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Query: UMLS:C0728731 (prematurity)
 7,134 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Involuntary infertility is a public health problem for couples in Africa where a suspected belt of low infertility stretches across Gabon, Cameroon, Peoples Republic of Congo, Central African Empire, Zaire, Uganda and Southern Sudan. No single factor has been isolated as the cause, however, secondary infertility is highly correlated with induced or spontaneous abortion. 388 patients were seen over a 2 year period in Cameroon. 149 were primary and 238 were secondary cases of infertility. Ages of patients ranged from 16-40 years. The majority of secondary cases had delivered their babies in private or public health facilities. It was hypothesized that an infection was contracted in the hospital. Puerperal infection was studied at the Central Maternity in Younde. Neisseria gonorrhoea was found to be 25% incidence, high enough to be considered an epidemic. Improved facilities for diagnosis and neonatology, particularly the prevention of prematurity, are needed. Women in Cameroon are more afraid of infertility than of cancer.
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PMID:Aetiology of infertility in the Came Roune. 56 48

Modern treatment for anovulatory infertility increases the incidence of multiple pregnancies with three or more fetuses and predisposes to prematurity with high perinatal mortality and mortidity. Premature labor was successfully treated in four multifetal pregnancies with ritodrine hydrochloride, a beta-mimetic drug relaxing the uterus. Another patient misdiagnosed as false labor was not treated and lost three out of four premature babies. Beta-mimetic treatment is indicated in multiple pregnancies even in false labor, or when painless progress in cervical dilatation is observed, to avoid asymptomatic progression into true labor. In contrast to singleton pregnancies, advanced labor with more than four centimeters cervical dilatation should not preclude good chances for successful treatment. Persistence in treatment and repreated use of the most effective intravenous route combined with oral ritodrine administration is needed because of marked tendency to recurrences of premature labor. Progressive increase in the dose of oral ritodrine may be indicated by decrease in therapeutic response. Maternal tachycardia should be considered as an index of patient responsiveness to the beta-mimetic treatment. The therapy is most successful when the patient is hospitalized from the first episode of treatment until at least the 37th week of pregnancy. This is probably less expensive than prolonged hospitalization of several prematures in an intensive care nursery.
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PMID:Premature labor treatment with ritodrine in multiple pregnancy with three or more fetuses. 62 89

Thirty patients with mild post-pubertal adrenal hyperplasia, characterized by raised urinary 17-oxosteroid levels and variable combinations of irregular menses, hirsuties, infertility, and spontaneous abortion, were treated with 2.5 to 10 mg of prednisone per day and all conceived (55 pregnancies). With this treatment, regular, ovulatory cycles occurred immediately in 25 patients, and after two to six months, in the rest. Treatment reduced raised 17-oxosteroid levels to normal and brought about some improvement in hirsuties and acne. Forty-seven pregnancies ended in the birth of liveborn infants; one of these died of prematurity and another had congenital emphysema. One pregnancy was terminated, two were of unknown outcome and five (9.4%) ended in abortion. Before treatment, 20 out of 22 pregnancies (91%) had ended in abortion.
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PMID:The treatment of mild adrenal hyperplasia and associated infertility with prednisone. 63 92

Forty patients aged 20 years or less who had been treated with 131I after surgery for papillary-follicular thyroid carcinoma were contacted for followup study. Five had died and two were unmarried; the remaining 33 were studied with respect to their subsequent reproductive histories and the health of the offspring. The mean age at the time of the first 131I therapeutic dose was 14.6 years (range 6-20), and the average followup interval, from that first dose until followup, was 18.7 years (range 14-25). The mean total dose of 131I was 196 mCi (range 80-691). The incidences of infertility (12%), miscarriage (1.4%), prematurity (8%), and major congenital anomaly (1.4%) found in this series are not significantly different from those in the general population. Thus, our study offers no overt evidence of genetic damage in children and adolescents treated with high doses of 131I for thyroid carcinoma.
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PMID:Subsequent fertility and birth histories of children and adolescents treated with 131I for thyroid cancer. 94 43

The Medical Research Council In-Vitro Fertilization (IVF) Register report on births resulting from assisted conception in Great Britain demonstrated a high incidence of preterm and low birthweight babies. This incidence remained high even when the analysis was restricted to singleton babies. The present paper investigates possible risk factors for prematurity, low birthweight and small-for-gestational-age (SGA) in singleton IVF births. Thirteen per cent of singleton IVF babies were preterm, 11% low birthweight and 17% small-for-gestational-age. Analysis by multiple regression indicated that hypertension during pregnancy was an independent risk for preterm delivery, low birthweight and SGA, bleeding during pregnancy for preterm delivery, and the number of embryos transferred and the type of infertility for low birthweight.
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PMID:Preterm delivery, low birthweight and small-for-gestational-age in liveborn singleton babies resulting from in-vitro fertilization. 158 53

Chlamydia is a sexually transmitted disease of epidemic proportions, infecting an estimated 4 million people a year. It results not only in infertility and ectopic pregnancy but also in infant morbidity and mortality. Ectopic pregnancy is responsible for 11 percent of maternal deaths. About 60 percent of infected women can transmit the bacteria at birth to their infants. Early detection and treatment of chlamydia in both men and women, especially prenatal women, is critical. Chlamydia trachomatis infection of the cervix was found in 8.1 percent of a group of 1,004 pregnant women at a hospital prenatal clinic by means of a direct fluorescent antibody test. The prevalence of C. trachomatis was only 0.7 percent in 277 pregnant women receiving prenatal care from private practitioners. All patients between 27 and 30 weeks gestation who tested positive were treated with oral erythromycin. Their partners were treated with tetracycline. The outcome of pregnancy in patients treated for chlamydial infection was compared with a control group of noninfected mothers from the same population. The frequency of premature rupture of the membranes, prematurity, and low Apgar scores among the treated women were not significantly different from those in the control group. There was a significant difference, however, between the two groups in the incidence of low mean birth weight infants and the presence of meconium. Children can acquire a chlamydial infection at birth from contact with infected cervico-vaginal secretions. If not detected and treated, these infected infants may develop conjunctivitis, bronchiolitis, and pneumonia. It is suggested, therefore, that all patients at prenatal clinics be screened for chlamydial cervicitis. Those testing positive and their partners should be treated.
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PMID:Prevalence of Chlamydia trachomatis infection in pregnant patients. 191 Jan 82

The obstetric risk associated with congenital uterine malformations was studied in a group of 67 women who had undergone hysterosalpingography (HSG) during an eight-year period. HSG was performed to investigate primary (21% of the cases) and secondary (19%) infertility (group 1) or recurrent early fetal loss (60%) (group 2). The study group was compared with a random control group of 130 patients with HSG-proven normal uteri, matched for the presenting symptom. Prematurity and intrauterine fetal death were found to be significantly more common (P less than .05) for women in group 1 with uterine anomalies. The mean birth weight for preterm infants (less than 37 weeks) was significantly lower (P less than .01) for women with malformed uteri. The incidence of antepartum bleeding during pregnancy (P less than .01), breech presentation and cesarean section (P less than .001) was significantly higher for the study group. Premature rupture of the membranes was diagnosed more frequently (P less than .05) only in group 1. Patients with congenital uterine anomalies are a high-risk obstetric group. Primary infertility may be a more common presenting complaint in women with uterine anomalies than previously recognized.
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PMID:Uterine anomalies. A retrospective, matched-control study. 195 11

To assess the benefits that can be expected from embryo reduction of multiple pregnancies after infertility therapy, we report 58 consecutive cases of selective termination using either a transcervical or a transabdominal approach. The initial number of embryos was five or more in 13 patients, four in 29 patients, and three in 15 patients. The miscarriage rate after transabdominal procedures (23%) was one half of that after transcervical aspiration. Forty pregnancies resulted in the live birth of one child or more. The rate of prematurity was strongly related to the number of embryos left. Mean gestational age at birth was 35.5 weeks but reached 37.7 weeks when only one embryo was left. A reduction in premature birth after selective termination appeared clear for pregnancies with four or more embryos but was less significant for triplets.
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PMID:Embryo reduction in multifetal pregnancies after infertility therapy: obstetrical risks and perinatal benefits are related to operative strategy. 201 5

Within the same in vitro fertilization (IVF) program, treatment trials leading to single and multiple ongoing gestation were compared. Rates of cesarean delivery, prematurity and perinatal mortality were found much higher among twin and multiple IVF pregnancies. Our work thus attempts at defining characteristics of proneness to multiple gestation in IVF treatment, in order to try and avoid its occurrence. The mean vitality score of embryos replaced is the most reliable criterion for this purpose, enabling one to replace no more than two embryos when the average score is high. Age of the patient and cause of infertility are almost nondiscriminant in this respect. Ovarian stimulation parameters such as total dosage of gonadotropin treatment and level of estrogenic response, as well as numbers of oocytes and embryos obtained, may serve as secondary criteria for assessing the twinning risk.
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PMID:Guidelines for the prevention of multiple pregnancy in treatment by in vitro fertilization. 208 73

Forty patients with multiple gestations, all resulting from infertility treatment, underwent transabdominal multifetal pregnancy reduction at an average of 12 weeks' gestation. Twenty-three women with triplets, 13 with quadruplets, and four with quintuplets had their pregnancies reduced to twins, except for two (one reduced from five to three and one from three to one). Twenty-eight women have delivered and 12 have ongoing pregnancies; none of the 40 lost the entire pregnancy after the procedure. There was one neonatal death from prematurity, and one fetus died because of growth retardation. Ten (36%) delivered after 37 weeks' gestation, 16 (57%) between 33-36 weeks, and two (7%) before 33 weeks. No maternal complications directly related to the procedure were encountered. We conclude that selective termination is a safe procedure that may improve multifetal pregnancy outcome.
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PMID:Transabdominal multifetal pregnancy reduction: report of 40 cases. 221 14


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