[The use of Doppler-ultrasound in obstetrics]. / Anvendelsen af Doppler-ultralyd i obstetrikken.

Several investigations have suggested an association between intrauterine growth retardation or an adverse neonatal outcome and increased vascular resistance in the fetal and maternal uteroplacental circulation assessed by Doppler-ultrasound. Meta-analysis of nine randomized controlled trials showed that the use of Doppler-ultrasound in the surveillance of high-risk pregnancies reduced the perinatal mortality considerably. Taken together, there is evidence to suggest that Doppler-ultrasound is a valuable tool for discriminating between normal small and "sick" small fetuses. Screening in unselected populations of low-risk pregnancies, however, seems to be without any benefit.

All-trans retinoic acid in acute promyelocytic leukemia in late pregnancy.

All-trans retinoic acid (ATRA) was used in a case of acute promyelocytic leukemia (APL) in late pregnancy. A very prompt maternal risk reduction was achieved with subsequent complete remission and spontaneous delivery of two live children in whom no fetal damage seems to have occurred.

All-trans retinoic acid in acute promyelocytic leukemia in late pregnancy.

All-trans retinoic acid (ATRA) was used in a case of acute promyelocytic leukemia (APL) in late pregnancy. A very prompt maternal risk reduction was achieved with subsequent complete remission and spontaneous delivery of two live children in whom no fetal damage seems to have occurred.

Iron supplementation during pregnancy.

192 pregnant women were consecutively randomized to either a vitamin-mineral pill or a vitamin mineral pill with a high iron content in a prospective, open, randomized investigation. The participants were advised about iron-rich foodstuffs twice during pregnancy. Iron status of the mother proved to be without any significance for the outcome of pregnancy. A serum ferritin level of 80 pmol/l in mid-pregnancy followed by a control in the last trimester was suggested as a guide in deciding of whether or not to prescribe supplementary iron during pregnancy.

No effect of intralesional injection of interferon on moderate cervical intraepithelial neoplasia.

Women with histologically confirmed cervical intraepithelial neoplasia grade 2 (CIN 2) were treated in a double blind investigation of treatment with intralesioneal interferon alpha-2b (Intron a). Before treatment commenced, the existence and the types of human papilloma-virus (HPV) were assessed in [35S] methionine-labelled cervical biopsies by the determination of specific protein markers. Pronounced side effects occurred in all the women treated with interferon and the trial was stopped when it became apparent that there were no obvious beneficial effects. No positive benefits of interferon treatment were detected on either the CIN 2 or on the persistence of HPV types. It is concluded that intralesioneal injection of interferon has no place in the treatment of CIN.

[The course of delivery in a group a low-risk primipara women]. / Fødselsforløb hos en gruppe lavrisiko-primiparae.

The course of delivery in 1,545 primiparae who were considered to be in the low-risk group at the commencement of labour as assessed by the previous directives issued by the Danish Ministry of Health (1976) were reviewed. 2/3 were delivered normally as episiotomy was not regarded as a complication. 1/3 had complicated deliveries. In 350, the contractions were abnormal and intervention was required. 1/3 of these were delivered instrumentally. Haemorrhage of more than 500 ml, intrauterine asphyxia and Apgar score less than or equal to 7 at 1 minute occurred frequently in this group. A total of 1,195 did not receive treatment to improve contractions and, in this group, instrumental delivery was undertaken in 10%. Following normal labour pains and spontaneous delivery, complications in the third stage were observed in 77 out of 1,075 patients, including haemorrhage of more than 500 ml in 38 patients. Six infants in this group had Apgar scores less than or equal to 7 at 5 minutes. In the group with abnormal contractions and/or instrumental delivery, haemorrhage of more than 500 ml, retention of the placenta and signs of perinatal asphyxia occurred, however, significantly more frequently. The authors consider that home deliveries in primiparae cannot be recommended. Primiparae should be advised to be delivered in hospital as it is not always possible to predict complications.

[Breech presentation deliveries]. / Fødsel med foster i underkropspraesentation.

A total of 5,519 consecutive single deliveries at term were analysed for maternal and foetal factors associated with breech presentation (UK). The protocol in this department for breech deliveries which permits vaginal delivery of foetuses estimated to be between 2,400 and 3,800 g in cases where the pelvis was considered to be clinically normal, was also evaluated. Breech presentation was found in 173 cases. In 102 of these circumstances were present which permitted trial of vaginal delivery. Seventy-seven were delivered vaginally. An increased frequency of low Apgar scores (less than 8) after one minute was demonstrated among infants delivered vaginally in the breech presentation on comparison with infants delivered by Caesarean section, whereas low scoring after five minutes occurred with the same frequency. One infant died during delivery. Follow-up of infants delivered in breech presentation (mean period of observation two years) showed developmental disturbances in three of the vaginally delivered infants and in five of those delivered abdominally. Two of the infants delivered abdominally had severe cerebral paresis and psychomotor retardation without evidence of intrauterine or severe neonatal asphyxia. On comparison with the population delivered in cephalic presentation (HST), significantly increased frequencies of primiparity and light-for-dates infants were found in the breech presentations. Low Apgar score after one minute was significantly more frequent in breech presentations while low Apgar scoring after five minutes occurred with the same frequency. The perinatal mortality rates in breech and cephalic presentations were 17.3 and 4.7 per 1,000 respectively. Following correction for lethal malformations, the rates were 5.8 and 3.8 per 1,000, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

[Amylase-producing lung tumors]. / Amylaseproducerende lungetumorer.

Raised serum amylase associated with pulmonary tumours is a rare phenomenon. On the basis of two cases, the literature is reviewed and the case histories are compared. The majority of tumours associated with raised serum amylase are adenocarcinomata and, in all of the cases in which determinations of isoenzymes were undertaken, the amylase-isoenzyme was of salivary gland type. In one of the authors' cases, immunhistochemical investigation revealed that the tumour cells contained amylase. In cases of hyperamylasaemia of unknown origin with increased amylase of salivary gland type, adenocarcinoma in the lungs should be considered as a possible diagnosis.