摘要:

Prospective uterine fluid sampling in 140 patients was performed using a Wallace catheter. The levels of human decidua-associated protein (hDP)-200 in the uterine fluid and in the serum, and the total protein concentration in the uterine fluid were determined. Uterine fluid volumes were scored during the hysteroscopy and no correlation was found with the phase of the menstrual cycle. The total protein concentration in the uterine fluid did not vary significantly during the menstrual cycle. The hDP-200 levels in uterine fluid were significantly higher than those in the serum, although considerable individual variation in the level of uterine fluid hDP-200 was found.

ISSN:0378-7346    

DOI:10.1159/000292413

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

The aim of this study was to determine the distribution of ET-1 levels in the term maternal-fetal dyad. We also compared the levels of ET-1 between umbilical vessels and assessed the effect of labor on the concentration of ET-1. The ET-1 levels were measured in plasma from 18 term maternal-infant pairs. Amniotic fluid ET-1 levels were also measured in 9 of these pregnancies. The ET-1 levels were determined by radioimmunoassay (RIA) after extraction of plasma using Sep-Pak C18 cartridges. There were no significant differences in the ET-1 levels between the umbilical artery and vein. However, there were significant differences in the umbilical artery concentration in women who labored when compared with those delivered without labor (6.0 ± 1.1 vs. 2.7 ± 0.7 pg/ml; t test, p = 0.022). ET-1 levels were lowest in the maternal plasma (0.9 ± 0.2 pg/ml) and highest in the amniotic fluid (83 ± 15 pg/ml). Assuming that elevated plasma ET-1 levels reflect increased bioactivity, the higher mean ET-1 levels in the cord vessels and in the amniotic fluid when compared to maternal levels suggest a role for ET-1 in the regulation of the fetoplacental circulation and in the constriction of blood vessels in the uterus after parturition. The higher levels of ET-1 in the umbilical artery of women who underwent labor implies that ET-1 is released as a result of the stress of labor.

ISSN:0378-7346    

DOI:10.1159/000292414

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

In this prospective randomized study we treated 60 couples with unexplained infertility with a combination of ovarian stimulation and either intrauterine insemination (IUI) or fallopian sperm perfusion (FSP). In the IUI we used a volume of 0.5 ml of inseminate and in the FSP a volume of 4 ml. The demographic characteristics of the patients, the stimulation parameters and the sperm data were not statistically different between the two groups. The pregnancy rate per cycle was 16.2% in the IUI group and 14.5% in the FSP group and the pregnancy rate per woman was 40 and 36.7%, respectively (not statistically different). We conclude that IUI and FSP are equally effective in the treatment of couples with unexplained infertility.

ISSN:0378-7346    

DOI:10.1159/000292415

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Atrial natriuretic peptide (ANP) is found to be elevated in preeclamptic patients despite the presence of hemodynamic characteristics such as vasocon-striction and hypovolemia. In this study, the effect on ANP secretion of plasma volume expansion with crystalloid solutions was investigated. Seven preeclamptic and seven normotensive pregnant women in their last trimester were compared. After basal ANP measurements, 0.9% Ringer’s solution, 15 cm3/kg body weight was infused within 30 min to expand the plasma volume. Blood sampling was repeated after the infusion. Maternal blood volume expansion was calculated from the decrease in hematocrit. Plasma ANP levels were corrected according to the degree of volume expansion. Basal mean levels in both groups were not different. Although the postinfusion levels of ANP in normotensive pregnant women were similar to the basal levels (means ± SE: 20.6 ± 0.41 and 27.2 ± 0.52 pg/ml, respectively, p = 0.10), the postinfusion ANP levels in preeclamptic women increased significantly (21.4 ± 0.31 and 34.1 ± 0.28 pg/ml, respectively, p = 0.01). Preeclampsia is associated with a greater increase in plasma ANP levels in response to volume expansion compared with normotensive pregnancy. The greater change in the right atrial pressure with volume expansion, due to decreased compliance of the capacitance vessels in preclamptic subjects might explain the greater change in the plasma level of ANP.

ISSN:0378-7346    

DOI:10.1159/000292416

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Lactate dehydrogenase (LDH), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) concentrations and platelet counts were measured in 26 normal pregnant women and 51 preeclamptic women. In the normal-pregnancy group, no significant changes were found in the results of these tests. In the preeclampsia group, ALT and AST concentrations were not significantly higher than those in normal pregnancy, but the LDH concentrations increased and the platelet counts decreased significantly through the pregnancy. The increases in LDH did not correlate with changes in ALT or AST. Preeclamptic women with small-for-gestational-age (SGA) infants had significantly higher LDH concentrations than those in the appropriate-for-gestational-age (AGA) group, but ALT and AST concentrations did not increase significantly. As reasons for the LDH increase in our subjects, liver damage was excluded and more active glycolysis in addition to severe cell damage due to chronic anoxemia were inferred. It is suggested that an increase in LDH is predictive of SGA infants in preeclamptic pregnancy, especially in those with normal liver function.

ISSN:0378-7346    

DOI:10.1159/000292417

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Mother-fetus exchanges at the placental level are found to be altered in women affected by hypertensive or diabetic pregnancies following the onset of microenvironmental, circulatory, trophic or tissue disorders. Our aim was therefore to assess the alterations occurring within the umbilical cord, particularly its venous endothelial component and underlying smooth muscle layer, using transmission (TEM) and scanning electron microscopy (SEM) and immunohistochemical analyses. Immunohistochemical data appear to support the ultrastructural evidence for an activated state of these vascular structures, in both conditions (hypertension and diabetes). Furthermore, mainly during diabetic pregnancies, extracellular matrix molecules such as tenascin and fibronectin also quantitatively increase at the vein wall level. The umbilical cord seems to be a structure capable of responding actively to abnormal microenvironmental conditions which seriously threaten the health of the fetus and also the mother herself.

ISSN:0378-7346    

DOI:10.1159/000292418

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Despite proven efficacy in interrupting uterine smooth muscle contraction for periods of 24–48 h, a recent clinical study concluded that the adrenergic β-receptor agonist, ritodrine hydrochloride (Yutopar®) had significant detrimental side effects. Our previous preclinical studies have shown that ritodrine reduces placental blood flow via a vascular steal phenomenon. Moreover, ovarian blood flow is reduced by approximately 40% by ritodrine treatment. Reduced ovarian blood flow during tocolytic treatment presented the possibility for a blood-flow-mediated decrease in progesterone secretion which would have negative effects on uterine quiescence. Pharmacological agents such as calcium channel blockers and magnesium sulfate have tocolytic potential. Magnesium sulfate infusion has a long clinical history of safety and efficacy; however, the possibility for latent detrimental hemodynamic and tissue/organ blood flow responses was unexamined. Therefore, the present studies examined hemodynamic and organ blood flow in near-term pregnant rats given intravenous MgSO4. Our results show that (a) peripheral vascular steal is not induced, and (b) placental perfusion is preserved during MgSO4 infusion. However, ovarian blood flow is significantly reduced and blood-flow mediated decrease in progesterone secretion requires consideration during implementation of tocolysis via MgSO4 infusion.

ISSN:0378-7346    

DOI:10.1159/000292419

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Fifty-two women who had labour induced by intravenous oxytocin were compared with 404 women in whom labour was induced by vaginal misoprostol (50–150 μg). The induction-to-delivery intervals in the oxytocin and misoprostol groups, respectively, had the following durations. With Bishop’s score < 6, 24.3 vs. 14.4 h (p = 0.002), with Bishop’s score ≥6, 10.5 vs. 7.6 h (p = 0.02), with ruptured membranes, 8.8 vs. 8.5 h (p = 0.83), and with intact membranes, 19.6 vs. 13.1 h (p = 0.005). The Caesarean delivery rate was 17.3% in the oxytocin group and 8.7% in the misoprostol group (p = 0.09). Maternal complications were few and drug side effects rare. It is concluded that vaginal misoprostol is a valuable and cost-effective alternative to intravenous oxytocin infusion for induction of labour.

ISSN:0378-7346    

DOI:10.1159/000292420

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Presented herein is a randomized prospective study performed to evaluate the efficacy of the addition of lymphocyte immunotherapy (LI) to progesterone (P) therapy (LI/P) for the prevention of spontaneous abortion (SAB) in primary aborters with a history of three SABs. The incidence of intrauterine pregnancies in four cycles was 23 of 35 (65.7%) patients for LI/P vs. 14 of 31 (45.1%) patients treated with progesterone alone. SABs occurred in 6 of 23 (26.0%) Ll/P-treated patients compared to 8 of 14 (57.1%) given progesterone alone. The mean number of previous abortions in both groups was 3.9. The mean age of the LI/P group was 34.1 vs. 33.6 years for the group treated with progesterone alone. These data could be interpreted to show that progesterone therapy and LI independently inhibit SAB or that LI/P acts synergistically to inhibit immune destruction. LI/P therapy was found to be more effective than progesterone therapy alone.

ISSN:0378-7346    

DOI:10.1159/000292421

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Immunocytochemical study in paraffin sections of human endometrium showed that the receptor contents for both oestrogen and progesterone receptors were lower than in the frozen sections although the staining patterns were similar in these two section types. Pretreating the specimens with proteolytic enzymes like trypsin, DNase and pronase improved the oestrogen receptor staining but a better result with progesterone receptor staining was obtained when no enzymatic pretreatment was applied to the sections.

ISSN:0378-7346    

DOI:10.1159/000292422

出版商:S. Karger AG    

年代:1995

数据来源: Karger