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Biomedical subjects

F A Manning

Publications and source records attributed to F A Manning.

At least 91 records · Page 5Linked to original sources
PubMed1982

Maternal smoking causes fetal hypoxia: experimental evidence.

Cigarette smoking during pregnancy has been related to poor perinatal outcome. To investigate the changes in maternal and fetal arterial blood gases associated with smoking, five chronically catheterized pregnant rhesus monkeys were exposed to standard cigarette smoking (N = 5) and nicotine-free herbal cigarette smoke (N = 3). The only consistently reproducible and significant finding was a drop in fetal PO2. The timing of the decline in PO2 and the similar responses to standard and nicotine-free cigarette smoke make carboxyhemoglobin the most likely causative factor.

Animals↗
PubMed1982

Antepartum determination of fetal health: composite biophysical profile scoring.

Antepartum detection, classification, determination of severity, and ultimately treatment of the fetus at risk for death and damage in utero form the very basis of modern perinatal medicine. The availability of accurate methods for assessing the fetus in utero are now becoming available. In extrauterine medicine, assessment of risk is based in part on the patient's activities and response to intrinsic and extrinsic stimuli. In extrauterine medicine, differentiation of normal sleep from coma is made by assessment of multiple biophysical variables and responses. It is most likely that the same principles hold true for differentiating the normal sleeping fetus from the asphyxiated fetus. Biophysical profile scoring offers one method for differentiation. It is likely that incorporation of this principle will improve the quality of perinatal care.

False Negative Reactions↗
PubMed1981

Fetal biophysical profile scoring: a prospective study in 1,184 high-risk patients.

The results of a prospective clinical management based on fetal biophysical profile scoring method was evaluated in 1,184 referred high-risk patients. Six perinatal deaths occurred in the study group (perinatal mortality of 5.06 per 1,000); only one fetus suffered unpredictable and unpreventable death (true false negative rate 0.8 per 1,000). In addition, 13 fetuses with major congenital anomalies were detected as a result of ultrasound scanning for fetal biophysical activities. These data suggest that this method can be used effectively to screen and manage a high-risk population.

Congenital Abnormalities↗
PubMed1981

Qualitative amniotic fluid volume determination by ultrasound: antepartum detection of intrauterine growth retardation.

Qualitative amniotic fluid volume (AFV) was determined by a linear array ultrasound method in 120 patients referred with a diagnosis of intrauterine growth retardation (IUGR). Eighty-nine of these patients were delivered of a normal infant; the false positive rate by clinical methods alone was 74.2%. Qualitative AFV was termed normal if at least one pocket of amniotic fluid measuring 1 cm in its broadest diameter was identified. Qualitative AFV was normal in 91 patients, and 86 were delivered of a normal fetus (93.4%). In contrast, qualitative AFV was decreased in 29 patients, and 26 were delivered of a fetus with IUGR (89.9%). These differences were highly significant. Perinatal morbidity was increased tenfold in patients with decreased AFV. Overall, 26 of 31 IUGR fetuses (83.4%) demonstrated decreased qualitative AFV.

Amniotic Fluid↗
PubMed1981

Simplified antepartum fetal heart assessment.

Antepartum fetal heart rate monitoring based on the association of fetal heart rate accelerations with fetal movements (non-stress test) is a standard method for fetal surveillance. Application of this method requires a continuous fetal heart rate recording monitor. Audible detection of heart rate accelerations was compared with recorded accelerations in 100 tests. A listening observer detected 77.7 per cent of all accelerations with an amplitude of at least 15 beats/minute. This allowed the detection of 94.2 per cent (82 out of 87) reactive non-stress tests. In no case was a non-reactive test called falsely reactive by the listening observer. This method may be useful for assessing fetal condition when continuous fetal heart rate monitors are not available.

Female↗
PubMed1981

Intrauterine fetal tachypnea.

In a previous case report, intrauterine fetal tachypnea was associated with sudden fetal death. The authors have observed a similar case of fetal tachypnea. Early intervention occurred and a normal fetus was delivered. Pathophysiologic mechanisms for the phenomenon are discussed.

Diabetes Complications↗
PubMed1980

Antepartum fetal evaluation: development of a fetal biophysical profile.

Five fetal biophysical variables, fetal breathing movements, fetal movements, fetal tone, qualitative amniotic fluid volume, and the nonstress test, were measured in the same observation period in 216 patients with high-risk pregnancies. All delivered within one week of the last observation. The relationship between individual biophysical variables and combinations of variables to the outcome of pregnancy as judged by five-minute Apgar score, fetal distress in labor, and perinatal mortality rate (PMN) was determined. For any single test, the false negative rate was low and was similar between tests, but the false positive rate was high (greater than 50%) and varied significantly between tests. Combining tests resulted in a significant change in both the false negative and false positive rates as compared to any single test. The most accurate differentiation of the normal from the compromised fetus was obtained when all five variables were studied. The PNM ranged from 0 when all variables were normal to 600 per 1,000 when all were abnormal. These data suggest that combined fetal biophysical testing is a more accurate method of antepartum fetal evaluation than any single method.

Adult↗
PubMed1980

Diurnal variations in maternal and fetal steroids in pregnant rhesus monkeys.

To examine diurnal changes in maternal and fetal steroids in chronically catheterized pregnant rhesus monkeys, we have measured cortisol (F), progesterone (P4), estone, and estradiol in maternal blood and F, P4, and dehydroepiandrosterone sulphate (DHAS) in simultaneous samples of fetal blood taken in the morning (0700--1000 h) and in the evening (1700--2100 h). In the mother, the concentrations of F, estradiol, and estrone were higher in the morning than in the evening. In contrast, progesterone was higher in evening than in morning samples. In fetal blood, there was no significant morning-evening difference for F; however, the concentrations of P4 and DHAS were higher in the evening than in the morning samples. In three individual monkeys, the concentrations of P4 and DHAS in serial samples of fetal blood were correlated. We conclude 1) that there are marked diurnal changes in the concentration of several steroids in samples of maternal and fetal blood and 2) that the concentration of F in maternal blood shows the opposite pattern to that of possible fetal adrenal steroids in fetal blood.

Animals↗
PubMed1980

Diagnosis of fetal death in utero by real-time ultrasound.

The efficacy of real-time ultrasound for the diagnosis of fetal death or hydatidiform mole was evaluated during a 1-year period. During this time, 116 patients were referred to the obstetric ultrasound service for the confirmation of clinical diagnoses. In 24 of 46 patients (52%) presenting in the first half of pregnancy, the referring diagnosis was confirmed. In 1 case of an early intrauterine pregnancy with a degenerating myoma, the ultrasound diagnosis of molar pregnancy was in error. In 48 of 70 patients (69%) referred after 20 weeks' gestation, the clinical diagnosis was confirmed. In no instance was either a false-positive or false-negative diagnosis made with real-time ultrasound in the last half of pregnancy. This method should prove to be the method of choice in diagnosing intrauterine fetal death.

Female↗
PubMed1979

Amniotic fluid phosphatidylglycerol and real-time ultrasonic cephalometry.

The fetal biparietal diameter (BPD) was measured at the time of real-time ultrasound-directed amniocentesis in 159 cases and a phospholipid profile was obtained from the amniotic fluid. BPD measurements of 9.0, 8.7, and 9.2 cm were then compared with a lecithin/sphingomyelin (L/S) ratio greater than or equal to 2.0 for the ability to predict the presence of phosphatidylglycerol (PG) in the profile. The data from the diabetic and nondiabetic patients were analyzed separately. The results demonstrated that in the presence of a L/S ratio greater than or equal to 2.0 the BPD does not aid in the identification of amniotic fluid samples which contain PG in either the diabetic or nondiabetic groups. The data also confirmed previous findings that the BPD is not a reliable predictor of the L/S ratio. It is concluded that for the detection of PG in amniotic fluid, the use of real-time ultrasonic cephalometry cannot substitute for the performance of the phospholipid profile.

Amniotic Fluid↗
PubMed1979

Immediate effect of amniocentesis on fetal breathing and gross body movements.

The incidence of fetal breathing movements (FBMs) has been observed to be significantly reduced at 24 and 48 hours after amniocentesis. The cause is unknown. We studied the immediate effects of amniocentesis on two fetal variables, FBMs and gross body movements (FMs). No effect was observed in the incidence of FBMs but an immediate increase in FMs occurred.

Amniocentesis↗
PubMed1979

Fetal breathing movements and the nonstress test in high-risk pregnancies.

Three hundred ninety-eight observations of fetal breathing movements (FBM) and the nonstress test (NST) were made in 223 patients. The presence of FBM was noted in a significantly higher proportion of tests with a reactive NST (88%) than a nonreactive NST (67%). Conversely, a significantly higher proportion of tests were reactive when FBM were present (82.6%) than when FBM were absent (49%). A significant relationship existed betweeen either test and the outcome of pregnancy as judged by the five minute Apgar score or the incidence of fetal distress in labor. Combining two normal tests did not improve the accuracy in predicting outcome; but the combination of both tests, when abnormal, produced a significant improvement in predicting fetuses likely to have an abnormal outcome. The combination of the normal with the abnormal test had a predictive accuracy similar to a single normal test in predicting a normal five-minute Apgar. This combination was associated with an incidence of fetal distress in labor intermediate between that seen with either the normal or abnormal test when alone. Neither a single test nor the combination of tests was helpful in identifying the small-for-gestational age (SGA) infants. These data indicate antepartum fetal evaluation may be improved when more than one biophysical variable is used.

Apgar Score↗