摘要:

Study of 10,454 consecutive newborn infants showed that 4.1% had a major malformation and 6.5% had a minor malformation. The incidence of major fetal malformations was increased in stillborn infants (14.1%), neonatal deaths (36.7%), and dysmature infants (8.6%), and when there was maternal hypoglycemia (5.8%), hyperglycemia (5.8%), or subnormal urinary estriol excretion (9.8%). Minor malformations were associated with fetal dysmaturity (9.7%) and subnormal estriol excretion (8.8%). Abnormalities of maternal glucose tolerance and urinary estriol excretion were associated with specific types of major malformations. These data showed that hypoglycemia was as important as hyperglycemia in the etiology of fetal malformations.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

A review of a 38-year experience with cesarean section at a community hospital shows considerable change in both the rate and indication for cesarean sections. A marked increase in the cesarean section rate was noted after 1972. This increase was due primarily to an increase in the primary cesarean section rate for cephalopelvic disproportion and labor abnormalities, fetal distress, and the breech presentation. As a result of this study, we anticipate a primary cesarean section rate of approximately 10%: 3–5% for cephalopelvic disproportion and labor abnormalities, 1–1 1/2% for fetal distress, 3% for breech presentation, and 1–2% for all other indications.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Oxytocin levels in plasma and amniotic fluid were measured by a specific radioimmunoassay with a sensitivity of 5 pg/assay tube. Twenty-one of 28 pregnant patients had detectable levels of oxytocin ranging from 2.7 to 24.0 pg/ml. In 11 subjects in labor the mean ± SE of maternal venous plasma oxytocin was a) 43.1 ± 11.2 pg/ml (range: undetectable-72.5 pg/ml) in the first stage, b) 114.1 ± 20.7 pg/ml (range: 18.8–140.0 pg/ml) in the second stage, and c) 63.9 ± 10.8 pg/ml (range: 3.9–117.5 pg/ml) in the third stage. In 24 patients with normal labor and vaginal delivery, mean ± SE oxytocin concentrations were as follows: maternal venous plasma 40.6 ± 11.6 pg/ml (range: undetectable-72.5 pg/ml), umbilical arterial plasma 114.8 ± 18.3 pg/ml (range: 14.0–350 pg/ml), and umbilical venous plasma 37.5 ± 5.5 pg/ml (range: 6.3–107.5 pg/ml). Similarly, in 11 patients who had cesarean section after the onset of labor, maternal plasma oxytocin was 51.7 ± 13.1 pg/ml (range: 45.5–151.7 pg/ml); umbilical arterial plasma was 121.3 ± 29.9 pg/ml (range: 34.0–344.8 pg/ml); umbilical venous plasma oxytocin was 36.6 ± 10.1 pg/ml (range: 11.0–25.0 pg/ml); and amniotic fluid oxytocin was 43.5 ± 12.5 pg/ml (range: 11.0–96.0 pg/ml). In contrast, in 10 patients with cesarean section without labor, oxytocin level in maternal plasma was 26.7 ± 7.8 pg/ml (range: undetectable-63.5 pg/ml); in umbilical arterial plasma was 47.1 ± 7.9 pg/ml (range: 1.2–77.1 pg/ml); and in umbilical venous plasma was 27.6 ± 6.8 pg/ml (range: undetectable-60.3 pg/ml). The umbilical arteriovenous difference in oxytocin concentration was significantly higher in patients with labor than in patients without labor (P< 0.01). The results indicated 1) that maternal plasma has detectable levels of oxytocin during pregnancy which increases during labor with peak levels during the second stage, 2) a higher fetal concentration of oxytocin which flows towards the maternal compartment, and 3) that the fetus is a possible source of oxytocin for the mother during human labor.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Acute inversion of the uterus is a rare emergency that occurs during the third stage of labor. Three cases of this complication are reported. General anesthesia, fundal pressure on a soft uterus, fundal implantation of the placenta, and adherent placenta were identified as the possible causes. Prompt recognition and replacement are essential in the management to preempt morbidities and mortality. The prevention, etiology, and management of this serious complication are discussed.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Four cases of liver adenoma associated with oral contraceptives complicating pregnancy are reported. All patients were symptomatic during pregnancy and 2 were admitted with rupture of the adenoma. One subsequently died. Increased growth and vascularity of adenomas during pregnancy is highly likely. The potential for development of lethal complications is considerable.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

The correlation between lecithin/sphyngomyelin ratio (L/S ratio) and amniotic fluid optical density at 400 (OD400) and 650 (OD650) nm was studied with 102 samples of fluid obtained from 72 patients. The accuracy of each method in predicting the respiratory outcome of the newborn was also evaluated in 28 patients who delivered within 48 hours after amniocentesis. Results indicate that the correlation between spectrophotometric analysis and L/S ratio is poor and that the latter is a better predictor of neonatal respiratory outcome. It is concluded that measurements of amniotic fluid optical density are not an acceptable substitute for the L/S ratio in evaluating fetal pulmonary maturity.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

The purpose of this study was to compare ultrasonic measurements of fetal abdominal circumference to ultrasonic measurements of fetal biparietal diameter, as a means of estimating fetal body weight. Of 58 fetuses who had abdominal circumferences measured, 48 (82%) of the predicted weights were within 15% of the actual birth weights. Forty-four of the same 58 fetuses had satisfactory biparietal diameter measurements, but only 21 (48%) of the predicted weights were within 15% of the actual birthweights. Ultrasonic measurement of abdominal circumference appears to be a more reliable index of fetal body weight than other currently available techniques.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Fetal breathing movements in 14 twin pregnancies were examined with ultrasonic technique. The twin fetuses I in cephalic presentation showed a significantly higher percentage of apnea and periodic breathing compared with twin fetuses II. No such difference was found in twin pairs with Twin 1 in breech presentation. Also in the control group of 27 singleton pregnancies, the fetuses in cephalic presentation had a higher incidence of apnea and periodic breathing than those in breech presentation. The position of the fetus seems to be decisive for the character of the breathing movements before birth.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

The estriol concentration of a morning sample of urine from high-risk pregnant women was correlated with the total 24-hour estriol excretion. One hundred seventy sample pairs compared the estriol concentration of the morning specimen with those of a 24-hour specimen of the previous day, while 110 sample pairs compared the value of morning specimen with those of a 24-hour specimen of the following day. Although there is highly significant statistical correlation between those sample pairs, they are of modest magnitude. The mean values of the sample pairs are significantly different. Also, the morning sample estriol concentrations are significantly more variable than those of the 24-hour specimen.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Real-time ultrasonography utilizing a hand-held linear array transducer provides a highly accurate method of identifying and evaluating the twin gestation. The rapidity of real-time scanning eliminates interpretational problems caused by fetal movements. Additionally, the versatility of transducer positioning facilitates recognition of appropriate fetal planes for assessment of viability and growth. A prospective study of 595 consecutive pregnancies yielded no misdiagnoses of the number of fetuses present and only one false positive diagnosis of fetal viability.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID