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Biomedical subjects

R Rudelstorfer

Publications and source records attributed to R Rudelstorfer.

At least 37 records · Page 2Linked to original sources
PubMed1988

[The older primipara: labor induction and rigidity of the soft tissues].

Textbooks and literature reports frequently view the primipara of advanced age as a group being at increased risk of prolonged labor, dystocia, injuries to the birth canal and fetal distress. Particularly, a rigid cervix and reduced elasticity of the soft tissues of the birth canal are claimed responsible for these risks. Clinically, this view causes a higher frequency of operative deliveries in this group of primipara. The aim of the study was to evaluate the influence of a rigid cervix and/or reduced elasticity of the soft tissues in the birth canal on the course of labor. According to the definition of the FIGO we identified 201 primipara of advanced age as being more than 35 years old in our database. 5966 primipara (age 18-34) served as control. No significant difference was found in regard to Bishop score, progress of labor, vaginal and perineal lacerations, fetal distress and anaesthesia. However, the overall frequency of operative deliveries was increased from 27% to 58% in the primiparas of advanced age. In particular, the incidence of caesarean section increased from 11.5% to 39%. In 66% rigid tissues were called as one of the reasons for operative delivery in this group of aged primipara. However, our analysis of clinical variables does not support the notion that these women in general have an increased frequency of dystocia and/or a more rigid cervix and decreased elasticity of the birth canal. We feel that in a considerable number of patients, the concern of the obstetricians and the women in a safer and less painful delivery by caesarean section are reasons for these increased operative procedures at the end of the reproductive period.

Adult↗
PubMed1988

[Comparison of Doppler flow measurements of the arcuate artery and uterine artery in fetal growth retardation].

Transabdominal Doppler velocimetry in the arcuate arteries has been the widest used technique for the assessment of uterine perfusion despite theoretical and physiological drawbacks. The size of arcuate arteries is beyond the resolution of modern scanners. They represent terminal branches of the uterine vasculature and do not provide information regarding total uterine blood supply. Transvaginal Doppler velocimetry of the main uterine arteries on its course through the parametrium by means of a newly developed frontally radiating 240-degree "panorama" sector scanner promised a solution. The aim of the study was to compare the A/B ratios in both arteries (i.e. arcuate vs. main uterine) in pregnancies with a growth retarded fetus below the 10th percentile, as defined by ultrasound biometry. We wondered firstly which vessel better demonstrates velocity waveforms leading to growth retarded newborns defined by a birth weight beyond the 10th percentile (Hohenauer) and secondly, how frequently pathological A/B ratios in the uterine vessels are associated with pathological A/B ratios in the umbilical arteries. In 25 growth retarded fetuses (ultrasound biometry), we found more often pathological waveforms in the arcuate arteries (n = 20) than in the main uterine arteries (n = 18). Pathological waveforms in all three vessels (arcuate, main uterine, umbilical) were found in 12, in the arcuate and umbilical vessels in 13, and in the main uterine and in umbilical artery in 17 cases. Six fetuses were within the normal weight range at delivery indicating normal fetal growth. Pathological A/B ratios in the main uterine artery were more often associated with a growth retarded newborn.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

[Sex behavior and vaginal flora in climacteric and postmenopausal females].

515 menopausal or postmenopausal women visiting the gynecologic clinic of a university hospital and having received no hormonal replacement therapy were screened for frequency of sexual intercourse and clinical symptoms typical for this period in life by a questionnaire. We found that a high percentage of women are still sexually active even with advanced age. It appeared that sex life is more intensive right after the menopause. A decrease of sexual intercourse after an age of 66 years and older seems to be secondary to the lack of a partner. Older women who remained sexually active had significantly more often a pathologic vaginal smear. We conclude that even in older women, when seen for consultation, it remains important to take into account possible sexual activity in regard to the diagnosis and therapy of vulvovaginitis.

Aged↗
PubMed1987

Scalp heat flux and its relationship to scalp blood pH of the fetus.

A method for directly assessing the metabolic rate of the fetus for optimal management of labor and delivery is still being studied. Since heat, an end product of metabolism, is dissipated from the fetal surface, we measured the heat flux from the fetal scalp and related it to the pH of fetal scalp blood, a measure of metabolism. In 25 human fetuses at risk of intrapartum hypoxia, after the membranes had ruptured and the cervix dilated to greater than 3 cm, we attached a heat flux transducer, a platelet of 2.5 cm diameter and 1 mm thickness, to the fetal scalp and recorded continuously the heat flux from then until delivery. We also obtained one sample of fetal scalp blood in all patients and two such samples in 13 patients for the analysis of pH. We found a significant correlation between heat flux measured immediately before the scalp blood sampling (presampling values) and the pH of fetal scalp blood (r = 0.736; n = 18 presampling values; p less than 0.001). Out of 13 fetuses with two scalp blood samples, the changes in the scalp heat flux paralleled changes in scalp blood pH in 11. We conclude that fetal scalp heat flux is related to the metabolic condition of the fetus. Measuring scalp heat flux during labor could be developed into a noninvasive method for a continuous and more direct assessment of the fetal metabolic rate.

Adult↗
PubMed1986

Experimental hypertension in pregnant sheep. III. Central hemodynamic alterations in the one-kidney model.

Experimental renal hypertension, with use of the one-kidney, one-clip model, was produced in nine pregnant ewes who were then studied during the last one third of gestation. The animals were chronically instrumented for the recording of arterial pressure, heart rate, and cardiac output; blood volume was determined weekly. The studies were carried out in four phases; a control period of 2 weeks, a surgery period of 1 week, a constriction or hypertensive period, and a postpartum period of 2 weeks. We detected no significant changes in heart rate or cardiac output during any phase of the study. The arterial pressure significantly increased during the constriction and postpartum phases (p less than 0.05). Blood volume remained relatively stable during the three pregnancy phases but significantly decreased in the postpartum phase (p less than 0.05). Systemic vascular resistance followed a pattern similar to that of the arterial pressure.

Animals↗
PubMed1986

Circulatory responses to hypovolemia in the pregnant and nonpregnant sheep after pharmacologic sympathectomy.

Circulatory responses to progressive hypovolemia, hypotensive shock, blood reinfusion, and recovery were studied in pregnant and nonpregnant sheep with an intact or pharmacologically ablated sympathetic nervous system produced by administration of 6-hydroxydopamine. These studies also provided an opportunity to assess the contribution of the sympathetic nervous system to the maintenance of vasomotor tone in the pregnant animal at rest. The results show the following: (1) Although there were some differences in the circulatory adjustments to the initial period of blood loss between intact and "sympathectomized" animals, the overall circulatory responses to progressive hypovolemia, shock, blood reinfusion, and recovery were not significantly different in animals with intact or ablated sympathetic nervous systems whether or not they were pregnant. (2) The reasons for the similarity of cardiovascular responses to hypovolemia are the marked increase in catecholamine outputs by the adrenal medulla, which was not affected by 6-hydroxydopamine, and the supersensitivity of the systemic vascular beds of the sympathectomized animal to catecholamines. (3) The contribution of the sympathetic nervous system to the maintenance of the resting vasomotor tone is considerably enhanced during pregnancy, as demonstrated by the chronic effects of adrenergic ablation on the resting arterial pressure. (4) The circulation of the pregnant uterus possesses the ability of autoregulation during chronic changes of perfusing pressure as demonstrated by the differences in the arterial pressure and uteroplacental vascular resistance between intact and sympathectomized animals.

Adrenal Medulla↗
PubMed1986

Heat flux and oxygen consumption of the pregnant uterus.

Heat flux (conductive and convective heat) and oxygen consumption of the pregnant uterus and its content were measured simultaneously in the same group of pregnant ewes during the acute postoperative period, during a chronic resting period, and during alpha- and beta-adrenergic-receptor stimulation with norepinephrine and ritodrine. Results indicated four conclusions. First, an excellent correlation existed between heat flux and oxygen consumption in the acute and chronic resting condition as well as during increasing uteroplacental vascular resistance and decreasing blood flow produced by norepinephrine infusion; the correlation was not as good during ritodrine infusion. Second, during rest, about 85% of heat generated by the pregnant uterus is eliminated through the uteroplacental circulation while the remaining heat diffuses through the myometrium. Third, during decreasing uteroplacental blood flow and elevated resistance, the pregnant uterus is able to maintain a normal thermostasis by widening the temperature difference in the blood entering and leaving the uterus and by increasing the myometrial heat exchange; oxygen consumption also is maintained at normal level through increase in oxygen extraction. Fourth, with the exception of uteroplacental circulation, the circulatory, metabolic, and thermal conditions of the pregnant ewe are not different after 5 hours from 5 to 7 days after the surgical procedure.

Animals↗
PubMed1986

Detection of antibodies in pregnancy serum reacting with isolated placental basement membrane collagen.

Adsorption of human IgG from pregnancy sera to placental basement membrane collagen could be demonstrated by an in-vitro assay. Polystyrene tubes were coated with purified type IV collagen and incubated with serum samples. Bound human IgG was detected using 125I labelled antihuman IgG. Median adsorption levels were 4000 (interquartile range 2500-9500) cpm/ml serum in 25 uncomplicated pregnancies and 21 000 (interquartile range 14 500-44 500) cpm/ml serum in 14 pre-eclamptic women. Specifity of the adsorption reaction could be demonstrated using uncoated tubes and collagenase treated coated tubes, which all showed low binding. In competition experiments with dissolved collagen fractions (type I, III, IV) most effective displacement of binding was observed with type IV collagen. This indicates collagen selectively of the adsorption reaction of human IgG to basement membrane collagen. Our in-vitro studies support immunohistological findings of IgG binding to trophoblastic basement membranes and their ultrastructural abnormalities detected in pre-eclamptic placenta.

Basement Membrane↗
PubMed1986

Laminin in pregnancy.

Laminin, a noncollagenous glycoprotein component of basement membranes, was measured in human serum by radioimmunoassay for the laminin P1 fragment. The concentration of immunoreactive laminin increased during pregnancy. Before delivery it was nearly twice the level found in nonpregnant women. After delivery levels dropped. Decreased serum concentrations were detected in placental insufficiency whereas increased concentrations were found in sera of preeclamptic women. Immunoreactive serum laminin seems to correlate with the amount or degradation of placental basement membranes in pregnancy.

Female↗
PubMed1985

[Effect of prenatal care in general practice and in the clinic on the course of pregnancy and labor].

The computerized case histories of 6666 children who were born during the years 1977 and 1981 at the 2nd Department of Obstetrics and Gynecology, Univ. of Vienna have been evaluated for the clinical and social data of the mothers, the duration of pregnancy and the well being of the infants at delivery and during the perinatal period. A comparison of three groups according to prenatal care (I no prenatal care; II "Mutter-Kind-Pass" program; III "Mutter-Kind-Pass" program plus clinical care) showed that a complete perinatal care (group III) leads to significantly less preterm deliveries, better Apgar-scores and lower perinatal mortality. The differences between groups I and II were minimal. The prenatal care therefore can only be judged as optimal if in addiction to the "Mutter-Kind-Pass" program the diagnostic abilities of a clinic are taken advantage of on time and if the gap between the 28th and 35th week of pregnancy can be covered by additional check ups.

Adult↗
PubMed1985

[In vitro test for the radioimmunological demonstration of the adsorption of maternal antibodies to placental basal membrane collagen].

Polystyrene tubes were activated by adsorption of placental basement collagen (Type IV collagen). Binding of maternal immunoglobulin from serum samples to immobilized collagen was detected with 125I-labeled Antihuman IgG. An almost complete loss of binding resulted by adding solubilized Type IV collagen to the serum or pretreating the coated tubes with highly purified collagenase as well as using uncoated tubes. A high adsorption rate of IgG to Type IV collagen (2029 +/- 388 cpm) was detected in patients with moderate to severe gestosis (n = 16) (index greater than or equal to 4). 925 +/- 192 cpm were measured in mild gestosis (n = 13). Only 315 +/- 24 cpm could be detected in samples of a healthy control group (n = 17). A correlation was found between the index of gestosis and adsorption of maternal IgG to Type IV collagen (r = 0,823). It is concluded that the concentration and adsorption of immunoglobulins binding to basement membrane collagen is related to the severity of the disease and may play an important role in the development of symptoms of gestosis.

Adsorption↗
PubMed1984

Circulatory and renal effects of beta-adrenergic-receptor stimulation in pregnant sheep.

The effects of beta-adrenergic-receptor stimulation with ritodrine on systemic and pulmonary hemodynamics and on renal handling of water and electrolytes were studied in unanesthetized, chronically instrumented pregnant sheep. Each animal was studied during control, ritodrine, and recovery periods, each lasting 60 minutes, with the use of three different modes of hydration. beta-receptor stimulation produced a significant increase in heart rate and cardiac output and a decrease in systemic vascular resistance. Pulmonary arterial and wedge pressures tended to increase. These circulatory effects were similar for the three types of hydration and they persisted after cessation of infusion. In terms of its renal effects, beta-receptor stimulation elicited a profound decrease in urine flow and in the excretions of sodium and potassium, irrespective of the mode of hydration. The antidiuresis and antinatriuresis were accompanied by no changes in plasma osmolality and sodium concentration, whereas plasma potassium levels decreased. All of these effects persisted for 60 minutes after the cessation of infusion. In the water-loaded experiments, the antidiuresis seemed to be related to increased antidiuretic hormone secretion; in the saline-loaded experiments, however, both the antidiuresis and antinatriuresis appeared to be related to increased renal reabsorption. The changes in renal hemodynamics seemed to have an insignificant role. The amount of fluid retained in the body was greater when ritodrine was infused with saline solution than with dextrose solution. These cardiovascular and renal studies suggest that a circulatory overload may be the major factor in the pathogenesis of pulmonary edema observed during beta-adrenergic-receptor stimulation.

Animals↗
PubMed1983

Heat flux from the fetal scalp during labor and fetal outcome.

In 40 deliveries a new variable, heat flux from the fetal scalp, was recorded and correlated with fetal outcome. The heat flux from the fetus, which reflects the temperature gradient between the warmer fetus and the mother was measured by a transducer attached to the fetal scalp after rupture of the membranes. In the last 20 min before delivery we found a statistically significant correlation (p less than 0.05) between heat flux from the fetus and pH of umbilical artery blood. Heat flux in the group with higher pH differed significantly from those with lower pH. We conclude that heat flux measurements could be developed and used for fetal monitoring.

Body Temperature↗
PubMed1982

[Non-enzymatic glucosylation of proteins].

The modification of haemoglobin A by glucose to haemoglobin A Ic is a classical example for a nonenzymatic glucosylation (n. e. glu.) reaction of a protein. It has been suggested, that various proteins are subjected to this process during hyperglycemia phases, if the protein meets certain steric, electrostatic and biochemical characteristics. In the present report n. e. glu. of haemoglobin, serum protein, collagen, basement membrane protein and alkaline phosphatase is discussed. It is suggested that n. e. glu. might influence protein function and forms thus the biochemical basis for specific complications of diabetes mellitus in an outside pregnancy.

Adolescent↗
PubMed1981

Heatflux from the fetus during delivery.

A new thermodynamic model for the fetus in utero is introduced. As the fetus is warmer than the mother, heat flows from the fetus to the maternal organism (i. e. uterine muscle, vagina). This heatflux was measured during delivery. The heatflux from the fetal head was 11 +/- 1.6 Watt/m2 (mean +/- SD). It was influenced by the maternal temperature (correlations statistically significant) in two births with pathological heart rate patterns in the cardiotocogram we observed a heatflux which deviated markedly from the norm. In conclusion, heatflux measurements could yield valuable information about the fetal metabolism and circulation of the fetomaternal unit, and could be applied as a additional method for fetal monitoring.

Body Temperature↗