Biomedical subjects

S Montan

Publications and source records attributed to S Montan.

28 records · Page 2Linked to original sources

PubMed1987

Fetal and uteroplacental haemodynamics during short-term atenolol treatment of hypertension in pregnancy.

Fetal circulation was studied by means of combined real-time and pulsed Doppler ultrasound in 14 women with pregnancy-associated hypertension before and during the first and third days of treatment with the beta 1-selective blocker, atenolol; in seven of the women the maternal uterine arcuate blood velocity waveform was also studied. Blood flow characteristics were normal both in the fetus and in the maternal arcuate artery, compared with those in uncomplicated pregnancies of corresponding gestational ages. Volume blood flow remained unchanged in the fetal descending aorta, and in the umbilical vein during atenolol treatment, whereas the pulsatility index increased in the fetal descending aorta and in the arcuate artery. This suggests that the peripheral vascular resistance, both on the maternal and fetal side of the placenta, increased during short-term antihypertensive treatment with atenolol.

Adult↗

PubMed1986

Effects of beta 1-adrenoceptor blockade in the treatment of hypertension during pregnancy in diabetic women.

The effects of beta 1-blockade were investigated in 18 hypertensive pregnant diabetic women. The same women served as controls, covering a period just before therapy. The blood pressure was reduced in 14 women (p less than 0.01). The change in blood glucose homeostasis was statistically not different from the control period. Insulin doses were not affected. The fetal heart rate was affected by therapy, causing a decrease in baseline rate (p less than 0.05) and in acceleration amplitude (p less than 0.05). Although the incidence of suspect fetal distress, intrauterine growth retardation and preterm delivery was high, all surviving infants had normal Apgar scores at 5 and 10 min. Perinatal mortality consisted of one stillbirth. Except for respiratory problems, the incidence of neonatal complications was low. All survivors were healthy at follow-up. We found beta 1-blockade to be effective and safe in this group of high-risk pregnancies, and suggest it as an alternative for anti-hypertensive therapy in diabetic pregnancy.

Adult↗

PubMed1986

Placental grading with ultrasound in hypertensive and normotensive pregnancies. A prospective, consecutive study.

Placental grading was studied prospectively with real-time ultrasound in 654 consecutive pregnancies. The placental maturation was clearly demonstrated in both unselected and hypertensive pregnancies. No differences in placental grading were found between normotensive and hypertensive pregnancies. Fetal outcome was not associated with different placental grades and a grade III placenta was not predictive of an adverse outcome. The value of antenatal placental grading in unselective and hypertensive pregnancies could not be demonstrated.

Female↗

PubMed1985

Cervical priming and/or induction by intracervical application of PGE2-gel in term patients with preeclampsia and unfavorable cervical states.

92 preeclamptic women with unfavorable cervical states were treated with intracervical application of prostaglandin E2 (PGE2) in gel for cervical priming and/or labor induction. 55 (60%) were delivered after a single PGE2-gel application. In 27 (29%) the cervical state was improved after 24 h and labor could be induced by oxytocin infusion. Thus, 89% of the women were delivered within 48 h after a single PGE2-gel application. In 10 women (11%) a second PGE2-gel application had to be done before oxytocin infusion. The frequency of cesarean sections was low (5%). No case of uterine hypertonus was seen. No gastrointestinal side effects were observed. All newborn infants had an apgar score at 5 min of more than 7 and were in good condition.

Adult↗

PubMed1985

Amniocentesis in treatment of acute polyhydramniosis in twin pregnancies.

A rare complication in twin pregnancy is acute polyhydramniosis. If left untreated, the perinatal mortality is 100%. The clinical courses of two cases treated with ultrasound-guided amniocentesis are presented. In the first case altogether 4875 ml amniotic fluid was drained. Both twins died within the first 24 hours of life after delivery in gestational week 26. In the second case 2150 ml amniotic fluid was drained. Both twins survived and were delivered in good condition in gestational week 35. We recommend ultrasound-guided amniocentesis to be performed in twin pregnancy affected by acute polyhydramniosis.

Adult↗

PubMed1985

Classification of the nonstress test and fetal outcome in 1,056 pregnancies.

During a 2 1/2-year period, 1 056 pregnant women (1 072 fetuses) were monitored with the nonstress test (NST) in the antenatal period. Testing time was 30 minutes. The NST was classified into one of four classes: normal, suspect pathological, slight pathological, and severe pathological. In 88.5% of the pregnancies, all NSTs were normal. Suspect, slight, or severe pathological NSTs occurred at least once in 8.1%, 2.1%, and 1.3% of the women respectively. All women with a severe pathological NST had high-risk complications. Lethal malformations excluded, there were only two perinatal deaths among the tested women. In the four different classes, the frequencies of cesarean section were 11%, 17%, 41%, and 79%. One-minute Apgar scores were less than 7 in 5%, 12%, 41%, and 64%. The need for referral to neonatal intensive care was 19%, 40%, 41%, and 93% respectively. A normal NST predicted normal fetal outcome in an excellent way, while the three pathological classes appeared to represent different degrees of impending fetal jeopardy.

Apgar Score↗

PubMed1984

Risk grouping of 113 patients with hypertensive disorders during pregnancy, with respect to serum urate, proteinuria and time of onset of hypertension.

In order to describe the outcome of a one-year material of hypertensive pregnancies, a retrospective analysis was made of the patients with respect to time of onset of hypertension, absence/presence of significant proteinuria, and maximum recorded serum urate values less or greater than 350 mumol/l. The material comprised 113 hypertensive patients, 3.7% of 3036 deliveries in 1980. Of these only 87 could be classified as intended. Twenty-two patients lacked information on serum urate values, and the remaining 4 did not fulfil the inclusion criteria. As the type of antihypertensive treatment was almost exclusively restricted to beta 1-selective betablockers, alone or in combination with hydralazine, the type of treatment given was analysed with respect to the classification system applied. From this retrospective study it is evident that most hypertensive patients tend to be older than the average pregnant woman and that they also tend to represent problems arising during recurrent pregnancies. Patients with additive risk factors such as proteinuria and high serum urate values tend to need more vigorous antihypertensive treatment and in that sense seem to be more difficult to treat. In our material, patients with an early rise in high blood pressure and high serum urate values accounted for the entire perinatal mortality of the hypertensive pregnancies. The values of serum urate monitoring and the future detection and monitoring of hypertensive pregnant patients is discussed.

Adult↗

PubMed1984

Fetal heart rate during treatment of maternal hypertension with beta-adrenergic antagonists. A preliminary report.

The effects of two different beta-adrenergic antagonists on maternal arterial pressure and fetal heart rate were studied in 8 pregnant women with pregnancy hypertension. The fetal heart rate was monitored by abdominal ECG recording under standardized conditions. Basal heart rate, long-term variability and short-term variability were calculated in a computer. Four patients received 50-100 mg atenolol once daily; the other 4 received pindolol 10 mg b.i.d. Reduction in mean arterial blood pressure was seen in both groups of patients. The basal fetal heart rate was decreased in atenolol-exposed fetuses but not in pindolol-exposed fetuses. In this preliminary study there was no apparent effect on the fetal heart rate variability.

Adrenergic beta-Antagonists↗

PubMed1984

Influence of the beta 1-adrenoceptor blocker atenolol on antenatal cardiotocography.

Forty term patients with pregnancy-induced hypertension were treated with the beta 1-adrenoceptor blocker atenolol (Tenormin R; ICI) for at least 7 days prior to parturition. The antenatal cardiotocography (CTG) was visually analysed before and during treatment. The mean basal fetal heart rate (FHR) decreased from 143 +/- 7 beats per minute (bpm) to 133 +/- 8 bpm. In 13.1% of the recordings in treated patients there was a decrease in long-term variability for a period of more than 20 minutes; this was observed in only 2.3% prior to treatment. The amplitude of the accelerations was reduced from 23 +/- 6 bpm to 18 +/- 4 bpm. It was demonstrated that atenolol affected antenatal CTG, and this has to be taken into consideration when interpreting antenatal CTG as one parameter for evaluation of fetal well-being.

Apgar Score↗

PubMedDate not supplied

Ultrasound measurement of the fetal cerebral ventricles: a prospective, consecutive study.

Real-time ultrasound was used in 654 consecutive pregnancies to obtain standard growth parameters for the fetal brain. Measurement of the width of the lateral ventricle (LVW) and hemisphere and their relationships to menstrual age, biparietal diameter, and birth weight were determined. The growth of the LVW was to a great extent independent of birth weight but dependent on menstrual age. Thirteen fetuses with a single ventricular width measurements exceeding +2 SD from the mean were separately evaluated, and all but one case were found to be normal.

Age Factors↗