摘要:

AbstractObjective: Our purpose was to examine the effects of intrapartum vaginal Group‐B streptococcal (GBS) colonization on neonatal signs of infection.Study Design: We performed a quantitative GBS culture of vaginal specimens in 1,280 pregnancies within 24 hours before delivery and examined signs of neonatal infection within 48 hours after birth. Among them, 287 pregnant women had premature ruptures of membranes.Results: The rate of vaginal GBS colonization in groups with and without ruptured membranes was 22.0% and 11.3%, respectively. The incidence of neonates with signs of infection born to GBS‐carrier women in each group was 28.6% and 8.8%, respectively. There were significant differences between the groups with regard to both the rate of colonization and the incidence of infection. Signs of neonatal infection increased in proportion to the maternal GBS concentration only in women with ruptured membranes.Conclusion: This study suggests that there is an important association between maternal GBS concentration and mild neonatal infections after birth, especially in women with premature ruptures of membra

ISSN:1341-8076    

DOI:10.1111/j.1447-0756.1996.tb00949.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractAcute abdominal pain during pregnancy presents a dilemma as signs and symptoms are often modified. Abdominal massage by traditional birth attendants (TBAs') during early labour is a common practice in the rural population, as it is perceived to give a soothening effect to the labouring mother. Many instances of abruptio placentae were reported in the past by this procedure, and in this case, the clinical picture presented as an abruptio placenta. Malpresentation and failure to progress were the indications for caesarean section despite the fetal demise. Severe post partum haemorrhage and failure to contract despite massive oxytocics resulted in the hysterectomy of the gravid horn, leaving the other horn intact.

ISSN:1341-8076    

DOI:10.1111/j.1447-0756.1996.tb00950.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractTesticular sperm was retrieved from a man with an epididymal obstruction, and an intracytoplasmic sperm injection was made into his wife's oocytes. In 4 mature oocytes treated, 2 fertilized eggs were obtained, and a clinical pregnancy was established with embryo transfers. Our experience demonstrated the possibility of fertilization and conception with testicular sperm.

ISSN:1341-8076    

DOI:10.1111/j.1447-0756.1996.tb00951.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractObjective: To evaluate the efficacy of intravaginal prostaglandin E1 methyl analogue misoprostol in cervical ripening in patients with unfavorable cervix (Bishop score<4) requiring labor induction.Method: A randomized controlled clinical trial of 62 women in the third trimester with various indications for induction of labor were randomly allocated to receive either 100 μg misoprostol inserted vaginally (32) or placebo similarly applied (30). Transvaginal sonography was performed to measure the cervical length before and 12 hrs after insertion.Results: The mean change in cervical length and Bishop score was significantly greater in the misoprostol group (24 mm and score 8) compared with in the placebo group (2.2 mm and score 1) (p = 0.001). All but one patients receiving misoprostol went into labor while only one in the placebo group did so. The interval from insertion to vaginal delivery was significantly shorter in the misoprostol group (12.0 vs 25.5 hrs, p<0.001). Delivery occurred within 24 hrs in 75% and 30% of patients in the misoprostol and placebo groups respectively. Uterine tachysystole occurred more frequently in the misoprostol group (38%) than in the placebo group (0%) (p<0.001). All could be rapidly reversed by tocolytics without apparent untoward intrapartum effects. No significant differences were noted in the 2 groups in terms of perinatal outcomes and mode of delivery.Conclusion: Intravaginal misoprostol is an effective, cheap and safe method for cervical ripening. The higher frequency of uterine tachysystole in the misoprostol group did not increase the risk of adverse intrapartum and neonatal outcomes

ISSN:1341-8076    

DOI:10.1111/j.1447-0756.1996.tb00952.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractPlacenta percreta is a rare but serious complication of pregnancy, and is rarely diagnosed in the second trimester of pregnancy. We report a very rare case of placenta percreta accompanied by spontaneous uterine rupture at 25‐weeks of gestation.A 30‐year‐old woman with severe abdominal pain was admitted to our hospital at 25 weeks of gestation. A laparotomy was immediately performed because of intraabdominal bleeding. The uterus revealed a perforation of the fundus. A supra‐vaginal hysterectomy was performed. A pathological investigation of the uterus revealed placenta percreta.The patient had neither gravity nor any prior uterine operation. It is very rare for placenta percreta to be recognized in a primigravida woman or in the second trimester of pr

ISSN:1341-8076    

DOI:10.1111/j.1447-0756.1996.tb00953.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractWe report a case of a rare lesion, a multilocular peritoneal inclusion cyst (MPIC), and describe in detail its appearance on MRI. A young woman with pain of the lower abdomen underwent surgical removal of a mass that was histologically diagnosed as an MPIC. The characteristic MRI features were a multilocular cystic mass with thin septa in the pelvic cavity, located both anterior and posterior to the uterus and the adnexa, showing hypointensity of the cyst contents on T1images and variable hyperintense signals on T2images.

