Corticosteroids, real-time ultrasound scanning and plasmapheresis in severe rhesus disease.
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Biomedical subjects
Publications and source records attributed to D L Woods.
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In a population characterized by short and underweight mothers, weight gain during the third trimester and post-delivery weight were found to be more important determinants of birth weight than was maternal height. These findings suggest that maternal energy stores during pregnancy, rather than genetic factors or childhood nutrition as reflected by height, influence fetal growth in undernourished communities.
The antibacterial activity of amniotic fluid against Escherichia coli in the last month of pregnancy was reduced in an unselected sample of mothers delivering in Cape Town. Amniotic fluid zinc, required for normal antibacterial activity, was also reduced. These findings offer an explanation for the high incidence of amniotic fluid infection previously reported.
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The gastric aspirate foam test was performed on 99 infants of low birth weight. In 59 of 61 infants with no respiratory distress, the test was positive. All infants who developed hyaline membrane disease (HMD) had negative or intermediate foam test results. There was no consistent relationship between the foam test result and the development of wet lung syndrome. Infants who were small for gestational age had a significantly lower incidence of HMD, as did infants with amniotic fluid infection syndrome. These data indicate that the gastric aspirate foam test is a reliable index of neonatal lung maturity.
The measurement of weight, length and head circumference at birth was used to document the size and shape of infants born at term in a population where mothers are relatively short and underweight. Different patterns of intrauterine growth are proposed to explain the variation in the infant's appearance at birth. Most of the small-for-gestational-age infants were proportionately stunted. This pattern of fetal growth is probably characteristic of infants born to undernourished mothers in economically developing communities, and reflects prolonged intrauterine growth retardation.
The stature and weight of Coloured primigravidas delivering at term in Cape Town were investigated. When compared with White mothers they were found to be significantly shorter, lighter and thinner. It is postulated that both childhood undernutrition and an inadequate diet during pregnancy are responsible for these findings.
The placentas of 1,081 infants born to Coloured primigravidas in Cape Town were examined. The values for gross and trimmed placental weight, chorionic surface area and thickness are given for each week of gestation from 32 to 41 weeks. These results indicate the pattern of placental growth and provide a basis for further studies to evaluate deviations of intra-uterine growth in this population.
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The incidence of amniotic fluid infection, determined by histological examination of the placenta and cord and cytological examination of gastric aspirate, was found to be high (52%) in term deliveries. A detailed histological system of grading the inflammatory response was used. No relationship was found between maternal nutritional factors or the baby's weight and inflammatory response, as judged by histological examination. The presence of pus cells in the gastric aspirate was of only limited diagnostic value. The absence of clinically obvious infection in the infants suggested amniotic fluid colonization without spread to the fetus.
In response to a sustained toneburst a negative baseline shift can be recorded from the human fronto-central scalp regions with an onset latency of approximately 150 msec. This auditory sustained potential is distinct both in its scalp distribution and in its stimulus relationships from the transient response occurring at the onset or offset of the toneburst. It differs from the contingent negative variation in that it can occur in the absence of attention or during sleep. Attention to the auditory stimulus can increase the amplitude of the sustained potential, possibly through the addition of an extra negative potential related to auditory expectancy or uncertainty.
The auditory sustained potential recorded from the human scalp increases in amplitude with increasing stimulus intensity. At rapid rates of stimulus presentation its amplitude decreases but proportionately less so than the amplitude of the transient onset auditory evoked potential. The frequency specificity of this rate effect is complex, suggesting that there may be two underlying components of the scalp-recorded auditory sustained potential. The amplitude of the auditory sustained potential is smaller when the tonal frequency of the stimulus is higher. With prolonged stimulus durations there is some adaptation of the amplitude of the auditory sustained potential. This potential is larger in amplitude when sounds are presented binaurally than monaurally, and has a symmetrical coronal scalp distribution that is unaffected by the ear of stimulation.
The site of the insertion of the umbilical cord into the placenta was determined in 940 consecutive term infants. No relation was found between birth weight and whether the cord was inserted centrally, eccentrically or marginally.
Pairs of twins born concordant for weight score equally on both neurological and external criteria. The assessed gestational age of discordant twins is significantly different; while scoring equally on neurological criteria, the lighter twin scores less on external criteria. It is suggested that this pattern of underscoring may also be present in growth retarded singletons. If external criteria are used in estimating the gestational age of growth retarded infants, the results should be interpreted with caution.
A large number of different components of the auditory evoked potential can be recorded from the human scalp using averaging techniques. It is now possible to evaluate with such evoked potential measurements the functioning of the entire human auditory system from the hair cell receptors to the association areas of cortex. This multiplicity of evoked potential components is important clinically since any one component measurement may be the most appropriate for a certain subject at a certain time, and also because the replication of objective audiological findings using more than one testing method allows greater confidence in the results. As well as providing an accurate means of determining the extent of a hearing loss, evoked potential studies can also provide information concerning the type and location of such a defect.