An evaluation of the tissue pH electrode for fetal monitoring using the fetal sheep as an experimental model

The performance of the Roche tissue pH electrode has been assessed by comparison of values recorded by the electrode with the pH of arterial blood, in fetal sheep. Observations were made under controlled conditions when the fetal pH was steady, during hypoxia, and after hypoxia. The results showed a highly significant correlation of the values recorded by the electrodes with the pH of arterial blood (r = 0.89, p < 0.001 during control; and r = 0.86, p < 0.001 during hypoxia and recovery). However, in about 10% of cases the insertion proved to be unsatisfactory, and in one half of the successful insertions there was a rapid initial drift which lasted up to 45 min. After stabilization, tissue pH values were symmetrically distributed about the arterial pH, with a SD of 0.07 unit. Multiple electrodes in the same fetus gave the same scatter. Movements of the electrode caused significant arterfacts. During hypoxia (produced by compression of the cord or administration of gas mixtures low in O₂), the electrodes lagged behind the changes in arterial pH by up to 10 min. The conclusion is that the inherent variability of the tissue pH electrode makes it unsuitable as an absolute indicator of fetal well-being, and that it cannot be used alone as an indication for operative intervention. Nevertheless, because of the limitations of conventional techniques, it should be valuable as an adjunct and, in particular, it should help in the interpretation of equivocal fetal heart rate tracings, thereby reducing the risk of fetal death.     

Use of prostaglandin for induction of second trimester abortions in high risk pregnancy

Experience with the use of prostaglandin F₂α (PGF₂α) and its methyl analogue for the termination of pregnancy associated with medical complications, prior laparotomy and uterine scars or tumours and abnormal pregnancies in 50 patients is presented. Complete or incomplete abortion occurred in 40 patients within 48 hours and in all of them within 78 hours. Vomiting and diarrhoea were the minor side effects encountered in a few patients. Two patients had blood losses of more than 500 ml. These results compare favourably with those results reported earlier on termination of pregnancy with prostaglandin in normal women as regards success rate, induction-abortion interval and side effects. This analysis indicates that PGF₂α and 15-me-PGF₂α are reasonably safe and effective for termination of pregnancy in high risk patients.     

Clinical profile and toxicology studies on four women immunized with Pr-beta-HCG-TT.

Clinical profile and toxicology studies on 4 women immunized with processed beta human chorionic gonadotropin conjugated to tetanus toxoid (Pr-beta-HCG-TT) are presented. The women responded to active isoimmunization by production of anti-hcg and anti-TT antibodies. The women were followed for 1 year with monthly clinical examinations including laboratory hepatic function tests, renal function tests, metabolic studies, endocrinal studies, and hematological studies. No abnormality was seen, indicating that active isoimmunization with Pr-beta-HCG-TT has no adverse or undesirable side effects in women of childbearing age.     

Modification of ovine fetal respiratory-like activity by chronic diazepam administration

Chronic maternal administration of diazepam resulted in a modification of fetal respiratory-like activity (FRLA) in the sheep. An over-all increase in this activity occurred. This increase was probably due to a rebound effect following periods of acute suppression with each administration of diazepam. Loss of central control in the regulation of FRLA was implied. A complete reversal of a circadian rhythm of FRLA was observed in animals receiving diazepam. These changes have implications with respect to the antenatal monitoring of the fetus and sequelae in the newborn infant.     

Psychosomatic gynaecology: Some geriatric considerations

The proportion of older women has increased also in the field of gynaecology. Increased therapeutic risks and longer periods of hospitalization make it more and more necessary to consider geriatric factors whenever a psychosocial evaluation is carried out. In two studies one involving over 500 women and the other over 300 women, these aspects were studied quantitatively, using as examples: cancer prevention, mastectomy and hysterectomy.From a sociological standpoint, it is significant that as older and older age groups were considered, the number of subjects who had received a higher education and whose IQ exceeded 100 kept on decreasing. Older women who had experienced more unpleasant menarches and childbirths tended often to show generalised anxiety concerning gynaecological interventions.Psychometric tests showed that as age increased nervousness, emotional lability, aggressive behaviour and tenseness increased in frequency. This is important for the gynaecologist in his pre- and postoperative psychosocial evaluations.Answers to questions concerning preventive behaviour were also influenced by age. Older women thought that preventive examinations should start at a later age than did younger women. They favoured longer time intervals between examinations. They were more confident they could detect themselves even small, more deeply embedded lumps in their breasts.The fear of experiencing a reduced sense of self-value after a mastectomy was more prevalent among older women than among younger women. The same holds true for the period of convalescence considered necessary after the operation.With increasing age, more women feared the negative psychosocial sequelae of a hysterectomy in the sexual, as well as other spheres. Surprisingly, as the age of the respondents increased, the radiation therapy was described as more harmful than the operation.     

妇科腹腔镜手术中转开腹手术的原因分析

目的探讨妇科腹腔镜手术中转开腹的原因,以期为临床治疗提供参考。方法选取2006年1月至2011年1月攀枝花市攀钢责任有限公司密地职工医院妇科共行腹腔镜手术988例,对患者的临床资料进行回顾性分析。结果中转开腹的患者19例,中转开腹率1.92%,其中中转开腹的最主要的原因为盆腔严重粘连,其发生率占中转开腹的52.63%;有下腹部手术史患者的中转开腹发生率明显高于无下腹部手术史的患者。结论术前严格掌握腹腔镜手术指征,正确掌握中转开腹时机是预防和治疗妇科腹腔镜手术并发症的有效措施。同时要提高术者的操作水平,减少不必要的副损伤,可加快患者康复,是治疗妇科疾病的可靠的方法。