摘要:

Background. The extension of the female corpus spongiosum is subject to controversy. The anterior continuation of the vestibular bulbs, or pars intermedia, is not commonly recognized as part of the corpus spongiosum. Some authors deny this part of the corpus spongiosum exists in females.Material and Methods. To investigate this controversy, anatomic and histologic studies were performed of the female corpus spongiosum. The specimens were taken from female‐to‐male transsexual surgical patients and from fresh female cadavers. They were compared to surgically amputated penises to establish the similarity in male and female anatomy.Results Conclusions. The female corpus spongiosum is proven to extend anteriorly from the bilateral vestibular bulbs to terminate as the enlarged glans clitoridis. This latter structure also consists of spongious tissue. The spongiosum is hypertrophied in hormonally treated female‐to‐male transsexuals. The cleft vulvar anatomy is homologue to its non‐cleft male co

ISSN:0001-6349    

DOI:10.3109/00016349509021194

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Background. Evidence about the influence of hypertension in pregnancy on later health and in particular the risk of cardiovascular disorders is conflicting, although a link has been suggested. In a population‐based study with a long follow‐up time the potential association between hypertension in pregnancy, preeclampsia and eclampsia with increased death rates from ischemic heart disease (IHD) was investigated.Methods. All 7543 case records at the main maternity hospital in Iceland during 1931–1947 were reviewed to identify women with hypertension in pregnancy, subdivided by parity and severity of disease into those with eclampsia, preeclampsia and hypertension alone. Information on those who had died was obtained from death certificates, supplemented by autopsy reports and hospital records. Death rates from IHD were compared to population data from public health and census reports during corresponding periods and between study groups.Results. Of 374 hypertensive women 177 had died. The death rate was slightly higher among women with any hypertension in pregnancy than in the reference population (RR=1.20; 95% CI 1.01–1.42). About half of the increase was attributed to excess mortality from IHD with a relative risk of dying of 1.47 (95% CI 1.05–2.02). The relative risk of dying from IHD was significantly higher among eclamptic women (RR = 2.61; 95% CI 1.11–6.12) and those with preeclampsia (RR=1.90; 95% CI 1.02–3.52) than those with hypertension alone. Parous women at the index pregnancy had a twofold higher risk of dying from IHD than primigravid women (RR = 2.05; 95% CI 1.19–3.55;p= 0.01).Conclusion. There is an indication of increased death rates among women with a history of hypertension in pregnancy, where ischemic heart disease may be more common than in the gen

ISSN:0001-6349    

DOI:10.3109/00016349509021195

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Background. High dose intravenous immunoglobulin has been reported to be advantageous in the treatment of alloimmunization during pregnancy. The mode of action is unknown.Method. High dose intravenous immunoglobulin was used as the sole prenatal treatment in six severely rhesus(D) sensitized pregnant women. Maternal and fetal anti‐D concentrations as well as fetal hemoglobin concentrations were studied. Seven pregnancies in rhesus(D) sensitized women served as controls. They received no treatment because they had milder forms of erythroblastosis fetalis or, in one case, a rhesus(D) negative fetus.Result. No obvious inhibitory effect of the treatment on maternal anti‐D production and transplacental anti‐D passage to the fetus was found. The fetal hemoglobin concentrations remained stable at about 80 g/L (hematocrit 27%) in five of six treated patients while there was a significant decrease in the control group.Conclusion. High dose intravenous immunoglobulin treatment seems to act mainly on fetal red cell destruction rate, possibly by blocking Fc receptor mediated macrophage phagocytosis. We claim that the treatment can successfully be used to prevent further deterioration of fetal anemia in rhesus(D) immunizations if started before severe fetal anemia (hemoglobin concentration<70 g/L. hematocrit<23%) and imminent hydrops fetalis a

