摘要:

Objective: To report the pregnancy outcome after transabdominal multifetal pregnancy reduction in multiple pregnancies achieved by intracytoplasmic sperm injection. Methods: One twin and 13 triplet pregnancies obtained by intracytoplasmic sperm injection underwent pregnancy reduction. Pregnancies were achieved with ejaculated sperm in 8, testicular sperm in 3, and epididymal sperm in 2 of these cases. All triplet pregnancies were reduced to twins at 10–12 weeks’ gestation by transabdominal potassium chloride injection. A twin pregnancy with spina bifida affecting 1 fetus was reduced to singleton at 18 weeks of pregnancy. Results: There was no failed procedure and no pregnancy loss within the first 4 weeks after the procedure. A complete miscarriage (7.1%) developed in 1 case at 17 weeks’ gestation which was due most probably to the incompetent cervix. In utero fetal death occurred in 1 fetus of another reduced pregnancy. Three of the reduced pregnancies delivered at term, after 37 completed weeks, four premature deliveries occurred between 31 and 35 gestational weeks, and four pregnancies were ongoing beyond 25 weeks’ gestation. A total of 16 fetuses, from seven twin and two singleton pregnancies, were delivered without perinatal mortality. Conclusions: Although the sample size was small, our experience indicates that the reduction of triplets obtained by sophisticated infertility treatments such as intracytoplasmic sperm injection using testicular or epididymal sperm seems to be a safe method and can be effectively used.

ISSN:0378-7346    

DOI:10.1159/000291399

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

In order to define the islet amyloid polypeptide (IAPP) levels in gestational diabetes mellitus (GDM) and their interrelationship with the insulin levels, we studied (1) the placental RNA from 10 women (5 with GDM and 5 normals) for IAPP expression by Northern blotting and (2) 10 women with GDM during a 100-gram oral glucose tolerance test and compared these with 11 normal women matched for obesity and age. Plasma levels of glucose, IAPP, insulin, and C peptide were determined. No IAPP expression was detected in any of the placentae after a long exposure. We could not demonstrate any differences in plasma IAPP levels (basal or stimulated) between the two groups of pregnant women. However, in women with GDM we found a lower IAPP/insulin ratio (p < 0.05) and a lower maximal IAPP/maximal insulin response ratio during the oral glucose tolerance test (p < 0.05) than in normal women. Therefore, IAPP does not appear to be directly involved in the development of GDM. The peripheral levels of IAPP relative to insulin are lower in GDM, a finding similar to that described in type 2 diabetes mellitus (non-insulin-dependent diabetes mellitus). This observation further confirms that GDM resembles the early stages of type 2 diabetes mellitus.

ISSN:0378-7346    

DOI:10.1159/000291400

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

The present study was performed to assess the rate of hypertensive complications in diabetic pregnant patients and the influence of White’s classification and the quality of the diabetic control. This study included 169 diabetic pregnant women who had delivered at the University Hospital of Botucatu Brazil from 1980 to 1981. The hypertensive disorders occurred in 29.8% of the cases. The incidence of the hypertensive process was the same in all classes of diabetic patients, and it was independent of the glycemic control. In patients with gestational diabetes (classes A and AB), chronic hypertension was the commnest type found; in patients with short-term diabetes (classes B and C) pregnancy-induced hypertension (PIH) and chronic hypertension with superimposed PIH was the most frequent type, and diabetic patients with vasculopathies (classes D-R) had preeclampsia and chronic hypertension with superimposed preeclampsia as the commonest type foun

ISSN:0378-7346    

DOI:10.1159/000291401

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

In order to compare the vaginal microflora of women in prolonged pregnancy with that of women who delivered at term, samples for quantitative aerobic and anaerobic microbiological culture were collected from 100 women at 42 weeks of gestation and from 60 women at term. The occurrence of lactobacilli-dominated flora was similar in women at term and women with prolonged pregnancy. However, non-hydrogen-peroxide-producing lactobacilli (p < 0.01) were significantly more common and Peptostreptococci species (p < 0.05) significantly less common in postterm women as compared with term controls. In postterm women, Candida albicans was more common (p < 0.001) in microfloras dominated by non-hydrogen-peroxide-producing lactobacilli than in floras dominated by hydrogen-peroxide-producing lactobacilli. The ecosystem of the vagina in asymptomatic postterm women was disrupted concerning the composition of lactobacilli as compared with term controls.

ISSN:0378-7346    

DOI:10.1159/000291402

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

The objective of this study was to compare the efficacy and safety of a single intravenous dose of 1 g ampicillin plus 0.5 g sulbactam to a single intravenous dose of 1 g cefotetan in the prevention of postoperative infection following cesarean delivery in high-risk patients. In this single-center comparative study, women who were to undergo cesarean delivery and who were at high risk of developing postoperative infection were randomized into two treatment groups. At the time the umbilical cord was clamped, one group was treated intravenously with 1 g ampicillin plus 0.5 g sulbactam, and the other was treated intravenously with 1 g cefotetan. The two groups were evaluated for evidence of postoperative infections and adverse experiences. A total of 170 women who were at high risk of developing postoperative infection following cesarean delivery (87 in the ampicillin/sulbactam group and 83 in the cefotetan group) were analyzed. Successful prophylaxis, absence of any infection including absence of febrile morbidity with no other symptoms, was reported in 69 of 87 (79%) patients receiving ampicillin/sulbactam and in 60 of 83 (72%) patients receiving cefotetan. One patient in each group had an infection at the incision site. There were no statistically significant differences in the rates of endometritis or urinary tract infections. The mean duration of hospitalization was 5.5 days for patients receiving ampicillin/sulbactam and 5.7 days for patients receiving cefotetan. A single intravenous dose of the combination of ampicillin/sulbactam was as safe and effective as a single intravenous dose of cefotetan when administered for the prevention of infections following cesarean delivery in patients at high risk of developing postoperative morbidity. Both antibiotics were safe and well tolerated with no unusual or unexpected events.

ISSN:0378-7346    

DOI:10.1159/000291403

出版商:S. Karger AG    

年代:1997

数据来源: Karger

ISSN:0378-7346    

DOI:10.1159/000294312

出版商:S. Karger AG    

年代:1916

数据来源: Karger

摘要:

To determine the relationship between abnormal fetal heart rate (FHR) patterns, fetal oxygen content by reflectance pulse oximetry, and the effects of maternal oxygen administration, 158 intrapartum women consisting of 120 women with normal FHR patterns, and 38 women with varying degrees of variable FHR decelerations were examined. A new reflectance pulse oximetry probe was attached to the fetal forehead to continuously monitor fetal oxygen saturation (SpO2) during labor. Oxygen was administered for 30 min at 5 liters/min by nasal canula in 32 women. No significant change in fetal SpO2 was seen in women with normal FHR patterns, but a significant decline in SpO2 was observed shortly before births. FHR decelerations less than 90 bpm occurred prior to the decline in fetal SpO2 Maternal oxygen administration was effective in increasing fetal SpO2 in fetuses with decreased SpO2 (SpO2 < 50%), but not in fetuses with high SpO2 (SpO2 > 60%). It is concluded that fetal SpO2 exhibits no change during normal labor but significantly declines shortly before birth, that relatively severe variable decelerations (< 90 bpm) can decrease fetal SpO2, and that maternal oxygen treatment at 5 liters/min is effective in augmenting fetal oxygen tension in fetuses with decreased oxygen tension.

ISSN:0378-7346    

DOI:10.1159/000291404

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Objective: To evaluate the role of local immunity in women with minimal endometriosis. Methods: Uterine endometrium and endometrial implants were obtained simultaneously from 30 infertile women with minimal endometriosis and examined immunohistochemically using antibodies of T cell, B cell, macrophage, Langerhans cell, immunoglobulin (Ig)G and complement (C) 3d. Serum IgG, IgA, IgM, C3, C4, antinuclear antibody and anti-DNA antibody were also examined in 24 of the women. Data from uterine endometrium and serum were compared with 10 fertile women without endometriosis as a control. Results: Microscopic examination revealed that the endometrial implants were divided into two groups: group 1 (n = 13) showed lymphocytic infiltration in the endometrial implants and group 2 (n = 17) showed no or slight lymphocytic infiltration. The endometrial implants of group 1 showed significantly more dense T-cell infiltration than those of group 2. Other types of infiltrating cells and deposits of IgG and C3d revealed no significant differences between groups 1 and 2. The immunohistochemical examination of the uterine endometrium and the serum data revealed no significant differences among all three groups. Cumulative pregnancy rates showed no significant difference between groups 1 and 2. Conclusion: The difference of local immune response in endometrial implants did not affect systemic immunity.

ISSN:0378-7346    

DOI:10.1159/000291405

出版商:S. Karger AG    

年代:1997

数据来源: Karger

ISSN:0378-7346    

DOI:10.1159/000294314

出版商:S. Karger AG    

年代:1916

数据来源: Karger

摘要:

The advent of the use of laparoscopy and lasers in gynaecology has added a further option for the treatment of endometriosis. This study is a retrospective review of the notes of 28 women who had endometriosis treated laparoscopically with an Nd:YAG laser. Results were assessed by subjective reporting of symptoms. Seventy-three percent of patients reported significant or complete resolution of symptoms at three to 26 months follow-up. No major complications were encountered. The results suggest this offers a further treatment option for endometriosis which merits further evaluation.

ISSN:0378-7346    

DOI:10.1159/000291406

出版商:S. Karger AG    

年代:1997

数据来源: Karger