PubMed Health⌕ Search

Biomedical subjects

F K Lotgering

Publications and source records attributed to F K Lotgering.

At least 37 records · Page 2Linked to original sources
PubMed1996

Tumor necrosis factor-alpha in response to endotoxin administration in the pregnant guinea pig.

OBJECTIVE: Our purpose was to test the hypothesis that an intramuscular endotoxin challenge induces production of tumor necrosis factor-alpha in the pregnant guinea pig and to investigate some of the metabolic effects. STUDY DESIGN: Twelve randomly selected guinea pigs at 33 days' gestation with a sampling catheter in the carotid artery received an intramuscular injection of a solution of endotoxin isolated from Bacteroides fragilis (n = 6) or of solvent alone (n = 6). Plasma values of tumor necrosis factor-alpha, hematocrit, and 6-keto-prostaglandin F1 alpha were determined before and several hours after injection. RESULTS: Tumor necrosis factor-alpha was detected in five of six guinea pigs, but it could not be demonstrated in five of six placebo animals. The hematocrit was significantly decreased, and prostaglandin F1 alpha significantly increased 24 to 48 hours after endotoxin injection. CONCLUSION: In pregnant guinea pigs an intramuscular endotoxin challenge induces the release of tumor necrosis factor-alpha, followed by a reduced hematocrit and an increased prostacyclin concentration. These effects could be involved in the pathogenesis of endotoxin-induced fetal growth retardation.

Animals↗
PubMed1996

Fetal heart rate and uterine contractility during maternal exercise at term.

OBJECTIVE: Our aim was to assess the physiologic response of human fetal heart rate and uterine contractility to moderately strenuous maternal exercise. STUDY DESIGN: We measured fetal heart rate and intrauterine pressure with the use of internal monitoring before, during, and after maternal exercise at a heart rate of 140 beats/min on a cycle ergometer in 30 term women admitted for elective induction of labor. The fetal heart rate tracings were assessed by three observers and were classified according to Fischer et al. and Nijhuis et al., and the frequency and intensity of uterine contractions were determined. RESULTS: Fetal outcome was good in all cases. There were no significant differences in Fischer scores between rest, exercise, and recovery periods. The fetuses displayed a heart rate pattern A and B, indicative of behavioral states 1F or 2F, 85% of the time, with state changes apparently independent of exercise. Uterine activity increased significantly during the exercise period, with a 5.5-fold increase in contraction frequency and a fourfold increase in time-pressure integral compared with rest, with rapid recovery after the exercise. CONCLUSION: Exercise in healthy pregnant women at term does not cause a change in fetal heart rate pattern suggestive of fetal distress or a change in fetal behavioral pattern, but it does significantly increase uterine activity.

Adult↗
PubMed1996

Peak ventilatory responses during cycling and swimming in pregnant and nonpregnant women.

This study was designed to determine whether pregnancy affects peak O2 uptake (VO2peak) during swimming compared with cycling. We studied 11 women at 30-34 wk gestation and 8-12 wk postpartum. We measured heart rate (HR), O2 uptake (VO2), CO2 output (VCO2), minute ventilation (VE), and lactic acid concentration. Peak HR was not significantly affected by the type of exercise or by pregnancy. VO2peak was 9% lower during swimming than during cycling but was not affected by pregnancy, with values for pregnancy cycling, pregnancy swimming, postpartum cycling, and postpartum swimming of 2.36 +/- 0.12, 2.11 +/- 0.11, 2.29 +/- 0.10, and 2.12 +/- 0.07 l/min, respectively. Peak VCO2 (VCO2peak) and peak VE were significantly lower during swimming than during cycling by 18-25%, but only VCO2peak during swimming was affected by pregnancy (-10%). Lactic acid concentrations were 12-17% lower after swimming than after cycling and 17-31% lower during pregnancy than postpartum. We conclude that perceived maximal exertion is reached at a lower percent maximal VO2 in swimming than in cycling and that the reduced energy expenditure is reflected by lower VO2peak, VCO2peak, and peak VE. Pregnancy, however, does not affect VO2peak in cycling or swimming.

Bicycling↗
PubMed1995

Dinoprostone priming of the cervix prior to termination of midgestation pregnancy with sulprostone.

OBJECTIVE: To determine if cervical ripening with the prostaglandin E2 analogue dinoprostone effectively shortens the induction-to-delivery interval in midpregnancy terminations with sulprostone. STUDY DESIGN: We retrospectively studied 100 women admitted for pregnancy termination at midgestation because of fetal anomalies between September 1989 and January 1993. Three regimens were used: 27 women received intramuscular sulprostone only, 29 women received intravenous sulprostone only, and 44 women received intravenous sulprostone after cervical priming with dinoprostone. Wilcoxon's rank sum test was used for statistical analysis. RESULTS: Dinoprostone priming did not significantly reduce the induction-to-delivery interval in either parous or nulliparous women. However, when divided into first and subsequent pregnancies, we found that primigravidae, but not multigravidae, had an induction-to-delivery interval that was significantly shorter by approximately 10.5 h when pretreated with dinoprostone. CONCLUSION: Dinoprostone priming of the cervix prior to termination of midgestation pregnancy with sulprostone (Nalador) effectively shortens the induction-to-delivery interval in women in their first pregnancy.

Abortifacient Agents, Nonsteroidal↗
PubMed1995

Critical limb ischemia after accidental subcutaneous infusion of sulprostone.

A 34-year-old patient was treated with constant intravenous infusion of sulprostone because of postpartum hemorrhage from a hypotonic uterus. The arm in which sulprostone had been infused was painful 23 h after infusion. A day later, the arm was found to be blueish, edematous and extremely painful as a result of arterial spasm. The vasospasm was probably caused by accidental subcutaneous infusion of sulprostone as a result of a displaced intravenous catheter. A diagnosis of critical limb ischemia was made. Treatment with the prostacyclin-analogue iloprost resulted in full recovery. Critical limb ischemia as a serious complication of sulprostone has not been previously reported.

Adult↗
PubMed1995

Spontaneous coronary artery dissection during pregnancy and post partum.

This report describes a 35-year-old 40 week pregnant woman who was hospitalized with a diagnosis of acute anteroseptal myocardial infarction. She sustained another, infero-posterior, infarction 4 days later. Coronary arteriography performed after successful Cesearean section displayed primary dissections of the right as well as both left coronary arteries. Her subsequent clinical course was uneventful with medical therapy. This patient is the first non-surgically treated survivor of peripartal spontaneous coronary artery dissection with a myocardial infarction prior to delivery.

Adult↗
PubMed1995

Anaerobic threshold and respiratory compensation in pregnant women.

In an effort to explore why CO2 output (VCO2) at peak exercise is lower during pregnancy than postpartum despite little change in the peak O2 uptake (VO2), we determined the VCO2/VO2 relationship during rapidly incremental exercise and estimated the anaerobic threshold (AT) and the respiratory compensation (RC) point. We measured heart rate, VO2, VCO2, and minute ventilation (VE) at rest and during cycle exercise tests with rapidly increasing exercise intensities until maximal effort in 33 volunteers at 16-, 25-, and 35-wk gestation and postpartum. Through modification of the V-slope method, we estimated the AT and RC point for each test by nonlinear regression analysis in a three-dimensional space (defined by VE, VO2, and VCO2) for a line assumed to have two breakpoints; we found a good fit for all tests. The AT and RC points were found at exercise intensities of approximately 50 and 80% peak VO2, respectively, with no significant differences between test periods. VE was significantly higher during pregnancy than during postpartum at rest and throughout incremental exercise. A lower peak VCO2 relative to peak VO2 during pregnancy compared with postpartum was reflected by a more shallow slope of VCO2 vs. VO2 above the AT point. This suggests that during pregnancy the buffering of lactic acid is reduced.

Adult↗
PubMed1994

Poor sensitivity of the fifty-gram one-hour glucose screening test for hyperglycemia.

To determine the sensitivity and specificity of the 50-g 1-h glucose screening test (GST) for hyperglycemia established in a home-monitored glucose profile (HGP) from blood sampled 1 h after each of the main meals on the following day, we prospectively studied 415 pregnant women at increased risk for gestational diabetes and compared 1 GST with 1 HGP. At the commonly recommended GST threshold of 7.8 mmol/l and an HGP threshold of 7.0 mmol/l, the sensitivity of the GST was 27%, the specificity 89%, and the likelihood ratio for a positive test 2.4. Therefore, we conclude that the 50-g 1-h glucose screening test discriminates poorly between pregnant women with and without postprandial hyperglycemia.

Blood Glucose↗
PubMed1993

Multiple coronary artery dissections in a woman at term.

We report a case of acute myocardial infarction caused by multiple coronary artery dissections in a pregnant woman at term. When reinfarction elicited fetal distress, Caesarean section was performed under carefully administered extradural anaesthesia, with maternal and fetal survival.

Adult↗
PubMed1992

[Gram staining and bacterial culture of stomach contents of the full-term neonate in prolonged status of ruptured membranes is not useful].

In an effort to evaluate the management of full-term neonates born after prolonged rupture of the membranes, we studied 159 full-term newborn infants born 24 hours or more after rupture of the membranes retrospectively. Gram stain and bacterial culture of a gastric aspirate of the neonates were significantly related; however, the predictive value of the Gram stain was low, both for a positive test (46%) and for a negative test (70%). A significant relation was not found between the Gram stain (presence of bacteria or greater than or equal to 4 leucocytes per high power field) or the bacterial culture on the one hand and the occurrence of clinical symptoms of infection on the other. In all cases the decision to treat the newborn with antibiotics was made on the basis of the clinical symptoms alone. In our opinion the routine study of Gram stain and bacterial culture of a gastric aspirate of full-term neonates born after prolonged rupture of the membranes is not useful; observation alone is sufficient.

Bacteria↗
PubMed1992

Maternal and fetal cardiovascular responses to strenuous bicycle exercise.

In a longitudinal study we investigated some cardiovascular responses to strenuous bicycle exercise in 33 healthy women during pregnancy and the postpartum period. The exercise electrocardiogram demonstrated depression of the ST segment in 12% of women in the absence of clinical signs of ischemia, and the incidence of these changes was unaffected by pregnancy. In spite of slightly different blood pressures at rest during the first and second trimesters of pregnancy, the blood pressure response to exercise at approximately 75% Vo2max was virtually unaffected by pregnancy. After a maximal bicycle test, the fetal heart rate was increased by an average of 4 beats/min, without a change in pattern. Tocodynamometry suggested a transient increase in uterine activity after maximal exercise in 6% of the tests. These findings support the view that strenuous exercise of limited duration is not harmful to the healthy mother and fetus.

Bicycling↗
PubMed1992

Arterial pressure response to maximal isometric exercise in pregnant women.

We studied the arterial pressure response to maximal leg exercise in 15 healthy volunteers at 29 and 35 weeks' pregnancy and at 8 weeks post partum. Resting mean arterial pressure at 35 weeks' gestation was similar to the postpartum control value of 88 mm Hg (range 73 to 111), but it was reduced by 10% at 29 weeks' gestation. Voluntary maximal effort averaged 2470 N (range 1450 to 3030) in the postpartum period, was similar at 29 weeks, and was reduced by 13% at 35 weeks' gestation. Mean arterial pressure showed a linear increase with force to a median maximum value of 131 (104 to 159) mm Hg, or 49% above the resting value in the postpartum period. The pressure response was unaffected by pregnancy, but was inversely related to maximal force, i.e., the individual's capacity to perform isometric exercise.

Adult↗
PubMed1992

Errors in predicting maximal oxygen consumption in pregnant women.

This study was designed to determine the accuracy of estimated values of maximal heart rate (HRmax) and oxygen consumption (VO2) during pregnancy. We measured HR and maximal VO2 (VO2max) at rest and during cycle (CE) and treadmill exercise (TE) tests with rapidly increasing exercise intensities during gestation and after delivery. Pregnancy was found to affect the linear relationship of HR and %VO2max so that the intercept increases with advancing gestation and the slope decreases. Estimated maximal HR (HRmax, est), 220 - age (yr) x beats/min, overestimated measured HRmax by 8% (CE) and 5% (TE). For VO2max estimated by Astrand's nomogram (VO2max, est1) and by linear extrapolation of submaximal values of HR and VO2 to HRmax, est (VO2max, est2), individual errors were large (SD 17-28%). Mean VO2max, est1 overestimated measured VO2max by 20% during CE but not during TE (-2%) and elicited the erroneous impression that VO2max decreases during CE in pregnancy. Mean VO2max, est2 values were not significantly different from measured VO2max values. This apparent accuracy resulted from two opposing errors: 1) HRmax, est overestimated HRmax, and 2) above 70% VO2max the slope of the HR-%VO2max relationship was significantly reduced. Therefore neither method to estimate VO2max can replace the measurement of VO2max.

Adult↗
PubMed1991

Maximal aerobic exercise in pregnant women: heart rate, O2 consumption, CO2 production, and ventilation.

This study was to determine whether pregnancy affects maximal aerobic power. We measured heart rate, O2 uptake (VO2), CO2 production (VCO2), and ventilation at rest and during bicycle (BE) and treadmill exercise (TE) tests with rapidly increasing exercise intensities at 16, 25, and 35 wk gestation and 7 wk after delivery. Maximal heart rate was slightly lower throughout pregnancy compared with the nonpregnant state during both BE [174 +/- 2 vs. 178 +/- 2 (SE) beats/min] and TE (178 +/- 2 vs. 183 +/- 2 beats/min). Maximal VO2 was unaffected by pregnancy during BE and TE (2.20 +/- 0.08, 2.16 +/- 0.08, 2.15 +/- 0.08, and 2.19 +/- 0.08 l/min for BE and 2.45 +/- 0.08, 2.38 +/- 0.09, 2.33 +/- 0.09, and 2.39 +/- 0.08 l/min for TE at 16, 25, and 35 wk gestation and 7 wk postpartum, respectively). As a result of increased VO2 at rest, the amount of O2 available for exercise (exercise minus rest) tended to decrease with advancing gestation, reaching statistical significance only during TE at 35 wk gestation (1.99 +/- 0.08 l/min vs. 2.10 +/- 0.08 l/min postpartum). Power showed a positive linear correlation with O2 availability during BE as well as TE, and the relationship was unaffected by pregnancy.(ABSTRACT TRUNCATED AT 250 WORDS)

Aerobiosis↗