摘要:

Abstract.The fetal heart rate (FHR) response to a controlled sound stimulus of 80 dB was registered in 152 at‐risk pregnancies. Thirty‐four of the infants showed signs of an intra‐uterine pathological condition at birth, whereas 118 infants were clinically unaffected. The mean heart rate response was significantly weaker in the pathological group than in the normal group. A FHR response of less than 15 bpm was found to give a test sensitivity of 53%. The differences between the two groups revealed by the sound stimulation test corresponded to differences in birth weights and in Apgar score after 1 minute. The results indicate that the sound stimulation test is sensitive to minor changes in the condition of the

ISSN:0001-6349    

DOI:10.3109/00016348409154642

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Abstract.The incidence of surgical complications associated with cesarean section (CS) was studied prospectively in 1319 patients undergoing CS during the years 1978, 1979 and 1980 (18% of all deliveries). The overall complication rate was 11.6% (9.5% patients with minor complications and 2.1 % with major complications). The complication rate for emergency operations was 18.9% and for elective CS, 4.2%—a highly significant difference, (p<0.001). Six risk factors were associated with the occurrence of surgical complications in emergency cases: Station of the presenting part of the fetus in relation to the spinal plane (p<0.001), labor prior to surgery (p<0.001), low gestational age (<32 weeks) (p<0.001), rupture of fetal membranes (with labor) prior to surgery (p<0.01), previous CS (p<0.01), and skill of the operator (p<0.05). However, no such risk factors were found in the elective group. The clinical relevance of these findings is summarized in two conclusions. Firstly, the proportion of emergency operations needs to be reduced, either in favor of elective procedures, or by allowing more patients to give birth by the vaginal route. Secondly, emergency CS requires great skill on the part of the surgeon, and should therefore not be entrusted to young, inexperienced obstetrician

ISSN:0001-6349    

DOI:10.3109/00016348409154643

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Abstract.Over a 3‐year period all infants (n = 7401) born at the Department of Obstetrics and Gynecology, Central Hospital, Borås Sweden, were studied for signs of respiratory disease. For all infants who developed signs of respiratory disorders the mode of delivery and the type of anesthesia used in cesarean section (CS) were analysed. The incidence of respiratory disorders in the whole material was 3.0% (n = 220) and the‐mortality rate for these disorders was 0.24%. There was a significantly higher incidence (p<0.001) of respiratory disorders in infants weighing ≥ 2 500 g born by CS vis‐à‐vis infants born by the vaginal route. The group born by elective CS under maternal general anesthesia had a higher (p<0.05) rate of respiratory disorders than those born by elective CS under maternal epi‐dural anesthesia. It is concluded that the risk of respiratory disorders in infants delivered by CS is related to the mode of deliveryper se.Consequently, a reduction in the proportion of such interventions ought to reduce the overall number of infants developing respiratory disease, as indicated in the

ISSN:0001-6349    

DOI:10.3109/00016348409154644

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Abstract.There are approximately 400000 births plus legal abortions in the five Nordic countries annually. During the 1970s the number of maternal deaths ranged from 14 to 33 per year, the overall mean rate being 7.2 per 100000 births. The rates declined somewhat from 1972 onwards, but otherwise there was no demonstrable change in frequency with time. Mortality rose steeply with increasing maternal age, with a rate of 28.5 for mothers over 35. The two most frequent causes of death were pre‐eclampsia/eclampsia and hemorrhage, comprising. 17.0 and 14.2% of the total, respectively. Legal abortion carried less risk of death than did pregnancy continuing to birth. Among the countries, Denmark and Sweden had the lowest average maternal mortality rates. The distribution of causes showed a predominance of abortion and thrombosis in Finland, and of hemorrhage and infection in Norway, but neither singular causes nor age‐specific birth distributions can explain inter‐country differ

ISSN:0001-6349    

DOI:10.3109/00016348409154645

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Abstract.Decidual and intramyometrial spiral arteries from 18 insulin‐dependent diabetic and 18 non‐diabetic women were compared histologically. All women were normoten‐sive and none had signs of pre‐eclampsia. None of the infants in either group had intra‐uterine growth retardation. Metabolic control in the diabetic women was assessed by pregnancy glucose level from the last trimester of pregnancy and by C‐peptide in amniotic fluid and cord blood as a measure of the fetal beta‐cell function. The intramyometrial and decidual parts of the spiral artery were normal in the non‐diabetic group. None of the diabetic patients showed pathological changes in the intramyometrial part of the spiral artery. Two of the 18 diabetic patients had pathological changes (intramural fibrosis) in the decidual portion of the spiral artery. These two women had signs of diabetic angiopathy (White's class D and F) and in one of them, the background diabetic retinopathy progressed markedly during pregnancy. The pregnancy glucose level was above normal (>6.2 mM/1) in 3 of 18 diabetics. The C‐peptide values in amniotic fluid and cord blood were above normal in 11 of 17 and in 5 of 17, respectively. Both patients with spiral artery lesions had pregnancy glucose levels in the upper range, 5.86 and 5.98 mM/1, respectively and the highest value of C‐peptide in the amniotic fluid and cord blood, suggesting exaggerated fetal

ISSN:0001-6349    

DOI:10.3109/00016348409154646

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Abstract.A study of antenatal cardiotocographs (CTG) in 250 patients with fetal growth retardation showed that non‐reactive tracings were associated with a significant increase in operative deliveries for fetal distress in labour, a high perinatal mortality rate, and fetal anomalies, and a low Apgar score of the infant, both at one and five minutes after delivery. A “ten‐point” scoring system was used to evaluate the CTG tracing. A score of 6 or less was associated with a significantly higher perinatal morbidity and mortality rate compared with those who had a score of 7 or more (

ISSN:0001-6349    

DOI:10.3109/00016348409154647

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Abstract.Two groups of mothers who underwent elective cesarean section under epidural analgesia, were studied with the aim of comparing the analgesic potency and side effects of two solutions: morphine‐bupivacaine and morphine‐saline. Each group comprised 100 patients.The intraoperative anesthesia was established with bupi‐vacaine plain, 5 mg/ml, in amount 85‐125 mg.Immediately after the infant was delivered, the mothers received a single epidural dose of 3 mg of preservative‐free morphine chloride mixed with either 5 ml of 0.25% bupiva‐caine (Group I) or 0.9% saline (Group II). The intraoperative observations showed “good effect” without need for supplementation of analgesia in 82 mothers in Group I, compared with 61 mothers in Group II (p<0.001).The postoperative observations showed that 82 mothers in Group I were satisfied with a single dose of morphine for more than 24 hours, while in Group II the corresponding number was 63 (p<0.01).A significant difference in the incidence of nausea and vomiting was found between the groups; 7 of the mothers experienced nausea and 4 vomited in Group I and 17 experienced nausea and 13 vomited in Group II (p<0.05, for both variables). Respiratory depression was seen in one mother during surgery immediately after supplementation of morphine‐bupivacaine analgesia with ketamine. Other side effects, such as itching, bradycardia and Homer's triad were rare.It may be concluded that a single epidural dose of morphine in bupivacaine will augment intraoperative analgesia and prolong postoperative analgesia. Less favorable results were obtained when morphine in saline was used. Synergism between bupivacaine and morp

ISSN:0001-6349    

DOI:10.3109/00016348409154648

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Abstract.The study included 18 infertile, hyperprolacti‐nemic women with preserved menstrual cycles. Among 13 women with consistently elevated prolactin (PRL) levels, 6 had either anovulatory cycles or luteal insufficiency, whereas 7 had apparently normal ovulatory cycles. Comparisons of these two groups showed that basal levels were similar but the PRL response to metoclopramide (MTC) and the day‐to‐day fluctuations were significantly lower in the group with altered oyulatory function. In this group the PRL response to MTC was significantly greater than in control patients with hyperprolactinemic amenorrhea (n = 12), but lower than in normal women (n = 10). The PRL response to MTC in hyperprolactinemic women with normal ovulatory function did not differ significantly from that of normal women, irrespective of whether hyperprolactinemia was sustained (n = 7) or intermittent (n = 5).The study indicates that the degree of autonomy of PRL secretion reflected by both the fluctuations in basal levels and the response to a dopamine antagonist, may be used to evaluate whether or not slightly elevated PRL levels are of clinical significance in relation to fert

ISSN:0001-6349    

DOI:10.3109/00016348409154649

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Abstract.Serial measurements of serum prolactin (PRL), chorionic gonadotropin (hCG), estradiol and progesterone were performed during 16 normal pregnancies. The same hormone analyses were performed in a woman with the galactorrhea‐amenorrhea syndrome and a pituitary adenoma during two pregnancies, with and without continued treatment with bromocriptine throughout gestation. The study indicates that marked differences in circulating PRL levels do not influence the fetoplacental hormone levels. Furthermore, tumor expansion may possibly be prevented and successful breast‐feeding can be achieved after treatment with bromocriptine throughout gestat

ISSN:0001-6349    

DOI:10.3109/00016348409154650

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Abstract.Late sequelae after laparoscopic Hulka clip sterilization were investigated in 100 women, with a follow‐up time of 1½—3 years. Of the patients, 18% showed menstrual disorders, and one patient complained of climacteric symptoms. Increased libido was reported by 34% of the women and decreased libido by 8%. Of the husbands, libido had increased in 18% of cases, while none of them reported decreased libido. Sexual intercourse was felt to be more satisfactory after sterilization by 40% of the women, while the others did not find any change. All the patients were asked whether they would again choose laparoscopic sterilization as a contraceptive method and all answers were unhesitatingly in the affirma

ISSN:0001-6349    

DOI:10.3109/00016348409154651

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY