Search

Objective: For the therapy of preeclamptic patients is Urapidil besides Dihydralazine another possible option for iv-therapy with good results in first clinical studies. Effects of both drugs on the newborns were observed. -, Methods: The maternal and fetal Urapidil plasma-concentrations and cardiovascular parameters of the newborns were observed in a randomised comparative therapy-study. -, Results: We found low fetal Urapidil plasma-concentrations as well as a less influence on cardiovascular parameters compared to dihydralazine. -, Discussion: With Urapaidil we have another therapeutic option in preeclampsia where we could not show any negative side-effects on the newborns.

Background: Weak expression of ABO antigens in newborns has been known for many years. In the near future reduced availability of polyclonal sera for ABO testing is to be expected. Therefore, it was the aim of our study to compare the suitability of monoclonal reagents for ABO testing of newborns to that of polyclonal sera., Material and Methods: One monoclonal and 1 polyclonal reagent of each of the specificities anti-A, and anti-B and anti-AB from 7 manufacturers were tested by titration with blood from 5 newborns of blood group A, 5 of blood group B, and 3 of blood group AB., Results: All monoclonal anti-A reagents showed better results than the polyclonal sera (for newborns of blood group A on the average of the 7 pairs of reagents 1.3 geometrical titration steps). Most of the monoclonal anti-B reagents showed higher titers than the polyclonal sera (on the average for newborns of blood group B 0.7 titration steps). Also most monoclonal anti-AB reagents were stronger than the polyclonal sera in testing newborns of blood group B the monoclonal anti-AB-reagents were slightly weaker than the polyclonal sera (on the average 0.4 titration steps)., Conclusion: Use of monoclonal reagents for ABO testing of newborns shows some advantages in comparison to the use of polyclonal sera.

Question: There are no available enzyme determinations for the neonatal period taking in account the considerable changes during the first hours of life. Moreover, in former studies the number of probands has been small and no standardized and optimized methods have been used for the determinations. It was the aim of the presented study to evaluate reference ranges for these enzymes in healthy newborns for the first week of life., Methods: We realized a controlled-prospective study about the serum activities of CPK, GGT, GOT, GLDH, LAP, LDH, and HBDH in healthy newborns (n = 87). The enzyme determinations were done for the first time in a serial manner at five fixed times: post partum (cord), 12, 24, 72, and 144 hours post partum with optimized test-kits., Results: The evaluated serum enzyme activities are stated with median, 25th, and 75th percentile by rank. We propose these results as reference ranges for these enzyme activities during the first 144 hours of life., Conclusion: For the first time reference ranges for serum enzyme activities concerning the striking activity changes during the first hours of life are evaluated for healthy newborn infants. These results enable comparative investigations in the case of newborn diseases.

One hundred eight newborns (gestational age 36 + 1.8 weeks and birth weight 2860 +/- 240 g) had muscle type Creatine-Kinase activity (CK-MM) assayed immediately after birth (CK-I) and serially at 6-10 h (CK-II), 20-30 h (CK-III) and 40-60 h (CK-IV) of age. Using statistical Regression analysis, CK-MM levels were correlated to four perinatal parameters: gestational age, birth weight, neonatal acidosis (pH less than 7.15), mode of delivery (vaginal/cesarean section). It was observed that CK-MM activity was dependent on gestational age and correlated to the mode of delivery at time III (600 U/l) and IV (400 U/l) comparing the mean serum values of 156 + 44 U/l observed in atraumatic delivery (p less than or equal to 0.05). Our results demonstrate markedly higher levels of CK-MM following vaginal delivery especially if complicated by forceps, vacuum and breech presentation, suggesting that birth trauma may be responsible for this phenomenon.

Postpartal increase in the plasma potassium concentration of asphyxiated newborn infants is a very rare complication with possibly deleterious outcome. In a group of 98 asphyxiated and 87 healthy infants we have not seen either a case of severe hyperkalemia or rhythm disturbances. We found lower reference-ranges for plasma potassium concentration in the group of healthy infants than previously published, which we would like to introduce. The pathogenesis of hyperkalemia in hypoxia is not yet fully understood. Further experimental investigations will be necessary.

The venous cord blood levels of free thyroxine (fT4), free triiodothyronine (fT3), reverse triiodothyronine (rT3), thyrotropin (TSH), thyroglobulin (TG) and thyroxine binding globulin (TBG) were studied in 56 mature and healthy newborns. Newborns with a gestational age less than 37 or more than 42 weeks, a delivery by forceps or cesarian section, a birth-weight less than 2500 g, a pH-value of the cord-artery blood less than 7.15, an Apgar-value after 1 minute less than 7 were excluded from the study. All mothers were non-smokers. The values of fT4 were 18.66 +/- 4.18 pmol/L, of fT3 were 1.59 +/- 0.75 pmol/L, of fT3 were 2152 +/- 666 pg/ml, of TSH were 7.83 +/- 4.49 mU/ml, of TG were 44.61 +/- 23.84 ng/ml, and of TBG were 25.61 +/- 5.42 micrograms/ml. A weak negative correlation was found between the TG-value and the pH-value of the cord-artery blood (r = -0.27, y = 191.55 - 22.82.x, p less than 0.05), and between the fT4 values and the gestational age (r = -0.34, y = 67.53-1.22.x, p = 0.01). The rT3-values were positively correlated to the gestational age (r = 0.29, y = -4571 + 167.x, p less than 0.03).

We examined the white blood count in 101 premature infants and full-term neonates on their first day of life (before or within the 12th hour), on 2nd, 3rd, 4th, 5th, 10th, 15th and 20th day of life. Infection was suspected in the course in 31 infants (without demonstration of pathogenic organisms). In 73 infants without infections we were therefore able to establish normal values. We could establish reference limits corresponding to the standard deviation for all kinds of white blood cells, except the whole leucocyte count. Because of considerable individual differences of the whole white blood cell count in newborns without infections we fixed for this reference limits from 5 to 20 Gpt/l. The means of leucocyte and neutrophil counts reached their maximum in the 12th hour after birth, decreased until the 5th day of life and leveled off then. The segmented neutrophils and the lymphocyte counts crossed over after the 5th day of life resulting in a relative lymphocytosis. The physiologic left shift decreased in the first days of life. These described changes after birth were significant.

The cortisol-day-rhythmic was studied in 93 spontaneously delivered newborns with a enzyme immunoassay. The results indicate that the cortisol-rhythmic is present both in umbilical cord and maternal venous blood.

Cholinesterase activity and concentrations of total protein, albumin and globulins were measured in the serum of 94 carefully selected prematures and newborns during the first week of life. Cholinesterase activity was significantly lower in prematures than in newborns. There was a weak correlation between serum concentration of albumin and cholinesterase activity. Total protein, albumin and gamma-globulins were significantly lower in premature babies. With the exception of alpha-1-globulin, all proteins correlated positively with gestational age. There was no difference in total serum protein concentration between small for gestational age infants and appropriate for gestational age infants. Postnatally, serum protein and cholinesterase activity rose by 27 44% within 7 to 10 weeks in prematures of 30-33 weeks of gestational age. A single infusion of 0.5 g/kg b.w. albumin transiently increased the protein concentration of prematures 1.5 fold; 7 to 10 weeks later, protein concentrations of treated and untreated prematures were no longer different. In conclusion, cholinesterase activity and protein concentrations correlated with gestational age. In prematures with disturbed microcirculation, albumin infusions resulted in a transient increase of protein concentration.

Sulfate conjugation represents a major pathway for the inactivation of free catecholamines. We investigated the ability of newborns to protect the body against an overflow of free catecholamines by sulfoconjugation. No difference of free catecholamines in the umbilical artery was found in preterm and term newborns. Furthermore, preterm and term newborns were able to form sulfoconjugated catecholamines. In term newborns, but not in preterm newborns, there was a significant relationship between free catecholamines and their respective sulfoconjugated forms (p less than 0.001). In comparison to term infants sulfoconjugated dopamine and norepinephrine were significantly decreased in preterm newborns, although the placental extraction rates of these catecholamines were markedly lower in preterm infants. This favors the conclusion, that synthesis rather than increased degradation may be responsible for the low levels of sulfoconjugated catecholamines in preterm infants. Thus, preterm newborns might be less able to inactivate free catecholamines by sulfoconjugation. The clinical importance of these results concerning treatment of preterm newborns with dopamine and noradrenaline has yet to be established.

According to the criteria formulated by the WHO a hemoglobin concentration of 11 g/% represents an anaemia requiring treatment. 28 placentas of patients with hemoglobin concentrations of 7.2 to 10.9 g/% were examined morphometrically to detect possible disturbances of placental development. The patients had all delivered between the 37th and 41st week. Weight, hematocrit and HbA content of the newborn were correlated with the maternal hemoglobin content. There was no influence of maternal hemoglobin concentration on weight and size of the placenta, degree of vascularization and epithelial plates of the terminal villi. In patients with severe anaemia villous areas were smaller and villous vascular areas appeared larger than usual. The ratio of weight of the newborn to weight of the placenta was more commonly decreased in patients with anaemia. In some cases of severe anaemia fetal HbA values were elevated. All newborns with a hematocrit of 50 or more were delivered of mothers with haemoglobin concentrations of 9.5 g/% or less. The weight of all newborns in this study were above the 10th percentile. 7 of 9 newborns with a weight of 3,200 g or less were delivered of patients with a hemoglobin concentration of 9.5 g/% or less. These results indicate that placenta and fetal organ systems are able to compensate for the maternal anaemia without any major complications.

In this paper we report about the actual supply of iodine of women in childbred determining iodine levels in serum and milk of the mothers. No significant differences were found between women without, with treated or with untreated goitre. In early childbred and 4 weeks after birth the iodine in milk amounts to about the half of the maternal serum level and does not further increase with continuation of nursing.

The article describes a method for the quantification of plasma fibronectin (FN) by means of electroimmunodiffusion after Laurell. By this means the fibronectin concentrations of healthy, mature newborns as well as of their mothers were determined. The average FN-level of the newborns lies at 33% related to the value for adults and at 48%, respectively, related to the maternal FN-content. There is no difference between male and female newborns. The FN-concentrations of the adults stated by us with 330 and 314 mg/l, respectively, for males and females correspond to the data in literature. Furthermore, the FN-content in plasma preparations was determined, with an average value of 2,356 mg/l this was highest in the factor-VIII-concentrate. The expediency and the prerequisites for a possible fibronectin substitution are discussed.