摘要:

Serum androgens, estrogens, ‘steroid-sensitive proteins’, thyroid components, and albumin were measured twice within a 4- to 5-week interval in 44 cases of early normal pregnancy (gestational weeks 8–18). Positive correlations were found in the total material between dehydroepiandrosterone sulfate (DHAS) and testosterone (T), unconjugated and total estrone, albumin, tetraiodothyronine, and calculated free tetraiodothyronine concentrations and within 2-week intervals between DHAS and T, estradiol-17β, and unconjugated and total estrone, and between T and estradiol-17β and unconjugated estrone. Positive correlations were also found between the rates of change in DHAS of albumin. No significant association was found between ‘steroid-sensitive proteins’ and androgens or androgen/estrogen ratios. Women giving birth to girls had significantly higher serum levels of pregnancy-associated α2-macroglobulin, thyroxine-binding globulin, and ceruloplasmin and lower ratios between T and sex hormone binding globulin than women giving birth to boys. The important role of placental aromatization in the metabolism of maternal androgens is well known. Albumin binding and thyroid status may also affect the metabolism of DHAS during pregnancy. The androgen/estrogen balance may be of little importance for the regulation of ‘steroid-sensitive’ proteins during early pregnancy. The mechanism behind the higher serum levels of pregnancy-associated α2-macroglobulin, thyroxine-binding globulin, and ceruloplasmin in women giving birth to girls remains

ISSN:0378-7346    

DOI:10.1159/000292325

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

This study examines two descriptive parameters of embryo morphology to determine if either parameter correlates with subsequent pregnancy rates (PRs). The two parameters were the evenness (similarity in size) of the blas-tomeres and the degree of cellular fragmentation. A total of 242 embryo transfers in which 4 embryos were transferred were included. Sixty-nine (28.5%) clinical and 62 (25.6%) viable pregnancies resulted. In all cases 4 embryos were transferred, but the number of embryos with even round blastomeres (grade 1) varied from 0 to 4. Statistically, there was no correlation between PR and number of grade 1 embryos transferred. When 4 grade 1 embryos were transferred, the PR was 33.3 versus 28.1% when no grade 1 embryos were transferred. There was, however, a statistical difference in the implantation rate; a higher frequency of multiple gestations occurred when 3 or 4 of the embryos transferred were graded 1:12.7 as compared with 6.7% when < 2 embryos were grade 1. The significance of the degree of cellular fragmentation in the embryos was also assessed. There was no statistical difference in the PR according to the number (0–4) of embryos transferred that did not have fragments (grade A). When 4 grade A embryos were transferred, the PR was 18.2 versus 26.1 % when there were no grade A embryos. Neither implantation nor multiple-birth rates correlated with fragmentation.

ISSN:0378-7346    

DOI:10.1159/000292326

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Objective: To determine if pregnant women with normal singletons will continue to have elevated serum human chorionic gonadotropin (hCG), given that they had an elevated serum hCG in the second trimester. Methods: Nineteen women with second-trimester hCG levels > 2.0 multiples of the median, and 20 women with second-trimester hCG levels < 2.0 multiples of the median were the subjects of this investigation. All study participants had serum hCG levels repeated during the third trimester of pregnancy. We used a chi-square test and Student’s t test for comparing categorical variables, and the means of continuous variables, respectively. Results: Using the criterion of ≥2.0 multiples of the median of the comparison group to define hCG elevation, women with elevated second-trimester hCG levels were approximately 4 times more likely to have a third-trimester elevation than were women with normal second-trimester hCG levels (risk ratio = 3.9; 95% confidence interval 1.6–9.8; p < 0.001). Adjustment for potential confounders did not materially alter the association. Conclusion: Women with elevated hCG in the second trimester continued to have elevations in the third trimester. The persistence of elevated hCG levels in pregnancies uncomplicated by fetal anomalies should be evaluated as a clinical marker of adverse pregnancy outcomes.

ISSN:0378-7346    

DOI:10.1159/000292327

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

An immunoradiometric assay for free β-human chorionic gonadotropin (FβhCG) is now available. Measurement of serum FβhCG has been shown to be valuable for the diagnosis of trophoblastic disease and for screening Down’s syndrome pregnancies. Urine specimens may be preferable to blood samples since collection of urine specimens usually are less inconvenient to patients than venipuncture. We have evaluated whether the immunoradiometric assay can be applicable to urine samples. The assay was sensitive and precise. When urine samples were diluted 4-fold or more, the diluted samples gave quantitative values, and recovery of βhCG added to urine samples was satisfactory. Creatinine corrected urinary FβhCG levels correlated with serum FβhCG levels. Thus, the immunoradiometric assay was considered to be applicable to urine samples. Serum FβhCG to hCG ratio has been reported to be important to distinguish among normal pregnancies, hydatidiform mole and choriocarcinoma. However, urinary FβhCG to hCG ratio did not significantly correlate with serum FβhCG to hCG ratio. And therefore, the clinical value of urinary FβhCG to hCG ratio should be further investigated.

ISSN:0378-7346    

DOI:10.1159/000292328

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

We observed the influence of commonly used oxytocin infusion for inducing labor on the fetal heart rate (FHR). The FHR was analyzed on-line by Sonicaid Computer System 8000. There were no statistical changes in all analyzed parameters during infusion of oxytocin. Our study shows that the standard dosage of oxytocin used for induction of labor has no negative influence on the FHR.

ISSN:0378-7346    

DOI:10.1159/000292329

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

To determine when the extrauterine environment becomes safer than the intrauterine environment with respect to fetal (neonatal) life, we analyzed all 4,896,505 livebirths, all 21,222 stillbirths, and all 7,513 early neonatal deaths after 26 weeks of gestation that were recorded between 1989 and 1992 in Japan. Although the risks of early neonatal death ( < 1 week of age) and of neonatal death ( < 4 weeks of age) greatly exceeded the risk of stillbirth at 26 weeks of gestation, those risks declined sharply by 39 weeks of gestation, then increased, while the risk of stillbirth within 1 and 4 weeks remained constantly low until 38 and 40 weeks of gestation, respectively, and increased thereafter. The risk of stillbirth within 1 and 4 weeks exceeded the risks of early neonatal death and of neonatal death at and beyond gestational weeks 40 and 38, respectively, for a singleton pregnancy. A similar reversal occurred at 37 and 35 weeks of gestation for a multiple pregnancy. Neonates born at 39 and 37 weeks of gestation for singleton and multiple pregnancies, respectively, had the best outcomes. It is concluded that the chance of survival for fetuses reaching 40 and 37 weeks of gestation for singleton and multiple pregnancies, respectively, were higher in the extrauterine than the intrauterine environment in Japan today.

ISSN:0378-7346    

DOI:10.1159/000292330

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

The purpose of this study was to compare the endocervical microflora of women in preterm and term labour and to determine whether the presence of a specific microflora is significantly associated with preterm labour. A prospective study was performed in Lithuania among 212 women in preterm labour (latent phase, n = 110; active phase, n = 102) and among 62 healthy women in term labour. Microbiological assessment included cultures for aerobic bacteria, yeasts, and Trichomonasvaginalis and direct immunofluorescence reaction for Chlamydiatrachomatis, Escherichiacoli (odds ratio 8.16; 95% confidence interval 1.27–340.23) and Staphylococcusaureus (odds ratio 7.79; 95% confidence interval 1.21-325.40) were significantly more often isolated from women in preterm than from women in term labour. The prevalence of C. trachomatis was the same in the preterm and in the term labour group. The pregnancy outcome during the latent or the active phase of preterm labour with or without C. trachomatis infection did not differ. It is concluded that E. coli and S. aureus are significantly more prevalent in endocervical cultures from Lithuanian women in preterm than from those in term labour.

ISSN:0378-7346    

DOI:10.1159/000292331

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

In an attempt to elucidate the potential association between genital infections and low birth weight (LBW) births, 51 women with LBW neonates were identified and compared to 51 women with normal birthweight (NBW) neonates. Both groups were matched according to age and parity. All women were subjected to interviews regarding socioeconomic background and obstetric history. They were examined clinically and tested regarding serum haemoglobin, malaria parasitaemia, syphilis and HIV serology. Cultures were taken from the vagina, endocervix, amniotic fluid and from various sites of newborn, including the conjunctivae and the stomach and from the interior of the placenta. Whilst socioeconomic background factors did not differ among cases and referents, previous neonatal death did. Significant differences were also found in mid-upper-arm circumference (OR 3.08) and body mass index (OR 6.00). The prevalence of alleged risk factors according to the antenatal card was similar among cases and referents. Birthweight < 2,000 g was significantly more often associated with chorioamnionitis than birthweight between 2,000 and 2,499 g (OR 5.46). Bacteriological findings did not show significant differences in cases and referents. Haemoglobin values and prevalence of malaria parasitaemia were similar as was the neonatal mortality. It is concluded that LBW births is difficult to predict by use of alleged risk factors in existing antenatal cards.

ISSN:0378-7346    

DOI:10.1159/000292332

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

In the present in vitro study we investigated the possible vasorelaxing effect of atrial natriuretic peptide (ANP) and cyclic guanosine monophosphate (cGMP) on small intramyometrial arteries precontracted by endothelin-1 (ET-1). Myometrial biopsies from normotensive pregnant women were obtained during cesarean section and arteries of resistance vessel size were dissected and mounted in a tissue chamber for isometric registration of contractile tone. In arteries preconstricted with ET-1 (10––8M), ANP produced a concentration-dependent relaxation of 19 ± 5% (mean ± SEM) and 27 ± 7% at concentrations of 10––7 and 3 × 10––7M, respectively. cGMP induced a relaxation of 13 ± 2, 18 ± 3, 25 ± 4 and 30 ± 7% at concentrations of 10––5, 10––4, 3 × 10––4 and 10––3M, respectively. Pretreatment with ANP did not attenuate the contraction produced by ET-1. We suggest that ANP may have a vasodilating effect on preconstricted human uteroplacental vessels. It also provides evidence for the role of other endogenous or exogenous vasodilators acting via cGMP-dependent mechanisms in the counteraction of ET-1 -induced contraction of the myometrial resistance vessels during pregnancy.

ISSN:0378-7346    

DOI:10.1159/000292333

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

We report the glucose and insulin response to a 300-min glucose tolerance test among 17 women athletes as compared with 11 normal, nonatheletic controls. Also reported is the relationship of the insulin area under the curve as a function of percentages of total fat (TF), subcutaneous fat, and internal fat of total volume (TV) quantified by magnetic resonance imaging overall and at six regional sites. Athletes had a more sensitive insulin response to the glucose tolerance test as compared with controls. The insulin area under the curve of athletes and controls was significantly (p = 0.05) related to their overall TF/TV%; athletes had significantly less TF/TV% as compared with the controls.

ISSN:0378-7346    

DOI:10.1159/000292334

出版商:S. Karger AG    

年代:1995

数据来源: Karger