ABSTRACT
OBJECTIVE: To test a possible association between activated protein C resistance and intrauterine fetal death. METHODS: The activated protein C anticoagulant activity and factor V R506Q mutation were assessed in 14 nonpregnant women with a history of intrauterine fetal death and 14 healthy controls. RESULTS: Four women in the study group were heterozygotes for the factor V mutation and none of the controls. The mean activated protein C activity of the study group was statistically significantly lower than that of the controls (P = 0.013). CONCLUSION: Resistance to activated protein C activity may be of etiologic importance in some cases of intrauterine fetal death.
Subject(s)
Activated Protein C Resistance/genetics , Factor V/genetics , Fetal Death/genetics , Mutation , Adult , Female , Heterozygote , HumansABSTRACT
As thrombosis of placental vessels may result in recurrent fetal loss, we analysed 39 consecutive women with recurrent fetal loss of unknown cause for activated protein C resistance. Factor V Leiden (FVL) mutation (19 cases) or APC resistance without FVL (nine cases) were found among these 39 women. Evaluation of 128 pregnancies in 19 patients with factor V Leiden mutation and 56 gestations in nine women with acquired APC resistance, revealed over 50% first-trimester abortions and 17% late abortions. Intra-uterine fetal death occurred in nine out of 19 FVL patients (47%). Only 34 of 184 gestations (18%) in hereditary or acquired APC-resistance women resulted in a live birth, with 11 of the 34 (32%) being premature deliveries. These data suggest that, in some patients with recurrent fetal loss, hereditary and acquired APC resistance are potential causes of vascular placental insufficiency.
Subject(s)
Abortion, Habitual/etiology , Factor V/genetics , Placenta/blood supply , Pregnancy Complications, Hematologic/etiology , Protein C Deficiency , Thrombosis/etiology , Abortion, Habitual/blood , Abortion, Habitual/genetics , Adult , Female , Heterozygote , Humans , Middle Aged , Mutation , Polymerase Chain Reaction , Pregnancy , Pregnancy Complications, Hematologic/blood , Thrombosis/geneticsABSTRACT
Two hundred consecutive women with uncomplicated pregnancies, at or within 4 days of their expected date of confinement, were prospectively randomized into 2 groups. One group had expectant management, with twice weekly surveillance tests, while the other group had 3 mg of vaginal prostaglandin E2 as outpatient treatment. There were 104 women in the expectant group and 70 in the induction group (26 women allocated to induction preferred no treatment). The average number of days to delivery was 1.6 in the induction group and 5.2 in the expectant group (p < 0.001). While meconium was much less frequent in the induction group (p < 0.002), all other outcome measures, including cesarean section rates, incidence of macrosomia, and Apgar scores, were similar in the two groups.
Subject(s)
Dinoprostone/administration & dosage , Labor, Induced , Adult , Ambulatory Care , Asphyxia Neonatorum/etiology , Asphyxia Neonatorum/prevention & control , Dinoprostone/adverse effects , Female , Humans , Infant, Newborn , Pregnancy , Pregnancy Outcome , Pregnancy, Prolonged , Prospective StudiesABSTRACT
Two optically active liquid anion-exchangers have been synthesized. The separation factors of the enantiomers of sodium (+/-)-mandelate and sodium-N-acetyl-(+/-)-alanate have been determined by batchwise equilibration of aqueous solutions of the salts with chloroform solutions of each of the exchangers. Sodium mandelate has been resolved by Craig countercurrent extraction with one of these exchangers. Optically pure products can be obtained even though the liquid ion-exchanger is not optically pure.
ABSTRACT
The racemic alcohols, 2-methylbutanol-l, 3-methylbutanol-2, pentanol-2 and hexanol-2 have been esterified with optically active mandelic or lactic acid, and the resultant mixtures of diastereoisomeric esters separated chromatographically with an optically inactive sulphonated polystyrene resin as the stationary phase and water or dilute aqueous sodium sulphate as the mobile phase. Lactate esters were more easily separated than mandelate esters. The Chromatographic separation of 26 mmole of (+/-)-3-methyl-2-butyl(+)-lactate and subsequent hydrolysis of the fractions containing only the ester of the (+)-alcohol yielded 1-2 mmole of pure 3-methyl-2-butanol.
