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Biomedical subjects

W N Spellacy

Publications and source records attributed to W N Spellacy.

At least 199 records · Page 11Linked to original sources
PubMed1976

Relation of obstetric parameters to the concentrations of four pregnancy-associated plasma proteins at term in normal gestation.

The relations between normal obstetric parameters and the maternal levels of four pregnancy-associated plasma proteins (PAPP) were studied, with the use of plasma samples taken from 187 normal pregnant women within seven days before delivery. PAPP-A levels were correlated with placental and newborn weights. The levels of this pregnancy protein was higher in primigravid women and in groups with higher diastolic blood pressure than in other groups. Women with extremely high PAPP-A concentrations were likely to have extremely large placental weight was not necessarily associated with a high PAPP-A level. PAPP-C was not correlated with placental or newborn weight. The relationship between PAPP-C and maternal age, as well as maternal weight, was significant by one but not in the other three statistical analyses employed. The pregnancy zone protein was found to be correlated with parity. In primigravid women, this protein additionally showed an inverse correlation with the placental weight. Human chorionic somatomammotropin was significantly related to placental weight and inversely related to maternal weight. Its relationship with newborn weight was best seen in primigravid subjects. Other parameters (systolic blood pressure, one- and five-minute Apgar scores, weeks of gestation, days before delivery, newborn sex, and newborn bilirubin level) were not related to any of these pregnancy proteins.

Adolescent↗
PubMed1976

Human pregnancy-associated plasma proteins during the postpartum period.

The plasma levels of four pregnancy-associated plasma proteins (PAPP's) and pregnancy zone protein (PZP) were studied in women after delivery of a single viable infant by gel immunodiffussion methods. Data from 89 random samples and 85 serial specimens from five women revealed that both PAPP-B and HPL (PAPP-D) disappeared within a day after delivery. PAPP-A showed a rapid drop in the first 2 or 3 days post partum and became nondetectable in 4 to 6 weeks, with a half-life of 3 to 4 days. PAPP-C had a sharp decrease by the second postpartum day and was not detected 3 to 4 weeks later, with a half-life of 1 to 2 days. None of the PAPP's was detected again during the rest of the 14 postpartum weeks studied. In contrast, the PZP showed a much slower decrease or even a temporary increase during the first 2 weeks post partum; it remained readily detectable over the entire 14 weeks studied.

Blood Proteins↗
PubMed1976

Carbohydrate and lipid metabolic studies before and after one year of treatment with ethynodiol diacetate in "normal" women.

A 3-hour oral glucose tolerance test was conducted in "normal" women before and after 12 months of contraceptive treatment with daily 0.25-mg ethynodiol diacetate tablets. There was no significant change in the subjects' weight between the two tests. All but the 3-hour individual group glucose values were significantly elevated at the 1-year test, and 16.7% of the tolerance curves became "borderline abnormal". The group plasma insulin values for the 0.5-, 1-, and 2-hour samples during the 1-year test were also significantly elevated. There was a significant decrease in the group fasting triglyceride levels but no change in the fasting cholesterol levels. These data suggest that some of the 19-norprogestogens may adversely affect carbohydrate metabolism.

Adult↗
PubMed1976

Lipid and carbohydrate metabolic studies after one year of megestrol acetate treatment.

A prospective study of lipid and carbohydrate metabolic parameters was made in 22 women who had taken a daily oral dose of 0.5 mg of megestrol acetate for contraception for 1 year. Studies of the fasting blood cholesterol and triglyceride levels demonstrated no significant change. A 3-hour oral glucose tolerance test was performed before and after 1 year of treatment. After therapy, the fasting blood glucose levels were normal but the 0.5- and 2-hour levels were elevated. All but one of the plasma insulin levels were elevated at the 1-year test. Since body weights and the fasting levels of plasma growth hormone were unchanged, they were probably not involved in the carbohydrate alteration. These results point out the need for long-term studies and the necessity for investigating the metabolic effects of all progestogen contraceptives.

Adult↗
PubMed1976

Glucagon, insulin and glucose levels in maternal and imbilical cord plasma with studies of placental transfer.

Plasma immunoreactive glucagon, as well as insulin and glucose levels, was measured in 62 women and their infants following a term gestation vaginal delivery. Simultaneously obtained samples were drawn from the maternal antecubital vein (MV), umbilical vein (UV), and umbilical artery (UA). Forty-seven of these subjects were untreated (control) and 15 had received a maternal intravenous injection of 1 mg of glucagon within 40 minutes of delivery. It was shown that the umbilical cord glucagon levels were not different from the maternal levels in the control subjects (mean MU, 181.0; UU, 191.9; UA, 161.0 pg/ml). There was no correlation between the maternal and umbilical glucagon levels or the UV glucagon levels and the insulin or glucose concentrations. Neither the fetal sex, placental weight, or infant weight were correlated with the MV or UV glucagon concentration. Following the glucagon injection, the maternal plasma glucagon levels rose significantly, whereas the umbilical blood values did not change. These results suggest that glucagon does not significantly pass through the human term placenta.

Blood Glucose↗
PubMed1976

Human placental lactogen and intrauterine growth retardation.

Serum human placental lactogen levels were measured after 36 weeks' gestation in 264 serum samples from 109 women with normal pregnancies and in 137 serum samples from 70 women with pregnancies complicated by fetal intrauterine growth retardation (IGR). The fetal and placental weights were significantly lower in the IGR groups while the maternal ages were not different. There was a significantly lower hPL value at each week from 36 to 41 (except for the 39th) in the IGR group. Sixty percent of the women with IGR had hPL values less than 6 mug/ml, and 18.6% were less than 4 mug/ml. It is suggested that a low serum hPL value obtained during the last month of pregnancy should alert the physician to the possibility of intrauterine problems, including IGR.

Female↗
PubMed1975

Studies of blood glucose and plasma insulin in "normal" women using mechanical contraception for 6 months.

A prospective study of carbohydrate metabolism was done with 56 "normal" women who were 4 to 11 weeks post partum. Each had a 3 hour oral glucose tolerance test performed before and after 6 months of using an intrauterine contraceptive device (IUCD). The results showed only slight changes in blood glucose and plasma insulin levels between the two tests. There were elevations of the fasting and 0.5 hour glucose values and the 2 hour plasma insulin value at the 6 month test. These data provide a further understanding of the changing metabolic parameters associated with pregnancy and they also give the "control" baseline information for comparison with other postpartum studies on the metabolic effects of contraceptive steriods.

Adult↗
PubMed1975

Effects of fetal sex and weight and placental weight on maternal serum progesterone and chorionic gonadotropin concentrations.

A prospective study of 268 normal pregnant women at term was undertaken in which serum concentrations of progesterone (P) and chorionic gonadotropin (HCG) were determined zero to four days before spontaneous labor. Neither HCG nor P changed significantly during these four days, although they were not measured serially in most women. There was no correlation between the HCG level and either the placental or infant weight, infant sex, or maternal serum progesterone concentration. The maternal serum P level was slightly but significantly correlated with the weight of the placenta (r equal to 0.24; p smaller than 0.001) but not with the fetal weight or infant sex. Thus, although the mass of trophoblastic tissue contributed in part to P concentration, other intracellular factors such as the cyclic adenosine monophosphate system are probably more important regulating mechanisms.

Birth Weight↗
PubMed1975

The effectiveness of human placental lactogen measurements as an adjunct in decreasing perinatal deaths. Results of a retrospective and a randomized controlled prospective study.

Serum human placental lactogen (HPL) levels were measured in high-risk pregnancies. A retrospective analysis of 101 gestations with a perinatal loss showed that the 71 stillbirths had abnormally low fetal-danger zone (F-D zone) HPL levels (50.7%) before the fetus died (normal smaller than 1%). With severe hypertension, 85.7% of the cases had F-D zone HPL values prior to fetal death. Abnormal low F-D zone HPL values were found in 20% of the 30 neonatal deaths. A 3 year randomized controlled treatment series was done with 2,7333 women (1,362 treatment and 1,371 control) who had serial serum HPL measurements performed at each prenatal visit. The frequency of F-D zone HPL values was similar (8.6% treatment and 8.2% control). The results showed that although the neonatal mortality rates were similar, the HPL treatment group had a significantly lower fetal death rate (2.6 vs. 14.2%) and thus perinatal mortality rate (3.4 vs. 15.0%). This study supports the usefulness of routine prenatal HPL measurements in the management of high-risk pregnancies.

Adolescent↗
PubMed1975

Amniotic fluid components as determinants of fetal maturity.

In order to evaluate the most reliable means of determining fetal maturity, six amniotic fluid components were analyzed from 99 women who were 22 to 40 weeks pregnant. The six parameters investigated were: amylase activity the lecithin to sphingomyelin (L/S) ratio, percentage of fat cells, and the concentrations of protein, creatinine, and bilrubin. In general, single components and combinations of two or three of the tests did not significantly enhance the predictive accuracy or reduce the error from that obtained with the L/S ratio used alone.

Adipose Tissue↗
PubMed1975

Comparison of the fetogram and L/S ratio for fetal maturity.

There were 254 cases studied in which two tests of fetal maturity were performed within 72 hours of each other. The two tests were an x-ray fetogram and an amniotic fluid L/S ratio determination. All fetograms were read by one author for the presence of distal femoral epiphysis (DFE). It was assumed that DFE permits estimation of fetal bone maturation and L/S ratio permits estimation of fetal lung maturity. The DFE results gave a 40% false-positive rate in predicting a mature L/S ratio (greater than 2.0) and a 38.7% false-negative rate. Of the 21 patients who delivered within 3 days of the performance of the two tests, all neonates did well when there were no visible DFE's but a mature L/S ratio. There is a significant lack of specificity and sensitivity of the fetogram DFE's in predicting a mature L/S ratio. Since infant lung maturation is a critical factor in predicting neonatal survival, these results suggest that the x-ray DFE is unacceptable as a single maturity test for use in a perinatal center managing complicated obstetric cases.

Amniotic Fluid↗
PubMed1975

Effects of diuril and dilantin on blood glucose and insulin levels in late pregnancy.

In order to evaluate the carbohydrate metabolic effects of certain drug therapies used in treating the toxemia syndrome, 75 term pregnant women were studied with two intravenous glucose tolerance tests performed 1 week apart. During the 2-hour tests, both blood glucose and plasma insulin were measured. The women were randomly assigned to three treatment groups, and during the week between tests they received:a) no drugs (control or C group);b) Diuril, 500 mg/day (Dgroup); or c)Dilantin, 100 mg, t.i.d. (DL group). Each group was of similar age, weight, and gestational age. There were no significant changes in any of the glucose curves. Both drug-treated groups demonstrated insulin changes. In contrast to the C group, the D group showed an elevation of the plasma insulin values during the second test, and the DL group had a lowering of plasma insulin levels in the second test. Thus, both drugs had minor effects on carbohydrate metabolism during short-term use. However, a more marked metabolic effect of these drugs must be considered when using them at higher dosages or for a longer duration.

Blood Glucose↗
PubMed1975

Effects of norethindrone on carbohydrate and lipid metabolism.

A prospective study was undertaken to investigate the carbohydrate and lipid metabolic effects of the oral contraceptive norethindrone. An oral glucose tolerance test was performed before and 1 year after the daily oral administration of 0.35 mg of norethindrome to 31 women. Measurements were made of glucose, insulin, cholesterol, and triglycerides. During the year there was no significant weight change in the women, and the fasting cholesterol values were unaffected by the steroid. The fasting triglycerides decreased as normally occurs in the late postpartum period. There was no change in the blood glucose curve, but there was a statistically significant elevation produced in all of the plasma insulin values. These data suggest that this 19-nor progestogen steroid can affect the peripheral activity of insulin and thus require higher blood levels in order to obtain the same glucose homeostasis.

Blood Glucose↗