摘要:

Abstract.171 samples of amniotic fluid were obtained by abdominal amniocentesis from 67 women with complicated pregnancies (isoimmunization, diabetes mellitus or toxaemia). The levels of heat‐labile alkaline phosphatase (HLAP), heat‐stable alkaline phosphatase (HSAP) and acid phosphatase (AcP) were determined and compared to the enzyme levels in 179 samples from women with normal pregnancies of corresponding gestational ages. HLAP showed two “peaks” of activity, one in the 15th–22nd week and the other at term. HSAP and AcP showed increased activity at term. HSAP was decreased (p<0.01) in isoimmunization between the 36th and 40th week. 11 cases of toxaemia with placental insufficiency showed no differences in the levels of HLAP and HSAP compared with normal pregnancy. AcP showed no differences between normal and complicated pregnancy. Samples contaminated by blood showed no significant increase in the acid‐ and alkaline phosphatase levels. Samples contaminated by meconium showed a complex pattern. Some samples had normal enzyme levels, some had high levels of HLAP only and some had high levels of HSAP and AcP. The origin of the enzymes is not known with certainty. HSAP in amniotic fluid is most likely not of placental but of intestinal origin. Determinations of acid‐ and alkaline phosphatase in amniotic fluid seem to be of little value in the clinical management of complica

ISSN:0001-6349    

DOI:10.3109/00016347809154191

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

Abstract.In spite of the rapid development of amniocentesis for genetic diagnosis, it is still only a small fraction of the mothers at risk who are having the procedure performed. The medical and public health problems associated with genetic amniocentesis are discussed on the basis of the experience gathered in a major medical center.

ISSN:0001-6349    

DOI:10.3109/00016347809154192

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

Abstract.(1) Measurement of fetal scalp blood pH aids the detection of fetal asphyxia. The investigation is done on patients whose fetus is at increased risk of death. (2) Special care in the collection and measurement of scalp blood pH is necessary to obtain satisfactory results. A change of 0.05 pH unit is significant. (3) Acidosis is present when scalp pH is<7.25. (4) A severe acidosis, pH<7.10, indicates a worse fetal prognosis. (5) Fetal metabolic acidosis is the commonest type of acidosis, but is less hazardous than asphyxial acidosis. (6) Fetal metabolic acidosis is associated with use of drugs, PET, fetal growth retardation, amniotomy and maternal starvation. (7) The possibility of transient acidosis needs to be taken into account when interpreting fetal scalp pH measurements. (8) Fetal scalp blood studies have helped in defining the influence upon fetal condition of maternal hyperoxygenation, duration of birth, maternal posture and the influence of drugs on fetal condition. (9) A controlled trial has shown that fetal intensive care, routine FHR monitoring and selected fetal scalp blood pH measurement in a high risk group is associated with improved biochemical and neurological status of the newborn. (10) Over the last eight years there has been a significant reduction of intrapartum anoxic stillbirths at the Queen Victoria Hospital. One of the probable reasons for this reduction in intrapartum stillbirths is the introduction of fetal diagnostic techniques. (11) Fetal heart rate monitoring is more help to the clinical obstetrician than scalp sampling–it is applicable both antepartum and intrapartum, more easily organized, and more easily learn

ISSN:0001-6349    

DOI:10.3109/00016347809154193

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

ISSN:0001-6349    

DOI:10.3109/00016347809154194

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

Abstract.Modern treatment for anovulatory infertility increases the incidence of multiple pregnancies with three or more fetuses and predisposes to prematurity with high perinatal mortality and morbidity. Premature labor was successfully treated in four multifetal pregnancies with ritodrine hydrochloride, a beta‐mimetic drug relaxing the uterus. Another patient misdiagnosed as false labor was not treated and lost three out of four premature babies. Beta‐mimetic treatment is indicated in multiple pregnancies even in false labor, or when painless progress in cervical dilatation is observed, to avoid asymptomatic progression into true labor. In contrast to singleton pregnancies, advanced labor with more than four centimeters cervical dilatation should not preclude good chances for successful treatment. Persistence in treatment and repeated use of the most effective intravenous route combined with oral ritodrine administration is needed because of marked tendency to recurrences of premature labor. Progressive increase in the dose of oral ritodrine may be indicated by decrease in therapeutic response. Maternal tachycardia should be considered as an index of patient responsiveness to the beta‐mimetic treatment. The therapy is most successful when the patient is hospitalized from the first episode of treatment until at least the 37th week of pregnancy. This is probably less expensive than prolonged hospitalization of several prematures in an intensive care nu

ISSN:0001-6349    

DOI:10.3109/00016347809154195

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

A basic understanding of the physiologic effects of the prostaglandins on the human reproductive system has been one of the diverse scientific interests of Professor Axel Ingelman‐Sundberg (19). Although the obvious clinical utility of these ubiqitous compounds directed early attention to their therapeutic aspects, more recently there has been renewed interest in the basic physiologic mechanisms of the prostaglandins in reproductive medicine. Undoubtedly, the work of Dr Ingelman‐Sundberg has stimulated many of his colleagues, students, and fellow scientists to pursue such basic studies in greater deta

ISSN:0001-6349    

DOI:10.3109/00016347809154196

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

Abstract.The incidence of complications associated with therapeutic termination of pregnancy was analysed in 1349 patients, whose average age was 26.3 years. Of the patients, 51.8% were 25 years or under; 56.3% were seen in or before the 8th week of pregnancy, and 17.4% had previously had one or more legal abortions. All the operations were performed under local anaesthesia and by the same doctor, who was an experienced gynaecologist. Complications associated with the operation occurred in 14 patients (1%), viz. infections in the uterus and tubes, 9 cases; incomplete abortion necessitating repeat curettage, 4 cases; and profuse bleeding requiring blood transfusion, 1 case. No uterine perforations or cervical ruptures were encountered.Questioned about subjective discomforts of the operation, 7.4% of the women answered that the discomfort had been considerable, whereas 62.6% described it as only slight; 4.8% would have preferred general anaesthesia.We conclude that therapeutic abortion can be performed safely and with an acceptably low incidence of complications in out‐patients, provided the operations are performed by an experienced gynaecologis

ISSN:0001-6349    

DOI:10.3109/00016347809154197

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

Abstract.The uterine neurotransmitter, noradrenaline, was examined histochemically and fluorometrically in guinea‐pigs during the estrous cycle and after pretreatment with sex steroids. In diestrous animals noradrenaline values were higher than in the estrous state. Treatment with estradiol or progesterone alone did not markedly influence the level of uterine adrenergic transmitter, whereas combined estradiol and progesterone administration caused a clear‐cut reduction in uterine noradrenaline. The quantitative changes in transmitter level did not reflect the marked alterations in weight during the various experimental conditions, and even inverse noradrenaline‐weight relationships were observed. The findings offer further support for the concept of a steroid‐mediated influence on uterine neurotransmission, where the uterine adrenergic nerves constitute a separate target for endocrine control, distinct from the rest of the

ISSN:0001-6349    

DOI:10.3109/00016347809154198

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

Abstract.In two groups of women the urethral pressure profile was recorded using a microtransducer catheter. Both groups were of approximately the same age, one consisting of continent women, the other of women with severe stress incontinence. Sixteen stress incontinent women were examined before and after pubococcygeal repair and 10 of these were also examined during the operation. The two groups were compared for differences in the urethral pressure profile in the continent and incontinent states. The stress incontinent women had a significantly shorter functional length of the urethra (10 mm) but the same maximal urethral pressure as continent women. Remarkable changes in these parameters were seen during the operation. However, at the examination 3 months postoperatively, they had totally disappeared. The only change in the urethral pressure profile which persisted after the operation was a higher pressure in the proximal part of the urethra, so that a urethral maximal pressure plateau had been established. This plateau was also seen, on a higher level, in the continent state.

ISSN:0001-6349    

DOI:10.3109/00016347809154199

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

Abstract.This short survey presents some methodological aspects on intraluminal pressure recordings in vivo from the female urogenital tract. The importance of adequate calibration is stressed and a calibration unit for different types of recording equipments is described. Calculations of measuring errors are outlined. The selection of recording catheters is discussed from both the theoretical and the practical point of view. Finally some practical aspects are considered on pressure recordings in vivo from the ureter, the bladder, the urethra and the uterus. This discussion is illustrated by pressure diagrams obtained with different recording techniques from the actual organs.

ISSN:0001-6349    

DOI:10.3109/00016347809154200

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY