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Biomedical subjects

R T Geirsson

Publications and source records attributed to R T Geirsson.

At least 55 records · Page 3Linked to original sources
PubMed1990

[Symphysis-fundus measurements in Scandinavia].

Since the late 1970s symphysis-fundus measurements have been used in the Nordic countries to predict fetal growth deviation. Via a questionnaire, sent to Nordic university hospitals representative of health care areas, existing practices have been investigated. Symphysis-fundus measurements are almost invariably obtained and plotted onto nomograms as part of routine antenatal care. Five normal curves are in use showing some variation, but there are considerable differences in the selection of material and in the statistical treatment of the data. Revision of some of these curves may be required.

Embryonic and Fetal Development↗
PubMed1989

Classification of perinatal and late neonatal deaths in Iceland. A survey from a defined population.

A retrospective case record analysis of all perinatal and late neonatal deaths in Iceland in the periods 1976-80 and 1981-85 was done and the causes of death classified according to the extended Aberdeen classification. There was a significant (p less than 0.0001) reduction in number of deaths between the two periods with perinatal mortality rates declining from 10.6/1000 in 1976-80 to 6.8/1000 in 1981-85. In 1976-80 there were 81 (33%) antepartum, 37 (15%) intrapartum and 128 (52%) neonatal deaths compared to 61 (38%) antepartum, 13 (8%) intrapartum and 86 (54%) neonatal deaths in 1981-85. Fetal abnormality was the most common cause of death in both periods followed by the category Low birthweight in 1976-80. In 1981-85 increased morphological detection of infection in infants of very low birthweight by placental examination and autopsies lead to a shift from the category Low birthweight to Maternal Disease, the second most common cause in that period. To achieve lower perinatal mortality rates efforts should be directed towards lowering antepartum losses near term and increasing survival of very low birthweight infants.

Congenital Abnormalities↗
PubMed1989

Can we expect to lower perinatal and neonatal mortality?

In a retrospective study of all perinatal and neonatal deaths in Iceland in 1976-85, the circumstances surrounding each death were carefully evaluated to assess the quality of care given and to identify cases of suboptimal care. In 1976-80, 87 or 35% of peri- and neonatal deaths were associated with suboptimal care and 46 or 29% of peri- and neonatal deaths in 1981-85. Most of the infants weighed more than 1500 g. Suboptimal care was most commonly seen in conjunction with antenatal care in both five-year periods, with a 25% (N.S.) reduction of cases in 1981-85. Suboptimal intrapartum care was significantly reduced (p less than 0.05) and there was a substantial reduction (62%), although not significant (0.1 greater than p greater than 0.05), of suboptimal neonatal care between the two periods. A few cases were attributable to maternal decisions taken against medical advice, most of them in the latter period. Perinatal care improved during the study period. The task of further lowering perinatal mortality rates depends on vigilance to abnormal findings in routine antenatal care.

Female↗
PubMed1989

Incidence and relation to parity of pregnancy-induced hypertension in Iceland.

A retrospective study was made to determine the incidence of pregnancy-induced hypertension (PIH, pre-eclampsia) in Iceland. One-fourth of all births in Iceland in 1985 were selected from the national birth registry files by random number allocation, a total of 904 women. Maternity records were found in 97.9% of the cases. The criteria used to define PIH were met in 17.4% of the women. There were 146 (16.5%) with mild PIH (blood pressure of greater than or equal to 140/90 mmHg with or without proteinuria after the 20th gestational week). Eight (0.9%) had severe PIH (blood pressure of greater than or equal to 160/110 mmHg with or without proteinuria after the 20th gestational week). Primigravid women formed one-third of the group and of these 20.9% had PIH compared with 15.4% of the parous women. The incidence in parous women was higher than usually reported.

Adult↗
PubMed1988

Birth trauma and brain damage.

