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Biomedical subjects

M Westgren

Publications and source records attributed to M Westgren.

At least 91 records · Page 5Linked to original sources
PubMed1993

Noninvasive test of microvascular endothelial function in normal and hypertensive pregnancies.

OBJECTIVE: To examine microvascular endothelial cell function in vivo in pre-eclampsia. DESIGN: Iontophoresis of acetylcholine (Ach), which gives rise to endothelial cell dependent vasodilatation, and of sodium nitroprusside (SNP), which elicits vasodilatation independently of functioning vascular endothelium. SETTING: Södersjukhuset, Stockholm, Sweden. SUBJECTS: Ten pre-eclamptic patients, ten healthy pregnant women and ten healthy nonpregnant women were examined. MAIN OUTCOME MEASURES: The degree of vasodilatation following iontophoretic administration of Ach compared with SNP was recorded with a laser Doppler technique, the data being analysed on a personal computer. RESULTS: Both Ach and SNP administration resulted in marked vasodilatation; the magnitude of the vasodilatation was similar in the three groups of women. CONCLUSION: Following iontophoretic administration of endothelial cell dependent or independent vasodilatators, laser Doppler measurement of blood flow demonstrated no microvascular endothelial cell dysfunction in pre-eclamptic women.

Acetylcholine↗
PubMed1993

Erythropoietin concentrations in amniotic fluid and umbilical venous blood from Rh-immunized pregnancies.

We set out to investigate prospectively the levels of erythropoietin in amniotic fluid and umbilical venous blood, and to attempt to relate these to fetal haemoglobin and lactate concentrations and to pCO2 and PO2 in Rh immunised patients studied before the onset of labor. Fetal blood was obtained by cordocentesis, and amniotic fluid by amniocentesis from a consecutive series of 36 Rh immunized patients at the time of fetal blood sampling. There was a close correlation (tau = 0.357, P = 0.0001) between the concentrations of erythropoietin in umbilical venous blood and those in amniotic fluid. Erythropoietin in umbilical venous blood correlated inversely with hemoglobin (tau = 0.453, P = 0.0001), and directly with lactate concentrations (tau = 0.450, P = 0.0005). When all other variables were considered, multiple regression analysis demonstrated hemoglobin concentration to be the only variable to be related to the level of erythropoietin in umbilical venous blood taken before transfusion. When the same analysis was performed on the same variables, adding erythropoietin concentration in amniotic fluid as the dependent variable, only erythropoietin in umbilical venous blood was found to be related to the level of erythropoietin in amniotic fluid. We conclude that the erythropoietin concentration in umbilical venous blood from Rh-immunized patients before the onset of labor, is related to fetal anemia. We also conclude that erythropoietin concentration in amniotic fluid is related to that in fetal blood, thereby indicating that the fetus is an important source of amniotic fluid erythropoietin in non laboring patients.

Amniotic Fluid↗
PubMed1993

Intrauterine intravascular transfusions in fetal erythroblastosis: the influence of net transfusion volume on fetal survival.

The intravascular volume load that an anemic fetus can tolerate was studied retrospectively in 124 consecutive intravascular transfusions in 35 erythroblastic fetuses. The tolerated volume load correlated well to the estimated fetal weight. Transfusion volume loads above 20 ml/kg of the estimated fetal weight resulted in a lower fetal survival. We recommend an upper transfusion limit at 20 ml/kg corresponding to approximately 20% of the feto-placental blood volume.

Blood Transfusion, Intrauterine↗
PubMed1993

Effects of cryopreservation on subsets of fetal liver cells.

Human fetal livers from 6 to 13 weeks postconception were analysed before and after cryopreservation. The percentages of cell subsets, detected by MoAbs, did not change significantly after cryopreservation. Compared with BM, fetal liver contained significantly smaller subsets of cells identified by MoAbs, with two exceptions. Fetal liver contained a mean of 47% M5 positive cells versus 31% in BM, and there was no difference in the numbers of CD34+ cells. The colony-forming capacity was studied: 53 colonies grew from 10(5) cells from fresh fetal liver compared with 51 colonies from cryopreserved cells. For fresh BM the corresponding value was 88 per 10(5) cells. Incubation time for fetal stem cells was 17-18 days while the corresponding time for BM cells was 8-10 days.

Antigens, CD↗
PubMed1993

Cryopreservation of fetal stem cells.

Fetal liver cells may be transplanted, in utero, to treat disorders affecting the hematopoietic system. Conventional immunological methods were employed to determine whether pooled cryopreserved cells could be a suitable basis for a tissue bank. We found that cryopreservation did not adversely change the population, viability or immunological capacity of human fetal liver cells and therefore, pooled and cryopreserved fetal stem cells may be suitable for transplantation.

Cryopreservation↗
PubMed1993

Pregnancy and delivery in women with a traumatic spinal cord injury in Sweden, 1980-1991.

OBJECTIVE: To evaluate the incidence of delivery in women after a traumatic spinal cord injury and to describe pregnancy outcome in this group of patients. METHODS: Between 1980-1991, 29 women with a traumatic spinal cord injury experienced 49 pregnancies and gave birth to 52 children in Sweden. A retrospective chart review of the antepartum, intrapartum, and perinatal records of these patients was performed. In addition, all patients participated in a telephone interview held by one of the authors. Of the 29 women, 12 had lesions above T5 and 17 had lesions at T5 or below. RESULTS: Antenatal complications occurred frequently in this group. Nine of 12 patients with lesions above T5 had symptoms of autonomic hyperreflexia during pregnancy and/or delivery. Only in a minority of the women was the problem recognized by the medical professionals. Nine of the infants (19%) were born preterm and two were small for gestational age. The perinatal mortality rate was two of 52 (3.8%) and occurred in two cases of abruptio placentae. Few of the patients were allowed to deliver vaginally. The cesarean delivery rate for women with lesions above T5 was 47% and for women with lesions below that level, 26%. CONCLUSION: The overall prognosis for these women was favorable. However, women with higher spinal cord lesions would probably benefit from referral to centers with a particular interest and expertise in the management of their problems.

Cesarean Section↗
PubMed1992

Fetal scalp and umbilical artery blood lactate measured with a new test strip method.

OBJECTIVE: To compare the measurement of lactate in fetal scalp and umbilical artery blood by a new dry reagent strip method with a commercially available enzymatic method using plasma (Monotest). DESIGN: Comparative study. SUBJECTS: Fetal scalp blood samples were obtained during labour from 24 fetuses and umbilical artery blood samples were obtained at birth in a further 51 deliveries. RESULTS: The concentration of lactate in scalp and umbilical artery blood measured by the reagent strip method correlated well (r = 0.94, P less than 0.001 and 0.95, P less than 0.001 respectively) with the enzymatic plasma method. The paper strip method tended to give lower readings than the enzymatic method when the fetal haematocrit was greater than or equal to 50%. CONCLUSIONS: The new dry reagent strip method which takes only 1 min to carry out and requires only 20 microliters of blood seems to be handy and reliable. This system provides a convenient and rapid test for measuring fetal blood lactate.

Evaluation Studies as Topic↗
PubMed1992

A four-year follow-up of hearing and development in children exposed in utero to vibro-acoustic stimulation.

OBJECTIVE: To obtain information of hearing and neuro-development in children exposed to vibro-acoustic stimulation in utero. DESIGN: Information collected from Swedish child care programmes. SETTING: Department of Obstetrics and Gynaecology, Karolinska Institutet, Danderyd University Hospital, Sweden. SUBJECTS: Children of 460 mothers exposed to vibro-acoustic stimulation for the assessment of fetal well-being during high- and low-risk pregnancies during 1985-1987. MAIN OUTCOME MEASURES: Auditory test (20-25 dB at eight frequencies between 500 and 8000 Hz) and general neurological examination at four years of age. RESULTS: No hearing damage or neuro-developmental abnormalities that could be connected to the vibro-acoustic stimulation were found. CONCLUSIONS: Vibro-acoustic stimulation, as applied in clinical practice, did not endanger either neurological development or hearing in children exposed in utero.

Acoustic Stimulation↗
PubMed1992

Vibro-acoustic stimulation in high-risk pregnancies; maternal perception of fetal movements, fetal heart rate and fetal outcome.

Maternal perception of fetal movement in response to vibro-acoustic stimulation was compared with antenatal fetal heart rate monitoring as a test of fetal well-being in a population of gravidae with high-risk pregnancies (n = 517), admitted to the high-risk ward at Danderyd Hospital, Karolinska Institutet; a total of 2,015 tests were performed. The sensitivity and the specificity of the test compared to the fetal heart rate tracing was 81% and 89% respectively. If the test was performed within 24 hours of delivery, its predictive value for fetal asphyxia (i.e. a 5-minute Apgar score < 7) was 14% (7/49). Ten per cent of the patients felt no fetal movement in response to stimulation (irrespective of gestational age). In five cases where fetal heart rate tracings were pathological, stimulation nonetheless produced fetal movement and fetal outcome was good. Pathological heart rate tracings and no fetal movement in response to stimulation were present in 30 cases (out of 251 with no fetal movements at stimulation), in seven of which the infants had 5-minute Apgar scores < 7. Although many patients underwent repeated vibro-acoustic stimulation, there was no evidence of fetal habituation to the test. On 24 occasions (i.e. 1.2%), the patient denied vibro-acoustic stimulation, mostly because of previous discomfort due to vigorous fetal response. Where resources are limited, maternal perception of fetal movements in response to vibro-acoustic stimulation might be a useful alternative for preliminary screening of high-risk pregnancies.

Acoustic Stimulation↗
PubMed1991

Iontophoresis of vasoactive drugs. Effect on peripheral blood flow during pregnancy.

The aim of this study was to evaluate whether iontophoretic administration of the vasoactive agents noradrenaline (NA) and angiotensin (AII) combined with measurement of skin blood flow with a laser Doppler technique could serve as a predictive method for pre-eclampsia. Nine healthy non-pregnant women, 9 healthy pregnant women and 9 pre-eclamptic patients were investigated. A significant reduction of skin blood flow was induced by NA in all three groups and by AII in the non-pregnant group. There was no significant difference between healthy pregnant and pre-eclamptic patients in the degree of reduction of blood flow with respect to NA and AII administration.

Angiotensin II↗
PubMed1991

Vibroacoustic stimulation and intrauterine sound pressure levels.

The sound pressure level in amniotic fluid generated by vibroacoustic stimulation, assessed with a hydrophone placed close to the fetal head, was studied in 16 subjects. The mean recorded sound pressure level was 115 dB and the highest level was 129 dB. The range of the background noise was 63.5-80.5 dB. There was no obvious relationship between the distance from the stimulator to the hydrophone and the intrauterine sound pressure level. Although sound pressure levels are high, they are probably reduced before reaching the cochlea of the fetus because of the surrounding amniotic fluid and the fluid in the middle ear.

Acoustic Stimulation↗
PubMed1990

Discomfort after outpatient abortion using paracervical block: a comparison between two opioids and one non-opioid drug for premedication.

One hundred and one patients undergoing outpatient abortion using local anesthesia were randomly allocated to one of three different premedications: morphine-scopolamine, pethidine or midazolam. The incidence of pain, anxiety, emetic (nausea-vomiting) and patient cooperation was analyzed. Discomfort was frequently noticed, 79 patients reported pain, 57 nausea and 26 vomited at least once during the postoperative period which lasted 2.6 h (mean value). There were no major differences in complaints among the different premedication groups. Nausea, though, was correlated to pain. Symptoms of pain, nausea and vomiting were frequent after abortion under paracervical block. These complaints were not found to be related to the type of premedication or other circumstances in the perioperative period.

Abortion, Induced↗
PubMed1990

Fetal heart rate responses to anemia in Rh isoimmunization.

On 52 occasions 24 Rh immunized women were monitored with a nonstress test (NST) prior to fetal blood sampling. Cardiotocographic characteristics were recorded for each NST. Fetal blood was analysed for hemoglobin and hematocrit. Fetal hemoglobin and hematocrit were positively correlated to long-term variability, acceleration amplitude and negatively correlated to deceleration amplitude (linear regression analysis; p less than 0.05). Decelerations were almost without exception associated with low concentrations of hemoglobin and hematocrit. In fetuses of 32 weeks' gestation or more, a loss of variability (less than or equal to 5 bpm) was associated with severe anemia. Hemoglobin and hematocrit were significantly lower in the group with a pathological NST (n = 15) compared with the group with a normal NST (n = 37) (Mann-Whitney U test; p less than 0.05). The predictive value of a pathological test was 13/15 concerning hemoglobin and hematocrit; whereas, the predictive value of a normal test was poor. A pathological NST, especially when decelerative, is a good predictor of fetal anemia, but a normal NST is no guarantee for a normal blood status.

Anemia↗