ISSN:1341-8076    

DOI:10.1111/j.1447-0756.1996.tb00954.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractObjective: Gonadotropin‐releasing hormone agonist (GnRHa) was used in the controlled ovarian hyperstimulation (COH) for thein vitrofertilization program. However, the traditional long protocol demanded more human menopause gonadotropin (hMG) and sometimes causes unnecessary delay in the procedure. A new 7‐ day GnRHa/hMG protocol required to conserve cost and time is thus evaluated for better outcome.Methods: Sixty consecutive IVF candidates less than 40 years of age were recruited for the study. Cases with severe male factor or polycystic ovarian disease were excluded. The perspective candidates were divided into two groups, one received the traditional, GnRHa/hMG protocol and the other received the new 7‐day regimen.Results: When comparing the results in pregnancy rate (33.3% vs 30%), cleavage rate (75.7% vs 75.5%), and the number of oocyte obtained (5.96 ± 0.91 vs 6.63 ± 0.90), the 7‐day GnRHa/hMG protocol is as good as those of the traditional regimen. The amount of hMG used nevertheless was significantly less (21.48 ± 0.78 vs 50.59 ± 2.07).Conclusion: The new regimen will surely reduce the cost to relieve patient's financial burden and to increase patien

ISSN:1341-8076    

DOI:10.1111/j.1447-0756.1996.tb00955.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractWe report a case of vertical transmission of HCV in a mother infected with both HCV and HIV. Our case suggests that coinfection with HIV, by causing an immune dysfunction, might be one of the risk factors for the transmission of HCV.

ISSN:1341-8076    

DOI:10.1111/j.1447-0756.1996.tb00956.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractObjective: To assess the factors that might influence the success rate, safety and reliability of chorionic villus sampling (CVS) and to evaluate the relationship between CVS and other congenital anomalies.Design: Analysis of the outcome of 750 cases of CVS (730 cases with transcervical and 20 cases with transabdominal).Setting: The outpatient prenatal genetic clinic of a university tertiary care center.Subjects: Seven hundred and fifty pregnant women that underwent CVS for prenatal genetic diagnosis from 7 to 12 weeks of gestation.Results: Advanced maternal age was the most common indication for CVS (32.8%). The overall sampling success rate was 98.0% (735/750), representing 93.9% at 7 to 8 weeks, 98.1% at 9 to 10 weeks, and 98.3% at 11 to 12 weeks of gestation. The majority of cases (93.1%) required one or two aspirations. Cytogenetic analysis routinely included direct overnight and long‐term culture methods which revealed 16 abnormalities (2.2%). Of 735 cases in which CVS was successful, 700 advanced to normal offspring, 17 had therapeutic termination, and 18 resulted in spontaneous abortions; there was an overall fetal loss rate of 2.4% (18/750).Conclusion: CVS in early pregnancy is a relatively safe and reliable method of prenatal genetic diagnosis capable of replacing genetic amniocentesis. However, it must be done by experienced personnel. No congenital anomalies were found to be related to CVS in this serie

ISSN:1341-8076    

DOI:10.1111/j.1447-0756.1996.tb00957.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractObjectives: To review the techniques, results and complications of the combined abdomino perineal repair and mersilene mesh sacrocolpopexy.Methods: From March 1988 to December 1993; 45 cases of pulsion enterocele were treated by a combination of the Zacharin type abdomino perineal repair and mersilene mesh sacrocolpopexy. Forty cases were followed from between 1 month and 18 months (mean 5.95 months). The notes were reviewed retrospectively.Results: There were 3 recurrences (7.5%). Complications were not insignificant: wound infection in 3, urinary tract infection in 6, bowel dysfunction in 8, ventral hernia, vaginal stricture necessitating surgical release, and brachial nerve plexus injury occurred once. In one patient a peritoneal cyst developed necessitating laparoscopic aspiration.Conclusion: The combined abdomino perineal and sacrocolpopexy procedure offers the restoration of normal anatomy and the relief of the symptoms of prolapse in 92.5% of patients. The complication rate is significant and it should be undertaken as a secondary procedure.

ISSN:1341-8076    

DOI:10.1111/j.1447-0756.1996.tb00958.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY