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Biomedical subjects

U Ulmsten

Publications and source records attributed to U Ulmsten.

At least 199 records · Page 11Linked to original sources
PubMed1982

Combined effects of diflunisal and nifedipine on uterine contractility in dysmenorrhoeic patients.

In eight nulliparous women with severe primary dysmenorrhoea, intrauterine pressure was recorded on the first day of menstruation before and after administration of diflunisal 1000 mg. Uterine activity was significantly decreased in all patients but abolished in none. Seven women experienced almost complete relief of pain. To four of the patients, including the one who did not become pain-free after diflunisal, nifedipine 30 mg was also given. Uterine activity was abolished in all, but the patient not responding to diflunisal had persistent pains. It is suggested that diflunisal may be used for treatment of pain in primary dysmenorrhoea. Addition of nifedipine can produce a further decrease in uterine activity, but whether combined therapy may offer therapeutic advantages remains to be established.

Adolescent↗
PubMed1982

Effects of intracervical PGE2-gel on myometrial activity and cervical state in first trimester pregnancy.

In 7 primigravidae admitted for first trimester abortion by dilatation and evacuation, 0.5 mg PGE2 in viscous gel (5 patients) or placebo gel (2 patients) was applied intracervically 6 hours prior to the operation. Throughout the treatment period intrauterine pressure was recorded. Application of placebo gel induced no cervical ripening or myometrial activation. In all patients receiving active gel, a marked improvement of the cervical state was induced by the treatment. In three cases, this priming occurred in parallel to minimal changes in myometrial activity, without regular uterine contractions. In two patients, marked uterine activation was registered due to partly extraamniotic application. It is suggested, that the PGE2-gel has a direct effect on the cervical tissues. Further, the risk of partially applying the gel in the extraamniotic space, thus stimulating the myometrium, depends on the gel volume relative to the dimensions of the cervical canal and the application technique.

Abortion, Therapeutic↗
PubMed1982

Influence of ketamine on non-pregnant uterus in vivo.

This investigation was performed to evaluate the effect of ketamine anesthesia on non-pregnant uterine activity. Seven healthy non-pregnant women took part in the study. Anesthesia was induced with an i.v. bolus injection of ketamine 2 mg/kg and maintained with a continuous i.v. ketamine infusion, mean dosage 39 micrograms/kg/min. Before induction of anesthesia, each patient was placed in the lithotomy position, and a catheter fitted with two microtransducers for monitoring of intra-uterine pressures was fed through the cervix into the uterine cavity. For determination of plasma concentrations of ketamine and norketamine, venous blood samples were collected. The assay was based on a gas-liquid chromatographic technique. It was found that ketamine induced an increased uterine activity, both in basal tone and intensity of contractions. Only minor effects on the frequency were observed. This stimulatory effect was simultaneous with a hemodynamic stimulation with increases in heart rate and arterial blood pressure, and with the peak plasma concentration of ketamine.

Adult↗
PubMed1982

Effects of radical hysterectomy with lymph nodes dissection on the lower urinary tract.

In 18 patients with carcinoma of the urine cervix stage I-II lower urinary tract function was evaluated by urethral pressure profile measurements and flow measurements before and after radical hysterectomy. A specially designed surgical procedure was used which avoided transection of the nerve supply to the lower urinary tract. The most conspicuous finding was a significant decrease detrusor activity 14 days after the operation. Urethral function was almost unaffected. One year postoperatively all patients had an almost normal function of the lower urinary tract with no residuals. It is concluded that the decreased detrusor function observed 14 days after the operation was due to a direct trauma of the bladder and the bladderwall bringing about a myogenic injury which temporarily paralyzed the bladder. If special attention is paid during surgery to save the nerve supply to the bladder and the urethra, longlasting postoperative dysfunction of the lower urinary tract can be avoided after radical hysterectomy for carcinoma of the uterine cervix without compromising radicality.

Adult↗
PubMed1982

Intracervical application of prostaglandin gel for induction of term labor.

A new gel for local application of prostaglandins has been elaborated. The new gel, based on a lyophilized prostaglandin E2 (PGE2) starch powder, seems to have solved most of the pharmaceutical and clinical problems associated with local administration of prostaglandins. In a randomized double-blind study, 50 nulliparous patients with an unfavorable cervical state at term were given 2 ml gel containing 0.5 mg PGE2 (PGE2 gel) or gel without PGE2 (placebo gel). The gel was deposited into the cervical canal. Among patients given PGE2 gel, 11 of 25 had induced labor, delivering without further stimulation within 24 hours. In patients given placebo gel, 2 of 25 were delivered with 24 hours. This difference is statistically significant (P less than .01). Patients undelivered after treatment with PGE2 gel achieved a considerable and statistically significant improvement of cervical score, whereas in patients in whom labor was not induced successfully by placebo gel treatment no significant changes in cervical score were registered. In a subsequent open study another 70 term patients of varied parity were given 0.5 mg PGE2 gel. Thirty-eight patients (54%) had successfully induced labor. Among the remaining undelivered patients, considerable ripening of the cervix occurred. Thus, the cervical score changed from a mean of 3.2 prior to treatment to a mean of 6.5 by 24 hours after treatment. Gastrointestinal discomforts were not observed. Signs of uterine hyperstimulation were registered in 1 patient.

Adolescent↗
PubMed1981

Comparative urodynamic studies of continent and stress incontinent women in pregnancy and in the puerperium.

Twelve pregnant women were examined by urethral pressure profile measurement and simultaneous urethrocystometry early in pregnancy (weeks 12 to 16), in the thirty-eighth week, and 5 to 7 days after delivery. All patients reported symptoms of stress incontinence starting at an early 5 to 7 days after delivery. All patients reported symptoms of stress incontinence starting at an early gestational age, it was found that that the stress incontinent women, compared to 14 continent, healthy women from whom measurements were obtained earlier, had shorter urethral lengths. Furthermore, no increase in urethral length during pregnancy was registered among the stress incontinent women, whereas such an increase did occur in the continent women. In contrast to the continent women, the incontinent patients had a low urethral closure pressure at rest and this pressure did not appear to increase sufficiently to compensate for the progressive increase in bladder pressure during pregnancy. As a result the urethral closure pressure in the stress incontinent women, therefore, decreased more and more during stress situations as pregnancy progressed, resulting in an increased leakage of urine.

Adult↗
PubMed1981

A new prostaglandin E2-gel for pretreatment of the cervix in nulliparous patients having a late first trimester termination of pregnancy.

A new PGE2-gel, based on a cross-linked starch powder, has been developed. This gel seems to have solved several of the pharmaceutical and practical problems connected with local administration of prostaglandins. In a three-center study 120 nulliparous patients were given 0.5 mg PGE2 in 2.2 ml gel intracervically prior to dilatation of the cervix and evacuation of the uterus in late first trimester. Considerable cervical dilatation was obtained within 15 h. The frequency of side effects, including pain and gastro-intestinal discomfort was low. The technique can be recommended for outpatients.

Abortion, Induced↗
PubMed1981

The incidence of primary dysmenorrhea in teenagers.

By means of a questionnaire we studied the menstrual patterns of 502 adolescent girls aged 10--19 years in 1979. The incidence of occasional or consistent primary dysmenorrhea was 43%. The incidence of dysmenorrhea increased considerably with increasing age and the interval between the menarche and the onset of dysmenorrhea was less than one year in 72% of subjects investigated. The occurrence of severe dysmenorrhea resulting in absence from school varied between 8 and 18% in various age groups.

Adolescent↗
PubMed1981

Maternal and foetal drug levels after epicutaneous application of a local anaesthetic formulation containing ketocaine for possible use as pain relief in labour.

A local anaesthetic formulation (A 2358) containing ketocaine, a local anaesthetic drug, was applied epicutaneously to the low back. Two compresses soaked with A 2358 were applied for 1 hour in 26 normal labours for relieving referred pain from the low back. The maternal blood ketocaine levels remained low, compared to higher systemic levels reported in other studies. Maternal heart rate and blood pressure were stable during the application time. The mean umbilical vein/maternal vein and umbilical artery/maternal vein concentration ratios were 0.20 +/- 0.10 and 0.21 +/- 0.09. In addition, the foetal heart rate findings and the conditions of the neonates were satisfactory, thus suggesting the foetal safety of this analgesic method.

Adolescent↗
PubMed1981

Postpartum incontinence.

From a questionnaire survey dealing with urinary incontinence during pregnancy and after childbirth 62 women were randomly selected. These women underwent simultaneous urethrocystometry including urethral profile measurement 7--14 days after parturition. From the case history two groups of patients could be distinguished. One group consisted of women who experienced only occasionally urine leakage after delivery. Pressure recordings in these previous patients were normal, moreover the urethral closure pressure was positive, also at cough provocations. The urethral length and pressure were similar to that found in continent females. The other group of patients reported stress incontinence of a more serious and permanent nature; the symptoms did not disappear after delivery. In all these women negative urethral closure pressures were recorded at cough provocations and simultaneously leakage of urine from the urethra was observed. In addition the urethral length was shorter and urethral resting pressure lower than that recorded in the first group of patients. The reversible symptoms in the first group of women may be a consequence of the pressure exerted by the uterus upon the bladder at coughing combined with a hormonal relaxation of the urethral suspension. In the second group, the enduring symptoms suggest irreversible damage to the urethra and its suspension system during pregnancy.

Female↗
PubMed1981

Single application of prostaglandin E2 in a viscous gel for induction of labor at term in patients with favorable cervix.

A single dose of 0.5 mg prostaglandin E2 in viscous gel was administered intracervically to induce labor in 150 patients with a favorable cervix. All but 5 patients (97 per cent) were delivered within 12 hours. No adverse maternal or fetal effects were registered. The method, which enables induction without primary amniotomy, was easy to perform and well accepted by the patients.

Adolescent↗