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Biomedical subjects

G Lindmark

Publications and source records attributed to G Lindmark.

At least 145 records · Page 8Linked to original sources
PubMed1984

Methodological problems in studies on hypertension therapy during pregnancy.

As yet, no distinct aetiological factor underlying hypertension in pregnancy has been disclosed, and there is therefore no clearcut treatment for this condition. The lack of well-defined end-points makes it difficult to plan and evaluate the results of studies on the treatment of hypertension during pregnancy. However, we cannot await the solution to the puzzle of pre-eclampsia before providing treatment for this hypertension. Well-designed investigations to determine the most effective form of such treatment are therefore of great value and must be carried out in spite of the many problems associated with these studies. If given due consideration, as discussed in this paper, this problem can be alleviated.

Apgar Score↗
PubMed1984

Radiographic pelvimetry--its use and possible radiation risk.

Radiographic pelvimetry is widely used in obstetrics. Every fourth primapara in Sweden is submitted to this radiographic examination. The frequency of the examination in the United States is estimated to a mean of 6% of all deliveries. The use of radiographic pelvimetry is now under intense debate and the missing argument in this discussion is a prospective study of an unselected group of parturients where progress and outcome of labour is referred to known pelvic dimension. Since the value of the method is questioned the frequent use of radiographic pelvimetry is justified only by an almost negligible radiation risk to the mother and her baby. Such a low risk is also an indispensable condition to allow the correct scientific evaluation of radiographic pelvimetry mentioned above. This paper presents the measurement results of absorbed radiation dose with the only radiographic pelvimetry method used in Sweden. The estimated radiation risk of the method, based on these figures, is 1 case of childhood malignancy in 50 000 pelvimetries. This corresponds to 4 years routine use of radiographic pelvimetry in Sweden. The annual incidence of childhood malignancy in Sweden is 220. The maternal risk is estimated to one tenth of the fetal risk.

Female↗
PubMed1983

The peroxidase activity and cellular content of granule proteins in PMN during pregnancy.

The cellular content of myeloperoxidase (MPO), chymotrypsin-like cationic protein (CCP) and lactoferrin (LF) of isolated polymorphonuclear leucocytes (PMNs) from pregnant women were analysed by immuno-chemical methods. The cellular levels of MPO and CCP were unaltered during pregnancy while the cellular levels of LF were increased during pregnancy and post partum (P less than 0.01). Peroxidase activity within isolated PMN was analysed by two methods, a Guaiacol method and a Chemiluminescence method. The activity was found to be reduced during pregnancy. The reduction was explained by the reduction in eosinophil peroxidase which in turn was a consequence of a reduced number of circulating eosinophils during pregnancy.

Adult↗
PubMed1983

Pleural effusion with dyspnea as the presenting symptom in chronic pancreatitis. A case report.

A middle-aged male presented with progressive dyspnea and massive, leftsided pleural effusion. No intrathoracic cause was found, but a very high amylase activity induced suspicion of pancreatic disease. ERCP showed marked changes consistent with chronic pancreatitis in the distal pancreas. The patient recovered completely after prolonged pleural drainage and later resection of the pancreatic tail. A short review on the pertinent literature is given.

Chronic Disease↗
PubMed1981

A comparison of the amniotic fluid cytology, lecithin/sphingomyelin ratio and creatinine in predicting fetal maturity at term.

The value of three amniotic fluid tests--ratio of lecithin/sphingomyelin, creatine concentration and the Nile blue cytological test for lipid--carrying cells--in predicting fetal maturity at term was investigated. The cytological test was the best individual test, and a combination of all three seemed to accurately diagnose functional immaturity. A sequential approach for maturity testing is suggested. It is also concluded that maturity testing at term is an appropriate means of preventing iatrogenic prematurity.

Amniotic Fluid↗
PubMed1979

Effect of segmental epidural block on the course of labour and the condition of the infant during the neonatal period.

Epidural block for vaginal delivery was given to 242 women during a 6-month period. Of these, 178 with a spontaneous start of labour and vaginal delivery were studied with respect to the effect of epidural block with bupivacaine-adrenaline on the course of labour and the condition of the infant in women with normal uterine activity and women with primary uterine inertia treated with oxytocin infusion. On average, the 178 women had already had a longer course of labour before the block was applied than women in control groups. The block per se had only a slight effect on the first stage of labour, but the effect on the second stage was more obvious, leading to outlet extraction in 50% of the primiparous women, compared to 12% of the controls. Transitory asphyxia at birth was observed in 4.5% of the infants of mothers with epidural block, but after 5 min, only 1% had an Apgar score of less than 7. Infants of mothers with epidural block were more often placed under observation or treated in the neonatal ward than infants in control groups.

Anesthesia, Epidural↗
PubMed1979

Effect of segmental epidural analgesia upon the uterine activity with special reference to the use of different local anaesthetic agents.

Segmental epidural block was given to 60 primiparous women during vaginal delivery, and the effect of the block on the uterine activity was studied after the first epidural injection. The women were divided into two main groups, according to whether or not oxytocin was used for stimulating the uterine contractions, and three different local anaesthetics--lidocaine-adrenaline, bupivacaine-adrenaline and plain bupivacaine--were tested. There was a transitory decrease in uterine activity in all women after the block was applied. In women with normal uterine activity before the block, a return to almost pre-analgesic values was noted within 30 min after the block, whereas in women treated with oxytocin there was still a reduction of 15-17% at this time. The reduction was caused by a decreasing intensity and at the same time an increase in the variability of the intensity, manifested as an increase in the coefficient of variation for this variable. There were no significant differences between the local anaesthetic agents tested, but addition of adrenaline to the bupivacaine solution resulted in a more marked decrease in uterine activity in women treated with oxytocin.

Anesthesia, Epidural↗
PubMed1977

A comparative study of uterine activity in labour induced with prostaglandin F2alpha or oxytocin and in spontaneous labour. II. Characteristics of uterine activity and their effect on the progress of labour.

In 76 women with spontaneous labour or labour induced with oxytocin or PGF2alpha, intra-uterine pressure was recorded during the first stage of labour. A statistical analysis was performed of the intensity and frequency of contractions, the total uterine activity and the variability of peak-to-peak intervals and amplitudes of contractions. The duration of the latent phase was shortened by 50% in induced labour compared with spontaneous, while the active phase was less affected. However, the intensity and frequency of contractions and the uterine activity in Montevideo Units were of the same magnitude in spontaneous as in induced labour, apart from two cases of hyperactivity found in the induction groups. The variability of intervals between contractions and amplitudes of contractions were also of the same degree in all groups and no overall tendency towards greater regularity was seen during progress of labour. If irregular intervals between contractions were noted, when active cervical dilatation had begun, the progress of labour was slower and more uterine work was needed for dilatation than when the uterine activity was more regular.

Female↗
PubMed1976

Outcome of twin birth. Review of 1,636 children born in twin birth.

During the five-year period 1964-68 96 733 births were registered in the 28 hospitals equipped with maternity facilities in the Uppsala hospital region. Of these babies, 1 636 were born in 818 twin deliveries. Data on gestational age, sex, weight and length at birth, birth order, hospital type, congenital malformations and perinatal mortality are analysed. Altogether 17.3 per 1 000 of the children born during this period were born in multiple births. The perinatal mortality for the twin babies was 64 per 1 000 born, with the mortality higher in the less specialized hospitals than the others. Twin no. 1 suffered perinatal death in 67 cases per 1 000 and twin no. 2 in 60 cases per 1 000. For twins of primiparae the losses were 92 per 1 000 children and for twins born to multiparae 51 per 1 000. Altogether 72 per 1 000 male twins died perinatally compared to 52 per 1 000 female twins. The most heavy losses occurred among the low-weight premature twins and in these cases both twins often suffered perinatal death.

Birth Weight↗
PubMed1976

A comparative study of uterine activity in labour induced with prostaglandin F2alpha or oxytocin and in spontaneous labour. I. Pattern of the uterine contractions.

The uterine contraction patterns and the changes in fetal heart rate (FHR) were studied in cardiotocographic recordings from 26 women in oxytocin-induced labour, 26 women in PGF2alpha-induced labour and 24 women during the later part of spontaneous labour. The contraction patterns and their effect on the FHR did not differ between the three groups. During the course of labour an increasing steepness of the upward slope of the contraction wave with increasing intensity of the contraction was found. High frequency of atypical contraction patterns, suggesting some degree of uterine incoordination was found during the active phase of labour in 10 patients, 8 of whom were primiparae. This incoordination could not be related to the effect of induction with either drug. Incoordinated contractions were associated with longer duration of labour and a tendency to more pronounced acidosis in the infant at birth, although mean values still fell in the normal range. Ominous FHR patterns were only seen in 2 cases of uterine hyperactivity during induction of labour.

Acidosis↗
PubMed1974

The induction of labour with prostaglandin F2alpha by intravenous infusion. I. Uterine activity, fetal heart rate and clinical condition of the newborns.

Attempt to induce labour with PGF2alpha was made for various indications in 22 primiparous and 27 multiparous patients being between the 35th and 44th weeks of pregnancy. Intravenous infusion of PGF2alpha was started with 3 mug/min. and increased in steps of 3 mug/min. at intervals of about one hour until labour-like contractions were recorded. This dose level was then maintained until delivery. Uterine activity and fetal heart rate was monitored prior to and throughout the infusion. The clinical condition of the newborns was also assessed by Apgar score and by physical examination one and four days after delivery. Labour was successfully induced with total doses ranging between 0.4 and 8.4 mg. In 88 per cent of the cases this resulted in vaginal deliveries within 2 to 12 hours. The latter part of the first stage as well as the second stage were remarkably short. Uterine hypertonus was observed in five cases (10%). Other types of abnormal uterine contractility patterns were fairly common. These were, however, not associated with pathological FHR changes except in one case where severe late decelerations were observed following marked uterine hyperactivity. The condition of the newborns was generally good and maternal side effects were very rare. PGF2alpha seems particularly valuable in cases of pre-term inductions where low Bishop scores are present but the risk of overstimulation demands careful supervision, if possible with cardiotochographic monitoring.

Adult↗
PubMed1974

The induction of labour with prostaglandin F2alpha by intravenous infusion. II. A comparison of fetal and maternal acid-base values with those found in oxytocin induced labour and in spontaneous labour.

Serial determination of fetal and maternal pH, Pco2 and BDECF was performed in 34 cases of labour inductions with intravenously administered prostaglandin F2alpha or oxytocin. These values were compared with those found in ten cases of spontaneous labour. With the exception of eight cases of "high risk pregnancies" all the remaining parturients were healthy and within the 38th to 42nd week of gestation. With regard to the cases of "uncomplicated" pregnancies the general patterns of the acid-base changes were very similar in the three groups. The BDECF values in fetal scalp blood, however, showed a more marked tendency to increase in the group induced with prostaglandin. Further analysis of this group revealed that the rise of BDECF values could be attributed to cases with episodes of uterine hypertonus or signs of uterine incoordination. In the "high risk" pregnancy group the pH values in fetal scalp blood were lower and the BDECF values higher than in the group of "normal" pregnancy cases. The general pattern and the magnitude of the acid-base changes do not seem to be influenced by the administration of oxytocin or prostaglandin F2alpha as induction agents providing uterine activity is normal. Abnormal uterine activity, initiated by any of the two induction agents, is, however, associated with an increased risk of fetal acidosis.

Acid-Base Equilibrium↗