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Biomedical subjects

M Koivisto

Publications and source records attributed to M Koivisto.

At least 73 records · Page 4Linked to original sources
PubMed1988

Two cases of large placental chorioangioma with fetal and neonatal complications.

Two cases of infants born from pregnancies complicated by large placental chorioangiomas causing congestive heart failure in the neonate as the main complication are presented. Chorioangiomas may be diagnosed early in pregnancy by ultrasound examination. Since both their maternal and their neonatal complications may indicate premature termination of the pregnancy or be conducive to premature birth, repeated ultrasound examinations, including fetal echocardiography, are suggested in order to optimize the timing of the delivery.

Adult↗
PubMed1987

Cry analysis in infants with Rh haemolytic disease.

The influence of hyperbilirubinaemia on the infants' cries and the feasibility of the use of cry analysis for the early identification of developing kernicterus were studied by analyzing the cries of 100 healthy one-day-old infants and 31 infants with Rh haemolytic disease of the newborn (Rh-HDN) by using sound spectrographic methods. The newborn infants with Rh-HDN were divided into three subgroups according to the findings in a neurological examination: an evident group (10 infants), a transient group (13 infants) and an asymptomatic group (8 infants) and followed up until one year of age. Cry recording and a neurological examination were carried out once for each of the healthy one-day-old infants and twice a day during the first week of life for the infants with Rh-HDN, and thereafter once a day until discharged and at the ages of 1 and 3 months. Additional neurological examinations were performed on the Rh-HDN infants at the ages of 6 and 12 months. Bilirubin determination was carried out in connection with the cry recordings during the first week of life. The effect of blood exchange transfusion on the cry sound was investigated in infants with a bilirubin level above 250 mumol/l (n = 12) and below this level (n = 15) before the procedure. An electroencephalography (EEG) was recorded once during the neonatal period and once during the follow-up. The cries of the healthy infants were used to develop a cry score comprising 16 characteristics (latency, duration of phonation, maximum and minimum pitch of fundamental frequency, occurrence and maximum pitch of shift, glide, melody form, biphonation, furcation, noise concentration, voice quality, double harmonic break, glottal plosives, vibrato and glottal roll), which was then applied to the analysis of the cries of the 31 infants with Rh-HDN. In addition, maximum pitch of fundamental frequency, furcation and combination of biphonation and/or furcation were studied. The cry score and maximum pitch of fundamental frequency increased most obviously in the infants in the evident group as compared with the values after birth in the various subgroups and with the values of the healthy one-day-old infants or the infants in the asymptomatic group day by day. Both parameters also increased in the asymptomatic group between days 2 and 3 as compared with the initial value after birth and with the healthy infants.(ABSTRACT TRUNCATED AT 400 WORDS)

Crying↗
PubMed1987

Pharmacokinetics of clonidine during pregnancy and nursing.

Pharmacokinetics of clonidine were examined in ten women during pregnancy, in nine during nursing, and in the newborns of these women. Clonidine crosses the placenta easily, and its concentrations were equal in maternal serum and umbilical cord serum. Amniotic fluid concentrations were up to four times that found in serum. Clonidine concentrations in milk were roughly twice that in maternal serum; in the serum of the newborns the concentrations were about half those of the mothers. All concentrations corresponded well to the doses of the drug. The neurologic examinations and assessments of serum electrolytes and blood glucose showed results parallel with those of newborns of nontreated mothers.

Amniotic Fluid↗
PubMed1985

Metoclopramide and breast feeding: efficacy and anterior pituitary responses of the mother and the child.

The purpose of this randomized, double-blind clinical study was to evaluate the efficacy of the antidopaminergic agent metoclopramide (MC) in the treatment of puerperal lactational insufficiency, and prolactin, TSH and free thyroxine responses of the mother and the child to this therapy. Therefore, 11 women received MC (10 mg 3 times daily orally) and 14 a placebo for 3 wk. MC increased the serum concentration of PRL from 57.5 + 45.5 U/l to 315.0 + 300.0 U/l (P less than 0.001), and the amount of daily milk yield in 8 women with established lactational deficiency rose from 285 + 75 ml to 530 + 162 ml (P less than 0.01) while the placebo was ineffective. Serum concentrations of TSH and free thyroxine did not change during either of the treatments. Serum concentrations of PRL, TSH and free thyroxine in the infants were similar in both groups and remained unchanged throughout the study. Our results suggest that MC is useful in the treatment of deficient puerperal lactation, and it does not stimulate the pituitary lactotropes or thyrotropes of the nursing infants.

Adult↗
PubMed1985

Neonatal septicaemia.

A total of 410 proved cases of neonatal septicaemia from seven Finnish hospitals seen between 1976 and 1980 were reviewed. The annual incidence of neonatal septicaemia was 3 per 1000 births, and overall mortality was 23%. Onset was early in most patients. Symptoms of septicaemia occurred within the first 24 hours of life in 44% and within the first week of life in 90%. In the very early onset disease (within 24 hours) mortality was 30%, compared with 17% in all other cases. Group B streptococcus was the leading cause in very early onset disease (52%) but mortality from infection with this organism was similar to that in other very early onset cases. It is concluded that very early onset neonatal septicaemia, probably of intrauterine origin and caused by group B streptococcus in one half of the cases, constitutes the major form of neonatal septicaemia in Finland and should receive the highest priority in preventive measures.

Enterococcus faecalis↗
PubMed1984

Hormonal changes during the perinatal period: FSH, prolactin and some steroid hormones in the cord blood and peripheral serum of preterm and fullterm female infants.

Fetoplacental endocrine function during the last third of gestation, and first 5 days post partum, was studied by hormone measurements of umbilical cord arterial and venous serum in preterm (31-37 weeks gestation) and fullterm (39-42 weeks gestation) female newborn. Furthermore, hormones were measured in peripheral serum of fullterm female infants of 1, 3 and 5 days of age. The data were compared with those obtained previously in corresponding age groups of males. FSH was significantly (P less than 0.05) higher in the cord serum of preterm females (5.4 +/- 1.8 IU/I, SE, n = 30) than in males (1.5 +/- 0.08 IU/l, n = 27), and decreased significantly (P less than 0.05) in preterm females towards fullterm. PRL levels increased in both sexes towards the end of gestation (P less than 0.01), and decreased post partum, but no sex differences could be detected. Testosterone was significantly higher in the male serum samples (P less than 0.01-0.05), but only minor sex differences were seen in cord serum, or post partum, concentrations of the other steroids measured, pregnenolone, progesterone, 17-hydroxyprogesterone and androstenedione. Significant arterio-venous difference (higher in the vein) were seen at term in progesterone and 17-hydroxyprogesterone. The levels of these two steroids also decreased most clearly after birth. Female serum testosterone peaked at d 1 post partum (0.084 +/- 0.014 microgram/l, SE, n = 11), decreased thereafter, but remained at the intrauterine level, suggesting that the low female levels of this steroid are of fetal, rather than placental/maternal origin. The same seems to be true for androstenedione. Our data suggest that the fetal ovary is quiescent during the last weeks of gestation.

Androstenedione↗
PubMed1983

Metoclopramide and breast feeding: transfer into milk and the newborn.

The pharmacokinetics and endocrinological effects of metoclopramide were investigated in 5 mothers with deficient lactation and in their children soon after delivery. In addition, the transfer of metoclopramide into breast milk was evaluated in 18 mothers during the 8th to 12th puerperal weeks. Metoclopramide was detected in all the milk samples studied, generally at a higher concentration than in maternal plasma. Metoclopramide was found in plasma from only 1 of the 5 neonates studied. Exposure of the child to metoclopramide, estimated by multiplying the daily breast milk volume by the concentration of metoclopramide in the milk, ranged from 6 to 24 micrograms/kg/day for the 5 children in the early puerperium to 1 to 13 micrograms/kg/day for the 18 children during the late puerperium. These quantities are considerably less than the therapeutic dose of 500 micrograms/kg/day recommended for children. However, the plasma concentration of prolactin in 4 out of 7 neonates sampled taken during administration of metoclopramide to the mother were higher than the highest plasma prolactin level in children of same age of untreated mothers. The plasma concentration of thyrotrophin in the newborns remained within the normal range.

Female↗
PubMed1983

Seasonal variation in serum-25-OH-D3 in mothers and newborn infants in northern finland.

Two groups, each consisting of twenty Finnish mother-neonate pairs and ten non-pregnant controls were studied for serum calcium, serum phosphate, serum alkaline phosphatase, parathormone index (PTHind) and S-25-OH-D3. The first series was collected in winter and the other in summer. The serum samples were taken on the third day after delivery. The concentrations of S-25-OH-D3 were significantly lower in the mothers than in the non-pregnant controls in winter, but the difference was not significant in summer. The concentrations of S-25-OH-D3 in the serum of the mothers were similarly significantly lower in winter than in summer, ten mothers exhibiting a value below the detection line in winter, but only two in summer. The concentrations of S-25-OH-D3 in the mothers and their newborn infants showed a close relationship, but when extremely low values existed in the mothers, the infant concentrations were slightly higher. The seasonal variation in S-25-OH-D3 was also significant in the neonates. Although calcium was decreased and alkaline phosphatase elevated when compared with the non-pregnant controls in the mothers in both groups, these values showed no seasonal variation, and the mean levels of serum calcium, phosphate, alkaline phosphatase and PTHind in the neonates also remained unaltered between the two groups. The results indicate that additional vitamin D should be supplied during pregnancy in the winter months at this latitude.

Adult↗
PubMed1983

Early closure of patent ductus arteriosus with indomethacin in preterm infants with idiopathic respiratory distress syndrome.

Thirty-seven preterm infants with idiopathic respiratory distress syndrome were prospectively studied for the effect of the early closure of patent ductus arteriosus with indomethacin on the course of idiopathic respiratory distress syndrome. Serial retrograde aortograms were performed in all infants in order to visualize the ductus arteriosus, apart from three patients, who died early and were evaluated aortographically only once. The ductus was initially open in 27 infants and closed in 10 infants. The infants with open ductus arteriosus were randomly divided into two groups. The first group consisted of 13 infants, in whom the ductus was closed with indomethacin at a median age of 18 hours. The other 14 infants served as controls. Total time on assisted ventilation and duration of exposure to additional oxygen were significantly shorter in medicated infants than in controls. Oxygenation of infants with an initially closed ductus was better from birth and duration of their ventilatory assistance and oxygen exposure were shorter than in infants with initial ductal shunting. The data suggest that the early closure of the patent ductus arteriosus with indomethacin in distressed preterm infants has a favourable effect on the course of idiopathic respiratory distress syndrome.

Clinical Trials as Topic↗
PubMed1983

Deoxycholic and sulpholithocholic acid concentrations in serum during infancy and childhood.

The concentrations of the two secondary bile acids (deoxycholic (DCA) and sulpholithocholic (SLCA) acid) were determined by radioimmunoassays in the serum of infants and children at ages ranging from 1 hour to 15 years. The same bile acids were measured also in the umbilical cord serum. The concentrations of the secondary bile acids in the serum of 1-hour old infants corresponded to those in the umbilical cord serum. Secondary bile acid serum concentrations were after the age of 7 days and up to the age of 3 to 6 months significantly lower than those in the umbilical cord serum. After the age of 6 months a significant increase in DCA serum concentrations could be shown. During the first 6 months of life DCA concentrations were clearly lower than those of SLCA. Our observations suggest that in the perinatal period DCA is mainly of maternal origin and that an alternate hepatic pathway may exist for the synthesis of lithocholic acid in early infancy.

Adolescent↗
PubMed1983

Pancreatic islet cell function and metabolic control in an infant with permanent neonatal diabetes.

A girl with typical clinical manifestations of neonatal diabetes was observed for 16 months with consecutive evaluations of pancreatic beta- and alpha-cell function and metabolic control. At the diagnosis both the plasma immunoreactive insulin (IRI) and C-peptide concentrations were inappropriate for the contemporaneous hyperglycemia. During the follow-up, the C-peptide fell twice below the detection limit but the beta-cell function recovered partially on both occasions. Based on 24-hour urinary C-peptide excretion, the endogenous insulin secretion was less than 10% of that in non-diabetic infants. When diagnosed the patient had plasma immunoreactive glucagon (IRG) and glucagon-like immunoreactivity (GLI) concentrations below the reference range for normal neonates. The IRG normalised within the first month, while the GLI increased to a level exceeding the reference range. Hemoglobin A1 had already risen at the time of diagnosis and subsequently rose to a level indicating poor metabolic control. The findings indicate an immature function of both beta- and alpha-cells at the diagnosis with the alpha-cells maturing within the first month. The recovery of the beta-cell function, after two failures in this patient with permanent neonatal diabetes, suggests that the beta-cell damage was at least partially reversible.

Diabetes Mellitus, Type 1↗
PubMed1983

Cell-mediated immunocompetence of children exposed in utero to short- or long-term action of glucocorticoids.

In the present study the in vitro sensitivity to mitogens (phytohemagglutinin, PHA, concanavalin A, Con A) and purified protein derivative (PPD) antigen of lymphocytes of children exposed in utero to short-term (n = 7) or long-term (over the whole pregnancy, n = 9) action of synthetic glucocorticoids was evaluated. Blood samples from these children and their age- and sex-matched controls were collected 3-4 and 3-10 years after delivery in the short-term and long-term exposure groups, respectively. After short- and long-term exposure to glucocorticoids the counts of all lymphocytes and alpha-naphthyl-acetate-esterase-positive lymphocytes in the peripheral blood, and the responses of T lymphocytes to mitogens or PPD antigen were similar in the subjects and their controls. The present data thus provide additional evidence of the safety of prenatal glucocorticoid prophylaxis for respiratory distress syndrome. Fetal lymphocytes also seem to be resistant to the extended action of exogenous glucocorticoids.

Child↗
PubMed1983

Serum calcium and 25-OH-D3 in mothers of newborns with craniotabes.

Serum calcium and 25-OH-D3 in mothers of newborns with craniotabes. The aim of this study was to investigate whether calcium or vitamin D balance during late pregnancy have influence on the outcome of newborn craniotabes. 27 mothers and their fullterm newborns with craniotabes in two series were studied for clinical findings, course of pregnancy and calcium and vitamin D metabolism after the pregnancy. Calcium and phosphorus balance were studied in the first 16 mother-newborn pairs and were studied in the first 16 mother-newborn pairs and compared to a control group. Serum 25-OH-D3 concentrations were determined in the next 11 pairs and compared to a control group delivering in the same season and also to unpregnant women. The course of pregnancy did not show retrospectively any significant alterations and the clinical findings except craniotabes of the newborns were normal. In four cases the fetal head was engaged before 33th of gestation. In mothers serum calcium level was lower (p less than 0.05) and the excretion of phosphorus decreased (p less than 0.05) after the pregnancy as compared to controls. The values of serum 25-OH-D3 were at the same level in mothers and newborns with craniotabes as compared to controls but the values of mothers were lower (p less than 0.001) as compared to unpregnant controls In conclusion, craniotabes of the newborns seems to have no unique etiologic factor. The changes of calcium and vitamin D metabolism during pregnancy may be considered as predisposing factors in some cases and early engagement in some other. Perhaps also other reasons can be found.

Alkaline Phosphatase↗
PubMed1983

Factors related to an improved outcome for twins.

We observed that perinatal mortality among the 220 twins born at our hospital in 1977-78 (3.6%) was significantly lower than for the 210 twins born in 1975-76 (11.0%). At the same time the frequency of postpartum asphyxia had decreased significantly. An analysis of factors related to the diagnosis and therapy revealed that during the later period both the diagnosis of twins and bed rest in hospital had been initiated significantly earlier than during the former period. The duration of pregnancy, length of stay in hospital, use of beta-adrenergic drugs or glucocorticoids, duration and type of delivery and birthweight of the infants were similar in both groups. Early diagnosis permits the greatest degree of readiness for both the mothers and the obstetrical and pediatric personnel in order to meet the possible complications commonly associated with a twin pregnancy and birth.

Asphyxia Neonatorum↗
PubMed1983

Effect of segmental epidural analgesia on neonatal serum bilirubin concentration and incidence of neonatal hyperbilirubinemia.

Neonatal serum bilirubin levels were determined at the ages of 12 hrs, 2 days, 3 days, 4 days and 5 days in 80 infants. Forty-three mothers had received segmental epidural analgesia at the height of Th 10-12 for pain relief during the first stage of labor. The analgesic agent used was 0.5% bupivacaine. The individual doses were of 4 ml. Thirty-seven mothers served as a control group. The groups were further divided into smaller groups according to whether oxytocin was used for induction or acceleration of labor--or not. The results showed no statistically significant differences in the neonatal serum bilirubin levels at different times between the epidural and the control groups, whether oxytocin was used or not. Nor did the incidence of neonatal hyperbilirubinemia cases differ between the groups.

Anesthesia, Epidural↗