摘要:

The potential risk of rhesus alloimmunization and the ensuing risk of fetal death with increasing parity were investigated in two groups of parturients; primiparous and grand multiparous (para ≥5) women with liveborns. It was hypothesized that significantly fewer women of the latter than of the former group would be rhesus negative, since grand multiparity would be expected to be associated with an increased risk of late fetal death in rhesus-negative parturients. Primiparous (n = 390) and grand multiparous (n = 755) parturients with liveborns were studied in order to identify D- and Du-negative individuals. Sixteen out of 390 primiparas (4.10%) and 28/755 (3.71 %) grand multiparas were D and Du negative. The difference did not reach statistical significance. It appears that being a D- and Du-negative grand multiparous parturient, in the absence of anti-D prophylaxis, is not a significant reproductive disadvantage to being primipara in terms of an increased risk of having stillborn babies.

ISSN:0378-7346    

DOI:10.1159/000292744

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

The corpus luteum function was evaluated in patients with surgically confirmed ectopic pregnancy (EP) in a multicenter study. In addition, the minimal threshold of serum progesterone (P) concentration required for salvaging intrauterine pregnancies (IUP) was also examined. Results show that single P or 17-OHP measurements are not diagnostic for EP, since mean P levels in EP were similar to those with spontaneous abortion though significantly lower than those in controls. 17-OHP levels in EP overlapped in 50% with IUP, and the mean levels were significantly lower only at 6–7 weeks. The 17-OHP levels when compared to hCG supports the view that corpus luteum defect is primary. In IUP, P levels < 8 ng/ml still were associated with viable (60%) pregnancy; thus no minimal threshold could be established.

ISSN:0378-7346    

DOI:10.1159/000292745

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Grand multiparous parturients with unexplained late fetal death (n = 70) and with surviving newborns (n = 755) were analyzed and compared regarding blood group in general and presence of D and Du antigens in particular. In the stillbirth group, none of the parturients had any signs of disease (syphilis, pre-eclampsia, placental abruption, severe anemia or fever) that could be associated with the fetal death. It was found that none of the parturients with stillbirth were D- and Du-negative while 28/755 (3.71 %) of parturients with live-born babies were D- and Du-negative. It is concluded that, among grand multiparous parturients with otherwise unexplained late fetal death, the risk of having fetomaternal rhesus incompatibility as stillbirth etiology is insignificant. The advantage of introducing anti-D immunoglobulin for prophylaxis against rhesus alloimmunization would presumably be insignificant.

ISSN:0378-7346    

DOI:10.1159/000292746

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Fibronectin production from amnion and placental tissues was evaluated in pregnant woman smokers and nonsmokers in order to examine if there were alterations of fibronectin metabolism in intrauterine tissues. In both amnion and placental tissues, cycloheximide inhibited the fibronectin output indicating that it was being synthesized. Mean fibronectin output by amnion in pregnant woman smokers was significantly lower than that in pregnant woman nonsmokers. In contrast, in the placenta from pregnant woman smokers, the output was significantly higher than that in pregnant woman nonsmokers. The present observations indicate that smoking alters an important biochemical constituent in amnion and placenta, possibly leading to some complications.

ISSN:0378-7346    

DOI:10.1159/000292747

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

In a prospective, randomized, double-blind study for the prevention of pregnancy-induced hypertension and preeclampsia, 41 primigravidae with positive roll-over test (28th-32nd week of pregnancy) received 80 mg aspirin/day or placebo until the end of the 37th week. In the patients treated with acetylsal-icylic acid (n = 22), 3 cases of proteinuria occurred, but no hypertensive pregnancy complication. In the placebo group (n = 19), 10 patients developed pregnancy-induced hypertension (6 of them preeclampsia). Group-specific differences concerning the occurrence of hypertension were statistically highly significant (p = 0.0004). No relevant differences were observed with regard to pregnancy duration, birth weight and umbilical artery pH value. The placebo group included 1 intrauterine death. No increased tendency to maternal or fetal bleeding was noticed.

ISSN:0378-7346    

DOI:10.1159/000292748

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

β-Endorphin (β-E) immunoreactivity was measured in the amniotic compartment of 52 normotensive and 45 hypertensive gestations. All the fetuses of the normal group were healthy and showed appropriate intrauterine growth, whereas only suffering and growth-retarded fetuses were included in the pathological group. As expected, amniotic β-E concentration was found to be significantly higher in hypertensive than in normotensive pregnancies (mean ± SEM: 129.1 ± 8.15 vs. 59.1 ± 2.68 pg/ml; p ≤ 0.005). A positive correlation between the hormone levels and the diastolic as well as the mean maternal blood pressure (r: 0.554; p ≤ 0.05 and r: 0.525; p ≤ 0.05, respectively) was present only in pregnancies complicated by hypertension. Furthermore, a negative correlation (r: ––0.555; p ≤ 0.05) linked amniotic β-E and the pulse pressure in normal but not in complicated pregnancies. Unless β-E in the amniotic compartment is also of amniochorial origin, our results suggest that the fetal endorphinergic tone is either activated by elevated diastolic and mean maternal pressure levels or lowered by increased pulse pressure values in normally elapsing pregnancies.

ISSN:0378-7346    

DOI:10.1159/000292749

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Pulsed-wave Doppler ultrasound was used to evaluate the influence of Braxton Hicks’ contractions on flow velocity waveforms in the uterine arteries. Flow velocity waveforms were obtained from a standardized site, at the crossing of the uterine artery with the external iliac artery near the uterine wall. Doppler signals were recorded in 16 healthy near-term nulliparous pregnant women. During Braxton Hicks’ contractions, a considerable increase in pulsatility index (PI) was found in the uterine arteries increasing from 0.71 ± 0.21 (mean ± SD) to 1.14 ± 0.67 (p < 0.005). Maternal heart rate decreased slightly but significantly during contractions. Despite the high PI values that were found during Braxton Hicks’ contractions, a diastolic notch in the flow velocity waveform was never noticed. The findings indicate that during Braxton Hicks’ contractions, resistance to blood flow in the uteroplacental circulation is considerably increased.

ISSN:0378-7346    

DOI:10.1159/000292750

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

In a view of the increased clinical interest in the presence of hormones in human milk, the objective of this study was to evaluate maternal plasma and milk cortisol levels in early puerperium and their relationship in breast-feeding in women who underwent elective cesarean section or who delivered vaginally. During the first 3 days of breast-feeding, plasma and milk cortisol levels declined significantly both in women who underwent elective cesarean section and in women who had spontaneous deliveries. Moreover, the breast-feeding procedure did not affect maternal plasma and milk hormonal levels, since no differences between the cortisol levels measured immediately before and after morning daily breast-feeding were detected. Furthermore, a very high positive correlation (p < 0.001) was found between plasma and milk cortisol concentrations. Therefore, maternal plasma cortisol levels can be considered a very reliable measure to predict the hormonal concentration in breast milk.

ISSN:0378-7346    

DOI:10.1159/000292751

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Human chorionic gonadotropin (hCG) exerts a clinically apparent negative feedback on the secretion of human thyroid-stimulating hormone (hTSH) in pregnancy, and the two have cross-reactivity for the TSH receptor in membrane preparations of the thyroid. We examined whether hTSH, in turn, has an influence on the secretion and synthesis of hCG in short-term cultures of human placenta at term. A dose- and time-dependent decrease in the extracellular hCG concentration caused by hTSH was demonstrated. To examine whether hTSH inhibits de novo synthesis of hCG or decreases hCG depletion, we determined the amount of hCG secreted and the size of the intracellular pool by using an enzyme immunoassay. By incorporating a radiolabeled amino acid in the hCG molecule, we measured the amount of hCG synthesized de novo. We concluded that hTSH acts by decreasing the rate of de novo synthesis of placental hCG.

ISSN:0378-7346    

DOI:10.1159/000292752

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

The extraordinary demands on obstetrical services that prevail in many developing countries necessitate critical reviews of existing norms for obstetrical management. Vacuum extractions were studied in this context as a part of the regular perinatal audit carried out at the Maputo Central Hospital, the only hospital in Maputo with emergency surgery catering to the 43,000 annual deliveries. Extractions performed with the fetal head above the ischiatic spines were associated with a high number of complications and an 81 % risk of neonatal asphyxia and also with a number of severe neonatal traumas. The risk of intracranial hemorrhage tended to be higher with extractions of fetuses with the head at or above the ischiatic spines, particularly when there was concomitant intrapartum asphyxia. It is concluded that a frequent perinatal audit of selected risk deliveries is a useful monitoring tool for examining prevailing indications for various obstetric interventions.

ISSN:0378-7346    

DOI:10.1159/000292753

出版商:S. Karger AG    

年代:1992

数据来源: Karger