摘要:

Analysis of autopsy data shows that, from the 26th through the 38th gestational weeks, fetal brain weight (BrW) is a function of the 3.124 power of the largest head circumference (HC). Because there is excellent correlation between prenatal ultrasound measurement and postnatal tape measurement of the HC, it is possible to determine fetal BrW in utero. An alteration of the BrW:somatic weight (SW) relationship is an important physical stigma of asymmetric intrauterine growth retardation (IUGR). The value of longitudinal studies of fetal BrW and SW as a means of discriminating between normal and asymmetric growth is tested in a population at risk for IUGR.

ISSN:0029-7844    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Prior studies on twin biparietal growth have resulted in conflicting conclusions. This study was designed to establish definitive criteria based on both ultrasonic biparietal diameter (BPD) and newborn anthropometric data for normal versus abnormal growth in multiple pregnancies. Fetal BPD and newborn head circumference values among concordant twins were similar to those of appropriate for gestational age (AGA) singletons at all gestational ages. Singleton standards can therefore be applied to evaluate the adequacy of twin BPD growth even in the third trimester. Ultrasonic criteria for the diagnosis of discordancy include an intrapair difference in BPD of 5 mm or more and an intrapair difference greater than 5% in ultrasonically measured fetal head circumferences. Discordant BPD growth noted prior to the third trimester suggests twin-transfusion syndrome and is associated with a high perinatal mortality. In contrast, divergent BPD growth beginning after 30 weeks' gestation appears to have a better prognosis.

ISSN:0029-7844    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Six hundred seventy-eight sonar measurements of the fetal biparietal diameter (BPD) were used to assess the intrauterine growth of 182 twins between 18 and 40 weeks' gestation. These values, as well as the weight and body length at birth, were related to the zygosity, which was determined by sex of the infants, histologic examination of placenta, or blood grouping. The mean BPD of twin 1 was larger than that of twin 2 in both monozygotic and dizygotic pairs throughout the study period (P <.001). The size of BPD of the dizygotic infants exceeded that of the monozygotic among both twins 1 (P <.001) and twins 2 (P <.001). The absolute intrapair differences of birth length and weight were larger among dizygotic than among monozygotic twins. These findings suggest that in late pregnancy a substantial one-way intertwin transfusion among monochorial twins does not occur frequently enough to mask the inherent genetically determined similarity between the twins. The appearance already in the second trimester of the difference in the longitudinally monitored BPD between monozygotic and dizygotic twins suggests that the discrepancy is determined early in gestation.

ISSN:0029-7844    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Carbohydrate metabolism was evaluated in 24 women with a twin pregnancy and 24 women with a singleton pregnancy. The groups were of similar age, parity, weight, and gestational age. In each woman an intravenous glucose tolerance test was done using a 25-g glucose load in the last half of gestation. Both blood glucose and plasma insulin levels were measured and statistically compared. The plasma human placental lactogen levels were significantly higher in the women with the twin gestation (7.3 ± 0.7 versus 4.7 ± 0.3 μg/ml). Although the glucose disappearance rates (K) were not different, there was a significantly lower fasting as well as 5− and 15-minute blood glucose value in the twin pregnancy group. There was also a significantly lower 15-minute insulin level in the twin group. The importance of these findings to the clinical management of twin pregnancies and to the understanding of the metabolic changes in pregnancy is discussed.

ISSN:0029-7844    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

The authors performed a prospective analysis of the value of a system for scoring the risk of preterm delivery (RPD). The RPD system predicts that approximately 10% of patients will have preterm labor and delivery. Although only one third of these patients deliver before term, they account for approximately two thirds of all preterm births. The discrimination of the RPD system is better for multi-gravid patients than for primigravid patients, and rescoring at 26 to 28 weeks' gestation improves the accuracy of prediction.

ISSN:0029-7844    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Although nausea and vomiting associated with early pregnancy are extremely common, the causal factors remain obscure. An endocrine etiology for this problem persists as a popular but unproved theory. The present study explores possible correlations between serum levels of human chorionic gonadotropin (hCG) and 17-hydroxyprogesterone (17-OHP) and the presence or severity of nausea and/or vomiting in women in the first 16 weeks of pregnancy. The occurrence and severity of nausea and/or vomiting in women with hydatidiform moles in relation to serum hCG levels were also investigated. Levels of hCG and 17-OHP in pregnant women grouped on the basis of severity of nausea and vomiting are compared to each other and to the levels found in normal pregnancies. No relationship could be established between the levels of hCG and 17-OHP and the incidence and severity of nausea and vomiting in either pregnant patients or in women with molar pregnancies.

ISSN:0029-7844    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Abruptio placentae and placenta previa are responsible for at least half the excessive fetal and neonatal deaths associated with maternal smoking during pregnancy. Data from a large prospective study were analyzed to determine if stopping smoking reduced the frequency of these disorders. Mothers who stopped smoking had a 23% lower frequency of abruptio placentae and a 33% lower frequency of placenta previa than women who continued to smoke during pregnancy. The mothers who stopped smoking had only about half as many fetal and neonatal deaths due to abruptio placentae and one third fewer losses to placenta previa than did mothers who continued to smoke. These seeming benefits of stopping smoking were greatest in mothers 30 years of age and older.

ISSN:0029-7844    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Uncertainty concerning the importance of luteal phase defects as a cause of female infertility is closely related to problems of diagnosis. A study was undertaken of the consistency of the parameters used in diagnosing luteal phase deficiency in 14 patients; results of randomized treatment regimens were also compared. Specific diagnostic criteria utilizing the basal body temperature (BBT) chart, endometrial biopsy, and progesterone levels were used. Prolactin and luteinizing hormone levels were measured at the time of progesterone determinations. Of the 29 cycles studied, only one third showed consistent abnormalities in BBT chart, endometrial biopsy, and progesterone levels. Discrepancy between the endometrial biopsy and the progesterone level occurred in at least 50% of all cycles studied. Prolactin levels were elevated in only 1 patient, suggesting a minor role for altered prolactin metabolism in luteal phase deficiency. Randomized treatment with progesterone vaginal suppositories, clomiphene citrate, and no treatment resulted in pregnancy in 5 of 14 patients (36%).

ISSN:0029-7844    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Condylomata acuminata virus accounts for a significant number of venereal infections in the western world and constitutes a major public health problem. Unfortunately, conventional therapeutic measures have given inconsistent and largely unsuccessful results for the elimination of genital warts. A 3.5-year experience with 110 women using the carbon dioxide (CO2) laser for evaporation of viral warts is presented. Six patients (5.5%) developed recurrent lesions and were retreated. Several patients were staged for 2 or 3 treatments because of extensive condylomata; this occurred especially during pregnancy and other altered states of immunity. The principal advantages of CO2laser therapy are precision, which results in sparing of normal tissue; probable elimination of the infective agent; and rapid healing without scar formation. Sixty-three patients had atypical cytology associated with condylomata acuminata; this finding suggests an association with lower genital tract neoplasia.

ISSN:0029-7844    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Attention is drawn to relaxation of the pelvic viscera, one of the remote complications of the surgical procedure employed for cure in invasive carcinoma of the vulva. Though seldom discussed in the literature, this problem complicated 17% of the 58 radical vulvectomy procedures in this series. Justification is discussed for the performance of reconstructive or preventive surgical procedures during the primary operation.

ISSN:0029-7844    

出版商:OVID    

年代:1980

数据来源: OVID