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Biomedical subjects

E Mueller-Heubach

Publications and source records attributed to E Mueller-Heubach.

At least 37 records · Page 2Linked to original sources
PubMed1981

Prolonged in utero retention and mummification of a Macaca mulatta fetus.

An intrauterine mummified fetus in a Macaca mulatta was delivered surgically 708 days after onset of the last menstrual flow. Supracervical hysterectomy and left salpingo-oophorectomy were done. The fetus consisted of a compressed but complete skeleton and hairy skin adherent to the intact, thin uterine wall. Placenta and umbilical cord could not be identified.

Abortion, Missed↗
PubMed1981

Comparison of continuous transcutaneous Po2 measurement with intermittent arterial Po2 determinations in fetal lambs.

This study determined the validity of transcutaneous Po2 (tcPo2) versus Pao2 determinations in the sheep fetus. In 7 fetal lambs catheters were placed in the carotid artery and the trachea, and ECG leads and a tcPo2 electrode were attached. Intermittently determined Pao2 values were compared to continuously recorded tcPo2 values. Fetal tcPo2 values ranging from 12 to 29 mmHg were achieved by changing the gas mixture the ewe breathed or by inflation of a balloon catheter in the maternal aorta. Transcutaneous Po2 correlated strongly with Pao2 (r = .91). These studies indicate that the tcPo2 electrode precisely and accurately reflects Pao2 in the fetal lamb. Limitations of tcPo2 measurements regarding prolonged attachment of the electrode to the fetal skin as well as fetal skin tolerance to the heat of the electrode have been identified. With this electrode the changes in oxygen tension can be compared with changes in fetal cardiovascular variables, eg, heart rate, blood pressure, and ECG, for a better understanding of the effects of hypoxemia on the fetus.

Animals↗
PubMed1980

Umbilical venous blood flow and its distribution before and during autonomic blockade in fetal lambs.

In nine chronically catheterized fetal lambs (120 to 135 days; term 147 days) umbilical venous blood flow and its distribution were measured by the radionuclide-labeled microsphere technique before and during autonomic blockade with atropine (0.20 to 0.25 mg/kg; seven studies) or phentolamine (0.10 to 0.12 mg/kg; six studies). Atropine significnatly increased mean fetal heart rate (182 to 207 beats/min), descending aortic blood pressure (49 to 55 mm Hg), and umbilical venous blood flow (210 to 239 ml/min/kg fetus), without changing umbilical venous blood pressure. Phentolamine decreased mean descending aortic pressure (48 to 45 mm Hg), but did not affect heart rate, umbilical venous blood pressure, or umbilical venous blood flow. Neither atropine nor phentolamine altered the distribution of umbilical venous blood flow to the ductus venosus, the liver, or the other fetal organs. These data indicate that the cholinergic nervous system only indirectly affects the basal umbilical venous blood flow in the near-term fetal lamb. This effect is small and is secondary to associated changes in heart rate and arterial blood pressure. Neither the cholinergic nor the alpha-adrenergic systems influence the basal distribution of umbilical venous blood flow.

Animals↗
PubMed1980

Effects of electronic fetal heart rate monitoring on perinatal outcome and obstetric practices.

Perinatal outcome and obstetric practices during 1970 and 1977 were compared. None of the 6,740 fetuses delivered with birth weights of 1,000 gm or greater in 1970 had electronic fetal monitoring (EFM). In 1977, 5,987 of 8,174 fetuses delivered had EFM (72.7%). High-risk factors were significantly more frequent in the pregnant patient population in 1977. The incidence of intrapartum stillbirths and severe birth asphyxia was significantly lower in 1977. These reductions remained significant when corrected for changes in obstetric practices other than EFM as well as for changes in patient population. The neonatal death rate was not significantly changed. The primary cesarean section rate increased from 4.4% to 10.1%, mostly because of a greater number of cesarean sections done for failure to progress in labor and breech presentation. Only 15% of the overall increase in cesarean section rate was because of a greater frequency of the indication of fetal distress. The incidence of severe birth asphyxia was the same among the unmonitored patients in 1970 and 1977. In 1977, however, the monitored patients had a significantly lower incidence of severe birth asphyxia than the unmonitored patients.

Asphyxia Neonatorum↗
PubMed1980

Fetal heart rate and blood pressure during prolonged partial asphyxia in the rhesus monkey.

Fetal heart rate (FHR) and fetal blood pressure (FBP) were recorded continuously in 20 anesthetized fetal monkeys near term while their oxygenation was progressively decreased by a stepwise reduction in uterine blood flow. Fetal blood was sampled periodically from the carotid artery and analyzed for pH and PO2. Hemoglobin saturation with oxygen (S) was derived from nomogram. During the study period, uterine contractions were either minimal or absent. FHR remained constant as long as S was greater than 55%. Below that it began to decline by 0.34%/% saturation. When S was less than 31%, FHR fell by 0.93%/% saturation. The correlation between FHR and PO2, and FHR and pH, was less consistent. Arterial FBP was maintained over the entire range of pH, PO2, and S. It is concluded that, under the conditions described, an unequivocal decrease in mean FHR signals a substantial reduction in the availability of O2 to the fetus.

Animals↗
PubMed1980

Fetal acid-base state following spinal or epidural anesthesia for cesarean section.

The authors compared fetal acid-base state and maternal blood pressure response in 111 women undergoing repeat cesarean section with either epidural or spinal anesthesia. Fetal umbilical acidemia (umbilical venous pH less than 7.25 or umbilical arterial pH less than 7.20) was more commonly observed following spinal anesthesia with a preanesthetic fluid load of 500 to 999 ml (20% of cases) than with epidural anesthesia (4% of cases. P > .05, chi 2). The incidence of fetal acidemia following spinal anesthesia was similar to that following epidural anesthesia when 1000 to 1500 ml of fluid was infused prior to spinal anesthesia. The maximum reduction in systolic blood pressure following spinal anesthesia was not related to preanesthetic fluid load; however, in cases of severe hypotension the hypotensive episode was shorter and easier to treat when the preanesthetic fluid load was 1000 to 1500 ml rather than 500 to 999 ml. These data suggest that women receiving spinal anesthesia for repeat cesarean section should be given an intravenous fluid load of 1 liter or more.

Acid-Base Equilibrium↗
PubMed1979

Pharmacologic inhibition of preterm labor.

Preterm labor is responsible for a majority of cases of perinatal morbidity and deaths. Prevention of preterm labor is not usually possible; thus pharmacologic treatment is the only recourse available. Numerous agents have been used to treat preterm labor, but none has proved to be superior. This report reviews the current information available about the pharmacology of labor-inhibiting drugs and discusses the clinical approach to the management of preterm labor.

Adrenergic beta-Agonists↗
PubMed1978

Use of supine pressor test to prevent gestational hypertension in primigravid women.

The supine pressor (roll-over) test was performed on 62 nulliparous patients under 20 years of age at conception. The 28 patients (45%) with positive tests were treated to prevent the development of gestational hypertension. Four of those with a positive test and two of those with a negative test developed gestational hypertension. Compared with a composite of other reported studies of this test in which the patients were not treated, our results indicated a statistically significant reduction in the incidence of gestational hypertension. The supine pressor test appears to be useful clinically in young nulliparous women.

Adult↗
PubMed1978

Effects of dexamethasone on leukocyte counts in pregnant sheep and fetal lambs.

In adult nonpregnant animals and human beings, glucocorticosteroids increase circulating leukocytes (predominantly neutrophils) and decrease lymphocytes, monocytes, and eosinophils. We were interested in studying effects of glucocorticoids on leukocyte counts during pregnancy to determine any differences between responses in the nonpregnant and pregnant states. After general anesthesia was administered, we placed catheters in a carotid artery and a jugular vein in pregnant sheep and in fetal lambs. Six days after surgery, we administered dexamethasone intravenously to the mother (0.2 mg. per kilogram) or to the fetus (0.06 mg. per kilogram) and obtained maternal and fetal jugular venous blood samples immediately before (control) and 3, 6, 12, 24, 48, and 72 hours after steroid injection. Administration of dexamethasone to the mother significantly increased total leukocyte and neutrophil counts (leukocytes per cubic millimeter blood) and decreased lymphocyte and eosinophil counts, but it did not change monocyte counts. Leukocyte counts returned to control values within 48 hours. Administration of dexamsthasone to the fetus rapidly increased total leukocyte and neutrophil counts, decreased monocyte and eosinophil counts, and had not effect on lymphocyte counts. Fetal leukocyte counts returned to control values by 24 hours after dexamethasone injection. Our results suggest that maternal and fetal leukocytes can respond to glucocorticoids as they do in the adult nonpregnant state.

Animals↗
PubMed1978

Lecithin/sphingomyelin ratio in amniotic fluid and its value for the prediction of neonatal respiratory distress syndrome in pregnant diabetic women.

In 101 diabetic pregnant women (Classes A through D) 146 determinations of the lecithin/sphingomyelin (L/S) ratio were carried out. Gestational ages were verified by serial fetal cephalometry. No L/S ratios of more than 2.0 were found before 34-1/2 weeks' gestation; however, in 42 per cent of patients the L/S ratio was below 2.0 at 36 weeks' gestation or later. Respiratory distress syndrome (RDS) was found in 16 neonates of women with L/S ratios of 2.0 or higher; however, RDS incidence varied depending on the mode of delivery. Abdominal delivery was performed before 37 weeks' gestation in 19 patients with L/S ratios of 2.0 or higher and resulted in neonates with RDS in 41 per cent of cases. Vaginal delivery was accomplished below 37 weeks' gestation in 10 patients with L/S ratios of 2.0 or higher and no subsequent neonatal RDS was observed. After 37 weeks' gestation neonatal RDS is rare, irrespective of mode of delivery. The data presented suggest that similar numerical values of the L/S ratio at different gestational ages have a different predictive value for the occurrence of neonatal RDS.

Amniotic Fluid↗
PubMed1978

Sinusoidal fetal heart rate pattern following intrauterine fetal transfusion.

Two patients with severe rhesus isoimmunization had sinusoidal fetal heart rate patterns following intrauterine fetal transfusion. A consistent temporal relationship between fetal transfusion and sinusoidal fetal heart rate pattern was observed. Survival of a fetus who had a sinusoidal fetal heart rate pattern after each of three transfusions suggests that this pattern may not be ominous when observed transiently after fetal transfusion.

Adult↗
PubMed1977

Effects of dexamethasone on maternal and fetal hemodynamic states and fetal oxygenation.

The effects of dexamethasone on maternal and fetal hemodynamic states and fetal oxygenation were determined in chronically instrumented unanesthetized pregnant ewes and fetal lambs. Intravenous injections of pharmacologic doses of dexamethasone to the mother failed to alter maternal blood pressure, heart rate, blood flow in the uterine artery supplying the pregnant horn, or uterine vascular resistance. Direct administration of dexamethasone to the fetus had no effect on fetal blood pressure, heart rate, acid-base state, or oxygenation. Furthermore, direct fetal administration of dexamethasone did not produce premature parturition.

Animals↗