摘要:

A series of 234 nulliparas and 71 multiparas with protracted descent patterns was studied. Cephalopelvic disproportion, minor malpositions, excessive sedation and conduction anesthesia were considered to be possible etiologic factors. Concurrent dysfunctional dilatation patterns were seen in 70.8%, most commonly, in protracted active-phase dilatation and secondary arrest of dilatation. Conservatism in the form of expectancy and Support resulted in generally better perinatal outcome than did uterotonic stimulation. Infants, delivered by midforceps operations consistently fared poorest. The worst results are obtained from midforceps utilized in the presence of cephalopelvic disproportion. Details of analysis with regard to etiology, treatment and prognosis are presented, together with a program of management for the patient with a protracted descent pattern.

ISSN:0029-7844    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

Fifty-one records of patients with delayed postpartal uterine hemorrhage were studied from a total of 20,651 deliveries during a 10-year period. After reviewing the literature and analyzing the records, the authors propose that retained placental tissue is the most likely basic cause for the delayed bleeding as well as for the histologic picture labeled subinvolution or noninvolution of the placental site. Suggestions for therapy are offered and include the prophylactic use of manual exploration of the uterus immediately postpartum in all parturients as well as preoperative curettage before planned hysterectomy.

ISSN:0029-7844    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

The relative role of maternal and fetal adrenal function in the production of maternal urinary estriol during pregnancy was studied by transuterine, intramuscular injection of adrenocorticotropin (ACTH) into the fetus and intravenous administration of ACTH to the mother. Normal untreated patients and patients in whom adrenal function was suppressed by administering dexamethasone to the mother served as subjects. At no time was urinary estriol excretion increased. It is suggested that an increase did not occur in normal patients because the enzyme involved in estriol synthesis was operating near maximum capacity. In patients who had taken dexamethasone prior to injection of ACTH, the quantity of ACTH might not have been sufficient to overcome the suppressive action of dexamethasone.

ISSN:0029-7844    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

The long-range effects of ligating one umbilical artery were studied in 12 lamb fetuses using chronic, implanted fetal arterial catheters. Their physiologic adjustments were compared to 14 control fetuses with intact umbilical circulation. The control fetuses reached normal arterial pH values within 1–2 days, whereas the umbilical artery ligated group did not reach normal pH values until 3–4 days, thus supporting the presence of a placental reserve capacity. In 7 fetuses who survived for more than 19 days with a ligated umbilical artery, malnutrition and retarded growth were observed in the presence of normal arterial blood pH and near normal arterial pO2values. In these malnourished fetuses, we observed a preferential continued development of the brain, heart, spleen and kidneys, but the liver, lungs and thymus failed to grow. Possible mechanisms of fetal adaptation arc discussed.

ISSN:0029-7844    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

Deo-medroxyprogesterone acetate (DMPA) 150 mg every 3 months, was administered as a contraceptive to 752 patients who were studied for 44 months. Side effects were similar to those seen with oral contraceptive agents. The major unwanted symptom was a completely unpredictable bleeding pattern. Regularity of bleeding cycles can be enhanced by monthly administration of enthinyl estradiol for 7 days. Only one drug-failure pregnancy occurred; fifty-four pregnancies occurred before, during, or after DMPA. No deleterious effects on pregnancy could be noted. Seventy-five percent of the patients conceived within 12 months after discontinuing DMPA. One patient developed questionable thrombophlebitis, but no cases of thromboembolic phenomenon were seen. DMPA appears to be a highly effective contraceptive agent, well-suited to a clinic-type population requiring infrequent motivation.

ISSN:0029-7844    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

An analysis of 30 deaths among 9633 patients who were using oral and vaginal contraceptives failed to reveal any relationship between oral contraceptives and deaths due to pulmonary embolism or to coronary thrombosis or infarction in the absence of a predisposing medical condition. Sixteen percent (16.6%) of the deaths were due to complications of pregnancy which would not have occurred if the pregnancies had been effectively prevented.

ISSN:0029-7844    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

Herpetic involvement of the endometrium, a site not previously described, was identified by characteristic intranuclear inclusions within the glandular epithelium. The relationship between herpetic infection of the female genital tract and neonatal herpesvirus infection is discussed. The present case report raises the possibility that some instances of fetal infection may be acquired from a placenta formed from already-infected endometrium. The correlative association between genital herpes and cervical carcinoma suggests the possibility that a similar relationship may emerge for other genital sites. Careful histologic study of uterine curettings and placental tissue can be invaluable in elucidating these relationships.

ISSN:0029-7844    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

An unusual case of what was thought to represent idiopathic retroperitoneal fibrosis confined to the pelvis and presenting as an advanced pelvic malignancy is presented. A need for awareness to the possible subsequent manifestation of a malignancy is emphasized by the diagnosis of a sarcoma involving the bony pelvis after 21/2 years of observation. The possible sequence of events in this unusual and interesting association is discussed.

ISSN:0029-7844    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

Menopausal depression is an important entity in the lives of many women. The authors review current thinking concerning-this condition. In contradistinction to the male, female psychology is seen as being dependent upon biology. Youth, attractiveness, sex, and motherhood are viewed as the important roles for women. Menopause is seen as a time of mortification, with service to the species over. This thinking has influenced the therapy offered for menopausal symptoms. Physiologic symptoms have been treated psychologically, and psychologic symptoms, physiologically. Frequently psychotherapy has been superficial or designed to gain acceptance of the biologic loss. Mature emotions and cognition have been given little emphasis. The authors suggest that rethinking current notions may aid in treating and preventing menopausal depression.

ISSN:0029-7844    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

A program is described wherein an indigent population has been able to obtain abortions in a state where it had been traditional not to provide this service. A review of the economic and medical problems of this program is presented to prepare others who will be confronted with these issues. Physicians must be cautious in maintaining abortion care as a compromising their medical facilities and their ability to deliver general obstetric and gynecologie care.

ISSN:0029-7844    

出版商:OVID    

年代:1970

数据来源: OVID