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Biomedical subjects

F C Miller

Publications and source records attributed to F C Miller.

71 records · Page 4Linked to original sources
PubMed1978

The effects of paracervical block on uterine activity and beat-to-beat variability of the fetal heart rate.

Paracervical block analgesia with the use of lidocaine hydrochloride provoked little change in uterine activity. The general trend in uterine activity was an increase, although there was considerable variation in individual response. Beat-to-beat variability in the fetal heart rate increased following the block. The increase in variability began almost immediately, with the greatest increase occurring at a time when one would expect maximum maternal and fetal lidocaine levels. It is proposed that this increase in fetal heart rate variability is an early sign of post-paracervical block hypoxemia and/or hypoxia.

Anesthesia, Obstetrical↗
PubMed1978

A rapid method for the presurgical cleansing of hands.

A new rapid method of presurgical cleansing of the hands has been evaluated in a clinical setting. The effectiveness of a 90 second jet wash has been compared with a standard 10-minute presurgical scrub. Bacteriologic cultures were obtained from the fingertips of interns, residents, and staff of the Department of Obstetrics and Gynecology of the Walter Reed Army Medical Center before and after 90-second jet washings and 10-minute conventional scrubs. The results showed that the 90-second jet wash was more effective in degerming the hands than the 10-minute standard brush scrub. Other advantages of the new method, such as the amount of time saved, the standardization of cleansing, and reduced skin irritation are discussed.

Antisepsis↗
PubMed1978

The effect of maternal blood sugar levels on fetal activity.

Nonstress testing of the fetal heart rate is an antepartum test for fetal well-being utilizing the fetal heart rate response to fetal movement. Performing the test during times of maximum fetal movement should reduce the time required for the test. In this study, fetal activity was evaluated before and during a 3-hour glucose tolerance test to determine the effect of maternal blood glucose levels on fetal activity. Fetal activity was monitored by a nurse at the bedside throughout the study, utilizing both the patient's perception of fetal movement and the recording of fetal movement by the tokodynamometer. Fetal activity increased significantly during the first 30 minutes after maternal ingestion of 100 g glucose and was significantly greater during the last 10 minutes of this time interval. No correlation could be found between absolute levels of glucose at any measured level and fetal activity.

Adult↗
PubMed1977

Fetal heart rate acceleration in response to acoustic stimulation as a measure of fetal well-being.

The search for better means of testing for antepartum fetal well-being is a major objective of perinatal medicine. This preliminary report explores the use of a 2,000 c.p.s. pure-tone auditory stimulus for "nonstress" testing, a comparison with the oxytocin challenge test (OCT), and a correlation with fetal outcome. Instead of waiting, when the fetus may be inactive or "sleeping," for a positive fetal heart (FHR) response following a fetal kick or movement, a rapid "nonstress" test may be performed by evoking an FHR acceleration after the application of a five-second auditory stimulation at 105 to 120 db. When FHR acceleration evoked exceeded 15 b.p.m., the subsequent OCT was always negative. Suspicious or positive OCT's were frequently obtained when no response to auditory stimuli occurred. Subsequent outcomes as well as safety and potential applications of this rapid test which may eliminate the need for many OCT's are discussed.

Acoustic Stimulation↗
PubMed1976

Quantitation of uterine activity in 100 primiparous patients.

An on-line technique for quantitating uterine activity by measuring the total area under the intrauterine pressure curve was utilized during the labor of 100 primiparous patients. Uterine activity was measured in uterine activity units (1 UAU=1 Torr minute). UAU's were calculated for each patient in both cumulative and noncumulative fashions. The rate of uterine activity (UAU per unit of time) increased as labor progressed, yet the total UAU's expended at each centimeter of dilatation progressively decreased with advancing dilatation. Thus, the rate of cervical dilatation increased faster than could be accounted for by the increase in uterine activity. The implication being that the efficiency of uterine contractions increases with advancing labor. It no longer appears reasonable to refer to labor in terms of elapsed time. Information regarding the "pattern of cervical dilatation" and uterine activity appears to be much more meaningful to the evaluation of progress in labor. Quantitation of uterine activity may provide useful information for the ongoing management of labor. Quantitation of UA does provide a means of evaluating the effects of specific events such as medication, anesthesia, and manipulation on UA.

Adolescent↗
PubMed1976

Effects of ritodrine hydrochloride on uterine activity and the cardiovascular system in toxemic patients.

The effects of ritodrine hydrochloride were evaluated in 25 toxemic patients in active labor utilizing continuous electronic monitoring of fetal and maternal cardiovascular systems and uterine activity. Fetal scalp blood and free flowing maternal antecubital venous blood was obtained for pH, Po2, Pco2, base deficit and blood glucose determinations prior to and immediately following the study period. The initial ritodrine dose was 50 mug/min for 15 minutes. The dose was increased by 50 mug/min each 15 minutes until there was a clinically apparent reduction in uterine activity. Once this was accomplished, the infusion was maintained for 30 minutes. There was a consistent increase in the maternal heart rate (MHR) and a significant rise in fetal heart rate (FHR) late in the infusion and in the postinfusion period. There was a widening of the maternal pulse pressure mainly due to a reduction in diastolic pressure with little change in the mean blood pressure. Maternal and fetal pH decreased and base deficit increased during the study although the PO2 and PCO2 remained unchanged. Maternal and fetal blood glucose rose significantly following ritodrine infusion.

Blood Glucose↗
PubMed1976

The effect of drugs on uterine activity.

Uterine activity was measured for a 30-minute preinjection period and a 30-minute postinjection period for six drugs commonly used in labor. Uterine activity was quantitated by measuring the area below the uterine pressure curve with an on-line technic utilizing a voltage control oscillator. Uterine activity readings were obtained every 2.5 minutes and reported in uterine activity units (UAU). Unmedicated labor demonstrated a relatively static increase in UAU per unit of time in labor. On comparing total UAU before and after injection, only magnesium sulfate was noted to cause a decrease in total UAU. Utilizing 10-minute summations of UAU, the pre- and postinjection periods were compared to the calculated expected UAU for the 30 minutes following the preinjection period (assuming no drug had been used). For each of the other drugs, the positive slope of the calculated expected UAU shifted to a negative slope of the actual observed UAU following drug administration.

Adolescent↗
PubMed1975

Significance of meconium during labor.

Continuous fetal heart rate (FHR) monitoring and routine fetal scalp blood sampling was utilized in the evaluations of 366 fetuses during labor. One hundred and six patients had meconium in the amniotic fluid at some time during labor. A total of 26,110 uterine contractions were monitored during these 366 labors. The incidence of FHR patterns as a percentage of uterine contractions was calculated for the meconium and nonmeconium groups. Although there was a 3 1/2-fold increase in the incidence of low five-minute Apgar scores (less than 7) in the meconium group, signs of fetal distress were, with rare esception, not significantly different from those in the nonmeconium group. The presence of meconium in the amniotic fluid without signs of fetal asphyxia (late decelerations and acidosis) is not a sign of fetal distress and need not be an indication for active intervention. The combination of fetal asphyxia and meconium staining of the amniotic fluid, however, does enhance the potential for meconium aspiration and a poor neonatal outcome. Universal fetal heart rate monitoring and appropriate fetal acid-base evaluation is recommended for following patients with meconium in the amniotic fluid during labor.

Acid-Base Equilibrium↗