摘要:

Serial measurements were made of the concentrations of maternal serum human placcntal lactogen (hPL) (300 determinations), estriol (E3) (460 determinations), and estetrol (E4) (275 determinations) in normal human pregnancy during the third trimester period. Simultaneous determinations of serum hPL, E3, and E4were also made sequentially on blood samples from 6 diabetic and 5 toxemic pregnant women to ascertain the relative usefulness of these parameters as indicators of fetal welfare. In uncomplicated diabetic patients controlled with insulin, all parameters increased with gestational age. In three pregnancies complicated by severe toxemia in which fetal distress progressed to intrauterinc fetal death, both serum E3and E4levels decreased progressively, but E4concentration started to decrease at least 1 day earlier than E3prior to fetal death. In other women, the E3levels appeared to drop or decrease significantly whereas the E3levels remained almost unchanged. Daily hPL levels remained low in chronic fetal distress and, therefore, appeared to be of minimal value for predicting either intrauterine death or acute fetal distress. Therefore, serum E4measurement seems to provide a more sensitive and reliable indicator of fetal morbidity than the measurement of serum E3during toxemic pregnancies.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

The pathogcnesis of placenta previa was analyzed in a large prospective study that included more than 1000 medical, demographic, hereditary, and postmortem variables. It caused 73 perinatal deaths per 100,000 births. The frequency of the deaths increased with short maternal stature, increasing parity, prior preterm deliveries, and prior perinatal deaths. More male infants died than females. Placentas showed diffuse hyperplastic enlargement of terminal villi, marginal decidual necrosis, and marginal thrombi. These abnormalities were likely related to blood loss and abruption. Both the infants who died and those who survived had a pattern of fetal growth retardation characteristic of undcrnutrjtion. Long-term physical growth and psychomotor development were normal in the surviving infants except for a small excess of neurologic abnormalities.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Shoulder dystocia is an infrequently encountered obstetric emergency varying in incidence from 0.15 to 0.60% of all deliveries. Previously identified risk factors include maternal obesity, previous infants weighing greater than 4 kg, maternal diabetes, and fetal macrosomia (> 4 kg). To evaluate the role of prolonged second stage of labor (PSS) as a warning sign for shoulder dystocia, 9864 deliveries at LAC-USC Women's Hospital were retrospectively reviewed. Ninety percent delivered vaginally and 4.89% had PSS with midpelvic delivery. Shoulder dystocia occurred in 0.37% of all vertex vaginal deliveries. In the absence of PSS and midpelvic delivery, the incidence of shoulder dystocia was 0.16%. However, with PSS and midpelvic delivery, the incidence of shoulder dystocia was 4.57% (P< 0.01). Infants weighing in excess of 4 kg were at increased risk of shoulder dystocia compared with infants weighing less than 4 kg. When PSS occurred and midpelvic delivery was attempted, the incidence of shoulder dystocia was 21% in infants weighing in excess of 4 kg; 8% had had failed vaginal delivery. All shoulder dystocias and failed vaginal deliveries occurred after use of the vacuum extractor. Immediate neonatal injury was apparent in 47% of infants with shoulder dystocia after PSS with midpelvic delivery. There were no maternal or fetal deaths related to shoulder dystocia during the study period.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

A study of the effect of posture on plasma renin activity (PRA) in the third trimester in 27 gravidas revealed a significantly greater increase in PRA in the supine position, compared to the left lateral. The women were classified into 3 groups: normal pregnancy, preeclampsia, intrauterine fetal death. There was no statistical difference in PRA among the 3 groups. It is assumed that the increase of PRA in the supine position was due mainly to mechanical pressure by the gravid uterus on the great vessels (regardless of whether the fetus was dead or alive) and that effective circulatory volume was thus reduced. However, low PRA in the left lateral position in women with preeclampsia seemed to correlate with more severe disease in these women.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Fifty-one women in labor had continuous monitoring of fetal scalp tissue pH, fetal heart rate by ECG, and uterine contractions. A miniature pH electrode secured by a double spiral fetal ECG electrode was used for measurement of fetal pH every 15 seconds. The results were correlated with fetal scalp blood pH values obtained simultaneously. Fetal scalp sampling is intermittent, requires repeated scalp incisions, is subject to errors due to air mixing and coagulation of the blood sample, and is uncomfortable for the parturient. Placement of the tissue pH electrode allows continuous data recording with the minimum discomfort to the patient and the least number of fetal scalp incisions. Clinical use of the tissue pH electrode might be a practical alternative to fetal scalp samples, if the data obtained accurately reflect fetal status.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

In order to accelerate fetal lung maturation 46 pregnant women were given either dexamethasone or betamethasone intramuscularly during 3 consecutive days during 29–36 weeks of gestation. At birth, the infants appeared to have intact humoral immune function in that they could produce normal amounts of immunoglobulinsIn utero, and 2 fetuses responded with increased synthesis of IgA or IgM following premature rupture of the membranes. The clinical course did not show any increased incidence of puerperal or neonatal illness attributable to intrauterinc infection.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Chromosome studies of embryos were done in abortions induced at the early stage of pregnancy in women 35 years of age and older who had no signs of threatened or spontaneous abortions and were considered to have oocytes of an advanced age. Karyotypes were successfully determined in 256 cases and the results were as follows: a) 2 of 123 cases in 35− to 39-year-old women showed an incidence of chromosomal anomalies as high as 1.6%; 7 of 117 cases in 40− to 44-year-old mothers an incidence of 6.0%; and 4 of 16 mothers in the 45− to 49-year-old age group an incidence of 25.0%; b) all chromosomal anomalies were trisomies, mainly trisomy 21 and 18. These results suggest that the incidence of chromosomal anomalies increases in older pregnant women, especially in premenopausal pregnancies, and that non-disjunction may occur during meiosis.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

To evaluate effects on the fetus and neonate, 53 paracervical blocks were administered to 38 low-risk parturients using a controlled superficial injection of 0.25% bupivacaine. Continuous fetal heart rate monitoring revealed no instance of bradycardia or late deceleration pattern. Apgar scores, cord arterial and venous pH values, and neurobehavioral evaluations of the neonates were similar to those observed in other low-risk patients. The effectiveness of pain relief of the blocks was less than expected or reported by other authors. Although we observed no harmful effects on the fetus or neonate from the superficial paracervical injection of bupivacaine, we did not find this combination of drug and technique to give dependable, effective pain relief in labor.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

The acid-base balances of 63 neonates delivered either spontaneously or by the vacuum extractor or low forceps were compared. The outcome was similar in neonates delivered by vacuum extractor or forceps. However, significant differences were noted in the pH and base deficit of infants born by instrumental versus spontaneous delivery. These differences were no longer present when groups with similar duration in the second stage of labor were compared. We conclude that the use of instruments for outlet vaginal delivery carries no additional risk for the fetus.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Simultaneous sampling of amniotic fluid from two sites within the amniotic cavity proximal and distal to the fetal mouth was performed. The lecithin-sphingomyelin (L/S) ratio of amniotic fluid obtained close to the fetal mouth was usually higher than that of amniotic fluid obtained from a site distal to the fetal mouth (20 of 26 cases). Differences of up to 0.7 in the two L/S ratios were measured. This suggested that pooling of amniotic fluid phospholipids occurred and in cases of borderline pulmonary maturity the site of amniocentesis may have influenced the predictive value of the L/S ratio.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID