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

High maternal serum-alpha-fetoprotein (A.F.P.) concentrations in the first half of pregnancy were associated with prematurity and high perinatal mortality. 94 singleton pregnancies without neural-tube defects but with A.F.P. levels equal to or greater than three times the normal median resulted in the birth of infants weighing, on average, 357 g less than controls (P less than 0-001). The mean head circumference of the infants was also smaller than that of the controls. The 1 stillbirth and 3 neonatal deaths yielded a mortality-rate more than three and a half times that for singleton births without neural-tube defects at the same hospital in the years 1974-76. The results suggest that some pregnant women who will deliver low-birth-weight infants at high risk of perinatal death may be identified by means of serum-A.F.P. measurement early in pregnancy.
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PMID:Maternal serum-alpha-fetoprotein and low birth-weight. 6 79

Infections in pregnancy with Ureaplasma urealyticum have been associated with a wide range of adverse outcomes, such as early abortion, stillbirth, prematurity, and neonatal morbidity and mortality. Causality has been difficult to demonstrate secondary to the high prevalence of asymptomatic lower genital tract (LGT) colonization and culture data from inaccessible or potentially contaminated sites. Between 1985 and 1989, 2461 second-trimester genetic amniocenteses were evaluated at the cytogenetics section of the Children's Hospital Medical Center of Akron. All were cultured for the genital mycoplasmas: Mycoplasma hominis and Ureaplasma urealyticum. A total of nine patients were positive, all for Ureaplasma urealyticum, with one patient excluded because of subsequent therapeutic abortion. In addition, complete follow-up data, such as indication for amniocentesis, serum alpha-fetoprotein levels, gestational age at parturition, and outcome of pregnancy, were available on 86 Ureaplasma-negative (U-) patients during an approximate 2-year span within the time-frame of the study. This was in part due to physician response to a questionnaire sent after amniocentesis. Of the eight positive cultures, 100 per cent were associated with an adverse outcome, defined as fetal loss or premature delivery. This was significant compared with the U- group (p less than 0.001) with a more than eight times greater risk of adverse outcome. Six (75 per cent) resulted in spontaneous miscarriage within 4 weeks of amniocentesis and at less than 21 weeks' gestation. Two (25 per cent) delivered prematurely, with one (12.5 per cent) neonatal death at 24+ weeks. Histological examination of all eight placentae and the seven fetuses revealed a 100 per cent incidence of chorioamnionitis and pneumonia, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Adverse outcome in pregnancy following amniotic fluid isolation of Ureaplasma urealyticum. 155 56

Maternal serum alpha-fetoprotein concentration was measured at 14 to 20 weeks' gestation in 138 twin pregnancies. All patients had at least one ultrasonographic examination (86% before 20 weeks' gestation). Two pregnancies were discordant for open fetal defects (one anencephaly, one gastroschisis). The median serum alpha-fetoprotein value in the remaining 136 twin pregnancies paralleled a curve 2.5 times the median curve for singleton pregnancies over the gestational range studied. Higher serum alpha-fetoprotein values correlated significantly with increasing incidence of fetal and neonatal death, premature delivery (less than 35 weeks' gestation), and twin-to-twin birth discordance (greater than 20%), most pronounced at greater than 4 multiples of the singleton median level. A significant negative correlation between alpha-fetoprotein and birth weight was observed (p less than 0.001), but was related more to prematurity than to poor fetal growth. Theoretically, serum alpha-fetoprotein screening detected 56.5% of the twins in this study when a cutoff level of 2.5 multiples of the median was used, enhancing twin detection in the study population by 40%. These data indicate that maternal serum alpha-fetoprotein screening has a valuable role in the management of twin pregnancy, both in the detection of twins and in the prediction of perinatal outcome in twin pregnancy.
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PMID:Maternal serum alpha-fetoprotein in twin pregnancy. 169 90

Reference values for postnatal serum alpha-fetoprotein (AFP) and concanavalin A (ConA) binding subfractions of AFP in preterm and term infants are presented. Preterm infants had 10-fold higher serum concentrations of AFP than did term infants at birth. The reduction of serum values of AFP was biphasic in both groups and differed significantly between the two groups. The first declining phase continued for approximately 4 months in preterm and for 2 months in term infants, and was related to the degree of prematurity. The AFP values reached adult levels by 12 months in preterm and by 9 months in term infants. The developmental pattern of the carbohydrate moiety of AFP was determined by ConA fractioning. The proportion of the ConA nonreactive subfraction of AFP in preterm and term infants at birth was 6% and 13%, respectively; it increased more rapidly in term than in preterm infants but reached 85% to 95% by the age of 6 months in both infant groups. Our results indicate that the postnatal maturation of AFP synthesis is dependent on gestational age. Malignant recurrences of neonatal sacrococcygeal teratomas were associated with an increase in serum concentration of AFP and a decrease in the proportion of the ConA nonreactive subfraction of AFP.
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PMID:Biphasic reduction and concanavalin A binding properties of serum alpha-fetoprotein in preterm and term infants. 170 32

Among 58,187 women tested, 1002 had a maternal serum alpha-fetoprotein measuring greater than or equal to 2.5 multiples of the median after correction for race, weight, and insulin-dependent diabetes. They were stratified into three groups: group 1, 2.5 to 2.9; group 2, 3.0 to 5.0; group 3, greater than or equal to 5.0 multiples of the median. The initial risk of a serious abnormality detected by ultrasonography or amniocentesis was 17% (5%, 12% and 65% in groups 1, 2, and 3, respectively). After correction for twins and dates, this risk became 23% (7%, 18%, and 71% in groups, 1, 2, and 3, respectively). Among the women with high maternal serum alpha-fetoprotein levels, 556 (77%) had normal ultrasonographic and amniocentesis studies, and the risk of adverse pregnancy outcome ws 27% (19%, 29%, and 70% in groups 1, 2, and 3, respectively). There was a statistically significant increase in late fetal and perinatal death, prematurity and growth retardation, oligohydramnios, abruptio placentae, preeclampsia, and congenital abnormalities. The overall risk for abnormality or adverse outcome was 24% in group 1, 41% in group 2, and 91% in group 3.
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PMID:Risks associated with an elevated maternal serum alpha-fetoprotein level. 171 19

In a study of 1,703 pregnancies, adverse clinical outcomes associated with unexplained elevated maternal serum alpha-fetoprotein (MSAFP) included intrauterine growth retardation (IUGR), prematurity, IUGR and prematurity, prematurity without IUGR, spontaneous abortion, and stillbirth. These findings have significant implications for careful obstetrical management of patients with elevated MSAFP.
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PMID:Study of the relationship between elevated maternal serum alpha-fetoprotein and adverse pregnancy outcome. 171 6

Serum alpha-fetoprotein levels were raised to 2.0 or more times the median for gestation in 30 of 507 singleton pregnancies after excluding pregnancies complicated by fetal neural tube defects. The serum alpha-fetoprotein levels were significantly more often elevated in pregnancies complicated by prematurity, fetal heart rate abnormalities, delivery of a small for dates infant, a perinatal death and admission of the baby to the neonatal unit. While the predictive value of an elevated serum alpha-fetoprotein was 76% for abnormal outcomes in general it ranged between only 16% and 46% for specific abnormalities. The usefulness of this assay relates only to its ability to predict an abnormal outcome when performed during the second trimester.
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PMID:Second trimester maternal serum alpha-fetoprotein as an indicator of fetal risk. 242 67

A pilot project of maternal serum alpha-fetoprotein (MSAFP) screening was carried out in Ontario from 1982 to 1985 to examine the feasibility and acceptability of screening a prenatal population for open fetal neural tube defects. A total of 8140 patients at low genetic risk were screened. Patient acceptance was excellent. Blood samples were taken at 16 to 18 weeks' gestation. If the MSAFP level was elevated, the assay was repeated and an ultrasound examination performed. Amniocentesis was offered to 67 women with unexplained persistently elevated levels. The outcome of pregnancy was known in 7473 patients (91.8%). Seven of nine known open fetal neural tube defects were detected. All were confirmed, and no unaffected fetuses were aborted on the basis of the screening results. The rates of perinatal death (6.7%), intrauterine growth retardation (11.7%) and prematurity (23.3%) were significantly higher among the patients with unexplained elevated MSAFP levels than among those with normal levels (p less than 0.001). Of 20 patients with unexplained low levels, 10 subsequently had spontaneous abortions and 10 gave birth to term appropriate-for-gestational-age infants. Seven of nine patients who gave birth to infants with autosomal trisomy had MSAFP values below the median. The findings indicate that MSAFP screening is feasible, accurate and acceptable in a low-risk area.
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PMID:Maternal serum alpha-fetoprotein screening: report of a Canadian pilot project. 244 May 47

Five hundred sixty women among 35,787 screened had an initial maternal serum alpha-fetoprotein (MSAFP) of 2.5 or more multiples of the median. They were divided into three groups: group 1, 2.5-2.9; group 2, 3.0-3.9; and group 3, over 4.0 multiples of the median. These groupings determined the relationship to adverse pregnancy outcome, defined as fetal death, fetus with significant anomalies, and prematurity/growth retardation. The overall risk of adverse outcome after an initial elevation was 38%, after excluding pregnancies with incorrect dates or multiple gestations with levels below 4.5 multiples of the median: 27, 39, and 45% in groups 1, 2, and 3, respectively. This risk rose to 86% for levels over 6.0 multiples of the median. There was a significant positive correlation between abnormalities and death detected with ultrasound and amniocentesis and those indicated by increasing MSAFP levels: 10, 20, and 31% in groups 1, 2, and 3, respectively. After normal ultrasound and amniocentesis studies, there was a trend toward increasing risks for fetal death after 20 weeks between groups 2 and 3 (5 and 11%), but not for growth retardation/prematurity (12, 17, and 13%). After an elevated MSAFP, the overall risk of a late pregnancy complication after normal ultrasound and amniocentesis was 22%: 19, 23, and 25% in groups 1, 2, and 3, respectively. This figure increased to 67% for levels above 6.0 multiples of the median.
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PMID:Pregnancy outcomes after increasing maternal serum alpha-fetoprotein levels. 247 46

The aim of this study is the evaluation of the reliability of vaginal fluid (VF) prolactin (PRL) for detecting prematurely ruptured membranes (PROM) and the comparison of this marker with vaginal fluid alpha-fetoprotein (AFP) and placental lactogen (HPL). In 21 pregnant women with recent or prolonged PROM from 20 to 41 weeks' gestation, in whom intact membranes were never found subsequently VF- and MS-PRL, -AFP and -HPL were measured by enzyme immunoassays, which are sensitive and very rapid. The same markers were also measured in MS, VF and urine samples (U) in 12 pregnant women of the same gestational age, without PROM, in whom the membranes were ruptured later during labor. In PROM, independently of prematurity and duration of PROM VF-PRL levels were significantly higher (2-10-fold) than the paired MS-PRL (p less than 0.0001) and ranged from 130 to 2315 ng/ml. In contrast, VF-PRL and urine PRL concentrations in pregnancies without PROM were very low or undetectable (range: 0-5 ng/ml and 0.15-1 ng/ml, respectively). Vaginal fluid AFP values in PROM from 20th to the 33rd week of pregnancy were significantly higher (5-50-fold) than the paired MS-AFP (p less than 0.01) and ranged from 103 to 5500 ng/ml. In PROM after the 33rd week of pregnancy, VF-AFP values were either lower (1/3), or equal to, or even higher (up to 2-fold) than MS-PRL. On the contrary in pregnancies with intact membranes, VF-AFP were always less than 9 ng/ml and urine AFP was undetectable (range: 0.2-1.1 ng/ml).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Vaginal fluid prolactin: a reliable marker for the diagnosis of prematurely ruptured membranes. Comparison with vaginal fluid alpha-fetoprotein and placental lactogen. 247 64


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