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Biomedical subjects

L Spätling

Publications and source records attributed to L Spätling.

At least 37 records · Page 2Linked to original sources
PubMed1992

The variability of cardiopulmonary adaptation to pregnancy at rest and during exercise.

OBJECTIVE: To examine the cardiopulmonary adaptation to normal pregnancy in sitting women during rest and bicycle exercise. DESIGN: A longitudinal study beginning early in pregnancy and ending 8-12 months after delivery. SETTING: University Hospital, Zurich, Switzerland. SUBJECTS: 20 women were monitored every second week during pregnancy from 8 to 14 weeks gestation, twice in the puerperium and twice 6-8 weeks and twice 8-12 months after delivery. All the women finished the study, but not all of them participated in every visit. MEASUREMENTS AND MAIN RESULTS: The results obtained 8-12 months after delivery are considered the non-pregnant data and are presented first so that any change in pregnancy will be more obvious. Values given below refer to the median except when stated otherwise. At rest: 1. Oxygen consumption increased significantly from a median of 182 ml/min in the non-pregnant state to 256 ml/min by 8-11 weeks gestation, and peaked at 300 ml/min at 32 weeks. At 6-8 weeks after delivery the value was 225 ml/min. 2. Oxygen consumption per kg increased significantly from 3.0 ml/min in the non-pregnant state to 4.3 ml/min by 8-11 weeks gestation and peaked at 5.0 ml/min soon after delivery. At 6-8 weeks after delivery the value was 3.4 ml/min. 3. Carbon dioxide production generally showed changes similar to those of oxygen consumption. 4. Respiratory quotient did not show any significant changes. 5. Ventilation increased from a median of 9.4 l/min in the non-pregnant state to 10.5 l/min by 8-11 weeks and then slowly increased to 12.6 l/min in late pregnancy. 6. Respiratory rate did not change significantly. 7. Tidal volume showed a median of 563 ml in the non-pregnant women and rose significantly to 632 ml in early pregnancy, peaking at 715 ml in late pregnancy. 8. Alveolar ventilation increased significantly from a non-pregnant value of 3.4 l/min to 6.2 l/min in early pregnancy, peaking at 6.7 l/min at term; 6-8 weeks after delivery the value was 4.5 l/min. 9. Ventilation equivalent for oxygen fell significantly from the median non-pregnant value of 52 to 42 in early pregnancy and remained at that level until 6-8 weeks after delivery when it was 44. 10. Ventilation equivalent for carbon dioxide showed similar changes to those for oxygen. 11. Alveolar carbon dioxide tension fell significantly from a median non-pregnant level of 4.6 kPa (34 mmHg) to 4.0 kPa (30 mmHg) in early pregnancy. It began to increase in the puerperium and was 4.3 kPa (33 mmHg) 6-8 weeks after delivery. 12. Mixed venous carbon dioxide tension fell significantly from a median of 5.9 kPa (44 mmHg) to 5.2 kPa (39 mmHg) during pregnancy. 13. Transcutaneous carbon dioxide tension decreased significantly in early pregnancy from 8.8 kPa (66 mmHg) in the non-pregnant women, and from 20 weeks gestation remained at 6.9 kPa (52 mmHg). 14. Transcutaneous oxygen tension showed a non-significant increase from 10.0 kPa (75 mmHg) in the non-pregnant women to 11.1 kPa (83 mmHg) during pregnancy. 15. Cardiac frequency increased gradually from a non-pregnant median of 80 b.p.m. to about 90 b.p.m. in the last 2 months of pregnancy. In the puerperium the median was 75 b.p.m. 16. Cardiac output increased significantly by almost 50% from the non-pregnancy level to that at 8-11 weeks gestation. 17. Cardiac output per kg also increased significantly by 50% from the non-pregnant level to that at 8-11 weeks gestation. From mid-pregnancy there was a gradual fall until delivery. 18. Stroke volume increased significantly from a median of 31 ml in the non-pregnant state to 51 ml in early pregnancy, and remained at this level until delivery. In the puerperium the stroke volume was 63 ml. 19. Oxygen pulse increased significantly from a median of 2.2 ml in the non-pregnant women to 3.1 ml in early pregnancy and remained at that level. 20. Individual curves.(ABSTRACT TRUNCATED AT 400 WORDS)

Adaptation, Physiological↗
PubMed1990

[Magnesium, calcium, hemoglobin, hematocrit, estriol and human placental lactogen with magnesium substitution in pregnancy].

In a randomised double-blind study 568 women were given orally either 15 mmol magnesium-aspartate hydrochloride per day or aspartic acid as placebo. The outcome of pregnancy was significantly improved in the magnesium group (fewer maternal hospitalisations, reduction in preterm delivery and less frequent referral of newborn to the neonatal intensive care unit). In the 437 patients with regular intake of tablets, haematocrit, haemoglobin and calcium show a decrease up to 20 weeks of gestation (wks) and an increase during the last 8 wks, whereas magnesium stays at a low level. Oestriol and HPL are rising steadily during gestation. In all parameters, no differences were found between the magnesium and placebo group, except for a higher level of oestriol at 33 to 36 wks and a lower level above 36 wks in the magnesium group. Because of the numerous benefits throughout the pregnancy magnesium supplementation is recommended for all pregnancies.

Aspartic Acid↗
PubMed1989

Bolus tocolysis: treatment of preterm labor with pulsatile administration of a beta-adrenergic agonist.

The treatment of premature labor with beta-adrenergic substances is complicated by side effects. Although most human control mechanisms are pulsatile, therapy is usually administered continuously. We designed a microprocessor-controlled pump to allow pulsatile tocolytic infusion, hoping to reduce the total dose and thus the side effects. In 33 patients pulsatile bolus tocolysis was compared with continuous tocolysis in a control group of 38 patients. Bolus tocolysis required considerably less beta-sympathomimetic agent for comparable therapeutic success (median dosage 3.0 versus 15.9 mg, p less than 0.001). Duration of therapy under bolus tocolysis was also significantly shorter (p less than 0.05). Birth weight was higher after bolus tocolysis (median 3070 versus 2580 gm, p = 0.05). Additional indicators favored bolus tocolysis but were not statistically significant: a longer gestational period, fewer infants weighing less than 2500 gm, and a lower incidence of respiratory distress syndrome. Pulmonary edema occurred in one patient during continuous tocolysis.

Adrenergic beta-Agonists↗
PubMed1989

Magnesium in pregnant women and the newborn.

In this article the importance of Mg for pregnant women and fetal outcome is reviewed. The physiological changes of Mg-containing body fluids and of tissues are discussed. Mg supplementation during pregnancy seems to be necessary and the efficacy on maternal health and on the newborn are reported. Serum Mg levels decrease during pregnancy and there is a 25% increase of renal Mg excretion. Mg supplementation has a positive effect, with reduced incidence of hospital admission and preterm labour, while the gestational age of the fetus is longer. Convulsions may occur in newborns with hypomagnesaemia. Hypermagnesaemia of the newborn following MgSO4 infusions to toxaemic mothers has been reported.

Female↗
PubMed1988

[Performance training in pregnancy. Report of respiratory and cardiovascular physiologic changes in a pregnant high-performance athlete in comparison with a sample of normal pregnant patients].

Against the background of dramatic changes that took place in the history of sports during the past one hundred years, we are today discussing with regard to the compatibility of sport and pregnancy whether the extent of sports activities before pregnancy contributes to the amount of stress tolerated during pregnancy. Animal experimental studies on the effect of physical stress on the foetus cannot always be transferred to man, and hence recommendations made to pregnant women are often purely empirical. The article reports on the results of an examination of a professional woman athlete during pregnancy: Various maternal circulatory and respiratory parameters were recorded in this primigravida of 25 years of age, who had been regularly active as a competitive runner for 12 years, during the 24th week of pregnancy and from the 28th week of pregnancy onwards, at intervals of 14 days and post partum, at rest and during steady-state load on a bicycle ergometer (6 minutes each at 40 and 70 watts load, respectively) and a step-by-step load increasing every minute by 15 watts until attainment of a maternal heart rate of 150 beats per minute. The results were compared with those in a group of pregnant women who had not been competitive sportswomen. During continued training as per schedule up to the 36th week of pregnancy of the athlete, there was hardly any change in performance, and there was a marked difference against the other women. The pulse at rest was lower by a mean of 30 beats in the athlete during pregnancy, clearly indicating maintenance of the economic cardiac mechanism known to occur in trained persons, which produces a greater cardiac output via an increased stroke volume at a lower heart rate. This difference was impressively demonstrated under different loads. Another example of more economic management of an identical load is also seen, for instance, in the lower oxygen uptake and lower respiratory rate. Even at a maternal heart rate of 150 beats per minute the foetus of the athlete did not show any signs of stress under test conditions. In a measurement "at site" during the 38th week of pregnancy under routine and training conditions with relevant sprints and a maternal heart rate increase to more than 170 beats per minute, however, foetal behaviour displaying bradycardia clearly showed the existence of tolerance limits for foetal supply.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1988

Magnesium supplementation in pregnancy. A double-blind study.

The effect of magnesium supplementation in pregnancy was studied in 568 women who were treated with 15 mmol magnesium-aspartate-hydrochloride per day or aspartic acid as placebo given orally during pregnancy from less than or equal to 16 weeks. Allocation to the two groups was performed according to the women's birthdates. Magnesium supplementation during pregnancy was associated with significantly fewer maternal hospitalizations, a reduction in preterm delivery, and less frequent referral of the newborn to the neonatal intensive care unit. The results suggest that magnesium supplementation during pregnancy has a significant influence on fetal and maternal morbidity both before and after delivery.

Adult↗
PubMed1986

Effect of ritodrine and betamethasone on metabolism, respiration, and circulation.

In order to obtain information on pharmacologic side effects of the most commonly used betamimetic in obstetrics, ritodrine (R) was infused under standardized, controlled conditions in one male and four nonpregnant female volunteers in increasing doses from 0.9 to 7.2 micrograms/kg/min. In second series, the same was done after premedication with 12 mg betamethasone (B), intravenously, 30 minutes before the start of the R infusion. Ritodrine caused increases in cardiac and respiratory work that were associated with rises in energy requirements and impaired efficiency of breathing. Premedication with betamethasone potentiated all side effects with the exception of diffusion capacity.

Adult↗
PubMed1985

Influence of different prostaglandin applications on cervical rheology.

The softening effect of prostaglandin (PG) on cervical tissue prior to elective pregnancy termination is quantified by a new technique for the measurement of the elastance and relaxation of the cervix. The method is based on the pressure-volume relation of a compliant balloon placed in the cervical canal. These properties have been measured before and after different applications of prostaglandins in 58 patients electively terminating pregnancy. Application techniques used included high pressure jet application of PGE2 into the tissue of the portio uteri and the internal cervical os (120 micrograms), PGE2 and PGF2 alpha in Tylose gel (100 micrograms/0.5 ml); PGE2 as an intracervical tablet (150 micrograms) and PGE2 oral tablets placed into the posterior fornix of the vagina. Significant changes in cervical elastance were seen with the intracervically applied PGE2 in Tylose gel and the vaginally applied PGE2 tablets. The intracervically applied PGE2 gel also gave significant changes in cervical relaxation. No side effects other than mild cramping (2 patients) were seen with any of the applications in this study.

Abortion, Induced↗
PubMed1984

[Additional magnesium therapy in tocolysis: clinico-chemical monitoring parameters].

Pregnancy can result in magnesium deficiency, which may precipitate premature labour usually reversed by betamimetic therapy. Inclusion of magnesium in tocolytic therapy is useful for possible reduction of premature labour as well as for cardioprotection. 35 patients with premature labour received Fenoterol + 20 mmol/day magnesium aspartate hydrochloride (Mg-asp-HCl) orally or 30 or 40 mmol/day Mg-asp-HCl and magnesium sulphate (MgSO4) (1:1) i.v. Before and during this therapy, Mg, Ca, K, Na, Cl, creatinin and urea as well as human placental lactogen (HPL) and oestriol (E3) were determined. There were no significant changes in the level of these under oral magnesium therapy. Under intravenous administration, plasma levels of magnesium rose significantly. In the following weeks, the levels dropped in spite of continuing the therapy. The other parameters showed no important changes. Under i.v. administration of 40 mmol/day Mg-asp-HCl, the HPL increase was highly significant. If this could be taken as a hint of better placental function such a positive side effect of magnesium therapy could prove beneficial to "small-for-age" foetuses. Co-medication of 20 mmol/day Mg-asp-HCl (oral) or 40 mmol/day Mg-asp-HCl and MgSO4 (1:1, i.v.) is recommended.

Adolescent↗
PubMed1982

Influence of prolactin on metabolism and energy production in perfused corpus luteum bearing bovine ovaries.

Eight bovine ovaries with a corpus luteum were perfused for 4 h in a haemoglobin-free semi-synthetic perfusion medium in a closed circuit. After an initial prolactin (PRL)-free perfusion phase, 4.7 ng/ml ovine PRL was added in the 1st h, followed by 47 ng/ml in the 2nd h and 470 ng/ml in the 3rd h. Glucose and oxygen consumption and the production of lactate, pyruvate and CO2 were measured, while perfusion pressure and pH-value were recorded continuously. Under the influence of PRL anaerobic glucose metabolism was stimulated by 40.5% and oxidative phosphorylation was inhibited. Energy production from aerobic glucose metabolism rose by only 0.25%. Unlike PRL, Human Menopausal Gonadotropin (hMG) and Human Chorionic Gonadotropin (hCG) stimulated aerobic metabolism. This may indicate that PRL is the "older" hormone in phylleogenetic terms.

Animals↗