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Biomedical subjects

E Saling

Publications and source records attributed to E Saling.

At least 19 recordsLinked to original sources
PubMed1992

Postterm pregnancy: computer analysis of the antepartum fetal heart rate patterns.

The purpose of this study was to establish reference ranges for numerical fetal heart rate (FHR) data in postterm pregnancy and to compare them with the patterns of fetuses under undisturbed condition at term. FHR was analysed on-line by Sonicaid Computer System 8000. A statistically significant decrease in the number of accelerations and decrease of variation in postterm pregnancy was observed. The duration of high variation (high episodes) in the 42nd week of gestation was statistically lower than in the pregnancy at term. These observations should be taken into account by clinicians in the interpretation of FHR records in postterm pregnancy.

Cardiotocography↗
PubMed1992

Small for gestational age twins: a retrospective analysis of clinical and acid-base status immediately after delivery.

In a retrospective study on 86 twins born between 1971 and 1990, the clinical and acidity status of small for gestational age twins in cases of uncomplicated labor was analysed and compared with the status of appropriate for gestational age twins. No difference was observed in Apgar score and umbilical blood pH between growth retarded and normal twins. The single fact of growth retardation without other factors of risk during labor has no influence on clinical status of small for gestational age twins.

Acid-Base Equilibrium↗
PubMed1992

Effect of the vibratory acoustic stimulation on fetal heart rate patterns of premature fetuses.

The purpose of this study was to examine the heart rate patterns before and after a standardized external vibratory acoustic stimulation in a group of 24 healthy premature fetuses at 32-35 weeks gestational age. FHR was analysed on line by Sonicaid Computer System 8000. A significant increase in the number of accelerations and an increase of variation after stimulus were observed. All other FHR patterns such as baseline, high and low episodes did not change significantly.

Acoustic Stimulation↗
PubMed1992

Time interval in twin delivery--the second twin need not always be born shortly after the first.

In order to evaluate the influence of the time interval on the second twin in twin deliveries, we have used more precise criteria than have been used in the literature to date. The following parameters of the twins were analyzed: normal CTG of the second twin recorded continuously during labor and pH value of the umbilical artery blood after delivery as well as clinical state according to the modified Apgar score. We could not find a general influence of the time interval on pH and clinical status of the second twin. Our results indicate that in cases of uncomplicated twin delivery with a normal cardiotocogram there is no necessity for the second twin to be born as soon as possible after the birth of the first twin.

Acid-Base Equilibrium↗
PubMed1991

[Sudden infant death: characteristics of later "SIDS" victims during pregnancy and labor].

We analysed the pregnancy and delivery courses in 23 children, who subsequently died of SIDS in Berlin. 83% (n = 19) of these children had died by the 6th month of their life, and more than 90% by the 8th month. The first precautionary health examination during pregnancy was performed markedly late, in 22% of the pregnant women only after the 20th week of gestation. 55% of all "SIDS mothers" had smoked more than 10 cigarettes daily during the pregnancy period (control group: 8%). Preterm delivery rate was 30%, i.e. almost three times that of the control group. Almost one-third of all the examined children had a birth weight below the 10th percentile (control group: less than 7%). 61% of all mothers of the examined group by us were unmarried or divorced (control group: 16%). Whether these anomalies--which must of course also be considered as being somehow connected with one another--are causally connected with SIDS, requires to be clarified by more extensive studies. At the present time we can only recommend to make an effort to convince families, in whom several of the above mentioned anomalies occur, to accept special counselling and care as well as meaningfully employed home monitoring.

Birth Weight↗
PubMed1991

Effect of continuous lumbar epidural anaesthesia during labour on fetal transcutaneous carbon dioxide.

The effect of epidural anaesthesia during labour on fetal transcutaneous carbon dioxide (tcPCO2) was observed on 27 fetuses. Our results show that in the course of epidural anaesthesia there is an increase in fetal tcPCO2. We can see a slight increase even before administering the test dose, while preparatory measures are undertaken for the epidural anaesthesia. After administering the test dose and after giving the main dose there is a further increase in fetal tcPCO2, which continues for up to 30 min after the main dose has been given. The results suggest that it is important to consider any pathological conditions in the fetus, so as to avoid the possibility of additionally endangering the fetus during epidural anaesthesia.

Adult↗
PubMed1991

Computer analysis of the antepartum fetal heart rate patterns in the intrauterine growth-retarded human fetus using Sonicaid System 8000.

A total of 28 pregnant women with growth-retarded fetuses were studied to examine the antepartum fetal heart rate patterns between 30 and 39 weeks of gestation. Sonicaid Computer System 8000 was used to analyze on line 200 cardiotocograms. We found that there is an increase in the number of accelerations, an increase in variation assessed in beats per minute and in milliseconds, an increase in duration of high episode and a decrease in the number of decelerations.

Acceleration↗
PubMed1991

The effect of maternal oxygen administration on fetal and maternal blood flow values using Doppler ultrasonography.

Thirty-one pregnant women divided into three groups (AGA prepartum, SGA prepartum without distress, AGA in labor) were examined using Doppler ultrasonography before, during and after oxygen administration to mothers via a face mask. The aim of the study was to find out if there was any effect on the blood flow values in the fetal aorta, the umbilical artery, the fetal common carotid artery and the uterine arcuate arteries. The resistance index (RI) did not change in those vessels during maternal hyperoxygenation with one exception: in the group of SGA fetuses the RI in the fetal aorta increased significantly. Blood flow velocity and volume blood flow remained unchanged in the fetal aorta during oxygen administration.

Aorta↗
PubMed1990

Vaginal and cervical pH in normal pregnancy and pregnancy complicated by preterm labor.

A prospective study was performed in order to determine vaginal and cervical pH in pregnancy. In normal pregnancy vaginal pH (using a pH meter with connected glass electrode) was found to be between 3.8 and 4.0 (1 SD +/- 0.3) at the introitus, mid-vaginal, and at the anterior and posterior fornix. In patients with preterm labor (n = 50) or prolonged rupture of the membranes (PROM, n = 35) pH was increased significantly to 4.2-4.5 (1 SD +/- 0.7) resp. to 5.2-6.1 (1 SD +/- 0.8). Cervical pH ranges between 6.5 and 7.0 in all groups studied. Elevated pH values are due to disturbed vaginal flora. We recommend vaginal pH measurement for an quick detection of infection in cases with preterm labor and for clarifying PROM in suspicious cases.

Bacterial Infections↗
PubMed1990

Quantitative relationships between pain intensities during labor and beta-endorphin and cortisol concentrations in plasma. Decline of the hormone concentrations in the early postpartum period.

In 38 women with uncomplicated vaginal delivery at term, the different pain intensities during spontaneous labor were correlated to the plasma beta-endorphin and cortisol concentrations simultaneously examined. The pain intensities subjectively assessed were numerically categorized. The women in labor categorized to pain intensities 0 to III were in comparable stages of cervical dilatation. The hormone concentrations were measured by means of radioimmunoassay. The lowest hormone levels were found after abolition of pains of labor by epidural anesthesia: beta-endorphin 42 pg/ml, cortisol 318 ng/ml (mean values). The hormone concentrations rose progressively with increasing intensities of labor pain. The highest concentrations were observed in the first few minutes after delivery i.e. immediately after cessation of the extreme pains of expulsive labor: beta-endorphin 118 pg/ml, cortisol 449 ng/ml. Statistically significant, positive correlations were calculated between beta-endorphin and cortisol concentrations in plasma and the self-reported pain intensities (p less than 0.001 and p less than 0.01 resp.). Thus, highly elevated beta-endorphin levels in plasma do not abolish pain, probably they modulate it. Within the first four hours postpartum the concentrations of the two stress-stimulated hormones dropped rapidly. The endorphin level fell from 118 pg/ml immediately after delivery to 38 pg/ml in the above mentioned period, the cortisol level from 449 ng/ml to 302 ng/ml. One to three days after delivery the beta-endorphin and cortisol concentrations in maternal plasma were largely normalized, this means they then approximately corresponded to the values being found in nonpregnant women under normal conditions.

Adrenal Cortex↗
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↗
PubMed1989

Umbilical cord blood coagulability, acidosis and intracranial hemorrhage.

The relationship between blood pH and blood coagulability and alternations in the fibrinolytic system was studied using blood samples obtained from the umbilical artery of 178 cases. Further studies were performed on this relationship in 5 cases of intracranial hemorrhage detected by ultrasonography, and the following results were obtained: 1. A definitely significant correlation was noted between the hepaplastin value and blood pH and these values markedly decreased in the acidosis group. 2. Changes in FDPs and SFMC were not so obvious as changes in the hepaplastin values, but activation of the fibrinolytic system was noted in the acidosis group. 3. No consistent finding was obtained with respect to changes in At-III. 4. Among five cases of intracranial hemorrhage, abnormalities in the coagulation and fibrinolytic system were noted in cases of acidosis, indicating that presence of acidosis is associated with severe intracranial hemorrhage. 5. The necessity of future studies on biochemical changes during acidosis was discussed.

Acid-Base Equilibrium↗
PubMed1989

Myoglobin in third trimester amniotic fluid of human pregnancy--a potential indicator of fetal hypoxia.

195 amniotic fluid samples from the third trimester were examined for their content of myoglobin by means of radio-immunoassay. 151 of the samples were obtained intrapartum, the rest (44) was taken antepartum by transabdominal amniocentesis within one week prior to delivery. Depending on the myoglobin levels measured, different amniotic fluid groups were defined: (A) amniotic fluids containing no myoglobin or traces of it (less than 3 ng/ml), (B) amniotic fluids with moderately elevated myoglobin levels (3-10 ng/ml), (C) amniotic fluids with high myoglobin levels (greater than 10 ng/ml). Myoglobin levels above 3 ng/ml could be measured in 98 of the 151 samples taken intrapartum. In the amniotic fluids drawn antepartum the proportion of "myoglobin-positive" samples (greater than 3 ng/ml) amounted to only 22.7% (10 out of 44 samples). In pregnancies with amniotic fluids showing high myoglobin levels intrapartum, the prevalence of meconium staining of the samples, pathological cardiotocograms intrapartum and metabolic acidoses in umbilical artery blood samples was significantly higher than in pregnancies with myoglobin-negative amniotic fluids. The frequency of cesarean sections for fetal distress rose with increasing myoglobin levels in amniotic fluid, being 5.7, 13, and 18.2% in Group A, B and C respectively. In the pregnancies in which the amniotic fluid samples were taken antepartum, the prevalence of meconium-stained amniotic fluid increased with elevating amniotic fluid myoglobin (p less than 0.05, Group A vs. Group C). The frequency of cesarean sections for fetal distress and of neonatal depression immediately after delivery was considerably heightened in the cases with myoglobin-positive amniotic fluids antepartum compared to those with myoglobin-negative liquor.(ABSTRACT TRUNCATED AT 250 WORDS)

Amniocentesis↗
PubMed1989

Determination of vaginal pH by pH indicator strip and by pH micro electrode.

Vaginal pH measurement is a screening method of vaginal infection in pregnancy. We tested two different methods of pH determination. In freshly taken vaginal fluid measurements were carried out with special pH indicator strips and pH micro glass electrode. About 100 microliters of vaginal fluid is enough when pH indicator strips are used, and 200 microliters when the micro electrode is used. The accuracy of the pH measurement by indicator strip is about 0.1-0.2 pH and by electrode 0.01 pH. Both methods show a good correlation between pH 4.0 to 7.0 (p = 0.0000). Until a pH of up to 4.3 we recommend the pH determination by indicator strips. In all cases with the possible risk of infection (pH values greater than 4.3) the micro electrode should be used.

Female↗
PubMed1988

[Use of a stapling device in abdominal cesarean section].

This is a report on the use of a stapling device for caesarean sections. The device can be inserted right and left after a very small median uterotomy. It cuts the uterine wall and at the same time places clips on the edges of the wound. The clips are made of a hydrolysable material that can be absorbed in the tissue and can also be used for surgical stitching. Haemostasis is definitely assured. No adverse reactions or disadvantages for the patients have been noticed to date.

Cesarean Section↗
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↗