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Biomedical subjects

J van Eyck

Publications and source records attributed to J van Eyck.

49 records · Page 3Linked to original sources
PubMed1988

The blood flow velocity waveform in the fetal internal carotid and umbilical artery; its relation to fetal behavioural states in the growth retarded fetus at 37-38 weeks gestation.

In eight women whose fetuses showed evidence of intrauterine growth retardation (IUGR), the relation was examined between the blood flow velocity waveform in the fetal internal carotid and umbilical artery and fetal behavioural states at 37-38 weeks gestation. In both vessels there was a virtual overlap of pulsatility index values originating from state 1F and 2F, reflecting behavioural state independency. In the internal carotid artery this state independency is associated with moderately reduced pulsatility index values.

Blood Flow Velocity↗
PubMed1988

The Doppler flow velocity waveform in the fetal internal carotid artery with respect to fetal behavioural states. A longitudinal study.

Doppler flow velocity waveforms in the fetal internal carotid artery were recorded in 21 normal pregnancies during fetal behavioural state IF (quiet sleep) and 2F (active sleep) according to Nijhuis and co-workers, from the 36th week of gestation onwards. The present study confirms the earlier finding of a significant reduction of the pulsatility index (PI) in state 2F as compared to state 1F at 37-38 weeks of gestation and demonstrates that this difference in PI exists throughout the entire period, in which fetal behavioural states have been described. Furthermore, it is demonstrated that there is a significant reduction in PI of this vessel during the last 4 weeks of gestation, suggesting a haemodynamic redistribution, favouring blood supply to the brain during the latter weeks of gestation.

Blood Flow Velocity↗
PubMed1988

Human fetal behavior and blood flow in term pregnancies: a review.

A review is presented of the latest data on the relationship between the blood flow velocity waveform in the lower thoracic part of the fetal descending aorta, internal carotid and umbilical artery and fetal behavioral states, in particular state 1F and 2F [1], in the normal-growing and growth-retarded fetus at term. Fetal neurological development, expressed by the emergence of fetal behavior and eventually resulting in well-distinguishable fetal behavioral states, is clearly associated with specific hemodynamic adaptations. The asymmetrically growth-retarded human fetus is capable of modifying this relationship. In the analysis of blood flow velocity waveforms for clinical purposes, fetal behavioral states and fetal heart rate have to be taken into account for a proper interpretation of recorded data.

Animals↗
PubMed1987

The blood flow velocity waveform in the fetal internal carotid and umbilical artery; its relation to fetal behavioural states in normal pregnancy at 37-38 weeks.

The relation between the blood flow velocity waveform in the fetal internal carotid artery (n = 12) and umbilical artery (n = 15) and fetal behavioural states at 37-38 weeks of gestation was studied. In the fetal internal carotid artery, under standardized fetal heart rate conditions, the pulsatility index (PI), as a measure of peripheral vascular resistance, was significantly lower during behavioural state 2F (active sleep) compared with state 1F (quiet sleep) according to the classification by Nijhuis et al. (1982), suggesting increased fetal cerebral blood flow during state 2F. In the umbilical artery, no significant difference in PI between the two behavioural states could be established. This suggests a fetal origin of the state dependency observed in fetal blood flow velocity waveforms.

Blood Flow Velocity↗
PubMed1987

Cerebral and umbilical arterial blood flow velocity waveforms in normal and growth-retarded pregnancies.

A combined sector and pulsed Doppler system was used to study the pulsatility index in the fetal internal carotid artery and umbilical artery in 156 normal pregnancies and 42 cases of intrauterine growth retardation (birth weight below the tenth percentile). All pregnancies were in the third trimester. In normal pregnancies, there was a gestational age-related fall in pulsatility index for both the umbilical artery and the umbilical artery/internal carotid artery ratio. No such fall was established for the pulsatility index in the internal carotid artery. In growth-retarded pregnancies, raised pulsatility index values in the umbilical artery were associated with reduced pulsatility index values in the internal carotid artery, suggesting the presence of a "brain-sparing" effect. When fetal causes of growth retardation were excluded, the sensitivities of the pulsatility index in the internal carotid artery, the umbilical artery, and for the umbilical artery/internal carotid artery ratio were 65, 83, and 88% at the 1 standard deviation (SD) cutoff level; and 48, 60, and 70% at the 2 SD cutoff level. Growth-retarded fetuses with structural or chromosomal defects had normal pulsatility index values in the internal carotid artery.

Blood Flow Velocity↗
PubMed1986

The blood flow velocity waveform in the fetal descending aorta; its relationship to behavioural states in the growth-retarded fetus at 37-38 weeks of gestation.

In 12 patients with intrauterine growth retardation (IUGR), the relationship between the blood flow velocity waveform at the lower thoracic level of the fetal descending aorta and fetal behavioural states at 37-38 wk of gestation was studied. A significant inverse relationship (P less than 0.001) was established between pulsatility index (PI) and fetal heart rate (FHR) in state 1F and 2F. The PI as a measure of peripheral vascular resistance, demonstrated a marked increase compared to normal pregnancy. There is a virtual overlap of PI values originating from state 1F and 2F according to the classification by Nijhuis et al. (J.G. Nijhuis, H.F.R. Prechtl, C.B. Martin, Jr. and R.S.G.M. Bots (1982) Early Hum. Dev. 6, 177-195). The peripheral vasoconstriction present in IUGR seems to overrule state dependent PI fluctuations. The marked rise in PI, particularly at lower FHR and the constancy of PI in relation to fetal behavioural states can be considered vascular adaptations, which are instrumental in the centralization of the fetal circulation, with the aim of favouring blood supply to the brain, heart and adrenals during IUGR.

Aorta, Thoracic↗
PubMed1985

The blood flow velocity waveform in the fetal descending aorta: its relationship to fetal behavioural states in normal pregnancy at 37-38 weeks.

In 13 normal pregnancies, the relationship between the blood flow velocity waveform at the lower thoracic level of the fetal descending aorta and fetal behavioural states at 37-38 weeks of gestation was studied. The pulsatility index (PI), as a measure of peripheral vascular resistance, was significantly lower during state 2F compared to state 1F according to the classification by Nijhuis et al. (Nijhuis, J.G. et al. (1982) Early Hum. Dev., 6, 177-195), suggesting an increased perfusion of the fetal skeletal musculature to meet the energy demand needed for the raised muscular activity during state 2F; A significant inverse relationship (P less than 0.001) was established between PI and FHR in state 2F; this was mainly determined by a significant rise in end-diastolic flow velocity (P less than 0.02). Both the behavioural state and FHR should be taken into account when evaluating flow velocity waveforms in the fetal descending aorta during the latter weeks of pregnancy.

Aorta↗
PubMed1983

Prenatal diagnosis and management of omphalocele.

The prenatal diagnosis of omphalocele by real-time sonography is important for intrauterine and neonatal management and prognosis. The prognosis and mortality rate is determined rather by the presence of serious associated anomalies such as cardiovascular and chromosomal defects, than by the omphalocele itself. Obstetric management in the presence of an omphalocele should therefore include immediate amniocentesis for chromosomal analysis and ultrasonic scanning of the fetus for other structural abnormalities. The obstetric management should be coordinated by the neonatologist and pediatric surgeon to ensure timely and optimal care of the infant.

Adult↗
PubMed1979

Danazol treatment of chronic cystic mastopathy: a clinical and hormonal evaluation.

Danazol, a new synthetic steroid, was administered at a dose of 400 mg daily for two months to 16 premenopausal women with chronic cystic mastopathy. The clinical and hormonal effects (serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin, progesterone, testosterone and urinary oestrogens, pregnanediol, pregnanetriol, androsterone and etiocholanolone) were evaluated after 4 and 8 weeks of treatment. Using the same dosage and duration of treatment, danazol (13 patients) was compared with placebo (12 patients) in a double blind randomized clinical trial. Danazol proved to be significantly more effective than placebo in relieving symptoms. Combining the open and double blind study (27 patients), danazol treatment resulted in complete relief in 14 patients and improvement in 11. The main endocrine changes during danazol treatment were related to the drug's ovulation inhibiting effect. Amenorrhoea, irregular bleeding and weight gain (mean 2.1 kg) were significant side effects.

Adult↗
PubMedDate not supplied

Liver rupture postpartum associated with preeclampsia and HELLP syndrome.

Liver rupture is a rare perinatal complication with high maternal mortality. In a multiparous woman with preeclampsia and Hemolysis, Elevated Liver enzymes, and Low Platelet count (HELLP) syndrome, liver rupture was suspected 10 h after a cesarean section. Laparotomy revealed liver rupture which was treated by perihepatic packing. Eventually, the mother was discharged with her baby 88 days after admission. Clinical symptoms, maternal hemodynamics by Swan-Ganz monitoring, and laboratory findings were not predictive until the emergency situation and the consecutive complications required multidisciplinary management.

Adult↗
PubMedDate not supplied

The blood flow velocity waveform in the fetal descending aorta; its relationship to fetal heart rate pattern, eye and body movements in normal pregnancy at 27-28 weeks of gestation.

In 13 normal pregnancies at 27-28 weeks of gestation the blood flow velocity waveform at the lower thoracic level of the fetal descending aorta was studied in relation to fetal heart rate pattern (FHRP), fetal eye movements (FEM) and fetal body movements (FBM). State parameter combinations in which high fetal heart rate (FHR) variability was present, were associated with a significant reduction in pulsatility index (PI) as compared with periods in which low FHR variability was present, irrespective of FEM and FBM, indicating a reduced peripheral vascular resistance. At 27-28 weeks of gestation FHR variability and PI might be linked to baroreceptor sensitivity. PI values derived from combinations FHRP-A, FEM(-), FBM(-) and FHRP-B, FEM(+), FBM(+) showed a significant inverse relationship (P less than 0.05) with FHR. FHR and FHR variability should be taken into account when studying flow velocity waveforms in the fetal descending aorta at 27-28 weeks of gestation.

Aorta, Thoracic↗
PubMedDate not supplied

Treatment of twin-twin transfusion syndrome by laser and digoxin. Biophysical and angiographic evaluation.

OBJECTIVES: A combination of surgical and medical approaches may address both the underlying pathophysiological processes and the most threatening symptoms in twin-twin transfusion syndrome (TTTS). CASE: A primigravida with monochorionic twin pregnancy was referred with signs of TTTS at 16 weeks. One twin was severely hydropic with normal amniotic fluid, the co-twin had anhydramnios. Laser treatment was performed. Nevertheless, signs of severe cardiac decompensation in the recipient remained unchanged. After treatment with digoxin restoration of congestive heart failure and a resolution of the hydrops were achieved. Activity and inter-twin contacts increased significantly. At 37 weeks 2 healthy boys were delivered. Postnatal computerangiography of the placenta revealed no arteriovenous anastomoses. CONCLUSIONS: This case suggests that a combined causal and symptomatic therapy in cases with cardiac decompensation of the recipient can be beneficial as demonstrated by echocardiography, venous Doppler and behavioral analysis. Computer angiography of the placenta may demonstrate the effect of laser treatment.

Adult↗