ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

The contribution of obstetric management to quality of life of surviving low birth weight infants is unclear. A possible association between maternal chorioamnionitis and development outcome was evaluated. One hundred twenty-seven mother/infant pairs with infant birth weight less than 2000 g were studied. The antenatal course was complicated by chorioamnionitis, premature rupture of membranes without chorioamnionitis, premature labor, or abruptio placenta. Analysis of variance was performed using these four diagnosis groups. After potentially confounding variables were taken into account, the overall difference in the four groups in Mental Development Index (Bayley Scales) was borderline (P= .138). However, significant differences remained between the group with chorioamnionitis and the group with premature rupture of membranes without chorioamnionitis (P= .017). The potential advantage of leaving infants in utero after premature rupture of membranes may be offset by disadvantage of chorioamnionitis with respect to future development in surviving infants.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

To ascertain what proportion of preterm deliveries are attributable to the association with Chorioamnionitis, the authors examined prospectively the placentas from all 2774 women who delivered at the Johns Hopkins Hospital during 1980. The incidence of preterm delivery was 5.4% (110 of 2027) when neither Chorioamnionitis nor premature rupture of membranes (PROM) was present, 11.9% (29 of 243) when Chorioamnionitis was present without PROM, and 56.7% (51 of 90) when both Chorioamnionitis and PROM were present (P< .05). Only 27 of 333 cases of histopathologic Chorioamnionitis or 8.1% had maternal antepartum fever, and only 11 of 333 or 3.3% had neonatal sepsis. Using logistic regression analysis to control for confounding variables, approximately 25% of the preterm deliveries were statistically attributable to histopathologic Chorioamnionitis, occurring either alone or in association with PROM. In light of the infrequency with which histopathologic Chorioamnionitis is clinically evident, the strong relationship between histopathologic Chorioamnionitis and preterm delivery suggests that occult antepartum infection of the genital tract is an important cause of preterm delivery.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

To evaluate the metabolic basis of gestational glucose intolerance (gestational diabetes), the response of normal pregnant women (N= 6) and lean (N= 23), and obese (N =12) gestational diabetics to the physiologic challenge of a 400− kcal mixed meal breakfast tolerance test was studied. Obese patients with gestational diabetes were more hyperglycemic than the lean gestational diabetics in both the fasting and postprandial periods. Women with gestational diabetes had a more prolonged glycemic response and a later insulin response to meal stimulation than normal control subjects. Fasting and postprandial insulin levels were higher in the obese gestational diabetes group, whereas those of lean subjects fell below the values of the control group. The percent specific binding of insulin to red blood cell receptors was lower in both gestational diabetes groups than in control subjects, with the most marked decrease in the obese group. Mean fasting plasma levels of total cholesterol and triglyceride and plasma glucagon levels during the meal tolerance test were not significantly different among the three groups. Obese gestational diabetics had significantly larger infants and placentas than lean gestational diabetics. These findings, taken together, suggest that the pathophysiology of gestational diabetes differs between obese and lean patients. Lean gestational diabetics appear to develop glucose intolerance on the basis of relative insulin deficiency in contrast to obese gestational diabetics who manifest glucose intolerance characterized by insulin resistance, hyperinsulinemia, and decreased insulin binding to red blood cell receptors.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

The high concentrations of prolactin (hPRL) in human amniotic fluid appear to be derived principally from maternal decidua. The present study evaluated both the biologic and immunologic activity of amniotic fluid hPRL obtained from normal and selected complicated pregnancies. Biologic and immunologic activities of amniotic fluid hPRL were also compared with lecithin: sphingomyelin ratios and phosphatidylglycerol content. No significant correlation existed between amniotic fluid hPRL activities and fetal lung maturation. However, a significant increase in amniotic fluid hPRL concentration as well as specific biologic activity of the hormone was found in pregnancies complicated by hypertension. These findings suggest alterations in the synthesis of decidual hPRL and/or its transport to the amniotic fluid that may influence pregnancy-induced hypertension.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

The tocolytic and cardiovascular effects of intravenous nicardipine HC1, a calcium entry blocker, were studied in 20 pregnant rabbits. Premature uterine activity was induced by extraovular infusion of prostaglandin F2-α and three different nicardipine HC1 dose schedules were tested. Significant dose-related inhibition of both electrical and mechanical uterine activity was observed. Treatment was also accompanied by a significant rise in pulse rate and a decrease in both diastolic and systolic blood pressure. It is concluded that nicardipine HC1 is a potent tocolytic agent that deserves further evaluation for possible clinical use.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Obstetric decisions regarding premature (23 to 32 weeks' gestation) infants must be based on gestational age. However, most reports of the survival of premature infants are based on birth weight. The present report relates the perinatal survival and morbidity of 105 newborns to the obstetric gestational dating criteria between 23 and 32 weeks' gestation. Gestational age was determined from at least four obstetric criteria including the first day of the last menstrual period, early pelvic examination, the earliest auscultation of fetal heart tones with a fetoscope, fundal height measurements in centimeters between 20 and 30 weeks' gestation, and sonographic gestational age measurements. At 23 to 26 weeks' gestational age, nine (39%) of 23 neonates survived. Five of nine survivors had moderate to severe intracranial hemorrhage, three had moderate to severe bronchopulmonary dysplasia, and three had moderate to severe retrolental fibroplasia. At 27 to 29 weeks' gestational age, 25 (93%) of 27 neonates survived. Of the 25 survivors, three had moderate to severe intracranial hemorrhage, one had moderate to severe bronchopulmonary dysplasia, and one had severe retrolental fibroplasia. At 30 to 32 weeks' gestational age, 52 (95%) of 55 neonates survived. Three of the 52 (6%) survivors had serious neonatal morbidity consisting of moderate to severe intracranial hemorrhage (three neonates) and moderate to severe bronchopulmonary dysplasia (one neonate). Thus, ten of 34 (29%) survivors between gestational ages of 24 to 29 weeks had a serious morbidity versus only three of 52 (6%) survivors between 30 to 32 weeks' gestation (P < .01).

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Standardized bovine cervical mucus penetration by human sperm in vitro provides information for evaluating male fertility. Normal semen specimens from 20 sperm donors and 17 infertile men were tested for cervical mucus penetration. Rigorous control of test temperature was necessary to guarantee the reliability and reproducibility of cervical mucus penetration. Sperm washing was found to significantly improve cervical mucus penetration for infertile men, from 18 ± 2.2 to 27 ± 3.4 mm,P< .025. Sperm washing for normal donors had no apparent effect on cervical mucus penetration (58 ± 1.5 mm prewash, 55 ± 1.7 mm postwash,P> .1). The authors conclude that: 1) temperature for cervical mucus penetration testing is critical to reliability, and 2) cervical mucus penetration is a useful screening tool for in vitro procedures proposed to improve sperm function.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

One hundred and two patients were treated for primary adenocarcinoma of the uterine cervix over a ten-year period from 1973 to 1982. Of these, 51 patients underwent initial surgical management that included a pelvic and para-aortic lymphadenectomy with a radical hysterectomy or a surgical staging operation. Clinical lesion size, grade, and depth of stromal invasion were correlated with lymph node metastasis and survival. The incidence of positive lymph nodes was 14.6% for stage I and 40.0% for stage II. Positive lymph nodes were documented in none of 15 patients with lesions smaller than 2 cm, 16.7% (five of 30) with 2 to 4 cm, and 82.3% (five of six) with larger than 4 cm; 5.3% of grade 1 tumors, 11.1% of grade 2, and 50.0% of grade 3. There were no lymph node metastases (zero of six) in patients with a tumor that had a depth invasion of less than 2 mm, whereas positive nodes were found in 11.1%) (two of 18) patients with 2 to 5 mm of invasion, 28.6% (two of seven) with 5 to 10 mm, and 57.1% (four of seven) with greater than 10 mm of invasion. Five-year survival was 82.9% for stage I and 42.9% for stage II patients; 91.7% with negative lymph nodes, and 10% with positive nodes (P< .0001). The size of the primary tumor (P< .0001), tumor grade (P< .05), and depth of invasion (P< .05) correlated with patient survival. Large tumors (greater than 4 cm) of cervical adenocarcinoma and those of high tumor grade correlate with a high likelihood of pelvic and paraaortic lymph node metastasis. Conversely, no patient with small lesions (less than 2 cm) had lymph node metastasis, whereas one of these patients with a grade 3 lesion invasive to a depth of 5 mm recurred in the lung. Lesions of intermediate dimension (2 to 4 cm) were associated with lymph node metastases when high tumor grade or invasion greater than 5 mm was present. All but one patient with lymph node metastases died with distant metastases

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

The records of 94 patients with epithelial ovarian carcinoma of low malignant potential were examined. These records were contributed by Walter Reed Army Medical Center, Naval Hospital, Bethesda, MD, and Naval Hospital, Portsmouth, VA. A review of microscopic sections from each of the 94 tumors confirmed that these were lesions of low malignant potential. The tumors occurred in patients of a younger age than that generally described for invasive epithelial ovarian carcinoma. Forty-seven of 94 patients had stage I disease. The corrected five- and ten-year survival rates were 95 and 87%, respectively. Adjunctive postoperative therapy may not influence survival.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID