bluuebunny/crossref_metadata_2025 huggingface dataset:
Ca 125 in the Follow—Up of Patients with Ovarian Cancer
Authors: Halila Hannu , Lehtovirta Pentti , Stenman Ulf‐Håkan , Seppälä Markku
Published: November 2007

The value of CA 125 measurement in the diagnosis and follow–up of ovarian cancer was studied in 102 patients. The CA 125 levels were elevated in 88% (3221365) of samples from 82 patients with clinical evidence of disease and in 14% (561403) of samples from 58 patients without clinical evidence. Preoperative levels were elevated in 84% (44152) of the patients, and in 100% of those with stage III and IV disease. In patients with non–mucinous tumors the preoperative levels were elevated in 95% of cases (38140). CA 125 levels were significantly correlated with the course of disease in 88% (36141) of patients whose tumor regressed, and in 87% 120123) of those whose tumor progressed. Before second–look surgery of 48 patients, the sensitivity of the CA 125 test was 35% and the specificity was 86%. The results suggest that, although far from infallible, CA 125 is a useful marker for ovarian cancer. It is useful for monitoring the course of chemotherapy, but normal levels do not rule out the possibility of persistent or recurrent disease.
Amylase Activity and Fast–Migrating Amylase Isoenzymes in Serum and Cyst Fluid from Patients with Ovarian Neoplasms
Authors: Henriksen Rudi , Brock Axel
Published: November 2007

160 patients with various ovarian tumors were studied to establish whether total amylase activity and the occurrence of fast migrating amylase isoenzymes in serum could serve as indicators of ovarian cancer. It was found that patients with benign and malignant ovarian tumors could not be classified by means of total amylase activity. Electrophoretic separation of the amylases revealed fast‐migrating forms in serum from 10 of 47 patients with malignant ovarian neoplasms; 8 of these 10, and altogether 19 of the 47 patients had a serous cystadenocarcinoma. Two of the 109 patients with benign ovarian tumors also showed the pattern with fast‐migrating amylases; both of them had a serous cystadenoma. Four patients with borderline tumors showed normal amylase patterns. Tumor origin of these fast‐migrating amylase forms in serum was substantiated by 1) amylase reactive cells detectable in tumor tissue, and 21 surgical removal of tumor followed by complete disappearence of the fast‐migrating amylase forms in serum. Normal serum amylase patterns do not exclude the presence of a malignant ovarian tumor, but occurrence of these abnormal amylase forms in serum may indicate that an ovarian tumor is a cystadenocarcinoma.
Fetal Cardiac Function in Response to Long‐Term Maternal Terbutalin Treatment
Authors: Sørensen Keld E. , Børlum Karl‐Gerhardt
Published: November 2007

Abstract. To evaluate whether long‐term human fetal exposure to 0‐adrenergic receptor agonists elicit alterations in the human fetal heart, a fetal echocardiographic examination was performed in 9 fetuses between the 24th and 35th week of gestation (median 28 weeks) and 9 age‐matched controls. Examinations were performed during long‐term tocolytic terbutalin treatment. Drug dosages varied between 7.5 and 20.0 mg/day (median 10.0 mg/day) and treatment durations prior to examination varied between 14 and 60 days (median 25 days). No significant differences were noted between the exposed fetuses and their controls as regards FHR, left ventricular dimensions, interventricular septal thickness, left ventricular contractility (fractional shortening) and the derived left ventricular stroke volume. Despite the limited number of subjects it is believed that long‐term terbutalin exposure does not have any untoward major fetal left ventricular consequences.
Evaluation Of Three Simple Physiologic Tests As Predictors Of Pregnancy‐Induced Hypertension: A Pilot Study
Authors: Eneroth‐Grimfors Eva , Bevegård Sture , Nilsson Bo A.
Published: November 2007

Abstract. In order to try to find a method for predicting pregnancy‐induced hypertension (PIH), the roll‐over test, isometric handgrip test and cold pressor test were performed on 40 healthy pregnant women in their 29th to 31st week of pregnancy. All these three tests proved positive (rise in diastolic pressure of at least 20 mmHg) in more than 50% of the subjects. None of the women in the study developed PIH (blood pressure 140190 or more on at least two consecutive occasions). These results indicate that none of these simple physiologic tests is of use as a predictor of PIH.
Surgical Management of Life‐Threatening Obstetric and Gynecologic Hemorrhage
Authors: Fehrman Hans
Published: November 2007

Abstract. Life‐threatening obstetric or gynecologic hemorrhage can often be controlled by ligation of the uterine arteries or the internal iliac arteries. Following a description of the pelvic blood supply, the distribution and capacity of the collateral system and the hemodynamic changes after ligation, attention is called to these procedures of treatment and the consequent results, as described in the litterature. There IS no reason to fear tissue necrosis after ligation and knowledge of the abovementioned possibilities of ligation may contribute to the avoidance of unnecessary emergency hysterectomy.
Measurements of Fetal Head Compression Pressure During Bearing Down and Their Relationship to the Condition of the Newborn
Authors: Svenningsen Leif , Lindemann Rolf , Eidal Kristin
Published: November 2007

Abstract. Fetal head compression pressure (FHCP) and its clinical importance has been investigated in a group of 46 spontaneous births. Measurement of FHCP was facilitated using a compression transducer positioned between the fetal head and the wall of the birth canal. This method not only constitutes a means of quantitating the forces acting directly on the fetal head, but also provides information about the intracranial pressure generated during delivery. The latter extrapolation is based on the principle of applanation. The technique provides an objective and reliable estimate of intracranial strain and therefore a means of comparing the forces generated under different delivery modes. The condition of the same neonates at birth was assessed using umbilical artery pH, Apgar score, neurobehavioral testing and fundoscopic examination. The mean amplitude of FHCP in the different deliveries ranged from 38 to 390 mmHg (5–52 kPa) with an overall mean of 157.9 mmHg (21.1 kPa). The study indicated that the appearance of retinal hemorrhages in the newborn cannot be explained by exposure of the fetal head to abnormally high compression during birth. Other explanations must be sought for infants with a neurobehavioral deficit, reduced Apgar score, or umbilical artery acidosis at birth. It is concluded that a relatively short period of high FHCP has no obvious consequences for fetal well‐being, at least within the limits described in the present report.
Hysteroscopy in an Ivf‐Er Program: Clinical experience with 360 infertile patients
Authors: Seinera P. , Maccario S. , Visentin L. , Digregorio A.
Published: November 2007

Abstract. Three hundred and sixty patients underwent hysteroscopy before entering the IVF program. The procedure was successful in 332 patients; obstructive tubal disease was pre‐ sent in 247 (70%); 148 showed uterine abnormalities (44.5%) such asendornetrial polyps, adhesions, hypoplasia, malformations, or severe cervical stenosis; 114 patients had normal hysterographic findings, in whom hysteroscopy revealed a false‐negative rate of 36.8%. In 281 patients (84.6%) hysteroscopy was carried out under general anesthesia, in most cases associated with laparoscopy. There were no anesthetic complications, uterine perforations or other significant problems. In an IVF program, hysteroscopic evaluation can reduce the failure rate due to intra‐uterine abnormalities. Hysteroscopy, which permits one to optimize an IVF attempt, becomes an essential procedure before introducing a patient into an IVF program.
Ethinylestradiol and Desogestrel, Alone or in Combination with two Doses of Estriol: Effects on plasma proteins
Authors: Cullberg Göran , Mattsson Lars‐Åke
Published: November 2007

Abstract. Nineteen fertile women were treated with three differently composed oral contraceptives in a cross‐over study and were randomly allocated to begin with one of the three preparations The tablets contained 0030 mg ethinylestradiol + 015 mg desogestrel alone (A) or in Combination with either 05 mg estriol (B) or 2 mg estriol (CI After two treatment cycles on each preparation, blood samples were obtained and analysed for ceruloplasmin, SHBG, prealbumin, transcortin and thyroxine‐binding globulin No differances were found in the induction of liver protein synthesis It was concluded that the addition of estriol in doses of 05 or 2 mg did not influence the effects induced by ethinylestradiol.
Allergic Reaction to an Amide Local Anesthetic in Segmental Epidural ANALGESIA
Authors: Erkkola Risto , Kanto Jussi , Mäenpää Juhani , Kero Pentti , Hovi‐Viander Marja , Viander Markku
Published: November 2007

Abstract. A very serious case of anaphylactoid reaction to bupivacaine occurred during epidural analgesia. A rise in complement 3 activation products and a decrease in immunoglobulin E were observed, while bupivacaine toxicity was ruled out by normal serum concentration. Severe maternal hypotension, and a sudden decrease in the fetal heart rate were detected clinically. By a cesarean section, a baby girl was delivered, who at the age of 1 year appears normal.
Septic Abortion Caused by Salmonella Enteritidis
Authors: Dalaker Knut , Andersen Børg Marit , Løvslett Kjell , Revhaug Arthur , Berdal Børn
Published: November 2007

Abstract. Septic abortion caused by salmonella infection is rare. Here we report a case of septic abortion due to Salmonella enteritidis. The route of infection was probably transplacental.
Endometriosis with Ascites
Authors: Chichareon S. B. , Wattanakitkrailert S.
Published: November 2007

Abstract. Endometriosis associated with ascites is a rare entity. Since 1954 only 12 cases have been reported. We report here another case, seen at Songklanagarind Hospital. Clinical course, line of investigation and operative findings are described, and the management is presented. The point of diagnosis, appropriate management and possible etiologic mechanisms are discussed.

Ascites in the female patient draws clinical awareness to possible genital malignancy if cardiac, hepatic, and renal disease and tuberculosis can be ruled out. However, some other benign condition can cause ascites, although it is an unusual entity. One such condition is endometriosis.
EFFECT OF EPIDURAL VS. GENERAL ANESTHESIA ON BREASTFEEDING
Authors: Lie B. , Juul J.
Published: November 2007

Abstract. In a prospective interview study, two groups each consisting of 28 sectio caesarea patients were compared concerning the course of breastfeeding. The women in the two groups were delivered under either epidural analgesia or general anesthesia. The two groups were identical with respect to age, parity, participation in antenatal preparatory courses and former breastfeeding. A significantly higher breastfeeding frequency and longer breastfeeding periods were were found after epidural analgesia than after general anesthesia.
PREGNANCY OUTCOME AFTER METROPLASTY IN WOMEN WITH MULLERIAN ANOMALIES
Authors: Helm Peter , Sørensen Søren Stampe
Published: November 2007

Abstract. Pregnancy outcomes in 22 consecutively operated women with Mullerian anomalies are described. In 16 women the indication for metroplasty was two or more spontaneous abortions and/or premature deliveries The frequency of successful pregnancies increased from 5% before to 76% after operation. In 6 women metroplasty was performed on account of infertility. It is argued that infertility rarely constitutes an indication for metroplasty, and only when concurrent causes of infertility have been excluded. Several of the postoperative pregnancies and deliveries presented serious complications. Cesarean section is therefore recommended in some deliveries after metroplasty.
PROSTAGLANDIN VAGINAL SUPPOSITORIES IN NON PREGNANT WOMEN REQUIRING CERVICAL DILATATION PRIOR TO HYSTEROSCOPY
Authors: Hald Finn , Kristoffersen Sven Erik , Gregersen Erik
Published: November 2007

Abstract. A randomized doubleblind investigation of prostaglandin vaginal suppositories prior to hysteroscopy was untertaken in 30 non‐pregnant women. PGE2 in 14 of 15 treated patients we found a softening and a dilatation of the cervical canal, but with a relatively high frequency of side effects‐nausea, vomiting and diarrhea. No serious bleeding or side effects were observed.
OVARIAN CYSTS IN WOMEN WITH INFLAMMATORY BOWEL DISEASE
Authors: Nissen Kamilla Rothe , Lenz Susan , Sørensen Søren Stampe , Christensen Knud Chr.
Published: November 2007

Abstract. The frequency of ovarian cysts in patients with Crohn's disease (CD) or ulcerative colitis (UC) is believed to be higher than in the normal population, but this aspect has not been studied hitherto. The prevalence of ovarian cysts in the normal population is unknown. By ultrasonic scanning, we studied the frequency of ovarian cysts in 61 patients with CD, 64 with UC, and in 100 controls. The findings were positive in 3 out of 61 with CD, 5 of 64 with UC, and in 2 of 100 controls. There is a tendency to a higher frequency of ovarian cysts in patients with inflammatory bowel diseases than in the normal population, but no statistically significant difference.
A RANDOMIZED TRIAL OF THREE COPPER IUDS
Authors: Bratt Harald , Skjeldestad Finn Egil , Valentin Katharina Cullberg
Published: November 2007

Abstract. A randomized prospective trial of three copper IUDs, Nova‐T, MLCu375 and MLCu250, including 200 of each, is presented. Insertion was done at the hospital outpatient clinic on normally menstruating women and on women in puerperio. Follow‐up was scheduled after 12, 24 and 36 months. Pregnancy rates were low for all 3 models. Pearl Indices after 3 years were 0.5, 0.9 and 0.8 for Nova‐T, MLCu375 and MLCu250 respectively (NSI. Abnormal bleeding andlor pain was the most frequent termination cause. Minor differences in the termination rates because of abnormal bleeding and/or pain were found and are discussed. The continuation rates based on all medically relevant IUD removals were 74%, 73% and 81% after 3 years for Nova‐T, MLCu375 and MLCu250 respectively. No important difference in clinical performance between the three copper IUDs could be demonstrated.
RELATION BETWEEN STEROID RECEPTOR LEVELS AND PROLACTIN LEVEL IN THE ENDOMETRIAL STROMAL CELLS
Authors: Tamaya T. , Arabori K. , Okada H.
Published: November 2007

Abstract. The levels of estrogen receptors (ERs), progesterone receptors (PRs), androgen receptors (ARs) and prolactin (PRL) in the stromal cells were determined during the secretory phase of the endometrium. The total levels of cellular ER during the early and mid‐secretory phases and those in cellular PR during the mid‐secretory phase were significantly higher than those during the late secretory phase. No changes were seen in stromal AR level during these phases. The total ER levels was always significantly higher than those of other receptors in any phase of endometrium. The total AR level was significantly higher than the PR level in any phase of endometrium except that in late secretory phase. Cytosol PRL levels were low in 42% of the subjects in whom PRL was detected. The cytosol PRL level in these subjects was inversely correlated only to cellular ER levels.
FAT‐SOLUBLE 17β‐ESTRADIOL: A WAY OF REDUCING DOSAGE IN STEROID HORMONAL SUBSTITUTION?
Authors: Schubert Werner , Cullberg Göran
Published: November 2007

Abstract. Eight ovariectomized women were given 0.5 mg 17β‐estradiol cyclo‐octyl acetate (E2COA) dissolved in arachis oil+0.15 mg desogestrel, and 2 mg micronized 17β‐estradiol (mE2) + 0.15 mg desogestrel orally in a crossover fashion for 20 days each. The preparations were taken on 10 days together with a meal, on 10 days 3 hours after a meal. Blood samplings were performed 3 h after capsule ingestion for analysis of serum estradiol (S‐E2), estrone (S‐E1) and sex hormone binding globulin (SHBG). Before treatment, all women had climacteric complaints. During treatment these symtoms were alleviated and no discomfort was reported. No differences in serum levels of estrogens were found in either of the preparations when capsules were taken with or without food. However, serum levels of E2 were found to be 100% higher per mg substance given after E2COA vis‐à‐vis mE2. This indicates either a delayed breakdown and/or a better resorption. The E1/E2 ratio after E2COA was only half that after mE2 intake. This hints at another route of resorption. SHBG concentrations were somewhat elevated following mE2 administration, whereas a slight decrease was found after E2COA. The resulting post‐treatment difference was significant, suggesting a less estrogenic liver effect by E2COA. No accumulation of E2 or E1 was seen after either of the preparations. Our findings support the hypothesis that E2COA. being fat soluble, is resorbed via the lymphatic system. By avoiding the first liver pass the dosage of estrogen can be halved.
BILATERAL TUBAL PREGNANCY
Authors: Andersen Erik Søgaard , Møller Niels Gyldholm
Published: November 2007

Abstract. A case of simultaneous bilateral tubal pregnancy in a 29‐year‐old patient is presented. The diagnosis was confirmed by pathologic examination, showing chorionic villi in both locations. The possibility of this rare diagnosis should always be kept in mind and careful examination of both adnexa should be performed in cases of ectopic pregnancy.
Operative Treatment of Recurrent Cancer of the Uterine Cervix after Radiotherapy
Authors: Ibsen Thomas Bjern , Serensen Bent L. , Knudsen Jens B. , Serensen H. Mygind
Published: November 2007

During the period 1976–83, 47 women were operated on for recurrent or persistent cancer of the uterine cervix following initial radiation therapy. The operations performed were Wertheim's operation combined with dissection of the pelvic nodes, or some type of pelvic exenteration. With a 5‐year survival of 31% in our material, surgical treatment of centrally located recurrences is a realistic possibility. We recommend an exenterative procedure as the operation is technically easier and the complications require less radical surgical treatment. The operation should only be done on narrow indications in the hope of achieving a cure, and the selection of patients must thus be stringent.
Meningismus as Main Symptom in Toxic Shock Syndrome
Authors: Lund Lars , Nielsen Dorthe , Andersen Erik Soegaard
Published: November 2007

A case of toxic shock syndrome (TSS) with meningismus as main symptom is presented. The case illustrates that, in cases of rigidity of the neck and back, not directly explainable, TSS should be considered as a possible diagnosis. Toxic syndrome ITSS) is a severe, acute infectious disease with great variations in symptornatology (1,2). Its lethality is approximately 5% (3). The prognosis depends on early diagnosis and treatment.
The Maternal‐Infant Center in the Control of Hepatitis B
Authors: González L. , Roses A. , Alornar P. , Del Valle J. M. , Ferrer A. Garau P. , Llinares M. Mairnó R. , Lardinois I. Blanco R.
Published: November 2007

A seroepidemiologic survey of HBV infection was carried out in four population groups served by the Maternity Hospital of Majorca, an island in the Mediterranean. The prevalence of HBV markers (HBsAg, anti‐HBs, anti‐HBc), determined by enzyme‐immunoassay, reached 17.2% among 864 parturients, 17.2% in 783 hospital personnel, 2.7% and 19.2% among the 186 children and 73 husbands of parturients with no HBV markers, 22.8% and 43.8%, respectively, among the 44 children and 48 husbands of HBsAg chronic carrier parturients. The prevalences of HBsAg in the same groups reached 0.9%, 1.5%, 0% and 0%, 11.4% and 2.1%. respectively. The carrier state represents 50% of all infection cases among children and 4.8% among husbands of carrier women. The prevalence of markers, which was especially high among personnel working in maintenance services (39.1%). on surgical wards (35.3%), among midwives (27.6%) and in cleaning and laundry services (27.1%), and laboratories (21.4%), is used as an indicator in defining priorities for the vaccination of people at risk. Sixty‐seven newborn babies of HBsAg carrier mothers were administered one dose of HBlG and three doses of hepatitis B vaccine; at 12 months of age, the seroconversion rate was 98.5%, whereas 1 child (1.5%) became a chronic carrier. Maternity hospitals represent the ideal centers in which to carry out the detection of HBsAg in pregnant women prior to parturition, to ensure that all newborns of chronic carrier women receive passive‐active immunization, and to screen their family contacts and vaccinate those who are found susceptible to the infection.
Trainability of the Pelvic Floor
Authors: Nielsen A. Cathrine , Sigsgaard Lnga , Olsen Mette , Tolstrup Marianne , Danneskiold‐Samsoee Bente , Bock Johannes E.
Published: November 2007

The contractibility and trainability of the pelvic floor were investigated during pregnancy and after vaginal delivery in 86 healthy primiparae. One group (TG) (n = 38) was instructed in training the pelvic floor from the 33rd week of pregnancy, whereas the other group (non‐TG) (n = 39) was not. Both groups were measured by perineometry five times between 33rd–39th week of pregnancy and approximately 8 weeks after delivery. Half of the women were also measured 8 months post partum. At the beginning of the study both groups showed the same strength of the pelvic floor. 8 weeks and 8 months after delivery the TG were significantly (p < 0.05) better able to contract the pelvic floor compared with the non‐TG. 8 months post partum, the TG had regained the initial values of pelvic floor contraction as from 33rd week of pregnancy, whereas the non‐TG had not. During pregnancy there was a better ability to contract the pelvic floor in the TG vis‐à‐vis the non‐TG, though not significantly so. No difference in the course of delivery was observed, and the frequency of complications was the same in the two groups.
Estimated Prevalence of Müllerian Anomalies
Authors: Serensen S. Stampe
Published: November 2007

Among 167 women who underwent laparoscopic sterilization in the course of one year, 1.2% were found to have a bicornuate uterus. Of them, 111 were offered follow‐up by hysterosalpingography (HSG), and the history of their menstrual pattern as well as reproductive potential was recorded. Evaluation of the HSG exposures revealed 3.6% moderately to severely septate uteri (H/L > 0.20), and a total of 15.3% had fundal anomalies IH/L > 0.10). In women who had always had normal fertility and menstrual cycles of less than 35 days, the corresponding frequencies of septate uterus were 1.2% and 11.8% respectively. Among women who had had oligomenorrheic periods exceeding one year in duration, the frequency of müllerian anomalies was significantly higher (21.1% at H/L > 0.20 and 36.8% at H/L > 0.10) than in the above‐mentioned groups. A control group of infertile oligomenorrheic women revealed that the material was comparable with previously published populations as regard the occurrence of minor müllerian anomalies. It is concluded that the HSG‐diagnosed prevalence of developmental uterine anomalies is in general somewhat higher than usually assumed.
Obstetric Behavior and Ultrasonic Uterine Characteristics of Oligomenorrheic Women
Authors: Sørensen S. Stampe , Lenz S. , Karlsen J.
Published: November 2007

Two groups of age‐, parity‐, and pregnancy‐matched women, viz. 78 with oligomenorrhea (A) and 78 with normal menstrual intervals (B), plus all women with regular menstruation but in whom severe Müllerian malformations had been diagnosed during the same period (C) were followed in a prospective study to detect complications, sonographic changes, and the serum oxytocinase concentration during pregnancy and labor. Among the matched groups A and B, ultrasonic scanning revealed uterine changes in 45% and 9%. respectively (p < 0.0005) during the 2nd trimester. Among the oligomenorrheic women who had HSG, fairly mild Müllerian malformations were fo—in 40%. The sonographic method in these mild and moderate anomalies had its Iimmations, and the findings were interpreted in several cases as fibroma or contractions. Complications occurred in 51% of the group A women who carried their pregnancies to term versus 20% in group B (p < 0.0005). Among the primiparae the complication rates were 47% and 22%, respectively (p < 0.025). Bleeding in early pregnancy (25%), an unstable fetal lie (28%), malpresentations (14%), and premature contractions or delivery (11%) were more common in group A (p < 0.05—0.01). On stratification of the oligomenorrheic group without or with Müllerian anomalies (A2 and A) the overall complication rates were 55% and 73%, respectively, and 86% in group C. Mutually, these differences are not statistically different, but all differ significantly from the control group (B) (p < 0.005). As regards specific complications, group A1, unlike the other groups, differed statistically from the control group only in malpresentation. No differences in the serum oxytocinase concentration between the three main groups were demonstrable. It is concluded that obstetric complications in women with the syndrome ‘minor Müllerian anomalies and oligomenorrhea’ are presumably not due solely to the congenital anatomic effect, but rather to its combination with pathophysiological muscular dysfunction.
Reimplantation of a Benign Ovarian Tumor
Authors: Asmussen Mogens , Nielsen Mette Harring , Rygaard Carsten
Published: November 2007

An unusual case of a benign ovarian tumor, which had been torn off its primary usual anatomical site and transplanted to a new intra‐abdominal location with new blood supply from the omentum, is described.
Response to Human Chorionic Gonadotropin in Patients with Ovarian Tumors
Authors: Scirpa P. , Mango D. , Liberati M. , Manna P. , Tartaglia E. , Ricci S. , Iacona T. , Mancuso S.
Published: November 2007

The results of hCG stimulation on peripheral levels of androstenedione (A), testosterone (T) and estrone (El) were examined in 14 patients with ovarian tumors and in 9 tumor‐free subjects, after the menopause. Following hCG injection, 9 postmenopausal patients with ovarian tumors showed a significant rise in A peripheral levels. The responsive subjects generally had significant increases in A baseline levels, too. The remaining 5 subjects with advanced or poorly differentiated ovarian cancer with no stroma were not responsive to hCG. Moreover, in the tumor group, 7 subjects had increased baseline T and/or El and in 3 of them an increase of these steroids was observed following hCG. In the absence of ovarian tumor, no subject in the control group was responsive to hCG administration. The results of the present investigation seem to confirm the in vivo responsiveness to hCG of ovarian tumors.
Cryosurgical Treatment Of CIN I–III
Authors: Einerth Yngve
Published: November 2007

One hundred and seventeen patients (age range 18–40 mean 28 years), with ectocervically located intraepithelial neoplasia (CIN), histologic grades I–III, were treated with cryosurgery during the period 1974–80. The initial cure rate was 93.2% overall, and 88.1% for CIN III. During long‐term follow‐up (7–12 years, mean 9.8) two failures occurred, one after 2.5 years, the other after 7 years, giving a long‐term cure rate of 91.5% overall, and of 86.5% for CIN III. all patients but one were available to follow‐up (i. e a loss to follow‐up rate of 0.8%). There were no significant early or late complications, nor any untoward effects with regard to pregnancy or fertility. Thus cryosurgical treatment of ectocervically located CIN gives good long‐term results. Scrupulous selection of patients, consisting of a meticulous colposcopic investigation, histologic diagnosis based upon cervical biopsy and curettage, is important to avoid the hazards of invasive cancer.
Structural and Ultrastructural Patterns of the Human Preovulatory Endometrium Following Clomiphene Citrate Treatment
Authors: Fedele Luigi , Marchini Maurizio , Baglioni Andrea , Dorta Milena , Candiani Giovanni Battista
Published: November 2007

To investigate ultrastructural modifications in the endometrium of women receiving clomiphene citrate (CC) treatment, we performed endometrial biopsies in the preovulatory phase in 17 patients with anovulatory infertility and 16 normo‐ovulating women with tubal or male sterility. Histology, scanning and transmission electron microscopy (SEM and TEM) revealed midproliferative phase aspects in 11.7% of the treated group and 6% of the controls, late prolif erative aspects in 76.4% and 82%, and postovulation days 1–3 characteristics in 11.7% and 12% respectively. No significant differences were observed between the patients and controls; our data indicate that CC taken in a dose not exceeding 100 mg/day from day 3 of the cycle can induce endometrial maturation that is almost identical with that of a spontaneous preovulatory phase. This type of endometrium should therefore allow implantation of a fertilized egg and maintain unmodified the complex biohumoral relations with the embryo.
The Value of Endometrial Curettage in the Follow‐Up of Hydatidiform Mole
Authors: Flam Folke , Lundström Viveca
Published: November 2007

Multiple curettages in the follow‐up of patients with hydatidiform mole are often performed in Sweden. Of 36 patients developing trophoblastic neoplasia after molar evacuation, 24 underwent one or more endometrial curettages. The objective was generally to verify a diagnosis of malignant disease. However, in only one patient was a histopathological proof of choriocarcinoma obtained. In 3 other patients, malignancy could not be ruled out. It is demonstrated that development of malignancy after hydatidiform mole is rarely proven by endometrial curettage.
Pregnancy and Ventriculoperitioneal Shunt
Authors: Hassan Adnan , El Moumani Abdel Wali
Published: November 2007

Reported cases of pregnancy occurring in association with an extracranial shunt for hydrocephalus are very few. This report documents two uncomplicated pregnancies in a patient with ventriculoperitoneal shunt. Abdominal pain was the most frequent symptom in our patient.
Comparison of Induced Versus Non‐Induced Labor in Post‐Term Pregnancy: A Randomized Prospective Study
Authors: Bergsja Per , Gui‐Dan Huang , Su‐Qin Yu , Zhi‐Zeng Gao , Bakketeig Leiv S.
Published: November 2007

Objecfive To determine the proper management of pregnancy in uncomplicated cases going beyond 42 weeks.

Design Randomized controlled trial of induction of labor at or shortly after the 42‐week limit, versus close monitoring without induction except when indicated for medical reasons.

Setting Hospital's obstetrical department Study population: 188 pregnant women, randomly allocated to two groups with 94 in each.

Interventions Induction of labor by stripping of membranes and i.v. oxytocin infusion, with artificial rupture of membranes when the cervical opening was 3 cm or more in diameter. The control group was followed with clinical, biochemical and electronic tests, intervention being applied according to needs.

End points Frequency and modes of operative delivery, maternal and perinatal rnorbidity and mortality.

Main results The distribution of gestational age (in weeks) at birth was almost identical in the two groups, but there were more operative deliveries in the control group than in the induction group (64 versus 48, p < 0.05). Maternal complications and perinatal morbidity rates were equally distributed between the groups. There was one perinatal death in the induction group and two deaths among the controls.

Conclusion With due reservation for small numbers, routine induction after term may result in fewer operative deliveries. No other advantage has been demonstrated when compared with close monitoring and intervention when medically indicated.
The Performance of a Simple Scoring System Screening for Low Birthweight Infants for Gestation in an Unselected Pregnant Population
Authors: Sijmons Edith A. , Vervest Harry A.M. , Kerkhof Mieke , Reuwer Paul J.H.M. , Bruinse Hein W.
Published: November 2007

Identification of poor fetal growth is an important objective of antenatal care. We evaluated the validity of the Wennergren score to predict small for gestational age and/or underweight for length infants (low ponderal index). To 405 randomly chosen pregnant women from our university hospital population, this numerical scoring system was applied at 28 and 34 weeks of gestation. Birthweights below the 2.3rd and 10th centile and ponderal indexes below the 3rd and 10th centile were used as outcome standards. The sensitivity of predicting SGA infants ranged from 28.4% for infants below the 10th birthweight centile at 28 weeks, to 66.7% for infants below the 2.3rd centile at 34 weeks. Figures for low ponderal indices ranged from 25.0% to 50.0%.

In contrast to the promising performance of the Wennergren score as described in the Scandinavian literature, this score was not useful as a screening test for SGA or underweight for length infants in a Dutch hospital population.
The Unborn and Newborn Child. I: Risk Factors Predicting Complicated Delivery in a General Population of 4,102 Women
Authors: Holst Kirsten , Hilden Jørgen , Henningsen Inge
Published: November 2007

Among the 56 risk factors (RF) in pregnant women, used by the Danish National Board of Health, those that can predict complicated delivery (CD) were identified. The significance of parity, maternal age, social class and civil status was also analysed. The material comprises a Danish county cohort of 4,102 deliveries. The 56 original RFs affected 56% of the population. Women (8.8%) with twin pregnancy, fetus in breech, footling and transverse lie, or having an elective cesarean section were analysed separately. The incidence of CD was otherwise 39%. Of all the women, 8.7% had only prepregnancy RFs with a CD rate of 52%; 19.2% had only pregnancy RFs other than special conditions mentioned with a CD rate of 52%; 3.6% had both prepregnancy and pregnancy RFs with a CD rate of 62%. When the special conditions separately analysed were included, 14 RFs of the original 56 were found to predict complicated delivery. These affected 40% of the population. Primiparity was also a RF. The conceptional age of a primipara raised the odds in favor of CD by a factor 1.09 for each year. Social class and civil status were of no significance for CD.
Maternal Bilirubin, Cord Bilirubin, and Placenta Function at Deliveryd the Development of Jaundice in Mature Newborns
Authors: Knudsen Aage , Lebech Morten
Published: November 2007

The study material comprised 213 newborns with a birth weight above 2000 g, and their mothers. At delivery, blood samples were obtained from the umbilical cord and the mother's cubital vein for determination of the transplacental bilirubin gradient and assessment of placental function by means of the HPL concentration in the rnaternal blood. The HPL concentration showed no relation to the transplacental bilirubin gradient or the umbilical cord bilirubin concentration. Therefore, to the extent that the the HPL concentration reflects the rate constants for bilirubin transfer, an increased transplacental bilirubin gradient or an increased cord bilirubin concentration could not be explained by an impaired ability of the placenta to transfer bilirubin. When the infants who became jaundiced were compared with the non‐jaundiced, significantly higher transplacental bilirubin gradient (p<0.00001), cord bilirubin (p<0.00001) and maternal bilirubin values at the time of delivery (p<0.03) were found among the jaundiced infants. On the basis of the results it was possible to define subgroups of infants with significantly higherllower risk of subsequent jaundice.
Effects of Isradipine, A New Calcium Antagonist, on Postpartum Uterine Activity
Authors: Ingemarsson I. , Arulkumaran S. , Wide‐Swensson D. , Forman A. , Andersson K.‐E. , Ratnam S. S.
Published: November 2007

The effects of a new calcium antagonist, isradipine (PN 200–110) on postpartum uterine activity and the maternal cardiovascular system were investigated. Uterine activity was recorded by a microtip transducer catheter inserted transcer‐vically within 45 min of normal vaginal delivery. 0.5 mg of isradipine was given as a bolus injection during 5 min to 7 women with spontaneous uterine activity and 1 mg was given during a 15‐min period to another 8 women with oxytocin‐stimulated uterine activity. Matched controls with similar pre‐injection activity (±5%) but not given the drug were selected for comparison. The effects of the drug in 3 women (given 1 mg of isradipine) were compared with those in matched controls and in women given 0.25 mg of terbutalin i.v. as a bolus injection. lsradipine had a marked inhibitory effect on both spontaneous and oxytocin‐stimulated uterine activity. The inhibitory effect of 1 mg of isradipine seemed comparable to that of 0.25 mg of terbutalin. The inhibition occurred within 1–2 min after the injection and was sustained throughout the study period (2 h). A transient reduction of the systolic (mean maximum decrease 10–15%) and diastolic blood pressure (mean maximum decrease 15–2096) was seen, particularly during the injection period. Hypotension (systolic blood pressure < 80 mmHg) was not recorded. A moderate increase in pulse rate (mean maximum increase 22–27%) was seen in all cases. The results show that isradipine given as a bolus injection can inhibit early postpartum uterine activity, with minimal side effects.
Estrogen and Progesterone Receptors in Uterine Leiomyomas
Authors: Marugo Mario , Centonze Michele , Bernasconi Donatella , Fazzuoli Laura , Berta Silvia , Giordano Giulio
Published: November 2007

The purpose of our study was to evaluate the contrasting data between estrogen receptors (ER) and progesterone receptors (PgR) in uterine leiomyomas, endo‐metrium and myometrium. Uteri were obtained from 30 women undergoing hysterectomy for uterine leiomyomas (24 premenopausal and 6 postmenopausal patients). Cytosolic and nuclear ER and PgR were analysed in uterine tissues by the method of single saturation point assay at a final concentration 5 nM of [3H‐17P]estradiol and [3H]ORG‐2058. Our results confirm that leiomyomas undergo changes similar to those observed in other uterine tissues during the menstrual cycle. The ER levels show decreased values during the postovulatory phase. After subdividing leiomyomas according to their topographic criteria, as submucous or subserosal, we observed that ER and PgR are significantly more numerous in submucous than in subserosal myomas, both in proliferative and in the secretive phase of the cycle. These results agree with the hypothesis that leiomyomas have a different etiology and may explain why some myomas decrease after progestin therapy (submucous), while others (subserosal) remain unchanged.
Maternal Heart Disease
Authors: Bitsch Mikael , Johansen Christoffer , Wennevold Alf , Osler Mogens
Published: November 2007

Among 87 pregnancies complicated by heart disease, delivered during the decade 1977–86, 70 (81%) had a congenital heart malformation. 7 (8%) an acquired heart disease and 10 (11%) arrhythmias or conduction disturbances. The incidence was 0.3 %. The corresponding data from a report from Rigshospitalet during the 1950s were: 42%. 49%, and 9%, respectively, and an incidence of 0.9%. Ventricular septal defect (VSD) and atrial septal defect (ASD) were the most frequent malformations. The women were classified according to the NYHA before, during and after the pregnancy. All women except 4 re‐entered their original functional class. In 51 cases, ECG showed completely normal sinus rhythm, while in 36, various degrees of arrhythmia or conduction disturbance were found as well as left or right ventricular hypertrophy and/or strains. Nine infants had congenital defects, 4 of which were a heart malformation (4.6%). One infant died. Gestational duration, weight and perinatal mortality did not differ significantly from that of the general population. Two women died, one of primary pulmonary hypertension and one with a rupture of the thoracic aorta. Rheumatic heart disease is no longer a significant factor in relation to pregnancy in Denmark, but congenital heart disease is still of great importance, because more survive and reach the age of fertility. Today most women can be brought safely through pregnancy, but obstetric, cardiologic and anesthesiologic expertise is still mandatory for a successful course and outcome of pregnancies complicated by heart disease.
Oral Administration Of The Prostaglandin Enisoprost Induces Uterine Activity And Softens The Cervix During First Trimester Pregnancy
Authors: Pulkkinen Martti O. , Cohen Helen , Vuento Maarit
Published: November 2007

48 patients in the first trimester of pregnancy received a single oral dose of placebo or enisoprost (prostaglandin E1 analogue): 10, 25, 50, 100, 200 or 400 μg. Uterine activity was recorded for 1 h before and for 4 h after administration of the study drug with a Millar microtransducer. There was a dose‐related increase in mean resting and active pressure, but not in frequency of pressure cycles. At the highest dose used, namely 400 ug, all 6 subjects bled. Enisoprost dilated the cervix and any further dilatation required was easy to accomplish.
The Clinical Significance Of The Genital Microbiologic Flora At Vacuum Aspiration Following Miscarriage
Authors: Knudsen Aage , Junge Ole , Kjægaard Benedict , Højbjerg Tove , Christiansen Ole Bjarne
Published: November 2007

85 women undergoing vacuum aspiration following miscarriage were studied. At the time of vacuum aspiration, immunofluorescent stainings for detection of C. trachomatis proved positive in 5.9% of the patients. Group 8 streptococci were isolated in 7.5%, coliforms in 3.5%, and Gardnerella vaginalis in 51% of the patients. The overall frequency of postabortal pelvic inflammatory disease (PID) was 3.5%. whereas 40% of chlamydia‐positive women contracted postabortal PID (p < 0.05). No significant relation between other microorganisms and postabortal PID was observed. The duration of postabortal bleeding was unrelated to the genital microbiologic flora. Based on anamnestic information about previous pregnancies and duration of preoperative bleeding it was possible to define subgroups at risk of harboring C. trachomaris and coliforms. The clinical significance of this is unknown.
Bilateral Female Pelvic Actinomycosis
Authors: Hansen Lars Kjaersgård
Published: November 2007

A case of bilateral actinornycotic salpingitis is described. The woman used an IUD and the course of the dis ease was protracted. Later, Actinomyces israeiii was coin cidentally identified from vaginal cultures. Attention is drawn to the need for distinction between the presence of Actinomyces israelii and actinomycosis.
Maternal Mortality in Jamaica: Socioeconomic Factors
Authors: Golding Jean , Ashley Deanna , McCaw‐Binns Affette , Keeling Jean W. , Shenton Terry
Published: November 2007

Socioeconomic factors relating to all maternal deaths identified during the 12 months of the Jamaican Perinatal Morbidity and Mortality Survey were compared with a control population of over 10,000 women. The maternal mortality rate was 11.5 per 10,000 livebirths. Initial analyses revealed (a) that the risk of maternal death declined with increasing maternal education level, (b) that mothers who lived in households with direct pumped water and/or flush toilets enjoyed a reduced risk; (c) mothers who were themselves the major wage earner and (d) those living in households where the major wage earner and source of income was an agricultural worker or farmer were at increased risk of maternal death. A previous analysis showed that the mother's age, her parity and variables indicating access to medical care were important. Logistic regression showed that only maternal age and toilet facilities were independently associated with maternal mortality.
Primary Invaswe Squamous Cell Carcinoma of the Vagina
Authors: Malmström Henric , Simonsen Ernst , Tropé Claes
Published: November 2007

Neoplastic lesions of the vagina account for 1% of all gynecologic malignancies. The overall 5‐year survival rate for this disease is poor. This study comprised 58 patients with diagnosis of squamous cell carcinoma of the vagina treated between 1960 and 1984. Median age at diagnosis was 70 years. The lesions were staged according to FIGO. The numbers of patients in various stages were: I/13, II/24, III/12 and IV/9 and according to histologic differentiation: low grade/11, medium grade/17 and high grade/25; not recorded, 5. Twenty patients were treated with primary surgery and irradiation, 30 were treated with intracavitary and/or external irradiation only. The 5‐year corrected survival rates were: St I/50%, St II/30%, St III/17% and St IV/0%; grade 1/57%, grade 2/32% and grade 3/17%, younger than 70 years of age/43% and older than or 70 years of age/21%. The incidence of rectovaginal or vesicovaginal fistulas amounted to 17%. The treatment results of primary carcinoma of the vagina are poor. Prognostic factors for survival should be considered at treatment planning.
Establishment and Characterization of a Subline Predisposed to Pulmonary Metastasis from a Human Gestational Choriocarcinoma Cell Line in Nude Mice
Authors: Kanazawa Koji , Adachi Shigemi , Yoshiya Norio , Honma Shigeru , Takahashi Hiroaki , Takeuchi Shoshichi
Published: November 2007

A subline predisposed to pulmonary metastasis was successfully derived by repeating in vivo selection of GCH‐1, a human gestational choriocarcinoma cell line, in nude mice. While the parent line GCH‐1, transplanted subcutaneously to nude mice, induced pulmonary metastasis in a few of the host animals, the newly established subline GCH‐l(m) successfully metastasized to the lungs in 100% of them. Compared with GCH‐1, GCH‐l(m) exhibited a higher degree of cell atypia, a lower capacity for cell growth and markedly higher productivity for human chorionic gonadotropin (hCG). Another characteristic of this subline was its enhanced growth after the addition of a pulmonary extract obtained from nude mice. The relationship of these findings to the mechanisms of metastasis of this cancer was discussed.
Breech Extraction Versus Cesarean Section for the Remaining Second Twin
Authors: Berglund Lars , Axelsson Ove
Published: November 2007

All second twins delivered by cesarean section (CS) after vaginal birth of the first twin (n = 38) and all breech‐extracted second twins (n = 282) in Sweden during 1973–81 were identified. Data from the medical records of all CS second twins were extracted and compared with breech‐extracted second twins from the same departments born within 2 years of the CS twin (n = 25). Second twins delivered after maternal general anesthesia had lower 5‐min Apgar scores, irrespective of mode of delivery. Maternal morbidity was substantial in the CS group. The results encourage the use of breech extraction under local anesthesia rather than CS when there is a need for a quick delivery of the second twin and when both alternatives are available.
Uterine Size, Parity and Umbilical Cord Length
Authors: Sørnes Torgrim , Bakke Trygve
Published: November 2007

It seems to be a widely held notion that the uterine cavity is larger during a woman's later pregnancies than during her first pregnancy. The direct evidence for this is, however, scarce. The umbilical cord length at term is one measure of the fetal intra‐uterine mobility, and therefore indirectly of the space in which the fetus moves. If the uterine cavity is larger during later pregnancies, the cord length of the babies in these pregnancies should be longer. We have compared the cord lengths of 1839 babies, divided into three groups: babies born of primiparous, secundiparous and tertiparous women. The difference in mean cord length is statistically significant between the first and the third group. This supports the theory of a larger intra‐uterine space in later pregnancies. We also examined 159 mothers, measuring the umbilical cord length of their first and second babies. A significant positive correlation was found, in that the first baby tended to have the shorter cord. A control group with matching, but unrelated babies showed no such correlation. The results seem to us to support the stated theory further.