摘要:

SummaryA five year review (1981–1985) of the management and outcome of 85 diabetic pregnancies is presented. Management was based on self blood glucose monitoring and frequent outpatient attendances. With increasing experience of this system the median number of days spent as an inpatient during pregnancy progressively decreased. A good standard of diabetic control was maintained, and we did not observe any increase in perinatal morbidity. In the last three years of the study there was an increase in mean birth weight and in the number of babies whose birth weight exceeded the 90th centile for gestational age.There was no relationship between blood glucose control in the last 10 weeks of pregnancy and the incidence of neonatal problems, or the incidence of birth weight>90th centile. There was a relationship between elevated mean glycosylated haemoglobin levels in the last 10 weeks of pregnancy and an adverse neonatal outcome.

ISSN:1340-9654    

DOI:10.3109/01443619009151150

出版商:Taylor&Francis    

年代:1990

数据来源: WILEY

摘要:

SummaryThe outcome in 80 patients who had routine repeat uterine curettage following primary evacuation of hydatidiform mole was compared with that of 76 patients in whom a routine repeat curettage was not performed. The incidence of need for chemotherapy at the end of a 1 year follow up was 16 per cent in the‘curettage’group and 18 per cent in the‘no curettage’group. This difference was not significant. In only 7–5 per cent of patients was trophoblastic tissue obtained during the routine repeat curettage. The histological yield did not predict the course of the disease. Repeat curettage after primary evacuation of molar pregnancy should not be performed as a routine procedure.

ISSN:1340-9654    

DOI:10.3109/01443619009151151

出版商:Taylor&Francis    

年代:1990

数据来源: WILEY

摘要:

SummaryThe histological material from 100 consecutive cases of legal abortion were re-examined. Abnormalities and unexpected findings were revealed in 23 per cent. Many of these could have been predicted by ultrasound examinations both before and after the abortion. Even units which use ultrasound routinely should continue to send aborted material for histological examination, for medicolegal reasons, and for the detection of gestational trophoblastic disease.

ISSN:1340-9654    

DOI:10.3109/01443619009151152

出版商:Taylor&Francis    

年代:1990

数据来源: WILEY

摘要:

SummaryDuring the ten years, 1977–1986, in the Medway towns, Kent, 193 women underwent surgery for ectopic pregnancy. One ectopic pregnancy was found every 233 deliveries, that is 0–43%.The incidence of ectopic pregnancy was examined in relation to the calendar year of conception. The denominator was‘reported pregnancies’, the total of live births, stillbirths, legal abortions and ectopic pregnancies. The annual number of ectopic pregnancies increased steadily from 11 in 1977 to 23 in 1986, an 82 per cent increase in the rate per 1000 reported pregnancies, from 2–5 to 4–6 (P<0.001). The incidence of ectopic pregnancy per 100000 women aged 15–44 increased from 16–7 in 1977 to 31–3 in 1986 (P<0.001).The rising incidence of ectopic pregnancy poses questions regarding the aetiological factors, and has serious implications on subsequent fertility and maternal mortality in the first trimester, as well as increased demands on hospital facilities. The index of suspicion among doctors dealing with suspected ectopic pregnancy should be increased.

ISSN:1340-9654    

DOI:10.3109/01443619009151153

出版商:Taylor&Francis    

年代:1990

数据来源: WILEY

摘要:

SummaryHuman parvovirus infection in adults is often unnoticed, i and usually insignificant. Infection during pregnancy can have devastating effects on the fetus. A high maternal serumα-fetoprotein in the presence of intra-uterine parvovirus infection heralds a particularly poor pro-gnosis. A raisedα-fetoprotein should warn clinicians that the pregnancy is at increased risk, and should prompt further investigation; it is suggested that in addition to the TORCH screen, measurement of maternal B19 IgM be made.

ISSN:1340-9654    

DOI:10.3109/01443619009151154

出版商:Taylor&Francis    

年代:1990

数据来源: WILEY

摘要:

SummaryA random allocation study was performed to compare the clinical value of daily fetal movement counting with that of hormone assessment (oestriol and hPL) in the monitoring of apparently normal pregnancies for fetal well-being. Patients with known risk factors and those in whom complications occurred during the study were excluded.In the group counting fetal movements, 577 women recorded 35 189 daily counts, for a mean of 70 days each. The group evaluated with hormone assessments had an average of five determinations of serum total oestriol and human placental lactogen. Patient compliances were 86·8 and 99·5 per cent, respectively.Women having hormone assessments were seen more often as outpatients but the frequencies of hospital admission were identical. Other aspects of management did not differ. Women making fetal movement counts more frequently designated their monitoring procedure as troublesome or expressed insecurity.The number of patients studied was inadequate to assess the methods for prediction of adverse fetal outcome in apparently normal pregnancies.

ISSN:1340-9654    

DOI:10.3109/01443619009151155

出版商:Taylor&Francis    

年代:1990

数据来源: WILEY

摘要:

SummaryThe results of all fetal blood sampling carried out in labour (n= 419) at the National Maternity Hospital in Dublin between 1 January 1984 and 31 December 1984 are reported. The overall sampling rate was 5·4 per cent. A low result (pH7·25) was associated with a low intervention rate (3 per cent) and a relatively low incidence of asphyxia (10 per cent). Although this may appear to be a good method of detecting birth asphyxia, most asphyxiated babies (63 per cent) and most babies who had abnormal neurological signs on discharge from hospital (88 per cent) had had a normal fetal blood sample result. Far from being helpful, these normal scalp pH results early in labour may have provided the obstetrician with a false sense of security. Correlation of the scalp pH with the umbilical venous pH value at delivery was only satisfactory (r= 0.66,n= 24) when the fetal blood sample was obtained within 30 min of delivery.Many of these early fetal blood measurements were unnecessary and more acidotic fetuses would have been detected by sampling only those with an abnormal fetal heart rate pattern.

ISSN:1340-9654    

DOI:10.3109/01443619009151156

出版商:Taylor&Francis    

年代:1990

数据来源: WILEY

摘要:

SummaryThe recognised limitations of clinical estimation of fetal weight have resulted in the widespread use of ultrasound for this purpose. Despite this there is no evidence that clinical methods are less accurate than ultrasound. We have compared the results of fetal weight estimation in 79 cases who delivered within 24 hours of a clinical assessment with that of 158 matched cases in which fetal weight was predicted using ultrasound within 72 hours of delivery. There was no difference overall between the results with the two methods, although in small and average sized babies ultrasound tended to be more accurate. In macrosomic babies clinical methods appeared to be more useful.

ISSN:1340-9654    

DOI:10.3109/01443619009151157

出版商:Taylor&Francis    

年代:1990

数据来源: WILEY

摘要:

SummaryPovidone-iodine powder was tested as a prophylactic against perineal wound breakdown in 87 mothers requiring episiotomy for delivery. Though the infection rates were similar on days 2 and 5 of the study to those in 96 patients of the control group, by the 10th day 13·5 per cent of control patients had wound breakdown compared to 3·5 per cent in those treated.

ISSN:1340-9654    

DOI:10.3109/01443619009151158

出版商:Taylor&Francis    

年代:1990

数据来源: WILEY

摘要:

SummaryThe use of prophylactic intravenous cephradine to reduce the incidence of infection following caesarean section was examined. The incidence of infection, defined as a pyrexia of more than 37.5°C after the first 24h, was reduced (P<0·01) from 39 per cent in the control patients (n= 100) to 20 per cent in the patients treated with cephradine (n= 101). Cephradine prophylaxis was more effective (P<0.05) at Hammersmith Hospital, where the infection rates were higher (23 per cent in control patients) than at Northwich Park Hospital (controls–16 per cent infections). Stepwise logistic regression analysis indicated that the primary variables which were important in reducing the incidence of infection were the administration of cephradine (P<0.001) and the pre-operative absence of skin pathogens (P<0.05). The commonest skin pathogen involved was Staphylococcus aureus.

ISSN:1340-9654    

DOI:10.3109/01443619009151159

出版商:Taylor&Francis    

年代:1990

数据来源: WILEY