摘要:

The effect of hypoxemia on the pulsatility index (PI) of the umbilical artery flow velocity waveform and placental vascular resistance was studied. Fetal hypoxemia was induced by maternal breathing of a low-oxygen gas mixture. Umbilical venous blood flow was measured with an electromagnetic flowmeter. Placental vascular resistance (PVR) was defined as the ratio perfusion pressure (mean arterial pressure minus umbilical venous pressure) and umbilical blood flow. Umbilical artery velocity waveforms were obtained by a 5-MHz pulsed Doppler device around one umbilical artery in 4 lambs and by a transcutaneous 4-MHz continuous wave Doppler transducer in 3 lambs. Fetal arterial oxygen content was lowered from 2.28 ± 0.18 to 0.93 ± 0.15 mM(p < 0.05), while pCO2 and pH remained unchanged. Control values of the hemodynamic variables were compared with values during deepest hypoxemia. Fetal heart rate, mean arterial and umbilical venous pressure, PVR and the umbilical artery PI did not significantly change, whereas umbilical blood flow increased from 436 ± 64.7 to 491 ± 65.9ml/min (p < 0.05) during deepest hypoxemia. Individual regression analysis, however, showed a significant inverse correlation of umbilical venous pressure whereas PVR had a positive correlation with actual oxygen content. It is concluded that acute fetal hypoxemia slightly decreases PVR, but does not affect the umbilical artery PI in sheep. Decreasing fetal oxygenation is associated with an increase in pressure in the umbilical vein.

ISSN:0378-7346    

DOI:10.1159/000293104

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

Growth hormone (GH), placental lactogen (PL), prolactin (PRL), insulin-like growth factor I (IGF-I) and IGF binding protein-1 (IGFBP-1) were determined in serum by radioimmunoassays (RIAs) in 12 women during pregnancy. GH and PL were analyzed by two monoclonal antibodies (Mab 3 and Mab 1) raised against pituitary GH. Serum IGFBP-1 had reached maximum levels at midpregnancy while PRL, PL and IGF-I increased continuously during pregnancy. Mab 1 which cross-reacts with PL, measured consistently higher levels of PL in serum than a commercial PL RIA (p < 0.01) due to interference of cross-reacting serum proteins in the Mab 1 RIA. The GH-specific Mab 3 showed decreasing GH levels in unfractionated serum throughout gestation, but detected GH-immunoreactive proteins of approximately 40–200 kD after molecular sieve chromatography of pooled serum from late pregnancy. It is suggested that the formation of GH complexes of large molecular mass account for the successive disappearance of monomeric GH during pregnancy.

ISSN:0378-7346    

DOI:10.1159/000293105

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

The hypercoagulable state in patients with toxemia of pregnancy was investigated in comparison with normal pregnant women using new coagulation parameters, mainly thrombin-antithrombin III (TAT) complexes, α2-antiplasmin-plasmin complexes (PIP), and D-dimer FDP. When the patients were categorized by the classification of the WHO Study Group (1985), significant increases of TAT complexes and α2-PIP complexes with decreases of the ATIII level were observed in the groups with preeclampsia and severe gestational hypertensive disease as compared to normal pregnant women. A significant increase of D-dimer FDP was observed in a group with severe gestational hypertensive disease. Additionally, the relationship between clinical signs and the hypercoagulable state in the patients was analyzed using canonical correlation analysis as a multivariate analysis. The clinical signs and coagulation parameters had a significantly high correlation of λ1 = 0.7219, p < 0.01. The results showed that clinical signs were associated with simultaneous coagulation abnormalities. The indices obtained from the results of canonical correlation analysis, which were called the clinical index and the coagulation index, should be useful in evaluating the efficacy of anticoagulation therapy.

ISSN:0378-7346    

DOI:10.1159/000293106

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

An attempt to predict neonatal well-being in vaginal delivery was made in groups of 103 term small for gestational age (SGA) and 103 term adequate for gestational age (AGA) newborns, by assessing cardiotocography scores immediately before birth. For assessment, modified Fischer scores (from 0 to 10, normal ≥ 8) and subjective visual scores (from 0 to 6, normal ≥5) were used. Modified Fischer scores had a sensitivity of 25% in detecting acidosis (umbilical artery pH < 7.20) in SGA cases; and of 50%, in AGA cases. Visual scores had a sensitivity of 75 and of 50%, respectively. Specificities in these groups were 64 and 65%, and 56 and 60%, respectively. The positive predictive values in all groups were below 10%. It is concluded that intrapartal cardiotocographic scoring is neither very sensitive nor specific in the prediction of neonatal condition in term vaginal SGA and AGA deliveries.

ISSN:0378-7346    

DOI:10.1159/000293107

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

A 30-year-old infertile women with stage IV endometriosis was treated initially with endoscopic surgery, danazol and intrauterine insemination to no avail. Before starting ovulation induction for in vitro fertilization, transvaginal sonographic guided aspiration of endometrioma was performed. One month after the procedure the patient became pregnant and delivered a normal child at term.

ISSN:0378-7346    

DOI:10.1159/000293108

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

We evaluated the efficacy of cabergoline, a new ergoline derivative, in blocking puerperal lactation in a group of women delivered by cesarean section. In a single-blind controlled trial 36 women were randomly allocated to treatment with cabergoline 1 mg in a single dose p.o. (n = 18) or bromocriptine 5 mg/day p.o. for 14 days (n = 18). Treatment was started about 50 h after delivery. Clinical assessment of breast signs and determination of serum prolactin were performed just before treatment and at 3,5,7 and 14 days. In the cabergoline-treated group milk secretion was inhibited in 17 women (94.4%). Maximum decrease of serum prolactin was ––89.7% at 5 days, and the prolactin-lowering effect of cabergoline was still present at 14 days. In the bromocriptine group milk secretion was inhibited in 16 women (88.9%). Maximum prolactin decrease (––86.9%) was reached at 3 days. Persistent side effects were comparable in the two groups. This study demonstrates that a single oral dose of 1 mg cabergoline is as effective in suppressing puerperal lactation as a full treatment with bromocriptine, even in women delivered by cesarean section.

ISSN:0378-7346    

DOI:10.1159/000293109

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

Gestrinone has a biophysical antiestrogenic effect. But the mechanism of its antiestrogenic effect is not clear. Gestrinone blocked the increase of estrogen binding of nuclear type II sites and uterine weight in the estrogen-treated immature rabbit. Competitive assays indicated that gestrinone, at low concentrations (0.4 ∼ 4 nM), inhibited [3H]-estradiol binding to nuclear type II sites. This inhibitory effect was the same as the addition of 20 μM diethylstilbestrol. This inhibition with gestrinone on [3H]-estradiol binding to nuclear type II sites appeared only when used at concentrations less than an equivalent molar of [3H]-estradiol. Time course analysis of the gestrinone binding inhibition showed that within the first 6 min gestrinone did not inhibit specific [3H]-estradiol binding to nuclear type II sites. This gestrinone-mediated inhibition was not observed in soluble fractions such as the cytosolic and KCl-extracted nuclear binding sites. These results suggest that gestrinone acts primarily on the nuclear fraction and then it operates the inhibitory mechanism on estradiol binding to nuclear type II sites.

ISSN:0378-7346    

DOI:10.1159/000293110

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

The relations between clinical signs of infection and postoperative endometritis were studied among 429 women with negative preoperative chlamydial and gonococcal cultures. Clue cells and a vaginal smear not dominated by rods and positive amine tests were more common among the 12 patients (2.8%) with endometritis. In the stepwise logistic regression procedure the presence of > 20 % clue cells remained statistically significant and was associated with the highest relative risk, 5.6, with 95% confidence limits 1.82–17.2. This also implies clinical significance – women with clue cells constitute a group at risk of postabortal endometritis.

ISSN:0378-7346    

DOI:10.1159/000293111

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

Thirty-four women with genuine stress incontinence and low urethral closure pressure were studied pre-and postoperatively. A modified Burch retropubic urethropexy was performed in 29 patients with a cure rate of 78 %, improvement in 7%, and failure in 15%. The modified Stamey procedure was performed in 5 patients with significant pelvic floor relaxation with a cure rate of 40% and improvement in 60%. If urethral mobility is present, traditional anti-incontinence procedures appear to be a reasonable alternative in patients with low urethral pressure.

ISSN:0378-7346    

DOI:10.1159/000293112

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

Adenoid cystic carcinoma of Bartholin’s gland is a rare tumor, of which 45 cases including the present one have been reported in the literature. Although the histogenesis of this tumor is still controversial, the tumor is suspected to be of myoepithelial origin, and most studies have been performed on the salivary glands with few reports concerning Bartholin’s gland. We report a case of adenoid cystic carcinoma of Bartholin’s gland with regard to its histogensis. A typical tumor nest had three main components: true luminary structures containing sialomucins, solid monotonous cells of a myoepithelial nature, and numerous pseudocysts containing abundant proteoglycans and basal membrane-like materials. From these results we speculate that reserve cells located in the intercalated small ducts of Bartholin’s gland may have the potential to differentiate into two cell types, myoepithelial and luminary cells, the former forming the pseudocysts.

ISSN:0378-7346    

DOI:10.1159/000293113

出版商:S. Karger AG    

年代:1991

数据来源: Karger