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Biomedical subjects

M Lancet

Publications and source records attributed to M Lancet.

At least 37 records · Page 2Linked to original sources
PubMed1988

Ovarian tumors in pregnancy.

Thirty-eight women were operated for an ovarian tumor diagnosed during pregnancy, with an incidence of 1/2328 deliveries. The diameter of all tumors was above 5 cm. Of the 31 women operated before delivery, seven were untreated and 24 received supportive progestational therapy. The rate of abortions was 85.7% in the untreated group and 10% in the hydroxy-progesterone-caproate group (HPC) (P less than 0.02). When the women received a total dose of HPC of more than 300 mg, 9 of 10 pregnancies reached term with a live child. Two ovarian malignancies were found, 5.3% of all cases. In 42.9% of the women there were fertility problems later in life. Ovarian tumors during pregnancy should be removed as soon as possible, irrespective of the age of the pregnancy. If fully progesterone therapy is given, the danger of abortions is reduced to a minimum. Prophylactic antibiotic treatment should also be administered.

17 alpha-Hydroxyprogesterone Caproate↗
PubMed1988

Complications associated with genital colonization in pregnancies with and without cerclage.

Cultures from the cervical milieu were taken from 24 antibiotic-treated patients (group A) and from 25 patients with no antibiotic treatment (group B). Both groups had undergone cerclage and were compared to 30 randomly chosen pregnant patients without cerclage (group C). Positive cultures were obtained in 70.8% and 48% before cerclage and in 66.7% and 68% after cerclage in groups A and B, respectively. These were not significantly different from group C (56.7%). Escherichia coli was found in over 75% of positive cultures. The rate of premature deliveries and premature rupture of the membranes were significantly higher in the cerclage groups. Maternal morbidity was significantly higher in group A compared to B and C. Our data suggest that bacterial colonization of the cervix and the vagina is not influenced by cerclage and antibiotics. It is concluded that cervical cerclage is associated with increased morbidity, therefore it is indicated only for definite anatomic and/or functional defects.

Administration, Oral↗
PubMed1988

Lactic dehydrogenase, alkaline phosphatase and human chorionic gonadotropin in a pure ovarian dysgerminoma.

Pure dysgerminoma is considered to be a nonsecretary ovarian tumor. In this study serum lactic dehydrogenase, human chorionic gonadotropin, and alkaline phosphatase levels were highly elevated in a 21-year-old woman with unilateral ovarian pure dysgerminoma and fell sharply to normal levels after removal of the tumor. In order to establish the source of these elevated serum enzymes and hormone, the tumor was homogenized and the level of these substances was found to be several times higher than that of normal homogenized ovarian tissue. In addition, the presence of lactic dehydrogenase and alkaline phosphatase in the dysgerminoma cells was shown by histochemical methods. This is the first report providing evidence that pure dysgerminoma contains and secretes enzymes and hormones which may constitute tumor markers useful for the diagnosis and follow-up of patients with this type of neoplasm.

Adult↗
PubMed1988

Ritodrine-induced pulmonary edema unmasking underlying peripartum cardiomyopathy.

Pulmonary edema was induced by an increase in the dose of ritodrine in a patient receiving the drug for 28 days because of preterm contractions. After initial therapy, the cardiologic evaluation revealed peripartum cardiomyopathy. This is the first report of ritodrine causing pulmonary edema by unmasking underlying asymptomatic cardiomyopathy. This may have been the cause of some of the previously reported cases of ritodrine-induced heart failure.

Adult↗
PubMed1988

The growth discordant twin.

The study of growth discordancy in twin gestation has gathered great momentum in recent years. Divergent intertwin growth is believed to be a direct result of the process of twinning and of the inability of the uterine environment to provide for the increased demand of multiple fetuses. The smaller twin faces increased risk of perinatal mortality and morbidity as well as reduced physical and mental development in later life. The advent of ultrasonography enabled a fairly accurate prediction of growth disparity. Although extensive investigative efforts have clarified many questions regarding divergent twin growth, the question how to manage such pregnancies remains to be answered. The present article is a review of the literature concerning the clinical aspects of growth discordant twins.

Diseases in Twins↗
PubMed1988

Iniencephaly: prenatal ultrasonographic diagnosis--a case report.

A case of iniencephaly, diagnosed prenatally at 19 weeks of gestation, is presented. The main findings of the ultrasound examination were anencephaly, almost complete absence of cervical structures and cervical and thoracic rachischisis. Amniotic fluid alpha-fetoprotein was markedly elevated. The diagnosis of iniencephaly was confirmed after termination of pregnancy. This case demonstrate the feasibility of the prenatal diagnosis of this rare neural tube defect.

Abnormalities, Multiple↗
PubMed1988

Management of labor with umbilical cord prolapse: a 5-year study.

Fifty-one cases of cord prolapse, in which delivery was not imminent and the fetus was still alive, were managed by filling the bladder with 500-700 mL of saline and by intravenous ritodrine. Delivery was by cesarean section as soon as possible. Among the cases so managed, there were no perinatal deaths. The mean 5-minute Apgar score was 9.5, and in only three cases was it less than 7. In eight cases, fetal distress continued after treatment, as compared with 33 cases before this type of treatment started (P less than .001); no difference was found in the outcome between neonates weighing less than or greater than 2500 g.

Administration, Intravesical↗
PubMed1988

Growth discordancy in appropriate for gestational age, term twins.

We compared 14 term (37 weeks or more), discordant (15% or more birth weight difference), but not growth-retarded (2500 g or larger) twin pairs with 28 randomly selected term and appropriate for gestational age twin pairs without discordancy. The comparison of the two subgroups showed no significant difference in maternal age, parity, gestational age, incidence of maternal hypertension, or perinatal outcome. It is suggested that discordancy is not a risk factor when the twin pair has reached term and the lighter twin weighs at least 2500 g.

Birth Weight↗
PubMed1987

Re-evaluation of the obstetrical risk for the older primipara.

The obstetric data relating to 92 older primiparas (OP) treated as regular obstetric patients and data relating to 92 older multiparas (OM) are compared to a previous study of 98 OP, which led to the conclusion that OP should not be managed as high-risk patients during gestation. No difference was found between the two periods regarding complications of pregnancy, gestational age and birth weight, onset of labor, perinatal morbidity and mortality. Nevertheless, cesarean deliveries were significantly higher in the study group. It seems that the conservative attitude towards OP during pregnancy is justified, but at labor, more rigid indications for cesarean section should be applied to establish objective patient care.

Adult↗
PubMed1987

Predisposing factors in the formation of true knots of the umbilical cord--analysis of morphometric and perinatal data.

Fifty-four umbilical cords with a true knot were analysed and compared to 108 normal cords. True knots were found in 1.22% of births. They occurred at a significantly higher rate in longer cords (P less than 0.00001), in male fetuses (P less than 0.05) and in multiparous women (P less than 0.003). Signs of fetal distress were observed more frequently in female fetuses, especially in those with longer cords. A true knot seems to disrupt the significant correlation (P less than 0.007) between cord length and birth weight that we observed in controls. The present study reviews the literature on the subject and suggests a possible mechanism for true knot formation.

Birth Weight↗
PubMed1987

Follicular fluid contents as predictors of success of in-vitro fertilization-embryo transfer.

In order to establish criteria for selection of the best ova in in-vitro fertilization-embryo transfer (IVF-ET) programes we have examined the follicular fluid (FF) levels of plasminogen activator (PA), collagenolytic activity, progesterone (P) and alpha 2 macroglobulin (alpha 2M) and related them to the success of pregnancy. PA activity was similar in FF of pregnant and nonpregnant cycles, 13.8 +/- 3.9 mU/ml versus 14.6 +/- 2.9 (mean +/- SEM) respectively. By contrast, FF from pregnant cycles exhibited lower collagenolytic activity (49.6 +/- 3.9% versus 67.9 +/- 3.0; P less than 0.001). Likewise, in a semi-quantitative assay of alpha 2M, only 18.4% of the aspirates from pregnant cycles showed a precipitation line, whereas 76.8% of those from non-pregnant cycles were positive. Levels of P in aspirates from pregnant cycles were in the intermediate range, as compared with those from non-pregnant cycles (0.06-5.5 micrograms/ml versus 0.02-12.0 micrograms/ml). All these assays can be completed before ET and performed in IVF-ET programmes. In conclusion, it seems that a combination of follicular alpha 2M levels and collagenolytic activity, and to a lesser extent addition of P assay, may serve as good criteria for selecting the best embryos for establishment of pregnancy.

Cleavage Stage, Ovum↗
PubMed1987

Vaginal delivery of the second twin in breech presentation.

The obstetric performance of 39 vertex-breech twin-pairs was compared with that of 48 vertex-vertex pairs. No difference was found between the two groups in maternal age, parity, gestational age, birth weight, and Apgar scores. The second twin in breech presentation had a higher incidence of very low birth-weight (less than 1500 g), but of borderline significance (P = .05), and a significantly (P less than .03) longer hospitalization period. The cesarean section rate was 7.7 and 10.4% for the breech and vertex second twin, respectively. In our view, breech presentation of the second twin is not an indication for cesarean section.

Apgar Score↗
PubMed1987

New immunochemical method for rapid detection of human choriogonadotropin in urine.

We describe a visual assay for rapid detection of choriogonadotropin (hGC) in human urine, and evaluate a pregnancy test kit that is based on this assay and designed for use by the general public. The assay involves the formation of an antibody-antigen complex between the anti-hGC antibodies coated on the membrane protein of Staphylococcus aureus bacteria, prestained with hematoxylin, and the hGC concentrated on a column of Sepharose-concanavalin A. The test was calibrated to detect as little hGC as 0.9 (SD 0.15) int. unit/mL. The kit, clinically tested with 448 urine samples, was 99.6% accurate. Simple to perform, the test gives highly reliable results as early as five days after the missed menstrual period.

Chorionic Gonadotropin↗