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 7,134 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A study of the incidence of genital tract mycoplasmas in couples attending an infertility clinic and in a group of pregnant women showed that the frequency of isolation was significantly higher in the infertile group (P less than 0.001). In pregnancy, if mycoplasmas were isolated at the first prenatal visit, these organisms were harbored throughout pregnancy. Five percent of the women, however, developed the infection during pregnancy. No relationship was observed of female genital mycoplasmas with prematurity or babies small for gestational age. Treatment with doxycycline (Vibramycin, Pfizer Ltd., Sandwich, Kent, UK) was effective in eradicating mycoplasmas in 91% of couples, but the subsequent pregnancy rates in treated and untreated groups were similar. It appears that mycoplasmas are implicated neither in the etiology of reproductive failure nor in a poor pregnancy outcome.
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PMID:The role of mycoplasmas in reproduction. 685 80

Multiple pregnancies do raise the extraordinary problem of their frequency: conceptions of this type have taken on epidemic proportions as a result of the growth of infertility treatment. The study details the obstetric management, neonatal outcome, and follow-up data of women who were delivered of twins, triplets and more. The management of multiple pregnancies includes early diagnosis, meticulous follow-up, and early decrease of maternal activity. Data on the prognosis of triplet pregnancies are of particular importance when the option of selective termination is considered. The most common complication is preterm labor. The prematurity rate is 50% in twin, 95% in triplet and 100% in multiple pregnancy of higher order. The perinatal mortality was 20 to 80 per 1,000 in twins and 40 to 250 per 1,000 in triplets. During last years, a number of changes took place: introduction of medically assisted procreation, early diagnosis via ultrasound scans, considerable increase in the number of cesarean sections in the case of multiple pregnancies, improved prognosis for premature and growth retarded newborns.
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PMID:[Multiple pregnancies]. 749 59

Nutrition during pregnancy has become an integral component of prenatal care. This review will focus on new topics and recent research on established areas, including the influence of caffeine on infertility, intrauterine growth, prematurity, and fetal behaviours; anthropometric factors influencing birthweight and maternal weight postpartum, and during lactation; the cost-benefit of prenatal outcomes; and the influence of smoking and individual nutrients, including n-3 fatty acids, vitamin K, and folic acid, on reproductive outcome.
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PMID:Nutrition during pregnancy. 782 68

A retrospective review of the 289 women over the age of 40 years and delivering at the Turku University Central Hospital between 1986-1990 is presented. Forty-seven women were nulliparous and 242 multiparous. The proportion of women over 40 of all parturients during this time period was 2.1%. Infertility was treated in 12% of couples. There were three multifetal pregnancies, all spontaneous. 88% of the women had a first trimester amniocentesis or chorion villus biopsy for fetal chromosomal analysis. The most common pregnancy-related complications were prematurity (11%), gestational diabetes (8%), pre-eclampsia (7%) and infectious diseases (11%). The rate of Caesarean section was high, 26% (among the primipara 36%). The perinatal mortality rate was very low, 3.4 per thousand, and neonatal mortality rate 6.8 per thousand. The incidence of congenital anomalies was 2%, and most of these anomalies were cardiac. Large-for-date babies were overpresented in this population and primipara had a higher rate of small-for-gestational age babies than in the normal population. Although advanced maternal age alone does not carry major risks of abnormal pregnancy outcome, the higher frequency of complications among some subgroups may explain the high rate of Caesarean sections in this population.
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PMID:Pregnancy in women over forty. 809 78

Sexually transmitted pathogens are associated with a wide range of anomalies and diseases, including recurrent genital herpes, urethritis, syphilis, prostitis, genital ulcers, perihepatitis, unexplained infertility, infant prematurity, low birth weight, and neonatal death or malformations. Prompt diagnosis of sexually transmitted diseases (STDs) is essential to ensure appropriate specific treatment and to reduce complications. Extensive studies on the etiology of male infertility include poorly treated infections such as STDs, epididymitis, complications associated with mumps, delayed treatment of undescended testes, repair of inguinal hernia, varicocele, endocrine disorders, anomalies of the reproductive tract and male accessory organs, trauma, surgery, heat-cold injury, and active-passive immunization.
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PMID:Sexually transmitted diseases and related genital pathologies in oligozoospermia. 821 96

During the period of September 5, 1986 to November 27, 1991, 200 consecutive women with 3 or more fetuses underwent transabdominal multifetal pregnancy reduction in the Perinatal Unit of the Mount Sinai Medical Center, New York City. These patients were principally referred by infertility specialists from all over the eastern US. All of the procedures were performed in the first trimester by the transabdominal injection of potassium chloride into the thoraces of those fetuses that underwent feticide. All of the pregnancies had been completed, and outcome data had been obtained in every case. At the time of the procedure, 88 women had triplets, 89 had quadruplets, 16 had quintuplets, 7 had from 6-9 fetuses. Reductions resulting in triplets were done at the patient's request, and reductions resulting in singletons were only done for medical indications. There were no cases of chorioamnionitis or other maternal complications attributable to the procedure. 181 women were delivered of 1 or more live infants after 24 weeks gestation, and 19 lost all of their fetuses before that time. The mean gestational age for all women delivered after 24 weeks was 35.7 weeks. The mean gestational age at delivery varied inversely with the initial number of fetuses, from 36.1 weeks for women who presented with triplets to 33.8 weeks for those who had 6 or more fetuses. This trend was statistically significant by linear more than 4 weeks after the reduction procedure had been performed. The loss rates were 7.9% for those who presented with 3 or 4 fetuses, 12.5% for those with 5, and 42.9% for those with or= 6. This trend was statistically significant. 2 neonates died in the first week of life, and 1 died at 10 months of age because of the sequelae of severe prematurity. Only 2 surviving infants showed evidence of chronic morbidity related to early delivery, and all of the other 351 infants were developing normally.
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PMID:First-trimester transabdominal multifetal pregnancy reduction: a report of two hundred completed cases. 833 48

Nineteen sets of triplets were delivered in the National Maternity Hospital between January 1st 1980 and December 31st 1990 inclusive. Thirteen triplet pregnancies resulted from spontaneous ovulation and six from ovulation induction therapy for infertility. Management was conservative. Bed rest and home monitoring were not advised routinely and cervical cerclage and tocolytic agents were not used. Ten of the patients were delivered by caesarean section. The prematurity rate was 79% and five sets of triplets were delivered before 32 weeks gestation. The perinatal mortality rate was 35/1000. This reflects a general improvement in the obstetric and neonatal care of triplet pregnancy over the past decade.
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PMID:A review of triplet pregnancy. 822 24

WHO estimates 250 million new cases worldwide of sexually transmitted diseases (STDs) each year. STDs of growing concern are chlamydial infections responsible for pelvic inflammatory disease (PID) in women and pneumonia and ophthalmia in newborns, and incurable viral infections, including Herpes simplex virus, human papilloma virus (HPV), hepatitis B virus, and HIV infection. HPV types 16 and 18 are associated with cervical intraepithelial neoplasia, one of the most serious complication of STDs. PID is another serious STD complication because it tends to recur and causes chronic abdominal pain, eventually resulting in hysterectomy, infertility, ectopic pregnancy, or chronic backache. STDs adversely affect pregnancy, often leading to ectopic pregnancy, stillbirth, prematurity, congenital and perinatal infections, and puerperal maternal infections. Genital ulcer diseases, e.g., chancroid, facilitate HIV transmission. HIV infection boosts the virulence of STD pathogens, e.g., Herpes simplex virus. Many people with STDs are asymptomatic and the clinical profile of STDs is always in flux, thus resulting in less than optimal case detection. Obstacles of STD treatment include antibiotic resistance of betalactamase-producing Neisseria gonorrhoea strains and the immunocompromising effect of HIV infections. Tourists are responsible for introducing HIV infection into many countries. Some countries (e.g., Saudi Arabia) require a negative HIV test before foreigners can work in those countries. Health resources are not keeping up with the spread of STDs and HIV. Governments should embark on health education campaigns to stem the spread of HIV. They should also integrate AIDS prevention with the control of other STDs.
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PMID:Sexually transmitted diseases in the age of AIDS. 847 83

Zinc is present in and indispensable to all forms of life. Zinc is essential for the normal growth of human beings, and zinc proteins have been shown to be involved in the transcription and translation of the genetic material. Zinc deficiency has been incriminated in infertility, abortions, malformations, fetal intrauterine growth retardation, premature and postmature births, perinatal death, and abnormal deliveries with dystocia and placental ablation. Risk groups for developing zinc deficiency, which in turn might modify the expression of the underlying disease, are found among those with insufficient food intake, especially in protein malnutrition; abnormal mucosal uptake, as in celiac disease; abnormal intestinal losses, as in steatorrhea and inflammatory bowel disease; abnormal renal excretion, as in diabetes with insufficient metabolic control; alcoholism; and treatment with diuretic drugs. Zinc deficiency could be identified by means of fasting serum or plasma samples or the more laborious estimation of zinc in leucocytes or monocytes if sampling and handling is carefully performed and if stressful situations and acute-phase reactions as fever, delivery, or abortion are avoided. Zinc therapy in identified low-zinc groups has given favorable results and has reduced the frequencies of premature birth, placental ablation, perinatal death, and postmaturity. It is suggested, as we did in 1980, that these data are compatible with the presence of a zinc-deficiency syndrome in pregnancy, which includes increased maternal morbidity, abnormal taste sensations, abnormally short or prolonged gestations, inefficient labor, atonic bleeding, and increased risks to the fetus such as malformations, growth retardation, prematurity, postmaturity, and perinatal death.
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PMID:Zinc status in pregnancy: the effect of zinc therapy on perinatal mortality, prematurity, and placental ablation. 849 61

An evaluation of the outcome of pregnancies resulting from intracytoplasmic sperm injection for severe male factor infertility was conducted by analysing the data obtained from the patients and/or their obstetrician/gynaecologist on standardized questionnaires. The data from 424 pregnancies between April 1991 and September 1994 were analysed. Early pregnancy loss before 16 weeks occurred in 99 cases (23.3%), including 48 clinical abortions (11.3%), 47 subclinical pregnancies (11.1%) and four ectopic pregnancies (0.9%). Vanishing twins and triplets, which could be regarded as early embryonic wastage, were found in 36 cases (8.5%). One pregnancy was interrupted at week 15 of gestation because of anhydramnios, and four pregnancies (0.9%) ended in spontaneous late abortions before 26 weeks. A total of 320 pregnancies (75.5%) resulted in the birth of at least one child; 222 of these (69.3%) were singletons, 93 were twins (29.1%) and five were triplets (1.6%). The problems of prematurity and low birthweight were especially related to the multiplicity of pregnancies. Furthermore, from among the total of 423 babies born, we have observed three cases of stillbirth and five cases of neonatal mortality. The perinatal mortality rate was therefore 18.9 per 1000 births. The results of this study show that the obstetric outcome of these pregnancies was similar to that obtained after conventional in-vitro fertilization and other assisted reproduction techniques.
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PMID:Obstetric outcome of 424 pregnancies after intracytoplasmic sperm injection. 856 98


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