摘要:

In an acute fetal lamb model the relation between arterial PCO2 (PaCO2), transcutaneous PCO2 (tcPCO2) and pH was studied at different conditions of stress. Occlusion of the maternal common iliac artery for 8 min, umbilical cord obstruction for 5 min and placental embolization were performed subsequently, every time with an interval of 1 h for fetal recuperation. During the first 2 experiments arterial values changed rapidly after occlusion and returned nearly to normal within 30-60 min after the end of occlusion. TcPCO2 started to increase several minutes after occlusion and reached its maximum about 5 min after the end of occlusion. Afterwards a gradual decrease towards the onset value was observed. During placental embolization tcPCO2 did not increase until 15 min before fetal death. It is concluded that tcPCO2 can follow a gradual trend, but not quick changes in PaCO2.

ISSN:0378-7346    

DOI:10.1159/000291808

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Recent evidence suggested that periovulatory treatment with an immunomodulatory agent such as verapamil might be an effective alternative to conventional treatment for endometriosis ssociated subfertility. In particular, it has been reported that the drug might reduce the accentuated macrophage peritoneal activation demonstrated in patients with endometriosis. In this study, we compared the effect of the calcium antagonist verapamil with those of gestrinone, danazol and testosterone on human monocyte phagocytosis in an attempt to evaluate any significant differences in their ability to influence a parameter of cell inflammatory activation. Peripheral blood monocytes were isolated from 37 healthy women. Monocyte function was determined by phagocytosis of fluorescent microspheres after an overnight incubation in the presence or absence of the various agents. This study indicates that verapamil at the pharmacological concentration of 0.4 μg/ml, the systemic level in patients taking 40-80 mg/8 h p.o., significantly inhibits monocyte function. A lower immunosuppressive but still significant effect was achieved in this assay system with gestrinone at a concentration of 3 × 10-8M). The pharmacological concentration of danazol (10-6M) and the physiologic concentration of testosterone (10-8M) did not significantly affect this immunologic test system. These results provide evidence that verapamil is able to exert a slightly greater immunosuppressive effect than steroidal drugs on monocyte phagocytosis. However, due to the small differences observed, further studies on the biological mechanism of the drug seem to be necessary to completely elucidate its potential role in endometriosis-associated subfertility.

ISSN:0378-7346    

DOI:10.1159/000291809

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

The purpose of the study was to develop a Doppler modality for effective assessment of the fetoplacental circulation. Calculations based upon a theoretical model were employed to predict downstream pulsatility values in the fetoplacental circulation. The clinical study included 83 pregnancies between 32 and 36 weeks of gestation. Sixty-nine women were recruited from our low-risk clinic and had uncomplicated pregnancies. Fourteen patients had complications suspected to be associated with placental pathology. All 83 patients demonstrated UA Doppler indices within the normal limits for the gestational age. The study included intraplacental and UA Doppler waveform analyses. The ratios between intraplacental and UA PI values (at the cord insertion to the placenta) were calculated. Nineteen patients with intraplacental to UA (placental cord insertion) PI ratios > 1 (abnormal) had adverse pregnancy outcome. The study demonstrates the importance of detailed scanning of the intraplacental pulsatile waveforms and the importance of using the ratio between the intraplacental and UA Doppler indices as an additional method for evaluation of the fetoplacental circulation. The method might be proven more effective mainly in the early stages of placental disease when a relatively small number of the placental terminal arterioles are affected with a negligible effect on the UA Doppler indices, and also in the evaluation of the large placenta. A fetal growth classification based on detailed intraplacental velocimetry and cord to intraplacental flow gradient is proposed.

ISSN:0378-7346    

DOI:10.1159/000291810

出版商:S. Karger AG    

年代:1997

数据来源: Karger

ISSN:0378-7346    

DOI:10.1159/000292204

出版商:S. Karger AG    

年代:1916

数据来源: Karger

摘要:

A new method for estimating the fetal weight is described, based on symphysis-fundus height and gestational age. The relationship between ultrasound-estimated fetal weight, gestational age, and symphysis-fundus height was determined using multiple regression analysis in a low-risk group. The accuracy of the regression formula was tested retrospectively on two target populations: a second low-risk group and a higher risk group undergoing elective delivery. The formula overestimated weight by 3.6%. The standard deviation of the random errors for the first group was 10.3% whereas in the second it was 11.9%. Fetal weight estimation using symphysis-fundus height and gestational age can be performed with an accuracy comparable to that of ultrasound.

ISSN:0378-7346    

DOI:10.1159/000291811

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Objective: To investigate parameters of fetal well-being (characteristics of non-stress test, NST, and antepartum fetal heart rate, FHR, patterns) and selected neonatal outcomes in pregnant women on methadone maintenance. Study Design: A matched case-control study of methadone-treated women receiving prenatal and intrapartum care at a Bronx municipal hospital during 1992–1994. 102 NSTs obtained from 24 methadone-treated women after 35 weeks of pregnancy were compared to 96 NSTs from a control group (n = 24), matched for maternal age, parity, and gestational age. All NSTs were evaluated for general characteristics including time interval between initiation and achievement of reactive NST (2 accelerations > 15 bpm lasting for at least 15s in a 20-min period), baseline, amplitude of fluctuation, frequency of fluctuation, accelerations and decelerations. The scoring system described by Lyons et al. was used for all NSTs. All nonreactive NSTs were followed with biophysical profile tests. Results: The frequency of nonreactive NSTs was significantly higher for methadone-maintained women compared to controls (19.6 vs. 4.2%; p < 0.01). The average length of time to achieve reactive NST was significantly (p = 0.0016) longer for the methadone-treated group when compared to controls (35.50 ± 20.96 vs. 14.85 ± 9.03 min). The total score (Lyons et al.) was significantly lower (p < 0.0007) for the methadone-treated group compared to controls. Mean birth weight, Apgar scores at 1 and 5 min, meconium, and umbilical cord artery pH were not significantly different for methadone-exposed neonates compared to controls. Conclusion: Methadone maintained pregnancies are significantly associated with a higher incidence of nonreactive NSTs, longer intervals to achieve reactive NSTs and lower NST scores compared to controls. This may reflect an altered response in fetal central nervous system neurotransmitters and changes in fetal behavior induced by methadone.

ISSN:0378-7346    

DOI:10.1159/000291812

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

We measured thrombin-antithrombin III (TAT) complexes and antithrombin III (AT III) in amniotic fluid and blood plasma of 39 parturient women. TAT was measured by ELISA. Partigen plates were used for measuring the antigen of AT III, and activity was determined using chromogenic substrate. While AT III activity and AT III antigen were below 20% of plasma values, TAT concentration was 2–4 times higher in amniotic fluid than in blood plasma (over twice at the onset of labour, i.e. 54.2 ± 26.4 and 20.7 ± 10.7 ng/ml, and approximately 4 times after childbirth, i.e. 108.9 ± 49.2 ng/ml in amniotic fluid and 27.8 ± 13.2 ng/ml in blood plasma, respectively). We have concluded that thrombin generation and TAT formation in amniotic fluid are of significantly higher intensity than in plasma, and they increase during l

ISSN:0378-7346    

DOI:10.1159/000291813

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Several in vitro studies reported on increased levels of progesterone secretion from placental tissue. This was not tested in vivo. To study the issue we examined progesterone levels in women presenting with premature labor before treatment, and 24 and 48 h after beginning ritodrin treatment. A control group consisted of women treated with indomethacin for preterm labor. There were 13 women in the ritodrin group and 12 in the control group. The mean concentration of progesterone in the ritodrin group was 161.7 ± 74.2, 132 ± 50.2 and 145 ± 49.8 ng/ml before treatment, and 24 and 48 h after ritodrin treatment, respectively. The mean progesterone concentration of the group treated with indomethacin was 129 ± 45.6, 132 ± 49.5 and 138.6 ± 53.5 ng/ml before treatment, and 24 and 48 h after treatment, respectively. There were no statistically significant differences between the groups or within each group before and after treatment. Ritodrin treatment does not affect progesterone levels in vivo as demonstrated by in vitro studies.

ISSN:0378-7346    

DOI:10.1159/000291814

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

We examined the endothelin (ET)-1 and -2 concentration in peripheral blood serum of 27 pregnant patients with EPH gestosis who underwent cesarean section between the 32nd and 38th week of gestation (group Gc). The control group consisted of 26 healthy pregnant women who underwent cesarean section due to fetal malpositions (group Kc). ET concentration in umbilical venous blood serum in 22 cases of EPH gestosis (group Gp) and 20 cases from the control group (group Kp) was measured after delivery. ET concentration was determined with use of a radioimmunoassay method after extraction with column chromatography. The mean ET concentration was 41.55 pg/ml in group Gc and was significantly higher than in group Kc – 6.77 pg/ml. The mean ET concentration in umbilical blood serum in group Gp was 50.59 pg/ ml and was significantly higher than in Gc and Kp groups – where ET concentration was 17.11 pg/ml. These studies indicate that the high level of ET may play an important role in pathogenesis of EPH gestosis as well as having influence on uteroplacental and umbilicoplacental circulation.

ISSN:0378-7346    

DOI:10.1159/000291815

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

The endocrine effects of surgical trauma are incompletely understood. We have measured serum levels of cortisol, 17α-hydroxyprogesterone (17-OHP), dehydroepiandrosterone (DHA), 4-androstene-3,17-dione (A4) and total (free + conjugated) estrone (tE1) before, during and up to 6 days after surgery in 30 postmenopausal women undergoing repair of vaginal prolapse. Anesthetic procedures were standardized. During surgery and the early postoperative hours the serum steroid pattern closely resembled that found during a diagnostic ACTH challenge test with a simultaneous increase in all adrenocortical steroids, while tE1 levels were unchanged. During the late postoperative period the levels of cortisol, 17-OHP and A4 were still elevated up to 24 h after surgery while the levels of DHA were normal or even decreased. The postoperative pattern of adrenocortical steroids may reflect a redistribution of the intra-adrenal steroid flux in favor of cortisol production. The tE1 levels were elevated in the early and, most pronounced, in the late postoperative phase. tE1 was positively correlated to A4 in the early but not in the late postoperative phase. The late increase in tE1 probably reflects an impaired bowel function in connection with surgery, leading to increased reabsorption during enterohepatic circulation.

ISSN:0378-7346    

DOI:10.1159/000291816

出版商:S. Karger AG    

年代:1997

数据来源: Karger