ISSN:0378-7346    

DOI:10.1159/000288967

出版商:S. Karger AG    

年代:1910

数据来源: Karger

ISSN:0378-7346    

DOI:10.1159/000293091

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

Thirty-five patients attending an emergency room with a positive pregnancy test and suspected ectopic pregnancy underwent an ultrasonographic examination with both the transabdominal and the transvaginal techniques. Twenty-four out of 26 ectopic pregnancies were correctly diagnosed on admission, combining results of the two techniques, the sensitivity of the two techniques used separately being 88.4% (transvaginal) and 76.9% (transabdominal). In our unselected symptomatic patients, the transvaginal technique showed to be advantageous but not essential in the management of ectopic pregnancy. The surgical outcome of these patients suggested that a prompt diagnosis of ectopic pregnancy did not warrant a conservative treatment.

ISSN:0378-7346    

DOI:10.1159/000293092

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

Twenty-four women with second-trimester cervical incompetence underwent emergency cerclage. The appropriateness of cervical cerclage was analyzed according to a scoring system (Cervical Incompetence Scale; CIS) which measures the degree of cervical effacement, cervical dilatation and protrusion of fetal membranes into the cervical canal. Patients with low CIS (0–3 points) were found to have a more favorable pregnancy outcome than patients with high-score cervical incompetence (5–8 points), i.e. fewer complications following the procedure, 33.3 and 87.5%, respectively, fewer pregnancy losses (22.2 and 75%, respectively) and a significantly prolonged postoperative pregnancy course (mean gestation 33.2 and 24.4 weeks at delivery, respectively). The chances of a successful pregnancy outcome were evaluated at 87.5%; the outcome was successful in patients with low CIS presenting with effacement of the uterine cervix of < 50%, cervical dilatation of < 1.5 cm and with fetal membranes remaining in the cervical canal. On the basis of these results, we conclude that the emergency cerclage operation in carefully selected patients with midtrimester cervical incompetence may improve the outcome of pregnancy. This selection is facilitated by the use of a new cervical incompetence scoring system described herein.

ISSN:0378-7346    

DOI:10.1159/000293093

出版商:S. Karger AG    

年代:1991

数据来源: Karger

ISSN:0378-7346    

DOI:10.1159/000316553

出版商:S. Karger AG    

年代:1910

数据来源: Karger

摘要:

Despite common use in obstetrics for almost 50 years, there is still disagreement concerning optimal clinical protocols for the use of oxytocin. This disagreement arises in part from inadequate data on oxytocin phar-macokinetics and pharmacodynamics. This report evaluates the uterine response to fixed doses of oxytocin (1–3 mlU/min) over long infusion times (up to 120 min) in 10 patients with secondary arrest of dilatation. The uterine activity increased from 132 ± 61 Alexandria units during the control period to 199 ± 64 Alexandria units at an infusion rate of 1 mlU/min. Increasing the infusion rate to 2 mlU/min increased the uterine activity to 240 ± 64 Alexandria units. The uterine activity increased until a steady state was achieved between 40 and 70 min after the initiation of infusion. Continuing the infusion at a fixed rate for more than 90 min appears to result in a decreasing uterine activity. Patients requiring oxytocin for augmentation of labor developed adequate uterine activity with dose rates of 1–3 mlU/min. Clinical protocols for oxytocin augmentation with an interval of 40–60 min between increases in the dosing seem reasonable based on these pharmacodynamic data.

ISSN:0378-7346    

DOI:10.1159/000293094

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

The effects of estradiol-17β (E2) and clomiphene citrate (CC) on pituitary-uterine function in ovariectomized (OVX) rats were compared in two experiments. In experiment 1 CC completely blocked E2 stimulation of uterine weight when administered concurrently for 10 and 30 days. In experiment 2, content of total (occupied and unoccupied) uterine nuclear estrogen receptors was increased by E2, but not by CC, compared to OVX controls. Only a fraction of the nuclear receptors was occupied in E2-treated rats, whereas all of these receptor sites were occupied in CC-treated rats. In addition, uterine cytoplasmic estrogen receptors were increased by E2 and diminished by CC treatment. Both E2 and CC were effective in preventing the postovariectomy rise in serum luteinizing hormone (LH) and follicle-stimulating hormone (FSH), although LH was always inhibited to a greater extent than FSH. After 30 days of treatment, pituitary gonadotropins were also substantially reduced by E2 and CC, suggesting that long-term treatment decreased both pituitary synthesis and release. An increase in pituitary weight observed in E2-treated rats only was due largely to the stimulation of lactotropes, as serum prolactin was increased. In summary, although CC and E2 similarly depressed pituitary gonadotropin secretion, they exhibited marked differences in the stimulation and occupancy of uterine estrogen receptors and the stimulation of pituitary prolactin secretion.

ISSN:0378-7346    

DOI:10.1159/000293095

出版商:S. Karger AG    

年代:1991

数据来源: Karger

ISSN:0378-7346    

DOI:10.1159/000288968

出版商:S. Karger AG    

年代:1910

数据来源: Karger

摘要:

The intrinsic innervation of the human uterine artery was investigated histochemically, and the motor responses to some of the demonstrated peptides and other humoral factors were studied on isolated vascular preparations. There were nerves with specific immunoreactivities for tyrosine hydroxylase, dopamine β-hydroxylase, neuropeptide-Y (NPY), vasoactive intestinal peptide (VIP) and peptide histidine methionine, and enzymatic reactivity for acetylcholine esterase. The most effective stimulator of smooth muscle contractility was arginine vasopressin followed in order by oxytocin, noradrenaline together with NPY, noradrenaline alone and dopamine. No effect was seen with acetylcholine and tyrosine, and VIP caused inconsistent relaxation of contractile activity induced by PGF2α. These results suggest that the uterine blood flow is regulated by complex interactions of factors, some occurring in nerve terminals and some being circulating humoral factors.

ISSN:0378-7346    

DOI:10.1159/000293096

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

The effect of an intravenous infusion of secretin (2.0 CU/kg/h) on serum prolactin (PRL) and estradiol levels and plasma levels of vasoactive intestinal polypeptide and somatostatin (SRIH) was studied in 8 healthy and normally cycling women during the midfollicular phase (cycle day 7), at midcycle (day 14), and during the midluteal phase (day 21) of the menstrual cycle. When compared to basal preinfusion levels, a significant decrease in serum PRL levels was observed at steady state concentrations of plasma secretin (+ 30 to + 60 min) both during the follicular (p < 0.03) and the luteal (p < 0.0001) phases. At midcycle a nonsignificant decrease was observed. A significant and negative correlation existed between serum PRL and plasma secretin levels in the follicular phase (r = ––0.33; p < 0.05) and in the luteal phase (r = ––0.73; p < 0.0001). The plasma concentrations of SRIH increased significantly at steady state conditions of secretin at midcycle (p < 0.02) and in the luteal phase (p < 0.04), while no effect was found during the follicular phase. A significant and positive correlation between plasma levels of SRIH and secretin was observed at midcycle (r = 0.63; p < 0.002) and in the luteal phase (r = 0.46; p < 0.02). No effect of secretin on plasma vasoactive intestinal polypeptide and serum estradiol concentrations was demonstrated. These results suggest that the suppression of PRL in the follicular phase of the spontaneous menstrual cycle can be ascribed to an effect of secretin alone. In the luteal phase, however, there is evidence for an additional effect of SRIH, and indirectly possibly also progesterone, to cause a more pronounced inhibition of PRL release.

ISSN:0378-7346    

DOI:10.1159/000293097

出版商:S. Karger AG    

年代:1991

数据来源: Karger