[Studies on the anticomplementary effect of maternal-fetal serum pairs and of amniotic fluid].
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Amniotic Fluid↗
Biomedical subjects
H J Seewald
Publications and source records attributed to H J Seewald.
[Determination of total estrogens in female myoma patients before and after operative therapy].
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Adult↗
[Behavior of reaction times under the effect of ovosiston].
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Acetates↗
[Concentration of heavy metals (Pb, Cd, Hg) in maternal blood].
BACKGROUND: It was the aim of these investigations to find out, whether or not pregnancy risks result from the heavy metal concentrations of the mother's blood (Pb, Cd, Hg). MATERIALS AND METHODS: The control group is composed of 125 women in child bed. Women with hypertonia during the pregnancy (n = 11), women after premature delivery (n = 25) and after a miscarriage (n = 21) are the risk collective. Blood: The investigations were carried out in EDTA-blood. Questionnaire: Place of residence, profession, nourishment and tooth amalgam surface. From this we received information about risk factors for a heavy metal burden. METHODS: The Cd- and Pb-concentrations were measured by "Graphitrohr-AAS with Zeemancorrection" and the Hg-concentration by "Cold-Vapour-AAS". RESULTS: 1. Women in child bed in the Jena area have a heavy metal concentration of Pb, Cd and Hg in the lower reference range. 2. At the risk pregnancies (hypertonia during the pregnancy, premature delivery and miscarriage) no increased heavy metal burden was found. 3. There was a significant correlation between the blood mercury level of women in child bed and the number of tooth amalgam fillings. DISCUSSION: In the Jena area women in child bed have a heavy metal concentration in the lower reference range. Environmental heavy metal burden producing frequent miscarriage, premature delivery and hypertonias in the pregnancy could not be shown. The tooth amalgam filling significantly increased the Hg-burden. Environmental stress and eating habits may also play a role. CONCLUSION: At the risk pregnancies (hypertonia during the pregnancy, premature delivery and miscarriage) no increased heavy metal burden was found.
Adult↗
[Nitroglycerin patch for tocolysis--a prospective randomized comparison with fenoterol by infusion].
OBJECTIVE: To evaluate tocolytic efficacy of transdermal glyceryl trinitrate (GTN) in comparison to fenoterol per infusionem in a prospective randomized multicenter study. PATIENTS AND METHODS: 50 pregnant women between 27 and 35 weeks of gestation with preterm labour were treated with either GTN patches (0.4-0.8 mg/h) or fenoterol per infusionem (60-120 micrograms/h) up to stop of contractions or 35 weeks in maximum. The primary outcomes were the prolongation of gestation by 48 h, 7 days or up to 37 weeks of gestation as well as the neonatal outcome. The progression of cervical ripening and maternal side effects during tocolysis were assessed as secondary outcome criteria. RESULTS: There was no difference in successful tocolysis for 48 h and 7 days in both groups, whereas significantly more women passed 37 weeks after GTN therapy. So mean duration of pregnancy, birth weight and height were greater, whereas transfer into neonatal care unit was significantly rare after GTN. There were no differences in neonatal outcome and progression of cervical ripening during tocolysis. Maternal side effects during GTN were fewer and weaker compared with fenoterol. Circa 70% of GTN treated women had a headache temporary, whereas more than 90% of the patients with fenoterol suffered from tachycardia and tremor. CONCLUSIONS: Tocolytic efficacy of transdermal GTN was at least equivalent to the established beta-mimetic therapy with fenoterol. Because of the lower preterm delivery rate transfer into neonatal care for control was significantly rarer after GTN with equally good neonatal outcome in both groups. Beside the headache transdermal GTN therapy had lower maternal side effects in comparison to fenoterol.
Administration, Cutaneous↗
[Acoustically evoked brain magnetic activity in normal and growth retarded fetuses during the third trimester of pregnancy].
The fetal magnetoencephalogram with a 31 chanal biomagnetometer made by Philips was measured in a fetal 1F-phase in 20 normotroph unimpaired and in 14 growth retarded fetuses with a birth weight < 5 percentile after completed 36th gestational week. Trough defined acoustic stimulations, which were applied over the maternal abdominal wall, it was possible to measure acoustic evoked cerebromagnetic field changes using a special computer programs. The registrated evoked cerebromagnetic field changes had a latence time of 112.8 +/- 18.4 ms in normotroph fetuses and 130.9 +/- 18.5 ms in hypotroph fetuses. The difference was significant (p < 0.01). The presented results lead to the conclusions that the fetal magnetoencephalography makes a differentiation between normal and disturbed fetal cerebral integrity possible.
Embryonic and Fetal Development↗
[Fetal movement and acceleration behavior in unimpaired and impaired newborn infants].
The following biophysical examination parameters were found by CTG-synchronous registration of fetal body and respiratory movements and compared in 7 fetuses impaired at birth (pHa less than 7.20, 1- and 5-minute Apgar scores less than or equal to 7 points) and 76 unimpaired born fetuses (pHa greater than or equal to 7.20, 1- and 5-minute Apgar scores greater than or equal to 8 points): number of fetal body movements per 10 minutes examination time; total and mean durations of these movements per 10 minutes; number of fetal respiratory movements per 10 minutes; number and total duration of fetal respiratory movement periods per 10 minutes; frequency of fetal respiratory movements; proportion of 10-minute periods with and without fetal body and/or respiratory movements and the amounts of the quotients from the amplitude of accelerations in fetal heart rate resulting from fetal body movements and the durations of these body movements. The mean interval between biophysical examination and childbirth was 11 days. Principally, the impaired born fetuses were less active in their movements than were unimpaired born fetuses. Apart from the frequency of fetal respiratory movements and the proportion of 10-minute periods without fetal body movements, the above mentioned parameters differ significantly with a probable error of alpha = 0.05. All biophysical parameters were registered on an uterus without labour and the cardiogram as well as the biophysical profile--with the exception of one fetus from the group of impaired borns--being unremarkable. The 10-minute periods without fetal body or respiratory movements were excluded from analysis.
Apgar Score↗
[Correlation of the magnitude of fetal movement associated fetal heart rate accelerations, amplitude of "classical" accelerations and transcutaneous fetal oxygen partial pressure].
An attempt is made to provide non-empirical evidence of the "classical" amplitude of sporadic fetal heart rate accelerations of 15 bpm. Sporadic, fetal movement associated fetal heart rate accelerations are generally regarded as an indication of fetal wellbeing. A minimal amplitude of 15 bpm with unknown duration of the associated fetal body movement seems to be a prerequisite to establish an unimpaired fetal condition as reliably as possible. Including the "classical" acceleration amplitude in a ratio from the acceleration amplitude and associated fetal body movement and comparison of these calculated values with a total of 3851 actual ration from acceleration amplitudes and durations of associated body movements of 175 normotrophic and 72 hypotrophic fetuses showed that only a hypothetical acceleration amplitude of 15 bpm yields ratios which correspond to the actual values of unimpaired fetuses. There is a significant positive correlation between the actual ration and the transcutaneous basal fetal partial pressure of oxygen during birth.
Blood Gas Monitoring, Transcutaneous↗
[Movement and acceleration behavior of eutrophic and hypotrophic fetuses sub partu].
Cardiogram synchronous registration of fetal body and respiratory movements (real-time ultrasonic examination) was employed to compare the movement and acceleration behaviour of 130 normotrophic fetuses to that of 13 fetuses with body weights between the 6th and the 10th weight percentiles according to Kyank and of 13 fetuses with body weights less than or equal to the 5th percentile. The mean duration of examination was 80 minutes. The normotrophic fetuses exhibited the highest movement activity and reactivity of the cardiovascular system. In 88.6%, accelerations of fetal heart rate were associated with fetal body movements and were independent of fetal weight. Comparison with a previous communication of the authors revealed that intranatal fetal movement activity and reactivity of the cardiovascular system were only slightly below that with a uterus without labour. The only exception were fetal respiratory movements with significantly fewer intranasal observations.
Cardiotocography↗
[Clinical and immunologic results of immunotherapy with pooled buffy coat transfusions in females with habitual abortion].
In a multicenter study we have evaluated the effect of immunotherapy with pooled buffy coats on women with habitual abortions. 21 women were selected under the same criteria with respect to clinical, immunological and blood banking conditions. All women have had at least two miscarriages with the same partner and no living child (except one case). Additionally, all well-known reasons for abortions were excluded. The couples were tested for HLA-A, B and C antigens as well as for the presence of HLA-antibodies. The couples with recurrent spontaneous abortions suggested a significantly higher compatibility in two or more antigens in comparison to the control couples with children and without any abortion. Before treatment there was no case with cytotoxic HLA antibodies. 10 women received each two pooled buffy coats intravenously before pregnancy at time intervals of 3 weeks. 15 women were treated in early pregnancy until the 28th week of gestation at the same application intervals. In the meantime 10 of 15 women have delivered at term a healthy and mature child with normal weight. Four of 15 are still pregnant in the third trimester of pregnancy. In one case the pregnancy resulted in an abortion. The buffy coat transfusions were well tolerated and led in no case to the formation of antierythrocytic antibodies. 12 of 21 women treated developed HLA antibodies at various time intervals during immunotherapy, mainly with a low titre. In 7 of 10 cases the antibodies occurred in the treatment period before pregnancy, in 5 of 15 cases during pregnancy.(ABSTRACT TRUNCATED AT 250 WORDS)
Abortion, Habitual↗
[Methodologic problems and initial results of synchronous CTG computer-assisted registration of fetal movements by ultrasound].
Aim of the studies is the registration of latent criteria of hypoxia in fetuses with intrauterin growth retardation diagnosed by ultrasonography. Under standardized conditions, 19 pregnant women with hypotrophic and 20 with eutrophic fetuses were examined between weeks 36 and 40 of gestation. Concomitantly, fetal body and respiratory movements as well as the antenatal phonocardiotocogram were registered. The following apparatuses were used (fig. 1): ultrasound unit "sono Diagnost R" from Philips, FRG; six-channel recorder "6 NEK 401" from VEB Kombinat Messgerätewerk Zwönitz, GDR; lab-oriented computer "K 1520", VEB Kombinat Robotron Dresden, GDR; fetal monitor "MT 810" (with autocorrelation) from Toitu Co., LTD, Tokyo, Japan; There were close correlations between fetal body movements and accelerations in the cardiogram. The duration of the fetal body movements influenced the duration as well as the amplitude of the corresponding accelerations. A. comparison between the two groups examined reveals that these medium term changes in the heart rate were less marked in the hypotrophic fetuses than in the control group. The differences between the two groups were statistically significant (fig. 2, 3, 4, 5). Fetal respiratory movements influence the range of beat-to-beat-variability in the cardiogram. In the group of hypotrophic fetuses this range increased significantly by 1.4 bpm during one segments of respiratory movement. For the group of eutrophic fetuses the increase in the range of beat-to-beat-variability was 1.8 bpm. We did not find a significant difference between both groups.(ABSTRACT TRUNCATED AT 250 WORDS)
Female↗
[Fetal movement and heart acceleration behavior in eutrophic and hypotrophic fetuses in the 36th to 40th week of pregnancy].
By means of combined ultrasonic and cardiographic monitoring, the movement and acceleration behaviours of 44 eutrophic fetuses were compared to those of 19 fetuses with body weights between the 6th and 10th weight percentiles according to Kyank and to 21 fetuses with body weight not greater than the 5th weight percentile. The eutrophic fetuses moved more frequently and--related to 10 minutes examination time--over longer total periods than did the fetuses with intrauterine growth retardation. The longest mean duration of isolated fetal movement, however, was observed in the hypotrophic fetuses. With regard to fetal resting and activity stages, the highest percentage (10%) of fetal resting stages was found in the fetuses less than or equal to the 5th weight percentile. 93% of all accelerations in fetal heart rate obviously resulted from fetal movements, duration and amplitude of the accelerations depending on the duration of fetal movements. The degree of heart rate responses to fetal movements was different in the three groups examined. Standard weight fetuses responded most intensively. The percentage of fetal movements resulting in accelerations was highest (76%) in the group of the eutrophic fetuses as well. The mean duration of acceleration was most marked in the group of fetuses less than or equal to the 5th weight percentile (32.8 sec) and so was the mean acceleration amplitude in the normotrophic fetuses (19.7 bpm). Decelerations following accelerations in fetal heart rate did not differ in the three groups examined with regard to their number, amplitude and duration.
Female↗
[Parturient studies of the cardiotocogram score and transcutaneous oxygen pressure in hypotrophic and eutrophic fetuses].
Semiquantitative and quantitative principles of cardiotocogram evaluation are necessary for the evaluation of subacute and chronic oxygen deficiency in fetuses. By means of tcPO2 measurement it is possible to check these evaluation principles for their relation with fetal oxygen pressure. From 59 tcPO2 cardiotocograms, a total of 99 30-minute-intervals were analysed. 27% of the fetuses showed growth retardation (below the tenth weight percentile according to Kyank). Fetal oxygen pressure was statistically significantly (alpha less than 0.05) correlated with changes in the CTG score according to Hammacher. In the group with hypoxemic oxygen pressure (below 11 mmHg/1.47 kPa) the correlation was particularly high, and the CTG score of 5 points was significantly poorer than the 3 points in the nonhypoxemic control group. Our investigations essentially confirm the grading of the CTG score by Hammacher. Hypotrophic fetuses showed a significantly poorer CTG score, and their oxygen pressure of 12.9 mmHg (1.7 kPa) was significantly below that of the control group (15.4 mmHg/2.1 kPa).
Blood Gas Monitoring, Transcutaneous↗
[Classification of subpartal fetal heart rate oscillations by tcpO2 measurement].
There is no uniform opinion on the clinical value of FHR variability. It is possible to study connections between FHR variability and fetal oxygen tension by means of tcpO2 measurement. 856 episodes from 64 tcpO2 CTGs with more than 2 300 single characteristics were used for analysis. 31% of the fetuses examined exhibited signs of intrauterine growth retardation. The frequency of variability revealed a statistically significant correlation with oxygen tension (p less than 0,001). In hypotrophic fetuses the amplitude of variability was significantly correlated with oxygen tension (p less than 0,001). Silent and narrowly undulatory oscillations reached the significantly lowest oxygen tension values of 11,8 mmHg (1,6 kPa) and 15,2 mmHg (2,03 kPa), respectively, as compared to 20,5 mmHg (2,73 kPa) and 24,2 mmHg (3,23 kPa) for undulatory and saltatory oscillations, respectively. The control group of eutrophic fetuses revealed an inversely proportional, statistically significant behaviour of the amplitude of variability and fetal oxygen tension (p less than 0,001). Classification by means of tcpO2 limits (less than or equal to 11 mmHg = hypoxemic and greater than or equal to 12 mmHg = non hypoxemic) confirmed the traditional classification of the amplitude of variability in fetal growth retardation.
Female↗
[Comparison of transcutaneous oxygen pressure measurement with computer automatic CTG analysis sub partu].
514 labors from 20 tcpO2-cardiotocograms with about 10 000 events were computerized. By means of tcpO2-measurement we found a higher correlation between the fetal condition basing on a discriminant function (DF) than to the quantitative solitary parameters (residual-bradycardia, fetal heart frequency, dip area, lag time and bradycardia-index). The boundary ranges from the quantitative CTG-interpretation: "normal", "praepathological" (warning signs) and "pathological" (hypoxie signs) were confirmed for practice. The tcpO2-curve basing on quantitative analysis of their parameters (base line, slope of pO2 referring to labors and the delay time) is good adapted for examination of solitary CTG-parameters in relation to clinical practice.
Computers↗
[Significance of tcPO2 limit values in classification of cardiotocograms].
The continuous transcutaneous measurement of oxygen pressure has got an important method for the improvement of CTG-changes. A quantitative evaluation of the tcPO2-curve allows a better prediction of hypoxemia and acidosis with help of the CTG. Precondition is the examination of bound-values from the tcPO2-parameters: Baseline of oxygen pressure (PB), decrease of oxygen pressure (PD) and its delay time (DL). For this purpose we used 1 027 contraction patterns from 48 tcPO2-CTGs with 12 000 single parameter-values. It seems, that 11-12 mmHg (1,47-1,6 kPa) is a significant bound. CTG-pattern with PB greater than or equal to 15 mmHg (2 kPa) are not connected with hypoxemia and PB-values less than or equal to 10 mmHg (1,33 kPa) show the hypoxemic image of the CTG. The contraction-related decrease of oxygen pressure (PD) and its delay time (DL) are useful for estimation of the importance of variable decelerations. PD less than 2 or 3 mmHg (0,27-0,4 kPa) and DL higher than 46 seconds allow a classification of variable decelerations to the not hypoxemic type. PD equal to or greater than 5 mmHg (0,67 kPa) and DL between 40 and 20 seconds are suspicious for the hypoxemic type. These investigations are the supposition for a computer-aided classification of CTG-pattern with bound-values of the tcPO2-curve.
Female↗