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Query: UMLS:C0029713 (immaturity)
 4,335 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Perinatal deaths were systematically investigated over a 25-month period in a Zimbabwean district and were classified into pathological subgroups according to Wigglesworth. There were 319 perinatal deaths (a rate of 30.6 per 1000) including 83 normally formed macerated stillbirths, 28 cases of congenital malformation, 79 deaths associated with immaturity, 111 due to asphyxial conditions developing in labour and 18 specific problems. Syphilis infection was a contributory factor among 27 cases, hypertension in 39 cases, amniotic fluid infection in 31 cases and diabetes in 11 cases. An avoidable factor was detected among 242 cases (75.6%) involving the mother in 120 cases, the maternity centres in 28 and the hospital in 94. These data suggest that educational programmes should try to convince all the pregnant women to attend an antenatal clinic at least once. A further perinatal mortality reduction might be obtained through treatment for syphilis, hypertension, diabetes and amniotic fluid infection, closer monitoring of the fetal condition during labour and skillful management of dystocia.
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PMID:Perinatal mortality audit in a Zimbabwean district. 278 80

In an attempt to identify causes of perinatal mortality and thence devise preventative strategies on the island of Jamaica, a study was made of the 1847 singleton perinatal deaths occurring over the 12-month period between 1 September 1986 and 31 August 1987. Complications of the pregnancy were elicited by questioning the mother as well abstracting data from the antenatal and clinical obstetric records. The deaths were classified using the Wigglesworth categorisation and the three largest groups were chosen for special study: antepartum fetal deaths, deaths of live birth from immaturity and deaths from intrapartum asphyxia. The medical features of the pregnancies were compared with data similarly obtained from 9919 women delivering singletons in the 2 months of September and October 1986 and who survived the first week of life. Unadjusted statistically significant associations were found with maternal syphilis, vaginal infection or discharge, bleeding in the first two trimesters, bleeding in the third trimester, lowest haemoglobin, highest diastolic and first diastolic blood pressures, highest level of proteinuria, diabetes and antenatal eclampsia. Logistic regression taking account of social, environmental and health behaviour variables showed the following significant relationships. Antepartum fetal death was associated with adjusted odds ratio (AOR) for syphilis 2.88 [95% confidence interval (CI): 1.91, 4.32], bleeding in third trimester 3.86 [2.73, 5.44], highest diastolic blood pressure (P < 0.0001), highest level of proteinuria (P < 0.0001), lowest Hb (P < 0.0001) and antenatal eclamptic fits AOR 4.62 [1.47, 14.50]. Deaths from immaturity were independently associated with bleeding < 28 weeks AOR 3.50 [2.39, 5.13], bleeding 28 + weeks AOR 1.93 [1.16, 3.22], highest diastolic blood pressure (P < 0.01) and highest level of proteinuria (P < 0.0001). Infection featured in deaths associated with intrapartum asphyxia, with syphilis AOR 2.17 [1.44, 3.26] and vaginal infection/discharge (P < 0.01) independently associated; other strong associations were bleeding < 28 weeks AOR 2.10 [1.57, 2.81], bleeding 28 + weeks AOR 2.32 [1.62, 3.33], highest diastolic blood pressure (P < 0.0001), first diastolic blood pressure (P < 0.0001) and antenatal eclampsia AOR 6.70 [2.63, 17.13]. For all perinatal deaths combined, independent features were syphilis AOR 2.06 [1.49, 2.85], vaginal infection/discharge (P < 0.001), bleeding < 28 weeks AOR 2.01 [1.60, 2.53], bleeding 28 + weeks AOR 2.65 [2.02, 3.48], highest diastolic blood pressure (P < 0.0001), first diastolic blood pressure (P < 0.0001), proteinuria (P < 0.0001) and antenatal eclampsia AOR 4.22 [1.76, 10.14]. The results help identify areas for monitoring and identifying pregnancies at highest risk.
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PMID:Medical conditions present during pregnancy and risk of perinatal death in Jamaica. 807 3

Placental evaluation is important in congenital syphilis (CS) since clinical and serologic findings necessary to fulfill the diagnostic criteria of syphilis may be absent at birth, making early accurate diagnosis difficult. We examined 25 placentas from mothers with syphilis as confirmed by positive RPR rapid plasma reagin and fluorescent treponemal antibody absorption tests to determine which histopathologic features should raise the suspicion of CS. The 25 examined placentas were from 162 syphilitic mothers who delivered at our institution in 1990. Of the 27 infants delivered (including two pairs of twins), four were stillborn and three died at 1 day of age. Eleven of 23 liveborn infants fulfilled the Centers for Disease Control criteria of probable CS. Seven of the 25 placentas showed a well-defined constellation of histopathologic changes that included proliferative vascular changes, chronic villitis, relative villous immaturity, and, in six placentas, acute villitis. All seven of these placentas showed the presence of spirochetes by special stains. Six also had plasma cells in the basal decidua. Recognition of these placental changes, although nondiagnostic, should lead the pathologist to seek additional clinical history and ancillary tests. Placental histopathologic examination is an additional parameter to be considered in the diagnosis of CS.
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PMID:Placental histopathology in syphilis. 831 56

Puberty today occurs about 2 years earlier than it did at the beginning of the century. The age of menarche is now usually between 11-13 years, while the establishment of spermatogenesis and appearance of the 1st ejaculation usually occurs between 13-15 years. The ages at which adolescents feel mature, want to behave like adults, and initiate sexual activity are now lower than in the past. Sexual relations may occur between adolescents before they are fully capable of recognizing their consequences as autonomous and responsible acts guided by a system of moral convictions. Both marriage and parenthood may have unfavorable consequences for future personality development, sexual adjustment, and the personal-social adaptation of the individual. In Cuba, the persistence of traces of bourgeois mentality can be seen in the tendency to teach young girls false concepts of female behavior. Traits such as submissiveness, passivity, and fragility are stressed, and girls are taught to inhibit their sexuality from a very young age. Adolescent boys are expected to display virility and machismo. Adolescent boys may be so interested in the physical aspects of sexual activity that they deprecate the aspects, considering them to be weak female traits. Boys are more likely to separate the sexual object and the love object, while such duality is unusual in girls. Among the most serious problems of adolescent sexual activity in Cuba is a high rate of abortions among young adolescents. Some adolescents are promiscuous and have frequent changes of partner. The age group 15-19 years has the 3rd highest rate of syphilis and the 2nd highest of gonorrhea. The proportion of births to minors has increased from 22% in 1973 to almost half in some provinces. Divorce rates have been in constant increase in Cuba, and psychosocial immaturity of very young spouses is a principal factor in divorce. The widening temporal gap between attainment of puberty and marriage, which is likely to be postponed until the completion of ever more time-consuming educations, is a factor in increased premarital sex although it is not a determinant of it. An adequate sex education program would help adolescents develop responsible attitudes and good foundations for their future sexual adjustments. It would also help prevent adolescent pregnancy, with its frequent negative consequences.
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PMID:[Sex education and the problem of early sexual relations among adolescents]. 1228 Aug 15

The paper describes the clinical picture and management of congenital syphilis. In the introduction the origin of syphilis is mentioned. The etiologic agent -- Treponema pallidum subsp. pallidum (Tp) -- is transmitted to fetus almost exclusively via placenta. Perinatal infections are less frequent, and postnatal infections are only exceptionally. The symptoms of congenital syphilis may be divided into prenatal (syphilis materno-fetalis), neonatal, and rarely seen postnatal. Prenatal symptoms causing the immaturity of fetus are recognizable from the 7th month of pregnancy and associated with miscarriages, premature deliveries of still-born babies or live neonates with congenital syphilis. Neonatal and postnatal symptoms are manifested only after birth. They may present immediately at birth, develop within first two years of life as early congenital syphilis, or (similarly to acquired syphilis) later in life as a late localized form, often seen many years after birth, even at puberty -- late congenital syphilis. The clinical picture depends on many factors -- primarily on the duration of the infection in mother and the stage of pregnancy.
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PMID:[Issues of congenital syphilis in the past twenty years. II. Clinical picture]. 1664 51