Haitian women have a high relative incidence of clinical presentation with peripartum cardiomyopathy (PPCM): an incidence estimated at one case per three hundred live births, a ten-fold occurrence compared to American...Haitian women have a high relative incidence of clinical presentation with peripartum cardiomyopathy (PPCM): an incidence estimated at one case per three hundred live births, a ten-fold occurrence compared to American women. Our Abstract has been to test the hypothesis that some Haitian women may have a forme fruste of PPCM while still without clinical symptoms. Method: A preliminary case-control study was conducted at the Hospital Albert Schweitzer (HAS), Deschapelles, Haiti, in which 25 apparently healthy postpartum women, without cardiovascular symptoms and with a normal cardiovascular clinical examination, were selected from a consecutive list of obstetrical deliveries and screened by echocardiography for left ventricular dysfunction. Result: Four out of 25 patients (16% ) had asymptomatic left ventricular dysfunction that subsequently evolved towards either improvement or deterioration. Supporting evidence for the existence of asymptomatic left ventricular dysfunction or forme fruste PPCM is presented. A hypothetical schema of the pathophysiology of PPCM explains how a latent phase of variable duration may exist prior to onset of detectable clinical heart failure. Conclusion: Screening Haitian women during the last month of pregnancy or in the early postpartum period may help to detect asymptomatic left ventricular dysfunction. Early detection and treatment of PPCM in a known high risk population could lead to improvements in maternal and fetal mortality and morbidity.展开更多
To compare serum levels of nitric oxide (NO) and endothelin- 1 (ET- 1), and urinary concentrations of NO and cyclic guanosine monophosphate (cGMP) between preeclamptic and normotensive pregnant women. Method: Ninety-o...To compare serum levels of nitric oxide (NO) and endothelin- 1 (ET- 1), and urinary concentrations of NO and cyclic guanosine monophosphate (cGMP) between preeclamptic and normotensive pregnant women. Method: Ninety-one preeclamptic (48 mild, 43 severe) and forty healthy normotensive pregnant women above 32 gestational weeks were recruited into study. Chemiluminesence technique was used for measuring plasma and urinary NO levels, and radioimmunoassay was used to determine plasma ET- 1 and urinary cGMP levels. Result: Plasma and urinary NO, and urinary cGMP levels were significantly lower in preeclamptics than in the control group (respectively, p < 0.001, p < 0.001, p < 0.01). Plasma ET- 1 levels were significantly higher in the preeclamptics than in the control group (p < 0.001). There were significant negative correlations between plasmaET- 1, plasma NO and urinary NO and cGMP in all groups. There were positive correlations between plasma NO, urinary NO and cGMP in all groups. Conclusion: The imbalance between NO and ET- 1 may play a significant role in the pathophysiology of preeclampsia.展开更多
To compare the efficacy and safety of arithmetic and geometric increases in oxytocin infusion dosage during induction of labor. Methods: A total of 120 pregnant women requiring induction of labor at term were randomly...To compare the efficacy and safety of arithmetic and geometric increases in oxytocin infusion dosage during induction of labor. Methods: A total of 120 pregnant women requiring induction of labor at term were randomly assigned to receive oxytocin at dosages increasing arithmetically or geometrically. Maternal demographics, labor delivery data, and newborn outcomes were compared. The setting was the maternity unit of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. Results: The mean maximum rates of oxytocin delivery needed to achieve adequate uterine contractions were similar in the 2 groups (24.66 ± 8.34 mU/min vs 26.38 ± 8.77 mU/min, P = 0.24). Labor duration was significantly shorter in the geometric progression group (496.33 ± 54.77 min vs 421.34 ± 63.91 min, P < 0.001). There were no differences in the rates of cesarean sections, vaginal deliveries, or uterine hyperstimulation, or in neonatal outcomes. Conclusion: A geometric rise in the rate of oxytocin infusion delivery reduced the duration of labor without affecting the rates of cesarean sections and uterine hyperstimulation, or newborn outcomes.展开更多
To detect possible changes in main blood vessels within leiomyomas after uterine artery ligation using color Doppler sonography. Method: Blood flow in main leiomyoma blood vessels was measured before and after the pro...To detect possible changes in main blood vessels within leiomyomas after uterine artery ligation using color Doppler sonography. Method: Blood flow in main leiomyoma blood vessels was measured before and after the procedure in 14 women who also had abnormal uterine bleeding, pelvic pain or pressure, and/or anemia. Results: Of the 14 patients, 13 reported complete disappearance of preoperative pain or pressure and 1 reported significant relief. Within 1 week to 4 months after uterine artery ligation, major blood flow within leiomyomas had significantly decreased in all patients. Eight months after the procedure, 1 of the women became pregnant. Conclusion: Laparoscopic uterine artery ligation via a lateral retroperitoneal technique is a safe and effective treatment for leiomyomas. Color Doppler sonography verified the ability of the procedure to diminish blood flow within leiomyomas in all patients.展开更多
