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Biomedical subjects

M Maresh

Publications and source records attributed to M Maresh.

8 recordsLinked to original sources
PubMed1992

Comparison of the maternal and fetal effects associated with intermittent or continuous infusion of extradural analgesia.

Eighty normal primigravidae received an extradural dose of 0.25% bupivacaine and were then allocated randomly to receive "top-ups" of 0.25% bupivacaine (group A) or an infusion of 0.125% bupivacaine (group B). Group B received supplementary top-ups if required. Group A required more top-ups (147 vs 80) (P < 0.01). No maternal advantage was demonstrated from each regimen. Fetal state was assessed by analysis of the cardiotocograph during labour and the condition of the fetus at delivery. Three different patterns of late deceleratory episodes were identified (grades 1-3). Total numbers of episodes per group were similar (group A, 71; group B, 69). More episodes in group A were related to top-ups (42/71 vs 18/69; P < 0.01) but the incidence of episodes after a top-up was similar (group A, 42/147 (28.6%); group B, 18/80 (22.5%)). In group A, 31/42 events (73.8%) were transient compared with 11/18 persistent episodes (61.1%) (> 10 min duration) in group B. However, the difference in the deceleratory patterns did not influence the condition of the fetuses at delivery.

Adolescent↗
PubMed1991

Life events and low birthweight--analysis by infants preterm and small for gestational age.

Social stress was assessed in 92 women with low-birthweight babies and 92 controls using the detailed LEDS measure of life events and severe chronic difficulties. The low-birthweight group was divided into preterm delivery (n = 40), small for gestational age (SGA) (n = 40) and mixed groups. Multivariate analysis was performed using a binomial-logit model to examine whether social factors were independently and significantly associated with low birthweight once the effect of demographic factors, obstetric factors and smoking/drinking were taken into account. Comparison of preterm births with controls indicated that three factors were significantly associated: a previous low-birthweight baby, severe life event/difficulty and bleeding during pregnancy. For SGA babies the factors were: previous low-birthweight baby, low social support and smoking. By using a reliable measure of life events and adequate numbers of low-birthweight babies, this study overcame the potential inaccuracies of previous studies and indicates a more specific relation between social stress and low birthweight.

Female↗
PubMed1991

The effects of diabetes on placental lipase activity in the rat and human.

Lipase activities were measured at pH 4 and pH 8 in the placentas of rats made diabetic by streptozotocin treatment and also in the placentas of women classified as having 1) impaired glucose tolerance or type 2 diabetes, 2) type 1 diabetes with no associated vascular complication, and 3) type 1 diabetes with associated vascular disease. In both sets of experiments, the placentas were compared with normal control groups. The placental lipase activity measured at pH 8 was not significantly different in either streptozotocin-treated rats or impaired glucose tolerance/diabetic women as compared with controls, whereas the lipase activity measured at pH 4 increased significantly as compared with controls in both species. Furthermore, in the women there was a significant correlation between placental lipase activity at pH 4 and birth weight in impaired glucose tolerance/type 2 diabetes. It is suggested that the increased placental lipase activity may contribute to the increased fetal weight in human diabetic pregnancy, by contributing to the increased fat transfer across the placenta from mother to fetus.

Animals↗
PubMed1990

Data collection for an obstetric department.

A well-designed computerized data collection system allows an accurate, complete data-set to be compiled for all pregnant women. It should be able to produce all the documentation necessary for pregnancy care, with minimum delay, and avoid repetitive data entry. Data is stored on computer on the back of operational tasks so that it may be subsequently used for audit. In addition it may be used for research purposes. Patient care can be improved if the computer is programmed to react to certain items being entered by requesting further relevant data-items. This therefore acts as a teaching method. A further extension of this is to use the data to help reach a diagnosis and thus suggest a logical management. A computerized data collection system cannot bring order out of chaos. Before introducing one there must be well-stated objectives of what is required from it. It must be clearly stated what is to be collected by whom and for what purpose. Apart from the capital outlay there may be a need to set money aside for revenue purposes for additional staff involved in maintaining the system. If a large system is being introduced then this will have considerable implications with regard to the work done by some staff, and job descriptions may need renegotiation--an aspect usually overlooked.

Data Collection↗
PubMed1990

Absent maternofetal potassium gradient at term.

Mean (SE) umbilical venous plasma potassium concentrations at 5.5, 10, 20, and 30 minutes after the start of laparotomy at term were 4.75 (0.15), 5.95 (0.26), 6.81 (0.23), and 7.59 (0.81) mmol/kg plasma water. Maternal peripheral venous plasma concentrations were 4.30 (0.13) before and 4.26 (0.23) mmol/kg plasma water after laparotomy. Plasma calcium concentration in maternal and cord blood did not change significantly.

Cesarean Section↗
PubMedDate not supplied

Computers in obstetrics.

Computers are being used increasingly often in obstetrics for many applications from producing routine documentation to research, and from audit to helping decision making. This article attempts to span this whole field to give a feel for the uses to which we should be putting the computer.

Decision Support Techniques↗