摘要:

&NA;Morphologic studies were performed on 25 uteri obtained at different times during the menstrual cycle, ranging from 2 to 140 hours following the onset of menstruation. The amount of endometrium desquamated varied; usually only the more superficial parts—the compacta layer and small areas of the spongiosa— were shed, but in some instances desquamation extended almost to the muscularis. The remaining spongiosa, depleted and shrunken, is misleading in its appearance, resembling a basalis layer. Actually, such a layer appears morphologically distinct only during the initial parts of the cycle and undergoes secretory changes at the same rate as the rest of the endometrium. Desquamation and regeneration coexist, desquamation appearing almost complete by 60 hours, whereas regenerating epithelium is seen as early as 36 hours. Complete regeneration takes place by 140 hours after the initiation of menstruation.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

&NA;A review of recent experience with clomiphene citrate at the Yale‐New Haven Medical Center yields the following conclusions: 1) Clomiphene citrate administered at high doses (150 mg and 200 mg) is effective in inducing ovulation in women who would otherwise have failed to conceive if treatment were restricted to only lower dosage regimens. 2) Therapy with clomiphene citrate should be initiated with the 50‐mg dose. The 100‐mg dose should be reserved for those who fail with the lower dose. 3) Children resulting from clomiphene‐induced ovulations appear to be developing normally both mentally and physically. Congenital malformations found in children from clomiphene‐induced pregnancies are those seen commonly in general obstetric practice resulting in no significant problems for the children. 4) After 3 ovulations with clomiphene citrate approximately 50% of the patients can be expected to conceive. A 50% conception rate after 3 ovulations with clomiphene citrate does not represent a discrepancy between ovulation rates and pregnancy results, for it agrees statistically with the results obtained for the general population.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

&NA;Ovarian follicular growth was stimulated in 4 patients with clomiphene resistant polycystic ovary (PCO)‐like disease, with “pure” human pituitary FSH during 10 cycles. In 8 cycles additional hCG was given to induce ovulation. Serum LH and FSH and plasma estradiol and progesterone were determined daily. From the response patterns of steroidogenesis, four functional stages of follicular development can be distinguished, each subsequent stage being characterized by an increasing spontaneous estradiol production and a decreasing capacity to produce extra estradiol in response to stimulation with additional hCG. It is concluded that the unpredictable response to gonadotropin stimulation of patients with PCO‐like disease is due to the varying state of development of the follicles at the start of the stimulation. The suggestion is made, based on the different responses in 3 cycles of the same patient (EW), that the lack of positive estrogen feedback in patients with PCO‐like disease may be a hyposensitivity to estrogens rather than an absolute insensitivity.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

&NA;Inin vitrostudies it was found that, in the presence of added NADPH, the human placenta metabolizes progesterone to 20&agr;‐hydroxy‐4‐pregnen‐3‐one at increasing rates as pregnancy advances. A fivefold increase in 20&agr;‐hydroxysteroid oxidoreductase activity is observed in term placentas compared with the enzymic activity of placentas of 12 to 20 weeks' gestation (368 ± 53 pmoles/mg protein/hr vs 71 ± 8 pmoles/mg protein/hr). The 5&agr;‐reductase and 3&bgr;‐hydroxysteroid oxidoreductase activities were similar in placentas obtained from early and late human pregnancies.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

&NA;Twenty‐five patients reporting a marked diminution in fetal activity at term in otherwise normal pregnancies were compared with 25 controls, matched for age, parity, and other factors, in whom movements were reported to be vigorous. Fetal well‐being was assessed by maternal serum human placental lactogen concentration, maternal urinary estriol excretion, and fetal scalp blood acid‐base values and hemoglobin concentration. Fetal biologic maturity was assessed by liquor creatinine concentration, percentage of orange cells on Nile blue staining, and “shake” testing. The 2 groups of patients showed no difference in fetoplacental well‐being or degree of fetal biologic maturity.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

&NA;Three hundred fifty real‐time scans were performed on pregnant women for various indications. Placental localization was satisfactorily obtained in 173 of 174 studies. Estimates of fetal gestation from directly measured biparietal diameter were ±2 weeks of actual gestation in 153 of 172 (88.9%) measurements. The presence or absence of fetal motion and cardiac activity established a diagnosis of fetal viability or fetal death in 32 patients after the first trimester. Accurate diagnosis was made in 52 of 57 patients with threatened abortions, and two of these errors occurred in scans performed before completion of the eighth postmenstrual week. Because of the ability to demostrate fetal motion, real‐time sonography should have many applications in obstetrics.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

&NA;&bgr;‐Adrenergic agents are used to inhibit preterm labor and glucocorticoids to accelerate fetal pulmonary maturation. A study was designed to investigate the metabolic effects of intravenous infusion of ritodrine (150 to 100μg/min) or isoxsuprine (200 to 150μg/min) in a series of 28 patients with gestations of 28 to 40 weeks, with and without concomitant dexamethasone therapy. Ritodrine was more potent than isoxsuprine in increasing the circulating levels of cyclic AMP, glucose, insulin, and triglycerides. The diabetogenic effect of both ritodrine and isoxsuprine was so slight that it did not have any clinical significance in women with normal glucose tolerance. The results were similar when these &bgr;‐adrenergic tocolytics were given to women concomitantly with intramuscular dexamethasone therapy, although dexamethasone appeared to minimally impair carbohydrate metabolism. Both ritodrine and isoxsuprine caused a significant fall in serum iron and potassium, and this effect was unaltered by dexamethasone. Serial serum potassium levels should be obtained during long‐term infusion of &bgr;‐mimetics.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

&NA;A total of 2702 transabdominal amniocenteses performed at the Los Angeles County‐University of Southern California Medical Center were reviewed, with particular emphasis on 392 samples performed beyond 41 weeks' gestation. A significant rise in the percent of amniocenteses with meconium staining was found to occur at and beyond 39 weeks. Meconium‐stained fluid at amniocentesis was found to be associated with an increased incidence of babies weighing > 4000 g, maternal diabetes mellitus, and cesarean deliveries, in comparison to samples with clear amniotic fluid. Infants with meconium‐stained fluid had an increased incidence of low 1‐minute Apgar scores, but all 5‐minute Apgar scores were 7 or greater. Ten perinatal deaths occurred after an amniocentesis with clear fluid in prolonged pregnancy, with four of these occurring within 7 days of amniocentesis. Lecithin/sphingomyelin (L/S) ratios less than 2.0 were found in 6% of amniocenteses performed beyond 41 weeks. However, none of the newborns with low L/S ratios developed subsequent neonatal respiratory distress syndrome. Amniotic fluid creatinine values or blood‐contaminated fluid were not found to be correlated with fetal outcome. No fetal mortality was attributable to amniocentesis. In view of the significant amount of false‐positive and falsenegative results, and the rare inherent danger associated with amniocentesis, its use solely to demonstrate the presence or absence of meconium staining appears to be of questionable value in the management of prolonged pregnancy.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

&NA;Amniography for the visualization and confirmation of suspected neural tube defect was performed in 9 midtrimester gravidas. In all cases, amniotic fluid alpha‐feto protein (AFP) was abnormally elevated. Four cases of ariencephaly and one of spina bifida were demonstrated by amniography. These pregnancies were terminated and the defects were confirmed by gross pathologic examination. In 4 remaining cases, amniography was normal. Three of these pregnancies proceeded to term, culminating in the birth of a normal child. The fourth patient had spontaneous abortion of a normal fetus at 23 weeks of gestation. The experience reported here suggests that amniography is an important adjunctive diagnostic technique in the prenatal diagnosis of neural tube defect, and if used correctly, may significantly reduce the chance of false‐positive diagnosis.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

&NA;Seventy‐two patients with gestational diabetes were randomly treated with insulin (20 units NPH and 10 units regular) and diabetic diet, diet alone, or neither. Of the 27 patients treated with insulin and diet, 2 (7%) had babies weighing more than 8½ pounds. Of the 11 patients treated with diet alone, 4 (36.4%) had babies weighing more than 8½ pounds. Of the 34 patients treated with neither diet nor insulin, 17 (50%) had babies weighing more than 8½ pounds. These data support the hypothesis that treatment of the gestational diabetic with insulin will reduce the incidence of fetal macrosomia.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID