摘要:

This follow-up study presents the effects of DES on the genital tract of male and female offspring of mothers who were part of a double-blind, placebo-controlled investigation during 1951 and 1952 aimed at determining the effect of DES on pregnancy. Epididymal cysts, hypotrophic testes, and capsular induration were the more common genital lesions found in 25% of 163 DES-exposed males as compared to 6% in 168 control males. Semen analysis data on 39 subjects of the DES-exposed group and 25 subjects of the control group showed that 26% of the DES-exposed group produced an ejaculate volume under 1.5 ml; no such cases were observed in the control group. The average values for sperm density and total motile spermatozoa per ejaculate, although in the normal range, were more than two times lower in the DES-exposed group as compared to the controls. A quality score of > 10 (“severely pathologic semen”) was found in 28% of the DES-exposed group as compared to 0 in the control group. An association of pathologic semen quality with physical abnormalities was found only in the DES-exposed group. Two cases of azoospermia, one without genital abnormalities on physical examination and one with bilateral hypotrophic testes were observed so far in the DES-exposed group. Eighteen percent of 229 DES-exposed female patients had irregular menstrual cycles (oligomenorrhea) as compared to 10% of 136 controls. The history of pregnancy revealed a lower incidence of pregnancy in the DES-exposed group (18%) than in the control group (33%). Circumferential ridges of the vagina and cervix were seen in 40% of 229 DES-exposed females but in none of 136 controls. Colposcopic findings in the vagina revealed adenosis in 66.8% of the DES-exposed females and in 3.6% of the control group. Dysplastic lesions were more prevalent in the vagina and cervix of the DES-exposed subjects. No cases of cancer were observed in either the male or female offspring.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

Rh immunization occurring during a first pregnancy with no history of preceding abortion or transfusion may result when Rh incompatible fetal to maternal bleeding ensues early enough in the gestation to initiate a maternal immune response before parturition. Alternatively, the initial antigenic stimulus could be the consequence of maternal to fetal transfer of Rh-in-compatible erythrocytes while the patient herself was in utero or at the time of her own delivery. These hypotheses were tested by I) analysis of the blood group and Rh of 22 Rh-immunized primigravidas, their infants, and their own mothers; 2) comparison of the number of fetal cells in the maternal circulation during the antepartum period in 20 women at high risk for fetal to maternal bleeding with their matched controls; and 3) Rho(D) antibody determinations in 70 Rh-negative infants born to Rh-positive mothers. The results indicate that antepartum fetal to maternal bleeding is the usual cause of Rh immunization in primigravidas, and the Rh-negative woman with blood group A, B, or AB who gestates an ABO compatiblc Rh-positive male is at highest risk. The antepartum use of anti-Rho(D) immune globulin has potential prophylactic value in this situation.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

Fifty multiparous patients at 37 weeks or more of gestation with a vertex presentation and a Bishop score of 7 or more had labor induced with oral Prostaglandin E2 tablets. All responded and delivered vaginally. The induction to delivery time averaged 4 hours and 44 minutes. The average number of tablets required was 3.64. Four women experienced nausea and an additional 4 women had some vomiting. Two patients showed hypertonus and 11 had frequent contractions. Many progressed rapidly after they began active labor. There was no evidence of fetal distress. Guidelines are suggested for the use of oral Prostaglandin E2 tablets to adequately control the labor process and prevent hy-percontractility.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

The lecithin-sphingomyelin (L/S) ratio is acknowledged to be superior to most procedures for predicting fetal lung maturity in normal pregnancy. In complicated gestations, however, errors have been reported. This study involves 686 normal gestations and 389 pregnancies complicated by fetomaternal diseases. The L/S ratio, creatinine level, and percent of fat-staining cells were measured in samples of amniotic fluid from these patients. The results showed good correlation of all three tests with fetal maturity as measured by weight, Dubowitz criteria, and incidence of respiratory distress syndrome in the normal patients. In the complicated pregnancies, however, the creatinine was unacceptable in up to 30% of the cases. The L/S ratio likewise decreased in accuracy for all parameters of fetal maturity measured. The Nile blue staining of the fetal cells appeared to be the most consistent technic in these cases. A fetal maturity battery comprised of these three assays and other methods of assessing fetal health is advocated in pregnancies complicated by certain disease states.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

Among the methods available for the midtrimester diagnosis of neural tube defects, it has been suggested that amniography be used to determine the presence of meningomyelocele. Twelve studies are reported in which the procedure was utilized. In 3 cases, a neural tube defect was present but was not detected by this method. The experience reported here challenges the value of this procedure and suggests that it should be evaluated further by utilizing it in cases where a positive diagnosis has been made by other methods and pregnancy termination is to be performed.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

The case of a 37-year-old primigravida with severe obstructive lung disease and alpha1-antitrypsin deficiency is reported. Serial pulmonary function studies and arterial blood gases were obtained during the antenatal and postpartum periods. Intrauterine fetal growth was monitored with serial ultrasonic fetal biparietal diameter determinations. Serial oxytocin challenge tests were used to monitor uteroplacental function. Aggressive chest physiotherapy was used to maintain good maternal bronchopulmonary hygiene. A normal female infant was delivered vaginally at 38 weeks' gestation following an uneventful labor. The available obstetric literature regarding the outcome of pregnancy in patients with obstructive lung disease and cystic fibrosis is reviewed. This literature suggests that pregnancy in a patient with severe obstructive lung disease should be considered a medical indication for therapeutic abortion. Successful delivery of this patient with severe obstructive lung disease and alpha1-antitrypsin deficiency suggests that these conditions arc not a contraindication to successful outcome of pregnancy for both mother and child.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

The bacteriostatic effect of amniotic fluid was studied using four pathogenic organisms which are encountered in the perinatal period,E. coli, S. aureus, L. monocytogenes,and Group B beta hemolytic streptococci. Amniotic fluid inhibited the growth of all four organisms, with a wide degree of individual variation among specimens. The greatest degree of inhibition was noted forL. monocytogenesand the least forE. coli.The time in gestation in which the amniotic fluid sample was obtained did not appear to be related to its bacteriostatic capacity. The ability of amniotic fluid to inhibit the growth of certain pathogenic organisms may be significant in prevention of perinatal infection.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

The consistency of results using Nile blue staining of fetal cells in amniotic fluid to estimate fetal maturity has been demonstrated. Recently, evidence to support this method has been published from this laboratory. Several biochemical and technical factors were cited as important to the success of the method. This report deals with further testing of several Nile blue dyes (hydrochloride and sulfate) necessitated by changes in production and federal regulation of this compound. The results show Nile blue hydrochloride (HCI) to be the most superior dye regardless of color index. Buffered solutions (6.6) of Nile blue A (sulfate) improve its performance, but not to levels demonstrated by the HCI preparation. Storage at room temperature adversely affects each dye; however, the sulfate variety appears to be the most unreliable under these circumstances. For best results, it is recommended that Nile blue HCI be used and the solution (buffered or normal) be kept refrigerated.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

Forty patients with placenta accreta, increta, or percreta are presented. Clinical features revealed an average age of 29.S years and an average parity of 3–2-1. Twenty-five had no antepartum complications. Nine were admitted with silent hemorrhage, of which 6 had a total placenta previa and 1 a low-lying previa. Postpartum hemorrhage occurred in 39% with an associated perinatal mortality of 25% and 1 maternal death. Histopathologic evaluations revealed the predominant factor to be an absent decidua. Etiologic in decidual deficiency was a previous cesarean section (12 patients). Therapy consisted of total abdominal hysterectomy in 38 patients.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

Preliminary results of a retrospective study of 773 cases of hysteroscopic sterilization are presented. Of the 524 cases tested for tubal patency, 186 (35.5%) were considered failures either because of incomplete blockage of the tubes or pregnancy. Fifty-nine pregnancies (23.7%) were reported in the 249 cases which were not tested for tubal patency. In the total population 25 complications were designated as major, for a major complication rate of 3.2%. These included uterine perforation, bowel damage, peritonitis, ectopic pregnancy, and 1 death from bowel perforation with peritonitis. The implications of these excessively high failure and complication rates are discussed, and plans are described for further analysis of the data.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID