摘要:

AbstractAlthough the current literature attests to the merits of a trial of labor in the patient with a prior cesarean section, some controversies remain. For example, can women with two or more sections be allowed a trial of labor and can patients who undergo a trial of labor receive oxytocin or prostaglandins for induction? Also, do certain indications for previous cesarean section such as relative cephalo‐pelvic disproportion/failure to progress or the diagnosis of breech or twins in the present pregnancy constitute an indication for elective repeat cesarean delivery? These questions along with some other controversies are discussed in the light of newly accumulated data in the English literature and our own experience over the last decade in a major university‐based tertiary medical center.

ISSN:0020-6695    

DOI:10.1016/S0020-7292(96)80002-6

出版商:Wiley    

年代:2002

数据来源: WILEY

ISSN:0020-6695    

DOI:10.1016/S0020-7292(96)80001-4

出版商:Wiley    

年代:2002

数据来源: WILEY

摘要:

AbstractObjective: To review the management of eclampsia in our institution. Method: The prevalence, management and outcome of women with eclampsia over a period of 8 years were reviewed at our referral medical center. There were 444 patients with eclampsia among 5757 deliveries (1 in 12.96 deliveries or 7.71% of deliveries). Most of the cases were uneducated and had received no antenatal care. One hundred eighty‐one cases were nulliparous (40.77%). High parities of more than five were observed in 27.93% of cases. A standard magnesium sulfate regimen, similar to Prichard's intramuscular regimen, was used. Results: Magnesium sulfate effectively controlled the convulsions. The incidence of abdominal delivery among 397 cases with ante‐ and intrapartum eclampsia was 50.12%. Perinatal mortality was very high (591.47%0) for all cases. Maternal complications were serious and led to maternal death in 42 women (9.46%). Conclusion: Eclampsia is still a serious obstetric complication particularly in uneducated women who do not receive antenatal care.

ISSN:0020-6695    

DOI:10.1016/S0020-7292(96)80003-8

出版商:Wiley    

年代:2002

数据来源: WILEY

摘要:

AbstractObjective: The aim of the study was to evaluate the significance of unexplained elevated maternal serum alpha‐fetoprotein in singleton pregnancies as a predictor of fetal risk. Method: A retrospective study of 1582 consecutive women who attended the antenatal clinic at Oldham and District General Hospital, Oldham, UK, over a 6‐month period. One hundred pregnant women with elevated serum alpha‐fetoprotein concentrations were classified as the index group and were matched against a control group. All the women in the index group underwent amniocentesis and detailed ultrasonography. The incidence of antepartum hemorrhage (placental abruption and placenta previa), preterm labor and intrauterine growth restriction (IUGR) in the two groups was analyzed and the results subjected to χ2analysis. Results: None of the patients in the index group had chromosomal abnormalities or birth defects. IUGR occurred in 18 (18%) of the index group babies but in only four (2%) in the control group (P<0.0000006). Placental abruption occurred in five (5%) in the index group compared with two (2%) in the control group (P<0.03), while preterm labor occurred in nine (9%) in the index group compared with two (2%) in the control group (P<0.005). Conclusion: Women with unexplained elevated maternal serum alpha‐fetoprotein are at increased risk of preterm labor, antepartum hemorrhage (placental abruption) and IUGR.

ISSN:0020-6695    

DOI:10.1016/S0020-7292(96)80004-X

出版商:Wiley    

年代:2002

数据来源: WILEY

摘要:

AbstractObjective: The prognostic factors of endometrial cancer are closely correlated. A multivariate analysis was carried to compare the importance of each factor. Method: A multivariate analysis was performed of 19 clinicopathologic prognostic factors obtained from 144 endometrial cancer patients who had been surgically treated in our hospital between January 1971 and December 1993. Results: Significant prognostic factors according to the Kaplan‐Meier method were depth of invasion, vascular invasion, nuclear grade, cervical involvement, lymph node metastases, intraperitoneal cytology, serous adenocarcinoma, DNA ploidy, type of hysterectomy and surgery only or combined with chemotherapy or radiotherapy. Multivariate analysis showed that vascular invasion and nuclear grade were more significant than structural grade, histologic subtype or DNA ploidy. Conclusion: Multivariate analysis is useful for extracting important recurrent factors from mutually related prognostic factors. Vascular invasion and nuclear grade are singled out as the most useful histologic prognostic factors.

ISSN:0020-6695    

DOI:10.1016/S0020-7292(96)80005-1

出版商:Wiley    

年代:2002

数据来源: WILEY

摘要:

AbstractObjective: The purpose of this study was to examine the effect of intranasal and oral norethisterone (NET) on ovarian folliculogenesis. Methods: Sixteen healthy, sterilized women with regular menstrual cycles were recruited to the study. NET 300 μg per day was administered orally (n = 8) or intranasally (n = 8) for two consecutive menstrual cycles. Serial pelvic ultrasonography was performed to monitor ovarian follicular growth. Results: Ultrasonographic evidence of normal follicular growth and ovulation was observed in 10 cycles whilst 22 cycles were anovulatory. Formation of follicular cysts was seen in 14 cycles, 13 of which were anovulatory and in one ovulation was observed in the opposite ovary. The size of the cysts varied between 27 and 44 mm. The cysts disappeared when NET treatment was discontinued. A positive correlation between cyst size and estradiol levels was observed with intranasal NET in 50% of cyst cycles. In three cycles, although normal follicular growth and endocrine profile were observed, the follicles failed to rupture. These were classified as luteinized unruptured follicles. Immature follicles<10 mm were seen in six cycles. Conclusion: The study showed that NET administered either orally or intranasally evidently disturbs normal follicular growth and rupture.

ISSN:0020-6695    

DOI:10.1016/S0020-7292(96)80006-3

出版商:Wiley    

年代:2002

数据来源: WILEY

摘要:

AbstractSexul violence is a significant global problem. The unequal power between men and women is considered tobe the main reason for violence against women. Women who are exposed to sexual assault are great consumers of medical and social care. The Swedish government has reacted to the problem by establishing an expert center for battered and raped women. The center has three main tasks: treatment in a professional and empathic way; research into and development of medical and psychosocial treatment of patients and the underlying causes of sexual violence; education and information of the general public.

ISSN:0020-6695    

DOI:10.1016/S0020-7292(96)80007-5

出版商:Wiley    

年代:2002

数据来源: WILEY

摘要:

AbstractThe quality of abortion in Turkey's public sector hospitals is investigated using multiple research methods including observations of actual procedures, interviews with medical staff and clients, and an inventory of materials and equipment. The results suggest that women who obtain abortions in public sector hospitals have a higher abortion rate than the general population. They are likely to receive a vacuum aspiration with minimal pain control medication. Clinical infection control procedures are insufficient, as are interpersonal communication practices including counseling on reproductive health issues and providing factual information. Links with family planning services are strong and the majority of abortion patients who desire family planning receive a contraceptive method, either through direct provision of postabortion contraceptives or referral.

ISSN:0020-6695    

DOI:10.1016/S0020-7292(96)80008-7

出版商:Wiley    

年代:2002

数据来源: WILEY

ISSN:0020-6695    

DOI:10.1016/S0020-7292(96)80009-9

出版商:Wiley    

年代:2002

数据来源: WILEY

ISSN:0020-6695    

DOI:10.1016/S0020-7292(96)80010-5

出版商:Wiley    

年代:2002

数据来源: WILEY