ISSN:0001-6349    

DOI:10.3109/00016348909013273

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Socioeconomic factors relating to all maternal deaths identified during the 12 months of the Jamaican Perinatal Morbidity and Mortality Survey were compared with a control population of over 10,000 women. The maternal mortality rate was 11.5 per 10,000 livebirths. Initial analyses revealed (a) that the risk of maternal death declined with increasing maternal education level, (b) that mothers who lived in households with direct pumped water and/or flush toilets enjoyed a reduced risk; (c) mothers who were themselves the major wage earner and (d) those living in households where the major wage earner and source of income was an agricultural worker or farmer were at increased risk of maternal death. A previous analysis showed that the mother's age, her parity and variables indicating access to medical care were important. Logistic regression showed that only maternal age and toilet facilities were independently associated with maternal mortality.

ISSN:0001-6349    

DOI:10.3109/00016348909013274

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

We have studied the cesarean section frequencies and changing spectrum of indications in Norway during six consecutive 3‐year periods from 1967 to 1984. The data set consists of 1,046,162 births notified to the Medical birth registry of Norway, of which 52,426 were specified as cesarean sections, the frequency rising from 1.9% in 1967–69 to 9.7% in 1982–84. A check for completeness of cesarean section notification was made against the birth protocols of the largest obstetrical unit in Norway. The error rate was about 3%. Information on the indication for performing cesarean section was missing in 11.4% of the cases. We grouped thirty‐one specified indications under seven headings. In 1967–69 the operation was most often performed for ‘maternal’ reasons, followed by ‘mechanical’, ‘abnormalities of fetal presentation’ and ‘acute placental’ conditions. Throughout the study period, ‘mechanical’ (which can also be labelled ‘dystocia’) accounted for about one third of the indications for cesarean section, while ‘maternal’ (including high maternal age and pre‐eclampsia) and ‘acute placental’ (placenta praevia and placental abruption) decreased in relative importance. ‘Fetal presentation’ (including twins) doubled its relative share, while increasing from 2.4 per 1000 births in 1967–69 to 24.8 per 1000 births in 1982–84. A steep rise in the group ‘fetal asphyxia’ corresponded to the period when the mess of electronic monitoring devices was introduced, in the early 1970s. ‘Fetal asphyxia’ had a higher relative share of the indicati

ISSN:0001-6349    

DOI:10.3109/00016348909013275

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

A retrospective analysis was made of the second deliveries of 492 women who had previously undergone emergency cesarean section with a clinical indication of cephalopelvic disproportion and had undergone X‐ray pelvimetry. In their index (second) pregnancy, 234 (47%) had an elective cesarean section; 122 (25%) gave birth vaginally and 136 (28%) had undergone an emergency cesarean section. Maternal height had a moderate value as a surrogate measure of pelvic capacity. A trial labor was more often allowed in women with larger obstetrical conjugate (inlet) measurements but likelihood of a successful outcome of labor was not influenced by the above pelvic measurements. A baby weighing more than 4000 g was associated with a greatly reduced chance of a vaginal delivery. The study confirms the limitations of X‐ray pelvimetry measurements and proposes that antenatal estimation of fetal size may be of benefit in determining the likelihood of success in a trial la

ISSN:0001-6349    

DOI:10.3109/00016348909013276

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

A retrospective study was made to determine the incidence of pregnancy‐induced hypertension (PIH, pre‐eclampsia) in Iceland. One‐fourth of all births in Iceland in 1985 were selected from the national birth registry files by random number allocation, a total of 904 women. Maternity records were found in 97.9% of the cases. The criteria used to define PIH were met in 17.4% of the women. There were 146 (16.5%) with mild PIH (blood pressure of ≥/ 140/90 mmHg with or without proteinuria after the 20th gestational week). Eight (0.9%) had severe PIH (blood pressure of ≥/160/110 mmHg with or without proteinuria after the 20th gestational week). Primigravid women formed one‐third of the group and of these 20.9% had PIH compared with 15.4% of the parous women. The incidence in parous women was higher than usual

ISSN:0001-6349    

DOI:10.3109/00016348909013277

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

The natural course of uterochorionic vascular resistance during the first trimester of pregnancy is described. We performed a weekly study using a pulsed Doppler in 25 normal pregnancies, with a total of 191 examinations made. The flow velocity waveform was studied simultaneously in the retrochorionic area as well as in the uterine arteries. Different velocimetry indices were analysed, which demonstrated the feasibility of the (D/S) × 100 index for study of the retrochorionic vessels and of the Pourcelot index (S‐D/S) for the uterine arteries. A gradual weekly decrease in flow resistance was found, with significant differences before [D/S]× 100 = 52,01±8,33; S‐D/S=0,83±0.09]vs after the 9th week [(D/S) × 100=58,9±8,78; S‐D/S=0,72±0,10]. Further evaluation of its predictive and diagnostic value in gestational pathology

ISSN:0001-6349    

DOI:10.3109/00016348909013278

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

The purpose of this study was to examine if a short umbilical cord might give rise to fetal distress of such a severity that would necessitate operative delivery. Review of the literature gave little clarification. Out of a database consisting of 7212 births, 5885 were included in the study according to pre‐set criteria. The incidence of operative delivery was then compared with cord length. A significantly higher incidence of forceps deliveries and vacuum extractions was found when cord length was less then 40 cm. The incidence of cesarean section was also higher for the shorter cords. There was no increased need for neonatal resuscitation for the babies with the shortest cord

ISSN:0001-6349    

DOI:10.3109/00016348909013279

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Because of the crucial importance of guiding current thinking in the field of HPV epidemiology, the concept of the existence of HPV DNA in histologically normal squamous epithelium was re‐evaluated. A series of 102 randomly collected cervical punch biopsies, previously proved to contain the DNA of HPV types 6, 11, 16, 18, 31 or 33 by in situ hybridization were subjected to analysis for the localization of HPV DNA, i.a., whether found in the normal epithelium or at the lesion site only. This material consisted of a representative series of flat, endophytic and papillary HW lesions with all histological grades from HPV‐NCIN to HPV‐CIN 111, and the six HPV types in the same proportions as they occur in non‐selected series of HPV lesions. Weak signals of HW DNA were found in the basal cells in 6/102 (5.8%) of the biopsies. HPV DNA was constantly present in the parabasal cells in 25/102 (25.4%). in the intermediate cell layers in (98/102, 96%), and in the superficial cells of all 102 lesions. Noteworthy was the constant failure to reveal even weak signals of HPV DNA (of any of the six types) in histologically normal squamous epithelium of any of the 87 lesions, where such an epithelium was detectable. The present findings confirm our previous ‘impression’ that HW DNA rarely if ever appears in the histologically normal squamous (or columnar) epithelium in the genital tract, when analysed using the in situ hybridization. Thus, great care should be exercised in interpreting results that suggest the discovery of HW DNA in normal genital tract epithelium, unless based on firm documentation by in situ hy

ISSN:0001-6349    

DOI:10.3109/00016348909013280

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

A series of 119 women with Human papillomavirus (HPV) infections of the uterine cervix and/or vagina were included in the present study, where the efficacy of cryotherapy and CO2‐laser vaporization was assessed after a mean follow‐up of 14 months (SD 6 months) after treatment, as related to the natural history of the disease. Routine Papanicolaou (PAP) smears with HPV‐induced changes were the basis for patient recruitment. Patients with cervical HPV lesions (HPV‐NCIN, HPV‐CIN l or II) were randomly allocated into laser (55 women) and cryotherapy (42 women) groups. Women with combined lesions (HPV‐CIN&HPV‐VAIN) were treated by laser (22 patients). The cure rate after laser vaporization was practically identical to that of cryotherapy, 64% and 54%, respectively (difference not statistically significant). The success rate was significantly lower (40%) for the combined lesions (HPV‐CIN&HPV‐VAIN)(p<0.05). The residual disease encountered in patients after the first treatment with cryotherapy and laser was classified as HPV‐NCIN in 78.9% and 37.0%, respectively. The number of patients is still too small to draw reliable conclusions on the effects of these therapy modes, as related to HPV type of lesion (HPV 6, 11, 16, 18, 31 and 33). The cure rates for both cryotherapy and laser in our treatment groups were significantly higher than the spontaneous regression rate (p<0.001), suggesting that treatment by either cryotherapy or CO2,‐laser vaporization significantly changes the natural history of genital HPV infections. More patients and longer follow‐up are still needed, however, to fully establish the efficacy of the current treatment modalities in gynec

ISSN:0001-6349    

DOI:10.3109/00016348909013281

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

A total of 323 pairs of specimens from women with Papanicolau class II or III cytology were examined for human papillomavirus (HPV) types 6, 11, 16 and 18 by spot hybridization. Each pair consisted of a representative biopsy specimen and a smear specimen from cervical, vaginal or, more rarely, vulvar lesions. We found a close correlation between HPV findings in biopsies and smears. In 83.9% (271) of the cases, both specimens were either positive for a given HPV type or negative. No discordant HPV‐types in the two types of specimens were found. In 15.8% (51) of the cases, one specimen proved positive for a given HPV‐type while the other specimen from the same patient was negative. In 8.0% (26) of the cases, the biopsy specimen proved positive and the corresponding smear specimen was negative. On the other hand, in 7.7% (25) of the cases we were able to detect HPV DNA in the smear specimen, whereas the corresponding biopsy specimen was negative. We suggest that a smear specimen would be advantageous for screening large groups of patients for the presence of a HPV infection in the genital tract. By using smear specimens together with biopsy specimens it is possible to maximize the number of HPV infection diagno

ISSN:0001-6349    

DOI:10.3109/00016348909013282

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY