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Biomedical subjects

W Chaim

Publications and source records attributed to W Chaim.

At least 37 records · Page 2Linked to original sources
PubMed1996

Maternal plasma and amniotic fluid cortisol and progesterone concentrations between women with and without term labor. A comparison.

OBJECTIVE: The purpose of the present study was to determine the amniotic fluid and maternal plasma concentrations of cortisol and progesterone in nonlaboring women at term and to compare them to those in women with active labor at term. STUDY DESIGN: A prospective, cross-sectional study. Soroka Medical Center of Kupat Holim, Faculty of Health Sciences, Ben-Gurion University of the Negro, Beer-Sheva, Israel. Thirty-five healthy women with normal term pregnancies were classified according to labor status into two groups: group A (16 women with spontaneous, active labor at term) and group B (19 women not in labor). RESULTS: We found a significant increase in the median concentration of plasma cortisol in women at term in active labor in comparison to those not in labor. In addition, the median concentration of cortisol in amniotic fluid in women in labor was also significantly higher than that in women not in labor. In contrast, no significant changes in median maternal plasma or amniotic fluid progesterone concentrations were detected between the groups. CONCLUSION: Human parturition is associated with a significant increase in the concentration of cortisol in both maternal plasma and amniotic fluid. These findings suggest that cortisol plays an important but still-undetermined role in human parturition.

Adult↗
PubMed1995

Breech presentation and cesarean section in term nulliparous women.

OBJECTIVE: To examine pregnancy outcome in nulliparous women with single term breech presentation. METHODS: Two departments of Obstetrics and Gynecology at the same hospital used different approaches to deliver nulliparous women with singleton breech presentation at term. One department (A) delivered by trial of labor and the other (B) delivered by elective cesarean section. Prospectively and blinded to obstetric condition, parturients were assigned to either department in a systematic alternate fashion. The study period covered 8 years (1985-1992). The pregnancy outcome parameters examined were: Apgar score, intra- and post-partum death and maternal and neonatal morbidity. Neonatal morbidity was classified in three major categories: non-neurological trauma, neurological signs and respiratory problems. RESULTS: The study included 264 women of whom 135 delivered in department A and 129 in department B. Department A had 35 vaginal and 100 cesarean births and department B 10 vaginal and 119 cesarean births. There was no intra-partum death and the only post-partum death occurred among vaginal deliveries. The Apgar score was significantly worse at 1 and 5 min in vaginally delivered babies of department B. Neonatal morbidity was significantly more frequent after vaginal births (P < 0.01). Maternal morbidity was significantly higher following cesarean sections (P < 0.01). Babies of vaginal deliveries had significantly higher non-neurological trauma (P < 0.01) and pathological neurological signs (P < 0.01) than those delivered by the abdominal route. CONCLUSION: The level of risk for mother and child in the nulliparous with term singleton breech, suggests cesarean section as the preferred route of delivery.

Adult↗
PubMed1995

Intra-uterine infection in women with preterm premature rupture of membranes: maternal and neonatal characteristics.

OBJECTIVE: Our purpose was to determine the prevalence of intra-uterine infection in patients with preterm premature rupture of membranes and to evaluate the clinical characteristics of women and neonates according to the presence or absence of intrauterine infection. STUDY DESIGN: Trans-abdominal amniocentesis was performed in 90 consecutive patients admitted with preterm premature rupture of membranes. Maternal clinical parameters evaluated included maternal age, origin, gravidity, parity, habitual abortion, previous perinatal death, previous preterm birth, urinary tract infection, fetal distress, abruptio placentae, gestational diabetes, admission-delivery interval and cesarean rate. Neonatal clinical parameters evaluated were gestational age at delivery, birth weight, Apgar score, neonatal gender, perinatal death and neonatal sepsis. RESULTS: The prevalence of intra-uterine infection was 66.6% (60/90). No differences between patients with intra-uterine infection and those without intra-uterine infection were observed in maternal age, origin, gravidity, parity, habitual abortion, previous perinatal death, fetal distress, abruptio placentae, gestational diabetes, admission-delivery interval, cesarean section, neonate's gender, Apgar score at 5 min and neonatal sepsis. On the other hand, gestational age at delivery, birth weight and Apgar score at 1 min were significantly different between the groups. CONCLUSION: An intra-uterine infection was found in two thirds of women presenting with preterm premature rupture of membranes. Women presenting with preterm premature rupture of membranes and intra-uterine infection had a lower gestational age at delivery and consequently had a lower neonatal birth weight than those without intra-uterine infection.

Amniotic Fluid↗
PubMed1995

Hypertensive disorders in twin pregnancies.

This study investigates the influence of hypertensive disorders on twin pregnancies for an unselected, population-based series. Between 1986 and 1991, out of a total of 56,381, 766 (1.3%) were twin deliveries at our institution, the only tertiary care hospital serving a population of about 400,000 inhabitants. The incidence of hypertensive disorders was significantly higher in twin gestations than in singleton pregnancies, at 3437/55,615 (6.2%) vs 85/766 (11.1%) (p < 0.001, OR = 1.8, 95% CI = 1.4-2.3). Hypertensive disorders were significantly higher in twin as compared to singleton pregnancies, regardless of parity, and even after adjusting for maternal age. More instrumental or surgical deliveries were needed when pregnancies were complicated by hypertension, in twin as well as singleton gestations. Despite the association between prematurity and hypertensive disorders, and prematurity and perinatal mortality, no significant difference was found in perinatal mortality between hypertensive and normotensive twin pregnancies. The neonatal death-rate in normotensive and hypertensive twin pregnancies (3.7% and 3.5% respectively) was higher than that of stillbirths (respectively 2.3% and 0%).

Delivery, Obstetric↗
PubMed1995

Eradication of viridans streptococci from the amniotic cavity by parenteral antibiotic administration. A case report.

BACKGROUND: A growing body of evidence suggests that infection plays a key role in the pathogenesis of preterm labor and delivery. Recently, localized intrauterine infection was recognized as a major factor in preterm labor. CASE: We report a case of successful eradication of Viridans streptococci from the amniotic cavity in a patient with preterm labor and intact membranes at 30.5 weeks of gestation by parenteral administration of antibiotics. Following this treatment, preterm labor was arrested, and pregnancy prolonged until term delivery. CONCLUSION: Parenteral antibiotic treatment may be seriously considered for select patients presenting with preterm labor associated with microbial invasion of the amniotic cavity.

Adult↗
PubMed1994

Eradication of Viridans streptococci from the amniotic cavity with transplacental antibiotic treatment.

We report a case of eradication of Viridans streptococci from the amniotic cavity in a patient with preterm labor and intact membranes by transplacental antibiotic treatment. Following this modality of treatment, preterm labor was arrested and the pregnancy continued uneventfully until normal term delivery. We suggest that transplacental antibiotic treatment should be seriously considered as part of the medical armamentarium for treatment of patients with preterm labor and microbial invasion of the amniotic cavity.

Administration, Oral↗
PubMed1994

Human preterm birth is associated with systemic and local changes in progesterone/17 beta-estradiol ratios.

OBJECTIVE: The purpose of this study was to determine whether human preterm birth is associated with changes in 17 beta-estradiol and progesterone concentrations in maternal plasma and amniotic fluid. STUDY DESIGN: Forty healthy women in preterm labor with singleton pregnancies and intact membranes at 32 to 36 weeks of gestation who underwent amniocentesis for evaluation of the microbiologic status of the amniotic cavity were classified into the following two groups: 20 women who were delivered within 1 week from the amniocentesis (preterm delivery group) and 20 who were delivered at term (term delivery group). Maternal plasma and amniotic fluid concentrations of progesterone and 17 beta-estradiol were measured with sensitive and specific commercially available radioimmunoassay kits. RESULTS: The median amniotic fluid concentration of 17 beta-estradiol was significantly higher in women delivered prematurely than in those who were delivered at term (1.5 ng/ml vs 0.9 ng/ml, p = 0.0001). Moreover, the median plasma 17 beta-estradiol concentration was also significantly higher in the preterm delivery group than in the term group (14.1 ng/ml vs 6.9 ng/ml, p = 0.022). In contrast, no significant difference was found in amniotic fluid and plasma concentrations of progesterone between these two groups (24.5 ng/ml vs 27.5 ng/ml and 132.0 ng/ml vs 107.5 ng/ml, respectively). The median amniotic fluid progesterone/17 beta-estradiol ratio was significantly lower in the preterm delivery group than in those delivered at term (18.4 vs 33.6, respectively, p = 0.0017). Moreover, the median plasma progesterone/17 beta-estradiol ratio was also significantly lower in the preterm delivery group than in the term group (9.8 vs 17.0, respectively, p = 0.016). CONCLUSION: Human preterm birth is associated with significantly lower progesterone/17 beta-estradiol ratios than those of women with preterm labor delivered at term.

Adult↗
PubMed1994

Association between preterm birth and increased maternal plasma cortisol concentrations.

OBJECTIVE: To measure the amniotic fluid (AF) and plasma concentrations of cortisol in women with preterm labor and intact membranes. METHODS: Thirty-eight normal healthy women with singleton gestations, preterm labor, and intact membranes at 32-36 weeks' gestation underwent amniocentesis for evaluation of the microbiologic status of the amniotic cavity. Nineteen women delivered within 1 week of amniocentesis (preterm labor and delivery group), and 19 delivered at term (preterm labor and term delivery group). Maternal plasma and AF concentrations of cortisol were measured with sensitive and specific, commercially available radioimmunoassay kits. RESULTS: The median plasma cortisol concentration was significantly higher in women who delivered prematurely than in those who delivered at term (260 versus 240 ng/mL; P = .014). However, no significant differences in median AF cortisol concentrations were detected between the groups (13 versus 14 ng/mL). CONCLUSIONS: Although maternal plasma cortisol concentrations were significantly higher in women with preterm birth, no similar changes were found in the AF. The rise in maternal plasma cortisol may be related to the stress mechanism of labor.

Adult↗
PubMed1993

[C-reactive protein as a marker of infection in women with preterm delivery].

There is a strong association between systemic and intrauterine infection and preterm delivery. C-reactive protein (CRP) is considered a nonspecific marker for intrauterine inflammation. We determined its blood level in 100 women who presented with preterm labor and intact membranes and delivered prematurely. CRP levels were used as a noninvasive marker for infection to compare clinical characteristics between women who delivered prematurely at 31-36 and 24-30 weeks of gestation. Women who delivered earlier than the 24th week of gestation had a higher rate of positive CRP levels than those who delivered later, 54% vs 24%, respectively (p < 0.0001). Moreover, women from the lower gestational age group with positive CRP levels had significantly different clinical characteristics than those in the same group but with negative CRP levels. There was a significant difference between Jewish and Bedouin women in cervical dilatation and time interval from hospitalization to delivery between those with positive CRP and those with negative CRP levels. We conclude that patients who delivered prematurely at 24-30 weeks had higher rates of an inflammatory etiology than women who also delivered prematurely, but at a more advanced gestational age.

Adult↗
PubMed1993

Successful treatment of preterm labour by eradication of Ureaplasma urealyticum with erythromycin.

Ureaplasma urealyticum was detected in the amniotic cavity of a woman with premature contractions at 32 weeks of pregnancy. Treatment with Erythromycin base was instituted for a period of ten days. Amniotic fluid analysis performed 48 hours after discontinuation of antibiotic treatment revealed sterile amniotic fluid. The pregnancy continued uneventfully until 39 weeks.

Administration, Oral↗
PubMed1993

Meconium stained amniotic fluid is associated with maternal infectious morbidity in pre term delivery.

The purpose of the study was to determine if intra partum meconium stained amniotic fluid (MSAF) is associated with infectious morbidity in women with pre term delivery. The study group was composed of 89 women with pre term delivery and MSAF. The control group comprised 89 women with pre term delivery and clear amniotic fluid, matched for maternal age, gravidity, parity, gestational age, rate of premature rupture of membranes, breech presentation and mode of delivery. The parameters of maternal infectious morbidity were compared between the two groups during pregnancy, delivery and puerperium. The prevalence of recurrent urinary tract infections was significantly higher in the study group than those in the control group, 7.8% (7/89) vs. 0% (0/89), respectively (p = 0.02). During delivery women with MSAF had a significantly higher rate of clinical chorioamnionitis than women without MSAF, 6% (6/89) vs. 0% (0/89), respectively (p = 0.03). Histological chorioamnionitis was also significantly higher in patients with intra partum MSAF, as compared to those the clear amniotic fluid, 11.2% (10/89) vs. 0% (0/89), respectively (p = 0.03). In addition, women in the study group had a significantly higher post partum infectious morbidity rate and endometritis than women in the control group [52.8% (47/89) vs. 37.1% (33/89) (p = 0.05); 18% (16/89) vs. 7.8% (7/89) (p = 0.03), respectively]. We conclude that intra partum MSAF should be considered as a potential marker for infectious morbidity in women with pre term labor and delivery.

Adult↗
PubMed1992

[Limulus amebocyte lysate assay for diagnosing intraamniotic infection].

The value of the Limulus amebocyte lysate assay (LAL) in the diagnosis of intraamniotic infection was determined in amniotic fluid from transabdominal amniocenteses in 51 women in preterm labor with intact membranes. The prevalence of positive amniotic fluid cultures was 21.5% (11/51) in detecting intraamniotic infection. The LAL was positive in 19.6% (10/51), its sensitivity 81.8% (9/11), specificity 97.5% (39/40), positive predictive value 90.0% (9/10), and negative predictive value 95.1% (39/41). Similarly, in detecting women who would fail tocolysis and deliver prematurely, its sensitivity was 27.6% (8/29), specificity 90.9% (20/22), positive predictive value 80% (8/10), and negative predictive value 48.8% (20/41). We conclude that LAL is a simple, rapid and sensitive test for detecting intraamniotic infection in women in preterm labor.

Amniotic Fluid↗
PubMed1992

Pregnancy with an intrauterine device in situ and preterm delivery.

We determined the prevalence of preterm delivery in a population of women who conceived with an IUD in situ and compared the results with those in a group of women without any contraceptive method. The study group consisted of 16 women who conceived with a copper IUD in situ. The control group comprised 48 women matched for age, gravidity and parity. The prevalence of preterm delivery was significantly higher in the study group than in the control group (18.7% (3/16) vs 2% (1/48)), respectively. (P = 0.045, Fisher's exact test.)

Adult↗