尿钙及尿微量白蛋白检测在妊高征早期诊断中的临床意义

目的　评价尿钙及尿微量白蛋白检测在妊高征早期诊断中的临床意义。方法　收集９８ 例孕２４～３２ 周健康孕妇的２４ 小时尿样,采用自动生化仪测定尿钙排泄量,放射免疫法测定尿微量白蛋白的排泄量,按最终是否发生妊高征分成妊高征组（１４ 例） 和正常妊娠组（８４ 例） 。结果　妊高征组尿钙排泄量为（１－４３±０－３７） ｍｍｏｌ／２４ｈ ,正常妊娠组为（３－２６±０－７５） ｍｍｏｌ／２４ｈ,妊高征组尿钙排泄量显著低于正常妊娠组（ Ｐ＜ ０－００５） 。妊高征组尿微量白蛋白排泄量为（１２－６８ ±６－８１） μｇ／２４ｈ ,正常妊娠组为（６－０８±３－４８） μｇ／２４ｈ,妊高征组尿微量白蛋白排泄量显著高于正常妊娠组（ Ｐ＜ ０－０５）。结论　在妊高征临床症状出现４～８ 周之前,即出现尿钙排泄量减少及尿微量白蛋白排泄量增多。这一特征可作为妊高征早期诊断的指标。     

妊高征患者血清抗中性粒细胞胞浆抗体的检测及临床意义

目的 探讨妊高征患者血清避性粒细胞胞浆抗体（ＡＮＣＡ）的表达及其在妊高征发病中的作用。方法 用间接免疫荧光方法检测３７例妊高征患者（妊高征组）和３９同期非妊高征肝妇（对照组）血清中ＡＮＣＡ的表达。结果 妊高征级轻、中、重度妊高征患者ＡＮＣＡ的阳性率分别为３３．３％、８８．９％、８６．４％,其分型以细胞质荧光染色型（ｃ－ＡＮＣＡ）为主,对照组ＡＮＣＡ阳性率为１３．２％,明显低于妊高征组（Ｐ〈０．００     

孕鼠高血糖对胎鼠胰岛功能的影响

目的　探讨孕鼠高血糖对胎鼠胰岛β细胞分泌胰岛素功能的影响。方法　２８ 只妊娠 Ｓ Ｄ 大鼠随机分成两组,实验组在妊娠晚期持续性静脉输注高渗葡萄糖;对照组同期输注无菌蒸馏水。采用胎鼠胰岛细胞进行胰岛素抽提实验、胰岛素释放试验及灌流试验,研究胎鼠胰岛β细胞功能的变化。结果　实验组胎鼠每个胰腺内胰岛素平均水平为（３ ３２９ ．８１ ±１６３ ．３９）ｎｇ;单位重量胰腺组织胰岛素水平为（１５８ ．５６ ±２３ ．３４）ｎｇ／ｍｇ。对照组胎鼠胰腺内胰岛素平均水平为（２ ３９０ ．０４ ±１５１ ．３９）ｎｇ ;单位重量胰腺组织胰岛素水平为（１２５ ．７９ ±１７ ．９７）ｎｇ／ｍｇ 。两者比较,差异有显著性（ Ｐ＜ ０ ．０５） 。在低糖或高糖 Ｈａｎｋｓ 液中温育胰腺组织２ 小时,实验组胎鼠胰岛素释放量：低糖时为（２４ ．２２ ±４ ．６３）ｎｇ／ｍｇ ;高糖时为（７３ ．７３ ±５ ．９４）ｎｇ／ｍｇ 。对照组胎鼠胰岛素释放量：低糖时为（２０ ．５２ ±２ ．３１）ｎｇ／ｍｇ ;高糖时为（５３ ．３５ ±７ ．５３）ｎｇ／ｍｇ 。两组比较,差异有显著性（ Ｐ＜ ０ ．０５） 。在胰岛素灌流试验中,实验组胎鼠胰岛素分泌时相高峰出现早且峰值高于对照组。结论     

Soluble LH-HCG receptor and oestradiol as predictors of pregnancy and live birth in IVF

Research question

Circulating soluble LH-HCG receptor (sLHCGR) is a first-trimester marker for screening pregnancy pathologies and predicts premature or multiple births before fertility treatment. Oestradiol per oocyte at ovulation induction predicts IVF treatment outcomes. We asked whether sLHCGR levels are stable during fertility treatment and whether, alone or with oestradiol, they could improve prediction of fertility treatment outcomes.

First and Third Trimester Uterine Scar Thickness in Women With Previous Caesarean: A Prospective Comparative Study

Background

Lower uterine segment (LUS) thickness in the third trimester of gestation is associated with the risk of uterine scar defect at delivery. It was suggested that first trimester residual myometrial thickness (RMT) could also predict uterine scar defect at delivery.

Estrategia de detección de disfunción tiroidea en la gestación: cribado universal o selectivo

Objective

To estimate the effectiveness of selective versus universal screening for thyroid dysfunction (TD) during pregnancy.

Low-field MRI pelvimetry

The purpose of this study was to evaluate the usefulness of low-field MRI pelvimetry and to correlate the results with X-ray pelvimetry. A total of 19 women underwent low-field MRI pelvimetry. Mediosagittal and transverse planes were used to measure the diameters of the minor pelvic cavity. Correlations between MRI and X-ray pelvimetry were 0.96 for the sagittal inlet, 0.94 for the sagittal outlet, 0.93 for the transverse diameter (diameter transversa, DT) and 0.94 for the bispinous distance (interspinous distance, IS). The repeatability of the measurements was good. For fetuses with cephalic presentation it was also possible to determine the biparietal diameter (BPD). Low-field MRI pelvimetry was well accepted by the patients. The scanning time was less than 6 min, which is comparable with the time of X-ray examination with two planes. Magnetic resonance imaging provides a reliable method to image pelvic structures and soft tissue without ionizing radiation. Received 2 October 1995; Revision received 27 December 1995; Accepted 19 June 1996     

Changing management of gallstone disease during pregnancy

Background: Symptomatic gallstones may be problematic during pregnancy. The advisability of laparoscopic cholecystectomy (LC) is uncertain. The objective of this study is to define the natural history of gallstone disease during pregnancy and evaluate the safety of LC during pregnancy. Methods: Review of medical records of all pregnant patients with gallstone disease at the University of California, San Francisco, from 1980 to 1996. Results: Of approximately 29,750 deliveries, 47 (0.16%) patients were treated for gallstone disease, including biliary colic in 33, acute cholecystitis in 12, and pancreatitis in two. Conservative treatment was attempted in all patients but failed in 17 (36%) cases. Two patients required combined preterm Cesarean-section cholecystectomy and 10 required surgery in the early postpartum period for persistent symptoms. Seventeen patients required cholecystectomy during pregnancy for biliary colic (10), acute cholecystitis (six), and pancreatitis (one). Three patients were treated with open cholecystectomy. Fourteen patients underwent LC at a mean gestational age of 18.6 weeks, mean OR time of 74 min, and mean length of stay of 1.2 days. Hasson cannulation was utilized in 11 patients. Reduced-pressure pneumoperitoneum (6–10 mmHg) was used in seven patients. Prophylactic tocolytics were used in seven patients, with transient postoperative preterm labor observed in one. There were no open conversions, preterm deliveries, fetal loss, teratogenicity, or maternal morbidity. Conclusions: In past years, symptomatic gallstones during pregnancy were managed conservatively or with open cholecystectomy. LC is a feasible and safe method for treating severely symptomatic patients. Received: 3 April 1997/Accepted: 5 July 1997     

抗孕唑啉对啮齿类动物终止妊娠药效学研究

目的:研究抗孕唑啉(L14105)的终止妊娠作用及其作用靶部位。方法:用多种啮齿类动物观察终止早孕及中孕作用;用组织学和细胞培养法观察对细胞的损伤;放射配基分析对子宫胞浆孕酮受体的结合力。结果:L14105对小鼠、大鼠、金黄地鼠与豚鼠均有较强的抗早孕作用,并可致豚鼠中孕堕胎;对体外培养人蜕膜细胞具杀伤力,早孕大鼠用药后24～48h蜕膜细胞开始损伤、胚胎吸收;对大鼠子宫胞浆孕酮受体结合力微弱。结论:L14105对多种啮齿类动物具有很强的终止早孕与中孕活性,其作用靶部位可能为蜕膜细胞。     

Pregnancy following incontinence surgery

A two-page questionnaire was distributed to 304 members of the American Urogynecology Society. Ninety-nine of the 149 respondents reported that they had performed continence surgery on patients who specifically stated their desire for future childbearing. One hundred and eleven recommended the Burch colposuspension, 29 favored the sling procedure, and others advocated different procedures. Urologists as a subset more often recommended either a sling or needle suspension. Twenty-eight percent of respondents felt a trial of labor and vaginal delivery was indicated following incontinence surgery, but 40% stated that they would always perform cesarean section in these patients. A total of 40 vaginal deliveries and 47 cesarean sections were reported. When postpartum continence status was known, only 73% of women who had vaginal deliveries were continent, whereas 95% were continent following cesarean section. Fisher's exact test revealed this to be a statistically significant difference (P=0.0344).The opinions expressed in this article do not reflect the views or opinions of the United States Navy or the Department of Defense.Editorial Comment: This study presents interesting information about current practice trends regarding a difficult medical situation without any clear guidelines. However, whether any true clinical consensus was reached based on the data collected is questionable. The study does, however, serve to open the topic of how to manage the incontinent female who desires further childbearing, for further study. Clearly, more rigorous objective data are needed before far-reaching statements can be made regarding the route of delivery following incontinence surgery.