摘要:

The use of breast stimulation to promote cervical ripening and initiate labor has been studied frequently. However, the various mechanical methods that have been suggested cannot be adequately controlled by the physician. We studied breast electrostimulation as a controllable method of initiating labor in 21 women. This technique successfully induced labor in 15 women, including all nine with premature rupture of membranes. The six (of 12) women without premature rupture of membranes who failed to go into labor each had a Bishop score of 4 or less. All of the successfully induced women delivered vaginally. The time interval from the start of stimulation to birth ranged from 2–13.5 hours, and all infants were born in good condition. Uterine hyperactivity occurred in five cases, but was controlled easily by adjusting the electrical variables of the stimulation. Further work will be needed to establish clearly the indications and safety of breast electrostimulation for induction of labor.

ISSN:0029-7844    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Methamphetamines are a popular class of recreational drugs sometimes abused by women of childbearing age. The effects of methamphetamine abuse on pregnancy outcome and embryofetal development are not known. In this study, we compared pregnancy and fetal outcome in 52 women who abused methamphetamines with a randomly selected control group of 52 non-drug-abusing women. Body weight, length, and head circumference were significantly decreased in neonates born to mothers who abused methamphetamines during pregnancy. However, the frequency of congenital anomalies was not significantly increased in this group.

ISSN:0029-7844    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Present data on the harmful fetal effects of maternal alcohol use have seriously questioned the safety of ethanol treatment, as once prescribed for arresting premature uterine contractions. Therefore, we analyzed retrospectively the fate of infants whose mothers took ethanol for threatened first- or second-trimester abortion in 1968–1973. One hundred thirty-six patients were given an average of 38 g of ethanol (10–120 g) per day for two to 34 days, whereas 103 comparable patients received no ethanol treatment. The immediate and long-term effects on each woman's offspring were followed from birth to age 14. No infant had typical fetal alcohol effects. Fetal growth and the rates of fetal/neonatal deaths and anomalies were similar in both groups. Furthermore, there was no difference in postnatal growth and development. Thus, ethanol treatment as once prescribed for threatened abortion evidently did not cause fetal damage.

ISSN:0029-7844    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The effects of orthostatic stress on cardiac output and systemic vascular resistance have not been previously studied in pregnancy. A Doppler technique of measuring cardiac output was used to study 15 nonpregnant women, 14 pregnant women in the first trimester, and 16 pregnant women in the third trimester. Subjects were studied in recumbent, sitting, and standing positions. In each group, the change from recumbent to standing positions resulted in a fall in cardiac output of 1.7–1.8 L/minute (P=.001). Systemic vascular resistance rose in each group (P=.001). The magnitude of the rise was greatest in nonpregnant women and smallest in the third trimester (P=.005). The observed fall in cardiac output and rise in systemic vascular resistance may be clinically significant in pregnancies complicated by uteroplacental insufficiency.

ISSN:0029-7844    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

We describe four obese, chronically hypertensive women presenting with antepartum pulmonary edema in whom invasive hemodynamic monitoring showed elevated wedge pressure, normal to high cardiac index, and normal systemic vascular resistance. Echocardiography revealed large chambers, thick walls, and increased left ventricular mass with normal systolic but abnormal diastolic function. These findings are indicative of intrinsic volume overload occurring in the presence of impaired left ventricular relaxation, a combination resulting in high filling pressures and pulmonary congestion. Diuretic therapy is indicated in this subset of patients, who could not be recognized by the usual clinical parameters such as history and physical examination, chest x-ray, and arterial blood gas.

ISSN:0029-7844    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Sixty consecutive wound infections were studied among 1104 women undergoing cesarean section. Wound infections caused by cervical-vaginal flora were associated with prolonged labor, particularly with greater duration of fetal monitoring and number of vaginal examinations, and with organisms isolated from the endometrium at cesarean section. In contrast, women with wound infections caused by Staphylococcus aureus had neither prolonged labor nor S aureus isolated at cesarean section. The 25% of wound infections associated with S aureus represent potentially preventable conditions that presumably arise from exogenous sources.

ISSN:0029-7844    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

When a woman requests sterilization, how does her physician decide whether to operate? To answer this question, we analyzed the responses of 341 gynecologists to a survey consisting of clinical vignettes using a new statistical technique, conjoint analysis. The patient factors found to be statistically significant (allP<.00005), in order, were age, parity/timing, and race. Other significant factors (allP<.05) were marital status, family income, and educational level. Within those factors, physicians were most willing to sterilize older, postpartum, parous, black, married, poor, or well-educated women. Groups of physicians analyzed by age, gender, race, practice locale, practice type, religion, and religiosity were remarkably similar in their ordering. By a separate analysis, physicians were more willing to sterilize a diabetic woman than a woman in good health. This study supports the conclusions that factors including age, parity, timing, race, and health influence some gynecologists' decisions to sterilize and that not all gynecologists are willing to sterilize all patients.

ISSN:0029-7844    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Two hundred seventy-two intubated infants who weighed less than 1751 g were enrolled in a clinical trial of phenobarbital prophylaxis of postnatal germinal matrix hemorrhage. The incidence of germinal matrix hemorrhage was 3.1% (one of 32) among infants born to women with toxemia, and 23% (55 of 240) among those born to women without toxemia. The apparent protective effect of toxemia could not be explained by intrauterine growth retardation, mode of delivery, or maternal receipt of any medication. Infants born to toxemic women were less likely than their peers to develop pneumothorax, become acidotic, and to require extensive respiratory assistance. This apparently protective effect of maternal toxemia was not seen in infants born to nontoxemic, hypertensive women. Thus, maternal toxemia, but not hypertension, might reduce the risk of germinal matrix hemorrhage by reducing the occurrence and/or severity of pulmonary and related problems that place infants at high risk of germinal matrix hemorrhage.

ISSN:0029-7844    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The pathologic findings in placentas from ten multiple gestations complicated by the so-called vanishing twin phenomenon were studied to confirm the ultrasonographic evidence. Five pregnancies resulted from in vitro fertilization and embryo transfer, and five conceptions were spontaneous. The pregnancies were studied by repeat ultrasound examinations between five and 12 weeks' gestation. Firsttrimester bleeding was the only clinical sign of this phenomenon. Postpartum evidence of the vanishing twin phenomenon was found in five cases. Morphologically, the lesions were characterized by well-delineated plaques of perivillous fibrin deposition, associated in one case with embryonic remnants. This focal degenerative change of the placental mass, which also exists in about 25% of placentas from uncomplicated term pregnancies, may be the only clue to the disappearance of one conceptus.

ISSN:0029-7844    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

We compared 14 term (37 weeks or more), discordant (15% or more birth weight difference), but not growth-retarded (2500 g or larger) twin pairs with 28 randomly selected term and appropriate for gestational age twin pairs without discordancy. The comparison of the two subgroups showed no significant difference in maternal age, parity, gestational age, incidence of maternal hypertension, or perinatal outcome. It is suggested that discordancy is not a risk factor when the twin pair has reached term and the lighter twin weighs at least 2500 g.

ISSN:0029-7844    

出版商:OVID    

年代:1988

数据来源: OVID