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Biomedical subjects

G Pardi

Publications and source records attributed to G Pardi.

At least 109 records · Page 6Linked to original sources

Plasma beta-endorphin, beta-lipotropin, and met-enkephalin concentrations during pregnancy in normal and drug-addicted women and their newborn.

Most studies of plasma beta-endorphin concentrations in pregnant women show that these are highly elevated. This might indicate a role for opiate peptides during pregnancy and in the fetus-mother relationship. We measured plasma beta-endorphin, beta-lipotropin, and met-enkephalin concentrations in normal and drug-addicted women during pregnancy, labor, and delivery, and in their newborn infants. Peptides were measured by RIA after extraction and concentration on silica columns and separation by high pressure liquid chromatography. In both normal and drug-addicted mothers we found an increase in plasma beta-endorphin during pregnancy, without a concomitant increase in plasma beta-lipotropin or metenkephalin. Only beta-lipotropin increased dramatically in both groups at delivery, whereas beta-endorphin and met-enkephalin remained unchanged. Peptide concentrations in umbilical plasma were similar to those in peripheral plasma of the mothers. On day 1 of life plasma beta-endorphin, beta-lipotropin, and met-enkephalin concentrations in the newborn from normal mothers were higher than in nonpregnant adult subjects and gradually decreased toward normal adult values by day 5 of life. Plasma beta-endorphin, beta-lipotropin, and met-enkephalin concentrations of newborn infants of drug-addicted mothers increased dramatically on day 2 and 3 of life, up to 1000-fold the concentrations of normal adults, and remained elevated up to 40 days after birth. In conclusion, beta-endorphin, beta-lipotropin, and met-enkephalin concentrations during pregnancy are not affected by drug addiction, whereas in the newborn of drug addicted mothers concentrations of these compounds are markedly increased.

Adult↗

Effectiveness of routine ultrasound in screening congenital defects.

During one year 26 cases of fetal malformations were diagnosed by means of ultrasound alone at the 1st Department of Obstetrics and Gynaecology of the University of Milano. Frequency of congenital defects first detected in the Centre was 5.6% which can be estimated to be approx. 25% of the anomalies detectable at birth in an unselected population. The total number of congenital defects detected was 31. A wrong diagnosis was done in two suspected cephaloceles resulted to be a cystic hygroma of the neck and a nuchal cephaloematoma while a pleural effusion was misdiagnosed as a thoracic cyst. On the other hand a precise evaluation of diagnostic errors (false negatives) has not been possible. Most malformations not detected by scanning involved splanchnic organs rather than central nervous system (Tab. V). Ultrasonic procedures for measurement of fetal head and trunk could partly account for this result. Termination of pregnancy was performed in 4 cases and post-partum surgical correction in 3 (Tab. I). Antenatal diagnosis of fetal malformations should be then considered as a major end-point of routine US.

Amniotic Fluid↗

Perinatal management of exomphalos diagnosed in late pregnancy.

The intrauterine diagnosis of a huge exomphalos, which was aspirated by transuterine puncture 1 hour prior to caesarean section, is reported. The authors emphasize that this prenatal procedure is able to minimize the risk of rupturing the exomphalos sac.

Adult↗

The intraventricular conduction time of fetal heart in pregnancies complicated by rhesus haemolytic disease.

The duration and shape of the fetal QRS complex were studied in 88 pregnancies complicated by rhesus isoimmunization. A clear correlation between ventricular depolarization time and haemoglobin levels at birth was observed. A single QRS value greater than 4 SD above the normal mean value, or a tendency to rapid increase was very suggestive of a bad prognosis, while a QRS duration below +4 SD or declining in sequential determinations reflects a temporary compensation of fetal conditions. From the QRS complex analysis a clear indication appeared of the constant and early involvement of the heart in terms of myocardial hypertrophy and/or cardiac enlargement. The sensitivity of QRS to anaemia and the feasibility of continuous non-invasive monitoring might allow, with the determination of bilirubin concentration in amniotic fluid, improvement in the management of rhesus haemolytic disease.

