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Biomedical subjects

G Pontonnier

Publications and source records attributed to G Pontonnier.

At least 73 records · Page 4Linked to original sources

[Neuroleptic analgesia in the management of labor].

Neuroleptic analgesia, which is used for the major part of the conduct of labour, has the advantage of abolishing the pain of uterine contractions without altering the mother's state of consciousness. A study of the effects of droperidol together with phenoperidine on the mother and the child has been carried out. Clinical results, the parameters of the intra-uterine pressure curves and the fetal heart rates as well as of the acid base balance and the pO2 of the mother and infant during dilatation of the cervix and the two first hours of life have been monitored. The conclusion is that neuroleptic analgesia does not cause neonatal depression and can be used as a method for conducting labour so long as very strict monitoring conditions are applied.

Acid-Base Equilibrium↗

Some physical and biochemical parameters during normal labour.

A statistical study of parameters of uterine contraction, fetal heart rate, acid-base balance and glycaemia has been made in 30 patients during spontaneous and clinically normal labour for each 2 cm of cervical dilatation. The study of uterine contractility gives the mean values and 95% limits of parameters of uterine contraction as labour progresses. The fetal heart rate is stable during dilation, on the other hand, during the expulsive phase, alterations of fetal heart rate appear, modifications which give evidence of trial that expulsive phase is for the fetus. The study of fetal and maternal acid-base balance shows little change during cervical dilatation, changes towards acidosis during expulsive phase, as importance of feto-maternal relationships. These relationships meet again on the study of glycaemia.

Acid-Base Equilibrium↗

Endometrial progesterone concentrations during the menstrual cycle.

Endometrial progesterone concentrations have been determined during the menstrual cycle and compared to plasma progesterone and estradiol-17 beta concentration. There is a good relationship between endometrial and plasma progesterone concentrations but none between endometrial progesterone and estradiol-17 beta concentration.

Corpus Luteum↗

[Therapeutic trials in pregnant women].

The increasing use of medications during pregnancy and labour leads to the question of their true effectiveness and the absence of harmful effects, for both mother and foetus. Study of the action of medications given to the pregnant woman requires clinical trials with precise methodology including, as an essential stage, the definition of an experimental protocol. Random distribution of the subjects to the various groups and statistical analysis of the results based upon objective criteria are essential. No study of the action of a medication as far as mother and foetus should be undertaken without prior parmacological and pharmacokinetic trials.

Clinical Trials as Topic↗

[Primary management of labor using neuroleptic analgesia].

Within the limits granted, neuroleptanalgesia constitutes a very interesting technique in the major part of management of labour. In particular it has the advantage of preserving maternal consciousness. On the other hand, it allows analgesia of rather long duration, which renders early management of labour possible while still respecting its physiology. The institution of this technique demands the presence at the parturients bedside, not only of the obstetrician and the medwife but also that of a qualified anesthetist. As in all cases of major management of labour it engages the responsability of the obstetrical team which undertakes it and this is even more so, the earlier it is started. To us its indications seem comparable with those of Gamma OH: the early management of labour however has the advantage over the latter of preserving maternal consciouness. Moreover it proved to be particularly interesting in the management of breech presentations. But if its properties are an advantage in the indications which we have just mentioned, they can constitute an invonvenience and restrain its use under different circumstances: its slowness of induction, the absence of narcosis which limits the effect on cervical resistance means that one prefers the Toulouse method using pentothal for the management of labour after 7 centimeters of dilatation. In conclusion, it seems important to us to state that neuroleptanalgesia is not the ideal method for management of labour any more than is thiopental or Gamma-OH. Other techniques merit being studied. Their study must obey strict rules in order to specify the risks and therefore the indications and limits. It should cover different fields which are, pharmacology, the objective assessment, by quantitative criteria, of the effects on uterine contraction, on the mother's clinical and biological state as well as that of the fetus in utero, then that of the child in the first hours of live and up to the first years of his development.

Acid-Base Equilibrium↗

[Study of fetal heart rate in deliveries complicated by fetal acidosis].

A study has been carried out on the parameters of the graph of the fetal heart rate (the basal rate and dips) in 44 cases of acute fetal distress with a pH lower than 7.2 in the blood and in 30 normal deliveries. The statistical analysis confirms that there is a significant rise in the number of heart rate abnormalities such as persistent bradycardia or persistent tachycardia and with dips during deliveries with fetal acidosis. The frequency of these abnormalities increases with the degree of acidosis. Sometimes the abnormalities in the fetal heart rate precede the appearance of the acidosis. All the same the discovery of these abnormalities does not by itself make a precise diagnosis of fetal distress because we do find these abnormalities in a certain number of cases even in normal deliveries. Only measuring fetal pH at a definite time can establish the diagnosis of fetal distress and the severity of the condition.

Acidosis↗