摘要:

AbstractObjectives: To investigate the cesarean section (CS) rate in the Riyadh area, its trend and relationship to perinatal mortality (PNM). Methods: Based on delivery data obtained from the Ministry of Health hospitals, Saudi Arabia, for a total of 12 years, yearly rates of CS, PNM and the ratios of obstetricians and beds per 10 000 population were computed for the Riyadh area and compared with the overall rates for Saudi Arabia. Correlation coefficients were used to investigate the relationship between the CS rate and each of the stated variables. Results: Riyadh had significantly lower rates of CS and PNM than Saudi Arabia as a whole. The CS rate in Riyadh showed a positive trend (increasing from 4.4 to 6.7%) while the PNM rate revealed a significant decreasing trend (decreasing from 21.6/1000 to 16/1000 live births). A negative association existed between the Riyadh rates of PNM and CS (r = −0.2375) and PNM and the availability of obstetricians (r = −0.8693). Conclusions: From our data it was not possible to establish a cause and effect relationship between the CS and PNM rates.

ISSN:0020-6695    

DOI:10.1016/0020-7292(94)02282-4

出版商:Wiley    

年代:2000

数据来源: WILEY

摘要:

AbstractObjective: To assess the association between previous term pregnancies and the prevalence of overweight in a group of urban women, controlling for the influence of age. Methods: One thousand twelve women, living in middle and low socioeconomic areas of Mexico City, were interviewed at home and their reproductive histories studied. Height and weight were measured in a clinical setting using controlled procedures. Overweight (BMI>25) was the dependent variable used to calculate odds ratios and to perform a multiple logistic regression analysis. Results: Age and parity were significantly associated with the prevalence of overweight. Controlling for age, two or more previous pregnancies significantly increased the magnitude of the association. Conclusion: During the reproductive years parity seems to increase the risk of overweight in low and middle socioeconomic level urban women.

ISSN:0020-6695    

DOI:10.1016/0020-7292(94)02284-6

出版商:Wiley    

年代:2000

数据来源: WILEY

摘要:

AbstractObjective: To evaluate a procedure for cesarean section, consisting of a number of surgical techniques adopted from various sources and further developed. Methods: The principal elements of the cesarean section procedure followed were: the Joel‐Cohen method for opening the abdomen, suturing the uterus in one layer, and non‐closure of the visceral and parietal peritoneal layers. The postoperative recovery of women who underwent this procedure (JCl−− group) was compared with that of women who had undergone a Pfannenstiel incision, in which the uterus is sutured in two layers, and both peritoneal layers sutured (Pf2++ group). Results: The incidence of postoperative febrile morbidity was 7.7% in the JCl−− group compared with 19.8% in the Pf2++ group (P<0.05). Adhesions were found in 6.3% of repeat operations after the JCl−− operation compared with 28.8% after the Pf2++ operation (P<0.05), and there was a non‐significant trend toward fewer postoperative analgesics in the JCl−− group. Conclusion: The cesarean section procedure we have devised is not only safe, but has a lower risk of long‐ and short‐term complications.

ISSN:0020-6695    

DOI:10.1016/0020-7292(94)02306-J

出版商:Wiley    

年代:2000

数据来源: WILEY

摘要:

AbstractObjectives: The aim of this study of retained second twins admitted to Korle‐Bu Hospital between 1988 and 1993 was to identify the factors contributing to the mode of delivery, perinatal and maternal mortalities, and draw up recommendations to improve outcome. Methods: The study consisted of a review of record cards, outpatient admission and discharge books, delivery books, and inpatient case notes of women admitted with retained second twins of 28 weeks' or more gestation during the study period. Results: Of the 65 cases fully reviewed, 33 (approximately 50%) were delivered by cesarean section due mainly to abnormal lie with or without shoulder impaction. The rest were assisted deliveries, mainly vertex deliveries or breech extractions. The perinatal mortality of the retained second twins was 38.5% compared with 12.3% for the first twins. Although in general the longer the interdelivery interval, the greater the second twin perinatal mortality risk, no clear direct correlation could be established. There was one perioperative maternal mortality due to anaphylactic reaction to intramuscular morphine injection. Conclusion: Irrespective of the antenatal course and early labor findings, twin delivery should be undertaken in a unit equipped for cesarean section and assisted delivery. The unacceptably high perinatal mortality of retained second twins could thus be significantly reduced.

ISSN:0020-6695    

DOI:10.1016/0020-7292(94)02307-K

出版商:Wiley    

年代:2000

数据来源: WILEY

摘要:

AbstractObjective: This study investigated whether a combined regimen of ipriflavone and 1α vitamin D is effective in stopping postmenopausal bone loss. Methods: Ninety‐eight postmenopausal women were recruited and randomly assigned to one of four groups: group 1, ipriflavone alone; group 2, 1α vitamin D alone; group 3, combined regimen of ipriflavone and 1α vitamin D; group 4, no treatment. Vertebral bone mineral density, measured by dual energy X‐ray absorptiometry, serum alkaline phosphatase, calcitonin, parathyroid hormone, osteocalcin, urinary calcium and hydroxyproline were measured before and at the 6th, 12th and 18th month of the study. All comparisons were made using Student's t‐test of means. Result: There was a significant reduction in vertebral bone loss in the patients receiving the combined therapy (mean loss after 18 months 0.33% in the combination group vs. 2.37%, 1.15% and 3.70% in the ipriflavone alone, 1α vitamin D alone, and control groups, respectively; P<0.001). Conclusion: These findings suggest that the combined regimen could prevent postmenopausal bone loss.

ISSN:0020-6695    

DOI:10.1016/0020-7292(94)02280-C

出版商:Wiley    

年代:2000

数据来源: WILEY

摘要:

AbstractObjective: To determine whether chromocystoscopy could be used for the urological monitoring of cervical carcinoma. Methods: The absolute ejaculation time (AET, the interval of time between the intravenous injection of dye and the ejaculation of dyed urine in the bladder from either of the ureters) and the relative ejaculation time (RET, the difference of time between the two ejaculations) were retrospectively studied in relation to intravenous urography (IVU) and radionuclide renography (RR) in 141 patients. Results: A significant probability of normal IVU and RR was found when the AET was ≤7 min or the RET ≤4 min and when no interval occurred between the two ejaculations. Pathological IVU and RR were found when there was no ejaculation from one or both ureters after 12 min. Conclusions: Chromocystoscopy could be used for monitoring cervical cancer patients. An abnormal chromocystoscopy could indicate the need for further radiological examinations.

ISSN:0020-6695    

DOI:10.1016/0020-7292(94)02296-B

出版商:Wiley    

年代:2000

数据来源: WILEY

摘要:

AbstractWe present a case of prenatally diagnosed mediastinal cystic hygroma with spontaneous resolution. To our knowledge, this is only the second case report of mediastinal cystic hygroma diagnosed prenatally, and the first one with spontaneous resolution perinatally. Our case shows that, in the absence of hydrops fetalis, mediastinal cystic hygroma in a fetus with normal karyotype can be associated with a normal outcome. Therefore we recommend fetal karyotyping, a careful search for other anomalies and close sonographic follow‐up in such cases.

ISSN:0020-6695    

DOI:10.1016/0020-7292(94)02286-8

出版商:Wiley    

年代:2017

数据来源: WILEY

摘要:

AbstractWe report three cases of adenosarcomas arising from extraendometrium of the uterus: one arising from the ovary, one from the paracolpium and one from the endocervix of the uterus. Microscopically, they consisted of an admixture of benign‐appearing epithelial and mesenchymal components with hypercellularity and minimal atypia. Two of the tumors were initially misdiagnosed as endometriosis and one was diagnosed as adenofibroma. One patient had several recurrences and died 7 years after the initial laparotomy and another patient had sarcomatous overgrowth which invaded the muscular tissues of the large intestine. Thus it appears that adenosarcoma occasionally shows grave clinical behavior, despite the benign or low‐grade appearance of its microscopic features. Problems of diagnosis and management of this tumor are discussed. An aggressive therapeutic approach including wide surgical excision is recommended even in questionable cases.

ISSN:0020-6695    

DOI:10.1016/0020-7292(94)02267-3

出版商:Wiley    

年代:2000

数据来源: WILEY

摘要:

AbstractThe aim of this report is to draw the attention of clinicians to the possible occurrence of endometrial cancers of rare histological type among women currently undergoing or having in the past undergone tamoxifen therapy, in particular for breast cancer. We report a case of heterologous mixed malignant müllerian tumor occurring in an 80‐year‐old woman. At 69, she had been diagnosed with breast cancer and received tamoxifen for a total of 55 months over a 6‐year period. In the 5th year after cessation of tamoxifen therapy, an endometrial carcinosarcoma was diagnosed. Although the association between tamoxifen use and endometrial cancer is recognized, only a few reports of occurrence long after cessation of therapy exist. We believe ours is the second for this particular histological type. Tamoxifen may have played a role in the occurrence of this tumor although it is also known that this type of tumor may arise de novo in elderly women. The etiologic hypothesis obtained from this case description will now be tested in a formal epidemiological investigation which hopefully will provide more definitive evidence.

ISSN:0020-6695    

DOI:10.1016/0020-7292(94)02285-7

出版商:Wiley    

年代:2000

数据来源: WILEY

摘要:

AbstractThe majority of problems that women are confronting today originate from a lack of respect for human and reproductive rights. Escalating war crises are producing an enormous number of civilian victims, of whom women and children comprise the major part. Rape used as a war tactic in Bosnia has proven to be a very powerful tool. War in Bosnia has provided a tragic incentive to work on strategies and tactics for reaching the victims in such chaotic and unpredictable circumstances.

ISSN:0020-6695    

DOI:10.1016/0020-7292(94)02302-F

出版商:Wiley    

年代:2000

数据来源: WILEY