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Biomedical subjects

R T Richards

Publications and source records attributed to R T Richards.

8 recordsLinked to original sources
PubMed1981

Hypoxic-ischemic encephalopathy in term neonates: perinatal factors and outcome.

Ninety-five infants of 37 weeks' gestation or greater with evidence of hypoxic-ischemic encephalopathy following perinatal asphyxia were prospectively identified in the neonatal period. The degree of encephalopathy was graded the staging system of Sarnat and Sarnat. Six infants died, 78 infants were sequentially followed in the Neonatal Follow-up Clinic, and in five additional infants, follow-up information was available. The mean duration of follow-up was 19.3 months. Fifty-eight (65%) of the 89 infants followed were normal or mildly handicapped, six (7%) died, and the remainder had significant handicap. There was no significant relationship between any of over 100 obstetrical antepartum or intrapartum variables and outcome. Infants with five-minute Apgar scores of 0 to 3, seizures within the first day of life, Stage II or III encephalopathy, or a suppressed electroencephalogram had a significantly greater incidence of severe handicap or death. In addition, although there were fewer females, they had a significantly greater incidence of handicap. There appeared to be an improved outcome in the last two years (1977-1978) compared to the first two years (1975-1976), suggesting that improved recognition and neonatal management may lead to a decrease in significant sequelae.

Apgar Score↗
PubMed1975

The effect of increased maternal PaO2 upon the fetus during labor.

The effect of increased maternal PaO2 upon the fetus during labor was studied in 36 subhuman primates. The animals were divided into two groups, one in which the fetus was not asphyxiated and showed no evidence of fetal distress (Group I) and another in which the fetus was acidotic, hypoxic, and exhibited the pattern of late deceleration of the heart rate (Group II). One hundred per cent oxygen was administered to the mothers for a period of 30 minutes. Elevation of maternal PaO2 to 430 mm. Hg increased fetal oxygen levels in Group I. and in most instances in Group II, without significant changes in the acid-base state. In Group II, maternal hyperoxemia also abolished or reduced the frequency of late deceleration of the fetal heart in most animals but had little or no effect on fetal blood pressure. Termination of high-concentration oxygen to the mother resulted in a fall in maternal and fetal oxygen levels to their original values and the reappearance of late fetal heart decelerations. Thus, administration of high-concentration oxygen to the mother for the treatment of fetal distress may be of some benefit. The problems of fetal acidosis and hypotension are not cured, however, and may still progress if there is placental insufficiency or cord compression. Therefore, this treatment should be regarded as a temporary supportive measure only.

Acid-Base Equilibrium↗
PubMed1972

Respiratory movements and rapid eye movement sleep in the foetal lamb.

1. In foetal lambs from 40 days gestation (0.27 of term) onwards delivered into a warm saline bath, apparently spontaneous breathing movements were present intermittently. They became deeper and more rapid with increasing age.2. In foetal lambs (from 0.66 of term) in which observations were made for many days after chronic implantation of tracheal, carotid and amniotic catheters, rapid irregular respiratory movements were present up to 40% of the time, and brief gasps also were seen.3. The presence of these movements was unrelated to the foetal carotid blood gas values over a wide range of spontaneous variation.4. These foetal breathing movements were accompanied by comparatively small alterations of pulmonary volume recorded from a tracheal flowmeter, insufficient to clear the tracheal dead space. Occasionally a more prolonged expiration led to the outward flow of fluid.5. A description is given of sleep and wakefulness in foetal lambs from 0.78 of term.6. Rapid irregular breathing was associated with rapid eye movement sleep as seen in a warm saline bath or, in utero, as inferred from records of eye movements and electrocortical activity.7. Respiratory movements were often associated with relatively large variations in foetal heart rate, blood pressure and descending aortic blood flow.8. Rapid irregular foetal breathing was unaffected by section or blockade of the cervical vagi, but was abolished by general anaesthesia.9. It is concluded that respiratory movements are normally but intermittently present in the foetal lamb over the greater part of gestation.

Amniotic Fluid↗
PubMed1967

Lead poisoning.

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History, 19th Century↗