摘要:

Data were collected prospectively on 381 patients admitted for stimulation of labor because of premature rupture of the membranes and 808 patients for induction of labor. The induction was by primary amniotomy in 337 cases, and the remaining 471 cases, because of relatively unfavorable cervical conditions, were treated without primary amniotomy. Induction of labor failed on the first day in 181 of the cases with an unfavorable cervix. All patients were delivered vaginally of one living infant in cephalic presentation. The predictive value of the Bishop pelvic score and other factors regarding the duration of labor (induction-delivery time) and the inducibility of labor (latency period) were evaluated by multiple regression analyses. The influence of parity on duration of labor was found to be very constant and highly significant, whereas it seemed to have only little influence on inducibility. The only factor of significant importance to inducibility thus seems to be the prelabor cervical condition. Of the 5 components in the Bishop score, dilatation was found to be most important and should be weighted at least twice the value given it by Bishop. A new pelvic score for prelabor evaluation of inducibility is proposed on the basis of these results.

ISSN:0029-7844    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

A prospective investigation was undertaken to determine whether present antepartum methods of fetal assessment were useful in predicting postmaturity. Thirty-two (22%) of 147 strictly defined postdate pregnancies produced infants with signs of postmaturity. Clinical findings, fetal heart rate testing (primarily nonstress tests), and fetal movement charting were not found to be reliable predictors. Singlevoiding estrogen: creatinine (E:C) ratios were significantly (P<.0001) lower in fetuses with subsequent findings of postmaturity than in those without such signs, and all subnormal values were associated with postmature infants. Twenty-four of 29 pregnancies with oligohydramnios diagnosed by ultrasonography produced postmature infants, whereas 110 of 118 pregnancies with either pockets or an adequate volume of amniotic fluid produced infants who were not postmature. Of the fetal surveillance methods used in the authors' clinic, subnormal E:C ratios and ultrasonic evidence of oligohydramnios were the most reliable predictors of postmaturity.

ISSN:0029-7844    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Factors affecting the survival of 136 consecutive live-born infants delivered at 24 to 28 weeks' gestation during a 4-year period were analyzed. After careful assessment of gestational age, perinatal care for the fetus of at least 26 weeks' gestation was aggressive. Survival at 26 weeks was 45% and at 28 weeks, 92%. Multivariate analysis showed that the set of variables that best predicts neonatal outcome is gestational age, antepartum glucocorticoid administration, and resuscitation at birth.

ISSN:0029-7844    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Traumatic morbidity in the newborn of a diabetic mother occurs in 3 to 9% of vaginal deliveries in diabetic pregnancies. Prediction of diabetic macrosomia by ultrasound measurement of chest diameter and biparietal diameter is evaluated in this study. A macrosomia index was calculated for 70 diabetic pregnancies by subtracting the biparietal diameter from the chest diameter (chest — biparietal diameter). Twenty-three macrosomic infants (weight greater than 4000 g) were delivered. In this study 20/23 (87%) of the infants weighing greater than 4000 g had a chest — biparietal diameter of 1.4 cm or greater. There were 4 cases of shoulder dystocia in 15 patients delivered vaginally. In this study, cesarean section for all fetuses with a chest — biparietal diameter of 1.4 cm or greater would reduce the incidence of traumatic morbidity from 27% to 9%.

ISSN:0029-7844    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

This descriptive study of sexual behavior and response in 1500 obstetric patients registering for prenatal care demonstrates complex interactions of various sociodemographic factors. Variables most predictive of coital frequency during pregnancy include marital status, gestational age, parity, and race, as well as some unique combinations of statistics. Orgasmic response increases with patient age but lack of understanding of the terminology makes further interpretation unreliable. Dyspareunia is experienced infrequently during pregnancy. When it occurs, it decreases coital frequency in single women more than in married women. Studies examining differences or changes in sexual behavior during pregnancy versus fetal outcome must take into account that factors known to affect fetal outcome are also associated with changes in sexual behavior.

ISSN:0029-7844    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Amniotic fluid alpha-fetoprotein (AFP) assays and detailed ultrasound examinations were performed in 376 prenatal patients at risk for a neural tube defect (high-risk group). In addition, 2436 patients who underwent amniocentesis for other indications underwent preamniocentesis ultrasound screening and amniotic fluid AFP assays (low-risk group). There were 10 neural tube defects in the high-risk group (7 open and 3 closed) and 3 in the low-risk group (all open). Two of the 3 closed defects were detected prenatally. The predictive value of an elevated AFP level for ah abnormal fetus was much higher in the high-risk (6 of 6,100%) than in the low-risk group (1 of 6,17%). When both ultrasound and AFP assay results were normal, the chance of a normal outcome was very high in both the high- and low-risk groups (99.7 and 100%, respectively). It was of particular interest that in the low-risk group, the likelihood of an abnormal outcome in women with elevated AFP and a normal ultrasonogram was low (0 of 5).

ISSN:0029-7844    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Plasma volume determinations for 9 women with severe chronic hypertension who delivered live-born infants with birth weights appropriate for gestational age (AGA) were compared with those for 7 women with chronic hypertension whose pregnancies ended in intrauterine fetal demise. Plasma volume determinations using Evans blue dye dilution technique were performed at 20 to 25 weeks' gestation (12 patients) and at 26 to 29 weeks' gestation (16 patients). In addition, plasma volume measurements were performed at 8 weeks post partum in 5 patients who had intrauterine fetal demise. Analysis of the clinical course, laboratory findings, and pregnancy outcome revealed that the degree of plasma volume expansion was the factor most significantly differing between the 2 groups of patients. The plasma volumes of 9 women who delivered AGA infants were comparable with those values previously reported for normal singleton pregnancy. In contrast, each patient with intrauterine fetal demise demonstrated failure in plasma volume expansion at 20 to 25 weeks' gestation when compared with her own postpartum value. In each of the 6 patients who had a second plasma volume determination at 26 to 29 weeks' gestation, there was a decrease (mean decrease, 13.5%) from the value at 20 to 25 weeks. Plasma volume determinations may be very helpful in making clinical decisions regarding women with severe hypertension. Plasma volume determination may be most helpful in identifying a subgroup of women who are at particular risk for having infants with intrauterine growth retardation and intrauterine fetal demise.

ISSN:0029-7844    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Cord plasma vasopressin concentration, determined by radioimmunoassay, was higher in arterial than in venous blood in 122 (84%) infants; the highest vasopressin values were recorded in 21 acidotic infants (mean cord pH, 7.13) delivered per vaginam and the lowest values in 50 infants delivered by cesarean section. Cord vasopressin levels were not elevated in infants delivered by cesarean section because of obstructed labor. There was a lack of correlation between vasopressin levels and the length of labor or cervical dilatation; a significant correlation was found between cord arterial vasopressin values and pH. Low vasopressin values were recorded in a group of 22 healthy infants (mean cord pH, 7.29) delivered by low forceps operation.

ISSN:0029-7844    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

In an 8-year period, 16 cases of parturitional septicemia due to the Enterobacteriaceae in the immediate postpartum period were identified that were not due to pyelonephritis. Fourteen of the 16 patients had more than 100,000 colonies per milliliter of urine of the same member of the Enterobacteriaceae as was present in the blood. Twelve of the 16 patients had concomitant endometrial cultures. In 11 patients the same isolate was recovered from urine and endometrium as had been recovered from the intravascular compartment. The data suggest an etiologic relationship between asymptomatic bacteriuria and septicemia due to the Enterobacteriaceae in which the maternal implantation site affords the principal portal of infection.

ISSN:0029-7844    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Blood samples were obtained from 145 preovulatory and postovulatory hirsute women and the plasma was analyzed for total testosterone (T), T index, and free T concentration as well as the fraction of free T percentage and that bound by testosterone-estradiol binding globulin. Fifty-six patients were subjected to a 2-week dexamethasone (DXM) suppression test to delineate the source of androgen excess. Presuppression and postsuppression samples were also analyzed for plasma T concentrations and its free and bound fractions. The total T, T index, and free T were elevated in 58, 66, and 55% of hirsute women, respectively. The percentage of bound T fraction was decreased in only 39% of hirsute women, whereas the percentage of free T fraction was increased in 30% and decreased in 11% of hirsute women. The postovulatory hirsute women had a normal percentage of free and bound T fractions, although their total plasma concentrations were elevated. They also had a lower frequency of abnormal levels in all T measurements than preovulatory hirsute women. The DXM seems to deplete the plasma binding globulin; thus the bound T fractions in the pdst-DXM samples were lower than the pre-DXM values. The total T may be a better measure than the free T values in evaluation of the DXM suppression test for hirsute women.

ISSN:0029-7844    

出版商:OVID    

年代:1982

数据来源: OVID