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Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Seventeen cases of prolapse of the amniotic membranes through a partially dilated endocervical canal are presented. Most of the patients had no prior history of incompetent cervix and less than half had either a therapeutic or spontaneous abortion. The prolapsed amniotic membranes are accompanied by uterine contractions and usually occur in the late second or early third trimester of pregnancy. Ultrasound was useful in confirming clinical findings, defining the extent of the prolapsed amniotic membranes, determining fetal viability, and demonstrating contents of the amniotic membranes. Tocolytics, abdominal amniocentesis, and cervical cerclage were of little benefit in preventing immediate delivery. Of the 17 patients, ten were live births and eight were stillbirths or immediate death due to prematurity.
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PMID:Prolapsing amniotic membranes: detection, sonographic appearance, and management. 333 93

The reproductive toxicity of a single oral dose/mouse (15-50 mg/kg) of cyclopiazonic acid (CPA) in the early phase of pregnancy (day 2-8) was investigated. Male mice used in this study were untreated. A limited number of pregnant mice were treated with 66 mg/kg ergonovine maleate (po, sc) to compare its effect with that of an equivalent dose of CPA (50 mg/kg). Among control sperm-positive mice treated with po NaHCO3 solution, 97.5% were gravid on necropsy day (pregnancy day 12). A single dose of CPA (15-50 mg/kg, po) given on days 2 to 8, decreased the pregnancy rates significantly. In groups treated with a single dose of CPA on pregnancy day 4 to 8, vaginal hemorrhage was observed 1 to 7 days after treatment, and it usually resulted in termination of pregnancy (abortion). Fetal resorption rates were higher than the control rate only in the groups treated with 30 mg/kg CPA po on day 4 or 8. CPA decreased body weight gains and the weights of uteri with fetuses. The ovary weights were generally not changed. Ergonovine maleate (66 mg/kg, sc, po) had no significant effect on all of the parameters examined. The estrous cycle returned without any delay in sperm-positive mice in which nidation of fertilized eggs had been inhibited by CPA, and also in nonpregnant mice (used for the LD50 determination) surviving near lethal doses of CPA (50-70 mg/kg, po). The oral LD50 value for CPA in nonpregnant mice was 64 +/- 4.4 mg/kg, and the toxicity signs were ptosis, hypokinesia, hypothermia, action tremor, cessation of food and water intake and resulting cachexia. The duration and intensity of these toxic signs were dose dependent.
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PMID:Toxic effects of cyclopiazonic acid in the early phase of pregnancy in mice. 357 73

This study compares 2 groups of sterilized women: 1) a group of 118 sterilized women who requested reversal between 1978 and 1984 at the Radboud University Hospital in the Netherlands and 2) 116 matched controls, who did not request reversal. The reason for the request for reversal in 89 cases (75%) was a new partner and in 26 cases (22%) the wish for more children with the same partner. Women who regret being sterilized usually do so soon after the procedure. The mean length of time between sterilization and request for reversal was 3.8 years, measured from the date the patient presented for reversal. In 20% of the patients, the sterilization took place in combination with another gynecologic or obstetric procedure, such as abortion, prolapse operation, cesarean section, or an operation for ectopic pregnancy. This combination, although clearly arranged to save the patient another anesthesia, bears the risk of making the sterilization not a well-considered and free choice. 27 of the patients reported that their relationship at the time of sterilization was already poor; some of the women said they had kept silent about their marital problems fearing that otherwise they would not be sterilized. Another alarming discovery was that 12 of the patients were sterilized after their divorce under the age of 30 years. The reason for requesting a reversal of sterilization was a divorce and a new partner in 3/4 of the cases.
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PMID:Women regretting their sterilization. 375 96

Three adult female rhesus monkeys (Macaca mulatta) in a breeding colony of approximately 75 adult females developed a clinical condition characterized by protrusion of the cervix through the vulva during pregnancy and/or following parturition. The Gilliam round-ligament uterine ventro-suspension procedure (hereafter called the Gilliam uterine suspension or uterine suspension procedure) was used to return the cervix to a normal anatomical position. Following the procedure, one female delivered a normal live infant, but reprolapsed. After a second suspension procedure, she again became pregnant and delivered a normal live infant without a reoccurrence of the prolapse. A second animal never became pregnant despite repeated breedings to different males for two years. The third animal became pregnant twice following the procedure. The first pregnancy terminated in abortion at two months of gestation, while the second pregnancy ended in an apparent dystocia, necessitating a cesarean section and delivery of a dead fetus. The animal died post-operatively. This surgical procedure successfully salvaged one of these animals which otherwise had no reproductive future.
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PMID:Surgical correction of genital prolapse in three rhesus monkeys. 404 52

Estrogens, whether natural or synthetic, have a wide range of clinical uses in the human female. In prepubertal females, estrogens are used in treating gonadal dysgenesis, excessive height, and genital infections. During the reproductive years, estrogens are used in managing 1) menstrual disorders (amenorrhea, menorrhagia, dysmenorrhea); 2) infertility (poor cervical mucus and anovulation); 3) pregnancy (abortion, lactation suppression); 4) dermatological disorders (acne vulgaris, hirsutism); 5) combined estrogen/progestogen usage for contraception; and 6) postcoital contraception. During the climacteric/postmenopausal years, estrogens are used in treating menopausal syndrome and breast cancer as well as various genital problems (infection, atropic vaginitis, genital prolapse). In the human male, estrogens are used in treating prostatic carcinoma and sexual problems. Estrogen therapy should be used with caution, and benefits should be weighed against the hazards. Possible side effects and alternative forms of treatment should be considered.
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PMID:Clinical uses of estrogens. 700 4

According to a 3-year collaborative study estimating maternal mortality rates from 41 hospitals affiliated with teaching centers in India, maternal mortality was 721 per 100,000 live births. Community studies in rural areas of Sirur, Pachod, and Ambula reported maternal mortality as 210-253 per 100,000. Cohort studies conducted by the Indian Council of Medical Research reported maternal mortality as 530 per 100,000 based on data from rural areas of Varanasi, 460 per 100,000 in urban Delhi, and 450 per 100,000 in urban Madras. The Ministry of Health gave the rate as 460 per 100,000 in 1984, while UNICEF gave a figure of 400 per 100,000 for 1980-91. India has 1 out of 4 of the world's maternal deaths, or 1 every 6 minutes. The risk of maternal death has been calculated to be one in 64. Risk is unevenly distributed geographically. Risk is low in Kerala compared to Uttar Pradesh or Madya Pradesh. In 1992 maternal mortality was calculated to be 1320 per 100,000 births based on 5 district hospitals. The cause of maternal deaths was anemia in 25% of cases. 75% of cases were accounted for by eclampsia, sepsis, hemorrhage, and abortion. Anemia (pre-existing the pregnancy) is acerbated by the demands of pregnancy and causes congestive heart failure and death. Blood losses of greater than 150 ml (due to hemorrhages of pregnancy and labor) can be fatal. During 1982-89 anemia was responsible for 17-24% of all maternal deaths in rural areas. Morbidity from pregnancy-related causes included obstetric fistulae, pelvic inflammatory disease, anemia, genital prolapse, and urinary incontinence. Quality of maternal care is an important factor in reducing maternal mortality and morbidity. Societal factors such as illiteracy and malnutrition, early marriage, poorly supervised pregnancies, and lack of transportation during emergencies are other determinants of mortality and morbidity. About 10% of maternal deaths are attributed to unsafe abortion. The government aim for the year 2000 of 100% prenatal care and care during delivery will require professional commitment and thousands more midwives in rural areas.
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PMID:How safe motherhood in India is. 765 33

Efforts are underway to reduce the incidence of maternal mortality in the world, and concern is increasingly being expressed about the incidence of maternal morbidity. Maternal morbidity can be classified as 1) obstetric morbidity (direct, indirect, or psychological); 2) gynecological morbidity (direct, indirect, or psychological); and 3) contraceptive morbidity. Maternal morbidity has a debilitating effect on families and, thus, on entire societies. The complications leading to morbidity include ectopic pregnancy, spontaneous abortion, obstructed labor, abruptio placentae, severe postpartum hemorrhage, and uterine rupture. The longterm effects of these complications include uterine prolapse, urinary fistulas, and Sheehan syndrome (amenorrhea, failure of lactation, and infertility). In addition to conducting research to determine the extent and varieties of morbidity encountered in a population, a program to combat morbidity should 1) include an educational program for potential clients, 2) improve client confidence through the provision of necessary services like sanitation and of screening services, 3) network with other organizations providing services, and 4) incorporate proper epidemiological and record-keeping procedures.
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PMID:Reproductive morbidity. 765 38

One encounters a variety of radiopaque foreign objects when reviewing plain film radiographs of the abdomen. Recognizing such devices can offer important clues about a patient's medical history. Accordingly, intrauterine contraceptive devices (IUCD), tubal sterilization, varicoceles, inferior vena cava (IVC) filtration, and vaginal pessaries are discussed with reference made to an IUD, tubal sterilization clips, embolization coils for bilateral varicoceles, an IVC filter, and a vaginal pessary in five attached anteroposterior radiographs of the lower abdomen and pelvis for five different patients. IUCDs confer long-term, passive, reversible, and inexpensive protection against unwanted pregnancy. They may, however, induce menstrual complications as well as an increased risk of pelvic inflammatory disease and ectopic pregnancy. They can also be spontaneously expelled from the uterus without being noticed by the client. An IUCD increases the risk of spontaneous abortion unless removed in cases where intrauterine pregnancy occurs. Complications at the time of insertion include pain, syncope, and uterine perforation. Tubal sterilization is an effective, though largely irreversible method of contraception. Complications include an increased risk of ectopic gestation in the event of pregnancy and the usual risks of hemorrhage, infection, injury to adjacent structures, and anesthesia-related complications. A varicocele is a dilation of the pampiniform venous plexus of the scrotum. They are more often unilateral than bilateral, occurring in up to 20% of men most often on the left side. Although most cases are probably insignificant, varicoceles can decrease sperm count and motility and cause abnormal morphology. Correction of varicoceles has been shown to improve sperm quality and can increase the chances of fertility. Percutaneous venous embolization techniques have recently been developed to that end. Procedural risks include perforation of the vein, intimal dissection, inadvertent embolization of vessels via collateral channels, and reactions to contrast media. IVC filters are a feasible alternative treatment for deep venous thrombosis and pulmonary embolism among patients in whom anticoagulants are contraindicated or for those in whom anticoagulation therapy has failed. Introduced via the femoral or jugular veins, they are permanent metallic devices placed within the lumen of the IVC to filter thrombi which migrate from the deep veins of the lower extremities. Contraindications to IVC filter insertion include severe coagulopathy and thrombosis involving all venous access routes, while complications include hematoma at the insertion site, migration or tilting of the device due to poor anchoring in the IVC wall, and vena cava obstruction. A pessary is a prosthetic device used to support pelvic structures when their natural support is lacking. They are usually made of plastic or rubber and inserted into the vagina to aid in the non-operative treatment of uterine prolapse, proctoceles, and cystoceles. They must be properly fitted and removed every few months for cleaning.
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PMID:Radiology rounds. Intrauterine contraceptive device. 821 57

We report a 40-year-old Japanese woman with antiphospholipid antibody syndrome (APS) associated with myasthenia gravis (MG). She had a history of miscarriage at the age of 27 followed by pulmonary embolism 3 weeks later. At the age of 40, she developed diplopia, bilateral ptosis and easy fatigability. Serum anti-acetylcholine receptor antibody and tensilon test were positive. She was diagnosed as having MG. The laboratory test revealed mild thrombocytopenia, prolonged activated partial thromboplastin time (aPTT) and positive findings for both beta 2-glycoprotein I-dependent anticardiolipin antibody and lupus anticoagulant. She fulfilled the diagnostic criteria of APS, but did not the criteria proposed by American Rheumatism Association for SLE. An extended total thymectomy was performed after administration of oral prednisolone and low-dose aspirin. This is a patient who had APS associated with MGs: both are known to result from autoimmune abnormality. The clinical and laboratory manifestations of APS were ameliorated after removal of the thymus, suggesting that thymectomy alleviates APS symptoms.
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PMID:[A case of antiphospholipid syndrome associated with myasthenia gravis]. 939 64

The objectives of the present study were to assess the reproductive performance and cumulative incidence risk of reproductive disorders and to compare the success of artificial insemination (AI) to natural service (by handmating; NS) in dairy cattle kept in smallholder herds under a zero-grazing system in a rural highland area of Tanzania. Data on occurrence of all normal and abnormal reproductive events were collected for 215 adult animals belonging to 74 households. The median and range of the intervals: intercalving, calving to first service, and calving to pregnancy were 477 (335-860), 154 (38-486) and 206 (61-567) days, respectively. Breed and parity did not affect the reproductive parameters (P>0.05). However, cows in the milked group had a shorter median calving interval than those in the suckled group (P<0.001). The overall percentage pregnant and the percentage pregnant to first service were higher in the NS than in the AI group (49 vs. 32%; P=0.007) and (67 vs. 25%; P<0.001), respectively. The median numbers of services per pregnancy were not different between the AI (3) and NS (2) groups (P=0.17). The cumulative incidence risk of abortion, dystocia, prolapse, retained fetal membranes, mastitis, milk fever and cyclic non-breeders were 16.0, 1.7, 2.5, 4.2, 5.0, 1.7, and 6.1%, respectively. Hoof overgrowth (4.6%) and hoof deviation (4.6%) were the most-frequent digital problems. We concluded that reproductive parameters and cumulative incidence risk of abortion show suboptimal reproductive performance in rural-based, zero-grazed smallholder dairy herds in Tanzania particularly those using AI.
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PMID:Suboptimal reproductive performance of dairy cattle kept in smallholder herds in a rural highland area of northern Tanzania. 1082 59


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