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Biomedical subjects

K Teramo

Publications and source records attributed to K Teramo.

At least 73 records · Page 4Linked to original sources
PubMed1992

Premature rupture of the membranes: effect of penicillin prophylaxis and long-term outcome of the children.

To assess the value of prophylaxis with penicillin in women with premature rupture of membranes (PROM) and the long-term outcome of children born after prolonged PROM, we studied 221 women with this condition. Penicillin (5 mu twice, 6 hours apart) was given intravenously to 50 women and placebo to 51 women, whereas 76 comparable patients were treated without penicillin or placebo. The time interval between PROM and delivery ranged from 14 hours to 56 days. Chorioamnionitis occurred more frequently (p less than 0.05) among patients with placebo (14%) than among those treated with penicillin (2%). One puerperal endometritis appeared in the placebo group compared with none in the penicillin group. One newborn (1.7%) born to a mother with placebo prophylaxis developed septicemia, compared with none in the penicillin group. The outcomes of pregnancies complicated with PROM treated without penicillin or placebo were comparable with those in the placebo group. In addition, we compared somatic and psychomotor development of 159 children born to mothers with prolonged PROM (more than 12 hours; mean, 5.6 days; range, 14 to 1344 hours) with those of 43 children born at similar gestational age within 5 hours after PROM. No pulmonary sequelae could be linked to the long time period between PROM and delivery, but infants born soon after PROM more often (p less than 0.05) had cerebral palsy (8 of 43, 18.6%) than did infants born after prolonged PROM (7 of 159; 4.4%). We conclude that, in cases with PROM, penicillin prophylaxis decreases maternal and neonatal infectious morbidity and that the long interval between PROM and delivery does not impair the long-term outcome for these children.

Adult↗
PubMed1992

Incidence of primary toxoplasma infections during pregnancy in southern Finland: a prospective cohort study.

Congenital toxoplasmosis may develop after maternal primary infection during pregnancy. Since toxoplasmosis in adults is usually asymptomatic, the only way to find the pregnancies at risk of acute toxoplasmosis (i.e. seronegative mothers) is to perform serological screening of all pregnant women. We studied toxoplasma-specific antibodies in 16,733 pregnant women in the first, second, and third trimesters over an 18-month period in the Helsinki area, with a population of 820,700. The participation rate in our study was 90.2% of all pregnancies in the area. The overall prevalence of toxoplasma seropositivity was 20.3%. The incidence of primary infection was 2.4/1000 pregnancies at risk. Our data on incidence suggest an annual occurrence of 131 cases of primary toxoplasma infections during pregnancy in Finland. Primary toxoplasma infection appears to be a significant risk to the fetus even in countries where the prevalence of toxoplasma seropositivity is low. The feasibility of mass screening for toxoplasma infections during pregnancy should be considered in order to reduce the morbidity and mortality due to congenital toxoplasmosis.

Adolescent↗
PubMed1992

The program for antenatal screening of toxoplasmosis in Finland: a prospective cohort study.

16,733 pregnant women were studied for toxoplasma specific antibodies during an 18-month period. The number of specimens was 44,181. The IgG seropositivity of mothers was 20.3%. The incidence of primary toxoplasma infections during pregnancy was 4.2 per 1000 seronegative pregnancies by using the traditional criteria, IgG seroconversion and/or a positive IgM. By using the IgG activity test as an additional criterion, the incidence was 2.4 per 1000 seronegative pregnancies. Due to transmission rate of 40%, the number of congenital toxoplasma infections in Finland is more than 50 per year. The evaluation is going on and the cost-benefit analysis will reveal the effectiveness of antenatal screening.

Antibodies, Protozoan↗
PubMed1990

C-reactive protein in preterm premature rupture of the membranes.

The usefulness of maternal C-reactive protein (CRP) measurements in the diagnosis of chorioamnionitis and puerperal and neonatal infectious morbidity was studied among 147 patients with preterm rupture of the membranes (PROM). Thirty-three patients developed chorioamnionitis, 10 patients developed puerperal endometritis, and 21 newborn infants developed neonatal infections. There was no difference in the highest antepartum CRP between patients with or without chorioamnionitis. The overall test performance for CRP was poor suggesting that elevated antepartum CRP may be misleading in the diagnosis of chorioamnionitis. However, use of serial CRP measurements increases the test performance. The high negative predictive value suggests that CRP is useful in predicting the absence of chorioamnionitis.

Adult↗
PubMed1990

Protein binding of antiepileptic drugs during pregnancy, labor, and puerperium.

Twenty-four epileptic women were followed-up during late pregnancy, labor, and early puerperium in order to detect possible alterations in serum protein binding of antiepileptic drugs (AEDs). The total and free concentrations of carbamazepine (CBZ), phenytoin (PHT), and valproate (VPA) in maternal serum were measured. In addition, the concentrations of albumin, alpha 1-acid glycoprotein (AGP), and free fatty acids (FFA) were also measured. Total AED concentrations during labor were influenced by changes in drug dosages; total PHT increased during the first puerperal weeks. During labor the free fraction of CBZ remained stable, whereas PHT and particularly VPA free fractions increased. This phenomenon was parallel to the increase in FFA concentration; FFA concentrations decreased again during the first days postpartum. Albumin and AGP concentrations were low during pregnancy and labor, and increased after delivery. The total umbilical CBZ and PHT concentrations were not significantly different from maternal concentrations. The total VPA concentration in umbilical serum was significantly higher than that in maternal serum. The free fraction of CBZ was higher and that of PHT and VPA lower in umbilical than in maternal serum at delivery. Umbilical cord serum had a higher albumin but a lower AGP and FFA concentration than maternal serum. The changes in PHT and particularly VPA free fraction associated with changes in FFA concentration should be considered when assessing the total concentration of these drugs in maternal and umbilical serum.

Adult↗
PubMed1989

Surfactant proteins in the diagnosis of fetal lung maturity. II. The 35 kd protein and phospholipids in complicated pregnancy.

The major surfactant protein with a molecular weight of 35 kd and also saturated phosphatidylcholine and phosphatidylglycerol were analyzed in specimens of amniotic fluid; 68 were from cases of maternal diabetes, 41 from preeclampsia or maternal hypertension, 26 from premature rupture of the fetal membranes, and 45 from normal pregnancies. The relationship between the individual surfactant components was studied after covariance adjustment for the length of gestation. In severe early-onset preeclampsia, the 35 kd surfactant protein/saturated phosphatidylcholine ratio was significantly higher than in the other pregnancies. In diabetic pregnancies (classes B to D without preeclampsia), the phosphatidylglycerol/saturated phosphatidylcholine ratio was lower than in the other pregnancies. Isolated surfactant complex showed similar abnormalities. In severe early-onset preeclampsia and insulin-dependent diabetes without vascular disease, the phosphatidylglycerol/saturated phosphatidylcholine ratio correlated negatively with fetal growth. In four samples of amniotic fluids from cases of severe early-onset preeclampsia, the 35 kd protein falsely predicted lung maturity. All had abnormally high 35 kd protein/saturated phosphatidylcholine ratios (greater than 2 SD of controls). According to the present results, the 35 kd protein may give a false mature test result in severe preeclampsia.

Amniotic Fluid↗
PubMed1989

Comparison of menstrual history and basal body temperature with early fetal growth by ultrasound in diabetic pregnancy.

The time of ovulation and conception of 24 insulin-dependent (Type I) diabetic women was estimated by monitoring the basal body temperature (BBT). The mean (+/- SD) duration of the menstrual cycle was 28 (+/- 2) days. Conception occurred, on the average, on the 18th day of the cycle. The fetal crown-rump length was measured by ultrasound scan every 2 weeks between 6 and 14 weeks of pregnancy. When menstrual history was used for dating, there was an apparent early fetal growth delay by a mean of 4 days. When the dates were corrected by BBT, the fetal growth was identical with the standard mean crown-rump length diagram by Robinson & Fleming. The findings of our study suggest that early fetal growth delay reported by Pedersen & Mølsted-Pedersen does not exist in diabetic pregnancy. The small fetuses observed could be explained by an error in the gestational age.

Adult↗
PubMed1989

Correlation of HbA1C, glycated serum proteins and albumin, and fructosamine with the 24-h glucose profile of insulin-dependent pregnant diabetics.

To assess the value of various methods for long-term follow-up of diabetic patients, we compared the concentrations of fructosamine in serum with those of various glycated proteins: hemoglobin (HbA1C), total serum proteins (G-prot), and albumin (G-alb), assayed in 30 pregnant insulin-dependent diabetics every two weeks after initial determination of a 24-h blood glucose profile. HbA1C correlated best with the 24-h glucose profile during the succeeding 10-35 days (r = 0.65-0.68, P less than 0.001). G-prot and G-alb correlated nearly as well as HbA1C 10-20 days after the glucose profile (r = 0.54-0.64, P less than 0.01-0.001), but only weakly after 25-35 days. Values for fructosamine did not correlate significantly with the glucose profile 10-35 days after it (r = 0.23-0.36). Evidently the fructosamine assay is not an adequate alternative to HbA1C, G-alb, or G-prot as an index to long-term control of blood glucose in such patients.

Blood Glucose↗
PubMed1988

Asthma and pregnancy: a prospective study of 198 pregnancies.

A study was designed to investigate whether asthma, when carefully managed, is associated with an increased risk of complications in connection with pregnancy. One hundred and eighty one asthmatic women were monitored during 198 pregnancies. Antiasthmatic treatment consisted of inhaled beta 2 adrenergic drugs, beclomethasone, sodium cromoglycate, oral theophylline, and systemic corticosteroids as needed. Postpartum information on asthmatic symptoms and infant feeding was collected by means of a questionnaire. A control group of 198 non-asthmatic pregnant women was matched for age and parity. Atopic women had less severe asthma than non-atopic women. During pregnancy 40% of the patients were managed with the same antiasthmatic medication as before pregnancy; 18% needed less and 42% more medication. Pre-eclampsia occurred more often in asthmatic than control subjects, especially in patients with severe asthma. Hypoglycaemia occurred more often in infants of mothers with severe asthma than in infants of mothers with less severe disease. Theophylline medication at term did not influence labour or delivery. Asthma caused no emergencies during labour. Among the asthmatic subjects 28% of babies were delivered by caesarean section compared with 17% in the control group. There was no difference between asthmatic and control subjects with regard to length of gestation, birth weight, incidence of perinatal deaths, low Apgar scores, neonatal respiratory difficulties, hyperbilirubinaemia, or malformations. It is concluded that severe asthma or systemic corticosteroid treatment (or both) during pregnancy seems to increase the incidence of mild pre-eclampsia in the mother and hypoglycaemia in the infant. The findings suggest that careful supervision of asthma during pregnancy and labour by obstetricians and chest physicians working in close collaboration should prevent most of the serious obstetric and neonatal complications of asthma in pregnancy reported by previous authors.

Adolescent↗
PubMed1988

[Fetal asphyxia].

Explore the source record for details and available documents.

Asphyxia Neonatorum↗
PubMed1987

A controlled study of the influence of continuous subcutaneous insulin infusion treatment on diabetic retinopathy during pregnancy.

Forty consecutive pregnant patients with insulin-dependent (Type I) diabetes mellitus were randomized at the end of the first trimester for treatment with conventional insulin therapy (CIT) or continuous subcutaneous insulin infusion therapy (CSII). Nine patients randomized into the CSII group declined the pump treatment. The mean glycosylated haemoglobin (Hb AIc) decreased (p less than 0.001) both in the CIT and the CSII groups with no difference between the groups. Some deterioration in retinopathy was found in 2/18 patients in the CIT group, in 5/13 in the CSII group, and in 3/9 of those who declined the pump treatment. The proportion of patients whose retinopathy progressed did not differ significantly between the groups, and in the majority the deterioration was mild. However, two patients in the CSII group developed acute ischaemic retinopathy, which progressed to proliferative stage in spite of laser treatment. In these two cases the decrease in the Hb AIc level was among the greatest and fastest in the study. These data suggest that a rapid near normalization of glycaemic control by CSII during pregnancy can accelerate the progress of retinopathy in poorly controlled diabetic patients.

Adult↗