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Biomedical subjects

M Koivisto

Publications and source records attributed to M Koivisto.

At least 109 records · Page 6Linked to original sources
PubMed1978

Neurologic activity of infants following anesthesia for cesarean section.

Elective cesarean section was performed in a consecutive series of 30 patients with full-term pregnancies who were not in labor. Epidural (lidocaine, 1.5 per cent, with epinephrine, 1:200,000) and general anesthesia (thiopental, nitrous oxide-oxygen, succinylcholine infusion) was used alternately. Neonatal acid-base values and Apgar scores showed no significant difference between the two anesthetic groups, and most infants were vigorous at birth. The neurologic recoveries of the infants showed no significant difference between the two groups. In the group receiving epidural anesthesia, there was a significant correlation between maternal hypotension and weak rooting and sucking reflexes of the infants during the first two days. All infants of high-risk obstetric patients in the series, independent of anesthetic technique used, had abnormal neurologic activity, as evidenced by either depression of muscle tone and the reflexes or all the tested variables. Neurologic assessment as followed in this series is a sensitive indicator of the effects of fetal stress factors acting during cesarean section.

Adult↗
PubMed1978

Maternal, foetal and neonatal blood creatine-phosphokinase-activities and creatine-phosphokinase-isoenzymes after labour with and without epidural analgesia and after caesarean section.

Maternal, cord and neonatal blood creatine-phosphokinase (CK) activities and CK-isoenzymes were determined in connection with 24 labours after normal pregnancies. In eight cases there was a normal vaginal delivery; in another eight cases there was a normal vaginal delivery with segmental epidural analgesia; and in the remaining eight cases there was an elective caesarean section under general anaesthesia. The lowest maternal blood CK-activities were seen in connection with caesarean section. There was a statistically significant difference in the maternal CK levels after delivery between cases with caesarean section and normal labour (P less than 0.05) and between cases with caesarean section and labour with segmental epidural analgesia (P less than 0.001). Most of the maternal CK-activity was of muscular type, and there were no statistically significant differences in isoenzyme fractions between the different groups. The neonatal blood CK-activities were at their peak at the age of 1 day in all groups. Between the groups there were no statistically significant differences in cord or neonatal blood CK-activities at any time. Most of the cord and neonatal blood CK-activity was also of muscular type, and there were no significant differences in the CK-isoenzyme fractions between the groups.

Adult↗
PubMed1978

Umbilical cord and neonatal cortisol levels. Effect of gestational and neonatal factors.

To evaluate the effect of the type of delivery, gestational age, maternal dexamethasone treatment, and neonatal complications on the serum cortisol levels in early infancy, a total of 92 neonates were investigated with 611 cortisol determinations (specific radioimmunoassay after Lipidex chromatography). Umbilical cord blood samples were taken immediately after delivery and capillary blood samples from the infant's heel 30--60 minutes after delivery and at 8:00 AM and PM on the second, fourth, and sixth days of life. Umbilical cord cortisol concentration after elective cesarean section was lower than after emergency cesarean section or after normal vaginal delivery, while neonatal cortisol values did not show any correlation with the type of delivery. Prematurity did not affect neonatal cortisol levels. In postterm infants the activation of cortisol production was retarded to some degree. After maternal dexamethasone therapy, neonatal cortisol concentration decreased 30--60 minutes after delivery, but from the second day on it was at the same level as in infants without maternal therapy. Respiratory distress syndrome, especially in fatal cases, caused an elevation in neonatal cortisol levels, while hyperbilirubinemia did not have an effect on plasma cortisol concentrations of the neonates.

Adult↗
PubMed1977

Neonatal polycythemia and chest roentgenograms.

Chest roentgenograms of 34 newborns with a hematocrit of 75 or more at the age of 12 hours were studied. An analysis was made of the findings during the first four days of life and the results were compared with those of 18 newborns with a hematocrit of 65 or less. The cardiothoracic ratio (CTR) was found to be greater in the polycythemic infants than in the non-polycythemic infants, and greatest of all in infants with symptomatic polycythemia. Prominent pulmonary vascularity and pulmonary hyperaeration were seen more often in polycythemic newborns than in non-polycythemic infants. Eleven infants in the polycythemic group and three in the non-polycythemic group had some symptoms or signs.

Cardiomegaly↗
PubMed1977

Adrenocorticotrophic hormone during the first day of life.

