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Biomedical subjects

K Ueland

Publications and source records attributed to K Ueland.

At least 37 records · Page 2Linked to original sources
PubMed1983

Polycythemia rubra vera and pregnancy.

Polycythemia rubra vera is a rare complication of pregnancy. Only 13 pregnancies occurring in eight women have been reported. The maternal outcome is uniformly good except for an apparent association of pregnancy-induced hypertension. The perinatal outcome is poor and is due to the frequent occurrence of abortion, preterm delivery, and stillbirth. The etiology of the disease is discussed along with symptoms and diagnostic criteria. A young woman who successfully negotiated two pregnancies is presented. Guidelines for hematologic monitoring and management during pregnancy and the early puerperium are proposed.

Adolescent↗
PubMed1982

Favorable results of neonatal intensive care for very low-birth-weight infants.

From 1961 to 1976, 229 infants with birth weights ranging from 751 to 1,000 gm were admitted to the Stanford University Hospital Intensive Care Nursery. The overall neonatal mortality for these infants was 63% (144/229), and there were ten late deaths. Before 1967, no infant in this group who required mechanical ventilation survived; thereafter, 30% (34/114) of the ventilated patients survived. Of the 75 long-term survivors 60 participated in a high-risk infant follow-up program; these included 23 infants who had received mechanical ventilation. The mean birth weight of these infants was 928 +/- 67 (SD) gm. Seventeen children (28%) had significant morbidity: seven (12%) with severe handicaps and ten (17%) with moderate handicaps. During this same period, seven infants weighing less than 750 gm at birth were also observed. The three infants who had not required ventilatory support thrived; the other four infants had required respirators and were significantly handicapped. More recently, neonatal mortality for infants with birth weights from 751 to 1,000 gm has improved: for 1977 to 1980, it was 28% (33/118). Furthermore, neonatal mortality for ventilated infants in this weight group was 27% (26/95). These data indicate an improved prognosis for very low-birth-weight infants, even with ventilatory support.

California↗
PubMed1979

The stretch modulus of human cervical tissue in spontaneous, oxytocin-induced, and prostaglandin E2-induced labor.

A total of 62 strips of cervical tissue from 28 patients at term were tested for stiffness (stretch modulus) by elongation and measuring the tension produced by a given stretch. The stretch modulus was taken as the slope of the linear regression curve derived from the linear portion of the stress-strain relationship. The data were obtained from three patient categories: (1) 17 strips from seven patients undergoing spontaneous labor, (2) 18 strips form 10 patients with labor induced by PGE2, and (3) 27 strips from 11 patients with labor induced by oxytocin. The stretch moduli of cervical tissue obtained from spontaneous and oxytocin-induced labor patients were similar. The stretch moduli of cervical tissue obtained from PGE2-induced labor patients were significantly lower than those from either the spontaneous or the oxytocin-induced labor groups. These results show that PGE2, when used for induction of labor at term, has the ability to lower the stiffness of cervical tissue. This property of prostaglandin may be useful therapeutically for the indicated induction of labor in patients with an unfavorable cervix.

Cervix Uteri↗
PubMed1976

Maternal cardiovascular dynamics. VII. Intrapartum blood volume changes.

Blood volume was measured in 75 normal pregnant women at term and serially at 10 and 60 minutes and on Days 1 and 3 post partum in women delivered vaginally and on Days 1, 3, and 5 in women who underwent cesarean section. The mean blood volume at term was 5.95 L. and 83.3 c.c. per kilogram, an increase of 44 and 16%, respectively, over nonpregnant values. The increment appeared to be related to lean body mass and the weight of the neonate alone and to the combined weights of the neonate and placenta, but the wide range of values precluded statistical significance. The blood volume loss at 60 minutes post partum was 610 c.c. (10.2%) for patients delivered vaginally and 1,030 c.c. (17.4%) for those delivered by cesarean section. The blood volume showed a steady decline to Day 3 post partum in the vaginal delivery group, whereas it remained fairly stable from 60 minutes to Day 5 post partum in the surgically delivered group. Remarkably, the volume had declined by the amount, 16.2%, in both groups on the third postpartum day. On the other hand, the hematocrit showed a rise of 5.2% in the former group and a decline of 5.8% in the latter. A remarkable tolerance for blood loss at delivery was demonstrated. A more realistic definition of postpartum hemorrhage is strongly recommended.

Birth Weight↗
PubMed1976

Reduction of the stretch modulus of human cervical tissue by prostaglandin E2.

Samples of cervical tissue were obtained from women immediately following term delivery from spontaneous labor or oral PGE2-induced labor and from a small nunber of nonpregnant women in the reproductive years undergoing hysterectomy for benign gynecologic disease. The measured strips were placed in a well-oxygenated bath at 37 degrees C. containing Ringer's solution and stretched at a constant rate while continuously recording length and tension. The data were converted to stress-strain diagrams. Each curve contained a long linear portion which allowed one to compute a stretch modulus for each sample. A total of 71 strips from 23 patients was used. The average stretch modulus from the oral PGE2-induced patients was significantly lower than the spontaneous labor group (p less than 0.005), which, in turn, was significantly lower than the stretch modulus of the nonpregnant cervical tissue. It was also noted that the yield point was lower in the PGE2 series when compared to the spontaneous labor series (p less than 0.05). The effect of the PGE2 at a bath concentration of 10(-5) to 10(-6)Gm. per cubic centimeter was to materially reduce the stretch modulus within 5 to 15 minutes of the drug addition in both the PGE2-induced and spontaneous labor series. The results of these experiments indicate that PGE2 has the effect of reducing cervial stiffness.

Cervix Uteri↗
PubMed1976

A comparison of the effects of the inhalation of 4% and 8% fluroxene in the pregnant primate.

A comparison was made of the effects of inhalation of 4% fluroxene (n = 5) and 8% fluroxene (n = 5) in pregnant monkeys. Measurements of maternal arterial blood pressure, heart rate, cardiac output, total peripheral resistance, uterine blood flow, fetal heart rate and arterial blood pressure, and maternal and fetal blood gas levels were made. Inhalation of 4% fluroxene for 20 minutes produced little change in maternal hemodynamics and was well tolerated by the fetus. Fluroxene 8% inhaled for a similar 20-minute-period produced a significant decrease in maternal blood pressure (--27%), total peripheral resistance (--32%), and uterine blood flow (--27%) and lowered the level of maternal fetal exchange.

Anesthesia, Inhalation↗
PubMed1976

An audit of obstetric care in a university family medicine department and an obstetrics-gynecology department.

The care of obstetric patients in a university family medicine department was compared with that in the obstetrics-gynecology department of the same university. The obstetric service patients tended to be at higher risk due to a higher black population (24.2 percent vs 6.3 percent), greater prepregnancy weight (mean 154.0 lbs vs 113.9 lbs), and a greater number of patients referred from the community because of prenatal complications. However, the family medicine patients had a higher incidence of premature rupture of membranes (26 percent vs 11 percent), and were therefore at risk for several complications. Family medicine nulliparas had first stages of labor which lasted an average of 12.2 hours as opposed to obstetric service nulliparas whose first stages averaged only 9.2 hours. There were more family medicine than obstetric service patients who received no anesthesia (18.0 percent vs 10.2 percent). Elective low forceps were used more often by obstetric service physicians than by family physicians (28.2 percent vs 15.3 percent). Mothers on the family medicine service had more puerperal complications than those on the obstetric service (16.0 percent vs 5.6 percent). No serious discrepancies in quality of care could be found between the two services.

Academic Medical Centers↗
PubMed1975

Respiratory depression in newborn monkeys at Caesarean section following ketamine administration.

Ketamine, currently being evaluated as an obstetric anaesthetic agent, is said to provide analgesia without depression of the protective airway reflexes or depression of the respiratory or cardiovascular systems. We have studied the effects of ketamine on the uterine blood flow, the foetus and the newborn in five monkeys (Macaca nemistrina). Uterine blood flow, (UBF) was measured by the steady-state infusion technique using tritiated water as the indicator. All of the variables were measured during a control period and again at 10 and 90 min after the administration of ketamine in doses of 2 mg/kg in three monkeys or 1 mg/kg in two. Maternal respiration was maintained at normal physiological levels without significant variation. The maternal mean arterial pressure (MAP), cardiac output (CO), and stroke volume (SV) did not change significantly, but heart rate (HR) did increase significantly following the injection of ketamine and remained increased for the duration of the study. UBF, a-v oxygen difference, and the oxygen consumption of the uterus and its contents remained stable throughout. During the intrauterine period the foetus did not seem to be affected by the two doses of ketamine. However, the three newborn monkeys delivered of the mothers who had reveived ketamine 2 mg/kg had profound respiratory depression. This was not seen in the two infants delivered from mothers receiving 1 mg/kg. Others have shown that neonatal depression is dose- and time-related. We conclude that ketamine should be administered to obstetric patients in small single doses or by continuous infusion in very low concentrations.

Anesthesia, Obstetrical↗
PubMed1975

Maternal and fetal responses to halothane in pregnant monkeys.

Maternal cardiac output, blood pressure, heart rate, fetal blood pressure, heart rate and respiratory blood gases, and uterine blood flow were measured in six pregnant monkeys during halothane-nitrous oxide and oxygen anesthesia and compared to theses same parameters observed during nitrous oxide and oxygen anesthesia. Halothane 1.5% was associated with a decrease in maternal arterial pressure (54%), heart rate (10%), cardiac output (17%), total peripheral resistance (40%), and uterine blood flow (38%). Mean fetal heart rate decreased 18% and mean fetal blood pressure 22%. These changes in fetal hemodynamics were probably related to a direct depression of the fetal cardiovascular system and its usual compensatory mechanism as well as the fetal asphyxia secondary to the decrease in uterine blood flow.

Anesthesia, General↗