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Biomedical subjects

P River

Publications and source records attributed to P River.

9 recordsLinked to original sources
PubMed1986

Good diabetic control early in pregnancy and favorable fetal outcome.

This study of 74 diabetic pregnant women shows that tight maternal blood glucose control before the 32nd week of gestation significantly reduces the incidence of fetal macrosomia (11%) when compared with that of patients with fair to poor control before the 32nd week of gestation (44%, P less than .05) or with those whose good diabetic control was not achieved until after the 32nd week of gestation (34%, P less than .05). The macrosomic infant produced by a diabetic mother is associated frequently with an elevated amniotic fluid C-peptide level, which shows the evidence of intrauterine fetal hyperinsulinism. The use of tight diabetic control early in pregnancy to reduce the risk of fetal macrosomia and/or neonatal complications is of clinical importance in the management of diabetes in pregnancy.

Amniotic Fluid↗
PubMed1983

Immunoglobulin concentrations in newborn infants associated with intrauterine growth retardation.

Immunoglobulin G, A, and M (IgG, IgA and IgM) levels were measured in paired maternal and cord serum samples from 18 pregnancies with intrauterine growth retardation (IUGR) and 55 with normal growth (adequate-for-gestational-age pregnancies) delivered vaginally at 36 weeks' gestation or later. Cord blood levels of IgG, IgA, and IgM in IUGR infants were found significantly lower than those in infants with adequate-for-gestational-age growth. Lower Lower levels of cord IgG in IUGR may be due to a defect in the active transport of IgG across the placenta. Lower levels of cord IgM and IgA suggest an impairment of synthesis of immunoglobulins in the IUGR infants. There was no difference in cord immunoglobulin concentrations between infants with intrapartum fetal heart rate (FHR) decelerations and those without FHR decelerations in either the IUGR or the adequate-for-gestational-age group. No difference was observed in maternal immunoglobulin concentrations among the study groups.

Adult↗
PubMed1982

Fetal outcome in hypertensive disorders of pregnancy.

Fetal outcome was evaluated in 157 hypertensive pregnant women whose underlying disease had been established by renal biopsy. The patients had pathologic diagnoses of preeclampsia (95), nephrosclerosis (23), nephrosclerosis with superimposed preeclampsia (13), interstitial and tubular nephropathy (seven), and normal findings (six). Pregnancy outcome in this selected group of patients was extremely poor, with the perinatal mortality rate being 134 per 1,000. There were 21 perinatal deaths; three quarters of these were stillbirths, and most were encountered below the fiftieth weight percentile and before 30 weeks' gestation. In addition 22% of the infants were small for gestational ages, and 40% of the infants were born before term. Most of the perinatal mortality (81%) was in women with preeclampsia. The worst fetal outcome was encountered in multiparous preeclamptic women, over 50% of whom manifested nephrotic-range proteinuria during pregnancy. Despite the presence of hypertension throughout most of their gestation, women with nephrosclerosis alone had the best fetal survival rate.

Apgar Score↗
PubMed1981

Prenatal assessment of fetal outcome by amniotic fluid C-peptide levels in pregnant diabetic women.

Amniotic fluid C-peptide (AFCP), insulin, and glucose levels were measured in 33 diabetic and 126 nondiabetic pregnant women at greater than or equal to 36 weeks' gestation. Levels of AFCP distinguished diabetic from nondiabetic patients more reliably than amniotic fluid (AF) insulin or glucose. Levels of AFCP in diabetic patients correlated well with infant birth weight adjusted for gestational age (large for gestational age greater than adequate for gestational age), degree of diabetic control (fair to poor control greater than good control), or diabetogenic infant morbidity, but did not correlate with classes of diabetes within the limits of the population studied. We conclude that AFCP is a useful prognostic index for predicting fetal outcome in diabetic pregnancies. A level of AFCP of greater than or equal to 1.0 pmoles/ml is associated with an increased risk of macrosomia in infants of diabetic mothers.

Adult↗
PubMed1981

Oxytocin challenge test and intrauterine growth retardation.

On the basis of analyses of the nonstressed fetal heart rate test (NST) and the oxytocin challenge test (OCT) in 85 fetuses with intrauterine growth retardation (IUGR), the predictive power of NST/OCT on fetal outcome and the mechanism of a positive OCT in IUGR were investigated. These fetuses with IUGR exhibited high incidences of nonreactive NSTs (35.3%) and positive OCTs (40%) attributable to a combination of compromised placental function and diminished fetal reserve. Adverse fetal prognosis is most accurately predicted by the joint occurrence of a nonreactive NST and a positive OCT (92%). In such cases, when IUGR is strongly suspected, liberal use of cesarean section is recommended to assure good fetal outcome.

Cesarean Section↗
PubMed1981

Amniotic fluid C-peptide as an index for intrauterine fetal growth.

Amniotic fluid C-peptide (AFCP) was monitored as an indicator of the amount of insulin secreted by the fetus in utero. Levels of amniotic fluid and cord blood C-peptide, insulin, and glucose were measured in 103 nondiabetic infants at greater than or equal to 36 weeks's gestation. Infants were grouped according to birth weight and gestational age at delivery, as follows: small gestational age (SGA, less than or equal to 10%, n = 11), average for gestational age (AGA, 10% to 90%, n = 75), large for gestational age (LGA, greater than 90%, n = 17). AFCP correlated best with infant weight-gestational age percentile classification: low AFCP in SGA infants and high AFCP in LGA infants. The data from this study suggest that a persistently low production of insulin by SGA fetuses and a high production of insulin by LGA fetuses may lead to the different intrauterine growth rates observed.

Amniotic Fluid↗
PubMed1980

Acid-base characteristics of fetuses with intrauterine growth retardation during labor and delivery.

The maternal and fetal cord blood from 37 infants with intrauterine growth retardation (IUGR) and 108 normal growth (AGA) infants were compared for lactate, pH, and blood gas values in an attempt to find whether there is any difference in stressed response in IUGR fetuses during labor and delivery. Both maternal and fetal blood lactate levels increased with progression of labor, fetal lactate being higher than the maternal lactate. Without intrapartum fetal heart rate decelerations, IUGR fetuses did not show a difference in umbilical arterial lactate, pH, and blood gases, compared to AGA fetuses. With intrapartum fetal heart rate decelerations, IUGR fetuses demonstrated a significantly higher lactate level than that of AGA fetuses. We conclude that IUGR fetuses tolerate labor less well than do AGA fetuses. In the presence of late decelerations, earlier intervention is preferable because of the increased likelihood of metabolic acidosis.

Acid-Base Equilibrium↗
PubMed1980

An OCT-reactivity classification to predict fetal outcome.

Based on analyses of the oxytocin challenge test (OCT) in 293 cases, an OCT-reactivity classification is proposed to improve the predictive value of OCT for fetal outcome. All of the 6 perinatal deaths occurred in the 2 groups associated with nonreactive pattern. The positive nonreactive test had 90% accuracy of predicting a sick infant, and the negative reactive test assured good fetal outcome. A nonreactive pattern seems to reflect a compromised fetus, as a high incidence of this pattern was found in patients with pre-eclampsia-hypertension, intrauterine growth retardation (IUGR), low and falling estriol levels, and suspected fetal problems. A positive OCT seems to reflect the limits of fetoplacental reserve under the stressed condition. A high incidence of positive OCT was associated with IUGR, low estriol levels, and a small placenta.

Adult↗