Biomedical subjects

S L Stramm

Publications and source records attributed to S L Stramm.

5 recordsLinked to original sources

PubMed1995

Distance from an intrauterine hydrophone as a factor affecting intrauterine sound pressure levels produced by the vibroacoustic stimulation test.

OBJECTIVE: The purpose of this study was to determine whether intrauterine sound pressure levels produced by vibroacoustic stimulation were associated with distance from an intrauterine hydrophone in human parturients and to evaluate the effects of distance on the spectrum of the stimulus. STUDY DESIGN: Measurements of intrauterine sound were taken in eight volunteer parturients in normal active-phase labor by use of an intrauterine hydrophone. Vibroacoustic stimulation was performed on the maternal abdomen directly overlying the hydrophone; at distance of 5, 10, 15, 20, and 25 cm from the hydrophone; and at the maternal sternum. Intrauterine sound pressure levels were tape-recorded for later analysis. Fetal heart rate and fetal movement were assessed with each vibroacoustic stimulation. Spectral analyses were performed by taking the fast Fourier transform of the tape-recorded stimulation at each position. RESULTS: Analysis of variance with repeated measures indicated a statistically significant decrease (F = 4.1, p = 0.004) in the sound pressure levels as distance increased. Spectral analysis indicated large variability between and within subjects. CONCLUSION: Sound exposure of the fetal ear is on average decreased as the distance between the ear and the vibroacoustic stimulation is increased. The spectrum of the stimulus produced with vibroacoustic stimulation is highly variable.

Acoustic Stimulation↗

PubMed1993

Randomized trial of oral indomethacin and terbutaline sulfate for the long-term suppression of preterm labor.

OBJECTIVE: Our purpose was to determine the efficacy and safety of long-term oral tocolysis with indomethacin or terbutaline sulfate. STUDY DESIGN: Seventy-one patients at 26 to 32 weeks' gestation admitted for preterm labor were prospectively randomized to receive oral indomethacin or terbutaline sulfate after successful intravenous tocolysis. Patients were monitored weekly for cervical change, maternal side effects, amniotic fluid volume, and constriction of the fetal ductus arteriosus. Patients receiving indomethacin were converted to terbutaline at 34 weeks or with the occurrence of fetal ductal constriction or oligohydramnios. RESULTS: Of 71 patients randomized six were excluded after randomization. Thirty-three patients were randomized to indomethacin and thirty-two to terbutaline. There were no differences in the percentage of patients achieving 34 weeks of gestation. No differences in neonatal outcome were noted. Nine (27%) fetuses receiving indomethacin had constriction of the fetal ductus arteriosus, and 13 (38%) had oligohydramnios. Most patients on terbutaline reported beta-mimetic side effects (53%), but only one required discontinuation of therapy. CONCLUSION: Both indomethacin and terbutaline sulfate are effective tocolytics, but major fetal side effects are common with long-term indomethacin use.

Adult↗

PubMed1992

The effect of maternal intravenous glucose administration on fetal activity.

OBJECTIVE: The study was designed to objectively evaluate the effect of maternal intravenous glucose infusion on fetal activity. STUDY DESIGN: Twenty-one volunteers at 30.7 +/- 3.0 weeks' gestation were objectively evaluated for fetal activity with a Doppler monitor before and during an intravenous glucose test. Baseline fetal activity monitoring began 10 minutes before a fasting blood glucose level was obtained. A standard 1-hour intravenous glucose tolerance test was then performed, and fetal activity monitoring was continued for the duration of the test. Twenty-one women at 29.8 +/- 3.0 weeks' gestation volunteered to serve as controls and were continuously monitored for fetal activity. The control patients did not receive intravenous glucose. RESULTS: Linear regression analysis revealed an increase in fetal activity in both groups; however, the increase in the glucose infusion group was significantly greater than in the control group. CONCLUSIONS: Maternal glucose infusion causes short-term stimulation of fetal activity; however, some other factor in the monitoring process also stimulates fetal activity.

Blood Glucose↗

PubMed1991

Uterine activity after preterm premature rupture of the membranes.

Preterm premature rupture of the membranes complicates few pregnancies but is a major contributor to overall perinatal morbidity and mortality. Although a reduced incidence of preterm premature rupture of fetal membranes has been reported in women who had antepartum uterine activity monitoring, there are few data regarding uterine activity after preterm premature rupture of fetal membranes. Therefore daily uterine activity monitoring was performed in 101 consecutive women with preterm premature rupture of fetal membranes between 26 and 34 weeks' gestation. The mean gestational ages at rupture and delivery were 31.4 +/- 2.3 and 33.7 +/- 4.5 weeks, respectively. A significant increase in contraction frequency was identified within 24 hours of onset of preterm labor (p less than 0.005). A contraction frequency of four or more per hour predicted the onset of labor within 24 hours with a sensitivity of 72%, a specificity of 90%, a positive predictive value of 54%, and a negative predictive value of 95%. These results indicate that most women with preterm premature rupture of fetal membranes exhibit a baseline contraction frequency that is similar to that of women with intact membranes and premature labor. An abrupt increase in contraction frequency is a warning of impending labor.

Adult↗

PubMed1990

Objective tocodynamometry identifies labor onset earlier than subjective maternal perception.

The ability of women instructed in self-detection of uterine contractions to identify the abrupt rise in uterine activity known to precede the onset of labor has not been evaluated. This study was designed to assess the temporal relationship between objective uterine activity monitoring, subjective maternal perception of uterine activity above a commonly used threshold value (four or more contractions per hour), and progressive cervical change. Daily tocodynamometry (7-9 AM) was recorded in 79 women with preterm premature rupture of the membranes from admission until the onset of spontaneous labor (5.3 +/- 6.3 days). The subjects were at bed rest, received no tocolytic therapy, and were instructed in the signs of labor and uterine self-palpation. Patients simultaneously provided a subjective assessment of uterine activity (four or more contractions per hour). The majority of uterine activity recordings (78%) revealed fewer than four contractions per hour, and the patients' subjective reports agreed in almost all instances (97.6%). On 91 days, four or more contractions per hour were recorded objectively, but the patients' subjective reports agreed in only 25 instances (27%). On the day of labor onset, significantly more women had an objective assessment (32%) (P less than or equal to .01). Patients subjectively identified labor onset 10.6 +/- 6.7 hours after objective monitoring indicated increased uterine activity, and when subjectively identified, both cervical dilatation (4.9 +/- 2.5 cm) and effacement (85 +/- 30%) were significantly advanced (P less than or equal to .001) compared with the admission examination (1.1 +/- 1.2 cm; 20 +/- 30%).(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiotocography↗