Gynecologic and Obstetric Investigation

Bersinger, N.A.; Malek, A.; Benz, B.; Keller, P.J.; Schneider, H.

doi: 10.1159/000293763pmid: 3391424

The capacity of the freshly delivered human term placenta to produce and release placental proteins during in vitro dual perfusion was investigated. The organ was perfused in separate closed circulations and aliquots of medium were taken at regular intervals from both maternal and fetal circuits. The placental proteins human chorionic gonadotrophin (HCG), human placental lactogen (HPL), pregnancy-specific β₁-glycoprotein (SP₁), and pregnancy-associated plasma protein A (PAPP-A) were quantified in these media as well as in the placental tissue before and after the perfusion. It was found that the four above-mentioned proteins were synthesised during the perfusion interval (90 min to 3 h) while pregnancy-associated α₂-glycoprotein and prolactin were only washed out. The mean production of HCG, HPL, SP₁, and PAPP-A was decreased when either cycloheximide, puromycin, iodoacetic acid, or 2,4-dinitrophenol had been added to the perfusing medium. Amongst these four antimetabolites iodoacetic acid most severely affected both the total release and net synthesis. It is concluded that the above four proteins are synthesised de novo by the perfused placenta in the absence of maternal tissue and that this synthesis is energy-dependent.

Nienhuis, S.J.; van Vugt, J.M.G.; Hoogland, H.J.; Ruissen, C.J.; de Haan, J.

doi: 10.1159/000293764pmid: 2968943

A study was made of the interexaminer variability of Doppler velocity waveform determinations of the fetal circulation. Three investigators recorded Doppler ultrasound tracings of the blood velocity in the fetal thoracic and abdominal aorta and umbilical artery in 23 uncomplicated pregnancies. Of these recordings, a hard copy was made, and the pulsatility indices were computed. An analysis of variance was performed and the reliability calculated. The interexaminer variability was nonsignificant in measurements of the three blood vessels under examination. Both thoracic and abdominal aorta measurements showed poor reliability (intraclass correlation coefficient of reliability 0.30 and 0.19, respectively) due to high random errors. Umbilical artery measurements showed a better reliability (intraclass correlation coefficient of reliability 0.61), and, therefore, these hold the greatest clinical applicability.

Jimenez, Dolores M.; Pocovi, Miguel; Ramon-Cajal, Juan; Romero, Manuel A.; Martinez, Heraclio; Grande, Francisco

doi: 10.1159/000293765pmid: 3391425

Plasma lipids and lipoprotein cholesterol distribution were measured in 60 normal pregnancies studied longitudinally at 12, 20, 28, and 36 weeks of gestation and 3 and 40 days postpartum. Total cholesterol, unesterified cholesterol, phospholipids, triglycerides and cholesterol in low- and very-low-density lipoproteins rose progressively during pregnancy. Maximal values were reached at 36 weeks for total cholesterol, unesterified cholesterol and low-density lipoprotein cholesterol and at partum for triglycerides, very-low-density lipoprotein cholesterol and phospholipids. High-density lipoprotein cholesterol was hardly affected by pregnancy. During the second half of pregnancy and postpartum period, high-density lipoprotein cholesterol was consistently and negatively correlated with triglycerides and very-low-density lipoprotein cholesterol. In each period studied total cholesterol showed very high positive correlation with low-density lipoprotein cholesterol but a weak correlation with high-density lipoprotein cholesterol.

Gabrilovac, Jelka; Zadjelović, Josip; Osmak, Maja; Suchanek, Ernest; Županović, Željko; Boranić, Milivoj

doi: 10.1159/000293766pmid: 3391426

NK cell activity was determined in peripheral blood of 24 women during pregnancy, and compared to NK activity of 40 healthy nonpregnant women in generative age. An increase in the first trimester was followed by a significant decline of NK activity in the second trimester, and a further fall in the third trimester of pregnancy. The initial rise of NK activity was predominantly due to primigravidas, whereas the fall in the second trimester was mainly due to multigravidas. There was a significant negative correlation between NK activity and the increasing levels of estrogen hormones (β-estradiol, estriol and estrone) in the sera of pregnant women. However, when analyzed for each trimester of pregnancy separately, a significant (p < 0.02) negative correlation was only found with β-estradiol, suggesting that high doses of this hormone could contribute to pregnancy-associated NK suppression.

Arabin, B.; Siebert, M.; Jimenez, E.; Saling, E.

doi: 10.1159/000293767pmid: 3391427

In 30 of 137 high-risk pregnancies we observed absent end-diastolic velocities indicating a high downstream impedance, which could be proved by histomorphological findings of the placenta. On the average the loss of end-diastolic velocities occurred 2–3 days before suspicious and nearly 8 days before pathological cardiotocographic findings. The perinatal mortality was high when absent velocities had been observed before the 32nd week, a cesarean section was obligatory in all but 1 case. All fetuses were growth-retarded. In 9 cases we were able to determine the ratio of blood flow volume in the common carotid arteries to that of the fetal aorta. The values were significantly increased as compared to values of undisturbed pregnancies, demonstrating a redistribution of fetal blood in favor of cerebral circulation.

Ahldén, S.; Andersch, B.; Stigsson, L.; Olegård, R.

doi: 10.1159/000293768pmid: 3391428

The aim of the present study was to identify obstetrical factors predicting sepsis neonatorum following a full-term pregnancy. In 1982 26 infants out of 2,977 full-term pregnancies had septicemia. For comparison 42 women of corresponding age were randomly selected. A stepwise regression analysis was performed in order to evaluate the association between seven different variables and sepsis neonatorum. We found that prolonged rupture of the membranes (p < 0.003) and primary amniotomy (p < 0.02) were the most important factors predicting sepsis neonatorum (r² = 0.22). Factors such as cervical ripening, vaginal examinations, intrauterine monitoring devices, prolonged labor and prolonged pregnancy did not add to the predicted power of the analysis.

Breborowicz, G.; Moczko, J.; Gadzinowski, J.

doi: 10.1159/000293769pmid: 3391429

The analysis of short-term variability of fetal heart rate in the frequency domain was performed. The fetal activity states (quiescence, trunk rotation, body movements, fetal breathing movements) were taken into account. The differences between the shapes of power spectra in physiological and growth-retarded fetuses were discussed.

Lunde, Ottar; Hoel, Per Sigurd; Sandvik, Leiv

doi: 10.1159/000293771pmid: 3391430

The ovarian morphology in 149 patients with the clinical syndrome of polycystic ovaries (group I) is described. The ovaries from 10 age-matched women (group II) with no signs of ovarian disorder were investigated as a reference material. The number of cysts documented for group I was twice that of the reference group and the ovarian volume three times that of the normals. No significant difference in follicle number was seen between the two groups. The tunica albuginea was thicker in group I with more pronounced atretic changes. The duration of symptoms for group I correlated significantly with body mass index, thickening of tunica, degree of stromal hyperplasia and the calculated means of ovarian volume. A correlation was also seen between ovarian volume, degree of follicular atresia and stromal hyperplasia, as well as between the thickness of the tunica albuginea, number of follicles and degree of follicular atresia.

Yamamoto, Kazuhiko; Katoh, Setsushi; Nakayama, Satoru; Kijima, Satoshi; Takahashi, Kentaro; Murao, Fuminori; Kitao, Manabu

doi: 10.1159/000293773pmid: 3292351

Primary malignant neoplasms of the fallopian tube are the least common of all the gynecologic malignancies, and constitute only about 0.1–1% of all such malignancies. The actual 5-year survival is 64% in those with stage I, 60% in cases of stage II, and 18% and 25% for stages III and IV, respectively. Therefore, early detection of these neoplasm stages is most important to attain a cure. The preoperative diagnosis of this neoplasm has rarely been reported because these lesions are not common. We present herein the clinical and sonographic features in 4 Japanese women with fallopian tube carcinoma. While the sonographic features alone are not distinct enough to establish a definite preoperative diagnosis, the findings as seen in our patients suggest inclusion of tubal carcinoma in the differential diagnosis.

Seeger, H.; Zwirner, M.; Voelter, W.; Lippert, T.H.

doi: 10.1159/000293775pmid: 3391431

Relaxin and human chorionic gonadotropin (HCG) were determined in the blood serum of women during normal and pathological pregnancy in the 1 st trimester. In normal pregnancy, the hormones showed similar behavior in their secretion pattern up to the 7th week with continuously increasing concentrations. Thereafter different patterns in their secretion developed. In pathological pregnancy, both relaxin and HCG concentrations were significantly lower than in undisturbed pregnancy, following an almost parallel course without peaks.