摘要:

&NA;A retrospective study of 4224 deliveries to women age 19 or younger was conducted. The purpose of the study was to evaluate the characteristics of teenage pregnancy in an urban, predominantly nonwhite, socioeconomically depressed population. A total of 10,011 infants were delivered during the study period, with 42% (4224) of the infants born to teenagers. It is concluded that teenage pregnancy among the urban, nonwhite poor is characterized by poor outcome, primarily as a reflection of the high‐risk obstetric population from which it derives, and only secondarily due to any risk inherent to maternal age. In addition, a striking characteristic of pregnancy in this age group is its tendency to repeat itself. Teenage pregnancy is a sociologic problem with medical consequences, and medical programs as they presently exist are incapable of bringing about the ultimate solution—prevention.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

&NA;In a prospective study, infants of high‐risk mothers delivered over a 1‐year period were evaluated by clinical, biochemical, and behavioral methods. Of 67 newborns whose mothers had oxytocin challenge tests (OCTs), 54 were delivered after negative tests, and 13 after positive tests. Infants with positive OCTs had poor state organization and reflexive performance when compared with negative‐OCT babies. These infants also showed evidence of intrauterine malnutrition, but did not have any greater asphyxiation than the negative OCT group. These results are consistent with the hypothesis that a positive OCT implies pathological placental respiratory insufficiency, which may be superimposed, in many instances, on impairment in utero of the placenta's nutritional function. The clinical manifestation of such dysfunction is the alteration in subtle neonatal neurobehavior.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

&NA;During the years 1974‐1977 ultrasonic placentography demonstrated midtrimester placenta previa (MTPP) in 123 women. The procedure was performed because of vaginal bleeding in 65 cases and prior to amniocentesis in 58 asymptomatic cases. Eighty‐eight patients were found to have grade I placenta previa (PP), 12 to have grade II, 14 to have grade III, and 9 patients to have grade IV PP. These different variants of PP were correlated with the ultimate outcome of these pregnancies: Bleeding due to PP or PP at term were reasons for cesarean section in 4 cases of grade I PP, in 2 cases of grade II, in 7 cases of grade III, and in 7 out of 9 cases of grade IV PP. Among those patients who had grades III and IV PP, 13 out of 23 had premature or immature deliveries. These results suggest that finding of MTPP, especially symptomatic MTPP, should alert the physician to the clinical significance of PP later in pregnancy.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

&NA;Fetal swallowing and voiding were measured using colloidal gold and an ultrasonic scanner, respectively. Subjects in the study were in their 38‐40th week of pregnancy. Cases were divided into 3 groups: normal, hydramnios, and oligohydramnios. The normal group had a mean swallowing rate of 198 ml/day and a mean voiding rate of 23.6 ml/hr. No significant differences were found among these rates and the corresponding rates in the other 2 groups. It is concluded that mechanisms other than fetal swallowing and voiding can contribute to the control of amniotic fluid volume at term.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

&NA;A total of 4517 successful antepartum nonstress tests (NST) was performed on 2003 high‐ (28%) and low‐ (72%) risk obstetric patients. Most patients were monitored from 32 to 34 weeks' gestation onward. A reactive NST was defined as 2 accelerations in 10 minutes—15 beats/min minimum amplitude; 15 seconds minimum duration. The test was repeated at the next visit in low‐risk patients with reactive NST or in 1 week in high‐risk patients with this response. Nonreactive tests were followed immediately by a stress test in high‐risk patients, but only after repeat nonreactive NST within 24 hours in low‐risk patients. About 88% of low‐risk and 86% of high‐risk patients demonstrated reactive NST only. Late decelerations during subsequent stress testing or labor, low Apgar scores, and perinatal deaths were more common in low‐risk pregnancies than in highrisk pregnancies and more common in those with nonreactive NST than in those with reactive NST. High‐risk/reactive NST babies, however, fared better than low‐risk/nonreactive NST babies. Of the 16 perinatal deaths 6 died antepartum, 2 died in labor, and 8 died as neonates. Presumed asphyxia accounted for 6 deaths while significant anomaly accounted for 5; sepsis and trauma accounted for 2 each. In only 2 instances was a reactive NST followed by a death from apparent asphyxia. Routine NST testing appears to improve the resolution of maternal risk classification and may contribute to better perinatal outcome.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

&NA;The epidemiologic characteristics of 298 cases of eclampsia treated from 1967 to 1974 in the Siriraj Hospital, Bangkok, Thailand, are described. The incidence of eclampsia was 0.2% of all deliveries, and the nulliparas had a higher incidence than the multiparas in all age groups. About 90% of patients had inadequate or no antenatal care, and 43% of patients suffered their first convulsion after admission to the hospital. Although the patient's own neglect was the major causative factor, physician error played some role in the development of eclampsia. The maternal mortality rate was 4.7%, and factors influencing maternal and perinatal death rates are discussed. The rate of cesarean section for eclamptics was 7%, as compared to a 3% rate for the general obstetric population. The findings suggest that more frequent use of properly timed cesarean section can improve the outlook for both the fetus and mother. An active program aimed at reducing the incidence of eclampsia and its maternal and perinatal mortality is emphasized.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

&NA;Labor induction in humans by the injection of 18 mg of betamethasone (Celestone) into the amniotic sac was investigated in a group of 19 pregnant women. Eight of the cases were high‐risk pregnancies of 36‐39 weeks' gestation, and 11 were normal pregnancies of 40‐42 weeks' gestation. A group of 19 women at similar stages of pregnancy served as a control group. The criterion for the efficacy of the technique was the onset of labor or rupture of the membranes within 72 hours of the injection. Contrary to other reports, it was concluded that the technique is ineffective since no significant difference was found between the experimental and control groups.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

&NA;Controversy exists as to whether cortisol acts physiologically to accelerate human fetal lung maturation. Recent data from this laboratory showed that cortisol and corticosterone conjugates (GCS) rise fivefold in amniotic fluid late in pregnancy and correlate well with the palmitic/stearic (P/S) ratio (&ggr; = 0.79). In this study GCS was compared with various tests of fetal maturation. In a series of 38 cases compared with the lecithin/sphingomyelin (L/S) ratio, the GCS and palmitic acid had the highest concurrence (84% agreement), followed by the “shake” test (82%), cortisol (74%), cytology (64%), gestational age determined by ultrasound (63%), and creatinine (47%). The GCS correlate better than cortisol itself, probably because cortisol in amniotic fluid is derived from the chorionic membrane as well as from fetal urine. These observations provide convincing evidence of a physiologic link between fetal lung maturation and alteration in fetal steroid production.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

&NA;Maternal glucocorticoid treatment affects estrogen synthesis by decreasing estrogen precursors. Whether glucocorticoid has any effect on the placental conversion of estrogen precursors to estrogen is not known. A study was therefore undertaken to investigate the effect of 100 mg of intravenously administered dehydroepiandrosterone sulfate (DHEAS) on estradiol (E2), estriol (E3), and testosterone (T) serum levels. The test was conducted for 5 hours in 10 women treated with intramuscular dexamethasone and in 8 controls during the last trimester of pregnancy. The initial E2and E3serum concentrations were lower in women treated with dexamethasone than in controls, while T serum levels did not display any difference. Following the injection of DHEAS there was a significant increase in E2, with maximal levels reached between 1 and 3 hours after injection in both groups. Maximal levels of E2were equal for both groups. There was no change in E3levels after DHEAS administration in the nontreated group, while the increase in the dexamethasone group was significant. A significant rise in T, with maximal levels reached at 1 hour after infusion, was similar in both groups. It is concluded that maternal dexamethasone does not inhibit the conversion of DHEAS either to E2in the placenta or to E3and T.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID