ISSN:0001-6349    

DOI:10.3109/00016349509021173

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Background. The aim was to construct a new symphysis‐fundus (SF) height growth chart, based on ultrasound‐dated singleton pregnancies.Methods. We made a population‐based study of all women, from the catchment areas of three district antenatal clinics, who registered for antenatal care during 1986. The growth of the SF height was measured on 403 women with singleton pregnancies.Results. During pregnancy each woman made on average 14.0 (s.d. 2.8) visits to the antenatal clinic, where the SF height was measured on average 10.4 (s.d. 2.6) times. All but two women had an ultrasound examination. Using proper longitudinal methods a new SF height growth chart was constructed.Conclusion. The mean values of the present curve, based on longitudinal data, were almost identical with the mean values of a recently presented curve based on stratified cross‐sectional data. Both these Swedish studies were population‐based and the pregnancies were ultraso

ISSN:0001-6349    

DOI:10.3109/00016349509021174

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Background All maternal red cell antibodies found during pregnancy in a 12 year period have been compiled. The efficacy of the current antenatal screening and management programme has been ascertained by reviewing the outcome of all newborns to these immunized mothers.Method. Patient selection was carried out by computerised searching for all known records of registered antibodies during the study period. Each mother's obstetric record and her baby's hospital file was studied and relevant clinical treatment and laboratory data on both mother and child was recorded and analysed.Results. Eight hundred and twenty‐one alloantibodies were detected in 629 immunized pregnant women with 753 fetuses. An overall antibody incidence of 0.57% was observed which included 373 clinically significant antibodies found in 261 mothers (0.24%). Multiple antibodies were present in 8.2% of all samples. Anti‐D, by itself or in combination with other Rh‐antibodies, caused more severe forms of hemolytic disease of the newborn (HDN) with 46% of all Rh‐positive babies having phototherapy and 29% having exchange transfusion. Three of 18 Fya‐positive infants required phototherapy and one required exchange transfusion and in the 16 Kell‐positive babies, three required phototherapy and one required exchange transfusions.Conclusions. Few antibodies to blood group antigens other than those in the Rhesus system were (bund to cause severe HDN. Antibodies that are generally considered non‐significant did not cause HDN in this study. All antibodies that induced HDN were delected in time so that adequate measures could be taken to reduce the effects in the newborn. The antenatal screening and management programme currently in use is considered t

ISSN:0001-6349    

DOI:10.3109/00016349509021175

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Objective. To test the hypothesis that in pregnancies complicated by intrauterine growth retardation (IUGR) maternal cardiovascular adaptation is already abnormal in the first weeks of pregnancy.Setting. University Hospital Maastricht, Maastricht, The Netherlands.Subjects. Fourteen healthy pregnant women, recruited from the subfertility clinic. Ten pregnancies were uneventful and four pregnancies resulted in the birth of growth retarded infants.Methods. Maternal cardiovascular status was followed longitudinally by combined M‐mode and Doppler echocardiography. Studies were performed weekly between the fifth and 10th week, at 14, 25 and 35 weeks and postpartum. Differences between the two groups were analyzed by nonparametric tests.Results. In early pregnancy, the IUGR group differed from the normal group by a consistently smaller left atrial diameter and a cardiac output that failed to increase. Postpartum the subjects in the IUGR group had a significantly smaller left atrial diameter and faster mean circumferential fiber shortening.Conclusion. Maternal hemodynamic adaptation in the first weeks of pregnancy is defective in IUGR pregnancies, presumably associated with a concomitant inadequacy of the vascular filling stat

ISSN:0001-6349    

DOI:10.3109/00016349509021176

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Aim of study. It is well established that the cervical ripeness is of great prognostic value at labor induction. The available methods of measuring the cervical ripeness are not satisfactory. This study was therefore initiated to investigate if there is any correlation between cervical fetal fibronectin and cervical ripening at term.Method. Three groups were included in this study: women with unripe cervices, women with spontaneous cervical ripening and those with PGE2‐induced cervical ripening. Fetal fibronectin was measured by ELIZA after sampling from the cervical canal.Results. The cervical fetal fibronectin was low in women with unripe cervices. In women with favorable cervices a ten fold higher level was found. The fibronectin level was even higher after PGE2‐induced ripening.Conclusion. Conclusively an increased amount of cervical fetal fibronectin is registered during the cervical ripening process. A level of>0.80 μg/ml of cervical fetal fibronectin seems to indicate a favorable ce

ISSN:0001-6349    

DOI:10.3109/00016349509021177

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Background. The present study was designed to determine neonatal mortality and morbidity in non‐malformed singleton term infants delivered in breech presentation and identify a possible correlation between outcome on the one hand and mode of delivery, parity and birth weight on the other.Methods. Register‐based cohort study of all (n=15718) singleton term breech deliveries of non‐malformed infants in Denmark 1982–1990. Process and outcome measures: mode of delivery, gestational age, birth weight, congenital malformations, intrapartum death, Apgar scores and early neonatal death.Results. A total of 3247 (20.7%) term infants were delivered vaginally, 7106 (45.3%) by elective and 5356 (34.1%) by emergency cesarean section. Infants delivered vaginally and by emergency cesarean section had significantly higher rates of mortality (intrapartum and early neonatal death) and morbidity (low Apgar scores) when compared to those delivered by elective cesarean section. In vaginal deliveries, parity was not correlated with outcome, but infants with a birth weight above 4000 grams had significantly higher rates of low Apgar scores.Conclusions. Register data on singleton term breech deliveries imply that vaginal delivery is associated with increased mortality and morbidity. However, validation of data and additional information from the medical records are needed before a recommendation of whether selection of parturients, structure of perinatal care or professional skills need to be improved, or all singleton term infants in breech presentation should be delivered by cesarean

ISSN:0001-6349    

DOI:10.3109/00016349509021178

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Background. Intraperitoneal absorption of electrolyte‐free irrigating fluid may occur secondary to uterine perforation during endometrial resection, but the clinical course of this complication is known from only a few case reports.Methods. We studied symptoms, biochemical changes and the kinetics of solute equilibration over the peritoneal membrane in 10 healthy awake women who were subjected to an experimental absorption situation by receiving an intraperitoneal infusion of 25 ml/kg of a solution containing glycine 1.5% and ethanol 1% over 20 min. We also compared the use of breath ethanol and serum sodium samples to indicate the presence of irrigating fluid in the peritoneal cavity.Results. All infusions caused lower abdominal pain. The solute gradients between the peritoneal pool and plasma were reduced according to mono‐exponential functions with a half‐time of 33±5 min for ethanol, 92±9 min for sodium, 103±9 min for potassium, and 124±10 min for amino acids (mean±s.e.mean). Twenty minutes after infusion, the breath ethanol level reached a plateau which could be used to predict the infused volume within ±15% of the true value. In contrast, the serum sodium concentration decreased slowly and was only 3.0±0.7 mmol/l below baseline at 2 hours after infusion.Conclusions. The calculated rates of transperitoneal solute equilibration can be used to assess the need for substitution of electrolytes in patients who absorb irrigating fluid into the peritoneal cavity. Measurement of ethanol in the expired breath is more useful than serum sodium to indicate the existence of

ISSN:0001-6349    

DOI:10.3109/00016349509021179

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Background. Only few indications have appeared in the literature concerning a possible relationship between the use of oral contraceptives and low back pain. In our daily work we often meet women who have been recommended to abandon their use of oral contraceptives depending on coexisting low back pain. In order to assess the opinions of a possible relationship between oral contraceptives and low back pain this study was undertaken.Methods. A validated questionnaire was sent out to physicians, physiotherapists and midwives dealing with either contraceptive counselling or low back pain. A modified questionnaire was sent to medical‐and physiotherapist students to assess whether the opinions were a result of the education or the working experience.Results. A total of 225 questionnaires were sent out and 206 (91%) were returned. Sixteen percent thought there was a relationship between the use of oral contraceptives and risk of low back pain. Thirty percent had seen patients with low back pain that was interpreted as being affected by use of oral contraceptives. Twenty‐five percent recommended at least some patients with low back pain to change their contraceptive method. Among the students there was a difference in opinion between the first and the last year students indicating that their opinions had been influenced by their education.Conclusions. Evidently many professionals dealing with oral contraceptives and low back pain believe that there is a relationship between oral contraceptives and low back pain, despite the lack of scientific evidence. These recommendations might influence the contraceptive safety for the individual woman and the possible relationship between use of oral contraceptives and low back pain should therefore be more thoroughly investigated before general recommendations are gi

ISSN:0001-6349    

DOI:10.3109/00016349509021180

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Background. Possible relationships between menarche and fertility and fecundity later in life have not been fully clarified.Methods. A cross‐sectional study was made in a random sample of 3743 women, aged 15–44 years, in the county of Copenhagen; 78% responded. Telephone interviews were made with a sample of the non‐respondents.Results. Associations were observed between early menarche and increased risk of pelvic inflammatory disease (odds ratio 2.4 (1.4–4.1)) and spontaneous abortion (OR 3.1 (1.6–5.7)) later in life. On the other hand, no association was found with irregular bleedings or amenor‐rhoea; nor was a significant relationship established with fertility or fecundity. Late menarche was associated with underweight (OR 3.1 (1.4–6.9)), and early menarche with excess weight (OR 5.0 (2.4–10.6)). A significant positive correlation (R=0.17) was found between menarcheal age and final body height.Conclusions. Menarche was not associated with fatuity or fecundity. Early menarche was associated with pelvic inflammatory disease and spontaneous abortion. Menarche showed relationships with we

ISSN:0001-6349    

DOI:10.3109/00016349509021181

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Background. To evaluate T lymphocyte subsets in pelvic and paraortic lymph nodes, in patients with FIGO stage I endometrial carcinoma at different degrees of myometrial invasion and with lymphovascular space invasion. The aim was to define an eventual modulation of regional immune reactivity useful in the therapeutic approach of the disease.Methods. Twenty‐two women with FIGO stage I endometroid adenocarcinoma were consecutively recruited and selected for immunological study. All the patients underwent primary surgery characterized by radical hysterectomy (Piver's type III) with bilateral salpingo‐oophorectomy and systematic pelvic plus paraaortic lymphadenectomy. Lymphocyte tipization was performed by Beckton Dickinson monoclonal antibodies (CD4, CD8, CD56 and CD16) immunohistochemically in frozen‐sections (immune assay on lymph nodes). For statistical evaluations, Student's t test and one way analysis of variance were used.Results. Significantly higher percentages of CD4+ lymphocytes were found in pelvic than in paraaortic lymph nodes; however, by analyzing T lymphocyte content in the different pelvic nodal groups, we also observed significantly higher percentages of CD16 + and CD56 + cells in obturator nodes when compared to iliac stations. A significant increase of CD16 + and CD56+ cell percentages was then defined with respect to myometrial involvement and lymphovascular space invasion, in pelvic nodes.Conclusions. From our results, we could not define any clinical importance of nodal lymphocyte distribution in patients with early stage endometrial carcinoma; however, the observed nodal immune reactivity in presence of myometrial invasion seems interesting, with or without lymph vascular space involvement as possible expression of neoplastic systemic diff

ISSN:0001-6349    

DOI:10.3109/00016349509021182

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY