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Biomedical subjects

E Saling

Publications and source records attributed to E Saling.

At least 127 records · Page 7Linked to original sources
PubMed1980

[Human placental lactogen (HPL) levels in the maternal serum following long-term intake of xantinol nicotinate (Complamin Retard) (author's transl)].

Apart from rest in bed, various pharmacotherapeutic approaches are recommended in the treatment of chronically deficient foetal supply. Xantinol nicotinate (Complamin retard) was examined with regard to its influence on the human placental lactogen (HPL) values in a preliminary study followed by a double-blind study. In the first experimental series, 53 pregnant women were treated on an in-patient basis because of suspected placental insufficiency. In 22 women treatment was effected by ordering complete rest in bed, whereas 31 women received for at least three weeks Complamin retard in addition to the "rest in bed" treatment. Rise in HPL levels was significantly more frequent with the Complamin group than with the group of women who had rested in bed only without receiving any pharmacotherapy. A double-blind study was conducted also in patients suspected of placental insufficiency. 25 pregnant women received Complamin retard for three weeks in succession, whereas 25 other pregnant women were given placebo tablets only. Here, too, it was statistically evident that the HPL values increased more often with the Complamin than with the placebo group of patients.

Clinical Trials as Topic↗
PubMed1980

[Obstetric spoons (author's transl)].

The article describes "obstetric spoons" which are easy to apply and which can be used as well as the forceps and the vacuum extractor for vaginal-operative termination of labor. These spoons offer the following advantages: They are an effective and relatively harmless instrument which can be applied rapidly and easily even by those who are less skilled. During extraction, the spoons are only slightly pressed onto the head of the child by the operator's hands; the additional pressure required is exercised by the soft parts of the mother. It is hardly critical if the spoons are not applied exactly in transverse diameter. If the traction force applied is too strong, they separate and slide over the head without exercising any further pressure. This counteracts any possible overforceful extraction. The spoons can also be applied simultaneously in combination with vacuum extraction and girdle expression, which renders even complicated vaginal surgical procedures from the mid-pelvic plane relatively harmless with regard to the strain exercised on the child.

Extraction, Obstetrical↗
PubMed1979

Amniotic fluid concentrations of 3,3',5'-tri-iodothyronine (reverse T3), 3,3'-di-iodothyronine, 3,5,3'-tri-iodothyronine (T3) and thyroxine (T4) in normal and complicated pregnancy.

Amniotic fluid concentrations of 3,3',5'-tri-iodothyronine (rT3), 3,3'-Di-iodothyronine (3,3'-T2), 3,5,3'-tri-iodothyronine (T3) and T4 were studied in 384 women during normal and complicated pregnancy. An inverse correlation was observed between decreasing rT3 and increasing 3,3'-T2 concentrations in amniotic fluid with gestational age. The mean rT3 level in normal pregnancy was 2.81 nmol/1 at 12-20 weeks and decreased significantly to 1.06 nmol/1 at 36-42 weeks of gestation. The mean 3,3'-T2 concentration was 49.1 pmol/1 at12-20 weeks increasing to 119 pmol/1 at 36-42 weeks. The mean T4 value of 3.83 nmol/1 at 12-20 weeks was about half that of later periods. The T3 concentration in a random sample of 45 amniotic fluids ranged from less than 28 to 370 pmol/1 (mean 102 pmol/1). The mean rT3, 3,3'-T2 and T4 values measured in patients with intra-uterine malnutrition, gestation diabetes, tocolysis, placental insufficiency and rhesus incompatibility at 31-40 weeks of gestation were not significantly different from those in uncomplicated pregnancy. Significantly decreased rT3 and T4 concentrations were found in toxaemia. From the results obtained in complicated pregnancy it may be concluded that measurements of iodothyronines, especially rT3, in amniotic fluid have insignificant diagnostic value in the recognition of intra-uterine lesions with the probable exception of fetal hypothyroidism. The analysis of the dependence of iodothyronine concentrations on the gestational age showed a maximum of rT3 and T4 levels between 20 and 30 weeks of pregnancy. This marked rise of iodothyronine concentrations in amniotic fluid at mid-gestation may be due to the onsetting maturation of the hypothalamic-pituitary-thyroid control system of the fetus.

Adult↗
PubMed1978

First experience with continuous pH measurements on fetus during delivery.

First experience with continuous pH measurement is reported. It was possible to apply well calibrated electrodes to the fetal scalp in 22 cases. Of these 22 cases eight must be regarded as failures because of unstable values. Of the remaining 14 measurements, seven were of good (or acceptable) quality and seven of poor quality. The size of the electrodes and the excessive depth of penetration are probable reasons for these failures. An important condition for obtaining reliable pH values is a perpendicular position of the electrode in the fetal scalp. An indicator for correct position of the electrode appears to be the irregularity in the recording of the pH curve. Experience so far indicates that the pH electrode in its present form is not suitable for routine use.

Electrodes↗
PubMed1978

Influence of long-term beta-mimetic therapy on the lecithin content of amniotic fluid.

The lecithin content of 157 amniotic fluid samples taken from 60 patients who had been treated with Fenoterol over a long period of time (longer than 30 mg/daily per os for 14 days; intravenous infusion for longer than 7 days) was calculated thin-layer chromatographically according to Kynast and Saling. These lecithin levels were statistically compared with the levels in a control (Wilcoxon test). It emerged that the lecithin levels in the long-term beta-mimetic therapy group were significantly lower, i.e., from 33/0 to 39/6 (33/0-34/6, p less than 0.05; 35/0-39/6, p less than 0.01). The answer to the question how often levels occur in the long-term group which are below the as critical described level of 3 mg Lec/100 ml amniotic fluid appears to be clinically important. It is shown that values below the critical level from 33/0 to 39/6 are much more frequent in the long-term beta-mimetics therapy group than in the control group. There is no known explanation for this. It was concluded that the application of beta-mimetics in cases of long-term tocolysis should only be discontinued when the lecithin content of the amniotic fluid lies above the critical limit of 3 mg Lec/100 ml.

Administration, Oral↗
PubMed1978

[Modification of the vacuum extraction device (author's transl)].

The article describes a bell-shaped vacuum extractor with a rigid tube neck connected via a ball and socket joint. The advantages of this device over the "classical" device described by Malmström (2), are as follows: Easier insertion of the bell adjusted at an angle of 90 degrees, improved pushing-up of the bell for fastening to the head when this is still in elevated position, better placing of the bell at the desired location, better manipulation into the desired direction of pull, possibility of pushing up the anterior part in case of late cesarean section, and better sealing of the suction tube at the point of transition from the tube to the flexible hose. Another improvement concerns the adhesion, achieved by means of ring-shaped notches on the inside of the bell.

Cesarean Section↗
PubMed1976

The significance of the time interval in twin delivery.

In order to evaluate the influence of the time interval on the second twin in twin deliveries, we have used more precise criteria than have been used in the literature to date. In the period from July 1, 1970 to December 31, 1974, 35 twin deliveries in our hospital were analyzed, in which both twins fulfilled the following criteria: 1. vertex presentation 2. vaginal deliveries 3. birth weight above 2000 g. We analyzed various parameters in the clinical and acidity score of the second twin alone as well as in comparison to the first twin. The following points of view were considered: 1. The more sensitive aspect of morbidity was utilized by including the assessment of the state of the newborn rather than just mortality. 2. Since Caesarean sections in twins are often performed for a fetal indication, short time intervals between the birth of both infants correlate intrinsically with a higher risk for the second twin. Therefore we considered only vaginal deliveries in order to exclude this intrinsic correlation. 3. By excluding infants below a birth weight of 2000 g, the influence of the low birth weight of the second twin was eliminated. 4. The frequently occurring positional anomalies of the second twin will deteriorate the conditions independent of the time interval. therefore we have considered only births from vertex presentations. A comparison of the acidity state demonstrated that the actual pH values in the umbilical artery blood of these second twins (Fig. 1) decrease statistically significantly with increasing time intervals. this is also true for metabolic acidity (pHqu40). The differences of the actual pH values (Fig. 2) and the pHqu40 values between the first and second twin decreases significantly also with an increasing time interval. Our results indicate that obstetricians, according to the clinical conditions, should accomplish the birth of the second twin as soon as possible after the birth of the first twin.

Delivery, Obstetric↗
PubMed1976

The reliability of pH-values in fetal blood samples - A study of the second stage.

In 119 cases fetal blood analysis (FBA) was done in the last 15 minutes before birth together with blood sampling from the umbilical artery (UA) immediately after delivery before the first breath. Using the measured pH-values we investigated the relationship between these variables, in particular the degree of influence of considerable caput succedaneum on pH-values in peripheral blood. Our investigation was performed during the time just before delivery, when the disturbance of blood circulation in the presenting fetal part whuld have the highest influence on pH-values measured from peripheral blood samples. We kept in mind especially the critiques of FBA by WULF et al. [21] and ASSALI [2]. As other authors have concluded, we found a high degree of correlation between the pH evaluated by FBA and that determined in the umbilical artery blood. The coefficient of correlation was: pHact r=0.82 pHqu40 r=0.78. The relationship between the corresponding pHvalues in peripheral (FBA) and arterial (UA) blood is given in Fig. 1 a and Fig. 1 b. The correlation of quadrants showed for the actual pH as well for the pHqu40 p less than 0.01. As derived form this, a high degree of correlation between the pH-values can be seen. The mean pH-values were: (see article) 42 of the children had a severe or moderate caput succedaneum. Fig. 2a and 2b show the relationship between central and peripheral pH-values in these cases. Again a good correlation between the pH-values was observed as in the whole collective. The coefficient of correlation was: pHact r=0.78 pHqu40 r=0.79. Caput succedaneum seems to have only minimal influence on the pH of blood obtained from the presenting fetal part. These results lead us to conclude that blood sampling from the presenting fetal part in the second stage provides almost indentical pH-values as in the central fetal blood.

Blood Specimen Collection↗
PubMed1975

External cephalic version under tocolysis.

We currently consider the external version of the fetus from a breech to a vertex presentation near term the best solution to the disadvantages of a breech delivery for mother and child. Version at such a late time in gestation is only possible with the aid of the tocolytic relaxation of the uterus as recommended by us. This method offers two important advantages over the conventional method of external version, the performance of which after the 34th week of gestation has been discouraged because of the poor chance for success: 1. Because of the relatively decreased intrauterine space during the last month of pregnancy the fetus will revert less readily to a breech. 2. In the event of a complication during external version the immediate operative delivery of the mature infant near term is possible. After the presentation of the fetus has been diagnosed by ultrasound the mother is given 20-50 micrograms Fenoterol (Partusisten) intravenously simultaneously with an inhalation analgesia. The version itself is effected by positioning the hands of the operator against the fetal forehead and by turning the infant as in a backwards roll. If this fails, the dose of the tocolytic agent may be increased. In cases with extended legs the chances for success appear to be decreased. The completed version should be confirmed with an ultrasound examination and the undisturbed status of the fetus should be documented with a cardiotocogram immediately after the version. The following results were achieved: The external version was successful in 43 of 57 pregnant women (75%). If the material is selected more critically, over 80% of the attempted versions should be successful. We have now delivered 40 infants as vertex presentations after a previously diagnosed breech presentation. The frequency of breech deliveries in our hospital has decreased by 2.6% from 5.4% to 2.9% since the introduction of version. The decrease is statistically significant. Convincing evidence that version has decreased fetal risk from breech delivery is found in a comparison of the newborn status. The decrease in the percentages of clinically depressed and acidotic newborns is also statistically significant. The failure rate does not appear to increase with increasing gestational age. There is no correlation between parity and failure or between maternal age and failure. So far we have seen no serious complications. In 5 of 24 cardiotocograms recorded a transient fetal bradycardia occurred immediately after the version which disappeared after a few minutes of maternal lateral position.

Acidosis↗