摘要:

Effects of heavy, moderate, and rare alcohol consumption on fetal development were analyzed in a prospective study of 469 mother-infant pairs. Differential effects of heavy drinking in early and late gestation were evaluated by separate analysis of neonates born to women who reduced consumption before the third trimester. Using x2analysis, multiple regression, and matched sets, statistically significant associations (P<.01) were observed between sustained heavy drinking and both intrauterine growth retardation and congenital anomalies. These associations were independent of eight other risk factors. No differences were observed between offspring of rare and moderate drinkers. Infants born to women who reduced heavy drinking did not differ in growth from offspring of rare and moderate drinkers but demonstrated a higher frequency of abnormalities. Sustained heavy drinking represents a major risk; reduction in midpregnancy can benefit the newborn. Identification and therapy of heavy drinking are important components of prenatal care.

ISSN:0029-7844    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Ninety-three obstetricians and 79 other health professionals were asked to estimate the likelihood of a normal outcome among infants surviving a five-minute Apgar score of 3 or less, a clinical indicator of moderately severe perinatal asphyxia. The answers given represented an approximately tenfold overestimation of the rate of handicap in comparison with published data.

ISSN:0029-7844    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Fetal pulmonary maturity evaluation was performed on 237 amniotic fluid specimens from 202 gravidas using: 1) optical density (OD) 650, 2) shake or foam stabilization test, and 3) lecithin:sphingomyelin ratio. One hundred thirty-one gravidas delivered within 48 hours of specimen collection, including nine of 11 women delivering respiratory distress syndrome-affected infants and 40 delivering premature infants. The efficiency of each test in predicting fetal pulmonary maturity status was calculated and showed that statistically, OD 650 was significantly better at predicting fetal pulmonary maturity in preterm infants and all infants. Twenty-six of 27 infants of diabetic mothers (classes A through R) had mature OD 650 values; none developed respiratory distress syndrome. The authors confirm that the OD 650 is reliable in most clinical settings and superior to the shake test. The authors recommend its primary use when sophisticated phospholipid studies are not immediately available.

ISSN:0029-7844    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Tocolysis was attempted in only 2.5% of 570 consecutive low birth weight deliveries in the years 1980 through 1981. The reasons for rejecting therapy in the majority of cases are discussed. Prospectively, tocolysis was attempted in only 13.8% of all patients in preterm labor, with an 82% success rate. If tocolytic therapy were not used, and a calculation made with allowance for usually acceptable false diagnosis and failure rate, the general low birth weight rate would rise minimally and insignificantly (P=1.4). It is concluded that availability of tocolytic agents must not be expected to lower the overall low birth-weight rate, although it will benefit the appropriately selected individual patient.

ISSN:0029-7844    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Nonstress fetal heart rate (FHR) recording was used as a primary test to detect fetal distress in 145 pregnant women with insulin-dependent diabetes. Testing was performed every second day beginning with the 32nd week of pregnancy and daily after the 34th week until delivery. One hundred eighteen (81.4%) had normal, nine (6.2%) suspicious, and 18 12.4%) pathologic FHR recordings. Poor metabolic control of diabetes was observed in 25 (17.2%) of the 145 pregnancies during the last trimester of pregnancy. Nine of these 25 women (35%) with poor metabolic control had a suspicious or pathologic FHR recording, which was significantly more frequent (P<.02) than in women with good metabolic control (18 of 120,15%). The mean value (± SD) of hemoglobin Arcduring the last trimester in diabetic women with pathologic FHR records was 7.63 ± 0.87%, which was significantly higher (P<.02) than in diabetic women with normal FHR records (6.91 ± 0.83%). None of the 145 fetuses monitored died in utero. It was concluded that no obvious iatrogenic morbidity was caused by early intervention in cases with pathologic FHR recordings.

ISSN:0029-7844    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Fertility and pregnancy complications were assessed in 137 women at risk of having inherited the gene for autosomal dominant polycystic kidney disease. Seventy-six (55%) of these subjects were found to have polycystic kidney disease (multiple renal cysts). The remaining 61 women served as controls. The prevalence of fertility, spontaneous abortion, stillbirth, and symptoms consistent with urinary tract infection were not different in the two groups. However, the frequency of hypertension first diagnosed during pregnancy (with or without preeclampsia or eclampsia) and the frequency of pregnancy-unrelated hypertension were higher in women with polycystic kidney disease. No evidence was found that pregnancy had an adverse effect on the natural course of polycystic kidney disease. The incidence of renal failure was not higher in women with polycystic kidney disease who had three or more pregnancies than in women of similar ages who had two, one, or no pregnancies.

ISSN:0029-7844    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

The purpose of the present clinical investigation was to determine the risks associated with mild chronic hypertension in pregnancy. Two hundred eleven consecutive pregnancies complicated by mild chronic hypertension (diastolic blood pressure, 90 to 110 mmHg) were analyzed. All patients were followed closely throughout pregnancy with frequent prenatal visits and serial assessment of fetal status. Antihypertensive drugs were discontinued at the time of the first prenatal visit. Only 13% of these patients required antihypertensive medications later in pregnancy. There were 2 stillbirths and 4 neonatal deaths for an overall perinatal mortality of 28.1/1000. However, the majority of deaths (5 of 6) occurred among the 21 patients with superimposed preeclampsia. This subgroup was also characterized by a high rate of growth-retarded infants (32%). For patients without superimposed preeclampsia, 5.3% of the infants were small for gestational age and there was only one perinatal death. Thus, for patients with mild chronic hypertension, discontinuance of antihypertension medications does not adversely affect the antepartum course or perinatal outcome. In fact, in the absence of superimposed preeclampsia, the perinatal mortality for these patients approaches that of the general obstetric population. Therefore, in pregnancies complicated by mild chronic hypertension, factors other than increased blood pressure per se might be responsible for the poor perinatal outcome reported in such pregnancies.

ISSN:0029-7844    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Ultrasound scan showed some degree of placenta previa in 503 patients. Of this group, 5.6% (28) had clinically significant bleeding or documented placenta previa at delivery. A scoring system based on placental localization was not successful in predicting who was at high risk for bleeding. However, the likelihood of clinically excessive bleeding did significantly increase if the placenta previa was noted after 30 weeks' gestation. The study did not find a greater incidence of small-for-gestational-age babies in women with low-lying placentas.

ISSN:0029-7844    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

The sensitivities of serum bile acid assays and some conventional liver function tests were studied in the early diagnosis and follow-up of intrahepatic cholestasis of pregnancy using 30 healthy pregnant women and 45 patients with intrahepatic cholestasis of pregnancy. Primary (cholic acid [CA] and chenodeoxycholic acid [CDCA]) and one secondary (deoxycholic acid [DCA]) bile acid were analyzed by radioimmunoassays and transaminases (SGPT and SGOT), alkaline phosphatase (AP), gamma-glutamyltranspeptidase (r-GT), and total and direct bilirubin were measured from the 16th to the 20th week of pregnancy until 35 to 60 days postpartum. When the first pathologic CA value appeared in the group of eight patients followed up before symptoms, in every case the CA:CDCA ratio was over one; there were mild itching symptoms in four cases, pathologically increased SGPT in four cases, elevated CDCA, AP, and r-GT levels in three cases, and elevated SGOT values in one case. Total and direct bilirubin concentrations were normal in all cases. Of all the analyses of the intrahepatic cholestasis of pregnancy patients (N=45) before delivery, CA was over the normal reference limit in 71%, CDCA in 57%, SGPT in 65%, SGOT in 59%, AP in 46%, r-GT in 35%, total bilirubin in 17%, and direct bilirubin in 38%. The correlation coefficients were significant (P<.001) between the primary bile acids and SGPT, SGOT, AP, and total and direct bilirubins. In the early diagnosis and follow-up of IHC of pregnancy the most sensitive indicators are: an increased CA level, a CA:CDCA ratio over 1, and an increase in SGPT activity.

ISSN:0029-7844    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Group B streptococcal cells, either viable or heat-killed, contain a substance that induced fever in rabbits with maximal responses occurring four hours after intravenous injection. In contrast, supernatant fluids failed to induce significant fever. Group B streptococcal cells also enhanced host susceptibility to lethal shock by endotoxin as much as 40,000-fold. A graph of log streptococcal cell dose used for pretreatment versus log LD50 endotoxin gave a straight line with a slope of approximately -1. Rabbits that received both streptococcal cells and endotoxin showed initial fever followed by hypothermia, labored breathing, watery diarrhea, evidence of vascular collapse, and finally death. Animals that received streptococcal cells or endotoxin alone showed only fevers and mild diarrhea. A possible theory for the cause of death in the neonate infected with group B streptococci is presented.

ISSN:0029-7844    

出版商:OVID    

年代:1983

数据来源: OVID