摘要:

In the human myometrium. the formation of gap junctions in the various stages of labor and, in correlation with the concentration of progesterone in the maternal blood, has not been described adequately. The accepted hypothesis that raised concentrations of progesterone in maternal blood in animals prevent the formation of gap junctions was scrutinized in human niyometrium. Myometrial tissue was examined by electron microscopy for the presence of gap lunctions and analyzed morphometrically in 17 women who had an elective or emergency cesarean operation at the 38th or 39th week of pregnancy. The concentrations of progesterone and estradiol in the maternal and cord blood was measured by means of radioimiiiunoassay. The frequency and area of gap junctions varied in relation to the presence or absence of labor. In the myometrium of women in labor, gap junctions were most frequent (5.2/1000 μm of cell membrane), their area largest (0.32 μ2/1000 μm of cell membrane) and their fractional area greatest (0.20%). When the women were not in genuine labor or when contractions were weak, the percentage fractional areas of gap junctions were low (0.020‐0 090) and the gap junctions very small. In the pre‐ and active phases of labor, the concentration of progesterone in maternal blood was significantly higher (p<0.025 and 0.03 respectively) than in women who were not in labor.Hence, despite high concentrations of progesterone in the maternal and cord blood at term, the myometrium presented numerous gap junctions of relatively larg

ISSN:0001-6349    

DOI:10.3109/00016349409006247

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Study Objective. To analyse the yield of fetal liver tissue in first trimester abortions and to evaluate the number of nucleated cells obtained from each fetal liver during the sixth to twelfth week of gestation.Design. Prospective descriptive studyLocationUniversity Hospital.MaterialWomen seeking abortion during a 12 month period 1992/1993.Results. Out of 1271 women seeking abortion, 152 were asked whether they were willing to donate fetal tissue for fetal transplantation. Of these women, 105 (69%) accepted the proposal and undcrwent a modified low suction vacuum curettage. Fetal liver tissue was obtained in 61 (58%) of these procedures. The frequency at which tissue was retrieved was strongly related to gestational age and rose from 29% in week 6 to 79% in the tenth to twelfth week of gestation. The mean number of nucleated cells obtained from each fetal liver demonstrated a conconiitant increase with gestational age, rising from 16 to 43 × 106per liver during these weeks of gestation. Of the 61 cases in which fetal liver was obtained. four subjects were shown to be abnormal by laboratory analyses and 11 did not alter the mandatory follow‐up appointment. This left 46 cases for use in the program of fetal to fetal transplantations.Conclusions. Most women seeking abortion seem to be in favor of the idea of fetal tissue donation lor the treatment of other fetuses. The possibility of obtaining fetal liver tissue and the number of fetal stem cells retrieved are closely correlated to gestational age. A tissue bank appears to facilitate the operation of a fetal to fetal stem cell transplantation progr

ISSN:0001-6349    

DOI:10.3109/00016349409006248

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Study objective. Goal of the study was to analyze the relationship between anticardiolipin antibodies lupus anticoagulant and the risk of intrauterine late fetal death.Design. A case‐control study was conducted in a network of general and teaching hospitals in northern Italy. Cases studied were 99 women (median age 27 years), without clinical evidence of systemic lupus erythematosus or other immunological disorders who had an ‘unexplained’ intrauterine fetal death at or after the 20 weeks of gestation. The control subjects tiere 85 women (median age 28 years) who gave birth at term (>37 weeks gestation) to healthy infants on randomly selected days at the same hospitals where cases had been identified.Results. The presence of lupus anticoagulant was detected in four of the 99 cases (4%. 95% confidence interval 2% ‐15%) and none of the 85 controls. A total of 10 out of the 89 cases (11%. 95 confidence interval 6%‐23%). but none of the 79 controls for whom anticardiolipin antibodies value was available had elevated anticardiolipin antibodies; this difference was statistically significant (x2= 9.38

ISSN:0001-6349    

DOI:10.3109/00016349409006249

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

All departments of Obstetrics and Gynecology, as well as all private clinics in Sweden offering assisted cwnception, were surveyed by means of a questionnaire to determine the utilization rate and outcome of multifetal pregnancy reduction (MFR) for the period I January 1986 to 30 June 1992. The response rate was 100%. Multifetal reduction was performed in 26 women, giving an average utilization rate of 1/7 multiple births of three or more for the entire period. Of the various techniques used, intracardiac or intrathoracic injection of a potassiuni chloride solution was predominant. The experience of each center with multifetal reductioiis varied between one and six procedures. In this series, the overall complete pregnancy loss was 27% (n = 7). In 73% (n= 19) of women the pregnancy continued to delivery. One fetus died in utero in the second trimester, one child died from a subtentorial hemorrhage perinatall). and one child had a malformation of the right foot and hand. It seems necessary to limit MFR to a few centers in Sweden in order to maintain and increase the experience of the operators involved, and to decrease the fetal loss rate associated with the procedure. However. the ultimate goal is to make these procedures unnecessary when methods of avoiding excessive ovulation are refined and by limiting the number of replaced embryos in IVF‐treatmen

ISSN:0001-6349    

DOI:10.3109/00016349409006252

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

During ihe years 1979‐91 252 women with polycystic ovarian syndrome (PCOS) have been treated with ovarian electrocautery through the laparoscope in Aker University Hospital. Ovulation was obtained in 92% of the total series, and pregnancy in 84% of the women with PCOS as the sole cause of their infertility. Additional treatment with clomiphene citrate to the non‐responders increased the pregnancy rate to 89% The response to ovarian electrocautery was inlluenced by body weight, with an ovulation rate of 96‐97% in the slim and moderately obese women decreasing to 70% in the really obese ones. When ovulation was established. the pregnancy rateper sewas independent of body weight ‐ when ovulation was established. the pregnancy rates of slim and overweight women with PCOS being 92% and 95%, respectively. In the responders (who ovulated following ovarian electrocautery), the annual rate of cessation of ovulation was 3‐4% only. Even after a period of contraceptive use following the ovarian electrocautery, ovulation was resumed and pregnancy obtained within a few months. Therefore, ovarian electrocautery is proposed as the primary treatment in women with PCOS undergoing laparoscopy for any reason, infertility being a present, future oi hypothetical problem only. When, on the other hand, infertility is not an issue, PCOSper seconstitutes no reason to perform la

ISSN:0001-6349    

DOI:10.3109/00016349409006253

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

We compared transvaginal sonography and hysteroscopy with dilatation and curettage findings in 45 women with atypical postmenopausal bleedings. The histological diagnosis was atrophy in eight (17.8%) women. hormonal effects in 14 (31.1%), endometrial polyp in 19 (42.2%) xnd adenocarcinoma in four (8.8%). Hysteroscopy detected 16 (78.9%) of the 19 cases wirh polyps and two of the four with carcinoma. Sensitivity and specificity for endometrial pathology were 86.9% and 91.7% respectively. A polyp was directly diagnosed by transvaginal sonography in 13 (57.9%) women and an infiltrative endometrial cancer in two. Sensitivily and specificity for endometrial pathology were 73.9%) and 95.7% respectively. All but one case of endometrial pathology were found when the endometrium (both layers) was thicker than 5 mm. Thus, an endometrial thickness of ≥ 5 mm had a sensitivity of 95.7%, a specificity of 45.5% and a positive predictive value of 64.7% for endometrial pathology. This study shows that transvaginal scanning allows detection of an endometrial pathology in the vast majority of cases and it may be used as the first diagnostic step in the investigation of women with atypical postmenopausal bleedin

ISSN:0001-6349    

DOI:10.3109/00016349409006254

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Two cases of osteoporotic fractures in young women are presented, which highlight the risks and need for prophylactic therapy.

ISSN:0001-6349    

DOI:10.3109/00016349409006255

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

A placebo‐controlled trial to evaluate the efficacy and the safety of intramuscular injection of interferon‐p has been performed on 37 patients suffering from cervical intraepithelial neoplasia II (CIN II) associated with human papillomavirus (HPV) infection of the cervix: twenty‐two patients were treated with interferon‐β (2 × 106I.U. daily) for ten days; fifteen received placebo (2 ml of saline solution daily) for ten days. Prior to therapy, and at day 70, 190. 370. 550, 730 after the beginning of treatment, patients were examined by colposcopy and punch biopsies of the cervix. Results showed a progressive amelioration in the interferon‐β treated patients. which was statistically significant at any control station (70, 190, 370, 550, 730 days) as compared to placebo treatment. Percentages of lesions that regressed, persisted or progressed were 36.4%, 54.5%, 9.1% respectively in the Interferon‐β group, and 0%, 67.7% and 33.3% respectively in the placebo group. Interferon‐β administered intramuscularly has shown to be an ellicacious treatment of CIN II (cervical intraepithelial neoplasia II) associated with HPV infection, without evident side effects; it can be used in patients requiring medical treatment with at least one‐year monitoring by cervical biopsies or as an adjuvant surgical treatment (which remains the principal treatment) in the management of patients suffering from CIN II associate

ISSN:0001-6349    

DOI:10.3109/00016349409006256

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

When correcting a complete uterine septum, it is recommended that one should spare the cervical portion to avoid the possible risk of cervical incompetence. However, it may be difficuh to create a communication between the uterine cavities above the internal os. In seven piitients with complete septate uterus we incised the cervical portion with Metzenbaum scissors and the corporal portion with microscissors under hysteroscopic guidance. The operating times were shorter and the distension fluid deficit smaller compared with nine historicill controls in whom the cervical septum was spared. No intraoperative or obstetric complications were associated with cervical septal section. This modified technique is simple, rapid, s'ire, inexpensive, and may be considered among the alternative treatments to correct a complete septate uterus.

ISSN:0001-6349    

DOI:10.3109/00016349409006257

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

A case is described of a uterine rupture resulting from a car accident occurring in a woman who was wearing a seat belt as generally recommended. The rupture was initially not recognised and only became apparent after attempts to induce labor which led to expulsion of the fetus into the abdominal cavity.

ISSN:0001-6349    

DOI:10.3109/00016349409006259

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY