摘要:

The purpose of this study was to determine whether or not the immunoreactive relaxin contained in human pregnancy serum is biologically active. Relaxin was extracted from pooled serum of women in the third trimester of pregnancy. The extraction also was performed on pooled male serum and pooled serum from women in the follicular phase of the menstrual cycle. The extraction process began with delipidation of the serum followed by extraction of relaxin using 0.1% HCI per 50% acetone. Dialysis then was performed to remove low molecular weight substances (less than 3500 daltons). The partially purified extracts were applied individually to a muscle segment in the in vitro rat uterine horn bioassay for relaxin. The extracts of both male serum and female follicular-phase serum, containing no immunoreactive relaxin, resulted in tetanic contractions of the muscle segment. The extract of pregnancy serum, containing immunoreactive relaxin, produced inhibition of rat uterine horn contractility. This represents the first demonstration of relaxinlike bioactivity in human serum.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Ultrasound examination to measure the fetal biparietal diameter (BPD) and examine amniotic fluid for the presence or absence of free-floating particles was performed in 213 patients undergoing amniocenteses for maturity testing at term. A modified lecithin to sphingomyelin ratio (L/S) was performed on all samples. A BPD greater than or equal to 92 mm predicted 37 of 111 (33%) mature L/S ratios of nondiabetic pregnancies. The presence of free-floating particles predicted 48 of 138 (35%) mature L/S ratios of nondiabetics. Combined, a BPD greater than or equal to 92 mm and/or the presence of free-floating particles predicted 57 of 110 (52%) mature L/S ratios of nondiabetics. It is concluded that a BPD greater than or equal to 92 mm and the presence of freefloating particles are independent yet complimentary predictors of fetal lung maturity.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

A prospective, randomized study was conducted comparing the use of betamethasone and early delivery, early delivery alone, and expectant management in patients in the 28th to 34th week of pregnancy with premature rupture of the membranes (PROM). Tocolytic drugs were used to delay delivery until 24 hours had elapsed after the first dose of steroid or 24 to 48 hours of latent period had elapsed in the second group. There were ho significant differences in maternal age, gestation at PROM, maximum maternal temperature, birth weights, maternal hospital days, respiratory distress, maternal sepsis, or delivery routes in the three groups. Comparisons with one other similar prospective, randomized study support the concept that expectant management offers less risk from tocolytic side effects.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

One hundred and three women who developed acute chorioamnionitis at 37 weeks' gestation or beyond were studied retrospectively. Clinical findings included fever (99.2%), fetal (82%) and maternal (19.4%) tachycardia, uterine tenderness (16.5%), and foul-smelling amniotic fluid (8.7%). Three of the 46 women who underwent cesarean section subsequently required addition of a second or third antibiotic for serious pelvic infection, whereas two had a subcutaneous wound infection requiring open drainage. Importantly, between zero and ten hours of the diagnosis of chorioamnionitis, a critical time interval where delivery impacted on neonatal infectious morbidity was not identified. Additionally, in the initial 24 hours after rupture of the fetal membranes there was no association between fetal, neonatal, or maternal complications versus duration of membrane rupture. These data suggest that immediate operative delivery of term gestations complicated by acute chorioamnionitis will not reduce neonatal morbidity.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

In 80 consecutive twin pregnancies, prenatal measurements of fetal biparietal diameter (BPD) and abdominal diameter were made and growth curves were calculated using routine ultrasound examinations. Nineteen percent of the infants were growth retarded. Growth retardation was found in both fetuses in four pregnancies and in one fetus in 22 other pregnancies. Linear regression analysis between birth weight and gestational age showed the standard deviation of birth weight to be proportional to gestational age. A more linear growth curve also was found when the mean fetal weight was calculated by use of the BPD and abdominal diameter measurements in the formula developed for singletons. The estimated weight compared with birth weight in 62 twins who had ultrasound examinations less than seven days before delivery showed a significant correlation (r=0.89,P<.001) with a coefficient of variation of 12.4%. The identification of intrauterine growth retardation (IUGR) in twin pregnancies by ultrasound had a sensitivity of 62%, a specificity of 98%, and a predictive value of positive and negative test of 93% and 83%, respectively.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

This investigation has reexamined the measurement of the femur length and the use of this measurement as a growth and dating parameter. Straight-line measurements of shaft length were found to be smaller than measurements made along the bone curvature. However, the maximum difference did not exceed 2 mm. Thus, because of its simplicity, use of straight-line measurements appears justified. The optimal (R2=96.1%) growth curve model was a linear-quadratic function, with variability around the regression line increasing with menstrual age. The optimal (R2=96.8%) dating curve model was a linear-quadratic function in which logemenstrual age is a function of femur length. The variability associated with age estimates increased with femur length. These data were used to construct new standard curves for growth assessment and dating of fetuses using femur length measurements.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

A prospective randomized study was performed to determine the usefulness of x-ray pelvimetry before oxytocin induction or augmentation. Two hundred primiparous women were entered into this study. Agreement on pelvic size by the clinical and radiologic assessment occurred in 76.5% of the cases. When the total groups were compared, there were no differences in pregnancy outcome. In the induction of labor subgroups there were less forcep deliveries and lower five-minute Apgar scores in the pelvimetry group. In the augmentation subgroups there were no differences. The subgroup of patients diagnosed clinically to have a borderline pelvis, had a higher incidence of cesarean section (P<.05) if they had x-ray pelvimetry. These results suggest that the elimination of x-ray pelvimetry in primigravida women does not lead to a compromise in infant outcome when electronic fetal monitoring is used.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

A review of 4320 consecutive term deliveries identified 258 women (6%) delivered at a gestational age of 42 weeks or longer. The group accounted for 30% of all cesarean sections for fetal distress, 30% of all infants with a low five-minute Apgar score, 40% of neonatal intensive care admissions, 60% of neonatal deaths, and 30% of all stillbirths. Nonstress tests were performed on 228 women with a postmature pregnancy. Results were defined as normal (score 7 to 10) in 83.4%, inconclusive (score 5 to 6) in 12.2%, and abnormal (score 1 to 4) in 4.4% of these cases. Monitored patients did significantly better than patients in the nonmonitored group, and so did those with normal nonstress test scores when compared with the abnormal scores. Whereas perinatal mortality in the monitored group was similar to that in the nonpostmature population, the perinatal morbidity was significantly higher.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Seven of eight women who had given birth to infants with early onset or intrauterine infection caused by group B streptococci remained carriers of the same serotype of group B streptococci up to 38 months after their pregnancy. In contrast, only 34 of 88 group B streptococci carriers who had given birth to healthy infants harbored the same serotype at the 34 months' follow-up (P=.009). Among the control subjects, 29 of 71 showed increased serum levels at followup of antibodies against the serotype isolated at delivery, a significantly higher proportion compared with the mothers of infected infants/fetuses. The results indicate that mothers of group B streptococci-infected infants are chronic urogenital carriers of group B streptococci without responding immunologically against the organism.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

To assess the relationship between increasing numbers of previous cesarean sections and the subsequent development of placenta previa and placenta accreta, the records of all patients presenting to labor and delivery with the diagnosis of placenta previa between 1977 and 1983 were examined. Of a total of 97,799 patients, 292 (0.3%) had a placenta previa. The risk of placenta previa was 0.26% with an unscarred uterus and increased almost linearly with the number of prior cesarean sections to 10% in patients with four or more. The effect of advancing age and parity on the incidence of placenta previa was much less dramatic. Patients presenting with a placenta previa and an unscarred uterus had a 5% risk of clinical placenta accreta. With a placenta previa and one previous cesarean section, the risk of placenta accreta was 24%; this risk continued to increase to 67% (two of three) with a placenta previa and four or more cesarean sections. Possible mechanisms and clinical implications are discussed.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID