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Hemodynamic profile of severe pregnancy-induced hypertension
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Citations from the Literature
cent among those treated wtih tetracycline. Failure of prophylaxis was associated with postpartum maternal endometritis (P = 0.05). Among newborns exposed to maternal infection with Chlamydia trachomatis, chlamydial conjunctivitis developed in 10.1 percent given silver nitrate and in 7.2 percent given tetracycline (95 percent confidence interval for the difference in rates, - 4.7 to 10.5 percent), yielding reductions in the incidence of chlamydial ophthalmia of 68 and 77 percent, respectively, as compared with the historical controls. We conclude that tetracycline is as effective as silver nitrate in preventing gonococcal ophthalmia neonatorum.
Jlarlydetection of visual defects in infancy Hall DMB; Hall SM Department of Child Health, St George’s Hospital Medical School, London S WI7 ORE, UK BR.‘h4ED. J.; 2%/6625 (823--824)/1988/ To determine the part played by screening in detecting visual defects questionnaires were sent to 240 families with blind or partially sighted children identified from the Family Fund’s database. Questions were asked on social and family background, the visual disorder and its severity, and other disability, and how and when the disabilities were discovered and subsequently managed. Data from 189 families were analysed, constituting all those with children with major visual defects from the 219 families who replied. The visual defect was first discovered in 111 children by parents, friends, and neighbours, and in 36 by a doctor at the neonatal examination. In only three children who did not have a family history of visual impairment was the defect discovered during a formal screening examination at a child health clinic. Dissatisfaction about medical services was expressed by about a third of the parents, particularly a lack of provision of information and consideration of their worries and a failure to refer the child promptly to educational and treatment services. Visual defects in children under 5 are generally detected by family and friends, not by screening, but detection by the medical profession could be improved by increasing awareness and observation and quick referral.
The neurological eondition of the newborn infant with maternal hypertension, examined at term Martikainen MA; Airaksinen EM; Heinonen KM; Castren ML Department of Paediatrics, Kuopio University Central Hospital, SF-70210 Kuopio, Finland EARLY HUM. DEV.; 1612-3 (107-118)/1988/ The aim of this prospective study was to examine the effect of maternal hypertension on the neurological condition of the newborn infant. Of the babies born between April 1984 and March 1986, 54 preterm, 151 full-term AGA and 24 full-term SGA neonates with maternal hypertension were compared, respectively, with 128 preterm, 144 full-term AGA and 73 fullterm SGA neonates without maternal hypertension. Preterms were examined at term + or - 1 week and full-term neonates at 3-5 days postpartum by the Dubowitz method (Clinics in Developmental Medicine, Vol. 79, Heinemann, London, Int JGynecol Obstet 28
1981). The respective fullterm groups differed mostly in regard to movement and tone, with preterm groups differing in the predominant state and in auditory orientation. The differences were clearest between preterm AGA groups. The neurological condition of the infants was affected more by pre-eclampsia than by hypertension as such. Statistical analysis was carried out with the t-test, &P-test and stepwise discriminant analysis.
Hemodynamic profile of severe pregnancy-indoced bypertension Cotton DB; Lee W; Huhta JC; Dorman HF Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX 77030. USA Ah4. J. OBSTET. GYNECOL.; 15813 I (523-529)/1988/ Cases of severe pregnancy-induced hypertension or eclampsia were studied in forty-five women by catheterization of the right side of the heart to define the presenting hemodynamic profile associated with this disorder. These women could not be easily categorized into one specific hemodynamic pattern. Most patients had high-normal to elevated systemic vascular resistance indices (mean 2726 f 120 dynes - set - cm-’ - m’). The mean cardiac index was 4.14 + 0.13 L * min-’ - m*. The severity of hypertension was largely attributable to a disproportionate rise in the systolic component (mean 193 f 3 mm Hg) compared with diastolic blood pressure (mean 110 + 3 mm Hg). Women with eclampsia had significantly lower arterial blood pressure and systemic vascular resistance indices when compared with those of the rest of the study group. Analysis of Starling curves indicated that all patients had normal or hyperdynamic left ventricular function. A modest correlation was observed between central venous pressure and pulmonary capillary wedge pressure (r = 0.59). This disparity most likely results from the maintenance of normal to high cardiac output in the presence of an increased left ventricular aferload. The majority of patients with severe pregnancy-induced hypertension do have normal to high cardiac indices and pulmonary capillary wedge pressures accompanied by normal or hyperdynamic left ventricular function. This is true despite the presence of severe hypertension.
Outcome of pregnancy in underweight women after spontaneous and induced ovulation Van der Spuy ZM; Steer PJ; McCusker M; et al Cobbold Laboratories and Department of Obstetrics and Gynaecologv, University College and Middlesex School of Medicine, London WIN BAA, UK BR. MED. J.; 2%/6627 (%2-%5)/1988/ Low material weight before pregnancy and poor weight gain during pregnancy are known to result in an increased prevalence of low birthweight infants. Low body weight is also an important cause of amenorrhoea. The hypothesis that amenorrhoeic underweight women who become pregnant after induction of ovulation are more at risk of delivering low birthweight infants than underweight women who ovulate spontaneously was investigated. Forty one pregnant women in whom
Citations from the Literature
cent among those treated wtih tetracycline. Failure of prophylaxis was associated with postpartum maternal endometritis (P = 0.05). Among newborns exposed to maternal infection with Chlamydia trachomatis, chlamydial conjunctivitis developed in 10.1 percent given silver nitrate and in 7.2 percent given tetracycline (95 percent confidence interval for the difference in rates, - 4.7 to 10.5 percent), yielding reductions in the incidence of chlamydial ophthalmia of 68 and 77 percent, respectively, as compared with the historical controls. We conclude that tetracycline is as effective as silver nitrate in preventing gonococcal ophthalmia neonatorum.
Jlarlydetection of visual defects in infancy Hall DMB; Hall SM Department of Child Health, St George’s Hospital Medical School, London S WI7 ORE, UK BR.‘h4ED. J.; 2%/6625 (823--824)/1988/ To determine the part played by screening in detecting visual defects questionnaires were sent to 240 families with blind or partially sighted children identified from the Family Fund’s database. Questions were asked on social and family background, the visual disorder and its severity, and other disability, and how and when the disabilities were discovered and subsequently managed. Data from 189 families were analysed, constituting all those with children with major visual defects from the 219 families who replied. The visual defect was first discovered in 111 children by parents, friends, and neighbours, and in 36 by a doctor at the neonatal examination. In only three children who did not have a family history of visual impairment was the defect discovered during a formal screening examination at a child health clinic. Dissatisfaction about medical services was expressed by about a third of the parents, particularly a lack of provision of information and consideration of their worries and a failure to refer the child promptly to educational and treatment services. Visual defects in children under 5 are generally detected by family and friends, not by screening, but detection by the medical profession could be improved by increasing awareness and observation and quick referral.
The neurological eondition of the newborn infant with maternal hypertension, examined at term Martikainen MA; Airaksinen EM; Heinonen KM; Castren ML Department of Paediatrics, Kuopio University Central Hospital, SF-70210 Kuopio, Finland EARLY HUM. DEV.; 1612-3 (107-118)/1988/ The aim of this prospective study was to examine the effect of maternal hypertension on the neurological condition of the newborn infant. Of the babies born between April 1984 and March 1986, 54 preterm, 151 full-term AGA and 24 full-term SGA neonates with maternal hypertension were compared, respectively, with 128 preterm, 144 full-term AGA and 73 fullterm SGA neonates without maternal hypertension. Preterms were examined at term + or - 1 week and full-term neonates at 3-5 days postpartum by the Dubowitz method (Clinics in Developmental Medicine, Vol. 79, Heinemann, London, Int JGynecol Obstet 28
1981). The respective fullterm groups differed mostly in regard to movement and tone, with preterm groups differing in the predominant state and in auditory orientation. The differences were clearest between preterm AGA groups. The neurological condition of the infants was affected more by pre-eclampsia than by hypertension as such. Statistical analysis was carried out with the t-test, &P-test and stepwise discriminant analysis.
Hemodynamic profile of severe pregnancy-indoced bypertension Cotton DB; Lee W; Huhta JC; Dorman HF Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX 77030. USA Ah4. J. OBSTET. GYNECOL.; 15813 I (523-529)/1988/ Cases of severe pregnancy-induced hypertension or eclampsia were studied in forty-five women by catheterization of the right side of the heart to define the presenting hemodynamic profile associated with this disorder. These women could not be easily categorized into one specific hemodynamic pattern. Most patients had high-normal to elevated systemic vascular resistance indices (mean 2726 f 120 dynes - set - cm-’ - m’). The mean cardiac index was 4.14 + 0.13 L * min-’ - m*. The severity of hypertension was largely attributable to a disproportionate rise in the systolic component (mean 193 f 3 mm Hg) compared with diastolic blood pressure (mean 110 + 3 mm Hg). Women with eclampsia had significantly lower arterial blood pressure and systemic vascular resistance indices when compared with those of the rest of the study group. Analysis of Starling curves indicated that all patients had normal or hyperdynamic left ventricular function. A modest correlation was observed between central venous pressure and pulmonary capillary wedge pressure (r = 0.59). This disparity most likely results from the maintenance of normal to high cardiac output in the presence of an increased left ventricular aferload. The majority of patients with severe pregnancy-induced hypertension do have normal to high cardiac indices and pulmonary capillary wedge pressures accompanied by normal or hyperdynamic left ventricular function. This is true despite the presence of severe hypertension.
Outcome of pregnancy in underweight women after spontaneous and induced ovulation Van der Spuy ZM; Steer PJ; McCusker M; et al Cobbold Laboratories and Department of Obstetrics and Gynaecologv, University College and Middlesex School of Medicine, London WIN BAA, UK BR. MED. J.; 2%/6627 (%2-%5)/1988/ Low material weight before pregnancy and poor weight gain during pregnancy are known to result in an increased prevalence of low birthweight infants. Low body weight is also an important cause of amenorrhoea. The hypothesis that amenorrhoeic underweight women who become pregnant after induction of ovulation are more at risk of delivering low birthweight infants than underweight women who ovulate spontaneously was investigated. Forty one pregnant women in whom