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Biomedical subjects

I Ingemarsson

Publications and source records attributed to I Ingemarsson.

At least 127 records · Page 7Linked to original sources
PubMed1980

The accuracy of abdominal ECG for fetal electronic monitoring.

The aim of this study was to investigate the quality of the abdominal fetal electrocardiography (aFECG), and compare the short term and long term variability registered by this method with the direct fetal electrocardiography (dFECG). With three cardiotocographs the aFECG, the dFECG and the maternal ECG were registered simultaneously and stored on a magnetic tape. After analogue-digital conversion, the information was calculated in a computer system. The variability registered by aFECG and dFECG was compared allowing a difference of both one beat and two beats/min. From nine patients in early labour 30651 heart beats were registered by dFECG. By aFECg 27720 beats were registered. Within a window of +/- 10 ms 98.5% of all pulses registered by aFECG were found. The correlation coefficients for short term variability were 0.75 and 0.91. For long term variability the correlation coefficients were 0.94 and 0.98. To allow calculations of the short term variability the registration of the instantaneous fetal heart rate is necessary. In the antenatal period only indirect methods for electrocardiography are possible. The present report shows that with the abdominal electrocardiography the short term and long term variability can be judged. the quality of the registrations is good enough to allow computer calculations of the information.

Electrocardiography↗
PubMed1980

A one-year study of routine fetal heart rate monitoring during the first stage of labor.

At the Department of Obstetrics and Gynecology, University Hospital, Lund, Sweden 90 per cent of all deliveries are monitored with cardiotocography (CTG). The fetal heart rate recording (FHR) together with various pregnancy- and delivery data, are continuously analysed. The present paper is an account of FHR changes during the first stage of labor of all patients registered during 1977. FHR-changes occurred already during the 1st stage of labor in more than 90 per cent of all deliveries where the newborns' Apgar score was less than 7 at 1 minute. Tachycardia, silent pattern, and late and combined decelerations, rarely occurred in the material, but were dominant at deliveries where the newborns' Apgar score was less than 7 at 1 and 5 minutes. This relationship was even more pronounced when these changes occurred together.

Apgar Score↗
PubMed1980

Relation between maternal urogenital carriage of group B streptococci and postmaturity and intrauterine asphyxia during delivery.

The obstetrical significance of maternal urogenital carriage of group B streptococci (GBS) was investigated in a prospective study comprising 799 parturients and their infants. 128 mothers were GBS carriers. Fetal heart rate recording showing abnormal baseline frequency and concomitant late decelerations during delivery were found in 6 infants born of GBS carriers (5%) and in 7 (1%) of non-carriers (P < 0.01). The pH of fetal blood was determined in 14 (11%) GBS carriers and in 53 (8%) non-carriers. 6/14 (43%) infants of GBS carriers had pH values below 7.20, in contrast to 4/53 (8%) of the non-carrier group (P < 0.01). Mothers of infants showing signs of intrauterine asphyxia had the same amount of antibodies to GBS as mothers of infants without signs of asphyxia. Among the GBS carriers, 11/128 (9%) were delivered later than the 42nd week of pregnancy. A smaller proportion of non-carriers, 21/671 (3%), were delivered postterm (P < 0.01).

Antibodies, Bacterial↗
PubMed1980

Effect of ritodrine on labor after premature rupture of the membranes.

The effect on labor of administering ritodrine after a premature rupture of the membranes (PROM) was studied in a double-blind trial in 30 patients. The patients were selected according to the following criteria: 28 to 36 weeks' gestation, only 1 fetus, cervix dilated 4 cm or less, and absence of pyrexia or other signs of uterine infection. Fourteen patients received ritodrine and 16 received a placebo. The 2 groups were statistically comparable. None of the patients receiving ritodrine delivered within 24 hours. The difference between the 2 groups was statistically significant with respect to the number of patients delivered within 24 hours (P less than 0.05). However, after 24 hours, there was no difference between the groups as regards the length of pregnancy. The infections registered in the mothers of infants were few and easily controlled. The incidence of idiopathic respiratory distress syndrome (IRDS) was low in the study and allows no conclusions concerning the benefit of prolonging the pregnancy for more than 24 hours after PROM.

Clinical Trials as Topic↗
PubMed1980

Intrapartum electronic fetal monitoring in low-risk pregnancies.

The value of fetal monitoring in low-risk pregnancies was evaluated in 4278 deliveries, 85% of all low-risk patients delivered in 1977 and 1978 at the University Hospital of Lund. An irreproachable tracing was recorded in less than half the cases. Fetal heart rate changes demanding scalp pH measurements or operative intervention for fetal distress occurred in about 10% of all deliveries. In only 30 patients (0.7%) was cesarean section performed for fetal distress. No intrapartal deaths occurred. The perinatal mortality (antenatal deaths excluded) was 0.14%. Only 3 of 1000 newborns had an Apgar score less than 7 at 5 minutes. The reported negative implications of routine fetal monitoring, such as overdiagnosis of fetal distress, cannot be verified in this study when electronic fetal monitoring and pH measurements are combined. The excellent fetal outcome suggests benefits from routine electronic fetal monitoring even in low-risk pregnancies.

Apgar Score↗
PubMed1980

Selection criteria for oxytocin stress test.

The main aim of the investigation was to study in which patients oxytocin stress test (OST) should be used. From 1071 patients routinely monitored with antenatal cardiotocography ( = non-stress test) 112 were selected for 151 OSTs for two reasons: 1) normal or suspect pathologic non-stress test (NST) 2) slight or severe pathologic NST regardless of risk classification. In the first group of 85 OSTs, only 2 proved positive. In the second group of 66 OSTs, 22 were positive. The oxytocin stress will give little additional information to the NST when the latter is normal; the OST could be restricted to the relatively few patients with pathologic NST.

Female↗
PubMed1979

Inhibition of prostaglandin-induced uterine activity by nifedipine.

The effects of the calcium antagonist, nifedipine, on uterine activity induced by prostaglandins F2 alpha (PGF2 alpha) and E2 (PGE2) were studied in women undergoing therapeutic midtrimester abortion, and in patients with a missed abortion in the 16th to 27th week of pregnancy. In the five subjects receiving intra-amniotic PGF2 alpha (25 to 40 mg) for midtrimester abortion, nifedipine (30 mg orally) decreased uterine activity from a mean of 372 to 203 Montevideo Units. The effect on the intensity of the contractions was pronounced; frequently and basal tone were little affected. In patients with missed abortion, uterine contractions were induced by extra-amniotic application of PGE2 (0.5 to 1.5 mg) in a viscous gel. The activity was often more irregular than that in the women receiving intra-amniotic PGF2 alpha. However, nifedipine (30 mg orally) had a marked inhibitory effect on the uterine contractions. It is concluded that nifedipine can be used for treatment of uterine hyperactivity induced by prostaglandins. Combined treatment with beta 2-adrenoceptor stimulants might be considered.

Abortion, Therapeutic↗
PubMed1979

Selection criteria for antenatal cardiotocography.

The present report considers two questions: 1) Which patients should be monitored routinely and 2) the interpretation of antenatal cardiotocography. During 26 months 812 patients with risk pregnancies were monitored with antenatal CTG. Most of them were daily registered. One hundred and seventeen (14.5%) showed pathological CTG changes. The CTG patterns were put into four classes according to the degree of seriousness. A comparison between high risk and low risk pregnancies showed that nearly all abnormal CTGs occurred in the high risk group. Within the high risk group, patients with essential hypertension and intrauterine growth retardation had pathological CTG changes in 20--30%. The study shows that high risk pregnancies should be monitored regularly at short intervals to allow early diagnosis of fetal distress. The value of routine CTG in low risk pregnancy can be questioned.

Echocardiography↗
PubMed1978

Transplacental passage of atenolol in man.

Maternal and umbilical serum concentrations of atenolol, a hydrophilic, cardioselective beta-adrenoceptor antagonist, were studied at delivery in seven cases of pregnancy hypertension. The drug had been administered to each patient for at least one week. Atenolol was detected in both maternal and umbilical serum in six cases, showing that there is transplacental passage of the drug. In the seventh case, who had stopped taking atenolol more than one day before delivery, neither maternal nor umbilical serum contained a measurable quantity of the drug. Atenolol concentration varied 3- to 6-fold between individuals, but there was no systematic difference between maternal and umbilical levels. It seems reasonable to assume that during steady state conditions the blood level of atenolol in mother and fetus is approximately equal, and that fetal accumulation of the drug does not occur.

Adult↗
PubMed1978

Long-term follow-up of preterm infants in breech presentation delivered by caesarean section. A prospective study.

All forty-two breech infants delivered by caesarean section before the 37th gestational week since Jan. 1, 1975, were followed up prospectively. Outcome in this group was compared with that for all forty-eight breech infants delivered vaginally in 1971-74, before the introduction of routine caesarean section. Delivery by caesarean section significantly reduced the frequency of severe prolonged asphyxia, and neonatal mortality was reduced from 14.6% to 4.8%. At 12 months of age 24% of those delivered vaginally had developmental or neurological abnormalities compared with 2.5% of those delivered by caesarean section.

Asphyxia Neonatorum↗
PubMed1977

[Breech delivery].

Explore the source record for details and available documents.

Birth Injuries↗
PubMed1976

Effect of terbutaline on premature labor. A double-blind placebo-controlled study.

The effect of terbutaline, a "selective" beta2-receptor stimulator, was compared with that of placebo in 30 patients in premature labor. Treatment consisted of an intravenous infusion for at least 8 hours, and then of subcutaneous injections four times daily for 3 days together with peroral treatment, which was continued until the end of week 36 of pregnancy. In 12 of 15 terbutaline-treated patients (80 per cent) premature labor was arrested beyond the treatment period, compared with three of 15 in the placebo group (20 per cent). This difference is statistically significant (p less than 0.01). No serious side effects were observed. During infusion, there was an increase in maternal heart rate. This was more pronounced in the terbutaline group (30 per cent) than in the placebo group (9 per cent). There were no adverse effects on blood pressure, but fetal tachycardia was observed more frequently in the terbutaline than in the placebo group. The results suggest that terbutaline is a safe, potent, and well-tolerated inhibitor of premature labor.

Apgar Score↗
PubMed1976

Effects of terbutaline on myometrial activity, uterine blood flow, and lower abdominal pain in women with primary dysmenorrhoea.

The effects of the selective beta2-receptor stimulator terbutaline (0-25 to 0-5 mg given intravenously) on myometrial activity, local uterine blood flow, and lower abdominal pain were examined during the first day of menstruation in 11 women with severe primary dysmenorrhoea. All had maximum intrauterine pressures between 200 and 350 mm Hg. During uterine contractions of high amplitude or long duration, the local endometrial blood flow decreased markedly, and the patients experienced the most intense pain. Terbutaline inhibited the myometrial activity, increased the blood flow, and relieved the pain.

Adult↗