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Lindblom, Bo; Lundberg, Jan M.; Lunell, Nils‐Olov; Nisell, Henry; Norén, Hakan; Wolff, Kerstin
doi: 10.3109/00016349109007870pmid: 1746248
This study was performed to evaluate the in vitro effects of a new polypeptide, endothelin‐1 (ET‐1) on small intramyometrial vessels in comparison with the action of noradrenalin (NA). In connection with cesarean section, myometrial biopsies were obtained and small arteries (100–500 um in diameter) were excised. Cylindrical segments of these vessels were used for registration of contractile activity after administration of ET‐1 and NA. ET produced vasoconstriction and was approximately three times as powerful and 70‐fold as potent as NA. It is suggested that ET may be involved in the regulation of human utero‐placental blood flow.
Rognerud Jensen, Odd H.; Guimaraes, Mirian S.
doi: 10.3109/00016349109007871pmid: 1746249
Ninety‐tour women with high‐risk pregnancies were referred to the Aker University Hospital, Department of Obstetrics, and monitored by Doppler velocimetry and conventional cardiotocography. The peak systolic/end diastolic (A/B) ratio was measured in the velocity waveform obtained in the umbilical artery blood flow. The non‐stress test (NST) was classified according to the Fischer scores. In this mixed group of high‐risk pregnancies, the sensitivity of the A/B ratio to predict fetal growth retardation was 71%, predictive value 57% and specificity 77%. The corresponding values for NST were 39%, 65% and 90%. It is concluded that Doppler velocimetry is more sensitive than cardiotocography for identifying fetal growth retardation. In an attempt to further improve the detection rate of fetal pathology, the cases with abnormal NST scores were added to those with high A/B ratios and collectively defined as abnormal. In consequence, only an insignificant improvement in sensitivity (79%) could be achieved. When the A/B ratio is normal, there seems little justification for expending time, effort and resources in routine use of cardiotocography.
Berge, Lillian Nordbø; Rasmussen, Svein; Dahl, Lauritz Bredrup
doi: 10.3109/00016349109007872pmid: 1746250
To investigate developments in perinatal care, all fetal and neonatal deaths among those born after at least 24 weeks of gestation at the University Hospital of Tromsø, Norway from 1976 to 1989, were subjected to medical audit. A decrease in total mortality rate was found when based on maturity (≥24 weeks; 19.9–13.4%; p<0.01), and/or birth weight (≥500 g; 19.2–13.4%; p<0.05). This was mainly due to a decrease in fetal deaths (14.8–6.6%; p<0.0001). Deaths during labor (5.4–1.1%; p<0.001), and deaths before the onset of labour (9.4–5.5%; p<0.05) declined. The neonatal death rate remained virtually constant (5.2–6.8%). The incidence of conditions affecting the placenta and the umbilical cord, causing asphyxia and intra‐uterine growth retardation, declined, from 9.2 to 5.0% (p<0.01), as did that caused by immaturity (2.8–1.3%; p<0.05). The rates of death caused by cerebral hemorrhage, respiratory distress syndrome, infections, and malformations did not change. There was no significant proportional change in the causes of death from the first to the last period. The rate of fetal death following suboptimal care declined (2.4–0.4%; p<0.01), while the corresponding neonatal death rate remained unchanged (0.9–1.1%). The proportions of both fetal and neonatal deaths occurring after suboptimal care were low (fetal: 16.2, 8.8, and 5.6%; neonatal: 17.1, 23.5, and 16.2%). These differences did not reach statistical significance. The ratio of neonatal to fetal deaths increased from the first (26.1%) to the last period (50.7%; p<0.01), due mainly to a significant shift from fetal to neonatal death among those weighing 500–999 g (19.6–56.0%; p<0.01). It is concluded that prophylactic efforts to avoid preterm birth and IUGR, and further therapeutic efforts in neonatal intensive care are needed to bring down mortality rates at our hospital in the future.
Silber, Märta; Larsson, Bertil; Uvnäs‐Moberg, Kerstin
doi: 10.3109/00016349109007873pmid: 1684080
Oxytocin concentrations increased during pregnancy and during medication with low‐dose oral contraceptives (o.c). Postprandial somatostatin concentrations were lower during medication with o.c. Insulin concentrations were elevated during pregnancy with the same tendency during medication with o.c. Gastrin levels were unaffected during the peripartal period and during medication with o.c. Women who were breastfeeders at 3 months after delivery had higher concentrations of oxytocin and lower somatostatin concentrations post‐prandially during pregnancy and fasting at 3 months after delivery compared with non‐breastfeeders at 3 months after delivery. Metabolic and behavioral implications are discussed.
Abduuabbar, Hassan S.O.; Marzouki, Khalid M.H.; Zawawi, Tarif H.; Khan, Ahmed S.
doi: 10.3109/00016349109007874pmid: 1746251
Fifty‐two normally pregnant women underwent echocardiography to examine their pericardium in the first, second and third trimester. Pericardial effusion was noted in 15.3% of the women (n=8) in the first trimester, 19.2% (n=10) in the second trimester and 44.2% (n=23) in the third trimester of pregnancy. Pericardial effusion during pregnancy was found to be completely resolved in all patients who underwent an echocardiogram 6 weeks post delivery (n=U). There was no statistically significant difference in age, hemoglobin, total protein, albumin/globulin ratio or mean blood pressure during pregnancy between those who developed pericardial effusion and those who did not. The frequency of occurrence of pericardial effusion in primigravidas at 69.2% (9/13) was higher than that in multigravidas, with a ratio of 35.9% (14/39), the difference being statistically significant (p < 0.025). The frequency of occurrence of pericardial effusion in patients who gained more than 12 kg during pregnancy at 67.7% (11/17) was higher than in patients who gained less than 12 kg, with a ratio of 34.3% (12/35), the difference being statistically significant (p < 0.025).
Henriques, Carsten Ulrik; Damm, Peter; Tabor, Ann; Goldstein, Henri; Mølsted‐Pedersen, Lars
doi: 10.3109/00016349109007875pmid: 1746252
In order to screen for fetal neural tube defects and chromosome abnomalities, amniocentesis was carried out in 334 women with insulin‐dependent diabetes mellitus (IDDM) between 1979 and 1987. Two cases (0.6%; 95% confidence limits 0.1–2.2%) of fetal chromosome abnormality were found: one case of Klinefelter's syndrome and one case of de novo translocation. This is comparable to the overall incidence of chromosome abnormality found at birth and is also comparable to the incidence of fetal chromosome abnormality (1.0%) found by amniocentesis at our Department in a group of 2,264 young non‐diabetic women with little risk of contracting genetic disorders. The results suggest that maternal IDDM does not increase the risk of fetal chromosome abnormality and consequently screening by amniocentesis for chromosome abnormalities among diabetic women does not seem to be indicated.
Hsieh, T'Sang T'ang; Chen, Kuang Chao; Cheng, Bor Jen; Chiu, Tsung Hong
doi: 10.3109/00016349109007876pmid: 1746253
Three uremic patients receiving hemodialysis for more than 5 years became pregnant and proceeded to the third trimester. A variety of complications were noted, including threatened abortion, vanished twin, preterm premature rupture of membranes, polyhydramnios, intra‐uterine fetal death, intra‐uterine growth retardation, premature labor and hypertension. Two of these 3 mothers gave birth to healthy babies under the management of the high‐risk pregnancy team.
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