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Biomedical subjects

B Arabin

Publications and source records attributed to B Arabin.

At least 55 records · Page 3Linked to original sources
PubMed1991

[Fetal behavior in multiple pregnancy: methodologic, clinical and scientific aspects].

In multiple pregnancy, an intense supervision of the fetal condition is indicated during pregnancy and delivery. With the aid of a recently developed actocardiograph originally described by Maeda, it is possible to monitor the fetal heart rate (FHR) and fetal movements (FM) of twins simultaneously on one tracing by 2 external Doppler transducers. Additional methods (stimulation, real-time and Doppler ultrasound) were tested in combination with the equipment. In addition, FHR tracings of triplets were registered during delivery simultaneously with FM and contractions. First patterns of "twin behaviour" are described. It may be concluded that this way of recording is of definite practical and potential scientific value.

Apgar Score↗
PubMed1990

[Diagnosis and therapy of hyperthyroidism in pregnancy].

In pregnancy hyperthyroidism occurs with a prevalence of 0.04-0.2%. It occurs even less frequently de novo in previously undiagnosed patients. Within a short period of time we treated 3 patients, who also developed signs of pre-eclampsia. Specific principles of the management during pregnancy are explained.

Adult↗
PubMed1989

[Analysis of fetal reactions to acoustic stimuli with various registration technics].

The aim of the study was to standardize the types of fetal reactions to a short acoustical stimulation in relation to gestational age and the fetal behavioural state. We used polygraphic monitoring in 74 normal pregnancies to investigate the types of fetal reactions after an acoustical stimulation with a bell or a so-called larynx vibrator. A distinction was made between a very short reaction and a so-called long-term reaction with a long-lasting change in a fetal behavioural pattern. After the 26th gestational week, we observed at the so-called "passive" fetal stage a fetal reaction to the bell in 80% and a reaction to the vibrator in 100%. In the "active" fetal state, there was only a reaction in 54 and 62% of the fetuses respectively. The number of "long-lasting" reactions was relatively increased in the active state and after stimulation with the vibrator. After stimulation with the bell and the vibrator, the actocardiograph tracing showed a heart-rate acceleration in 76% and 61% respectively and a so-called cluster of fetal movements in 88% and 100% respectively. A fetal reaction to acoustical stimulation can be diagnosed most accurately by combining the heart-rate acceleration and the clustering of fetal movements. It still has to be checked to what extent a negative response to acoustical stimulation is indicative of possible fetal distress. In cases with negative tests, further monitoring methods have to be applied in order to exclude fetal hypoxia.

Acoustic Stimulation↗
PubMed1989

[The prospective value of Doppler blood flow measurement in uteroplacental and fetal blood vessels--a comparative study of multiple parameters].

Doppler blood flow parameters of uteroplacental and fetal vessels (umbilical artery, fetal aorta, fetal common carotid artery) were tested to determine their clinical value in predicting IUGR or fetal hypoxia, considering the time interval from the examination to the delivery. More than 2 weeks before the delivery, only Doppler parameters of uteroplacental vessels revealed a sensitivity of detecting IUGR of above 50%, using the resistance index. In the last two weeks before the delivery, there was a significant increase of the clinical value of fetal blood flow parameters. The sensitivity of the ratio of the mean blood flow velocity of the fetal common carotid artery to the fetal aorta with a view to detecting a pathological CTG was 94% with a specificity of 60%. In summary, we conclude that blood flow parameters of uteroplacental vessels can be used for screening examinations. Blood flow parameters of fetal vessels are indicated for the supervision of risk pregnancies. The redistribution of the fetal circulation is reflected in the ratio of blood flow parameters of the common carotid artery to the umbilical artery or to the fetal aorta. These parameters seem to be helpful for the early detection of imminent fetal hypoxia in cases with risk pregnancy. Even when a suspicious or pathological CTG does not allow an exact diagnosis of fetal hypoxia, this does not change the basic meaning of this study.

Blood Flow Velocity↗
PubMed1988

Course and predictive value of fetal heart rate parameters.

The present study concerns the developmental character of the fetal heart rate (FHR) pattern and the implications of predicting the perinatal outcome. Data from 443 patients undergoing 2193 nonstress tests were analyzed retrospectively. We found a significant increase of accelerations more than 15 beats/min, of accelerations associated with fetal movements, of fetal movements registered by the tocotransducer, the frequency of oscillations, and of the Fischer score values throughout gestation. The number of short FHR decreases and the mean baseline level declined throughout gestation. A long duration of absent or reduced baseline variability registered even 6 weeks before delivery was associated with low Apgar score values. Late decelerations and contractions registered early in pregnancy were also correlated to a poor outcome. Tachycardia and a low number of accelerations were only correlated to a poor perinatal outcome shortly before the delivery. Fetal movements not associated with FHR accelerations were an early indicator of a poor neonatal outcome. Scoring systems did not generally improve the predictive value of FHR patterns.

Apgar Score↗
PubMed1988

Quantitative analysis of fetal behavioural patterns with real-time sonography and the actocardiograph.

Fetal heart rate patterns, isolated and clustered fetal movements, fetal eye and breathing movements were analysed simultaneously and semiquantitatively in 20 uncomplicated pregnancies in accordance with the classification of fetal behavioural states by Nijhuis and with the aid of two ultrasound scanners and the actocardiograph. According to our own definition state 1 F, 2 F, 3 F and 4 F were observed in 29, 34, 8, and 14% of the registration time. In 15% no state could be identified. Using only the actocardiograph state 1 F, 2 F and 4 F could be identified in around 75%. Periods without a state diagnosis could not be assessed by the actocardiograph alone. The combination of the actocardiograph and one ultrasound scanner for the observation of fetal eye movements reached a similar diagnostic accuracy as the polygraphic monitoring with two ultrasound scanners.

Eye Movements↗
PubMed1988

Obstetrical characteristics of a loss of end-diastolic velocities in the fetal aorta and/or umbilical artery using Doppler ultrasound.

In 30 of 137 high-risk pregnancies we observed absent end-diastolic velocities indicating a high downstream impedance, which could be proved by histomorphological findings of the placenta. On the average the loss of end-diastolic velocities occurred 2-3 days before suspicious and nearly 8 days before pathological cardiotocographic findings. The perinatal mortality was high when absent velocities had been observed before the 32nd week, a cesarean section was obligatory in all but 1 case. All fetuses were growth-retarded. In 9 cases we were able to determine the ratio of blood flow volume in the common carotid arteries to that of the fetal aorta. The values were significantly increased as compared to values of undisturbed pregnancies, demonstrating a redistribution of fetal blood in favor of cerebral circulation.

Aorta↗
PubMed1987

[Pathophysiologic and clinical aspects of measuring blood flow in utero-placental vessels, the umbilical artery, the fetal aorta and the fetal common carotid artery].

It was the aim of this study to conduct simultaneous qualitative analysis of blood flow spectra of uteroplacental and foetal vessels in normal pregnancy, in growth retardation and in EPH gestosis using the pulsed Doppler method. In 237 women who had delivered we performed 291 measurements in uteroplacental vessels, 318 in the umbilical artery, 339 in the foetal aorta and 130 in the foetal common carotid artery. The blood flow spectra were evaluated with the help of the resistance and pulsation index ratio (RI/PI) as a measure of the resistance of the subsequent vascular system. We observed in uteroplacental vessels in EPH gestosis and retardation a significant elevation of the index values in the wall of the uterus outside or inside the placental margin. In foetal vessels we noted a highly significant increase of RI and PI in the umbilical artery and the foetal aorta--simultaneously, however, a drop in the index values in the foetal common carotid artery. These changes point on the one hand to the increased resistance in the capillary net of the placenta and a possible vascular constriction in the region of the lower abdominal organs and extremities, whereas on the other hand they point towards a compensatory lowering of the vascular resistance in the cerebral circulation--possibly as an expression of the risk of hypoxia.(ABSTRACT TRUNCATED AT 250 WORDS)

Aorta↗
PubMed1987

Simultaneous assessment of blood flow velocity waveforms in uteroplacental vessels, the umbilical artery, the fetal aorta and the fetal common carotid artery.

We investigated simultaneously blood flow velocity waveforms of uteroplacental vessels, the umbilical artery, the fetal aorta and the fetal common carotid artery. In pregnancies with intrauterine growth retardation or preeclampsia we found low diastolic velocities in uteroplacental vessels, the umbilical artery and the fetal aorta and high diastolic velocities in the common carotid artery. Abnormal waveforms of the common carotid artery were most effective in predicting fetal compromise and might be a valuable clinical tool for the supervision and therapy of high-risk pregnancies in the future.

Aorta↗
PubMed1986

[Effects of routine administration of methylergometrin during puerperium on involution, maternal morbidity and lactation].

The objective of the prospective randomized study reported here, based on 880 puerperae, was to study the effects of methylergometrin on involution, puerperal morbidity, and lactation. Over 4 weeks 444 mothers were given 0.125 mg of methylergometrin 3 times a day, while 436 were given the same dose of placebo. The following differences were found: in the treated group involution of the uterus was accelerated in the first few days following birth, but after 4 weeks there were no longer any significant differences. Post-partum pains were almost twice as intense in the treated group as in the untreated group. It proved impossible to reduce the number of cases of infection (lochiostasis, axillary temperature over 37.5 degrees C) by administering Methergin during the puerperium; following spontaneous births there were actually more cases of endometritis in the treated group. The number of patients with severe afterbleeding after spontaneous birth was also higher in this group. Lactation among untreated puerperae averaged 880 g during the first six days, while among treated patients it was only 563 g. Even after 4 weeks there were still differences in the quantity of milk produced. The incidence of infection and afterbleeding was significantly lower in mothers who breast-fed their children, irrespective of whether they had taken Methergin or not. We therefore consider that routine treatment of puerperae with methylergometrin is no longer justified; we continue to advocate breast-feeding, not least in view of the fact that it reduces maternal morbidity.

Breast Feeding↗
PubMed1985

[Problems and limits of mammographic cancer diagnosis. Comparison of preoperative radiologic diagnosis with histologic findings in 335 patients with subcutaneous mastectomy].

Subcutaneous mastectomy was performed in 335 patients between 1974 and 1982. In 265 of these, original mammographies were available which were analysed retrospectively and compared with the final histological finding of the subcutaneous mastectomy preparation. The rate of newly discovered non-invasive carcinomas in this was 11%, whereas the rate of invasive carcinomas was 8%. Radiological criteria: high degree of dysplasia, difficult assessment and mastopathy associated with large cysts, are associated with a significantly increased number of malignant histological findings. The radiological criteria of mastopathy, such as adenosis, fibrosis, indurating oedema of stroma, small-cyst mastopathy, as well as parenchymal patterns according to Wolfe, are not important with regard to our group of patients in respect of further selection of risk patients. Criteria of malignancy which are typical of carcinoma, are on the whole rarely recognised, because their assessment is often difficult. In patients with preceding carcinoma of the other breast, indication for subcutaneous mastectomy in case of "unclear" mammography has proved justified: In 4 out of 18 cases, a non-invasive or invasive carcinoma was found. Indication for primary subcutaneous mastectomy was too liberal in case mammography had been assessed as "benign", for the carcinoma rate was only 1/73. In radiologically "unclear" findings, the number of subsequently discovered non-invasive and invasive carcinomas was distinctly higher (in each case 6 out of 58). In such cases an attempt should be made to confirm preoperative diagnosis by means of additive measures before performing subcutaneous mastectomy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1981

Control of fetal size with multiple ultrasonic measurements.

I) Out of eight different bone and soft-tissue parameters, the abdominal circumference correlates best with the birth weight: r = 0.89. Only the combination of the abdominal and the thorax circumference has a better value: r = 0.91. However, all our parameters are linear. The employment of area or volume parameters would probably still improve fetal weight estimation. II) For diagnosing intrauterine growth retardation measurement of thigh diameter seems to be of some value. The quotients of soft-tissue parameters/bone parameters are partly independent of gestational age. Therefore they may support the diagnosis of small-for-date babies where gestational age is uncertain. Prospective studies with serial measurements should be carried out to verify the feasibility and practical utility of our parameters.

Birth Weight↗
PubMedDate not supplied

Feto-feto-fetal triplet transfusion syndrome (FFFTTS).

We report a case of feto-feto-fetal-transfusion-syndrome (FFFTS) in a spontaneous monochorionic triamniotic triplet pregnancy primarily diagnosed at 17 weeks of gestation. During the course of pregnancy, sequentially two triplets appeared as donor. Symptoms of a recipient (polyhydramnios, tricuspid valve insufficiency, and ascites) were present in the third triplet. The second of the donor twins died in utero at 25 weeks. At 27 weeks, a cesarean section was performed mainly due to pre-eclampsia. The first donor triplet developed normally, whereas the recipient showed periventricular leucomalacia and neurological impairment.

Cesarean Section↗