رسالة جامعية
Clinical, biochemical and morphological aspects of cervical ripening in the first trimester
| العنوان: | Clinical, biochemical and morphological aspects of cervical ripening in the first trimester |
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| المؤلفون: | Vukas Radulovic, Nina |
| سنة النشر: | 2009 |
| المجموعة: | University of Gothenburg: GUPEA (Gothenburg University Publications Electronic Archive) |
| مصطلحات موضوعية: | cervical ripening, misoprostol, nitric oxide, electron microscopy, miscarriage, IL-8, MMP-1, MMP-8, MMP-9 |
| الوصف: | Background: The uterine cervix has the ability to be transformed from being a rigid organ in non-pregnant women to become a loose structure that dilates and allows passage of the foetus at parturition. This process, cervical ripening, has been described similar to an inflammatory reaction of the extracellular matrix involving activation of inflammatory cytokines, matrix metalloproteinases and breakdown of the collagen framework. Cervical ripening can be induced prior to surgical termination of pregnancy by agents such as prostaglandins (PGs) and nitric oxide (NO). It appears reasonable that ripening takes place as a spontaneous event in women with miscarriage before expulsion of gestational products. Aims: The aims of the thesis were to investigate clinical, morphological and biochemical aspects of cervical ripening in the first trimester, both when induced by PGs or NO donors and when spontaneously occurring in women with symptomatic and silent miscarriage. Methods: Nulliparous women admitted for surgical termination of pregnancies in the first trimester were randomized to cervical priming with either gemeprost or misoprostol (Study I), and to misoprostol or isosorbide mononitrate (IMN) (Study II). In Study I and II, the efficacy of cervical priming was measured by tonometry. Side effects were also estimated. In Study III cervical biopsies from women treated with misoprostol or IMN were analyzed using electron microscopy (EM). Inflammatory parameters were analyzed by ELISA (IL-8) and immunohistochemistry (IHC) (MMP-1, MMP-9). In Study IV biopsies were obtained from nulliparous women suffering symptomatic or silent miscarriage and from women undergoing surgical termination of pregnancy. Morphology was studied by EM and inflammatory parameters by ELISA (IL-8) and IHC (IL-8, MMP-1, MMP-8, MMP-9). Results: There was no difference in baseline cervical dilation and cumulative force to dilate the cervix to 10 mm in women treated with misoprostol compared to gemeprost. Cervical resistance was higher in women treated ... |
| نوع الوثيقة: | doctoral or postdoctoral thesis |
| وصف الملف: | application/pdf |
| اللغة: | English |
| ردمك: | 978-91-628-7830-6 91-628-7830-1 |
| العلاقة: | I.Gemeprost versus misoprostol for cervical priming before first-trimester abortion: a randomized controlled trial. Ekerhovd E, Radulovic N, Norström A. Obstet Gynecol. 2003 Apr;101:722-5.::doi::10.1016/S0029-7844(02)02734-5; II.Outpatient cervical ripening before first-trimester surgical abortion: a comparison between misoprostol and isosorbide mononitrate. Radulovic N, Norström A, Ekerhovd E. Acta Obstet Gynecol Scand. 2007;86:344-8.::doi::10.1080/00016340601134598; III.Cervical priming in the first trimester: morphological and biochemical effects of misoprostol and isosorbide mononitrate. Vukas Radulovic N, Ekerhovd E, Abrahamsson G, Norström A. Acta Obstet Gynecol Scand. 2009;88:43-51.::doi::10.1080/00016340802585440; IV.Cervical tissue changes in women with miscarriage: a morphological and biochemical investigation. Vukas Radulovic N, Ekerhovd E, Abrahamsson G, Norström A. Accepted for publication in Acta Obstet Gynecol Scand.; http://hdl.handle.net/2077/20456Test |
| الإتاحة: | http://hdl.handle.net/2077/20456Test |
| رقم الانضمام: | edsbas.648734CC |
| قاعدة البيانات: | BASE |
| ردمك: | 9789162878306 9162878301 |
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