Effects of changes in perinatal care on perinatal mortality in Vellore, India.
Explore the source record for details and available documents.
Female↗
Biomedical subjects
M Mathai
Publications and source records attributed to M Mathai.
Growth pattern of the Indian fetus.
OBJECTIVES: To determine the pattern of intrauterine growth and the gestation at birth of Indian fetuses. METHOD: One hundred twenty consecutive women who had reliable menstrual histories, low-risk pregnancies and who were booked for delivery at the Christian Medical College Hospital, Vellore, before 20 weeks' gestation were recruited to the study. Ultrasound fetal biometry was carried out at 4-weekly intervals from 20 weeks and at weekly intervals after 36 weeks until delivery. RESULTS: Growth patterns of fetal biparietal diameter and femur length were comparable to those reported in Western populations. However there was a lag in growth of abdominal circumference (AC) after 28 weeks in comparison with that reported in Western populations. The median gestation at delivery following spontaneous labor was 39 weeks. No association was observed between rate of growth of AC and gestation at birth. CONCLUSION: Slowing of growth of the fetal AC after 28 weeks and a shorter length of gestation result in the birth of smaller babies in this ethnic group. The implications of these findings are discussed.
Adult↗
The normal preterm foetal heart rate pattern.
A longitudinal study was carried out on 38 women with low risk pregnancies. These women had cardiotocography at 27-28 wk initially, at fortnightly intervals thereafter until 36 wk and at weekly intervals thereafter until delivery. All cardiotocographs were analyzed by one investigator who was not aware of the individual clinical situation. Of the 232 cardiotocographs, 12 (0.5%) of poor quality were excluded from analyses. The mean base-line heart rate decreased from 142.5 (SD 6.03) beats per min at 27-30 wk to 138.2 (SD 7.4) at term. Analysis of variance for repeated measures showed that the decrease in foetal heart rate with gestation was statistically significant (P < 0.001). The number of accelerations increased with gestation (P = 0.002). There were no significant changes in variability and decelerations with increasing gestation.
Female↗
Effects of central losartan on plasma renin and centrally mediated natriuresis.
Because intracerebroventricular (ICV) infusion of hypertonic saline or angiotensin II (Ang II) both induce water drinking, vasopressin secretion, natriuresis and increased arterial pressure, the possibility that common neural pathways mediate responses to ICV Ang II and hypertonic saline has been investigated. This was done by testing the effect of ICV infusion of the Ang II antagonist losartan on the natriuretic and pressor responses to ICV hypertonic NaCl in sheep. The effect of ICV losartan on plasma renin concentration (PRC) was also investigated. Infusion of losartan (1 mg/hr) into a lateral ventricle prevented both natriuretic and pressor responses to infusion of 0.6 mol/liter NaCl into a lateral ventricle at 1 ml/hr. In another experiment, ICV losartan at 1 mg/hr caused a pronounced increase in the PRC of Na-depleted sheep, while ICV Ang II at 3 micrograms/hr decreased PRC. The results suggest that: (i) a central angiotensinergic pathway may mediate osmoregulatory responses to centrally administered hypertonic saline, and (ii) a central angiotensinergic pathway may have a tonic inhibitory influence on renin secretion in Na-depleted animals.
Angiotensin II↗
Prevalence of genital mycoplasma & ureaplasma infections in pregnancy & their effect on pregnancy outcome.
A cohort of 200 women with singleton pregnancies attending the antenatal clinic, were studied to determine the prevalence of genital mycoplasma and ureaplasma infections in pregnant women and the effect of infection on pregnancy outcome. Vaginal and endocervical swabs were taken at 26-30 wk and again at 36-38 wk of pregnancy and cultured for mycoplasma and ureaplasma. Forty (20%, 95% CI 14.5-25.6%) women were found to be infected with arginine metabolising mycoplasmas and 79 (39.5%, 95% CI 32.7-46.3%) with ureaplasma at either site or either time. The mean +/- SD birth weight of infants born to women infected with mycoplasma alone was 2879 +/- 471 g while that of infants born to women infected with ureaplasma alone was 2964 +/- 412 g. Mean +/- SD birthweight of infants born to women infected with both organisms was 2969 +/- 389 g while that of infants born to uninfected women was 2919 +/- 432 g. These differences were not statistically significant. The median gestation at delivery was 39 wk in the cohort; the differences among the groups were minor and statistically not significant. Thus, although genital mycoplasma/ureaplasma infections were frequent, no association was observed between infection and pregnancy outcome.
Female↗
Inter- and intra-observer variation in the amniotic fluid index.
OBJECTIVE: To measure inter- and intra-observer reliability in the amniotic fluid index (AFI). METHODS: To measure inter-observer reliability, three observers measured the AFI at random in 32 patients without knowing each other's results. To determine intra-observer reliability, each investigator made repeated measurements on ten other patients. Patients at 26-41 weeks' gestation who were referred for an antenatal ultrasound examination were asked to participate. Intra-observer reliability and inter-observer reliability were expressed as intra-class correlation coefficients. Inter-observer agreement was also expressed as the kappa statistic after dichotomizing the AFI (less than 8 cm, 8 cm or more). RESULTS: The intra-class correlation coefficient for intra-observer reliability exceeded 0.8, and for inter-observer reliability it was 0.67 (95% confidence interval [CI] 0.52-0.79), with an overall kappa of 0.44 (95% CI 0.22-0.65). The percentage disagreement between pairs of observers reached 22-28%. CONCLUSION: Measurements of AFI have good intra-observer and moderate inter-observer agreement. In clinical use, an AFI level near a cutoff value should be interpreted with caution.
Amniotic Fluid↗
A randomized controlled trial of valethamate bromide in acceleration of labor.
A randomized controlled study of valethamate bromide administered by intramuscular injection in acceleration of labor was done in 60 consecutive primigravidae and 60 consecutive multigravidae admitted in labor at 2-4 cm cervical dilatation. There was no difference observed in the rate of cervical dilatation between those who received valethamate bromide and those who received normal saline. However, maternal tachycardia was observed in significantly more women primigravida RR 1.97, 95% CI 1.3-3.0; multigravida RR 2.16, 95% CI 1.3-3.6) who had received valethamate bromide.
Female↗
Passive maternal smoking and birthweight in a south Indian population.
OBJECTIVE: To determine the effects of passive maternal smoking on birthweight. DESIGN: Cohort of consecutive singleton live births. SETTING: Teaching hospital in South India. SUBJECTS: 994 infants and their mothers. MAIN OUTCOME MEASURE: Birthweight. RESULTS: All the women were themselves non-smokers; 520 (52%) were passive smokers while the remainder were not exposed to tobacco smoke. Infants born to passive smokers were on the average 55 g lighter than those born to non-smokers. Passive smoking was associated with a decrease in birthweight of 63 g (95% CI 12-114 g) even after adjusting for other variables known to affect birthweight.
Adult↗
Influence of exposure to tobacco smoke on serum alpha fetoprotein levels of women in midtrimester pregnancy.
The influence of exposure to tobacco smoke on maternal serum alpha-fetoprotein (AFP) levels at 16 wk gestation was examined. Urinary cotinine levels were used to quantify exposure to tobacco smoke. Significantly higher levels of maternal serum AFP were found in 101 women who had more than 1.0 microgram cotinine/mg urinary creatinine compared with 180 women whose urinary cotinine levels were below this level [(mean +/- SD) 1.23 +/- 0.64 and 1.06 +/- 0.54 respectively; 95 per cent CI of difference of means 0.01-0.31; P < 0.05]. There was a mild albeit statistically significant correlation between urinary cotinine levels and maternal serum AFB (r 0.099; P < 0.05). However, the difference in maternal serum AFP levels between the two groups was not found to be significant, when adjustments for maternal body mass index were made.
Body Mass Index↗
Candida antibodies in amniotic fluid.
Amniotic fluid samples were tested for specific immunoglobulins against Candida albicans by indirect immunofluorescence. Nineteen of the 23 samples tested contained specific IgA while specific IgG antibodies were detected in only seven samples (P less than 0.01). None of the samples contained specific anticandidal IgM (P less than 0.001). These 23 samples and a further 30 amniotic fluid samples were tested for Candida mannan antigen by latex agglutination. Mannan was not detected in any of the samples tested. It is concluded that anticandidal IgA in amniotic fluid is naturally occurring.
Amniotic Fluid↗
Elongated styloid process: an overview.
Stylalgia is a condition that causes a dull, nagging pain in the oropharynx, often referred to the ear and the mastoid region. The clinical diagnosis is certain if the elongated styloid process is palpated through the tonsillar area. Radiological investigations, such as orthopantomograms, give information about the medial angulation. The treatment of choice is surgical shortening of the process. Trans-tonsillar fossa excision is a simple technique and does not involve greater morbidity than a routine tonsillectomy.
Adult↗
Maternal smoking, urinary cotinine levels and birth-weight.
The smoking habits of 300 consecutive pregnant women and of other members of their household were obtained by interview at 16 and 32 weeks' gestation and after delivery. Urine samples for estimation of cotinine were collected at the same times during pregnancy and on admission in labour. Both self-reports of active maternal smoking and urinary cotinine levels were significantly associated with lighter babies but urinary cotinine correlated the better. Active maternal smoking was associated with a decrease in birth-weight of 12 g for every cigarette smoked in a day while there was a decrease of 25 g in birth-weight for every microgram of cotinine/mg of urinary creatinine. Passive maternal smoking was associated with a decrease of 66 g in mean birth-weight but this decrease was not statistically significant. Self-reports of active and passive smoking accounted for 43% of the variation in urinary cotinine levels suggesting that urinary cotinine assays can be used to assess and monitor exposure to tobacco smoke in pregnancy.
Birth Weight↗
Centrally mediated increased sympathetic activity is not important in the genesis of ACTH-induced hypertension in sheep.
1. Adrenocorticotrophin (ACTH) administration to sheep produces a rapid adrenally dependent hypertension which is maximal after 3 days and associated with increased cardiac output (CO) and heart rate (HR), while calculated total peripheral resistance remains unchanged. 2. This study investigated the proposal that a centrally mediated increase in sympathetic activity is important in the development of ACTH-induced hypertension. 3. Concomitant intravenous infusions of either clonidine (60 micrograms/kg per day) or methyldopa (60 mg/kg per day) with ACTH (5 micrograms/kg per day) failed to inhibit the increase in mean arterial pressure (MAP) observed with ACTH. 4. In a separate experiment clonidine abolished the increase in CO and HR but not the pressor response associated with ACTH administration. 5. These results do not support a role for centrally mediated increase in sympathetic activity in the genesis of ACTH-induced hypertension.
Adrenocorticotropic Hormone↗
Prediction of small-for-gestational-age infants using a specially calibrated tape measure.
Explore the source record for details and available documents.
Developing Countries↗
Screening for light-for-gestational age infants: a comparison of three simple measurements.
Fundal height, abdominal girth and abdominal length were measured during routine examination in our antenatal clinic. Standard graphs of fundal height, abdominal girth and the ratio of fundal height to abdominal length were drawn using data from 250 consecutive women with uncomplicated pregnancies. These graphs were used to predict low-birthweight-for-gestation (LGA) in 150 high-risk and 208 low-risk pregnancies. Fundal height measurements had high sensitivity (78-84%) and specificity (84-88%) and were therefore most reliable in screening for LGA babies.
Abdomen↗
Antimicrobial activity of amniotic fluid in South Indian women.
Samples of amniotic fluid obtained from 48 South Indian women in the third trimester of pregnancy were studied for antimicrobial activity. The growth of Staphylococcus albus, Candida albicans and Clostridium perfringens was inhibited by nearly all samples studied while the growth of Staphylococcus aureus, Escherichia coli and Bacteroides fragilis was inhibited by 50%, 42% and 18% of samples respectively. The growth of Streptococcus faecalis was not inhibited. Using radial immunodiffusion, IgG was measurable in all 10 samples studied (mean 23 mg/dl), whereas IgA was measurable in only three of these samples (mean 1.32 mg/dl). However, while specific IgA against C. albicans was detected by indirect immunofluorescence in 93% of samples, specific IgG against C. albicans was detected in only 26% of samples (P less than 0.001). Amniotic fluid obtained from parous women had greater inhibitory activity against E. coli (P less than 0.05) than did the amniotic fluid obtained from nulliparae.
Amniotic Fluid↗
Congenital hypertrophic pyloric stenosis.
Explore the source record for details and available documents.
Age Factors↗