早吸史勤吸吮对早泌乳的影响

为了探讨产后半小时内早吸吮、勤吸吮对早泌乳的影响。选择１１６例足月妊娠孕产妇，分别在第二产程及产后半小时抽取母亲静脉血，采用放射免疫双抗法（ＤＡＲＩＡ）测定胎儿娩出前、吸吮后和未吸吮时，母血清垂体催乳素（ＰＲＬ）值。结果表明：第二产程时且血清ＰＲＬ值无显著差异。而产后半小时早吸吮的母亲体内知清中ＰＲＬ水平明显高于未吸吮的血清ＰＲＬ值，早吸吮母亲泌乳早。     

早吸吮加乳腺理疗促进早开奶的效果观察

目的：探讨早吸吮加乳房理疗对乳汁分泌的影响。方法：对373例产妇产后进行观察,其中246例给予乳房理疗,127例只进行婴儿早吸吮。结果：观察组泌乳始动时间为20．15±5．3小时,产后48小时纯母乳喂养率为97．15％,产后72小时纯母乳喂养率为98．37％,乳汁充足者9837％;对照组泌乳始动时间为29．6±8．6小时,产后48小时纯母乳率34．65％,乳汁充足者54．33％。两组统计学处理有显著差异（P〈0．05）。结论：早吸吮加乳腺理疗对早开奶和增加乳汁量有明显效果．值得临床推广应用。     

婴儿早吸吮与产妇泌乳的观察

目的:为了解婴儿早吸吮与产妇泌乳的关系。方法:对160例产妇采取了母乳喂养的观察。并设早吸吮组100例和对照组60例进行效果观察。结果:早吸吮组12小时泌乳率达63%,对照组12小时泌乳率达17%,两组效果有显著差异。结论:婴儿早吸吮有利于母亲乳汁的分泌,为母乳喂养创造了良好的条件。     

早吸吮和乳房排空对纯母乳喂养的影响

２３９对母婴早吸吮、乳房排空与产后４个月内纯母乳喂养关系的观察结果表明：早吸吮可使婴儿更快地学会正确的吸吮姿势，使母亲增强纯母乳喂养的信心。乳房排空能使乳汁分泌增多，有助于４个月内纯母乳喂养率的提高。此外母亲学会排空乳房也为日后可能出现的母婴暂时分离提供纯母乳喂养的可能性。因此，产后采取早吸吮、乳房排空的措施有利于纯母乳喂养，值得提倡。     

早接触早吸吮在县级中医院妇产科应用体会

目的:探讨产后早接触早吸吮对母婴的影响。方法:选择2009年8月—2011年8月在我院分娩且存活的新生儿1885例。在产后30分钟内,给新生儿皮肤进行接触并吸吮母亲乳头。结果:产后5—10分钟内进行早接触早吸吮者,胎盘娩出时间在15分钟之内者占98.18%,胎盘娩出时间在15—30分钟之内者占1.82%,产后出血发生率0.27%;产后10—20分钟内进行早接触早吸吮者,胎盘在15分钟内娩出者81.63%,15—30分钟内娩出者18.37%,产后出血发生率1.02%;产后20—30分钟内早接触早吸吮,胎盘15分钟内娩出者占70.37%,15—30分钟内娩出者占29.63%,产后出血发生率2.78%,92%的母亲乳汁分泌良好,100%的新生儿均吸吮成功,且安静,舒适,皮肤红润。结论:早接触早吸吮能促使胎盘娩出,减少产后出血,使新生儿体温稳定,吸吮良好。     

哺乳期妇女血清泌乳素与泌乳关系的探讨

哺乳期妇女血清泌乳素与泌乳关系的探讨成要平，王冬英，张延丽，张薇，池瑞英为了探讨母婴同室、按需哺乳与早泌乳、多泌乳间的关系，我们检测了母婴同室哺乳期妇女血清垂体生乳素（ＰＲＬ）水平，并设非母婴同室哺乳期妇女为对照组，现将研究结果报道如下。一、资料与方...     

应用蒂洛安后泌乳量的变化

应用放射免疫分析法测定了蒡洛安（硫酸普拉酮钠，ＤＨＡＳ）１００ｍｇ用药组、２００ｍｇ用药组各３０例及对照组６０例孕产妇，在入院时，产后第１天、产后第３天血清中雌二醇（Ｅ２）、垂体泌乳素和血浆中催产素的含量变化，并观察其产后泌乳量。     

新生儿出生后即时母婴皮肤接触和早吸吮对母儿的影响

新生儿出生后即时母婴皮肤接触和早吸吮对母儿的影响烟台毓璜顶医院（２６４０００）张艳芳刘玉芳董礼琴刘梅芳我院自１９９３年９月实行母婴同室，１９９４年８月实行纯母乳喂养并坚持新生儿出生后即时母婴皮肤接触和早吸吮。本文以１９９４年９月～１２月的皮肤接触及早...     

体外受精-胚胎移植周期中黄体期血清性激素水平与妊娠率的关系

目的探讨体外受精－胚胎移植（ＩＶＦ－ＥＴ）周期中黄体期血清性激素水平的变化及与妊娠率的关系。方法随机选取６２个采用卵泡刺激素／绝经期促性腺激素／绒毛膜促性腺激素（ＦＳＨ／ｈＭＧ／ｈＣＧ）促超排卵的ＩＶＦ－ＥＴ周期（６２例患者）,采用放射免疫测定技术,测定其自然周期与促超排卵周期中黄体期血清雌二醇（Ｅ２）、孕酮（Ｐ）、催乳素（ＰＲＬ）水平,观察其妊娠情况。结果促超排卵周期中黄体期血清性激素水平明显高于自然周期（Ｐ＜０．０５）。补充黄体酮者的Ｐ、Ｐ／Ｅ２值,明显高于未补充黄体酮者（Ｐ＜０．０５）。临床妊娠者的Ｅ２水平明显低于未妊娠者,而Ｐ／Ｅ２、ＰＲＬ值明显高于未妊娠者（Ｐ＜０．０５）,并且当Ｐ／Ｅ２值为３００～４００、ＰＲＬ值为６０～１００μｇ／Ｌ时妊娠率最高。结论ＩＶＦ－ＥＴ周期中黄体期血清性激素水平对妊娠有影响,其中Ｅ２、Ｐ协同发挥作用,ＰＲＬ在一定范围内有利于胚胎着床。在ＩＶＦ－ＥＴ中应适当补充黄体酮,调节性激素至最适水平,可提高临床妊娠率     

血清一氧化氮一氧化氮合成酶与宫缩乏力性产后出血关系的研究

目的：探讨血清NO及NOS与产后出血的关系及意义。方法：对无妊娠合并症及胎盘因素的61例妊娠足月未临产，因臀位、胎儿偏大、骨盆等因素而行剖宫产的孕妇，进行术前及术后半小时血清NO及NOS含量的测定，并测量产后2小时内出血量。结果：产后出血组术前及术后NO、NOS含量较非产后出血组明显增高，差异极显著（P＜0．001）。且术前、术后血清NO及NOS含量与产后出血量呈正相关，差异极显著（P均＜0．01）。结论：测定血清NO及NOS含量，可预测产后出血的发生，从而正确选择剖宫产时机。     

米非司酮配伍米索前列醇终止早孕出血原因的研究

探讨采用配伍方法进行药物流产后出血时间长的原因。方法一组２２例,服米非司酮及米索前列醇药物流产,二级２０例采用吸宫术终止妊娠。分别于妊囊排出或吸宫后第５、１４、２４天抽肘静脉血测血ｈＣＧ、Ｐ、Ｅ２ＦＳＨ、ＬＨ及ＰＲＬ,同时记录出血时间。     

Effects of pregnancy, delivery and lactation in hyperprolactinemia with prolactin producing pituitary adenoma

The effects of pregnancy, delivery and lactation on changes in serum prolactin (PRL) values were investigated in patients with hyperprolactinemia. Thirty-seven patients with hyperprolactinemia who wished to become pregnant were treated by transsphenoidal surgery, bromocriptine therapy, or a combination of the two. In 33 patients whose pre-pregnancy serum PRL concentration exceeded 30ng/ml, only in two did serum PRL return to the normal range below 30ng/ml after pregnancy, delivery and lactation. However, the serum PRL concentration was decreased in 28 patients. When classified according to the pre-pregnancy serum PRL concentrations, PRL less than or equal to 100 (Group A), 100 less than PRL less than or equal to 200 (Group B) and 200 less than PRL (Group C), patients with the greatest pre-pregnancy serum PRL concentration showed the greatest reduction. The ratios of post-pregnancy serum PRL to pre-pregnancy PRL in group A, B and C were 91.4 +/- 22.1%, 81.5 +/- 7.0% and 65.0 +/- 6.5% (Mean +/- SE), respectively. Group C with the highest pre-pregnancy serum PRL concentration consisted almost entirely of patients with macroadenoma. Thus, the reduction in serum PRL after pregnancy, delivery and lactation was considered to be the result of a decrease in the size of the adenoma due to adenoma enlargement over the sella turcica through the estrogen effects during pregnancy, and from impairment of pituitary circulation.     

罗哌卡因用于分娩镇痛对产妇泌乳的影响

目的 探讨罗哌卡因用于足月产妇阴道分娩镇痛对催乳素(PRL)水平、泌乳始动时间及泌乳量充足率的影响.方法 选择北京市海淀区妇幼保健院产科2006年1月至2007年6月足月阴道分娩产妇124例,随机分为分娩镇痛组75例,对照组49例.分娩镇痛组产妇应用硬膜外电子镇痛泵持续泵入罗哌卡因用于分娩镇痛,先以0.125%罗哌卡因3 ml注入硬膜外腔,观察5 min无异常反应后再注入12 ml,将麻醉平面控制在胸10以下,以5 ml/h(0.104 mg/min)的速度持续泵入罗哌卡因,直至宫口开全后关闭镇痛泵.对照组为自然分娩产妇,不用任何镇痛措施.应用微粒子化学发光法分别测定两组产妇产前、产后0、2、6、12和24 h血清催乳素水平,记录泌乳始动时间和每日新生儿哺乳次数,并以新生儿排尿次数和哺乳后睡眠时间判断泌乳量充足与否,测量产后24 h的新生儿体重下降情况.结果 (1)两组产妇催乳素水平产后即开始升高,于产后2 h达到高峰,并于产后24 h维持在较高水平上.(2)分娩镇痛组产妇催乳素水平在产后2、24 h分别为(19.5±8.4)、(14.5±5.6)nmol/L,对照组产妇催乳素水平在产后2、24 h分别为(22.6±7.2)、(16.9±5.7)nmol/L,两组分别比较,差异均有统计学意义(P<0.05).(3)分娩镇痛组产妇泌乳始动时间在产后24 h内者为73例(97%,73/75),泌乳量充足率在产后48 h内为73%(55/75),产后24 h新生儿体重下降(57±42)g;对照组产妇泌乳始动时间在产后24 h内为45例(92%,45/49),泌乳量充足率在产后48 h为57%(28/49),产后24 h新生儿体重下降(62±40)g,两组分别比较,差异均无统计学意义(P>0.05).结论 (1)罗哌卡因用于分娩镇痛可影响产妇的催乳素分泌,但不影响泌乳始动时间和泌乳量充足率.(2)罗哌卡因用于分娩镇痛时,产妇催乳素仍处于较高水平,以满足泌乳的必要条件.     

Studies on metoclopramide (MCP) loading test during pregnancy and puerperium for the evaluation of lactating capacity

To evaluate the correlation between prolactin (PRL) secreting capacity and puerperal lactation, 66 women who had delivered normally without any complications during pregnancy were studied. They were divided into two groups depending on the lactating state a month after the delivery: The breast feeding group (group A, 40 cases), and the supplementary feeding group (group B, 26 cases), respectively. 10 mg of metoclopramide (MCP) loading was carried out in the 36th week of gestation and in the third day of the puerperium, and serum levels of PRL (at 0, 30, 60 min. after the MCP loading) were measured by RIA. Serum levels of insulin, glucose, triglyceride, free fatty acid, cholesterol and lipoproteins were also examined. There was no significant change in the serum levels of the various, substances during pregnancy and puerperium. Also, no significant change could be seen in the MCP loading test in the 36th week of gestation. However, on the third day of puerperium, serum PRL after 30 min. of the MCP loading showed a significant increase in group B compared with group A (587.1 +/- 202.9 vs. 431.2 +/- 196.6 ng/ml, p less than 0.02, mean +/- standard deviation). These results suggested that the MCP loading test during the early stage of puerperium might be an important index to use in determining whether the mother was ready to breast feed.     

Inhibition of puerperal lactation by means of a single injection of bromocriptine retard

The efficacy, tolerance and acceptability of a single i.m. injection of 50 mg bromocriptine retard (in polylactic acid microspheres), given within 12 h after delivery for suppression of lactation, were investigated in 47 mothers not willing to breast-feed. Slight to moderate breast discomfort was noticed during the first postpartum days in 23% of the patients but lactation was indeed prevented in all cases and no rebound lactation occurred in any case. Only six patients exhibited at least two symptoms of mammary engorgement (congestion and pain or milk let-down): in this group, blood mean PRL levels were significantly less suppressed on postpartum days 2, 6, 21 and 28 (p less than 0.05 to p less than 0.001) than in the group of mothers completely free of any mammary symptoms. Slight side-effects (mostly dizziness), as mentioned at systematic request, were recorded in 34% of the patients; only 3 patients required treatment for their side-effects. Recovery of ovarian function was evident quite early (by day 28 in 72% of the patients), thus requiring early onset of contraception.     

In vivo studies on prolactin function in the female rat: Divergent effects of treatment with bromergocryptine and antisera to rat prolactin

The effect of suppression of prolactin (PRL) serum levels on early pregnancy and lactation in the rat by means of either bromergocryptine (BEC) or rabbit antiserum to rat PRL has been examined. BEC terminated early pregnancy when given on any day from 1 to 6 and significantly impaired lactation performance when injected during the lactation period. Antibodies against rat PRL, however, showed no effect on either early pregnancy or lactation, although the sera of the treated rats contained free PRL antibodies as evidence for sufficient dosage of antiserum. This finding can be explained in two ways: either the antibodies are not able to neutralize the biological activity of the bound PRL, or the effect of BEC is not mediated by PRL-suppression alone but requires a second component not provided by the specific antiserum.     

Endocrine and clinical results in administering lisuride for inhibiting lactation

Lisuride is a potent direct Dopamine agonist and has an effective Prolactin-lowering effect. 64 post-partum women have been divided in two groups: 44 patients with personal reasons to inhibit lactation and 20 patients normally breast-feeding, as control group. The inhibition of lactation has been carried out with Lisuride using 3 X 0.2 mg daily over 10 days, starting within 24-28 hours from delivery. In all the patients we have dosed Prolactin (PRL), LH, FSH, 17-beta Estradiol (E2) in basal conditions (1st day after delivery) and on the 5th and 10th day of assumption of the drug. At the 10th day-control the inhibition of lactation, without symptoms, has been obtained in 39 out of 44 patients treated (86.3%). It is clear how, in comparison with the control group, Lisuride leads to a rapid fall of PRL and seems to promote an earlier restoration of hypothalamus-pituitary-ovary axis, as is shown by the behaviour of gonadotropin and estradiol.     

Integrated Concentrations of Prolactin in Breast-Feeding Mothers

Summary: Mean 24-hour integrated concentrations of serum prolactin (PRL) in 8 breast-feeding mothers (62 ± 10.4 μg/1) was significantly higher than in 4 control subjects (14.8 ± 3.3 μg/1). No correlation was found between the mean integrated concentrations and time after delivery or breast-feeding status. There was no relationship between the mean integrated concentration of PRL or the basal PRL and the frequency of feedings, the total suckling time, the mean interval between feedings or the longest interval between feedings in the 24-hour period. The study provides conclusive evidence for increased prolactin secretion in long-term puerperal lactation.     

Hormonal control of lactation

We studied the mechanism of normal lactation, especially the roles of prolactin (PRL) and oxytocin (OXT) in the initiation of lactation, the lactation in the women complicated with endocrinological disorders, and medical therapies for stimulation and suppression of lactation. The level of serum PRL increases as pregnancy progresses, and reaches to a peak on the day of delivery. Despite high PRL level, milk secretion does not appear during pregnancy, because the sex steroid hormones suppress binding of PRL to the receptor in the mammary gland. The initiation of milk secretion in puerperal women seems to be closely related to an increase in PRL levels induced by adequate suckling. In the mechanism of suckling-induced PRL increase, OXT from posterior pituitary seems to have an important role. Furthermore, the poor response of PRL to suckling was due to insufficient stimulation to the nipples by suckling because the size of nipples were relatively small in these mothers. The other mechanism involved in lactation is suckling-induced OXT secretion. OXT stimulates milk ejection. Anxiety or fear may inhibit the OXT release. We demonstrated that the number of pulsatile release of OXT by nursing was significantly decreased by the psychological stress induced by mental calculation. In the puerperal women with prolactinomas after surgery, the serum PRL level did not increase during pregnancy and milk secretion in puerperium was poor. In the puerperal women with diabetes mellitus, milk secretion was also poor. One of the causes may be related to the low PRL response to suckling stimuli. PRL stimulates milk yield in the mammary gland, but is not commercially available.(ABSTRACT TRUNCATED AT 250 WORDS)     

舌下含服卡前列甲酯栓预防产后出血的临床研究

目的 探讨舌下含服卡前列甲酯栓预防产后出血的效果。方法 将正常的单胎头但足月妊娠阴道分娩者１３９０例分为两组。研究组８１０例,在第二产程末胎头娩出前舌下含服卡前列甲酯栓１ｍｇ;对照组５８０例,在胎儿娩出后静脉注射催产素２０ＩＵ,观察产后２小时出血量。结果 产后２小时内的出血量,研究组及对照组分别为１７６．４３ｍｌ和１９６．７３ｍｌ,差异有极显著性（ｐ〈０．０１）。结论 舌下含服卡前列甲酯栓促进子宫