摘要:

For the past two decades, significant advances have been made in the treatment of anovulation. The use of therapeutic agents for induction of ovulation, however, has given rise to several adverse reactions, the most important and serious of such complications being the ovarian hyperstimulation syndrome (OHSS), which can be fatal. It is characterized by gross ovarian enlargement, ascites, pleural effusion, hemoconcentration and thromboembolic disorder, which are potentially lethal conditions. The main pathogenic mechanism is considered to be increased capillary permeability, especially of the ovarian vessels, causing acute body fluid shift from the intravascular compartment to the peritoneal and pleural cavities. An experimental model of OHSS suggests that prostaglandins mediate this increased capillary permeability and transudation. Management is based on the concept of the pathogenic mechanism and includes maintenance of intravascular volume by plasma volume expanders, reduction of capillary permeability and prevention of thromboembolic complications. Surgical intervention is indicated only in cases of ovarian torsion or rupture and should be as conservative as possible.

ISSN:0001-6349    

DOI:10.3109/00016348809004267

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Until recently most of the current in vitro fertilization and embryo transfer (IVF‐ET) programs used laparoscopy for oocyte retrieval and included hospitalization in the treatment. The establishment of a successful ambulatory IVF program that uses ultrasonically guided oocyte aspiration, is described. Between August 1985 and February 1987, 384 percutaneous transvesical ultrasonically and transvaginally guided follicle aspirations were performed on 414 patients, following ovarian stimulation with hMG and hCG. Ninety two clinical pregnancies were confirmed by ultrasound. The clinical pregnancy rate was 26.8% when based on the number of embryo transfers. There were 16 multiple pregnancies (17.4%), 18 miscarriages (19.5%), and two tubal pregnancies (2.1%). The most important factors contributing toward the success of this program were rigid adherence to clinical and laboratory protocols, and the maintenance of a strict quality control. The ambulatory management was very well accepted by the patients, who during the entire period of ovarian stimulation had minimal disruption of their routine activitie

ISSN:0001-6349    

DOI:10.3109/00016348809004268

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

The results of hCG stimulation on peripheral levels of androstenedione (A), testosterone (T) and estrone (El) were examined in 14 patients with ovarian tumors and in 9 tumor‐free subjects, after the menopause. Following hCG injection, 9 postmenopausal patients with ovarian tumors showed a significant rise in A peripheral levels. The responsive subjects generally had significant increases in A baseline levels, too. The remaining 5 subjects with advanced or poorly differentiated ovarian cancer with no stroma were not responsive to hCG. Moreover, in the tumor group, 7 subjects had increased baseline T and/or El and in 3 of them an increase of these steroids was observed following hCG. In the absence of ovarian tumor, no subject in the control group was responsive to hCG administration. The results of the present investigation seem to confirm the in vivo responsiveness to hCG of ovarian tumor

ISSN:0001-6349    

DOI:10.3109/00016348809004269

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

The purpose of this study was to investigate whether the mode of delivery for fetuses in breech presentation in any way influenced the frequency of congenital hip dislocation. In 13,559 singleton births 583 fetuses were in breech position, and the cesarean section rate was 39.1%. Eighty‐three infants were born with congenital hip dislocation, 11 of whom had been in breech position. Of these 11, cesarean section was required in 5 cases. There was no difference in frequency of congenital hip dislocation between fetuses in breech presentation delivered by cesarean section vs. by the vaginal route. The frequency of breech presentation in congenital hip dislocation was 13.3%. Including 7 external versions, the rate was 21.7%. Female to male ratio was 41. The frequency of congenital hip dislocations in infants born in vertex presentation was 5.5 per mille and for infants born i breech presentation it was 18.9 per mill

ISSN:0001-6349    

DOI:10.3109/00016348809004270

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Low zinc concentrations in plasma have been reported in pregnancy complications such as pre‐eclampsia and intra‐uterine growth retardation, as well as in non‐pregnant individuals with gastrointestinal and eating disorders. The present study looked at the plasma zinc concentration in hyperemetic and normal pregnant women at the same stage of gestation, as well as total thyroxin concentration in these two groups, since abnormal thyroid function is a common phenomenon in hyperemetic women. No difference in plasma zinc concentration was found between normal and hyperemetic women, which suggests that hyperemesis gravidarum is not associated with a low plasma zinc concentration. Hyperemetic women did have, however, significantly higher total thyroxin concentrations, and on further examination, a significant correlation was found between plasma zinc concentration and total and free thyroxin, free tri‐iodothyronin, and human chorionic gonadotropin. The significance of our findings is di

ISSN:0001-6349    

DOI:10.3109/00016348809004271

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Primiparas with hypertension first recognized in pregnancy and an age‐ and parity‐matched control group, normotensive throughout pregnancy, were monitored during 5–6 years with blood pressure recordings performed in a standardized way. At the end of the study period, 21 out of 49 women with hypertension in pregnancy had developed hypertension requiring therapy or borderline hypertension, compared with 2 women in the control group who had developed borderline hypertension. Therapy was required in 7 of the women. Factors associated with increased risk of developing hypertension were gestational week at diagnosis of gestational hypertension, 1st diastolic blood pressure during follow‐up, family history, smoking,

ISSN:0001-6349    

DOI:10.3109/00016348809004272

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Singleton placentas from 330 consecutive births were examined for size, shape, cord insertion, allanto‐chorial vascular pattern and lobes. These factors were considered regarding possible interactions and correlation to pregnancy and perinatal outcome. Marginal cord insertion was correlated to extrachorial and bilobate placenta and to magistral or mixed allanto‐chorial vascular pattern. A paucity of lobes (<151 was associated with extrachorial placenta, marginal cord insertion, pre‐eclampsia, gestational age less than 38 weeks and small for gestational age infants. The common denominator for abnormal configuration and marginal cord insertion seemed to be the paucity of

ISSN:0001-6349    

DOI:10.3109/00016348809004273

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

The influence of maternal diabetes on Group B Streptococcus (GBS) colonization and GBS urinary infection was investigated. The population under study comprised 1,050 pregnant women (70 of them diabetics, the remaining 980 non‐diabetics). A higher prevalence of GBS colonization was found among diabetics (20% versus 10.9%) (p>0.05). The rate of colonization was not correlated to the severity of the diabetes condition. Urinary infection was diagnosed on 8.6% of diabetic patients, versus 7.1 % of non‐diabetics (p>0.05). Urinary infection by GBS occurred with similar frequency in both groups (0% in diabetics and 1% in non‐diabetics). The possible etiological implications are commented on, and vaginal and rectal cultures are recommended for GBS screening in the pregnant diabetic pa

ISSN:0001-6349    

DOI:10.3109/00016348809004274

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Prenatal karyotyping of fetuses having an abnormal sonogram was undertaken in 27 pregnancies between 17 and 39 weeks, using fetal blood obtained by percutaneous umbilical cord blood sampling under ultrasound guidance. Eight chromosomal abnormalities (29.7%) were detected, including 45, X (2 cases), trisomy 21(1 case), 46, XY, −13,+t(13, 13) (1 case), 47, XX, +18 (3 cases), 47, XXY (1 case). Nineteen fetuses had a normal karyotype (46, XX: 9 cases, 46, XY: 10 cases). The fetal karyotype was available within 72 h and fetal management was planned accordingly. We concluded that in fetuses with an abnormal sonogram, rapid karyotyping using fetal blood obtained under ultrasound guidance had important implications in obstetric and neonatal management and would facilitate genetic counsellin

ISSN:0001-6349    

DOI:10.3109/00016348809004275

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

One hundred and seventeen patients (age range 18–40 mean 28 years), with ectocervically located intraepithelial neoplasia (CIN), histologic grades I–III, were treated with cryosurgery during the period 1974–80. The initial cure rate was 93.2% overall, and 88.1% for CIN III. During long‐term follow‐up (7–12 years, mean 9.8) two failures occurred, one after 2.5 years, the other after 7 years, giving a long‐term cure rate of 91.5% overall, and of 86.5% for CIN III. all patients but one were available to follow‐up (i. e a loss to follow‐up rate of 0.8%). There were no significant early or late complications, nor any untoward effects with regard to pregnancy or fertility. Thus cryosurgical treatment of ectocervically located CIN gives good long‐term results. Scrupulous selection of patients, consisting of a meticulous colposcopic investigation, histologic diagnosis based upon cervical biopsy and curettage, is important to avoid the hazards

ISSN:0001-6349    

DOI:10.3109/00016348809004276

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY