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J L Bartha

Publications and source records attributed to J L Bartha.

24 records · Page 2Linked to original sources
PubMed1998

Umbilical blood flow and neonatal morphometry: a multivariate analysis.

OBJECTIVE: To study the relation between the state of umbilical blood flow and neonatal morphometry. STUDY DESIGN: We have recorded data from 460 pregnant women. Umbilical systolic to diastolic ratio was measured within the 3 days prior to the birth. Weight, height, head and chest circumferences, ponderal and head to chest circumferences ratio were considered for the study. RESULTS: In a univariate analysis, the best correlated variable to S/D ratio was the weight (r=-0.35). However, a forward stepwise multiple regression analysis demonstrated that the best predictors of S/D ratio were height and ponderal index. Small-for-gestational-age fetuses with placental insufficiency (n=20) had a significant more pronounced decrease of weight, height, head circumference and chest circumference than those with normal placental perfusion (n=31). The degree of decrease of ponderal index and HC/TC was similar in both groups. CONCLUSIONS: Umbilical blood flow is one important factor determining newborn morphometry. If only one growth variable is considered, the best correlation with umbilical S/D ratio is found to be the weight. The multivariate regression analysis concluded that the two most influential factors by umbilical blood flow are height and ponderal index and the rest of the morphometric parameters lost their significant correlations when adjusted by these variables. The impairment on neonatal morphometry in small-for-gestational-age fetuses associated to placental insufficiency is more severe than that with normal placental perfusion. However, it does not have a more pronounced decrease of ponderal index than the rest of causes of small-for-gestational-age fetuses.

Adult↗
PubMed1997

Maternal serum alpha-fetoprotein in placental abruption associated with preterm labor.

OBJECTIVE: To evaluate maternal serum alpha-fetoprotein levels in women with preterm labor. METHOD: Maternal serum alpha-fetoprotein level was measured in 58 women in preterm labor with intact membranes. Maternal levels and multiples of the median were compared in groups with preterm labors of different etiologies and between those with and without placental abruption. Women with vaginal bleeding were also studied separately. Sensitivity, specificity and predictive values were calculated for 2 multiples of the median. Chi squared, Fisher exact test, Mann Whitney U-test, Kruskal-Wallis test and logistic regression were all used. RESULTS: Those cases with placental abruption (n = 9) had a higher maternal serum alpha-fetoprotein level than the other groups (P = 0.033) and than that of all of them, in total, (n = 49) without placental abruption (P = 0.001). If only women with vaginal bleeding were taken into consideration (n = 13) the maternal serum alpha-fetoprotein level was higher in those with placental abruption (P = 0.001). If we had the criterion of 2 multiples of the median, sensitivity was 66.67%, specificity 95.92%, the positive predictive value 75%, and the negative predictive value 94%. In women with vaginal bleeding sensitivity was 100%, specificity 71.43%, the positive predictive value 75%, and the negative predictive value 100%. CONCLUSIONS: Maternal serum alpha-fetoprotein level is higher in women with preterm labor and placental abruption. This measurement could be used as a biochemical marker of placental abruption in cases of preterm labor.

Abruptio Placentae↗
PubMed1997

Third-trimester maternal serum beta-HCG level and umbilical blood flow in fetal growth retardation.

OBJECTIVE: To determine the relationship between maternal serum beta-HCG level and umbilical artery systolic/diastolic ratio in fetal growth retardation. METHODS: Maternal serum beta-HCG was measured in 57 pregnant women in the third trimester, 31 with a fetal growth retardation and 26 with a normal growth. The systolic/diastolic ratio was measured in a midsection of the umbilical cord the same day of the biochemical determination. RESULTS: The serum beta-HCG level was statistically significant higher in pregnant women with a fetal growth retardation associated with a high systolic/diastolic ratio (n = 9) (P < 0.001). There were no differences between the fetuses with a normal growth (n = 26) and those with an intrauterine growth retardation and a normal systolic/diastolic ratio (n = 22). There was a significant positive correlation between maternal serum beta-HCG level and umbilical artery systolic/diastolic ratio (P < 0.01). CONCLUSION: Fetal growth retardation due to Doppler-defined vascular placental insufficiency is associated with a higher maternal serum beta-HCG level.

Adult↗
PubMed1997

Carbohydrate metabolism. Evaluation in women with de novo hypertension in late pregnancy.

OBJECTIVE: To evaluate carbohydrate metabolism in both diabetic and nondiabetic women with de novo hypertension in late pregnancy. STUDY DESIGN: Sixty-nine nondiabetic pregnant women were studied: 33 with gestational hypertension, 15 with preeclampsia and 21 normotensives in the control group. Eight women with gestational diabetes and hypertension were evaluated separately. Glucose and insulin serum levels were evaluated in the fasting state and during an oral glucose load. Glucose-independent parameters were used to evaluate insulin response, insulin activity and glucose tolerance in fasting and postglucose ingestion states. Student's t test was used. RESULTS: Fasting glycemia was lower in both groups with de novo hypertension in late pregnancy than in the control group. Glycemia was higher throughout the oral glucose load in gestational hypertension than in preeclampsia. Insulinemia during the oral glucose load was higher in gestational hypertension than in both the control and preeclampsia groups. Fasting corrected insulin response and glucose tolerance were higher in gestational hypertension and preeclampsia than in the control group. In the postglucose ingestion state, insulin activity and glucose tolerance was lower in gestational hypertension than in preeclampsia. Women with gestational diabetes and hypertension were very insulin resistant. CONCLUSION: Glucose tolerance was not only decreased but also increased in the fasting state in de novo hypertension in late pregnancy due to a high insulin response. In the postglucose ingestion state, the gestational hypertension trend was toward insulin resistance even though normal insulin activity occurs in preeclampsia. Gestational diabetes associated with gestational hypertension was characterized by high insulin resistance.

Adult↗
PubMed1992

A trial of labor after cesarean section in patients with or without a prior vaginal delivery.

OBJECTIVE: To determine the outcome of labor in women with a previous cesarean section, with or without prior vaginal delivery. METHOD: Records were reviewed for 1065 women with a previous cesarean section at 'Virgen Macarena' Hospital who were attended for a subsequent labor. RESULTS: Chi-squared tests demonstrated that women with previous vaginal delivery (n = 346) had a significantly higher rate of vaginal delivery after a trial of labor (95.24%) than those without previous vaginal delivery (n = 719) (82.95%). All the ruptures of uterine scar (n = 4) were found in women without previous vaginal delivery. CONCLUSION: It appears that a cesarean section in a multiparous woman is not a determinant fact in her reproductive history and the risk of rupture of uterine scar did not appear to be present.

Cesarean Section↗