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Biomedical subjects

M Glezerman

Publications and source records attributed to M Glezerman.

At least 55 records · Page 3Linked to original sources
PubMed1994

Human preterm birth is associated with systemic and local changes in progesterone/17 beta-estradiol ratios.

OBJECTIVE: The purpose of this study was to determine whether human preterm birth is associated with changes in 17 beta-estradiol and progesterone concentrations in maternal plasma and amniotic fluid. STUDY DESIGN: Forty healthy women in preterm labor with singleton pregnancies and intact membranes at 32 to 36 weeks of gestation who underwent amniocentesis for evaluation of the microbiologic status of the amniotic cavity were classified into the following two groups: 20 women who were delivered within 1 week from the amniocentesis (preterm delivery group) and 20 who were delivered at term (term delivery group). Maternal plasma and amniotic fluid concentrations of progesterone and 17 beta-estradiol were measured with sensitive and specific commercially available radioimmunoassay kits. RESULTS: The median amniotic fluid concentration of 17 beta-estradiol was significantly higher in women delivered prematurely than in those who were delivered at term (1.5 ng/ml vs 0.9 ng/ml, p = 0.0001). Moreover, the median plasma 17 beta-estradiol concentration was also significantly higher in the preterm delivery group than in the term group (14.1 ng/ml vs 6.9 ng/ml, p = 0.022). In contrast, no significant difference was found in amniotic fluid and plasma concentrations of progesterone between these two groups (24.5 ng/ml vs 27.5 ng/ml and 132.0 ng/ml vs 107.5 ng/ml, respectively). The median amniotic fluid progesterone/17 beta-estradiol ratio was significantly lower in the preterm delivery group than in those delivered at term (18.4 vs 33.6, respectively, p = 0.0017). Moreover, the median plasma progesterone/17 beta-estradiol ratio was also significantly lower in the preterm delivery group than in the term group (9.8 vs 17.0, respectively, p = 0.016). CONCLUSION: Human preterm birth is associated with significantly lower progesterone/17 beta-estradiol ratios than those of women with preterm labor delivered at term.

Adult↗
PubMed1994

The significance of serum progesterone levels on the day of hCG administration on IVF pregnancy rates.

The aim of the present study was to evaluate the relationship between serum progesterone level on the day of human chorionic gonadotropin (hCG) administration (day 0) and pregnancy rate among patients undergoing in vitro fertilization and embryo transfer. Serum progesterone levels were analyzed retrospectively in 160 cycles. In 56 women ovarian stimulation was induced by gonadotropins only (group A). In 104 cases a gonadotropin releasing hormone (GnRH) analog was given prior to gonadotropin administration (group B). At least three embryos were transferred in all cases. A significantly (p < 0.01) higher serum progesterone level (> or = 1 ng/ml) on day 0 was observed in the 43 patients of group A who did not conceive compared with the 13 who conceived. No significant difference in serum progesterone levels on day 0 was found between the 37 patients of group B who conceived and the 67 who did not. The pregnancy rate (0.36) in group B was significantly (p < 0.05) higher than that in group A (0.23). However, the pregnancy rate (0.35) in patients in group A with low progesterone levels (< or = 1 ng/ml) was not significantly lower than that in group B. We demonstrated that elevated progesterone levels (> or = 1 ng/ml) on day 0 in patients receiving stimulation with gonadotropin only, might be detrimental to pregnancy. In view of these results, we suggest that early oocyte retrieval should be considered in patients whose progesterone level on the day of hCG administration exceeds 1 ng/ml following stimulation with gonadotropin only.

Adult↗
PubMed1994

Association between preterm birth and increased maternal plasma cortisol concentrations.

OBJECTIVE: To measure the amniotic fluid (AF) and plasma concentrations of cortisol in women with preterm labor and intact membranes. METHODS: Thirty-eight normal healthy women with singleton gestations, preterm labor, and intact membranes at 32-36 weeks' gestation underwent amniocentesis for evaluation of the microbiologic status of the amniotic cavity. Nineteen women delivered within 1 week of amniocentesis (preterm labor and delivery group), and 19 delivered at term (preterm labor and term delivery group). Maternal plasma and AF concentrations of cortisol were measured with sensitive and specific, commercially available radioimmunoassay kits. RESULTS: The median plasma cortisol concentration was significantly higher in women who delivered prematurely than in those who delivered at term (260 versus 240 ng/mL; P = .014). However, no significant differences in median AF cortisol concentrations were detected between the groups (13 versus 14 ng/mL). CONCLUSIONS: Although maternal plasma cortisol concentrations were significantly higher in women with preterm birth, no similar changes were found in the AF. The rise in maternal plasma cortisol may be related to the stress mechanism of labor.

Adult↗
PubMed1994

Premature delivery of small versus appropriate-for-gestational-age neonates. A comparative study of maternal characteristics.

Prematurity and growth retardation of the fetus are major factors affecting perinatal outcome. The purpose of this study was to compare maternal characteristics of 63 women who delivered a preterm, small-for-gestational-age (SGA) neonate with those of 63 women matched for parity and gestational age who delivered a preterm, appropriate-for-gestational-age (AGA) neonate. All women delivered at the Soroka Medical Center between January 1, 1985, and December 31, 1990. Mothers of SGA neonates were more likely than those of AGA neonates to be over the age of 35 years (P = .043), to have hypertensive disorders and oligohydramnios (P < .001), to have induced labor (P < .001) and to deliver by cesarean section (P < .001). In addition, they had a higher rate of morbidity in the puerperium (P = .015) and were more likely to have longer hospitalization (P = .002). In contrast, previous preterm deliveries were significantly more common in the AGA group than in the SGA group (P = .034). The results of this study indicate that women who deliver preterm SGA neonates belong to a special subgroup with unique characteristics in comparison to those who deliver preterm AGA neonates.

Adolescent↗
PubMed1993

[Early ultrasonic diagnosis of conjoined twins].

Conjoined twins is a rare congenital malformation occurring in 1:30,000-1:100,000 live births. Its early prenatal detection was extremely rare prior to the introduction of obstetric ultrasonography. We report 3 cases of early ultrasound diagnosis of conjoined twins at 9, 15 and 19 weeks of pregnancy, respectively. The diagnosis at 9 weeks of gestation was made via the transvaginal approach, and to the best of our knowledge is the earliest diagnosis reported in the English literature. In all 3 cases the fetuses were of the thoraco-omphalopagus type and had a shared heart. Pregnancy was discontinued in all 3 cases using methods appropriate for the first and second trimesters of pregnancy.

Abortion, Therapeutic↗
PubMed1993

Maternal mortality in southern Israel.

Between 1969 and 1991 there were 166,410 births in Southern Israel with 13 maternal deaths (7.8/100,000). In the Jewish population there were 119,130 deliveries with 7 maternal deaths (5.9/100,000), and the Bedouins had 47,280 deliveries with 6 maternal deaths (12.7/100,000). Prenatal care was an important preventive factor. 7 maternal deaths occurred among 151,088 women who had received prenatal care (4.6/100,000), whereas 6 such deaths occurred among 15,322 without prenatal care (39.1/100,000) (P value 0.0005). Ten of the 13 women who died were over 24 years old. Eight of the 13 patients were multiparous. Live births occurred in 6 patients and stillbirths in 5 patients. Hemorrhage, preeclampsia-eclampsia and pulmonary embolism were the leading causes of maternal death.

Cross-Cultural Comparison↗
PubMed1993

Successful treatment of preterm labour by eradication of Ureaplasma urealyticum with erythromycin.

Ureaplasma urealyticum was detected in the amniotic cavity of a woman with premature contractions at 32 weeks of pregnancy. Treatment with Erythromycin base was instituted for a period of ten days. Amniotic fluid analysis performed 48 hours after discontinuation of antibiotic treatment revealed sterile amniotic fluid. The pregnancy continued uneventfully until 39 weeks.

Administration, Oral↗
PubMed1993

Estrogen and progesterone receptors in the uterine artery of rats during and after pregnancy.

Changes in the level of estrogen and progesterone receptors in the uterine artery of the rat were studied during pregnancy in order to evaluate the estrogen dependency of this artery. The weight of the uterine artery and its content of estrogen and progesterone receptors were measured. The steroid receptor content was also measured in the uterus and aorta as the tissues of these organs are estrogen-responsive and non-responsive, respectively. The uterine artery weight increased more than fourfold up to the middle of pregnancy and towards the end of pregnancy increased even further. The increase in weight was parallel to the increase in the level of plasma 17 beta-estradiol. During pregnancy a dramatic increase was detected in the number of uterine artery estrogen receptors. The estrogen receptor level was highest at term pregnancy, and following birth decreased to a low value. The level of progesterone receptors in the uterine artery increased modestly, though significantly, during pregnancy, and rose steeply at puerperium. No meaningful changes were seen in the aorta. The changes in estrogen and progesterone receptor levels in the rat uterine artery wall during and after pregnancy may suggest estrogen dependency of this tissue.

Animals↗
PubMed1993

Meconium stained amniotic fluid is associated with maternal infectious morbidity in pre term delivery.

The purpose of the study was to determine if intra partum meconium stained amniotic fluid (MSAF) is associated with infectious morbidity in women with pre term delivery. The study group was composed of 89 women with pre term delivery and MSAF. The control group comprised 89 women with pre term delivery and clear amniotic fluid, matched for maternal age, gravidity, parity, gestational age, rate of premature rupture of membranes, breech presentation and mode of delivery. The parameters of maternal infectious morbidity were compared between the two groups during pregnancy, delivery and puerperium. The prevalence of recurrent urinary tract infections was significantly higher in the study group than those in the control group, 7.8% (7/89) vs. 0% (0/89), respectively (p = 0.02). During delivery women with MSAF had a significantly higher rate of clinical chorioamnionitis than women without MSAF, 6% (6/89) vs. 0% (0/89), respectively (p = 0.03). Histological chorioamnionitis was also significantly higher in patients with intra partum MSAF, as compared to those the clear amniotic fluid, 11.2% (10/89) vs. 0% (0/89), respectively (p = 0.03). In addition, women in the study group had a significantly higher post partum infectious morbidity rate and endometritis than women in the control group [52.8% (47/89) vs. 37.1% (33/89) (p = 0.05); 18% (16/89) vs. 7.8% (7/89) (p = 0.03), respectively]. We conclude that intra partum MSAF should be considered as a potential marker for infectious morbidity in women with pre term labor and delivery.

Adult↗
PubMed1993

Birthweight curves in southern Israel populations.

With the aim of establishing a standard range of birthweights at different gestational ages for Jewish and Bedouin populations, we analyzed 5.5 years of computerized delivery files. Strictly confirmed gestational age was required in this study. This is necessary for proper diagnosis of growth abnormalities, such as growth retardation and macrosomia, for research purposes and for assessment of perinatal morbidity and mortality at a given gestational age. Percentile distributions of birthweights of 46,529 infants are presented. The mean birthweight of male infants was 3,238 g (SD 529 g) and of female infants was 3,117 g (SD 504 g). From week 36 to week 41 of gestation, infants of Jewish mothers were significantly heavier than infants born to Bedouin women, particularly in primiparous women. In both Jewish and Bedouin births, male infants were significantly heavier than female infants after the 36th week of gestation, by 130 g in the former and 127 g in the latter. Although the set of birthweight percentile curves of Jews and Bedouins was similar to the Colorado birthweight curve, some differences were found. At 41 and 42 weeks of pregnancy our infants were heavier and exceeded the standard, whereas at weeks 35 to 38 the standard exceeded the median weight of the Bedouin infants. The differences between our population curves and the commonly used Colorado standard curve emphasize the need for locally based and periodically updated infant birthweight data.

Birth Weight↗
PubMed1993

The association between increased mean arterial pressure and abnormal uterine artery resistance to blood flow during pregnancy.

OBJECTIVE: To examine the relation between increased mean arterial pressure (MAP) and the uterine artery resistance index (RI) to blood flow in the third trimester of pregnancy. METHODS: One hundred consecutive patients in the third trimester whose pregnancies were complicated by hypertensive disorders, with or without proteinuria, had uterine artery resistance to blood flow measured using continuous-wave Doppler. RESULTS: The RI was in the normal range in 20 patients. Unilaterally abnormal RI was found in 32 and bilaterally abnormal RI in 46 (two subjects were excluded from this categorization because measurements were obtained from only one side of the uterus). A MAP below 100 mmHg was associated with a normal RI. All six subjects with MAP of 140 mmHg or greater had bilaterally abnormal RI. Mean arterial pressure values of 100-139 mmHg included 90% of the women with normal RI, 100% of those with unilaterally abnormal RI, and 87% of those with bilaterally abnormal RI. Proteinuric and nonproteinuric groups differed with respect to both MAP (P = .04) and RI (P = .01). Pregnancy outcome was less favorable in the unilaterally abnormal RI subgroup than in the normal RI subgroup. The bilaterally abnormal subgroup of patients had the most adverse pregnancy outcomes. CONCLUSIONS: Pregnant patients in the third trimester who have increased MAP but a normal uterine artery RI can expect a good pregnancy outcome. Increased MAP associated with abnormal uterine artery RI may result in an unfavorable pregnancy outcome, particularly in those with bilaterally increased RI to blood flow. Doppler measurement of uterine artery impedance is recommended in pregnancies complicated by hypertensive disorders.

Adult↗
PubMed1993

Efficacy of kallikrein in the treatment of oligozoospermia and asthenozoospermia: a double-blind trial.

OBJECTIVE: To assess the effect of kallikrein on sperm motility and sperm count in infertile oligozoospermic and asthenozoospermic men. DESIGN: Double-blind placebo-controlled clinical trial. SETTING: Multicenter trial in three andrologic clinics. PATIENTS: Infertile men with < 20 x 10(6) total sperm count and > 3 x 10(6) sperm cells/mL and/or sperm motility of < 30%. INTERVENTIONS: One hundred fourteen men received either placebo or 600 kallikrein units of kallidinogenase by mouth daily for 12 weeks. Semen analyses were performed before and at 6-week intervals during the trial. Compliance and incidence of adverse effects were assessed. RESULTS: The incidence of adverse effects was similar under placebo and under kallidinogenase treatment, usually mild, transient, and did not require the cessation of treatment in any patient. Kallidinogenase was not superior to placebo in improving sperm count and sperm motility. CONCLUSIONS: At the doses and for the duration given, our results were disappointing. The absence of a therapeutical effect, as evidenced in the present study may be due to the very low absorption rate of kallidinogenase after oral administration. Probably a much higher dose of kallidinogenase should be used to achieve a therapeutic affect.

Adult↗
PubMed1993

Relationship between C-reactive protein levels and intraamniotic infection in women with preterm labor.

The purpose of this study was to determine the relationship between C-reactive protein (CRP) levels and intraamniotic infection in 48 women presenting with preterm labor and intact membranes. Blood samples for CRP tests were obtained immediately before the performance of transabdominal amniocentesis. The prevalence of amniotic fluid cultures positive for organisms was 14.6%. In 16 women (33.3%) positive CRP levels were obtained. There were no significant differences in the prematurity rate or the prevalence of microbial invasion of the amniotic cavity between women with positive CRP levels and women with negative levels. The sensitivity, specificity, and positive and negative predictive values for the detection of amniotic infection were 71.5%, 73.2%, 31.3% and 93.8%, respectively. Based on these results, we suggest that in women with preterm labor and negative CRP levels, routine amniocentesis may not be essential to the initial workup.

Adult↗
PubMed1992

[Limulus amebocyte lysate assay for diagnosing intraamniotic infection].

The value of the Limulus amebocyte lysate assay (LAL) in the diagnosis of intraamniotic infection was determined in amniotic fluid from transabdominal amniocenteses in 51 women in preterm labor with intact membranes. The prevalence of positive amniotic fluid cultures was 21.5% (11/51) in detecting intraamniotic infection. The LAL was positive in 19.6% (10/51), its sensitivity 81.8% (9/11), specificity 97.5% (39/40), positive predictive value 90.0% (9/10), and negative predictive value 95.1% (39/41). Similarly, in detecting women who would fail tocolysis and deliver prematurely, its sensitivity was 27.6% (8/29), specificity 90.9% (20/22), positive predictive value 80% (8/10), and negative predictive value 48.8% (20/41). We conclude that LAL is a simple, rapid and sensitive test for detecting intraamniotic infection in women in preterm labor.

Amniotic Fluid↗