Blood Transfusion, Intrauterine↗

Malformation of the fetal urinary system. A new obstetrical approach.

A case of prenatal diagnosis of prune belly syndrome is described. The ultrasound presumptive diagnosis was that of low urinary tract obstruction. Neonatal mortality with this defect is estimated to be approximately 50% and mainly arises from kidney damage. In order to achieve further information for obstetrical management, intrauterine bladder evacuation was performed and fetal urine production rate monitored by ultrasound. This approach is proposed as a new method of diagnosis and temporary therapy for those fetal malformations determining urinary stasis.

Abdominal Muscles↗

[Preliminary data on the pharmacokinetics of digoxin in pregnancy].

The pharmacokinetics of digoxin were investigated in 8 pregnant women (2-3 months before delivery), in three women 3 months after delivery, and in 3 non-pregnant women, after i.v. injection of 500 microgram. Digoxin was evaluated in serum with the radioimmunoassay method. In pregnant women C1 (concentration of digoxin in the first compartment) and V1 (volume of the first compartment) were higher and C2, K1-2, K2-1 (exchange constants) and Kel (elimination constant) were all lower than the values obtained in both post-partum and non-pregnant women. Our data lead us to think that the exchange (both uptake and release) between the first and second compartment is lowered in pregnancy.

Adult↗

The intraventricular conduction time of fetal heart in uncomplicated pregnancies.

By means of a new averaging system, fetal electrocardiograms (ECGs) were obtained simultaneously from three orthogonal leads on the maternal abdomen. The duration of the QRS complex was measured in 421 pregnant women with uncomplicated pregnancies chosen at random between 17 and 41 weeks gestation. Normal standards were established and a close relation was found between QRS duration and the maturity of the fetus. A highly significant relation was observed in 78 patients between the birth weight and the QRS duration. Estimates of birth weight from QRS interval have a standard deviation of 302 g and this may allow the prediction of birth weight with reasonable accuracy. Information on the properties of the fetal ventricular conduction system can be derived from the data presented.

Birth Weight↗

Pharmacokinetics of furosemide in gestosis of pregnancy.

Furosemid 50 mg was administered orally and intravenously to twelve gestotic women for brief periods as a part of a randomized, multicentre clinical trial comparing the efficacy of bed rest and pharmacological treatment. The pharmacokinetic profile was investigated using a gas-liquid chromatographic technique. The plasma half-life after oral and intravenous administration was 115 +/- 37.1 and 71.8 +/- 26.3 min and plasma clearance was 153 +/- 48 and 152 +/- 23 ml/min, respectively (mean +/- SD). Comparative data from healthy pregnant women cannot be obtained for ethical reasons. The results show that gestosis has only a marginal if any effect on the kinetics of furosemide in comparison with published kinetic parameters in healthy volunteers, and patients with renal failure. The new-born babies where checked for side effects according to a protocol in use in a larger regional surveillance programme. No clinical side-effects were attributable to furosemide, but the small size of the group does not permit any definitive conclusions about this aspect.

Administration, Oral↗

Placental transfer to diazepam and its disposition in the newborn.

Diazepam (DZ) placental transfer in pregnant women at term, following single or repeated drug administration by various routes, was evaluated. DZ and its metabolite N-demethyldiazepam (NDZ) were constantly present in umbilical cord plasma at concentrations comparable to the mother's shortly after drug administration. N-methyloxazepam (MOX) was detected in cord plasma only in a limited number of cases following chronic DZ treatment. Postmortem analysis of fetal tissue concentrations showed accumulation of NDZ in heart and lungs. Differences in NDZ concentrations between venous cord (VC) and arterial cord (AC) plasms suggest metabolic degradation of DZ in the fetus. The DZ apparent plasma half-life in the newborn was found to be longer (31 plus or minus 2 hr) than previously observed in infants and children. The low drug clearance appears to be linked to reduced urinary excretion of hydroxylated metabolites, suggesting limited capability to dispose of DZ in the newborn.

Administration, Oral↗