Biomedical subjects

A Anyaegbunam

Publications and source records attributed to A Anyaegbunam.

39 records · Page 3Linked to original sources

PubMed1986

The significance of antepartum variable decelerations.

A total of 4886 nonstress tests were reviewed to establish the relationship between antepartum variable decelerations and perinatal outcome. The association between various fetal heart rate components and variable decelerations was also studied. The incidence of variable decelerations, defined as three or more decelerations greater than or equal to 15 bpm lasting at least 15 seconds in a 20-minute period, was 1.3%. The results suggest that in the presence of variable decelerations: there is a higher incidence of fetal distress in labor, low Apgar scores, neonatal intensive care unit admissions, and nuchal cord involvement; the presence of accelerations and normal variability is associated with good neonatal outcome, whereas their absence is associated with adverse outcome; the presence of accelerations or good variability is not independently correlated with neonatal outcome.

Apgar Score↗

PubMed1985

The heightened significance of prolonged bradycardia associated with intrauterine growth retardation.

The significance and management of prepartum bradycardia is not well established in prepartum fetal assessment. The incidence of prolonged bradycardia was 3.5% (45 per 1284), defined as a decrease of greater than or equal to 40 beats per minute of the fetal heart rate (FHR) below the baseline for at least 2 minutes. Thirty-two maternal, fetal, and FHR tracing characteristics were examined to study correlations between the variables, the presence of the bradycardia, and neonatal outcome. Neonatal outcome was evaluated by dividing the population into two groups. Group 1 consisted of infants with 1-minute Apgar scores less than 6 and NICU admissions greater than 24 hours. Group 2 comprised infants with 1-minute Apgar scores greater than 6 and no NICU admission or less than 24 hours NICU admission. IUGR was diagnosed in 40% of the patients. Statistically significant associations were found for correlations between Group 1 infants and IUGR (P less than .05), oligohydramnios (P less than .05), cesarean section rate (P less than .04), and the presence of meconium (P less than .01). There were no fetal heart rate characteristics found to be significantly associated with IUGR or neonatal outcome. The data do not support the need for immediate delivery in patients with prolonged prepartum bradycardia, but its presence does warrant a workup for intrauterine growth retardation.

Amniotic Fluid↗

PubMedDate not supplied

Clinical significance of increasing histologic severity of acute inflammation in the fetal membranes and umbilical cord.

The purpose of this study was to determine the importance of varying histologic stages of inflammation in the placental membranes and cord. Acute inflammation was histologically staged in fetal membranes and umbilical cord sections from 2899 placentas received from consecutive singleton deliveries. Then clinical data were collected for a subset of randomly selected placentas with stage 1 through stage 4 membrane inflammation (n = 212) and without significant inflammation (stage 0, n = 216). Statistical analyses revealed that increasing stage of membrane inflammation was associated with an increasing rate of funisitis, perinatal death, and preterm birth (P < .05). Inflammation permeating the entire trophoblastic layer of the chorion (stage 1) was associated with clinical symptoms of intrauterine infection and thus was an important pathologic finding. Acute necrotizing chorioamnionitis was very strongly associated with perinatal death and preterm birth. Acute funisitis was a more specific but less sensitive marker for perinatal complications than inflammation in the membranes. With increasing stage of funisitis, there was an increased incidence of clinical symptoms of intrauterine infection, preterm birth, and perinatal death. Almost three-fourths of the cases with histologic evidence of membrane inflammation were clinically silent. In conclusion, increasing histologic stages of inflammation of the membranes and cord are associated with an increased rate of perinatal morbidity and mortality. Stage I membrane inflammation provides a clinically acceptable minimum threshold for the reporting of pathologic changes.

Biomarkers↗