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Biomedical subjects

O Karjalainen

Publications and source records attributed to O Karjalainen.

At least 19 recordsLinked to original sources
PubMed1990

Ultrasound screening and perinatal mortality: controlled trial of systematic one-stage screening in pregnancy. The Helsinki Ultrasound Trial.

During a 19-month period, 95% of all pregnant women in the greater Helsinki area, Finland, entered a study to compare one-stage ultrasonography screening with selective screening according to antenatal hospital use, obstetric procedures, and fetal outcomes. Of 9310 women who entered the trial, 4691 were randomly allocated to ultrasound screening between the 16th and 20th gestational weeks and 4619 to follow-up only. Screened and control groups otherwise had the same antenatal care, which included ultrasonography according to usual practice. Screened women made fewer visits to the antenatal outpatient clinic than did women in the control group (2.3 vs 2.6). There were no differences in the number of labour inductions or mean birthweights in the two groups. Perinatal mortality was significantly lower in the screened than in the control group (4.6/1000 vs 9.0/1000); this 49.2% reduction was mainly due to improved early detection of major malformations which led to induced abortion. All twin pregnancies were detected before the 21st gestational week in the screening group compared with 76.3% in the control group; perinatal mortality in the small series of twins was 27.8/1000 vs 65.8/1000, respectively.

Evaluation Studies as Topic↗
PubMed1979

Menstrual regulation as a method for early termination of pregnancy.

116 women with documented or suspected pregnancy underwent an endometrial aspiration for early termination. Their menses delay was between 7 and 22 days. A standard 3 mm Vabra aspirator was used. 90.5% were actually pregnant. The success rate was 97.1%. The total complication rate was 6.8%, the most common complication being endometritis. Three patients required a re-evacuation because of prolonged bleeding. In this series there were two ectopic pregnancies and nine cases of ovum abortivum, of which one later turned out to be a hydatiform mole. The procedure was well tolerated by the patients. No sick-leave was given. The postoperative bleeding averaged 10 days in primigravid and 7 days in parous patients.

Abortion, Induced↗
PubMed1979

Pregnancy outcome after previous induced abortion.

The outcome of pregnancy was studied in 325 patients with an induced abortion in their previous pregnancy, together with 721 control patients. The patients were matched for age, parity and social class. Smoking and unplanned pregnancies were found to be more comon among abortion patients than among the control patients. As regards pregnancy complications, bleeding during pregnancy and placental retention were found to be significantly more common in the index group. No statistical differences were noticed in gestation length, birthweight, rate of spontaneous abortion and perinatal mortality in the pregnancy following induced abortion as compared with control patients.

Abortion, Induced↗
PubMed1978

Prenatal diagnosis of congenital nephrosis in 23 high-risk families.

The efficacy of maternal serum and amniotic fluid alpha-fetoprotein (AFP) estimation for the prenatal detection of congenital nephrosis was assessed in 23 pregnancies of couples with a previously affected child. At 15 to 18 weeks' gestation, amniotic fluid AFP concentration was elevated in seven of 23 cases, and maternal serum AFP level in five of these. Legal abortion was carried out at 18 to 19 weeks in all those cases where he amniotic fluid AFP concentration was abnormally high, and in all cases the fetus was found to be affected. The diagnosis of intrauterine congenital nephrosis was obvious by electron microscopic examination of the fetal kidney, but not by light microscopy. The child was born without congenital nephrosis in all 16 cases where amniotic fluid AFP level was normal, and in 16 of 18 cases (89%) where maternal serum AFP concentration was normal. Thus, the amniotic fluid AFP assay is more reliable and is recommended whenever congenital nephrosis is suspected on the basis of family history.

Abortion, Legal↗
PubMed1977

The effect of synthetic gestagens on progesterone formation in vitro in human placenta of early pregnancy.

Villous tissue from 26 placentae of 7-17 weeks was incubated with radioactive pregnenolone alone and with pregnenolone in the presence of progesterone and 9 synthetic gestagenic steroids and the progesterone formation was measured after 30 min. When progesterone was present in a concentration of 31 or 310 mumol/1 the conversion rate of labelled pregnenolone to progesterone was reduced to 88.6 and 82.2% of that of the respective control incubations. Dydrogesterone, allyloestrenol, lynoestrenol and norethynodrel under similar conditions did not inhibit the formation of progesterone. The inhibitory effects of megoestrol acetate, medroxyprogesterone acetate and norgestrel were close to that of progesterone. Norethisterone and methyloestrenolone were the most effective inhibitors of progesterone formation: when incubated in an equimolar concentration (35 mumol/1) with pregnenolone (50 microgram) the progesterone formation was reduced to 60.0-62.7% and 29.1-34.0% respectively of that of the respective control experiments.

Allylestrenol↗
PubMed1976

Congenital nephrotic syndrome: prenatal diagnosis and genetic counselling by estimation of aminotic-fluid and maternal serum alpha-fetoprotein.

Nine families in which a previous child had had congenital nephrotic syndrome (C.N.) sought genetic counselling and possible antenatal diagnosis of fetal disease. Maternal serum and amniotic-fluid alpha-fetoprotein (A.F.P.) assays were carried out between the 15th and 20th weeks of subsequent pregnancies. Seven women in whom A.F.P. concentrations were normal chose to continue pregnancy, and they were all delivered of a healthy child. Markedly raised amniotic A.F.P. concentrations were found in two cases; in one of these cases maternal serum-A.F.P. was also raised. These pregnancies were terminated, and electron microscopy of the fetal kidneys showed evidence of C.N. in the fetus--i.e., loss of foot processes and an increase in the mesangial matrix of the glomeruli. The outcomes of these at-risk pregnancies indicate that prenatal diagnosis and genetic counselling are possible in families with a history of C.N. The results also stress the importance of carefully examining fetal kidneys whenever amniotic-fluid A.F.P. concentration is raised in the absence of apparent malformations.

Amniotic Fluid↗
PubMed1975

Prenatal diagnosis and fetal pathology of I-cell disease (mucolipidosis type II).

Increased activity of several lysosomal hydrolases was demonstrated in amniotic fluid from a fifteenth week pregnancy in which the fetus had I-cell disease. Cultured cells from amniotic fluid had a decreased activity of the same enzymes. The diagnosis of I-cell disease was later confirmed by enzyme assays in cell cultures of fetal skin and by morphologic studies of several tissues from the aborted fetus. Electron microscopic studies of the fetal tissues and cultured fibroblasts had large numbers of typical inclusions of I-cell disease, thus substantiating the diagnosis and intrauterine manifestation of the disease. The results indicate that prenatal diagnosis of I-cell disease is possible with enzyme assays of amniotic fluid and in cultures of fetal cells from the fluid. Enzyme studies of amniotic fluid can provide a preliminary diagnosis within a few hours, but it is suggested that the definitive diagnosis should be based on assays in cultured cells from amniotic fluid.

Acetylglucosaminidase↗
PubMed1975

Urinary oestriol and serum activities of human placental lactogen and heat stable alkaline phosphatase as indicators of fetoplacental function.

The accuracy of urinary oestriol and serum levels of human placental lactogen (HPL) and heat stable alkaline phosphatase (HSAP) as indicators of feto-placental function was studied in 76 patients with high risk pregnancy. Feto-placental dysfunction was predicted correctly by plasma HPL in 80%, by urinary oestriol in 70%, by serum HSAP in 47%, and by the complementary use of HPL and oestriol in 90% of the cases. Normal fetoplacental function was predicted correctly by plasma HPL in 94%, by urinary oestriol in 96%, by serum HSAP in 80%, and by the complementary use of oestril and HPL in 100% of the patients. The probability of feto-placental dysfunction with a pathological value was 88% with urinary oestriol, 84% with plasma HPL and 100% with the parallel use of oestriol and HPL. A normal value assured undisturbed feto-placental function in 89% with urinary oestriol, in 92% with plasma HPL and in 96% with the parallel use of oestriol and HPL.

Alkaline Phosphatase↗
PubMed1975

Intrauterine diagnosis of chromosome anomalies.

Prenatal karyotype analysis was performed on cultured fetal cells obtained by transabdominal amniocentesis at the 15th and 20th week of pregnancy in 63 high risk pregnancies. The reason was advanced maternal age in 42 cases, a previous child with a chromosome anomaly in 13 cases, and parental balanced chromosome translocation in 7 cases. One mother was a haemophilia A carrier. Two mothers over 40 were found to be carrying a 21-trisomic fetus. In the group of parental balanced translocation one fetus showed an unbalanced translocation karyotype, two were karyotypically normal and four exhibited a balanced translocation identical with that of the parents. A therapeutic abortion was performed in the case of the unbalanced translocation, the two trisomic fetuses, and a male fetus of the haemophilia A carrier mother. After the abortion the prenatal chromosome findings were confirmed by cell cultures from fetal tissues. No immediate complications due to the amniocentesis were recorded, but two term fetuses died antenatally, one child was delivered prematurely, and one pregnancy terminated spontaneously foru weeks after the amniocentesis. Any casual relationship to the puncture was unlikely in these cases. All other pregnancies had a normal course and the outcome was in agreement with the prenatal studies. Although indications for prenatal karyotype analyses are evident in pregnancies at risk due to parental balanced translocation karyotype and advanced maternal age, the need for large-scale screening programmes is questionable, because the decision should be in the hands of the parents.

Amniocentesis↗