Biomedical subjects
Publications and source records attributed to S A Klein.
Eleven patients with moderate fetal bradycardia in labor were studied by fetal scalp blood pH, continuous tissue pH, and umbilical arterty pH at delivery. The neonatal outcomes and biochemical data demonstrated that moderate fetal brdycardia does not indicate fetal distress.
The relationship between different FHR patterns and fetal tissue pH in 68 high-risk gravidas in labor was analyzed. A tissue pH electrode was placed in the fetal scalp and tissue pH recorded on a fetal monitor every 15 seconds along with uterine contractions and continuous fetal heart rate. The tissue pH changes correlated with the FHR patterns in a manner consistent with current concepts of fetal stress. Trend monitoring of fetal tissue pH in labor may prove useful in the management of high-risk patients in labor.
A case of congenital mitral and aortic stenosis diagnosed from the fetal electrocardiogram (FECG) during labor is presented. Cardiologic work-up and autopsy findings in the neonate confirmed the diagnosis. This is the first case in which prenatal diagnosis of a specific anatomical lesion of the heart was made from the FECG and confirmed clinically as well as at autopsy.
Fifteen cases of fetal cardiac arrhythmia were detected by direct fetal electrocardiogram (FECG) during intrapartum fetal monitoring. The frequency of arrhythmia of 12.4/1000 monitored births. Thirteen of the arrhythmias were supraventricular. Atrial bigeminy was the most commonly observed arrhythmia, followed by atrial trigeminy. Two cases of ventricular arrhythmia were noted, one of which was a case of ventricular tachycardia. Arrhythmias were not related to drug treatment or to stage of labor. Variable decelerations occurred in association with arrhythmias in 73% of the cases. There were no nuchal cords seen at delivery, nor were there any instances of intrapartum fetal distress, fetal acidosis, or low Apgar scores associated with any arrhythmia. All arrhythmias resolved spontaneously without treatment. The neonatal course was uncomplicated in all cases. Intrapartum fetal arrhythmia is best detected by direct FECG. Appropriate management should include close observation for ominous fetal heart rate (FHR) patterns and fetal acid-base-studies. At present, there is no indication for drug treatment of intrapartum arrhythmia.
Explore the source record for details and available documents.
Fifty-one women in labor had continuous monitoring of fetal scalp tissue pH, fetal heart rate by ECG, and uterine contractions. A miniature pH electrode secured by a double spiral fetal ECG electrode was used for measurement of fetal pH every 15 seconds. The results were correlated with fetal scalp blood pH values obtained simultaneously. Fetal scalp sampling is intermittent, requires repeated scalp incisions, is subject to errors due to air mixing and coagulation of the blood sample, and is uncomfortable for the parturient. Placement of the tissue pH electrode allows continuous data recording with the minimum discomfort to the patient and the least number of fetal scalp incisions. Clinical use of the tissue pH electrode might be a practical alternative to fetal scalp samples, if the data obtained accurately reflect fetal status.
This study explored the effectiveness of progressive relaxation and large muscle exercise in improving the cognitive performance of hyperactive, impulsive males. Progressive relaxation and large muscle exercise were compared to an attentional-training placebo, a no-treatment control, and a nonhyperactive control. While no differences were found on the Continuous Performance Task, relaxation, exercise, and nonhyperactive control groups performed significantly better on the Matching Familiar Figures test than the no-treatment control. Results were suggestive of the effectiveness of both progressive relaxation and large muscle exercise in treating hyperactive, impulsive youngsters.