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Biomedical subjects

M Mazor

Publications and source records attributed to M Mazor.

At least 37 records · Page 2Linked to original sources
PubMed1991

[Fetal heart rate monitoring in ambulatory and resting mothers].

The nonstress test (NST) to assess fetal wellbeing is done over the course of 30 minutes with the patient lying in the semi-Fowler position. The test relates changes in fetal heart rate to fetal movement, and uterine contractions are also recorded. The purpose of this study was to determine whether the NST is affected by maternal ambulation, so that the patient must be lying down when it is performed. We did the NST during ambulation as well as with the patient reclining. There were no differences in fetal heart rate and/or uterine activity between the 2 tests. 50% of the women preferred the ambulatory method while 25% preferred reclining and 25% expressed no preference. We conclude, that the ambulatory NST is an acceptable alternative to the conventional test with the patient reclining.

Female↗
PubMed1991

Neutrophil attractant/activating peptide-1/interleukin-8 in term and preterm parturition.

The neutrophil is the leukocyte most frequently recruited into the amniotic fluid in cases of microbial invasion of the amniotic cavity. Neutrophil attractant/activating peptide-1/interleukin-8 is a newly identified cytokine that is capable of inducing selective neutrophil chemotaxis and activation. The purpose of this study was to examine the relationship between amniotic fluid concentrations of neutrophil attractant/activating peptide-1/interleukin-8, microbial invasion of the amniotic cavity, and parturition (term and preterm). Amniotic fluid neutrophil attractant/activating peptide-1/interleukin-8 was measured with an immunoassay validated for human amniotic fluid (sensitivity 0.3 ng/ml). Fluid was obtained from women in the following groups: midtrimester (n = 38), term not in labor (n = 38), term in active labor (n = 67), and preterm labor with intact membranes (n = 62). Fluid was cultured for aerobic and anaerobic bacterial and Mycoplasma. Sterile amniotic fluid from most women in the midtrimester of pregnancy and women at term not in labor did not contain immunoreactive neutrophil attractant/activating peptide-1/interleukin-8. Microbial invasion of the amniotic cavity was associated with increased concentrations of neutrophil attractant/activating peptide-1/interleukin-8. The amniotic fluid of women with preterm labor and sterile amniotic fluid who had preterm delivery contained higher neutrophil attractant/activating peptide-1/interleukin-8 levels than did the amniotic fluid of women who responded to tocolysis and had delivery at term. Term parturition is associated with increased concentrations of neutrophil attractant/activating peptide-1/interleukin-8 in the amniotic fluid. We conclude that neutrophil attractant/activating peptide-1/interleukin-8 is part of the host response to microbial invasion of the amniotic cavity and that increased amniotic fluid availability of this cytokine occurs in term and preterm parturition.

Adult↗
PubMed1991

Amniotic fluid white blood cell count: a rapid and simple test to diagnose microbial invasion of the amniotic cavity and predict preterm delivery.

The purpose of this study was to determine the value of amniotic fluid white blood cell count in the diagnosis of microbial invasion of the amniotic cavity. Amniotic fluid was retrieved by amniocentesis from 195 patients with preterm labor and intact membranes. Fluid was cultured for aerobic and anaerobic bacteria, as well as for mycoplasmas. The prevalence of a positive amniotic fluid culture was 12.8% (25/195). Patients with a positive amniotic fluid culture had a significantly higher median amniotic fluid white blood cell count than did patients with a negative amniotic fluid culture (median, 6 cells/mm3; range, 0 to 11,000 cells/mm3 vs median, 320 cells/mm3; range, 1 to 4480 cells/mm3; p less than 0.0001). An amniotic fluid white blood cell count greater than or equal to 50 cells/mm3 had a sensitivity of 80% (20/25), a specificity of 87.64% (149/170), a positive predictive value of 48.78% (20/41), and a negative predictive value of 96.75% (149/154) in the detection of a positive amniotic fluid culture for microorganisms. Although the sensitivity of an amniotic fluid white blood cell count (greater than or equal to 50 cells/mm3) in the detection of microbial invasion of the amniotic cavity was greater than that of the Gram stain of amniotic fluid (80% [20/25] vs 48% [12/25]; p less than 0.05), the specificity was lower (87.64% [149/170] vs 98.8% [168/170]; p less than 0.05). However, 88% (15/17) of all patients with an amniotic fluid white blood cell count greater than or equal to 50 cells/mm3 and a negative amniotic fluid culture had a spontaneous preterm delivery. We conclude that the amniotic fluid white blood cell count is a sensitive, simple, and inexpensive test for the detection of microbial invasion of the amniotic cavity. An elevated amniotic fluid white blood cell count is a risk factor for preterm delivery.

Adult↗
PubMed1991

Systemic administration of interleukin-1 induces preterm parturition in mice.

Interleukin-1 has been postulated as a signal for the initiation of preterm labor and delivery. Interleukin-1 is produced by human decidua, stimulates prostaglandin production by intrauterine tissues, and is present in the amniotic fluid of women with preterm labor and intraamniotic infection. The purpose of these studies was to determine whether interleukin-1 could induce parturition in an animal species. Timed-pregnant C3H/HeJ inbred mice (n = 24) (genetically endotoxin resistant) were randomized to receive either recombinant human interleukin-1 or sterile phosphate-buffered saline solution between days 15 and 17 of gestation (normal length of pregnancy, 20 to 21 days). Three consecutive subcutaneous injections of interleukin-1 or phosphate-buffered saline solution were administered within 6 hours. Examinations of the animals were performed by blinded observers. Parturition occurred within 24 hours in all of the interleukin-1-treated mice and in none of the control group. Vaginal bleeding was first noted 4 hours after the first interleukin-1 injection, and delivery began within 12 hours after the last interleukin-1 injection. Premature delivery occurred in all interleukin-1-injected mice. Laparotomy revealed that there were no remaining fetuses in utero. All mice in the control group delivered spontaneously between days 20 and 22. We conclude that systemic administration of interleukin-1 induces preterm labor and delivery in mice.

Animals↗
PubMed1991

Meconium-stained amniotic fluid: a risk factor for microbial invasion of the amniotic cavity.

The purpose of this study was to determine whether meconium-stained amniotic fluid is a marker for microbial invasion of the amniotic cavity. Amniocentesis was performed on 707 patients presenting with preterm labor and intact membranes. Meconium-stained amniotic fluid was present in 4.2% (30/707) of patients with preterm labor. The prevalence of positive amniotic fluid cultures was significantly higher in women with meconium-stained amniotic fluid than in women with clear fluid (33% [10/30] vs 11% [75/677]; p = 0.001; odds ratio = 4.01; 95% confidence interval = 1.6 to 9.4). Patients with meconium-stained amniotic fluid were also more likely to have failed tocolysis and delivered a preterm neonate more frequently than patients with clear fluid (83% [25/30] vs 38% (258/677); p = 0.0001; odds ratio = 8.1; 95% confidence interval = 2.9 to 24.4). We conclude that meconium-stained amniotic fluid is a risk factor for microbial invasion of the amniotic cavity and preterm delivery in women with preterm labor and intact membranes.

Amniotic Fluid↗
PubMed1991

Fibrolamellar carcinoma of the liver in pregnancy. A case report.

Fibrolamellar carcinoma of the liver is a rare tumor that has not been previously reported to occur during pregnancy. A 22-year-old, pregnant Arab woman with documented fibrolamellar carcinoma of the liver was followed at our high-risk pregnancy unit. Despite the severity of the disease, the pregnancy and delivery were uneventful.

Adult↗
PubMed1991

[Leukocyte esterase in the rapid detection of intraamniotic infection].

Several lines of evidence support the view that premature rupture of the membranes and premature labor are associated with bacterial infection of the amniotic cavity. The standard method of diagnosing intraamniotic infection is amniotic fluid culture, but the results become available only after 72 hours. Methods for more rapid diagnosis of bacterial invasion are therefor needed. We examined leukocyte esterase activity for this purpose. Amniotic fluid obtained from 62 women in preterm labor was cultured for aerobic, anaerobic and mycoplasma species. Leukocyte esterase activity was measured with a Bio-dynamics test strip. The sensitivity of the test was 50.0% and its specificity 93.4%. It was found to be a simple and rapid method for the detection of intraamniotic infection.

Amniotic Fluid↗
PubMed1991

Reduced frequency of hypertensive disorders in placenta previa.

The isthmic segment of the uterine artery's ascending branch has a freer course and wider diameter than distal parts of the vessel. Therefore, we assumed that this arterial segment would provide better blood flow and prevent hypoxia of the trophoblast. As a result, placenta previa pregnancies would be complicated by hypertensive disorders less often than are pregnancies with normally implanted placentas. To test this hypothesis, 491 placenta previa pregnancies, among a population of 106,866 pregnant women, were compared with pregnancies with normally implanted placentas. Clinically meaningful and statistically significant reductions in the rates and risks of hypertensive disorders were found in placenta previa pregnancies (P = .002, relative risk = 0.44, 95% confidence interval 0.25-0.78). The differences persisted when primiparous and multiparous women were examined separately and when preterm and term deliveries were separated. In a multivariate logistic regression analysis, patients with placenta previa had a third of the risk for hypertensive disorders compared with pregnant women with normally implanted placentas (relative risk = 0.36, 95% confidence interval 0.20-0.64), even after controlling for parity and preterm or term delivery. In the same model, primiparity and preterm delivery were each associated with a doubling of risk for hypertensive disorders, regardless of the placental implantation site. Thus, regardless of parity and preterm or term delivery, placenta previa and hypertensive disorders are inversely related.

Adult↗
PubMed1991

Management of post-date pregnancy: a case control study.

Post-date pregnancy is associated with higher rates of perinatal mortality and morbidity. The purpose of the present study was to compare the outcome of 200 post-date pregnancies, managed according to our protocol, to a matched control group of 200 healthy pregnant women delivered at term. The management protocol was based mainly on the pelvic score and nonstress test. Higher rates of labor induction, meconium-stained amniotic fluid, fetal distress, instrumental deliveries and cesarean sections were found in post-date pregnancies than in the control group (40% vs. 3% P = 0.0001, 31% vs. 15.5% P = 0.00001, 18.5% vs. 9.5% P = 0.007, 8% vs. 3% P = 0.02, 12.5% vs. 4% P = 0.002 respectively). Neonatal birth weight in the study group was significantly higher than in the control group (3,484.3 +/- 410.7 vs. 3,218.4 +/- 407.8 g P less than 0.001). Despite these differences between the groups, the perinatal morbidity and mortality rates were similar. These results can be partially attributed to the early antenatal monitoring and intensive follow-up.

Apgar Score↗
PubMed1990

Infection and labor. VI. Prevalence, microbiology, and clinical significance of intraamniotic infection in twin gestations with preterm labor.

The purpose of this study was to establish the prevalence, microbiology, and outcome of microbial invasion of the amniotic cavity in twin gestation presenting with preterm labor and intact membranes. Amniocenteses were performed on both sacs of 46 women with twin gestations, preterm labor, and intact membranes. Indigo carmine was injected to ensure sampling of both amniotic sacs. Amniotic fluid was cultured for aerobic and anaerobic bacteria, Mycoplasma hominis, and Ureaplasma urealyticum. A positive amniotic fluid culture of at least one sac was noted in 10.8% (5/46) of patients admitted in preterm labor and in 11.9% (5/42) of women delivered of preterm neonates. Of the five patients with microbial invasion of the amniotic cavity, three had microorganisms isolated from both sacs. The presenting sac was involved in all cases, supporting an ascending route for microbial invasion of the amniotic cavity in twin gestation. Polymicrobial infection was found in three of the eight amniotic sacs with positive cultures. In two cases different organisms were isolated from each sac. All patients with positive amniotic fluid cultures were delivered of preterm infants within 48 hours of amniocentesis. Patients with positive amniotic fluid cultures presented with preterm labor at an earlier gestational age and with more advanced cervical dilatation than did women with negative amniotic fluid cultures. Clinical evidence of chorioamnionitis subsequently developed in two of five women with positive amniotic fluid cultures. The interval between amniocentesis and delivery was shorter in women with positive amniotic fluid cultures than in women with negative amniotic fluid cultures (median: 3.5 vs 168 hours, p less than 0.0001). Infants born to women with microbial invasion of the amniotic cavity had a lower median birth weight and a higher incidence of respiratory distress syndrome than those born to women with negative amniotic fluid cultures (birth weight: 1085 vs 1975 gm, p = 0.024; respiratory distress syndrome: 37.5% vs 8.3%, p = 0.04).

Amniotic Fluid↗
PubMed1990

Preterm delivery: a risk factor for retained placenta.

The purpose of this study was to determine whether preterm delivery, with and without intraamniotic infection, is a risk factor for retained placenta. This complication occurred more frequently in women with preterm vaginal delivery than in women with term vaginal delivery (9.1% [21/231] vs 1.1% [6/561]; p less than 0.00001; odds ratio = 9.25). There was no significant difference in the prevalence of retained placenta between women with preterm labor and intact membranes and those with preterm premature rupture of membranes (8% [10/125] vs 10.4% [11/106]; p greater than or equal to 0.05). A positive amniotic fluid culture or clinical chorioamnionitis was not associated with a higher incidence of retained placenta. This study indicates that preterm delivery is associated with an increased risk of complications of the third stage of labor.

Adult↗
PubMed1990

Amniotic fluid glucose concentration: a rapid and simple method for the detection of intraamniotic infection in preterm labor.

The purpose of this study was to determine whether amniotic fluid glucose concentrations is of value in the rapid diagnosis of intraamniotic infection. Amniocenteses were performed in 168 patients with preterm labor and intact membranes. Amniotic fluid was cultured for aerobic and anaerobic bacteria, as well as Mycoplasma species. The prevalence of positive amniotic fluid cultures was 13.6% (23/168). Patients with positive amniotic fluid cultures for microorganisms had significantly lower median amniotic fluid glucose concentrations than patients with negative amniotic fluid cultures (median 11 mg/dl, range 2 to 30 mg/dl vs median 28 mg/dl, range 3 to 74, respectively; p less than 0.001). Amniotic fluid glucose concentrations below 14 mg/dl had a sensitivity of 86.9% (20/23), a specificity of 91.7% (133/145), a positive predictive value of 62.5% (20/32), and a negative predictive value of 97.8% (133/136) in the detection of a positive amniotic fluid culture. Amniotic fluid glucose determination is a rapid, sensitive, inexpensive, and simple test for the detection of intraamniotic infection in women with preterm labor and intact membranes.

Amniotic Fluid↗
PubMed1990

Amniotic fluid interleukin-1 in spontaneous labor at term.

The regulatory signals responsible for the increased biosynthesis of prostaglandins during parturition have not been established. Interleukin-1 (IL-1) is capable of stimulating prostaglandin production by intrauterine tissues and is an inflammation mediator. It has been postulated as a signal for the onset of labor in the setting of intrauterine infection. A study was designed to determine if spontaneous labor at term was associated with changes in IL-1 activity in amniotic fluid. Such fluid was retrieved from 41 women in labor and from 39 women who were not in labor at term. Immunodetectable IL-1 beta was present in 22 of the 41 women in labor but in only 8 of the 39 women without labor. IL-1-like bioactivity was not different between the two groups at a dilution of 1:4, but at dilutions of 1:12, 1:36 and 1:108, amniotic fluid from women in labor had significantly higher bioactivity than that from women not in labor. A significant correlation was found between the bioassay and immunoassay results. Our data show that inhibitors of IL-1 bioactivity are present in amniotic fluid and suggest that in a subset of laboring women at term, an inflammatory reaction may play a role in triggering the onset of parturition.

Amniotic Fluid↗