ISSN:0001-6349    

DOI:10.3109/00016349409006266

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:0001-6349    

DOI:10.3109/00016349409006267

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Objective. To define the histological lesions in the placenta associated with abnormal blood flow findings and to evaluate their possible clinical significance.Design. A prospective blind study.Setting. A clinical study at a teaching hospital, Malmö General Hospital, University of Lund, Sweden, morphological studies of placentas being performed at the Institute of Pathology, University of Lausanne, Switzerland.MaterialThirty‐seven pregnancies where intrauterine growth retardation (IUGR) was suspected.MethodsBlood velocimetry of the fetal descending aorta, umbilical artery and vein, and the maternal arcuate artery, using 2.5 MHz pulsed wave Doppler ultrasound. Histological examination of at least five random samples from each placenta.Main outcome measures. Frequency of small‐for‐gestational age (SGA) newborns (birth weight ≥ mean −2 s.d.) and of operative delivery for fetal distress.Results. Only the presence of placental infarction was significantly associated with IUGR and with intrauterine findings of abnormal blood velocity in the fetal descending aorta and umbilical artery.Conclusion. Placental infarction would seem to be a valuable morphological marker of uteroplacental vascular disease related to JUGR and impaired fetal and umbilical

ISSN:0001-6349    

DOI:10.3109/00016349409006268

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

A survey on drug intake during pregnancy was carried out in a sample of 3268 women who delivered live‐born infants in 11 hospitals located throughout Italy. A large questionnaire on drug use and other aspects of maternal life‐style was administered within five days of delivery to 3112 women who consented to the interview. An overall mean consumption of 2.17 drugs per woman was reported. Apart from dietary supplements, the most used drugs were tocolytics. analgesics, and antibiotics. The proportion of women who did not use any drug was 17.3%. The role of some non‐medical determinants of drug intake was evaluated as well. Geographic and socio‐economic factors were seen to increase drug intake up to 44%, while the presence of anxiety provoked a 60%) higher consumption of drugs other than dietary supplements. Other factors influencing drug use during pregnancy were rural vs. urban residence and smoking habits. The need for the recording of these socio‐economic factors in surveys on drug use during pregnancy is e

ISSN:0001-6349    

DOI:10.3109/00016349409006269

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Background. To study the influence of pre‐conceptional health status and immunosuppressive drug regimen on pregnancy outcome in renal allograft recipients.Methods. The study includes all pregnancies in renal allograft recipients in Norway in the period 1973‐1991. The data were collected from the patient records. Serum‐creatinine values, proteinuria. blood pressure, recent graft rejection, and immunosuppressive drug regimen before pregnancy as well as the interval from transplantation until pregnancy were related to the frequency of deliveries at term, preterm deliveries, and of induced and spontaneous abortionsResults. 54 pregnancies in 37 renal allograft recipients resulted in 31 term deliveries, 12 preterm deliveries, four spontaneous, and seven induced abortions. One induced abortion due to psychosocial reasons was excluded from the calculations. Post‐transplant intervals less than two years as compared to longer intervals were associated with an increased frequency of spontaneous and induced abortions (6/13 vs 4/40.p<0.01) and a non‐significant increase in the relation between preterm and term deliveries (3/4 vs 9/27). The few women with proteinuria, elevated serum‐creatinine values, and hypertension before pregnancy had an increased number of adverse pregnancy results. The women receiving cyclosporine A experienced a larger frequency of spontaneous and induced abortions (7/18 vs 3/35,p<0.05) and an increase in the relation between preterm and term deliveries (714 vs 5/27,p<0.01) as compared to the women who received prednisolone and azathioprine only.Conclusions. The results demonstrate the importance of pre‐conceptional consultation and may indicate a harmful effect of cyclosporine A on preg

ISSN:0001-6349    

DOI:10.3109/00016349409006270

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Background. The objective of the study was to compare women's use of obstetric analgesia, experience of pain in labor, and other aspects of the childbirth experience at an in‐hospital birth center and with standard maternity care. The birth center care was characterized by comprehensive antenatal, intrapartum and post partum care, on the same premises with a home‐like environment and the same team of midwives, restricted use of medical technology and pharmacological pain relief, and discharge within 24 h after birth.MethodsOf 1,230 women interested in birth center care and meeting low‐risk medical criteria in early pregnancy, 617 were randomly allotted birth center care (EG) and 613 standard obstetric care (CG). Data were collected by questionnaires two months post partum, and hospital records.Results. EG women used less pharmacological pain relief than CG women, but no difference was observed concerning the retrospective attitude to pain, or among primiparas, to the intensity of pain experienced. EG multiparas experienced pain in labor as more intense, than did CG multiparas, probably because of a more negative prenatal attitude to labor pain. EG women experienced more support from the midwife, and a greater freedom in expressing their feelings during the birth than CG women. EG primiparas were more satisfied with their own achievement and felt more involved in the birth process than CG primiparas. No differences were observed between the groups regarding overall experience of childbirth, anxiety during the birth or support from husband.ConclusionBirth center care gave women interested in a natural childbirth, by avoiding pharmacological pain relief, greater opportunity to give birth according to their prenatal wishes, and it contributed to a slightly more positive birth exper

ISSN:0001-6349    

DOI:10.3109/00016349409006271

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Background. Although several investigators have attempted to define the normal values of umbilical cord blood pH and gases, there is considerable controversy about the optimal cutoff values to diagnosis intrauterine asphyxia. A possible reason for this might be that several studies have included data from fetuses born after different duration of labor.ObjectiveTo determine the effect of labor and the duration of second stage of labor on umbilical arterial acid‐base status at birth in healthy term infants.MethodsUmbilical artery acid‐base status was determined in patients (n = 356) who met the following criteria: 1) singleton term pregnancy with no significant medical, obstetric, or neonatal complications; 2) vertex presentation if delivered vaginally; 3) neither regional nor general anesthesia applied if delivered vaginally; 4) no use of oxytocin; 5) normal fetal heart rate patterns; 6) clear amniotic fluid; 7) Apgar scores at 1 and 5 min ≥7; 8) appropriate fetal weight for gestational age. Patients were divided into three groups. A ‐ patients delivered by cesarean section (CS) in the absence of labor (n=135); B‐patients delivered by CS during first stage of labor (n = 62); C‐patients with vaginal birth (n=159). A Kruskal‐Wallis A YOVA with post‐hoc procedures and stepwise multiple regression analysis were performed.Results. 1) There were significant differences in cord arterial acid‐base values between study groups (pH: no labor CS. 7.27 ± 0.05 vs labor CS. 7.26 ± 0.05 vs vaginal birth, 7.24 ± 0.07,p61 min, 7.21±0.07.p<0.05). 3) Analysis of confounding variables which could influence the cord pH such as parity, usz of vacuum. gestational age, maternal age, and birth weight by stepwise multiple regression analysis indicated that only the duration of second stage of labor pain had a significant relationship with cord blood pH.ConclusionThere is a significant fall in umbilical artery pH and bicarbonate with the presence of labor and increased duration of second stage of labor in healthy term neonates. This should br taken into consideration in evaluating neonatal well‐being by cord blood

ISSN:0001-6349    

DOI:10.3109/00016349409006272

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Background. 1190 consecutivein vitrofertilization (IVF) treatment cycles from the Southampton University IBUPA Chalybeate unit, spanning a four year period, were studied retrospectively in order to assess the relationship between maternal age and implantation. Our aim was to evaluate the hypothesis that the number of transferred embryos can be determined by age alone.Method. The cases were allocated to two age groups, Group 1 was composed of patients of less than or equal to 35 years of age and Group 2 of patients greater than 35 years of age.Results. We found that the selection criteria used in our programme for abandoning treatment cycles led to significantly more older patients being excluded from oocyte collection (p<0.001). The patients from both groups that progressed to oocyte collection and embryo transfer showed no significant difference in embryo implantation. The overall implantation rate (12.4%) and clinical pregnancy rate per embryo transfer (22.8%) were achieved by being able to transfer comparable numbers of embryos in both age groups and in spite of the younger age group having a significantly better quality of transferred embryos.Conclusion. Although advancing maternal age predisposes to a reduced chance of success from IVF treatment, maternal age alone was not a useful predictor of embryo implantation or endometrial receptivity in completed IVF treatment cycles.

ISSN:0001-6349    

DOI:10.3109/00016349409006273

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Objective. To evaluate the risk of unwanted pregnancies, their outcome and the rate of resuming contraception after discontinuation of oral contraception (OC) prior to elective surgery.Design. A six months prospective follow‐up study.Setting. Orthopedic unit, operating on a total of 897 women during a period of 24 months.Subjects. Seventy‐eight healthy women in whom OC was stopped prior to elective orthopedic surgery.Outcome. Pregnancy rate, pregnancy outcome and reinstitution rate of OC.Results. Complete outcome data are available for 73 (93.5%) of 78 women who were asked to participate in the study. Five pregnancies were reported, giving a cumulated six month pregnancy rate of 6.8%. Three pregnancies were completed to term, one was ectopic and one terminated by induced abortion. Within six months after the operation the cumulative user rate of oral contraceptives was 74.2%. None of the women were readmitted to hospitals for severe illness during the study period.Conclusions. The women resumed oral contraceptives relatively soon after their first postoperative menstrual cycle. This may explain why the pregnancy rate during the first six postoperative months appears

ISSN:0001-6349    

DOI:10.3109/00016349409006274

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Objective. To investigate the predictive value of sacral nervous function, result of pelvic examination and hormonal status on sexuality before and after subtotal hysterectomy.Material and method. One hundred and four women were examined and interviewed one month before and one year after hysterectomy for non‐malignant diseases. Genital examination, sacral nervous function testing including vibrotactility were performed. and sex hormone levels were estimated at each occasion. The results were evaluated and compared using multivariate analyses.Results. Postoperative experience of multiple orgasm was negatively correlated to three out of five measured factors for pelvic sacral function: i.e. vibrotactility of the clitoris, the external anal reflex and the levator muscle strength. No correlations were found between tests for sacral nervous function and a latent factor for sexuality before and after the operation. Preoperative uterine size did not show correlation to either preoperative or postoperative sexual parameters nor did uterine pain during vaginal examination. The preoperative sex hormone levels, and the result of histopathological examination showed no correlation to sexual variables.Conclusion. Preoperative somatic findings including sacral nervous function and pelvic muscular strength cannot be used as predictors for sexuality after subtotal hysterectom

ISSN:0001-6349    

DOI:10.3109/00016349409006275

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY