摘要:

Abstract.In a group of 8 midtrimester pregnant patients, the uterine volume (V) had been increased by the intra‐amniotic instillation of 350 ml Macrodex and the changes in plasma progesterone (P) and intrauterine pressure (IUP) had been measured. In 2 of these 8 women the study was discontinued because of the early rupture of the fetal membranes. In 4 patients the P levels decreased slightly and IUP increased, culminating in abortion. In 2 patients the P levels increased distinctly, the IUP remained unchanged and pregnancy continued undisturbed. These findings support Csapo's conclusion that the ratio V/P controls IUP and thus the fate of pregnanc

ISSN:0001-6349    

DOI:10.3109/00016347409157741

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

Abstract.A new instrument designed for the measurement of the cervical consistency has been used in an investigation of 100 non‐pregnant and 49 pregnant women. The instrument consists of a mechanism for control of the force used, enabling the examiner to exert the desired pressure on the uterine cervix, and another mechanism for recording the tissue consistency. Both mechanisms were calibrated before each measurement. During measurement the instrument was held horizontally and pressed lightly against the anterior lip of the cervix. The cervical consistency is characterized by the angle α between the walls of the impressed surface recorded on the indicator mechanism of the instrument. The highest values of α are found in the softest tissues. The results showed a highly significant inter‐individual difference (F= 7.355>P, 90) between 30 of the non‐pregnant patients who had from 3 to 6 measurements performed in different menstrual cycles (intraclass correlationr= 0.612 ± 0.083). Variation about the individual mean is only 1/F—13.6%. In the non‐pregnant cervix a rise in the mean measured values was noted during the first phase of the menstrual cycle. The mean values for non‐pregnant women using a combined oral contraceptive were slightly higher. In normal pregnancies the measurements showed significantly different values in three different time intervals. The highest values were found near term. Within a few weeks after parturition the values fell and approached the “normal values” for

ISSN:0001-6349    

DOI:10.3109/00016347409157742

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

Abstract.Synthetic luteinizing hormone releasing factor (LRF) was administered intravenously in a dose of 200 μg to twenty normal lactating puerperal women and serum follicle‐stimulating hormone (FSH) and luteinizing hormone (LH) response to LRF was measured by double antibody radio‐immunoassay. Synthetic LRF failed to stimulate FSH secretion in all the eight volunteers in the 1st postpartum week. About half of the six subjects in the 3rd postpartum week responsed to LRF with a rise of serum FSH and LH. All the six lactating women in the 5th postpartum week were responsive to LRF and there was a concomitant rise in serum FSH and LH. These results suggest that gonadotrophic activity of the anterior pituitary is suppressed by an unknown mechanism during the first few weeks of puerperium and gonado‐trophin reserve function recovers completely around the 5th postpartum week. Thus, it might be assumed that puerperal anovulation or amenorrhoea is due to hypo‐thalamic‐pituitary dysfunction during the first few postpartum weeks and due to hypothalamic disorders after the 5th postp

ISSN:0001-6349    

DOI:10.3109/00016347409157743

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

Abstract.Techniques of fetal monitoring, including fetal blood samplingin utero, were employed to study the physiological effects of acute maternal carbon monoxide intoxication upon the fetal rhesus monkey. Nine term‐pregnant female monkeys were exposed to 0.1‐0.3 % inspired CO over 1‐3 hours. The mothers tolerated car‐boxyhemoglobin (COHb) levels exceeding 60 % without clinical sequelae. The fetuses promptly developed profound hypoxia upon exposure of the mothers to CO. However, the fetal COHb levels rose only gradually over the 1‐3 hours and thus contributed only slightly to the development of the early fetal hypoxia. Fetal hypoxia was associated with bradycardia, hypotension, and metabolic and, later, respiratory acidosis. A close correlation was noted between the severity of intrauterine hypoxia and the appearance of brain damage. Severe brain damage (brain swelling associated with hemorrhagic necrosis of the cerebral hemispheres) appeared only in those fetuses whose arterial O2content had fallen below 2.0 ml/100 ml for at least 45 min during the maternal CO int

ISSN:0001-6349    

DOI:10.3109/00016347409157744

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

Abstract.The DHEA‐S loading test was used to evaluate fetoplacental function in 105 pregnant women. The test gave 84% correct results in the 43 cases of fetoplacental deficiency. However, in the control group of 62 subjects it gave only 42% correct results. Measurement of estriol excretion in maternal urine is one of the biochemical tests routinely carried out on pregnancies at risk. The prognostic value of the test is, however, restricted by the big daily fluctuations in estriol excretion. Fluctuations of between 60% and 140% have been reported (12). In addition to the routine determination of estriol levels, the following tests are of importance for the biochemical evaluation of fetoplacental function: 15α‐hydroxyestriol (7), pregnanediol (8), placen‐tal lactogen (8), heat‐stable alkaline phosphatase (8, 14), and finally, the test discussed in this publication, the dehydroepiandrosterone sulphate (DHEA‐S) loading test (4). The present investigation evaluated the usefulness of this test in the early detection of danger to

ISSN:0001-6349    

DOI:10.3109/00016347409157745

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

Abstract.216 pregnant women with morning glucosuria observed twice at regular testing were subjected to intravenous glucose tolerance tests and serum lipid determinations. A Control Series consisted of 44 pregnant women. An additional group of 24 women with special obstetric histories was also studied. K‐values less than 1.0, pointing to diabetes mellitus, were observed in 4.4% of pregnant women with glucosuria, in 5.5% of the control group and in 26.1 % of women with special obstetric histories. No positive correlations were found between the K‐value and the duration of pregnancy at the time when glucosuria was detected, number of previous pregnancies, weight of newborn, maximal glucose content and 60 min glucose value during IVGTT. The serum lipid values (triglycerides, total and free cholesterol and non‐esterified fatty acids) were clearly elevated in all the groups. No correlation was found between the K‐value and serum lipid levels. It is concluded that the significance of screened glucosuria, even if recorded twice during pregnancy, is questionable. It is pointed out that it is worthwhile to study other groups, such as pregnant women with special obstetric histories, because of the high incidence of diabetes m

ISSN:0001-6349    

DOI:10.3109/00016347409157746

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

Abstract.Plasma progesterone levels were estimated by competitive protein binding in 815 samples from healthy pregnant women with uncomplicated pregnancies. This series includes 32 patients who were followed serially throughout pregnancy. The mean level increased from 47 ng/ml in week 22 to 148 ng/ml in week 41. The spread was large. Individual patients showed very large variations between two consecutive weeks.Diurnal variations were examined in 7 patients and short‐time variations during one hour in 5 patients. Large but non‐systematic variations were found in most cases. The maximal difference between values observed over a 24‐hour‐period was 123 ng/ml and during one hour 150 ng/ml.Plasma progesterone levels were studied in 87 cases of toxemia of pregnancy, 6 cases of hypertension, 54 cases of Rh‐immunization, 37 cases of diabetes and 5 cases of fetal growth retardation of unknown origin. The results indicate that no constant changes occur in plasma progesterone levels in these groups or in cases of impending fetal death.As the normal limits are very wide, the intraindividual variations large, and the progesterone values in high risk pregnancies are inconclusive, plasma progesterone estimates during the latter part of pregnancy seem to be of limited value.During human pregnancy large amounts of progesterone are produced by the placenta (1, 14). The production rate during the third trimester lies between 200 and 300 mg/day (9). Part of the progesterone produced is metabolized to pregnanediol and excreted in the urine as the 3‐glucuronidate (16). The percentage of conversion to pregnanediol seems to vary with the stage of gestation and is influenced by pathological alterations in risk pregnancies (2, 5).Large day to day variations in the urinary pregnanediol levels have been found. It is thus hardly surprising that the clinical value of serial determinations of urinary pregnanediol in late pregnancy has been limited.Recently useful methods for the assay of progesterone in plasma have been developed and applied to physiological and clinical studies. A number of reports dealing with the prognostic value of progesterone determinations in complicated pregnancies have been published (8, 12, 17). The number of cases investigated is, however, small and the results are, in many respects, inconclusive. The aim of the present investigation was to determine the normal limits during the latter half of uncomplicated pregnancies, circadian and short‐time variations, and to evaluate the prognostic value of progesterone determinations in plasma in high ris

ISSN:0001-6349    

DOI:10.3109/00016347409157747

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

Abstract.A combined vaginal and abdominal approach for simple, total hysterectomy, including an ample vaginal cuff, is described.

ISSN:0001-6349    

DOI:10.3109/00016347409157748

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

Abstract.Maternal cystine aminopeptidase activity (CAP) and total urinary oestriol excretion have been compared in 11 normal patients between 30 and 41 weeks gestation, in 9 patients with toxaemia of pregnancy and in 3 patients with a history of complication during the actual or previous pregnancy. The statistical correlation between maternal CAP and oestriol excretion in normal patients was poor (r=0.32). In patients with pre‐eclampsia the results were as follows: low CAP levels generally were associated with low oestriol excretion, whereas with high or normal CAP values there were varying levels of oestriol. CAP levels in blood are only related to the function of the placenta, whereas the oestriol excretion is related to the condition of the whole fetoplacental unit. Therefore serial CAP assays cannot replace oestriol assays in assessing the condition of the foetus and placenta. However, in some patients where intrauterine fetal death occurred, decreasing CAP values were observed before there was a significant change in oestriol excretion. This indicates that decreased placental function might be observed at an earlier stage using CAP than using oestriol determinations. CAP assay is therefore justified as a valuable test alongside estimation of oestriol excretion in judging the condition of the placenta during the last trimester. As the methods of CAP assays are simple and reproducible, CAP can be used on a large scale for detecting and monitoring pregnancies at risk, in order to get a more diversified picture with respect to the condition of the fetus and placenta during the last trimeste

ISSN:0001-6349    

DOI:10.3109/00016347409157749

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

Abstract.The socio‐medical aspects of 131 abortion patients under the age of 18 were analysed. The following results were obtained. The social background and school education of this group of abortion patients is somewhat above average compared with the general population in Finland. The family of the subjects is incomplete more often than is the case in the average Finnish population (34.3% compared with the average of 14.4%). The girls were more often illegitimate and more parents were divorced than expected. The relationship between the subject's parents is often seriously disturbed (32.6%). III health is frequent among the mothers of the subjects (23.7%). The home environment seems to have lacked security. The subjects are sexually relatively well informed. 87.8% stated they understood the consequences before their first intercourse. An attempt to prevent pregnancy was made in only 35.9%. The subjects began sexual intercourse earlier than is common in Finland: 32.1 % before the age of 15 compared with 0.6 % in general and had several partners: 66.5% compared with 11% in general. In many cases there was a positive emotional involvement of the subjects with their partners. Abortion is used as a means of prevention; 80.9% decided to have abortion immediately. Pregnancy is discovered early and medical services are effectively used. 11.4% arrived at the hospital after the 13th week of gestation. 25.2% of the parents did not know about the abortion. 33.6% of the subjects were under the influence of alcohol at the time of intercourse, none of the girls was under the influence of drugs. This group of patients are in need of continuous medical and social counsellin

ISSN:0001-6349    

DOI:10.3109/00016347409157750

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY