| 1. |
- Mattsby-Baltzer, Inger, 1949, et al.
(författare)
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IL-1beta, IL-6, TNFalpha, fetal fibronectin, and endotoxin in the lower genital tract of pregnant women with bacterial vaginosis.
- 1998
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Ingår i: Acta obstetricia et gynecologica Scandinavica. - : Wiley. - 0001-6349. ; 77:7, s. 701-6
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Tidskriftsartikel (refereegranskat)abstract
- In our studies on women with bacterial vaginosis (BV) in early pregnancy a strong association has been found between BV and the levels of endotoxin or interleukin-1alpha (IL-1alpha) in the lower genital tract. In the present study we investigated if an association could be found between BV and other cytokines (IL-1beta, IL-6, tumor necrosis factor alpha, TNF) or fetal fibronectin (FFN). The cytokine-inducing capacity of endotoxins present in the cervical mucus was explored in a monocytic cell assay.Cervical mucus or cervicovaginal fluid was collected from women with (BV) and without BV (nonBV) attending a family planning unit for first trimester abortion. The concentrations of IL-1beta, IL-6, TNF and FFN were determined by quantitative enzyme immunoassays. TNF was determined in 63 women (BV, n=25) out of whom 37 (BV, n=11) were analyzed for IL-1beta and the remaining 26 for IL-6 (BV, n=14). FFN was determined in another 36 women (BV, n= 19). The cytokine-inducing capacity of endotoxin-containing cervical mucus and purified endotoxin of Prevotella bivia were studied by an in vitro cell assay using a human monocytic cell line (THP-1).IL-lbeta and IL-6 were found in almost all women. The levels of IL-1beta, but not IL-6, TNF or FFN, were significantly increased in women with BV compared with the nonBV women (p<0.05). Purified endotoxin from P. bivia, and cervical mucus from BV women containing high levels of endotoxin were able to induce a cytokine response (IL-6) in monocytic cells in vitro.BV is associated with increased levels of IL-1beta in the lower genital tract of pregnant women in the first trimester. The ability of BV-associated endotoxins to induce cytokine production in monocytic cells may partly explain the increased IL-1beta levels.
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| 2. |
- Nielsen, Sven, et al.
(författare)
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Randomised trial comparing expectant with medical management for first trimester miscarriages
- 1999
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Ingår i: British journal of obstetrics and gynaecology. - : Wiley. - 0306-5456 .- 1470-0328 .- 1471-0528. ; 106:8, s. 804-807
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To compare the efficacy of antiprogesterone (mifepristone) in combination with a synthetic prostaglandin E1 analogue (misoprostol) for outpatient treatment of miscarriages. PARTICIPANTS: One hundred and twenty-two women with first trimester miscarriages. METHODS: The women were randomised to treatment with mifepristone 400 mg orally followed by a single oral dose of 400 microg misoprostol 48 hours later (n = 60) or expectant management (n = 62). Women were re-evaluated five days later. If retained intrauterine products of conception were found with an antero-posterior diameter above 15 mm on transvaginal ultrasound, surgical evacuation was performed. RESULTS: Eighty-two percent of the women randomised to pharmacological treatment and 76% of those randomised to expectant management had an empty uterine cavity after five days. Convalescence time was 1.8 days longer for women randomised to pharmacological treatment. Pain, bleeding, complications, and satisfaction with the treatment did not differ between the groups. CONCLUSIONS: Most cases of spontaneous incomplete miscarriage will become a complete miscarriage without intervention. This study shows that outpatient treatment with a combination of antiprogesterone and a prostaglandin E1 analogue did not increase the rate of complete miscarriage, compared with expectancy alone, by a clinical important degree.
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| 3. |
- Platz-Christensen, Jens Jörgen, et al.
(författare)
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Long, uniform Lactobacilli (Döderlein's Bacteria): a new risk factor for postoperative infection after first-trimester abortion.
- 1995
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Ingår i: Infectious diseases in obstetrics and gynecology. - 1064-7449. ; 3:3, s. 102-9
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Tidskriftsartikel (refereegranskat)abstract
- The production of hydrogen peroxide (H2O2) from different strains of lactobacilli in the vagina has been proposed to play one of the most important protective roles in the vaginal defense system. New data have, however, suggested that Döderlein's bacteria, with the morphological appearance of long lactobacilli, have a low production of H2O2 . The purpose of the present study was to correlate the morphology of lactobacilli with the incidence of infection following legal abortion.Seven hundred sixty-nine women with lactobacilli but without Chlamydia trachomatis or bacterial vaginosis in their vaginal wet smears who were to undergo legal abortions were divided into 6 different groups according to the morphological appearance of the lactobacilli. The postoperative infection rates in these different groups were compared. A phenotypic classification of some of the lactobacilli was performed.The presence of Döderlein's bacteria compared with a mixed flora of lactobacilli increased the risk of postoperative infection 3 times [relative risk (RR) = 3.0; 95% confidence interval (CI), 1.5-6.3]. After a logistic regression analysis, the only independent risk factors were the presence of Döderlein's bacteria and earlier gestational age.We found that the lactobacilli regarded as commensal organisms and "normal, healthy lactobacilli" in the vagina were present in only 18% of these women and that their presence might be hazardous. Therefore, we must reconsider our concept of the "normal" lactobacilli in the vaginal wet smears of healthy women.
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| 4. |
- Vural, Gürcan, et al.
(författare)
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Inflammatory signs in wet smear and Pap-smear compared with the histopathology from the female lower genital tract.
- 1995
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Ingår i: Acta obstetricia et gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 74:6, s. 451-4
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Tidskriftsartikel (refereegranskat)abstract
- In order to define the relationship between various criteria of female lower genital tract inflammation, we examined wet smears, cervical smears and biopsies from 131 patients. The presence of clue cells in rehydrated dry smears showed a positive correlation to the presence of clue cells in Papanicolaou stained smears, and to some extent with cytological evidence of inflammation (Kappa 0.48). Cytological inflammatory findings correlated well with the presence of clue cells in rehydrated dry smears, but signs of inflammation diagnosed by histopathology did not correspond to findings in cytological smears, probably because these methods reveal inflammation at different sites.
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