摘要:

Transvaginal amniotic puncture (TAP) was performed on 20 consecutive missed abortions immediately prior to dilatation and evacuation and the cytogenetic results compared. The information received from products of conception (POC) and TAP was in concordance in only 5 of 20 (25%) cases. Tissue obtained from POC yielded cells in all instances. However, only 3 of 20 POC samples yielded findings other than normal female. In contrast, 92.8% of the conclusive diagnoses would have been achieved by TAP alone. These data strongly suggest that TAP is superior to POC for accurate cytogenetic assessment of missed abortion and should lead to a reevaluation of our current understanding and management of pregnancy loss.

ISSN:0378-7346    

DOI:10.1159/000291531

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

An interesting feature in molar pregnancy is the association with preeclampsia. The reason for this has not been explained but could possibly be due to differences in vasoactive agents compared to normal pregnancy. The aim of this study was to examine the mRNA expression of the vasoconstrictor endothelin-1 (ET-1), its receptor ET-A and the endothelial constitutive nitric oxide synthase (ecNOS), forming the vasodilator nitric oxide, in hydatidiform moles. The results demonstrated the presence of mRNA expression of ET-1, ET-A and ecNOS in hydatidiform moles and that the level of mRNA expression did not vary from that in control placentas. Thus, the present data could not explain the increased frequency of preeclampsia in molar pregnancy.

ISSN:0378-7346    

DOI:10.1159/000291532

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

The aim of this study was to determine fetal fibronectin in vaginal fluid of women in prolonged pregnancy, its relationship to a modified Bishop score and its predictiveness of delivery within 3 days. Vaginal samples were collected from 80 women at 42 weeks of gestation for the fetal fibronectin assay. A modified Bishop score was estimated. Fetal fibronectin was determined by a quantitative enzyme immunoassay. The concentration of fetal fibronectin in vaginal fluid was elevated in only 36 of the 80 women. The Bishop score and the time between sampling and delivery were not associated with an elevated fetal fibronectin (≧ 0.05 mg/l). We conclude that fetal fibronectin is not a good indicator of delivery within 3 days. The findings add to our understanding of the complexity of the etiology of postterm labo

ISSN:0378-7346    

DOI:10.1159/000291533

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Objective: This prospective study examined purine metabolism in relation to free oxygen radical activity, as reflected by lipid peroxide levels in umbilical cord blood at birth. Setting: Departments of Obstetrics and Gynaecology and of Chemical Pathology, the Chinese University of Hong Kong, Hong Kong, and Purine Research Laboratory, UMDS of Guy’s and St. Thomas’ Hospitals, London, UK. Methods: Umbilical cord arterial and venous blood samples were collected from 132 singleton term deliveries for determination of hypo-xanthine, xanthine, inosine, uric acid, organic hydroperoxides (OHP) and malondialdehyde. Oxygen saturation, pO2, PCO2, pH, and base excess (BE) were also measured. Results: There was a significant correlation between umbilical arterial and venous levels of hypoxanthine, xanthine, inosine, uric acid and all acid-base parameters (p < 0.001). Significant arteriovenous differences were observed for all parameters with the exception of inosine, uric acid and OHP. Umbilical arterial xanthine and potassium correlated significantly with OHP, but hypoxanthine, inosine and uric acid did not. In 13 babies classified as severely asphyxiated at birth (umbilical arterial pH < 7.15, BE < -8), xanthine and OHP levels were significantly elevated when compared with non-asphyxiated babies. No significant differences were observed for hypoxanthine, inosine or uric acid. Conclusion: The findings indicate that OHP, either in cord arterial or venous blood, is the best marker of free oxygen radical activity in the fetus, and that this correlates with other evidence of cellular hypoxia-reperfusion injury. We propose OHP is a better measure of perinatal outcome than either acid-base balance or hypoxanthine.

ISSN:0378-7346    

DOI:10.1159/000291534

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Objective: The aim of the present study was to evaluate the dynamic changes in serially obtained amniotic fluid index values and to determine any association with intrapartum fetal distress in a term population. Materials and Methods: All patients, > 40 weeks of gestational age, evaluated at the Institute of Obstetrics and Gynecology, ‘G. Salesi’ Hospital, University of Ancona, between January 1,1994, and December 31,1995, participated in this longitudinal study. Women with an amniotic fluid index of > 50 mm, who also demonstrated a reactive nonstress test, underwent semiweekly amniotic fluid assessment until spontaneous labor. After 42 gestational weeks, the patients underwent an elective induction of labor. All patients were managed with continuous electronic fetal heart rate monitoring throughout labor. The incidence of intrapartum fetal distress, and meconium staining of amniotic fluid were evaluated with respect to the amniotic fluid index. Results: Of the 117 patients that were evaluated by ultrasound, 83 women had multiple amniotic fluid index measurements and were enrolled in the study. A serial decrease in amniotic fluid index was documented in 54 women; the mean decrease per week was 20.7 ± 15.4%. An increase in amniotic fluid index was noted in 17, while 11 women showed no change in amniotic fluid index over time. The 14 patients who underwent cesarean section for fetal distress had a significantly lower amniotic fluid index (p < 0.001) at the last sonographic examination than the normal outcome group. Significant differences were also observed for a serial decrease in the amniotic fluid index within a week (p < 0.001). The sensitivity and specificity of the 30% serial decrease in the amniotic fluid index cutoff point, with respect to intrapartum fetal distress were 86 and 93%, respectively. Conclusion: Longitudinal measurement of the amniotic fluid index seems to be an effective method in predicting intrapartum fetal distress in a term population.

ISSN:0378-7346    

DOI:10.1159/000291535

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Objective: To analyze the reproductive outcome in infertile couples which underwent intraperitoneal insemination (IPI). Methods: We analyzed a series of 216 couples who underwent IPI. Indications for treatment were unexplained infertility in 51 couples and male factor in 165. The 51 couples with unexplained infertility underwent a total of 71 cycles (20 couples underwent a second IPI cycle). The 165 couples with male factor underwent 243 cycles (165 first cycles and 78 second cycles). Results: Out of the 314 cycles performed, a total of 41 clinical pregnancies were observed, with a corresponding conception rate of 13.1%. The values of conception rates for unexplained and male factor infertility were 21.1 (based on 15 pregnancies) and 10.7% (based on 26 pregnancies), respectively. Out of the 41 pregnant women, 26 gave birth to a child, thus the overall livebirth rate was 8.3% (12.7 and 7.0%, respectively, for unexplained infertility and male factor diagnostic subgroups). Considering the couples with unexplained infertility, the conception rates were 9.0, 30.8 and 20.0% for strata of 10 millions of inseminated spermatozoa. The corresponding values were 6.8, 12.5 and 18.5%, respectively, in couples with male factor infertility (χ21 trend p < 0.05). Conclusion: In conclusion, this series provides quantitative estimates of pregnancy rates after IPI in Italian couples with unexplained infertility or male infertility and suggested that the number of motile sperm inseminated is a determinant of pregnancy with this techniq

ISSN:0378-7346    

DOI:10.1159/000291536

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

We studied the influence of changes in gain settings, log compression, persistence, preprocessing, and postprocessing on image density in the fetal liver model. Each parameter was studied while the others were held constant. The image density was objectively measured by electrooptical transmission densitometry using a transparent film output. Neither the persistence nor the preprocessing levels significantly changed image density. Postprocessing of sonographic images produced significant differences (p < 0.02) in mean image density of most of the various postprocessing curves and is a serious confounder of tissue echogenicity assessment. The data reconfirmed that there is a linear relationship (r = ––0.94 to ––0.997) between image density and gain setting. However, each log compression setting significantly changed (p < 0.0000001) this relationship, obviating possible image density calibration. Our data suggest that manipulation of image parameters by computed sonographic technology obviates accurate echogenicity ass

ISSN:0378-7346    

DOI:10.1159/000291537

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Objective: This study was designed to: (i) evaluate the effect of amnioinfusion on the latency period in patients with oligohydramnios for preterm premature rupture of membranes, and (ii) to investigate the relationship between changes in the amniotic fluid index and fetal heart rate short-term variability by computerized Hewlett-Packard cardiotocography, longitudinally estimated before and after prophylactic amnioinfusion. Materials and Methods: All singleton pregnancies with prolonged premature rupture of membranes after 25 weeks of gestation and seen at the Institute of Obstetrics and Gynecology, University of Ancona (Italy), between January 1994 and June 1995 were included in the study. Transabdominal amnioinfusion with 150–350 ml warmed normal saline (25–50 ml/min) was performed at weekly intervals. Amniotic fluid volume was assessed ultrasonographically by means of the four-quadrant technique on a weekly basis before and after each amnioinfusion, as well as the short-term variability by a Hewlett-Packard computerized cardiotocographic system. Results: 18 women were enrolled and underwent prophylactic transabdominal amnioinfusion at weekly intervals until delivery. Eighteen controls, who did not undergo prophylactic amnioinfusion, were recruited from our 1992-1993 series and included in the study. The median interval between premature rupture of membranes and delivery was 3.0 weeks (range 1–8 weeks), with an average delivery age of 33.0 weeks (range 27–36 weeks). The latency period was significantly longer in patients who underwent prophylactic amnioinfusion (mean ± SD, 4.1 ± 1.7 weeks) than in controls (1.7 ± 1.0 weeks; p < 0.001). An increase in both the weekly amniotic fluid index (linear regression analysis r = 0.8, p = 0.03) and the weekly short-term variability (linear regression analysis r = 0.82, p = 0.02) was observed among patients who underwent prophylactic amnioinfusion. A direct relationship was observed between the amniotic fluid index and short-term variability (linear regression analysis r = 0.54, p = 0.04). The mean values of fetal movements recorded by computerized tomography during the 20 min of observation significantly increased after amnioinfusion in comparison with those before it (2.6 ± 0.9 and 0.9 ± 0.7 respectively; p = 0.001). Conclusion: The present study has shown a positive effect of prophylactic transabdominal amnioinfusion on the latency period in patients with preterm premature rupture of membranes and oligohydramnios. Among the patients who underwent amnioinfusion, an interesting improvement in fetal heart rate short-term variability was associated with the progressive increase in amniotic fluid volume, as an expression of feta

ISSN:0378-7346    

DOI:10.1159/000291538

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Transcutaneous electrical nerve stimulation (TENS) has been proven effective in pain relief of primary dysmenorrhea (PD). We evaluated the efficacy of a new TENS device (Freelady, Life Care, Tiberias, Israel), designed to correct disadvantages of older models used in previous studies, in 102 nulliparous women with PD, who were treated with various types of pain relief medications. Marked pain relief was reported by 58 patients (56.9%) and moderate relief by 31 (30.4%). These subjective findings were supported by the fact that the same number of patients (58 and 31) either stopped analgesic use altogether during the trial or reduced the quantity of analgesics, respectively. The device examined proved to be efficient and safe in controlling the pain and disability caused by PD.

ISSN:0378-7346    

DOI:10.1159/000291539

出版商:S. Karger AG    

年代:1997

数据来源: Karger

ISSN:0378-7346    

DOI:10.1159/000294385

出版商:S. Karger AG    

年代:1916

数据来源: Karger