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Biomedical subjects

L I Mann

Publications and source records attributed to L I Mann.

At least 73 records · Page 4Linked to original sources
PubMed1976

Correlation of fetal heart rate patterns and fetal pH with neonatal outcome.

Fetal monitoring data in 200 consecutive cases was evaluated in the second hour prior to delivery to determine how neonatal outcome could be most accurately predicted. It was found that the correlation between ominous fetal heart rate-uterine contraction (FHR-UC) patterns and a depressed Apgar score at 1 minute was, at best, 37%. However, where the last fetal scalp blood pH (FSB-pH) was less than or equal to 7.2, neonatal depression occurred in 88% of cases. FSB-pH, therefore, provided a more reliable means of diagnosing fetal distress.

Apgar Score↗
PubMed1975

Midtrimester pregnancy termination by intramuscular injection of a 15-methyl analogue of prostaglandin F2 alpha.

Fifty patients between 12 and 20 weeks' gestation were treated with prostaglandin 15 (S) 15-methyl F2 alpha by repeated intramuscular injection of 250 mug at intervals of not less than 2 hours in order to evaluate its efficacy as an abortifacient. A success rate of 96 per cent was achieved with a mean initiaation-abortion interval of 16.5 +/- S.E.M. 1.12 hours. There were no serious complications. The most common side effects were vomiting in 82 per cent and diarrhea in 66 percent of cases. The abortifacient activity was correlated with serial serum progesterone determinations and continuous intra-amniotic pressure recordings in selected cases.

Abortifacient Agents↗
PubMed1975

Prolonged fetal bradycardia with recovery--its significance and outcome.

bradycardia lasting more than 21/2 minutes with a decrease in FHR of more than 30 b.p.m. were observed in the course of 15 monitored labors. The mean fetal pH during the 20 minutes following the bradycardia (early recovery) was significantly less than the mean pH obtained 30 minutes or more after the bradycardia (late recovery). Various types of periodic heart rate changes were observed during the early recovery period but few persisted into late recovery. Vaginal delivery occurred in 13 of 15 patients. Two cesarean sections were performed for indications unrelated to the prolonged bradycardia. The 5 minute Apgar score of all 15 neonates was 7 or greater.

Acidosis↗
PubMed1975

Effect of alcohol on fetal cerebral function and metabolism.

The effect of maternal alcohol infusions on fetal cerebral function in terms of the electroencephalogram (EEG) and fetal brain metabolism was studied in 10 fetal sheep experiments. A 9.75 per cent alcohol-dextrose solution was infused at the rate of 15 c.c. per kilogram of maternal weight for 1 or 2 hours. Fetal cerebral uptake of oxygen was unaffected. Blood flow was significantly increased as a result of a greater decrease in resistance than decrease in blood pressure. The cerebral uptake of glucose and the glucose-oxygen utilization ratio were significantly increased. The EEG showed a decrease in amplitude and slowing of the dominant rhythm as the blood alcohol concentration increased and became isoelectric on occasion during the postinfusion period associated with a severe fetal acidosis.

Animals↗
PubMed1975

Placental transport of alcohol and its effect on maternal and fetal acid-base balance.

The placental transport of alcohol and its effect on maternal and fetal acid-base balance studied in 10 sheep experiments by the maternal infusion of a 9.75 per cent solution of alcohol-dextrose at a rate of 15 c.c. per kilogram for 1 or 2 hours. Serial maternal and fetal blood sampling during and following the alcohol infusion revealed rapid placental diffusion of alcohol, a highly significant correlation between maternal and fetal blood alcohol concentrations, and a similar peak concentration of approximately 0.230 Gm. per 100 ml. in maternal and fetal blood that differed only in time of onset during the 1 and 2 hour infusion periods. Blood alcohol concentrations remained high for several hours during the postinfusion period. A significant maternal hyperlactacidemia and hyperglycemia were noted but did not result in significant alterations in maternal acid-base balance. An initial fetal metabolic acidosis and later mixed acidosis were observed during the alcohol infusion and worsened during the postinfusion period.

Acid-Base Equilibrium↗
PubMed1975

Cardiac performance during pregnancy: serial evaluation using external systolic time intervals.

Indirect systolic time indices were used to evaluate serial changes in left ventricular function during pregnancy in 13 normal patients and five patients with compensated cardiac conditions. Changes in both groups tended to parallel each other. In both groups, serial LVET index decreased, PEP index increased, and PEP/LVET ratio increased. Q-S2 index decreased in the normal group in midpregnancy and was inconsistent in the cardiac group. In the immediate postpartum period, LVET index returned to baseline values but PEP and PEP/LVET remained increased in both groups. Results of multiple comparison tests demonstrated that the largest (or smallest) value of each systolic time interval during pregnancy was observed in either the periods of the weeks 28 to 34 or 34 to 38. No significant differences were noted in intergroup comparison between the normal and cardiac groups. These data suggest that consistent changes in cardiac function may be determined during pregnancy by the noninvasive technique of indirect systolic time interval evaluation. These changes may reflect a change in left ventricular contractility, preload or afterload. The differences may persist even in the immediate postpartum period when cardiac output and heart rate have decreased to normal, suggesting residual changes in intrinsic left ventricular function. In patients with compensated heart disease, indirect tests of left ventricular function generally reflect the changes in normal pregnant women.

Adolescent↗
PubMed1975

Priming of the uterine cervix with oral prostaglandin E2 in the term multigravida.

A double-blind study evaluating two dose schedules of oral prostaglandin E2 (PGE2) was conducted in 56 normal "unripe" multiparas at term. The effect of PGE2 was evaluated by comparing the change in Bishop score of the cervix and patient's response to oxytocin induction of labor after the prostaglandin priming. In the two study groups (one group on a fixed PGE2 dosage and the other on a variable drug regimen) an average change of more than three points in the Bishop score was observed. In control group no significant change in cervical ripeness was observed. Nine of the 32 patients (28%) receiving prostaglandin delivered during the priming phase of the study, whereas only 1 control patient (4.2%) delivered during priming. Six of 24 control patients (25%) failed to deliver, wheras only 3 of 32 study patients (9%) failed. In the successfully induced patients, the response to oxytocin, as expressed by the time to active phase, total time of labor, and mean dose of oxytocin required, did not vary significantly when control and study groups were compared. It is concluded that PGE2 at either dosage schedule is effective in changing the Bishop score of the cervix and that it is not feasible to titrate the PGE2 dose in order to effectively ripen the cervix without a very high incidence of induction of labor. In those cases where priming was completed, without accidental delivery, the induction phase was successful more than 90% of the time. No adverse effect to mother or baby was observed during this study.

Administration, Oral↗
PubMed1975

Correlation of fetal heart rate-uterine contraction patterns with fetal scalp blood pH.

The significance of fetal heart rate-uterine contraction (FHR-UC) monitoring as a means of predicting the condition of the fetus during labor was studied by correlating 460 fetal pH determinations obtained from 216 patients with the analysis of the 20-minute FHR-UC record preceding the fetal scalp blood sample. Both qualitative and quantitative analyses of the FHR-UC record were performed. The results indicate a less than 10% chance of fetal pH less than or equal to 7.250 with an normal baseline FHR and no periodic changes or with periodic accelerations, early decelerations, and uncomplicated baseline bradycardia or tachycardia. Variable or delayed decelerations with a total surface area (TSA) of 1-100 for the 20-min period were associated with a fetal pH less than or equal to 7.250 in 23 and 34% of cases, respectively. Variable or delayed decelerations with a TSA greater than 100 had a 35 or 47% chance of fetal pH less than or equall to 7.250. It is concluded that FHR-UC monitoring can be used to screen the innocuous from the ominous periodic change but that fetal scalp blood pH must be obtained to identify accurately the true from the false-positive ominous pattern.

Female↗