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Biomedical subjects

L Stånge

Publications and source records attributed to L Stånge.

10 recordsLinked to original sources
PubMed1990

When does external cephalic version succeed?

From 1984 to 1987, 300 pregnant women with fetal malpresentations underwent an attempt at external cephalic version (ECV) during the last trimester. A consecutive analysis of factors associated with successful version was performed during this period. The final version rate after one or more attempts was 58%, being lower in nulliparous (39%) than in parous women (80%). Multivariate analyses (logistic regression) identified only three significant variables out of 16 with independent power to explain successful version. The overall most important factor was parity (p less than 0.001), followed by fetal presentation (p less than 0.001) and amount of amniotic fluid (p = 0.019).

Breech Presentation↗
PubMed1985

Surveillance of the diabetic pregnancy with antepartum fetal nonstress testing and urinary estriol excretion.

The value of daily fetal heart rate (FHR) nonstress test (NST) and 24-hour urinary excretion of estriol (E3) were compared in a consecutive series of 76 diabetic pregnancies. The NST scoring system (0-10 points) employed included monitoring of fetal movements in addition to evaluation of FHR decelerations, accelerations as well as frequency and amplitude of oscillations. Patients were delivered electively after 38 weeks of gestation unless spontaneous labor began earlier or if delivery was indicated for either maternal reasons or presumed fetal distress. Fetal distress was believed to be present if two consecutive NST scores were 6 points or less. Seven patients had a day-to-day E3 fall of 50% or more at least once. Six of these patients had normal NST scores and 5 of the infants showed no signs of asphyxia at delivery. Forty-two patients had E3 drops of 30-50% and 27 patients had E3 drops of less than 30%; in contrast, the NST scores were 6 or less in 15 patients but were normal the next day. These data indicate that measurements of urinary excretion of E3 give many false alarms of fetal jeopardy and that daily NST can replace measurement of urinary excretion of E3 and reduce unwarranted intervention and unnecessary prematurity.

Estriol↗
PubMed1983

Maternal blood flow and PO2 changes during abdominal decompression treatment of poor intrauterine fetal growth.

Maternal blood flow and tcPO2 were measured together with fetal heart rate during decompression treatment of four cases of poor intrauterine fetal growth. Increase in maternal blood flow was recorded when decompression was applied. Maternal tcPO2 and the fetal heart rate were not significantly changed during the treatment sessions. The results indicate that the mechanism of action for better intrauterine growth after treatment is related to increased placental blood flow. The treatment does not exert changes of maternal haemodynamics leading to possible damage for the fetus.

Decompression↗
PubMed1983

Insulin-induced hypoglycemia in pregnant diabetics. Maternal and fetal cardiovascular reactions.

Insulin (0.1 IU/kg bw) was injected intravenously in 9 pregnant diabetics in the last trimester of pregnancy. Maternal levels of blood glucose, estriol, human placental lactogen, blood pressure and pulse rate were measured and fetal heart rate (FHR) recorded. During hypoglycemia maternal blood pressure remained unchanged but maternal pulse rate tended to increase. Plasma levels of estriol and HPL remained unchanged. In 6 of the 9 patients there was a decrease in FHR variability during the hypoglycemic period. FHR variability increased after normalization of maternal blood glucose levels. The decrease in FHR variability could be a direct effect of glucopenia on the fetal heart.

Adult↗
PubMed1981

Insulin-induced hypoglycaemia in diabetic women during late pregnancy and one year post partum.

Insulin (0.1 IW/kg) later followed by glucose was injected intravenously in nine diabetic women in the supine position both during pregnancy and one year post partum. C-peptide was present in five subjects, indicating some residual beta-cell function. Their mean basal C-peptide level, before insulin, was twice as high in the pregnant as inthe non-pregnant state. C-peptide decreased progressively after insulin. The mean basal plasma glucose level was lower during pregnancy (4.8 mmol/l) than after it (9.6 mmol/l), but decreased to the same level (2.2 mmol/l) after insulin. The rate of fall in glucose was thus lower during pregnancy (kt = 2.54) than after (kt = 4.08), but was unrelated to the basal glucose levels. Basal levels of free fatty acids (FFA), 3-hydroxybutyrate (3-HB), cyclic AMP, and lactate were similar, while glycerol was lower during pregnancy. Insulin-induced changes in FFA, glycerol, 3-HB, cyclic AMP, and lactate were similar during and after pregnancy. Plasma amino acid concentrations were generally lower in pregnancy, significantly so only for arginine and glycine. Amino acid levels were unaffected by insulin in pregnancy, whereas leucine, isoleucine and tyrosine decreased significantly in the non-pregnancy, whereas leucine, isoleucine and tyrosine decreased significantly in the non-pregnancy, whereas leucine, isoleucine and tyrosine decreased significantly in the non-pregnancy state. We conclude that there are differences in metabolic responses to insulin in diabetic women during and after pregnancy, indicating a decreased sensitivity to insulin during pregnancy in some tissues.

3-Hydroxybutyric Acid↗
PubMed1979

Fetal tcPO2 and FHR variability.

The variability of fetal heart rate, expressed as oscillation amplitude, was correlated to fetal tcPO2 in mothers during normal labor without administering analgesics. There was no correlation between tcPO2 levels and FHR variability. Changes in tcPO2 occurred in a few cases simultaneously with FHR variability, but no consistent pattern could be established.

Blood Gas Analysis↗
PubMed1978

Hypervitaminosis a in early human pregnancy and malformations of the central nervous system.

A case of malformations of the fetal central nervous system following hypervitaminosis A in early pregnancy is reported. The mother was treated with 150 000 IU vitamin A daily during gestation days 19 to 40. Determination of urinary oestriol carried out in the 42nd week of pregnancy revealed a very low excretion (4.2-6.6) mumol/24 h). Induced delivery resulted in a microcephalic child who died after 18 min. The child had multiple malformations of the central nervous system and very small adrenal glands (1.5 g; normal 11 +/- 4 g). The very low urinary oestriol excretion is well explained by the hypoplastic adrenals, which in turn can be related to insufficient ACTH stimulation, a condition similar to anencephaly. The malformations shown in the present case are considered to be related to the high doses of vitamin A given to the mother, and the authors wish to warn against uncritical use of high doses of vitamin A in whomen of childbearing age.

Abnormalities, Multiple↗
PubMed1977

Effects upon the fetus of oxygen administration to the mother. A study in monkey.

Catheters were placed into assorted arteries and veins of 8 anaesthetized pregnant monkeys and their fetuses. Oxygen-sensitive electrodes were also inserted subcutaneously into 3 of the 8 fetuses. Periodic samples of maternal and fetal blood were analyzed for PO2, PCO2 and pH. Oxygen administration to the mothers reliably increased the PO2 of blood taken from the fetal carotid artery and less constantly augmented the PO2 of blood withdrawn from the femoral artery and vein. During 5-6 hours of study the oxygen tension of fetal blood samples of all animals progressively declined. However, the most marked declines in PO2 values at all fetal sites were regularly observed at those times as--or after--the mothers emerged from anaesthesia. At these times also the magnitudes of the increases in fetal blood PO2 brought about by administering oxygen to the mothers diminished markedly and in parallel at all sample sites. The closely similar magnitudes of these various reductions at all fetal sample sties indicate that the basic mechanisms leading to decreased oxygen delivery lie outside the fetuses and are most likely due to decreased maternal blood flow to the uterus because of increased maternal sympathetic stimulation. These reductions in oxygen delivery to the fetus are all regularly reversed by reanasthetizing the mothers. The studies carried out with oxygen-sensitive electrodes demonstrate that administering oxygen to the mothers regularly increases oxygen tension of fetal tissues but after a 50 sec delay.

Animals↗
PubMed1977

Quantification of fetal heart rate variability in relation to oxygenation in the sheep fetus.

Beat-to-beat variability has been suggested as a sensitive indication of fetal well-being. The suggestion originates from case reports of observed decrease in variability preceding clinical signs of fetal asphyxia and fetal death. Against this background a study was performed to evaluate possible changes in heart rate variability in relation to changes in fetal oxygenation. Chloralose-anesthetized sheep were used. Short-term hypoxia was produced without acidosis. The FECGs were recorded on magnetic tape and later analysed by scrutinizing each QRS complex prior to the trigger of a rate meter. The differential index (DI) described by Yeh and co-workers was chosen because it is easily computed and reflects the variability of coefficient of variation for two successive R-R intervals. In contrast to the generally held view of a progressive diminution of variability during the development of asphyxia, the variability was found to increase parallel with a decrease in fetal arterial PO2 determined on blood samples withdrawn at intervals and ranging between 26 and 10 mmHg. The correlation between variability and PO2 in the range below 8-10 mmHg is still to be determined.

Animals↗