Search PubMed⌕ Search

Biomedical subjects

S Skrablin

Publications and source records attributed to S Skrablin.

25 records · Page 2Linked to original sources
PubMedDate not supplied

[Relation between fetal hypoxia, neonatal asphyxia and hypoxic-ischemic encephalopathy].

Clinical data, duration of labour, mode of delivery and possibilities of fetal heart rate monitoring in predicting perinatal asphyxia and neonatal encephalopathy in 143 consecutively delivered asphyxiated infants and 143 paired healthy infants are analyzed. Perinatal asphyxia occurred in only 2.6% of normal pregnancies and significantly more frequently in pregnancies complicated by gestosis. It is far more common in children subject to operative deliveries (15-20%) and when labour lasts longer than 12 hours, either in vertex or breech presentations. The occurrence of encephalopathy is less frequent in children delivered by cesarean section (1.6%) and almost three times more frequent than in vaginal breech deliveries. In asphyxiated children delivered vaginally, significantly more frequently CTG scores were prepathologic (38% versus 3.4%). In the cesarean section group the differences are not significant in prepathologic CTG scores but are highly significant when CTG scores were pathologic (36% versus 2.7%). The mean duration of the pathologic heart rate pattern is significantly longer in mild asphyxia in comparison to the control group (45 minutes versus 12.5 minutes). In moderate asphyxia the pathologic CTG pattern lasted 72.1 minutes and in severe asphyxia 52 minutes.

Asphyxia Neonatorum↗
PubMedDate not supplied

[Electromyography of the uterus in monitoring pregnancies with symptoms of premature labor].

Characteristics of uterine muscle action potentials in 100 gravidas with symptoms of preterm labor or imminent abortion (presence of contractions with cervical changes) from 18th till the 32nd weeks of pregnancy are analysed. Twenty four gravidas with uncomplicated pregnancy were monitored electromyographically from the 20th weeks until term, once a week. There was low electrical activity in uncomplicated pregnancies up to 7 days before labor. A similar trend was observed in pregnancies that were finished before term. But, in symptomatic pregnancies finished preterm, the index of uterine muscle electrical activity (expressed in the percentage of voltage plus frequency) was continuously, although not significantly, above the values in symptomatic and asymptomatic term pregnancies. In only 2 out of 18 (11.1%) before term terminated pregnancies and in 45 out of 82 (54.9%) in term accomplished pregnancies, was electrical silence was registered during clinical symptoms (p less than 0.01). In preterm accomplished pregnancies, higher voltages and more frequent occurrence of biphasic and polyphasic spikes were registered (p less than 0.05), although the single parameter was of no prognostic significance. With a successful tocolytic treatment, the index of uterine muscle electrical activity was significantly reduced (from 57.16 to 20.86, t = 2.52, p less than 0.02) and was similar to that registered in symptomatic term pregnancies subjected to no tocolytic treatment. Although intravenous tocolysis was shown diminish voltage and frequency, in preterm delivered pregnancies no reduction in electrical activity was observed. Uterine electromyography could be used as a predictor of successful or unsuccessful tocolytic treatment.

Action Potentials↗
PubMedDate not supplied

[Peroral and intracervical administration of prostaglandin E2 for stimulation of term labor in premature rupture of fetal membranes].

The outcome of stimulation of labour in 219 primiparous patients with more than 6 hours following a premature rupture of the membranes, and with an ripe cervix, without the established labour, was analysed according to the mode of treatment. One hundred and thirty eight (138) women received PGE2 peroral tablets, 14 intracervical PGE2 gel, and 67 oxytocin intravenously. There were 73.2% vaginal deliveries in the group that received PGE2 per os, 77.5% in the group that received oxytocin, and 92.9% in the group that was given intracervical gel. The differences were significant. The cervix remained unripe in 9.4% patients that received PGE2 perorally, in 14.9% of those that received oxytocin, while in the gel group it became favourable in all parturients. Uterine polisistoly was encountered in 10.9% labours after peroral stimulation, in 7.1% in the gel group and in 1.5% in the oxytocin group, and perinatal asphyxia in 16.7%, 7.1% and 13.4%, respectively. When too frequent, especially if combined with oxytocin and given to patients with a moderately favourable cervix, peroral stimulation predisposes to uterine polisitoly. Intracervical application of PGE2 gel is the method of choice in primigravid patients with a premature rupture of the membranes and the unripe cervix (Bishop score O). In gravidas with a more favourable cervix (Bishop score 4-6) the administration of oxytocin is acceptable with less complications. In those with a moderately favourable cervix (Bishop score 1-4) the gel application proved to be preferable, although stimulation could be carried out as well.

Administration, Oral↗
PubMedDate not supplied

[The effect of segmental epidural analgesia on the duration of labor in spastic dystocia].

In 77 parturients, owing to spastic distotia, the labour was conducted in continuous epidural analgesia, while in the control group of parturients with the same diagnosis (N = 32), the intramuscular use of pethidine and diazepam was repeatedly applied. The epidural catheter was placed at the 2-3 cm dilated cervix. Carticain with or without fentanyl was used as a local anaesthetic. The average duration of labour from the beginning to the 2-3 cm cervical opening was 9.3 hours in the group of epidural analgesia applied parturients and 4.3 hours in the control group. The continuation of labor in the examined group lasted 3.7 hours and in the control group 12 hours. The difference is significant (p less than 0.01). A spontaneous vaginal delivery in the examined group was recorded in 77.9% women. There were 14.3% cesarean sections in the examined and 46.8% in the control group. A protracted labour was a significantly more frequent indication (p less than 0.01) for such a termination of labour in the control group.

Analgesia, Epidural↗
PubMedDate not supplied

[The effect of chronic kidney disease on the course and outcome of pregnancy].

In order to estimate the effect of renal disease on the pregnancy, and the effect of pregnancy on the natural course of renal disease, the course and outcome of the 37 pregnancies was analyzed in gravidas with chronic renal disease. The women were cared for between 1978 and 1990 at the Department of Obstetrics, School of Medicine University of Zagreb. Analysis of the results in this article is retrospective. Thirty-six pregnancies finished by vaginal or cesarean delivery or by abortion, while one pregnancy was ectopic and ended by laparotomy during the 20th week. There were 31 live births from 36 fetuses (86.1%), 5 stillbirths (13.19%), of which 2 pregnancies ended in fetal death (abortion). In addition, there were 6 instances of neonatal death (8.3%). Twenty-five percent of pregnancies finished before 37 weeks of gestation. In 6 of 34 (17.6%) deliveries amniotic fluid was meconium stained, and 5 of 31 (16.1%) infants were born hypoxic. There were 29 percent of growth retarded liveborn fetuses. Perinatal mortality was 167/1000. Renal insufficiency was noted in 12 of 37 (32.4%) pregnancies, 54% of pregnant women had hypertension, 8.1% hyperkalemia, 78.4% were anemic, 27% had significant bacteriuria and 21.6% overt pyelonephritis. There was one case of acute deterioration in renal function that required hemodialysis, and one case of preeclampsia. Renal insufficiency or hypertension reduce drastically the chances for a successful outcome of pregnancy in gravidas with kidney disorders. However renal insufficiency in the presence of hypertension, carries even poorer prognosis, with perinatal mortality of 428/1000.

Adult↗