摘要:

The ovaries of 377 women between the age of 40 and 70 years were measured by ultrasound. About one third of the patients were postmenopausal. Mean value, standard deviation and S.E.M. of the ovarian volume were calculated and related to age, parity and menstrual cycle. Ovarian size decreased with age in all women but bore no relation to parity and day of menstrual cycle in the menstruating group of women over 40 years of age. A diagram of the ovarian volume related to age is presented.In postmenopausal women the volume was related to estrogen treatment, age, parity and years since menopaus. In the group of women receiving orally administered estrogens for at least a year the p‐values for all parameters were>0.005. Furthermore, the ovarian volume of women under hormonal treatment did not decrease with age. On the other hand the most important factor for ovarian size in subjects not receiving estrogen treatment was age (p = 0.0056).The results presented here will serve as a prerequisite for sonar examination of the ovaries in women at high risk for developement of ovarian carcinom

ISSN:0001-6349    

DOI:10.3109/00016348709022039

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

A prospective study of the fetal heart rate pattern during labor before and after paracervical blockade (PCB) was performed. The material comprised 469 women in labor, or 28% of 1 673 women delivered during a 6‐month period. The majority of the anesthesias (87%) were administered by specially trained midwives. Bupivacain (Marcain) was the anestethic used. The injections were made at four different points at a cervical diameter of 3 − 9 cm. The concentration of the anesthetic was 0.25 or 1.25% generally in 10 ml of normal saline. A second PCB was administered in 54 patients at least one hour after the preceding one. Fetal heart rate (FHR) was recorded via a scalp electrode and the pattern studied 15 min before and 30 min after the injection of the anesthetic. Bradycardia was defined as a persistent deceleration exceeding 3 min and occurring within 30 min of the PCB. Variability and acceleration pattern persisted independently of the PCB. Following PCB, decelerations of all types increased, while the basal rhythm decreased by on average 1.5 beats/min. Following PCB fetal bradycardia occurred in 1.9%. The bradycardia persisted on average for 6.5 min with a lowest average FHR of 73 beats/min. Retrospectively, 6 out of 9 infants exhibited recognized risk factors for bradycardia. All infants with bradycardia scored 9‐10/5 min, according to the Apgar rating scale and all had a normal development with regard to growth, motor and speech development at the age of 2 years. There were no significant differences in vaginal operative deliveries between the PCB and the non‐PCB group. However, the incidence of acute cesarean section was significantly and appreciably lower in the PCB than in the vaginally delivered non‐PCB group. Judging by the Apgar rating scale the general condition of the infants at birth was significantly better in the PCB than in the vaginally delivered non‐PCB group. In conclousion: Apart from a 2% incidence of fetal bradycardia following PCB, no untoward effects have been observed. The incidence of acute cesarean section was lower and the general condition of the infants better in the PCB than in the non‐PCB group. Adequate teching of the technique, contra‐indications to PCB and the side effects of the anesthetic agent are needed. Thereafter, it would seem appropriate not only that doctors but also specially trained midwives should be able to use paracervical blockade in order to alleviate pain during the first

ISSN:0001-6349    

DOI:10.3109/00016348709022040

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

Four cases of massive ovarian edema (MOE) with symptoms persisting for 6 months and even up to 4 years are presented. No stromal changes other than edema were found histologically, and no functional anomalies were detected clinically. The reported cases are compared with the published data on MOE with stromal changes (fibromatosis, thecal hyperplasia, luteinization), concluding that there are at least two types of MOE: primary (without concomitant pathology), and secondary (superimposed on already altered ovaries).

ISSN:0001-6349    

DOI:10.3109/00016348709022041

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

Zinc and alkaline phosphatase were examined in 41 pregnant women (gestational weeks 35‐41) and in 12 women within 24 h of delivery. The serum‐zinc level was reduced in all the women, though to a lesser degree in women giving birth to small for gestational age (SGA) babies than in the control mothers. The difference between the two groups was significant (p = 0.019). Erythrocyte‐zinc increased during pregnancy, more in control mothers than in SGA mothers (p = 0.020). Granulocyte‐zinc was not significantly reduced in pregnancy and no difference was found between SGA mothers and control mothers. Alkaline phosphatase levels in serum and granulocytes were elevated equally in the two groups. These findings show that zinc level changes occur in pregnancy, but that the changes do not appear to be a dominant cause of SGA pregnancy, in Danis

ISSN:0001-6349    

DOI:10.3109/00016348709022042

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

A prospective study was made to evaluate whether bedrest in hospital is beneficial in pregnancies where intrauterine growth retardation (IUGR) was suspected. Diagnosis was based on routine fetometry at 32 weeks of gestation, in conjunction with general ultrasound screening. 107 patients with suspected IUGR‐pregnancies were divided into two groups, 49 in a hospital bedrest group and 58 in an ‘outpatient’ group. Fifteen women in the bedrest group refused hospitalization, and 8 women in the out‐patient group had to be hospitilised for medical reasons other than suspected growth retardation, leaving 79% of the women in their allocated group. The women in the bedrest group were hospitalized for a mean duration of 29.2 days (range 5‐54). The results suggest that bedrest in hospital is not beneficial, either to fetal growth or to pregnanc

ISSN:0001-6349    

DOI:10.3109/00016348709022043

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

The role of labor induction in patients scheduled for vaginal delivery following a previous lower segment cesarean section has been controversial. In Hong Kong, we have managed these patients by induction when there were obstetric or medical indications. A review of 137 patients who had labor induced for a trial of scar showed that induction of labor was a safe procedure and the rate of repeat caesarean section in these patients (18.2%) was similar to that in other patients with a trial of scar who had spontaneous onset of labor (12.9%). There were no serious maternal or fetal complications. Although the use of oxytocin in addition to amniotomy produced no difference in the outcome, we felt that it was useful in preventing a long induction delivery interval as well as avoiding a high failure rate of induction. We conclude that in patients selected for a trial of scar, planned induction of labor should be attempted when an indication for delivery arises, as a high proportion (more than 80%) of these patients gave birth vaginally. If induction were ruled out, most of these patients would have to be delivered by repeat cesarean section, with its associated morbidity and expense.

ISSN:0001-6349    

DOI:10.3109/00016348709022044

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

Severe maternal complications during β‐mimetic therapy have been reported. In a study of maternal complications related to intravenous tocolysis, which covering a period of 2 years, we paid special attention to the maternal ECG before and during treatment. There was a high prevalence of pretreatment ECG changes: tachycardia (23.6%), disorders of impulse conduction (43.6%), ST‐depression (14.5%) and disorders of repolarization (43.6%). During intravenous 0‐mimetic therapy there was an increase in the prevalence of tachycardia, prolonged QT‐time and disorders of repolarization. We also studied the course in time of the different ECG characteristics during treatment. With regard to the ST‐depression, a possible physiological adaptation to the β‐mimetic drug is described. We could not find this possible adaptation with regard to the other ECG characteristics. None of the women in the studied group showed clinical signs of myocardial ischemia, notwithstanding the high prevalence of ECG changes. We conclude that the ECG criteria for discontinuation of tocolytic therapy need

ISSN:0001-6349    

DOI:10.3109/00016348709022045

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

The diagnostic value of a test depends on the variability of the test results and the accuracy of the test. The object of this investigation was to estimate the observer variability and the accuracy, when intrapartum CTGs were assessed by experienced obstetricians. Fifty CTGs were evaluated twice by four obstetricians. They were asked to identify the CTGs belonging to the compromised infants. They were told the criteria for a compromised infant and the incidence (one‐ third). Eleven (22%) of the CTGs were assessed in the same way of all the obstetricians in both evaluations. Between the obstetricians, the accuracy ranged from 50 to 66%. We conclude that the considerable observer variability found in this and other investigations must severely impair the clinical value of electronic fetal monitoring (EFM). The variability must be reduced before the “true” predictive value and the cost/benefit of EFM can be esti

ISSN:0001-6349    

DOI:10.3109/00016348709022046

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

Of 36 cases of choriocarcinoma treated at the University Hospital Kuala Lumpur during 1980‐84 inclusive, 6 patients were found to have cerebral metastases. Intrathecal methotrexate and combination chemotherapy were started in all cases, with monitoring of tumor growth by serial β‐HCG assays and CT scanning of brain and lung. Chemotherapy was reduced because of severe toxicity in 2 patients, one of whom received radiotherapy to the brain. Four patients (66%) have now been in remission for 2.5–6 years. Two did not respond to therapy and died. The factors involved in therapy and response are dis

ISSN:0001-6349    

DOI:10.3109/00016348709022047

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

Sixty‐one term pregnant women, 29 nulliparous (Group A) and 32 multiparous (Group B) with unfavorable cervix and premature rupture of the membranes (PROM) were given 3 mg PGE2in suppository form for cervical ripening and labor induction. Five hours after starting the treatment, 12 women of the 29 in Group A and 21 of the 31 in Group B had a favorable cervix and established labor. The remaining 17 nulliparae and 11 multiparae still had an unfavorable cervix and were then given another PGE2suppository. Until the next morning, i.e. within 24 h, 19 nulliparous and 22 multiparous women gave birth whereas a further 5 nulliparous women who now had favorable cervix but no uterine contractions were delivered after stimulation with intravenous oxytocin. The remaining undelivered women were given another PGE2suppository. With or without additional oxytocin stimulation, all but 2 multiparous women could be delivered within a further 12 hours. The total number of instrumental deliveries in Group A was 2 caesarean sections due to disproportion (7%) and 5 ventouses. In Group B, 3 caesarean sections (9%) had to be carried out, one due to fetal distress and 2 due to failed induction. From the results of this study we conclude that vaginal application of 3 mg PGE2in suppository form can be used to induce labor in patients with PROM and unripe cervix. However, when the results are compared with those obtained in previous studies after application of PGE2in gel, the latter technique seems preferabl

ISSN:0001-6349    

DOI:10.3109/00016348709022048

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY