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Biomedical subjects

L Victorin

Publications and source records attributed to L Victorin.

16 recordsLinked to original sources
PubMed1976

Remaining sequelae with modern perinatal care.

The incidence of major sequelae-cerebral palsy (CP), psychomotor retardation (PMR), sensorineural hearing defect, and acquired hydrocephalus--has been studied retrospectively in a nonselected population of 6,5000 3-year-old children born in 1969 and 1970 at one Swedish hospital and treated uniformly according to the principles of modern perinatology. The total incidence of these four types of handicaps was 3.5 per 1,000 when children with congenital malformation syndromes, chromosomal aberrations, verified congenital viral infections, or toxoplasmosis were excluded. The incidence of CP was 1.2 per 1,000. Extreme immaturity, traumatic delivery, postnatal asphyxia, and hyperbilirubinemia were found to be relatively small factors as causes of sequelae in this population. Babies showing various degrees of intrauterine malnutrition were found to be the major remaining group at risk for PMR and/or CP, two thirds of children with these handicaps being recruited from the 16% of newborns with birthweights more than 1 SD below normal in relation to gestational age. The most important further gains can probably be made by earlier intrauterine diagnosis of these cases, induced termination of pregnancy in selected cases, and further studies on the perinatal treatment and adaptation of these infants.

Birth Weight↗
PubMed1975

Nutrition in low-birth-weight infants. III. Lipolysis and free fatty acid elimination after intravenous administration of fat emulsion.

Triglyceride linoleic acid in a fat emulsion for intravenous administration (Intralipid) was used as a marker in an evaluation of fat metabolism in newborn low-birth-weight (LBW) infants. Qualitative data on fatty acids as well as quantification of triglycerides and free fatty acids were obtained by gas-liquid chromatography. Influences on these parameters after a single and after repeated injections of Intralipid revealed differences between low-birth-weight infants appropriate-for-date (AFD) (n=8) and those light-for-date (LFD) (n=5). The LFD exhibited in comparison with the AFD infants an impaired lipolysis of injected triglycerides and a retarded elimination from plasma of released free fatty acids. In LFD, in general, this resulted in triglyceride accumulation and low free fatty acid levels. Heparin facilitated plasma triglyceride lipolysis and free fatty acid elimination from the blood stream.

Birth Weight↗
PubMed1975

An improved method of epidural analgesia with reduced instrumental delivery rate.

A detailed study on a modified technique of epidural analgesia (EDA) for pain relief in obstetrics has been performed. The aim of the modifications was to reduce the number of instrumental deliveries and at the same time to make the delivery as smooth as possible for the baby. This was achieved by the use of an anaesthetic with a favourable ratio between neonatal and maternal plasma levels (Bupivacaine) in low concentration (0.25%). A special technique of injection enabled us to limit the extent of the blockade. An epidural catheter was inserted between L2 and L3 and moved upwards 20 cm into the epidural space. 8-10 ml of the solution was then injected after a test dose. The blockade was continued by the repeated injection of smaller doses. As judged by the skin anaesthetic zones and by obstetric examinations, the patient was gradually positioned, during labour, from supine to half-sitting. The catheter was withdrawn at the end of the first stage of labour so that the lower sacral segments could be blocked. A group of 100 patients treated with the technique described was followed. The number of instrumental deliveries in the present series (15%) was significantly lower in similar series reported in the literature. The group of 100 patients treated with modified EDA was also compared with 100 control patients who received only conventional treatment without EDA. There was no differences in the number of abnormal presentations, while the number of caesarean sections and cases of atonic post-partum bleeding was insignificantly lower in the EDA group. The difference in the number of instrumental deliveries-although somewhat higher in the EDA group-was not statistically significant. The total length of labour was prolonged in the EDA group but EDA was not necessarily responsible for this undesired effect. The clinical status of the babies was found to be better after EDA than in control group, as judged from Apgar score. Furthermore, fetal bradycardia was significantly reduced with EDA. It is concluded that EDA, as used in this study, not only is a preferable way of achieving pain relif in the mother but also offers a means of facilitating the birth process for the infant, reducing the incidence of pre- and post-natal asphyxia.

Adult↗