摘要:

Attempts to induce ovulation have been made since the early 1920s, but the major breakthrough came in the early 1960s with the introduction of clomiphene citrate and the gonadotropins. Additional progress was made in the early 1970s with the introduction of bromocriptine and in the early 1980s with the introduction of pulsatile GnRH. At the present, ‘pure’ FSH and GnRH agonists are being evaluated as adjuncts to HMG for induction of ovulation. As more insight is gained in the neuroendocrine control of the ovulating cycle, we may soon be able to induce ovulation by direct manipulation of the central nervous system.

ISSN:0378-7346    

DOI:10.1159/000293679

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

From 1978 to 1986 a total of 189 pregnant diabetic women gave birth at our hospital. In this randomized prospective study the influence of maternal diabetes treatment in normoglycemic patients, continuous subcutaneous insulin infusion (n = 48) versus intensified conventional treatment (n = 41), is evaluated. These two groups of patients are further compared to patients (n = 28) who underwent conventional diabetes treatment during pregnancy. It can be shown from our data that the rate of complications such as preeclampsia, intrauterine growth retardation, premature labor and premature delivery can be reduced by intensified conventional and insulin pump treatment as compared to conventionally treated patients with late onset of pregnancy care. As expected, in the groups of CSIIand ICT patients no difference in the rate of pregnancy complications nor in fetal outcome could be demonstrated. Among CSII pregnancies 12/48 were complicated, in the ICT population the respective figure was 13/41 (CT: 20/28). The mean gestational age at the time of delivery ranged between 38 and 40 weeks, depending on the severity of maternal diabetes. CT patients were delivered earlier in all White classes. Fetal morbidity was nearly equal in CSII and ICT children, in CT patients it was greatly enhanced. Also the mortality (perinatal and neonatal) was considerably larger in CT patients (6/28), again, in the CSII and ICT population the mortality was nearly identical (2/48 and 3/41). We conclude, from our prospective information, that insulin pump therapy during pregnancy is indicated if intensified conventional treatment does no lead to normoglycemia. This may be the case if maternal diabetes is complicated by dysregulated insulin resorption, prolonged duration of diabetes, or inconsistant working or living conditions. It could be demonstrated that the higher primary costs of ICT as well as CSII therapy are very effective as compared to conventional treatment.

ISSN:0378-7346    

DOI:10.1159/000293680

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

Amniotic fluid from 16 diabetic and 78 healthy women at term was tested for capacity to cause mutations in Salmonella typhimurium bacterial tester strain TA98 (Ames test). Diabetes as well as heavy smoking increased the mutagenic activity of amniotic fluid. The difference between groups of diabetics and controls was significant in both nonsmokers and women who had smoked more than 5 cigarettes the last 48 h before delivery. It seems plausible that metabolic disturbances, perhaps enhanced by a lowered oxygenation, in some instances could produce mutagenic compounds. Mutagenic activity in amniotic fluid may be one of the factors underlying the increased incidence of congenital malformations in the offspring of diabetic women. Early mutations could cause such developmental errors in the embryos, and possibly also in future generations by damage to germ cells. Heavy smoking alone also caused an increase in mutagenic activity in term amniotic fluid. Our findings reflected an enhancing effect of smoking in diabetes. A pregnant diabetic woman who smoked would thus further endanger her already jeopardized pregnancy.

ISSN:0378-7346    

DOI:10.1159/000293681

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

Fetal echocardiographic and Doppler ultrasonographic prospective studies were performed in utero on 299 babies delivered at Hirata Municipal Hospital, Shimane, Japan, from May 1984 to June 1986. Two or three ultrasonographic examinations were performed on each fetus from 20 weeks of gestation to term. Three congenital heart anomalies and 12 fetal arrhythmias were diagnosed antenatally, but 3 heart anomalies (2 small ventricular septal defects and 1 moderate pulmonary stenosis) were not detected in utero. Routine echocardiographic screening appears to be a useful diagnostic tool to detect congenital heart anomalies and fetal arrhythmia antenatally.

ISSN:0378-7346    

DOI:10.1159/000293682

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

Serum chemistry studies and radiological examination of the lamina dura and phalanges were conducted in 50 pregnant women, 25 of whom had been administered calcium and vitamin D supplements during the 3rd trimester. The non-supplemented pregnant women showed significant hypocalcaemia, elevated serum heat-labile alkaline phosphatase activity, and resorption of the lamina dura. The supplemented group of pregnant women also showed resorption of the lamina dura, although the serum chemistry was essentially normal. It is suggested that, probably because of gestational hyperparathyroidism, mild resorption of the lamina dura may be a feature of normal pregnancy.

ISSN:0378-7346    

DOI:10.1159/000293683

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

The effects of an intravenous bolus injection of D2343 (0.75 or 1 mg) or terbutaline (0.25 mg) on spontaneous term labor were studied. The uterine activity was recorded by a transducer-tipped intrauterine catheter and calculated electronically by an uterine activity integrator module built in a conventional fetal monitor. After drug administration the uterine activity was reduced to a similar extent with D2343 and terbutaline but the contractions were abolished for a longer time with terbutaline injection (mean of 9.3–9.8 min compared with 17.0 min). Maternal blood pressure was unaffected in both groups but the increase in pulse rate was slightly higher in the D2343 groups. D2343 seems to have an effect ratio between uterine inhibitory capacity and cardiovascular side effects similar to terbutaline.

ISSN:0378-7346    

DOI:10.1159/000293684

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

Vaginal biopsies were obtained in 5 healthy women every third day during the menstrual cycle. The specimens were examined with morphometric technique and the mean nuclear size was correlated to values of estradiol and progesterone and caryopycnotic index. Cyclical changes of the histological appearance of the epithelium could be demonstrated. During estrogen influence a proliferation and maturation of the vaginal mucosa was seen whereas addition of progesterone was associated with a shedding of the superficial cell layers and a steady state of the basal part of the epithelium. At ovulation the epithelium reached maximal thickness and maturity. The histological architecture at this time may resemble a human-papilloma-virus (HPV)-infected mucosa. The difficulties in distinguishing an HPV-infected epithelium from normal are discussed.

ISSN:0378-7346    

DOI:10.1159/000293685

出版商:S. Karger AG    

年代:1988

数据来源: Karger

ISSN:0378-7346    

DOI:10.1159/000286716

出版商:S. Karger AG    

年代:1907

数据来源: Karger

摘要:

Predictable and reproducible epithelial damage can be created by prolonged splinting of the oviduct. Splinting is associated with the flattening of the mucosal folds, pressure atrophy and deciliation of the epithelium. To overcome this detrimental effect, a silastic splint releasing 3 μg/day of estradiol has been compared to an inert splint in rabbits. Scanning electron microscopic observations demonstrated a lesser mucosal damage and reciliation with the steroid-releasing splint.

ISSN:0378-7346    

DOI:10.1159/000293686

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

The present study shows the effects of two different steroid replacement therapies, with conjugated estrogens or with a new synthetic steroid derivative, ORG OD14, on plasma β-endorphin (β-EP) and β-lipotropin (β-LPH) levels in postmenopausal subjects. Blood samples were collected before treatment and after 1 2 and 4 months of treatment; a third group of patients was treated with placebo. After 2 months of treatment both groups of patients who underwent steroid supplementation showed circulating levels of β-EP and β-LPH higher than basal levels. ORG OD14 treatment increased β-EP and β-LPH levels more than conjugated estrogens at the 2nd month of therapy. No further change was found after 4 months. The two drugs were effective in reducing hot flushes and improving physical and psychological symptoms. These data indicate that sex steroids are able to increase β-EP and β-LPH secretion in postmenopausal women, with a concomitant relief of climacteric symptoms.

ISSN:0378-7346    

DOI:10.1159/000293687

出版商:S. Karger AG    

年代:1988

数据来源: Karger