摘要:

Ectopic pregnancy is now the second leading cause of maternal mortality in the United States. We describe changes in ectopic pregnancy mortality and characterize the risk of death from ectopic pregnancy for different groups, using ectopic pregnancy deaths identified by the national Vital Statistics System for 1970–1983, ectopic pregnancy-related deaths investigated by the Centers for Disease Control for 1979–1982, and ectopic pregnancy cases estimated from the National Hospital Discharge Survey for 1970–1983. During both 1970–1976 and 1977–1983, women of black and other races were at significantly increased risk of death from ectopic pregnancy compared with white women. This increased risk held for all ages and all geographic regions. Little variation existed in the risk of death from ectopic pregnancy by age and geographic region. From 1970–1983, the risk of death from ectopic pregnancy declined among all races and ages in all regions. These data suggest that black women, and in particular teenagers and older women, may have inadequate access to gynecologic and prenatal services. Active outreach may reduce the risk of death from ectopic pregnancy.

ISSN:0029-7844    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

One hundred fourteen cases of tubal pregnancy were examined for evidence of active or chronic salpingitis, other anatomic and functional etiologies, and the side of the corpus luteum relative to the pregnancy. A corpus luteum was found ipsilateral to the tubal pregnancy in 80 cases (70%) and contralateral in 18 (16%). In 16 cases (14%), the position of the corpus luteum could not be identified by inspection. No differences were noted among the groups in days from last normal menstrual period or the incidence of irregular bleeding. Of the 98 cases in which a corpus luteum was identified, 53 women (54%) had at least one condition that could be considered etiologic for tubal pregnancy, including 38 (39%) who had microscopic evidence of chronic salpingitis. No association was found between the laterality of the corpus luteum and the presence of risk factors, including mechanical factors. Possible explanations for absent corpora lutea in association with tubal pregnancies are discussed.

ISSN:0029-7844    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Chorionic villus sampling is being considered as an alternative to amniocentesis for genetic evaluation. The risk of subsequent spontaneous abortion from this invasive proce-dure, however, remains unclear. A prospective analysis of pregnancy outcome after ultrasound documentation of fetal viability at eight to 12 weeks' gestation was carried out in an uninstrumented population of patients to establish a background loss rate against which to evaluate the safety of chorionic villus sampling. All patients presenting to the authors' private practice from December 1983 to January 1986 were enrolled in the study. An ultrasound examination was performed at the first visit to confirm intrauterine pregnancy and assess gestational age; in gestations less than eight weeks, the sonogram was repeated four weeks later. Four hundred eighty-nine delivered patients are the subject of this study. We evaluated the differences between this group and those patients presenting either with a blighted ovum or beyond the first trimester, as well as the outcome of those patients with spotting early in gestation. This study suggests that if a live fetus is documented by ultrasonography at eight to 12 weeks' gestation, the risk of spontaneous abortion before 20 weeks' gestation in an uninstrumented population is 2.0%.

ISSN:0029-7844    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Birth weight-specific fetal death rates were evaluated for Alabama for the years 1974–1983. The fetal death rate for the total low birth weight group improved less than 20% during the decade, whereas the fetal death rate for the 2500–3999-g birth weight group improved 40%, and the fetal death rate for the group of 4000 g or more improved 71%. By 1983,76% of all stillbirths weighed less than 2500 g, compared with 66% in 1974. In contrast, in both years, only about 7% of live births weighed less than 2500 g. This study suggests that increased reporting of stillbirths of less than 500 g has contributed to the recent apparent lack of improvement in stillbirth rates in Alabama.

ISSN:0029-7844    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

The objective of this study was to compare the effectiveness of three sperm separation techniques for producing samples free of seminal fluid microbes. Each of 11 semen samples were separated by the following techniques: wash, with centrifugation only; swim-up, with undiluted semen layered beneath medium; and wash and swim-up, with centrifuged sperm cells overlain with medium. Microbiology for both aerobic and anaerobic organisms of semen and washes was determined by standard methods. The microbes isolated from semen were similar to those found in previous reports. However, the swim-up technique proved more successful than either the wash or the wash and swim-up methods for the recovery of sterile spermatozoa (ten of 11 versus four of 11,P< .05). It is recommended that the swim-up technique, with medium supplemented with penicillin and streptomycin, be used when preparing sperm samples for placement into the female reproductive tract.

