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Biomedical subjects

E Saling

Publications and source records attributed to E Saling.

At least 73 records · Page 4Linked to original sources
PubMed1985

[Child development after abdominal version of the fetus from breech presentation to vertex presentation near term].

The prospective study presented here describes the results of follow-up examinations of the developmental stage of 116 children born between 1977 and 1980 in whom abdominal version of the foetus from breech presentation to vertex presentation was performed near term. The children were examined according to the Denver Developmental Screening Test at the age of 2 to 5 3/4 years in various fields (social contacts, minor motor functions and adaptation, speech and major motor functions). Children with abnormal findings were subjected to special examinations. Those with disturbed development were re-examined after one year. In the entire group of children there were four with psychomotor retardation of speech, and two further children with minimal cerebral motor disturbances. The children had been detected early during infancy. These results, classified as secondary morbidity (disturbances of speech and minimal cerebral motor disturbances) were analysed taking into account the results of version (successful and unsuccessful version) and other obstetric factors (course of pregnancy and birth, method of delivery, biochemical examinations during and after birth, age of mother and socioeconomic status of parents).

Attention Deficit Disorder with Hyperactivity↗
PubMed1985

[Cardiotocography with or without fetal blood analysis].

It is the aim of obstetric medicine to achieve optimum safety for both mother and child with a minimum of surgery. In normal clinical routine, this demand cannot be fully met by the sole use of cardiotocography for monitoring the foetus sub partu. Obviously the weak point of cardiotocographical diagnosis is that often there is no imminent or beginning hypoxia or acidosis of the foetus associated with suspicious or pathological heartbeat patterns. This results in a large number of unnecessary deliveries by Caesarian section, or complicated vaginal surgery. We must draw the conclusion from this that cardiotocography is merely a-selective method. It is imperative to apply additionally a biochemical method for properly diagnosing foetal hypoxia or acidosis. The author also comments on accusations made by K. Hammacher in a preceding publication.

Acid-Base Equilibrium↗
PubMed1985

[The effect of low blood pressure on venous function during and outside of pregnancy and therapeutic consequences].

Orthostatic dysregulations occur ten times more frequently in gravidae with low blood pressure than in those in whom it is normal. This condition can result in a temporarily insufficient blood supply to the uterus and hence to the foetus. As a consequence, abortions, premature and abnormal births, and complications during labour and lying-in occur more frequently among hypotonic women. Pathophysiologically, orthostatic dysregulations are caused by large quantities of blood remaining in the peripheral veins. In this connection it is well known that the hormonal change-over during pregnancy reduces venous tone, thus causing venous return to the heart to deteriorate. It has not yet been investigated whether or respectively how low blood pressure in pregnant and non-pregnant women affects venous hemodynamics and what effect treatment with dihydroergotamine (DHE) has. In order to answer these questions the authors performed 240 venous function measurements in a total of 140 pregnant and non-pregnant, hypotonic and normotonic women. Using a simple, non-invasive photoplethysmographic method, light reflection rheography (LRR), a check was first made as to whether there are differences in venous pumping in non-pregnant hypotonic as opposed to normotonic women. In 20 normotonic subjects the delta R mean value for venous drainage was 165 mV, while in 20 hypotonic women it was only 114 mV (p less than 0.001). While, on the basis of a corresponding classification, all of the normotonic women were classified as having normal veins or merely slight venous insufficiency, 14 hypotonic women were found to have moderately severe or severe venous insufficiency (p less than 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[Avoiding cesarean deliveries by intravenous prostaglandin E2 administration (PGE2)].

The study reported here was prompted by the question whether caesarean deliveries which would otherwise be necessary can be avoided by intravenous infusion of prostaglandin E2 (PGE2). The authors consider intravenous administration of PGE2 during delivery to be indicated in cases which fail to respond to therapy after three local cervical maturation attempts and in standstills where oxytocin has no effect. Out of a total of 5835 women who gave birth at the Obstetrics Department of the Berlin-Neukölln Gynecological Clinic between 1980 and 1981, those who had been given intravenous infusions of PGE2 were identified and a check was made to establish whether this treatment offers any advantages. PGE2 infusion after unsuccessful intracervical application of PGE2 gel: Out of 1122 risk patients in whom cervical maturation prior to induction of birth appeared desirable, 43 (3.8%) still had a Bishop Score of less than or equal to 7 after three local applications of PGE2 gel. Attempts to achieve a vaginal delivery in spite of this, by means of PGE2 infusion, were successful in 60% of the cases. The mean rate of PGE2 infusion was 1.1 +/- 0.3 microgram/min. Four women were given oxytocin in addition, in an average dose of 9.3 +/- 1.1 mU/min. The average duration of labour was 10 hours 30 min. Complications in mother and child occurred no more frequently than in other risk births. PGE2 infusion in cases with standstill not responding to oxytocin treatment: In 82 parturients (1.4%) a standstill occurred during labour after initially normal dilation of the cervix, and could not be overcome by administration of oxytocin.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

First magnetoencephalographic recordings of the brain activity of a human fetus.

Using a one-channel neuromagnetometer adjusted to a special site on the mother's abdomen, we succeeded in recording prenatally, for the for the time, human fetal brain activity in late pregnancy. It was possible to record both the fetal auditory-evoked neuromagnetic field and to detect fetal brain activity by analysis of the frequency spectrum. Such measurements may soon prove valuable for the noninvasive investigation of human brain function.

Audiometry, Evoked Response↗
PubMed1985

Reliability of transcutaneous measurement of oxygen and carbon dioxide partial pressure with a combined Po2-Pco2 electrochemical sensor in the fetus during labor.

A combined single electrochemical sensor designed to measure synchronously and transcutaneously oxygen partial pressure and carbon dioxide partial pressure (RADIOMETER prototype) was applied onto the scalp in 21 fetuses during labor. The values of tcPo2 respectively tcPco2 were compared with the values of fetal blood analysis (FBA) and blood from the umbilical artery (UA): Comparing the tcPco2 with the values of the FBA we found the values to be very consistent (r = 0.95, p less than 0.001). For the comparison of the tcPco2 with the values of the umbilical artery, the correlation coefficient was lower (r = 0.76, p less than 0.05). The transcutaneous measurement of Po2 as compared with the values of the fetal blood analysis was also quite accurate (r = 0.83, p less than 0.001). Looking at the values of the transcutaneous measurement during the expulsion of the fetus and its comparison with the values of the umbilical artery, it was an interesting finding that values of the transcutaneous estimation of Po2 were much lower in some cases and no statistical correlation was found (p greater than 0.05). We conclude that the combined electrochemical sensor for measuring tcPco2 and tcPo2 is a new additional tool for studying the physiology and pathophysiology of the fetus during labor, but as the accuracy of Po2 and Pco2 in the fetal blood is influenced by the progress of labor, the special characteristic of the transcutaneous measurement has to be taken into account when values are interpreted.

Carbon Dioxide↗
PubMed1985

The influence of the progress of labor on the reliability of the transcutaneous PCO2 of the fetus.

Transcutaneous PCO2 measurements were performed on 105 fetuses during labor. A modified Severinghaus electrode was calibrated with 5% and 10% carbon-dioxide gas at 33 and 66torr. This corresponds to a drop in the PCO2 levels measured transcutaneously of about 13% and to an adjustment to the blood gas level. The levels measured transcutaneously were compared with data compiled from the fetal blood analysis and values of blood gas analysis from the umbilical artery immediately after delivery. The object of the study was to find out to what extent the progress of labor influences the conformity between the PCO2 levels measured transcutaneously and measured in blood. Comparing the data of the transcutaneous measurement (pb PCO2) with the pb PCO2 of the peripheral blood (pb PCO2) in cases without a caput succedaneum, we found a correlation coefficient of r = 0.79 and a slope of 1.1. On the other hand with the development of a caput succedaneum the correlation coefficient was lowered to r = 0.72 and the slope to 0.85. An influence of the propulsion of the fetal head in the birth canal on the accuracy of the transcutaneous measurement was also obvious. When the position of the fetal head was either above or in the interspinal plane, the correlation coefficient amounted to r = 0.85. With the progression below the interspinal plane, the correlation coefficient was clearly lowered. While our results show a good overall conformity between PCO2 levels measured transcutaneously and those from peripheral blood, our analysis shows also to what extent the conformity can be influenced both by the existence of a caput succedaneum and by the propulsion of the presenting part.

Carbon Dioxide↗
PubMed1985

Effect of beta-mimetic tocolysis on cervical ripening and plasma prostaglandin F2 alpha metabolite after endocervical application of prostaglandin E2.

To suppress uterine contractions during cervical ripening induced by prostaglandin E2 (PGE2) gel, beta-mimetic drugs were given orally 30 minutes before PGE2 application to 17 patients with unripe cervix. This prevented the increase in contraction frequency observed during the first four hours after PGE2 application in 17 controls. Nevertheless, cervical ripening proceeded at a similar rate and the clinical outcome was comparable in both groups. Prostaglandin E2 application caused a transient rise in plasma levels of the PGE2 alpha metabolite (13,14-dihydro-15-keto), which was not prevented by pretreatment with beta-mimetics. Patients with premature rupture of the membranes had higher initial plasma PGF2 alpha metabolite levels than those with intact membranes but cervical ripening proceeded with the same rate, and the effect of beta-mimetics was the same in both groups. Thus, cervical ripening induced by PGE2 does not depend on uterine contractions, and increased production of PGF2 alpha is unrelated to the ripening process. There was no difference between the three beta-mimetic agents in the present study.

Adrenergic beta-Agonists↗
PubMed1984

Correlation between transcutaneous pCO2 and the corresponding values of fetal blood--a study at a measuring temperature of 39 degrees C.

Continuous transcutaneous monitoring of fetal carbon dioxide partial pressure (tcpCO2) may become an important new method for investigating the physiology and pathophysiology of the fetus during labor, as well as an additional tool for fetal surveillance. In order to contribute to the standardization of this newly developed method, we measured tcpCO2 during labor in 105 fetuses. We then compared the transcutaneous pCO2 with the pCO2 of fetal blood gas analysis; the correlation between these two parameters was significant. The relationship between transcutaneous pCO2 and the pH from fetal scalp blood is described, as is the influence of the stage of labor on the correlation between transcutaneous monitoring and blood samples. tcpCO2 during labor appears to be a helpful additional tool, especially in fetuses with pathologic heart rate patterns in whom multiple fetal blood gas analysis would otherwise be necessary.

Carbon Dioxide↗
PubMed1984

Prevention of habitual abortion and prematurity by early total occlusion of the external os uteri.

Repeated late abortions and high-risk, low-chance premature births are among the problems of obstetrics and perinatal medicine still to be solved. It seems that a solution is on its way, through the early total cervix occlusion (ETCO) performed by us - a solution for at least some of these highly problematic cases. The special advantage of this measure is considered to be the avoidance of an infection ascending to the cervix and to the lower egg-pole resulting in abortion or premature birth. Early total occlusion of the os uteri has been performed on 28 women; 22 have since been delivered of healthy infants. Whereas previously from these 28 patients with a total of 99 wanted pregnancies only 14 infants (14%) survived, the rate of success after the introduction of ETCO lies at about 80% (22 out of 28). From this a high success rate can be expected in the future in these difficult cases.

Abortion, Habitual↗
PubMed1984

[Influence of fenoterol, ritodrine and clenbuterol on maternal oxytocin and PGFM levels].

In this investigation, the Oxytocin (OT) and 13, 14-Dihydro-15 Keto PGF 2-alpha (PGFM) levels were investigated in patients who required ripening of the cervix prior to induction of labour. Under randomized conditions four PGE2-Gel-groups and 1 Placebo group was formed. The patients who received PGE2-Gel were treated either with .4 mg PGE2-Gel intercervically without prior treatment with Betamimetica (n = 6) or 30 minutes prior to the application of .4 mg PGE2-Gel intercervically with 5 mb Fenoterol (n = 6) or 10 mg Ritadrine (n = 6) or 20 micrograms Clenbuterol (n = 6). These drugs were given by mouth. A control group of 6 patients received Gel without PGE2 Placebo. In previous investigations, it was shown that the Oxytocin level rises following the intercervical administration of PGE2-Gel to an unripe cervix whereas the PGFM level remains unchanged. Oral administration of Fenoterol inhibited the PG induced rise of the Oxytocin level and kept the Oxytocin level in the same range as following the administration of a Placebo. The present investigation served to check whether Ritadrine and Clenbuterol had an Oxytocin inhibiting effect as well as Fenoterol. It was found that administration of Betamimetica did not inhibit the ripening effect of PGE2-Gel on the cervix. Although labour did not start in 12 of 18 women treated with Betamimetica during four hours, the cervix ripened in the same manner as in women with labour. The administration of Placebo instead of PGE2-Gel showed no ripening effect (P less than 00001). Following the administration of Fenoterol the maternal heart rate increases significantly compared to Placebo.(ABSTRACT TRUNCATED AT 250 WORDS)

Clenbuterol↗
PubMed1984

[Value of treatment with dihydroergotamine for hypotension in pregnancy].

Hypotension during pregnancy must be taken seriously. This complication is definitely serious enough to merit treatment. However, examinations have been lacking so far proving the advantages or possible risks of antihypotensive therapy. A short while ago the authors reported on favourable results obtained with dihydroergotamin (DHE) in hypotensive patients. It was the aim of the present study to test this finding, which had been obtained with a relatively small group of patients, by employing a large group. The evaluation was based on the statistical data from 400 hypotensive pregnant women who had delivered during the time between 1.1. 1982 and 31.8. 1983 in the obstetrical department of the Berlin-Neukölln Hospital Pregnant women were considered to be hypotensive if they had appeared for examination at least three times up to the 28th week of pregnancy with a maximum systolic blood pressure of less than or equal to 110 mmHg and diastolic pressure of less than or equal to 60 mm Hg. In relation to the total number of births of 4763, the proportion of hypotensives was 8.4%. 204 (4.3%) hypotensive women were subjected to DHE treatment; 156 of these took regularly 2 X 2.5 mg DETMS retard, whereas compliance was irregular with the remaining 50 patients. 196 (4.1%) refused treatment. The fact that the percentage of women willing to undergo treatment was relatively low (39%) is attributed partly to pregnant women being afraid of taking drugs, and partly to the attitude adopted by gynaecologists who are often hardly convinced that hypotension is a grave sign.(ABSTRACT TRUNCATED AT 250 WORDS)

Dihydroergotamine↗
PubMed1984

Glycosylated hemoglobin (HbA1), glucose tolerance and neonatal outcome in gestational diabetic and non-diabetic mothers.

Glycosylated hemoglobin (HbA1) was determined in three subject groups: 69 non-diabetic mothers who were delivered of normal weight infants at term (Group I), 33 non-diabetic mothers who were delivered of macrosomic infants (greater than 4000 g) at term (Group II), 51 gestational diabetics in the 3rd trimester--before onset of the diabetes therapy (Group III). In all three groups diagnostic assessment of glucose regulation was done by means of the oral glucose tolerance test during the 3rd trimester. Glycosylated hemoglobin was assayed by cation-exchange chromatography in small disposable columns. The mean values and standard deviations of HbA1 were 6.51 +/- 0.46% in Group I, 6.59 +/- 0.42% in Group II and 7.11 +/- 0.56% in Group III. Between the HbA1 values of Group III (gestational diabetes) on the one hand and those of the non-diabetic groups I and II on the other, there were highly significant differences (p less than 0.001; x2-test). HbA1 values above 7.4%--i.e. above mean + 2 s. d. of HbA1 in the non-diabetic mothers--were with 95% probability abnormal and indicative of gestational diabetes. HbA1 values between 7.0% and 7.4% were suspected of impaired glucose tolerance and gestational diabetes respectively. Between the HbA1 levels in the non-diabetic groups and those in the gestational diabetic group there was a vast zone with overlapping values. HbA1 data situated in this transitional area could be found both in non-diabetic subjects and also in those with abnormal glucose regulation. HbA1 values below 6.0% excluded gestational diabetes or otherwise impaired glucose tolerance with a high degree of probability.

Birth Weight↗