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Biomedical subjects

E Saling

Publications and source records attributed to E Saling.

At least 55 records · Page 3Linked to original sources
PubMed1988

[Use of a stapling device in abdominal cesarean section].

This is a report on the use of a stapling device for caesarean sections. The device can be inserted right and left after a very small median uterotomy. It cuts the uterine wall and at the same time places clips on the edges of the wound. The clips are made of a hydrolysable material that can be absorbed in the tissue and can also be used for surgical stitching. Haemostasis is definitely assured. No adverse reactions or disadvantages for the patients have been noticed to date.

Cesarean Section↗
PubMed1988

Quantitative analysis of fetal behavioural patterns with real-time sonography and the actocardiograph.

Fetal heart rate patterns, isolated and clustered fetal movements, fetal eye and breathing movements were analysed simultaneously and semiquantitatively in 20 uncomplicated pregnancies in accordance with the classification of fetal behavioural states by Nijhuis and with the aid of two ultrasound scanners and the actocardiograph. According to our own definition state 1 F, 2 F, 3 F and 4 F were observed in 29, 34, 8, and 14% of the registration time. In 15% no state could be identified. Using only the actocardiograph state 1 F, 2 F and 4 F could be identified in around 75%. Periods without a state diagnosis could not be assessed by the actocardiograph alone. The combination of the actocardiograph and one ultrasound scanner for the observation of fetal eye movements reached a similar diagnostic accuracy as the polygraphic monitoring with two ultrasound scanners.

Eye Movements↗
PubMed1988

Obstetrical characteristics of a loss of end-diastolic velocities in the fetal aorta and/or umbilical artery using Doppler ultrasound.

In 30 of 137 high-risk pregnancies we observed absent end-diastolic velocities indicating a high downstream impedance, which could be proved by histomorphological findings of the placenta. On the average the loss of end-diastolic velocities occurred 2-3 days before suspicious and nearly 8 days before pathological cardiotocographic findings. The perinatal mortality was high when absent velocities had been observed before the 32nd week, a cesarean section was obligatory in all but 1 case. All fetuses were growth-retarded. In 9 cases we were able to determine the ratio of blood flow volume in the common carotid arteries to that of the fetal aorta. The values were significantly increased as compared to values of undisturbed pregnancies, demonstrating a redistribution of fetal blood in favor of cerebral circulation.

Aorta↗
PubMed1988

Effect of blood and meconium on the determination of phospholipids in amniotic fluid using high pressure liquid chromatography.

This paper presents the evaluation of the effects of blood and meconium on the determination of the phospholipids phosphatidylglycerol (PG), phosphatidylinositol (PI), phosphatidylethanolamine (PE), phosphatidylcholine (PC), sphingomyelin (SP) and lysolecithin (LL) in amniotic fluid. Phospholipids were analyzed by a new method using high pressure liquid chromatography (HPLC), which is based on the procedure of BRIAND et al. The method was extended for quantitative determination with lysolecithin as internal standard. The HPLC equipment consisted of two pumps, an HPLC programmer, an HPLC oven, a UV detector and an integrator. The chromatographic separation was achieved on a 25 cm DIOL-column and a 6 cm guard column packed with silica SI 60. The oven temperature was 55 degrees C and the detector wave length was 201 nm. The chromatographic mobile phase was composed of two solvents, acetonitrile and water. A solvent gradient was run from 2.4% water to 15% water between 5 and 13 minutes. Phospholipids were extracted according to the procedure of GLUCK. Before extraction 40 micrograms of LL as internal standard were added to 2.0 ml amniotic fluid. In a standard solution the phospholipids PE, PC, SP and LL were baseline separated, in the case of PG and PI a perpendicular division of the peaks was necessary. To evaluate the effect of contamination by blood and meconium, various amounts of blood and meconium were added to uncontaminated amniotic fluid samples. Contamination by blood caused a rise of the concentrations of PC, PE and SP up to tenfold. PG and PI concentrations were not affected by blood staining.(ABSTRACT TRUNCATED AT 250 WORDS)

Amniocentesis↗
PubMed1987

[Approach to a new compensatory management of the hypotrophic fetus].

