ISSN:1040-872X    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Recent studies have:(1) identified novel pathophysiologic processes that underlie spontaneous prematurity; (2) applied statistical methods and pathophysiologic models developed in other medical disciplines to the study of spontaneous prematurity; and (3) developed novel paradigms for the molecular dissection of the cascades, which culminate in preterm birth.

ISSN:1040-872X    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Sonographic techniques have been developed to study the biometry and behavior of the cervix during pregnancy which have led to a better understanding of the pathogenesis of pregnancy loss and preterm birth. Nomograms have been developed for singleton and twin gestations, and associations between cervical sonographic characteristics and various adverse pregnancy outcomes have been observed. The new concept of 'relative' cervical incompetence suggests that the cervix may be an independent contributor to preterm birth. The incorporation of cervical sonography in management schemes for the prevention of pregnancy loss or preterm delivery has the potential to impact favorably on perinatal outcome.

ISSN:1040-872X    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Corticosteroids used to enhance fetal maturation are one of the best studied interventions in perinatal medicine. The treatment has been shown to reduce neonatal morbidity and mortality. The intervention is also highly cost-effective. In this article, we review the evidence supporting the benefits of corticosteroids, controversial issues concerning their use, and current practice recommendations. The review will highlight the research presented at the recent National Institutes of Health Consensus Conference concerning corticosteroids. This research led the National Institutes of Health to advocate clinical practice guidelines on the appropriate use of corticosteroids

ISSN:1040-872X    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Preeclampsia affects two patients, the mother and the fetus. Traditionally, women with severe preeclampsia have been delivered without delay, regardless of fetal considerations. Although delivery is appropriate therapy for the mother, aggressive management with immediate delivery of a fetus remote from term leads to high neonatal mortality and morbidity resulting from prematurity. Recent studies have shown favorable neonatal outcomes after conservative management of severe preeclampsia. Candidates for conservative management should be selected carefully and managed with intensive maternal and fetal monitoring at a tertiary perinatal center.

ISSN:1040-872X    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Searches for clinical applications of Doppler ultrasound in feto-maternal medicine continue. Currently, there are three main areas of interest: Doppler velocimetry of the umbilical artery, uterine artery and the fetal circulation (cerebral and venous blood flow studies). Evidence from randomized trials suggests that if women with suspected intra-uterine growth retardation or pre-eclampsia are offered Doppler studies of the umbilical artery, a clinically important reduction in perinatal mortality may be expected. On the other hand, screening of low-risk women either by umbilical artery Doppler or uterine artery Doppler is unlikely to be cost-effective. The study of other fetal vessels provides a fascinating insight into vascular changes that occur in fetal compromise, but it is not known whether the use of these tests will actually reduce perinatal mortality and morbidity. None of the Doppler indices used so far, including the middle-cerebral artery to umbilical artery ratio, has been able to match the performance characteristics of umbilical artery Doppler. Until clear evidence emerges on its benefit or otherwise, comprehensive fetal assessment by Doppler ultrasound should be used for research purposes only and results of these tests should not be used to guide clinical practice.

ISSN:1040-872X    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The use of computers for analysis of fetal heart rate has developed rapidly, enabling reproducible, objective analysis of fetal heart rate patterns. The problems of observer differences in visual assessment of fetal heart rate, and the continuum of antepartum and intrapartum fetal condition can be clarified through the use of such approaches. Computerized fetal heart rate analysis presents opportunities to perform precise evaluations of the effects of environmental conditions, medications, and disease states on fetal heart rate parameters.

ISSN:1040-872X    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The intrapartum cardiotocogram has had a disappointing impact on clinical practice. Misinterpretation of the cardiotocogram not only causes an increase in unnecessary intervention but is also implicated in a large proportion of patients with birth asphyxia and avoidable perinatal morbidity. Over the past 10–20 years, groups have attempted to develop computer systems capable of analysing the cardiotocogram but with limited success. The likely explanation is that these conventional systems analyse the cardiotocogram in isolation from clinical factors. More recently, research has focused on the use of artificial intelligence techniques which can assess the whole clinical picture to support clinical decision making during labour. The current literature is reviewed and a system that has been validated by comparison of its performance with 1 7 experts is described.

ISSN:1040-872X    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1040-872X    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Approaches to the diagnosis of genetic disease using the tools of molecular genetics are being developed at a rapid pace as efforts to map the human genome progress. Technical challenges remain, however, in devising approaches to permit the wide diversity of pathogenic mutations to be identified in an efficient manner. Moreover, the possibility of population screening for carrier status for gene mutations raises important ethical and social questions. Major progress has been made in both areas and the list of disorders amenable to molecular diagnosis is expanding rapidly.

ISSN:1040-872X    

出版商:OVID    

年代:1996

数据来源: OVID