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PubMed1992

Case-control study of risk factors for cervical neoplasia in Denmark. II. Role of sexual activity, reproductive factors, and venereal infections.

Sexual, reproductive and venereal risk factors for cervical neoplasia were investigated in a population-based case-control study of 586 women with histologically verified, cervical squamous-cell carcinoma in situ, and 59 women with invasive squamous-cell cervical cancer, diagnosed from 1985 to 1986 in Copenhagen. Cases were identified from the computerized Danish Cancer Registry. An age-stratified control group (n = 614) was drawn at random from the female population in the study area by means of the Danish Central Population Register. A structured questionnaire was mailed to cases as well as controls. Increasing number of sexual partners exerted a significant effect on the risk both for carcinoma in situ, and invasive cancer, independently of age at first intercourse and other potential confounders. Conversely, the association with early age at first intercourse became statistically insignificant after allowance for other risk factors, although an increasing risk was still observed with decreasing age at sexual debut. Early age at first episode with genital warts was a significant risk factor for carcinoma in situ, perhaps indicating a possible increased susceptibility of the cervix epithelium during adolescence. A history of genital warts was a good predictor of risk for carcinoma in situ, whereas a history of previous gonorrhea was associated with an increased risk for invasive carcinoma. Women with multiple births had a significantly increased adjusted risk, especially for carcinoma in situ, although some association was also observed with invasive cervical cancer. The study supports the hypothesis of cervical neoplasia being a sexually transmitted disease, and that carcinoma in situ and invasive cervical carcinoma, to a high degree, have similar patterns of risk factors.

Adult↗
PubMed1986

Congenital malformations and genetic diseases in Iranian infants.

Data of 13,037 live-born infants from a hospital in Tehran, Iran were analysed for congenital malformations and genetic diseases. The results showed that the rates of joint dislocation, cleft lip, cleft palate and finger anomalies are similar to those of the other populations. The rates of chromosomal, thorax and abdominal, external genital anomalies and other syndromes were higher compared with other populations, whereas the rates of multiple births and limb anomalies were lower.

Congenital Abnormalities↗
PubMed1986

Reproduction rate and viability of Merino, Nilagiri and halfbred Merino. II. Age specific replacement rate and net reproduction rate.

Age specific replacement rate, net reproduction rate and intrinsic rate of population increase were estimated from records over a period of 11 years of Merino, Nilagiri and halfbreds. On an average for every 1000 ewes mated 830 ewes lambed, 917 lambs were born, 898 lambs were weaned and 422 ewe lambs survived to joining age (one and a half years) in Nilagiri sheep. The corresponding figures were 665, 685, 590 and 228 in Merino and 664, 709, 691 and 341 in halfbreds. Nilagiri ewes in intermediate ages had more multiple births and older ewes weaned more lambs. The flock strength was not maintained unless the ewes were kept till the fifth lambing in Merino, third lambing in Nilagiri and fourth lambing in halfbred Merino. These results along with the culling levels indicated that the low reproductive efficiency in halfbreds may not be critical enough to avoid introduction of Merino for improvement in productivity. However, the poor reproductive efficiency of the Merino in this country may necessitate repeat importations of Merino rams for production of halfbreds.

Age Factors↗
PubMed2004

Effect of prenatal exposure to ethanol on postnatal development of intestinal transport functions in rats.

BACKGROUND: Alcohol consumption by pregnant animals and humans leads to general growth impairment in their offspring, delayed growth and multiple birth defects collectively called "Fetal Alcohol Syndrome". In utero exposure of ethanol to rat pups causes damage to their developing intestinal epithelium which leads to impairment of nutrient assimilation and growth retardation during postnatal development. AIM: To determine the effect of prenatal exposure of ethanol on the postnatal development of rat intestinal Na(+)-dependent and independent D-glucose transporter along with the amino acids (glycine and Lleucine) transporter activity at 4, 8, 14, 20 and 30 days of postnatal age. The changes in the expression levels of Na(+)-dependent glucose transporter (SGLT1) mRNA was assessed at different days of postnatal age in rat pups. METHODS: Wistar strain albino female rats were fed ethanol at a dose of 2 g/kg body weight/day orally by Ryle's tube for one month before mating and during the entire period of gestation while the control females received isocaloric glucose. Transport studies were performed using the everted intestine of 4, 8, 14, 20 and 30 day-old control and ethanol-exposed pups employing the tissue accumulation method. The expression of SGLT1 mRNA at different days of postnatal age in control and ethanol-exposed rat pups was determined using a Northern Blot analysis. RESULTS: Prenatal exposure of ethanol to rat pups leads to a decrease in their body weight, intestinal length and weight and reduces the uptake capacities of SGLT1 as well as energy dependent glycine and L-leucine transporters with respect to their age-matched controls. However, the mRNA levels of SGLT1 remained unaltered in the ethanol-exposed pups at all ages of postnatal development compared to their controls. CONCLUSION: These findings suggest that in utero exposure to ethanol leads to a general delay in the postnatal development of the intestine of ethanol-exposed rat pups affecting mainly the development of intestinal energy dependent D-glucose and amino acid (glycine and L-leucine) transporters.

Animals↗
PubMed2006

Postnatal management of fetal and neonatal alloimmune thrombocytopenia: the role of matched platelet transfusion and IVIG.

We evaluated the effects of platelet transfusions and intravenous immunoglobulin (IVIG) in neonates with fetal and neonatal alloimmune thrombocytopenia (FNAIT) with and without antenatal treatment with IVIG. Records of neonates with FNAIT admitted between January 2000 and November 2005 were reviewed. The patients were divided into group I, treated antenatally with IVIG for known FNAIT, and group II, postnatally diagnosed with FNAIT. The primary outcome was the time interval to reach a platelet level above 100 x 10(9)/L in relation to the type of treatment. Nineteen neonates with FNAIT were identified, 13 in group I and 6 in group II. In group I, four children were born with a platelet count above 100 x 10(9)/L and never needed treatment, and four received a single matched platelet transfusion at birth with a maintained response. Five neonates received IVIG and one matched transfusion, with all but one rapidly responding. In antenatally treated cases, postnatal IVIG had no apparent effect on the platelet count. In group II, two neonates died on day 1 with severe intracranial hemorrhage. Two of the four other patients responded to a number of unmatched platelet transfusions, with one neonate rapidly responding after one matched transfusion, while another needed nine matched transfusions before a persistent adequate platelet count was reached after 9 weeks. Postnatal IVIG had no apparent effect on the platelet count in any of our cases. In neonates with FNAIT treated antenatally with IVIG, neonatal management using a single matched platelet transfusion was adequate in all cases. In neonatally diagnosed cases not treated before birth, multiple matched platelet transfusions may be required. We found no evidence to support the use of IVIG in neonates with FNAIT.

Female↗
PubMedDate not supplied

Acardiac twin with externalized intestine adherent to placenta: unusual manifestation of omphalocele.

TRAP (twin reversed arterial perfusion) syndrome produces an acardiac twin (acardiac monster, acardius, acardiacus, chorioangiopagus parasiticus, etc.). Acardiacs result from monozygotic multiple births in which three anatomic anomalies occur: (1) a fetus' cardiac development is disturbed; (2) artery-artery anastomosis carries blood from a normal ("pump") twin to the acardiac; (3) vein-vein anastomosis carries blood from the acardiac back to the normal twin. Whether reversal of blood flow in the acardiac results from or causes cardiac dysmorphogenesis has not been resolved. Acardiac twins demonstrate a complex constellation of malformations usually thought to result from reversed blood flow; omphalocele is particularly common. We report monochorionic monoamnionic male twins in which an acardiac twin demonstrated externalized intestines adherent to the placenta. The twins were delivered from a 30-year-old primigravida mother by cesarean section without maternal complications at 33 w. The mother has no significant past medical history. The macerated acardius had a 4-cm long attenuated umbilical cord with indeterminate number of vessels. Structures rostral to the thorax were absent save for one poorly developed hand and arm. The abdomen contained loose mesenchyme and no organs. The entire intestine (21 cm) along with two testes was located in a sac on the surface of the placenta. No histopathologic anomalies of formed structures were identified aside from spatial relationships and incomplete development. The normal twin required no intensive care and is doing well. To our knowledge, this is the first report of externalized intestine, which may represent an unusual consequence of omphalocele.

Adult↗
PubMed2005

Autopsy standards of body parameters and fresh organ weights in nonmacerated and macerated human fetuses.

Standards for body parameters and organ weights are important tools in fetal and perinatal pathology. Previously there has been only a weak emphasis on the effect of maceration on dimensions and weights. This study provides autopsy standards for body weight, body dimensions, and fresh organ weights for nonmacerated fetuses and for mildly, moderately, and markedly macerated fetuses at 12 to 43 weeks of gestation. Cases were selected from a consecutive series of 1800 fetal and perinatal autopsies. Cases with malformations, hydrops, infection, or chromosomal abnormality, fetuses from multiple births, and infants who lived longer than 24 h were excluded. In each case the maceration was graded and body weight and 4 body dimensions were recorded before organ examination. Organs were weighed immediately and before fixation. Growth curves were fitted according to appropriate mathematical methods and the effects of maceration on each value were tested statistically. We found that weights of the liver, thymus, and spleen markedly decrease with increasing maceration. The weights of the lungs, kidneys, and adrenals decreased modestly, whereas weights of the heart and brain changed only slightly. Body length increased slightly with maceration, whereas body weight and head circumference were unaffected. User-friendly charts and tables of mean values and standard deviations for nonmacerated and macerated fetuses are provided.

Anthropometry↗
PubMed2002

Pregnancy, delivery, and pouch function after ileal pouch-anal anastomosis for ulcerative colitis.

PURPOSE: This study was designed to evaluate the pregnancies, method of delivery, and functional results of females with chronic ulcerative colitis who have an ileal pouch-anal anastomosis. METHODS: A mailed questionnaire was sent to all females with an ileal pouch-anal anastomosis for chronic ulcerative colitis. Information on the pregnancy, method of delivery, and outcome was collected. Those females who had a successful pregnancy and delivery were contacted by telephone to clarify results and determine pouch functional results. Other clinical information was obtained from the Mount Sinai Hospital Inflammatory Bowel Disease database. RESULTS: Thirty-eight subjects had 67 pregnancies. Of these, 29 subjects had 49 deliveries. There were 25 vaginal deliveries and 24 cesarean sections. There were two pouch-related complications during the pregnancies and four pouch-related complications postpartum. All were treated nonoperatively. Stool frequency and day and night incontinence were increased during pregnancy in most subjects, but after delivery, prepregnancy function was restored in 24 (83 percent) of them. Five subjects (17 percent) had some degree of permanent deterioration in pouch function. Of these, three had vaginal deliveries, and two had cesarean sections. Multiple births and birth weight were not found to adversely affect subsequent pouch function. CONCLUSION: Pregnancy is safe in females with ileal pouch-anal anastomosis. Functional results are altered almost exclusively during the third trimester, but pouch function promptly returns to prepregnancy status in most females. A small proportion of females have long-term disturbances in function, but these are not related to the method of delivery. Thus, the method of delivery should be dictated by obstetric considerations.

Adult↗
PubMed2004

A meta-analysis of controlled studies comparing major malformation rates in IVF and ICSI infants with naturally conceived children.

PURPOSE: To estimate the risk of major malformations in IVF and ICSI infants. METHODS: Forty-four studies published in English since 1990 where the major malformation rate for IVF or ICSI cases was compared to an appropriate control group were reviewed. Nineteen studies met all selection criteria. In addition, a quality score was developed to assess each study based on sample size, timing of diagnosis, appropriateness of control group and other factors. RESULTS: In 19 studies, the major malformation rates ranged from 0-9.5% for IVF; 1.1-9.7 for ICSI; and 0-6.9% in the control groups. When ICSI was compared to IVF, and multiple births compared to singleton, there were no statistically significant differences. When data from 16 studies involving 28,524 IVF infants and 2,520,988 spontaneously conceived controls and 7 studies involving 7234 ICSI infants and 978,078 controls were pooled, we found an overall odds ratio for the 19 studies of 1.29 (95% CI 1.01-1.67). CONCLUSIONS: The overall odds ratio of 1.29 was statistically significant at the 5% level. These results may be useful for counseling ART patients and properly designing the consent forms used for ART procedures. It is not clear whether this risk is due to the procedures used in ART. We found that some of these studies have design flaws. All of them lacked an appropriate control group, i.e. infertile patients conceiving spontaneously. These flaws may create biases that would in almost all instances increase the risk of major malformations in the study group. Further research with better designed studies will likely result in a better estimate of the risk of major malformations associated with IVF and ICSI.

Congenital Abnormalities↗
PubMed1982

Identifying neonatal risk factors and predicting neonatal deaths in Georgia.

A predictive model which identifies 38% of the neonatal deaths by isolating only 11% of the births was formulated. It utilized existing vital records data for 230,585 single live births which occurred in Georgia for the period 1974-1976, to describe factors recorded on the birth certificate which are determinants of neonatal mortality on a statewide basis. Maternal age, race, premature birth, spontaneous abortion or stillbirth, complications related to pregnancy, complications not related to pregnancy, and type of birth (multiple gestation) were found to be statistically significant. It is proposed that private physicians evaluate patients on the basis of this model to facilitate estimates of risk of a neonatal death. In addition, public health physicians could utilize this model to make informed decisions in regard to the management of public health programs directed at the care of pregnant women.

Female↗
PubMed1987

Improved pregnancy rate with monitoring of gonadotropin therapy by three modalities.

The frequency of complications during gonadotropin therapy was reduced after the introduction of rapid estrogen assays. However, pregnancy rates remained low especially in normoestrogenic women. One hundred forty-three infertile normoestrogenic women were treated with human menopausal gonadotropin-human chorionic gonadotropin for 661 cycles. Almost all cycles were ovulatory. Whereas 53.7% of the patients conceived when drug administration was monitored by cervical score and serum estradiol levels only, 72.1% became pregnant when treatment was monitored by these modalities and real-time ultrasonography of the ovaries (p less than 0.05). Mean serum estradiol levels were significantly higher when ultrasonography was used to monitor response, but complications such as multiple births and ovarian enlargement did not occur more often. The data suggest that "true" ovulation occurs more often when ovarian imaging is used to determine drug dosage. Because of the higher pregnancy rate achieved by combined clinical (cervical score), biochemical (serum estradiol), and sonographic methods of monitoring, this approach should replace less extensive techniques.

Adult↗
PubMed1993

Prior parity reduces post-coital diurnal and nocturnal prolactin surges in rats.

Mating stimuli received by female rats activate a neuroendocrine mnemonic system which produces daily diurnal and nocturnal prolactin (PRL) surges for the first half of gestation, surges which help maintain corpora lutea function and a viable pregnancy. Since these PRL surges may be regulated in part by endogenous opioids and opioid sensitivity declines as a function of multiple births, we decided to investigate the possibility that prior parity might affect the post-coital diurnal and nocturnal PRL surges, reducing their magnitude and/or occurrence. Age-matched, nulliparous and primiparous rats were mated to males from our colony. On days 5 or 10 of pregnancy females received jugular catheters. Blood samples were collected at regular intervals from 1000 h on day 7 to 1000 h on day 8, and from 1000 h on day 12 to 1000 h on day 13 of gestation in separate sets of multigravid and primigravid rats. Measurement of plasma PRL by radioimmunoassay revealed that prior reproductive experience altered the patterns and levels of plasma PRL. Plasma PRL levels were significantly reduced during both the diurnal and nocturnal surges on days 7-8 in multigravid rats when compared with levels in primigravid rats. No differences in PRL levels were found between primigravid and multigravid groups on days 12 to 13 of gestation. The changes in diurnal and nocturnal PRL surges during early pregnancy indicate that prior parity reduces the subsequent secretion of PRL, possibly by altering the neuroendocrine regulation of this hormone.

Animals↗
PubMed1984

Increased deaths due to endocrine system diseases and allergies among mothers of dizygotic twins.

To test the hypothesis that mothers of DZ twins, who seem to represent a separate population from mothers of singletons in terms of levels of pituitary gonadotropins, height and weight, and reproductive and menstrual characteristics, have different patterns of disease and mortality, causes of non-cancer deaths were examined. Study subjects were 3,982 mothers of unlike-sexed (DZ) twins and other polyzygous multiple births, and a matched comparison group of 3,982 mothers of singletons only. A significantly increased risk of death due to diseases in ICD Group III, Allergic Endocrine System, Metabolic and Nutritional Diseases, was found among mothers of DZ twins (relative risk (RR) = 2.4, exact two-tail P = 0.024, exact 95% confidence limits 1.11 to 5.62). Of the 24 deaths among mothers of DZ twins, 18 were due to diabetes, 2 to diseases of the adrenal glands, 1 to a thyroid gland and, 3 to asthma. Of the ten deaths in the comparison group, nine were due to diabetes and one to asthma. Excluding the asthmas, the RR for endocrine system diseases is 2.33, exact two-tail P = 0.042, exact 95% CL 1.02 to 5.79. These observations are consistent with evidence in the literature which shows an association between endocrine system diseases and twinning, and between gonadotropic hormones and diabetes.

Connecticut↗
PubMed1975

Maternal malnutrition, low birthweight and related phenomena in man. Physiological and behavioral interactions.

The variables producing lowered birthweight include prematurity, maternal genetic tendencies, low prepregnancy weight, low weight gain during pregnancy, pathologies of pregnancy, multiple births, maternal malnutrition, and intrauterine growth retardation. Reductions in intelligence related to low birthweight are distributed equally among different socioeconomic groups. However, when mental subnormality is used as the criterion of impairment, low socioeconomic status is a better predictor of poor outcome than low birthweight. Even when general intelligence is not impaired, low birthweight children show specific cognitive, perceptual and behavioral signs of organic brain damage. In the absence of frank congenital abnormality, absolute birthweight is a better predictor of impaired intelligence than intrauterine growth retardation. Maternal malnutrition during the period of pregnancy does not influence offspring intelligence. Malnutrition throughout the maternal and offspring lifespan does impair intelligence, especially when surrounding social conditions are counterproductive to its development.

Animals↗
PubMed1993

The effect of mode of delivery on long-term outcome of very low birthweight infants.

A prospective 2-year neurodevelopmental follow-up was carried out on 69 very low birthweight (VLBW) infants (< 1501 g), born in the years 1985-87. The aim of the study was to determine whether there was a long-term advantage to cesarean section in these infants. The incidence of major disability and cognitive ability at 2 years of age were assessed, comparing modes of delivery. Cesarean section was performed in 38 out of 69 (55.1%) of the infants. Major disability was diagnosed in 11/69 (15.9%) of the children, of whom 7/38 (18.4%) were delivered by cesarean section, compared with 4/31 (12.9%) delivered vaginally. The difference, accounting for presentation and multiple birth was not statistically significant. Cognitive ability at 2 years of age was tested using the Mental Development Index (MDI) of the Bayley Scales, and was compared, according to mode of delivery, in 55 of 58 infants without major disability. There was no statistically significant difference between mean +/- S.E. in the MDI of 28 infants delivered by cesarean section (99.7 +/- 7.3) and that of 27 infants delivered vaginally (95.6 +/- 4). In summary, at 2 years of age, no clinically relevant benefit was found for VLBW infants who had been delivered by cesarean section.

Blindness↗
PubMed1990

Factors influencing lamb survival in a high fecundity Booroola Merino x South Australian Merino flock.

The effects of year of lambing, age of ewe and litter size on lamb survival and birthweight, and the effects of ewe mating weight and pregnancy wastage (ovulation rate minus litter size) on birthweight were examined in Booroola Merino x South Australian Merino ewes. Year of lambing, litter size and their interaction were significant (P<0.001) sources of variation for lamb survival. When birthweight was included as a linear and quadratic covariate for lamb survival, year of lambing and litter size and their interaction remained as statistically significant sources of variation. Year of lambing, litter size and pregnancy wastage contributed significantly (P<0.05) to variation in birthweight. Ewe liveweight at mating was not an important source of variation (P>0.05). Birthweight was significantly (P<0.05) reduced with an increase in pregnancy wastage. Improvement of birthweight of multiple birth lambs has some potential for increasing lamb survival. Other factors influencing lamb survival (year of lambing, litter size, pregnancy wastage) require further study so that strategies for reducing lamb loss in high fecundity Merino flocks can be developed.

Journal Article↗
PubMed1993

Cryopreservation of embryos as a means of germ plasm conservation in sheep.

Embryos were collected from 4 lines of Targhee sheep between 1986 and 1990. The lines were selected for preweaning growth rate (Lines DH and HW) or for multiple births (Line HT); Line C served as an unselected control group. Estrus was synchronized using fluorogestone acetate-impregnated vaginal pessaries, and ewes were superovulated with FSH. Embryos at the morula or blastocyst stage were surgically recovered from mature ewes at Days 5 to 6 and were frozen following morphological evaluation. The overall average number of freezable embryos per collection was 2.9, and did not differ significantly among years or among lines. Of the embryos collected between 1986 and 1988, 92 were transferred to 53 recipients in 1989, producing 53 lambs. Survival rates were 60.9 and 47.8%, respectively, for embryos evaluated as good and fair after thawing. Good-quality blastocysts yielded the highest survival rate (64.4%). Analyses indicated no significant effects of line, developmental stage or embryo evaluation on the incidence of lambing. It was concluded that embryos of morula or blastocyst stage can be successfully frozen for extended periods. The data on embryo yield and survival following cryopreservation were used to calculate numbers of donors needed to preserve and reconstitute a population of specified size.

Journal Article↗
PubMed1994

Induction of estrus with intramuscular injections of GnRH or PMSG in lactating goats (Capra hircus ) primed with a progestagen during seasonal anestrus.

In Experiment 1, goats in seasonal anestrus (n=154) were treated with sponges impregnated with 1 of 2 types of progestagen (MAP or FGA) followed by PMSG (400 IU im) 48 h before sponge removal. The type of progestagen used had no effect on kidding, abortion, pseudogestation, multiple births, stillbirths, number of live births per doe or gestation length. In Experiment 2, lactating goats (n=24) in seasonal anestrus were treated with progestagen sponges (MAP). At sponge removal they received one of the following treatments: 1 injection of PMSG (400 IU im), 1 injection of GnRH (125 mug im; GnRH-1), or 2 injections of GnRH (125 mug/injection im; GnRH-2) at a 48 h interval. Serum samples were taken at 6-h intervals for 96 h, starting 12 h after sponge removal. Heterologous radioimmunoassays were validated for the measurements of goat FSH, LH, E(2) and P(4). The onset of estrus (P=0.004), mean doe receptivity (P=0.0006), maximum preovulatory E(2) concentrations (P=0.0001) and LH peak concentrations (P=0.08) occurred significantly later for GnRH-1 and GnRH-2 than for PMSG treatment. The PMSG treatment induced a preovulatory LH peak in a greater number of goats (P=0.05) and gave a higher gestation rate than GnRH-1 and GnRH-2 treatments (57 vs 0 vs 12%; P=0.03). It is likely that the GnRH treatments administered did not reactivate the hypothalamo-pituitary-gonadal axis. Thus, intramuscular injections of GnRH in lactating goats primed with a progestagen were not as effective in regulating reproductive performance during seasonal anestrus as were injections of PMSG.

Journal Article↗