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Biomedical subjects

B Westin

Publications and source records attributed to B Westin.

At least 19 recordsLinked to original sources
PubMed1995

[Epidemiological indications for the etiology of proteinuria, hypertension in pregnancy and pre-eclampsia--a longitudinal cohort studies of all Swedish women giving birth between 1973 and 1981 to 3 singleton infants].

Based on centrally recorded data about all pregnancies that led to delivery in Sweden in the years from 1973 to 1981 this longitudinal study considers the course of pregnancies of all women who gave birth to their first three single babies during observation time especially regarding hypertension, proteinuria, pre-eclampsia and eclampsia-here subsumized under HP-disease. Incidence of HP-disease is shown to be 8.1% of all observed women, depending on the theoretical approach at a minimum of 34% and a maximum of 44% being due to primary, pregnancy-induced HP-disease. Some epidemiologic findings may give some hints on the etiology of HP-disease: In primary HP-disease mother's age is in the normal range, whereas infection of the urinary tract, diabetes mellitus, fetal deformity are found more frequently. Female fetus are over-represented with existence of HP-disease. The influence of HP-disease presence and parity on fetal development and fetal outcome are discussed.

Asphyxia Neonatorum↗
PubMed1992

Fetal heart rate response to acoustic stimulation in relation to fetal development and hearing impairment.

In twelve healthy pregnant women the fetal heart rate response to sound stimulation was tested every second week between the 22nd and the 34th week of the pregnancy. Habituation to the acoustic stimuli used was also investigated at the last examination. A high risk material for hearing impairment comprised 31 pregnant women. The stimuli were presented by a vibrator placed on the maternal abdomen over the fetal head. As stimuli pure tones were used in the form of pulses of one second at a frequency of 3000 Hz and with an onset and a decay time chosen not to cause audible clicks to a normal ear. The intensity of the tone pulse was set at a level calculated to correspond at the position of the fetal head to 110 dB sound pressure level in free field. Roughly 50% of the fetuses tested started to react with an increased heart rate in the 24th week of the development. Four weeks later all tested subjects responded to the test stimuli. Habituation of the motor 'startle' response was shown but the fetus heart rate change was consistent over 20 consecutive stimulations one min in between each. In 31 high risk subjects the responses from three fetuses must be considered as pathologic. These three children exhibited impaired auditory tests after birth and severe hearing impairment at the age of three years. All the others disclosed normal hearing at birth as well as at three years of age. Repeated significant increases in fetal heart rate following acoustic stimulation may appear as an indication of normal function of the hearing organ.(ABSTRACT TRUNCATED AT 250 WORDS)

Acoustic Stimulation↗
PubMed1991

Psychosocial job factors and symptoms from the locomotor system--a multicausal analysis.

The effects of physical and psychosocial work environment factors on emotions, psychosomatic and endocrine (cortisol and testosterone) states, back pain, symptoms of degenerative joint disease, and absenteeism for sickness, were studied in 147 men and 60 women in six occupations representing widely different physical and psychological activities. In most subjects, measurements were carried out twice to four times over one year. Statistical analyses were performed of the associations between different factor levels, such as age, gender, height, body mass index, and physical stressors at work. It was found that psychological work demands were associated with physiological indicators of strain (plasma cortisol and self-reported muscle tension) and that self-reported muscle tension was associated with several emotional reactions as well as with symptoms from the back, neck and shoulders. Little possibility for decision-making was associated with a high rate of absenteeism for sickness. In men, a high plasma testosterone level was associated with self-reported muscle tension. The results indicate that work environment factors influence mood, bodily tension and somatic symptoms, but that load on the locomotor system and opportunity to influence decisions play an important and more direct role in absenteeism for sickness.

Absenteeism↗
PubMed1987

Fetal heart rate pattern before and after paracervical anesthesia. A prospective study.

A prospective study of the fetal heart rate pattern during labor before and after paracervical blockade (PCB) was performed. The material comprised 469 women in labor, or 28% of 1673 women delivered during a 6-month period. The majority of the anesthesias (87%) were administered by specially trained midwives. Bupivacain (Marcain) was the anesthetic used. The injections were made at four different points at a cervical diameter of 3-9 cm. The concentration of the anesthetic was 0.25 or 1.25% generally in 10 ml of normal saline. A second PCB was administered in 54 patients at least one hour after the preceding one. Fetal heart rate (FHR) was recorded via a scalp electrode and the pattern studied 15 min before and 30 min after the injection of the anesthetic. Bradycardia was defined as a persistent deceleration exceeding 3 min and occurring within 30 min of the PCB. Variability and acceleration pattern persisted independently of the PCB. Following PCB, decelerations of all types increased, while the basal rhythm decreased by on average 1.5 beats/min. Following PCB fetal bradycardia occurred in 1.9%. The bradycardia persisted on average for 6.5 min with a lowest average FHR of 73 beats/min. Retrospectively, 6 out of 9 infants exhibited recognized risk factors for bradycardia. All infants with bradycardia scored 9-10/5 min, according to the Apgar rating scale and all had a normal development with regard to growth, motor and speech development at the age of 2 years. There were no significant differences in vaginal operative deliveries between the PCB and the non-PCB group.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, Epidural↗
PubMed1984

[Ultrasonic diagnosis of scar defects following cesarean section].

The clinical signs and the diagnosis of deficient healing of the scar following caesarean section are reviewed. Maternal mortality following repeated caesarean section is four times higher than by normal vaginal delivery. Uterine rupture is accompanied by a 25-fold increase in perinatal mortality. At the department of obstetrics at Danderyd's Hospital 2542 case histories were reviewed. Caesarean section rate was 11,3%. At reoperation 2,8% of the scars exhibited deficient healing.--Because of this experience the ultrasound method was used to examine the echo-structures between the urinary bladder and the amniotic cavity. A Real time US-apparatur Axiscan 5 B-S was used. Corresponding to the scar-region smooth or pathologically deformed structures were observed. The clinical diagnosis of the scar healing was made at the time of delivery. 68 patients were examined. In 31% of the cases a vaginal delivery was planned and carried through without complications. In an additional 9% vaginal delivery was planned but it was necessary to perform an acute caesarean section. Only in two of these cases the indication for operation was imminent scar-rupture. In the following 41 patients (60%) a planned caesarean section was performed. In no case there was clinical suspicion of defective scar healing.--In the whole material (n = 68) 1,5% fenestrations were found. Ten of the 15 (22%) deficiently healed uterine scars were diagnosed with aid of ultrasound before onset of labor. The ultrasonic risk group comprised 18% of the material. The sensitivity of the ultrasonic method was 67% and the specificity 96%.(ABSTRACT TRUNCATED AT 250 WORDS)

Cesarean Section↗
PubMed1981

Symphysis-fundus measurement in prediction of fetal growth disturbances.

Graphic supervision of pregnancy by symphysisfundus (SF) tape measurement was introduced in an area of north Stockholm in 1972. Subsequently a considerable and persistent drop in perinatal mortality was seen. SF-tape measurements reflect the fetal growth and correlate well with fetal crown-rump length. Over a 2-year period SF-growth data were collected for all infants admitted to the neonatal unit in the area. In all, 812 singletons were studied. Maternal smoking habits in the first trimester were recorded. A group of 283 normal neonates served as controls. A highly significant statistical difference was found on comparing the mean birth weights of infants associated with high, "normal", and low and/or static SF-curves from 34 weeks of gestation and onwards. The sensitivity in detecting LGA infants by high SF-curves was 74%, with a specificity of 84%. The proportion of mothers with uncertain expected dates of confinement (EDC) was high among those having "normal" SF-curves, yet giving birth to SGA infants. After correction for gestational age, the SF-curves adjusted for dates were in most cases low and/or static during the weeks prior to delivery. The sensitivity and specificity would thereby have increased to 95% and 93%, respectively, in detecting SGA infants had their dates been certain. Maternal smoking showed an overall incidence of 37% in the first trimester. No increase in incidence was seen among mothers to preterm infants. There was as could be expected a highly increased ratio of smoking mothers to infants with birth weight less than -1 S.D., regardless of gestational age. SF-tape measurement is recommended as a graphic method of supervising pregnancy for the detection of accelerated and retarded fetal growth. Early and correct determination of gestational age, however, is a prerequisite.

Birth Weight↗
PubMed1980

[Gravidogram of antenatal care (author's transl)].

The system of antenatal care in Sweden is reported. Every clinically healthy pregnant woman has to undergo more than 15 checks during pregnancy, including two examinations by a gynaecological specialist and the others by skilled midwives. Uterine growth (and, consequently, fetal growth) and increase of maternal bodyweight are kept under surveillance by means of gravidogram. All measured data are graphically recorded and compared to the standard values given in the gravidogram. Hence, early diagnosis is possible of major highrisk groups, such as retardation of fetal growth, macrosomia, twins and hydramnios. -- A catalogue of risk factors and a cervix score for assessment of cervical maturity are available for early detection of imminent premature delivery. -- The introduction of the gravidogram at Danderyds Hospital in 1972 has been followed by antepartum, intrapartum and neonatal mortality figures down by some 50 per cent as well as by unambiguous improvement in the general condition of newborns. Growing and widening use of the gravidogram throughout Sweden has been accompanied by increasingly visible decline of perinatal mortality. Systematic and improved antenatal care, consequently, is decisive for reduction of perinatal mortality and morbidity.

Body Weight↗
PubMed1977

Scintigraphic studies of uterine and placental growth and placental migration during pregnancy.

Placental scintigraphy with 113mIn (Indium) combined with cervical marking with a shielded 57Co (Cobalt) radioactive source was used to study uterine and placental growth in human pregnancy and placental location and migration in a total of 176 patients. Uterine length measurements can be used for selecting growth retarded fetuses. There was an approximately constant ratio between placenta diameter and uterine length (0.68 +/- 0.03). When the placenta was located on the ventral uterine wall, low implantation occurred in 61%. The corresponding figure for low implantation when the placenta was located on the dorsal uterine wall was 30%. The difference was highly significant. Placental migration was studied in 20 patients. Significant migration occurred in 11 cases. The placental margin closest to the internal cervical os migrated outwards about 3 cm on average.

Female↗
PubMed1977

Evaluation of a feto-pelvic scoring system in the management of breech presentations.

A feto-pelvic scoring system comprising maternal pelvimetric data, estimated fetal weight, type of breech presentation and previous obstetric history was used in selecting patients for cesarean section of vaginal delivery. A maximum score of 20 points was possible. Twelve points or less indicated cesarean section. During 1973-1975 224 singleton breech deliveries were evaluated. In 29.5% cesarean section was performed and in 83% of these it could be planned in advance. In 70.5% of cases, patients were allowed to deliver vaginally under continuous electronic monitoring of the fetal heart rate. There was one intrapartum death and only one early neonatal death of a small premature child. In two cases intrauterine death had occurred already in the antepartum period. The uncorrected perinatal mortality was 17.9 per 1000 but not significantly different from the uncorrected perinatal mortality of 8.0 per 1000 for all patients delivered at the Danderyd's Hospital during the period 1972-1975 (12832 births). The corrected mortality resulting from breech presentation was 8.9 per 1000. The infants exhibited similar and excellent 5 min Apgar scores whether delivered vaginally or by cesarean section or matched with a randomized control series of 1000 cephalic presentations.

Apgar Score↗