摘要:

To determine whether routine fetal monitoring inevitably increases the cesarean section rate, we studied the pertinent literature and analyzed the cesarean sections performed at Evanston Hospital during the last 8 years. Many authors have found a slight to moderate increase in cesarean section rates, whereas others have found no change or a decrease. At Evanston Hospital, the primary cesarean section rate has increased from 2.6% in 1968-1969 to 6.9% in 1974-1975. Only 19.2% of this increase is due to increased fetal distress; the magnitude of the increase is due to changes in other factors, notably, breech deliveries (29.5% of the increase) and “dystocia” (60.2% of the increase). The incidence of cesarean section is controlled by several complex variables, only one of which is fetal monitoring. To describe the fetal monitors as the cause of the increased cesarean section rate is to ignore these other equally profound changes in obstetric technic and philosophy.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

In a consecutive series of 600 pregnancies (618 infants) in 300 clinically diabetic patients, treated in Dublin, Ireland, the maternal mortality was 0 and the loss of viable infants was 9.5%. Therapeutic abortion and sterilization were not practiced. The cesarcan section rate was 23%. The major causes of perinatal loss were hyaline membrane disease and congenital malformations. Recent routine estimation of the L/S ratio in amniotic fluid led to a reduced incidence of respiratory distress syndrome and a consequent improvement in perinatal mortality. At a very early stage in pregnancy diabetic patients should be referred to a center in which physician, obstetrician, nurse, and pediatrician operate as a team. Strict control of diabetes is essential.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

Two groups of healthy women at term, who were not in labor 3 hours after premature rupture of the membranes, were studied. In one group labor induction with oral prostaglandin E2(PGE2) was begun 3 hours after rupture, and in the other group intravenous oxytocin induction was begun 12 hours after rupture. PGE2was successful in initiating active labor in 88% of women treated. Of the women who were observed for 12 hours, one-half began labor spontaneously during that time. Women in whom labor was induced with PGE2given 3 hours after rupture of the membranes had a shorter interval of rupture to delivery, a lower cesarean section rate, and shorter postpartum hospitalization. Although significant bradycardia did not occur in fetuses of those women given PGE2,10% of infants whose mothers were receiving oxytocin were delivered by cesarean section for this reason. It is concluded that oral PGE2is safe and effective for induction of labor in women with premature membrane rupture. The benefits, to both mother and fetus, of a shorter latent period are discussed.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

Cortisol and cortisone have been measured in amniotic fluid samples obtained within 24 hours of delivery of 50 premature infants. When expressed as cortisol/cortisone ratios, the ratio tends to rise with advancing gestational age, although statistical significance is not attained. Both cortisol concentration and the cortisol/cortisone ratio are significantly lower in the amniotic fluid of infants who develop respiratory distress syndrome than in those with mature lung function (cortisol: 19.2 ± 10.3 ng/ml vs 26. ± 9.4,P< .02; cortisol/cortisone ratio: 1.2 ± 0.6 vs 2.0 ± 0.8,P< .001). These findings also hold in the subgroup of infants less than 32 weeks' gestation but not in those infants at or beyond the 32nd week. The amniotic fluid cortisone concentration is significantly lower in infants born after spontaneous labor beginning with rupture of the membranes as opposed to after contractions or bleeding (13.2 ± 3.6 ng/ml vs 16.3 ± 6.1,P<.05), although the cortisol concentrations and the cortisol/ cortisone ratios are not significantly different.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

Alpha-fetoprotein was measured in 2209 amniotic fluid samples under improved assay conditions. All cases of open neural tube defects had elevated values greater than 5 SD above the mean. The false positive rate based on the 3 SD cutoff is estimated at less than 9.15%. Alpha-fetoprotein assays are recommended for all patients undergoing second trimester amniocentesis, optimally between 14 and 16 weeks' gestation.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

This report describes a case of a sinusoidal fetal heart rate (FHR) pattern encountered in a fetus at 34 weeks' gestation during antepartum fetal stress testing because of maternal hypertension. Delivery of the fetus was accomplished, and the newborn was found to he severely anemic and hypotensive due to a massive fetomaternal transfusion. Some pathophysiologic mechanisms are suggested, and the clinical significance of this finding is discussed.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

Twenty-eight twin pregnancies were monitored by serial ultrasonic cephalometry from 30 or 31 weeks' gestation. The rates of growth of the individual twins as determined by biparietal diameters were similar in 11 cases (39%) and divergent in 17 (61%). When the rates of growth were divergent, the lesser rate was always below the mean for singleton pregnancies, and the incidence of small-for-gestational-age babies was 18 of 34 (53%). It was apparent that the greater the difference in biparietal diameters within the 2 weeks preceding delivery, the higher the risk of a small-for-gestational-age baby being delivered. No comment could be made on the growth rate prior to 28 weeks except that at diagnosis there was little or no difference in biparietal diameters.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

The levels of unconjugated estrone and estradiol in maternal vein serum during labor, in cord artery serum, and in cord vein serum were measured in normal pregnancy and in pregnancy complicated by intrauterine growth retardation. The mean level of unconjugated estrone and estradiol in maternal vein serum was significantly lower in the group with intrauterine growth retardation than in the normal patients (P<0.001 and 0.025, respectively). The mean unconjugated estrone and estradiol level in the cord vein was lower only in the most severely growth retarded subgroup. There was no difference seen in the cord artery values between the groups.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

Thirty-six pregnant women and 15 normally menstruating women were each given 100µg of synthetic luteinizing hormone releasing hormone (LHRH) by a single intravenous injection. Human chorionic gonadotropin (hCG), luteinizing hormone (LH), and follicle stimulating hormone (FSH) levels were determined by specific radioimmunoassay (RIA) technics. For the determination of the serum LH levels, the LHβ-RIA method, which is unaffected by hCG at sample levels as high as 500 IU/ml, was used. Serum concentrations of LH and FSH were lower in pregnant women than in the normal women in the follicular and luteal phases. While the release of LH was observed in pregnant women following the administration of LHRH, the average net increase was less than that seen in both the follicular and luteal phases. During pregnancy, there was a progressive decrease in the LH response to LHRH, but no release of FSH.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

One hundred and one patients with polycystic ovary syndrome (PCO) were treated during an 11-year interval. Sixty-seven cases were classified as typical PCO with enlarged ovaries of probable ovarian origin (Type I) and 34 as atypical PCO of probable adrenal origin (Type II). Fifty-five patients were treated for anovulatory infertility with clomiphene citrate or other endocrine therapy as indicated. There was a 91% ovulatory response and 51% conception rate from therapy in cases of Type I PCO. In Type II PCO, adrenal suppressive therapy resulted in a 55% ovulatory response. Our data support the concept that anovulation of ovarian origin as seen in PCO Type I responds to clomiphene therapy, while anovulation secondary to adrenal hyperandrogenization should be treated by adrenal suppressive therapy.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID