Fetal and maternal medicine review最新文献

{"title":"PROGESTERONE AND THE CONTROL OF HUMAN PREGNANCY AND PARTURITION","authors":"S. Mesiano, Toni N. Welsh","doi":"10.1017/S096553950900240X","DOIUrl":"https://doi.org/10.1017/S096553950900240X","url":null,"abstract":"Almost 80 years ago George Corner and colleagues provided the first evidence that progesterone maintains pregnancy and that it does so, at least in part, by promoting myometrial relaxation. In the 1950s, Arpad Csapo proposed the “progesterone block hypothesis”, which posits that progesterone maintains pregnancy by promoting myometrial relaxation and that its withdrawal initiates a cascade of hormonal interactions that transforms the myometrium to a highly contractile state leading to the onset of labour. Csapo later proposed that contractility of the pregnant myometrium is determined by the balance between relaxation induced by progesterone and contraction induced by a cohort of signals including oestrogens, uterine distention and stimulatory uterotonins such as prostaglandins (PGs) and oxytocin (OT). According to this “seesaw” hypothesis, progesterone promotes myometrial relaxation by directly inducing relaxation and/or by inhibiting the production of, or myometrial responsiveness to, stimulatory uterotonins. These landmark concepts, though derived from studies of experimental animals, form the foundation for current understanding of progesterone's role in the physiology of human pregnancy. Remarkable progress has been made over the last 20–30 years in understanding the signal transduction pathways through which steroid hormones affect target cells. This knowledge has broadened the scope of Csapo's original paradigms and we are now beginning to unravel the specific signaling pathways and molecular interactions by which progesterone affects human myometrium and how its actions are controlled at the functional level. This is important for the development of progestin-based therapeutics for the prevention or suppression of preterm labour and preterm birth. Here we review recent progress in understanding the mechanisms by which progesterone sustains pregnancy and in particular how it promotes myometrial relaxation, how its relaxatory actions are nullified at parturition, and the hormonal interactions that induce progesterone withdrawal to determine the timing of human birth.","PeriodicalId":89369,"journal":{"name":"Fetal and maternal medicine review","volume":"20 1","pages":"97-118"},"PeriodicalIF":0.0,"publicationDate":"2009-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S096553950900240X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56975135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PRENATAL SCREENING AND DIAGNOSIS OF FETAL CHROMOSOMAL ABNORMALITIES – DILEMMA BETWEEN BEST EVIDENCE-BASED MODEL AND PRACTICABILITY","authors":"T. Lau, T. Leung","doi":"10.1017/S0965539509002435","DOIUrl":"https://doi.org/10.1017/S0965539509002435","url":null,"abstract":"","PeriodicalId":89369,"journal":{"name":"Fetal and maternal medicine review","volume":"20 1","pages":"161-177"},"PeriodicalIF":0.0,"publicationDate":"2009-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0965539509002435","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56975246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PROTEOMICS APPROACHES IN PRE-ECLAMPSIA RESEARCH","authors":"O. Clancy, J. Myers","doi":"10.1017/S0965539509002319","DOIUrl":"https://doi.org/10.1017/S0965539509002319","url":null,"abstract":"","PeriodicalId":89369,"journal":{"name":"Fetal and maternal medicine review","volume":"20 1","pages":"143-160"},"PeriodicalIF":0.0,"publicationDate":"2009-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0965539509002319","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56974578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SUBSTANCE MISUSE DURING PREGNANCY: ITS EFFECTS AND TREATMENT","authors":"P. Moran, Rm Madgula, E. Gilvarry, M. Findlay","doi":"10.1017/S0965539509002307","DOIUrl":"https://doi.org/10.1017/S0965539509002307","url":null,"abstract":"Prenatal care reduces the impact of illicit drug use on perinatal outcomes. Women who misuse substances are often excluded from mainstream society and, on becoming pregnant, feel guilty about their drug misuse and the potential effects this could have on their unborn baby. These women are vulnerable in many ways and agencies must ensure that they are not excluded from antenatal care. The latest enquiry into maternal deaths published in the UK (CEMACH report) highlights how women with socially complex lives who died were far less likely to have sought antenatal care early in pregnancy or to remain in regular contact with maternity services. Of the women who died from any cause, 11% had problems with substance abuse of whom 60% were registered addicts. Gaps in communication between agencies was highlighted as a particular problem.","PeriodicalId":89369,"journal":{"name":"Fetal and maternal medicine review","volume":"20 1","pages":"1-16"},"PeriodicalIF":0.0,"publicationDate":"2009-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0965539509002307","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56974135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PELVIC FLOOR ASSESSMENT","authors":"H. Dietz","doi":"10.1017/S096553950900237X","DOIUrl":"https://doi.org/10.1017/S096553950900237X","url":null,"abstract":"The topic of pelvic floor assessment is increasingly attracting attention from gynaecologists, colorectal surgeons, urologists and physiotherapists. This is not surprising, many women who have given birth naturally are affected by pelvic floor trauma, and so are their partners. Health professionals deal with the eventual consequences of such trauma, especially pelvic organ prolapse and faecal incontinence.","PeriodicalId":89369,"journal":{"name":"Fetal and maternal medicine review","volume":"20 1","pages":"49-66"},"PeriodicalIF":0.0,"publicationDate":"2009-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S096553950900237X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56974769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ENDOCRINOLOGY OF PARTURITION AND PREPARATION FOR LABOUR","authors":"V. Terzidou","doi":"10.1017/S0965539509002381","DOIUrl":"https://doi.org/10.1017/S0965539509002381","url":null,"abstract":"","PeriodicalId":89369,"journal":{"name":"Fetal and maternal medicine review","volume":"20 1","pages":"67-96"},"PeriodicalIF":0.0,"publicationDate":"2009-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0965539509002381","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56974645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TYPE 1 DIABETES IN PREGNANCY; INFLUENCES ON MOTHER AND FETUS","authors":"S. Nelson, R. Lindsay","doi":"10.1017/S0965539509002344","DOIUrl":"https://doi.org/10.1017/S0965539509002344","url":null,"abstract":"Type 1 diabetes complicates around 1 in 200 to 300 pregnancies in the United Kingdom. Historically maternal type 1 diabetes carried very high risks for mother and child. Introduction of insulin led to an immediate, marked decline in the previously very high rates of maternal mortality; in contrast an improvement in perinatal outcomes occurred more slowly but was nevertheless dramatic. This is strikingly demonstrated by the temporal decline in perinatal mortality in offspring of mothers with type 1 diabetes which was virtually universal before use of insulin in the 1920's, likely remained in excess of 20% even in the 1960's and fell to under 4% by the 1990's. The reasons for this more gradual improvement in perinatal outcomes cannot be defined with precision but will have been influenced by improved glycaemic management with use of intensive, multiple dose insulin treatment and home glucose monitoring; improvements in obstetric and neonatal management, and better management of complications of diabetes before and during pregnancy. In 1989 the St Vincent declaration proposed that pregnancy outcomes in women with type 1 diabetes should approximate those of the non-diabetic population. While the long term improvements in fetal outcomes have been dramatic, contemporary surveys confirm a persistent doubling or more of rates of congenital anomaly and a three to four fold increase in perinatal mortality in the UK and other European countries which will require further clinical innovation to overcome.","PeriodicalId":89369,"journal":{"name":"Fetal and maternal medicine review","volume":"20 1","pages":"17-47"},"PeriodicalIF":0.0,"publicationDate":"2009-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0965539509002344","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56974676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PRE-ECLAMPSIA AS A MARKER OF CARDIOVASCULAR DISEASE","authors":"L. Magee, J. Newstead, J. Ng, A. Côté, P. Dadelszen","doi":"10.1017/S0965539508002283","DOIUrl":"https://doi.org/10.1017/S0965539508002283","url":null,"abstract":"","PeriodicalId":89369,"journal":{"name":"Fetal and maternal medicine review","volume":"19 1","pages":"271-292"},"PeriodicalIF":0.0,"publicationDate":"2008-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0965539508002283","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56974257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"INTRAPARTUM ST ANALYSIS","authors":"H. Norén, K. Rosen","doi":"10.1017/S0965539508002295","DOIUrl":"https://doi.org/10.1017/S0965539508002295","url":null,"abstract":"The last century has seen dramatic developments in medical care as technological advances have been applied to both diagnosis and treatment. Some areas of obstetrics have been slow to benefit from these advances – and none more so than the care of the fetus in labour.","PeriodicalId":89369,"journal":{"name":"Fetal and maternal medicine review","volume":"19 1","pages":"325-358"},"PeriodicalIF":0.0,"publicationDate":"2008-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0965539508002295","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56973849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IS SHOULDER DYSTOCIA WITH BRACHIAL PLEXUS INJURY PREVENTABLE","authors":"E. Hamilton, A. Ciampi, A. Dyachenko, H. Lerner, Louise Miner, H. Sandmire","doi":"10.1017/S096553950800226X","DOIUrl":"https://doi.org/10.1017/S096553950800226X","url":null,"abstract":"The sequelae of shoulder dystocia with persistent brachial plexus injury (BPI) are among the most serious of obstetrical complications. Shoulder dystocia with BPI generally places second or third in the list of the top causes of permanent birth-related neonatal injuries. Apart from the devastating medical and social consequences of lifelong impairment for the family, ensuing litigation with its allegations regarding poor care exacts a heavy toll on the medical profession.","PeriodicalId":89369,"journal":{"name":"Fetal and maternal medicine review","volume":"15 1","pages":"293-310"},"PeriodicalIF":0.0,"publicationDate":"2008-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S096553950800226X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56974128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}