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Biomedical subjects

F Fallenstein

Publications and source records attributed to F Fallenstein.

At least 19 recordsLinked to original sources
PubMed1997

External four channel tocography in preterm labor. First results.

In order to known more about preterm labor the objective of our investigation was to look for a correlation between the spatial and temporal pattern of uterine contractions and the duration of pregnancy. 50 patients with preterm labor between 21 and 35 weeks of gestation underwent repeated measurements using four-channel tocography in which the pressure of contractions was registered simultaneously on the left and right sides at the fundus and the lower segment of the uterus. Half of all recorded signals were locally restricted (typical labor pattern in only one or two registration tracks). The following two phenomena were significantly associated with a shorter duration of pregnancy: 1. the reproducibility of a center of dominance (defined as the locus of registration with the highest sum of amplitudes), and 2. a predominant origin of labor in the right fundal region of the uterus. Four-channel tocography indicates whether preterm labor is likely to lead to preterm delivery. It may therefore help the obstetrician in deciding whether to use tocolytic therapy.

Adolescent↗
PubMed1994

External four-channel tocography during delivery.

OBJECTIVE: A four-channel tocographic technique was developed in order to improve present knowledge of spatial uterine motility. METHOD: Fifty-four women were monitored during labor. Four pressure transducers were attached in a square around the umbilicus. RESULTS: The origin of uterine contractions was generally determined to be in the upper right segment of the uterus. The rate of operative deliveries was decreased in the case of predominant upper right origin of labor. Most of the contractions with clear propagation patterns originated on the upper right side, continued to the left and then spread to the lower right part of the uterus. The highest relative intensity was also measured on the upper right side. CONCLUSION: Predominant upper right origin of labor may be important for unassisted or spontaneous delivery.

Adult↗
PubMed1994

[Plasma and myometrium electrolyte changes in the last trimester of pregnancy].

It is well known, that magnesium can positively influence preterm labour and that the magnesium level in the plasma is significantly lowered whereby magnesium excretion increases during pregnancy. These results lead to the question, whether the magnesium content in the myometrium is also reduced during pregnancy and whether blood parameters correlate with the concentration of magnesium in the myometrium. Myometrial tissues and blood samples from 127 patients, who underwent a Caesarean section, were analysed for magnesium, calcium, sodium and potassium. Erythrocytes, haemoglobin, haematocrit and the hormones oestradiol, oestriol and progesterone were analysed in the serum. We found a decrease in magnesium in the myometrium (p < 0.01) and in the plasma (p < 0.05) during pregnancy. Magnesium in the plasma correlates with magnesium in the myometrium (p < 0.001). These results indicate, that hypomagnesinaemia during pregnancy decreases the magnesium level in the myometrium.

Cesarean Section↗
PubMed1993

Therapeutic exercise for insulin-requiring gestational diabetics: effects on the fetus--results of a randomized prospective longitudinal study.

Regular physical activity is an established therapeutic adjunct in diabetes, but has not been offered to pregnant diabetics in the past; for sports might induce significant cardiovascular and hormonal changes that are able to reduce blood flow to the uterus and thus limit oxygen transfer to the fetus. Studying the impact of a medically supervised exercise program on gestational diabetes mellitus [GDM) in a randomised prospective longitudinal study, this paper aims to assess the effects of maternal moderate and strenuous exercise on the fetus. By evaluating shortterm fetal responses as reflected in heart rate patterns (FHR) and longterm-pregnancy complications and neonatal outcome, our results suggest that--in absence of ominous FHR changes or significant changes in uterine activity following the exercise sessions or increased diabetes-related peri- and neonatal morbidity--regular physical activity seems to be a safe therapeutic option for the fetus of GDM mothers.

Adult↗
PubMed1992

The variability of cardiopulmonary adaptation to pregnancy at rest and during exercise.

OBJECTIVE: To examine the cardiopulmonary adaptation to normal pregnancy in sitting women during rest and bicycle exercise. DESIGN: A longitudinal study beginning early in pregnancy and ending 8-12 months after delivery. SETTING: University Hospital, Zurich, Switzerland. SUBJECTS: 20 women were monitored every second week during pregnancy from 8 to 14 weeks gestation, twice in the puerperium and twice 6-8 weeks and twice 8-12 months after delivery. All the women finished the study, but not all of them participated in every visit. MEASUREMENTS AND MAIN RESULTS: The results obtained 8-12 months after delivery are considered the non-pregnant data and are presented first so that any change in pregnancy will be more obvious. Values given below refer to the median except when stated otherwise. At rest: 1. Oxygen consumption increased significantly from a median of 182 ml/min in the non-pregnant state to 256 ml/min by 8-11 weeks gestation, and peaked at 300 ml/min at 32 weeks. At 6-8 weeks after delivery the value was 225 ml/min. 2. Oxygen consumption per kg increased significantly from 3.0 ml/min in the non-pregnant state to 4.3 ml/min by 8-11 weeks gestation and peaked at 5.0 ml/min soon after delivery. At 6-8 weeks after delivery the value was 3.4 ml/min. 3. Carbon dioxide production generally showed changes similar to those of oxygen consumption. 4. Respiratory quotient did not show any significant changes. 5. Ventilation increased from a median of 9.4 l/min in the non-pregnant state to 10.5 l/min by 8-11 weeks and then slowly increased to 12.6 l/min in late pregnancy. 6. Respiratory rate did not change significantly. 7. Tidal volume showed a median of 563 ml in the non-pregnant women and rose significantly to 632 ml in early pregnancy, peaking at 715 ml in late pregnancy. 8. Alveolar ventilation increased significantly from a non-pregnant value of 3.4 l/min to 6.2 l/min in early pregnancy, peaking at 6.7 l/min at term; 6-8 weeks after delivery the value was 4.5 l/min. 9. Ventilation equivalent for oxygen fell significantly from the median non-pregnant value of 52 to 42 in early pregnancy and remained at that level until 6-8 weeks after delivery when it was 44. 10. Ventilation equivalent for carbon dioxide showed similar changes to those for oxygen. 11. Alveolar carbon dioxide tension fell significantly from a median non-pregnant level of 4.6 kPa (34 mmHg) to 4.0 kPa (30 mmHg) in early pregnancy. It began to increase in the puerperium and was 4.3 kPa (33 mmHg) 6-8 weeks after delivery. 12. Mixed venous carbon dioxide tension fell significantly from a median of 5.9 kPa (44 mmHg) to 5.2 kPa (39 mmHg) during pregnancy. 13. Transcutaneous carbon dioxide tension decreased significantly in early pregnancy from 8.8 kPa (66 mmHg) in the non-pregnant women, and from 20 weeks gestation remained at 6.9 kPa (52 mmHg). 14. Transcutaneous oxygen tension showed a non-significant increase from 10.0 kPa (75 mmHg) in the non-pregnant women to 11.1 kPa (83 mmHg) during pregnancy. 15. Cardiac frequency increased gradually from a non-pregnant median of 80 b.p.m. to about 90 b.p.m. in the last 2 months of pregnancy. In the puerperium the median was 75 b.p.m. 16. Cardiac output increased significantly by almost 50% from the non-pregnancy level to that at 8-11 weeks gestation. 17. Cardiac output per kg also increased significantly by 50% from the non-pregnant level to that at 8-11 weeks gestation. From mid-pregnancy there was a gradual fall until delivery. 18. Stroke volume increased significantly from a median of 31 ml in the non-pregnant state to 51 ml in early pregnancy, and remained at this level until delivery. In the puerperium the stroke volume was 63 ml. 19. Oxygen pulse increased significantly from a median of 2.2 ml in the non-pregnant women to 3.1 ml in early pregnancy and remained at that level. 20. Individual curves.(ABSTRACT TRUNCATED AT 400 WORDS)

Adaptation, Physiological↗
PubMed1990

[Magnesium, calcium, hemoglobin, hematocrit, estriol and human placental lactogen with magnesium substitution in pregnancy].

In a randomised double-blind study 568 women were given orally either 15 mmol magnesium-aspartate hydrochloride per day or aspartic acid as placebo. The outcome of pregnancy was significantly improved in the magnesium group (fewer maternal hospitalisations, reduction in preterm delivery and less frequent referral of newborn to the neonatal intensive care unit). In the 437 patients with regular intake of tablets, haematocrit, haemoglobin and calcium show a decrease up to 20 weeks of gestation (wks) and an increase during the last 8 wks, whereas magnesium stays at a low level. Oestriol and HPL are rising steadily during gestation. In all parameters, no differences were found between the magnesium and placebo group, except for a higher level of oestriol at 33 to 36 wks and a lower level above 36 wks in the magnesium group. Because of the numerous benefits throughout the pregnancy magnesium supplementation is recommended for all pregnancies.

Aspartic Acid↗
PubMed1989

Bolus tocolysis: treatment of preterm labor with pulsatile administration of a beta-adrenergic agonist.

The treatment of premature labor with beta-adrenergic substances is complicated by side effects. Although most human control mechanisms are pulsatile, therapy is usually administered continuously. We designed a microprocessor-controlled pump to allow pulsatile tocolytic infusion, hoping to reduce the total dose and thus the side effects. In 33 patients pulsatile bolus tocolysis was compared with continuous tocolysis in a control group of 38 patients. Bolus tocolysis required considerably less beta-sympathomimetic agent for comparable therapeutic success (median dosage 3.0 versus 15.9 mg, p less than 0.001). Duration of therapy under bolus tocolysis was also significantly shorter (p less than 0.05). Birth weight was higher after bolus tocolysis (median 3070 versus 2580 gm, p = 0.05). Additional indicators favored bolus tocolysis but were not statistically significant: a longer gestational period, fewer infants weighing less than 2500 gm, and a lower incidence of respiratory distress syndrome. Pulmonary edema occurred in one patient during continuous tocolysis.

Adrenergic beta-Agonists↗
PubMed1987

Is pulse oximetry reliable in detecting hyperoxemia in the neonate?

We tested the hypothesis that hyperoxemia defined as arterial PO2 above 12 kPa can be detected by pulse oximetry using 95% oxygen saturation as the upper limit. Thirty artificially ventilated neonates with an indwelling arterial catheter were studied registrating transcutaneous oxygen saturation (Ohmeda Biox 3700 Pulse Oximeter) and transcutaneous PO2 continuously during a 4-hour period and measuring arterial oxygen saturation and PO2 intermittently. 46 episodes of arterial hyperoxemia were observed. Pulse oximetry had a sensitivity of 30%, detecting 14 of these 46 hyperoxemic episodes, and a specificity of 93%. The accuracy for separating hyperoxemia from normoxemia by pulse oximetry could be improved by shifting the cut-off point from 95% to 92%. With this optimal cut-off point sensitivity was 70% and specificity 62%. We conclude that pulse oximetry is not reliable for detection of hyperoxemia.

Blood Gas Monitoring, Transcutaneous↗
PubMed1987

[Effects of compression stockings on blood circulation in late pregnancy].

The effect of Class II compression stockings on maternal and fetal circulation was studied in left lateral position and standing in 21 patients with uterovascular syndrome in late pregnancy. The effect of different compression pressures was analyzed in further seven women also suffering from uterovascular syndrome in late pregnancy. It was shown that the use of compression stockings causes a measurable improvement in maternal and fetal circulation. The most favourable compression pressure for the maternal circulation parameters measured is 40 mm Hg.

Adaptation, Physiological↗
PubMed1987

Combined electronic fetal heart rate and fetal movement monitor--a preliminary report.

We have tested a new Doppler ultrasound apparatus which registers both fetal movements and fetal heart rate with a single transducer. To evaluate the reliability of the recognition of movements we also observed them simultaneously by real time ultrasound. In 20 patients with normal pregnancies between the 30th and 42nd week of gestation, taking the real time ultrasound as reference the positive predictive value was 0.93 and the sensitivity 0.94. Maternal hiccups or coughing were recorded as fetal movements. Neither gestational age, the amount of amniotic fluid or the position of the placenta influenced the recognition of movement; nor did fetal breathing, maternal breathing, speaking or laughing.

Female↗
PubMed1986

Physiologic changes in pregnant women and their fetuses during jet air travel.

The physiologic reactions of pregnant women and their fetuses were studied during routine commercial flights. Ten healthy pregnant women (32 to 38 weeks of gestation) each undertook two flights. Maternal respiratory and heart rates, transcutaneous PO2 and PCO2, blood pressure, uterine activity, and fetal beat-to-beat heart rate variability were continuously monitored. During these flights, maternal heart rate and blood pressure increased, and PO2 decreased significantly while PCO2 remained unchanged. Respiratory rate showed a short increase during takeoff and landing but remained unchanged during the rest of the flight. Mean fetal heart rate was within normal limits during the whole flight. No bradycardia, prolonged tachycardia, or significant loss of heart rate variability was observed. This study indicates no hazards of commercial flights to the mother and the fetus in uncomplicated pregnancies.

Adult↗
PubMed1986

Transcutaneous carbon dioxide tension in newborn infants: reliability and safety of continuous 24-hour measurement at 42 degrees C.

In 58 newborn infants a new iridium oxide sensor was evaluated for transcutaneous carbon dioxide (tcPCO2) monitoring at 42 degrees C with a prolonged fixation time of 24 hours. The correlation of tcPCO2 (y; mm Hg) v PaCO2 (x; mm Hg) for 586 paired values was: y = 4.6 + 1.45x; r = .89; syx = 6.1 mm Hg. The correlation was not influenced by the duration of fixation. The transcutaneous sensor detected hypocapnia (PaCO2 less than 35 mm Hg) in 74% and hypercapnia (PCO2 greater than 45 mm Hg) in 74% of all cases. After 24 hours, calibration shifts were less than 4 mm Hg in 90% of the measuring periods. In 86% of the infants, no skin changes were observed; in 12% of infants, there were transitional skin erythemas and in 2% a blister which disappeared without scarring. In newborn infants with normal BPs, continuous tcPCO2 monitoring at 42 degrees C can be extended for as many as 24 hours without loss of reliability or increased risk for skin burns.

Blood Gas Monitoring, Transcutaneous↗
PubMed1985

[Reaction of mother and fetus to physical stress at high altitude].

The objective of the study reported here was to investigate the reactions of mother and fetus to high-altitude hypoxia combined with physical exercise. The climb was passive, by means of scheduled journeys of the Grap Sogn Gion AG aerial cableway in Laax (Switzerland). The valley station is at an altitude of 1100 m, the mountain station at 2200 m. The mother exercised on a bicycle ergometer set to 25 watts for 3 minutes. The following were measured continuously and noninvasively: heart rate, respiratory rate, systolic and diastolic blood pressure, Po2 and Co2, uterus activity, and fetal heart rate. Twelve pregnant women with an average gestational age of 36 weeks (30th-39th week) took part in the study. Ten of the women were primiparae and two multiparae. During the trip up the mountain the barometric pressure dropped on average from 668 to 583 mmHg. This resulted in a maximum difference in Po2 between the valley and mountain stations of 18 mmHg. There were no systematic changes in Po2. Respiratory rate, heart rate, systolic and diastolic blood pressure remained unchanged during the trip up the mountain. The physical exercise at the mountain station led to an increase in respiratory rate from 12 to 20 min-1, while heart rate rose from 103 to 128 min-1, systolic blood pressure from 117 to 144 mmHg, and diastolic blood pressure from 70 to 90 mmHg. Six of the 12 women had regular contractions even during the trip up the mountain; these either remained unchanged or became less frequent in the course of the study. The mean fetal heart rate only changed slightly.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[Effectiveness of low- and high-dose caffeine on idiopathic bradycardia and hypoxemia in premature infants].

The efficacy of low and high dose caffeine on idiopathic bradycardia and hypoxaemia was tested in premature infants. Among 41 infants admitted to the study 21 fulfilled the criterion for treatment, e.g. greater than 3 bradycardia or greater than 3 hypoxaemia during 6 h, and received a low dose of caffeine citrate (loading dose 10 mg/kg, maintenance dose 5 mg/kg/24 h) resulting in serum concentrations of 42 +/- 19 mumol/l (M +/- SD). Four infants had to be excluded later because a possible cause for the increased frequency of bradycardia and hypoxaemia was found. Ten infants met the treatment criterion once more and got a double dose of caffeine resulting in serum concentrations of 90 +/- 35 mumol/l. The efficacy of caffeine was evaluated by comparing for each infant the 12-h period preceding the treatment with three 12-h periods during treatment. Low dose caffeine reduced significantly the frequency of bradycardia (less than 0.01), but not the frequency of hypoxaemia. In those infants with insufficient response, who consequently got high dose caffeine, the frequency of bradycardia decreased significantly (p less than 0.01), whereas the frequency of hypoxaemia did not. These results have to be confirmed in a randomized placebo controlled trial.

Bradycardia↗