Narve Moe

Obstetric outcome in singleton pregnancies after assisted reproduction

Objective To compare the obstetric outcome of singleton pregnancies after various procedures of assisted reproduction with a control group. Methods Maternal and perinatal outcome in 355 assisted-reproduction singleton pregnancies (study group) with a duration of 140 days or more were compared retrospectively with a control group matched for age and parity. All assisted-reproduction pregnancies resulted from treatment in one university hospital, and all control subjects delivered in the obstetric department of the same hospital. The controls consisted of 643 women, also with singleton pregnancies, who were matched for age and parity. Results In the study group, the frequencies of pregnancy-induced hypertension and placenta previa were increased. More patients in the study group were delivered by elective cesarean. Pregnancies after assisted reproduction were of shorter duration, with an increased incidence of preterm birth. Infants in the study group had a lower mean birth weight than did those in the control group and were more frequently referred to a neonatal care unit. Conclusion Singleton pregnancies resulting from assisted reproduction represent obstetric risk cases, and the patients should be offered special attention during the pregnancy, which will probably be their only one.

Pregnancy outcome in renal allograft recipients in Nor

Background. To study the influence of pre‐conceptional health status and immunosuppressive drug regimen on pregnancy outcome in renal allograft recipients.

Antiphospholipid antibodies in pre-eclamptic women: Relation to growth retardation and neonatal outcome

The significance of antiphospholipid antibodies in pre‐eclamptic women has not been thoroughly elucidated. The purpose of this study was to determine the proportion of pre‐eclamptic women who were antiphospholipid antibody positive, and to elucidate the significance of these antibodies regarding growth retardation and neonatal outcome. Positive levels of anticephalin antibodies, which are antiphospholipid antibodies, were detected in 7 (19%) out of 37 pre‐eclamptic women, as compared with none of 40 in a control group of normotensive women at similar stage of pregnancy (p = 0.004). The birthweight percentiles of the neonates of anticephalin antibody positive women were significantly lower than those of the neonates of anticephalin antibody negative women (p = 0.018). Four of 7 infants of anticephalin antibody positive women were growth retarded (<2.5th percentile). This was a significantly larger proportion than that for anticephalin antibody negative women (3/30) (p = 0.004). The 95% confidence interval for the difference between the two proportions was 0.10 to 0.85. Two of the 7 neonates of anticephalin antibody positive women died during the neonatal period, compared with none of the 30 neonates of anticephalin antibody negative women (p = 0.003). Thus, our study suggests that positive levels of anticephalin antibodies in pre‐eclamptic women increase the risk for growth retardation and neonatal death.

Effects of betamethasone on plasma levels of estriol, cortisol and hcs in late pregnancy

Abstract. The effect of a single dose of betamethasone on the maternal plasma concentration of estriol and Cortisol was studied. The concentration of estriol decreased rapidly. A maximal suppression of about 70 per cent was seen after 6‐24 hours. A similar influence on the maternal plasma concentration of Cortisol was observed. HCS (human chorionic somatomammotropin) was not influenced by betamethasone. These facts have to be taken into consideration after treatment with synthetic corticosteroids in high risk pregnancies.

Retinal Hemorrhages in the Preterm Neonate

Abstract. The incidence and magnitude of retinal hemorrhages (RH) in a group of 23 preterm infants (29–35 weeks) born spontaneously in vertex presentation have been compared with those of 23 others (28‐35 weeks) born by gentle extraction with small forceps. Distribution to the groups was random. The overall frequency of RH in both groups together was low, 6%, with no statistically significant difference between the groups. No fundi with severe (grade III) hemorrhages were seen. Both the incidence and magnitude of RH were less in the preterm neonates when compared with previously reported figures in term infants born spontaneously or with forceps extraction. The study provides further evidence in support of the hypothesis that fetal head compression with venous congestion is the main cause of RH in the newborn.

The Intravenous Infusion of Prostaglandin F2α in the Management of in Trauterine Death of the Fetus

Abstract. Prostaglandin F2α (PGF2α) was given intravenously in the treatment of 16 cases of intrauterine death. Delivery was achieved without complications or side effects in 15 out of the 16 patients. A posterior cervical rupture occurred in one patient treated with cervical dilatation and PGF2α‐infusion.

Short-Term Progestogen Treatment of Endometrial Carcinoma: Histological, Histochemical and Hormonal Studies

Thirteen women with adenocarcinoma of the endometrium were treated with standardized doses of hydroxyprogesterone caproate for 3 weeks. Histological and histochemical studies of tumour tissue were performed before and after the treatment. Most of the well differentiated carcinomas showed secretory and acantho‐matous changes after the treatment, whereas such changes were more rarely seen in tumours with low degree of differentiation. There was a great variability in the enzyme pattern. Alkaline phosphatase activity seemed to decrease during the treatment, whereas acid phosphatase and adenosine triphosphatase activities were mostly unaffected. The serum levels of LH decreased, whereas the plasma level of corticoids and the urinary excretion of oestriol and pregnandiol showed no definite changes during the treatment.

Preeclampsia and Fetal Growth Retardation: Is There an Association with Antiphospholipid Antibodies?

Objective: To examine the association between antiphospholipid anti-bodies and preeclampsia/fetal growth retardation.Methods: In this prospective, observational study, six tests for antiphospholipid antibodies (IgG and IgM anticardiolipin and anticephalin antibody enzyme-linked immunosorbent assays, activated partial thromboplastin time and Russells viper venom time-based clotting tests) were performed on plasma from 200 unselected women with preeclampsia (145 cases of mild and 55 cases of severe preeclampsia) and 97 normotensive pregnant women of matched gestational age.Main Outcome Measures: Prevalence of antiphospholipid antibodies in preeclamptic women and controls, and the association between these autoantibodies and fetal growth retardation.Results: The IgG anticephalin antibody test and the activated partial thromboplastin time-based test for lupus anticoagulants were both positive in a significantly higher proportion of preeclamptic women (10.5% and 11.5%, respectively) than in controls (3.1% for...

Mutagenicity Testing of Amniotic Fluid from Diabetic Women, with Special Reference to Their Smoking Habits

Amniotic fluid from 16 diabetic and 78 healthy women at term was tested for capacity to cause mutations in Salmonella typhimurium bacterial tester strain TA98 (Ames test). Diabetes as well as heavy smoking increased the mutagenic activity of amniotic fluid. The difference between groups of diabetics and controls was significant in both nonsmokers and women who had smoked more than 5 cigarettes the last 48 h before delivery. It seems plausible that metabolic disturbances, perhaps enhanced by a lowered oxygenation, in some instances could produce mutagenic compounds. Mutagenic activity in amniotic fluid may be one of the factors underlying the increased incidence of congenital malformations in the offspring of diabetic women. Early mutations could cause such developmental errors in the embryos, and possibly also in future generations by damage to germ cells. Heavy smoking alone also caused an increase in mutagenic activity in term amniotic fluid. Our findings reflected an enhancing effect of smoking in diabetes. A pregnant diabetic woman who smoked would thus further endanger her already jeopardized pregnancy.

In vitro perfusion studies of single umbilical artery cords, the vasoactive effects of serotonin

BACKGROUND To investigate the vascular resistance and the vasoactive effects of serotonin in arteries from single umbilical artery (SUA) cords. METHODS The preparations were sampled from 10 patients with SUA cords. The control group (n=20) was matched according to gestational age, birth weight percentile, blood pressure and proteinuria. The arterial segments were perfused in vitro employing a constant perfusion rate and measuring alterations in perfusion pressure. Following an initial test with serotonin 10(-7) M the drug was administrated in stepwise increasing concentrations from 10(-10) to 10(-5) M. RESULTS The vascular resistance was significantly reduced in the SUA group compared to the control group (p<0.01). In about half of the preparations in both groups serotonin 10(-7) M induced a transient pressure decrease followed by a larger pressure increase. The remaining arteries showed a monophasic pressure increase. The maximum constrictory response calculated in percent of the prestimulatory perfusion pressure was significantly increased (p<0.01) in the SUA compared to the control group, but non-significantly increased (p=0.073) when calculated in absolute values (mmHg). CONCLUSIONS Arteries in SUA cords display reduced vascular resistance compared to arteries from normal cords in in vitro perfused preparations. The response pattern to serotonin was not altered, but the constrictory response might be increased in arteries from SUA cords.