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Biomedical subjects

M Yemini

Publications and source records attributed to M Yemini.

23 records · Page 2Linked to original sources

Treatment of premature labor contractions with combined ritodrine and indomethacine.

The results of combined ritodrine and indomethacine treatment (RI) in premature labor contractions were compared with ritodrine alone (R). One hundred and twenty patients with threatened premature labor in weeks 26-34 were studied. Sixty RI women received 100 mg ritodrine in infusion followed by 60 mg daily orally until 35 weeks and indomethacine 200 mg on the first day of treatment only. The R group included 60 women with identical tocolysis indices, age of pregnancy and anamnestic parameters who received ritodrine only. The mean prolongation index (PI) was 18.2 in the RI group, against 11.5 in the R patients (P less than 0.05). The mean prolongation of pregnancy was 5.6 weeks in the first and 3.6 in the control group (P less than 0.05). Birthweight and Apgar scores were similar in the two groups. In order to examine the possible early closure of the ductus arteriosus due to the indomethacin therapy, echocardiograms were done on all newborn in the RI group: the pre-ejection period and right ventricular ejection time ratio was 0.19-0.26 after delivery and 0.17-0.22 1 month later, which excludes pulmonary diastolic hypertension due to premature closure of the duct. The combined RI treatment is more effective that R alone and does not give rise to any complications in the mother or the fetus.

Adolescent↗

Non-aggressive management of post-date pregnancies.

A non-aggressive approach to the management of post-date pregnancies was tested in a clinical trial involving 156 patients who had reached 294 days of amenorrhea and had a pelvic score of 4 or less. Dates had been established with certainty in each case. In half of the patients (the study group) no time limit was imposed on the pregnancy, but the women were checked at frequent intervals for any increase in pelvic score and for changes in any of the following: fetal movement count recorded daily by the mother, an oxytocin challenge test, and amnioscopy. The pregnancy ended either through spontaneous contractions or through surgical induction carried out because of a change in any one of the parameters or an increase above 4 in the pelvic score. In the 78 control patients labor was induced surgically on day 294, even if the pelvic score was low. In the study group, labor started spontaneously in 52 patients; labor was induced in 17 women after they showed an elevated pelvic score, in 7 because of a pathologic parameter and in one because a mild pre-eclampsia developed. There were 7 cesarean sections in the study group compared with 16 in the control group (P less than 0.05). The average duration of labor was 6.7 h in the study group, compared with 9.4 h in the control (P less than 0.01). There was no significant difference between the two groups with regard to meconium staining during labor, pathologic fetal heart rate, or the 5 min Apgar score. In the study group there was one neonatal death as a result of severe congenital heart disease, and in the control group one infant died due to asphyxia. It is concluded that conservative management of prolonged pregnancies, with close supervision, gives better results than routine induction of labor at 42 wk. The importance of the pelvic score as an indication for induction is stressed. A protocol has been developed which can be used in cases of uncertain dates as well.

Clinical Trials as Topic↗

Incidence of autoimmune antibodies in failed embryo transfer cycles.

PROBLEM: The presence of antiphospholipid antibodies lupus anticoagulant (LAC), anticardiolipin antibody (ACA) as well as antinuclear antibody (ANA) has been associated with early spontaneous pregnancy loss and adverse pregnancy outcome. The purpose of this study was to investigate the possible role of autoimmune antibodies (LAC, ACA, and ANA) as a cause of implantation failure following embryo transfer (ET) after in vitro fertilization (IVF). METHOD: Three groups were studied: Group I, 56 patients who failed to conceive following ET; group II, 14 patients who have conceived following IVF-ET and delivered or are carrying an uncomplicated ongoing pregnancy; and group III, 69 patients who were new candidates for IVF-ET. RESULTS: Eighteen out of 56 (32.1%) of patients who failed to conceive following previous IVF-ET cycle (group I) tested positive for one or more of the autoimmune antibodies. None of the 14 patients of group II tested positive for autoimmune antibodies (P < .02). Seven out of the 69 patients (10%) of group III were found positive to one or more of the autoimmune factor. This rate is significantly lower than the rate of positive autoimmune antibodies detected in group I (P < .003). Fifteen patients of the 18 who tested positive for autoimmune antibodies and who had previously failed to conceive following ET underwent a subsequent IVF-ET cycle while being treated with prednisone and aspirin. Seven out of the 15 (46.6%) conceived and were able to sustain a clinical ongoing pregnancy. CONCLUSIONS: Patients receiving ET are carrying viable embryos within the intrauterine environment. Therefore, in this unique group of patients, failure to demonstrate a positive pregnancy test represents an implantation failure or a very early postimplantation loss. The results of this study suggest that periimplantation events may be affected by autoimmune antibodies. Very early miscarriage or implantation failure may be related to the same pathophysiological mechanism that causes recurrent miscarriages and is diagnosed incorrectly as infertility.

Adult↗

Effectiveness of silicone sheeting in preventing the formation of pelvic adhesions.

The uterine horns of 35 female rabbits were subjected to injury by cautery. Ten days later the adhesions were scored and lysed, and in 30 animals the lesion on one side was covered with a segment of silicone. The contralateral uterine horn served as an internal control. After 5, 10, or 15 days, the silicone was removed (groups A, B, and C, respectively). Five animals (group D) in which no silicone barrier was introduced served as an external control. The rabbits were killed ten days later, and the pelvic adhesions were scored again. A significant reduction in adhesion formation following lysis was found in groups A, B, and C. The largest difference between the treated and the untreated side was obtained in group A. In each of these groups, the mean adhesions score on the treated side was significantly lower following lysis than in group D.

Adnexal Diseases↗

Prolonged survival of allogeneic mouse skin grafts following preservation.

Skin of C57BL mice was preserved in skin-graft fluid at 4 C for six weeks. The mean survival time of such skin grafted to BALB/c mice was 17.1 +/- 0.29 (SD) days. Control grafts transplanted immediately after removal from animals had a mean survival time of 11.5 +/- 0.32 days, whereas in a second control group, transplanted with C57BL skin preserved up to two weeks in serum-free medium, rejection occurred after 10.9 +/- 0.16 days. Some hypotheses on the mechanism of such graft prolongation are discussed.

Animals↗