ISSN:0378-7346    

DOI:10.1159/000290841

出版商:S. Karger AG    

年代:1913

数据来源: Karger

摘要:

Retrospective examinations of 8,139 placentae were performed to clarify the relationship between placental disorders with massive intervillous fibrin deposition (MIFD) and intrauterine growth retardation (IUGR). Although the incidence of MIFD was low (0.4%), the small-for-date (SFD) birth rate in the MIFD group was significantly higher than that in the control group (62.9 vs. 8.3%; p < 0.001). Seventeen of 35 patients in the MIFD group had no clinical complications. MIFD itself was thought to be the main cause of IUGR in these patients. 78.4% of multiparae in the MIFD group gave unsuccessful obstetrical histories such as intrauterine fetal death and fetal growth retardation. Four of 6 patients with a history of MIFD and SFD delivery in a previous pregnancy repeated the same episode. These data indicate the MIFD recurrence rate in subsequent pregnancies must be high. Patients with a history of both SFD delivery and MIFD in previous pregnancies were defined as high-risk patients and they were given orally 30 mg of aspirin and 150 mg of dipyridamole daily and/or daily intravenous injection of 10,000 IU heparin during pregnancy. As a result, MIFD did not recur in all cases of the treated group and 87.5% (7/8) of the treated group could deliver approximate-for-date infants compared with 33.3% (2/6) of the untreated group (p < 0.05). These results indicate that anticoagulant and antiplatelet therapies are extremely effective for prevention of MIFD and IUGR due to MIFD.

ISSN:0378-7346    

DOI:10.1159/000292434

出版商:S. Karger AG    

年代:1994

数据来源: Karger

ISSN:0378-7346    

DOI:10.1159/000290842

出版商:S. Karger AG    

年代:1913

数据来源: Karger

摘要:

Serum paraoxonase (EC 3.1.1.2) may be implicated in the lipid metabolism. In order to substantiate this view we conducted a longitudinal study of interrelationships of serum paraoxonase, lipids and apolipoproteins during pregnancy. Fasting serum levels of paraoxonase, serum lipids (total, HDL and LDL cholesterols, triglycerides) and apolipoproteins (AI, All and B) were estimated in 91 pregnant women at 28 and 32 weeks of gestation and 6 weeks after delivery, and 40 nonpregnant women. Serum paraoxonase, total HDL and LDL cholesterol levels were significantly higher during pregnancy along with corresponding apolipoprotein (p < 0.001). The most striking increase was seen in serum triglycerides and paraoxonase levels (p < 0.001). Serum paraoxonase levels had a significant correlation with triglycerides (r: 0.45–0.60) and ApoAH (r: 0.32–0.41) in both pregnant and nonpregnant states (p < 0.001). Moreover, both serum paraoxonase and triglyceride levels at 28 weeks of pregnancy were negatively correlated with birth weight (r: 0.3, p < 0.05), suggesting a possible role of paraoxonase in energy delivery for fetal development derived from maternal hypertriglyceridemia.

ISSN:0378-7346    

DOI:10.1159/000292435

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Three patients with findings suggestive of invasive gestational trophoblastic neoplasm and lung metastasis were assessed by color Doppler transvaginal ultrasound, before and during chemotherapy. The sonographic findings were correlated with β-hCG levels measured at various stages of treatment. Results were compared with blood flow indices found during normal first trimester pregnancies, and those following elective termination of pregnancy. The mean resistance indices were significantly lower in the patients treated with chemotherapy (0.410 ± 0.04) than in the early pregnancy control group (5–8 weeks gestation; n = 20, resistance index = 0.494 ± 0.06). The difference between the groups was statistically significant (χ2; p < 0.05). No pathological flow patterns could be discerned in 10 patients, who after termination of pregnancy had β-hCG levels below 5 IU/ml. The response of gestational trophoblastic neoplasms to chemotherapy could be reliably assessed by observing the changes in flow resistance, which paralleled the gradual decrements in serial measurements of β-hCG levels. Thus, the statistically significant results of our study are very encouraging and may indicate that color Doppler flow is a noninvasive, reproducible, useful and highly reliable new diagnostic approach for the diagnosis and management of patients suffering from uterine malignant gestational trophoblastic disease.

ISSN:0378-7346    

DOI:10.1159/000292436

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

The umbilical-placental circulation is of vital importance for fetal survival and has a dominant effect on the cardiorespiratory physiology of the fetus. The mechanisms of regulation of umbilical vessels appear to differ from those regulating other vessels. Both clonidine and α-methyldopa have been used in the management of hypertensive complications of pregnancy. In contrast to α-methyldopa, clonidine does not require previous metabolization but acts directly on the receptors. The action of the two drugs on human umbilical artery was studied in vitro. Forty-eight human umbilical artery segments were dissected and perfused as follows: 9 segments with α-methyldopa, 10 with clonidine, 10 with yohimbine, 9 with α-methyldopa in combination with yohimbine, and 10 with pure Tyrode’s solution. α-Methyldopa had a statistically significant vasoconstrictive effect starting at 40 min (p < 0.05) and this effect was blocked by yohimbine (p < 0.05). Clonidine had no vasoconstrictive effect. The present data for clonidine do not confirm the presence of α2-adrenergic receptors in the umbilicoplacental circulation which had been indicated by the action of methyldopa.

ISSN:0378-7346    

DOI:10.1159/000292437

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

As part of a case control within cohort study 472 pregnant women answered a questionnaire post partum. Serum relaxin concentrations were measured by a homologous ELISA in samples collected from the women in the 30th week of pregnancy. Serum relaxin concentrations were not associated with pregnancy-associated pelvic pain. Thus, normal pregnant women without pelvic pain (n = 118) had mean concentrations of 343 pg/ml compared to 332 pg/ml in women (n = 59) with pelvic pain and some restriction in daily activities and to 349 pg/ ml in women (n = 9) with severe pregnancy-induced pelvic pain. The present results do not suggest a role for relaxin in symptom-giving pelvic relaxation during human pregnancy.

ISSN:0378-7346    

DOI:10.1159/000292438

出版商:S. Karger AG    

年代:1994

数据来源: Karger

ISSN:0378-7346    

DOI:10.1159/000290843

出版商:S. Karger AG    

年代:1913

数据来源: Karger

ISSN:0378-7346    

DOI:10.1159/000290844

出版商:S. Karger AG    

年代:1913

数据来源: Karger

摘要:

Patients with the HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count) require careful observation and expedient delivery. However, those who develop this syndrome peripartum do not always fulfill its diagnostic criteria before labor begins. We investigated the potential usefulness of liver and spleen CT evaluation in identifying such patients. Seven patients with this syndrome were studied by CT scanning on postpartum days 0–3 and again 3–4 weeks after delivery. Although 3 patients with severe thrombocytopenia had a reduced liver-spleen CT number ratio (< 1.1) and subsequent normalization, the remaining 4 with less severe thrombocytopenia demonstrated no CT changes. Thus, antepartum evaluation of liver and spleen by CT may not be sensitive enough to detect patients who develop HELLP syndrome during the peripartum period. Serial examination of platelet counts may be more useful than CT in detecting patients at risk for this peripartum syndrome.

ISSN:0378-7346    

DOI:10.1159/000292440

出版商:S. Karger AG    

年代:1994

数据来源: Karger