Search PubMed⌕ Search

Biomedical subjects

R Gagnon

Publications and source records attributed to R Gagnon.

At least 91 records · Page 5Linked to original sources
PubMed1989

Fetal heart rate patterns in the small-for-gestational-age human fetus.

A total of 24 pregnant women with growth-retarded fetuses were studied to examine the distribution of fetal heart rate accelerations between 30 and 40 weeks' gestation, as compared with those of fetuses of normal growth that were matched for gestational age and length of fetal heart rate tracings. Growth-retarded fetuses had significantly lower PO2 levels in the umbilical artery at birth (3 mm Hg less) than did healthy fetuses (p less than 0.05), but without metabolic acidosis. There was a larger proportion of small amplitude (less than 10 beats/min) and a smaller proportion of large amplitude (greater than 20 beats/min) fetal heart rate accelerations in the small-for-gestational-age fetuses than in the fetuses of normal growth. Although the number of accelerations was significantly reduced (50% less) in growth-retarded fetuses compared with healthy fetuses, there was no significant difference in the mean basal fetal heart rate and the mean number of decelerations between the two groups. Currently used definition of an acceleration as greater than or equal to 15 beats/min for greater than or equal to 15 seconds was applicable only in fetuses of normal growth. We hypothesized that a decrease in absolute acceleration frequency might be a useful index to detect the chronically hypoxemic fetus before severe metabolic acidosis and irreversible damage occurred.

Blood Gas Analysis↗
PubMed1989

Human fetal behavioral states after vibratory stimulation.

A total of 14 healthy pregnant women between 37 and 41 weeks' gestational age were studied to determine the effects of a 5-second external vibratory stimulus (100 Hz, square wave) on human fetal behavioral states. Fetal behavioral state observations were made with simultaneous recordings of fetal heart rate, gross fetal body movements, and fetal eye movement between 8:30 AM and 4:00 PM. During the first episode of behavioral state 1F (quiet sleep state) greater than or equal to 10 minutes duration on two consecutive half days, the vibratory stimulus was placed on the surface of the maternal abdomen over the fetal head. Each fetus received one 5-second vibratory stimulus during either the first or second half day of observation. The time at which the instrument was applied but no vibratory stimulus was administered was considered as the control period. All women were then observed for 2 hours after the control period and after stimulation. A transition period from a quiet sleep state to a stable active sleep state (state 2F, rapid eye movement sleep) averaged less than or equal to 3 minutes after stimulation, as compared with 23 minutes after the control period. These changes in fetal behavioral states persisted for 20 minutes after vibratory stimulation. There also was an immediate and sustained increase in long-term fetal heart rate variability, the number of fetal heart rate accelerations and gross fetal body movement during the first 20 minutes after stimulus, without changes in basal fetal heart rate. We hypothesize that changes in fetal behavior seen after application of low frequency vibratory stimulus are more physiologic than the profound changes in fetal heart rate and gross fetal body movement previously described after vibratory acoustic stimulation with an electronic artificial larynx.

Behavior↗
PubMed1989

Effects of low-frequency vibration on human term fetuses.

Thirteen healthy pregnant women between 37 and 41 weeks' gestational age were studied to examine effects of a 5-second external vibratory stimulus (100 Hz, square wave) on fetal heart rate, fetal breathing, and gross fetal body movement patterns. All fetuses were stimulated during an episode of low fetal heart rate variability (mean minute range less than or equal to 32 milliseconds for greater than or equal to 5 minutes) lasting at least 5 minutes. There was an immediate and sustained increase in long-term FHR variability, number of FHR accelerations, and gross fetal body movements after stimulation. Fetuses made breathing movements more irregularly after vibratory stimulus. We hypothesize that external low-frequency vibratory stimulus, applied during episodes of low fetal heart rate variability, causes a change from a state of quiet sleep to a state of rapid-eye-movement sleep in healthy term fetuses.

Acoustic Stimulation↗
PubMed1989

Cerebral oxidative metabolism in lambs during perinatal period: relationship to electrocortical state.

Cerebral oxidative metabolism and regional blood flow were studied, with changes in behavioral state over the immediate perinatal period, to determine the change in cerebral metabolism at birth and the relationship to behavioral activity. Nine unanesthetized fetal sheep (139-142 days gestation) were each studied during a period of high-voltage and low-voltage electrocorticogram (ECOG) activity and then again after cesarean delivery at 2 h of age while awake and at 24 h of age while awake and during a period of high-voltage ECOG sleep. Preductal arterial and sagittal vein blood samples were analyzed for O2 content, blood gases, and pH. Blood flow was measured with a radioactive microsphere technique. Cerebral oxidative metabolism showed no significant perinatal change, although a coupling to behavioral state was evident with significant increases during both the perinatal low-voltage ECOG state and the awake state at 24 h. Blood flow to the brain showed a significant perinatal decrease after birth and state-related increases during both the prenatal low-voltage ECOG state and the awake state at 24 h consistent with the tight coupling of flow and/or O2 delivery to metabolic needs reported for normal brain tissue. The cerebral metabolic rate of the prenatal low-voltage ECOG state suggested a level of functional excitation comparable with that of the awake state after birth, supporting the importance of the rapid-eye-movement (REM) state mechanism as a source of endogenous stimulation during the perinatal period of brain growth and development.

Animals↗
PubMed1989

Acoustic stimulation: effect on heart rate and other biophysical variables.

It is clear that external vibroacoustic stimulation produces remarkable changes in fetal heart rate and fetal movement patterns which are related to changes in fetal behavior. The clinical significance of these effects on human fetuses has been addressed by many authors in series of small number of patients involved. There is an obvious lack of uniformity in the different protocols used to determine the predictive value of fetal acoustic stimulation in the assessment of fetal health. Current knowledge of the normal responses of healthy human fetuses to acoustic stimulation and the limitations of this type of testing should be taken into account to determine more accurately the negative and positive predictive value for fetal outcome.

Acoustic Stimulation↗
PubMed1989

Stimulation of human fetuses with sound and vibration.

It is clear that external vibroacoustic stimulation with the EAL produces remarkable changes in FHR and fetal movement patterns that are related to changes in fetal behavior. The clinical significance of these studies has been addressed in small series on human fetuses by many authors. There is an obvious lack of uniformity in the different protocols used to determine the predictive value of FAS in the assessment of fetal health. Current knowledge of the normal responses of healthy human fetuses to acoustic stimulation and the limitations of this type of testing should be taken into account to determine more accurately the negative and positive predictive values for fetal outcome. Currently available data are not sufficient to evaluate clinical efficiency of such stimuli to predict fetal compromise.

Acoustic Stimulation↗
PubMed1988

Fetal heart rate and activity patterns in growth-retarded fetuses: changes after vibratory acoustic stimulation.

Seventeen pregnant women who subsequently were delivered of infants with birth weights less than the third percentile were studied for examination of fetal heart rate and fetal activity patterns before and after a 5-second external vibratory acoustic stimulation. None of the fetuses was acidotic at birth. A reduced time was noted during which accelerations in heart rate occurred (50% less) and long-term fetal heart rate variability (25% less) in small for gestational age fetuses compared with age-matched, normally grown fetuses. The incidence of gross fetal body movements was significantly lower (40% less) in small for gestational age fetuses than in those who were appropriate for gestational age. Fetal heart rate and fetal activity patterns after stimulation with the electronic artificial larynx in small for gestational age fetuses were similar to those of appropriate for gestational age fetuses.

Acoustic Stimulation↗
PubMed1988

Circulatory responses to prolonged hypoxemia in fetal sheep.

Experiments were conducted in 11 chronically catheterized pregnant sheep to determine the distribution of blood flow within the fetus during prolonged (48 hours) hypoxemia secondary to the restriction of uterine blood flow. Uterine blood flow was mechanically restricted with a polytetrafluoroethylene vascular clamp placed around the maternal common internal iliac artery such that mean (+/- SEM) fetal arterial oxygen tension decreased from 23.4 +/- 1.9 to 17.3 +/- 0.8 mm Hg at 1 hour of hypoxemia and remained low for 48 hours. There was an initial increase in fetal arterial carbon dioxide pressure from 48.5 +/- 0.9 mm Hg during the control period to 56.2 +/- 2.3 mm Hg at 1 hour; this parameter subsequently returned to control values, whereas base excess showed a transient decrease. Fetal cerebral, myocardial, and adrenal blood flows were significantly increased at 1, 24, and 48 hours of hypoxemia. In contrast, there was no change in nuchal muscle or renal blood flows with hypoxemia of this magnitude. Cotyledonary blood flow increased transiently by 38% at 1 hour of hypoxemia, but was not changed from control at 24 and 48 hours. These experiments demonstrate that the sheep fetus is able to maintain the normal protective circulatory adjustments seen with acute hypoxemia for up to 48 hours in the absence of progressive metabolic acidemia.

Animals↗
PubMed1988

Fetal heart rate and fetal activity patterns after vibratory acoustic stimulation at thirty to thirty-two weeks' gestational age.

Twenty pregnant women between 30 and 32 weeks' gestational age were studied to examine the effects of a 5-second external vibratory acoustic stimulus on the fetal heart rate, fetal heart rate variability, and fetal activity patterns. There was an immediate significant increase in the basal fetal heart rate for 10 minutes compared with controls. There was also a significant increase in the mean duration of fetal heart rate accelerations without any change in the number of fetal heart rate accelerations. There were no changes in long-term fetal heart rate variability, fetal breathing, and gross fetal body movements.

Acoustic Stimulation↗
PubMed1988

Umbilical and uterine artery blood flow velocities after vibratory acoustic stimulation.

Twelve healthy pregnant women between 37 and 41 weeks' gestational age were studied to determine the effects of external vibratory acoustic stimulation on the blood flow velocity waveform in the umbilical and uterine arteries. There was a significant decrease in umbilical peak-systolic/end-diastolic ratio during the first 5 minutes after stimulus after comparison with control ratios. Analysis of the frequency distribution of instantaneous fetal heart rate values during Doppler measurements suggested that the decrease in umbilical peak-systolic/end-diastolic ratio was due to fetal tachycardia rather than a change in the placental vascular resistance. The uterine artery peak-systolic/end-diastolic ratio was not altered after vibratory acoustic stimulation.

Acoustic Stimulation↗
PubMed1988

Fetal responses to vibratory acoustic stimulation: influence of basal heart rate.

Forty-three healthy pregnant women between 26 and 40 weeks' gestation were studied to determine the influence of prestimulation basal heart rate on the maximum amplitude of the first fetal heart rate acceleration after external vibratory acoustic stimulation. A significant negative correlation was found between the maximum amplitude of the first fetal heart rate acceleration and the prestimulation basal fetal heart rate from 30 weeks to term. In the presence of fetal tachycardia (basal fetal heart rate greater than 160 beats/min), more than 50% of fetal heart rate accelerations after stimulus were less than 15 beats/min amplitude. There was also a significant maturational process in the immediate fetal heart rate response to vibratory acoustic stimulation that occurred between 26 to 28 and 30 to 32 weeks characterized by a prolonged increase in basal fetal heart rate and an increase in the maximum amplitude of the first acceleration after stimulation.

Acoustic Stimulation↗
PubMed1988

Behavioral activity during prolonged hypoxemia in fetal sheep.

Experiments were conducted in unanesthetized, chronically catheterized pregnant sheep to determine the fetal behavioral response to prolonged hypoxemia produced by restricting uterine blood flow. Uterine blood flow was reduced by adjusting a vascular occluder placed around the maternal common internal iliac artery to decrease fetal arterial O2 content from 6.1 +/- 0.3 to 4.1 +/- 0.3 ml/dl for 48 h. Associated with the decrease in fetal O2 content, there was a slight increase in fetal arterial PCO2 and decrease in pH, which were both transient. There was an initial inhibition of both fetal breathing movements and eye movements but no change in the pattern of electrocortical activity. After this initial inhibition there was a return to normal incidence of both fetal breathing movements and eye movements by 16 h of the prolonged hypoxemia. These studies indicate that the chronically catheterized sheep fetus is able to adapt behaviorally to a prolonged decrease in arterial O2 content secondary to the restriction of uterine blood flow.

Adaptation, Physiological↗
PubMed1987

Maternal and neonatal outcome in pregnancies with no risk factors.

Between November 1979 and April 1984, 790 consecutive pregnant women who considered themselves as having a "normal" pregnancy were followed in private practice from 9 weeks' gestation until 6 weeks post partum. The women had no pre-existing disease or problem classified as a risk to the pregnancy at the time of their first visit, had a singleton pregnancy and gave birth at Notre-Dame Hospital, Montreal. Maternal complications occurred during the course of pregnancy in 181 women (23%). Complications were mostly related to obstetric conditions (10%), such as preterm labour, intrauterine growth retardation (IUGR) and antepartum hemorrhage, or to medical conditions (12%), the most prevalent of which was hypertension (77% of medical conditions). Neonatal complications occurred in 183 infants (23%). The corrected perinatal death rate was 2.5 per 1000. Prematurity, IUGR and dysmaturity/postmaturity accounted for nearly half of the complications. Hyperbilirubinemia occurred in 7% of the cases. Among women without any maternal complications during pregnancy, the frequency rate of neonatal complications was 19%, compared with 23% among the entire group of 790 women. Our results suggest that the absence of maternal complications does not protect the infant from a neonatal complication. Further refinement is needed to identify markers of obstetric, medical and neonatal complications in pregnancies with no risk factors.

Adult↗
PubMed1987

External vibratory acoustic stimulation near term: fetal heart rate and heart rate variability responses.

Twenty-five pregnant women between 36 and 40 weeks' gestational age were studied to examine effects of a 5-second external vibratory acoustic stimulus on the fetal heart rate and fetal heart rate variability. There was an immediate significant increase in the basal heart rate, which persisted for 1 hour after the stimulus, compared to that of the control subjects. There was also a significant increase in the total time during which accelerations occurred for the first 20 minutes after the stimulus. There were no changes in computer-derived indices of fetal heart rate variability. Maternal blood pressure and heart rate were not altered following vibratory acoustic stimulus. We hypothesize that external vibratory acoustic stimulus causes a change from a state of sleep to a state of wakefulness in near term healthy fetuses.

Acoustic Stimulation↗
PubMed1987

Patterns of human fetal heart rate accelerations from 26 weeks to term.

Computerized analysis of the distribution of 2598 fetal heart rate accelerations in 83 healthy fetuses at 26 to 40 weeks' gestation demonstrated that the currently used definition of an acceleration as greater than or equal to 15 beats/min for greater than or equal to 15 seconds is applicable only after 30 weeks' gestational age in fetuses with a basal fetal heart rate of less than or equal to 128 beats/min. A significant negative correlation was found between the mean hourly basal fetal heart rate and the mean amplitude of fetal heart rate accelerations from 30 weeks to term. There was also a significant maturational process in the pattern of fetal heart rate and fetal heart rate accelerations that occurred between 26 and 28 and between 30 and 32 weeks; this was characterized by a decrease in basal fetal heart rate, an increase in the amplitude of fetal heart rate accelerations, and an increase in long-term fetal heart rate variability.

Embryonic and Fetal Development↗
PubMed1987

Human fetal responses to vibratory acoustic stimulation from twenty-six weeks to term.

Eighty-three healthy pregnant women between 26 and 40 weeks' gestational age were studied to examine effects of a 5-second external vibratory acoustic stimulus on the fetal heart rate, fetal breathing, and gross fetal body movement patterns. There was an immediate fetal heart rate response, following stimulus, characterized by an increase in duration of fetal heart rate accelerations from 26 weeks to term with an increase in basal fetal heart rate after 30 weeks. There was also a delayed response after 33 weeks' gestation, which consisted of an increase in the number of fetal heart rate accelerations and the incidence of gross fetal body movements for up to 1 hour after a 5-second stimulus with the electronic artificial larynx. Term (36 to 40 weeks) fetuses made breathing movements more irregularly after vibratory acoustic stimulation. We suggest that human fetal responses to stimulation with the electronic artificial larynx may reflect a functional maturation of the fetal central nervous system.

Acoustic Stimulation↗
PubMed1987

Dialyzer reuse following manual reprocessing with a new sterilant, RenNew-D.

Dialysis patients are at risk for toxicity from formaldehyde used in the reprocessing of dialyzers for reuse; therefore, replacing formaldehyde as a dialyzer sterilant would be advantageous. The potential for RenNew-D as a sterilizing agent was investigated in seven stable in-center hemodialysis patients over 20 consecutive dialyses with cuprammonium cellulose hollow-fiber dialyzers. Treatment with RenNew-D showed no toxicity to patients or dialyzers except for two blood leaks occurring in one patient. The mean number of dialyzer uses was 4.9. In all the dialyzers that passed functional testing small solute clearances were maintained with reuse. The ability of RenNew-D to improve the biocompatibility of reused dialyzers was documented with mean neutrophil counts falling to only 78% of initial values during first reuse of dialyzers processed with RenNew-D compared with a decrease in neutrophil count to 2% of initial values during first use of the same dialyzers. Our results suggest that RenNew-D may be a useful alternative to formaldehyde for the purpose of dialyzer reuse. A reuse procedure that includes processing with RenNew-D is associated with improved biocompatibility, possibly because of maintenance of the blood-derived membrane coating established during prior dialysis.

Adult↗