Search PubMed⌕ Search

Biomedical subjects

P Oian

Publications and source records attributed to P Oian.

At least 19 recordsLinked to original sources
PubMed2001

Child births in a modified midwife managed unit: selection and transfer according to intended place of delivery.

BACKGROUND: As small obstetrical departments may not be able to give second-level perinatal care, the delivery unit at Lofoten hospital was for the years 1997-98 reorganized to a modified midwife managed unit. Women at low obstetrical risk were delivered at this unit and women at high risk were referred to the central hospital. We assessed the effectiveness of the risk selection. MATERIAL AND METHODS: The study was a prospective, pragmatic, population-based trial. Desired outcome was defined as a non-operative delivery at 35-42 weeks gestational age giving an infant not needing resuscitation. Intermediate outcomes: Operative deliveries, infants transferred to neonatal intensive care unit and infants diverging from normal. The intended place of delivery was ultimately decided at admittance to the midwife managed unit. RESULTS: Of the 628 women in study 435 (69.3%) gave birth at the midwife managed unit, 152 (24.2%) were selected to be delivered at the central hospital and 41 (6.5%) were transferred to the central hospital after admittance to the midwife managed unit. Desired outcome was recorded in 94% of the deliveries at the midwife managed unit as compared to 50.3% at the central hospital. Women who intended to be delivered at the midwife managed unit, needed fewer operative deliveries and relatively few infants were transferred to the neonatal intensive care unit or diverged from normal. CONCLUSIONS: As nearly 70% of the births occurred at the midwife managed unit and 94% of these deliveries had a desired outcome, this indicates an effective selection process. This model might be an alternative to centralization of births in sparsely population areas.

Adult↗
PubMed2000

Evidence of dysfunctional beta2-adrenoceptor signal system in pre-eclampsia.

OBJECTIVES: To determine how beta2-adrenoceptor binding and function differ between healthy women and those with pre-eclampsia. DESIGN: Case-control study. SETTING: Faculty of Medicine, University of Tromsø, Norway. PARTICIPANTS: Two groups of pregnant women: eight cases with pre-eclampsia, matched with eight healthy controls. METHODS: Venous blood was drawn from women in both groups after an overnight rest. The two groups were matched for gestational age which was (mean (SD)) 36 x 4 (3 x 8) and 36 x 5 (4 x 4) weeks for the pre-eclamptic and control groups, respectively. Six weeks after delivery a second blood sample was obtained. The binding and function of beta2-adrenoceptors were determined in isolated human mononuclear leukocytes. The levels of adrenaline and noradrenaline were determined in plasma from venous blood. RESULTS: An elevated density of functional beta2-adrenoceptors was observed in normal pregnancy [mean (SD) 390 (90) vs 270 (60) sites/cell postpartum], due to an increased fraction of receptors in high affinity state, with unaltered total receptor density. The number of functional beta2-adrenoceptors was reduced in pre-eclampsia [mean (SD) 80 (40) vs 240 (30) sites/cell postpartum], due to a reduction in the total receptor number with an unaltered fraction of high affinity receptors. In pregnancy, both unstimulated and isoprenaline-stimulated cAMP levels were reduced in the women with pre-eclampsia (0 x 5 (0 x 2) and 1 x 7 (0 x 9) pmol/10(6) cells, respectively) compared with the normal pregnant controls (mean (SD) 1 x 2 (0 x 3) and 4 x 7 (1 x 8) pmol/10(6) cells, respectively). Plasma catecholamine levels were not elevated in the women with pre-eclampsia. CONCLUSIONS: The increased number of functional beta2-adrenoceptors may contribute to the vasodilatation seen in normal pregnancy, while the reduced overall number of receptors may be one of several factors that account for increased peripheral vascular resistance in pre-eclampsia.

Adrenergic beta-Agonists↗
PubMed2000

Neonatal alloimmune thrombocytopenia due to anti-HPA 1a antibodies; the level of maternal antibodies predicts the severity of thrombocytopenia in the newborn.

Eleven thousand one hundred pregnant women were genotyped for human platelet antigen HPA 1, and 198 HPA 1bb women were followed in the pregnancy with quantitative assay for anti-HPA la antibodies. Antibodies were detected in 24 women, and nine children were born with severe thrombocytopenia (< 50x10(9)/L). All mothers with high levels of antibodies were delivered of children with severe thrombocytopenia. None of the newborn infants had clinical signs of intra-cranial haemorrhage. The level of maternal anti-HPA 1a antibodies is predictive for fetal thrombocytopenia and may be used in decisions related to time and mode of delivery.

Antibodies↗
PubMed2000

Skeletal muscle ultrastructure in normal pregnancy and preeclampsia.

The aim of this study was to assess by quantitative methods whether the assumed metabolic disturbance underlying preeclampsia would be reflected in muscle cell composition of lipid, mitochondria, or glycogen. We have reported mitochondrial dysfunction in preeclampsia, and since accumulation of lipid in skeletal muscle is a feature in mitochondrial disorders, our hypothesis was that preeclamptic women would have an increased content of triglyceride droplets. Quantitative investigation of the skeletal muscle ultrastructure was performed in 10 women with severe preeclampsia and in 6 normotensive pregnant women. Biopsy specimens from musculus rectus abdominis were taken during cesarean section and prepared for electron microscopy. Random pictures were taken by transmission electron microscopy, and point-counting stereology was performed. Preeclamptic women did not have a higher lipid volume fraction than normotensive pregnant women, and we had to reject our hypothesis. On the contrary, there was a tendency towards a lower triglyceride volume fraction in pre eclampsia. We did not detect differences in relative volumes of mitochondria or glycogen in skeletal muscle between the two groups.

Adolescent↗
PubMed2000

Antenatal, neonatal and post neonatal deaths evaluated by medical audit. A population-based study in northern Norway - 1976 to 1997.

BACKGROUND: Perinatal committees evaluate deaths by medical audit to improve antenatal and neonatal care. We report data from Troms County from 1976 to 1997. SUBJECTS AND METHODS: Antenatal, neonatal and post neonatal deaths (n=472) at > or = 20 weeks of gestation have been evaluated. Data were collected from the Medical Birth Registry of Norway and from medical records. Pregnancy risk factors, mortality rates, causes of deaths, non-optimal care and avoidable deaths were recorded. RESULTS: The death rate (all deaths per thousand total births) declined from 13.8 (1976-80) to 7.7 (1992-97), (p<0.001), due to a reduced death rate in preterms > or = 24 weeks (p<0.001) and in those between 500 and 1995 g (p<0.001). Antenatal deaths decreased (p<0.001) due to reduced intrapartum deaths (p<0.001). Prelabor deaths, unexpected intrauterine pre-hospitalization deaths included, did not change. Postnatal deaths declined (p=0.01) due to reduced early neonatal mortality (p=0.002). Deaths from malformations (p<0.001), fetal and neonatal infections (p=0.03) and placental disorders (p<0.001) declined. Non-optimal care (22.5% of deaths, 2.3%o of total births), avoidable deaths (13.1% of deaths, 1.3% of total births), and maternal neglect (7.5% of cases with non-optimal care, 0.6% of total births) did not change. Death during transport was rare (n=5), and no deaths occurred at maternity homes. Non-cohabitance, smoking and undiagnosed SGA new borns declined, and the level of education increased in the study population. CONCLUSION: The improvement is due to a reduction in intrapartum deaths and early neonatal mortality in preterms. A constant high rate of unexpected intrauterine deaths in non-hospitalized patients is a challenge for antenatal health care providers.

Adult↗
PubMed1999

[Eclampsia].

Explore the source record for details and available documents.

Anticonvulsants↗
PubMed1999

Late onset postpartum thrombocytosis in preeclampsia.

BACKGROUND: During pregnancy, changes in blood coagulation and fibrinolysis create a hypercoagulable state. In the puerperium this thrombogenicity is even higher, and the chance of developing thromboembolism is 3-5 times higher in this period than during pregnancy. In preeclampsia, platelets are activated and play a substantial role in the pathogenesis of the disease. Systematic information on longitudinal changes in platelet number and size postpartum after normotensive and preeclamptic pregnancies is not available. METHODS: We measured platelet number, mean platelet volume and the median volume of the 20% largest platelets in eleven preeclamptic and eleven normotensive pregnant women matched for mode of delivery. The blood samples were taken antepartum and every 2-3 days in the postpartum period until the platelet count decreased/normalized. RESULTS: In the preeclamptic group, the platelet count increased significantly from 240x10(9)/l antepartum to 621x10(9)/l on day 6-14 postpartum (p<0.01). In the control group, the platelet count increased from 214x10(9)/l antepartum to 251x10(9)/l on day 2-5 (p<0.01) and 351x10(9)/l on day 6-14 postpartum (p<0.01). The platelet count was significantly higher in the preeclamptic than in the control group 6-14 days postpartum (p<0.01). Antepartum, mean platelet volume and the median of the 20% largest platelets were significantly higher in the preeclamptic than in the control group. CONCLUSION: The platelet count is significantly increased postpartum both after normotensive, and 2-3 fold more after preeclamptic pregnancies. The time to peak values is between 6-14 days, usually at a time when patients are discharged from hospital.

Adult↗
PubMed1998

[Pregnancy, essential hypertension and chronic renal disease].

Women with chronic hypertension or renal disease are at a particular high risk of developing pre-eclampsia or eclampsia. Pre-eclampsia is associated with an increased risk of fetomaternal complications. In women with uncomplicated mild and moderate hypertension, pregnancy is usually normal. Treatment of high blood pressure aims at reducing maternal cardio- and cerebrovascular catastrophies, and the benefit of the treatment must be weighed against possible harmful effects on the foetus. In some cases, antihypertensive treatment can be discontinued, or medication changed. Preconceptional counselling is important both for women with chronic hypertension and, even more so, for women with renal disease, since the outcome of the pregnancy may be affected by the underlying disease.

Female↗
PubMed1998

Smoking, hemoglobin concentration and pregnancy-induced hypertension.

The aim of the study was to assess the effect of cigarette smoking on first- to second-trimester change in hemoglobin (Hb) concentration and the presence of pregnancy-induced hypertension (PIH). In smokers and non-smokers the mean difference between the first- and second-trimester Hb concentration was 1.5-1.6 and 1.3 g/dl, respectively (p < 0.0001). The incidence of PIH among smokers and non-smokers was 4.0 and 7.5%, respectively (p < 0.0001). The risk of PIH increased with increasing second-trimester Hb. After adjustment for factors including previous pregnancies, maternal age and weight gain by logistic regression analysis, the increased Hb declined and the decreased incidence of PIH in smokers persisted.

Female↗
PubMed1998

Capillary protein leak syndrome appears to explain fluid retention in cancer patients who receive docetaxel treatment.

PURPOSE: The aim of our study was to elucidate whether the fluid retention syndrome induced by docetaxel is caused by capillary protein leakage or by other mechanisms. PATIENTS AND METHODS: Twenty-four patients with advanced or metastatic non-small-cell lung cancer (NSCLC; 23 patients) or metastatic head and neck cancer (one patient) were included on this prospective, nonrandomized trial. Docetaxel 100 mg/m2 was administered every 3 weeks with 5 days of dexamethasone prophylaxis to avoid hypersensitivity reactions and edema formation. Transcapillary forces, ie, colloid osmotic pressure of plasma (COPpl) and interstitial fluid (COPint) and interstitial hydrostatic pressure (Pint), were measured before the start of treatment and after total docetaxel doses of 200 and 500 mg/m2 by means of the well-documented wick and wick-in-needle methods. Body weight, degree of edema, blood pressure, and heart rate and hemoglobin, hematocrit, albumin, and total protein values were registered in parallel. RESULTS: After a total docetaxel dose of 200 mg/m2, COPpl, COPint, and hemoglobin, hematocrit, albumin, and total protein values had decreased significantly; Pint and body weight were unchanged; and only mild edema was observed. These findings suggest a plasma volume increase followed by enhanced fluid filtration to the interstitium. After a cumulative docetaxel dose of 500 mg/m2, the COPpl continued to decrease significantly, but COPint remained unchanged despite a significant increase in mean body weight and edema formation. These observations support the theory of a capillary protein leakage. CONCLUSION: Docetaxel appears to induce an initial enhancement of fluid filtration followed by a capillary protein leakage that leads to edema formation.

Adult↗