Birth trauma is a rare primary cause of perinatal death, occurring at most only once in every 1000-2000 births. As a cause of brain damage and later handicap it is often difficult to dissociate injury at birth from the concomitant effects of asphyxia, growth retardation or preterm delivery. A continuum of reproductive casualty has been postulated, but for trauma is not proven. Among children with cerebral palsy and severe mental retardation trauma may be implicated in a few cases, possibly 1-2 of 1000 deliveries. Vaginal breech delivery has been related to a higher incidence of minimal brain damage syndromes and some of this damage probably has its origin in perinatal trauma. The pregnancies where there is particular risk of birth trauma include those where the infant is large for gestational age, has intrauterine growth retardation, is delivered preterm, is vaginally delivered in breech presentation or is from multiple gestation. Particular care must be given to diagnosis and preventive measures in these cases and competent handling is required if the disaster of brain damage caused by traumatic birth is to be minimized.

Attention Deficit Disorder with Hyperactivity↗
PubMed1987

Effective strategy for prenatal prediction of Duchenne and Becker muscular dystrophy.

Deletions in the gene sequence for Duchenne (DMD) and Becker (BMD) muscular dystrophy were detected in affected males with four cDNA probes, Cf56a, Cf23a, Ca1A, and Cf27. Most of the deletions were seen with only one of the probes. Cf23a detected all BMD deletions seen with Cf56a and some that were not. The same markers also detected restriction fragment length polymorphisms for those cases where deletions were not evident. The probes were also used successfully for prenatal diagnosis in two families each with two DMD affected males. In DMD families successive application of probes Cf56a, Ca1A, and Cf27 will give a 70% chance of detecting the mutation. BMD families should first be screened with the Cf23a probe.

Chromosome Deletion↗
PubMed1987

Survival after ovarian granulosa and theca cell tumours.

Ninety-two cases of ovarian granulosa and theca cell tumours were recorded in the Tayside Gynaecological Tumour Registry during the 30 year period 1948-78. A high follow-up rate was achieved through this centralised registry and exhaustive annual recall. At 20 years after initial treatment patient actuarial survival was 92% for the theca cell tumours and 34% for granulosa cell tumours.

Adult↗
PubMed1987

Total intra-uterine volume and symphysis fundus height. Is there a relation?

The concordance between measurements of total intra-uterine volume (parallel planimetric area method) and symphysis fundus height and the efficacy of these measurements in predicting birthweight by centile range was prospectively investigated in a blind study of 81 measurement sets in 74 women in the third trimester of pregnancy. Gestational length was determined by early ultrasound scans in all cases. Reference curves were from separate populations. Correlation between the measurements was significant, both at 32 weeks (p = 0.015) and 36 weeks (p less than 0.001), but only 21% of the variation in intra-uterine volume at 32 weeks and 63% at 36 weeks' gestation was attributable to changes in fundal height. Intra-uterine volume was therefore not accurately reflected by fundal height. Fundal height and intra-uterine volume were in the same centile range in 34% of cases. Maternal height and weight did not correlate with intrauterine volume, but there were significant relations with fundal height, particularly at 36 weeks. Birthweight correlated better with volume (r = 0.665) than with fundal height (r = 0.461) at 32 weeks, while at 36 weeks there was little difference (r = 0.691 and 0.794). In 54% of volume and 47% of symphysis fundus measurements there was agreement with the same centile range of birthweight. Predictive capacity of volume measurements appeared better for the lower birthweight ranges.

Birth Weight↗
PubMed1986

Lower genital tract infection with Chlamydia trachomatis and Neisseria gonorrhoeae in Icelandic women with salpingitis.

In a study of 225 women with acute salpingitis verified by laparoscopy or laparotomy we investigated the prevalence of gonococcal and chlamydial infection in the lower genital tract. Neisseria gonorrhoeae was isolated from 18.9% of the women and Chlamydia trachomatis from 38.5%. Women with positive cultures were significantly younger (p less than 0.01) than those with negative cultures. A trend toward more severe inflammatory changes of the tubes was found in women with positive cultures compared with those with negative cultures. The majority of women with positive cultures stated they had only one sexual partner during the preceding 6 months. Single women had more partners (mean 1.9) than those cohabiting (mean 1.2). The ratio of single/multiple partners for women with Chlamydia was 2.5:1, and for those with gonorrhea 1:1 (p less than 0.05). Of the men, 60% could be examined and about 50% had positive cultures. Microbiologic investigation of both partners is necessary in order to prevent reinfection of the woman.

Adolescent↗
PubMed1986

Intrauterine volume in pregnancy.

Intrauterine volume, a three-dimensional measure of growth, was evaluated in pregnancy. The ultrasonic method for measurement of volume was investigated for its accuracy and error potentials and then used to collect information on the growth of three volume components, - total intrauterine, intra-amniotic and placental volume, in the latter half of normal pregnancy. Against reference standards from the normal population, two other main groups, a non-selected and a pre-selected high-risk group, were studied, to test the hypothesis that a small intrauterine volume would predict the presence of a small-for-dates and possibly compromised baby. In previous times main interest in uterine volume had centered on its possible role in parturition. More recently ultrasound had been used to measure intrauterine volume in early pregnancy and a simple ultrasonic method of calculating total intrauterine volume had been used for diagnosing the small-for-dates fetus. The study showed that in a phantom model situation, a method based on serial parallel planimetric area measurements was significantly more accurate than a linear measurement method that assumed the uterine shape to be like a prolate ellipsoid. With the former method 93.3% of measurements were within +/- 5% of the true volume with a mean error of -0.43%. When the method was evaluated for its accuracy in women undergoing midtrimester termination or in women delivering near term, there was good correlation between ultrasonically and directly/indirectly measured intra-amniotic volume suggesting that the same level of accuracy could be expected in pregnancy as found in the phantom models. Intra- and interobserver variation was small. The PPA method was used for all measurements in pregnancy because of its superior accuracy. Data from 115 healthy women with no pregnancy complications were evaluated longitudinally to study normal growth and derive reference standards. Median and mean values for total intrauterine volume increased from around 1,000 ml at 20 weeks to 4,500 ml at 40 weeks. The standard deviation was large at any stage of pregnancy, also for intra-amniotic and placental volume. The rate of volume increase was near constant for total intrauterine and intra-amniotic volumes, except during the period 30-35 weeks, when a faster rise was observed. Placental volume growth decreased after 30 weeks. With growth of total volume following a largely linear trend, a tendency for ranking of volume levels was observed, but predictability of one measurement on the basis of earlier ones weakened with increasing separation of time points.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1986

The relation of birthweight to histological appearances in vessels of the placental bed.

Biopsy of the placental bed was attempted at caesarean section in 109 patients: 77 consecutive and 32 selected because of the maternal or fetal condition. Forty-seven (44%) of these biopsies were from the placental bed and contained spiral arteries suitable for comment. Histological examination separated the patients into four groups: comprising 11 whose vessels showed normal physiological changes, 20 who showed inadequate physiological change, 12 with acute atherosis, and four with a mixed pattern. There was no relation between these changes and maternal age, parity, race or smoking habit, but no physiological change and atherosis were more common in association with maternal hypertension. Mean adjusted birthweight was greatest in those with physiological changes, less in those without physiological changes or the mixed pattern, and least in those with atherosis. The four patients in the mixed group did not have any unifying clinical characteristics.

Arteries↗
PubMed1986

The relation between plasma urate and placental bed vascular adaptation to pregnancy.

Placental bed biopsies were obtained at caesarean section from 34 women. Their plasma urate was directly related to maximum mean arterial pressure and inversely to adjusted birthweight; but it was related most closely to the histological appearances of the spiral arteries in the placental bed. Nine women had physiological changes in the spiral arteries: their mean urate (233, SD 28.9 mumol/l) was significantly (P less than 0.001) lower than the mean urate in those who did not have adequate physiological changes (339, SD 90.3 mumol/l) or that in the nine women who had atherosis (397, SD 153.2 mumol/l). Raised plasma urate appears to be better related to maternal vascular pathology than to the clinical condition or infant birthweight.

Arteries↗
PubMed1985

Growth of total intrauterine, intra-amniotic and placental volume in normal singleton pregnancy measured by ultrasound.

