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Biomedical subjects

H Jenssen

Publications and source records attributed to H Jenssen.

10 recordsLinked to original sources

Neurobehavioral response of infants after paracervical block during labour.

30 parturient women were randomized into a group receiving paracervical block (PCB) and a control group. The infants were tested by a neurobehavioral examination immediately after birth, after 3 hours and 3 days. The examiner was unaware of the obstetrical management of the patients. No clinically significant differences could be detected between the two groups. Arterial and venous pO2, pCO2 and pH from the umbilical cord showed no differences between the groups.

Adolescent

Changes in fetal supraventricular extrasystoles during uterine contractions in labour.

The electrocardiogram and phonocardiogram were recorded from a fetus exhibiting supraventricular ectopic beats during labour. The ectopic beats showed increased amplitude of the first heart sound (S1) compared to sinus and postectopic beats; the R-S1 interval was prolonged and the mechanical systole, measured as the S1-S2 interval, shortened. During uterine contractions these parameters were measured every 10 sec. The S1 amplitude of the ectopic beats decreased; simultaneously the R-S1 interval increased and the S1-S2 interval shortened. The changes were delayed compared to the amniotic pressure curve. The changes found can be explained by a shift of blood between the fetus and placenta, caused by uterine contraction.

Adult

The effect of dexamethasone therapy in prolonged pregnancy.

Fifty-six patients, chosen by random sampling from a total group of 120 post-term women, received dexamethasone (Decadron, "MSD" 2 mg 3 times a day for 4 days, the other 64 patients acting as controls. The evolution of uterine activity was evaluated using pelvic score (PS) and a modified low dosage oxytocin sensitivyt test (OST) before (T1) and after (T2) the treatment. During the interval from the second to the 6th day inclusive after T1 35 women of the dexamethasone group and 15 of the control group had a spontaneous onset of labour (SO) (0.001 less than P less than 0.01). Five patients in the dexamethasone group with primary rupture of membranes started labour spontaneously within 12 hours after membrane rupture, 7 patients in the control group with primary rupture of membranes received oxytocin as labour did not start within 24 hours. Excluding patients artifically induced, the mean interval from T1 to SO was 6.8 days in the control group and 5.2 days in the dexamethasone group (P less than 0.001). In both groups PS and the sum of Montevideo units (MU) during OST increased from T1 to T2, the increase was significantly greater in the dexamethasone group than in the control group. We found no correlation between the results of OST and the T1--SO interval. Dexamethasone, as used in this study, may promote labour in prolonged human pregnancy. Due to its low potency, it is not a substitute for oxytocin in the induction of labour. The lowered placento-fetal quotient in the dexamethasone group warrants further study of the effects of steroid hormone on placental function.

Administration, Oral

Dysmenorrhea in industrial workers.

In two Norwegian industrial companies 234 women of menstruating age were examined by the industrial nurse with regard to menstrual complaints. Every second woman experienced pain, 23% had consulted a doctor previously, about 30% had to stay in bed, and about 30% had been absent from work recently due to dysmenorrhea. Although pain was prevalent in all age groups, there were age-specific differences in other complaints, such as headache and depression, which were more frequent among the older women. In a selected group of 32 women with severe complaints, the history and gynecological examination indicated secondary dysmenorrhea in only a few cases. Hormonal assays and endometrial biopsy indicated anovulatory cycles in 4 out of 12 women, in spite of dysmenorrhea.

Adolescent

The shape of the amniotic pressure curve before and after paracervical block during labour.

Paracervical block (PCB) given during labour reduces the uterine activity necessary for cervical dilatation. The aim of the present investigation was to find out whether this effect of PCB changes the form of the amniotic pressure curve. A preliminary investigation showed that the ascending limb of the amniotic pressure curve, A, consists of three phases. The first phase shows an increasing slope and is called the acceleration phase of the ascending limb, Aa; the second phase is rectilinear, Ar. The third phase has a decreasing slope, and is named the deceleration phase, Ad. The descending limb of the amniotic pressure curve, D, was found to have corresponding phases. The initial part has a downward increasing slope and is called the acceleration phase of the descending limb, Da. Then follows a rectilinear phase, Dr and finally a phase with a decreasing slope, the deceleration phase, Dd. The duration of each phase, except Dd, was measured during an observation and a treatment period in 27 patients receiving PCB, and 25 control cases who were given N2O/O2, pethidine, or a combination of both analgesics. The patients were strictly selected and allocated at random to either group. Local analgesia in combination with adrenaline was given at cervical dilatation 3-6 cm; 20 minutes were allowed to elapse from the administration of analgesia until registration of the contraction of the treatment period, to assure an established analgetic effect. PBC shortens Aa and Ad, but prolongs Ar. A + Da + Dr and Ad + Da are shortened while Dr is prolonged after PCB (Table IV). On the presumption that PCB inactivates a part of the lower uterine segment, the changes of Aa, Ar and Ad + Da were predictable. To determine the significance of adrenaline, another series of 21 patients were given PCB, injecting 0.25 per cent bupivacaine without adrenaline added to the solution. The duration of the phases before and after the block was compared. PCB without adrenaline brought about the same changes as it did with adrenaline, but the changes were smaller, only those of Aa, Ar, Dr and Ad + Da being statistically significant. The pressure curves of six patients receiving epidural block were examined using the same method as in the PCB and control groups. The changes typical of PCB did not occur after epidural block. The discovery of the six phases of the amniotic pressure curve, their change after PCB and the results of other investigators make possible a suggestion of the basic physiological processes that influence amniotic pressure during coordinated labour contractions. It is held that the form of the amniotic pressure curve can be explained in terms of contraction, relaxation, and propagation of a contraction and a relaxation wave.

Adult