Biomedical subjects

G D Anderson

Publications and source records attributed to G D Anderson.

At least 109 records · Page 6Linked to original sources

PubMed1984

Size-at-birth standards for an urban Canadian population.

By random sampling of all births occurring in Hamilton, Ont. over an 18-month period the percentile distributions of the newborn infants' weight, length, and head and chest circumferences were determined. The resulting standards may be used in the clinical evaluation of size for gestational age. The smoothed 50th percentile values for newborns of 40 weeks gestational age were as follows for boys and girls respectively: birth weight 3530 and 3355 g, crown-heel length 52.0 and 51.3 cm, head circumference 35.2 and 34.4 cm, and chest circumference 33.4 and 32.8 cm. The mother's height averaged 160.8 +/- 6.1 cm and her weight before the pregnancy 59.2 +/- 10.5 kg. The prevalence of cigarette smoking during pregnancy was 34.8%.

Birth Weight↗

PubMed1984

Estimation of tris(2-butoxyethyl) phosphate in biological fluids: novel intersubject variability in recovery from human serum.

Tris(2-butoxyethyl) phosphate (I), a plasticizer commonly found in evacuated blood collection tubes, displaces many basic drugs from their binding sites on serum proteins and causes them to redistribute from serum into red blood cells (i.e., artificially lowering serum or plasma drug concentration). Thus, the ability to quantitate I in serum or plasma may be helpful in establishing the suitability of various lots of evacuated blood collection tubes for use in drug level monitoring and pharmacokinetic studies. In the process of establishing a minor modification of an assay which has been reported, remarkable and reproducible interindividual variability (n = 10) in the slope of standard curves was observed (range, 0.0143-0.0486). This variability appeared to be caused by differences in the recovery of I from the serum of these individuals. The source of this difference seemed to be related to serum lipoprotein concentration since the slope of standard curves was highly correlated with serum triglyceride concentration (r = -0.800) as well as with the sum of serum triglyceride and cholesterol concentrations (r = -0.881). These observations suggest that the examination of interindividual differences in the recovery of drugs and related compounds from serum should be a routine part of assay development.

Adult↗

PubMed1984

Maternal organ distribution of cardiac output in the diet-restricted pregnant rat.

Maternal organ distribution of cardiac output was measured with 15-micron diameter, radioactively labeled microspheres in ad libitum-fed or 50% diet-restricted, term pregnant rats, and in ad libitum-fed nonpregnant rats. The diet-restricted dams had a 33% lower total cardiac output than the ad libitum-fed dams, but it was not significantly different from that of the nonpregnant rats. Placental blood flow in the diet-restricted rats was 30% lower than that in the ad libitum-fed rats. Except for a higher blood flow to the pancreas and a lower blood flow to the uterine tissue, blood flows to the other organs of the diet-restricted dams were not significantly different from those of ad libitum-fed pregnant dams. Blood flows to the lungs, small intestine and ovaries of the diet-restricted pregnant rats were higher than those in the nonpregnant rats. Dietary restriction resulted in a decreased percentage of the cardiac output being distributed to the pregnant uterus and an increased percentage to the hepatic portal circulation, thus maintaining a liver blood flow similar to that in nonpregnant rats. Thus, maternal liver blood flow, rather than that to the placentas, is protected during malnutrition.

Animals↗

PubMed1984

Clinical efficacy of cefoperazone in obstetric and gynecologic infections.

Compared with second-generation cephalosporins, cefoperazone, a third-generation cephalosporin, has demonstrated an extended antibacterial spectrum. In addition, it has a long serum half-life and requires only twice-a-day administration. In this study, 66 patients with clinically diagnosed obstetric and gynecologic infections were treated with cefoperazone, and 61 were evaluated for efficacy. An overall cure rate of 93% (57 patients) was achieved. In view of the excellent clinical response and convenience of twice-a-day administration, we conclude that cefoperazone is a clinically useful single agent for the initial empirical treatment of patients with obstetric and gynecologic infections.

Abortion, Septic↗

PubMed1984

Pregnancy outcome in 303 cases with severe preeclampsia.

The purpose of the present clinical investigation was to determine the influence of aggressive management, associated medical/obstetric complications, race, and gestational age on fetal, neonatal, and maternal risks associated with severe preeclampsia. Three hundred and three consecutive pregnancies complicated by severe preeclampsia were studied. All patients were delivered within 48 hours after admission to the perinatal center. In 91 patients the disease was superimposed on chronic hypertension. There was a significant difference between patients with and those without prior chronic hypertension regarding perinatal mortality (32 versus 7.7%), incidence of abruptio placentae (10 versus 4%), and frequency of small-for-gestational-age infants (33 versus 14%). Fifty-one patients (17%) had thrombocytopenia, 26 (8.5%) had hemolysis, elevated liver enzymes and low platelet count syndrome, and 22 (7.3%) had disseminated intravascular coagulopathy. There was significant difference between white and black patients regarding the frequency of thrombocytopenia (28 versus 13%), hemolysis, elevated liver enzymes, and low platelet count syndrome (19.7 versus 5.3%), and coagulopathy (13 versus 1.4%). However, most of this apparent racial difference resulted from higher incidence of abnormal hematologic findings among patients who had conservative management by private physicians before transfer. Perinatal survival was zero when severe preeclampsia developed at or before 28 weeks, whereas it was 100% when disease developed after 36 weeks' gestation. The above factors should be considered in counselling patients with severe preeclampsia.

Abruptio Placentae↗

PubMed1984

Comparison of the Lumadex-foam stability index test, lecithin: sphingomyelin ratio, and simple shake test for fetal lung maturity.

Amniotic fluid was obtained from 269 patients within 72 hours of delivery. The sensitivity, specificity, and predictive value of the Lumadex-foam stability index test, lecithin: sphingomyelin (L:S) ratio, and simple shake test were assessed in the diagnosis of respiratory distress syndrome (RDS), as well as the accuracy in identification of functional lung maturity in the growth-retarded fetus. The Lumadex-foam stability index test was found to be an accurate, quantitative, simple, and rapid measure of fetal lung maturity in the normal as well as abnormal pregnancy. The L:S ratio was accurate in the normal pregnancy, but became inaccurate in the small growth-retarded fetus. The nonquantitative simple shake test was accurate when it indicated fetal lung maturity, but an immature result was meaningless because of the large false-negative rate.

Amniotic Fluid↗

PubMed1984

Relationship of hypertensive disease to abruptio placentae.

The purpose of the present retrospective study was to examine the relationship between hypertension and abruptio placentae. Two hundred sixty-five consecutive cases of abruption were reviewed, with an emphasis on the occurrence and severity of hypertensive disease. The results confirm a close relationship between abruptio placentae and hypertension. The incidence of abruption was highest with eclampsia (23.6%), followed by chronic hypertension (10.0%) and preeclampsia (2.3%). In addition, those with eclampsia and chronic hypertension had a significantly higher perinatal mortality than those without these conditions. These data demonstrate that hypertension is associated with an increased risk of abruption. Furthermore, the degree of this increased risk is clearly dependent upon the specific type of hypertensive disorder.

Abruptio Placentae↗

PubMed1984

Inaccuracy of Dubowitz gestational age in low birth weight infants.

The Dubowitz gestational age was compared to the obstetric clinical age of 119 predominantly black mother-infant pairs for whom certain clinical criteria were met. Forty-five hypertensive and 74 nonhypertensive gestations with infant birth weight less than 2500 g were evaluated. Overall the clinical age was 33.6 +/- 4.5 weeks versus 34.7 +/- 4.3 weeks by Dubowitz age (P = NS). The Dubowitz age differed from clinical age by more than 2 weeks in 33.6% (40/119). Of gestations under 33 weeks (clinical age) (N = 45) the clinical age was 30.1 +/- 2.4 weeks as compared to the Dubowitz age of 32.2 +/- 2.7 weeks (P less than .01). Fifty-one percent (23/45) of Dubowitz ages were more than two weeks discordant with the clinical age. The Dubowitz assessment of gestational age may be unacceptably inaccurate in the determination of gestational age in low birth weight infants, particularly in those whose gestational age is less than 33 weeks. The findings suggest that studies in which conclusions were based on the Dubowitz age assessment may need reevaluation.

Female↗

PubMed1984

Effect of magnesium sulfate on electroencephalographic findings in preeclampsia-eclampsia.

Electroencephalograms (EEGs) were recorded in 36 eclamptic, 14 preeclamptic, and 13 normotensive control patients. In the eclamptic group, EEGs were recorded while patients were receiving intravenous magnesium sulfate (MgSO4) with serum magnesium (Mg) levels of 4.5 to 11 mg/dL, and recorded again after MgSO4 was discontinued (serum Mg levels 1.8 to 2.5 mg/dL). In preeclamptic patients, EEGs were recorded before starting MgSO4, during administration of the loading dose (serum Mg levels 6 to 10 mg/dL), and eight hours through the maintenance dose (serum Mg levels 3.6 to 6.2 mg/dL). Twenty-seven (75%) eclamptic patients had abnormal EEGs, four patients showed paroxysmal spike activity, and the others showed focal or diffuse slowing (delta waves). Seven (50%) preeclamptic women had abnormal EEGs (all had generalized slowing). In preeclamptic-eclamptic patients who had serial EEG recordings, the gross EEG findings obtained during MgSO4 infusion and in the absence of MgSO4 were similar. In addition, the abnormal EEG findings were frequent despite the serum Mg levels considered therapeutic in the clinical management of these patients. Two eclamptic patients had seizure activity at serum Mg levels of 9.6 and 11 mg/dL. These findings suggested that abnormal EEGs are frequent in preeclamptic-eclamptic patients. Abnormal EEG findings in such patients are not altered by serum Mg levels achieved in the clinical management of these patients.

Adolescent↗

PubMed1983

Plasma volume findings in patients with mild pregnancy-induced hypertension.

With the Evans blue dye-dilution technique, plasma volume was serially measured at 29 to 33 weeks' and 34 to 40 weeks' gestation in 74 pregnant women with documented mild pregnancy-induced hypertension (PIH) and 25 well-matched normotensive primigravid women. The relationship of plasma volume to clinical course, perinatal outcome, and other laboratory findings was subsequently analyzed. The patients with mild PIH were categorized into two groups based on infant outcome: appropriate for gestational age (AGA) and small for gestational age (SGA). The mean age, height, and hematocrit of the study and control patients were similar. The group of patients with mild PIH had significantly higher mean arterial blood pressures and uric acid levels (p less than 0.001). There was no difference in mean plasma volume findings between the normotensive group and the mild PIH group delivered of AGA infants. Plasma volume was reduced only in pregnancies with mild PIH with delivery of SGA infants. It is concluded that plasma volume is not reduced in most patients with mild PIH. However, plasma volume might be useful in identifying a subgroup of patients with mild PIH at risk for delivering an SGA infant.

Adult↗

PubMed1983

Eclampsia. III. Neonatal outcome, growth, and development.

Infants of 72 recently managed women with eclampsia before delivery were studied. Infants with gestational age of 36 weeks or less (56%) were analyzed separately from those infants of more than 36 weeks' gestation (44%). In addition, premature infants of eclamptic mothers were compared with 40 premature infants whose mothers did not have any medical complications. Intrauterine growth retardation was symmetrical in all seven infants whose mothers had eclampsia prior to 32 weeks. All neurological abnormalities were associated with abruptio placentae or intrauterine growth retardation. Among the preterm infants of eclamptic mothers and those of normotensive mothers, there was no significant difference in any commonly acquired laboratory data. Neonatal complications in premature infants of eclamptic mothers were frequent. However, neonatal complications of the low-birth weight infants were strikingly similar regardless of the presence of eclampsia. It is possible that most neonatal complications are consequence of prematurity, instead of a sole consequence of eclampsia. Observations from follow-up data (up to 4 years of age) suggest normal growth and development for infants of mothers with uncomplicated eclampsia.

Abruptio Placentae↗

PubMed1983

Cardiac output and uteroplacental blood flow in diet-restricted and diet-repleted pregnant rats.

Cardiac output and uteroplacental blood flow were measured with 15 mu radioactive microspheres in anesthetized pregnant rats which were fed: (1) ad libitum throughout gestation; (2) a 50% restricted diet from day 5 of gestation; and (3) a 50% restricted diet from days 5 to 13 of gestation and ad libitum from day 14 of gestation. An additional group of nonpregnant rats fed ad libitum was also used. Dietary restriction caused a net maternal weight loss and a 20% reduction in mean fetal weight and mean placental weight by day 21 of gestation. Restricted dams fed ad libitum during the last week of gestation showed a net maternal weight gain, while mean fetal weight, but not placental weight, was near that of the ad libitum--fed controls. In the diet-restricted rats, total cardiac output was reduced 30% relative to controls by days 20 and 21 of gestation, but cardiac output per unit maternal body weight was not significantly different. Dietary restriction decreased both total uterine and placental blood flow by about 65%. Diet repletion late in gestation did not significantly increase total cardiac output or cardiac output per unit body weight. Total uterine and placental blood flows were near those of controls, primarily because of an increased fraction of cardiac output distributed to the uterus.

Animals↗

PubMed1983

Effect of dietary restriction, during the last week only or throughout gestation, on cardiac output and uteroplacental blood flow in pregnant rats.

Cardiac output and uteroplacental blood flow were measured by using 15-microns radioactive labeled microspheres in ad libitum-fed nonpregnant female rats, and in pregnant rats: 1) fed ad libitum; 2) fed a 50% restricted diet from day 14 of gestation on; and 3) fed a 50% restricted diet from day 5 of gestation on. Dietary restriction induced fetal growth retardation regardless of duration. Cardiac output in both groups of diet-restricted dams was 30% less than that of the ad libitum-fed pregnant dams, and not significantly increased above that of the nonpregnant rats. Total uterine and placental blood flows in the dams fed the restricted diet during the last week of gestation were reduced 30-35% relative to the ad libitum-fed dams due to the reduced cardiac output. In the dams fed the restricted diet from day 5, total uterine and placental blood flows were reduced 60-65% due to both the reduced cardiac output and a decreased fractional distribution of cardiac output to the uterus. Dietary treatment had no effect on blood flow to the kidneys and ovaries. The results suggest that the reduced placental blood flow associated with maternal malnutrition-induced fetal growth retardation is caused by an inadequate expansion of maternal cardiac output, and, if malnutrition is severe enough, a fractional redistribution of cardiac output away from the uterus and developing conceptus occurs.

Animals↗

PubMed1983

Late postpartum eclampsia: an update.

Eclampsia occurring more than 48 hours postpartum has been observed in an unusual number of patients. From August 1977 to November 1982 at E. H. Crump Women's Hospital and Perinatal Center (Memphis), there were 132 documented cases of eclampsia, of which 36 (27%) occurred postpartum. Seventeen (47%) of these occurred more than 48 hours postpartum. Preeclampsia was diagnosed before the onset of convulsions in 12 patients, all of whom received intravenous magnesium sulfate postpartum. The mean duration of postdelivery magnesium sulfate therapy was 32 hours (range 24 to 72 hours). Headaches and visual disturbances were reported by all 17 patients before onset of convulsions. Physical and laboratory findings immediately after the convulsions were consistent with eclampsia. Treatment consisted primarily of intravenous magnesium sulfate. Neurologic consultation was obtained to rule out a neurologic disorder, and metabolic studies were also done. Electroencephalograms were done on 15 patients; eight of them showed patterns consistent with encephalopathy.

Blood Pressure↗

PubMed1983

Maternal-fetal correlations in patients with severe preeclampsia/eclampsia.

A prospective pair-controlled study of maternal, cord blood, and neonatal hematologic findings was done in 50 severely preeclamptic/eclamptic and 50 well-matched normotensive pregnancies. There were no neonatal complications in mature infants. Neonatal complications were similar in premature infants of both study and control group; however, neonatal deaths were higher in the study group. In the study group, there was a poor correlation between maternal and cord blood hematocrit (r = .07), platelet count (r = .11), and fibrinogen (r = .05). In addition, there was no correlation (r = .06) between maternal and cord blood thrombocytopenia. Within each subgroup, abnormal neonatal hematologic findings were usually associated with fetal growth retardation, perinatal asphyxia, acidosis, sepsis, or intracranial hemorrhage. The present findings suggest that abnormal hematologic findings described in neonates of severely preeclamptic/eclamptic pregnancies are the result of associated neonatal complications, rather than a direct consequence of preeclampsia.

Adolescent↗

PubMed1983

Pregnancy outcome in 211 patients with mild chronic hypertension.

The purpose of the present clinical investigation was to determine the risks associated with mild chronic hypertension in pregnancy. Two hundred eleven consecutive pregnancies complicated by mild chronic hypertension (diastolic blood pressure, 90 to 110 mmHg) were analyzed. All patients were followed closely throughout pregnancy with frequent prenatal visits and serial assessment of fetal status. Antihypertensive drugs were discontinued at the time of the first prenatal visit. Only 13% of these patients required antihypertensive medications later in pregnancy. There were 2 stillbirths and 4 neonatal deaths for an overall perinatal mortality of 28.1/1000. However, the majority of deaths (5 of 6) occurred among the 21 patients with superimposed preeclampsia. This subgroup was also characterized by a high rate of growth-retarded infants (32%). For patients without superimposed preeclampsia, 5.3% of the infants were small for gestational age and there was only one perinatal death. Thus, for patients with mild chronic hypertension, discontinuance of antihypertension medications does not adversely affect the antepartum course or perinatal outcome. In fact, in the absence of superimposed preeclampsia, the perinatal mortality for these patients approaches that of the general obstetric population. Therefore, in pregnancies complicated by mild chronic hypertension, factors other than increased blood pressure per se might be responsible for the poor perinatal outcome reported in such pregnancies.

Antihypertensive Agents↗

PubMed1983

A new obstetric unit. E. H. Crump Women's Hospital and Perinatal Center, Memphis, Tennessee.

Planning or renovation of a labor and delivery area is a major undertaking. It is often necessarily done in dynamic condition--changing facilities, numbers of deliveries, residents, students. Input from the large number of disciplines that provide care for mothers and babies should be sought in the early planning stages. Visiting other hospitals to see their facilities firsthand and to discuss the good and bad points of the facility is money well spent. A recent publication regarding design of perinatal facilities has much useful information. Early consultation with an architect who has designed several labor and delivery suites may help to prevent difficulties in the later phases of design. Imagination, forethought, perseverance, and a positive attitude will contribute to the success of this very difficult task.

Delivery Rooms↗

PubMed1983

Accelerated pulmonary maturity as measured by the Lumadex-foam stability index test.

The Lumadex-foam stability index test and lecithin:sphingomyelin (L:S) ratio were compared in the small preterm fetus. Amniotic fluid was obtained within 72 hours of birth from 70 high-risk patients whose infants were at 34 weeks' gestation or less and/or weighed less than 2000 g. Twenty-nine infants were small for gestational age. Eleven of the 41 appropriate for gestational age babies developed respiratory distress syndrome. Conclusions of the study were as follows: 1. The Lumadex-foam stability index test is an accurate, quantitative, and rapid measure of fetal lung maturity. 2. Growth retardation accelerates functional lung maturity in the preterm fetus. 3. The foam stability index value can discriminate between the small for gestational age and appropriate for gestational age fetus at 32 weeks' gestation or less and/or less than 1500 g birth weight. 4. The L:S ratio cannot discriminate between the small for gestational age and appropriate for gestational age fetus because the false-negative rate increases as fetal weight decreases.

Female↗