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Biomedical subjects

V Insler

Publications and source records attributed to V Insler.

194 records · Page 11Linked to original sources
PubMedDate not supplied

Loss of beat-to-beat variability and a negative oxytocin challenge test: an ominous prognostic sign.

The reputation of the predictive accuracy of a negative oxytocin challenge test (OCT) has been somewhat tarnished by recent sporadic reports of intrauterine fetal death relatively soon after a negative OCT. We have analyzed probable causes and the possibilities of reducing to a minimum "false-negative" results of the OCT. In particular, several of these reports did not take into account the loss of baseline fetal heart rate (FHR) variability recorded during the OCT and, in the absence of late decelerations, the OCT was interpreted as negative. We suggest that recordings showing a loss of baseline beat-to-beat FHR variability and a negative OCT illustrate a complete inability of the fetus to react to any stimulus and that, in these cases, a negative OCT should in no way be reassuring, but rather a warning sign of severe fetal compromise. Two cases are presented to illustrate this phenomenon.

Adult↗
PubMedDate not supplied

The relation between Apgar score and subsequent developmental functioning.

A randomly selected sample of 252 infants aged 5--18 months was evaluated through medical and developmental examinations. Developmental achievement scores and factors such as management of delivery and fetal distress were studied in relation to Apgar scores. Low-Apgar-score infants aged 5--8 months achieved consistently lower scores on all developmental fields. High-Apgar-score infants at younger and older ages did not differ on their achievement scores. Low Apgar score was much more frequent in infants delivered by vacuum extraction than in those delivered spontaneously, with forceps or by cesarian section. The frequency of low Apgar score was higher when fetal distress occurred.

Apgar Score↗
PubMedDate not supplied

Dibromochloropropane-induced reduction of the sex-ratio in man.

The present study evaluated the effect of paternal exposure to Dibromochloropropane (DBCP) during its production, on the sex ratio of offsprings conceived during the exposure period. The study population consisted of 30 families of which 13 fathers became azoospermic, 8 oligozoospermic and 9 normozoospermic. Of the 89 pregnancies recorded, 68 culminated in the birth of live infants. The prevalence of male infants conceived during the pre-exposure period was 52.9% , in contrast to 35.2% for boys conceived during exposure. For the combined azoospermic and oligozoospermic groups, a significantly low prevalence of male infants of 16.6% (p less than 0.025) was found. It is concluded that paternal exposure to DBCP during its production process is associated with a significant decrease in the sex ratio of offsprings conceived during the exposure period. This drop in the sex ratio might be a reflection of the early effect of DBCP on male reproductive performance before a state of severe testicular dysfunction and infertility is reached.

Antinematodal Agents↗
PubMedDate not supplied

Ovarian stimulation concomitant with pituitary-ovarian axis suppression by different GnRH agonists.

The present study compared the effect of gonadotropin therapy alone with a combination of gonadotropins and GnRH agonist on ovarian stimulation in anovulatory women and in spontaneously ovulating patients in an IVF program. Nineteen infertile patients were treated with combined GnRH agonist/gonadotropin therapy for induction of ovulation. Ten women received combined therapy for ovarian stimulation in the framework of an IVF-ET program. Twenty-one additional patients served as controls, receiving gonadotropins but not GnRH agonist for induction of ovulation or ovarian stimulation stimulation before IVF-ET. This study indicates that the GnRH agonists Buserelin, Decapeptyl, and Decapeptyl CR are similarly effective in their ability to down-regulate pituitary-ovarian axis function. The suppressive effect occurred by 14 days in 77% of the patients, and never required more than 28 days. Stimulation of ovarian function, when carried out in the presence of a suppressed pituitary-ovarian axis, required an increased dose of exogenous gonadotropins (26.4 vs. 16.5 ampules). Our data do not support the view that GnRH analogs can aid in the synchronization process of oocyte maturation.

Anovulation↗
PubMedDate not supplied

Specific IgG and IgA antibodies to Chlamydia trachomatis in infertile women.

IgG, IgA, and IgM antibody titers to Chlamydia trachomatis were determined in sera of 80 infertile women and 100 controls by a single antigen (L-2) immunoperoxidase assay. The infertile women included 50 with unexplained infertility and normal hysterosalpingogram (HSG) and 30 with abnormal HSG. The control sera included 50 from primiparous and 50 from multiparous women. The prevalence of C. trachomatis IgG antibody was significantly higher in infertile women with abnormal HSG as compared with infertile patients with normal HSG and controls (87% v. 20% and 10%, respectively). The geometric mean titer (GMT) of C. trachomatis IgG antibodies of infertile women with abnormal HSG was significantly higher than those of controls (20.7 v. 5.6). A significantly higher prevalence of C. trachomatis IgA antibodies was found in infertile women with both abnormal and normal HSG than in controls (77% and 14% v. 3% respectively). No C. trachomatis IgM antibodies (less than 2) were found in any of the infertile or control groups. The possibility that serum C. trachomatis IgA antibodies may serve as a marker for early recognition of persistent C. trachomatis is discussed.

Adult↗
PubMedDate not supplied

Immunoperoxidase assay for detection of specific IgG and IgA antibodies to human spermatozoa in infertile women.

A new immunoperoxidase antibody-membrane antigen (IPAMA) technique for the detection of IgG and IgA antibodies specific for sperm antigens is described. The technique utilizes as antigen sperm cells dried on glass slides and stored at -70 degrees C. Sera of 82 infertile women, 50 primiparas, 50 multiparas and 25 children were tested by IPAMA. Results obtained with the IPAMA test for sperm-specific IgG are compared with the results obtained by the sperm immobilization test (SIT). By the IPAMA technique, 11 of 82 infertile women (13.4%) were positive for sperm-specific IgG antibodies, 12 (14.6%) for IgA antibodies and three (3.7%) for both. In the control groups only two of 125 subjects were positive for sperm-specific IgG and none for IgA antibodies. The difference in the prevalence of anti-sperm antibodies between the control groups and the infertility group was highly significant (P less than 0.001). There was agreement between the results of the IPAMA and SIT as to the presence or absence of antibodies in seven of the 11 IgG-positive sera in the infertility group. Four more sera were IgG positive by IPAMA only. The two positive sera in the control group were detected by both IPAMA and SIT. Since the IPAMA technique is simple, does not require special equipment and utilizes stored antigen, it seems that this method could be useful in mass screening of infertile couples.

Adult↗
PubMedDate not supplied

Reproductive outcome following hysteroscopic adhesiolysis in Asherman's syndrome.

OBJECTIVE: To determine whether hysteroscopic adhesiolysis improves reproductive outcome in women with Asherman's syndrome and pregnancy failure. SUBJECTS: Ninety consecutive women who had undergone hysteroscopic adhesiolysis of intrauterine adhesions during a 5-year period. Only women in whom at least two previous pregnancies had ended with either a spontaneous abortion or a premature delivery accompanied by fetal or neonatal mortality and a hysteroscopic diagnosis of intrauterine adhesions were enrolled. RESULTS: Whereas pregnancy outcome prior to the operation was 18.3% term deliveries, 3.3% premature deliveries, 62.4% first-trimester abortions, and 16.0% late abortions, after hysteroscopic adhesiolysis pregnancy outcome was 68.6% term deliveries, 9.3% premature deliveries, 17.4% first-trimester abortions, and 4.7% late abortions. In women with two previous unsuccessful pregnancies, the operative success rate measured by delivering a healthy newborn improved from 18.3% preoperatively to 64% postoperatively. In women with three or more unsuccessful pregnancies the success rate improved from 18.3% to 75%. Successful outcome of adhesiolysis was observed in 61.9% of mild (stage I) and in 70.6% of moderate to severe cases (stages II and III) of intrauterine adhesions. CONCLUSION: Hysteroscopic adhesiolysis in women with Asherman's syndrome and poor reproductive performance contributes significantly to a successful reproductive outcome.

Female↗