Biomedical subjects

M Sharf

Publications and source records attributed to M Sharf.

At least 91 records · Page 5Linked to original sources

PubMed1978

Circulation parameters in the human uteroplacental region studied by a radioactive method.

Maternal placental circulation is of great importance, especially in pathological pregnancies, but methods of functional assessment have not been effective. The method used is based on a follow-up of the dynamic behavior of 113mIntracer labeling the mothers's blood at the uteroplacental region. After localization of the placenta two exponential curves of the dynamic behavior of the tracer, one placental and the other myometrial, were obtained. The measurement was made in the third trimester of pregnancy in 30 women with pathological pregnancies and in 51 pregnant control subjects. The clinically sensitive criteria for distinguishing between pathological and control placentas were found to be the ration between the specific blood flow in the placenta and that in the myometrium (lambda p/lambda m) and the slope (alpha) of the straight line passing through the points of this ratio. The value of lambda p/lambda m for pathological pregnancies was 5.4 +/- 1.0 (SD) vs 1.7 +/- 0.6 in control pregnancies, and the value of alpha for pathological cases was 6.3 compared with 1.5 for control subjects. These tests may be useful in the diagnosis of pathological pregnancies with interference in uteroplacental circulation.

Blood Flow Velocity↗

PubMed1977

Further investigation on the predictive value of human placental lactogen in high-risk pregnancies.

Blood samples were taken from 254 women with pregnancies with various complications and 119 completely normal pregnant women for measurement of serum human placental lactogen (hPL) during the third trimester. The value of this test in the management of these pregnancies was retrospectively evaluated through details of outcome. Serum hPL and urinary estriol were compared as tools for assessment of fetal condition. Serum hPL was found to be very efficient in the prenatal diagnosis of intrauterine growth retardation associated with maternal hypertension. Low hPL levels were recorded in all severely hypertensive patients who were delivered of small-for-dates infants (a 100 per cent prediction rate), while 30 per cent of these patients had normal estriol values. Prediction rate of postmature infants by serum hPL level was 70 per cent as compared to 50 per cent by urinary estriol level. The diagnostic significance of low hPL levels is emphasized, with stress upon its value in early detection of unfavorable intrauterine environment. The importance of preterm deliveries in pregnancies involving intrauterine growth retardation and low hPL levels is discussed and demonstration cases are presented.

Adult↗

PubMed1976

The significance of fetal electrocardiography in the diagnosis of intrauterine bradyarrhythmia.

From 11 cases of fetal bradycardia diagnosed by monitoring of 130 fetal electrocardiograms (ECG's) in high-risk pregnancies we have presented our experience in three selected cases of fetal bradyarrthythmia. Case 1 revealed on ECG blocked atrial premature beats simulating an extreme sinus bradycardia sequentially followed by conducted atrial premature beats. In case 2 we diagnosed ventricular premature beats in the form of persistent bigeminy which was controlled by intravenous propranolol. The last case illustrated the phenomenon of aberrant ventricular conduction known to occur in adult cardiology. The electrophysiologic basis of the variable arrhythmias was discussed. Detailed analysis of repeated direct fetal ECG's provided us with the diagnosis and understanding of the electrophysiologic mechanisms underlying the rhythm disturbances. This consequently determined the pharmacologic therapy and the obstetric approach relevant to each case. We have shown that by direct fetal electrocardiography it is possible to analyze accurately the rhythm disturbances. Persistent fetal bradycardia does not always signify fetal distress. We hope that this will lead to closer teamwork between the obstetrician and the cardiologist which will give an impetus to the future development of "fetal cardiology," thereby enhancing our understanding of the electrophysiology of the fetal heart.

Adult↗

PubMed1976

Lecithin/sphingomyelin ratio versus rapid surfactant test in normal and diabetic pregnancies.

Lecithin/sphingomyelin (L/S) ratio was measured and rapid surfactant test (RST) was performed on amniotic fluid samples drawn from 60 normal and 18 diabetic pregnancies, for determination of fetal lung maturity. The results were compared to the neonatal outcome. Comparison of L/S ratio and RST demonstrates a good correlation (95%) between the two tests in normal pregnancies. In diabetic pregnancies, however, correlation is notably lower (54%). Respiratory distress syndrome (RDS) was predicted in both L/S ratio and RST in 35-40% of normal pregnancies, with 60-65% of false negative results. In diabetic pregnancies the L/S ratio was as reliable as in normal pregnancies, but the RST was less reliable, with an RDS prediction rate of 18%. The assumption is made that increased amniotic fluid volume in diabetic pregnancies, results in dilution of the surfactant giving more false negative results in RST than are seen with L/S ratio, as in the latter, by measuring the ratio between the two constituents of amniotic fluid, the dilution factor is abolished. In diabetic pregnancies, a positive RST is reliable, but with negative results, L/S ratio must be determined for correct assessment of fetal lung maturity.

Adult↗

PubMed1975

Intrauterine diagnosis and control of fetal ventricular arrhythmia during labor.

A very rare case of a sustained fetal ventricular arrythmia in the form of bigeminy, trigeminy, and quadrigeminy during labor is described. The rhythm distrubance failed to respond to sedatives and narcotics but was successfuly reverted to sinus rhythm following the administration of intravenous propranolol to the mother. The significance and possible mechanism of the arrhythmia is discussed.

Adult↗

PubMed1975

Use of propranolol in dysfunctional labour.

Labour pains associated with fear and anxiety increase the blood level of catecholamines. This in turn causes dysfunctional labour due to the weak uterine contractions which follow stimulation of uterine adrenergic beta receptors. Intravenous propranolol was administered to ten primigravidae with typical dysfunctional labour. This was shortly followed by normal uterine activity and delivery without any significant maternal or fetal complications. To the best of our knowledge this is the first attempt to treat dysfunctional labour by the intravenous administration of a beta-blocking agent, and our preliminary results are encouraging.

Adrenergic beta-Antagonists↗

PubMed1975