Asia-Oceania journal of obstetrics and gynaecology最新文献

Carrier detection and prenatal diagnosis of Norrie disease (ND) were performed using the polymorphic L1.28, OTC, and 58-1 probes. L1.28 was polymorphic in 3 of the 5 ND families tested and informative in 2 families (40%). Probe 58-1 and OTC were informative in one of 3 families (33%) and in both of the 2 families (100%) tested, respectively. The major allele frequency was 73% in L1.28 (DXS7), 89% in 58-1 (DXS14), and 50% in OTC in our patient population. One of 5 families studies showed a recombination between probes (L1.28 and OTC) and the ND gene locus placing the ND locus proximal to L1.28 and OTC.

The trends in obstetric operative intervention at a major teaching hospital in Sydney, Australia, were reviewed during the decade 1979-1989. While the caesarean section rate has increased by 36.4%, forceps deliveries have decreased. The normal delivery rate has remained constant at 67%.

The adverse effects of l-methamphetamine on the development of rat embryos were studied by means of a whole culture system. The embryos explanted at 12.5th days of gestational age were cultured for a total of 24 hours. After pre-culturing for 6 hours, 4 groups of embryos received additional culturing for 18 hours with saline or various concentrations of l-methamphetamine; 0.5, 2.0 and 5.0 mumol/dl. There was no significant difference in the survival rate among 4 groups. The groups over 2.0 mumol/dl of l-methamphetamine showed significant reduction of crown-rump length, somite number, protein content, DNA content, and protein/DNA ratio. It is suggested that over 2.0 mumol/dl of l-methamphetamine reduces the development but not the survival of rat embryos under whole culture system.

Severe ovarian hyperstimulation syndrome is an uncommon but potentially lethal complication of treatment with in vitro fertilization and other assisted reproductive technologies. We describe such a case which was atypical in that ascites and hydrothorax occurred despite the absence of ovarian enlargement. Whilst the pathophysiology of the syndrome remains unclear, the clinician must remain alert to the possibility of such an unusual presentation of this syndrome.

We compared the assessment of follicular maturity by follicular diameter or follicular fluid (FF) volume and the subsequent fertilization and cleavage of the oocytes in 36 patients who had ovarian stimulation performed for in vitro fertilization and embryo transfer (IVF-ET). All patients received clomiphene citrate and human menopausal gonadotropin. The daily growth of follicles was assessed ultrasonically for 6 consecutive days before oocyte collection. The follicular diameter was found to be well correlated with the volume of follicular fluid. There were no significant differences among the dominant, second, and third follicles in the rates of oocyte recovery, maturation, fertilization, or cleavage. The rates of oocyte maturation and fertilization in FF volumes of 5.1 to 7.0 ml were significantly higher than in volumes of 1.1 to 5.0 ml, but the cleavage rates were similar. A smaller percentage of embryos developed to the four-cell stage when the oocytes were recovered from follicles with volumes of 1.1 to 3.0 ml. These observations suggest that follicular volume is a good parameter for judging the maturity of oocytes. It is also suggested that, although the oocytes of small follicles can be fertilized and cleaved, oocytes from larger follicles may have a better developmental capacity.

Chlamydia trachomatis usually causes asymptomatic cervicitis, but it sometimes ascends into the uterine cavity, fallopian tubes, or peritoneal cavity, causing pelvic inflammatory disease and infertility. In this study, we examined endocervical chlamydial antigens and serum chlamydial antibodies in infertile women and laparoscopically evaluated pelvic lesions according to our pelvic scoring system. In patients testing positive for a chlamydial infection, the total pelvic score was significantly higher than in patients testing negative. When each area examined was assessed separately, however, only the tubal score was significantly higher in the chlamydia infected patients. These findings may indicate that tubal lesions are the major cause of infertility in women with chlamydial infections.

In order to assess the pathophysiological role of melatonin (MLT) in nocturnal hyperprolactinemia (NH), nocturnal serum MLT and prolactin (PRL) levels were measured in samples collected every 2h over a 12-hour period (2000h-0800h) from 5 normal women and 9 women with NH under physiological light/dark condition (lights off from 2100h to 0600h). Furthermore, differences in the PRL response to acute oral administration of MLT (1 mg or 5 mg) during the daytime between the 2 groups was studied. Nocturnal MLT levels in patients with NH were significantly higher (p < 0.02) than in normal women. The maximal PRL levels (52.6 +/- 26.7 ng/ml at 2400h) during the night in patients with NH were significantly higher (p < 0.05) and were reached 4h earlier than in normal women. The response to administration of 1 mg of MLT was not different between the 2 groups. However, administration of 5 mg of MLT to normal women resulted in a rapid and prominent PRL release, similar to that observed at nighttime in patients with NH. These results indicate that the abnormal PRL release in patients with NH is not due to higher sensitivity to MLT. However, the elevated MLT levels in patients with NH may be related to the neuroendocrine disorder.

The 102 fetuses diagnosed by ultrasound to be asymmetrically growth-retarded had blood flow velocity waveforms of the umbilical artery studied. Sixty-two cases had normal blood flow, 28 had abnormal blood flow but with present end-diastolic flow, 8 had absent end-diastolic flow, and 4 had reversal of end-diastolic flow. Comparison was made between the blood flow status and other biophysical methods of antenatal surveillance and perinatal outcome. There is a strong correlation between abnormal blood flow and abnormalities detected by other biophysical methods of antenatal surveillance. Our study shows that fetuses with severe blood flow impairment tend to be more severely growth-retarded and to be delivered earlier. Our results also show abnormal blood flow to be associated with a poor perinatal outcome. Those fetuses with severe impairment of blood flow suffered a high incidence of operative delivery for fetal distress, acidosis at birth, perinatal mortality and morbidity. The association between abnormal blood flow and the 5-minute Apgar score is significant only in those with the severest impairment of blood flow. Our results are in close agreement with similar studies recorded in the literature.

In order to determine the prevalence of glucose intolerance in pregnancy, 2,230 consecutive women attending the antenatal clinic at the Aga Khan University Medical Centre in Karachi, Pakistan were subjected on the first antenatal visit, irrespective of gestational age, to a 75 g glucose challenge followed 2 hr later by plasma glucose determination. The test, was repeated at 28-32 weeks of gestation for those patients who had an abnormal initial screen at less than 28 weeks gestation followed by a normal glucose tolerance test and for those who had a risk factor for gestational diabetes even though the initial screen at less than 28 weeks gestation was normal. The initial glucose challenge test was abnormal (2 hr plasma glucose greater than 140 mg%) in 8.6% of the screened population. An oral glucose tolerance test on these patients revealed a prevalence for the entire population of 3.5% of gestational diabetes and 1.9% of impaired glucose tolerance test based on the modified O'Sullivan criteria. Patients with abnormal glucose tolerance test were older, had higher parity, a past history of macrosomia and a family history of diabetes compared to the controls. These patients also had a higher incidence of preterm labour and caesarean section. In the neonates hypoglycemia and hyperbilirubinemia were similarly higher. The fetal abnormality rate was 5.6% and the perinatal mortality was 28/1,000 which were higher than the controls.

Data is presented regarding 57 women who underwent reversal of sterilization procedure. In the majority (90%), the reason for request for reversal of procedure was loss of male child or more than one child. Thirteen subjects never came back for follow-up. Out of 39 subjects in whom follow-up is available for more than 3 months, in 35 (90%) the tubes are patent. There were 25 pregnancies in 21 subjects and incidence of viable pregnancy was 88% with only ectopic pregnancy (4%). In these 35 cases whose tubes were found to be patent post tuboplasty, 18 had laparoscopic ring application, 16 had abdominal tubal ligation and one had undergone vaginal tubal ligation. Thirteen subjects (62%) conceived within 6 months after reversal. In this series, no loupe or operating microscope was used.