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Biomedical subjects

R Depp

Publications and source records attributed to R Depp.

At least 55 records · Page 3Linked to original sources

Fetal baseline heart rate variability estimation. I. Comparison of clinical and stochastic quantification techniques.

Baseline fetal heart rate variability is an important parameter in the evaluation of fetal status during the intrapartum period. Prior descriptions of variability have largely been either visual-subjective or stochastic in nature. Unfortunately, correlation between the two has not been substantiated. Sample heart rate tracings were evaluated for variability by a panel of nine experts. Interobserver agreement in the evaluation of variability was high; correlation between visual subjective and stochastic methods was low. The implications are discussed.

Arrhythmias, Cardiac

The Northwestern University Multihospital Twin Study. II. Mortality of first versus second twins.

The results of a multihospital study involving a total of 588 twin pairs born in Chicago in 1970-1975 are reported, with special respect to differences in mortality between first and second twins by time as well as by cause of death. Mortality was higher in second than in first twins and most commonly occurred after delivery and was the result of immaturity and of respiratory distress syndrome.

Asphyxia Neonatorum

Fetal heart rate patterns and development in the first year of life.

The development of 50 high-risk infants who were provided intrauterine monitoring during labor was prospectively evaluated. Twelve infants had normal fetal heart rate patterns, 16 moderate-severe variable patterns, and 22 severe variable or late deceleration patterns. The parity, socioeconomic status, race of the mothers, and sex of the infants were similar in each group. The infants were examined neurologically 48 to 72 hours after birth and at 2, 4, 6, 9, and 12 months of age. Denver Developmental Standard testing was performed at 2, 4, 6, 9, and 12 months of age. A statistically significant developmental bias was seen favoring those infants with normal fetal heart patterns. Fetal heart rate patterns predicted abnormal performance more accurately than did Apgar scores. Although this data is incomplete, the duration of ominous fetal heart rate patterns appears to adversely affect development.

Apgar Score

Indications for early exchange transfusion in patients with erythroblastosis fetalis.

The postnatal rate of rise of the undirect bilirubin concentration was compared with cord hematocrit and bilirubin values in 44 newborn infants with Rh isoimmune hemolytic disease. Cord blood values failed to predict the severity of hyperbilirubinemia with sufficient accuracy to warrant their use as therapeutic guidelines. A statistically significant positive correlation was found between the cord serum indirect bilirubin concentration and its subsequent rise in 19 infants who had received antenatal phenobarbital therapy, but this relationship was not observed in untreated infants. The phenobarbital-treated infants had a slower postnatal rise of indirect bilirubin than did nontreated controls. There was no reliable indicator of the severity of hyperbilirubinemia other than careful monitoring of the serum bilirubin concentration during the early hours of life.

Bilirubin

Growth adjusted sonographic age. A simplified method.

It recently has been shown that the sonar predictive accuracy of gestational age can be markedly enhanced by separating fetuses into one of three cephalic growth patterns, namely, large, average, and small. In this way it becomes possible to adjust fetal age in relation to biparietal diameter (BPD) growth. In this report we are defining the application of a growth adjusted sonographic age (GASA). Additionally, we are introducing a table which simplifies the assignment of GASA on a routine basis.

Cephalometry

Alpha1-antitrypsin deficiency. Severe obstructive lung disease and pregnancy.

The case of a 37-year-old primigravida with severe obstructive lung disease and alpha1-antitrypsin deficiency is reported. Serial pulmonary function studies and arterial blood gases were obtained during the antenatal and postpartum periods. Intrauterine fetal growth was monitored with serial ultrasonic fetal biparietal diameter determinations. Serial oxytocin challenge tests were used to monitor uteroplacental function. Aggressive chest physiotherapy was used to maintain good maternal bronchopulmonary hygiene. A normal female infant was delivered vaginally at 38 weeks' gestation following an uneventful labor. The available obstetric literature regarding the outcome of pregnancy in patients with obstructive lung disease and cystic fibrosis is reviewed. This literature suggests that pregnancy in a patient with severe obstructive lung disease should be considered a medical indication for therapeutic abortion. Successful delivery of this patient with severe obstructive lung disease and alpha1-antitrypsin deficiency suggests that these conditions are not a contraindication to successful outcome of preganncy for both mother and child.

Adult

Maternal-fetal transport. A nurse team.

Northwestern Perinatal Center in Chicago, Illinois, developed and implemented a maternal-fetal transport system. The system is unique not only because it is in a metropolitan area but also because the transport teams are nurses only in more than 95% of the maternal-fetal transports. Rationale and design of the system, development of the team, discussion of problems, and certification process for nurses is presented.

Certification

Intrauterine fetal surgery: a nursing challenge.

Surgical treatment of the fetus in utero offers new options for selected families with fetal anomalies. Nurses caring for these families must be prepared to meet their unique needs. The diagnosis, treatment, support, and follow-up care of the family is discussed.

Amnion