bluuebunny/crossref_metadata_2025 huggingface dataset:
Perinatal mortality in an Egyptian maternity hospital
Authors: Serour G.I. , Younis N.M. , Hefnawi F. , El‐Bahy M. , Dagistany H.F. , Nawar M.
Published: April 2004

The factors affecting perinatal mortality during a period of 21 months were studied at Al‐Galaa Teaching Hospital, using the International Fertility Research Program's Maternity Record 903 to collect the data. There were 6990 deliveries during the 21 months and 580 hospital perinatal deaths. Certain high‐risk factors associated with perinatal mortality were identified including both biosocial and biomedical factors. The biosocial factors affecting perinatal mortality in this study are discussed, including maternal education, marital status, residence, hospital status as paying or non‐paying patient, maternal age, registration status, outcome of last pregnancy, parity/family size, antenatal care, maternal hemoglobin, and the weight and sex of the baby.
Response of unmarried adolescents to contraceptive advice and service in Nigeria
Authors: Ezimokhai M. , Ajabor L.N. , Jackson M. , Izilien M.I.
Published: April 2004

The responses of a group of all unmarried, sexually active teenagers in a developing country to offers of contraceptive service were assessed in a prospective, 30‐month study at a teaching hospital family planning center. Teenagers of this group constituted 7.2% of the clinic population. The default rate was very high (43.0%) and was most noticeable among users of oral contraceptives. The intrauterine device seemed more acceptable, as were injections of norethisterone enanthate. Possible reasons for this pattern of response are given, and the authors suggest giving new consideration to making the intrauterine device more suitable for and acceptable to teenagers of developing countries. The place of norethisterone enanthate in teenage contraception is also discussed.
Retroperitoneal fibrosis: A two decade experience and gynecologic manifestations
Authors: Kurzel Richard B. , Yoonesi Mahmood , Munabi Abraham
Published: April 2004

A 20‐year experience with idiopathic retroperitoneal fibrosis (RPF) is presented (6 cases). Its gynecologic manifestations with the simulation of pelvic malignancy is discussed. Three of the patients presented with pelvic masses, one of these a para‐vaginal mass. In one patient, RPF followed or was concurrent with invasive squamous cell carcinoma of the cervix, of which this is the first reported case. The subject of RPF is reviewed with the modes of management and evidence for an autoimmune etiology. Thrombocytopenia, a previously unreported finding with RPF, was noted in three of the six patients. The reversal of the A/G ratio in these patients is discussed, correlating this finding with the progression of azotemia.
Determination of zygosity of multiple births using simple observations
Authors: Zake E.Z.N.
Published: April 2004

Using simple observation tests, zygosity was determined in 1106 multiple births in a hospital in Mbale, Uganda, between 1971 and 1980. Seventy‐three percent were dizygotic and 26.9% were monozygotic. The study demonstrates the usefulness of simple observations to determine zygosity in multiple births, particularly in developing countries where sophisticated testing facilities may be lacking.
Subclinical abortions in patients treated with clomiphene citrate
Authors: Ho P.C. , Tang G.W.K.
Published: April 2004

Using radioimmunoassay for human chorionic gonadotrophin beta‐subunit, 39 treatment cycles of clomiphene citrate therapy were studied prospectively for incidence of subclinical abortions. Eight treatment cycles resulted in clinically recognizable pregnancies and three other treatment cycles ended up with subclinical abortions. The plasma progesterone levels in patients with subclinical abortions at the 13th day after ovulation were lower than those in patients with normal pregnancies.
Glucose and free fatty acid response to intravenous glucose during pregnancy
Authors: Iyengar Leela R. , Rao Veena A. , Kumar S.
Published: April 2004

Intravenous glucose tolerance tests were performed in undernourished and well‐nourished normal pregnant women and for toxemic women near term. Both blood glucose and free fatty acid levels were analyzed, till 90 min after glucose load. The results suggested that glucose response to intravenous load was poor both in normal undernourished and toxemic women as compared to well‐nourished women. However, the free fatty acid pattern was abnormal only in toxemic women in that the levels did not return to basal value even after 90 min of glucose load. Since human placental lactogen in pregnancy is known to regulate free fatty acid release for energy utilization, its deficiency in toxemia (commonly known to occur) could be implicated in the abnormal free fatty acid response seen in this investigation.
The influence of an early diagnosis on the results of surgical treatment of ectopic pregnancy
Authors: Fianu S. , Ingelman‐Sundberg A. , Vaclavinkova V.
Published: April 2004

The postoperative fertility of 292 cases of ectopic pregnancy treated 1972–1979 was studied. Of these 156 were operated upon during 1972–1976, when only determinations of HCG in urine were available and 136 during 1977–1979, when RIA‐determinations of HCG in serum made an earlier pregnancy diagnosis possible. In spite of the fact that the time of observation was shorter in the second group the pregnancy rate was 41% compared to 31% in the first one (P < 0.05). The rate of childbirth among the pregnancies in the second group was 72% compared to only 55% in the first one (P < 0.05).
Correlation between histopathologic features and estrogen receptor status in primary breast cancer
Authors: Mantouvalos H. , Makrygiannakis A. , Metallinos C. , Yianniou A. , Gouskos A.
Published: April 2004

Relationships between certain histopathologic features of tumor specimens and estrogen receptor (ER) status were investigated. Lobular and ductal carcinomas were found to be richer in ER than other histologic types. Well differentiated carcinomas were more often hormone receptor positive than poorly differentiated tumors. Lymphocytic and plasmatocytic infiltration in and around the tumor as well as elastosis also appeared to be related positively to ER status.
Hemoglobin E disease in pregnancy
Authors: Das Chanchal K.
Published: April 2004

Abnormal hemoglobin patterns such as hemoglobin‐E are rarely found in Western populations. The condition is fairly common in Southeast Asian countries such as Thailand, however. It is not commonly found in West Asian countries such as Saudi Arabia. A case report of hemoglobin E disease in pregnancy is made; its impact on pregnancy and labor is discussed.
Gonadal dysgenesis and somatic stigmata in patients with 45,X/46,Xr(X) ring chromosome
Authors: Portuondo JoséA. , Barral Araceli , Neyro JoséL. , Camarero María C. , Roman María D. , Uribarren Adolfo
Published: April 2004

Two cases of gonadal dysgenesis and stigmata of Turner's syndrome with ring chromosome X are described. Their features support the idea that ring chromosome X should be considered as a deletion in the genetic sense, affecting both the gonadal and statural determinants. Without knowing the cytogenetic findings, these patients are usually labeled as having Turner's syndrome. Furthermore, endocrine data and histologic examination of the gonads are indistinguishable from those of individuals with 45,X or 46XX gonadal dysgenesis.
Uterine perforation following medical termination of pregnancy by vacuum aspiration
Authors: Mittal Suneeta , Misra Sneh Lata
Published: April 2004

Out of 9344 first trimester elective abortions performed by vacuum aspiration, 37 uterine perforation cases occurred. The suction cannula was responsible for more than 50% of perforations. All cases were multiparous. In 56.8%, the duration of gestation was 6 weeks or less. One third of the cases had a history of child birth within the previous 6 months. Fundal and anterior wall perforations were most common. Cases with a retroverted uterus had a higher incidence of perforation (59.4%) than those with an anteverted uterus (32.4%). Exact pelvic assessment and proper technique and case management are important for preventing perforation.
Ectopic pregnancy resulting from transperitoneal migration of spermatozoa
Authors: Daya S.
Published: April 2004

Ectopic pregnancies have been reported in distal tubal segments following tubal sterilization procedures (Metz KGP, Mastroianni Jr L: Tubal pregnancy subsequent to transperitoneal migration of spermatozoa. Obstet Gynaecol Surv 34: 554, 1979). Conception in these situations has been presumed to occur as a result of recanalization of the occluded segment or via a fistulous communication between the two tubal segments. The possibility of transperitoneal migration of spermatozoa leading to such pregnancies is not often considered and is rarely reported (Metz KGP, Mastroianni Jr L: Tubal pregnancy distal to complete tubal occlusing following sterilization. Am J Obstet Gynaecol 131: 911, 1978). A case is presented here that provides support for this phenomenon.
A comparison of metronidazole and ampicillin prophylaxis to women with a history of pelvic inflammatory disease undergoing first‐trimester abortion
Authors: Heisterberg L. , Petersen K. , Sørensen S.S. , Nielsen D.
Published: April 2004

In a double‐blind controlled trial the efficacy of prophylactic metronidazole and pivampicillin to women with a history of pelvic inflammatory disease (PID) undergoing first‐trimester abortion was assessed. Thirty‐eight women received pivampicillin tablets 350 mg and 43 women metronidazole tablets 400 mg, given 1 h before and 4 and 8 h after the abortion. In the pivampicillin group 5 women (13.1%) and in the metronidazole group 8 women (18.6%) developed postabortal PID, a non‐significant difference (P > 0.05). The number of hospital days and amounts of antibiotics were not significantly different in the two treatment groups (all P‐values > 0.05). Women with a history of PID were found to be at risk of contracting postabortal PID.
Abscess formation post cesarean section due to a piece of latex glove
Authors: Confino Edmond , Zbella Edward , Gleicher Norbert
Published: April 2004

Pelvic abscesses may develop after retention of foreign bodies. A case is presented in which during drainage of a post cesarean section pelvic abscess a small piece of a latex glove was recovered. The formation of pelvic abscesses due to foreign bodies is discussed.
Subsequent pregnancy following labor of a very‐low‐birth‐weight infant
Authors: Cohen I. , Altaras M. , Ben‐Aderet N.
Published: April 2004

During a period of 5 years (1978–1982), 55 mothers with an average age of 27.5 ± 5.4 years, delivered 59 infants, weighing less than 1500 g. These infants had a mean birth weight of 1160.5 ± 263 g and a mean gestational age of 28.7 ± 2.25 weeks (range 25–32 weeks). Subsequently 47 (79.6%) survived and 12 (20.4%) died. There was a statistical difference of both mean gestational age and of mean gestational weight between survivors or infants with neonatal death. Twenty two of 29 mothers who subsequently became pregnant, gave birth to liveborn infants, who subsequently survived (four pregnancies terminated in induced abortion). Mean gestational age was 37 ± 3 weeks (range 32–41 weeks) (P < 0.001) and a mean birth weight was 2753.2 ± 570 g (range 1620–3600 g) (P < 0.001. All the 22 infants subsequently born weighed more than 1501 g, 7 (31.8%) infants weighed 1501–2500 g and 15 (68.2%) more than 2500 g. Similar data were obtained from a control group of 615 mothers (chosen at random) who delivered a normal infant at term, 202 subsequently became pregnant and 176 gave birth to a normal infant at term. Mean gestational age was 39.54 ± 1.24 weeks (P < 0.001) and mean birth weight was 3299.3 ± 412 g (P < 0.001). (In the control group 10 pregnancies terminated in induced abortions). The above data could be used in advising for future pregnancy outcome in regard to women with premature births.
Symphysiotomy as an alternative to cesarean section
Authors: van Roosmalen J.
Published: April 2004

The author compares the value of symphysiotomy to cesarean section in the management of cephalopelvic disproportion. He outlines the history of the procedure and reviews the literature on the subject. He then presents results of 54 symphysiotomies performed from 1976 to 1983 in two rural hospitals in the southwestern highlands of Tanzania, together with the outcome of subsequent labor in 25 other women with a history of previous symphysiotomy. The risk of maternal mortality after symphysiotomy is lower than after cesarean section when performed for cephalopelvic disproportion. Although different in nature, maternal morbidity after both operations is equally common. In contrast with findings reported in the literature, a history of previous symphysiotomy still constitutes a high obstetrical risk. The author concludes that symphysiotomy has a place in the management of cephalopelvic disproportion.
Maternal mortality in the Maltese Islands
Authors: Savona‐Ventura C. , Grech E.S.
Published: April 2004

Maternal mortality statistics from the Maltese Islands since 1935 are reviewed to show that there has been a marked decrease in maternal mortality rates. This decrease is probably related to reductions in family size and improvements in the perinatal care of mothers. Hypertensive disease is now the most important cause of maternal mortality.
Assessment of the glucose tolerance test in unselected pregnancy using 75 g glucose load
Authors: Li D.F.H. , Wang Z.‐Q. , Wong V.C.W. , Ma H.K.
Published: April 2004

A 75 g oral glucose tolerance test (OGTT) was performed in 618 unselected pregnant Chinese women between 24 and 28 weeks gestation. The glucose response at fasting, 1, 2 and 3 h were studied. At 2 h the glucose level at 2‐standard deviation and 4‐standard deviation above the mean came very close to the criteria of abnormality suggested by the World Health Organization (WHO): 8.3 mmol/l vs. 8.0 mmol/l for impaired glucose tolerance and 10.8 mmol/l vs. 11.0 mmol/l for gestational diabetes mellitus. The area under the glucose response curve also correlates best with the glucose levels at 2 h during the OGTT (y = 2.1x + 4.6, r = 0.885). The 75‐g OGTT interpreted with the WHO criteria seems appropriate for pregnant Chinese women. The 75‐g test has the added advantages of reducing administration cost and discomfort of the patients.
Maternal mortality in Anambra State of Nigeria
Authors: Chukudebelu W.O. , Ozumba B.C.
Published: April 2004

The maternal mortality rate (MMR) in 10 hospitals scattered all over Anambra State in a 5‐year period was studied. The hospitals covered urban, semi‐urban and rural areas. The MMR varied from 1.8 to 13 per thousand with a mean of 4.97 per thousand. The causes of and various factors influencing this high mortality rate are examined as well as the avoidable factors. Suggestions are made for its reduction based on accurate data collection, improved health facilities, improved socio‐economic status and basic education.
Primary hepatic pregnancy
Authors: Børlum K.‐G. , Blom R.
Published: April 2004

Abdominal pregnancies are a small fraction of ectopic pregnancies. They usually implant on the peritoneal surface after partial disruption of the initial implantation site in the tubes. The pelvic cavity is the preferential site, but they have been reported from all over the peritoneal cavity. In the present case the pregnancy was situated on the surface of the right liver lobe. Abdominal pregnancies usually present with acute hemoperitoneum and the pre‐operative diagnosis is extremely difficult. The possible role of IUDs as an etiological factor is briefly discussed.
Outcome of cesarean section in twin pregnancy
Authors: Unuigbe J.A. , Orhue A.A.E. , Feyi‐Waboso P.A.
Published: April 2004

In an 8‐year period (January 1978 to December, 1985), the 17,379 deliveries at the University of Benin Teaching Hospital (UBTH) consisted of 2089 cesarean sections (12.0%), 56 of which were associated with twin pregnancy. The main indications for cesarean section on the twin pregnancies were antepartum hemorrhage (placenta previa), malpresentation, cervical dystocia and previous cesarean section. The maternal mortality rate was 2% for all twin mothers delivered by cesarean section. There was no statistical difference in perinatal mortality rates (PMR) for all twin deliveries, vaginal twin deliveries and deliveries by cesareans section which were 111,113 and 100 per 1000 births, respectively. In the case of a retained second twin, however, recorded PMR was significantly higher (133 per 1000 births). Consideration of more liberal recourse to cesarean section in all cases of twins may reduce these unacceptably high perinatal death rates in twin pregnancy.
Effect of human menopausal gonadotrophin on the non‐pregnant uterine response to intrauterine administration of prostaglandin E2
Authors: Toppozada M. , Ismail A.A.A. , Hussien M.
Published: April 2004

The effect of intrauterine instillation of 50 μg of prostaglandin E2 (PGE2) on the non‐pregnant human uterus was evaluated in 10 volunteers, before and after systemic administration of human menopausal gonadotrophin (HMG). The cases were either in the early proliferative (n = 5) or late secretory (n = 5) phases of the cycle. Before HMG administration, the uterus responded to local PGE2 by stimulation in all the cases. After HMG treatment, no response to PGE2 was detected in eight cases and a decrease in uterine tonus was observed in two cases. The implications of these findings in certain physiological and pathological conditions relating to reproduction are discussed.
Outcomes of twin pregnancies at the Hospital Central of Maputo: retrospective study of 315 consecutive twin deliveries, January 1–September 30, 1987
Authors: Bugalho A. , Strolego F. , Carlomagno G.
Published: April 2004

Between January 1 and September 30, 1987, 315 (3.53% of total deliveries) consecutive twin gestations were delivered at the Department of Obstetrics and Gynaecology of the Hospital Central in Maputo Mozambique. There were 42 perinatal deaths (stillbirths + early neonatal deaths) among the 630 infants born (66.7 per 1000) and 21 early neonatal deaths among the 609 live‐born infants (34.5 per 1000). Early neonatal death frequency was higher among second twins than among first ones (50 per 1000 versus 19.7 per 1000), but the difference did not reach statistical significance. Most of the second twin early neonatal deaths (11/15) were associated with a breech vaginal delivery of the first twin.
Induction of labor by oral prostaglandin E2 in protracted pregnancy
Authors: Ismail A.A.A. , El‐Din Khowesah M. Mohie , Shaala S.A. , Anwar M.Y. , Darwish E.A. , Haiba N.A.
Published: April 2004

Induction of labor was performed in 20 pregnant females with postmaturity (> 294 days) using either oral PGE2 tablets (0.5 mg) or i.v. oxytocin drip (each group n = 10). The induction‐establishment interval was significantly shorter in the oxytocin group (P < 0.005). Moreover, the uterine activity (in Alexandria units) at 3 h post‐induction and at the end of the first stage of labor, was significantly higher with i.v. oxytocin (P < 0.005). However, the induction‐delivery interval did not differ in both groups. All cases delivered spontaneously with a satisfactory Apgar score.
Prostaglandin E2 induction of abortion and fetal demise
Authors: Wiley T.L. , Poole C.P. , Gookin K.S. , Wiser W.L. , Morrison J.C.
Published: April 2004

