摘要:

The significance of the lecithin sphingomyelin (L:S) ratio as a determining factor in fetal lung maturity is well established. An L:S ratio of greater than 2.0 to 2.5 is indicative of fetal lung maturity in most assays. The fluorescence polarization method (fluorescence polarization less than 0.320) has been associated with fetal lung maturity. The presence of phosphatidylglycerol in amniotic fluid has been related to fetal lung maturity and the absence of respiratory distress syndrome. Amniotic fluid samples from 235 amniocentesis procedures and vaginal pool collection at varying gestational ages were analyzed for L:S ratio, fluorescence polarization, and phosphatidylglycerol. All samples with meconium or hemolyzed blood contamination and selected complications of pregnancy were removed from the study. A positive result will predict the absence of respiratory distress syndrome, and a negative result will predict the presence of respiratory distress syndrome. Correlation of L:S ratio, fluorescence polarization, and phosphatidylglycerol were favorable. False-positive results in three (3.3%) fluorescence polarization samples were noted, whereas there were none (0%) in the L:S ratio sample and one (1%) in the phosphatidylglycerol sample. Twenty-four (77.4%), 28 (73.7%), and 37 (77%) were the number of false-negatives in the fluorescent polarization, L:S ratio, and phosphatidylglycerol samples. Fluorescence polarization, L:S ratio, and presence of phosphatidylglycerol compare favorably as fetal lung maturity tests. The prediction of respiratory distress syndrome is as sensitive with the three modalities. The specificity and the predictive value of a positive test is more favorable with L:S ratio and phosphatidylglycerol.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Thirty-six puerperal women with inadequate lactation were treated with 50 mg sulpirideN= 24) or placebo (N= 12) three times a day for two weeks. These treatments were supplemented with buccal oxytocin (100 IU, 300 IU, or 400 IU) or placebo preceding each breast-feeding on the sixth and 14th and on the seventh and 13th days of oral treatment, respectively. One woman treated with sulpiride and three women treated with placebo discontinued the trial because of the lack of the effect of treatment. The concentration of prolactin in maternal serum was higher (P<.001) during sulpiride than placebo treatment at one week (380 ± 43 ng/mlvs23 ± 7 ng/ml, mean ± SE) and two weeks of treatment (381 ± 38 ng/mlvs34 ± 10 ng/ml). Also, the daily breast milk yield, as measured objectively, was greater (P< .05) during sulpiride than placebo treatment both at one week (628 ± 51 mlvs440 ± 68 ml) and two weeks of treatment (684 ± 67 mlvs423 ± 60 ml). Various doses of oxytocin failed to stimulate the milk secretion in the presence or absence of sulpiride-induced hyperprolactinemia. Thus, sulpiride improved inadequate lactation, whereas exogenous oxytocin alone or together with sulpiride had no effect on lactation in these mothers whose infants were able to suckle normally.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

The syndrome of puerperal ovarian vein thrombosis is often a diagnostic enigma. In the past, laparotomy has been the most frequent modality used to establish the diagnosis. The clinical picture and characteristic mass have not accurately predicted the presence of this syndrome, resulting in potentially dangerous and unnecessary surgery. The use of computed tomography is suggested as a noninvasive ancillary method.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Patterns of postpartum contraceptive choice are analyzed in a middle class private practice population between the years 1966 and 1981. The effect of age, parity, difficulty in conceiving, future pregnancy plans, and type of delivery are noted. A general decline in the use of oral contraceptives and intrauterine devices with a corresponding increase in the use of barrier methods is documented. Although very few changes among contraceptive techniques occurred between six weeks and six months post partum, an appreciable number of patients, more than half the sample, did change contraceptive techniques between pregnancies. Thus, women perceive different needs at different times during their reproductive lives. To serve patients effectively, a wide range of contraceptives must be available to accommodate changing demands.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

This is a retrospective review of 335 elective sterilizations performed in a private community practice. One hundred sixteen minilaparotomy sterilizations and 219 laparoscopic Falope-Ring sterilizations were reviewed. The study indicates a significantly greater mean hospital stay (1.78 versus 1.05 days), requirement for postoperative analgesics (3.34 doses versus 1.76), operative time (23.35 versus 18.82 minutes), and number of days (5.2 versus 2.84) required to resume normal functional activity on a subjective basis in the minilaparotomy group. There were two subsequent pregnancies among the laparoscopic group and none in the minilaparotomy cases. Technical failures occurred in 2.7% of the laparoscopic group. The authors offer suggestions, based on their results, for counseling patients interested in sterilization procedures.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

In 93 patients with surgically proved ectopic gestation, the initial serum β-human chorionic gonadotropin (hCG) concentration ranged from 2.0 to 5260 ng/ml; in 33 (35%) the values were below 100 ng/ml. Of 25 patients with serial hCG data, 20 showed a plateau or fall in serum concentrations over at least 48 hours, thereby identifying the gestation as nonviable. Sixty-four patients underwent sonographic evaluation; 35 of these also underwent at least one quantitated hCG determination. Correlating a single hCG value with the sonographic diagnosis correctly identified the gestation as nonviable in 21% of the cases, but a definite diagnosis was not possible in the rest. For the clinically stable patient with a suspected ectopic pregnancy, serial hCG determinations offer a useful technique for evaluating gestational viability.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

In a study of 638 women attending a University Student Health Service outpatient gynecologic clinic, their symptoms were either lower genital tract infection or a history of suspected exposure to sexually transmitted diseases. Forty-two (6.6%) harboredChlamydia trachomatis, four (0.8%)Neisseria gonorrhoeas, and one (0.2%) both of these organisms.Chlamydia-positive patients were more likely to be using a contraceptive method, have multiple partners, and have partners with symptoms of urethritis (P= .05). TheChlamydia-positive patients were no more likely to have increased or abnormal vaginal discharge than were controls. Of the women harboringChlamydia trachomatis, only one of 36 (3%) of those who were available for follow-up at one to eight weeks posttreatment was still infected with the organism.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

To predict the duration of postoperative bladder drainage required after incontinence surgery, 30 patients were studied preoperatively using voiding-simultaneous urethrocystometry. Based on changes in bladder, urethral, and abdominal pressures, patients were divided into three groups. Patients who demonstrated adequate bladder contraction during voiding did not need prolonged catheterization (P< .005). Patients who did not demonstrate adequate detrusor contraction and used Valsalva maneuver during voiding were at 12 times greater risk of requiring prolonged postoperative catheterization (P< .05). Changes observed in urethral and abdominal pressures individually during voiding were not significant predictors of the need for prolonged catheterization. Preoperative knowledge of voiding mechanisms can predict postoperative catheterization need.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

One hundred seven patients undergoing major surgery for gynecologic malignancy participated in a controlled trial evaluating the effectiveness of pneumatic calf compression in the prevention of postoperative deep venous thrombosis and pulmonary embolism. External pneumatic calf compression was applied intraoperatively and for five postoperative days. All patients were prospectively screened for deep venous thrombosis with impedance plethysmography and125I-fibrinogen leg counting. Deep venous thrombosis and/or pulmonary emboli were detected in 18 of 52 control group patients (34.6%) whereas in seven of 55 (12.7%) of those treated with external pneumatic calf compression (P< .005). External pneumatic calf compression was most effective during the first five days postoperatively and also reduced the incidence of deep venous thrombosis in patients at highest risk. When applied during surgery and for five days postoperatively, external pneumatic calf compression significantly reduces the incidence of postoperative venous thrombosis.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

To evaluate the reliability of diagnostic criteria for separating intraepithelial squamous lesions into low- and high-risk categories, 25 lesions of the cervix were diagnosed as flat condyloma, atypical immature metaplasia, or cervical intraepithelial neoplasia with koilocytosis based on well-defined histologic criteria. The presumption was that flat condyloma and atypical immature metaplasia would be diploid/polyploid as compared to low-grade cervical intraepithelial neoplasia, which should be aneuploid. Using the major histologic parameter of the presence or absence of abnormal mitoses to distinguish the low- and high-risk lesions, it was found that all of five typical flat condylomas were diploid/polyploid and seven of eight atypical immature metaplastic lesions were diploid/polyploid; 11 of 13 cervical intraepithelial neoplasms with koilocytosis, however, were aneuploid. An additional histologic parameter of anisocytosis (variation in nuclear size) appeared much less reliable for segregating these lesions than the nature of the mitoses. Lesions for which ploidy values were particularly difficult to predict were extremely well-differentiated koilocytotic lesions with occasional abnormal mitoses. Whether these are true polyploid lesions in which the abnormal mitoses are a response to the virus, or whether they are very early aneuploid lesions that cannot be confirmed by microspectrophotometry, remains to be determined.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID