mmHg was seen at 20 min after administration. The hypotensive effect was not significantly enhanced in those women already taking medication to lower the blood pressure. The principal side effects were headache and cutaneous flushing. No adverse fetal effects were detected. This is the first study of the use of this drug to control hypertension in pregnancy. The apparent efficacy of nifedipine justifies its further investigation in controlled trials.

Adolescent↗
PubMed1984

Class 1 major histocompatibility complex antigens on human extra-villous trophoblast.

Using immunohistological techniques, class 1 products of the major histocompatibility complex (MHC) have been demonstrated on various forms of human extra-villous trophoblast in placental tissues taken from first, second and third trimester pregnancies. This contrasts with the absence of class 1 MHC antigens on all forms of villous trophoblast. The extra-villous trophoblast which reacted with antibodies to monomorphic class 1 MHC antigens consistently failed to bind HLA-A or HLA-B antibodies specific for the foetal phenotype. This suggests, but does not prove, that the MHC antigen expression of trophoblast may be restricted to HLA-C or some other undefined class 1 antigen.

Antibody Specificity↗
PubMed1983

Case-control study of severe pre-eclampsia of early onset.

Twenty four women with severe pre-eclampsia diagnosed before 34 weeks' gestation were compared with 48 randomly selected controls matched for age and parity. Subjects were studied in the puerperium using a questionnaire, clinical examination, and review of case records. A history of infertility, headaches (particularly migraine), pre-eclampsia in a previous pregnancy, or a raised serum alpha-fetoprotein concentration at the time of screening for neural tube defect in the index pregnancy were all identified as significant risk factors in the pre-eclamptic women. Maternal age, a history of chronic hypertension or renal disease, or excessive maternal weight were not significantly associated with pre-eclampsia. Almost all the infants of pre-eclamptic women showed retarded growth: 18 were below the 10th centile and only one weighed more than the 25th centile. Four babies died. These observations indicate that pre-eclampsia of early onset may differ from the late onset disease not only in its very high perinatal morbidity and mortality but in its distinctive maternal risk factors.

Adolescent↗
PubMed1983

Lymphocyte subsets in normal and pre-eclamptic pregnancies.

Peripheral blood lymphocyte subsets in normal and preeclamptic pregnancies have been studied by using the monoclonal antibodies OKT3 (T cells), OKT4 (helper/inducer T cells) and OKT8 (suppressor/cytotoxic T cells). In addition the numbers of mononuclear cells bearing Ia and monocyte antigens have been assessed by using the monoclonal antibodies OKIa1 and OKM1. No significant differences were found between 10 normal pregnant and 10 non-pregnant subjects. Ten preeclamptic patients were studied and showed an increase in OKT4-positive helper cells. This was significant in terms of percentage of mononuclear cells but not the absolute numbers or the helper/suppressor (OKT4/OKT8) ratio.

Adolescent↗
PubMed1983

Antenatal fetal heart-rate variability in relation to fetal acid-base status at caesarean section.

A quantitative comparison was made of fetal heart-rate (FHR) traces obtained shortly before delivery, and of umbilical artery blood gas values, in 49 women delivered by caesarean section for reasons other than fetal compromise and in 23 women delivered by section for antenatal fetal compromise judged from visual inspection of conventional FHR recordings. The FHR traces in the compromised group of fetuses were abnormal, with low variability and a high incidence of decelerations, but there was no significant difference from the normal group in metabolic acidaemia, as judged by the base excess of umbilical artery blood. The compromised group consisted almost exclusively of infants small-for-gestational age. These results suggest that the FHR pattern of the compromised fetuses is not the direct result of intrauterine asphyxia but of some other factor associated with growth retardation.

Acid-Base Imbalance↗
PubMed1983

Maternal hypertension with superimposed pre-eclampsia: effects on child development at 71/2 years.

Children born to women participating in a prospective study of hypertension during pregnancy were followed up from birth. Data on growth and development at the age of 71/2 years of 56 children whose mothers had superimposed pre-eclampsia are compared with results of 176 children whose mothers had only hypertension. Perinatal mortality in the hypertension-only group was similar to that for the hospital population in general at the time of their birth; but in the group who developed preeclampsia it was significantly higher. At the age of 71/2 years no differences were found in the frequency of health, handicap, sight and hearing problems, weight, height, head circumference, and standing and supine blood pressures. For six aspects of intellectual development children in the pre-eclampsia group had slightly higher mean scores; and in one of these, "perceptual matching' the difference was significant after adjustment had been made for confounding variables. Pre-eclampsia superimposed on hypertension does not increase the likelihood of impaired growth and development among children who survive the perinatal period.

Child↗
PubMed1983

Lymphocyte subsets defined by monoclonal antibodies in human pregnancy.

Using monoclonal antibodies, indirect immunofluorescence, and flow cytometry, the proportions and absolute numbers of various lymphocyte subsets in peripheral blood have been measured in normal human pregnancy. Groups of ten women were studied at 12, 28, and 36 weeks of gestation and compared with 16 nonpregnant control women. The percentage of T cells (OKT3+) was constant throughout pregnancy, and this was confirmed in three women studied serially prior to and throughout early pregnancy. A slight fall in the proportion of helper cells (OKT4+) and rise in the proportion of suppressor cells (OKT8+) was observed at 12 and 28 weeks, but these changes, and the resulting fall in helper/suppressor ratio, were not statistically significant. Absolute lymphocyte counts determined by white cell count and differential were lower during pregnancy. The absolute numbers of T cells, helper cells, suppressor cells, and Ia-bearing cells (mainly B cells) were significantly lower at 36 weeks' gestation. T cells and helper cells were significantly reduced in absolute number at 12 weeks' gestation. There was no change in the ratio of T cells to B cells at any stage of gestation. The lack of any significant change in the balance between helper and suppressor cells in peripheral blood suggests that these cells are not important in the immune adaptation to pregnancy.

Adolescent↗