ISSN:0001-6349    

DOI:10.3109/00016349509024399

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Background. The aim of the present study was to evaluate the expression of mRNA for the keratinocyte growth factor and the keratinocyte growth factor receptor in human endometrium at different stages of the menstrual cycle. The role of estrogen and progesterone in regulating the expression of the mRNAs encoding keratinocyte growth factor and its receptor was further examined by studying the effect of continuous progestin (endometrium exposed to levonorgestrel releasing intrauterine contraceptive device), and continuous estrogen (endometrium hyperplasia) on the endometrium.Methods. The expression of mRNA in endometrial samples was evaluated using reverse transcriptase polymerase chain reaction.Results. The expression of KGF mRNA was found to vary during the menstrual cycle, with the highest levels in the progesterone‐dominated late‐secretory stage endometrium. Keratinocyte growth factor mRNA expression was low in both the endometrium that had been under the influence of continuous progestin (atrophic endometrium) and continuous estrogen (hyperplastic endometrium). The highest level of keratinocyte growth factor receptor mRNA expression was seen in late‐proliferative stage of the menstrual cycle and in hyperplasia when the estrogen exposure to endometrium is high. A low receptor mRNA level was found in endometrium exposed to continuous progestin.Conclusion. The results suggest that keratinocyte growth factor mRNA expression is progesterone dependent, whereas keratinocyte growth factor receptor mRNA expression seems to be more estrogen than progesterone depe

ISSN:0001-6349    

DOI:10.3109/00016349509024400

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Background. Although hydralazine has been the drug of choice for treating pregnancy‐induced hypertension for some time owing to its effect on peripheral vascular tonus, its effects on utero‐ and feto‐placental circulation are less well understood.Methods. To evaluate the effect of hydralazine on placental circulation in cases of pre‐eclampsia, Doppler ultrasonography was used to record blood velocity in the arcuate and umbilical arteries in 12 pregnancies complicated by pre‐eclampsia, blood velocity in the maternal renal artery also being examined. The gravidae underwent Doppler ultrasonography after 24 hours bedrest in hospital (baseline values), and again 24 and 72 hours after starting oral hydralazine treatment at doses of 50 mg twice daily.Results. The gravidae showed increased heart rate and decreased blood pressure in response to treatment, but neither placental nor maternal renal blood velocity waveforms were affected.Conclusion. The results suggest that at recommended oral doses hydralazine has no effect on placental or maternal renal vascular r

ISSN:0001-6349    

DOI:10.3109/00016349509024401

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Background. Hypoxic complications are thought to be the result of vascular lesions in the maternal‐placental or fetal‐placental circulation, with a resultant decrease in blood flow. This study was designed 1) to explore what kind of pathophysiological changes occur in the maternal‐placental‐fetal circulations associated with acute fetal distress, and 2) to determine whether umbilical velocimetry can be used as a predictor of acute hypoxia in severe preeclampsia.Methods. Eighty‐nine cases of severe preeclampsia, who had Doppler ultrasonography, maternal blood chemistry and hematogram examinations all performed within two days of delivery or fetal death, were studied.Results. According to the absence or presence of acute fetal distress as determined by the fetal heart rate pattern, patients were divided into two groups: distress group and non‐distress group. There was no significant difference between the two groups in maternal general status. However, patients in the distress group had a significantly shorter gestation age on admission and at delivery (p<0.00001). In the distress group, the perinatal outcome was poor. Newborns in the distress group had, significantly, a lower birthweight, and a higher incidence of SGA, 1‐min Apgar scores of less than 7, and fetal acidosis (pH<7.2) (p<0.001). Doppler ultrasonography also showed a significantly higher incidence of abnormal umbilical artery Doppler waveforms in the distress group (p95th centile) as a predictor of acute fetal compromise, judged by the incidence of abnormal fetal heart tracing mandating emergency delivery, 1‐minute Apgar scores of less than 7, 5‐minute Apgar scores of less than 7, and a pH value for the umbilical arterial blood of less than 7.2, had a sensitivity of 40.5‐75%, specificity of 71.8‐80%, positive predictive value of 12.5‐75%, and negative predictive value of 64.5‐98.4%.Conclusion. In severe preeclampsia, early onset of disease superimposed with maternal hemoconcentration might initiate an acute insult and predispose t

ISSN:0001-6349    

DOI:10.3109/00016349509024402

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Background. The aim of this study was to examine the relationship between the maternal level of antiphospholipid antibodies (aPA) measured by anticardiolipin antibodies (aCL) and fetal growth retardation (SGA).Methods. A nested case control design was carried out in a prospective cohort study of 1552 para I and para II women. The study group consisted of all 138 women who gave birth to a SGA‐child (defined as birthweight<10th percentile). A control group of 276 women was randomly selected from mothers of non‐SGA children. Levels of aPA were measured in banked sera drawn from the women in the 33rd week of pregnancy and compared between cases and controls.Results. There were 3 (2.5%) sera with aPA above 97.5 percentile among the cases and 3 (1.2%) among the controls. This difference was not statistically significant.Conclusion. Antiphospholipid antibody measurements obtained at 33 weeks of gestation cannot be used to assess the risk of birth of a small for gestational age infant among parous wo

ISSN:0001-6349    

DOI:10.3109/00016349509024403

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Objective. To map the conformity between 24‐hour and conventional blood pressure (BP) monitoring (24BPM, CBPM) in pregnancy. Study design. Prospective comparative.Material and methods. A standardized single BP measurement and parallel 24BPM and CBPM were carried out in 99 women (125 recordings) hospitalized for hypertension.Results. Except for BP oscillation amplitude, corresponding variables correlated significantly between the methods. The mean systolic BP (SBP) was significantly higher with 24BPM compared with both CBPM (3.1 mmHg) and with the single BP measurement (4.6 mmHg). The mean diastolic BP (DBP) was significantly lower with 24BPM compared with CBPM (2.4 mmHg) and with the single measurement (2.7 mmHg). If a cut‐off at 140/90 mmHg had been used for the diagnosis of hypertension and with 24BPM as the golden standard, a false positive/negative diagnosis would have resulted in 35%/20% of cases with the single BP measurement, and in 24%/17% with CBPM.Conclusions. 24BPM and CBPM gave significantly correlated but different values of the BP. The differences were small in terms of absolute mm Hg values, but resulted in a high rate of false positive and false negative diagnoses of hypertension. 24BPM cannot substitute the traditional methods for BP monitoring in pregnancy unless a new definition of hypertension is establis

ISSN:0001-6349    

DOI:10.3109/00016349509024404

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Aim. To evaluate anal function after childbirth in 94 women in whom sphincter rupture occurred and in 19 control women. The findings of anorectal physiological assessment and history of childbirth were related to the presence of fecal incontinence. Methods. Anal manometry and electromyography were performed the first days after childbirth and repeated 3 months post partum together with measurement of pudendal nerve terminal motor latency.Results. Eighteen patients (19%) presented with incontinence. None of the controls developed fecal incontinence after delivery. Anal manometry showed that both incontinent and continent patients had decreased resting and squeeze pressures compared to control subjects (p2.0 milliseconds (odds ratio 2.18,p<0.05). Fecal incontinence could not be related to the weight or head circumference of the infant. The manometric and electromyographic findings, the use of pudendal nerve block, the length of the second stage of labor, the depth of rupture or the use of vacuumextraction could not be related to either fecal incontinence or pudendal nerve function.Conclusion. The manometric findings indicated damage to the anal sphincter apparatus in both continent and incontinent patients. Decreased pudendal nerve function characterized incontinent women. Accurate prediction of fecal incontinence in women with obstetric anal sphincter rupture is not possible.

ISSN:0001-6349    

DOI:10.3109/00016349509024405

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Objective. This study was designed to assess users' perceptions of and satisfaction with the Norplant contraceptive implant.Methods. A questionnaire was mailed to all women having had Norplant inserted one or two years before the study initiation in seven public out‐patient family‐planning clinics in the capital area of Finland, of whom 82% responded (n= 207).Results. Practically all women (97%) had experienced some side‐effects and 72% considered at least one of them to be disruptive. Of these side‐effects, bleeding irregularities proved most often bothersome during the first 6 months of use, but depression and nervousness were relatively more important reasons for early removal. Regardless of the ubiquity of side‐effects, 78% were satisfied with Norplant. High satisfaction was common especially among older users with their second set of capsules. Dissatisfaction with the method was best explained by the experience of unexpected and disruptive side‐effects.Conclusions. Our results suggest that mental problems related to Norplant use have received too little attention and that satisfaction is highest in carefully selected users among

ISSN:0001-6349    

DOI:10.3109/00016349509024406

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Objective. To evaluate the cumulative childbirth rate after completion of in vitro fertilization (IVF) treatment including three or, in a few cases, four stimulated cycles. Design. A cohort of 398 couples starting their first IVF treatment between January 1990 and December 1992 were followed until completion of their treatment.Results. Of 826 started cycles, embryo transfer was performed in 793 cycles, giving a mean of 2.0 completed cycles per couple. In addition, cryopreserved embryos were transferred in 228 cycles (0.57 cycles per couple). 204 couples completed their treatment with delivery or with an ongoing pregnancy, 95 couples underwent three stimulated cycles without achieving an ongoing pregnancy and 66 couples cancelled their treatment after one or two cycles because of varying reasons. In seven women no transfer took place. Twenty‐six women have not yet completed their planned cycles. Of 398 couples, where the vast majority had completed their IVF treatment, 51% (204) delivered as a result of the treatment.Conclusion. IVF treatment combined with freezing of surplus embryos, is a highly effective procedure giving a ‘take home baby rate’ on a cumulative basis of more than 50% within 1 to 3 c

ISSN:0001-6349    

DOI:10.3109/00016349509024407

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

In order to define the relationship between various criteria of female lower genital tract inflammation, we examined wet smears, cervical smears and biopsies from 131 patients. The presence of clue cells in rehydrated dry smears showed a positive correlation to the presence of clue cells in Papanicolaou stained smears, and to some extent with cytological evidence of inflammation (Kappa 0.48). Cytological inflammatory findings correlated well with the presence of clue cells in rehydrated dry smears, but signs of inflammation diagnosed by histopathology did not correspond to findings in cytological smears, probably because these methods reveal inflammation at different sites.

ISSN:0001-6349    

DOI:10.3109/00016349509024408

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY