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Biomedical subjects

L P Petersen

Publications and source records attributed to L P Petersen.

At least 19 recordsLinked to original sources
PubMed1984

Pregnancy complications in Sioux Indians.

The poor health status of Sioux Indians residing on reservations in South Dakota has been recognized for many years. The present report documents evidence of a high incidence of socioeconomic health-related disorders and pregnancy-related complications by comparing 342 pregnant white women and 405 pregnant Sioux Indian women. In collaboration with the Aberdeen Area Indian Health Service, beginning in 1976, a program was initiated to identify, assess risks, and provide patient management for pregnant Sioux Indians. This prenatal consultative program has proved effective in the reduction of fetal and infant mortality.

Adult↗
PubMed1984

A multifactorial pregnancy outcome index.

In the present study pregnancy outcome is defined as a combination of seven relatively independent factors. Outcome scores were assigned to each subject on the basis of the number of pregnancy and labor-related factors that were satisfied. An outcome index of seven indicated an excellent outcome, and an index value of zero indicated the poorest outcome. Clinical data for 821 subjects, including a selected sample of 102 high-risk patients, were recorded using the Hollister Record System forms. The contribution of each of these factors to the overall outcome was estimated by statistical analysis of all data from the 821 subjects. Validation of this multifactor index of pregnancy outcome was obtained by correlation analysis with established factors such as the number of previous term pregnancies, live births, abortions, and present preexisting risk factors. In addition, retrospective analyses relating pregnancy outcome index with maternal serum unconjugated estriol, zinc, and copper obtained from 102 high-risk patients, revealed that copper level at all third trimester gestations was systematically and significantly related to outcome level while no such relationship emerged from comparisons with estriol and zinc. Good and poor outcomes were related to low and high copper values, respectively. The results of this exploratory study suggest that maternal serum copper levels may be an alternative predictor of pregnancy outcome.

Abortion, Spontaneous↗
PubMed1983

Salivary unconjugated estriol levels in normal third trimester pregnancy - direct correlation with serum levels.

A radioimmunoassay for salivary unconjugated estriol concentration during the third trimester of normal pregnancy is described. The performance characteristics of the method were established by determining the non-specific binding, the blank value of the endogenous estriol free ("stripped") saliva, the recovery experiment and intra- and interassay coefficient of the variations. The corresponding serum samples were also analyzed by the same method. An excellent correlation was found between salivary and serum estriol concentrations.

Estriol↗
PubMed1981

Comparison of serum unconjugated estriol and estetrol in normal and complicated pregnancies.

It has been reported that determinations of maternal serum unconjugated estriol (E3) and estetrol (E4) concentrations provide clinicians with more or less identical information on fetal status. If this is true, then theoretically the levels of E3 should be equally correlated with those of E4 in all conditions of pregnancy. To resolve this question, a study of the relationship between E3 and E4 was performed before labor in normal and complicated pregnancies. In normal pregnancy, they were highly correlated (r = .683, P less than .0001); in complicated cases, they were still correlated, but at a lower level (r = .522, P less than .003). To determine the effect of labor on this correlation, E3 and E4 levels were measured in normal subjects during labor as well as in the corresponding fetuses. The correlations between material E3 and E4, maternal and fetal E4, maternal and fetal E3, and fetal E3 and E4 were highly significant. A similar study with complicated pregnancies, however, indicated no such correlation except between fetal E3 and E4. In addition, day-to-day variability of serial measurements of E3 and E4 on an individual basis was determined in normal and diabetic subjects. The variability was qualitatively determined graphically and quantitatively determined algorithmically. The results of calculated individual variabilities indicated that the variability of E4 was less than that of E3 in most cases. It is therefore concluded that complications in pregnancy and the onset of labor have some effect on E3-E4 correlations, and that measurement of E4 has an additional advantage due to less variability.

Estetrol↗
PubMed1981

Fetal and maternal serum copper levels before and during labor in normal and complicated pregnancies.

The effect of labor on maternal serum copper levels was determined in normal and complicated pregnancies. The mean value +/- SD (3.16 +/- 0.48 micrograms/ml) in 82 clinically normal subjects at term during labor was compared with that (2.22 +/- 0.49 micrograms/ml) obtained from 50 controls matched for gestational age who were not in labor. Similarly, the mean value in labor (3.56 +/- 0.46 micrograms/ml) in 25 subjects with a complicated pregnancy was compared with that (2.87 +/- 0.43 micrograms/ml) obtained from 25 similar subjects prior to labor. A statistically significant difference (P less than .001) was observed in both comparisons. Copper levels in the corresponding fetal serum from the subjects in labor (normal and complicated) were compared with those of the maternal serum samples. The mean value of fetal serum samples in mothers with complications was higher than that in normal mothers, but the difference was not statistically significant. This trend of a rise in serum copper level during labor was further confirmed by analysis of the same subject during and before labor in normal (12 subjects) and complicated pregnancies (9 subjects). Moreover, maternal serum estriol and estetrol levels were determined from the same samples in the 4 groups to find a possible relationship with the corresponding copper levels. No statistically significant correlation was noted. A possible explanation for the rise of the serum copper level with the onset of labor and its clinical implications are also discussed.

Copper↗
PubMed1980

Endocrine assessment of high-risk pregnancies.

For critical obstetrical judgment, no single laboratory test or biophysical technique has proved completely effective in preventing fetal deaths. Endocrine assessment of high-risk pregnancies has proved helpful in managing pregnancies with diabetes, hypertension, third trimester bleeding, suspected IUGR, and postdate pregnancies. No single endocrine test has proved to be effective in all cases, and much research remains to be done. Of the current endocrine factors being evaluated when all factors are considered, serum unconjugated estriol would appear to be the best predictor of fetal distress or well-being. However, it must be remembered that interpretation of laboratory values is difficult, and that there are many false positives and false negatives. Perhaps the greatest problem with estriol interpretation is short-term and daily fluctuations. If the estriol values are used as the only indicator for following high-risk pregnancies, there is a very likely possibility of delivering a normal premature infant that was wrongly diagnosed as having fetal distress. In the following high-risk pregnancies with estriols, the delivery decision should not be based on a single factor. Rather, the decision to deliver should be based on the estriol values, monitoring of the fetal heart rate (rhythm strip or OCT), amniotic fluid evaluation for fetal lung maturity, and clinical judgment.

Adrenal Glands↗
PubMed1979

Preeclampsia.

Explore the source record for details and available documents.

Abortion, Therapeutic↗
PubMed1979

Post-traumatic coma during pregnancy.

A pregnant woman suffered massive head injuries in an automobile accident at 6 weeks' gestation, but she successfully carried the fetus an additional 7 months. The patient remained comatose and required nasogastric feeding and skilled nursing care. The pregnancy was complicated by a persistent low-grade fever. Premature labor began at 34 weeks' gestation, and 24 hours after rapid vaginal delivery of a live 1640-g female, the mother suddenly died. The child is developing normally at 2 years.

Accidents, Traffic↗
PubMed1979

Predictability of gestational hypertension.

Eighty-five women at 28-36 weeks' gestation were studied prospectively in a clinical research center to assess a "roll over test" (RT) based on the original study by Gant et al. Patients were admitted to the hospital, placed on bed rest, and given a balanced diet. The test started 12 hours after admission. Blood pressure was measured every 10 minutes for an hour with the patient in the left lateral position, and then in the supine position for a second hour. The mean diastolic blood pressure was calculated in each position and the patients were sorted into 6 groups based on the magnitude of change in blood pressure. Seventeen patients developed gestational hypertension (GH). Only 3 of 20 (15%) patients with a positive RT developed GH, while 14 of 65 (22%) patients with a negative RT developed GH. Five of 12 patients who had an actual decrease in mean diastolic blood pressure also developed GH.

Adolescent↗
PubMed1978

Sequential determination of serum human placental lactogen, estriol, and estetrol for assessment of fetal morbidity.

Serial measurements were made of the concentrations of maternal serum human placental lactogen (hPL) (300 determinations), estriol (E3) (460 determinations), and estetrol (E4) (275 determinations) in normal human pregnancy during the third trimester period. Simultaneous determinations of serum hPL, E3, and E4 were also made sequentially on blood samples from 6 diabetic and 5 toxemic pregnant women to ascertain the relative usefulness of these parameters as indicators of fetal welfare. In uncomplicated diabetic patients controlled with insulin, all parameters increased with gestational age. In three pregnancies complicated by severe toxemia in which fetal distress progressed to intrauterine fetal death, both serum E3 and E4 levels decreased progressively, but E4 concentration started to decrease at least 1 day earlier than E3 prior to fetal death. In other women, the E4 levels appeared to drop or decrease significantly whereas the E3 levels remained almost unchanged. Daily hPL levels remained low in chronic fetal distress and, therefore, appeared to be of minimal value for predicting either intrauterine death or acute fetal distress. Therefore, serum E4 measurement seems to provide a more sensitive and reliable indicator of fetal morbidity than the measurement of serum E3 during toxemic pregnancies.

Estetrol↗
PubMed1977

The effect of posture and saline loading on plasma renin activity and aldosterone concentration in pregnant, non-pregnant and estrogen-treated women.

The effect of contraceptive ingestion and pregnancy on components of the renin-angiotensin-aldosterone system was compared in 17 non-pregnant women, 8 non-pregnant women taking oral contraceptives, and 11 pregnant women. Plasma renin substrate concentrations and the dynamic responses of plasma renin activity and aldosterone concentrations to upright posture and iv saline infusion were evaluated. Renin substrate was significantly higher in those women taking oral contraceptives and among the pregnant subjects than the other non-pregnant group. No significant differences in plasma renin activity or aldosterone concentrations were seen before or after postural stimulation among the 2 non-pregnant groups. After saline loading renin was higher and aldosterone lower in the contraceptive-treated group. In contrast, the pregnant group had significantly higher values at every point. The response to posture and saline among the pregnant subjects was similar in direction and magnitude to those of the non-pregnant groups. The urinary excretion of sodium before and after saline infusion was significantly lower in the pregnant group than in the non-pregnant groups. These observations suggest that estrogen-induced increases in renin substrate do not alone account for the increases in the renin-angiotensin-aldosterone system observed during pregnancy, but rather such increases appear to represent a physiological response to increased sodium need during pregnancy.

Adolescent↗