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Biomedical subjects

D A Davey

Publications and source records attributed to D A Davey.

At least 37 records · Page 2Linked to original sources
PubMed1988

Plasma volume expansion in pregnancy hypertension.

Stabilised human serum 500 ml was infused intravenously over 90 minutes in 14 hypertensive women in late pregnancy, and the haemodynamic changes were investigated and compared with those in 7 similar women who were not treated. There was a significant mean increase of 1,85 l in plasma volume, a decrease in diastolic and systolic blood pressure, and an increase in central venous pressure (CVP), pulse pressure and pulse rate in the treated group at 2 hours but not in the control group. After 24 hours most of the observations were not significantly different from the pretreatment levels except the CVP and pulse rate measurements which were still significantly raised. The CVP measurements in the hypertensive women before treatment were relatively low compared with those reported in normal women in late pregnancy. It is suggested that there may be an under-filling of the circulation in pregnancy hypertension and that plasma volume expansion may have an important therapeutic effect by increasing cardiac output and renal and uterine blood flow.

Blood Pressure↗
PubMed1988

The classification and definition of the hypertensive disorders of pregnancy.

Hypertension and proteinuria in pregnancy may be the result of a number of different disorders with different etiologies and pathologic characteristics. As the causes of hypertension and proteinuria in pregnancy are largely unknown, a new clinical classification of the hypertensive disorders is proposed and is based solely on the physical signs of hypertension and proteinuria. The classification is intended to define meaningful clinical categories by which all cases of hypertension and proteinuria occurring in pregnancy, labor, or the puerperium may be classified. New definitions of hypertension and proteinuria are also proposed; they are based on standardized methods of measurement and simple criteria of abnormality. It is hoped that this clinical classification and associated definitions will find general acceptance so that the incidence and outcome of the hypertensive disorders of pregnancy and the results of research in different centers may be compared and mutual understanding achieved.

Diagnosis, Differential↗
PubMed1988

The effect of sublingual nifedipine on uteroplacental blood flow in hypertensive pregnancy.

The effect of nifedipine on uteroplacental blood flow was investigated in nine hypertensive women in the trimester of pregnancy and compared with the effects of a placebo in nine similar hypertensive women. An index of uteroplacental blood flow was obtained, twice before treatment and once after treatment, by measuring the increase in radioactivity in the region of the placenta with a gamma camera following an intravenous injection of indium-113m. There was no significant change in the blood flow index in either the nifedipine- or the placebo-treated groups despite a significant fall in blood pressure with nifedipine. Nifedipine lowers the blood pressure without any apparent reduction in uteroplacental blood flow.

Adult↗
PubMed1984

The value of an auditory stimulatory test in antenatal fetal cardiotocography.

One hundred auditory stimulatory antenatal fetal cardiotocographic tests were compared to standard non-stress tests in patients with pregnancy hypertension. The incidence of equivocal tests was significantly reduced. The A.S.T. is a simple and reliable test for assessing fetal heart reactivity in hypertensive pregnancy.

Acoustic Stimulation↗
PubMed1983

Prazosin and oxprenolol therapy in pregnancy hypertension.

Prazosin (Minipress; Pfizer), the first purely alpha-blocking antihypertensive agent, was used to treat 22 pregnant patients with moderately severe hypertension (diastolic blood pressure persistently above 95 mmHg at gestational ages ranging from 18 to 33 weeks). Prazosin was used because it is a postsynaptic alpha-blocking agent producing no direct tachycardia or renin stimulation and because its action in producing visceral vasodilation might improve uteroplacental perfusion. Oxprenolol (Trasicor; Ciba), a beta-blocking agent with intrinsic sympathomimetic activity, was added to the prazosin regimen in 12 cases. In this group pregnancy was prolonged for an average of 32 days and 10 infants survived the neonatal period. Fetal loss, mainly due to abortion, was high in the patients who had significant proteinuria, and it was not possible to prolong the pregnancy in these cases. There were no significant maternal, fetal or neonatal side-effects attributable to this combined alpha- and beta-blocking therapy, which may have both theoretical and practical advantages over other current therapies.

Blood Pressure↗
PubMed1983

Neurofibromatosis and severe hypertension in pregnancy.

Four pregnant patients with neurofibromatosis (Von Recklinghausen's disease) either developed hypertension during pregnancy or had an exacerbation of a pre-existing chronic hypertension. Two patients required early termination of pregnancy for severe hypertension; a third had severe intrauterine growth retardation resulting in intrauterine fetal death; and one had an otherwise uneventful pregnancy and a live healthy infant. Because of the association between neurofibromatosis and hypertension, patients with neurofibromatosis require special antenatal care and management.

Adult↗
PubMed1982

A comparison of endometrial sampling with the Accurette and Vabra aspirator and uterine curettage.

Endometrial samples were obtained with the Accurette and the Vabra aspirator and were compared with samples obtained by dilation and curettage in 40 patients with postmenopausal bleeding. The degree of discomfort and patient acceptability of the two outpatient procedures, the adequacy of the samples for cytological and histological examination, and the cytological and histological diagnosis were compared. The Accurette and the Vabra aspirator could not be inserted in 5 out of 40 patients because of cervical stenosis. From approximately 30 of the remaining 35 patients, adequate samples were obtained. Six cases of endometrial hyperplasia and 3 of endometrial carcinoma were diagnosed by all the methods employed, except for 1 case of endometrial hyperplasia in which the sample obtained with the Accurette was inadequate for histological examination but was nevertheless adequate for cytological examination. Of the 5 patients in whom endometrial sampling by both the Accurette and the Vabra aspirator could not be performed because of cervical stenosis, 2 cases of endometrial carcinoma were found on uterine curettage. In patients with cervical stenosis, however, dilatation and curettage under general anaesthesia is mandatory. The Accurette has the advantage of being less expensive and more suitable for routine endometrial sampling for the detection of endometrial hyperplasia or carcinoma and dating of the endometrium in cases of infertility. Both the Accurette procedure and Vabra aspiration appeared to be reliable methods of obtaining endometrial samples.

Curettage↗
PubMed1982

The Peninsula Maternity and Neonatal Service. An urban community perinatal programme.

The first year of existence of the Peninsula Maternity and Neonatal Service (PMNS) is reviewed. Some 21000 deliveries per annum fall under the Service. The ethnic distribution in 1980 was 27% Black, 69% Coloured and 4% White. The perinatal mortality rates per 1000 births were 31,2 for Blacks, 29,4 for Coloureds and 15,0 for Whites, with an overall perinatal mortality rate for the PMNS of 29,2. The administration of the PMNS is described. The Midwife Obstetric Units are discussed under the following headings: function, workload, advantages, and continuing education. Research opportunities and the main problems in the PMNS are outlined.

Education, Continuing↗
PubMed1982

Intravenous labetalol and intravenous dihydralazine in severe hypertension in pregnancy.

The effect of intravenous infusion of labetalol and of dihydralazine in increasing doses was compared in 12 women with severe hypertension in pregnancy. In 5 our of 6 women labetalol produced a smooth, progressive fall in blood pressure to normal levels with minimal side effects. In 2 our of 6 women on dihydralazine the blood pressure control was satisfactory but in the remaining 4 patients treatment had to by discontinued because of unpredictable, sudden falls in blood pressure. One of the 6 infants of mothers treated with labetalol manifested signs of adrenergic blockade. Continuous infusion of labetalol appears to offer significant advantages in the management of severe hypertension in pregnancy and merits further trial.

Adult↗
PubMed1981

An evaluation of prostaglandin E2 administered intrarectally to induce labour.

Prostaglandin E2 (PGE) 4 mg administered as an intrarectal suppository failed to induce labour in 70% of patients with a favourable cervical score. This may indicate that intravaginally administered PGE, which is effective in inducing labour in 70% of patients, acts at least in part directly on the cervix.

Evaluation Studies as Topic↗
PubMed1981

Plasma adrenaline, noradrenaline and dopamine in pregnancy hypertension.

The resting plasma adrenaline, noradrenaline and dopamine were measured in nine hypertensive women and seven normotensive women in the third trimester of pregnancy on two successive days. The mean plasma adrenaline concentrations on the two days in the hypertensive women (442 and 298 pg/ml) were significantly higher than in the normotensive women (43.9 and 61.6 pg/ml). The mean plasma noradrenaline concentrations in the hypertensive women (232 and 274 pg/ml) were higher than in the normotensive women (48 and 110 pg/ml) and the difference was significant on Day 1 but not Day 2. The mean plasma dopamine concentrations in the hypertensive women (98.6 and 62.1 pg/ml) were higher than in the normotensive women (23.2 and 26.0 pg/ml) and the difference was significant on Day 1 but not Day 2. The plasma adrenaline/noradrenaline ratios were significantly increased in the hypertensive compared with the normotensive women on both days. It is suggested that sympathetic nervous system activity may be increased in some women with hypertension in pregnancy.

Adolescent↗
PubMed1980

The effect of sterilization by bipolar cautery and falope ring on menstrual bleeding patterns.

Bleeding patterns in women sterilized by the laparoscopic route using bipolar cautery and Falope ring are compared with those in women whose husbands had been vasectomized 1 year previously. No significant association exists between the technique of sterilization used and a change in duration or amount of bleeding. Although there was an increase in the amount and duration of bleeding in some cases, there was an equivalent decrease in amount and duration of bleeding in others. There is no significant difference in bleeding patterns between women who have had laparoscopic sterilization and women whose husbands have been vasectomized.

Female↗