ISSN:0001-6349    

DOI:10.3109/00016349509008932

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Objective. This study was designed to histochemically clarify the presence of nerves containing NADPH diaphorase, representing the catalytic activity of nitric oxide synthase, in the human female genital organ.Study design. Female genital organs were isolated for NADPH diaphorase staining by extensive or simple hysterectomy from ten patients.Results. Paracervical ganglia contained many nerve cells intensely stained. The nerve from the ganglia contained many axons intensely stained, which selectively innervated blood vessels distributing to the whole genital organ. NADPH diaphorase‐reactive nerve fibers around the vascular wall distributed in the adventitia, closely contacting to the medial layer. The distribution of the axons was much denser in the arterial wall than in the venous wall.Conclusion. The NADPH diaphorase‐reactive nerve fibers, possibly originated from paracervical ganglia. appear to play an important role in the regulation of uterine vascular tone by liberating nitric oxide, and such a neurogenic control may be predominant in the artery over the L

ISSN:0001-6349    

DOI:10.3109/00016349509008933

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Objective. To determine the accuracy of sonographic weight estimation of twin fetuses.MethodsIn 73 twin‐pregnancies, fetal weight estimation by ultrasound was performed within 7 days prior to delivery. Fetal head biparietal diameter and abdominal circumference were measured. The coefficient of correlation (r), and the ratio between estimated weight and actual weight were calculated.Results. The coefficient of correlation was r=0.954 between estimated weight and actual birth weight. The ratio between the two parameters was 1.025, the standard deviation 0.089. In our study, 41% of the antenatal estimated weights deviated less than 5% from the actual birth weight. For 72% of all estimated weights, the deviation was less than 10%. Ultrasonographic prediction of actual weight below the 10th percentile level showed a sensitivity of 85%, predictive value of 80% and specificity of 87%. In detecting inter‐twin discordance 2200, the respective values were 64%, 64% and 91%.Conclusions. Antenatal estimation of birth weight by ultrasound correlates well with the actual weights of twin fetuses. Prediction of individual fetal weight seems to be more accurate than prediction of inter‐twin discor

ISSN:0001-6349    

DOI:10.3109/00016349509008934

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Although magnesium sulfate has been a traditional or standard treatment for severe preeclampsia and eclampsia to prevent convulsions, its efficiency has always been in doubt and its induced side‐effects also make it controversial for use. In this study, 64 patients, diagnosed with severe preeclampsia, were randomized into group I (34 patients) managed with MgS04, and group II (30 patients) managed without MgS04. There were no occurrences of eclampsia in either group. Although there was no statistical significance in the final delivery method, group I had a higher rate in cesarean section, in which most were significantly due to fetal distress (p<0.05). Furthermore, group I had significantly more babies with poor apgar score than group II (p= 0.019). During the reatment period for those with a gestational age of less than 34 weeks, there were two patients withabruptio placentaein group 1 and the treatment periods were noted to be longer in group II than in group I. From the results of monitoring serum magnesium level in group I, when therapeutic level was achieved, magnesium sulfate induced great discomfort which might have led to the deterioration of the patients' condition. According to this study, magnesium sulfate's minimal efficiency. and its adverse side‐effects, also make magnesium sulfate a poor choice in the management of preeclampsia. Therefore, because of our poor understanding of the etiology of preeclampsia, suitable management should be undertaken without magnesium sulfate. Improvement of the patient's pathophysiological condition or termination of pregnancy as early as possible, is recommen

ISSN:0001-6349    

DOI:10.3109/00016349509008935

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Background. The purposes of this study were to explore whether serum levels of insulin, insulin‐like growth factor‐I (IGF‐I), insulin‐like growth factor‐binding protein‐1 (IGFBP‐1) and IGFBP‐3 in both maternal and fetal compartments were affected by the stress of labor, and to investigate the relationship between the fetal birthweight and serum levels of insulin, IGF‐I and IGFBPs.Methods. Blood samples were collected at the time of delivery from 147 parturients with vaginal delivery and 128 cases of Cesarean section (112 cases without labor and 16 cases with arrest of cervical dilatation during the active phase of labor). Serum concentrations of insulin, IGF‐I, IGFBP‐1 and IGFBP‐3 were determined by radioimmunoassays (insulin, IGFBP‐I and IGFBP‐3) and immunoradiometric assay (IGF‐I).Results. Maternal circulating IGFBP‐1 levels in parturients with normal spontaneous delivery (NSD) and in subjects receiving Cesarean section (CS) due to arrest of cervical dilatation during active phase of labor were higher than those undergoing scheduled CS without labor. By contrast, insulin levels in both maternal and umbilical cord serum were higher in parturients with CS without labor than those with NSD. No difference in maternal serum IGFBP‐3 levels was observed between NSD and CS at the time of delivery. As for all measurements (insulin, IGF‐I, IGFBP‐1 and IGFBP‐3), serum levels in pregnant women (from both NSD and CS) were strikingly higher than those in the fetus. Serum levels of IGFBP‐I in umbilical cords from both groups of NSD (p<0.02) and scheduled CS (p<0.01) were inversely correlated with birthweight (BW). By contrast, serum concentration of insulin and IGF‐I in umbilical cords from NSD (p<0.005 andp<0.01; respectively) and scheduled CS (p<0.001 andP&<0.05; respectively) were positively related to BW.Conclusions. From the present results, we conclude that insulin appears to be a regulator for circulating IGFBP‐1 during pregnancy. The fetal growth may not be well reflected by maternal serum IGFBP‐I levels, nor by IGFBP‐3. By contrast, cord serum IGFBP‐1 from CS group without labor may preeminently reflect fetal weight. In additional, serum concentration of insulin and IGF‐I in umbilical cord may also be good ind

ISSN:0001-6349    

DOI:10.3109/00016349509008936

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Background. Induction of labor in women with late fetal death is often difficult in settings with scarce resources. The purpose of this study was to assess the value of vaginal misoprostol for induction of labor in women with such fetal death.Methods. In Maputo 156 women with late fetal death were allotted in a non‐randomised way to either vaginal misoprostol or intravenous infusion of oxytocin. Treatment outcomes were compared as to cost‐effectiveness and safety. In the misoprostol group none received more than 800 µg. Oxytocin infusion followed an established routine. Statistical analyses were performed by EPI Info software.Results. In cases with Bishop's score<6 the induction‐to‐delivery interval averaged 14.8 hours in the misoprostol group and 31.0 hours in the oxytocin group (p=0.001). The corresponding values for women with Bishop's score<6 were 6.6 and 8.7 hours, respectively (p=0.4). Women with intact membranes had an induction‐to‐delivery interval of 13.8 hours in the misoprostol group and 26.9 hours in the oxytocin group (p=0.002). The corresponding values in women with ruptured membranes were 7.8 and 10.5 hours, respectively (p=0.6). Successful induction was achieved in 81% of misoprostol‐treated women at a dose of 100 pg or less.Conclusions. Vaginal misoprostol is a safe, low‐cost drug particularly suitable in women of high average parity having l

ISSN:0001-6349    

DOI:10.3109/00016349509008937

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Acta Ohstet Gynecol Scand1995; 74: 199–202. © Acta Obstet Gynecol Scand 1995Background. Many politicians and decision‐makers in health care consider assisted reproduction an expensive and exclusive treatment despite the results ofin vitrofertilizationiembryo transfer (IVF/ET) treatments having improved considerably during the last few years. With the improved results the costs in relation to successful outcome are decreasing.Aim and Methods. The aim of this study was to evaluate the cost‐benefit of IVF/ET treatments in a group of infertile couples. The benefit was measured as willingness to pay (WTP) for IVF/ET treatment and was related to the cost of IVF/ET. For the calculation of costs, data from one private and one public IVF clinic in Sweden during the period from January 1992 to March 1993 were used.Results and conclusions. The cost analysis showed a direct cost for IVF/ET of $3,170 per started treatment and $9,410 per delivery. Including the indirect cost, the total cost was $3,880 per started IVFIET treatment and $11,490 per delivery. The survey of the WTP showed that the infertile couples gave high economic priority to infertility treatment. A majority of the couples were willing to pay more for a child than the calculated direc

ISSN:0001-6349    

DOI:10.3109/00016349509008938

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Aim of study. To clarify the impact of the presence of pelvic inflammatory disease (PID) and activation of the acute phase response on the serum level of tetranectin (Se‐TN), a potential new tumor marker for ovarian cancer.Material and methods. The study group consisted of 70 patients with a laparoscopically verified PID and 47 healthy female controls.Results. Lower Se‐TN levels were found for the PID group compared to the control group (p<0.0001). It was not possible to relate the decreases in Se‐TN levels to any distinct bacterial strain. Neither was it possible to find any correlation between Se‐TN and severity of PID (p=0.5). A significant positive correlation was found between Se‐TN and ALB (p<0.001). A just significant negative correlation was found between Se‐TN and C‐reactive protein (CRP) (p= 0.04). while no correlation was found with any of the other acute phase reactants. Highly significant correlations were found between all the acute phase reactants and grade of PID.Conclusions. A slight, but significant reduction in Se‐TN was found in PID patients. The decrease was minor compared to the reported findings of very low Se‐TN levels for ovarian cancer patients. However, the finding is important in the assessment of TN used as a potential screening marker for ovarian cancer, or as a diagnostic tool for pelvic tumors. Furthermore, Se‐TN does not seem to behave as a negative a

ISSN:0001-6349    

DOI:10.3109/00016349509008939

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Background. Transvaginal ultrasonography is an accurate and reliable technique for measuring ovarian size. However, there is no consensus as to the normal ovarian size in postmenopausal women. The purpose of this study was to establish normal values for ovarian volume in postmenopausal age.Methods. A prospective study was undertaken, in which the ovaries of 311 healthy postmenopausal women were examined by transvaginal ultrasonography. Menopausal age ranged from one to more than 15 years. Three dimensions of each ovary were measured and ovarian volume of every menopausal year was calculated.Results. Curvilinear relationships were found between ovarian volume and menopausal age. Ovarian volume (as plotted on the nomogram) shows a progressive decrease from 8.6±2.3 cm3in the first menopausal year, to 2.2±1.4 cm3after more than 15 years after the menopause.Conclusions. These data represent a comprehensive characterization of normal ovarian volumes related to postmenopausal age.These baseline values provide the data which will assist the physician to obtain the sono‐graphic diagnosis of abnormal ovarian size, thus eventually establishing early diagnosis of ovarian tum

ISSN:0001-6349    

DOI:10.3109/00016349509008940

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Objective. To evaluate the significance of P‐HCG levels in peritoneal fluid and serum in the diagnosis of ectopic pregnancy.Study design setting. Obstetrics and Gynecology department of a regional general hospital.Subjects. Sixty‐two women who presented with a differential diagnosis of ectopic pregnancy vs. nonviable intrauterine pregnancy.Interventions. All patients underwent D&C and culdocentesis. P‐HCG was measured in simultaneously obtained peritoneal fluid (PF) and serum (S), and the PFiS ratio calculated.Results. Twenty‐three patients had an ectopic pregnancy (Group I). All 23 had higher β‐HCG concentrations in the PF than in the serum, with a mean PFiS ratio of 19.1 ± 16.9. Twenty‐four patients had an intrauterine pregnancy (Group II). The β‐HCG levels in the PF and serum were similar (mean PF/S 1.1 ±0.2). The difference in PFiS ratio between groups I and II was statistically significant (p<0.001).Conclusion. The measurement of P‐HCG in peritoneal fluid and serum is a useful diagnostic tool in differentiating ectopic from int

ISSN:0001-6349    

DOI:10.3109/00016349509008941

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY