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Ulstein, Magnar; Jensen, Tone Skeie; Irgens, Lorentz M.; Lie, Rolv Terje; Sivertsen, Erling
doi: 10.3109/00016349009036146pmid: 2244456
Pregnancy outcome was studied in a county in Norway 3 years prior to and 3 years subsequent to the Chernobyl nuclear plant accident on 26th April 1986. More detailed analyses have been performed for the 12 months prior to and subsequent to the accident. A significant increase in the spontaneous abortion rate the first year after the accident was followed by a slight decrease during the second and third years, but figures were still higher than the period prior to the accident. the rate of legal abortions was unchanged. During the entire observation period the number of births increased continuously, with the exception of a decrease in the last 2 months of 1986 and the first month of 1987. A higher incidence of spontaneous abortions was found for pregnancies conceived during the first 3 months after the accident. This increase in the spontaneous abortion rate is noteworthy, and more especially its long‐term persistence, which cannot be the result of external radiation. the internal radiation from food polluted by radioactive fallout is a possible explanation. Changes in nutrition in order to avoid polluted food may also be of importance.
Hellström, Ann‐Cathrin; Nilsson, Bo; Stånge, Lars; Nylund, Lars
doi: 10.3109/00016349009036147pmid: 2244457
From 1984 to 1987, 300 pregnant women with fetal representations underwent an attempt at external cephalic version (ECV) during the last trimester. A consecutive analysis of factors associated with successful version was performed during this period. the final version rate after one or more attempts was 58%, being lower in nulliparous (39%) than in parous women (80%). Multivariate analyses (logistic regression) identified only three significant variables out of 16 with independent power to explain successful version. the overall most important factor was parity (p < 0.001), followed by fetal presentation (p < 0.001) and amount of amniotic fluid (p = 0.019).
Ilagan, Nestor B.; Elias, Estela G.; Liang, Keh‐Chyang; Kazzi, George; Piligian, John; Khatib, Ghada
doi: 10.3109/00016349009036148pmid: 2244458
In a study of 82 cases of clinical chorioamnionitis in which no antibiotics were administered antenatally, significant villous edema was observed in 51 placentas (62%). Polymorphonuclear leukocyte invasion of the placental plate was found in 53 placentas (65%). the presence of SVE was significantly associated with placental bacterial recovery, occurrence of prolonged rupture of membranes, lower one minute Apgar score, the need for resuscitation and significant neonatal respiratory problems. Findings suggest that bacteria‐related placental villous edema can lead to significant perinatal and neonatal morbidities.
Manyonda, Isaac T.; Shaw, David E.; Drife, James O.
doi: 10.3109/00016349009036149pmid: 2244459
We studied primigravid women in spontaneous labor at term and given epidural analgesia. Two hundred such women giving birth in 1983 were compared with similar groups who gave birth in 1985 and 1987 after the introduction of ‘delayed pushing’ into our labor ward protocol. Four hundred controls were obtained in 1983 and 1985 by selecting from the labor ward register the next normal primigravid woman in spontaneous labor without epidural analgesia. the assisted delivery rate was significantly higher in all three epidural groups than in the controls (p < 0.001). Among epidural labors, there was no significant difference between 1983 and 1987 in the incidence of rotational or non‐rotational forceps, or of cesarean section. In each epidural group, women who waited more than 60 min were less likely to experience a normal spontaneous delivery than were those who did not (p < 0.001 in 1983; p = 0.006 in 1985 p = 0.035 in 1987). We conclude that to delay pushing beyond 60 min confers no benefit regarding mode of delivery.
Råidestad, Arne; Thomassen, Peter A.
doi: 10.3109/00016349009036150pmid: 2244460
Acute polyhydramnios in monozygotic twin pregnancy causes severe maternal discomfort and carries a high risk of premature labor. During the years 1980 to 1987, 36 patients with this complication were delivered in Sweden, giving an incidence of 1/20,000 births, or 1/200 twin births. In 18 patients (group A) who were treated with one or more amniotic taps, the delivery was postponed by 2 weeks, as compared with one week in 18 conservatively treated patients (group B). the peri‐ and neonatal death rate was 47% in group A and 58% in group B. Our own experience is that amniotic taps are safe if the amniotic fluid is removed slowly under prophylactic tocolysis. It gives symptomatic relief to the mother and may postpone labor until the gestational age of the twins is more compatible with survival.
Uvnäs‐Moberg, Kerstin; Widström, Ann‐Marie; Werner, Sigbritt; Matthiesen, Ann‐Sofie; Winberg, Jan
doi: 10.3109/00016349009036151pmid: 2244461
The aim of the present study was to examine suckling‐related plasma levels of oxytocin and prolactin in early and established lactation and to correlate hormone profiles to success of lactation performance. Fifty‐five primiparous women participated in the study. From each, 18 blood samples were drawn in connection with breast‐feeding on day 4 post partum and after 3‐4 months. Oxytocin and prolactin levels were determined with radio‐immunoassay. Basal levels of both hormones were significantly higher 4 days post partum than 3‐4 months later and after weaning. Basal prolactin levels fell significantly within 24 h of weaning. Oxytocin and prolactin levels rose in response to breast‐feeding—an effect which persisted during the lactation period. the suckling‐induced release of prolactin—but not that of oxytocin—was related to basal hormone levels. Basal as well as stimulated oxytocin levels obtained 4 days and 3‐4 months post partum correlated significantly, indicating that each woman has an individual, characteristic level of this hormone. Milk yield did not correlate with oxytocin or prolactin levels, but prolactin levels recorded 3‐4 months post partum did correlate with the remaining period of breast‐feeding. In addition, mothers who breast‐fed exclusively 3‐4 months post partum had significantly higher oxytocin and prolactin levels than those who gave supplementary feed. there was a significant correlation between oxytocin levels at 4 days and birth weight of the infant.
Wollen, Anne‐Lone; Flood, Per R.; Sandvei, Roar
doi: 10.3109/00016349009036152pmid: 2244462
Fallopian tube segments were removed from 20 women undergoing sterilization by laparoscopy or laparotomy. Ten of these patients used an intrauterine contraceptive device (IUCD). the other 10 had used neither IUCD nor oral contraceptives and served as controls. the ciliary ultrastructure was examined by light‐ and transmission electron microscopy. the IUCD users had a significantly reduced ciliary length and less well oriented cilia, as compared with the control group. Also, the proportion of cilia with a ciliary crown structure was significantly smaller in IUCD users than in the non‐users. the mechanism that may cause these alterations and their putative consequences are discussed.
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