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Biomedical subjects

O Axelsson

Publications and source records attributed to O Axelsson.

At least 73 records · Page 4Linked to original sources
PubMed1985

Screening for intrauterine growth retardation in late pregnancy.

A prospective study was performed on an unselected area-based population in order to improve the antenatal diagnosis of intrauterine growth retardation (IUGR). The clinical importance of simple clinical tests to follow fetal growth (measurements of the symphysis-fundus (SF) distance and recordings of maternal pregnancy weight gain) was investigated. Risk factors for IUGR, appearing in late pregnancy (vaginal bleeding, non-proteinuric pregnancy hypertension and pre-eclampsia) were also studied. A pathological SF curve (frequency 3.5%) was found to be valuable, but mainly as a screening instrument rather than a diagnostic tool for IUGR. Pre-eclampsia was the only risk factor appearing in late pregnancy that could be associated with IUGR. Previously we have recommended early pregnancy screening for the following high risk factors for IUGR: smoking, previous birth of a low birth weight infant, low pre-pregnancy weight, renal disease and addiction. When also screening for pre-eclampsia, 22% of the population exhibited at least one screening factor. Retrospectively we identified all severely growth-retarded infants (birth weight for gestational age less than or equal to -2 S.D.) born in 1980 (n = 27). 23 of these infants were delivered to mothers exhibiting high-risk factors for IUGR or a pathological SF curve. In this way a high-risk group for IUGR can be identified, which should be monitored more carefully during the last period of pregnancy.

Body Weight↗
PubMed1985

The clinical value of measurements of the symphysis-fundus distance and ultrasonic measurements of the biparietal diameter in the diagnosis of intrauterine growth retardation.

The diagnostic efficiency in the prediction of intrauterine growth retardation (IUGR) of repeated measurements of the symphysis-fundus (SF) distance and repeated ultrasonic measurements of the biparietal diameter (BPD) was investigated in 377 pregnancies, all at risk for IUGR. Measurements of the SF distance were found to be more effective than ultrasonic BPD measurements for antenatal diagnosis of IUGR. For every correct diagnosis there were three false positive when using SF measurements and ten when using ultrasonic BPD measurements. When the SF method is used, repeated ultrasonic BPD measurements add very little information. The SF curve is a very simple and inexpensive method and should be used as a screening instrument for severe IUGR. When the SF curve is assessed as pathological, ultrasonic measurements also including other fetal dimensions than only BPD are recommended as a way of diagnosing IUGR.

Cephalometry↗
PubMed1985

Concentration of unconjugated estriol in capillary whole blood from pregnant women.

A radio-immunological method applied to the estimation of unconjugated estriol in capillary whole blood is described. The concentration of unconjugated estriol in capillary whole blood and venous serum from 35 pregnant women was measured. Close relation was found between values in venous serum and capillary whole blood. The intra-assay variation was 4.9% for venous and 7.8% for capillary whole blood samples when analysed in duplicate. The day-to-day variability was of the same order for venous (10.0%) as for capillary (8.4%) samples. It is concluded that unconjugated estriol can be measured in small amounts (25 microliter) of capillary whole blood and that this method offers practical advantages over methods using venous serum or plasma.

Capillaries↗
PubMed1985

A prospective controlled trial of metoprolol-hydralazine treatment in hypertension during pregnancy.

In an open, controlled trial, treatment with a combination of metoprolol and hydralazine was compared with non-pharmacological management of mild and moderate hypertension in pregnancy. One hundred and sixty-one women participated in the study. The drug-treated group showed significantly better blood pressure control than the group not given antihypertensives. Induction of labor before term, because of maternal or fetal complications, was somewhat more frequent in the control group. Nine women in the treatment group and 5 in the control group developed albuminuria. Three infants in the drug-treated group died perinatally, and one in the control group. The outcome for the newborns was similar in both groups concerning birth weight, head circumference and Apgar score and in the frequencies of respiratory distress, bradycardia and hypoglycemia. The better blood pressure control achieved with these drugs makes it possible to treat the patient at home and reduce the risk of emergency delivery, but treatment does not seem to be mandatory for a good outcome of the pregnancy in cases of mild and moderate hypertension during pregnancy.

Adult↗
PubMed1985

Smoking, maternal age, and fetal growth.

In a prospective clinical study from an unselected area-based population, the influence on birth weight for gestational age (standardized birth weight) was studied with special respect to risk factors for intrauterine growth retardation. Smoking was the most important risk factor: 16% of the mothers smoked at least ten cigarettes per day, and the influence of smoking on standardized birth weight was highly significant (P less than .001). Maternal age in itself had no effect on standardized birth weight. However, among smokers the reduction in standardized birth weight became more pronounced with increasing maternal age (P less than .001). Longterm smoking has been reported to increase the risk of severe placental complications. This study emphasizes that elderly smokers also must be considered to be at a higher risk than younger smokers for developing fetal growth disturbances.

Aging↗
PubMed1984

Early pregnancy screening for intrauterine growth retardation.

In a prospective clinical study from Uppsala County, Sweden, in 1980, all pregnancies were screened early in pregnancy for 15 previously reported risk factors for intrauterine growth retardation (IUGR). This risk group (n = 639) was then compared with a randomly selected control group (n = 539). In the risk group, there were increased risks for the delivery of growth retarded infants, low birthweight infants and infants spontaneously delivered as prematures. 30% of the population exhibited risk factors. Smoking was the most important risk factor, 16% of the mothers smoked at least ten cigarettes per day and smoking was the main risk factor in the majority of cases with IUGR.

Birth Weight↗
PubMed1984

Factors influencing birthweight for gestational age, with special respect to risk factors for intrauterine growth retardation.

In a prospective clinical study from an unselected, area-based population, the influence on birthweight for gestational age of different factors was studied, with special respect to 15 risk factors for intrauterine growth retardation (IUGR) recognizable in early pregnancy. In the multiple regression analyses performed, birthweight for gestational age was used as the dependent variable. Only 10% of the variance in birthweight for gestational age could be explained. A correlation was found between the number of risk factors and birthweight for gestational age. Four risk factors had a significant negative influence on birthweight for gestational age: smoking, previous birth of a low birthweight infant, a low prepregnancy weight and addiction. No single risk factor influenced birthweight for gestational age as much as parity. When a risk factor was present the expected increase in birthweight for gestational age with increasing parity did not appear.

Birth Weight↗
PubMed1984

Symphysis-fundus measurements and intrauterine growth retardation.

A prospective study of the clinical value of the symphysis-fundus (SF) distance was performed on 528 women, all at risk for developing intrauterine growth retardation (IUGR). Four different types of SF curves were observed and denoted as normal, static, catch-up and low. A normal or static SF curve predicted a normal birthweight (specificity 92%), while a catch-up or low SF curve identified 79% of the infants with a birthweight below -2 SD for length of gestation. The differences in short-term morbidity between infants delivered by mothers with normal and pathological SF curves were mainly due to prematurity. We find the SF method to be a useful tool for detection of IUGR. Since correct estimation of gestational age is a prerequisite, we recommend an early ultrasonic measurement on all patients.

Birth Weight↗
PubMed1984

Combined vaginal-abdominal delivery of twins.

During the five-year period 1977-1981, 120 twins were delivered at the University Hospital, Uppsala, Sweden. 6 or 5%, were delivered by the combined vaginal-abdominal route. There was no case of foetal death among the second twins. Only one second twin had an Apgar score of less than eight at five minutes. Four mothers received blood transfusion because of blood loss related to the operation and two mothers developed fever during the puerperium. It is concluded that caesarean section may well be performed for rapid delivery of the compromised second twin, although the maternal morbidity is substantial.

Adult↗
PubMed1983

Serum levels of pregnancy-specific beta 1-glycoprotein (SP1) in women with pregnancies at risk.

Pregnancy-specific beta 1-glycoprotein (SP1) concentrations were measured by nephelometry in 133 serum samples from 74 women in their last trimester of pregnancy. All women carried one child but their pregnancies were complicated by pre-eclampsia, essential hypertension, diabetes mellitus or rhesus isoimmunization. Most of the women with pre-eclampsia or essential hypertension who gave birth to infants of normal weight had SP1 values evenly distributed within the reference range. Women with insulin-dependent diabetes mellitus who gave birth to infants to normal birth weight or large-for-date infants had SP1 levels well within the reference range and even showed a tendency to overrepresentation above the geometric mean. Women with rhesus isoimmunization all delivered infants of normal birth weight. Their SP1 values were near or above the geometric mean of the reference range. No special pattern of SP1 levels was observed in relation to the severity of the immunization.

Antibody Formation↗
PubMed1983

Human placental lactogen serum levels in venous and capillary blood from women in late pregnancy.

The concentration of human placental lactogen (HPL), in serum was measured in venous and capillary blood from 31 pregnant women. 14 women had uncomplicated pregnancies. The others had complications including preeclampsia, intrauterine growth retardation, and severe edema. The correlation between values of HPL in venous and capillary blood was high. In all cases the clinical information obtained on placental function was the same, whether HPL was measured in venous or capillary blood. The day-to-day variability was of the same order for capillary as for venous samples. It is concluded that capillary blood may well be used for measurement of HPL in pregnant women. Capillary blood could replace venous blood for measurement of HPL in the supervision of pregnancies complicated by preeclampsia or intrauterine growth retardation.

Blood Specimen Collection↗
PubMed1983

Pregnancy-specific beta 1-glycoprotein (SP1) in serum from women with pregnancies complicated by intrauterine growth retardation.

Serum concentrations of pregnancy-specific beta 1-glycoprotein (SP1) were measured by nephelometry in 37 women with single pregnancies complicated by intrauterine growth retardation (IUGR). Sixty-seven blood samples were examined for their contents of SP1 in pregnancy weeks 29 to 40. The SP1 values were compared with those obtained in a cross-sectional study of 323 women and a serial study of 21 women (210 samples) with uncomplicated single pregnancies. It was found that a serum SP1 value below 80 mg/l in a single blood sample drawn in pregnancy weeks 32 to 34 had a predictive value of 50% for IUGR and a value above or at 80 mg/l had a value of 93% for predicting a normal infant birth weight. Serial samples from individual women with uncomplicated single pregnancies showed an average increase in the SP1 concentration of 49% from pregnancy weeks 30 to 36. In serial samples from six women with IUGR infants there was no such increase, or a decrease occurred. It is concluded that SP1 measurements in maternal serum are valuable for the detection and monitoring of pregnancies complicated by IUGR.

Female↗
PubMed1982

Comparison between serum levels of oestriol in venous and capillary blood from pregnant women.

The concentration of unconjugated oestriol in serum was measured in venous and capillary blood from 41 pregnant women. 22 women had uncomplicated pregnancies. The others had different kinds of complications including severe oedema and pre-eclampsia. The correlation between values of unconjugated oestriol in venous and capillary blood was high. In 77 out of 78 samples the conclusions drawn about the feto-placental function from venous and capillary blood were similar. The day-to-day variability was of the same order for capillary as for venous samples. A few samples were analysed for total oestriol and also in this case a high correlation was found between capillary and venous blood. It is concluded that capillary blood samples may well be used for estimation of total and unconjugated oestriol. Capillary blood could replace venous blood for estimation of unconjugated oestriol in the management of high risk pregnancies.

Capillaries↗
PubMed1982

Serum levels of cortisol, dehydroepiandrosterone, dehydroepiandrosterone sulphate, estrone and prolactin after surgical trauma in postmenopausal women.

Changes in serum hormone concentrations induced by surgical trauma were studied by determination of cortisol, dehydroepiandrosterone (DHA), dehydroepiandrosterone sulphate (DHAS), estrone (E1) and prolactin in 25 postmenopausal women. Blood samples were collected before, during and after mastectomy (14 women) and cholecystectomy (11 women). A slight peroperative increase in DHA preceded a marked postoperative decrease whereas no significant changes were seen concerning DHAS. The posttraumatic increase in cortisol values was delayed in relation to that of DHA, reaching its maximum on the first postoperative day. There was a pronounced postoperative increase in estrone which was only slightly (r = 0.3) correlated to the concomitant changes in the serum levels of DHA and cortisol indicating that other factors than increased availability of precursor steroids might influence this change. Prolactin levels showed an about fourfold peroperative increase and were normalized on the first day after surgery. No significant differences in preoperative values were seen between the groups although generally more pronounced and retarded changes were seen after cholecystectomy than after mastectomy.

Adrenal Cortex Hormones↗
PubMed1981

Assessment of placental function by estimation of testosterone in plasma after an intravenous injection of dehydroepiandrosterone sulphate (DHAS).

The response of plasma testosterone to an intravenous injection of 50 mg dehydroepiandrosterone sulphate (DHAS) was measured in 22 pregnant women. In 15 women with uncomplicated pregnancies a rapid and steep increase of plasma testosterone was observed, most women having their maximum testosterone value recorded as soon as 5 minutes after the injection. Three women with preeclampsia had delayed maximum values. They delivered infants of low birth-weight or with low Apgar scores. One woman with pre-eclampsia had a normal response and gave birth to a healthy infant of normal birth-weight. Out of 3 women with intrauterine growth retardation (IUGR) 2 had an abnormal and 1 a normal response. It is concluded that the plasma response of testosterone to an injection of DHAS is a reflection of placental function.

Dehydroepiandrosterone↗