摘要:

Among 2475 maternal deaths that occurred in the United States from 1974 to 1978, 408 were related to pregnancies with abortive outcomes, and 2067 were related to other causes. Ectopic pregnancy was the most frequent cause of death in the former group. Embolism, hypertensive disease of pregnancy, obstetric hemorrhage, and obstetric infection were the most common causes of death in the latter group. Women who were 30 years of age or older or of minority race were at increased risk of death. Nationwide surveillance of maternal mortality is feasible and should help to increase the safety of childbearing.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

In a technician-oriented routine ultrasound program, the value of screening an entire obstetric population for predicting gestational age based on a single measurement was evaluated over selective scans performed on the basis of uncertain menstrual history. Consecutive pregnancies of 4527 women were scanned, and the results were analyzed. Gestational ages were determined by both menstrual history and ultrasonic crown-rump length or biparietal diameter (BPD) measurements. The estimated date of confinement based on ultrasound measurements was compared with menstrual history in its ability to predict the actual onset of spontaneous labor. Of patients with optimal menstrual history, 84.7% delivered within ± two weeks of the date predicted. Only 69.7% delivered within ± two weeks of the estimate date of confinement based on suspect menstrual history. Crown-rump length measurements were as predictive (84.6%) as optimal menstrual history. Biparietal diameter measurements done between 12 and 18 weeks' gestation were significantly more accurate in gestational predictions (89.4%) than those based on menstrual history (P< .001). It is concluded that ultrasound cephalometry before 18 weeks is the single best dating parameter.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

This retrospective study was designed to analyze the safety and efficacy of β-sympathomimetic agents used to treat premature labor in insulin-dependent diabetic women. The study evaluated 12 insulin-dependent diabetic women who experienced 15 pregnancies complicated by premature labor. A group of 30 insulin-dependent diabetic women who delivered at term served as matched controls. Treatment consisted of parenteral and oral administration of β-sympathomimetic drugs (ritodrine and isoxsuprine). Premature labor was diagnosed, and tocolytic treatment was initiated at a mean gestational age of 31.5 ± 0.9 weeks. The mean gestational age at the time of delivery was 35.8 ± 0.5 weeks. Delivery was delayed in the study group by a mean of 30.5 ± 6.6 days. No fetal or infant deaths occurred in the study group, and there was no difference between the two groups in the incidence of neonatal morbidity. No maternal complications occurred. There were no significant differences in hemoglobin A, levels between the two groups at any period of gestation. Thus, β-sympathomimetic drugs may be used safely to treat premature labor in patients with insulin- dependent diabetes, provided they are administered under strictly controlled clinical settings.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

All pregnancies that were complicated by a previous cesarean section were reviewed for a five-year period from 1978 to 1982. Of 799 such pregnancies, 216 underwent a trial of labor, and 66% experienced successful vaginal delivery. When the primary cesarean section was for cephalopelvic disproportion, 54% delivered vaginally, 75% breech, and 70% for fetal distress or other nonrepeating indications. There was no evidence of uterine scar disruption in the vaginally delivered group. Vaginal delivery after previous cesarean section can be a safe alternative for carefully selected patients cared for in the proper environment.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Enzymatic peroxidase oxidation was used to study albumin-bilirubin binding in the serum of pregnant women, their term infants, and nonpregnant women. When the bilirubin titration curves were corrected for differing albumin concentrations in the three groups, the bilirubin binding of pregnant women was inferior to that of control women but better than that of their infants. Diminished maternal binding could not be explained by altered affinity. This suggests that the function of albumin during pregnancy is impaired by a factor common to both fetal and maternal circulations that appears to act by decreasing the number of available bilirubin binding sites.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

This investigation was undertaken to determine whether or not histologic examination of the placenta contributed to a better understanding of the cause for an intrauterine fetal death. The placentas of stillborn fetuses delivered after the 20th gestational week were examined during a 4.5-year period (January 1979 to June 1983). Adequate information about the clinical history, autopsy examination, and placental histologic examination was available in 89 cases. Delivery was usually within the first week after the fetal death. Significant histologic aberrations in the placenta were found in 87 (98%) cases. The most frequent abnormalities were those of vascular insufficiency, hemorrhagic endovasculitis, retroplacental hematomata, acute chorioamnionitis with fetal involvement, and erythroblastosis/hydrops. Histologic abnormalities were supportive of prior impressions in 67 (77%) cases, contradictory to prior impressions in ten (11%) cases, or the sole contributors in explaining the cause of death in ten (11%) cases. Routine histologic examination of the placenta after a recent fetal death provides helpful information in counseling the parents and in planning any future childbearing.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

External cephalic version under tocolysis at term was investigated during a prospective study at the Los Angeles County/University of Southern California Medical Center from October 1, 1979 to March 16, 1983. Two hundred twelve patients were considered for attempted version. Forty-one patients were excluded, and 23 patients as previously reported were randomized to the control group. The procedure was successful in 73% (108 of 148). Of the 102 successful versions observed until delivery (six lost to follow-up), 93% (95 of 102) presented in labor with a vertex presentation; seven fetuses reverted to abnormal lies. The cesarean section rate in the success group with a vertex presentation was 24% (23 of 95).

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Endorphins and β-lipotropin have been implicated as the modulators of pain during the labor process. To investigate their possible role during parturition, the present study was undertaken to determine the levels of β-endorphin, β-endorphinlike immunoactivity, and β-lipotropin during labor and delivery. Fourteen patients were evaluated at 4 cm dilatation, complete dilatation, at the time of delivery, and immediately postpartum. In addition, samples were obtained from nine nonpregnant control subjects. The venous levels of β-endorphinlike immunoactivity and β-lipotropin were determined, and the β-endorphin level was calculated. The maternal cerebrospinal fluid (CSF) levels and the newborn umbilical venous level also were determined in the delivery room. A gradual rise was noted in the β-endorphin, β-lipotropin, and β-endorphinlike immunoactivity values up to the time of delivery. There was noted to be a modest decrease in their levels in the immediate postpartum period. These levels were significantly elevated over control samples for both β-endorphinlike immunoactivity and β-lipotropin (P< .05). Values for β-endorphin were not significantly different from control levels. In addition, maternal CSF levels were found to show modest elevations above the simultaneously drawn venous specimens. The umbilical cord venous samples drawn at delivery were also higher than the simultaneous maternal venous levels. These values, although elevated over control values, were not statistically different from simultaneously drawn maternal venous levels.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

One hundred normotensive young primigravidas underwent an isometric handgrip exercise test between 28 and 32 weeks of gestation. The same individual performed the tests and the results were withheld from the physician taking care of the patient. The study demonstrates a sensitivity of 81% and a specificity of 96.5%. These results demonstrate a reliable predictive ability of this simple exercise test for gestational hypertension.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

A prospective, double-blind, placebo-controlled study was performed to determine the effectiveness of single-dose antibiotic prophylaxis in decreasing infectious complications after primary cesarean section. One hundred women at high risk for postoperative infectious morbidity were randomly assigned to receive either placebo or one 2-g dose of ceftizoxime at cord clamping. The incidence of endometritis in the antibiotic group was 6.0 versus 24.5% in the placebo group (P< .05). The incidence of febrile morbidity in the group receiving one dose of ceftizoxime was 14.0 versus 32.7% in the placebo group (P< .05). Single-dose ceftizoxime prophylaxis significantly reduced the incidence of endometritis and febrile morbidity in high-risk patients undergoing cesarean section.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID