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Biomedical subjects

K Bremme

Publications and source records attributed to K Bremme.

At least 91 records · Page 5Linked to original sources
PubMed1987

15-Keto-13,14-dihydroprostaglandin F2 alpha and prolactin in maternal and cord blood during prostaglandin E2 or oxytocin therapy for labor induction.

15-keto-13,14-dihydroprostaglandin F2 alpha plasma levels were measured in pregnant women following labor induction with either oral PGE2 treatment or intravenous oxytocin, both combined with amniotomy. The median time to start of contractions was 62 minutes in the PGE2 treated group and 45 minutes in the oxytocin treated group (p less than 0.01; median test). The increase in 15-ketodihydro-PGF2 alpha appeared earlier in the PGE2 group but not in the oxytocin group (p less than 0.001 and p = 0.210, respectively). At delivery, the 15-ketodihydro-PGF2 alpha values had further increased in both treatment groups. The increase was significantly higher in the PGE2 treated patients compared with oxytocin treated patients (p = 0.03; contrast test). Despite higher 15-ketodihydro-PGF2 alpha concentrations throughout parturition, PGE2 women did not deliver more rapidly than oxytocin infused women. There was no correlation between 15-ketodihydro-PGF2 alpha blood concentrations and either onset of contractions or labor time. The decrease in maternal serum prolactin concentration during parturition was pronounced (p less than 0.001) in the PGE2 group but occurred also in oxytocin treated patients (p less than 0.02). A single oral dose (0.5 mg) of PGE2 taken by non-pregnant women led to significant (p less than 0.05) increases in 15-ketodihydro-PGF2 alpha levels in blood plasma after 10 minutes. This increase persisted for at least 90 minutes. It is suggested that oral PGE2 may be transformed into PGF2 alpha and/or induce endogenous PGF2 alpha biosynthesis.

Adult↗
PubMed1986

Steroid hormones in emetic and non-emetic pregnancy.

Nausea and/or vomiting in early pregnancy is common enough to be generally accepted as normal or 'physiological'. The specific etiology of these complaints is still obscure. One possibility is that endocrine factors may play some part. In this study, 102 healthy pregnant women, of whom 62 complained of nausea, were followed throughout pregnancy and the circulating levels of cortisol, testosterone, dehydroepiandrosterone sulphate (DHEA-S), progesterone, oestradiol and total and free oestriol were measured. In early pregnancy, serum levels of cortisol and progesterone were significantly lower in emetic subjects. In the last trimester, significantly higher DHEA-S concentrations and lower testosterone values were found in women who had suffered from nausea and vomiting in early pregnancy compared to asymptomatic subjects. Overt differences were found between emetic and non-emetic pregnancy and it is concluded that endocrine factors are of etiological importance in emesis gravidarum.

Dehydroepiandrosterone↗
PubMed1986

Blood pressure regulation in third-trimester pregnant women receiving tocolytic terbutaline infusion.

Terbutaline (20 micrograms/min) was infused during 30 min in 17 women in whom a manual external manipulation of a breech presentation was going to be attempted. A significant increase in systolic (P = 0.003) and a decrease in diastolic blood pressure (P = 0.04) was noted at the end of the infusion but no change in mean arterial blood pressure was obtained. At the same time aldosterone serum levels had dropped significantly (P = 0.009) and plasma angiotensin II showed a marked increase (P less than 0.001) which continued during the next 30 min. All changes were normalized after the infusion. The angiotensin-converting enzyme activity remained unchanged, as did vasopressin plasma levels. The combined results of terbutaline provocation have been interpreted to mean that blood pressure regulation in third-trimester pregnant women is similar to that in nonpregnant individuals. The increase in dehydroepiandrosterone sulphate (P less than 0.05) noted at the end of infusion was suggested to be related to the blood pressure changes and was unrelated to fluctuations in serum cortisol. The latter steroid increased between 30 and 60 min, e.g. during the manual external manipulation, and was interpreted as being due to maternal stress.

Adult↗
PubMed1986

Non-steroid hormones and tissue polypeptide antigen (TPA) in emetic and non-emetic pregnancy.

In order to investigate further the endocrine and metabolic features of the common condition emesis gravidarum, serum concentrations of some non-steroid hormones and tissue polypeptide antigen (TPA) were determined in 102 healthy pregnant women. 62 complained of nausea and vomiting in early pregnancy. Significantly higher and lower levels of human chorionic gonadotropin were noted in early and late pregnancy, respectively, in women with emesis gravidarum. A significant rise in serum prolactin and TPA was found throughout pregnancy in all subjects, no differences between emetic and non-emetic pregnancies being registered. Serum concentrations of growth hormone (hGH) showed a significant decline as pregnancy advanced. Emetic women demonstrated higher hGH levels in late pregnancy than did asymptomatic subjects. Free T4 concentrations remained stable when comparing early with late pregnancy, no dissimilarities being found between women with and without nausea and vomiting in pregnancy. These data do not support the hypothesis of major metabolic disturbances as an etiologic factor for nausea and vomiting in pregnancy. However, as overt differences between emetic and non-emetic pregnancy were found, hormonal factors may be involved in the pathogenesis of this condition.

Adult↗
PubMed1986

Effects of infusion of the beta-adrenoceptor agonist terbutaline on serum magnesium in pregnant women.

Seventeen third trimester pregnant women received a 30-min intravenous infusion of terbutaline 20 micrograms/min. The drug caused a prompt (30 min) drop in serum potassium (p less than 0.001) and a decrease after 120 min in serum magnesium concentrations (p less than 0.002). No significant changes in calcium or sodium levels were observed. The altered serum magnesium concentrations were significantly (p less than 0.05) correlated to increases in plasma free fatty acid levels but not to elevated plasma glucose concentrations. Whatever the mechanism for the lowering of serum magnesium may be, the potential danger of administering a beta-adrenoceptor agonist to pregnant women with low serum potassium and magnesium levels is underlined.

Adult↗
PubMed1985

Maternal and cord serum levels of tissue polypeptide antigen (TPA) in normal pregnancies.

The tumor antigen and cytoskeleton protein tissue polypeptide antigen (TPA) have been determined in maternal serum throughout pregnancy. TPA levels in serum from pregnant women (n = 70) were not different from those in nonpregnant women (n = 61) until pregnancy week 28, from which time levels increased until parturition. Duplex pregnancies (n = 7) had higher serum TPA concentrations than simplex pregnancies, which was significant in pregnancy weeks 28 (p less than 0.014) and 32 (p = 0.05). Maternal serum TPA concentrations did not change during abortion or parturition and the mixed umbilical blood concentration of TPA equaled that in the mother's serum just after parturition. The correlation between placenta weight and maternal serum TPA levels was significant (p = 0.025). The decline of TPA after labor indicated a t1/2 for serum TPA of 7.5 days.

Abortion, Induced↗
PubMed1984

Prediction of time to delivery from start of contractions in induced labor: a life table analysis approach.

Labor was induced in a total of 200 patients. Outcome of treatment was compared with respect to time to delivery from start of contractions. Prognostic variables compared here were, e.g. dilatation, parity and Bishop score. All comparisons were performed with a life table technique, both bivariate and multivariate. Parity showed a strong relation to prognosis and so did cervical dilatation. The degree of cervical dilatation as in spontaneous labor is the factor in the Bishop index that correlated best to the outcome of treatment. With the two predictors parity and dilatation, a scoring system was constructed.

Actuarial Analysis↗
PubMed1984

Prediction of start of contractions in labor induced with oral prostaglandin E2 or oxytocin: a life table analysis approach.

Labor was induced for medical reasons at or near term in altogether 200 patients. All women had amniotomy and were then randomly assigned to either oral prostaglandin E2 (PGE2) or intravenous infusion of oxytocin (Oxy). In this study PGE2 and Oxy treatment were compared with respect to time to contractions. Other not randomized but prognostic variables compared here were, e.g. dilatation, parity and Bishop score. All comparisons were performed with the life table technique. Labor was established earlier in the Oxy group than in the PGE2 group of patients. In both treatment groups parity and dilatation were more strongly related to start of contractions than to Bishop score.

Actuarial Analysis↗
PubMed1984

Hormone levels in amniotic fluid and maternal serum in women who undergo spontaneous abortion after second trimester amniocentesis.

Second trimester spontaneous abortion occurring on the average 1.5 weeks after amniocentesis in 15 symptom-free women has been studied. Thus, hormone (total estriol, hCG, prolactin, and hPL) levels in amniotic fluid and maternal serum were compared to those in 60 women who also underwent second trimester amniocentesis but went to term without complications. The abortion group had significantly (p less than 0.01) elevated levels of total estriol in maternal serum and in amniotic fluid, significantly (p less than 0.01) increased prolactin concentration in amniotic fluid, and decreased (p less than 0.05) hCG levels in maternal serum. It is suggested that these differences may relate to fetal adrenal stress response in the subsequent abortion group indicating an abnormality which may or may not be aggravated by amniocentesis.

Abortion, Spontaneous↗
PubMed1984

Estriol and cholic acid in maternal serum in induced labor.

Prostaglandin E2 (PGE2), but not oxytocin, treatment to induce parturition brought about an increase (p less than 0.001) in maternal serum levels of total estrogens (conjugated and nonconjugated estriol). There was no increase in nonconjugated estriol. To explore if the changes were related to an altered enterohepatic circulation, cholic acid assay in maternal serum was used. There were no changes in cholic acid which parallelled those in total estrogens. It is concluded that PGE2 does not appear to affect enterohepatic circulation of steroids, and it is suggested that the increase in total estrogens may be caused by changes in the kidney excretion of estriol.

Adolescent↗
PubMed1983

Fetal sex dependent hormone levels in early pregnant women with elevated maternal serum alpha-fetoprotein.

Maternal serum and amniotic hormone levels have been investigated in two groups of women in pregnancy weeks 18-21. One group (B) was composed of women with high alpha-fetoprotein levels in serum without fetal abnormality, and a matched control group (A) with normal alpha-fetoprotein levels in serum. Amongst group B women were four pregnancy complications: two spontaneous abortions, one premature delivery, and one cesarean section due to fetal asphyxia. Group B women were significantly different from group A women. Thus, higher maternal serum levels of total estriol (P = 0.030), testosterone (P = 0.016), and alpha-fetoprotein (P = 0.018) were noted in the presence of male fetuses; and higher hPL (P = 0.004), FSH (P = 0.037), and alpha-fetoprotein (P = 0.002) concentrations in women carrying female fetuses, who were accompanied by lower total estriol concentrations (P = 0.045). Differences between groups B and A in terms of amniotic fluid analyses were only related to female fetal sex. Thus, group B showed higher hPL (P = 0.028), testosterone (P = 0.020), and FSH (P = 0.006) levels, and lower alpha-fetoprotein (P = 0.013) concentrations. It is concluded that elevated maternal serum levels of alpha-fetoprotein are accompanied in female fetuses by an endocrine milieu different from that of matched controls. This difference may put the conceptus at a disadvantage, but the majority of the girls were born on time without signs of small-for-date.

Adult↗
PubMed1983

An evaluation of early pregnancy HCG determination as a prognostic tool for fetal outcome.

In a retrospective study of 150 pregnant women with high or low serum HCG levels at the time they sought acute advice at the ward, two categories of women were found: a majority (n = 111) who had abdominal pain and/or vaginal bleeding, and a minor group (n = 39) who worried about their condition but were otherwise symptom free. The underlying reason for the difference in clinical outcome amongst 'bleeding' and 'concern' women with both high and low HCG serum values are discussed. It is concluded that women with abnormal HCG levels in early pregnancy deserved close attention in the 3rd trimester.

Abortion, Spontaneous↗
PubMed1982

The regulation in vitro of placental release of human chorionic gonadotropin, placental lactogen, and prolactin: effects of an adrenergic beta-receptor agonist and antagonist.

An experimental model for the study of placental tissue release of hormones has been explored. It has been shown that the trophoblast in Ringer-glucose solution releases human placental lactogen (hPL) and chorionic gonadotropin (hCG) in a time- (10 to 180 minutes) and temperature- (4 degrees and 37 degrees C) dependent manner. The adrenergic beta-receptor agonist terbutaline caused an increase in hCG secretion but did not affect hPL. With a mixed trophoblast/decidua preparation, prolactin release was not found to be time and temperature related. Terbutaline increased prolactin release and timolol decreased it. The data suggest tha adrenergic mechanisms are involved in hCG and prolactin secretion from the placenta.

Chorionic Gonadotropin↗
PubMed1982

An old problem revisited--hyaline membrane disease and Cesarean section.

The incidence of hyaline membrane disease (HMD) was investigated retrospectively in 159 preterm infants below 35 weeks gestation, weighing less than 2,000 g, and born during the 5-year interval 1975-79. The incidence of HMD was compared between infants delivered by elective Cesarean section, Cesarean section after the onset of labor and by the vaginal route. A significant difference (P less than 0.001) was found in the frequency of HMD dependent on the mode of delivery; 50% of infants delivered by elective Cesarean section developed HMD versus 19.2% in the vaginally delivered group. In infants delivered vaginally premature rupture of membranes (PROM) lowered the incidence of HMD to 5% compared to 32.4% in infants without PROM (P less than 0.01). When infants (less than 2,000 g) delivered vaginally without PROM were compared with those delivered by elective Cesarean section, no difference in HMD-incidence was observed. Out of 43 infants with birthweight above 2,000 g, who developed HMD during the 5-year period the majority had been delivered by elective Cesarean section. The possible effect of fetal stress on lung maturation is discussed.

Birth Weight↗
PubMed1982

Changes in maternal serum aldosterone, potassium and prolactin levels during beta-receptor agonist treatment in third trimester pregnancies.

Beta-receptor agonist (terbutalin or isoxsuprin) administration to pregnant women either because of premature labor (therapy group; T; n = 8) or as prophylactic treatment (prophylaxis group; p; n = 8) resulted in a marked drop in serum potassium (p less than 0.001) during the first two hours of infusion in all patients. In five diabetic women in the P group the prolactin was significantly decreased (P less than 0.01) as was serum aldosterone levels (p less than 0.01). These changes were not observed in the T group. The two groups of pregnant women responded with a significant increase in free fatty acids (FFA) and glucose but the magnitude and the time coarse differed. Thus in T women, FFA reached a peak after 30-60 minutes into treatment and then returned to baseline levels. A closer analysis revealed that this pattern was only obtained in patients receiving terbutalin. Among women given prophylactic treatment with terbutalin, a continuous increase in FFA was noted over the initial two hours (p less than 0.001). The increase in serum glucose was continuous in the two patient groups (p less than 0.001). It is suggested that beta-receptor agonists in diabetic women induces a dopaminergic type of response since serum prolactin levels but not TSH concentrations were affected. The possibility that an increased PGE2 synthesis at the expense of PGF2 alpha might mediate this effect of beta-receptor agonists in discussed. It is also suggested that an increased prostaglandin synthesis might interfere with aldosterone secretion. The possibility that falling serum potassium levels may activate dopaminergic systems via PGE2 synthesis is also emphasized.

Adult↗