ISSN:0001-6349    

DOI:10.3109/00016349409029399

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Ehlers‐Danlos syndrome (EDS) comprises a group of heritable disorders of connective tissue. The present classification comprises ten or more types, based on a combination of clinical, genetic and biochemical criteria (1). The inheritance is usually autosomal dominant, but rarely recessive and X‐linked recessive cases occur. To some extent, the basic genetic defects involving collagen genes have been identitied

ISSN:0001-6349    

DOI:10.3109/00016349409029400

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Objective: To study health and health care during pregnancy for manual workers compared with non‐manual employees.Design: A prospective population‐based study of all women who were registered for antenatal care during 1986 in the catchment areas of three health centers.Subject: Three district antenatal clinics in southern Sweden.Setting: 409 pregnant women; of whom 403 with singleton pregnancies; of whom 185 were manual workers and 175 were non‐manual employees.Main outcome measures.: Problems encountered (registered according to the international classification of diseases) and measures taken.Results: The study population resembled all women who gave birth in Sweden during the same year. Both manual workers and non‐manual employees registered for antenatal care in early pregnancy (96% and 97%, respectively, before 15 completed weeks). The women in both groups made the same number of visits to the antenatal clinics (median 17 and 13 respectively). There were no differences between the two groups of women as regards the percentage figures for obstetric problems encountered during pregnancy. The manual workers had a higher frequency of diseases of the musculoskeletal system (mainly low‐back pain) compared with the non‐manual employees (RR = 1.89; 95% CI = 1.20‐2.98), and they were sicklisted more often (RR = 1.21; 95% CI = 1.01‐1.46). On the other hand, their frequency of amniocentesis was lower (RR = 0.39; 95% CI = 0.19‐0.80); the reason for this was that the manual workers were younger than the non‐manual employees. Otherwise, there were no differences between the two groups of women as regards the percentage figures, either for non‐obstetric problems encountered, or measures taken, or regarding the outcome of pregnancy.Conclusion: In Sweden, both manual and non‐manual working women appear to enjoy equal antenatal health and receive equal antenatal care. This conclusion is based on a small study population, meticulously monitored prospective

ISSN:0001-6349    

DOI:10.3109/00016349409029401

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Background. Pre‐eclampsia is regarded as a primary placental disorder, in which defect placentation causes endothelial and cardiovascular disturbances. Evidence of disturbed neural cardiovascular control in this condition has been suggested, as well as in other hypertensive diseases. The purpose of the present study was to non‐invasively evaluate the sympatho‐vagal balance during normal and pre‐eclamptic pregnancy.Methods. In twelve healthy pregnant women, thirteen pre‐eclaniptic women and ten non‐pregnant controls. Heart rate, blood pressure and breathing movements were registered and recorded on B tape recorder for off‐line analysis. Variability in heart rate, blood pressure and breathing movements were computed by an autoregressive spectral analysis algorithm. Heart rate variability was quantitated as the area under the spectral curve, and Student's t‐test was performed on logarithmic values.Results. Heart rate variability contained two major components in power, a low frequency peak predominantly attributed to sympathetic tone, and a high frequency peak reflecting vagal tone. Women with pre‐eclampsia were characterized by a significantly reduced high frequency peak compared to healthy pregnant (p= 0.03) and non‐pregnant (p= 0.02) women. In the low frequency band there were no significant differences in power between the groups. Blood pressure variability did not differ between the groups.Conclusion. The present results indicate that pre‐eclampsia is associated with decreased vagal control of the heart. Furthermore, the results indicate that pregnancyper sedoes not change s

ISSN:0001-6349    

DOI:10.3109/00016349409029402

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The association of preeclampsia with thrombocytopenia and prolonged bleeding time is reported The analysis of bleeding time (Simplate II) and the platelet count (Automatic Coulter Counter) in 41 patients with different grades of preeclampsia is presented. Our results suggest that the decrease in the bleeding time observed in moderate preeclampsia and the increase observed in severe preeclampsia are not mainly dependent on the platelet count.

ISSN:0001-6349    

DOI:10.3109/00016349409029403

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Perinatal health care is an important part of a nation's health care system. In the Nordic countries this type of health care is provided by the national public health systems without cost for the women. The societal costs of the care provided have, however. not been known. The aim of the present study was to estimate societal costs of antenatal and obstetrical care in a Norwegian county during a twelve month period 1988‐89. A total of 1908 women delivered during the registration period. The mean total cost was estimated to NOK 36.300 per woman. Primary care antenatal visits accounted for 8%. outpatient visits (inclusive ultrasound screening) 4%, and hospital care in connection with delivery represented 36% of the total cost. The major determinant of societal costs was sick leave during pregnancy, contributing 43% to the total cost. This underlines the importance of the ongoing debate about sick leave in pregnancy. The mean cost of primary care based antenatal care, averaging 10.8 visits per woman. was estimated to NOK 2.800. An important factor was use of patients' own time. accounting for 3% of this amount. The prevalence at the time of admission for delivery of five important complications or obstetrical conditions (pre‐eclampsia. placenta previa, intrauterine growth retardation, twin pregnancy, and breech presentation) was recorded. The mean total societal cost for women with the indicator conditions was approximately one fifth greater than for women without any of the indicator conditi

ISSN:0001-6349    

DOI:10.3109/00016349409029404

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Background.Thrombocytopenia in pregnancy, during and after delivery can be an indicator of seriouh preeclampsia or any condition accompanied by disseminated intravascular coagulation (DIC). In order to recognize thrombocytopenia, it is important to know theexpectedplatelet count in healthy women. Literature search gave no information regarding changes of platelel count in healthy women shortly after uneventful pregnancies and uncomplicated deliveries, either vaginal or cesarean section. The intention of this study was to investigate whether there were any such changes.Methods.Blood samples were taken on admission to the obstetric ward, first and third day after vaginal delivery (11 patients) or cesarean section (11 patients). Platelet count, hemoglobin coilcentration and hematocrit was measured for each blood sample.Results.There was no significant change in platelet count after vaginal delivery. Following cesarean section there was a median decrease in platelet count of 12.5′%, the first postoperative day, and a median increase of 5% the third postoperative day.Conclusions.Platelet count remains unchanged after uncomplicated vaginal delivery. Shortly following normal pregnancy and uncomplicated cesarean section platelets should be expected to decrease slightl

ISSN:0001-6349    

DOI:10.3109/00016349409029405

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Objective.To analyze the trends in vaginal operative deliveries in Italy.Design.Analysis of information on all deliveries after the 28th week of gestation. Routinely collected by the Italian Central Institute of Statistics using a standard form.Setting.National data on all Italian deliveries in the period 1981‐85.Subjects.All deliveries occurred in Italy in the period.Results.Forceps and vacuum delivery were reported in 1981 respectively in 0.9 and 2.1/100 deliveries. Similar percentages were observed during the whole considered quinquennium for viicuum extraction, but the forceps delivery rate decreased to 0.6/100 in 1985. Nulliparous women more frequently had an operative vaginal delivery: the rates of forceps and vacuum deliveries were respectively 1.1 and 3.7/100 in nulliparae and 0.3 and 1.0 in women reporting one or more previous births. There was a direct relationship between vacuum delivery rate and birth weight: vacuum deliveries were reported for respectively 0.9 and 2.3/100 infants weighing less than 2500 g and 22500 g. Likewise. vaginal operative deliveries were more frequent in term or post‐term births, and vacuum deliveries among singleton births than multiple ones (2.3 vs 1.71100 deliveries).Conclusions.Operative vaginal delivery rates in Italy in the mid 1980′s were lower than in most developed countries. The reasons for forceps and vacuum extraction were similar to other developed countries with regard to obstetric determinants, but some differences emerged for socio‐demographic

ISSN:0001-6349    

DOI:10.3109/00016349409029406

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Study objectives.To examine sperm donors' motivations and emotional reactions to the role of donors and to measure their willingness to provide information about themselves to recipients and offspring.Design.A prospective trial in which the 26 subjects who were actively functioning as sperm donors in our fertility clinic at the time of investigation were asked to fill in a questionnaire and return it anonymously and voluntarily.Main results.8% of the donors stated purely altruistic motivation. 32% purely financial and 60% a combination of both. The acceptance rate for providing non‐identifying, phenotypic. descriptive information to recipients is 76%, for providing medical information it is 60% and the provisioii of psychosocial infornmation is accepted by 28% to 40%, depending on the item. 20% of donors are willing to continue donation if the present rules of anonymity are revoked.Conclusions.Most donors do not seem to feel any close relationship to donor offspring and at least 60% found anonymity to be essential for their further functioning as donor

ISSN:0001-6349    

DOI:10.3109/00016349409029407

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Background. To measure the cumulative incidence of first and second repeat induced abortion and what differentiates first‐time repeaters from non‐repeaters.Methods. The study population comprised 2925 women who had their first induced abortion at the University Hospital of Trondheim, Norway between January 1, 1987 and December 31. IOYI. Repeat induced abortion within the study period was measured as a cumulative incidence of second and third induced abortion. Survival analyses and logistic regression analysis were applied using ‘repeater’ as the dependent variable.Result. The cumulative incidence of second induced abortion was 3.7% at end of first year, 7.1% at end of second year, 9.9% at the end of third year, and 12.3% at four completed years of observation. The cumulative incidence of third induced abortion was 0.1% at the end of first year. 0.6% at the end of second, 1.3%, at the end of third and 2.0% at four years of Observation. The cumulative incidence of the third abortion, measured as the time at risk from the second to the third abortion, remained twice that of the cumulative incidence of the second abortion after one year of observation (p<0.001). At the first abortion. Variables predicting a risk for repeat induced abortion were age, occupational status and becoming pregnant is a result of a contraceptive failure.Conclusion.Repeat induced abortion is inevitable. The incidence of repeat induced abortions doubled from the second to the third abortion, indicating that the moral threshold for choosing an abortion after recognition of an unplanned pregnancy is the first induced abortion. More detailed studies on the effect of intensified contraceptive counselling programs after the first abortion are

ISSN:0001-6349    

DOI:10.3109/00016349409029408

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY