ISSN:0001-6349    

DOI:10.3109/00016349409013382

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:0001-6349    

DOI:10.3109/00016349409013383

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:0001-6349    

DOI:10.3109/00016349409013384

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Objective. To investigate linkage between the renin gene restriction fragment length polymorphisms in families with a history of preeclampsia/eclampsia.Methods. Nine Icelandic families with at least three affected females in two or three generations were investigated. DNA from lymphocytes was digested with the endonuclease restriction enzymeBglI and restriction fragments were transferred by Southern Blotting. Hybridisation was effected with the32P‐oligonucleotide‐labeled diallelic genomic probe pHRnX 0.8. LOD scores were calculated by the Liped program for two forms of inheritance patterns. Affected sib pairs were analysed.Results. Frequencies of the 9.0 kb and 5.0 kb alleles were 0.67 and 0.33, with no significant differences between affected females and spouses and combined LOD scores of −2 for recombination values of 3%. Allele sharing in affected sibs was not different from the expected random assortment.Conclusion. The linkage analysis provides evidence to exclude alteration of the renin gene in pregnancy as being directly responsible for the manifestations of preeclampsia or eclampsia in these fam

ISSN:0001-6349    

DOI:10.3109/00016349409013385

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Background. The reports on plasma concentrations and physiological function of atrial natriuretic peptide (ANP) during pregnancy are conflicting. In a recent prospective study, including 40 healthy primigravidae, we found a highly significant decrease in the plasma concentration of ANP (p‐ANP) during the third trimester and the results indicated that ANP takes part in regulation of blood volume and renal function during pregnancy as in the nonpregnant state. In order to test these results, a study was performed in primigravidae with twin pregnancy to test if the accentuated physiological changes here were followed by a corresponding greater decrease in p‐ANP.Methods. Ten healthy primigravidae with twin pregnancy were examined four times during pregnancy plus 12 weeks after delivery. Each time the following were measured: p‐ANP, aldosterone, renin, blood volume (carbon monoxide), cardiac output (Doppler), blood pressure and sodium excretion. Interdependence of the changes in ANP and in the other parameters was tested using Spearman's rank correlation test on the delta (Δ)‐values (the differences in measurements between investigations). The results were compared to the results obtained during singleton pregnancy using the Mann‐Whitney rank sum test.Results. All pregnant values of p‐ANP during twin pregnancy were lower than 12 weeks after delivery,p<0.01. In the 20th, 28th, and 32nd week p‐ANP was lower in twin pregnancy than in singleton pregnancy,p<0.05. There was a negative correlation between changes in p‐ANP and changes in: a) blood volume, R=‐0.8,p<0.0001, b) aldosterone, R=‐0.66,p<0.0001, c) renin, R=‐0.52,p<0.01, d) cardiac output, R=‐0.68,p<0.0001. There was a positive correlation between changes in p‐ANP and changes in: a) fractional excretion of sodium, R = 0.73,p<0.0001, and b) total peripheral resistance, R = 0.61,p<0.0001.Conclusion. The results suggest that the competitive relationship between ANP and the renin‐aldosterone system in regulating sodium balance and fluid volume is preserved during pregnancy. The vasodilatation during preg

ISSN:0001-6349    

DOI:10.3109/00016349409013386

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Introduction:The objective of this study was to determine whether the circulatory levels of endothelins, potent vasoconstrictor polypeptides produced mainly by endothelial cells, are increased in growth‐retarded fetuses.Study design:Fetal venous serum samples, withdrawn by ultrasound‐guided cordocentesis from 11 growth‐retarded fetuses and 10 normally‐growing fetuses who underwent the procedure because of other unrelated indications, were examined for immunoreactive endothelin‐1,2 by radioimmunoassay.Results:Higher mean endothelin‐1,2 levels were found in the sera of growth‐retarded fetuses than in controls (16.8 ± 4.2 versus 10.9 ± 4.3 fmol/ml,p= 0.008). Within the growth‐retarded group, there were no differences in endothelin‐1,2 levels in the presence of either abnormal umbilical Doppler, asymmetry of growth‐retardation, maternal signs of preeclampsia, or fetal acidosis.Conclusion:High levels of endothelin‐1,2 in the fetoplacental circulation may be pathophysiological important in fetal growth retardation. However, the clinical significance of these elevated levels

ISSN:0001-6349    

DOI:10.3109/00016349409013387

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The outcome for 70 fetuses with abdominal wall defects detected by routine second trimester ultrasound during the years 1983‐90 was investigated. In 65 of the 70 cases the prenatal diagnoses were correct. Thirty‐two women had their pregnancies terminated by legal abortions. Thirty‐eight pregnancies continued. Six of these ended with spontaneous abortion or intrauterine fetal death. Thirty‐two infants were born alive. Nearly all cases with associated malformations and all cases with chromosomal defects were in the omphalocele group. The neonatal survival for infants with gastroschisis and infants with omphalocele without associated malformations or chromosomal defects was hig

ISSN:0001-6349    

DOI:10.3109/00016349409013388

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Objective. First, to study tobacco exposure among pregnant Finnish women in 1986 and 1990. Second, to study the objectively measured exposure in different socioeconomic classes and in different geographical regions. Third, to assess the value of serum thiocyanate concentrations in estimating fetal tobacco exposure.Design. Tobacco exposure was measured from maternal and umbilical serum samples by measuring the concentration of nicotine metabolite, cotinine. In addition, the concentrations of thiocyanate were measured from umbilical serum samples. The occupations of the mothers were obtained from the Finnish Birth Registry, and the area of residence from laboratory records.Setting. Finland.Subjects. 1323 infants born in late February‐early March in 1991, 1263 mothers of these infants during antenatal visits in Autumn 1990, and 976 pregnant mothers during antenatal visits in Autumn 1986. The mothers and infants studied represented all newborn infants and their mothers during one week in one country.Measurements and main results. In 1986, 21.3% of Finnish mothers and in 1990 21.2% were exposed to tobacco. In 1986, exposed mothers were on average 1.4 (95% confidence interval 0.9‐1.8) years younger than nonexposed mothers, and in 1990, exposed mothers were on average 1.6 years (95% confidence interval 1.1‐2.3) younger than nonexposed mothers. 28.5% of mothers classified as unskilled workers were exposed, but only 9.1% of those classified as upper white‐collar. There were no significant geographical differences in exposure. Although umbilical serum thiocyanate levels were always elevated in exposed infants, high serum thiocyanate concentrations were detected in infants not exposed to tobacco.Conclusions. More than 20% of pregnant Finnish mothers and their fetuses were exposed to tobacco in 1986 and 1990. Young women and women in low socioeconomic classes were the most seriously exposed. Measurement of serum thiocyanate concentrations did not yield reliable estimates of e

ISSN:0001-6349    

DOI:10.3109/00016349409013389

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Objective. To assess the incidence rate of cervical incompetence diagnoses in Denmark 1980‐1990 according to maternal age, to analyse regional variations, to investigate how often cerclage is applied, and finally to estimate abortion rates among women with cervical incompetence with and without cerclage.Design. A register‐based retrospective cross section study.Setting. All Danish gynecological departments.Material and methods. Since 1977, all hospitalized patients in Denmark have been centrally recorded by diagnosis according to the ICD classification and by operation codes in The National Patient Register. From this database, all women with cervical incompetence (CI) and cerclage in the period 1980‐1990 were identified. From the same database all cases of spontaneous abortions were registered.Results. A total of 2756 cases of cervical incompetence were registered in the period 1980‐1990, corresponding to an incidence rate of 4.6/1000 births. The risk of cervical incompetence increased from 2/1000 births among women 15‐19 years old to 7.5/1000 births among women 35‐39 years old. The incidence rate of the Cl‐diagnosis fell 44% from 1980 to 1990. The incidence rates in different counties ranged from 1.7/1000 births to 10.0/1000 births. The average length of stay in hospital among patients with cervical incompetence was three weeks. Among patients with cervical incompetence, 61% were treated with cerclage. This per cent increased from 29% among women 15‐19 years old to 68% among women 35‐39 years old. 13.5% of women with CI experienced spontaneous abortion. This percentage increased from 12% for women 15‐19 years old to 17% among women 40‐44 years old (p<0.01). Among women with CI and cerclage, the abortion rate was 17.6%.Conclusion. In the period 1980‐1990 the incidence rate of cervical incompetence in Denmark was on the average 4.6/1000 births. The incidence rate of the Cl‐diagnoses has fallen significantly during the last decade, and it increases four‐fold with increasing age. Six out of ten patients with cervical incompetence

ISSN:0001-6349    

DOI:10.3109/00016349409013390

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Objective. The purpose of this study was to investigate, in a prospective manner, whether fetal heart rate (FHR) variability serves as a reliable single predictor of fetal outcome.Methods. We undertook a prospective study of 2,200 consecutive deliveries. Preterms<37 weeks, twins, stillbirths and fetal malformations were excluded from the study. FHR tracings were analyzed for variability in every delivery. Three windows were evaluated: 1) early in labor (30 min); 2) in the active phase of labor − 1 h prior to complete cervical dilatation (30 min); and 3) throughout the second stage of delivery, in segments of 30 min. Using the tracings taken at admission and prior to delivery, FHR variability was scored according to five previously used evaluative methods, and was correlated to the following three fetal outcome parameters: a) arterial cord blood pH6,<7; and c) immediate outcome (‘good’ defined as newborn going home after 2‐5 days, with no neonatal intensive care unit (NICU) admission).Results. 1. The majority of cases with adverse fetal outcome exhibited good FHR variability (mean, 80%). 2. Low FHR variability is not common in newborns with adverse general outcome (mean, 11.5%). 3. The predictability of FHR variability (using the five most common scoring methods) for evaluating adverse fetal outcome revealed low sensitivity (mean, 20.3%) and low predictive value (mean, 11.6%).Conclusion. FHR variability by itself cannot serve as the only indicator of fetal wellbeing. The presence of low variability should alert the physician; however, good FHR variability should not be interpreted as r

ISSN:0001-6349    

DOI:10.3109/00016349409013391

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY