ISSN:0001-6349    

DOI:10.3109/00016349209006223

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:0001-6349    

DOI:10.3109/00016349209006224

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

There have been many attempts during the last years to restrict smoking because of the significant health hazards. In particular the high prevalence of smoking among women in their reproductive years has been a matter of concern.This review was prompted in order to make the medical profession, and gynecologists in particular. confident with the underlying data. This will hopefully result in enabling them to provide balanced information to their patients, not overemphasizing the dangers of smoking, but rather presenting ways to properly recognize and treat tobacco dependence. It is a widely held view that the various risks imposed by smoking are very modest. A doubling of the risk for a rare problem may not prevent many women from continuing to smoke. However, a doubling of the risk for early miscarriage or a significant reduction of success rate in the treatment of infertility may be much more discouraging. The purpose of this review is to list the various effects smoking may have on the different phases of reproduction and to present an overview of the explanation models which have been suggested. Late effects on the child and its development will also be discussed. Hopefully, this will lead to proper concern about the problems and thus increase the motivation to quit smoking even before attempting a pregnancy. In addition, we give some hints on smoking cessation programs.

ISSN:0001-6349    

DOI:10.3109/00016349209006225

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

In an open prospective study with therapeutic monitoring, 34 women with climacteric symptoms, FSH>40 IU/L and LH>25 IU/L were treated for 12 months with an cstradiol‐depot‐patch (Estraderm TTS) SO micrograms twice a week and medroxyprogesterone acetate 10 mg tablets from 12th to 25th day of cycle. During the first months a significant improvement was seen in hot flushes and other climacteric inconveniences in terms of Kupperman's menopause index.During the study period FSH and LH were suppressed and the estrogen values were normalized. The fraction of free estradiol compared to protein bound estradiol remained unchanged during the whole treatment.The serum‐lipids and serum‐SHBG at inclusion were within normal limits and did not change during 12 months of treatment. Thus from these parameters no sign of any liver induction was seen. Ten patients had short term skin symptoms while four withdrew from the study because of persistent skin symptoms.Nine patients withdrew From the study, in five cases this was related to the therapy while in the other four it was due to other causes.Twenty‐five (74%) women wished to continue the treatment after

ISSN:0001-6349    

DOI:10.3109/00016349209006226

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

In order to estimate whether women with polycystic ovary syndrome (PCOS) have an increased risk of developing myocardial infdrction, a risk factor model was applied on 33 women with PCOS and 132 age matched referents.The risk factor model was established from independent risk factors for myocardial infarction in a prospective population study of 1462 women in Goteborg, Sweden. The independent risk factors were age. manifest hypertension, manifest diabetes mellitus, central obesity measured as increased waist to hip circumference ratio and serum trigly‐ceride concentration.A considerably increased risk (relative risk of 7.4) of developing myocardial infarction was observed for women with PCOS compared to age‐matched referents.Since the risk factors include variables correlated to obesity, the results indicate that advice on dietary restriction is an important part of the treatment once the diagnosis is establis

ISSN:0001-6349    

DOI:10.3109/00016349209006227

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Lupus anticoagulant (LA) and anticardiolipin antibodies (ACA) have been reported to he associated with fetal loss.Objective. Our aim was to estimate the incidence of LA and to examine the correlation hetween LA and ACA in pregnant women.To investigate the clinical significance of LA and ACA in an obstetric population.Study design. A prospective, cross sectional study of 2856 consecutive women admitted to a department of obstetrics and gynecology for delivery or due to pregnancy complications during an 11 month period.Methods. Activated partial thromboplastine time (Am) was determined in all patients. LA and ACA were determined if APTT ≥ 35 sec. For reference ACA was determined in a group of randomly selected patients with APTT<35 sec. The results were analyzed in relation to the obstetrical records.Results. Overall incidence of APTT ≥ 35 sec.: 7.0%, significantly more frequent in patients with early spontaneous abortion (18.6%) and intrauterine growth retardation (17.5%).Incidence of LA 0.07%. The patients had undetectable ACA and no clinical condition related to LA.Incidence of ACA class IgM (IgM‐ACA) in patients with APTT ≥35: 20.4%. significantly higher than in the reference group (9.6%).Uncomplicated pregnancy in 84% of patients with IgM‐ACA.No cases of ACA class IgG(IgG‐ACA) in patients with APTT ≥ 35 but two cases in the reference group (one normal pregnancy, one spontaneous abortion).Conclusion. LA is a rare manifestation with uncertain significance in otherwise healthy pregnant women. IgM‐ACA in low titer occurs relatively frequently during n

ISSN:0001-6349    

DOI:10.3109/00016349209006228

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

In twelve healthy pregnant women the fetal heart rate response to sound stimulation was tested every second week between the 22nd and the 34th week of the pregnancy. Habituation to the acoustic stimuli used was also investigated at the last examination. A high risk material for hearing impairment comprised 31 pregnant women.The stimuli were presented by a vibrator placed on the maternal abdomen over the fetal head. As stimuli pure tones were used in the form of pulses of one second at a frequency of 3000 Hz and with an onset and a decay time chosen not to cause audible clicks to a normal ear. The intensity of the tone pulse was set at a level calculated to correspond at the position of the fetal head to 110 dB sound pressure level in free field.Roughly 50% of the fetuses tested started to react with an increased heart rate in the 24th week of the development. Four weeks later all tested subjects responded to the test stimuli.Habituation of the motor ‘startle’ response was shown but the fetus heart rate change was consistent over 20 consecutive stimulations one min in between each.In 31 high risk subjects the responses from three fetuses must be considered as pathologic. These three children exhibited impaired auditory tests after birth and severe hearing impairment at the age of three years. All the others disclosed normal hearing at birth as well as at three years of age. Repeated significant increases in fetal heart rate following acoustic stimulation may appear as an indication of normal function of the hearing organ. Several consecutive acoustic stimulations without any fetal responses in heartbeat rate is an indication of a possible hearing impairm

ISSN:0001-6349    

DOI:10.3109/00016349209006229

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Today several very early abortion methods are available; effective and safe, medical as well as surgical. The aim of the present study is to estimate women's attitudes towards three early abortion methods, to see if one or several of these methods are preferable ‐ or best avoided ‐ for psychological reasons, and to assess if women of a certain social or psychological background would benefit from a specific abortion method. Three groups of women were interviewed two weeks after a first trimester abortion; 1/43 women having an ‘ordinary abortion’ with preoperative ripening of the cervix followed by a vacuum aspiration under heavy sedation, 2/40 women having a modified Karman exeresis with a paracervical block, 3/45 women having a medical abortion with RU 486 and prostaglandin.There was a noticeable difference in the effect the three abortion methods had on the women taking part in the study. Women with a medical abortion reported more bleeding and somewhat more pain and moral considerations than the other women, but also a relief to be spared a surgical procedure. Most of the women said they preferred the abortion method they had just experienced. A short waiting time appeared to be more important than whether a surgical or a medical method was used. Which abortion method is the best in each case is dependent on a variety of personal reasons, and can only be decided by each woman, in consultation with her

ISSN:0001-6349    

DOI:10.3109/00016349209006230

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The endometrial thickness and echogenic pattern were prospectively evaluated in 100 patients undergoing IVF‐treatment. On the day before oocyte aspiration (day‐1) the endometrium was significantly thicker in the group of patients achieving an ongoing pregnancy than in the group that failed to conceive. The minimal endometrial thickness on day‐1 compatible with an ongoing pregnancy was 9 mm. Before oocyte aspiration two different endometrial patterns could be distinguished, a multilayered, ‘triple line’, hypoechogenic endometrium (A) and an isoechogenic pattern (B). Other studies have, in addition. described a hyperechogenic endometrium with a poor pregnancy rate but that pattern could in the present study only be demonstrated after follicle aspiration. 32 clinical pregnancies occurred. Among patients with endometrial pattern A, 36% conceived and among patients with pattern B 23% conceived which was not significantly different. It is concluded that the day before aspiration an endometrial thickness of at least 9 mm appears to be required for an ongoing pregnancy. In all cases a triple line (hypo‐or isoechogenic) pattern was evident before

ISSN:0001-6349    

DOI:10.3109/00016349209006231

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Thirty‐eight consecutive female patients with frequency, urgency or urge incontinence were treated with maximal electrical pelvic floor stimulation. Diagnostic cystometry was performed in 34 cases. Detrusor instability was found in 13 patients, sensory urgency in 13 and hyperreflexia in eight cases.The effect of the treatment was evaluated by subjective assessment and micturition charts filled in for 48 hours.63% were cured or improved. The success rate was the same among elderly and younger patients. Detrusor instability and hyperreflexia improved in about 75% of the cases. A good correlation was found between the subjective assessment and the micturition chart recordings.Maximal electrical stimulation has a good effect on certain types of lower urinary tract dysfunction with few side‐effects. It is well tolerated even by elderly patie

ISSN:0001-6349    

DOI:10.3109/00016349209006232

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY