摘要:

&NA;Six fetal biophysical variables—the nonstress test, fetal movements, fetal breathing movements, fetal tone, amniotic fluid volume, and placental grading (biophysical profile)— were assessed in 150 high‐risk pregnancies during a 30minute observation period. The predictive value of the nonstress test alone, biophysical scoring, and contraction stress test alone in the identification of the healthy fetus as well as the fetus in jeopardy are discussed. The relationships between individual variables and combinations of variables to the outcome of pregnancy, as reflected by abnormal intrapartum fetal heart rate patterns, meconium during labor, fetal distress, and perinatal mortality rate were determined. The biophysical profile of all hypoxic fetuses was analyzed. These data suggest that the biophysical profile is more accurate in the identification of the hypoxic fetus than any other single method; therefore, a new protocol including the biophysical profile for antepartum fetal evaluation is presented.(Obstet Gynecol 62:271, 1983)

ISSN:0029-7844    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

&NA;The clinical outcome of 141 consecutive diabetic pregnancies managed in the National Maternity Hospital between January 1, 1979, and October 31, 1982, is described. Patients with gestational diabetes were excluded. There were 12 spontaneous abortions, and the perinatal mortality in 129 viable pregnancies was 31/1000. The malformation rate was 6.4%. Significant perinatal morbidity occurred in 20% of infants. The incidence of cesarean section was 20%. Spontaneous labor after 38 weeks occurred in 30% because there was a deliberate policy to allow all uncomplicated pregnancies to continue to term. This policy had benefits for the infant as well as the mother because there was a notable reduction in neonatal morbidity. Possible explanations of high cesarean section rates in other centers are discussed.(Obstet Gynecol 62:279, 1983)

ISSN:0029-7844    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

&NA;In a population of 1065 singleton, low birth weight infants (1000 to 2500 g) delivered vaginally from vertex presentation, the neonatal mortality and morbidity of 394 delivered by low forceps were compared with those of 671 delivered spontaneously. There were no significant differences between the groups, either across the population as a whole or among any of the following birth weight subgroups: 1000 to 1500 g, 1501 to 2000 g, and 2001 to 2500 g. The data in the current study, as well as those from previous reports, argue against the routine use of prophylactic low forceps delivery and in favor of a more individualized approach to the vaginal delivery of infants in vertex presentation in this weight group.(Obstet Gynecol 62:283, 1983)

ISSN:0029-7844    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

&NA;The interval between the first symptoms of threatened preterm labor and delivery was studied and found to be correlated with the incidence of respiratory distress syndrome (RDS), independent of treatment with corticosteroids or betamimetics and the state of the membranes. The incidence and severity of RDS decreased when labor was postponed for a period ranging from 12 hours to three weeks after admission. The decrease was most marked in a steroidtreated group but also occurred in the placebo‐treated and untreated groups. The combination of orciprenaline and betamethasone was more effective in postponing delivery in early pregnancies than was the combination of orciprenaline and placebo. Treatment with betamimetics and corticosteroids is therefore indicated in cases of active preterm labor.(Obstet Gynecol 62:287, 1983)

ISSN:0029-7844    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

&NA;A study was undertaken to determine whether newborn infants of women in a statewide high‐risk program had less perinatal mortality and higher birth weight than newborn infants of high‐risk women not in the program. The number of fetal and neonatal deaths was twice as high in the nonprogram group, but there was no statistical difference in birth weight distribution in the two groups. Possible reasons for the program's effectiveness are the facts that a greater number of program women had more prenatal visits and were delivered in a Level II or Level III hospital by appropriate personnel.(Obstet Gynecol 62:294, 1983)

ISSN:0029-7844    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

&NA;In a prospective investigation, 247 patients underwent ultrasonically guided midtrimester amniocentesis. Maternal serum &agr;‐fetoprotein (AFP) was measured before and after the procedure. In 229 patients, preamniocentesis AFP exceeded 19 μg/liter. Forty‐eight (21.0%) of these displayed a significant elevation of AFP induced by the procedure, indicating fetal‐maternal bleeding. This event was correlated with anterior placental location (P< .025) and was followed by a significantly reduced mean fetal birth weight (3143 versus 3385 g,P< .05). In addition, a nonsignificant (.10 <P< .20) doubling of the risk of giving birth to a child small for gestational age was observed. These findings suggest that amniocentesis represents a potential hazard to the fetus. The implications in relation to the widening indications for amniocentesis are discussed.(Obstet Gynecol 62:297, 1983)

ISSN:0029-7844    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

&NA;Although the primary purpose of maternal serum &agr;‐fetoprotein (AFP) screening is to detect open neural tube defects, the technique is of value in the diagnosis of other fetal abnormalities. Six patients from the Alpha‐Fetoprotein Screening Program, Perinatal Region IV, were found to have twice elevated maternal serum AFP levels associated with severe early second‐trimester oligohydramnios. Five of the fetuses were found to have urinary tract abnormalities. The source of the elevated maternal serum AFP is not clear. Pregnancy prognosis appears poor. These cases should be thoroughly studied so that patients may be accurately informed of the recurrence risk.(Obstet Gynecol 62:301, 1983)

ISSN:0029-7844    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

&NA;To study whether gestational diabetes is the result of abnormal endocrine pancreatic adaptation to pregnancy, &agr;‐ and &bgr;‐cell sensitivity to glucose was determined during pregnancy and post partum in seven women of normal weight who had gestational diabetes. Glucose was infused intravenously in quantities producing similar increases in plasma glucose in pregnancy and post partum, and the plasma glucose curves obtained closely resembled those found during an oral glucose tolerance test. The insulin response to the infusion was 3.5 times greater in pregnancy (P< .02), whereas glucagon was suppressed similarly in pregnancy and post partum. These findings resemble previous ones in normal women. It is concluded that pancreatic &agr; and &bgr; cells adapt similarly to pregnancy in women with gestational diabetes and in normal women.(Obstet Gynecol 62:305, 1983)

ISSN:0029-7844    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

&NA;A synthetic analogue, deamino‐ethyl‐oxytocin, which competitively inhibits vasopressin action on uterine activity both in vitro and in animal experiments was developed. The uterine effect of this analogue was studied during the recording of intrauterine pressure in 16 gynecologically healthy women. Increased uterine activity and dysmenorrhea‐like pain was induced by infusing lysine vasopressin in a dose of 0.08 μg/min. Deamino‐ethyl‐oxytocin inhibited vasopressin action, the threshold dose being approximately 200 μg given as a single intravenous injection for about 20 minutes. When given intranasally the drug was also shown to be effective in inhibiting vasopressin‐induced uterine activity and symptoms. These results suggest that deaminoethyl‐oxytocin could be of therapeutic value in primary dysmenorrhea, a condition associated with increased vasopressin secretion.(Obstet Gynecol 62:309, 1983)

ISSN:0029-7844    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

&NA;Serum zinc concentration and the partitioning of serum zinc between serum albumin and &agr;2‐macroglobulin were measured in ten pregnant and five nonpregnant women fed controlled diets. The diet, prepared from blended foods, provided 16 mg/day of zinc. The pregnant women maintained total serum zinc concentrations which were approximately 19 to 27% lower than those of the nonpregnant controls. The decrease in serum zinc was associated with a decrease in serum albumin concentration. Although the pregnant women had lower concentrations of albuminbound zinc and &agr;2‐macroglobulin‐bound zinc, the two groups maintained the same distribution of zinc in serum; approximately 75% was albumin‐bound and 25% bound to &agr;2‐macroglobulin. Given the expansion of maternal blood volume, a pregnant woman could have a larger circulating pool of zinc than a nonpregnant woman. The decline in serum zinc concentration with pregnancy appears to be a normal physiologic adjustment and is not necessarily indicative of inadequate zinc nutriture.(Obstet Gynecol 62:313, 1983)

ISSN:0029-7844    

出版商:OVID    

年代:1983

数据来源: OVID