A study of smoking and pregnancy with special references to fetal growth.
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Adult↗
Biomedical subjects
S Kullander
Publications and source records attributed to S Kullander.
Antineoplastic-drug effect evaluated with a new X-ray stereophotographic measurement of the tumour volume.
A method for determination and follow up of the size of inoperable intraabdominal tumours has been devised. At laparotomy, tantalum balls are deposited into the capsule of the tumour. An X-ray stereophotogrammetric method determines their position, which define a polyhedron whose volume can be computer calculated. The value of the method was proved in four patients with inoperable ovarian carcinoma, which provides a simple way for the continuous follow up of the effect of antineoplastic therapy in advanced malignant tumours.
Abdominal Neoplasms↗
Intrauterine breathing movements and fetal presentation.
Fetal breathing movements in 14 twin pregnancies were examined with ultrasonic technique. The twin fetuses I in cephalic presentation showed a significantly higher percentage of apnea and periodic breathing compared with twin fetuses II. No such difference was found in twin pairs with Twin ti in breech presentation. Also in the control group of 27 singleton pregnancies, the fetuses in cephalic presentation had a higher incidence of apnea and periodic breathing than those in breech presentation. The position of the fetus seems to be decisive for the character of the breathing movements before birth.
Female↗
Coagulative and fibrinolytic studies on postmenopausal women treated with a new non-steroidal oestrogen.
Treatment of postmenopausal women with a non-steroid oestrogen (P1496) in a dose of 50 mg a day for 2 ,days before operation for prolapse did not suppress the histochemically determined fibrinolytic activator content of the vessel wall. Neither was any change found in the concentration of P&P-complex (prothrombin, factor VII, factor X), factor VIII, antithrombin III, alpha1-antitrypsin, alpha2-macroglobulin or the inhibitors of urokinase induced plasminogen activation. Nothing suggested a thrombogenic effect of this non-steroidal oestrogenic compound.
Aged↗
Fever and parturition. An experimental study in rabbits.
The hyperthermic effect of purified lipopolysaccharides (Pyrexal, Wander) was tested and analyzed in pregnant rabbits. The fever produced premature deliveries - probably caused by oxytocin, released from the posterior pituitary - in 50% of 40 tested rabbits on the 31st day of gestation. Injections of Syntocinon had a roughly equally strong effect. In control animals injection of saline did not accelerate delivery. The offspring of several animals, in which hyperthermia had been induced, were born dead. Fever during pregnancy thus can result in premature delivery and in injury to the fetus. Fever and febrile conditions occurring during pregnancy should therefore be treated as promptly and as effectively as possible.
Animals↗
Hormonal screening for twin pregnancies.
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Evaluation Studies as Topic↗
Ultrasound and human-placental-lactogen screening early detection of twin pregnancies.
In the past five years gradual introduction of ultrasonic screening of pregnant women increased the ante-partum detection of multiple pregnancy from 60% in 1971 to 95% in the first half of 1975. At the same time the average gestational age for dection of multiple pregnancies diminished from thirty-three to twenty-five weeks. The corresponding figures for 1963 were 32% and thirty-six weeks. Plasma human-placental-lactogen concentrations were assessed for their value in selecting a smaller target group for subsequent ultrasonic screening. All but 2 of 39 twin pregnancies examined by single H.P.L. determinations had H.P.L. values more than 1 S.D. above the mean of the normal distribution. The use of plasma-H.P.L. screening might lower the proportion of patients requiring ultrasonography for antepartum diagnosis of multiple pregnancies to 16% of the total pregnant population.
Evaluation Studies as Topic↗
A prospective study of drugs and pregnancy. I. Psychopharmaca.
A prospective study has been performed on the use of psychopharmaca during 6 376 pregnancies and its correlation to certain socio-medical variables and pregnancy outcome. An association between drug use and later miscarriage or legal abortion was demonstrated and is conceivably due to an increased use of such drugs in unwanted pregnancies. No indication of an association between drug use and birth of a dead or defective infant was found. Pregnancies where psychopharmaca were used during the first trimester had, on average, a longer duration than pregnancies where such drugs were not used, but birth weight of full-term infants was not affected.
Abnormalities, Drug-Induced↗
On radiation-decreased fibrinolytic activity of vessel walls.
Fibrinolytic activity was histochemically determined in biopsy specimens of the walls of human veins (vv. epigastricae superficiales) obtained from 15 patients after irradiation of the lower abdomen because of malignant genital diseases and compared with non-irradiated controls. The activity was significantly lower (p less than 0.001) after radiotherapy.
Female↗
A prospective study of drugs and pregnancy. II. Anti-emetic drugs.
In a prospective study of anti-emetic drug use during 6 376 pregnancies, the previously demonstrated negative correlation between the use of such drugs and miscarriage was confirmed. It is probably completely due to less frequent and possibly less severe morning sickness complaints in pregnancies ending with a miscarriage. A slight positive correlation is found between the use of anti-emetics and infant malformation. A detailed analysis showed that this was mainly due to a high incidence of drug use (mainly promethazine) among women giving birth to infants with congenital dislocation of the hip. The probable indirect relationship is discussed.
Abnormalities, Drug-Induced↗
A prospective study of drugs and pregnancy. 3. Hormones.
Results froma prospective study in Malmö performed in 1963-65 are used to discuss the possible role of hormonal drugs in human fetal maldevelopment. Appr. 2 per cent of all women had a child born were treated with gestagens during early pregnancy and slightly more had used Primodos as a pregnancy test. No harmful effect on embryonic development can be demonstrated.
Abnormalities, Drug-Induced↗
A prospective study of drugs and pregnancy. 4. Miscellaneous drugs.
The results are presented of a prospective study on drug use during pregnancy involving antibiotics, analgesic drugs and iron and vitamin preparations. The study was conducted in Malmö between 1963 and 1965. No unfavourable effect of the use of antibiotics, mainly penicillin and sulphonamides, could be demonstrated. Among 15 women who had an infant with hypospadias, three had used penicillin during the first trimester, but this may well be coincidental. Analgesic drug use shows a variability which resembles that previously described for psychopharmaca. No effect on the malformation rate or infant survival could be found. A possible lengthening of the mean duration of pregnancy occurred after the use of analgesic drugs during the 2nd or 3rd trimesters. Women who are going to have a dead or malformed infant use iron and/or vitamin preparations less often during late pregnancy than women who prove to have a normal infant. When such drugs were used, the percentage of pregnancies ending in birth before the 38th week is reduced, and the birth weight among term babies is higher. The associations between pregnancy outcome and the use of iron and vitamin preparations is probably indirect, due to social factors associated with drug use.
Abnormalities, Drug-Induced↗
Exposure to drugs and other possibly harmful factors during the first trimester of pregnancy. Comparison of two prospective studies performed in Sweden 10 years apart.
474 women in mid-pregnancy, interviewed at ten different hospitals in Sweden, were questioned on a number of social and medical items: e.g., drug use, contraceptive technique used before pregnancy, exposure to possibly deleterious factors in the environment. The study, compared with a similar study made ten years earlier in Sweden, showed little or no difference in the use of iron and/or vitamin preparations, analgesic drugs, antibiotics, or endocrine drugs; but a drastic reduction is noted in the use of psychotropic drugs and of antihistaminic drugs. A marked decrease in frequency of first trimester X-ray exposures can be found, but no marked changes in smoking habits. Appr. 18% of the women used contraceptive pills within 6 months of becoming pregnant---3 had used them during early pregnancy. About 4% (18 women) had used IUD---one became pregnant with a Cu-UID (intra-uterine device inpregnated with copper).This type of study can provide some information on the prevalence of relatively common factors, but it must be considerably extended in order to permit an analysis of rare events, e.g., use of most drugs.
Abnormalities, Drug-Induced↗
Effect of cortisone and acth on the phospholipids of human amniotic fluid and lung tissue in early gestation.
Fifteen physically healthy women who received permission for legal abortion on sociomedical grounds in the second trimester of pregnancy were given either cortisone acetate per os or adrenocorticotrophic hormone (ACTH) intramuscularyly for 3 days previous to hysterotomy. Eight other patients served as controls. The phospholipid composition of amniotic fluid, fetal lung washings, and lung tissue was analyzed. In the cortisone group there was a significant increase in the proportion of palmitic acid in the lung tissue lecithins linked to a corresponding decrease in the oleic acid. A similar tendency was observed in the ACTH group, but the changes were not significant. The investigation suggests that the human fetal lung already at this early stage of development is capable of responding to the action of cortisone by a relative increase in the synthesis of dipalmitoyllecithin.
Adrenocorticotropic Hormone↗
On some late effects of early bilateral oophorectomy in women.
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Adult↗
Effect of 2 br-alpha-ergocryptin (CB 154) on serum prolactin and the clinical picture in a case of progressive gigantomastia in pregnancy.
A 24 year old woman who had epilepsy since the age of 7 years and who was still using antiepileptics, developed an excessive mamary growth (gigantomastia) during pregnancy. Treatment with CB 154 (Sandoz), 2 Br-alpha-ergocryptin in a dose of 2.5 mg three times a day from the 27th week of pregnancy, resulted in prompt improvement with a corresponding decrease in the plasma prolactin, return of the breast temperature to normal, and disappearance of the EEG-abnormalities. After parturition and subsequent mammoplasty the woman soon became pregant again. During this pregnancy, which terminated in the birth of a normal child, treatment with CB 154 was started early and continued throughout pregnancy with success and without side effects.
Adult↗
Letter: Human placental lactogen in screening for multiple pregnancies.
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Female↗
On some late effects of bilateral oophorectomy in the age range 15-30 years.
Between 1910 and 1940, 146 young females, aged 15-30 years, underwent bilateral salpingo-oophorectomy as part of a radical operation for salpingo-oophoritis. These women or their records were reviewed in 1971. 42 women had died in the meantime. More than half (22) of them had died from cardiovascular diseases, 5 from carcinoma of the uterus and 4 had committed suicide. None had died from carcinoma of the breast. Of 68 who were still alive, information by questionnaire was obtained and 32 were admitted to hospital for extensive examination. 32 age-matched women to be operated on for prolapse but with no other known disease of the reproductive tract served as controls. A further control group was added as 11 of the 68 were found to have menstruated again after the operation which had evidently not completely removed the gonads. Complete oophorectomy was found to have been followed by: (a) an increased incidence of cardiac symptoms and nervous diseases as well as an increased use of drugs; (b) a significant increase in the frequency of coronary vascular diseases in ages up to 70 years; (c) an increase in the serum cholesterol and triglycerides, most significantly in the ages below 60-65 years. Women with symptomatic coronary disease had a higher serum cholesterol level than women without and women with signs of peripheral vascular diseases had a significantly higher concentration of serum triglycerides; (d) an increased frequency of fractures (radius and femoral neck), increased osteoporosis and thinner cortical bone. The brittleness of the skeleton was correlated with low excretion of oestrogens in the urine. No vertebral compression or abnormal decrease in height was observed. (e) an increased adrenocortical activity with significantly increased excretion of 17-ketosteroids, 17-OH-ketosteroids and low polar total oestrogens. This activity abated in women above 65 years. (f) a traumatic psychological experience of the accompanying sterility while sexuality seemed to be largely unaffected in many of them. Almost half of the women examined by the psychiatrist were unusually mentally active and agile and they had a lower excretion of estriol than the rest.
Adolescent↗