11 results on '"Kublickas, Marius"'
Search Results
2. Preeclampsia and risk of end stage kidney disease: A Swedish nationwide cohort study
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Khashan, Ali S., Evans, Marie, Kublickas, Marius, McCarthy, Fergus P., Kenny, Louise C., Stenvinkel, Peter, Fitzgerald, Tony, and Kublickiene, Karolina
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Preeclampsia -- Complications and side effects ,Chronic kidney failure -- Risk factors -- Demographic aspects ,Hypertension ,Women's health ,Kidney diseases ,Cardiovascular diseases ,Pregnancy ,Medical research ,Pregnant women ,Regression analysis ,Women ,Comorbidity ,Biological sciences - Abstract
Background Preeclampsia has been suggested to increase the risk of end-stage kidney disease (ESKD); however, most studies were unable to adjust for potential confounders including pre-existing comorbidities such as renal disease and cardiovascular disease (CVD). We aimed to examine the association between preeclampsia and the risk of ESKD in healthy women, while taking into account pre-existing comorbidity and potential confounders. Methods and findings Using data from the Swedish Medical Birth Register (MBR), women who had singleton live births in Sweden between 1982 and 2012, including those who had preeclampsia, were identified. Women with a diagnosis of chronic kidney disease (CKD), CVD, hypertension, or diabetes prior to the first pregnancy were excluded. The outcome was a diagnosis of ESKD, identified from the Swedish Renal Registry (SRR) from January 1, 1991, onwards along with the specified cause of renal disease. We conducted Cox proportional hazards regression analysis to examine the association between preeclampsia and ESKD adjusting for several potential confounders: maternal age, body mass index (BMI), education, native country, and smoking. This analysis accounts for differential follow-up among women because women had different lengths of follow-up time. We performed subgroup analyses according to preterm preeclampsia, small for gestational age (SGA), and women who had 2 pregnancies with preeclampsia in both. The cohort consisted of 1,366,441 healthy women who had 2,665,320 singleton live births in Sweden between 1982 and 2012. At the first pregnancy, women's mean (SD) age and BMI were 27.8 (5.13) and 23.4 (4.03), respectively, 15.2% were smokers, and 80.7% were native Swedish. The overall median (interquartile range [IQR]) follow-up was 7.4 years (3.2-17.4) and 16.4 years (10.3-22.0) among women with ESKD diagnosis. During the study period, 67,273 (4.9%) women having 74,648 (2.8% of all pregnancies) singleton live births had preeclampsia, and 410 women developed ESKD with an incidence rate of 1.85 per 100,000 person-years. There was an association between preeclampsia and ESKD in the unadjusted analysis (hazard ratio [HR] = 4.99, 95% confidence interval [CI] 3.93-6.33; p < 0.001), which remained in the extensively adjusted (HR = 4.96, 95% CI 3.89-6.32, p < 0.001) models. Women who had preterm preeclampsia (adjusted HR = 9.19; 95% CI 5.16-15.61, p < 0.001) and women who had preeclampsia in 2 pregnancies (adjusted HR = 7.13, 95% CI 3.12-16.31, p < 0.001) had the highest risk of ESKD compared with women with no preeclampsia. Considering this was an observational cohort study, and although we accounted for several potential confounders, residual confounding cannot be ruled out. Conclusions The present findings suggest that women with preeclampsia and no major comorbidities before their first pregnancy are at a 5-fold increased risk of ESKD compared with parous women with no preeclampsia; however, the absolute risk of ESKD among women with preeclampsia remains small. Preeclampsia should be considered as an important risk factor for subsequent ESKD. Whether screening and/or preventive strategies will reduce the risk of ESKD in women with adverse pregnancy outcomes is worthy of further investigation., Author(s): Ali S. Khashan 1,2,*, Marie Evans 3, Marius Kublickas 4, Fergus P. McCarthy 2,5, Louise C. Kenny 6, Peter Stenvinkel 3, Tony Fitzgerald 1,7, Karolina Kublickiene 3,* Introduction The [...]
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- 2019
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3. Maternal near miss and maternal death in the World Health Organization's 2005 global survey on maternal and perinatal health/Deces maternels et deces maternels evites de justesse dans le cadre de l'enquete mondiale sur la sante maternelle et perinatale realisee en 2005 par l'Organisation mondiale de la Sante/Cuasieventos maternos y mortalidad materna en la encuesta mundial 2005 de la Organizacion Mundial
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Souza, Joao Paulo, Cecatti, Jose Guilherme, Faundes, Anibal, Morais, Sirlei Siani, Villar, Jose, Carroll, Guillermo, Gulmezoglu, Metin, Wojdyla, Daniel, Zavaleta, Nelly, Donner, Allan, Velazco, Alejandro, Bataglia, Vicente, Valladares, Eliette, Kublickas, Marius, and Acosta, Arnaldo
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Infants -- Patient outcomes ,Mothers -- Patient outcomes ,Medical records -- Surveys -- Health aspects -- Research ,Public health -- Surveys -- Health aspects -- Research ,Health ,World Health Organization -- Surveys - Abstract
Objective To develop an indicator of maternal near miss as a proxy for maternal death and to study its association with maternal factors and perinatal outcomes. Methods In a multicenter cross-sectional study, we collected maternal and perinatal data from the hospital records of a sample of women admitted for delivery over a period of two to three months in 120 hospitals located in eight Latin American countries. We followed a stratified multistage cluster random design. We assessed the intra-hospital occurrence of severe maternal morbidity and the latter's association with maternal characteristics and perinatal outcomes. Findings Of the 97 095 women studied, 2964 (34 per 1000) were at higher risk of dying in association with one or more of the following: being admitted to the intensive care unit (ICU), undergoing a hysterectomy, receiving a blood transfusion, suffering a cardiac or renal complication, or having eclampsia. Being older than 35 years, not having a partner, being a primipara or para > 3, and having had a Caesarean section in the previous pregnancy were factors independently associated with the occurrence of severe maternal morbidity. They were also positively associated with an increased occurrence of low and very low birth weight, stillbirth, early neonatal death, admission to the neonatal ICU, a prolonged maternal postpartum hospital stay and Caesarean section. Conclusion Women who survive the serious conditions described could be pragmatically considered cases of maternal near miss. Interventions to reduce maternal and perinatal mortality should target women in these high-risk categories. Objectif Mettre au point un indicateur pour les deces maternels evites de justesse en tant qu'indicateur indirect des deces maternels et etudier son association avec des facteurs maternels et des evenements perinatals. Methodes Dans le cadre d'une etude transversale multicentrique, nous avons recueilli des donnees maternelles et perinatales a partir des dossiers hospitaliers d'un echantillon de femmes, constitue des parturientes admises pour accoucher dans 120 hopitaux appartenant a huit villes d'Amerique latine sur une periode de deux a trois mois. Nous avons applique une methode de sondage aleatoire stratifie a plusieurs degres et par grappe. Nous avons evalue l'occurrence en milieu hospitalier de ia morbidite maternelie severe et les associations de cette derniere avec les caracteristiques maternelles et les evenements perinatals. Resultats Sur les 97 095 femmes etudiees, 2964 (34 pour 1000) presentaient un risque important de deces en association avec une ou plusieurs des conditions suivantes : avoir ete admise dans une unite de soins intensifs, avoir subi une hysterectomie, avoir recu une transfusion sanguine, avoir souffert d'une complication cardiaque ou renale ou encore d'une eclampsie. Par ailleurs, avoir pius de 35 ans, ne pas avoir de partenaire, etre primipare ou quadripare et plus et avoir subi une cesarienne lors de la precedente grossesse etaient des facteurs independamment associes a l'occurrence de la morbidite maternelle severe. Ces facteurs etaient aussi positivement associes a une frequence accrue des petits poids et des tres petits poids de naissance, de la mortinatalite, des deces neonatals precoces, des admissions en soins intensifs neonatals, des sejours hospitaliers prolonges des meres pendant le postpartum et des cesariennes. Conclusion Les femmes qui survivent aux situations graves precedemment decrites peuvent etre considerees pratiquement comme des cas de deces maternel evite de justesse. Les interventions pour reduire la mortalite maternelle et perinatale doivent viser les femmes appartenant a ces categories a haut risque. Objetivo Elaborar un indicador de los cuasieventos maternos como medicion indirecta de las defunciones maternas y estudiar su relacion con diversos factores maternos y con Ios resultados perinatales. Metodos Mediante un estudio transversal multicentrico, a lo largo de un periodo de dos a tres meses reunimos datos maternos y perinatales de los registros hospitalarios de una muestra de mujeres ingresadas para dar a luz en 120 hospitales de ocho paises de America Latina. Aplicando un diseno aleatorio, polietapico, estratificado y por conglomerados, evaluamos les casos intrahospitalarios de morbilidad materna grave y la relacion entre esta y las caracteristicas de la madre y los resultados perinatales. Resultados De las 97 095 mujeres estudiadas, 2964 (34 por 1000) presentaron un mayor riesgo de morir asociado a alguno de los siguientes factores: ingreso en la unidad de cuidados intensivos, histerectomia, transfusion de sangre, complicacion cardiaca o renal, y eclampsia. Tener mas de 35 anos, carecer de pareja, ser primipara o acumular un minimo de tres partos anteriores y haber sido sometida a cesarea en el embarazo precedente fueron factores asociados independientemente a morbilidad materna grave. Se observo que estaban relacionados tambien positivamente con lo siguiente: un peso bajo o muy bajo al nacer, mortinatalidad, mortalidad neonatal precoz, ingreso en la UCI neonatal, estancia prolongada de la madre en el hospital tras el parto, y cesarea. Conclusion Los casos de las mujeres que sobreviven a los graves problemas aqui descritos pueden conceptuarse en la practica como cuasieventos maternos. Las intervenciones encaminadas a reducir la mortalidad materna y perinatal deberian focalizarse en las mujeres de esas categorias de riesgo., Introduction Approximately 15 000 women die every year in Latin America and the Caribbean of causes related to pregnancy. The maternal mortality ratio (MMR) for the region, which is around [...]
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- 2010
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4. Endothelium-derived hyperpolarizing factor in preeclampsia: heterogeneous contribution, mechanisms, and morphological prerequisites
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Luksha, Leanid, Nisell, Henry, Luksha, Natallia, Kublickas, Marius, Hultenby, Kjell, and Kublickiene, Karolina
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Preeclampsia -- Research ,Vascular endothelium -- Research ,Vascular resistance -- Research ,Cardiovascular research ,Biological sciences - Abstract
We hypothesized that in preeclampsia (PE), contribution of endothelium-derived hyperpolarizing factor (EDHF) and the mechanism/s of its action differ from that in normal pregnancy (NP). We aimed to assess endothelial function and morphology in arteries from NP and PE with particular focus on EDHF. Arteries ([approximately equal to] 200 [micro] m) were dissected from subcutaneous fat biopsies obtained from women undergoing cesarean section. With the use of wire myography, responses to the endothelium-dependent agonist bradykinin (BK) were determined before and after inhibition of pathways relevant to EDHF activity. The overall responses to BK in arteries from PE (n = 13) and NP (n = 17) were similar. However, in PE, EDHF-mediated relaxation was reduced (P < 0.05). All women within the PE group were divided into two subgroups: with more (group 1) or less (group 2) than 50% reduction of EDHF-typed responses after 18-[alpha]-glycyrrhetinic acid (an inhibitor of myoendothelial gap junctions, MEGJs). The division showed that 1) MEGJs are principally involved when the EDHF contribution is reduced; and 2) when the EDHF contribution is similar to that in NP, the H202 and/or cytochrome P-450 epoxygenase products of arachidonic acid (AA), along with MEGJs, confer EDHF-mediated relaxation. In contrast, MEGJs were the main pathway for EDHF in NP. The abundant presence of MEGJs in arteries from NP but deficiency of them in PE was observed using transmission electron microscopy. We conclude that PE is associated with heterogeneous contribution of EDHF, and the mechanism behind EDHF-typed responses is mediated either by MEGJs alone or in combination with [H.sub.2][O.sub.2] or cytochrome P-450 epoxygenase metabolites of AA. gap junctions; small arteries; pregnancy
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- 2008
5. Methodological considerations in implementing the WHO Global Survey for Monitoring Maternal and Perinatal Health/Considerations methodologiques dans l'application de l'Enquete mondiale de l'OMS sur la surveillance de la sante maternelle et perinatale/Consideraciones metodologicas a raiz de la Encuesta mundial OMS de vigilancia de la salud materna y perinatal
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Shah, Archana, Faundes, Anibal, Machoki, M'Imunya, Bataglia, Vicente, Amokrane, Faouzi, Donner, Allan, Mugerwa, Kidza, Carroli, Guillermo, Fawole, Bukola, Langer, Ana, Wolomby, Jean Jose, Naravaez, Alberto, Nafiou, Idi, Kublickas, Marius, Valladares, Eliette, Velasco, Alejandro, Zavaleta, Nelly, Neves, Isilda, and Villar, Jose
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World Health Organization -- Surveys ,Maternal health services -- Surveys ,Health surveys -- Methods - Abstract
Objective To set up a global system for monitoring maternal and perinatal health in 54 countries worldwide. Methods The WHO Global Survey for Monitoring Maternal and Perinatal Health was implemented through a network of health institutions, selected using a stratified multistage cluster sampling design. Focused information on maternal and perinatal health was abstracted from hospital records and entered in a specially developed online data management system. Data were collected over a two- to three-month period in each institution. The project was coordinated by WHO and supported by WHO regional offices and country coordinators in Africa and the Americas. Findings The initial survey was implemented between September 2004 and March 2005 in the African and American regions. A total of 125 institutions in seven African countries and 119 institutions in eight Latin American countries participated. Conclusion This project has created a technologically simple and scientifically sound system for large-scale data management, which can facilitate programme monitoring in countries. Objectif Mettre en place dans 54 pays repartis dans l'ensemble du monde un systeme mondial de surveillance de la sante maternelle et perinatale. Methodes L'Enquete mondiale sur la surveillance de la sante maternelle et perinatale de I'OMS s'est operee par le biais d'un reseau d'etablissements de soins, selectionnes par echantillonnage en grappe stratifie a plusieurs niveaux. Une information ciblee sur la sante maternelle et perinatale a ete extraite des registres hospitaliers et entree dans un systeme de gestion des donnees en ligne, specialement developpe. Les donnees ont ete recueillies sur une periode de deux a trois mois dans chaque etablissement. Le projet a ete coordonne par I'OMS et appuye par les bureaux regionaux de I'OMS et par ses coordinateurs nationaux en Afrique et dans les Ameriques. Resultats L'enquete initiale a ete realisee entre septembre 2004 et mars 2005 en Afrique et dans les Ameriques. Ont participe au total a l'enquete 125 etablissements de sept pays africains et 119 etablissements de huit pays d'Amerique latine. Conclusion Ce projet a cree un systeme technologiquement simple et scientifiquement rigoureux pour la gestion grande echelle des donnees, pouvant faciliter la surveillance programmatique dans les pays. Objetivo Establecer un sistema mundial de vigilancia de la salud materna y perinatal en 54 paises de todo el mundo. Metodos La Encuesta mundial OMS de vigilancia de la salud materna y perinatal se llevo a cabo a traves de una red de instituciones sanitarias seleccionadas mediante muestreo polietapico estratificado por conglomerados. La informacion focalizada y resumida sobre la salud materna y perinatal extraida a partir de las historias clinicas se introdujo en un sistema de gestion de datos en linea especialmente desarrollado. A lo largo de un periodo de dos a tres meses se reunieron datos en cada institucion. El proyecto fue coordinado por la OMS y respaldado por las oficinas regionales de la OMS y los coordinadores en los paises en Africa y las Americas. Resultados La encuesta inicial se llevo a cabo entre septiembre de 2004 y marzo de 2005 en las regiones de Africa y de las Americas. Participaron en total 125 instituciones de siete paises africanos y 119 instituciones de ocho paises latinoamericanos. Conclusion Este proyecto ha generado un sistema tecnologicamente sencillo y cientificamente solido para gestionar datos a gran escala, lo cual puede facilitar la vigilancia de los programas en los paises. [TEXT NOT REPRODUCIBLE IN ASCII], Introduction The WHO Global Survey on Maternal and Perinatal Health aims to develop a network of health institutions worldwide that collects up-to-date information on services provided and on how evidence-based [...]
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- 2008
6. Caesarean delivery rates and pregnancy outcomes: the 2005 WHO global survey on maternal and perinatal health in Latin America
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Villar, Jose, Valladares, Eliette, Wojdyla, Daniel, Zavaleta, Nelly, Carroli, Guillermo, Velazco, Alejandro, Shah, Archana, Campodonico, Liana, Bataglia, Vicente, Faundes, Anibal, Langer, Ana, Narvaez, Alberto, Donner, Allan, Romero, Mariana, Reynoso, Sofia, Giordano, Daniel, Kublickas, Marius, and Acosta, Arnaldo
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Cesarean section -- Health aspects ,Cesarean section -- Patient outcomes ,Pregnant women -- Health aspects - Published
- 2006
7. Caesarean delivery rates and pregnancy outcomes: the 2005 WHO global survey on maternal and perinatal health in Latin America
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Villar, Jose, Valladares, Eliette, Wojdyla, Daniel, Zavaleta, Nelly, Carroli, Guillermo, Velazco, Alejandro, Shah, Archana, Campodonico, Liana, Bataglia, Vicente, Faundes, Anibal, Langer, Ana, Narvaez, Alberto, Donner, Allan, Romero, Mariana, Reynoso, Sofia, Karla, Simonia de Padua, Giordano, Daniel, Kublickas, Marius, and Acosta, Arnaldo
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World Health Organization ,Cesarean section -- Patient outcomes - Published
- 2006
8. Maternal and neonatal individual risks and benefits associated with caesarean delivery: multicentre prospective study
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Villar, Jose, Carroli, Guillermo, Zavaleta, Nelly, Donner, Allan, Wojdyla, Daniel, Faundes, Anibal, Velazco, Alejandro, Bataglia, Vicente, Langer, Ana, Narvaez, Alberto, Valladares, Eliette, Shah, Archana, Campodonico, Liana, Romero, Mariana, Reynoso, Sofia, de Padua, Karla Simonia, Giordano, Daniel, Kublickas, Marius, and Acosta, Arnaldo
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Vaginal birth after cesarean -- Analysis ,Mothers -- Patient outcomes ,Mothers -- Risk factors - Published
- 2007
9. A comparison of myogenic and endothelial properties of myometrial and omental resistance vessels in late pregnancy
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Kublickiene, Karolina-Rasa, Kublickas, Marius, Lindblom, Bo, Lunell, Nils-Olov, and Nisell, Henry
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Myometrium -- Physiological aspects ,Vascular resistance -- Measurement ,Pregnancy -- Physiological aspects ,Nitric oxide -- Physiological aspects ,Health - Abstract
Uterine arteries may respond more sensitively to increases in blood pressure than abdominal arteries. Researchers obtained uterine and abdominal arteries from term pregnant women and compared the contraction response of uterine muscle arteries to that of abdominal arteries. Nitric oxide inhibitors did not increase the contraction tone of arteries, suggesting that nitric oxide does not contribute to the contraction response. A drug-induced relaxation response was more pronounced in uterine than abdominal arteries. Uterine arteries may have different contraction and relaxation properties than other arteries.
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- 1997
10. A comparison of myogenic and endothelial properties of myometrial and omental resistance vessels in late pregnancy
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Kublickiene, Karolina-Rasa, Kublickas, Marius, Lindblom, Bo, Lunell, Nils-Olov, and Nisell, Henry
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Acetylcholine -- Comparative analysis ,Pregnancy -- Comparative analysis ,Pregnant women -- Comparative analysis ,Nitric oxide -- Comparative analysis ,Endothelium -- Comparative analysis ,Health - Abstract
Byline: Karolina-Rasa Kublickiene, Marius Kublickas, Bo Lindblom, Nils-Olov Lunell, Henry Nisell Keywords: Pregnancy; resistance arteries; myogenic; nitric oxide; acetylcholine Abstract: OBJECTIVE: Our purpose was to compare myometrial and omental resistance arteries from term pregnant women with respect to myogenic behavior in the presence or absence of a nitric oxide synthase inhibitor and to compare distensibility and acetylcholine-mediated dilatation in these vessels. STUDY DESIGN: Intramyometrial (n = 17) and omental (n = 14) resistance arteries from term normal pregnant women were studied in a pressurized arteriograph system. Myogenic tone was evaluated during increments in intraluminal pressure from 20 to 120 mm Hg with and without inhibition of nitric oxide synthase. Endothelium-dependent relaxation was assessed by evaluating the response to acetylcholine (10.sup.-6 mol/L) in arteries pressurized at 70 mm Hg. RESULTS: Myogenic tone was greater at all pressure steps in the myometrial than in the omental arteries (p < 0.05). Inhibition of nitric oxide synthase with N.sub.I-nitro-l-arginine had no influence on myogenic tone in either group. Relaxation to acetylcholine was greater in myometrial (18% [+ or -] 4%) compared with omental vessels (7% [+ or -] 2%, p < 0.05). The passive distensibility (Ca.sup.++-free solution and in the presence of papaverine) of arteries from the myometrium and the omentum was similar. CONCLUSION: Normal pregnancy is associated with different mechanical properties of resistance vessels from the two vascular beds studied. Basal nitric oxide release does not modify myogenic tone, at least under no-flow conditions. Acetylcholine-induced relaxation is greater in myometrial than in omental arteries. (Am J Obstet Gynecol 1997;176:560-6 Author Affiliation: Huddinge and Uppsala, Sweden Article History: Received 29 April 1996; Revised 19 November 1996; Accepted 3 December 1996 Article Note: (footnote) [star] From the Departments of Obstetrics and Gynecology, Karolinska Institute, Huddinge University Hospital,aUppsala University.b , [star][star] Supported by grants from the Karolinska Institute, the Swedish Medical Research Council (grant No. 9512), the Swedish Society of Medicine, and the General Maternity Hospital Memory Foundation., a Reprint requests: Karolina-Rasa Kublickiene, MD, Department of Obstetrics and Gynecology, Karolinska Institute, Huddinge University Hospital, S-141 86 Huddinge, Sweden., aa 0002-9378/97 $5.00 + 0 6/1/79569
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- 1997
11. Routine measurements of umbilical artery lactate levels in the prediction of perinatal outcome
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Westgren, Magnus, Divon, Michael, Horal, Mikalel, Ingemarsson, Ingemar, Kublickas, Marius, Shimojo, Nobuo, and Nordstrom, Lennart
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Fetal blood -- Analysis ,Lactic acid -- Measurement ,Health - Abstract
Lactate levels in umbilical cord blood may indicate a lack of oxygen at birth as accurately as acid-base balance but lactate analysis may be easier. Lactate appears in blood when pH is low, as occurs with oxygen deprivation. Researchers analyzed 4,045 umbilical cord blood samples for the presence of lactate using a new electrochemical method that produces a result in one minute. Lactate levels were highest in fetuses that were delivered by cesarean section because of fetal distress. Lactate levels were much higher among vaginal deliveries than among elective cesarean sections. Neither umbilical blood acid-base measurements nor lactate measurements alone may accurately predict the neurologic outcome of newborns. The advantages of lactate analysis are its ease of use and low cost.
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- 1995
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