PHARYNGO-CONJUNCTIVAL FEVER - SCHOOL OUTBREAKS IN ENGLAND DURING THE SUMMER OF 1955 ASSOCIATED WITH ADENOVIRUS TYPE-3, TYPE-7, AND TYPE-14
PHARYNGO-CONJUNCTIVAL FEVER - SCHOOL OUTBREAKS IN ENGLAND DURING THE SUMMER OF 1955 ASSOCIATED WITH ADENOVIRUS TYPE-3, TYPE-7, AND TYPE-14
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DOI：
10.1136/bmj.2.5037.131
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发表时间：
1957-01-01
影响因子：
--
通讯作者：
MCDONALD, JC
中科院分区：
文献类型：
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作者：
KENDALL, EJC;RIDDLE, RW;MCDONALD, JC
讨论没有详细说明潜在的原因，马尔帕斯(1938)提出，在三次堕胎后，自发治愈的机会是27%。然而，Swyer和Daley(1953)发现这种悲观的评估太低了；大约50%的这样的妇女有机会在不治疗的情况下生产活婴儿。当然，在有习惯性流产史的情况下，在怀孕前或怀孕期间进行Lash或Shirodkar类型的手术并不困难，如果患者随后怀孕，自然会倾向于声称任何成功的结果都应归功于手术本身。在我们看来，只有在获得反复早期膜破裂的病史，或者如果能够证明内部OS的实际功能不全的情况下，手术才能成功。很明显，由于习惯性流产的原因相对罕见，要积累一系列足以产生统计上显着结果的病例将需要很长时间。发表这一初步沟通，是希望能激励该领域的其他工作者沿着类似的路线进行调查和治疗。总结颈椎内口不足是习惯性流产的偶然原因。这种功能不全可能是先天性的，也可能是妇科手术或分娩或流产时的创伤所致。这种缺陷可从反复早期胎膜破裂继而流产的病史中被怀疑，并可通过特殊的X光技术或通过4号宫颈扩张器自由进入宫腔而在非妊娠妇女身上得到证实。在妊娠期间，可以通过观察胎膜膨大和宫颈部分扩张来证实这一点，但没有出血或明显的子宫收缩。
Discussion Without detailing the underlying causes, Malpas (1938) suggested that after three abortions the chance of spontaneous cure was 27%. Swyer and Daley (1953), however, found that this pessimistic assessment was far too low; that approximately 50, of such women had a chance of pro-ducing a live baby without treatment. It is, of course, not difficult, in cases where there is a history of habitual abortion, to perform a Lash or Shirodkar type of operation, either before or during pregnancy, and if subsequently the patient carries to term there would be a natural tendency to claim that any successful result was due to the operation itself. In our opinion, success can be attributed to the operation only if a history of repeated early rupture of the membranes is obtained, or if actual incompetence of the internal os can be demonstrated. It is quite obvious that to amass a series of cases sufficient to produce statistically significant results will take a long time owing to the relative rarity of this cause of habitual abortion. This preliminary communication is published in the hope that it may stimulate other workers in this field to carry out investigation and treatment along similar lines.Summary Deficiency of the internal cervical os is an occasional cause of habitual abortion. Such insufficiency may be either congenital or the result of trauma at gynae-cological operation or during childbirth or miscarriage. The deficiency may be suspected from the history of repeated early rupture of the membranes followed by abortion, and may be demonstrated in the non-pregnant woman by a special x-ray technique or by the passage of a No. 4 cervical dilatorfreely into the uterine cavity. During pregnancy it may be confirmed by the observation that the membranes are bulging and that the cervix is partially dilated in the absence of bleeding or obvious uterine contractions.