ISSN:0001-6349    

DOI:10.3109/00016349009006150

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

In the 1920s, peritonitis following abortion was an extremely serious condition, attended by a high risk of lethal outcome for the unlucky victim. Surgical intervention had been tried, but fallen into disrepute. In the first article in fasciculus I of Acta Obstet‐ricia et Gynecologica Scandinavica in 1930, J. J. Chy‐denius wrote Uber die operative Behandlung der dif‐fusen Abortperitonitiden (1), an account of the change from conservative to operative treatment of the condition. at the University clinic in Helsinki. During eleven years, 1919‐1929, the Department had treated 3221 abortees, of whom 56 (1.7%) were stricken by diffuse peritonitis. Of the latter, 27 were treated conservatively, and only one of these survived. Before 1925, surgical treatment did not seem to matter much one way or the other, as seven out of eight patients who were operated upon also died. However, in 1925 matters seemed to improve. Operative intervention became more frequent, accomplished first by small incision and drainage, later by more radical laparotomy with removal of one or both adnexa and in some cases amputation of the uterus, plus incision and drainage through the vagina. Between 1925 and 1929, nine out of 21 patients so treated survived. The author was quick to point out that the two groups (operated and non‐operated) were not strictly comparable. Both because of small numbers and der untereinander sehr verschie‐denen Eigenart der Falle kann jedoch keine statis‐tische Behandlung des Materiales in Betracht kom‐men. They were not unaware of the golden rule for statistical comparisons even in those days. Take heed, co

ISSN:0001-6349    

DOI:10.3109/00016349009006151

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Expectations of labor and childbirth can affect the degree of in‐labor pain or discomfort experienced by the mother. By ascertaining whether expectations of labor experience are realistic or not, women can be prepared during the antenatal period to cope better with labor pain. The purposes of this prospective study were to 1) determine if pregnant women had realistic expectations of the labor experience, 2) determine if women who expected to have more pain during labor actually experienced more pain, than those not expecting to experience so much pain, and 3) determine if attending midwives assessed in‐labor pain as intense as the mothers did. Fifty primiparas, 88 multiparas, and 12 full‐time employed mid‐wives participated in the study. The Visual Analogue Scale (VAS) was used to rate the expected and actual in‐labor experience. A 3‐point rating scale was used by the midwives to rate in‐labor pain. Neither primiparas nor multiparas were found to have realistic expectations of the labor experience. Mothers experienced more pain and discomfort than expected, and the multiparas anticipated their need for medication to be greater than what was actually needed. The mothers reported that they felt less lonely and received more support from personnel during labor than they had expected. Multiparas who expected to experience more pain reported more pain than those expecting to experience less pain in stages I and III of labor. There was no significant correlation between midwives' and mothers' rating of the intensity of in‐labor pain during sta

ISSN:0001-6349    

DOI:10.3109/00016349009006152

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

We have previously reported the existence of a phospholipase C‐sensitive form of factor VII‐probably a factor VII‐phospholipid complex in normal pregnancy. By bivariate regression analysis, the level of this complex shows highly significant positive correlations with serum triglycerides (r=0.90, p<0.0001) and blood platelet count (r=0.67, p=0.0004). This high degree of correlation was verified by stepwise multiple regression analysis. It is presently not known how this factor VII complex fo

ISSN:0001-6349    

DOI:10.3109/00016349009006153

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Phenytoin sodium was administered intravenously as a single 900 mg dose in 33 consecutive women with eclampsia immediately on admission. No untoward effects were observed either in the mother or subsequently in the neonate. Since the patient's level of consciousness is unaltered by the drug, it could be monitored serially as part of neurological assessment. The risks of pulmonary aspiration, respiratory depression and airway obstruction arising from deep sedation which occurs with standard regimens, were averted. Control of convulsions was adequate without the need for any complicated drug related patient monitoring.

ISSN:0001-6349    

DOI:10.3109/00016349009006154

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Since 1982 we have accelerated fetal maturation with intra‐amniotic thyr‐oxine (T4) in more than 140 patients. The purpose of this analysis was to determine the rate of change of the ratio of lecithin to sphingomyelin (LIS) after administration of T4 at different gestational ages, and to compare the responses to the first and the second administration of T4. Fifty‐nine cases in which administration of T4 was continued for 2 weeks or more, and in which at least 3 determinations of L/S had been performed, were identified. Gestational age of the fetus at the inititiation of treatment ranged from 26 to 31 weeks (mean 29.3 weeks). Thyroxine was administered weekly in 200 to 500 mcg doses.Administration of T4 prior to the 27th week did not change the L/S. From the 27th and 31st week of gestation, the slope of the L/S, after the initial dose of T4 increased from 0.331wk to 1.05/wk. In contrast the slope of the untreated patients changed little reaching a maximum of 0.22 at the 33 week. L/S>2 was observed in 80% of cases after 2 weeks of therapy, when it had been initiated after the 26th week.The response to the second dose was about twice that of the first in fetuses 5 30 weeks, but was similar to that seen after the initial dose in fetuses>30 weeks. Phosphatidylglycerol (PG) was detected in amniotic fluid in 51% of cases after 2 weeks of treatment, and in 6 instances as early as at the 30th week.Responsiveness of L/S to T4 treatment of the fetus is a function of gestational age and of prior exposure

ISSN:0001-6349    

DOI:10.3109/00016349009006155

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Serum 5α‐pregnane‐3,20‐dione (5αDHP) and progesterone (P) concentrations were studied in 11 women with uncomplicated pregnancies and deliveries during spontaneous labor and immediately after delivery. Blood samples were drawn 3–6 times during labor, as soon as possible post partum and 1, 3, 6 and 12 h post partum. P and 5αDHP were analysed using RIA methods. There were no significant changes during labor in serum concentration of P and 5αDHP, the values being 366 nmol/l ± 25 SE and 128 nmol/l ±16 SE respectively. Whereas an earlier study has shown a significant decrease in 5αDHP serum concentration between late pregnancy and spontaneous labor, this study showed no decrease during labor, indicating that the decrease occurred before the onset of labor. After parturition, the elimination of P from serum was faster and proportionally greater than for 5αDHR with a half‐life of 38 min for P and 58 min for 5αDHP. About 2—3 h post partum the serum concentrations stabilized just above luteal phase values. 12 h post partum, P and 5αDHP were 12% and 23% respectively

ISSN:0001-6349    

DOI:10.3109/00016349009006156

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

A high maternal hemoglobin level during pregnancy has been correlated to a low birth weight and a low placental weight, but has not been investigated in relation to placental factors.In 330 consecutive deliveries, placental lesions, birth weight and placental weight were studied in a multiple regression analysis in relation to maternal hemoglobin concentration, taking into consideration possible confounding factors such as smoking, hypertensive disorders, weight gain, pri mi parity, gestational age and sex. A high maternal hemoglobin concentration (>130 g/l) was correlated with a low birth weight, acute infarcts and syncytial knots. Intervillous thrombosis was more common in non ‐ smokers and multiparous women, increasing in incidence as gestational age advanced. Infarcts and microscopic perivillous fibrin were correlated with hypertension. Microscopic perivillous fibrin was slightly associated with a high hemoglobin level (>130g/l) in a bivariate analysis. These findings may indicate that a high maternal hemoglobin level impairs the uteroplacental circulatio

ISSN:0001-6349    

DOI:10.3109/00016349009006157

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Milligram‐range doses of E2prostaglandins have long been used to induce labor or abortion in the second and third trimesters of pregnancy. Enprostil, a synthetic dehydroprostaglandin E2structural analogue, is administered in microgram doses for the treatment of acute duodenal ulcer and acute gastric ulcer. This study examined the effect of the ulcer‐healing dose and twice the ulcer‐healing dose upon women in the first trimester of pregnancy. Two hundred and seven women who had requested legal abortion in the first trimester participated in two randomized, double‐blind, placebo‐controlled, parallel studies. They received two doses of enprostil 35 μg (the recommended dose for the treatment of duodenal and gastric ulcer) (n=51), 70 μg (twice the recommended dose) (n=53), or placebo (n = 103) 12 h apart. No drug‐induced abortions occurred in any of the first‐trimester pregnancies. Vaginal bleeding occurred in 4% of volunteers receiving the lower dose and 4% receiving the higher dose of enprostil. Vaginal bleeding occurred in up to 2% of volunteers on placebo. Although not recommended for pregnant women, if enprostil is given inadvertently to pregnant women with ulcers, it is unlikely to endanger the pregnancy during the

ISSN:0001-6349    

DOI:10.3109/00016349009006158

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Medication with Clomiphene Citrate and its effects on the quality of cervical mucus and the addition of exogenous estrogens in order to suppress abnormal mucus secretion are controversial issues. We have prospectively studied a group of 19 anovulatory women who were treated with clomiphene citrate in order to characterize those patients most likely to respond to the addition of exogenous estrogens. On day 14 of the cycle, 17 β estradiol and cervical ‐re were measured and 1 mg estradiol benzoate was injected intramuscularly. Cervical scores were below 7 in 12 out of the 19 patients before estradiol benzoate administration. In these patients, 17 β estradiol rose from 751±541 to 1321±648 pg/ml (p<0.03).and cervical scores rose from 3.75±2.1 to 7.1±3.7 (p<0.0l), after estradiol benzoate administration. Patients with cervical scores of 8‐12 did not improve significantly. In the 12 patients with cervical scores below 7, those (n=6) with 17 β estradiol below 600pg/ml experienced a significant improvement in cervical score, in contrast to those (n=6) with 17 8 estradiol above 600pg/ml who had no improvement. The reduction in cervical mucus accomplished with clomiphene citrate can be further improved by adding exogenous estrogens, mainly in patients who have low 17 β estradiol levels concomitant with low cer

ISSN:0001-6349    

DOI:10.3109/00016349009006159

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY