[Anomalies of the umbilical cord and coexistence of congenital malformations].
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Congenital Abnormalities↗
Biomedical subjects
S Karchmer
Publications and source records attributed to S Karchmer.
[Current treatment of eclampsia].
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Abortion, Therapeutic↗
[Acid-base balance in the newborn infant. II. 3 technics of sample collection and the difference between amniotomy].
The study included 32 healthy newborns to evaluate the acid-base balance between two groups of newborns whose mothers underwent early or late amniotomy. The results were compared to the first study finding important differences, unquestionable due to amniotomy and age. Significant difference was found only in PO2 between arterial blood and arterialized capillary showing difference in pH, PCO2 and CO2 between the two capillaries. With the criterion pointed out in this work, the usefulness of late amniotomy and the stabilization of acid-base balance is established in newborns under 4 hours of age. Arterial blood is still being proposed to obtain an "ideal" acid-base balance and the arterialized capillary as a practical and useful method.
Acid-Base Equilibrium↗
[External fetal electrocardiograms with P wave. Report of 6 cases].
The purpose of this report is to present six pregnancies in which by means of external fetal electrocardiography, besides the feto-maternal QRS complexes, a clear fetal P wave can be identified. The number of electrocardiograms taken per patient was of one or more. In one of the cases this finding has persisted from the 26th to the 30th weeks of pregnancy. When analyzing the clinical characteristics of the cases, the only commun finding was that each one of the pregnancies averaged between nineteen and twenty six weeks of amenorrhea. Attention is called to search for the possible reasons by which commonly the fetal P wave can not be detected. Findings of other authors are discussed.
Adult↗
[Magnitude and causes of maternal mortality in the Federal District (1988-1989)].
Despite the availability of health resources to provide prenatal and delivery care for all pregnant women in the Federal District, the maternal mortality ratio is extremely high. Based on the study of all the maternal deaths which occurred in the Federal District during 1988 and the first semester of 1989 (n = 433), a ratio of 11.4 deaths per 10,000 registered live births was estimated. This is almost twice as high as the ratio reported through vital statistics. The maternal mortality ratio is higher among women delivered in public assistance hospitals as compared with those delivered in social security hospitals. This is due to the high percentage of women arriving with severe complications and to the lower standards of obstetric care in the former. About 75% of the deaths were due to one of the following causes: hypertensive disease of pregnancy, hemorrhage and infection. A detailed study of hospital records undertaken by a maternal mortality committee revealed that 85% of the deaths were preventable with the technology and resources available. The committee identified errors in medical judgment as the main factor involved in the chain of causation leading to potential preventable deaths.
Adolescent↗
Maternal influences on cord blood lead levels.
We constructed models of umbilical cord blood lead (PbB), with and without the addition of maternal PbB at delivery and earlier in pregnancy, to determine which factors explaining cord PbB depended upon maternal PbB and which did not. We prospectively studied women of low-to-middle socioeconomic status who lived in the Valley of Mexico from 12 weeks of pregnancy to delivery. We measured maternal venous PbB during pregnancy and at delivery, and umbilical cord PbB (1-38 micrograms/dl, 0.05-1.83 mumol/l). We used multiple regression analyses to model cord PbB and a logit analysis to model the maternal-cord PbB relationship. Older mothers using lead-glazed pottery and canned foods delivered babies with increased cord PbB, while those with occasional alcohol use during pregnancy, high milk intake, and more spontaneous abortions delivered babies with lower cord PbB. Maternal PbB at 36 weeks of pregnancy and at delivery independently explained additional variance in cord PbB, but maternal PbB earlier in pregnancy did not. Some of the effects of lead-glazed pottery, maternal abortions, alcohol use, and canned food use on cord PbB were mediated through maternal PbB. The effects of maternal age and milk intake on cord PbB were independent of their influence on maternal PbB near delivery. Cord PbBs were higher than maternal PbBs at delivery in 33% of the cases, and were predominant in mothers over 30 and those drinking milk less than once per day. Measurable influence of maternal PbB on delivery cord PbB is limited to the four to eight weeks prior to delivery. Many factors suspected of influencing bone lead also control cord PbB, some of them independently of their effect on maternal delivery PbB. Minimizing fetal exposure near the end of pregnancy may require long-term control of maternal lead exposure and good management of pregnancy and diet.
Adolescent↗
[Hyperlipidemias as a coronary risk factor in the newborn].
This article reviews the risk factors of the coronariopathy in the newborn. The authors state that the early diagnosis of the risk factors is an important step in the prevention of ateromatous plaques. Some people are now in the investigation of the normal levels of cholesterol and triglicerides in the blood of the umbilical cord. This values seems similar in different places all over the world and have served to establish the possible interrelation between the newborn hiperlipidemia and the coronary risk.
Adolescent↗
[Electrocardiography, stress and the third pregnancy trimester].
Twelve patients whose ages ranged between 19 and 36 years, were studied. The gestational ages were between the 35th and the 39th week of pregnancy. The exercise performed was the one proposed by Kemp and Ellested. The analysis of the records comprised the electrocardiographic changes described by Dr. Chavez in his so called "syndrome of circulatory changes during pregnancy". Not all the characteristics were found in our cases, although this could be explained by the differences in the gestational age. The most common findings were the ST changes. In nine of our cases, they were more marked and appeared immediately after exercise and this makes us think that it could be due to the double load on the cardiac overload, that the exercise effects upon the cardiac muscle due to pregnancy. We could also advocate sympathetic and parasympathethic mechanisms, since in the final tracing this changes not only disappeared but were in some cases smoller than in the control. Regarding the cardiac rate it was found that it did not increase as shown in Robinson's Table. Nevertheless in eight cases, final tracings did not return to control levels and we could imply an "excess of heart rate" which is thought by Sheffield as a warning sign of coronary insufficiency. We will learn more about this after these same patients have had their-follow up studies when they are not pregnant. A larger series of cases is needed in the different trimesters of pregnancy as well as their reevaluation after the hormonal effects of pregnancy are over to ases the significance of this changes as well as their prognostic meaning during labor or as a warning sign of future coronary pathology.
Adult↗
[Serum lipids and electrophoresis of lipoproteins in the normal newborn infant].
The levels of plasma lipids and the values of the different electrophoretic fractions of lipoproteins were measured in cord blood of 300 new borns selected at random. The value found are expressed as me +/- S.D. (limits X +/-2s) and were the following: total cholesterol 80.4 +/- 17.5 (limits 45-115) mg./100 ml., LDL cholesterol (by precipitation) 33+/-11 (limits 11-55) mg./100 ml., betalipo-protein (by immunodifusion) 142.7+/-26.4 (limits 90-195) mg./100 ml. and triglycerides 35+/-13 (limits 9-61) mg./100 ml. The figures for the different electrophoretic fractions of lipoproteins were expressed in per cent of the total area and were the following: betalipoproteins 42.9+/-10.3 (limits 22-63%), prebetalipoproteins 3.09+/-2.79 (limits 0-8.6%) and alphalipoproteins 53.8 +/- 9.5 (limits 35-73%). The beta/alpha ratio was 0.91+/-0.33 (limits 0.25-1.6).
Blood Protein Electrophoresis↗
[Mechanism of adaptation of the newborn infant].
An analysis of the mechanisms of adaptation of the newborn infant, immediately after birth, is put forth. Emphasis is placed upon cardiorespiratory and metabolic homeostasis, with a description of the internal medium variations in neonates seeking spontaneous equilibrium. In Mexico City this takes 4 hours. Hypoxia is stressed as one of the most important complications of the neonatal period, requiring rapid and efficient management of the infant to avoid severe complications or even death. Intra and extracardaic hemodynamic changes, stabilization of central arterial pressure as well as sufficient cardiac output, due to proper left ventricle function are described in reference to the cardiovascular sphere. A brief mention is made of the work of both ventricles during the first days of life. The diverse hemodynamic behaviour in different vascular areas of the newborn infant might be due to the concentrations of circulating gases, pH, enzyme factors and circulating hormones.
Acid-Base Equilibrium↗
[Hyperlipidemias and abnormalities in the electrophoresis of lipoproteins. Incidence in newborn infants].
We studied 300 newborns in whom total cholesterol, cholesterol of low density lipoproteins, triglycerides and lipoprotein electrophoresis were determined in umbilical cord blood. Pure hypercholesterolemia was found in 14 cases (4.7%), hypertriglyceridemia in 15 cases (5.0%) and increase in cholesterol and triglycerides in 4 cases (1.3%). Lipoprotein electrophoresis showed increase in betas in 23 cases (7.6%), prebetas in 24 (8.0%) and in both, betas and prebetas, in 6 cases (2.0%). Betas /alphas index was always found elevated when other electrophoretic fractions had some abnormality.
Blood Protein Electrophoresis↗