Immunoglobulin D in amniotic fluid, maternal and fetal serum

Amniotic fluid, maternal and cord serum IgD determinations were performed in 30 healthy pregnant women during labor. Immunoglobulin D was determined by simple radial immunodiffusion by using low concentration immunoplates. Maternal serum IgD mean level amounted to 4.39 mg/100 ml, while in fetal serum and amniotic fluid no immunoglobulin D was detected in any of the cases presented. The absence of IgD in the amniotic fluid supports the view of a special mechanism which exerts selective inhibition of its passage into the amniotic cavity

Grand-multiparity in Greece

The incidence of grand-multiparity in Greece over a period of 19 years (1956-1974) as well as its influence upon pregnancy and labor are analysed. Its relationship to socioeconomic level and possible reasons for its constant decrease are also discussed. © 1978

Mepivacaine local cervical anesthesia for diagnostic hysteroscopy: A randomized placebo-controlled study

The purpose of this study was to evaluate the efficacy and safety of local cervical application of mepivacaine hydrochloride for reducing pain associated with hysteroscopy. Among the patients who underwent hysteroscopic evaluation over a 6-year period (1994-1999) at the hysteroscopy unit of the First Department of Obstetrics and Gynecology of the University of Athens, in 245 anesthesia was necessary. In 45 patients, general anesthesia was decided on, for various reasons. The remaining 200 patients were randomized into two groups of 100. Patients of the study group were given local anesthesia by local cervical injection of mepivacaine hydrochloride, and patients in the control group received normal saline injection. All patients evaluated their pain, using an 11-point (0-10) analog scale, during the procedure as well as 30 and 60 min afterward. The use of local mepivacaine effectively and safely reduced pain associated with hysteroscopy and endometrial biopsy, as the mean value of pain assessment in the study group was notably inferior to that reported by the control group. Still, when unpaired Student's t test was applied for statistical evaluation, the difference was statistically nonsignificant

E. Coli Growth Inhibition by Amniotic Fluid

Abstract. Amniotic fluid samples were collected aseptically from 29 normal pregnancies, between the 38th and 41st week of gestation and checked for sterility in the laboratory, in order to investigate in vitro the effect of the liquor on the growth of E. coli. Brain Heart Infusion (B.H.I.) and Ringer solution were used as controls. E. coli cultures were inoculated in amniotic fluid, B.H.I., Ringer solution and amniotic fluid plus B.H.I. and incubated at 37°C for 48 hours. At 0, 1, 3, 6, 12, 24, 36 and 48 hours of incubation, surface viable counts were performed to estimate the number of E. coli viable cells. The growth of E. coli in B.H.I. started during the 1st hour after inoculation and continued over 48 hours; in Ringer solution the mean growth curve was almost identical to that of B.H.I. In amniotic fluid the growth of E. coli began from the 1st hour of inoculation but the growth curve was much lower, became static in 24 hours and a permanent inhibition was observed thereafter. The addition of a small amount of B.H.I. in amniotic fluid enhanced the growth of E. coli, but the growth curve was lower in comparison to the curves of the two controls studied. In conclusion, after 48 hours of inoculation in amniotic fluid, 26 of the 29 cases showed bacteriostatic or bactericidal activity of the liquor upon the growth of E. coli. 1976 Acta Obstet Gynecol Scan

Endometrial abnormalities in breast cancer patients with tamoxifen therapy

Objective Evaluation of the effect of tamoxifen therapy on endometrium in patients who have previously undergone surgery for breast cancer. Design An analysis of hysteroscopic findings and their correlation with those from previous vaginal ultrasonography and subsequent endometrial sampling. Setting The hysteroscopy unit of a university clinic. Subjects 64 patients referred from the breast clinic, who had previously undergone surgery for breast cancer and who were receiving adjuvant tamoxifen therapy, with either suspicious findings on routine vaginal ultrasonography or abnormal uterine bleeding. Of the patients, 22 were premenopausal (group A) and 42 postmenopausal (group B). Each group was divided in two subgroups, comprising either symptomatic patients (groups A1 and B1) or asymptomatic patients (groups A2 and B2). Intervention Diagnostic hysteroscopy. Results All six patients of group A1 were found to have hyperplastic endometrium on hysteroscopy. Subsequent biopsy after dilation and curettage (D&C) revealed simple endometrial hyperplasia in all samples, plus endometrial polyps in two cases. Despite suspicious appearances on vaginal ultrasonography, all 16 asymptomatic premenopausal patients (group A2) were found on hysteroscopy to have normal endometrium. Among the 29 patients with postmenopausal uterine bleeding (group B1) 22 showed hyperplastic endometrial findings on hysteroscopy. The histopathological results from the subsequent D&C, confirmed the hysteroscopic findings, showing various degrees of endometrial hyperplasia and three adenocarcinomas (4.7% of the total number of patients or 10.3% of those with postmenopausal bleeding). Normal or atrophic endometrium was observed in nine of the 13 patients in group B2; there was one polyp, and three cases of hyperplastic endometrium, which were found to be simple hyperplasia on pathological investigation. Conclusions Monitoring of the uterine cavity in patients receiving tamoxifen therapy is mandatory, especially where there is postmenopausal bleeding. Hysteroscopy findings display a considerably higher degree of correlation with endometrial pathology results, than do vaginal ultrasonography findings

The inhibitory effect of amniotic fluid on the growth of Staphylococcus aureus

In the late 1940s, some researchers found that amniotic fluid had an inhibitory effect on bacterial growth due, they believed, to the presence of lysozymes. Later other authorities asserted that amniotic fluid facilitates bacterial growth. More recently, studies have indicated that liquor amnii has a remarkable antibacterial activity. To further examine this antibacterial action, the present study of the effect of amniotic fluid on Staphylococcus aureus was undertaken

Genetic amniocentesis in women 20-34 years old: associated risks

The aim of this retrospective controlled study is to evaluate the impact of predisposing factors on amniocentesis-related fetal loss. It comprises 3910 consecutive cases of women, aged 20-34 years, who had genetic amniocentesis during the years 1992-97 (study group). The control group comprised 5324 women under 35, at low risk for Down syndrome, during the same period. The fetal losses in both groups were analysed, in respect of: (a) maternal historical conditions; and/or (b) bleeding during current pregnancy. The leading indication for amniocentesis in women 20-34 years was maternal anxiety, mainly for marginal age (33-34 years), which accounted for a remarkable 34.4% of the study group. Total fetal loss rate up to the 28th week was 2.1% in the study group versus 1.5% in controls. A history of previous spontaneous or induced abortions, as well as bleeding during the current pregnancy, was associated with a substantial rise of fetal loss in both groups. In cases with no predisposing factors, the added fetal loss rate was 0.03%. previous abortions and bleeding during the current pregnancy are associated with the most fetal losses after amniocentesis. In the absence of these, the added fetal loss rate (0.03%) is non-significant. Copyright (C) 2000 John Wiley & Sons, Ltd