The growth of total intrauterine, intra-amniotic and placental volume during the latter half of pregnancy was studied longitudinally with ultrasound in 115 healthy women with normal singleton pregnancies. A parallel planimetric area method was used. The range and distribution of normal values between 20 and 40 weeks was determined for a main study group of 103 primiparous women with which values from 12 parous women were compared. Total intrauterine volume increased from a median of 1006 ml to 4420 ml, intra-amniotic volume from 716 ml to 3406 ml and placental volume, calculated as the difference between total intrauterine and intra-amniotic volume, increased from 259 ml to 801 ml. Variation between individuals was wide at all stages of pregnancy. No significant difference was found between primiparous and parous women. Between successive 5-week periods from 20 to 40 weeks there was evidence that women tended to maintain their initial volume ranking. During the 30-35 week period, rate of growth of total intrauterine and intra-amniotic volume was somewhat faster than the near constant mean rate at other times, while the rate of growth of placental volume decreased after 30 weeks towards term.

Adolescent↗
PubMed1985

Efficacy of intrauterine volume, fetal abdominal area and biparietal diameter measurements with ultrasound in screening for small-for-dates babies.

The efficacy of total intrauterine, intra-amniotic and placental volume measurements with ultrasound in screening for low birthweight (less than or equal to 10th and less than or equal to 3rd centile) was compared prospectively with fetal biparietal diameter and abdominal area measurements at 32 and 36 weeks gestation in an unselected population of 362 women. In all of them the gestation was dated by ultrasound in the first half of pregnancy. Reference values were from a separate normal population studied previously. Total intrauterine volume showed the highest sensitivity in predicting babies weighing less than or equal to 10th centile (58% at 32 weeks and 62% at 36 weeks) and those weighing less than or equal to 3rd centile (78% at 32 weeks and 83% at 36 weeks). A higher number of false-positive tests resulted in a lower predictive value of a positive test (mean 34% for babies weighing less than or equal to 10th centile) than that found for abdominal area (mean 54%). Abdominal measurements selected a smaller 'at risk' group. Biparietal diameter, intra-amniotic and placental volume measurements had inferior predictive capability than total intrauterine volume and abdominal area. For screening purposes abdominal area measurements are presently more suitable than intrauterine volume. The higher sensitivity of intrauterine volume, particularly in early third trimester, is an advantage that requires further investigation with reference to intrauterine growth retardation.

Adult↗
PubMed1985

Intrauterine volume, fetal abdominal area and biparietal diameter measurements with ultrasound in the prediction of small-for-dates babies in a high-risk obstetric population.

The value of fetal biparietal diameter and abdominal area, total intrauterine, intra-amniotic and placental volume measurements for predicting small-for-dates babies in a high-risk obstetric population was investigated in 130 women. A parallel planimetric area method was used to measure volume. The commonest risk factors were suspected intrauterine growth-retardation, hypertensive complications and previous poor obstetric history. The prevalence of birthweight at and below the 10th or 3rd centiles was 30 and 16% respectively. Fetal abdominal area and total intrauterine volume measurements had the highest and comparable sensitivity, specificity and positive predictive value in the detection of infants with birthweights of less than or equal to 10th and less than or equal to 3rd centiles. While these measurements are of use in consolidating the clinical diagnosis of small-for-dates fetuses (growth retardation), high false positive rates (10% and 16-17% for birthweights less than or equal to 10th centile, and less than or equal to 3rd centile respectively) make further discriminatory tests necessary for part of the population.

Adolescent↗
PubMed1985

Size at birth in Iceland.

Anthropometric standards for weight, length and head circumference of Icelandic infants at birth are presented. The material concerning weight and crown-heel length consisted of 43 364 newborns, the total number of infants born in 1972-1981. The standards for head circumference were based on 28 978 infants born in 1975-1981. Multiple births and stillbirths were excluded from the material, leaving single livebirths with an estimated length of gestation of 28-44 weeks. No further exclusions were made. The material was compared with previous standards used in Iceland as well as with other studies of all single livebirths in geographically defined populations. Standards for crown-heel length and head circumference were compared with other studies based on more limited and selective materials. The differences between these studies emphasize the need for an international agreement on the methodology for measurement and recording of infant growth during the perinatal period.

Birth Weight↗