摘要:

The effect on labor of administering ritodrine after a premature rupture of the membranes (PROM) was studied in a double-blind trial in 30 patients. The patients were selected according to the following criteria: 28 to 36 weeks' gestation, only 1 fetus, cervix dilated 4 cm or less, and absence of pyrexia or other signs of uterine infection. Fourteen patients received ritodrine and 16 received a placebo. The 2 groups were statistically comparable. None of the patients receiving ritodrine delivered within 24 hours. The difference between the 2 groups was statistically significant with respect to the number of patients delivered within 24 hours (P < 0.05). However, after 24 hours, there was no difference between the groups as regards the length of pregnancy. The infections registered in the mothers and infants were few and easily controlled. The incidence of idiopathic respiratory distress syndrome (IRDS) was low in the study and allows no conclusions concerning the benefit of proloning the pregnancy for more than 24 hours after PROM.

ISSN:0029-7844    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

The efficacy of real-time ultrasound for the diagnosis of fetal death or hydatidiform mole was evaluated during a 1-year period. During this time, 116 patients were referred to the obstetric ultrasound service for the confirmation of clinical diagnoses. In 24 of 46 patients (52%) presenting in the first half of pregnancy, the referring diagnosis was confirmed. In 1 case of an early intrauterine pregnancy with a degenerating myoma, the ultrasound diagnosis of molar pregnancy was in error. In 48 of 70 patients (69%) referred after 20 weeks' gestation, the clinical diagnosis was confirmed. In no instance was either a false-positive or false-negative diagnosis made with real-time ultrasound in the last half of pregnancy. This method should prove to be the method of choice in diagnosing intrauterine fetal death.

ISSN:0029-7844    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

A single-transducer mechanical sector scanner was used to examine the first-trimester fetus. Fifty-six examinations of 31 patients demonstrated an orderly developmental progression of fetal activity beginning with beating of the fetal heart (7 weeks), progressing ot fetal trunk movement (8 weeks), and culminating in individual fetal limb movement (9 weeks). The mechanical sector real-time scanner is capable of providing a high-resolution image of the first-trimester fetus and the earliest fetal movements.

ISSN:0029-7844    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

A retrosepective study was conducted of 50,300 conseutive deliveries between July of 1973 and January of 1978. There were 40 instances of face presentation with gestational age greater than 36 weeks and fetal weight greater than 25000 g for an incidence of 1 per 1250 deliveries. Cesarean section was performed in 50% of cases. Spontaneous vaginal delivery occurred with mentum anterior presentation 88% of the time, with mentum transverse presentation 45% of the time, and with mentum posterior presentation 25% of the time. Fetal heart rate (FHR) monitoring was available for review in 29 of the 38 (76%) live births. Internal techniques were used in 79% and external techniques in 21% of the cases. The FHR patterns were classified according to the predominant pattern seen in the first stage of labor. In 59% (17 of 29), variable decelerations were noted, and severe variable decelerations were present in 29% (8 of 29). Late decelerations were noted in 24% (7 of 29) of cases. Only 4 patients completed labor without variable or late decelerations. There were 38 live births and 2 stillbirths. Both of the stillborns were noted to have tight nuchal cords which were believed to be the cause of death. One death occurred intrapartum. Of the 38 live births, there were 14 (37%) with 1-minute Apgar scores of 6 or less and 5 (13%) with 5-minute Apgar scores less than 7. Four of the 5 low 5-minute Apgar scores occurred in babies with mentum posterior position. Of the 23 patients monitored by internal electrodes, no serious trauma was noted as a result of the electrode placement.

ISSN:0029-7844    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

The supine position in late pregnancy is associated with many hemodynamic changes caused by compression of the inferior vena cava and a resulting fall in cardiac output. To investigate the effect of this position on uteroplacental blood flow, 22 women with normal (N = 12) or hypertensive (N = 10) pregnancy were investigated using the intravenous133Xe washout method, in both the supine and left-tilted (45-degree) lateral positions. The intervillous blood flow (113 ± 48 ml/min/dl) was lower in the supine position than in he left-tilted position (141 ± 48 ml/min/dl) (P < 0.01), while the myometrial blood flow was similar in both (9.0 ± 3.3 ml/min/100 g in supine and 8.7 ± 2.7 ml/min/100 g in left-tilted position). The results suggest that the autoregulation system for uterplacental circulation is operative only in the nonplacental component of the pregnant uterus.

ISSN:0029-7844    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

The first study on the use of corticosteroids to accelerate fetal pulmonary maturity reported an increased riks of fetal death in pregnancies complicated by hypertension-edma-proteinuria syndromes. Since that publication the use of corticosteroids to accelerate fetal lung maturity in women who are preeclamptic has been of great concern. This study provides evidence that when continuous fetal heart rate (FHR) monitoring is used, the use of corticosteroids to accelerate fetal lung maturity can be considered even in the presence of severe preeclampsia.

ISSN:0029-7844    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Echocardiography and systolic time-interval measurements were performed to assess left ventricular size and function in 15 women receiving oral contraceptives and in a control group. There was no significant difference in heart rate (78 ± 9 versus 72 ± 12 beats/min), blood pressure (116 ± 8/72 ± 7 versus 110 ± 11/67 ± 9 mmHg), left ventricular ejection time/preejection period (LVET/PEP) (0.31 ± 0.05) versus 0.l20 ± 0.05), left ventricular internal dimension in diastole (4.3 ± 0.3 versus 4.3 ± 0.5 cm) or systole (2.7 ± 0.3 versus 2.6 ± 0.4 cm), shortening fraction (0.37 ± 0.05 versus 0.41 ± 0.05), or mean normalized velocity of circumferential shortening (1.30 ± 0.21 versus 1.31 ± 0.23). Therefore, young, healthy women receiving oral contraceptives do not appear to be at increased risk with respect to abnormalities of ventricular volume or contraction.

ISSN:0029-7844    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

In an effort to provide information on maternal immuno-compentence, a study was undertaken to measure lactin-induced transformation of maternal lymphocytes. Whole-blood culture was used. The phytohemagglutinin (PHA)-induced lymphocyte transformation of 137 pregnant women was significantly (P < 0.05 to 0.001) diminished until 32 weeks' gestation, and the concanavalin A (Con A)- induced lymphocyte transformation of 116 pregnant women was also significantly (P < 0.01 to 0.001) diminshed at all stages of gestation, as compared with those of 39 nonpregnant women. In addition, the Con A-induced lymphocyte transformation of ovarian venous blood and uterine venous blood from a pregnant woman was prominently diminished, as compared with that of basilic venous blood. It is suggested that there are maternal T-cell sub-populations that have different reactivities to PHA and Con A.

ISSN:0029-7844    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

World-wide, clinicians apparently prefer to insert the intrauterine device (IUD) during the bleeding phase of the menstrual cycle. To examine the benefits and risks of inserting IUDs at various times during the menstrual cycle, data on over 9000 women having copper T-200 IUD insertions were analyzed. During the first 2 months after IUD insertion: 1) rates of IUD expulsion are lower the later in the menstrual cycle the IUD is inserted; 2) rates of IUD removal for pain and bleeding and rates of accidental pregnancy are higher the later in the minstrual cycle IUD is inserted, particularly after day 17. The present analysis sugests that the above are probably causal associations. It is estimated that 1000 insertins before day 11 will result in 9 more terminations of IUD use for expulsion, pain and bleeding, and accidental pregnancy than if the insertions are done after day 11. Furthermore, the copper T-200 IUD can be inserted with relative safety on the day it is requedsted if the woman's history indicates that she is unlikely to be pregnant. There is no justification for a blanket policy oos inserting IUDs only during the menses.

ISSN:0029-7844    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Of 106 patients with carcinoma in situ (CIS) of the vulva, 102 have been followed from 1 to 15 years. The average age of the patient was 47 years; however, 40% were under the age of 41. Twenty-seven percent had associated cervical malignancy. Only 4 patients developed invasive cancer. Of these, 2 were postmenopausal and the 2 younger patients had been immunosuppessed becasue of systemic disease; thus the subsequent invasive cancer. The incidence of recurrence was essentially the same whether the patient was treated by vulvectomy or wide local excision. In view of the uncertainties about the invasive potential of CIS of the vulva in young patients and the absence of a proved need for an extensive procedure, it is suggested that this entity be treated only by local excision.

ISSN:0029-7844    

出版商:OVID    

年代:1980

数据来源: OVID