bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect on Fertility of Ligation of the Left Spermatic Vein in Men Without Clinical Signs of Varicocele
Authors: Fogh‐Andersen P. , Nielsen N. C. , Rebbe H. , Stakemann G.
Published: December 2009

Abstract. Improvement of sperm qualities and fertility after operation for varicocele is well‐documented. The effect does not appear to relate to the degree of dilatation of the spermatic veins. For this reason 22 men with severely impaired fertility but without any clinical sign of varicocele were offered operation, i.e. ligation of the left spermatic vein(s). Fertility was evaluated by repeated sperm examinations. On average, the childlessness lasted for 3.5 years before the operation took place. A sperm examination was performed on average 6.3 months postoperatively. In half the cases improvement of sperm quality was found. In 9 cases no change was observed, and in one man the sperm quality was reduced. In 7 cases conception occurred within 16 months. The improvement of both sperm quality and the conception rate were highly significant in comparison with a non‐operated control group with the same severely impaired fertility and without clinical sign of varicocele.
Cervical Pregnancy
Authors: Lange Aksel P. , Sjølie Anne K.
Published: December 2009

Abstract. Within the last ten years 2 cases of cervical pregnancy have been recorded in the Gynecological department of the Odense University Hospital. The case histories are given. In one of the cases the diagnosis was made clinically. In the other the diagnosis isthmico‐cervical pregnancy was confirmed by pathological examination. The diagnostic criteria and treatment are described and discussed. The occurrence of cervical pregnancy is presumed to be more common than assumed to date, inasmuch as a number of early cases without complications are probably recorded as spontaneous abortions.
Intra‐Uterine Transfusion in the Management of Pregnant Women with Severe Rhesus Isoimmunization
Authors: Bock Johannes E.
Published: December 2009

Abstract. Intra‐uterine transfusion may be a life‐saving procedure in severe cases of rhesus isoimmunization. Yet it may be technically difficult and poses a real hazard to the fetus. This material consists of 51 intra‐uterine transfusions performed in 34 severe rhesus (anti‐D) isoimmunized pregnant women. The selection of patients was based upon an evaluation of the severity of fetal erythroblastosis (past obstetric history, serological and amniotic fluid examinations). The major criterion for selection was the concentration of amniotic fluid bilirubin. The technique employed was based upon a fluoroscopic television control system. The most serious complications were blood‐stained amniotic samples in 15% of the amniocenteses and vaginal leaking of amniotic fluid and preterm labour after the performance of the intra‐uterine transfusions in 33%.
PSYCHODIAGNOSTIC FOLLOW‐UP OF NEOVLETTA®‐A NEW LOW DOSE ORAL CONTRACEPTIVE
Authors: Fedor‐Freybergh Peter , Hjelmqvist Margareta , Zador Göran
Published: December 2009

Abstract. In 45 somatically healthy women the possible occurrence of psychic effects of a new low dose combined oral contraceptive was studied using different psychodiagnostic test methods. All the participants were previous users of some of the standard combined oral contraceptives, but had discontinued either due to experienced side‐effects, due to fear of such effects or due to other reasons. Four patients dropped out before the end of the six‐month‐observation period. Women who discontinued previous use of oral contraceptives due to side‐effects or due to fear of side‐effects exhibited a more pronounced degree of neuroticism compared to those who terminated due to other reasons. Those who experienced side‐effects during earlier medication had initially a higher depression score than the two remaining groups suggesting that women's basic psychic nature seems to play an important role in the development of psychic symptoms during oral contraceptive therapy. None of the three groups developed additional signs of depression during treatment. Moreover, no impairment of the sexual function, assessed by a number of parameters, was found. The findings clearly indicate that Neovletta® did not cause any psychic disturbance in the patients studied.
Increasing Caesarean Section Rate
Authors: Johnell H. E. , Östberg H. , Wåhlstrand T.
Published: December 2009

Abstract. At the University Hospital in Uppsala 719 Caesarean Sections (C.S.) were performed 1966–1970. The total number of deliveries was 16708. The C.S. rate increased from 2.0% to 7.8%. This trend was mainly due to an increasing frequency of C.S. performed for cephalopelvic disproportion fetal distress “bad obstetrical history” and failed induction of labour with intravenous oxytocin drip. No maternal deaths occurred. The perinatal mortality was 5.0%. In infants with a birth weight of 1500 g or less the perinatal mortality was 57% and in infants with a birth weight of more than 2500 g and a gestational age of 37 weeks or more it was 0.9%. In 207 elective C.S. on healthy mothers at term no perinatal deaths were noted.
Distribution of Blood Flow in Myomatous Uteri as Measured by Locally Injected 133XENON
Authors: Forssman Lars
Published: December 2009

Abstract. Regional blood flow in the myometrium and myomata has been measured during laparotomy in 11 patients using locally injected 133Xenon. Blood flow was calculated from the wash‐out curves using both initial slope technique and compartment analysis. Assuming equal partition coefficients in myometrium and myomata the following values in ml ± min−1 ± 100 g−1 are seen: initial slope technique–myometrium 15.6±2.29, myomata 5.1±0.95, compartment analysis–myometrium 20.01±3.21, myomata 5.5±1.16. The blood flow was always lower in myomata than in myometrium of the same uterus. The main reason for the reduction of blood flow per unit weight of uterus in patients with myomata previously reported thus seems to be low blood flow in the myomata. A slight reduction of blood flow in the surrounding myometrium, however, also seems probable.
A New Technique for the Localization of the Cervix AT 113mIN Placental Scintigraphy
Authors: Edeling Carl Johan , Weber Jan , Brøchner‐Mortensen Jens
Published: December 2009

Abstract. Sixty women in the third trimester of pregnancy were examined with 113mIn placental scintigraphy because of bleeding. In 24 of the cases, the scintigraphic procedure was initiated by application of a Meyers ring containing 113mIn round cervix. In the other cases, the fundus and the symphysis pubis were marked by means of a small radioactive source. Complete placenta praevia was correctly detected in 8 cases and marginal placenta in 4 cases. The scintigraphic localization of the placenta was correct in all the women where the ring was used, whereas when the external marker was used, seven errors occurred. The authors therefore recommend this new technique in order to facilitate the evaluation of the scintigrams.
Lumbar Epidural Analgesia in Labour
Authors: Raabe Nils , Belfrage Patrick
Published: December 2009

Abstract. Lumbar epidural block was given for pain relief to 296 women in labour. Bupivacaine was used as the analgesic agent and the technique is described in detail. Satisfactory analgesia was obtained in 92% of the cases during the first stage of labour and in 84% during the second stage of labour. The frequency of instrumental deliveries and of occipito‐posterior position increased but the clinical condition of the newborn seemed to be unaffected.
Congenital Annular Constrictions Due to Amniotic Bands
Authors: Isacsohn M. , Aboulafia Y. , Horowitz B. , Ben‐Hur N.
Published: December 2009

Abstract. Amniotic bands which become involved with fetal parts, especially the extremities, are producd by rupture of the amnion during pregnancy with the consequent union of the extra‐embryonic mesoderm in fibrous strings. An infant with the amniotic band syndrome, in whom an annular constriction of the left leg and right hand was found, is described. He was treated successfully by multiple Z‐plasties and a plaster cast to correct the clubfoot. The oedema of the leg persisted for 5 weeks and then subsided completely. The role of amniotic abnormalities in the production of congenital malformations is reappraised. The microscopic and histological investigation of the placenta and membranes should accompany every case of fetal malformation in abortuses, stillbirths, and affected newborn.
Studies in Diabetic Pregnancy: I. Serum Lipids
Authors: Skryten A. , Johnson P. , Samsioe G. , Gustafson A.
Published: December 2009

Abstract. The serum lipid values at different stages of pregnancy in twenty‐six pregnant diabetic women attending a special antenatal clinic at the Department of Obstetrics and Gynecology, were compared with the corresponding values in four control series composed of non‐diabetic pregnant women. Control series were studied at weeks 10, 22, 34 and after delivery, respectively. Serum triglycerides were higher in the diabetic women at week 10 (p>0.01), week 34 (p>0.05) and after delivery (p>0.05). Furthermore, in the diabetic women, infant birth weights were correlated (r=0.52, p=0.05) with maternal serum triglyceride values at week 31. Women with the highest serum triglyceride values (<250 mg/100 ml) were delivered of infants with a higher birth weight (p>0.05) than those women with lower serum triglyceride values (>250 mg/100 ml). Intra‐uterine deaths (n=4) were not related to maternal serum triglyceride values, but mean blood glucose values (during the whole pregnancy) were higher (p>0.001) in mothers with intra‐uterine deaths. Elevated plasma free fatty acids (FFA) in the diabetic mother would be a possible cause for elevated serum triglycerides through increased liver triglyceride synthesis, while in the fetus an excess of plasma FFA (passing through the placental barrier) together with normal or elevated plasma insulin would be a likely explanation for increased triglyceride synthesis in adipose tissue and thereby of increased fat depots and body weight.
Inhibitory Effect of Decidua on Fibrinolysis Induced by Urokinase and by the Fibrinolytic Activity of the Rat Ovum
Authors: Liedholm Percy , Åstedt Birger
Published: December 2009

Abstract. With the use of a technique, which permits the study of fibrinolytic enzymes and inhibitors in organ culture, human decidua was found to produce inhibitors capable of inhibiting plasminogen activation induced by urokinase as well as activators released from kidney explants. Also the medium in which rat and human decidua had been cultured was found to inhibit fibrinolytic activity of the rat ovum. The inhibitors emanating from the decidua are presumably of importance for facilitating the implantation of ova.
Effect of a Copper and a Plastic IUD on the Histochemistry of Endometrial Enzymes in the Rabbit During Early Pseudopregnancy
Authors: Grundsell Hans , Håkansson Leif , Hägerstrand Inga
Published: December 2009

Abstract. The influence of a copper and a plastic IUD on the localization and intensity of alkaline and acid phosphatase and beta‐glucuronidase activity in the rabbit endometrium during early pseudopregnancy was investigated. The activities of the two lysosomal enzymes, acid phosphatase and beta‐glucuronidase were increased in surface epithelial cells in the presence of both types of IUDs. The alkaline phosphatase activity was almost completely abolished in surface and glandular epithelial cells in uterine horns.
Video Display System for Fetal and Maternal Monitoring
Authors: Larsen J. Falck , Jaszczak P. , Jørgensen F. Vernon , Thorup E.
Published: December 2009

Abstract. Signals from different fetal and maternal monitoring equipment were combined in a video system. Analogue curves and digital figures were displayed on the same screen and included warning signals. Sweeps for different curves are selected individually. It is possible to show fast and slow changing parameters on the same screen. The system has great flexibility and signals from equipment from different manufacturers may be added easily.
The Efficacy of Melphalan in the Combined Chemotherapy of Malignant Trophoblastic Disease
Authors: Wiqvist N. , Lundström V. , Eneroth P.
Published: December 2009

Abstract. Steadily progressive improvement in the diagnostic and therapeutic management of malignant trophoblastic disease has occurred over the last few decades. The most important diagnostic aid is the determination of serum HCG by sensitive radioimmunoassay which allows the detection of minute amounts of the hormone and permits discrimination between LH and HCG. Therapeutic advances include the use of combinations of different cytostatic drugs which have increased the cure rate from approximately 50% to a range of 80–95% (1, 2, 3, 4, 5, 6, 7). Malignant trophoblastic disease is rare in the Scandinavian countries which effectively limits opportunities to acquire experience within individual centers. However, a series of 23 cases has been collected at the Karolinska Hospital during the last 10 years. Patients who developed resistance against methotrexate were successfully treated by a combination of an alkylating agent melphalan (Alkeran), actinomycin D and methotrexate. In some cases this modification of a triple‐therapy regimen has turned out to be life‐saving.
45, Xo Turner's Syndrome without Evidence of Mosaicism in a Patient with two Pregnancies
Authors: Philip John , Sele Vagn
Published: December 2009

Abstract. A case of Turner's syndrome (45, XO) with two pregnancies is reported. There was no evidence of mosaicism after chromosomal investigation of 5 different tissues (2 ovaries, blood, skin, uterus). Pregnancy occurred in both cases after withdrawal of substitutional hormone therapy. The first pregnancy ended with abortion of a macerated hydrocephalic female fetus. Chromosome studies could not be carried out. The second pregnancy ended with delivery by caesarian section of a normal boy (46, XY). Prenatal chromosome analysis was not carried out for ethical reasons.
Studies on the Mode of Action of Clomiphene Citrate
Authors: Buhl Jørgensen S. E. , Starup J. , Roos J. , Micic S.
Published: December 2009

Abstract. In order to further investigate the mode of action of clomiphene citrate, 5 oophorectomized women in the age range 28 to 41 years were followed with weekly determinations of serum FSH and LH for 20 weeks after the operation. They received no treatment during the first 4 weeks but during the next 16 weeks they were given estradiol 2 mgx2 daily orally, and from the 12th to the 16th week in addition clomiphene citrate 50 mgx2 daily. The high level of FSH after the oophorectomy decreased gradually during the treatment with estradiol alone, but this effect was partly neutralized by clomiphene citrate, as we observed a significant increase in FSH within 1 week of initiating treatment with clomiphene citrate. On the other hand, we did not find any significant changes in FSH within 4 weeks after treatment with clomiphene citrate was discontinued. The high level of LH after oophorectomy did not show any significant changes during the whole treatment period. It is concluded that clomiphene citrate primarily stimulated FSH secretion, most probably by a competition with estradiol for the receptor sites in the hypothalamus or the pituitary. In addition, it is concluded that clomiphene citrate has a prolonged effect, probably because of a tight binding to the receptor sites.
THE EFFECT OF BETA‐RECEPTOR‐STIMULATING AGENTS ON THE UTERO‐PLACENTAL BLOOD FLOW
Authors: Elnäs S. , Joelsson I. , Lewander R. , Lundqvist H. , Lunell N. O. , Sarby B. , åström H.
Published: December 2009

Abstract. The influence of salbutamol, a beta‐2‐receptor‐stimulating agent, on the blood flow through the uteroplacental unit was evaluated in the human. Serial placenta scintigrams were analysed quantitatively, after injection of 0.5 mCi Indium‐ 113m, by means of a gamma‐camera connected on line to a computer. The examinations were performed in the third trimester of pregnancy. No sedation was used. Uterine contractions were not present. Salbutamol caused an increase in activity over the placental region, corresponding to a 15% increase in blood volume. The rise time of the initial phase of isotope accumulation (calculated from 5 to 95% of final activity) was prolonged by 100% during salbutamol infusion. As the rise time is proportional to the volume/flow ratio of blood in the uteroplacental region, our data indicate that salbutamol infusion causes a decrease in blood flow in the absence of uterine contractions.
LATE SEQUELAE OF INDUCED ABORTION IN PRIMIGRAVIDAE
Authors: Koller Oddmund , Eikhom Siri Nome
Published: December 2009

Abstract. In a retrospective study a group of 137 women with legal abortion in their first pregnancy was compared with a group of 133 women with spontaneous abortion (before 28 weeks) and a group of 129 women who had a delivery (beyond 28 weeks) in their first pregnancy. Three cases of ectopic pregnancy were recorded in the second pregnancy in the legal abortion group, none in the other groups. The delivery group showed the best reproductive performance, while the spontaneous abortion group had the highest frequency of early abortion and the induced abortion group the highest frequency of late spontaneous abortion and premature delivery, and in addition a trend towards earlier spontaneous onset of labour in their second pregnancy. There was a conspicuous decline of the reproductive performance in the third and fourth pregnancy of the induced abortion group and a highly significant increase of the rate of late abortion, compared with the overall rate of late abortion in the department. The induced abortion group showed an increased rate of spontaneous primary and premature rupture of the membranes and also a definite trend towards lower weight of the newborn, especially beyond 41 weeks of pregnancy. There was a close correlation between induced abortion in girls below 17 years of age on the one hand and repeated abortion and/or unmarried state in the second pregnancy on the other. A significant correlation was revealed between early menarche and legal abortion in the first pregnancy and also between early menarche and unmarried state in the first pregnancy as found in a random series of 250 first pregnant women.
INHIBITION OF PUERPERAL LACTATION
Authors: Dewhurst C. J. , Harrison Robert F. , Biswas S.
Published: December 2009

Abstract. Bromocriptine and placebo were randomly allocated for three weeks to 52 postpartum patients requiring lactation suppression. Bromocriptine significantly lowered plasma prolactin levels and suppressed breast milk, breast pain and engorgement quicker than placebo. No side‐effects were noted and rebound lactation did not occur. Menstruation appeared to re‐start sooner when Bromocriptine was given.
PROLACTIN RESPONSIVENESS TO TRH IN AMENORRHEIC WOMEN WITH AND WITHOUT GALACTORRHEA
Authors: Macgregor Carlos , Maldonado David , Canales Elias S. , Soria Jorge , Zarate Arturo
Published: December 2009

Abstract. Sixty women were given intravenous injection of 200 μg TRH to assess its diagnostic potential as a stimulus to PRL release. Following the administration of TRH, there was a prompt increase in serum PRL to 614.6%, to 296%, to 282.1 %, and 34% in normal women, amenorrheic patients, non tumoral galactorrhea cases, and patients with pituitary tumors respectively. The TRH response above baseline of PRL levels was statistically significant in all groups, but the women with pituitary tumors which showed a blunted response. The per cent of increment of PRL levels after TRH was similar in amenorrheic women regardless the presence or not of galactorrhea; this increase was significantly greater than in patients with pituitary tumors (p < 0.01). The per cent of increment above baseline of PRL was significantly greater in menstruating women than in amenorrheic patients (p < 0.001). In basis of present data: 1) there is a diminished PRL secretion after TRH in amenorrheic women regardless the presence of galactorrhea or hyperprolactinemia; 2) a blunted response to TRH in hyperprolactinemic women may be indicative of a pituitary tumor.
TREATMENT OF CLIMACTERIC AND POSTMENOPAUSAL WOMEN WITH 17‐β‐OESTRADIOL AND NORETHISTERONE ACETATE
Authors: Furuhjelm Mirjam , Carlström Kjell
Published: December 2009

Abstract. Thirty‐four climacteric and 175 postmenopausal women were treated with three different preparations containing microcrystalline‐17β‐oestradiol and norethisterone acetate for climacteric symptoms and symptoms of oestrogen deficiency. 56 of the women (mean age 52 ± 5.2 years) were treated with trisekvens® (Group I), 131 women (mean age 53 ± 6.3 years) with trisekvens® forte (Group II) and 22 women (mean age 55.3 ± 5.2 years) with estrofem® forte (Group III). The patients were followed for 2 1/2–3 1/2 years. All patients were subjected to a general and a gynaecological examination. Two or more serum samples were obtained from 145 of the patients during the treatment. Laboratory investigations included Autochemist® analysis of serum levels of triglycerides, cholesterol, Ca++, Na+, K+, alkaline phosphatase, creatinine, glucose, protein, albumin, haptoglobin, zinc sulphate, Fe, TIBC, bilirubin, ALAT and ASAT and radioimmunoassay of serum levels of FSH, LH and low polar oestrogens (LPE).

S‐cholesterol levels fell during the treatment in all three groups and in patients with elevated S‐cholesterol levels the values were reverted to normal after 6 months' treatment. There was no change in S‐triglycerides except in group I where a slight increase (P < 0.01) was observed after 24 months' treatment. There were no other changes in the values obtained from the Autochemist® analysis. Serum levels of FSH and LH decreased during the treatment and this decrease was more pronounced in groups II and III. Serum LPE levels increased in group I for climacteric women to values observed during a normal luteal phase and in postmenopausal women to values found during the proliferative phase. In groups II and III the serum LPE values in postmenopausal women increased to levels corresponding to the luteal phase. Large individual variations in serum LPE levels were observed even during a rigorously standardized tablet intake, which might be explained by individual differences in absorption.

The therapy resulted in a disappearance of the climacteric symptoms (vasomotor symptoms, nervousness, irritability and sleep disturbances) and a considerable improvement of the symptoms caused by oestrogen deficiency (atrophic changes in the vulva, the vaginal mucosa, urethra and bladder, and the state of the skin and skeletal mineral depots). Few side effects were observed. 34 of the patients discontinued their treatment with the oestrogen preparations: 14 changed to another type of oestrogen and 20 stopped completely, 2 of them due to the discovery of mammary carcinoma. In general the oestrogen preparations tested were well tolerated. The oestrogen dose used in trisekvens® forte and estrofem® forte seems to be sufficient for an adequate oestrogen replacement therapy in climacteric and postmenopausal women.
RESULTS OF OPERATIVE TREATMENT OF STRESS URINARY INCONTINENCE WITH SPECIAL REFERENCE TO PREOPERATIVE CLINICAL AND RADIOLOGICAL EVALUATION
Authors: Jouppila Pentti , Kauppila Antti , Yllkorkala Olavi , Ala‐Ketola Lasse , Järvinen Pentti A.
Published: December 2009

Abstract. Operative results of stress urinary incontinence are discussed on the basis of a follow‐up study made 3–5 years after the operation. The series consisted of 301 patients operated on during 1969–1971. The most significant anamnestic feature was the great number of multiparas: 67% of the patients had given birth to at least 4 children. The choice of the operative method was based on Green's urethrocystographic classification into type I and type II. The healing was complete or satisfactory in 85% of the total material. In the group operated on according to type I the outcome was good in 88%, while in the type II group it was good in 84%. Incontinence of degree I was cured in 89% of the cases, while patients of degree III in only 72%. If there was a significant urgency component observable in the incontinence symptoms preoperatively, a good outcome was only attained in 64%. In pure or dominant stress incontinence the corresponding outcome was 88%. Hysterectomy combined to the operation seemed to improve the results. Age, parity, duration of the incontinence symptoms, weight and changes of weight after the operation had no significant effect on the healing. The authors emphasize the importance of careful differential diagnosis based on the anamnesis and examinations in choosing the therapeutic method for incontinence patients.
Feto‐Maternal Bleeding
Authors: Jørgensen Jan
Published: December 2009

Abstract. Blood samples from pregnant women and from mothers before and after delivery were tested for the occurrence of feto‐maternal bleeding (f.m.b.) using Kleihauers acid‐elution technique and a counting technique described by Schneider. It was assumed that f.m.b. had occurred, when there was a clinically significant difference between the values of hb‐F cells per million cells in two blood samples. F.m.b. had occurred in nearly 2/3 of the mothers after pregnancy and delivery. The f.m.b.'s were most often less than 0.1 ml and only a few per cent had f.m.b.'s between 0.1 and 1 ml. Abortion, complicated pregnancies, amniocentesis, pre‐eclampsia, caesarean section and other kinds of complicated deliveries increased the risk of especially larger f.m.b.'s.
Serum HCG and HPL in Twin Pregnancies
Authors: Thiery Michel , Dhont Marc , Vandekerckhove Dirk
Published: December 2009

Abstract. Serum HCG and HPL levels were determined in 154 samples derived from 39 twin and one triplet pregnancies. Compared with singleton gestations, these levels were respectively 2.5 and 1.5 times higher throughout gestation. Analysis of these data in terms of predictive accuracy for the existence of a twin indicates that neither assay can serve for screening purposes though simultaneous determination of HCG and HPL may provide a fair index of suspicion.
Evaluation of a Feto‐Pelvic Scoring System in the Management of Breech Presentations
Authors: Westin Björn
Published: December 2009

Abstract. A feto‐pelvic scoring system comprising maternal pelvimetric data, estimated fetal weight, type of breech presentation and previous obstetric history was used in selecting patients for cesarean section or vaginal delivery. A maximum score of 20 points was possible. Twelve points or less indicated cesarean section. During 1973–1975 224 singleton breech deliveries were evaluated. In 29.5% cesarean section was performed and in 83% of these it could be planned in advance. In 70.5% of cases, patients were allowed to deliver vaginally under continuous electronic monitoring of the fetal heart rate. There was one intrapartum death and only one early neonatal death of a small premature child. In two cases intrauterine death had occurred already in the antepartum period. The uncorrected perinatal mortality was 17.9 per 1000 but not significantly different from the uncorrected perinatal mortality of 8.0 per 1000 for all patients delivered at the Danderyďs Hospital during the period 1972–1975 (12832 births). The corrected mortality resulting from breech presentation was 8.9 per 1000. The infants exhibited similar and excellent 5 min Apgar scores whether delivered vaginally or by cesarean section or matched with a randomized control series of 1000 cephalic presentations.
Incidence of Sterility in Women Operated on in Childhood for Perforated Appendicitis
Authors: Geerdsen J. , Hansen J. Bech
Published: December 2009

Abstract. Of 80 women who had appendicectomy in childhood 78 were reviewed with reference to sterility. Thirty‐nine of them had been operated on for acute perforated appendicitis (APA) and 39 for acute non‐perforated appendicitis (ANPA). There was no statistically significant difference in the incidence of sterility between the two groups. In the APA group the incidence of sterility differs from that in sterility models with the same age composition. It may therefore be advisable for young girls to have appendicectomy at the least indication.
The Immunological Paradox of Pregnancy
Authors: Damber Mats‐Göran , von Schoultz Bo , Stigbrand Torgny
Published: December 2009

Abstract. During a normal pregnancy the fetus can be regarded as a transplant inside the uterus. The reason why this transplant is not rejected is still unclear. In this work various models for this immunological paradox and recent results within the field of pregnancy immunology are discussed.

From an immunological point of view the development of a normal pregnancy is almost impossible. During all stages the embryo can be regarded as a transplant (4), but instead of the expected rejection an intimate parasitic graft‐host relationship is established.

The sperm has already been shown to be the carrier of transplantation antigenes and thus theoretically capable of initiating an immune response. The fertilized egg also carries transplantation antigenes on its surface after the first division. Foreign transplantation antigenes release in the receiver a cell mediated immune reaction, which normally causes a rejection within some weeks.
The Influence of the Bony Pelvis in Persistent Occiput Posterior Position
Authors: Holmberg Nils Gunnar , Lilieqvist Bengt , Magnusson Sigurdur , Segerbrand Erik
Published: December 2009

Abstract. Roentgenologic pelvimetry has been performed in 68 consecutive cases of occiput posterior position. The results point to an influence from a transverse narrowing of the pelvis or a tendency towards large dimensions. In many cases, however, no clear correlation to pelvic dimensions is found. A significant difference exists in the rate of obstetrical complications between nulliparous and parous women. The reasons for this and for the persistent OP position are discussed.
Efficacy of Primary Radiation ih Carcinoma of the Ehdometrium: Five‐year follow up of unselected material from a specific region in the north of Sweden
Authors: Kjellgren Olle , Sigurd Jörgen
Published: December 2009

Abstract. A case material from the northern part of Sweden comprising all known cases of carcinoma of the endometrium during the years 1963–1969 is presented. A clinical experiment has been carried out in which 320 patients with carcinoma of the endometrium have been uniformly treated. The patients have been given primary radiation treatment, mostly with radium packing according to a modified Heyman method. About two thirds of the patients have had a prophylactic operation with total removal of the uterus and the adnexa about six weeks after the radiation treatment. Patients with contraindications to surgery have had a curettage three months after radiation treatment. The primary cure rate and the complications have been reported in a previous paper. The five‐year survival rate in stage I in cases treated with radiation and surgery was 92%. The survival rate corrected for intercurrent death was 93%. The survival rate in cases treated with radiation only was 71%. The survival rate corrected for intercurrent death was 88%. The total survival rate in stage I was 85% and the survival rate corrected for intercurrent death in stage I was 92%. The total survival rate in the whole case material including all stages was 75.3% and the survival rate corrected for intercurrent death in the total material was 82.8%.
The Effect of Oxytocin on Hypertonic Saline Abortion
Authors: Sandström Bo , Solheim Folke , Magnusson Sigurdur
Published: December 2009

Abstract. Oxytocin was infused in 22 randomly selected pregnant women after extraamniotic hypertonic saline instillation. In another 24 pregnant women no oxytocin was infused at midtrimester abortion. There was no difference between the two groups in mean time from saline injection to expulsion of the fetus.
Studies in Cholestasis of Pregnancy
Authors: Samsioe G. , Johnson P. , Gustafson A.
Published: December 2009

Abstract. Eight pregnant women, complaining of generalized pruritus with lipoprotein‐X (LP‐X) in their serum and diagnosed as cases of cholestasis of pregnancy (CP)—were studied during pregnancy and after delivery. Ten women with uncomplicated normal pregnancy served as controls. LP‐X, liver function tests and relative fatty acid composition of serum lecithin (determined by gas‐liquid chromatography, GLC) were followed. the fatty acid composition in liver and serum lecithin is determined by the synthesis pathways of lecithin in the liver. the faster and quantitatively dominating cytidine‐diphosphate diglyceride pathway, pathway I, causes the appearance of lecithin with palmitic acid (16:0) in 1‐position and oleic (18:1) or linoleic (18:2) acid in 2‐position, while pathway II, with methylation of phosphatidyl‐ethanolamine (cephalin) preferentially causes the appearance of lecithin with stearic acid (18:0) in 1‐position and arachidonic acid (20:4) in 2‐position. Pathway I is enhanced by oestrogenic and pathway II by cholestatic influence. During pregnancy women with CP were characterized in their serum lecithin fatty acid composition by a high palmitic (16:0) and a high oleic (18:1) acid content, in agreement with earlier studies. After delivery, in women with prior CP a decrease in palmitic (16:0) and linoleic (18:2) acids and an increase in stearic (18:0) acid, was interpreted as decreased influence on the major lecithin synthesis pathway I and an enhancement of pathway II. in addition, after delivery in the lactating mother, serum lecithin fatty acid composition data revealed an essential fatty acid (EFA) “consumption”. It was earlier shown, that women with previous CP (when studied 8–21 months after delivery) had as judged from their serum lecithin fatty acid composition, a “basic metabolic defect”, expressing presumably an estrogen enhanced pathway II of liver lecithin synthesis. in the present study, soon after delivery (on day 4–8) women with prior CP showed, however, less pathway II influence than women with a prior normal pregnancy. This was interpreted as a persistence of the cholestatic influence on liver lecithin synthesis pathways at this short time after delivery. Serum lecithin fatty acid composition appears to be a sensitive variable for the evaluation of metabolic influences in the liver.
Ultrasonic Assessment of Fetal Growth
Authors: Wladimiroff J. W. , Bloemsma C. A. , Wallenburg H. C. S.
Published: December 2009

Abstract. Consecutive ultrasonic measurement of fetal biparietal diameter (B.P.D.) and fetal chest area was carried out in 152 normal and 59 complicated pregnancies between 25 and 40 weeks of gestation. in normal pregnancy the mean fetal head area (B.P.D.2) varied from 45.0 cm2 at 25 weeks to 98.0 cm2 at 40 weeks. the mean chest area varied from 31.3 cm2 at 25 weeks to 94.3 cm2 at 41 weeks. A normal curve of the head‐to‐chest relation was constructed. in the group of complicated pregnancies, two types of fetal growth retardation could be recognized. the first type was characterized by a normal head‐to‐chest relationship (symmetric type), the second type was characterized by an abnormal head‐to‐chest relationship (asymmetric type; relatively large head area). During fetal growth acceleration head‐to‐chest‐relationship was abnormal (relatively large chest area).
Ectopic Pregnancies and the Use of Intrauterine Device and Low Dose Progestogen Contraception
Authors: Rantakylä P. , Ylöstalo P. , Järvinen P. A. , Vuorjoki A.
Published: December 2009

Abstract. In a series of 71 ectopic pregnancies ten were associated with the use of an intrauterine device (IUD) and three with the use of low dose progestogen contraception. For comparison a series of 800 legal abortions were studied and in 20 of these cases pregnancy originated while an IUD was in utero and in 13 during the use of low dose contraceptive pills. When using the above‐mentioned contraceptive methods the possibilities of an ectopic pregnancy should be taken into consideration.
Histamine Metabolism in Normal Pregnancy and in Toxaemia of Pregnancy
Authors: Granerus G. , Gillbrand B. , Wetterqvist H.
Published: December 2009

Abstract. The urinary excretion of histamine and its metabolites, methylhistamine, methylimidazoleacetic acid and imidazoleacetic acid, was measured under standardized dietary conditions in 24 women with normal pregnancies and in eleven patients with toxaemia of pregnancy. in addition, histamine metabolism was studied in five healthy women at delivery and in four other healthy pregnant women during treatment with aminoguanidine, which is an inhibitor of diamino oxidase (histaminase). A slight increase in the urinary excretion of methylimidazoleacetic acid was observed in normal pregnancy as well as in toxaemia of pregnancy compared to non‐pregnant women. in two toxaemic patients and in one of the healthy subjects the urinary excretion of unmetabolized histamine was moderately increased. Despite the very high diamino oxidase activity in the plasma and in the uterus during pregnancy, there were no signs of altered catabolism of endogenous histamine in the pregnant women. Smoking increased the urinary excretion of the quantitatively dominant histamine metabolite, methylimidazoleacetic acid, in pregnant subjects as it also does in nonpregnant subjects. the necessity of standardized dietary conditions in the study of histamine metabolism in man was again emphasized.
A Comparative Study of Uterine Activity in Labour Induced with Prostaglandin F2A Or Oxytocin and in Spontaneous Labour: Ii. Characteristics of Uterine Activity and Their Effect On the Progress of Labour
Authors: Lindmark Gunilla , Nilsson Bo A.
Published: December 2009

Abstract. In 76 women with spontaneous labour or labour induced with oxytocin or PGF2a, intra‐uterine pressure was recorded during the first stage of labour. A statistical analysis was performed of the intensity and frequency of contractions, the total uterine activity and the variability of peak‐to‐peak intervals and amplitudes of contractions. the duration of the latent phase was shortened by 50% in induced labour compared with spontaneous, while the active phase was less affected. However, the intensity and frequency of contractions and the uterine activity in Montevideo Units were of the same magnitude in spontaneous as in induced labour, apart from two cases of hyperactivity found in the induction groups. the variability of intervals between contractions and amplitudes of contractions were also of the same degree in all groups and no overall tendency towards greater regularity was seen during progress of labour. If irregular intervals between contractions were noted, when active cervical dilatation had begun, the progress of labour was slower and more uterine work was needed for dilatation than when the uterine activity was more regular.
Ultrastructure of the Human Placenta at Term: Observations on Placentas from Newborn Children of Smoking and Non‐Smoking Mothers
Authors: Asmussen Inger
Published: December 2009

Abstract. The placenta was chosen as a possible model for evaluating the vascular injury and tissue injury provoked by tobacco smoking in the human body. Full term placentas from 4 smokers and 3 non‐smokers were studied in the transmission electron microscope. Pronounced changes were found in the group of smokers. the characteristic findings were broadening of the basement membrane of the placental villus, increase in collagen content of the villus, decrease in vascularisation and intimal changes in the villous capillaries and arterioles, with pronounced intimal oedema. Since similar changes have been reported previously from human umbilical arteries, and since these changes also can be induced in animal arteries by exposure to carbon monoxide or perfusion with nicotine, this study supports the concept that tobacco smoking is harmful to the human vascular system and tissues.
The Suppression of Puerperal Lactation with Bromocryptine
Authors: Willmott M. P. , Colhoun E. M. , Bolton A. E.
Published: December 2009

Abstract. The therapeutic value of 2‐Br‐α‐ergocryptine for the suppression of puerperal lactation was studied in 30 normal women; 16 received the drug, 14 were controls. in six women plasma levels of FSH, oestradiol and alpha‐lactalbumin were measured in labour and in the early puerperium. Brom‐ergocryptine was found effectively to suppress milk production and alleviate breast pain and congestion, with no side effects and minimum rebound lactation. the inverse relationship between prolactin and FSH levels reported elsewhere in non‐pregnant women did not appear to occur in the early postpartum period. Although there was a significant rise in alpha‐lactalbumin levels in labour and the puerperium over non‐pregnant levels, there was no difference between lactating and non‐lactating women.
The Myometrial Response to Intra‐Uterine Administration of PGF2α and PGE2 in Dysmenorrheic Women
Authors: Lundström V.
Published: December 2009

Abstract. Serial recordings of uterine contractility during different phases of the menstrual cycle were carried out in five dysmenorrheic women, and in two subjects during the acute stage of severe dysmenorrheic pain.

The sensitivity and reactivity of the uterus to intrauterine administration of small doses of PGF2α and PGE2 were studied. A relative insensitivity of the uterus was found in the proliferative phase and around ovulation. The uterus was highly sensitive to the stimulatory effect of PGF2α in the secretory phase and at menstruation but probably not more sensitive than in normal women. The corresponding results with PGE2 were rather variable in that small doses did not induce any response or slight stimulation whereas high doses occasionally caused an inhibition in the secretory phase and during menstruation.

The results indicate that PGF2α may be a significant factor in eliciting uterine hypercontractility and dysmenorrheic pain. Whether the occasional inhibitory effect of PGE2 is of any significant importance in the pathogenesis of dysmenorrhea cannot be stated.
Evaluation of Fetal Maturity by Amniotic Fluid Creatinine Concentrations and Lecithin/Sphingomyelin Ratio
Authors: Skjæraasen J. , Maltau J. M.
Published: December 2009

Abstract. In a material of 144 samples of amniotic fluid from the last trimester, creatinine concentration, lecithin/sphingomyelin (L/S) ratio and their correlation, have been examined. Amniotic fluid creatinine concentration (a.f.c.) increased gradually through the last trimester up to 39 weeks (273–279 days p.m.) with median values of 2 mg/100 ml at 37 weeks and 2.5 mg/100 ml at 39 weeks gestation. The great range makes a.f.c. of doubtful value in assessment of gestional age in individual samples. The correlation between a.f.c. and L/S ratio was highly significant (Kendall's T=0.56). Even so lung maturity cannot be predicted from a.f.c. A low L/S ratio with a.f.c. ≥2 mg/100 ml was found in 8–9%, while a.f.c. 1.1–1.9 mg/100 ml was combined with L/S ratios ≥2 in a great number of cases. A.f.c. <1.1 mg/100 ml was invariably correlated with low L/S ratios.
Neonatal and Prospective Follow‐Up Study of Infants Delivered by Vacuum Extraction (VE)
Authors: Blennow G. , Svenningsen N. W. , Gustafson B. , Sundé B. , Cronquist S.
Published: December 2009

Abstract. Forty infants delivered by vacuum extraction have been studied in the neonatal period—neurological examination, neonatal CSF‐examinations, skull X‐ray examination, transillumination and sonoencephalography—and at 14 months of age—developmental and behavioural evaluation, neurological examination, skull X‐ray examination, sonoencephalography and electroencephalography. Two infants died in the neonatal period but in both cases a life‐threatening situation for the fetus required immediate delivery. CSF cytological signs of haemorrhage were observed in 42% of the 26 infants who had a successful lumbar tap, compared to 10% found in normal deliveries. The result of the neonatal neurological study did not differ from that in a control group. The result of the skull X‐ray examination and sonoencephalography were also within normal limits. In the follow‐up study behavioural problems were found in 25%, but otherwise very few abnormalities were found. The deviations found do not for the present indicate any later signs of brain lesions. It is concluded that this prospective study has shown that VE‐delivery in fullterm babies seem to imply no risk of serious cerebral sequelae. Further follow‐up studies at a later age in order to evaluate the incidence of so‐called minimal brain damage in VE‐delivered children are required.
Stilbestrol Administration in the Puerperium and its Effect on the Prolactin Excretion of Non‐Lactating Patients
Authors: David Amnon , Romem Izhak , Lunenfeld Bruno , Kaufman Miriam , Serr David M.
Published: December 2009

Abstract. The relationship between stilbestrol treatment and placebo treatment was studied in 2 groups of non‐nursing patients. Plasma prolactin levels were evaluated in these 2 groups on day 1, 3 and 7 of the treatment, by a radioimmunoassay technique with the double antibody method using Serono hPRL kit. Our results show that prolactin values increased significantly in the stilbestrol‐group and decreased in the placebo group. It seems that the main reason for “the drying up of milk” is the lack of stimulation of the nipples, which after a relatively constant time of 5–10 days will lead to decreased prolactin levels. Stilbestrol treatment is not effective in “drying up” the milk more rapidly in patients who do not want to nurse. When patients have symptoms a combination of analgesia and breast support usually brings relief within 24 to 48 hours.
The effects of longacting paracervical block anesthesia on the abortifacient efficacy of intra‐amniotic pgf2α and hypertonic saline
Authors: Ragab M. I. , Edelman D. A. , Laufe L.
Published: December 2009

Abstract. A comparative study was conducted to evaluate the effects of repeated, longacting paracervical blocks on the abortifacient efficacy of intraamniotic prostaglandin F2α (PFG2α)—40 mg initially and an additional 20 mg after 24 hours—and hypertonic saline augmented with intravenous oxytocin, for patients at 16 to 20 weeks' gestation. Patients were randomly assigned to the 2 abortion procedures, and one half (50) of the patients induced with each procedure received serial, longacting paracervical blocks. For those patients aborted with saline, the rates of complications, side effects, incomplete abortion, and cumulative abortion were similar for patients whether they did or did not receive paracervical blocks. Among the PGF2α‐treated patients who were administered paracervical blocks, there was a significant reduction in the rates of gastrointestinal side effects and incomplete abortion and a significant difference in the cumulative abortion rates. Within 32 hours of the initial PGF2α instillation, 98% of the patients who received paracervical blocks aborted compared to 70% of those who did not receive paracervical blocks. Although the cumulative abortion rates of PGF2α‐treated patients with paracervical blocks and saline‐treated patients were similar, the rate of incomplete abortion for the PGF2α‐treated patients was significantly lower. Additional studies will be necessary to evaluate the safety and advantages of using paracervical block anesthesia as an adjunct to midtrimester abortion procedures.
Cryosurgical treatment of dysplasia and carcinoma in situ of the cervix uteri
Authors: Einerth Yngve
Published: December 2009

Abstract. Fifty‐nine patients (age range 18–40 years, mean 28 years) with dysplasia or carcinoma in situ of the cervix uteri were treated with cryosurgery. Healing occurred in 54 patients (91.6%) after one treatment (“double‐freeze” technic) and in 2 patients after refreezing. No early or late complications occurred during a follow‐up period of 7–37 months. Five of the patients with carcinoma in situ were followed immunologically with determinations of serum TPA (tissue polypeptide antigen), which can be employed as a parameter of malignancy. In all instances, the initially elevated TPA normalized after cryosurgical treatment. Cryosurgery is a simple, painless and safe treatment method in ectocervically localized carcinoma in situ and dysplasia that is particularly suited for out‐patient use.