摘要:

Eight pregnancies ranging from 27-32 weeks' gestation were treated for preterm labor with oral indomethacin. The dosage regimen was 25 mg every four hours in four patients and 25 mg every six hours in the other four patients. The maximum duration of indomethacin therapy was 72 hours. In three patients, fetal ductus arteriosus constriction mandated discontinuation of indomethacin at 24 hours. Sonographic assessment of hourly fetal urine output was performed before therapy, at multiple regular intervals during therapy, and 24 hours after the last dose of indomethacin. A dramatic decline was noted from the mean baseline fetal urine output of 11.2 mL/hour. The mean fetal urine output at five, 12, and 24 hours during therapy was 2.2, 1.8, and 1.8 mL/hour, respectively (P<.05). Twenty-four hours after completion of indomethacin therapy, the mean fetal urine output was 13.5 mL/hour. Poor correlation (r=0.14, P<.05) was noted between maternal serum indomethacin levels and hourly fetal urine output. This significant decline in urine output is consistent with other results in neonatal and adult animals and humans. Furthermore, it implies a role for prostaglandins in controlling urine output during fetal life.

ISSN:0029-7844    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Cerebrospinal fluid activity of a dynorphin-converting enzyme transforming prodynorphin-derived peptides to [Leu]enkephalin-Arg6 was measured in 12 women at term pregnancy before cesarean section and in eight nonpregnant, nonpuerperal controls. In pregnant women, the dynorphin- converting enzyme activity was significantly lower (mean ± SD 6.8 ± 3.8 U/L) than in nonpregnant controls (11.7 ± 2.6 U/L; P<.01). Furthermore, prodynorphin-derived [Leu]enkephalin-Arg6-containing polypeptides were significantly increased in samples from pregnant women (P<.05). This indicates that a reduced activity of opioid peptide-degrading enzymes might contribute to an increased resistance to pain at term pregnancy.

ISSN:0029-7844    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Data were collected prospectively on factors that might affect the success or failure of external cephalic version, using a protocol including fetal monitoring, ultrasound, tocolysis, and external version after 37 weeks' gestation. Patients were accepted into the protocol whether or not risk factors for failure were present. Sixty-seven patients were admitted to the study and 40 (60%) underwent successful version. Using X2 analysis, we found that failure of external version was significantly associated with obesity, descent of the breech into the pelvis, decreased fluid, and fetal back positioned posteriorly. Thirteen women were in active labor; this had no effect on the success rate providing that descent had not occurred. Two factors, descent of the breech into the pelvis and posterior position of the fetal back, had an independent effect on success after controlling for other variables.

ISSN:0029-7844    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The tissues from 16 cases of adenosquamous carcinoma (pseudoglandular squamous cell carcinoma or adenoacanthoma of the sweat glands of Lever) and 26 cases of invasive squamous cell carcinoma of the vulva were studied for the presence of human papillomavirus (HPV) genomes using Southern blot hybridization on fresh tissues. Types 1, 2, 3, 4, 5, 6, 16, and 18 HPV DNA probes and in situ hybridization were used on formalin-fixed paraffin sections using type 2, 6, 16, and 18 HPV DNA probes. Only one case of adenosquamous carcinoma contained an undetermined type of HPV DNA, whereas five cases of squamous cell carcinoma contained HPV DNA. Three of these five cases contained type 16, one type 6 HPV, and two an undetermined type. These results demonstrate HPV DNA associations with malignancy of the vulva that are similar to those observed elsewhere in the genital tract.

ISSN:0029-7844    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Nine cases of condylomatous carcinoma (squamous cell carcinoma arising in condyloma acuminatum) of the vulva were studied for their clinical history, histopathology, and presence of human papillomavirus (HPV) DNA. Condylomatous carcinoma occurred primarily in an elderly population with a mean age of 70 years. There was an antecedent history of vulvar condyloma in 77%, with a median of nine months before the documentation of an invasive lesion. The disease had a good prognosis, with few recurrences and no metastasis or deaths from the disease. Human papillomavirus DNA was demonstrated to be present in 55% of these tumors by either filter or in situ hybridization techniques. Both HPV 6 and HPV 16 DNA were identified in an equal number of cases.

ISSN:0029-7844    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Lichen planus is an uncommon cutaneous disease that can affect the vulva. Vulvar pruritus and pain are common symptoms in patients with genital involvement. Examination reveals an erythematous, friable vestibule with adherent exudate. Marked resorption of the labia minora and atrophy may occur in time. Diagnosis is based on associated clinical findings involving the oral mucosa and/or the skin and on vulvar biopsy.

ISSN:0029-7844    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

A retrospective study of 29 patients with invasive carcinoma of the vagina was completed at The Milton S. Hershey Medical Center, Pennsylvania State University, for a tenyear period from 1976-1986. The overall incidence was 1.3% of all gynecologic malignancies. Twenty-four patients (83%) had squamous cell carcinoma and five (17%) had adenocarcinoma. Squamous cell carcinoma was most commonly located in the upper anterior and lateral vaginal vaults, whereas adenocarcinoma was found more often in the lower anterior and lateral vaginal vaults. The majority of the patients (96%) were managed by a combination of wholepelvis irradiation and brachytherapy. Twenty-four percent of the patients had a recurrence in the vagina only, indicating the need for better local control. The overall survival rate was 48%. Patients with previous hysterectomy were more likely to develop serious treatment-related complications.

ISSN:0029-7844    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Between July 1980 and September 1987, 3185 major gynecologic operations were performed in our residency program. Ureteral injury occurred in 17 cases, 14 of which (0.4%) were accidental. In 16 cases, the injury was noted intraoperatively and repaired primarily; one injury was repaired after identification on the fourth postoperative day. Large pelvic masses, which limited exposure, and tumor invasion of the parametrium contributed to ureteral injury. Preoperative intravenous pyelogram or computed tomography did not prevent ureteral damage. Sixteen ureteroneocystostomies were performed with good result. One ureteroureterostomy leaked, but healed over a percutaneous stent without problems. All patients subsequently had normal renal function.

ISSN:0029-7844    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

To facilitate accurate and standard methods of reporting pathologic uterine corpus enlargement, we constructed a nomogram using the gravid uterine corpus volumes from five to 20 weeks' gestation in 186 patients. The volume was calculated by measuring the maximum length and anteropsterior and transverse diameters of the uterine corpus, and using the formula for the volume of a prolate ellipsoid: V=0.52 x (L x AP x T). Clinicians can use the nomogram for better understanding in assessing uterine volume.

ISSN:0029-7844    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

To better define the incidence, causes, and risk factors associated with maternal deaths, the Maternal Mortality Collaborative in 1983 initiated national voluntary surveillance of maternal mortality. The Maternal Mortality Collaborative reported 601 maternal deaths from 19 reporting areas for 1980-1985, representing a maternal mortality ratio of 14.1 per 100,000 live births. Overall, 37% more maternal deaths were reported by the Maternal Mortality Collaborative than by the National Center for Health Statistics for these reporting areas. Older women and women of black and other races continued to have higher mortality than younger women and white women. The five most common causes of death for all reported cases were embolism, nonobstetric injuries, hypertensive disease of pregnancy, ectopic pregnancy, and obstetric hemorrhage. Compared with national maternal mortality for 1974-1978, ratios were lower for all causes except for indirect causes, anesthesia, and cerebrovascular accidents. Fatal injuries among pregnant women are not commonly reported to maternal mortality committees. As maternal mortality from direct obstetric causes continues to decline, clinicians will need to emphasize preventing deaths from nonobstetric causes.

ISSN:0029-7844    

出版商:OVID    

年代:1988

数据来源: OVID