Abnormal Pregnancies

Considerations in the selection of ARV treatment regimens at both the programme level and at the level of an individual patient should include the potency, side effect profile, the potential for maintenance of future treatment options, the anticipated adherence of the patient population with a regimen, coexistent conditions (e.g., co-infections, metabolic abnormalities), pregnancy or the risk thereof, the use of concomitant medications (i.e. potential drug interactions), the potential for primary acquisition of resistant viral strains, and cost and access (Table 8). 

The clinical value of pregnanediol determination is found in gynecological disorders, in cases of abnormal pregnancies, and as evidence of actively secreting corpus luteum and ovulation during the normal menstrual cycle. 

Okey AB, Giannone JV, Smart W, Wong JM, Manchester DK, Parker NB, Feeley MM, Grant DL, Gilman A. Binding of 2,3,7,8-tetrachlorodibenzo-p-dioxin to AH receptor in placentas from normal versus abnormal pregnancy outcomes. Chemosphere 1997 34 1535-1547. 

Sprince, H., Lowy, R. S., Folsome, C. E., and Behrman, J. S., Studies on the urinary excretion of xanthurenic acid during normal and abnormal pregnancy a survey of the excretion of xanthurenic acid in normal nonpregnant, normal pregnant, pre-eclamptic, and eclamptic women. Am. J. Obstet. Gynecol. 62, 84-92 (1951). 

Steegers-Theunissen RP, Renter WO, Borm GF, Thomas CM, Merkus HM, Op de Coul DA, De Jong PA, van Geijn HP, Wouters M, Eskes TK. Factors influencing the risk of abnormal pregnancy outcome in epileptic women a multi-centre prospective study. Epilepsy Res 1994 18(3) 261-9. 

Hormones of both synthetic and biological origin are known endocrine disruptors. The best known of these is diethylstilbesterol (DES), a synthetic estrogen that was prescribed by physicians to prevent spontaneous abortions in women from 1948 to 1971. Daughters of women who took DES have suffered a host of reproductive problems including a reduction in fertility, abnormal pregnancies, immune system disorders, periods of depression, and early onset of vaginal clear-cell adenocarcinomas and reproductive tract cancer. Known hormonal endocrine disruptors are listed in Table 4.5. 

Decreased fertility Menstrual abnormalities Pregnancy loss... 

Gluck L, Kulovich MV. Lecithin/sphingomyelin ratios in amniotic fluid in normal and abnormal pregnancy. Am J Obstet Gynecol 1973 115 539-46. 

Kornman LH, Morssink LP, Wortelboer MJM, Beekhuis JR, De Wolf BT, Pratt JJ, et al. Maternal urinary p-core hCG in chromosomaUy abnormal pregnancies in the first trimester. Prenat Diagn 1997 17 135-9. 

The 3j8-hydroxy-A steroid content of amniotic fluid (S12) is compared with that in adult and infant urine and umbilical cord blood in Fig. 6. Schindler and co-workers have assayed several 3/3-hydroxy-A steroids and others in amniotic fluid for both normal and abnormal pregnancies (S4, S5). 

Yagami, Y., and Ito, Y., 1965, Immunological assay of human serum chorionic gonadotrophin in normal and abnormal pregnancy. J. Jpn. Obstet. Gynecol. Soc. 12 82-88. 

Did the timing of any abnormal pregnancy outcome coincide with present employment ... 

A Method for Estriol Estimation in Amniotic Fluid and Its Use in the Study of Normal and Abnormal Pregnancy 73. Steroids 13(5) 651-670 (1969) CA 71 ... 

Brody, S., and Carlstroem, G. (1965) Human chorionic gonadotropin in abnormal pregnancy. Serum and urinary findings using various immu-noassay techniques. Acta Obstetricia et Gynecologica Scandinavica, 44, 32-44. 

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