ISSN:0001-6349    

DOI:10.3109/00016349509021196

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Background. To investigate chronological changes of subjective symptoms during a normal pregnancy in nulliparous and multiparous women.Methods. Prospective data were collected using a 20‐item questionnaire (general fatigue, headache, palpitation, nausea/vomiting, fever, insomnia, edema, abnormal abdominal size, urinary frequency, lumbago, fetal descent, genital bleeding, watery discharge, high frequency of uterine contraction, increase in frequency of uterine contraction, strong intensity of uterine contraction, increase in intensity of uterine contraction, no change of uterine contraction at rest, high frequency of fetal movements, strong intensity of fetal movements) at Tsushima Izuhara Hospital in Nagasaki Prefecture, Japan. Seven hundred and twenty‐nine nulliparous and 588 multiparous normal pregnant women were questioned from 1988 to 1992. A simple (chi‐square test) analysis of appearance percentages in each item for every term of pregnancy was made.Results. Each symptom showed different chronological patterns. In the simple analysis, there were significant differences (p<0.05) in 10 symptoms (headache, palpitation, fever, insomnia, lumbago, fetal descent, watery discharge, increase in frequency of uterine contraction, strong intensity of uterine contraction, strong intensity of fetal movements) between nulliparous and multiparous subjects. In the multiparous group, there was a higher severity in eight of the ten symptoms, except for fever and watery discharge.Conclusions. The multiparous group had more complaints than did the nulliparous subjects. These normal patterns are of practical clinical use concerning subjective symptoms of preg

ISSN:0001-6349    

DOI:10.3109/00016349509021197

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Background. The objectives of this study were (i) to assess the effect of hypertensive disorders of pregnancy on the risk of stillbirth, and (ii) to characterize the relationship between hypertension and stillbirth separately by gravidity, race, ‘explained’ versus ‘unexplained’ causes of stillbirth, and antepartum versus intrapartum stillbirths.Methods. The study was based on a retrospective cohort of approximately 400,000 pregnancies identified through the birth and fetal death certificates in North Carolina, USA, between 1988 and 1991. Multivariable polytomous logistic regression was used to generate odds ratios comparing stillbirth risk in hypertensive compared to non‐hypertensive mothers, adjusted for potential confounders.Results. The risk of chronic hypertension was 7.6 per 1000 pregnancies, while pregnancy‐induced hypertension (PIH) and eclampsia were reported in 36.6 and 6.0 per 1000 pregnancies, respectively. Pregnancies among chronic hypertensives were more likely to result in losses after 28 weeks gestation (RR=3.29, 95% CI: 2.43–4.43), while the risk ratio was 2.16 (95% CI: 1.45–3.22) for losses prior to 28 weeks' gestation. Pregnancies to patients with PIH were at 1.42 (95% CI: 1.15–1.79) times greater risk of terminating in late stillbirth, while the risk ratio for eclampsia was 2.23 (95% CI: 1.51–3.30). The risk ratio for ‘explained’ antepartum stillbirth was higher than intrapartum stillbirth for all of the hypertensive diseases.Conclusions. Hypertensive disorders were found to have a strong adverse impact on stillbirth suggesting that early diagnosis of hypertension during pregnancy and adequate medical intervention may help reduce

ISSN:0001-6349    

DOI:10.3109/00016349509021198

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Background. This study was performed in women who had attended the clinic for contraceptive advice to determine whether a history of casual sex with a foreign male, previously unknown to them (SFM) in their home country (Sweden), constituted an increased risk for acquiring sexually transmitted diseases (STD) as compared to women without such an experience (COMP).Methods. Of 996 women enrolled, and who were subjected to a structured deep‐interview performed by midwives, 595 (59.7%) stated that they had experienced casual sex within Sweden with for them a previously unknown Swedish male (SSM).Results. A history of SFM was reported by 120 (12.0%) women. A history of chlamydial infection (26.0%) and gonorrhea (13.0%) were more common in the SFM women than in either the COMP (16.0% and 3.0%) or the SSM (19.0% and 4.0%) groups. Genital warts (8.0%) and bacterial vaginosis (23.0%) were found more often in the SFM group as compared to both the COMP (3.0% and 12.0%) and the SSM (4.0% and 13.0%) group. Women in the SFM group more often had a current genital chlamydial infection (13.0%) than those in the COMP group (8.0%.). When adjustment was made for markers of sexual risk taking, only genital warts remained significantly (p=0.05) associated with SFM as compared to both SSM and COMP.Conclusions. To conclude, the study shows that women with experience of SFM had, more often, a history of one or more STDs and were more often carriers of STD agents than those lacking experience of SFM and/or SSM. However, there was no such difference when comparing the SFM and SSM women when making adjustments for sexual risk behavior. Thus a sexual risky lifestyle is more important than the origin of the sex partner for acquiring STDs with possible exception of HIV/AIDS in the society studie

ISSN:0001-6349    

DOI:10.3109/00016349509021199

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Background. To investigate whether the conjunctival epithelium shows cyclical maturation changes during the ovarian cycle and to study the cytological appearance of the conjunctiva in postmenopausal and pregnant women.Patients. Fifteen menstruating women with ovulatory cycles, ten postmenopausal women. and twelve pregnant women in the second or the third trimester of their pregnancy.Interventions. Conjunctival and vaginal smears were taken on a near‐daily basis.Main outcome measures. The percentage of the parabasal, the intermediate and the superficial cells (Maturation Index) in each specimen was determined.Results. In the conjunctival smears of the menstruating women cyclical maturation changes were noted. These changes were parallel to those of the vaginal smears, but to a minor degree. No cyclical changes were found in either the postmenopausal women or in the pregnant women, showing an extreme shift to the left in the Maturation Index.Conclusion. Conjunctiva appears to be a relatively estrogen‐sensitive epithel

ISSN:0001-6349    

DOI:10.3109/00016349509021200

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Background. To reevaluate whether spironolactone, a steroid receptor antagonist, is effective in improving premenstrual syndrome (PMS) in a double‐blind, placebo‐controlled cross over study.Methods. Thirty‐five women with PMS were given one tablet of 100 mg spironolactone or placebo daily from day 14 of the menstrual cycle until the first day of the following menstruation. Two pretreatment cycles were observed for diagnosis in each woman, followed by 6 treatment cycles with spironolactone and placebo applied in either the first or second 3 months. The assessment of symptoms and diagnosis of PMS were based on prospective daily self‐ratings made by the women using a validated visual analogue scale.Results. The treatment with spironolactone was associated with an improvement in PMS symptoms compared to placebo as judged by significant decrease in negative mood symptom scores (p<0.001) and somatic symptom scores (p<0.001). Of the individual symptoms, spironolactone significantly improved irritability, depression, feeling of swelling, breast tenderness and food craving in comparison to placebo. A lasting effect of spironolactone was observed in women started with spironolactone after cross over to placebo.Conclusions. Spironolactone appears to be an effective therapy for the negative mood changes and somatic symptoms

ISSN:0001-6349    

DOI:10.3109/00016349509021201

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Background. To study the effectiveness of three different cervical ripening agents in terms of dilatation ability and patient discomfort in connection with legal first trimester abortion.Methods. Three randomized trials among unselected nulliparous women were performed 1: hygroscopic tentversusgemeprost, 2: misoprostolversusgemeprost and 3: misoprostol administered orally 17versus10 hours before vacuum curettage was performed.Main outcomes. Dilatation ability, frequent gastrointestinal side effects, severe pain (patients' perception).Results. In Trial 1, there was a tendency of a greater dilatation ability using the hygroscopic tent, while the experience of pain was a greater problem with gemeprost. In Trials 2 and 3, there were no significant differences in the dilatation abilities or gastrointestinal patient discomfort. There was a tendency towards a higher demand for narcotic analgesics in patients treated with gemeprost compared with all other groups.Conclusions. Gemeprost and misoprostol showed almost identical ability to dilate and caused patient‐experienced discomfort to the same degree. The use of misoprostol may be preferred as it has the advantage of being both less expensive and easier to administe

ISSN:0001-6349    

DOI:10.3109/00016349509021202

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Background. Our purpose was to characterize women expressing ambivalence when applying for abortion.Material and methods. Data were collected, by self‐administered questionnaires, from 339 women. Thirty percent were in doubt about the decision when the abortion was due. Socio‐economic factors more often influenced the choice among ambivalent women than among those not in any doubt.Results. Ambivalent women more often felt exposed to social pressure and some felt that the abortion was not their own choice. Their decision‐making was marked by doubt during the entire process.Conclusions. There is a need for professional support during this decision‐making process. Many of the ambivalent women stated that their decision might not have been the same under different personal circum

ISSN:0001-6349    

DOI:10.3109/00016349509021203

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY