PubMed Health⌕ Search

Biomedical subjects

T Ikenoue

Publications and source records attributed to T Ikenoue.

At least 109 records · Page 6Linked to original sources
PubMed1988

[The effect of amniocentesis on pregnancy prolongation in patients of threatened premature labor with intact membranes].

The effects of amniocentesis on the prolongation of the gestational period was retrospectively reviewed in patients, in premature labor with intact membranes between 24 and 36 weeks of gestation. Amniocentesis was performed on 55 patients (study group) to evaluate fetal lung maturity and to detect subclinical intraamniotic infection, while the remaining 170 patients (control group) did not receive this procedure. Isoxsuprine was used as the primary tocolytic agent in all the patients. There was no difference in the incidence of spontaneous rupture of the membranes during tocolysis (3/55 vs. 7/170), cesarean deliveries (3/55 vs. 10/170), and adjunctive use of magnesium sulfate with isoxsuprine (11/55 vs. 31/170). A statistical analysis of the time interval from amniocentesis to vaginal delivery at each score of the tocolysis index failed to show any evidence that amniocentesis might induce labor. Moreover, no maternal or neonatal morbidity was attributable to amniocentesis. These data suggest that the use of amniocentesis may be a helpful procedure in the management of premature labor with intact membranes with minimum effect on the outcome of the clinical course.

Adult↗
PubMed1987

Clinical evaluation of antithrombin III concentrate (BI 6.013) for disseminated intravascular coagulation in obstetrics. Well-controlled multicenter trial.

Antithrombin III (AT III) is known to be the most important inhibitor of serine protease in the coagulation system. In the presence of heparin, AT III is converted from its progressive activity state to an immediate activity state. In disseminated intravascular coagulation (DIC) in the field of obstetrics, the treatment has to be initiated very early. Heparin treatment, on the other hand, is critical since frequently postpartal or postoperative wound bleeding is present. We, therefore, established diagnostic criteria for the early diagnosis of DIC and investigated the clinical efficacy of a therapy with AT III in a well-controlled comparative study versus the injectable synthetic protease inhibitor FOY. The results of the trial showed that the AT III group (92%; n = 24) was significantly (p less than 0.001) superior in clinical efficacy to the FOY group (60%; n = 15). No side effects whatsoever were observed after treatment with AT III concentrate (Behring Institute). From these results, it could be concluded that a single therapy with AT III concentrate can sufficiently control the symptoms of DIC in the field of obstetrics without the risk of increased bleeding.

Adult↗
PubMed1987

[Correlation between disaturated phosphatidylcholine in amniotic fluid and fetal lung maturation].

The concentrations of disaturated phosphatidylcholine (DSPC), the major component of pulmonary surfactant, were quantified on 528 amniotic fluid samples, which did not show the contamination of blood or meconium and were uncomplicated by polyhydramnios or severe congenital anomalies incompatible with life. 396 samples of amniotic fluid (29 RDS cases) obtained 72 hours before delivery were used to evaluate the reliability of DSPC as a specific indicator in pedicting fetal lung maturation. DSPCs were determined according to the method described by Mason et al. and lecithin/sphingomyelin (L/S) ratios were measured by using two dimensional thin-layer chromatography. The critical points of DSPC and L/S ratio were defined as 1.0mg/dl, 2.0 respectively. The results are as follows. There was a gradual increase in DSPC levels of amniotic fluid with increasing maturity until 35 weeks of gestational age and a rapid rise from 36 weeks to term. About 70% of the amniotic fluids having a significantly higher DSPC level greater than or equal to 5.0mg/dl within 35 weeks of gestation were found to be obtained from pregnant women whose pregnancy was complicated by PROM, threatened premature labor or cervical incompetency and who eventually underwent preterm labor. Out of 58 samples, in which DSPC and the L/S ratio were measured simultaneously, two markers agreed in 47 cases in an immature or a mature value for predicting fetal lung maturation. RDS was correctly predicted in 27 of 60 cases (false negative, 55.0%) with DSPC levels less than 1.0mg/dl. When DSPC levels were 1.0mg/dl or more, there were only two of 336 (0.6%), false positives.(ABSTRACT TRUNCATED AT 250 WORDS)

Amniotic Fluid↗
PubMed1986

[The perinatal factors associated with the development of neonatal RDS in cases of placenta previa].

Sixty-two cases of preterm placenta previa were managed in our hospital since September, 1979 through August, 1983. These were reviewed and analysed retrospectively for the perinatal factors in terms of the development of respiratory distress syndrome (RDS). Conservative management was employed in 56 cases (90%), which consisted of antepartum blood transfusion (7 cases: 11.3%), tocolysis for inhibition of premature labor (37 cases: 59.7%), and prenatal steroid administration (8 cases: 12.9%). Nineteen cases (31%) were delivered from 28 to 33 weeks, 20 cases (32%) from 34 to 36 weeks, and 23 cases (37%) after 37 weeks. When regular uterine contractions occurred at less than 10 minute intervals at the initiation of tocolysis, the majority of the cases had to be delivered within 7 days or less. Ten of the 39 preterm neonates in this study developed clinical RDS. All of these were delivered at between 28 and 33 weeks, associated with neonatal asphyxia. Three perinatal factors were significantly associated with the development of clinical RDS in comparison with the control group of non-RDS preterm neonates. These were neonatal asphyxia, maternal bleeding (greater than 500 ml) and no prenatal steroid administration.

Abruptio Placentae↗
PubMed1986

[The maternal, fetal and neonatal clinical characteristics in cases delivered between 24 and 32 weeks' gestation].

The clinical characteristics of 346 infants delivered between 24 and 32 weeks' gestation in our perinatal medical center were reviewed retrospectively in order to investigate the fetal development and maturation process in human pregnancy. Sixty nine infants were stillborn. The remaining 277 live-born infants were admitted in the neonatal intensive care unit. The one hundred and ninety three surviving infants were discharged from the neonatal unit. The neonatal survival rate by gestational week at birth was characterized by an abrupt increase at 26 weeks of gestation and a stepwise increment thereafter. Fetal cardiovascular responses to acute stress such as hypoxemia became different at 26 weeks of gestation from those of more preterm young infants. The capability to respond to various respiratory intensive support became evident at 28 weeks of gestation. The neurological development stability seems to be obtained at 30 weeks' of gestation. The neurological developmental disorders were not directly related to the length of gestational age at birth in the range of 26 and 32 weeks. The intrauterine growth retardation became clinically evident from 28 weeks. Those infants whose growth was retarded in utero showed a remarkably adverse outcome both in mortality and mobility in this series.

Delivery, Obstetric↗
PubMed1984

Intrauterine growth of chronically instrumented rhesus monkey fetuses.

The effect of surgical and experimental manipulations on intrauterine growth of the fetus was investigated in 61 rhesus monkey fetuses in which chronic preparations were attempted. The surgical procedure consisted of hysterotomy and insertion of vascular catheters and included unilateral ligation of the fetal carotid artery. The mother was kept in a restraining chair after the operation for the duration of the preparation (0 to 39 days). Thirty-four fetuses who died within 48 hours after operation served as the control group for the growth parameters. The remaining fetuses that survived 7 days or more after the operation were included in the experimental group. Body weight, crown-rump length, crown-heel length, and foot length of the fetus and placental weight were measured at the termination of the preparation. There were significant linear correlations between all parameters and gestational age. Comparison between the control and experimental groups revealed that none of the parameters from the experimental group differed significantly from those of the control group. No relationships were found between the duration of the preparation and any of the parameters. Total brain weights from 19 fetuses exhibited a significant increase with gestational age and these values were within the normal range reported previously. There were no significant differences in weight between right and left cerebral hemispheres. No evidence of unequal blood flow to the cerebral hemispheres was found with the radioactive microsphere technique. The data suggest that the surgery performed on both the mother and the fetus and prolonged maternal restraint did not alter intrauterine fetal development.

Animals↗
PubMed1982

Fetal heart rate accelerations and late decelerations during the course of intrauterine death in chronically catheterized rhesus monkeys.

The appearance of late decelerations and the disappearance of accelerations in the fetal heart rate were observed during the days that preceded intrauterine fetal death in nine chronically instrumented rhesus monkeys. All nine animals had recovered satisfactorily from the initial surgical procedure, as evidenced by normal biophysical and biochemical parameters. After recovery, all the fetuses had shown accelerations and no late decelerations with spontaneous uterine contractions. The mean duration of the preparations was 16.1 days. The duration of the preterminal observation period varied from 3 to 13 days, during which time no experiments were performed. The fetuses died during labor at a mean gestational age of 143 days. Late decelerations were the first sign of fetal deterioration and occurred with a slight but significant decrease in fetal PaO2 without changes in pH, whereas accelerations in fetal heart rate were still present. The loss of accelerations in fetal heart rate was a later phenomenon and was associated with significant reductions in fetal pH and PaO2.

Animals↗
PubMed1981

Effect of acute hypoxemia and respiratory acidosis on the fetal heart rate in monkeys.

The fetal heart rate (FHR) response to acute nonacidemic hypoxemia and to acute respiratory acidosis was studied in unanesthetized pregnant monkeys by means of chronically implanted catheters and electrodes. Average FHR and short- and long-term FHR variability were analyzed separately. The FHR response to either hypoxemia or hypercapnia consisted of slowing and increased variability. The slowing was more consistent with hypercapnia than with hypoxemia. Long-term FHR variability increased with both test stresses. The increase in short-term FHR variability was much greater in response to hypoxemia than to hypercapnia. Both the FHR slowing and the increases in variability in response to the test stresses were reduced by prior administration of atropine to the fetus.

Acidosis, Respiratory↗
PubMed1980

Cardiac systolic time intervals in fetal monkeys: ventricular ejection time.

The VET of the fetal cardiac cycle, measured as the interval between the semilunar valve opening and closing signals of the ultrasound Doppler cardiogram, was studied in chronically catheterized fetal rhesus monkeys. VET varied inversely with FHR between approximately 150 and 250 bpm. Below 150 bpm, however, there was no further prolongation of VET. VET was not related to gestational age. VET, corrected for heart rate, was shortened in the presence of combined hypoxemia and acidosis, but not when either hypoxemia or acidemia was present alone. Corrected VET was shortened by epinephrine, but was not consistently altered by atropine. VET was not affected by changes in the concentration of glucose in fetal blood.

Animals↗
PubMed1978

Antepartum evaluation of the pre-ejection period of the fetal cardiac cycle.

The pre-ejection period (PEP) of the cardiac cycle was studied in 65 antepartum fetuses by means of a noninvasive technique which used simultaneous recordings of abdominal fetal electrocardiogram (FECG) and ultrasound fetal Doppler cardiogram (FDCG). Although most of the fetuses were products of high-risk pregnancies, 45 fetuses had uneventful perinatal courses. The PEP's from these fetuses demonstrated a significant positive relationship with gestational age (p is less than 0.01). Uterine contractions induced for antepartum stress testing of the fetus were founnd to prolong the PEP by approximately 9.1 per cent in five cases (four fetuses). The average PEP of antepartum fetuses between 38 and 40 weeks was shorter than that of intrapartum fetuses by approximately 9.5 per cent. Comparison between clinical outcome and the PEP's of the fetuses who were born within a week after the last determination of PEP revealed a strong correlation between prolonged PEP duration and abnormalities in the perinatal course.

Electrocardiography↗
PubMed1978

Cardiac systolic time intervals in fetal monkeys: pre-ejection period.

The systolic time intervals of the fetal cardiac cycle were studied by means of simultaneous recordings of electrocardiogram (ECG) and ultrasound Doppler cardiogram (DCG) in chronic preparations of fetal rhesus monkeys. Recordings were made under physiologic conditions as well as during various experimental stresses. The pre-ejection period (PEP) showed no significant relationship with heart rate in the unstressed fetuses, but the acceleration of heart rate induced by epinephrine was accompanied by shortening of PEP. The PEP increased with advancing fetal age. The PEP was inversely correlated with left ventricular end-diastolic pressure and arterial pulse pressure, but showed a positive correlation with both systolic and diastolic arterial blood pressure. The PEP also exhibited strong negative correlation with arterial blood pH. the prolongation was essentially the same whether acidosis was of respiratory or metabolic origin. The PEP increased slightly but significantly during nonacidemic hypoxemia; however, there was no correlation between Pao2 and PEP Epinephrine shortened the PEP significantly, whereas the effect of atropine was inconsistent. Alteration of the plasma glucose level by injection of insulin or glucose did not affect PEP. These findings demonstrate that the PEP may be a useful indicator of fetal cardiac performance, reflecting both myocardial contractility and the hemodynamic state of the cardiovascular system.

Acidosis↗
PubMed1976

Circulatory response to atropine in sheep fetus.

Atropine was given to the semichronic sheep fetus intravenously. Fetal heart rate, fetal perfusion pressure, and carotid blood flow increased. Cerebral blood flow was measured with the radioactive microsphere technique. Atropine was capable of increasing the cerebral blood flow. Elevation of carbon dioxide also caused an increase in cerebral blood flow, adding to the effect of atropine.

Animals↗
PubMed1976

Effect of thyrotropin-releasing hormone on secretion of thyrotropin, prolactin, thyroxine, and triiodothyronine in pregnant and fetal rhesus monkeys.

The effect of thyrotropin-releasing hormone (TRH) on the pituitary-thyroid axis and on prolactin secretion was studied in pregnant Rhesus monkeys during the latter period of gestation and in non-pregnant female controls. The baseline plasma concentrations of TSH, T3, T4, and prolactin (PRL) of pregnant monkeys did not differ from those of non-pregnant monkeys. After administration of TRH, plasma prolactin rose to higher levels in pregnant monkeys than in non-pregnant monkeys whereas there was a similar response of plasma TSH, T4 and T3 in both groups. The baseline plasma TSH was elevated and plasma T3 was decreased in the fetus compared with the mother. Administration of TRH iv to the maternal monkey caused a larger response in the fetal plasma TSH than in that of the mother and was followed by larger increments in plasma T4 and T3 concentrations in the fetuses than in the mothers. The larger increments of plasma TSH and thyroid hormones in the fetus compared with the mother also occurred when TRH was given iv to the fetus. There was a significant rise of plasma prolactin in both mother and fetus after administration of TRH to mother or fetus; the increase of plasma PRL was much higher in the mother than in the fetus. The data show that TRH can cross the primate placenta in either the maternal to fetal or fetal to maternal direction. The fetal thyroid of the Rhesus monkey during the latter period of gestation can release both T4 and T3 in response to TSH.

Amniotic Fluid↗
PubMedDate not supplied

Vasopressin and catecholamine responses to 24-hour, steady-state hypoxemia in fetal goats.

The purpose of the present study was to determine the effect of prolonged hypoxemia without acidemia on fetal stress hormones. Twenty-four-hour hypoxemia was conducted in nine chronically catheterized pregnant goats to determine fetal plasma concentrations of arginine vasopressin (AVP), epinephrine (E), and norepinephrine (NE). Nine experiments were performed. Six resulted in nonacidemic, steady-state hypoxemia, and three incidentally resulted in hypoxemia with progressive acidemia. In steady-state hypoxemia, fetal PO2 decreased significantly from 28.1 +/- 2.4 Torr to 18.8 +/- 2.5 Torr, fetal PCO2 also decreased significantly by about 5 Torr, and pH values did not change significantly. Fetal plasma concentrations of AVP, E, and NE were significantly increased at 1 h of hypoxemia. As hypoxemia continued, AVP returned to control level by 24 h, while E and NE remained elevated throughout the hypoxemic period. In the three experiments with progressive acidemia, AVP, E, and NE increased further as fetal acidosis progressed. We conclude that fetal AVP acts as a shorter-term stress hormone than E and NE in steady-state hypoxemia. This adaptive response is present without progressive acidosis. We also conclude that accompanying acidemia is a more potent stimulus for AVP, E, and NE than isolated hypoxemia during longer-term studies.

Acidosis↗