摘要:

Objective. The purpose of the present review article is to analyze the scientific background for the use of vaginal cones in measurement of pelvic floor muscle (PFM) strength and effect on female stress urinary incontinence (SUI).Material and methods. Literature search is based on articles written in English language compiled from MEDLINE, EMBASE, BIOSIS, and SCISEARCH from 1985 up to 1993. Only one study and one abstract were found dealing with methodology of cones used as measuring devices for PFM strength. Six articles were found evaluating the effect of cones on PFM strength and/or SUI.ResultsThe analysis of the literature revealed that there is low correlation between PFM strength (measured by vaginal squeeze pressure and vaginal palpation) and ability to hold the cones in incontinent women. The theoretical basis for strength development using cones can be questioned. The studies evaluating effect on PFM strength and SUI have flaws in design, outcome variables and measurement of PFM strength. Including drop out rates, subjective improvement rates vary between 30–63% in uncontrolled studies.Conclusion. It is concluded that cones may not be used as objective measuring devices for PFM strength. There is a need for prospective controlled randomized studies applying reliable and valid outcome variables to evaluate the effect of cones in treatment of SU

ISSN:0001-6349    

DOI:10.3109/00016349509008913

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

With respect to recent reports suggesting an involvement of cadmium in preterm labor, the effects of this ion on the activity of myometrial strips from term pregnant women were examined. The interactions of cadmium with calcium and oxytocin on myometrial activity were also studied. Cadmium alone inhibited spontaneous contractile activity already in a concentration of 10−9M and in 10−3M myometrial contractions were almost completely abolished. Responses to Ca2+and oxytocin were significantly increased by exposure to cadmium in low concentration (10−9M‐10−8M), whereas higher concentration of Cd2+had inhibitory action. These results suggest that cadmium not only blocks Ca2+channels in the human my‐ometrium. but also interferes with intracellular mechanisms involved in excitation‐contraction coupling. The increased responses to Ca2+and oxytocin in the presence of low amounts of Cd2+support a role of cadmium in mechanisms of

ISSN:0001-6349    

DOI:10.3109/00016349509008914

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Objective. To use a direct immunofluorescence technique employing a fluorescein labeled anti‐idiotypic antibody that recognizes the estrogen receptor (ER) order to assess the distribution of ER in the uteri of normal women throughout the normal menstrual cycle and of a woman exposed prenatally to diethylstilbestrol (DES).Subjects. Included in the study were 25 women aged between 35 and 50 years and an amenorrheic patient diagnosed as “DES Syndrome”.Localization. Localization of ER expression in frozen sections of uterine tissue was achieved by direct immunofluorescence using a fluorescein labeled anti‐idiotypic antibody that interacts with ER.Results. Analysis of the immunofluorescence staining indicated that in the normal human endometrium the intensity of ER staining varied according to the phase of the cycle as well as according to the cell type. On the other hand, endometrial ER evaluation of the patient with DES syndrome showed minimal expression of ER and after treatment with conjugated estrogens, endometrial biopsy revealed a significant increase in ER expression.Conclusions. These findings indicate that the fluorescein labeled anti‐idiotypic antibody can be used to detect ER in normal and pathological human endometrium and to monitor changes in ER expression in the endometrium during hormona

ISSN:0001-6349    

DOI:10.3109/00016349509008915

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Background. The aim of this study was to investigate the possible association between Doppler velocimetry and synthesis of prostacyclin (PGI2) and thromboxane A2(TxA2) in umbilical cord vessels. The hypothesis was that an altered balance between PGI2and TxA2production is associated with a change of artery flow resistance.Methods. 17 cases with a suspicion of intrauterine growth retardation and 21 normal pregnancies were studied. The umbilical artery pulsatility index (PI) and venous mean velocity were recordedin vivoby Doppler velocimetry. Cord vessel prostanoid synthesis was determinedin vitro. The Mann‐Whitney U test and simple linear regression were used for statistical analyses.Results. The umbilical vessel synthesis of both PGI2and TxA2was in general lower in small‐for‐gestational age (SGA) cases (n=10) compared to appropriate‐for‐gestational age (AGA) (n=28). In the vein, the PGI2/TxA2ratio was significantly lower in SGA cases. No certain correlations were found between umbilical artery PI and venous velocity, respectively, and PGI2or TxA2, or their ratio.Conclusion. The prostanoid synthesis was in general lower in SGA cases, resulting in a significantly lower PGI2/TxA2ratio in the umbilical vein. This indicates that fetal growth retardation might be associated with a disturbed endothelial function in this vessel. The synthesis of PGI2and TxA2in the juxtaplacental umbilical cord vessels was not correlated to the umbilical artery PI or venous flow velocity. It is possible that an altered release of prostanoids in the placental vasculature and tissue accounts for the rise of umbilical artery flow resistanc

ISSN:0001-6349    

DOI:10.3109/00016349509008916

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Background. A prospective study was performed to elucidate the etiology of intrauterine fetal death and to evaluate diagnostic procedures.Methods. Sixty‐six stillbirth cases with a gestational age of more than 25 complete weeks were studied. using an extensive test protocol. The validity of the cause of death was classified as certain. probable, possible and unexplained. The extent to which the diagnostic measures had been performed was classified: patients in whom none or only a few tests were performed, patients partially tested and patients completely tested.Results. The cause of death was certain in 57%, probable in 20%, and possible in 11% of the cases. In only 12% of the cases did the cause of death remain entirely unexplained. The principal causes of IUFD were infections, including premature rupture of the membranes (15%). anomalies (11%), preeclampsia‐associated conditions (9%) and intrauterine growth retardation of unknown etiology (8%). In this series, less well‐known conditions, such as circulating maternal autoantibodies and feto‐maternal transfusion, also appeared to play an important role in causing intra‐uterine fetal death.Conclusions. An extensive and relevant test protocol provides information as to the cause of death in the majority of cases. Future protocols should include tests for autoimmune antibodies and feto‐maternal

ISSN:0001-6349    

DOI:10.3109/00016349509008917

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Background. To study the comparative diagnostic value in premature rupture of membranes (PRM) of three amniotic components: fetal fibronectin (EN), alphafetoprotein (AFP), diamino‐oxydase (DAO).Methods. 131 pregnant women took part in our prospective study. Three samples were obtained successively for each patient in a random order. Two clinical situations were studied: group A of 68 women with clinical certain PRM and group B of 63 women with a highly unlikely PRM.Results. fFN is the best marker for diagnosis of PRM (sensitivity of 94% and specificity of 97%). AFP and DAO are complementary: the NPV is greater for AFP (87% against 84%) whereas the PPV is greater for DAO (95% against 86%).Conclusion. Apart from its value in predicting premature labor, vaginal fFN represents a diagnostic test of PRM with good specificity and sensitivit

ISSN:0001-6349    

DOI:10.3109/00016349509008918

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Background. Two hundred and forty‐eight consecutive deliveries with a 0.25% bupivacaine paracervical block (PCB) using a superficial injection technique were studied prospectively during the progress of labor in the three month study period. Parturients with signs of fetal distress were excluded. Pain level and the maternal, fetal and neonatal effects related to PCB were evaluated.Methods. Pain intensity level was assessed on a visual scoring scale (0–10). The intrapartum fetal heart rate patterns were recorded and reviewed to correlate the incidence of paracervical fetal bradycardia.Results. Parturients with PCB were provided a significant reduction (p<0.001) in pain levels and the change in pain scores could be maintained until the beginning of the second stage. After the block, bradycardia patterns were noted in five (2.0 %) fetuses, a fetal heart rate ranged from 60 to 105 beats per minute with an onset time of 2–20 minutes after the block and a duration of 4–12 minutes. All newborns in the bradycardia group were delivered va‐ginally without signs of asphyxia.Conclusions. PCB in selected parturients with a low‐dose superficial technique has been shown to be an effective analgesic modality with minimal fetal and neonatal side‐effects, but post‐blockade fetal bradycardia cannot be wh

ISSN:0001-6349    

DOI:10.3109/00016349509008919

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

We monitored the electrocardiogram of 20 fathers while their child was born. Paternal heart rate rose on average by 53% during delivery from the starting point frequency (72 beats/min.) to the maximum (115 beats/min.) just before the birth of the child. Judging from the heart rate variation, paternal sympathetic activity increased by 25% and vagal tone decreased by 22% during delivery. No derangements in cardiac function were encountered, not even in the man who fainted.

ISSN:0001-6349    

DOI:10.3109/00016349509008920

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

A prospective series of 90 consecutive pregnancies (70 singleton, 16 twin and 4 triplet pregnancies) resulting in births of 114 infants afterin vitrofertilisation (IVF) at Rigshospitalet were compared to a control group of pregnancies and deliveries in 70 non‐IVF infertility patients with singleton pregnancies and 20 women with normal fertility with twin (n=16) or triplet (n=4) pregnancies. No differences in the incidence of third trimester pregnancy complications, abnormal fetal karyotypes or malformations were found. The number of women with spontaneous onset of labor and the gestational age at delivery were similar in the IVF and control groups. In singleton deliveries, the birth weight was lower (p<0.025) in the IVF group (median 3145 g, range 8904300 g) than in the control group (3399 g, 2592–4850 g), whereas in multiple gestation similar birth weights were found in the IVF and control groups. We conclude that the birth weight in singleton deliveries after IVF is lower than the birth weight in infertility patients treated differently. The cause of this difference remains obsc

ISSN:0001-6349    

DOI:10.3109/00016349509008921

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Objective. To determine the association between antibody response toUreaplasma urealyticumand pregnancy outcome in women with ureaplasmal invasion of the amniotic cavity.Methods. A cross section study was performed in our high risk pregnancy unit. Three groups of pregnant women were identified: 1) 271 women at the midtrimester of pregnancy (16–20 weeks), who underwent transabdominal amniocentesis for genetic indications 2) 161 consecutive women admitted with preterm labor and intact membranes. 3) 118 consecutive patients with preterm premature rupture of membranes. Amniotic fluids were cultured forUreaplasma urealyticum, Mycoplasma hominisand also for other aerobic and anaerobic bacteria. Serum antibodies to Uu were measured by a specific enzyme‐linked‐immunosorbent‐assay.Results. The prevalence of positive AF cultures with Uu in the 3 study groups was 2.9%, 4.3% and 17.8%, and the prevalence of antibodies to Uu in the AF‐colonized patients was 50%, 86% and 57%, respectively. Adverse pregnancy outcome (preterm birth, low birth weight or fetal death) among all AF colonized women, was significantly higher in patients with antibodies to Uu than in those without antibodies; preterm delivery 90% vs. 43%, and low birth weight infants or fetal death 85% vs. 28%,p=0.006 and 0.001 respectively.Conclusion. Women with intraamniotic infection with Uu and elevated levels of antibodies to Uu, had a higher rate of preterm delivery, and low birthweight infantdfetal death than those without antib

ISSN:0001-6349    

DOI:10.3109/00016349509008922

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY