Search

The aim of this prospective study was to compare triple test screening (alpha-fetoprotein, beta-chorionic gonadotrophin and unconjugated oestriol) with amniocentesis in the detection of fetuses with Down's syndrome in women of 35 years of age or more. Between 1992 and 1996, maternal serum markers were evaluated in 1406 women who had amniocentesis for prenatal diagnosis of chromosomal abnormalities related to a maternal age of 35 or more years. Sixteen fetuses with Down's syndrome were identified in the whole group by amniocentesis and karyotyping. The group with negative triple test screening consisted of 919 pregnancies and included two fetuses with trisomy-21 (false negatives). With triple test screening in the age group over 35, there was a detection rate of 87.5% for cut-off points ranging from 1:200 up to 1:350, with corresponding false positive rates ranging between 23% and 34%. In our population, if we had practiced the policy of offering amniocentesis only to women screening positive for the ages of 35 and 36 and to all pregnant women of 37 or more, we would have carried out 30% less amniocenteses. In this group of 1406 women, 33 abnormal karyotypes were detected with amniocentesis (16 Down's syndrome included) and equal number of elective abortions were carried out. Nevertheless, 19 healthy fetuses and neonates were lost after amniocentesis. Considering the high detection rates that can be achieved with triple test screening, the existing procedure related risk of amniocentesis (0.5-1.0%), and the facts that conception in women over 35 years of age is usually more difficult and the background loss usually higher than in younger women, we believe that in the future women over 35 should be offered a choice between non-invasive and invasive procedures after being thoroughly informed. [ABSTRACT FROM AUTHOR]

In order to ascertain correlates of gestational age and predictors of prematurity, all the mothers delivered in 1993 at the maternity clinic of the First University Department of Obstetrics and Gynaecology and at one division of a private maternity hospital in Athens, Greece, were interviewed. From a total of 3,770 deliveries, those involving multiple pregnancies or Caesarean deliveries were excluded, as were pregnancies with an apparent duration of less than 150 or more than 300 days. The analysis was eventually based on 2,538 singleton deliveries. The duration of gestation was modelled as an outcome variable through multiple regression. The following factors were found to be significantly (p<0.05) related to the duration of gestation: maternal education, +0.8 day per 3 schooling years; family integrity, single compared to currently married mother, -3.7 days; parity, multiparous (4+ births) compared to primiparae, +2.8 days; age at menarche, +1.8 days per 2 years; maternal age, +3.9 days for younger than 20 years and -1.7 days for older than 30 years in comparison to women 20-29 years old; maternal weight before pregnancy, +0.4 day per 5 kg; coffee drinking, +0.7 day per cup per day; tobacco smoking, -1.8 days per 0.5 pack per day. Bleeding during any trimester of pregnancy and maternal diabetes were significantly associated with shorter duration of gestation by 6.7 and 8.2 days respectively. The constellation of risk factors for a pre-term delivery in Greece appears similar to that in other populations. However, a positive association between coffee drinking and duration of pregnancy has not always been demonstrated in other studies and the longer duration of pregnancy among very young women represents an unusual finding. At the range of variation under investigation the individual factors are not powerful predictors but their combination could identify women at high risk for prematurity. [ABSTRACT FROM AUTHOR]

Synchronization of the availability of good quality oocytes from donors and adequate endometrial maturation of recipients are very important for the success of an oocyte donation programme. A flexible protocol for the endometrial preparation of recipients is important in timing embryo transfer between days 17 and 19 of the cycle (‘window of receptivity’). The purpose of this study was to evaluate the effect of the length of oestradiol administration to recipients on pregnancy outcome. Oestrogen administration was 8 mg/day, but its length varied prospectively from 6 to 27 days, followed by the addition of progesterone (100 mg daily Lm.) for 2–4 days according to the availability of good quality oocytes. Pregnancy outcome was evaluated regardless of age, indication for oocyte donation or number of embryos transferred per patient The pregnancy rate per cycle was comparable when oestradiol was administered from 6 to 11 days before progesterone addition, while it dropped significantly thereafter. The variation in progesterone administration did not affect pregnancy outcome. These findings provide us with a greater flexibility by allowing us to vary oestradiol administration to recipients from 6 to 11 days prior to progesterone, reducing considerably, therefore, the need to cancel embryo transfer because of oocyte unavailability. Thus we can arrange to transfer embryos between days 17 and 19 of the recipient's cycle so as to obtain the best possible clinical outcome. [ABSTRACT FROM PUBLISHER]

A total of 323 women of reproductive age (19–40 years) were submitted to a complete investigation of infertility routinely including hysterosalpingography and hysteroscopy. In 177 cases (54.7%) no pathological conditions were found by either of the applied methods, while in 65 cases (20.1%) similar abnormalities were observed by hysterosalpingography and hysteroscopy with a global correlation of 74.8%. Hysterosalpingography also presented false positive results in 11.7% and false negative ones in 13.3% of all the studied cases. In conclusion, the combined use of these techniques in infertility investigation gives complete and accurate information about the uterine cavity, despite the disadvantages of hysterosalpingography due to false positive and false negative results. [ABSTRACT FROM PUBLISHER]

Examines the changes of cardiac output during vaginal delivery. Patients and methods used in the study; Measurements of haemodynamic variables in the different stages of labour; Conclusion.