The plasma concentration of ACTH (by radioimmunoassay) was measured in 56 healthy parturients and their newborns. Umbilical cord and maternal venous blood were collected immediately after delivery. In addition one venous blood sample was taken from 50 newborns at the age of 15, 30, 60 min, 2, 6, 12, or 24 h. The maternal and cord plasma ACTH levels were higher than the levels in healthy nonpregnant women. There are no differences between the mean maternal (226 +/- 146 pg/ml) and cord (226 +/- 147 pg/ml) values of ACTH. The high ACTH levels of cord plasma remain unchanged for 30 min, decrease significantly during the 1-6 h after birth, because of the elimination process of the circulated foetal ACTH, and increase over the next 12-24 h and slightly thereafter indicating an initiation of neonatal pituitary ACTH secretion. The plasma ACTH level in the mothers with membranes ruptured for 1-5 h was significantly (P less than 0.05) higher compared with that in the mothers with membranes ruptured for less than 1 h. However, the duration of ruptured membranes appeared to have no effect on the cord blood ACTH level.

Adrenocorticotropic Hormone↗
PubMed1977

ACTH levels in maternal, fetal and neonatal plasma after short-term prenatal dexamethasone therapy.

The effect of prenatal dexamethasone therapy (12, 8 and 4 mg doses given intramuscularly on three consecutive days) on ACTH levels in maternal plasma (n=33), mixed umbilical cord plasma (n=31) and plasma from the newborn (n=29) was studied, and the results were compared with those obtained in 56 healthy parturients and 50 of their newborn. Maternal ACTH after delivery was significantly lower in the mothers treated with dexamethasone than in the control group. Cord ACTH values were similar in the two groups. ACTH levels fell during the early neonatal period, but only at 12 to 24 hours were the ACTH levels significantly lower in the dexamethasone group than in the controls. Gestational age, birth weight and the interval between the dexamethasone therapy and delivery had no significant effect on cord ACTH levels. Short-term prenatal dexamethasone therapy seemed to have very little effect on ACTH secretion in the mother, in the fetus and in the newborn.

Adolescent↗
PubMed1976

Primary hypothyroidism, growth hormone deficiency and congenital malformations in a child with the karyotype 46,XY,del(1)(q25q32).

Primary thyroidal hypothyroidism, growth hormone deficiency, congenital malformations and mental retardation occurred in a child with an interstitial deletion of one of the No. 1 chromosomes. Two bands were missing, so that the karyotype could be written: del(1)(pter leads to q25::q32 leads to qter). The possible relationship between the clinical features and chromosomal deletion are discussed.

Abnormalities, Multiple↗
PubMed1975

Serum tri-iodothyronine, thyroxine, and thyrotrophin concentrations in newborns during the first 2 days of life.

The serum concentrations of tri-iodothyronine (T3), thyroxine (T4), and thyrotrophin (TSH) were measured in 10 term newborn infants between birth and the age of 2 days by radioimmunoassay. The mean concentration of T3 in maternal serum was 1.62 mug/l, and it increased from the low cord blood level of 0-63 mug/l to the peak value of 1-76 mug/l within the first 2 hours of life. Mean serum T4 concentrations increased from the cord blood level of 145 mug/l to the peak value of 205 mug/l within the first 24 hours of life. The postnatal increase of the mean serum TSH concentrations from the cord blood level of 5-7 mU/l to the peak value of 20-6 mU/l within 2 hours was similar to the increase of T3. These data confirm earlier reports which show that T3 secretion is low at birth and TSH secretion is stimulated strongly but transiently after birth, and that the low T3 secretion is rapidly normalized in 2 hours along with the TSH release. Because of these strong and rapid changes, we recommend screening of the function of the pituitary-thyroid axis in neonates after the age of 24 hours.

Adult↗
PubMed1975

Spectrographic analysis of pain cry in neonates with cleft palate.

52 phonations of 13 cleft palate neonates were analyzed by sound spectrographic methods. 17 phonetical attributes were included in the study and the first signal after the pain stimulus was analyzed. The cries of the cleft palate infants were compared with the crying of 75 normal babies of the same age. No change in the fundamental frequency, melody type and duration of the cries was seen in association with these anatomical defects. Two of the characteristics studied, vibrato and the 'tonal pit', occurred significantly more often in cries of the cleft palate infants than in cries of the control series. The changes in the qualities seen in association with cleft palate and/or cleft lip do not mimic the abnormalities produced by brain damage.

Cleft Lip↗
PubMed1975

Twin pregnancy. A clinical study of 335 cases.

In order to study the complications and therapeutic outcome of twin pregnancies, a retrospective survey was carried out in the University Central Hospital of Oulu. Twin deliveries during 1965-1973 numbered altogether 335, and their relative frequency was 1.7 %. The deliveries took place in the 37.2th gestational week on an average. The mean weights of the infants were 2590 g (A) and 2562 g (B). Perinatal mortality in the total series was 9.3 % (A 9.0 % and B 9.6 %). Pregnancy terminated before the 37th week in 29.2% of the cases. Perinatal mortality in this group was 27.0 %, while the corresponding value in the full-term group was 1.7 %. The perinatal mortality of primigravidas (14.1 %) was about twofold compared with that of the multiparas (7.2 %). Twin pregnancies were complicated by hyperemesis gravidarum, pre-eclampsia, anaemia, pyelonephritis and hepatosis more often than were the single pregnancies. The complications which contributed towards an increase of perinatal mortality included uterine bleeding in early and late pregnancy, hydramnion and superimposed pre-eclampsia. The complications generally associated with twin pregnancies and the increased perinatal mortality involved require that mothers with twin pregnancy, particularly primigravidas, should be subjected to intensified follow-up and treatment.

Adolescent↗
PubMed1975

Twin pregnancy. The role of active management during pregnancy and delivery.

In a series of 335 twin patients delivered over 1965-1973, active management was promoted during the pregnancy and delivery. The twin diagnosis was made in the 33.7th gestational week on an average. The diagnosis was made prior to delivery in 83.0 % of the cases, and during 1971-1973 the diagnosis was made before the 32nd week of pregnancy in 40.2 % of the cases. The perinatal mortality (PNM) rates were highly significantly (p less than 0.001) lower, the birthweights of A and B higher (p less than 0.001), and the number of gestational weeks at delivery greater (p less than 0.001) in the group diagnosed during pregnancy than in the group in which the twins were not diagnosed until at delivery. 56.4 % of the patients stayed in hospital for more than 2 days during the pregnancy and 34.9 % for over 10 days. The average period of hospitalization was 11.3 days. The perinatal mortality (PNM) of both the A and the B infants was lowest in the group hospitalized for over 10 days. In the group which had stayed in hospital for over 10 days the mean birthweight of the A infants was higher by 100 g and that of the B infants by 94 g than in the group not hospitalized despite the early diagnosis of twins. The average duration of delivery was 9.3 hours. Active efforts were made to shorten the interval between the births of the two infants, and it was 17.5 minutes on an average. This interval was not, however, related to the PNM rate of the B twins. On the basis of our findings, we wish to emphasize particularly the importance of the early diagnosis of twins.

Birth Weight↗
PubMed1975

Twin pregnancy. Neonatal morbidity and mortality.

The neonatal morbidity and mortality rate of 335 twin pairs born during the years 1965-1973 was investigated. 649 twins were born alive. 29 % of the twins were preterm. 31 % of the twins were small for date infants, and 41 % weighed less than 2 500 g. Mean birth weight was 2 590 g in A twins and 2 560 g in B twins. The neonatal mortality (0-28 days) was 7.1 %. The most common causes of death were the respiratory distress syndrome, intracranial haemorrhage and anoxia. Low one minute Apgar scores occurred more often in B twins than among A twins. Breech delivery gave low one minute Apgar scores more often than did spontaneous vertex delivery in both twins. Full term twins and infants weighing more than 2 500 g had fewer low one minute Apgar scores than the preterm infants and those with low birth weight. Neonatal disorders were equally common in both twins except the birth asphyxia and/or aspiration syndrome, which were more frequent in the B twins. The respiratory distress syndrome was diagnosed in 8 % of A twins and 12 % of B twins. Hypoglycaemia was recorded for 8 %, and hyperbilirubinaemia exceeding 15 mg % for 7 %. Infections occurred in 6 %. Transfusion syndrome was verified in 7 % and malformations in 6 %. Although mortality in twin pregnancies has declined, neonatal morbidity is very high. Twin pregnancies thus form a high risk group for obstetricians and pediatricians.

Apgar Score↗