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Biomedical subjects

A Kivikoski

Publications and source records attributed to A Kivikoski.

At least 19 recordsLinked to original sources
PubMed1984

Norethisterone acetate and ethinylestradiol in early human pregnancy.

In a double-blind randomized trial, 25 women (8-9 weeks pregnant) received 20 mg norethisterone acetate (NET-AC) and 0.04 mg ethinylestradiol (EE2), 25 women receiving placebo. The patients were followed by ultrasound and the products at curettage studied macroscopically and microscopically. In an open trial, ten patients (5-9 weeks pregnant) received NET-AC + EE2, 11 serving as controls. The concentrations of plasma progesterone, estradiol-17 beta, 17 alpha-hydroxyprogesterone, norethisterone, and FSH were followed. The frequency of intrauterine hemorrhage in early pregnancy was not affected by NET-AC + EE2. Ultrasound was not reliable when studying the occurrence of decidual hemorrhages during early pregnancy. The pharmacokinetics and bioavailability of NET remain unchanged during early pregnancy. The treatment with NET-AC + EE2 had no effect on the heights and the time courses of the mean plasma values of progesterone, estradiol-17 beta, 17 alpha-hydroxyprogesterone, and FSH. No differences were found between treated and nontreated patients in the pathology of the placenta or decidua as determined by both macroscopic and microscopic examinations. The hypothesis of Papp and Gardo, that decidual hemorrhages may be induced in early pregnancy as a consequence of a "withdrawal effect" of hormonal pregnancy tests, is not supported by the results of this investigation.

17-alpha-Hydroxyprogesterone↗
PubMed1984

Problems and benefits in early diagnosis of ectopic pregnancy.

A 5-yr retrospective study is presented of 168 consecutive patients operated on for ectopic pregnancy during 1977-1981, showing the prevalent features and trends of this disorder and its diagnosis. The overall incidence was 1.48% of deliveries, with a range of 1.00-2.34%. The number of unruptured cases (52.1%) in the series reflects the low gestational age. Some of the problems (and benefits) commonly associated with early diagnosis are surveyed. The presenting symptoms at arrival are compared between patients with an IUD in situ (33.3%) and those without, and between patients with a delay in diagnosis (47.6%) and those without. The use and the results of the diagnostic procedures are also compared between the latter two groups. An absence of clear amenorrhoea was significantly more common (P less than 0.005) in IUD-users than in non-users. Spotting was almost significantly more common (P less than 0.025) among patients with a delayed diagnosis than in those who underwent an operation on the first day seen. It is shown that patients whose diagnosis was delayed had had significantly more often either curettage (P less than 0.001) or an ultrasound examination which (in spite of a positive pregnancy test) did not show an intrauterine pregnancy (P less than 0.005) than those whose diagnosis was not delayed. It is emphasized that the physician should be on the alert in excluding the possibility of ectopic pregnancy in IUD patients and suspected spontaneous and threatened abortions, especially. In such cases an active laparoscopy is again recommended.

Abortion, Threatened↗
PubMed1983

The incompetent cervix during pregnancy diagnosed by ultrasound.

Ninety-one pregnant patients in mid-trimester were examined for suspected cervical incompetence using ultrasound. This diagnosis means that detached membranes at the internal os are bulging into a dilated cervical canal. In 13 cases cervical dilatation was found. These patients were operated on using McDonald's purse-string suture. Only one of these patients had premature rupture of the membranes and was delivered at 35 weeks. In all other operated cases the pregnancy continued beyond 37 weeks. Ultrasound is an objective method of diagnosing incompetence of the cervix in pregnancy.

Female↗
PubMed1982

"Menstrual induction" with Sulproston.

The PGE2-analogue Sulproston (16-phenoxy-omega-17,18,19,20-tetranor-PGE2-mythylsulfonylamide) was administered to 200 medically and gynecologically normal women who were 17 +/- 0.4 days beyond their expected menstrual period and who had a positive pregnancy test. The intramuscular impact dose (500 micrograms repeated after 4 hours) caused an immediate tonic uterine contraction which compromised the estradiol 17 beta, progesterone and chorionic gonadotropin production within the fetoplacental unit, and thereby allowed the evolution of cyclic uterine activity, cervical dilatation and tissue expulsion. Pregnancy termination was complete in 92% of women, 5.5% required surgical curettage and 2.5% were given a second Sulproston treatment 2-3 weeks after the first to remove retained tissue from the uterus. The medical induction of menstruation was preferred by 83% of the women who had previously experienced surgical termination of pregnancy. Normal menstruation resumed in all women after 36 +/- 0.9 days. The majority of 42 women questioned found Sulproston a satisfactory, safe, simple and effective drug regimen for "menstrual induction".

Abortifacient Agents, Nonsteroidal↗
PubMed1975

The effect of systematic treatment of toxaemia of pregnancy upon fetal prognosis.

Systematic therapy for pre-eclampsia including diuretics was investigated in 604 patients in whom therapy was begun immediately the first symptoms appeared and continued until delivery. The control group consisted of 368 patients with toxemia from the two previous years who received no systematic therapy but who also underwent delivery at either the Turku City Maternity Hospital or the Women's Clinic of Turku University Central Hospital. Cases of pre-eclampsia gravis were significantly reduced (2.3 as compared with 7.3%). A significant difference was seen in the percentage of premature deliveries. In the experimental group this was 4.3% and in the control group 11.2%, (p less than 0.001). There was also a significant difference in the perinatal mortality, the values being 2.3 and 4.6%, respectively (p less than 0.05). The overal premature birth rate during these two periods remained unchanged, at 5.5 and 5.7%. The difference between the overall perinatal mortality rates was also slight (1.8 and 2.2%).

Acetazolamide↗