ISSN:1340-9654    

DOI:10.3109/01443619109013492

出版商:Taylor&Francis    

年代:1991

数据来源: WILEY

摘要:

SummaryA population screening programme for neural tube defects, consisting of maternal serumα-fetoprotein estimations combined with ultrasound scanning but avoiding the use of amniocentesis, was evaluated. In 23 369 pregnancies screened by ultrasound in the early part of the second trimester, 76 fetuses were affected by a neural tube defect. Of these 70 were correctly predicted while six were missed. Three of these six defects missed by ultrasound scan were associated with elevated maternal serumα-fetoprotein levels. The sensitivity of the programme was 92–1 per cent, and the specificity and predictive value of a positive test 100%, since there were no false positive diagnoses. Of 620 women with an elevated level ofα-fetoprotein, 7–5 per cent had fetuses affected by neural tube defects or related abnormalities, while 47–4 per cent had no identifiable cause. As a marker for abnormality serumα-fetoprotein estimation was useful, in these women the use of high resolution ultrasound reduced the need for amniocentesis, avoiding the problems associated with that procedure.

ISSN:1340-9654    

DOI:10.3109/01443619109013493

出版商:Taylor&Francis    

年代:1991

数据来源: WILEY

摘要:

SummarySkeletal malformations affect one out of every 500 newborn babies in Italy. Genetic counselling enables identification of women at risk for these abnormalities, and ultrasound scanning permits prenatal diagnosis. Of 49 patients studied between October 1984 and June 1988, 29 women had a greater risk of fetal skeletal abnormalities than that in the general population. With ultrasound scanning, no false positive diagnoses were made. In four women at increased risk, pathological features were foundin uteroby ultrasound and in two women the diagnosis was missed and made after birth. One of these was a case of hypophosphataemic rickets, diagnosed by X-ray at 10 months of age; the other was monitored for cleft lip and palate, but a cleft lip was found only at birth.

ISSN:1340-9654    

DOI:10.3109/01443619109013494

出版商:Taylor&Francis    

年代:1991

数据来源: WILEY

摘要:

SummaryFour fetuses with obstructive uropathy had club foot diagnosed on ultrasound before 18 weeks of pregnancy in the presence of normal amniotic fluid volume. One had trisomy-18 while the karyotype in the others was normal.Oligohydramnios in the presence of obstructive uropathy may merely be associated with, rather than the cause, of club foot.

ISSN:1340-9654    

DOI:10.3109/01443619109013495

出版商:Taylor&Francis    

年代:1991

数据来源: WILEY

摘要:

SummaryFifty-eight babies with exomphalos and gastroschisis are reviewed with regard to mortality, incidence of accompanying severe congenital abnormality, birth weight and neonatal morbidity. The effect of antenatal diagnosis,in uterotransfer, and mode of delivery on outcome was studied.The main factors affecting outcome were the type and severity of the abdominal wall defect, the birth weight and the presence of other congenital abnormalities. Mode of delivery did not appear to influence outcome.

ISSN:1340-9654    

DOI:10.3109/01443619109013496

出版商:Taylor&Francis    

年代:1991

数据来源: WILEY

摘要:

SummaryThe velocity of blood flow was estimated by Doppler examination in three sites of the fetal circulation repeatedly throughout the day to evaluate the diurnal variations in these measurements. The intracardiac, umbilical arterial and uterine arterial waveforms were recorded in 24 normal pregnancies, ranging from 18 to 30 weeks gestational age. Studies were performed at 10 a.m., 1–2 p.m. and 4–5 p.m.Analysis of variance showed no significant change in combined cardiac output, or in uterine or umbilical blood flow velocities in this gestational age range, between the three times of the day.

ISSN:1340-9654    

DOI:10.3109/01443619109013497

出版商:Taylor&Francis    

年代:1991

数据来源: WILEY

摘要:

SummaryThe effect of route of delivery and use of epidural anaesthesia on the mortality and morbidity of extremely premature babies was studied using retrospective data and multivariate analysis to correct for confounding variables. Women delivering babies less than 32 weeks after the last menstrual period or of birth weight less than 1500g were included and babies dying before the onset of labour, before admission to this hospital or with lethal congenital abnormalities were excluded. Survival to one month and absence of significant intraventricular haemorrhage were chosen as end points. The only group in which caesarean section appeared to confer a significant benefit was those with a gestational age of less than 27 weeks. Epidural anaesthesia conferred no significant benefit. There was no evidence that the effect of the route of delivery or of an epidural anaesthetic varied with the presentation.

ISSN:1340-9654    

DOI:10.3109/01443619109013498

出版商:Taylor&Francis    

年代:1991

数据来源: WILEY

摘要:

SummaryOf 372 pregnant women previously delivered by caesarean section, 199 (53 per cent) were allowed to labour at Queen Charlotte's and Chelsea Hospital in 1985 and 1986. Previous caesarean section performed before labour or during normal labour increased the likelihood of being allowed to labour in the subsequent pregnancy compared with a first caesarean section during abnormal labour. Vaginal delivery was four times more likely in the group who had not previously laboured. Half the women who did not have an‘unavoidable' indication for elective repeat caesarean section had X-ray pelvimetry which contributed towards selection for planned labour but did not correlate well with outcome. Abnormal labour and a diagnosis of fetal distress were both more likely to recur in women allowed to labour whose previous caesarean section had been for these reasons.

ISSN:1340-9654    

DOI:10.3109/01443619109013499

出版商:Taylor&Francis    

年代:1991

数据来源: WILEY

摘要:

SummaryThe value of routine intrapartum cardiotocography has yet to be proved despite widespread use. The confounding effects of treatment paradox and relative risk assessment are possible reasons for this.The pattern of management within 10000 consecutive deliveries was examined, using an‘independence Bayes' probability model to demonstrate changing relationships between test results, obstetric intervention and neonatal outcome.The incidence of birth asphyxia in the Prince of Wales hospital decreased by 33 percent between 1985 and 1986. This is shown to have been associated with improvements in the selection of patients for intrapartum cardiotocography and for elective caesarean section, and with an increased rate of intervention for fetal distress. The incidence of fetal distress also decreased, suggesting that factors other than intervention in response to fetal distress were partly responsible for improved perinatal outcome. A higher than expected incidence of asphyxia where delivery was by emergency caesarean section in the absence of fetal distress suggests cardiotocography can also have a detrimental effect on perinatal outcome.

ISSN:1340-9654    

DOI:10.3109/01443619109013500

出版商:Taylor&Francis    

年代:1991

数据来源: WILEY

摘要:

SummaryThe faecal and vaginal carriage rates ofListeria monocytogenesin 500 and 1365 pregnant women, respectively, were investigated.Listeria monocytogeneswas isolated from the faeces of eight pregnant women (1–6 per cent), but not from any of the high vaginal swabs. The results' indicated that the carriage ofListeria monocytogenesin the faeces is unlikely to pose a source of contamination of the vagina.

ISSN:1340-9654    

DOI:10.3109/01443619109013501

出版商:Taylor&Francis    

年代:1991

数据来源: WILEY