摘要:

The first stage of the implantation is the adhesion of the embryonic pole of the blastocyst to the decidua. Such a phenomenon has been demonstrated to be dependent on the presence of glycoproteic compounds, produced partly by the decidua and partly by the embryo. CA125 is an antigenic determinant associated to a glycoprotein expressed by various embryonic tissues. The objective of our research has been to measure the production of CA125 by the embryo in the initial phase of its development. Patients were recruited from our in vitro fertilization program. The culture medium used for the oocytes and for the embryos was collected and CA125 levels were measured. The results indicate that there is not a statistically significative difference between the values of CA125 measured in the mediums where a pronucleus or an embryo was present and the negative controls. From our data, therefore, it can be concluded that CA125 expression begins later in the human embryonic development than 8-cells-stage embryo.

ISSN:0378-7346    

DOI:10.1159/000292044

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Thirty patients with unruptured ectopic pregnancy (4–10 weeks’ gestation) were treated locally with methotrexate (MTX) under sonographic guidance. The transvaginal puncture was performed under analgesic sedation using an automatic puncturing device. Local MTX therapy was successful in 25 patients (83.3%). Eighteen of these patients had received a single MTX instillation with a total dose of 10 mg, 7 patients had received a second instillation with 10 mg because of plateauing hCG levels after the first instillation. In 5 patients MTX therapy was unsuccessful. Surgical intervention was necessary within 4 h to 15 days after MTX treatment, due to severe tubal bleeding (n = 1) or the development of an increasing peritubal hematoma (n = 4). Patients with an outer trophoblast diameter 5,000 mlU/ml the success rate was 70% (7/10) and in patients with demonstration of cardiac activity of the embryo 63% (5/8). The fluid aspirated from the ectopic cavity showed an average hCG concentration that was 53 times higher than in the serum. The decline in hCG to values below 10mlU/ml ranged between 7 and 75 days (mean 28 days). The hysterosalpingography performed 4–6 months after MTX therapy showed tubal patency on both sides in 85.7% of the patients examined. In the meantime 4 of these patients gave birth to healthy chi

ISSN:0378-7346    

DOI:10.1159/000292045

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

One hundred and six third trimester pregnant women with prelabour rupture of membranes preterm were randomised to either peroral amoxicillin 0.75 g 3 times daily (n = 50) or placebo (n = 56) in a blinded way. The patients were hospitalised in bed for 7 days unless contractions started and delivery ensued. Only 1 patient was discharged after 7 days of treatment, while the remaining ones delivered within 1 week after admission. The average rupture-to-expulsion interval was 68.4 h in the placebo group and 91.7 h in the amoxicillin group, implying a significantly prolonged stay by 43% in the amoxicillin group (p = 0.03). The other outcome variables registered (birth weight, stillbirth prevalence, vaginal haemorrhage and postpartum endometritis-myometritis) did not differ significantly in the two treatment groups. There was a trend towards a longer duration of stay in the neonatal ward among newborns in the amoxicillin group suffering neonatal death (p = 0.06). It is concluded that antibiotic treatment of this group of women may be justified in settings were sexually transmitted diseases and other genital infections are prevalent, whereas such treatment is less likely to have an effect when genital infection is rare.

ISSN:0378-7346    

DOI:10.1159/000292046

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

The purpose of this study was to elucidate whether the use of intravenous ampicillin (vs. placebo therapy) in women in early active-phase preterm labor reduces infectious complications postpartum in mothers and their newborns. A randomised, double-blind, placebo-controlled study was carried out on 102 women with gestational age < 37 completed weeks in the active phase of labor (dilatation of cervix ≧ 4 cm). Enrolled women received a loading dose of 5 g of ampicillin (n = 44) or placebo (n = 58) in intravenous infusion twice, 4 h apart. In a few cases, this interval was shortened in order to obtain a minimum interval of 1 h between the last dose and delivery. There was a significant reduction in the ampicillin group (vs. the placebo group) of the prevalence of neonatal infection (OR 19.0; 95% CI 5.5–80.8), histological chorioamnionitis (OR 5.9; 95% CI 2.0–19.4) and puerperal endometritis-myometritis (OR 3.7; 95% CI 1.3–10.3). It is concluded that women in the active phase of preterm labor and their newborns benefit from treatment with intravenous ampicillin. Antibiotic treatment reduces the incidence of neonatal infectious morbidity, of puerperal endometritis and of histological chorioamn

ISSN:0378-7346    

DOI:10.1159/000292048

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

This study was performed in order to assess whether the use of oral ampicillin vs. placebo therapy in women with latent-phase preterm labor delays delivery and improves pregnancy outcome. A prospective, randomised, double-blind, placebo-controlled study was performed of 110 women at 22–34 weeks of gestation. Patients received oral ampicillin 1 g (n = 59) or placebo (n = 51) every 8 h for 7 days. Outcome measures comprised gestational age at delivery, birth weight, Apgar score, perinatal death, neonatal infection, fetal growth restriction, histological chorioamnionitis and puerperal infection. In the ampicillin and placebo groups, respectively, the average gestational age at birth was 36.6 and 33.8 weeks (p < 0.05) and average birth weight 2,885 and 2,336 g (p 35 weeks and for birth weight ≧2,500g was 3.9 (95% CI 1.6-9.4). Neonatal infection (OR 15.5; 95% CI 4.6–65.7), intrauterine growth retardation (OR 9.6; 95% CI 2.8–41.3), histological chorioamnionitis (OR 13.0; 95% CI 3.4–72.2) and puerperal endometritis-myometritis (OR 65.3; 95% CI 9.3–2,715.7) occurred significantly less frequently among ampicillin-treated than among placebo-treated women. It is concluded that women in latent phase of preterm labor benefit from treatment with oral ampicillin, which prolongs the gestational age at delivery with ensuing increase in birth weight, reduction in the prevalence of histological chorioamnionitis and in neonatal and puerperal infectiou

ISSN:0378-7346    

DOI:10.1159/000292049

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Twenty-two hospitalized patients, diagnosed as having hypertensive disorder of pregnancy, were selected from two University Clinics. Maternal serum samples were analyzed for serum group II phospholipase A2 (PLA2-II) by time-resolved fluoroimmunoassay. At the same time, umbilical artery blood flow velocities were measured with color Doppler sonography for orientation and pulsatile Doppler sonography for recording waveforms. Nineteen normoten-sive third-trimester pregnant patients served as a control group. Maternal serum PLA2-II was elevated in 8 cases with preeclampsia. This elevation was invariably associated with decreased blood flow velocity in the umbilical artery. In 1 case, the clinical condition allowed simultaneous follow-up of serum enzyme and blood flow velocity: a further rise of serum PLA2-II was linked to a further decrease in the blood flow velocity of the umbilical artery. A large spillover of the elevated PLA2-II content from the preeclamptic placenta into the maternal serum is associated with a decrease in blood flow velocity in the umbilical artery. The enzyme might serve as a link between local proximal (placenta) and systemic distal (umbilical arterial blood flow) effectors.

ISSN:0378-7346    

DOI:10.1159/000292050

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

The aim of this research was to study the concentration of urinary trypsin inhibitor in amniotic fluid (AF) and its effect on myometrial contraction in term and preterm deliveries. Urinary trypsin inhibitor was measured in AF of term and preterm labor. Immunohistochemical staining of amnion and myometrium was carried out. Isometric uterine contraction was studied to elucidate the effect of AF and urinary trypsin inhibitor on the contractile activity of term and preterm myometrium. The effect of urinary trypsin inhibitor on the production of prostaglandin E2 (PGE2) from myometrial cultures stimulated by IL-8, IL-1 and LPS was verified. Urinary trypsin inhibitor was significantly increased in AF of cases of preterm delivery (p < 0.0001). Amnion and myometrium of preterm deliveries were faintly stained for urinary trypsin inhibitor compared to term delivery. Amniotic fluid and urinary trypsin inhibitor could successfully inhibit myometrial contraction. Also, urinary trypsin inhibitor could significantly inhibit the production of PGE2 in the myometrial cell cultures stimulated by IL-1 and LPS (p < 0.001 and 0.0005). IL-8 has no significant effect on PGE2 production from myometrial cell culture. Urinary trypsin inhibitor suppresses myometrial contraction in term and preterm deliveries. It may play a role in maintaining normal pregnancy and preventing preterm delivery.

ISSN:0378-7346    

DOI:10.1159/000292051

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

The change in plasma concentration of human hepatocyte growth factor (hHGF) in pregnant women with HELLP (hemolysis, elevated liver enzyme and low platelets) syndrome was investigated, and the following results were obtained. (1) The plasma concentration of hHGF in pregnant women did not change with the gestational stage. (2) The plasma concentration of hHGF in pregnant women with EPH (edema, proteinuria and hypertension) gestosis was 0.19 ± 0.07 ng/ml and did not differ greatly from that in control pregnant women. (3) The plasma concentration of hHGF in pregnant women with HELLP syndrome was 1.79 ± 0.35 ng/ml; it was increased prominently compared to control pregnant women. (4) The plasma concentration of hHGF in pregnant women with HELLP syndrome changed parallel to the clinical symptoms of the syndrom

ISSN:0378-7346    

DOI:10.1159/000292052

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

We immunohistologically studied the hepatic tissue sections in cases with the syndrome of hemolysis, elevated liver enzymes, and low platelets (HELLP syndrome; n = 2) and acute fatty liver of pregnancy (AFLP; n = 2) compared to necropsy controls. Unlike in the AFLP cases, a marked infiltration of neutro-phils in liver tissues was found in both cases of the HELLP syndrome. Immunostaining with the antihuman (polyclonal) TNF-α, IL-lβ, IL-8 and antihuman neutrophil elastase (monoclonal antibody) was performed in paraffinembedded hepatic tissue sections. Liver tissues in HELLP syndrome patients were stained strongly with TNF-α and neutrophil elastase antibody. The strongest staining pattern was observed in the eclamptic case, whereas in the AFLP cases, as in the necropsy controls, a very weak staining for anti-TNF-α and elastase antibody was found. The liver sections of the HELLP syndrome cases were moderately stained with polyclonal IL-lβ and IL-8 antibodies whereas AFLP and controls had a very faint staining. Significant correlations were found between the numbers of necrotic hepatocytes and elastase dots in the same microscopic fields (randomly selected) of liver sections from two cases of HELLP syndrome (r2 = 0.63; p < 0.0001), which might suggest a neutrophilmediated tissue damage in such a disease. This study suggests that a cytokine-and neutrophil-mediated liver injury occurs in the HELLP syndrome but not in

ISSN:0378-7346    

DOI:10.1159/000292053

出版商:S. Karger AG    

年代:1996

数据来源: Karger

ISSN:0378-7346    

DOI:10.1159/000291550

出版商:S. Karger AG    

年代:1915

数据来源: Karger