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Biomedical subjects

C W Redman

Publications and source records attributed to C W Redman.

At least 253 records · Page 14Linked to original sources
PubMed1981

Numerical analysis of the normal human antenatal fetal heart rate.

A numerical method for separation of the frequency components of the fetal heart rate, and for identifying episodes of high or low variation, was applied to 196 64-minute ultrasound records in normal pregnancies during the last half of gestation. Most variables of heart period variation increased with gestation, as did the incidence of accelerations. Before 35 weeks, accelerations of greater than or equal to 14 beats/minute did not occur in all records. Cyclic episodes of low and high variation ("unreactive' and "reactive' episodes), associated with rest-activity cycles, could be identified from 27 weeks onwards. After 36 weeks gestation the length of low variation episodes increased and the variation during these episodes fell. Near term, low variation episodes lasted up to 40 minutes. It is concluded that on scrutiny of fetal heart rate records for evidence of normality, or otherwise, due account should be taken of gestational age.

Female↗
PubMed1981

Monoclonal antibodies to human syncytiotrophoblast.

Two monoclonal antibodies, NDOG1 and NDOG2, have been produced which are directed towards human syncytiotrophoblast. The antigens detected by these antibodies are absent from human liver, heart, kidney, brain and from normal human sera. The NDOG1 antigen but not NDOG2 antigen is a component of pregnancy sera and falls to undetectable levels within 6 hours of placental delivery. This molecule is not human chorionic gonadotrophin, human placental lactogen, placental alkaline phosphatase. SP1 or PAPP-A. Immunoperoxidase staining shows that both antigens are on apical aspects of the syncytiotrophoblast and not in the villous stroma.

Antibodies, Monoclonal↗
PubMed1981

HLA A, B, C antigens are expressed on nonvillous trophoblast of the early human placenta.

Samples were taken from the human chorionic sac at 6 wk postconception and were stained with monoclonal antibodies to trophoblast and to HLA antigens by means of an indirect immunoperoxidase technique. Antibody to HLA A, B, C antigens did not stain chorionic villous trophoblast in accordance with previous studies, but did stain nonvillous trophoblast of the cytotrophoblast cell columns and cytotrophoblastic shell. Antibody to HLA DR antigens showed no staining of trophoblast. This is the first demonstration of HLA antigens on a human fetal tissue in direct maternal contact. We have discussed the immunologic implications of this finding.

Abortion, Induced↗
PubMed1980

Nonstressed antepartum heart rate monitoring: implications of decelerations after spontaneous contractions.

Fetal outcome in 98 patients with spontaneous antepartum late decelerations was studied by combining the data of two obstetric departments. Heart rate variability was used to classify the different patterns into two categories: terminal and decelerative. In 14 of the 47 pregnancies in which a terminal pattern was found, intrauterine death occurred within a week. Of the remaining 33 fetuses, 71% were acidemic at elective cesarean section (CS). In contrast, all of the 51 fetuses with a decelerative cardiotocogram (CTG) survived the antenatal period, and only two of 25 were acidemic at elective CS. Labor was induced in 20 patients with a decelerative CTG, and fetal distress occurred in 12, of whom 10 were eventually delivered by CS. All fetuses with a repetitive decelerative heart rate pattern antepartum developed distress in labor. In contrast, an isolated deceleration, on one occasion only, was not associated with distress during labor, except in growth-retarded fetuses. The clinical implications of these findings are discussed and the results are compared with those of oxytocin contraction stress tests.

Acidosis↗
PubMed1980

Hypertension during pregnancy with and without specific treatment; the development of the children at the age of four years.

In a controlled trial pregnant women who were hypertensive before the 28th week of gestation were randomly allocated to treatment with methyldopa or no anti-hypertensive treatment. The children from these pregnancies have been re-examined at four years of age and their development compared with a random sample from the same maternity hospital population. Their health, height, weight, and the incidence of sight, hearing and speech problems did not differ. None had gross neurological abnormalities. Boys in the treated hypertensive group had significantly smaller heads than in the other two groups, but there was no correlation between head circumference and developmental score in this group (r = 0.020). On average the children in the random sample were the most advanced when assessed by a global score of development. In each developmental sector the mean score for the treated hypertensive group was consistently higher than the untreated hypertensive group. We conclude that maternal hypertension is associated with slight developmental delay in early childhood. There are some indications that treatment with methyldopa may reduce this effect.

Child Development↗
PubMed1979

The concentrations of the prostaglandins E and F, 13 14-dihydro-15-oxo-prostaglandin F and thromboxane B2. In tissues obtained from women with and without pre-eclampsia.

The concentrations of prostaglandins E (PGE) and F (PGF), 13, 14-dihydro-15-oxo-prostaglandin F (PGFM) and thromboxane B2 (TXB2) were measured by specific radioimmunoassays in tissues obtained from women with and without pre-eclampsia. The concentrations of PGE in the amnion, chorion, decidua and placenta obtained from subjects with pre-eclampsia were significantly lower than those from subjects without pre-eclampsia. The concentration of PGE in these tissues increased significantly with gestational age and correlated with urinary oestrogen excretion. PGF concentrations were lower in the amnion and placenta of the pre-eclamptics compared to those without pre-eclampsia. The concentrations of PGFM in the amnion, decidua, and myometrium were lower in the pre-eclamptics. No significant difference in the TXB2 concentrations between the two groups of subjects were found. It is suggested that the altered tissue concentrations of prostaglandins in pre-eclamptics are due to the effects of gestational age and oestrogens and may or may not be involved in the pathogenesis of pre-eclampsia.

Adolescent↗
PubMed1979

Coagulation problems in human pregnancy.

Coagulation problems in pregnancy are primarily associated with overactivity of the intrinsic clotting system. This accounts for the increased incidence of thrombo-embolism during pregnancy. Where specific obstetric complications cause clotting problems the common underlying feature is usually placental pathology as in abruptio placentae, pre-eclampsia or hydatidiform mole. Abnormal activation of the clotting system is an early, and occasionally the first detectable feature of pre-eclampsia, but there is no evidence that this is a primary change. Therefore the role of anticoagulant treatment in the management of pre-eclampsia remains questionable. A new test for estimating factor VIII consumption is proving to be a sensitive index of early activation of the clotting system and can be used for the diagnosis of early pre-eclampsia.

Abruptio Placentae↗
PubMed1978

HLA antigens in severe pre-eclampsia.

When the HLA types of 80 pre-eclamptic women and their husbands and 83 control couples were compared significantly more pre-eclamptic women had only one identifiable HLA B antigen, and were presumed to be homozygous at this locus. Those who were homozygous for HLA B were more likely to be homozygous for HLA A as well, and more likely to be homozygous for HLA A as well, and to have more severe pre-eclampsia. There was neither increased HLA incompatibility nor greater antigen-sharing between pre-eclamptic women and their husbands, but maternal HLA A and B homozygosity reduced the number of antigenic disparities between pre-eclamptic women and their husbands. The data are consistent with the hypothesis that maternal recessive immune-response genes may contribute to the development of pre-eclampsia. Alternatively maternal HLA homozygosity may predispose to fetal changes comparable to runting.

Epitopes↗
PubMed1978

Circulating immune complexes in pre-eclampsia.

Sixteen patients with severe pre-eclampsia had more IgG-containing and C1q-binding circulating soluble immune complexes than did 16 matched women with normal pregnancies. The clinical features of preeclampsia may be explained by damage due to such complexes, although raised complex levels were also present in a few women with normal pregnancies. As immune complexes are so heterogenous in terms of the type of antigen, class and subclass of immunoglobulin, size, and complement-binding capacity, further investigations are needed to determine their role in normal and pre-eclamptic pregnancies.

Antigen-Antibody Complex↗
PubMed1978

Early platelet consumption in pre-eclampsia.

One hundred and thirty-one women with chronic hypertension were studied serially during pregnancy to determine the sequence of events in the development of superimposed pre-eclampsia and to discover the time of onset. Twenty-seven women developed a sustained rise in plasma urate concentrations, which began at about 28 weeks' gestation and which is characteristic of pre-eclampsia. The mean platelet count was already significantly reduced and continued to fall until delivery, which was on average at 36 weeks' gestation. A comparable but smaller decrease in platelet count was seen in 55 women who had borderline but consistent increases in plasma urate concentrations. In 49 women whose plasma urate concentrations remained steady the platelet count did not change significantly before delivery. The reduced platelet count in women who develop pre-eclampsia suggests that increased platelet consumption is an early feature of the disorder.

Adult↗
PubMed1978

Neonatal head circumference and the treatment of maternal hypertension.

In a random controlled trial of methyldopa for the treatment of hypertension in pregnancy presenting before 28 weeks gestation, the newborn in the treated group had relatively smaller head circumferences. This difference persisted at two months of age when correction had been made for birth weight, gestation and sex, but was no longeer detectable at six or twelve months. Within the treated group no relationship was found between neonatal head circumference and the total amount or duration of methyldopa received during pregnancy. Comparison of treated and untreated groups according to the time of entry to the study showed that significant differences in neonatal head circumference were only present in patients who entered between 16 and 20 weeks gestation. It is possible that this could be a sensitive period for the interaction of fetal head growth and the onset of specific treatment in hypertensive pregnancy.

Clinical Trials as Topic↗