This is a report on a new possibility of effecting direct compensatory supply of vitally essential substances on the hypotrophic foetus. Supply of amino acids and other important substances is effected via an indwelling catheter introduced into the abdominal cavity of the foetus. To avoid infections it is advisable to provide for sufficiently long tunnelling of the mother's skin and to implant an application capsule into the abdominal wall of the mother in such a manner that the system is in no way openly connected to the outside, treatment being effected transcutaneously through the mother's skin. It is well known from peritoneal dialyses that the peritoneum is highly permeable especially for low molecular substances. A report is given on a case where the system could however be applied for 9 days only because of premature rupture of the foetal membranes and subsequent birth of a viable child. During the intraperitoneal supply of the foetus it was possible to show by instillation of 13C leucine (effected in cooperation with paediatricians) that the foetus had taken up the supplied amino acids and had metabolised and excreted these via the placenta and finally the mother's expiratory air to a slight extent only; the major part had, therefore, been utilised for anabolism. The article discusses potential risks that can be envisaged at the present moment, such as intestinal injuries during puncture, infections and premature rupture of the membranes.

Adult↗
PubMed1987

[Pathophysiologic and clinical aspects of measuring blood flow in utero-placental vessels, the umbilical artery, the fetal aorta and the fetal common carotid artery].

It was the aim of this study to conduct simultaneous qualitative analysis of blood flow spectra of uteroplacental and foetal vessels in normal pregnancy, in growth retardation and in EPH gestosis using the pulsed Doppler method. In 237 women who had delivered we performed 291 measurements in uteroplacental vessels, 318 in the umbilical artery, 339 in the foetal aorta and 130 in the foetal common carotid artery. The blood flow spectra were evaluated with the help of the resistance and pulsation index ratio (RI/PI) as a measure of the resistance of the subsequent vascular system. We observed in uteroplacental vessels in EPH gestosis and retardation a significant elevation of the index values in the wall of the uterus outside or inside the placental margin. In foetal vessels we noted a highly significant increase of RI and PI in the umbilical artery and the foetal aorta--simultaneously, however, a drop in the index values in the foetal common carotid artery. These changes point on the one hand to the increased resistance in the capillary net of the placenta and a possible vascular constriction in the region of the lower abdominal organs and extremities, whereas on the other hand they point towards a compensatory lowering of the vascular resistance in the cerebral circulation--possibly as an expression of the risk of hypoxia.(ABSTRACT TRUNCATED AT 250 WORDS)

Aorta↗
PubMed1987

Fetal distress and the condition of the newborn using cardiotocography and fetal blood analysis during labour.

The efficacy of electronic fetal monitoring combined with fetal blood analysis during labour in identifying fetal distress was investigated in a retrospective study. Operative delivery for fetal distress diagnosed during labour was performed in 9% of 2659 deliveries. All had continuous fetal heart rate monitoring and 22% had a fetal scalp blood analysis. Operative delivery had been performed in 53% of the infants who were acidotic at birth (umbilical artery pH less than 7.20) and in 46% of those with a low modified Apgar score (less than 7). These results show that the use of continuous fetal heart rate monitoring and fetal scalp blood sampling detects fetal distress without resulting in a high rate of operative delivery.

Apgar Score↗
PubMed1987

Simultaneous assessment of blood flow velocity waveforms in uteroplacental vessels, the umbilical artery, the fetal aorta and the fetal common carotid artery.

We investigated simultaneously blood flow velocity waveforms of uteroplacental vessels, the umbilical artery, the fetal aorta and the fetal common carotid artery. In pregnancies with intrauterine growth retardation or preeclampsia we found low diastolic velocities in uteroplacental vessels, the umbilical artery and the fetal aorta and high diastolic velocities in the common carotid artery. Abnormal waveforms of the common carotid artery were most effective in predicting fetal compromise and might be a valuable clinical tool for the supervision and therapy of high-risk pregnancies in the future.

Aorta↗
PubMed1987

Comparative study of application techniques for the tcPCO2 measurement in the fetus.

In order to investigate the advantages and shortcomings of two application techniques proposed for the tcPCO2 electrode in the fetus we performed a trial using two electrodes with different modes of fixation synchronously. Comparing the transcutaneously measured values with the values of the fetal blood we found a statistically significant correlation for both techniques (r = 0.83 and 0.80, respectively). The mean values of the tcPCO2 though were significantly higher when the suction fixation was used compared with the glue fixation.

Blood Gas Monitoring, Transcutaneous↗
PubMed1987

Plasma immunoreactive beta-endorphin, ACTH and cortisol concentrations in mothers and their neonates immediately after delivery--their relationship to the duration of labor.

In 29 cases of vaginal delivery with normal outcome and 4 cases of cesarean section, the concentrations of beta-endorphin, ACTH and cortisol were determined in maternal venous and umbilical venous plasma immediately postpartum. According to duration of labor and mode of delivery the cases examined were classified into three groups: Group A (18 cases) = vaginal delivery of less than 10 hours' duration, Group B (11 cases) = vaginal delivery of more than 10 hours' duration of labor, Group C (4 cases) = cesarean section under general anesthesia. With the exception of one, the deliveries took place at term. The 33 neonates were in a very good clinical state 5 minutes after parturition (11 Saling points as median value). For measurement of the hormone concentrations radioimmunoassays were used. In Group a the mean beta-endorphin concentration in maternal plasma amounted to 150.9 +/- 16.3 pg/ml, that in neonatal plasma to 239.2 +/- 23.5 pg/ml (means +/- SEM). In Group B plasma beta-endorphin, both maternal and neonatal, was slightly higher than in Group A: 153.0 +/- 12.0 pg/ml (maternal) and 260.9 +/- 37.1 pg/ml (neonatal). The differences between maternal and neonatal beta-endorphin levels were statistically significant: Group A p less than 0.01, Group B p less than 0.05; chi 2-test. The mean ACTH concentrations in the plasma of the newborn infants were also found to be considerably higher compared with those in the plasma of their mothers: Group A 78.2 +/- 16.5 pg/ml (maternal) and 98.0 +/- 23.3 pg/ml (neonatal); Group B 98.0 +/- 20.1 pg/ml (maternal) and 165.8 +/- 39.6 pg/ml (neonatal).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1986

[Early child morbidity and late development following primary abdominal cesarean section in breech presentation near term].

This study concerns the results obtained in respect of early morbidity and late development of 115 and 57 children, respectively, born between 1978 and 1983, who had been delivered by primary low cervical Caesarean section shortly before term. Early morbidity of the 115 children was analysed taking into consideration the risk factors, such as premature rupture, gestation diabetes, EPH gestosis, condition following Caesarean section, abnormal amnioscopic and antepartal cardiotocographic findings, as well as the methods of anaesthesia employed. In the study on late development 57 children between 1 1/4 and 6 years of age were followed up and examined with regard to several faculties (social contact, fine motoricity and adaptation, speech and gross motoricity) according to the Denver Developmental Screening Test. Children with abnormal findings were subjected to special examination. Children with abnormal findings were also subjected to a positional test according to Vojta and to the Munich functional developmental diagnosis after Hellbrüge et al. While employing physiotherapy after Bobath and early rehabilitation training by the parents, these children were followed up at regular intervals. There was no clinically relevant acidosis in the group of 115 newborn. A total of 44 newborn (38%) displayed slight to medium enhanced acidity (pH value, umbilical artery: 7.20 to 7.29) according to the stage classification after Saling and Wulf. Slight to medium acidosis (umbilical artery pH 7.10 to 7.19) was seen in 3 cases only (2.6%). In 112 newborn we found a correlation between the good Apgar score values (7-10) and normal acidity in the umbilical artery blood (act. umbilical artery pH greater than or equal to 7.30). In the remaining 3 newborn with lower Apgar scores (3-6) there was no acidosis in the umbilical artery blood. In the follow-up group (57 cases) we found one child with psychomotor retardation of speech (disturbed articulation and reduced vocabulary) and 6 children with slight motor disturbances in the early developmental stage. These disturbances were recorded as slight central disturbances of coordination according to Vojta within the framework of early diagnosis. Four of these children received early treatment according to Bobath. When they were between 1 and 1 1/2 years of age, all the 4 children showed normalisation of motoricity during the follow-up checks. The other two children displayed spontaneous regression of the mild central disturbance of coordination when they were 5 and 6 months of age.(ABSTRACT TRUNCATED AT 400 WORDS)

Acid-Base Equilibrium↗
PubMed1986

Effect of oral zinc application during pregnancy.

The beneficial effects of the oral application of zinc aspartate in pregnancy is investigated in a randomly selected study group of 179 patients and a control group of 345 patients. This study confirms the prophylactic effectiveness of zinc replacement in reducing the overall complication rate for both mother and fetus and in particular for large-for-date and small-for-date infants. The therapy is well tolerated and accepted by the patients and causes no side effects. The results are in line with those of other working groups reporting on zinc as an important element with protective effects on fetal growth and development in pregnancy.

Adult↗
PubMed1985

Measurement of transcutaneous pCO2 and pO2 in the fetus during labor.

We used newly developed transcutaneous electrodes to measure continuously the partial pressure of oxygen (tcpO2) and carbon dioxide (tcpCO2) in 34 fetuses during labor, having simultaneous cardiotocography (CTG) and temperature measurements. We observed that tcpO2 and tcpCO2 varied with contractions during the first and second stages of labor. In some cases changes in the transcutaneous values corresponded well with changes in the CTG, we also detected changes in the fetal gas metabolism that were not noticeable on the cardiotocographic tracing. We defined the characteristic of the tcpO2 and tcpCO2 during the second stage of labor and found that the tcpO2 decreased and the tcpCO2 rose at this time.

Carbon Dioxide↗