PubMed Health⌕ Search

Biomedical subjects

M Phillippe

Publications and source records attributed to M Phillippe.

47 records · Page 3Linked to original sources
PubMed1982

Delivery of the second twin.

A retrospective chart review of all twin deliveries between April 1, 1977, and March 20, 1980, at the Boston City Hospital and the Brigham and Women's Hospital revealed corrected neonatal mortality rates of 0 for 74 twins in nonvertex presentation delivered by cesarean section and 0 for 76 second-born twins extracted vaginally. Breech extraction of 76 second-born twins weighing more than 1499 g at birth was not associated with a statistically significant increase in the incidence of 5-minute Apgar scores of 7 or less when compared to 74 similarly asymptomatic twins in nonvertex presentation delivered by cesarean section. Vaginal delivery may be considered when the second twin, weighing more than 1500 to 2000 g, is in breech presentation.

Apgar Score↗
PubMed1982

The effects of vaginal contamination on two pulmonary phospholipid assays.

During the examination to confirm premature rupture of membranes, amniotic fluid unavoidably contaminated with cervical mucus and other vaginal debris can often be obtained from the posterior fornix. This study was undertaken to determine the validity of phospholipid measurements on contaminated amniotic fluid. Fifteen paired amniocentesis and vaginally contaminated samples of amniotic fluid were used to measure the lecithin/sphingomyelin ratio and saturated phosphatidylcholine (SPC). The amniocentesis specimens had a mean L/S ratio of 3.94 +/- 0.22 (mean +/- SEM), and contaminated samples had a mean L/S ratio of 3.82 +/- 0.29 (mean +/- SEM). Paired t-test was unable to demonstrate a significant difference (p greater than 0.10), and the correlation coefficient between paired L/S samples was r = 0.79. SPC measurements on the amniocentesis fluid had a mean value of 1,243 microgram/DL +/- 217 (mean +/- SEM) as compared to the contaminated-specimen mean of 1.375 micrograms/dl 223 (mean +/- SEM). Paired t-test likewise was unable to demonstrate a significant difference (p greater than 0.10), and the correlation coefficient between paired SPC samples was r = 0.93. Within the design of this study, we were unable to demonstrate a statistically significant effect of brief vaginal contamination on the measurement of the L/S ratio or SPC.

Amniocentesis↗
PubMed1981

Diabetic nephropathy and perinatal outcome.

We studied the effect of diabetic nephropathy on the course of pregnancy, perinatal outcome, and infant development and determined the influence of pregnancy on maternal hypertension and renal function. Maternal proteinuria usually increased during pregnancy (greater than 3 gm/24 hours in 69%), and hypertension was present by the third trimester in 73%. The degree of proteinuria correlated with diastolic pressure and creatinine clearance. After pregnancy, proteinuria declined in 65% of the mothers, hypertension was absent in 43.5%, and the expected rate of fall in creatinine clearance was not accelerated. Among 35 patients, abortion occurred spontaneously or was performed electively in 25.7%, and 71% of the remainder underwent delivery before 37 weeks. Birth weight was related to maternal blood pressure and creatinine clearance. Neonatal morbidity was common, but the perinatal survival rate was 89%. Infants seen at follow-up without congenital anomalies had normal development at 8 to 36 months of age. We concluded that perinatal outcome has significantly improved for diabetic women with nephropathy.

Adult↗
PubMed1981

The fetal and maternal catecholamine response to insulin-induced hypoglycemia in the rat.

This study was undertaken to evaluate the catecholamine response of the fetal rat to insulin-induced hypoglycemia in the mother. Twenty-four Sprague-Dawley rats at day 21 of gestation were used. Hypoglycemia was induced with regular insulin; then at timed intervals, the rats were anesthetized with pentobarbital. When the rats were completely unresponsive, the abdomen was opened, the fetuses were exteriorized, and fetal blood was obtained by sectioning the axillary vessels. Maternal blood was obtained from the vena cava. Plasma glucose was measured by the glucose oxidase technique. Norepinephrine, epinephrine, and dopamine were measured by radioenzymatic assay. Maternal animals demonstrated a fall in glucose to a nadir of 23 +/- 0.7 mg/dl (mean +/- SEM) and a significant rise in plasma epinephrine to a maximum of 2,548.0 +/- 1,071.2 pg/ml. Fetal glucose fell to a nadir of 23.8 +/- 3.3 mg/dl (mean +/- SEM) and fetal catecholamines demonstrated a rapid significant rise: norepinephrine rose to a maximum of 5,077.3 +/- 932.6 pg/ml; epinephrine rose to a maximum of 4,295.8 +/- 538.9 pg/ml; dopamine rose to a maximum of 869 +/- 203.3 pg/ml. The fetal correlation coefficients were r = -0.56 (p less than 0.01) for plasma glucose compared to norepinephrine and r = -0.58 (p less than 0.01) for plasma glucose compared to epinephrine. The maternal correlation coefficient for plasma glucose compared to epinephrine was r = -0.54 (p less than 0.01). These data demonstrate that the near-term fetal rat is able to respond significantly to hypoglycemia with a rapid output of catecholamines.

Animals↗
PubMed1981

Catecholamines in human amniotic fluid.

This study was undertaken to determine the amniotic fluid levels of epinephrine (E), norepinephrine (N), and dopamine (D) at different gestational ages in the human. Amniotic fluid obtained from 32 pregnant women undergoing amniocentesis for medical indications was analyzed with a radioenzyme assay for these catecholamines. The gestational ages ranged from 17 to 39 weeks. No patient was in active labor at the time of amniocentesis. The data obtained in this study demonstrated a rise of all three catecholamines at the end of the third trimester: N = 362.7 +/- 61.2 pg/ml (+/- SEM), E = 179.6 +/- 45.4 pg/ml (p < 0.05), and D = 2717.0 +/- 836.6 pg/ml (p < 0.01). The physiologic role for the increasing amounts of catecholamines, especially D, in amniotic fluid is known; however, these amines could be the stimulus for the intrauterine synthesis of prostaglandins as parturition approaches.

Amniotic Fluid↗
PubMed1980

Ultrasound-facilitated intrauterine transfusions.

Ultrasound-facilitated intrauterine transfusion was performed on 35 fetuses. Eleven fetuses were hydropic and less than 26 weeks' gestation at the time of the first intrauterine transfusion (IUT). Only two (18%) neonates survived. Twelve fetuses were not hydropic and less than 26 weeks' gestation at time of IUT. Six (50%) neonates survived. Corrected neonatal survival rates for three hydropic and nine nonhydropic fetuses transfused after 26 weeks were 100% and 78%, respectively. The presence of ascites documented by ultrasound is an adequate indication for an IUT and permitted earlier detection of sicker fetuses; however, as a therapeutic aid, ultrasound neither diminished the fetal morbidity and mortality associated with the procedure nor completely eliminated the need for radiography to confirm proper intra-abdominal localization of the transfusion tubing.

Ascites↗
PubMed1980

Pregnancy complicated by the Kasabach-Merritt syndrome.

The Kasabach-Merritt syndrome is the association of cavernous hemangiomas and consumption coagulopathy marked by anemia, thrombocytopenia, and hypofibronigenemia. Exacerbation of the consumption coagulopathy has been described in the 2 previous reports of this syndrome when associated with pregnancy. The authors report a third patient whose delivery and postopartum course were marked by increased coagulation abnormalities and subsequent hemorrhage. This patient's 32-day hospital course and need for multiple blood transfusions, clotting factors, platelets, heparin, and finally epsilon-aminocaproic acid underscore the need for patients with this syndrome to deliver in a referral center hospital where replacement therapy and hematologic consultation are readily available.

Adult↗
PubMedDate not supplied

Steroid hormone modulation of cAMP production in response to beta adrenergic receptor stimulation in genital tract myocytes.

beta-Adrenergic receptor stimulation results in smooth muscle relaxation through activation of adenylyl cyclase and subsequent cyclic AMP (cAMP) production. The present study was performed to evaluate the effects of steroid hormones (i.e. testosterone and hydrocortisone) on beta 2-adrenergic receptors and their signal transduction in the DDT1 MF-2 genital tract myocyte. Radioligand binding studies demonstrated that these two steroid hormones produced a 70 to 80% increase in the density of beta 2-adrenergic receptors in these myocytes. Stimulation of the beta 2-adrenergic receptors with isoproterenol resulted in a significant increase of cAMP in control myocytes; cells treated with testosterone for 24 h demonstrated a comparable response to isoproterenol, whereas hydrocortisone for 24 h resulted in a 50% greater cAMP response. In contrast to the response at 24 h, stimulation of myocytes after testosterone treatment for 48 h resulted in a cAMP response comparable to that seen in response to hydrocortisone at 24 h. Studies performed using theophylline demonstrated similar cAMP responses at 24 h between the control and testosterone-treated myocytes, thereby ruling out the possibility that the delayed increase of the cAMP response after testosterone was caused by stimulation of phosphodiesterase. Direct stimulation with forskolin resulted in greater cAMP production in the testosterone-treated myocytes compared to controls, thereby refuting the possibility that testosterone directly suppresses adenylyl cyclase activity at 24 h. These findings suggest that although both testosterone and hydrocortisone produce a twofold increase in beta 2-adrenergic receptor density in the DDT1 myocytes, beta 2-adrenergic receptors expressed in response to hydrocortisone appear functional at 24 h resulting in increased cAMP production, whereas those expressed in response to testosterone require 48 h to demonstrate increased functional activity.

Animals↗