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S Newbold

Publications and source records attributed to S Newbold.

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The effect of uterine contractions on the T/QRS ratio of the fetal electrocardiogram.

The aim of this study was to establish whether the T/QRS ratio of the fetal electrocardiogram (ECG) was influenced by uterine contractions. Data was collected from 55 women during labour using a purpose built computer which also measured background noise. The T/QRS ratio was measured on individual complexes and the measurements averaged. Measurements made during periods of excessive noise were excluded. The average T/QRS ratio during contractions showed a small but significant increase of 1.02% (principally in the second half of the contraction). The significance of this small increase is uncertain and for most fetuses the ratio would remain in the normal range during contractions. The higher T/QRS ratios, recorded in the noisy records, draw attention to the importance of accounting for this problem when fetal ECG data are reported.

Electrocardiography↗

Comparison of the T/QRS ratio of the fetal electrocardiogram and the fetal heart rate during labour and the relation of these variables to condition at delivery.

The T/QRS ratio of the fetal electrocardiogram (ECG) was recorded to within 30 min of delivery from 105 women in labour. There were no significant differences in the mean T/QRS ratio in the last hour of record between those with normal and intermediate, or abnormal fetal heart rate (FHR) patterns. In 66 labours the mean T/QRS ratio in the first hour of record was compared with that of the last hour; the only significant change was a small decrease in the mean ratio from 11% to 7% in a group of 11 fetuses with an abnormal FHR pattern throughout the recording time. Eight babies were born with evidence of acidosis (umbilical artery pH less than or equal to 7.16), and another four were born in poor condition (1 min Apgar score less than 4) without evidence of acidosis; none had a mean last hour T/QRS ratio significantly different from the previously established normal range.

Apgar Score↗

Variation in the T/QRS ratio of fetal electrocardiograms recorded during labour in normal subjects.

The T/QRS ratio of the fetal ECG was obtained during labour from 25 women with normal pregnancies. The poor signal-to-noise ratio of the unprocessed signals, chiefly due to baseline wander, led to a wide variation between individual measurements. This problem was overcome by data averaging, the ratio being expressed as a mean over 1-min epochs. The average T/QRS ratio of each labour record ranged from 4% to 23% with a mean of 10% (for all 25). The average range (between 5th and 95th centile) of the 1-min T/QRS ratios was 13% and there were no significant changes as labour progressed. The effect of contractions on the T/QRS ratio was measured from eight subjects and found to be inconsistent.

Adolescent↗

Giant esophageal carcinoma.

Carcinoma of the esophagus is a devastating disease that produces various degrees of esophageal obstruction by virtue of its circumferential, constricting type of growth pattern. Because of the relatively small diameter of the esophageal lumen, a limited-sized tumor can produce severe obstructive symptoms. Carcinoma of the esophagus is, as a rule, fairly well localized to its wall or the immediate mediastinal parietes in cases where there is extension beyond the esophageal musculature.(1) Large, bulky, exophytic types of esophageal carcinomas that produce symptoms mainly as a result of extrinsic pressure are unusual.

Carcinoma, Squamous Cell↗

Face to face.

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Adaptation, Psychological↗