ISSN:0020-6695    

DOI:10.1016/0020-7292(95)02478-U

出版商:Wiley    

年代:2017

数据来源: WILEY

摘要:

AbstractIt is necessary to differentiate between complications of pregnancy and population risk groups for those complications. The latter have limited use as most complications occur in the low risk groups. Complications of pregnancy need to be treated in health facilities that can provide blood transfusions, cesarean section, removal of placenta and induction of labor. A plan must exist for each pregnant woman to be moved to such a facility, since it is not possible to predict who will have the complication. Early detection and effective treatment of complications and family planning services to prevent unwanted pregnancies is the way to lower maternal mortality.

ISSN:0020-6695    

DOI:10.1016/0020-7292(95)02479-V

出版商:Wiley    

年代:2017

数据来源: WILEY

摘要:

AbstractObjective: To determine whether there is an association between the level of glycemic control and perinatal complications in pregnant diabetic patients. Methods: Two hundred sixty confirmed cases of pre‐existing diabetes, gestational diabetes and impaired glucose tolerance were analyzed to assess risk factors, modality of treatment, level of blood sugar control and effect on perinatal morbidity and mortality. Results: Risk factors for the development of diabetes included age (>25 years), East Indian ethnic origin, glycosuria, and a history of diabetes in a first‐degree relative. Treatment consisted of diet alone or in combination with soluble insulin. There is a marked increase in perinatal mortality and maternal morbidity if normoglycemia is not maintained. Conclusions: A greater emphasis must be placed on the detection of diabetes in pregnancy and effective treatment should be instituted as early as possible to achieve normoglycemia if associated complications are to be reduced.

ISSN:0020-6695    

DOI:10.1016/0020-7292(95)02390-X

出版商:Wiley    

年代:2000

数据来源: WILEY

摘要:

AbstractAlmost all maternal and child deaths represent merely the endpoint of the ‘road to death’ — a combination of factors that include high‐risk pregnancy, socioeconomic disadvantage and inadequate health care. Unregulated fertility is the underlying cause of most high‐risk pregnancies. They are: unwanted; in mothers younger than 20 or older than 35; closely spaced; and in women who already have several children. The resulting morbidity and mortality create a cycle of further disadvantage, further increases in child mortality and further high‐risk pregnancies. Family planning is the single most important exit from the ‘road to death.’ Over the past 40 years it has contributed to the worldwide reduction in child mortality, and for every 100 women provided with family planning, a woman's life is saved.

ISSN:0020-6695    

DOI:10.1016/0020-7292(95)02480-Z

出版商:Wiley    

年代:2017

数据来源: WILEY

摘要:

AbstractObjective: To investigate the perinatal outcome and obstetric complications of women delivering for the 10th time or more. Methods: Four hundred twenty women of great grand multiparity were analyzed in a modern health care setting and compared with our general population of obstetric patients, with regard to past history, maternal age, gestational age, mode of delivery, fetal outcome and intercurrent medical/obstetric problems. Results: The study group showed significantly lower rates of low birth weight infants and instrumental delivery. No significant difference was seen in the incidence of cesarean section, pathologic fetal presentation, maternal hypertension, gestational diabetes, hemorrhage, or perinatal morbidity or mortality. There was a slightly higher incidence of twin births compared with the general population. Conclusion: It is probable that women capable of reaching their 10th delivery are basically healthy. If offered adequate perinatal care, they are not a high‐risk group during subsequent deliveries.

ISSN:0020-6695    

DOI:10.1016/0020-7292(95)02417-B

出版商:Wiley    

年代:2000

数据来源: WILEY

摘要:

AbstractToday's population in South Asia is estimated at 1.2 billion. With an average annual growth of 2%, it increases by more than 24 million people each year, the highest increment in the world. Despite recent improvements in the contraceptive prevalence rate, all countries in the region experience high levels of unmet need for contraception, Several of the region's characteristics have a bearing on the challenge of promoting and providing family planning services: women's status is particularly low; the persistence of son preference results in higher female than male mortality at all ages; the young age structure means an increasing number of people entering childbearing ages. Being predominantly rural, the region experiences shortages of trained health personnel as well as major problems of accessibility to basic health services.

ISSN:0020-6695    

DOI:10.1016/0020-7292(95)02481-Q

出版商:Wiley    

年代:2017

数据来源: WILEY

摘要:

AbstractObjective: To determine the economic feasibility (from the patient's viewpoint) of laparoscopic adnexectomy (LA) in a developing country. Method: Forty‐four LA cases of benign ovarian cysts or tubal pregnancy were compared with 44 conventional open adnexectomy (OA) cases treated during the same period and matched by diagnosis, procedure and degree of difficulty. Result: The postoperative hospital stay was 1.3 ± 0.6 days (mean ± S.D.) and 5.3 ± 1.1 days (P<0.001) for the LA and OA groups, respectively. LA cases had a shorter recovery period (5.8 ± 2.2 days vs. 27.2 ± 6.6 days, P<0.001), but higher hospital charges (US$463.3 ± 84.9 vs. US$229.8 ± 92.2, P<0.001), caused mainly (89.2%) by disposable laparoscopic instruments. Incremental cost‐benefit analysis revealed a possible saving with LA for higher income patients (US$9.2 per day). Conclusions: LA in Thailand may have economic benefit only to the higher income patients. Benefits to other patients in developing countries will depend on future cost reductions of disposable instruments and/or more effective use of reusable instruments.

ISSN:0020-6695    

DOI:10.1016/0020-7292(95)02393-Q

出版商:Wiley    

年代:2000

数据来源: WILEY

摘要:

AbstractThe potential long‐term impact of danazol on coronary risk hinges on its effect on lipoprotein metabolism rather than its influence on total plasma lipids. Danazol may exert a regulatory influence on three key processes in lipoprotein metabolism: hepatic lipase activity; low‐density lipoprotein receptor function; and lecithin:cholesterol acyl‐transferase activity. Danazol decreases plasma fibrinogen and lipoprotein (a) levels, promotes fibrinolysis and causes a rise in plasminogen. Such changes are beneficial as they inhibit the process of thrombosis. Androgenic properties of danazol produce effects on plasma lipids and lipoproteins which oppose estrogen‐induced changes. The usual recipients of danazol therapy are premenopausal females, in whom the absolute risk of ischemic heart disease is low. If the drug were shown to increase ischemic heart disease risk, detrimental factors must be weighed against its considerable and proven clinical benefits.

ISSN:0020-6695    

DOI:10.1016/0020-7292(95)02511-A

出版商:Wiley    

年代:2002

数据来源: WILEY

摘要:

AbstractAfrica lags behind the rest of the developing world in most demographic, health and economic indicators of social development, but some progress has been made in contraceptive prevalence and fertility decline. Many challenges remain for governments on that continent to meet the basic reproductive health needs of their rapidly growing populations. With the sustained support of the international community, there is reason to be hopeful.

ISSN:0020-6695    

DOI:10.1016/0020-7292(95)02482-R

出版商:Wiley    

年代:2017

数据来源: WILEY

摘要:

AbstractObjectives: Our purpose was to detect anatomic variations in postmenopausal bone loss and to determine the risk factors most affecting bone mass in Japanese women. Methods: One hundred sixty‐six Japanese women (54 premenopausal and 112 postmenopausal), aged 40–68 years, were enrolled in the study. Bone mineral densities (BMD) of the lumbar spine (L2–4) and total body were measured by dual energy X‐ray absorptiometry and the results were subjected to statistical analysis. Results: Among the various sites studied, the lumbar spine (L2–4) showed the fastest bone loss after menopause. Multiple regression analysis indicated that two factors, number of years since the menopause and body mass index (BMI), affected lumbar spine (L2–4) BMD. Conclusion: Measurement of lumbar spine (L2–4) BMD is suitable for evaluating postmenopausal osteoporosis. The risk factors for postmenopausal bone loss were a long period after menopause and a low BMI.

ISSN:0020-6695    

DOI:10.1016/0020-7292(95)02419-D

出版商:Wiley    

年代:2000

数据来源: WILEY