摘要:

Severe intractable atonic postpartum hemorrhage can be treated by either uterine packing or surgical techniques. However, certain prostaglandins possess properties of potential value for the control of postpartum uterine atony. Two hundred fifty micrograms 15-methyl prostaglandin F2&U0251;(15-methyl PGF2&U0251;) was given intramuscularly to 16 subjects for whom a uterine pack or operative management was the only other alternative. Fifteen patients responded satisfactorily following a mean of 1.75 injections (437.5 µg); only 1 patient required hysterectomy. The latter had a case of severe intrauterine infection. The incidence of side effects was very low. The use of intramuscularly administered 15-methyl PGF2&U0251;in uncontrollable atonic postpartum hemorrhage appears to be a valuable lifesaving medical tool in critical cases.

ISSN:0029-7844    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

The relationship of induction-to-delivery and uterine incision- to-delivery intervals to neonatal outcome was studied in 105 parturient women undergoing cesarean section. Sixty patients received general anesthesia and 55 were given spinal anesthesia. During general anesthesia, induction- to-delivery intervals of more than 8 minutes and uterine incision-to-delivery intervals of more than 3 minutes were associated with significantly more instances of neonatal acidosis (umbilical artery pH 7.31 versus 7.22) and greater incidence of low 1-minute Apgar scores (4% versus 73%). In the groups receiving spinal anesthesia, prolongation of uterine incision-to-delivery interval by more than 3 minutes was found to be the only important factor influencing fetal outcome, as determined by an increased acidosis (umbilical artery pH 7.30 versus 7.18) and by depressed Apgar scores (0% versus 62%).

ISSN:0029-7844    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

In a case-control (N= 1427 and 3001, respectively) study of deliveries in Connecticut the incidence of congenital malformations was 52 per 1000 live births. Of all mothers, 44.5% used at least 1 prescribed drug during pregnancy. Case mothers were more likely than controls to have used a prescription drug (odds ratio [o]=1.3,P<.0001), particularly an antidepressant (o=7.6), narcotic analgesic (o=3.6), or tranquilizer (o=2.3);P<.01 for all associations. There was a synergistic relationship with tranquilizer use and smoking in pregnancy, resulting in ao=3.7 (P<.01) risk for those exposed to both. The synergistic relationship of tranquilizers-cigarettes with malformations supports existing pharmacologic research and suggests that epidemiologic study of the impact of simultaneous maternofetal exposure to environmental agents may further explain the etiology of some congenital malformations.

ISSN:0029-7844    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

The estimated time of ovulation (ETO) was correlated with the day of defined postovulatory infertility in 66 hormonally normal menstrual cycles from 24 subjects for each of 15 different natural family planning methodologies. Inherent weaknesses were identified in methods based upon calendar calculations or basal body temperature only. These weaknesses could be removed for the basal body temperature- only methods if symptoms, especially the peak mucus symptom, were added to the temperature records. However, the peak mucus symptom alone had the greatest precision of all methods studied. No advantage could be identified in combining the basal body temperature with the peak symptom.

ISSN:0029-7844    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Cytogenetic studies were performed in 35 cases of complete hydatidiform mole, and the results were correlated with maternal age and other clinical parameters. The rate of occurrence of aneuploid cells in the 18- to 39-year age group was 19% of the total cells; the rate in the 43- to 52-year age group was 25%. The rate of aneuploid cells between 2n and 3n was 20% in the latter group but only 7% in the former group. Aneuploid cells were not found in normal villi but were found to predominate in invasive mole and choriocarcinoma. These results suggest that hydatidiform mole may have a greater potential for malignant transformation in patients 40 years and older than in younger patients.

ISSN:0029-7844    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Sixteen patients with lower genital intraepithelial neoplasia were treated by 5-fluorouraciI (5-FU)/chemosurgery: colposcopically directed excision of neoplastic epithelium pretreated with topical 5-FU. 5-FU loosens the neoplastic epithelium, facilitating its removal from the underlying stroma in a safe, minimally traumatic fashion. 5-FU/ chemosurgery was undertaken in patients with vaginal neoplasia or those with lower genital neoplasia who were immunosuppressed or had a neoplastic syndrome, because conventional methods are often difficult or inadequate for these problems. In all 16 patients, the neoplasia went into remission. Two immunosuppressed patients developed recurrences of lesser dysplasia when 5-FU maintenance therapy was interrupted because of pregnancy. It was found that 5-FU/chemosurgery, followed by monthly 5-FU maintenance, may be the best treatment for intraepithelial neoplasia of the vagina or lower genital intraepithelial neoplasia in patients who are immunosuppressed or have neoplastic syndrome.

ISSN:0029-7844    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

To evaluate the role of hexamethylmelamine (HMM) in the treatment of endometrial cancer, 20 women with metastatic or recurrent endometrial carcinoma received HMM orally at a dose of 8 mg/kg/day. Six patients (30%) showed a partial response, with a median duration of response of 3.5 months and a range of 1 to 7 months. Two patients responded to HMM as a second-line agent following previous treatment with nonhormonal chemotherapy. There were no complete responses. The major toxicities noted with HMM therapy were nausea, vomiting, and neurotoxicity. In 6 patients (30%), therapy with HMM was discontinued because of toxicity. Although HMM is active against endometrial cancer when given at a dose of 8 mg/ kg/day, it appears to have limited usefulness because toxicity precludes its prolonged administration.

ISSN:0029-7844    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Fourteen preoperative variables were individually assessed on 408 patients with primary vulval cancer to determine their effect upon survival. Age, clinical node involvement, secondary tumor spread, tumor size, and menses were found to be the best individual indicators of survival time. Further analyses explored the dependence of survival time on these 5 variables jointly. Age was allowed for by dividing the patients into 4 age groups; in each of these strata 4 prognostic categories, based on the variables clinical groin node involvement and secondary tumor spread, were defined: category 1, impalpable nodes and no secondary tumor spread; category 2, palpable nodes and no secondary tumor spread; category 3, impalpable nodes and secondary tumor spread; and category 4, palpable nodes and secondary tumor spread. Survival curves for each of these categories were plotted and showed progressively worsening prognoses from group 1 through group 4. It is believed that such methods should be used preoperatively to produce staging criteria and estimates of prognosis more objective and informative than those in common use.

ISSN:0029-7844    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Ten patients with intraepithelial carcinoma of the vulva that extended to the anus were studied. The patients were seen and treated over a 3-year period, from January 1976 through December 1978. During the 10-year period before 1976 the authors had encountered no patients with this problem. Treatment consisted predominantly of a skinning vulvectomy with split-thickness skin graft and excision of the anal disease. Failure to recognize the extension to the anus will result in persistent disease following surgical therapy.

ISSN:0029-7844    

出版商:OVID    

年代:1981

数据来源: OVID

ISSN:0029-7844    

出版商:OVID    

年代:1981

数据来源: OVID