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Biomedical subjects

J F Pearson

Publications and source records attributed to J F Pearson.

At least 37 records · Page 2Linked to original sources
PubMed1982

Ritodrine in the management of fetal distress.

The potential value of a bolus injection of ritodrine in the management of fetal distress was examined in 24 patients. Following the injection of ritodrine, uterine activity measured over a period of 14.7 +/- 6.3 (SD) min was reduced to 22 (+/- 12.4 SD)% of the pre-existing values. The cardiotocographic tracings showed a reversion to a normal or less ominous pattern in 14 of the 16 patients where this could be evaluated. The infants in the ritodrine group took less time to establish regular respirations. The perinatal neurobehaviour in the ritodrine and control groups did not differ. Two mothers who were given ritodrine and who received atropine premedication developed tachycardia and marked systolic hypertension. The administration of a bolus of ritodrine may have a place in the management of fetal distress when caesarean section is unavoidably delayed, but atropine premedication must be avoided as the combination can lead to potentially serious cardiovascular complications.

Adult↗
PubMed1978

A six-point scoring system for antenatal cardiotocographs.

A six-point scoring system for antenatal cardiotocography based upon baseline fetal heart rate (FHR) ad FHR response to fetal movements and Braxton-Hicks contractions has been described and tested in 89 patients. The 'six-point score' obtained within 24 hours of delivery or death of the fetus (D--1) was shown to be strongly associated both with the one-minute Apgar score and the nutritional status of the infant as reflected by centile birth weight. In 21 patients whose D--1 'six-point score' was 4 or less, analysis ofthe cardiologicographs performed on the previous day (D--2) showed that 14 infants already showed evidence of hypoxia. In the remaining seven patients, however, the previous day's six-point score had been normal (5 or 6); in six of these patients a persistently low daily fetal movement count or placental abruption led to repeat cardiotocography. Hypoxia affected the three components of the score in a progressive manner. Firstly there were alterations in the response of the FHR to Braxton-Hicks contractions followed by changes in the FHR response to fetal movements. Finally, fetal movements ceased and baseline FHR changes occurred mainly in the form of a trachycardia. The method of scoring was simple to use and could standardize reporting.

Female↗
PubMed1977

Response to a Valsalva manoeuvre before and after epidural block.

In pregnant patients at term the cardiovascular response to a Valsalva manoeuvre has been evaluated in the lateral and supine positions, before and after epidural block (T8-S5). There was no difference in the pattern of response under these four conditions. After epidural block, there was a tendency to a greater degree of hypotension and a slower recovery. In labour such repeated hypotension could account for the increase in fetal acidosis when the second stage of labour is conducted in the supine position.

Anesthesia, Epidural↗
PubMed1976

Fetal activity and fetal wellbeing: an evaluation.

The clinical value of the 12-hour daily fetal movement count (DFMC) as a test of antepartum fetal wellbeing was assessed. The lowest 2-5% of 1654 DFMCs recorded by 61 women who subsequently delivered healthy infants fell below 10 movements per 12 hours. This level was taken as the lower limit of normal for clinical purposes. A normal DFMC in a population at risk was associated with a satisfactory fetal outcome. A low DFMC was associated with a high incidence of fetal asphyxia, and when fetal death occurred fetal movements rapidly diminished and stopped 12 to 48 hours before death. The DFMC is a generally applicable method of monitoring fetal welfare during pregnancy which provides an inexpensive adjunct or even an alternative to the more expensive placental function tests in current use.

Apgar Score↗
PubMed1976

The relation between ease of forceps delivery and speed of cervical dilatation.

An attempt has been made to predict a difficult forceps delivery. The duration of the 7 to 10 cm cervical dilatation interval was measured from the completed cervimetric chart in 952 consecutive patients who delivered spontaneously between December 1973 and September 1974. The 7 to 10 cm cervical dilatation intervals of this group were compared with those of 378 consecutive patients in whom forceps were applied with the fetal head in the occipito-anterior position and 83 consecutive patients where Kielland's forceps rotation from the occipito-tranverse or occipito-posterior position was performed. The forceps deliveries were graded as 'easy', 'moderately difficult', or 'difficult'. In only 5% of the spontaneous delivery group did the 7 to 10 cm cervical dilatation interval exceed two hours. In the occipito-anterior and Kielland's forceps groups an 'easy' delivery could be expected if the 7 to 10 cm cervical dilatation interval was less than two hours. The greater this interval increased beyond two hours, the greater was the proportion of 'moderately difficult' and 'difficult' forceps deliveries.

Analgesia↗
PubMed1975

Doppler ultrasound and fetal activity.

The possibility that Doppler ultrasound, as used in routine fetal monitoring by external cardiotocography, might stimulate fetal activity was investigated. A mean increase in fetal activity of over 90% was found, as judged by the fetal movement count.

Female↗
PubMed1975

Posture and epidural block in pregnant women at term. Effects on arterial blood pressure and limb blood flow.

Upper and lower limb blood flow was measured in 4 fullterm pregnant women in the left lateral and supine positions before and after epidural block. Radial artery mean blood pressure was recorded in 6 full term pregnant women under the same conditions. Before epidural block there was a much greater reduction in lower limb blood flow (39-1%) than in upper limb blood flow (13-5%) when women moved from the lateral to the supine position; this was probably the result of aortic compression. Mean radial artery pressure increased slightly by 4-6% due to maternal overcompensation in the upper part of the body. After epidural block, patients in the lateral position had a mean rise in lower limb blood flow of 25% and a reduction in upper limb blood flow of 37-2%. The mean arterial pressure remained unchanged. In the supine position there was no further reduction of upper limb blood flow; this was accompanied on average by a 9% fall in mean radial arterial pressure indicating decompensation in the mother. The leg blood flow fell less, 26-9% than before epidural block. In the supine position, a greater flow to the legs, associated with a decreased mean arterial pressure, would be expected to lead to a diminution in placental perfusion, which is the probable mechanism for foetal decompensation. Therefore the supine position should be avoided with an epidural block. In other patients it would be wise not to rely upon maternal compensatory mechanisms.

Anesthesia, Epidural↗
PubMed1975

Hirschsprung's disease associated with congenital heart malformation, broad big toes, and ulnar polydactyly in sibs: a case for fetoscopy.

Successful fetoscopy using a 9 mm laparoscope was carried out on an 18-week pregnancy of a healthy woman who had had two previous male infants with bilateral double big toes, bilateral ulnar supernumerary digits associated with short segment Hirschsprung's disease, and ventricular septal defect of the heart, a syndrome apparently not previously described. The fetus was found to be normal, but an amniotic membrane defect was detected, which accounted for amniotic fluid leakage from 24 weeks up to delivery by caesaren section of a normal male infant at 35 weeks. The possible genetic basis and recurrence risk, put at probably one in four for this syndrome, is discussed. The indications for fetoscopy are set out and a fundal approach at laparotomy after placental localization is recommended for the procedure.

Endoscopy↗