To evaluate the use of amniotic membrane grafts in cases of vaginal and cervical agenesis. Methods: Five girls with complete cervical and vaginal agenesis underwent cervicoplasty and vaginoplasty using amniotic membra...To evaluate the use of amniotic membrane grafts in cases of vaginal and cervical agenesis. Methods: Five girls with complete cervical and vaginal agenesis underwent cervicoplasty and vaginoplasty using amniotic membrane grafts. Result: Excellent epithelization and patency of cervix and vagina was achieved in all cases. Conclusion: Amniotic membrane may be used as an allograft in cervical reconstruction. It is inexpensive, readily available, of low antigenicity and does not necessitate repeated cervical dilatation. The performance of the reconstructed cervix during labor is yet to be observed. To the author’ s knowledge, this is the first series reported in the literature in which amniotic membrane was used for cervical reconstruction.展开更多
文摘Haitian women have a high relative incidence of clinical presentation with peripartum cardiomyopathy (PPCM): an incidence estimated at one case per three hundred live births, a ten-fold occurrence compared to American women. Our Abstract has been to test the hypothesis that some Haitian women may have a forme fruste of PPCM while still without clinical symptoms. Method: A preliminary case-control study was conducted at the Hospital Albert Schweitzer (HAS), Deschapelles, Haiti, in which 25 apparently healthy postpartum women, without cardiovascular symptoms and with a normal cardiovascular clinical examination, were selected from a consecutive list of obstetrical deliveries and screened by echocardiography for left ventricular dysfunction. Result: Four out of 25 patients (16% ) had asymptomatic left ventricular dysfunction that subsequently evolved towards either improvement or deterioration. Supporting evidence for the existence of asymptomatic left ventricular dysfunction or forme fruste PPCM is presented. A hypothetical schema of the pathophysiology of PPCM explains how a latent phase of variable duration may exist prior to onset of detectable clinical heart failure. Conclusion: Screening Haitian women during the last month of pregnancy or in the early postpartum period may help to detect asymptomatic left ventricular dysfunction. Early detection and treatment of PPCM in a known high risk population could lead to improvements in maternal and fetal mortality and morbidity.
文摘To compare serum levels of nitric oxide (NO) and endothelin- 1 (ET- 1), and urinary concentrations of NO and cyclic guanosine monophosphate (cGMP) between preeclamptic and normotensive pregnant women. Method: Ninety-one preeclamptic (48 mild, 43 severe) and forty healthy normotensive pregnant women above 32 gestational weeks were recruited into study. Chemiluminesence technique was used for measuring plasma and urinary NO levels, and radioimmunoassay was used to determine plasma ET- 1 and urinary cGMP levels. Result: Plasma and urinary NO, and urinary cGMP levels were significantly lower in preeclamptics than in the control group (respectively, p < 0.001, p < 0.001, p < 0.01). Plasma ET- 1 levels were significantly higher in the preeclamptics than in the control group (p < 0.001). There were significant negative correlations between plasmaET- 1, plasma NO and urinary NO and cGMP in all groups. There were positive correlations between plasma NO, urinary NO and cGMP in all groups. Conclusion: The imbalance between NO and ET- 1 may play a significant role in the pathophysiology of preeclampsia.
文摘To compare the efficacy and safety of arithmetic and geometric increases in oxytocin infusion dosage during induction of labor. Methods: A total of 120 pregnant women requiring induction of labor at term were randomly assigned to receive oxytocin at dosages increasing arithmetically or geometrically. Maternal demographics, labor delivery data, and newborn outcomes were compared. The setting was the maternity unit of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. Results: The mean maximum rates of oxytocin delivery needed to achieve adequate uterine contractions were similar in the 2 groups (24.66 ± 8.34 mU/min vs 26.38 ± 8.77 mU/min, P = 0.24). Labor duration was significantly shorter in the geometric progression group (496.33 ± 54.77 min vs 421.34 ± 63.91 min, P < 0.001). There were no differences in the rates of cesarean sections, vaginal deliveries, or uterine hyperstimulation, or in neonatal outcomes. Conclusion: A geometric rise in the rate of oxytocin infusion delivery reduced the duration of labor without affecting the rates of cesarean sections and uterine hyperstimulation, or newborn outcomes.
文摘To detect possible changes in main blood vessels within leiomyomas after uterine artery ligation using color Doppler sonography. Method: Blood flow in main leiomyoma blood vessels was measured before and after the procedure in 14 women who also had abnormal uterine bleeding, pelvic pain or pressure, and/or anemia. Results: Of the 14 patients, 13 reported complete disappearance of preoperative pain or pressure and 1 reported significant relief. Within 1 week to 4 months after uterine artery ligation, major blood flow within leiomyomas had significantly decreased in all patients. Eight months after the procedure, 1 of the women became pregnant. Conclusion: Laparoscopic uterine artery ligation via a lateral retroperitoneal technique is a safe and effective treatment for leiomyomas. Color Doppler sonography verified the ability of the procedure to diminish blood flow within leiomyomas in all patients.
文摘To evaluate the use of amniotic membrane grafts in cases of vaginal and cervical agenesis. Methods: Five girls with complete cervical and vaginal agenesis underwent cervicoplasty and vaginoplasty using amniotic membrane grafts. Result: Excellent epithelization and patency of cervix and vagina was achieved in all cases. Conclusion: Amniotic membrane may be used as an allograft in cervical reconstruction. It is inexpensive, readily available, of low antigenicity and does not necessitate repeated cervical dilatation. The performance of the reconstructed cervix during labor is yet to be observed. To the author’ s knowledge, this is the first series reported in the literature in which amniotic membrane was used for cervical reconstruction.
