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Biomedical subjects

C W Redman

Publications and source records attributed to C W Redman.

At least 271 records · Page 15Linked to original sources
PubMed1978

Closing volume during normal pregnancy.

Serial lung function studies were performed in ten healthy, primiparous women aged 21--28. Measurements were made at two-monthly intervals during pregnancy and included functional residual capacity (FRC), total lung capacity (TLC), vital capacity (VC), specific conductance (SGaw) and closing volume (CV) on each occasion. Closing volume expressed as formular: (see text), showed a progressive rise during pregnancy in all subjects with a linear relationship to time (P less than 0.001, P greater than 0.01, respectively). No consistent changes in lung volume could be shown during pregnancy over the study period. It is suggested that the increase in closing volume during pregnancy might result in abnormalities of distribution of ventilation sufficient to explain the maternal blood gas disturbances of pregnancy.

Adult↗
PubMed1978

Thromboxane B2 and human parturition: concentrations in the plasma and production in vitro.

The concentration of thromboxane B2 has been measured in the plasma of women during late pregnancy, during term and pre-term labour, in women with pre-eclampsia and in umbilical cord arterial and venous plasma. In addition, the rates of production of thromboxane B2 in vitro were determined for placental tissues obtained after spontaneous vaginal delivery or elective Caesarean section. The results obtained indicate significant differences during parturition between the sources and controlling mechanisms of thromboxane and prostaglandin production.

Female↗
PubMed1977

Factor-VIII consumption in pre-eclampsia.

In 50 women with high-risk pregnancies, increased factor-VII consumption, as estimated by the difference between the levels of factor-VIII-related antigen and factor-VIII clotting activity, correlated with the severity of pre-eclampsia, particularly when measured by increases in plasma-urate. Longitudinal studies of the evolution of pre-eclampsia demonstrated that increased factor-VIII consumption usually but not always developed before hyperuricaemia. The earliest time that abnormal factor-VIII consumption was demonstrated was at 18 weeks' gestation in a woman who had had two previous stillbirths. Subcutaneous heparin and oral dipyridamole failed to reverse the coagulation abnormality, and the fetus died in utero at 28 weeks' gestation. The renal and coagulation changes characteristic of pre-eclampsia were also seen in a patient without hypertension. This suggests that the concept of pre-eclampsia may need to be widened to include a non-hypertensive syndrome characterised by these changes in clotting and renal function.

Adult↗
PubMed1977

Hypertension during pregnancy, with and without specific hypotensive treatment. I. Perinatal factors and neonatal morbidity.

In a prospective study, women who were hypertensive before the 28th wk of gestation were randomly allocated into two groups: those who received specific hypotensive therapy (Ht) and those who did not (Hu). The outcome was compared with a random sample of the hospital population (S) ascertained after delivery. In both hypertensive groups there was a higher incidence of clinical signs of possible fetal distress and instrumental delivery. Although there was no difference between the groups in the distribution of birthweight above and below the mean for gestational age, the treated hypertensive group had an excess of infants with relatively smaller head circumferences for their gestational age compared with both the untreated hypertensive group and the hospital sample. Tube-feeding was also more frequent in the treated hypertensive group. In the untreated hypertensive group there were more infants whose neurological status was categorized as questionable or abnormal in the neonatal period, compared with the sample. The different problems encountered by infants in the two hypertensive groups emphasized the need for further study of these babies. Their development during the first year of life will be examined in a subsequent paper.

Female↗
PubMed1977

Hypertension during pregnancy, with and without specific hypotensive treatment. II. The growth and development of the infant in the first year of life.

The growth and development of three groups of infants were prospectively assessed from birth to 12 mth. In two groups the mothers had been hypertensive before the 28th wk of gestation; one group was randomly allocated to specific hypotensive therapy, the other group was allocated to no specific treatment. The third group was a sample of the hospital population. General health, and the incidence of sight and hearing problems did not differ. Infants in the treated hypertensive group had had more perinatal problems, and there was an excess of infants with relatively small heads for their gestational age at birth. At 6 mth their heads were still smaller than the hospital sample, but by the age of 1 yr the difference was no longer present. The neurological status of infants in the untreated hypertensive group was less favourable in the neonatal period, and there was still an excess of infants in this group rated questionable on neurological assessment at the age of 12 mth. In both hypertensive groups there was an excess of infants with delayed fine-motor function at 6 mth, and in the untreated group there was an excess with delayed gross-motor function at 12 mth compared with the hospital sample. Our varied findings draw attention to the dangers of assessing the effects of different pregnancy conditions in terms of neonatal mortality and morbidity alone. Our date indicate that follow-up should extend for longer than 12 mth when the effects of adverse pregnancy factors and their management are under consideration. Further evaluation will be made when these children are 4 yr old.

Child Development↗
PubMed1977

Plasma urate and serum deoxycytidylate deaminase measurements for the early diagnosis of pre-eclampsia.

The value of measuring plasma urate and serum deoxycytidylate deaminase (dCMP deaminase) for the early diagnosis of pre-eclampsia has been investigated in 45 patients. A combination of increased blood pressure and increased plasma urate identified 19 patients with a high incidence of fetal and maternal morbidity ascribable to pre-eclampsia. Seventeen of the 19 patients also had an increased serum dCMP deaminase. Serial antenatal observations for a mean period of 104 days (36-179 days) on 33 of the patients demonstrated that plasma urate and serum dCMP deaminase increased together as early changes in the development of pre-eclampsia. In six patients, blood pressure, plasma urate and serum dCMP deaminase all increased but in only one was the rise in blood pressure the first change. Elevations of plasma urate and serum dCMP deaminase are therefore both early features of pre-eclampsia. Serial measurements can give warning of the disorder before the appearance of other clinical features. The change in dCMP deaminase is probably another reflection of early renal involvement in the pre-eclamptic process.

Blood Pressure↗
PubMed1977

Treatment of hypertension in pregnancy with methyldopa: blood pressure control and side effects.

A total of 242 women with moderate hypertension in pregnancy completed a controlled trial of methyldopa (Aldomet). The hypotensive effect of methyldopa was similar to its action in non-pregnant individuals and greatly reduced the frequency of severe hypertension occurring antenatally and in labour. As pregnancy advanced, an increasing daily dose of methyldopa was needed and there was a greater use of additional hypotensive therapy. Seventeen (14-5 per cent) women assigned to methyldopa had to be transferred to another drug or had to stop treatment completely because of minor side effects, of which the commonest were lack of energy and dizziness. No serious side effects were encountered. Nine per cent of the untreated women developed severe hypertension which required treatment later in their pregnancies. Six weeks after delivery, nearly all the patients were able to stop treatment.

Blood Pressure↗
PubMed1976

Fetal outcome in trial of antihypertensive treatment in pregnancy.

242 women completed a controlled trial of methyldopa ('Aldomet') for moderate hypertension in pregnancy. Active treatment was associated with a significantly improved fetal outcome, due in part to a reduced number of mid-pregnancy abortions. There were 9 pregnancy losses in the control group, which included 4 mid-pregnancy abortions, and 1 fetal loss in the treated group. The birthweight and maturity of viable infants were similar in treated and control groups, and a detailed multivariate analysis confirmed that hypotensive treatment had no effect on fetal growth in utero. The better outcome associated with treatment was not due to the prevention of pre-eclampsia, and may be partly due to a direct or indirect effect of methyldopa on uterine activity. Methyldopa is safe to use for the treatment of hypertension in pregnancy in the context of close medical and obstetric supervision.

Abortion, Spontaneous↗
PubMed1976

Plasma-urate measurements in predicting fetal death in hypertensive pregnancy.

The relation of perinatal mortality to plasma-urate concentrations and blood-pressure was studied in 332 pregnant patients with hypertension. Perinatal mortality was markedly increased when maternal plasma-urate concentrations were raised, generally in association with severe pre-eclampsia of early onset. Plasma-urate was a better indicator than blood-pressure of prognosis for the fetus. Maternal hypertension, even severe, without hyperuricaemia, was associated with an excellent prognosis for the fetus. Conversely, when maternal hypertension was mild and hyperuricaemia was severe, the prognosis for the fetus was poor. These findings suggest that, in terms of fetal health, changes in renal handling of urate may be a more important feature of pre-eclampsia than the hypertension.

Blood Pressure↗
PubMed1976

Reversed diurnal blood pressure rhythm in hypertensive pregnancies.

1. Reversal of the normal diurnal blood pressure pattern has been demonstrated in women with severe hypertension and renal impairment in pregnancy (pre-eclampsia). 2. Maximum arterial pressure occurred at night in these women. The phenomenon was not due to hypotensive drug therapy or posture. Patients with uncomplicated essential hypertension in pregnancy retained a normal diurnal blood pressure pattern. 3. Nocturnal hypertension in pre-eclampsia is of theoretical interest and practical importance.

Blood Pressure↗
PubMed1976

The role of coagulation and fibrinolysis in preeclampsia.

The coagulation and fibrinolytic systems play a key role in maintaining the integrity and patency of the vascular compartment. Pregnancy induces extensive physiological changes in these systems, thus creating an enhanced capacity to produce fibrin and a diminished ability to remove it. Fibrin deposition localized to the uteroplacental circulation is a feature of normal pregnancy. In women with fatal eclampsia, disseminated intravascular coagulation with fibrin deposition in the renal glomeruli is well documented. The condition of preeclampsia is not well defined. Nonetheless, evidence of intravascular coagulation, as shown by elevated levels of fibrin degradation products and reduced platelet counts, has been found in many women with preeclampsia. Serial studies showed that thrombin generation, as indicated by the ratio of factor VIII-related antigen to factor VIII coagulant activity, is considerably in excess of that which occurs in normal pregnancy, and its appearance coincides with the development of the clinical features of preeclampsia. Heparin therapy has bot been proven of value in established preeclampsia, but this fact does not disprove that role that intravascular coagulation may play in the pathogenesis of the disease. A controlled trial ina high-risk group of low-dose he;arin and an antiplatelet agent from the 16th to the 18th weeks of pregnancy onwards is required to elucidate the role of intravascular coagulation in preeclapmsia and its effect on the fetus.

Blood Cell Count↗
PubMed1976

Variability of blood pressure in normal and abnormal pregnancy.

Using an automatic indirect method of measurement, diurnal blood pressure patterns have been studied in normal and hypertensive pregnancies. In the last trimester, normotensive and hypertensive pregnant subjects show small but significant increases of blood pressure that develop especially during the evening and night. This change is more clear-cut for the systolic than the diastolic pressure. The tendency to a relatively greater increased pressure at night is exaggerated in preeclampsia. This fact explains earlier observations of a dimunution of the nocturnal fall of blood pressure in preeclampsia. In very severe preeclampsia, the nocturnal increase of blood pressure may be so exaggerated as to reverse the normal diurnal blood pressure pattern. These changes have been documented sequentially, and their implications are discussed briefly.

Blood Pressure↗
PubMed1975

Prolactin in hypertensive pregnancy.

Plasma prolactin levels were measured in 68 pregnant women with hypertension at 32 weeks gestation. They were raised in pregnancies with pre-eclamptic features, most significantly in women with a rising plasma urate level. No correlation was found between the level of the untreated blood pressure and prolactin. Proteinuria did not influence prolactin levels independently of changes in the plasma urate. The differences in prolactin levels could not be ascribed to the drugs administered.

Edema↗