ISSN:0029-7844    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

The skin collagen content, skin thickness, metacarpal index, and forearm bone mineral content in postmenopausal women showed a similar decline of between 1–2% per year after the menopause. All four parameters showed a decline that was significant when compared with the years from the menopause. Significant correlations between all four parameters suggest that a similar pathology causes the decrease in bone mass and skin thickness—a decline in the connective tissue element that is common to both bone and skin.

ISSN:0029-7844    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

The Core-Tex surgical membrane, expanded polytetrafluoroethylene, has been used as a pericardial graft with minimal adhesion formation reported. The purpose of this study was to assess its efficacy as a barrier method for diminishing postoperative peritoneal adhesions in an animal model. Fifteen New Zealand white rabbits underwent laparotomy, with scrape and cut lesions created bilaterally on the uterine body and horns, respectively. On one side, the lesions were covered with the graft using 7–0 Gore-Tex suture; the contralateral side served as an internal control. After four weeks, the adhesions were graded and mean adhesion scores were calculated. The Gore-Tex score was 4.1 times higher than the control for scrape lesions and 1.9 times higher for cut lesions, but the difference was not statistically significant in either case. Overall, the Gore-Tex mean adhesion score was 2.3 times higher than the control, a statistically significant difference. The Gore-Tex surgical membrane did not appear to be an effective adjuvant for postoperative adhesion prophylaxis in this animal model.

ISSN:0029-7844    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

This study was undertaken to examine whether spontaneous labor at term is associated with changes in the amniotic fluid concentrations of arachidonate lipoxygenase metabolites. Amniotic fluid was obtained from 15 women at term in active labor (with cervical dilatation of at least 6 cm) and from 15 nonlaboring control women matched for maternal age, parity, and gestational age. Cultures of amniotic fluid for bacteria and mycoplasma were negative. Products of arachidonate lipoxygenase metabolism-12-hydroxyeicosatetraenoic acid (12-HETE), 15-hydroxyeicosatetraenoic acid (15-HETE), and leukotriene B4-were measured by radioimmunoassay. The median concentrations of 12-HETE, 15-HETE, and leukotriene B4 in the amniotic fluid of nonlaboring women were 11.50 ng/mL, 0.45 nglmL, and 21 pg/mL, respectively, and in the amniotic fluid of laboring women, 24.63 ng/mL, 4.34 nglmL, and 96 pg/mL, respectively. The differences between labor and nonlabor amniotic fluid concentrations of all three lipoxygenase products were significant (P C .05, Wilcoxon test). These observations are consistent with involvement of products of the lipoxygenase pathway of arachidonic acid metabolism in the mechanism of human parturition.

ISSN:0029-7844    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Normal labor begins most frequently between midnight and 2 AM, presumably because of an unidentified circadian labor-activating mechanism. We used records of the Collaborative Perinatal Project to determine whether such a circadian mechanism is present with intrauterine growth retardation (IUGR) or preterm birth, and whether chorioamnionitis is associated with alternative patterns. In the absence of chorioamnionitis, both preterm births and term births with IUGR demonstrated nocturnal labor onset distributions like those of control term deliveries, which had a peak incidence at 1:45 AM and an amplitude of 35%. With chorioamnionitis, in contrast, there was a different circadian distribution of term labor onset hour, with a peak at 7:45 PM and a 32% amplitude. A similar trend was found among preterm births. These data suggest the presence of the normal nocturnal labor-activating mechanism in both growth-retarded term deliveries and a defined subset of preterm deliveries. Chorioamnionitis appears to be associated with a prominent, unidentified alternative laboractivating mechanism that is maximal in the evening.

ISSN:0029-7844    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

A retrospective review of placental material derived primarily from preterm deliveries was conducted and inflammatory changes graded on a scale of 0–3. Reviewers were blind as to the clinical outcomes. Other reviewers, unaware of the pathologic results, surveyed the clinical data, and results were combined for analysis. The findings suggest that placental and membrane inflammation probably precedes preterm spontaneous rupture of membranes in 8–30% of cases without labor. The duration of ruptured membranes and labor enhance the frequency of inflammation. Inflammation is not associated with significant puerperal infection unless cesarean delivery occurs. Perinatal morbidity and mortality were not significantly enhanced nor associated with conservative management of spontaneous preterm rupture of membranes in this population beyond the influence of fetal weight and gestational age.

ISSN:0029-7844    

出版商:OVID    

年代:1987

数据来源: OVID