Biological research in pregnancy and perinatology
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Biol Res Pregnancy Perinatol · Jan 1987
The value of maternal and fetal blood gas analysis in cesarean sections under general anesthesia.
Maternal and fetal blood gas values were studied in 90 selected mothers of comparable age, weight, duration of pregnancy and hematocrit values undergoing cesarean section under balanced general anesthesia in four differing clinical situations: elective with and without placental dysfunction, and emergency with and without fetal distress in apparently normal mothers. Pre-induction (Fi O2 0.21) and pre-delivery (Fi O2 0.60) maternal blood gas analysis, along with umbilical cord blood gas analysis were performed in all cases. ⋯ Of the remaining 54 cases (60%) with similar mean maternal gas values the neonates showed an apgar score of less than seven in the first minute. The score improved in three minutes in 35 of them (66%), and umbilical cord blood gas values showed a low pH (umbilical vein 7.22 +/- 0.02 units, umbilical arterial 7.21 +/- 0.01 units) but satisfactory pO2 (umbilical vein 39.4 +/- 1.9 torr, umbilical arterial 2.5 +/- 1.3 torr).(ABSTRACT TRUNCATED AT 250 WORDS)
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Biol Res Pregnancy Perinatol · Jan 1985
Comparative StudyIncreased retraction of fibrin clots by endothelial cells of infants of diabetic mothers.
Cultured endothelial cells (EC) from the umbilical veins of infants of non-diabetic mothers induced retraction of fibrin clots formed by addition of thrombin to cell-free plasma. Fibrin clot retraction activity increased with time, reaching a maximum within 24 hours and was inhibited at 4 degrees C or in the presence of EDTA. ⋯ However, compared to normals, these cells induced greater retraction. Since the retraction of fibrin clots is thought to promote the exposure of sub-endothelial layers and since such an exposure plays a major role in thrombogenesis, we suggest that retraction of fibrin clot by EC should be taken into account in evaluating pre-thrombotic states.
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Biol Res Pregnancy Perinatol · Jan 1984
ReviewObstetric analgesia: pharmacokinetics and its relation to neonatal behavioral and adaptive functions.
The neonatal pharmacokinetic and neurobehavioral properties of certain agents used in obstetric analgesia are reviewed (local anesthetics, opiates, inhalation agents, benzodiazepines). Fetal and neonatal pharmacokinetic alterations partly explain the neurobehavioral differences observed between different drug groups and ways of drug administration. The most effective and safest method with fewest neonatal neurobehavioral effects appears to be regional epidural analgesia performed with plain bupivacaine. ⋯ Inhalation agents and parenteral pethidine (meperidine) are still clinically useful alternative compounds in circumstances where epidural analgesia is not possible. Pharmacokinetically and according to neurobehavioral assessments, inhalation agents appear to be more attractive than pethidine. Benzodiazepines, especially after high or repeated doses, may cause the so-called floppy-infant syndrome, at least partly, due to a slow neonatal drug elimination.
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Over the last 12 years several studies have found that the frequency of certain anomalies in children born to mothers treated with antiepileptic drugs during pregnancy has almost doubled. In 1968 Meadow reported certain malformations that suggest a congenital syndrome involving craniofacial abnormalities and that add to the high level of suspicion pointing to phenytoin. Moreover, multi-drug antiepileptics including phenytoin have been reported to induce carcinogenic damage and coagulation defects. ⋯ Two main aspects must be considered: the disease and its severity which determines the necessity of high dosages of antiepileptic drugs. The administration of phenytoin to pregnant epileptic patients is clearly questionable. Thus the aim of this paper is to evaluate the risks of this drug and compare them with its expected therapeutic benefits.