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Biomedical subjects

R Erkkola

Publications and source records attributed to R Erkkola.

At least 55 records · Page 3Linked to original sources
PubMed1994

The effects of regional anaesthesia for caesarean section on maternal and fetal blood flow velocities measured by Doppler ultrasound.

We studied the effects of spinal anaesthesia (Group S), epidural anaesthesia (Group E), and combined spinal and epidural anaesthesia (Group SE), on maternal and fetal blood flow in 24 healthy parturients (n = 8/group) with uncomplicated singleton pregnancies using Doppler technique. Prior to the induction of anaesthesia, the patients were prehydrated with balanced electrolyte solution 15 ml.kg-1 over a period of 15 min. After the induction of regional anaesthesia, the systolic blood pressure was maintained within 15% limits of the preoperative values using prophylactic etilefrine infusion in Groups S and SE. The flow velocity waveforms of the maternal femoral artery, the main branch of the uterine artery (placental side), the foetal umbilical and middle cerebral arteries were recorded by Doppler technique before and after prehydration as well as after onset of T7 analgesia and the pulsatility indices (PI) were derived. Rapid intravenous prehydration had no effects on uteroplacental or fetal circulation as indicated by unaltered uterine, umbilical, and fetal middle cerebral artery PIs. After the onset of T7 analgesia, the uterine artery PI was increased in Group S indicating increased uterine vascular resistance while no changes occurred in Groups E and SE. No adverse effects were observed on the neonates as indicated by the Apgar score and the umbilical artery and vein acid-base status in any of the groups.

Adult↗
PubMed1994

Review of beta-lactam antibiotics in pregnancy. The need for adjustment of dosage schedules.

beta-Lactam antibiotics represent the oldest class of antibiotics used in the treatment of infections, and benzylpenicillin (penicillin G) is still the most commonly used antibiotic agent during pregnancy. There is a number of studies to suggest that the pharmacokinetics of beta-lactam antibiotics are altered during pregnancy, indicating faster elimination of these antibiotics and lowered plasma concentrations. These changes are largely related to the physiological changes taking place in the maternal body. Generally, drugs are used cautiously during pregnancy, and dosages used may sometimes be inadequate. With regards to antibiotic agents, assurance of adequate therapy by applying pharmacokinetic knowledge when dosage schedules are designed should be a major concern so that the pregnancy is protected from the hazards of infection.

Anti-Bacterial Agents↗
PubMed1994

Serum testosterone, androstenedione and luteinizing hormone levels after short-term medroxyprogesterone acetate treatment in women with polycystic ovarian disease.

BACKGROUND: Medroxyprogesterone acetate (MPA)-treatment suppresses serum gonadotropin and androgen concentrations in women with polycystic ovarian disease (PCOD). This study was designed to determine serum testosterone (T), androstenedione (A) and luteinizing hormone (LH) patterns in a group of oligomenorrheic PCOD patients after MPA-treatment. METHODS: The study group consisted of 11 women with ultrasonographically diagnosed PCOD. Blood samples were drawn in the morning in fasting conditions first during oligomenorrhea and then within one week after MPA-induced bleeding. After that the sampling was repeated four times at one week intervals. Student's paired t-test was used for statistical calculations. RESULTS: The levels of T, A and LH decreased significantly after MPA-treatment. During the follow-up the T and A concentrations increased significantly till the third sampling week, after which no further increases were found. CONCLUSIONS: Our results show that T and A secretion return to levels characteristic of PCOD after discontinuation of MPA-treatment within a few weeks in women with PCOD.

Adult↗
PubMed1994

Postpartum diagnosis of placenta accreta with colour Doppler sonography.

Placenta accreta, although uncommon, is becoming an increasingly important clinical problem associated with placenta praevia and previous Caesarean section. A case report is presented of a woman with post partum partial placenta accreta diagnosed with color Doppler ultrasound. The aetiology, risk factors, clinical conditions, treatment and sonographic diagnosis are shortly reviewed.

Adult↗
PubMed1994

Hypoglycemia is common in preterm infants in intensive care.

The blood glucose concentration was measured once daily during the first five days of life in forty appropriate-for-gestational age preterm infants in intensive care. They received human milk and 10% glucose perorally and intravenously. Moderate hypoglycemia (B-Gluc < 2.5 mmol/l) was common in these infants (42%) during the first three days of life. Four infants had severe hypoglycemia (B-Gluc < 0.6 mmol/l) during the first day of life. These data suggest that screening for hypoglycemia will be needed for optimal treatment in preterm infants in intensive care.

Blood Glucose↗
PubMed1994

Meconium aspiration syndrome.

In the years 1977-82, 43 infants with the meconium aspiration syndrome (MAS) were managed at the Department of Paediatrics of Turku University Central Hospital (TUCH), Finland. Among 5,353 deliveries in one year the incidence of meconium staining was 8.7%. By extrapolation, the incidence of meconium aspiration in all newborns is approximately 0.13%. The mean duration of the pregnancies was 39.2 +/- 2.6 (SD) weeks and the weight of newborns was 3570 +/- 692 g which were similar to those of the reference group. The rate of Cesarean sections in the group with MAS was significantly higher than in the reference group (40% and 11.6%, respectively). Sixty-nine per cent of the newborns with MAS showed signs of depression during or after labour, while the incidence of same symptoms in the reference group was only 2.7% (P < 0.001). None of the infants with MAS died. Late sequelae were encountered in three babies in 1 to 6 years of follow-up.

Child↗
PubMed1994

Plasma endothelin-1 in the neonatal respiratory distress syndrome.

In order to study the contribution of the vasoconstrictory peptide endothelin-1 (ET-1) to the elevation of the pulmonary vascular resistance in the neonatal respiratory distress syndrome (RDS) seven preterm infants were studied at 2, 24 and 48 hours of age for plasma ET-1 concentrations and systolic pulmonary artery pressure (PAP), measured by Doppler sonography. Plasma ET-1 levels were high during the first day after birth, but declined soon to normal levels thereafter. During the study period, the systolic PAP also decreased, whereas the systemic pressure remained unchanged. There were no correlations between plasma ET-1 and vascular pressures, but there was a significant association between ET-1 and the requirement of supplemental oxygen and the arterial-alveolar oxygen tension ratio. Our results thus suggest that high plasma ET-1 levels in the acute phase of RDS reflect the severity of the pulmonary disease, but may not significantly contribute to the elevation of the pulmonary vascular resistance in the RDS.

Echocardiography, Doppler↗
PubMed1994

Incidence of bronchopulmonary dysplasia during an 11-year period in infants weighing less than 1500 g at birth.

We studied the occurrence of bronchopulmonary dysplasia (BPD) during an 11-year period in infants weighing less than 1500 g at birth and looked for differences between the periods 1980-1985 (216 infants) and 1986-1990 (217 infants). During the neonatal period, 91 infants died, which gives a neonatal survival rate of 79%. Forty-nine infants developed BPD, which is 11% of all infants and 14% of the infants surviving the neonatal period. The incidence of BPD did not change during the two study periods (11.6% and 11.1%). On the other hand, the study populations changed in many respects. The number of infants with a birth weight of less than 1000 g increased, the incidence of severe RDS increased, and infant mortality decreased. Hence, there was a small decrease in the incidence of BPD in infants surviving the neonatal period from 14.9% to 13.8%. Severe RDS and a birth weight of less than 1000 g were clearly related to the development of BPD. In these two risk-groups the decrease in the incidence of BPD in neonatal survivors was pronounced.

Birth Weight↗
PubMed1994

Hydatidiform mole in a 56-year-old woman.

We present a rare case of a hydatidiform mole that occurred in a 56-year old woman. The main symptom was prolonged vaginal bleeding, and the gynaecological examination revealed a markedly enlarged uterus. Sonography revealed a 9 x 15 cm large cystic tumour in the pelvis. At operation, a suspicion of trophoblastic disease was arosen. Serum human chorion gonadotropin was still markedly elevated on the fifth postoperative day. After removal of the uterus and adnexae the recovery and the 3-year follow-up have been uneventful.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1994

Comparison of intravaginal and two intracervical prostaglandin E2 gels in pre-induction of labour.

A randomized study was undertaken to compare the effect of vaginal (1 mg of dinoprostone/2.5 ml gel) and intracervical (0.5 mg of dinoprostone in 2.5 ml of two different vehicles) on induction of labor and perinatal outcome. Sixty women (n = 20/20/20) who presented with an unfavorable cervix and a specific indication for the induction of labor participated in the study. There were no significant differences between the groups with respect to maternal age, weight, parity, gestational length or Bishop scores before prostaglandin E2 preinduction. Labour was induced with prostaglandin gel alone in twenty-two patients and with oxytocin infusion on the following morning after gel application in seven patients; altogether the rate of successful induction was 48.3%. The rate of uterine hyperstimulation was 16.7% with most cases in the groups receiving intracervical prostaglandin E2. Neonatal asphyxia diagnosed with umbilical vein and artery blood gas analysis was seen in eleven neonates who were delivered by labor induced with prostaglandin gel alone (50%). Prostaglandin pre-induction decreases the need for Cesarean sections in complicated pregnancies, but because of the risk of uterine hyperstimulation and neonatal asphyxia prostaglandins should be used only with specific indications.

Administration, Intravaginal↗
PubMed1994

Maternal mortality in Finland 1970-89.

All cases of maternal death in the years 1970-89 in Finland were reviewed, and the clinical background was analyzed. There was a 47% decrease in the mortality when the two decades were compared. In the 1980's the maternal mortality was 4.74 per 100,000 births, which is comparable to figures from the other Nordic countries.

Abortion, Illegal↗
PubMed1994

The fetal cardiovascular function in chronic placental insufficiency is different from experimental hypoxia.

Ten mothers at normal term pregnancy were rendered mildly hypoxic by allowing them to breathe a gas mixture of 10% oxygen and 90% nitrogen. The fetuses were studied with Doppler ultrasound and computer assisted cardiotocography. There was vasodilatation in the cerebral vasculature while the utero-placental blood flow decreased. No changes in fetal haemodynamics occurred. The fetal heart rate was correlated inversely to the heart rate variation. There was a positive correlation between the heart rate variation and the umbilical flow velocity waveform index. In a group of 30 subjects with severe pre-eclampsia and/or severe intrauterine growth retardation, the fetal heart rate variation was inversely correlated to the umbilical blood flow. Hence, the study shows a clear physiological difference in fetal heart function during short-term hypoxia compared to that during long term placental insufficiency.

Adult↗
PubMed1994

Acute exercise- and drug-induced potassium shifts during pregnancy.

The exercise- and drug-induced potassium shifts in pregnant women was studied. Six healthy nonpregnant women, six healthy pregnant women and four hypertensive, pregnant women on labetalol performed a bicycle exercise test. Blood samples for plasma potassium concentrations were drawn before, during and after the exercise. The exercise-induced plasma potassium increase was 0.9 +/- 0.2 mmol/l in healthy control women and 0.8 +/- 0.1 mmol/l in healthy pregnant women. In hypertensive pregnant women on labetalol the increase was 0.3 +/- 0.3 mmol/l (P < 0.01). There was a negative correlation (r = 0.941, P = 0.05) between the plasma potassium and labetalol concentration. Our results suggest that the potassium exchange during normal pregnancy is not changed. Labetalol reduced the exercise-induced plasma potassium increase which contrasts to other beta-blocking agents which usually augment the plasma potassium increase caused by exercise.

Adult↗
PubMed1994

Diagnostic transabdominal amnioinfusion in a case of anhydramnion and fetal kidney dysplasia.

Diagnostic transabdominal amnioinfusion was performed at 32 weeks of gestation in a case of anhydramnion. Before saline infusion, no exact fetal structures could be identified by sonography. Also, there was a total diastolic block in the fetal aorta (FA) and umbilical artery (UA). After infusion of 270ml of saline, the diastolic blocks in the FA and UA disappeared, and, after another infusion of 410ml of saline, severe fetal congenital kidney abnormalities were identified. Transabdominal amnioinfusion is a practical aid to fetal sonography in severe oligohydramnion and anhydramnion.

Adult↗
PubMed1994

Flow velocity waveforms in the uterine artery in high risk pregnancies.

Blood flow velocity investigations by applying Doppler method have emerged as a useful tool in obstetrics and gynaecology. The final role of the method is still to be established. Thus far, the umbilical artery Doppler indices have been preferred to the utero-placental indices. We have analysed the Doppler indices from the main branch of uterine artery in 280 women with singleton pregnancy in the third trimester. While fetal blood flow velocities in the cerebral arteries or in the umbilical artery are still unchanged, the increase in the uterine artery resistance may serve as an early indicator of the increased risk to the fetus.

Adult↗
PubMed1993

DNA aneuploidy in ectopic pregnancy and spontaneous abortions.

The nuclear DNA content of 55 ectopic tubal pregnancies was studied by flow cytometry from paraffin embedded tissue blocks. An abnormal amount of DNA content was found in 24% of the cases. This was a significantly higher percentage than encountered in 92 spontaneous abortions studied by the same method in the same population (8%, P = 0.01). The result indicates that, in addition to the maternal factors, abnormal embryogenesis with grave chromosomal aberrations may play a major role in the etiology of ectopic pregnancy.

Abortion, Spontaneous↗
PubMed1993

Risk factors and deliveries associated with preterm, severely small for gestational age fetuses.

Maternal and fetal risk factors and deliveries associated with 153 singleton, preterm, severely small for gestational age (SGA) fetuses were compared to the corresponding data of 153 next-born preterm appropriate for gestational age (AGA) fetuses matched for gestational age. Maternal history of previous delivery of an infant of SGA status, pre-eclampsia, hypertension without proteinuria, oligohydramnios, and fetal congenital anomalies were identified as risk factors for preterm, severely SGA deliveries. In the preterm, severely SGA group the rate for abdominal deliveries was 82%. Of these operations, 40% were emergency cesarean sections, many of which involved pre-eclampsia cases. If congenital malformations were excluded, perinatal mortality rate was 7% in the preterm SGA group and 4.6% in the preterm AGA group. Preterm, severely SGA fetuses constitute a perinatal risk group, which cannot be avoided. However, awareness of and familiarity with the risk factors associated with preterm, severely SGA cases can better equip the attending physician to consider appropriate perinatal care options.

Cesarean Section↗