Biomedical subjects
Publications and source records attributed to E Cavatorta.
The Authors describe the results of a study on the cardiotocographic tracings during labour of pregnant women, whose fetuses were affected by Down syndrome. The high incidence of cardiotocographic alterations in these fetuses does not seem to be in relation with congenital cardiac disease.
The Authors are refering to the appearance of unknown deceleration in "APC" cardiotocograms. There is no relationship between these decelerations and the uterine contractions or fetal movements. These decelerations are called "sporadic" and are an indication of fetal risk. However, it is not necessary to have an immediate delivery.
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Intravascular coagulation causes fetal risk, because it produced placental damage in E.P.H. gestosis. F.D.P. values are above the normal range of the third trimester in 11 out of our 13 cases. Fetal risk is revealed by pathological C.T.G. patterns; fetal death occurred in 4 cases. Therefore, high F.D.P. values are considered D.I.C. indexes, and a sign of fetal risk.
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Intrapartum fetal monitoring has provided a method by which the clinician can more accurately determine the status of the fetus during labor. More recently, investigations have been directed toward antepartum FHR monitoring studies to determine fetal well-being prior to the onset of labor. In this study, the results of "stress" monitoring are presented. The Authors have used three types of stress-tests: 1) oxytocin stress test 2) step-test 3) Oxygen stress test. The positive tests appears to correlate meaningfully with intrauterine compromise and neonatal status.
The Authors consider the cases of delivery occurred in the Clinic of Obstetrics and Gynaecology of Parma University in the five-year period 1971-5 and the relative perinatal mortality. Whereas fetal mortality during labour has gone to be progressively reduced by the modern monitoring techniques, considerable importance is still attached to pre-partum fetal mortality. As a result of the examination of the causes, EPH Gestosis appears to be the most responsible one and the Authors emphasize its inadequate prophylaxis.
The AA. have examined 9 cases of normal pregnancy, 5 cases of E.P.H. gestosis and 5 cases of diabetes mellitus, for which cases caesarean section had been planed, determining the aminogram of the amniotic fluid, of the mother's venous plasma and of the umbilical venous plasma; the 3 samples were performed about contemporaneously. Both in the normal pregnancies and in those complicated by E.P.H. gestosis and by diabetes mellitus, the concentration of amino acids was higher in the umbilical venous plasma than in that of the mother and higher in the latter than in the amniotic fluid, with the exception of glycine, taurine, glutammic acid and aspartic acid in the normal pregnancies, of taurine in the gestosic pregnancies, of taurine, citrulline, glutammic and aspartic acid in the diabetic pregnancies.
In the present study the authors, on the basis of the existing literature, analyse the delivery problem in previous cesarean section patient, especially about maternal mortality and morbidity. After cesarean section vaginal delivery may occur only in selected patients, with precautionary measures and continuous monitoring in labor. The maternal mortality is lower in vaginal delivery patients after cesarean section than in iterative cesarean section patients; also the post operating complications are more frequent after iterative cesarean section. Perinatal mortality is in relation to uterine rupture, perinatal morbidity to iatrogenic prematurity and neonatal respiratory adaptation.