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Biomedical subjects

G S Sykes

Publications and source records attributed to G S Sykes.

8 recordsLinked to original sources
PubMed1989

Changes in fetal monitoring practice in the UK: 1977-1984.

A postal survey was undertaken between 1985 and 1987 to assess the changes that have taken place in fetal monitoring practice since 1977. Replies were received from 253 (92%) of 276 consultant obstetric units canvassed. Biophysical methods of assessing fetal well-being in the antepartum period are almost universally employed and are accepted as the best discriminators of the need to deliver the pregnancy. The number of fetal heart rate monitors on labour wards has increased by 88%. Overall, 63% of units monitor more than 60% of their patients in labour, and 87% permit suitably trained midwives to apply fetal scalp electrodes, which must now be regarded as standard practice. There is still a need for a simplified technique for fetal blood sampling. The perinatal mortality rate correlates with a prematurity factor and probably bears a greater relation to the population served than to the degree of monitoring provided.

Cardiotocography↗
PubMed1987

Correlation of colposcopy and histology findings in pre-clinical neoplasia of the cervix.

The histology findings of pre-clinical neoplasia of the cervix at cone biopsy were compared with the previous colposcopic assessment in fifty-eight patients. In 84.5% of cases colposcopy prediction was within one grade of the histology findings. This close correlation is important where suitability for local ablative therapy depends on accurate colposcopic assessment prior to tissue destruction.

Biopsy↗
PubMed1984

Continuous, noninvasive measurement of fetal oxygen and carbon dioxide levels in labor by use of mass spectrometry.

Clinical evaluation of the continuous, simultaneous measurement of fetal scalp surface oxygen and carbon dioxide partial pressures by mass spectrometry was undertaken for 52 labors. The mass spectrometer (MM8-80, V.G. Gas Analysis, Winsford, England) was easy to operate and had good long-term stability. The mean drifts for both oxygen and carbon dioxide over the study periods were less than 2 mm Hg. The mean (+/- SD) cervical dilatation at the time of transducer application was 6.1 (+/- 1.9) cm and the mean (+/- SD) duration of the studies was 169 (+/- 122) minutes; 10.5% of the transducer applications were unsuccessful. Falls in fetal scalp surface oxygen levels and rises in carbon dioxide levels were more frequent with late than with variable and with variable than with early fetal heart rate decelerations and with increasing severity and frequency of decelerations. Fetal scalp surface pressure changes also occurred with fetal heart rate variability changes, including some related to behavioral state changes. There was not a constant reciprocal relationship between oxygen and carbon dioxide changes, and fetal heart rate patterns were not related to actual blood gas levels. Fetal scalp surface measurements were related to both fetal blood sample and umbilical artery results. Trends in both oxygen and carbon dioxide levels during the course of labor were compared and related to other fetal variables, and most of the time the scalp surface measurements were an accurate guide to systemic blood gas levels. Maternal oxygen administration resulted in significant increase in fetal scalp surface oxygen levels, and on two of eight occasions it also led to decreases in fetal carbon dioxide levels. Scalp surface gas measurement by means of mass spectrometry is a powerful new method of intrapartum fetal monitoring, which should increase the precision of fetal surveillance as well as allow the accurate assessment of both established and new methods for optimizing labor and delivery.

Carbon Dioxide↗
PubMed1984

Effect of delays in collection or analysis on the results of umbilical cord blood measurements.

Changes in umbilical cord blood pH, PO2 and PCO2 were measured when blood was stored in preheparinized polyethylene syringes in the refrigerator for up to 6 h after delivery, and when there was delayed sampling up to 1 h after delivery from umbilical cord segments left at room temperature. Blood stored in the refrigerator usually showed a decrease in pH and increases in PO2 and PCO2, but the mean rates of change were small: -0.005 units/h for pH; +0.06 kPa/h for PCO2 and +0.03 kPa/h for PO2. Changes in the three variables in blood collected from umbilical cords up to 1 h after delivery were small and not systematic. Much of the variation was within the limits of accuracy of the ABL-3 (Radiometer) blood-gas analyser. The results showed that while immediate collection and analysis of umbilical cord blood is advisable for the greatest accuracy, it is not essential. As long as the delay is not excessive, the results can still be used as a useful guide to the biochemical condition of an infant at birth.

Blood Preservation↗
PubMed1983

Fetal distress and the condition of newborn infants.

In a prospective audit of the obstetric management of 1210 consecutive deliveries the association was investigated between the need for operative delivery for fetal distress during labour and the condition of the newborn infant. Operative delivery was performed for only 11.5% of the newborn infants with severe acidosis at birth (umbilical artery pH less than 7.12, base deficit greater than 12 mmol (mEq)/1), 24.1% of those with an Apgar score less than 7 at one minute, and 15.8% of those with both severe acidosis and a one minute Apgar score less than 7. Most of the infants delivered operatively were in a vigorous condition at birth and did not have severe acidosis. Fetal blood sampling was done in 4.0% of labours. As none of the fetal blood values were less than 7.20 and only three of the infants sampled in utero suffered severe acidosis at birth, fetal blood sampling would have had to be performed much more often to provide a useful guide to metabolic state at birth. While the large majority of "at risk" fetuses had continuous fetal heart rate monitoring in labour, this had not been provided in 48.7% of the labours of infants with severe acidosis, 38.7% of infants with a one minute Apgar score less than 7, and 47.4% of infants with both severe acidosis and a one minute Apgar score less than 7. Continuous fetal heart rate monitoring was associated with a much higher incidence of operative delivery for fetal distress than was intermittent fetal heart rate auscultation. These results suggest an urgent need to review present methods for assessing the intrapartum condition of the fetus, making the diagnosis of fetal distress, and assessing the condition of the infant at birth.

Acidosis↗
PubMed1982

Birth asphyxia.

Explore the source record for details and available documents.

Acidosis, Respiratory↗
PubMed1981

Actinomyces-like structures and their association with intrauterine contraceptive devices, pelvic infection and abnormal cervical cytology.

A total of 1919 cervical cytology smears from South Galmorgan family planning clinic patients were studied and actinomyces-like structures were identified in 38. All 38 were from women reported as having an intrauterine contraceptive device (IUCD) and they represent 25 per cent of the 147 women in the whole study who were reported as having an IUCD. There was no evidence of pelvic infection or significant increase in gynaecological problems amongst these 38 women, but there was a significant increase in atypical and dyskaryotic cells in the cervical smears.

Actinomycosis↗