Carsten Lenstrup

Intraoperative surgical complication during cesarean section: an observational study of the incidence and risk factors

Background. The study was intended to estimate the incidence of intraoperative surgical complications with the impact of the educational level of the surgeon and a history of previous cesarean section on intraoperative complications at cesarean childbirth.

Warm Tub Bath During Labor Effects on plasma catecholamine and P-endorphin-like immunoreactivity concentrations in the infants at birth

In this study 13 women bathed in a warm tub bath during the first stage labor after a strictly normal pregnancy. The control group consisted of 9 women who did not want warm tub bath. Apgar scores at 1 and 5 minutes were recorded and plasma adrenalin, noradrenalin were measured in umbilical arterial blood at birth, together with pH, pCO2, and base excess and beta‐endorphin‐like immunoreactivity in umbilical venous blood. No differences were found between the groups. No beneficial effect was found on infant condition of a warm tub bath during labor.

PREDICTIVE VALUE OF ANTEPARTUM FETAL HEART RATE NON-STRESS TEST IN HIGH-RISK PREGNANCY

Abstract. For antepartum evaluation of high‐risk pregnancies the non‐stress test (NST) was performed in order to predict favorable or adverse fetal outcome. Between January 1, 1980 and December 31, 1980, 4078 NSTs were performed on 454 women with high‐risk pregnancies. The NSTs were evaluated for pathology by a CTG pathology score. The NST interpretation were normal 95%, slight pathological 4% and severe pathological 1%. The group of women in whom all NST results were normal gave birth to healthy babies. In tact with an increasing number of pathologica‐NSTs and with worsening CTG pathology score, a significant increase was found for cesarean section rate, acute operative delivery, low Apgar score, low umbilical cord artery pH and infants born small for gestational age or clinically dysmature. The frequence of perinatal morbidity was almost the same, irrespective of whether the NSTs showed accelarations or not on one or more occasions. To identify fetuses suffering from retarded intra‐uterine growth the predictive value of normal NST was 97.3% and the predictive value of pathological NST was 34.8%. To identify perinatal morbidity the predictive values were 87.4% and 55.1% respectively. The NST appears to be a realiable test for antepartum assessment of fetal well‐being in high‐risk pregnancies.

Predictive Value of Antepartum Non-Stress Test in Multiple Pregnancies

Abstract. Twentyseven sets of twins in the last trimester of pregnancy underwent 122 antepartum nonstress tests (NST). The NSTs were evaluated by a cardiotocography score. The last test was performed less than one week antepartum. Fifty fetuses had a normal NST, 13 were smallforgestational age, but only one of these required intensive neonatal care. Four fetuses had one or more pathological NSTs; all 4 were SGA, and these required intensive neonatal care. The pathological variables in the cardiotocograms were reduced variability, absence of spontaneous accelerations, and (late) decelerations. There was no perinatal mortality. Pathological NST was associated with a statistically significantly increased rate of neonatal morbidity, reduced intrauterine growth and a low one minute Apgar score. For the evaluation of retarded intrauterine growth, the predictive value of a normal NST was 95.7%, and the predictive value of a pathological NST was 75.0%‐ The assessment of fetal wellbeing in multiple pregnancy by nonstressed antepartum cardiotocography is of clinical value and seems to be a better predictor of perinatal morbidity than are serial estriol analyses and serial biparietal diameter measurements.

Predictive Value of a Single Unstressed Antepartum Cardiotocogram in Apparently Uncomplicated Pregnancy: Introduction of a new cardiotocography score

Abstract. Antepartum CTGs were recorded in 88 pregnant women in the 36th week of pregnancy, approximately. The CTGs were evaluated according to three different CTG scoring systems. A new CTG score is now presented. The three systems are compared according to their ability to predict retarded intra‐uterine growth. Nine infants were born small‐for‐date; 8 of these had s suspect CTG. In 7 of these cases reduced variability was present for more than 25% of the registration time. When variability is reduced for more than 25% of the registration time there is a statistically significantly higher rate of infants born small‐for‐date (p<0.001).

On the evaluation of routine ultrasound screening in the third trimester for detection of light for gestational age (LGA) infants

Based upon 2 194 consecutive pregnancies with known gestational age, formulas for weight deviation predicted in the 32nd and 37th gestational week were estimated by multiple linear regression on the measurements of the abdominal d iameter (AD) and the biparietal diameter (BPD) of the first 64% of the pregnancies. The usefulness of the screening was evaluated on the remaining 36%. An attempt to diagnose light for gestational age (LGA) infants resulted in either a low sensitivity or a low predictive value of a positive test.

Computer Description of the Cardiotocogram

Abstract. Principles of calculations used for computer description of the cardiotocogram (CTG) were evaluated. Fetal heart rate (FHR) and intrauterine pressure (IUP) were recorded simultaneously on magnetic tape. Subsequent quantitative analysis was performed on a general purpose digital minicomputer. The program automatically detects decelerations, accelerations and uterine contractions. The following variables are determined automatically: baseline level and variability; duration, amplitude, area, latency time and lagtime of the alterations; uterine resting tone; duration, amplitude and area of uterine contractions. Trends of all variables can be presented graphically. The program can function off‐line, as well as on‐line, using about seven minutes of computational time to describe one hour of CTG.

THE DOUBTFUL VALUE OF TRANSITORY CONTRACEPTION AFTER LAPAROSCOPIC ELECTROCOAGULATION OF THE FALLOPIAN TUBES

Abstract. Twelve pregnancies were recorded after 472 laparoscopic electrocoagulations of the fallopian tubes. Eleven of these cases were seen more than 12 weeks after the sterilization and 1 was seen 11 weeks after.