摘要:

In a prospective clinical study from an unselected areabased population, the influence on birth weight for gestational age (standardized birth weight) was studied with special respect to risk factors for intrauterine growth retardation. Smoking was the most important risk factor: 16% of the mothers smoked at least ten cigarettes per day, and the influence of smoking on standardized birth weight was highly significant (P<.001). Maternal age in itself had no effect on standardized birth weight. However, among smokers the reduction in standardized birth weight became more pronounced with increasing maternal age (P<.001). Longterm smoking has been reported to increase the risk of severe placental complications. This study emphasizes that elderly smokers also must be considered to be at a higher risk than younger smokers for developing fetal growth disturbances.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

The hemodynamic changes after intravenous administration of hydralazine were assessed using M-mode echocardiography in 13 pregnant patients with severe hypertension. The patients were divided into two groups: eight who had preeclampsia (group 1) and five who had essential hypertension and/or superimposed preeclampsia (group 2). Patients in group 1 had significantly lower pretreatment cardiac indexes and higher systemic vascular resistances (P<.01) than did patients of group 2, despite similar mean blood pressure values. Thirty minutes after intravenous administration of 12.5 mg hydralazine, a significant decrease in mean arterial pressure (21%) and systemic vascular resistance (41%) and also a significant increase in heart rate (22%) and cardiac index (33%) were observed in group 1. The hemodynamic response in group 2 was attenuated; the mean arterial pressure and systemic vascular resistance fell by an average of 11 and 13%, respectively. The posthydralazine percent changes in mean blood pressure for the total patient population did not correlate with the initial values of blood pressure (r=.091). In contrast, the percent reduction in systemic vascular resistance after administration of hydralazine inversely correlated with the control values of vascular resistance (r=-.742). These findings indicate that cardiovascular response to acute hydralazine administration is related to the baseline hemodynamic setting. M-mode echocardiography seems to be a reliable method for comprehensive analysis of cardiovascular effects of pharmacologic intervention in pregnant women with hypertension.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

The gross and microscopic effects of exposing placenta and umbilical cord to meconium were studied in vitro. Gross staining begins with one hour and is a surface phenomenon proportional to length of exposure and meconium concentration. Pigment penetration into the membranes with subsequent uptake by macrophages is dependent primarily on exposure length. Eight of 11 placentas exposed to various meconium solutions were found to have meconium pigment- laden macrophages in the amnion after one hour. These were seen in the chorion somewhat later. Although only three of 11 placentas showed chorionic pigmented macrophages at one hour, 12 of 12 exhibited this finding after three hours. Amniotic epithelial degeneration also showed a time correlation. These findings, especially the microscopic changes described, permit more accurate determination of the defecation-to-birth interval.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Dilatation and evacuation was reported recently to be a safe and effective method for the treatment of intrauterine fetal death. The current authors have treated ten cases of intrauterine fetal death with dilatation and evacuation. Five patients (50%) developed coagulopathy, one of whom also developed endometritis. Patients who developed coagulopathy were significantly older than those who did not. Previous pregnancy also was associated with the development of coagulopathy. Five of six multigravidas developed coagulopathy, whereas none of the four primigravidas developed this complication. Other factors that may have contributed to the development of coagulopathy are discussed. The authors conclude that dilatation and evacuation for midtrimester intrauterine fetal death may not be as safe as has been reported.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

In 19 healthy women the levels of plasma lipoprotein fractions were determined before conception, at exact: gestational ages every six to 8 weeks during pregnancy, and eight weeks after delivery. The high density lipoprotein level was elevated in the 14th week and showed a maximum rise by 41% in the 28th week of pregnancy because of a doubling of the high density lipoprotein2level. The low density lipoprotein level decreased in early pregnancy but then increased continuously. The very low density lipoprotein triglyceride concentration showed a continuous increase from week 14, and in week 36, it was three times higher than before pregnancy. During lactation, eight weeks after delivery, the low density lipoprotein concentration remained elevated, whereas the other lipoproteins had returned to prepregnancy levels.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

The relative frequency of Kell (K:1) antibodies in pregnant women and a series of cases of Kell hemolytic disease of newborns were evaluated to review the strategy of managing potential disease. Among reproductive-aged women, Kell antibodies are about 60% as frequent as Rho(D) antibodies, but Kell disease is only 3% as common as Rhohemolytic disease. The reason is related to frequent transfusion- alloimmunization by Kell antigen and the low frequency of the K:1 gene among fathers. Kell hemolysis is severe in about half of cases. Amniocentesis is indicated in only a few circumstances: previous child with erythroblastosis fetalis, significant increase in maternal Coombs titer, presence of Kell antigen in the father, and after comparison, of the relative risks of hemolytic disease and amniocentesis in each patient. Screening for Kell antigen before transfusing premenopausal women would be a means of avoiding erythroblastosis, but the rarity of severe disease does not justify this approach.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

The ultrasonically determined growth of the fetal liver during normal pregnancy is presented. The normal range of fetal liver sizes for each week of pregnancy from 20 weeks' gestation to term was determined. A linear relationship between fetal liver and abdominal circumference measurements also is described. Value and potential applications of this new fetal parameter are discussed.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

To evaluate the significance of the route of delivery for preterm breech deliveries, a retrospective study was performed on 136 infants in breech presentation, weighing less than 1500 g. Thirty-seven (27%) were delivered vaginally, and the remaining 99 (73%) by cesarean section. Although perinatal mortality was higher in the vaginally delivered infants than in those born by cesarean section (54 versus 37%), statistical significance was not shown. One-fourth of the deaths in the vaginal delivery group occurred intrapartum. Although most previous studies have suggested improved outcome with delivery by cesarean section, the present study fails to demonstrate any statistically significant difference. Whether there is, in fact, no difference in outcome attributable to the route of delivery or a difference exists that is not demonstrable by a retrospective study is an open question. It is concluded that the design of the present retrospective study, as in all published studies on this subject, confounds the results and thereby makes conclusions precarious. The limited value of nonrandomized retrospective studies for the evaluation of a certain obstetric procedure is discussed.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Inorganic sulfate (SO4) is an essential metabolite for the synthesis of sulfated mucopolysaccharides and steroid sulfates in the fetus and placenta. The authors' previous study of pregnant women at delivery revealed a substantial increase in serum SO4compared with nonpregnant adults. To determine whether or not this difference was related to altered renal handling, creatinine clearance and SO4reabsorption was measured in 43 women in the third trimester of pregnancy and in 22 nonpregnant control subjects. Serum SO4was 32% higher in the pregnant women than in control subjects. Urinary excretion of SO4was unchanged, but absolute reabsorption of SO4was significantly higher. Blood pressure, serum creatinine, and serum chloride were significant predictors of serum SO4. As a group, women with hypertension (diastolic blood pressure greater than 80 mmHg) had a significantly higher serum SO4than those with normal blood pressure. One result of the increased SO4reabsorption by maternal kidney is that it generates a larger maternal reservoir on which the fetoplacental unit can draw for its biosynthetic needs.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Forty-eight of 100 pregnant women received a 100-g (nonfasting) glucose screening test at about 28 weeks' gestation, followed by a 100-g glucose tolerance test. Another 52 received a 100-g (nonfasting) glucose polymer screening test followed by a 100-g glucose polymer tolerance test. Mean plasma glucose one hour after the glucose screening test was significantly lower than after the glucose polymer screening test. A further 178 women received a glucose polymer screening test and a glucose polymer tolerance test (230 in total). These women and the infants they delivered were studied to derive diagnostic criteria for the 100-g glucose polymer tolerance test by correlating maternal carbohydrate tolerance with indexes of neonatal metabolic performance, and to determine an adequate method of screening for carbohydrate intolerance of pregnancy (gestational diabetes). Diagnostic criteria similar to those of O'Sullivan and Mahan were also developed for the glucose polymer tolerance test. These values are up to 5% lower than those recommended by the National Diabetes Data Group (1979) for the 100-g glucose tolerance test.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID