| 1. |
- Lindhagen, T, et al.
(författare)
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Fertility and outcome of pregnancy in patients operated on for Crohn's disease
- 1986
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Ingår i: International Journal of Colorectal Disease. - 1432-1262. ; 1:1, s. 25-27
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Tidskriftsartikel (refereegranskat)abstract
- Fertility and outcome of pregnancy were assessed in all 78 women below 40 years of age in a total, unselected series of patients with Crohn's disease, diagnosed during a 17-year period and consecutively treated with resectional surgery, in most cases at an early stage. The median follow-up time after the primary operation was 12.8 years. During the observation time there were 87 pregnancies in 44 patients. Neither the number of live births, nor the frequency of abortions differed from that expected in the general population. There was no still birth. The localization of the disease was not significant. In conclusion, there were no indications of any negative influence of surgical intervention.
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| 2. |
- Grant, Adrian, et al.
(författare)
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Routine formal fetal movement counting and risk of antepartum late death in normally formed singletons
- 1989
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Ingår i: The Lancet. - 1474-547X. ; 334:8659, s. 345-349
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Tidskriftsartikel (refereegranskat)abstract
- The routine recommendation to women to count fetal movements daily during late pregnancy for the prevention of antepartum late fetal death in normally formed singletons has been evaluated. 68,000 women were randomly allocated within thirty-three pairs of clusters either to a policy of routine counting or to standard care, which might involve selective use of formal counting or informal noting of movements. Antepartum death rates for normally formed singletons were similar in the two groups, regardless of cause of prior risk status. Despite the counting policy, most of these fetuses were dead by the time the mothers received medical attention. The study does not rule out a beneficial effect, but at best, the policy would have to be used by about 1250 women to prevent 1 unexplained antepartum late fetal death, and an adverse effect is just as likely. In addition, formal routine counting would use considerable extra resources.
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| 3. |
- Rannevik, G., et al.
(författare)
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Epostane in nonpregnant females: effects on progesterone, 17 alpha-hydroxyprogesterone, and 17 beta-estradiol of two dose levels given for one month
- 1988
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Ingår i: Fertility and Sterility. - 1556-5653. ; 50:6, s. 893-902
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Tidskriftsartikel (refereegranskat)abstract
- So far, the use of epostane, a relatively new inhibitor of 3 beta-hydroxysteroid dehydrogenase/delta 5-delta 4 isomerase enzyme system (3 beta-HSD), has been confined to short-term interference with luteal and placental function. This study explored whether epostane treatment from the beginning of the cycle for approximately 1 month would also inhibit ovarian follicular function. Twenty females with regular cycles received epostane 150 mg/day (ten healthy volunteers) or 600 mg/day (ten patients with endometriosis). Blood samples were drawn three times per week during control and treatment cycles. At 150 mg/day the mean total area under the serum concentration curve (AUC) of estradiol (E2) was somewhat higher than during the control cycles, despite apparently lower preovulatory E2 surges. During medication the highest value of E2 was found during the luteal phase. The mean AUC of progesterone (P) and 17 alpha-hydroxyprogesterone (17-OHP) during the luteal surge was decreased by approximately 45% each. At 600 mg/day all evaluable patients had lower AUC of E2 than during the control cycle. The mean decrease in AUC of P and 17-OHP was much more pronounced than in the lower dose group. Six of the ten patients showed no hormonal signs of follicular development and, consequently, anovulation. The capacity of epostane to modulate or inhibit, depending on the dose, ovarian follicular steroidogenesis and ovulation may prove valuable in a variety of clinical conditions.
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| 4. |
- Valentin, Lil, et al.
(författare)
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Fetal movement in the third trimester of normal pregnancy
- 1986
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Ingår i: Early Human Development. - : Elsevier BV. - 1872-6232 .- 0378-3782. ; 14:3-4, s. 295-306
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Tidskriftsartikel (refereegranskat)abstract
- Changes in fetal motor activity may reflect changes in central nervous function and in the health of the fetus. Recording of fetal movement (FM) has therefore been suggested as a method of assessing fetal well-being. To establish the normal range of FMs in the third trimester of pregnancy, FMs were studied cross-sectionally in 180 and longitudinally in 6 healthy women with normal pregnancies. FMs were recorded simultaneously by the mother and by a FM detector using four piezo-electric crystals attached to the maternal abdomen. The recordings lasted for 45 min (cross-sectional study) or 30 min (longitudinal study). The median numbers of FMs recorded during 45 min by the FM detector and by the mother were 85 (2.5th percentile, 14; 97.5th percentile, 232) and 41 (2.5th percentile, 10; 97.5th percentile, 135), respectively. The median 45-min incidences of FMs recorded by the FM detector and by the mother were 8.1% (2.5th percentile, 1.3; 97.5th percentile, 30.2) and 3.7% (2.5th percentile, 0.9; 97.5th percentile, 15.6), respectively. Neither the number nor the incidence of FMs changed appreciably as gestational age advanced. The interindividual variance in the number and incidence of FMs was two to three times greater than the intra-individual variance (longitudinal study). The large variation in the quantity of FMs recorded during 30 and 45 min limits the value of using quantitative FM recording for antepartum fetal monitoring. Individualized normal limits of the quantity of FMs might be preferable to general limits.
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| 5. |
- Valentin, Lil, et al.
(författare)
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Pregnancy outcome in women perceiving decreased fetal movement
- 1987
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Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115. ; 24:1, s. 23-32
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Tidskriftsartikel (refereegranskat)abstract
- Out of 1914 women who had been instructed to count fetal movements (FMs) throughout the third trimester of pregnancy, 158 consulted the delivery ward staff about decreased FMs; they constituted the study group. Each woman who reported decreased FMs was examined by cardiotocography, analysis of plasma estriol and objective recording of FMs. Appropriate clinical management was decided on by the obstetrician in charge. In 133 (84%) of the 158 women, the results of the fetal examinations proved normal and no intervention was undertaken; in one of these cases the fetus died within 48 h. In two previously uncomplicated pregnancies the maternally perceived decrease in FMs coincided with seriously and persistently abnormal fetal heart rate test results. In both cases caesarean section was carried out within 24 h; the babies had Apgar scores less than or equal to 6 at 1 and 5 min but subsequently developed normally. Babies with congenital malformations (p = 0.001) and small-for-gestational age babies (p = 0.040) were significantly more common among consulters than non-consulters. The fetuses of women who report decreased FMs constitute a risk group and should be carefully monitored; if abnormalities are disclosed there is a potential for improving the fetal outcome by taking appropriate action.
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| 6. |
- Valentin, Lil, et al.
(författare)
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Recording of foetal movements: a comparison of three methods
- 1986
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Ingår i: Journal of Medical Engineering & Technology. - : Informa UK Limited. - 1464-522X .- 0309-1902. ; 10:5, s. 239-247
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Tidskriftsartikel (refereegranskat)abstract
- As decreased foetal movement (FM) may indicate impaired foetal health, FM recording has been suggested as a method of assessing foetal well-being. A non-intrusive, automated method of recording FM (FM-detector), was compared with maternal and ultrasonographic assessment of FMs in 24 women in the third trimester of pregnancy. The FM-detector detected a greater proportion of ultrasonographically recorded FMs than the mothers did (median 70% and 38%, respectively; p less than 0.001). Parity, gestational age, placental site or thickness, maternal weight or the distance from the maternal abdominal surface to the amniotic cavity did not affect the ability of the FM-detector to detect ultrasonographically recorded FMs. The estimation of FM strength by the FM-detector agreed fairly well with the assessment of FM strength by the ultrasound observer. The FM-detector would seem suitable for clinical use, as in the examination of pregnant women complaining of feeling 'less FM'.
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| 7. |
- Valentin, Lil, et al.
(författare)
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Subjective recording of fetal movements. I. Limits and acceptability in normal pregnancies
- 1984
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - 1600-0412. ; 63:3, s. 223-228
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Tidskriftsartikel (refereegranskat)abstract
- Maternal counting of fetal movements is increasingly used as a clinical method for assessment of fetal health. The present study established normal limits for two methods of subjective fetal movement recording. Four hundred-and-seventeen randomly selected women with low-risk pregnancies recorded the time necessary for 10 fetal movements every morning and also the number of fetal movements during 15 min every evening. The study was carried out between gestational week 34 and parturition. Two hundred-and-twenty-two consecutive women answered a questionnaire after the end of the study. 70% of the women counted fetal movements every day; 66.5% preferred the evening to the morning recording. In a strictly selected normal group (n = 129), no significant change was found in the number of fetal movements or in the time for 10 fetal movements with advancing gestation or approaching parturition. The results of the evening sessions were not influenced by maternal parity, fetal weight, or fetal sex. The great interindividual variation in the results does not allow the application of general normal limits. A method for establishing individual normal low limits for each pregnancy was designed.
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| 8. |
- Valentin, Lil, et al.
(författare)
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Subjective recording of fetal movements. II. Screening of a pregnant population; methodological aspects
- 1986
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - 1600-0412. ; 65:6, s. 639-644
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Tidskriftsartikel (refereegranskat)abstract
- 1914 women were asked to count fetal movements for 15 minutes every evening from the 28th week of pregnancy until parturition. An individual lowest limit for number of fetal movements was calculated from the first five counts. The women were instructed to contact the maternity ward for fetal evaluation as soon as their count fell below the lowest limit on two consecutive evenings (alarm signal). 79% of the women did record fetal movements, the proportion of those who did so being significantly higher in nulliparae and women 20-35 years old than in multiparae, teenagers and women older than 35 years. The mean duration of the registration period was 11.4 (SD 3.2) weeks and the median interval from the end of the registration period to delivery was 0.32 weeks. 31% of the women with an alarm signal on their Fetal Movement Charts never reported the decrease in the fetal movements count. 30% of the women who did report a reduction in the number of fetal movements did so despite the absence of an alarm signal. We conclude that most pregnant women are willing and able to count fetal movements but that they have difficulty in following the instructions concerning when to report a decrease in number of fetal movements.
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| 9. |
- Valentin, Lil, et al.
(författare)
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Subjective recording of fetal movements. III. Screening of a pregnant population; the clinical significance of decreased fetal movement counts
- 1986
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - 1600-0412. ; 65:7, s. 753-758
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Tidskriftsartikel (refereegranskat)abstract
- In order to determine the clinical significance of decreased fetal movement counts, pregnancy outcome was compared between women with decreased fetal movement counts on their Fetal Movement Charts (FMC) (n = 161) and women with normal fetal movement counts (n = 1,354). 1,515 women in the third trimester of pregnancy counted fetal movements for 15 min in the evening and noted the count on a FMC. An individual lowest normal limit for the number of fetal movements was calculated from the first five consecutive counts. A decrease in fetal movements was defined as two consecutive counts below the lowest limit (alarm signal). The alarm signal was associated with an increased risk of placental insufficiency (p less than 0.001) and imminent premature labor (p less than 0.001) and thereby indirectly with an increased risk of the birth of a baby with birth weight less than 2,500 g (p less than 0.05), preterm baby (p less than 0.05) or small-for-gestational age baby (p less than 0.05). The alarm signal was also associated with an increased risk of the birth of babies with congenital malformations (p less than 0.05), respiratory disturbances (p = 0.01) and hypoglycemia (p less than 0.05). The short-term method of fetal movement counting can be used to preselect a group of pregnant women whose unborn fetus is at particular risk.
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