胎膜早破孕妇血清及羊水中细胞因子的变化

目的 探讨细胞因子联合监测在胎膜早破中的作用.方法 采用放射免疫法和酶联免疫吸附实验对46例胎膜早破孕妇母血清、羊水中白细胞介素(IL)-6、IL-8和肿瘤坏死因子-α水平进行监测,并以正常足月妊娠孕妇26例做对照组.结果 胎膜早破孕妇母血清中IL-6、IL-8和羊水中IL-6、IL-8,肿瘤坏死因子-α水平均较正常足月妊娠组高,差异显著(P＜0.01;P＜0.05);母血清中肿瘤坏死因子-α虽高于对照组,但差异不显著(P＞0.05);随着破膜时间延长母血中IL-6、IL-8和羊水中IL-6、IL-8及肿瘤坏死因子-α有增加趋势;绒毛膜羊膜炎患者13例,其母血、羊水中上述三种细胞因子水平均明显高于非绒毛膜羊膜炎患者,差异显著(P＜0.05).结论 细胞因子联合监测对识别胎膜早破孕妇存在绒毛膜羊膜炎起辅助诊断作用.     

Disposition of Ethanol in Maternal Venous Blood and the Amniotic Fluid

The disposition of ethanol and acetaldehyde in maternal venous blood and amniotic fluid was studied over a time course following ingestion of 0.3 g/kg of ethanol by six healthy pregnant women at 16- to 18-weeks gestation. A time lag occurred in appearance and elimination of ethanol in and from the amniotic fluid when compared with maternal venous blood. Acetaldehyde was present in the maternal venous blood of four subjects but was found in the amniotic fluid in only one subject. Data from this clinical trial can be used by nurses who counsel pregnant women.     

Detection of Carcinoembryonie Antigen and Alphafetoprotein in Serum and Ascitic Fluid from Patients with Ovarian Cancer

Summary: Samples of serum from 108 patients and ascitic fluid from 15 patients with different types of ovarian cancer were tested for carcinoembryonie antigen (CEA) and alphafetoprotein (AFP) by radioimmunoassay. CEA was detected in serum in 63% of patients; the incidence was highest in those with serous (76%) and endometrioid carcinoma (67%). AFP was detected in serum in only 17% of patients: 20% of those with serous carcinoma, 25% with endometrioid carcinoma, and none with mucinous carcinoma. High AFP levels were present in 3 of 7 patients with germ cell tumour. There was no correlation between serum levels of CEA and AFP, but 14 patients showed detectable levels of both antigens. CEA was detected in the ascitic fluid of 12 of the 15 patients studied: in 2 of them, it was present in ascitic fluid but not in serum. This finding supports the value of using other biological fluids for the detection of CEA.     

The Development of Action Lines in an Australian Maternal Serum Alphafetoprotein Screening Service for Neural Tube Defects

A retrospective study covering the period from January 1, 1980 up to June 30, 1982 was conducted, producing the first definitive normal range for maternal serum alphafetoprotein from the Royal North Shore Hospital in Sydney. The normal range established is based on and applicable to the pregnant women tested at this NSW laboratory. Maternal serum alphafetoprotein levels had been determined by radioimmunoassay for 3,182 pregnancies between 13 and 20 weeks' gestation. Five anencephalics and 2 open spina bifidas were noted in the study. Only one of these abnormalities (spina bifida) was associated with maternal serum alphafetoprotein levels within the normal range, the remainder all having elevated levels. Low false positive and false negative rates of 1.16% and 0.03% respectively were obtained in this study.     

Maternal Cell Contamination of Amniotic Fluid Samples Obtained by Open Needle Versus Trocar Technique of Amniocentesis

Objective: To determine the incidence of maternal cell contamination (MCC) in the open-needle amniocentesis sampling technique compared with the trocar-in-place technique.Methods: A retrospective analysis was conducted on 2,498 mid-trimester amniocenteses performed in two tertiary care centres in Canada. The University of Alberta centre used the open-needle (without the trocar) technique and the University of British Columbia centre used the standard (with the trocar in place) technique. Data were gathered regarding the nature of the amniotic fluid, number of needle passes, amniocentesis results, and the occurrence of maternal cell contamination. The statistical analysis used logistic regression, and controlled for the potential confounders of bloody fluid taps and requirement for more than one needle insertion.Results: The incidence of maternal cell contamination was 1.16% with the open-needle technique and 0.78% with the standard trocar-in-place technique (p < 0.315), with a power of 42%.Conclusion: The data suggested there is no significant increase in maternal cell contamination with the open-needle versus trocar-in-place techniques of amniocentesis. However, the small sample size, combined with the low prevalence of the outcome of interest (MCC), provides insufficient power to draw firm conclusions about the difference in MCC between the two techniques.     

母血羊水中IL—6和IL—8水平与绒毛膜羊膜炎关系的研究

目的 探讨白细胞介素－６（ＩＬ－６）和白细胞介素－８（ＩＬ－８）在监测胎早破中的作用。方法 采用酶联免疫吸附实验对４６例胎盘早破孕妇母血清,羊水中ＩＬ－６和ＩＬ－８水平进行监测,并以正常足月妊娠孕妇２０例做对照组。结果 胎膜早破孕妇母血清ＩＬ－６,ＩＬ－８和羊水中ＩＬ－６和ＩＬ－８水平均较正常足月妊娠组高。差异差异（Ｐ〈０．０１,Ｐ〈０．０５）;随着破膜时间延长母血ＩＬ－６、ＩＬ－８和羊水中ＩＬ－     

Total Proteins in Human Amniotic Fluid

Summary: The study of the biochemical constituents of amniotic fluid is essential in the diagnosis of fetal disorders which result in high concentrations of metabolites in the fetal serum, that can be detected by amniotic fluid examination. The present study is based on the estimations of total protein concentration in the amniotic fluid of normal pregnancies at different gestational weeks. The total protein concentrations, determined by the method of Lowry et al (1951), revealed a characteristic trend during different gestations, with a progressive rise from the 12th week till the 24th week, and then a gradual decline from the 30th week till the 40th week of gestation. Thus, in the third trimester, the total protein decreased with advancement of pregnancy, indicating an inverse relationship with gestational age.     

妊娠晚期特发性羊水量异常羊水的生化改变探讨

目的:探讨妊娠晚期特发性羊水量异常者的羊水生化改变.方法:对73例妊娠晚期特发性羊水异常患者(59例特发性羊水过少、14例特发性羊水过多)进行羊水10项生化指标检测和分析,与同期随机选取的50例无妊娠合并症和并发症的单胎足月孕妇羊水进行比较.结果:特发性羊水过少组羊水中钠浓度、钙浓度、葡萄糖及渗透压较正常组降低,肌酐浓度升高,其差异有统计学意义(P<0.05);特发性羊水过多组各项羊水生化参数与羊水量正常组差异无统计学意义(P>0.05).结论:妊娠晚期特发性羊水过少者羊水中的钠浓度、钙浓度、葡萄糖及渗透压有改变.     

Amniotic Fluid Embolism — 2 Case Reports and a Review of Maternal Deaths From This Cause in Australia

Amniotic fluid embolism (AFE) is a dramatic, rare and frequently lethal complication of pregnancy. Perusal of the National Health and Medical Research Council reports on Maternal Deaths in the Commonwealth of Australia for the years 1964-1984 (1-7) shows that there have been 1,193 maternal deaths in this 21-year period, of which 54 (4.5%) were due to AFE. This paper presents data regarding these deaths and also describes 2 cases of AFE which occurred at Caesarean section performed for placenta praevia, one of which was lethal.     

病理学诊断在羊水栓塞诊断中的价值

目的:评价病理学诊断在羊水栓塞诊断中的价值.方法:健康孕晚期山羊12只,根据其股静脉中注入不同羊水性质随机分成3组:原羊水组、过滤羊水组、胎粪污染羊水组,每组4只.在羊水注入3小时后取心脏血和股静脉血查找羊水成分,同时将动物处死,取肺组织行病理学检查.结果:12只动物的中心血和外周血均找到羊水成分,肺组织均可见不同程度的肺水肿及炎性反应,原羊水组1只(25.0%)、胎粪组4只(100%)动物肺组织中找到了羊水成分,过滤羊水组无一例见羊水成分.结论:依靠病理学诊断羊水栓塞可能是不可靠的.     

The Role of Amniotic Fluid Analysis

Amniocentesis is a practical tool in daily obstetrics. The rapid and relatively safe procedure can enhance the clinician's judgement in important decisions concerning the fetal maturity, Rh iso-immunization, and genetic counseling and, to a lesser degree, in placenta localization and diagnoses of fetal well-being and congenital abnormalities. The indications and technique for amniotic fluid analysis me presented, and possible complications are discussed.     

The Determination of Peroxidase in Amniotic Fluid.

Analyzing total peroxidase activity in amniotic fluid is extremely simple, requiring only 1 1/2 minutes of incubation at room temperature and a spectrophotometer. Peroxidase, clearly detectable at as early as 17 weeks' gestation in the amniotic fluid, increases 100-fold by term. The increase follows a predictable rising curve and can be used to estimate the fetal age. Maturation of the fetal salivary gland is most probably the source of rising amniotic fluid peroxidase levels. Samples from complicated pregnancies are lower than normal, do not increase as rapidly, and probably can be bracketed into their own ranges for gestational age evaluation.     

Significance of Amniotic Fluid Glucose in Late Pregnancy

Glucose levels were estimated in over 150 amniotic fluid samples and were found to fall with advancing gestational age. Significantly lower levels were found in post-term pregnancies and in association with fetal growth retardation. Amniotic fluid glucose estimation was found to be superior to human placental lactogen in distinguishing between normal pregnancies and those complicated by fetal growth retardation. The role of the membranes in influencing the level of amniotic fluid glucose was investigated using in vitro perfusion experiments. The permeability of the membranes to glucose decreased with advancing gestational age.     

天花粉与利凡诺尔中期引产时血和羊水中的激素变化

采用放射免疫法,测定天花粉和利凡诺尔中期引产前后,母血与羊水中人绒毛膜促性腺激素(HCG)、雌二醇、雌三醇、孕酮、皮质醇和催乳素浓度的变化,结果表明:(1)天花粉引产过程中,母血浆HCG 的下降速度较雌二醇、雌三醇和孕酮为快,但与引发流产的时间无显著关联,它们的相关系数分别为0.52,-0.20,-0.07和0.07(P>0.05)。(2)利凡诺尔引产过程中,母血浆HCG 的下降速度与雌二醇、雌三醇和孕酮的下降率并无显著差异(P>0.05),且四种激素的下降速度均较慢。(3)两种引产过程中羊水雌二醇和皮质醇均有显著升高(P<0.01)文中对天花粉和利凡诺尔中期引产的机理提出进一步探讨,为寻找更有效的抗早孕方法提供了理论依据。