Biomedical subjects
Publications and source records attributed to D T Liu.
A case of severe osteoporosis following administration of low dose subcutaneous heparin in pregnancy is reported. Possible reasons for the condition are suggested which caution against the indiscriminate use of subcutaneous heparin in pregnancy.
Blind transcervical aspiration for trophoblast was carried out on 137 patients undergoing elective termination of early pregnancies. Trophoblast was obtained from 45 patients (33%) usually at the first attempt. Collection was not necessarily more successful between 8 and 11 weeks of gestation. In only 13 patients (9%) was trophoblast collected without contamination by maternal tissue, or blood. Perforation of the amniotic sac in one patient (1%), bleeding either observed, or detected histologically (34%) and introduction of infection (4%) constitutes a real threat to fetal survival. Maternal serum alpha-fetoprotein estimation appears useful and may forewarn likelihood of fetal damage. Although transcervical aspiration should encounter ready acceptability as an out-patient procedure, modifications in the technique are essential before clinical application for detection of gene, or chromosome anomalies can be considered.
An improved method involving pH changes in the process for the preparation of intermediate-purity antihemophilic concentrate offers several advantages over the standard method. Antihemophilic concentrates thus prepared are more soluble, more purified and more stable than the standard antihemophilic concentrates. High-potency antihemophilic concentrates with good solubility may be obtained by concentrating the [in-process] solution before lyophilization.
A patient with a history of familial intestinal lymphangiectasis and exudative enteropathy was observed during 2 consecutive pregnancies. Normal pregnancy is compatible with the condition and pregnancy need not aggravate the disease.
Antenatal fetal heart rate (FHR) as an indicator of fetal status was evaluated in two separate studies. The first attempted to determine, in 30 minutes of continuous recording from each of 50 antenatal patients, relationships between spontaneous FHR changes and fetal condition before and after birth. No significant association was found between observed FHR patterns and antenatal or neonatal fetal status. The second study used induction of labour as a stress test, because similar conditions to that required for oxytocin stress testing were present and there was the advantage of direct FHR recording. In 150 induced and monitored labours, FHR changes associated with the first six suitable contractions seldom related to Apgar scores at birth or development of fetal distress in active labour. Fetuses showing no response to contractions tended to have better Apgar scores than those which showed FHR decelerations. Results from these studies do not substantiate reports that FHR changes arising spontaneously, or in response to induced contractions, reflect satisfactorily the existing or subsequent fetal status.
A simple score, derived by allocating points to a selection of factors which influence the outcome of pre-term labour, was found to relate to the success of treatment. Used as a measure of the situation before therapy, this score can define a baseline allowing a realistic comparison of therapeutic methods. In this series, despite treatment, a large number of patients still were delivered before term and within a few days of admission to hospital. Thus it would seem that although drugs suppress uterine activity, they cannot neutralize the adverse effects of other factors associated with pre-term labour.
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Aspiration curettage proved acceptable to patients and medical staff when incorporated into a busy outpatient practice. The diagnostic reliability of curettings obtained was shown to be 93.5 per cent accurate. In all patients where mucus only is obtained, where symptoms persist or recur, or when aspiration curettage is too distressing, conventional curettage is mandatory.
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A study of 70 fetal heart rate (FHR) traces throughout labour has allowed analysis of FHR responses associated with approximately 7000 individual uterine contractions. The significance of the less emphasized FHR patterns has been assessed and an attempt has been made to identify any trend or progression in the occurrence of these patterns. Transient acceleration was the most frequently occurring response in early labour and was the first observed response in the majority of cases. Decelerations became prevalent as labour progressed. A hypothesis is proposed to explain the observed overall progression in FHR responses and the possible physiological mechanisms underlying the cyclic changes in response patterns which occur throughout the course of labour.
In vitro cervical dilatations were carried out on 33 uteri removed by hysterectomy for conditions not involving the cervix from parous women in their reproductive span of life. A specially designed force measuring dilator was used for all the tests. The analysis of the results involved the application of a thick-walled cylindrical stress determination technique. Using this approach it was possible to calculate quasi-elastic moduli for different degrees of dilatation and obtain theoretical distributions of radial and circumferential stress across the cervical wall. These results indicated a yielding of the cervical tissue at about 9 to 11 mm. dilatation in a significant number of cases.
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