The possibility of an association of early pregnancy loss (EPL) with residential exposure to ELF magnetic fields was investigated in a case-control study. Eighty-nine cases and 102 controls were obtained from the data of an earlier study aimed at investigating the occurrence of EPL in a group of women attempting to get pregnant. Magnetic-field exposure was characterized by measurements in residences. Strong magnetic fields were measured more often in case than in control residences. In an analysis based on fields measured at the front door, a cutoff score of 0.5 A/m (0.63 microT) resulted in an odds ratio of 5.1 (95% confidence interval 1.0-25). The results should be interpreted cautiously due to the small number of highly exposed subjects and other limitations of the data.

The aim of this study was to examine the relationship between maternal peripartal infectious morbidity and amniotic fluid colonization by U. urealyticum. Amniotic fluid specimens for bacterial and mycoplasmal cultures were obtained by aspiration at nonelective cesarean section from 98 pregnant women. Amniotic fluid cultures revealed micro-organisms in 70 (71%) parturients and U. urealyticum was the most frequently isolated species, detected in the specimens from 38 (39%) women. In the total study population, the prevalence of clinically defined infectious morbidity was 26%, including 8 (8%) patients with chorioamnionitis, 11 (11%) with endometritis, 5 (5%) with urinary tract infection, and 4 (4%) with wound infection. A significant association between the amniotic fluid U. urealyticum colonization and increased maternal peripartal infectious morbidity was observed (p < 0.0027; relative risk 4.1; 95% confidence limits 1.6 to 10.7). Amniotic fluids positive for U. urealyticum were significantly more often positive for other potentially pathogenic bacteria (p < 0.0024) and particularly for Bacteroides spp. (p < 0.0074). Our results support the existence of an association between amniotic fluid U. urealyticum invasion and maternal infectious morbidity. However, U. urealyticum was not usually isolated alone from amniotic fluids but combined with other pathogenic bacteria, the severity of infections were not enhanced when U. urealyticum was present and parturients with diagnosed infections managed well without specific antibiotic against U. urealyticum. Hence, it appears that the significance of U. urealyticum in maternal infections in this study population was mainly based on its interactions with other bacteria.

Serum levels of C-reactive protein (CRP), white blood cell count (WBC), amniotic fluid white blood cells (Gram staining) and leukocyte esterase (LE) activity were measured serially and prospectively in 30 pregnant women in labor at term. Results were retrospectively compared with amniotic fluid bacterial culture results. Leukocyte esterase activity was measured by the dipstick test (Nephurtest) and an in vitro photometric method. Amniotic fluid samples were collected through an intrauterine transvaginal pressure catheter. The serial CRP and WBC levels from admission to the delivery and CRP levels from delivery to the first post partum day increased statistically significantly. Levels of both markers correlated significantly with duration of labor. Both amniotic white blood cells and leukocyte esterase activity increased during labor. Bacterial colonization of amniotic fluid was not clearly associated with amniotic LE-activity or leukocyte count as determinated by Gram stain. The tests evaluated cannot be regarded as reliable methods in distinguishing intra-amniotic infection during labor and vaginal delivery at term.

Risk factors for postoperative fever, endometritis and wound infection were analyzed in 761 consecutive cesarean sections. Postoperative fever was observed in 12%, endometritis in 4.7% and wound infection in 3% of cases. The relative risk for postoperative fever was increased in cases with postoperative hematoma (relative risk = 16.0), in cases with blood loss over 500 g (relative risk = 1.8) and if the duration of labor exceeded 6 h (relative risk = 1.9). The only significant risk factors for endometritis were amnionitis (relative risk = 8.7), postoperative hematoma (relative risk = 5.0) and age under 24 years (relative risk = 3.0). Wound infections were less frequent in cases with previous cesarean sections (relative risk = 0.15) and after elective cesarean sections (relative risk = 0.22), but duration of operation over 1 h (relative risk = 2.8), induction of labor (relative risk = 3.2) and puerperal endometritis (relative risk = 7.9) increased the risk of wound infection. By elimination of amnionitis and postoperative hematomas the rate of endometritis would have diminished only from 4.7% to 3.8%, a percentage equally unacceptable; diagnostics and prevention should be directed to young patients undergoing caesarean section. Besides technical procedures prevention of endometritis is important for the prevention of wound infection. In hospitals with low postcesarean infectious morbidity antibiotic prophylaxis seems to be unwarranted.

The effect of cigarette smoking on conventional semen parameters was studied in voluntary men of reproductive age (n = 190). Special attention was focused on sperm motility and its quantitative and qualitative change in vitro during the observation period. The sperm output war normal in both smokers (n = 54) and non-smokers (n = 1 lo), but semen volume was smaller (p < 0.03) in heavy smokers (> 16 cigarettes/day) than non-smokers. In sperm morphology there was no differencies between study groups. The only clear difference between men with different smoking habits was in the percentual change in the sperm motility during 24 hours.At the time of first examination, the sperm motility was better (p < 0.02) in heavy smokers than those who smoked less than 16 cigarettes per day and the motility decreased more rapidly (p < 0.007) in heavy smokers than non-smokers. The objectively measured initial mean velocities of the whole sperm population and of the progressive spermatozoa were slightly higher in subgroup of smokers than in non-smokers. The rapid decrease in the survival spermatozoa in smokers may be uneconomical and harmful in respect of fertility. Zigarettenrauchen und Spermaqualitat bei Mannern im fortpflanzungsfahigen AlterZusammenfassung: Es wurde der EinfluB des Zigarettenrauchens auf die gebrauchlichen Spermaparameter bei 190 Freiwilligen im fortpflanzungsfahigen Alter untersucht. Besondere Aufmerksamkeit wurde auf die Beobachtung der Spermatozoenmotilitat und ihre quantitativen und qualitativen in-vitro-Veranderungen gelegt. Die Spermatozoendichte war in der Gruppe der Raucher (n = 54) und der Gruppe der Nichtraucher (n = 110) normal, aber das Ejakulatvolumen war bei starken Rauchern (mehr als 16 Zigaretten pro Tag) geringer (p < 0.03) als bei Nichtrauchern. Bezuglich der Spermatozoenmorphologie ergaben sich keine Unterschiede zwischen beiden Gruppen. Der einzige Mare Unterschied zwischen Mannern, welche verschiedenartige Rauchgewohnheiten haben, lag in der prozentualen Veranderung der Spermatozoenmotilitat wahrend eines Beobachtungszeitraumes von 24 Stunden. Zum Zeitpunkt der ersten Untersuchung war die Spermatozoenmotilitat bei starken Rauchern besser (p < 0.02) als bei Rauchern, welche weniger als 16 Zigaretten pro Tag rauchten und die Motilitat nahm bei starken Rauchern schneller als bei Nichtrauchern ab (p < 0.007). Die objektiv gemessenen initialen Durchschnittsgeschwindigkeiten der gesamten Spermatozoenpopulation und der progressiven Spermatozoen waren geringffigig hoher in der Gruppe der Raucher gegenuber der Gruppe der Nichtraucher. Die rasche Abnahme der Zahl lebender Spermatozoen bei Rauchern kann beziiglich der Fertilitat unokonomisch und schadlich sein.