Showing papers on "Pregnancy published in 1973"
TL;DR: In both groups, vascular resistance to infused angiotensin II (more than 8 ng/kg/min required to elicit a pressor response of 20 mm Hg in diastolic pressure) was demonstrated as early as the 10th wk of pregnancy, with a clear separation of the two groups by the 22nd wk.
Abstract: The present study was designed to ascertain sequentially the pressor response to angiotensin II in young primigravid patients throughout pregnancy in order a) to define when in pregnancy resistance to the pressor effects of angiotensin II develops; b) to define the physiologic sequence of events leading to this resistance; and c) to ascertain whether sensitivity to infused angiotensin II could be detected before the onset of clinical signs of pregnancy-induced hypertension. With this prospective approach, two separate groups of patients were defined. The first group of patients remained normal throughout pregnancy. The second group consisted of those patients who, while clinically normotensive during the initial phase of the study, ultimately developed hypertension of pregnancy.192 patients were studied; of these, 120 patients remained normotensive and 72 developed pregnancy-induced hypertension. In both groups, vascular resistance to infused angiotensin II (more than 8 ng/kg/min required to elicit a pressor response of 20 mm Hg in diastolic pressure) was demonstrated as early as the 10th wk of pregnancy. In the group that remained normotensive, maximum mean vascular resistance occurred at 18-30 wk of pregnancy, (mean pressor dose required being 13.5 to 14.9 ng/kg/min). In those subjects who developed pregnancy-induced hypertension, the mean maximum dose required was 12.9 ng/kg/min, which was observed at the 18th wk of pregnancy. By the 22nd wk there was a clear separation of the two groups, with the mean dose requirement of the subjects destined to develop hypertension being progressively less than that of those who remained normal. The difference between the two groups became significant (P < 0.01) by 23-26 wk of pregnancy. Among patients requiring more than 8 ng/kg/min on one or more tests done between wk 28-32, 91% remained normotensive. Conversely, during the same time period among patients requiring less than 8 ng/kg/min, on at least one occasion, 90% developed pregnancy-induced hypertension.
1,177 citations
579 citations
TL;DR: It is suggested that an association exists between general major organ system maturation of the fetus—“functional maturity”-and the L/S ratio, independent of gestational age or birth weight.
552 citations
TL;DR: Clinical history, including previous abnormal pregnancy history, birth of a large baby, maternal obesity, and family history of diabetes, is demonstrated to be an insensitive screening factor in the selection of gestational diabetic patients.
479 citations
TL;DR: Children of mothers who smoked 10 or more cigarettes a day are on average 1·0 cm shorter and between three and five months retarded on reading, mathematics, and general ability compared with the offspring of non-smokers.
Abstract: A national sample of several thousand children has been followed longitudinally from birth. At the ages of 7 and 11 years physical and mental retardation due to smoking in pregnancy has been found, and this deficit increases with the number of cigarettes smoked after the fourth month of pregnancy. Children of mothers who smoked 10 or more cigarettes a day are on average 1·0 cm shorter and between three and five months retarded on reading, mathematics, and general ability compared with the offspring of non-smokers, after allowing for associated social and biological factors.
432 citations
TL;DR: A normal curve of fetal crown-rump length was derived from 214 examinations on 80 patients and by using these values in a further “blind” series it was found possible to predict the maturity of pregnancy to within three days, between the sixth and the 14th weeks of pregnancy.
Abstract: A method is reported by which the “in utero” crown-rump length of the fetus may be determined by sonar in the first trimester of pregnancy. The accuracy of the technique was assessed by comparing the sonar and the direct postabortum measurements of fetuses in cases of missed abortion. A normal curve of fetal crown-rump length was derived from 214 examinations on 80 patients and by using these values in a further “blind” series it was found possible to predict the maturity of pregnancy to within three days, between the sixth and the 14th weeks of pregnancy.
361 citations
TL;DR: Age was found to have a disproportionately adverse effect, enhanced slightly by obesity, on the pregnancies of gestational diabetic patients when compared with those of negative control patients.
299 citations
TL;DR: Analysis of data from the 1970 National Fertility Study indicates that Blacks are much less successful than whites in delaying and preventing pregnancy, and white Catholics are less successful in delaying, but just as successful in preventing pregnancy as white non-Catholics.
Abstract: Data obtained from the 1970 National Fertility Study are analyzed to determine the incidence of contraceptive failure according to intent social background and method. Analyzed by life-table procedures the data indicate that 40% of contraceptive users fail to achieve their goal of either delaying (26%) or preventing (14%) pregnancy. Those women who are relatively young at the beginning of their exposure to risk are much more likely to fail than older women. Pregnancy order and educational attainment do not affect contraceptive failure rates when intent and age are held constant. Blacks are much less successful than whites in delaying and preventing pregnancy and white Catholics are less successful in delaying but just as successful in preventing pregnancy as white non-Catholics. Attempts to prevent or delay pregnancy were much more successful in 1970 than 1955 partially because of the use of oral contraceptives but also because of greater care taken no matter which method was used. Failure rates by method with intent and age constant are as follows: pill--6% IUD--12% condom--18% diaphragm--23% foam--31% rhythm--33% and douche--39%. These figures reflect the characteristics of those who use each method as well as the method itself. Methodological problems with this analysis are discussed along with their implications.
222 citations
Journal Article•
TL;DR: The results suggest that the duration of infertility prior to surgery and the degree of endometrial involvement are central factors in the obstetric prognosis of patients undergoing conservative surgery for endometriosis.
222 citations
TL;DR: In a prospective study of cytomegalovirus infection in 1,040 pregnant women in London 319 of the white Englishwomen but only 28 of the immigrant Asian women were without antibodies at the onset of pregnancy, but the overall incidence of fetal infection after primary infection in the mother was almost 50%, and was higher in early pregnancy.
Abstract: In a prospective study of cytomegalovirus infection in 1,040 pregnant women in London 319 (42%) of the white Englishwomen but only 28 (10%) of the immigrant Asian women were without antibodies at the onset of pregnancy. Out of 254 susceptible white women and 16 susceptible Asian women 8 (3%) and 3 (16%) respectively experienced primary infection during the course of pregnancy. The overall incidence of fetal infection after primary infection in the mother was almost 50%, and was higher in early pregnancy. One out of the five infected infants was found to be mentally retarded. Reactivation of latent infection was recognized in 0·7-2·9% of pregnant women; this occurred without involving the fetus.
184 citations
TL;DR: During the first 7 weeks of pregnancy, the diagnosis of intrauterine pregnancy cannot be made with certainty by determination of any of these steroid hormones, but good correlation was found between HCG and E 1 and E 2 levels.
TL;DR: It is suggested that maternal serum-A.F.P. levels may be useful in the screening of large numbers of pregnancies for possible central-nervous-system malformations.
TL;DR: As a group, infants born to heroin addicts were small for gestational age; all organs were affected.
TL;DR: Drugs that may carry a risk of teratogenicity if administered early in pregnancy are listed, as are those drugs that, if administered later in pregnancy, may adversely affect fetal functioning or the functioning of the newborn infant at or after birth.
Abstract: The epidemiology of drug consumption during pregnancy has been studied retrospectively in 911 randomly selected mothers. The drugs used, the proportions of pregnant women taking them, the duration and timing of drug administration were ascertained. Excluding iron, drugs were prescribed for 82 % of women during pregnancy and the average number of drugs prescribed for these women was 4. Self‐medicated drugs were taken by 65% of mothers and the average number of drugs taken by these was 1.5. The proportion of mothers taking different categories of drugs ranged from 82% to 1.2%. The mean duration of drug therapy for the various categories of drugs ranged from 125 to 10 days. The duration of treatment with individual drugs was also ascertained. Some drugs tended to be administered early, some late, and some throughout pregnancy. A drug “consumption in pregnancy” factor has been calculated by which the over‐all consumption of a drug can be measured and comparisons made of the consumption of one drug relative to another. Drugs that may carry a risk of teratogenicity if administered early in pregnancy are listed, as are those drugs that, if administered later in pregnancy, may adversely affect fetal functioning or the functioning of the newborn infant at or after birth.
TL;DR: The data show that the risk of teratogenic effects is lower than one might have expected from some of the studies carried out on rats and mice, but they do not answer the question of whether or not lithium isTeratogenic in man.
Abstract: We have collected information about 118 children born to mothers who were given lithium treatment during the first trimester of pregnancy. The data show that the risk of teratogenic effects is lower than one might have expected from some of the studies carried out on rats and mice; they do not answer the question of whether or not lithium is teratogenic in man. The data were collected retrospectively and therefore overestimate rather than underestimate the risk of teratogenicity.
TL;DR: Changes in cell-mediated immunity during pregnancy may contribute to the known increased severity of viral infections in the gravid state.
Abstract: A significant depression in cell-mediated immunity, measured by phytohemagglutinin and mixed-lymphocyte-culture responsiveness was observed in 11 pregnant women. Specific cell-mediated immunity to rubella virus, measured by a 51Cr-release microassay, was also found to be diminished during pregnancy. The mean (± S.D.) specific immune release for 13 seropositive subjects during pregnancy was 4.3 ± 5.9 per cent as compared to a mean of 19.9 ± 0.9 per cent in 14 seropositive nonpregnant women. This impairment in specific cell-mediated immunity to rubella virus was shown to be transient because there was subsequent increase in immunity in each of four subjects studied post partum. Thus, these changes in cell-mediated immunity during pregnancy may contribute to the known increased severity of viral infections in the gravid state. (N Engl J Med 289:604–606, 1973)
TL;DR: Until more definitive data are available it would be prudent to emphasise the need to document the absence of pregnancy before undertaking oral contraception and to reconsider the risk-benefit ratio of pregnancy testing with hormonal agents.
TL;DR: The administration of high dosages of estrogen in the postovulatory period appears to be effective in lowering pregnancy rates following mid-cycle exposure to the 0.3 to 0.03 per cent range.
TL;DR: Serum-phenytoin levels in women of childbearing age must be controlled until the aetiological role of pheny toin in human malformation is further evaluated.
TL;DR: Comparisons indicate that women with epilepsy experience an excess of complications during pregnancy and labour, and that their babies are more frequently born prematurely and of low birth weight, and moreover have an exceed of congenital malformations and higher perinatal and neonatal mortality rates.
Abstract: Information derived from the compulsory national scheme of medical registration of births in Norway has been utilized in a study of the course and outcome of pregnancy in women with epilepsy The series comprises 371 pregnancies in women with epilepsy and, as controls, 112530 pregnancies in women reporting no disease before or during the pregnancy Comparisons indicate that women with epilepsy experience an excess of complications during pregnancy and labour, and that their babies are more frequently born prematurely and of low birth weight, and moreover have an excess of congenital malformations and higher perinatal and neonatal mortality rates Epileptics, undoubtedly, constitute a high risk group in need of special attention during pregnancy and special care during labour A proper interpretation of the findings in terms of causation, however, will call for additional data obtainable only through especially designed inquiries
TL;DR: Mechanisms are presented to help explain the possible relationship between the maternal withdrawal and the fetal death and an increased stillborn and neonatal mortality rate in the over-all pregnant drug-addicted population.
TL;DR: Maternal undernutrition before the third trimester had little or no influence on fetal body, organ, and cellular growth while such effects were pronounced in late gestation.
Abstract: 467 gestations were culled from 1044 autopsies on well preserved stillborn and newborn infants examined at Babies Hospital New York City between 1960-68. Organ weights and body measurements were taken from autopsy protocols. Maternal statures had little correlation with fetal growth but mothers pregravid body weight weight gain and low-calorie diets during pregnancy correlated to fetal growth. Before the third trimester Maternal undernutrition had little or no influence on fetal body cellular and organ growth while effects were pronounced in late gestation. Except in the most undernourished mothers fetal body and organ growth improved with successive pregnancies. In poorly nourished mothers successive neonates were more poorly growth retarded. Larger brain sizes were recorded in newborns of mothers who were best nourished. When not too severe the growth retardation is probably reversible with adequate postnatal nutrition. Dutch males were exposed to severe famine in utero from 1944-45 but had a normal mental performance when later examined for military service.
TL;DR: Of 38 subjects undergoing amniocentesis for antenatal spina bifida detection 1 case is reported in which a raised alpha fetoprotein (AFP) level was detected and led to pregnancy termination and the fetus delivered had anencephaly and a large spina Bifida.
TL;DR: Plasma volume and glomerular filtration rate were measured serially during pregnancy and again three months after delivery in nine healthy multigravidae with normal past obstetric histories, and in eleven multIGravidae who had a history of reproductive failure (“poor reproducers”).
TL;DR: Pregnancy was observed 105 times in narcotic-addicted women in the Methadone Maintenance Treatment Program of the Beth Israel Medical Center and followup revealed normal growth and development.
Abstract: Pregnancy was observed 105 times in narcotic-addicted women in the Methadone Maintenance Treatment Program of the Beth Israel Medical Center. There was no maternal mortality. Complications of pregnancy and fetal wastage were unremarkable. One third of the infants were premature by weight. Management in labor was modified only by the addition of methadone hydrochloride treatment. No serious effects attributable to methadone were seen in the neonatal period, and followup revealed normal growth and development.
TL;DR: In this article, Billewicz et al. showed that subtle and progressive changes in the shape of the glucose response curve were observed in healthy pregnant women with no family history of diabetes.
TL;DR: A study of 150 samples of amniotic fluid confirms the value of α-fetoprotein (A.F.P.) estimation in the detection of open neural-tube defects early enough in pregnancy to allow termination.
TL;DR: The renal lithium clearance of a manic-depressive woman rose when she became pregnant and fell to the prepregnancy level when she gave birth and emphasizes the need for frequent determinations of the serum lithium concentration and appropriate dosage adjustments during pregnancy and delivery.
Abstract: The renal lithium clearance of a manic-depressive woman rose when she became pregnant and fell to the prepregnancy level when she gave birth. The lithium clearances of four healthy women were higher during pregnancy than after delivery. This emphasizes the need for frequent determinations of the serum lithium concentration and appropriate dosage adjustments during pregnancy and delivery.