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Biomedical subjects

G Faxelius

Publications and source records attributed to G Faxelius.

29 records · Page 2Linked to original sources

Neonatal left ventricular performance after vaginal delivery and cesarean section under general or epidural anesthesia.

Left ventricular systolic time intervals, plasma norepinephrine concentration, hematocrit, and blood pressure were recorded in infants delivered vaginally and by cesarean section from mothers under epidural or general anesthesia. Each group comprised 12 infants. Left ventricular ejection time and the preejection period were longer in infants delivered vaginally, although the concentrations of norepinephrine found were greater than those found in the cesarean section groups. Hematocrit and blood pressure were unrelated to the mode of delivery or the anesthetic technique. The isovolumic contraction time, however, was significantly shorter after epidural anesthesia 15.6 +/- 7.6 msec (mean +/- 1 SD) than after general anesthesia 20.5 +/- 8.0 msec at 30 minutes (p less than 0.05), 14.8 +/- 6.2 msec, and 20.9 +/- 5.7 msec at 2 hours respectively (p less than 0.001). These differences in left ventricular dynamics are probably related to the effects of anesthetics that have traversed the placenta rather than to mode of delivery.

Anesthesia, Epidural↗

Catecholamine surge and metabolic adaptation in the newborn after vaginal delivery and caesarean section.

The immediate postnatal metabolic adaptation and sympatho-adrenal activation were studied in infants delivered vaginally or by elective caesarean section. Vaginally delivered infants showed high catecholamine levels at birth compared to infants born by caesarean section under epidural or general anaesthesia. Umbilical arterial glucose levels were significantly higher in the vaginal group than in both caesarean section groups. At 30 min, all groups showed a marked decrease with several infants showing asymptomatic hypoglycaemia in the caesarean section group. C-peptide levels showed no difference at birth but later became significantly higher in the vaginal group. Although the levels of free fatty acids and glycerol were low at birth, they were significantly higher in the vaginal group. In all groups they increased substantially with time. Considering the marked differences in catecholamine levels, the differences in metabolic adaptation were unexpectedly small. This implies an attenuated metabolic response to sympatho-adrenal stimulation in the newborn.

Adaptation, Physiological↗

Catecholamine surge and lung function after delivery.

Lung function was measured at 30 minutes and again at 2 hours after birth in 12 infants delivered vaginally, in 15 infants delivered by elective caesarean section under general anaesthesia (GA), and in 15 delivered under epidural anesthesia (EDA). Umbilical arterial blood was analysed for pH and for concentrations of catecholamines and cortisol. No important differences in gestational age, birthweight, Apgar scores, or haematocrit were found among the three groups. Tidal volume and minute ventilation measured 30 minutes after birth were lower in infants delivered by caesarean section than in those delivered vaginally and at 2 hours the tidal volume was still lower in the babies delivered by caesarean section than in those delivered vaginally. Dynamic compliance was lower at 30 minutes in the group that had a caesarean section than in the vaginal group, and this difference was significant at two hours. Tidal volume, minute ventilation, and dynamic compliance in the GA and EDA groups did not differ. The catecholamine and cortisol concentrations at birth were higher in the vaginal group than in the group delivered by caesarean section. Two hours after birth there was a significant correlation (r = 0.84) between the catecholamine concentrations of the infants born vaginally and lung compliance. The lower dynamic lung compliance in infants delivered by elective caesarean section might be explained by delayed absorption of liquid in the lung due to lack of catecholamine surge.

Anesthesia, Epidural↗

An old problem revisited--hyaline membrane disease and Cesarean section.

The incidence of hyaline membrane disease (HMD) was investigated retrospectively in 159 preterm infants below 35 weeks gestation, weighing less than 2,000 g, and born during the 5-year interval 1975-79. The incidence of HMD was compared between infants delivered by elective Cesarean section, Cesarean section after the onset of labor and by the vaginal route. A significant difference (P less than 0.001) was found in the frequency of HMD dependent on the mode of delivery; 50% of infants delivered by elective Cesarean section developed HMD versus 19.2% in the vaginally delivered group. In infants delivered vaginally premature rupture of membranes (PROM) lowered the incidence of HMD to 5% compared to 32.4% in infants without PROM (P less than 0.01). When infants (less than 2,000 g) delivered vaginally without PROM were compared with those delivered by elective Cesarean section, no difference in HMD-incidence was observed. Out of 43 infants with birthweight above 2,000 g, who developed HMD during the 5-year period the majority had been delivered by elective Cesarean section. The possible effect of fetal stress on lung maturation is discussed.

Birth Weight↗

Quantitation of serum antibodies to surface antigens of group B streptococci types Ia, Ib, and III: low antibody levels in mothers of neonatally infected infants.

A method has been developed for the detection in human sera of antibodies to surface antigens of group B streptococci (GBS), types Ia, Ib, or III. The sera were absorbed with GBS type II and then added to a suspension of GBS of the type against which antibodies were to be measured. After incubation and washing of the bacteria, the antibodies present on the surface of the cells were quantitated with radiolabelled protein A. Antibodies of IgG class were detected, probably specific for types Ia, Ib, or III, with the exception that the Ib GBS suspension used could detect some antibodies to type Ia. With this method it was found that 6/7 mothers to infants with GBS septicemia had low levels of serum antibodies to the infant's type of GBS. Urogenital carriers of GBS, giving birth to neonatally healthy infants, had higher serum antibody levels against the colonizing type.

Adult↗

Red cell volume measurements and acute blood loss in high-risk newborn infants.

Red cell volume was measured in 259 infants admitted to a high-risk newborn unit. Red cell volume was measured using 50Cr tagging which subsequently was activated to 51Cr for counting. Total blood volume was calculated using the corrected whole body hematocrit. A low red cell volume was frequently associated with a maternal history of vaginal spotting, with placenta previa or placenta abruptio, with nonelective cesarean section, and with deliveries associated with cord compression. Asphyxiated infants without a history suggestive of blood loos often had a low red cell volume. An early central hematocrit below 45% correlated with a low red cell volume, but a normal or high hematocrit was often associated with low red cell measurements. The total blood volume depended largely on whether the tagging was done long enough after the blood loss for plasma volume equilibration to have occurred. Very low red cell volume values were associated with a high mortality rate, but birth weight played a dominant role in survival, even at low red cell volume levels.

Asphyxia Neonatorum↗

Studies on photopherapy in newborn infants. Influence on protein binding of bilirubin and salicylate and on activity of acetylsalicylic acid esterase.

Phototherapy of newborn infants with hyperbilirubinemia was shown to result in an increase in hematocrit values and in the activity of the erythrocyte enzyme acetylsalicylic acid esterase. The elevation of the enzyme activity also could be produced in light-treated rabbits and in vitro after illumination of blood from adult volunteers. The binding of bilirubin to serum albumin and of salicylate to plasma proteins did not alter, nor did the concentrations of albumin or total proteins in plasma. It is concluded that light does not increase the unbound fraction of bilirubin in blood.

Animals↗

Disseminated intravascular coagulation and congenital neuroblastoma.

A newborn infant with congenital neuroblastoma complicated by disseminated intravascular coagulation is described. At birth the infant showed liver and spleen enlargement and shortly thereafter malignant cells were found in the bone marrow. On the fifth day of life the infant started to bleed and coabulation analysis indicated disseminated intravascular coagulation. Heparin therapy corrected the coagulation anomaly and irradiation and chemotherapy temporarily improved the general condition of the infant. The infant finally succumbed from tis primary neoplastic disease.

Adrenal Gland Neoplasms↗