Prostaglandin E2 (PGE2) suppositories have been shown to be active contractile agents and are effective in uterine evacuation for mid‐trimester abortion or fetal demise. In this study, 85 patients were treated with vaginal PGE2 suppositories. When laminaria were used in patients with closed cervices, and compared to those who had minimal cervical dilatation, there was no difference in the time from induction to expulsion. Ninety‐three percent of the 85 patients aborted successfully within 24 h. In each of the seven “failures”, three or less suppositories were used prior to a dilatation and evacuation procedure. In this study, 81% of the abortions were complete, and in one‐third of the remaining patients dilatation and curettage was performed just after delivery of the fetus. The incidence of minor side‐effects ranged from 12 to 21%, and there were no major complications. It is concluded that the use of vaginal prostaglandin E2 suppositories for induction of mid‐trimester abortion or fetal demise in the third trimester is safe and effective.
Pregnancy in a non‐communication rudimentary uterine horn
Authors: Seoud M.A.‐F. , Khalil A.M. , Abdel‐Karim F.W. , Suidan J.S.
Published: April 2004

A case of pregnancy in a rudimentary uterine horn is presented. The pregnancy ended in fetal demise at the end of the second trimester. The diagnosis was missed by ultrasonography on two occasions and was made only at laparotomy following failure to initiate uterine contractions. Histologic examination of the myometrium of the rudimentary horn revealed extensive interstitial fibrosis. A high index of suspicion of pregnancy in a rudimentary horn is recommended whenever adequate ecbolic infusions fail to induce myometrial contractions.
New technique for managing second trimester intrauterine fetal death
Authors: Malpani A. , Malpani A. , Krishna U.
Published: April 2004

In this study, a new method for terminating second trimester pregnancies complicated by intrauterine fetal death is analysed. The technique consisted of a combination of extraamniotic ethacridine lactate with intramuscular sulprostone (16‐phenoxy‐ω‐17,18,19,20 tetranor PGE2 methyl sulfonylamide). Objective documentation of the efficacy of this method was obtained by continuous monitoring of intrauterine pressure in two patients. The method was found to be simple, safe, cheap and effective and deserves increased acceptance.
HIV antibody screening in a gynecology and obstetrics clinic Ankara, Turkey
Authors: Rota S. , Yildiz A. , Güner H. , Erdem M.
Published: April 2004

In 416 pregnant women, admitted to our outpatient obstetric clinic for antenatal care between December 1987 and August 1988, HIV antibody assesments were performed by ELISA technique. No seropositive case was reported.
Effect of fetal sex and race on amniotic fluid lecithin concentration
Authors: Fadel H.E. , Saad S.A. , Nelson G.H. , Davis H.C.
Published: April 2004

Amniotic fluid lecithin phosphorus concentration (AF‐Lec) was measured in 209 healthy women at 31.7–42.7 weeks gestation. The patients were divided into four groups according to race and fetal sex. No differences in AF‐Lec between black and white nor between male and female fetuses were found. The relationship of AF‐Lec to gestational age and the incidence of “mature” AF‐Lec was not different among the four groups. We conclude that there is no effect of fetal sex, race, or the interaction between them on fetal lung development as measured by AF‐Lec.
Laparoscopic surgery for tubal pregnancies utilizing laser
Authors: Huber J. , Hosmann J. , Vytiska‐Binstorfer E.
Published: April 2004

Nine cases of ectopic pregnancy were treated by laser supported tubotomy and subsequent endoscopic evacuation by a forceps. The location of the ectopic pregnancies were as follows: ampulla (one patient); isthmus (five patients); and fallopian tube (three patients, in two of whom the whole tube was a hematosalpinx). The incision in the tube was made on the antimesenteric side according to the position and size of the ectopic pregnancy using an ND YAG laser. Tissue destruction of the Nd YAG laser was diminished by using a crystal. After the incision, the conceptional debris was removed by a forceps. In all cases the fallopian tube was left open. Three months after the operation an X‐ray was performed. In all nine cases, patent tubes could be documented on the affected and on the contralateral side. In the two patients with hematosalpinx, adhesions of the treated tube were found.
Ovarian fibroma — clinical and histopathological characteristics
Authors: Sivanesaratnam V. , Dutta R. , Jayalakshmi P.
Published: April 2004

Twenty‐three cases of ovarian fibroma, comprising 3% of all benign tumors seen over a 20‐year period, were analyzed. It was unilateral in all cases affecting more commonly the left ovary (70%). Whilst a majority of cases (77%) were encountered in the reproductive age group, the tumor was rare before the second decade. Only in 13% of cases was ascitis clinically detectable. This was not influenced by the size and weight (average of 9.3 × 10.8 × 11.1 cm and 959 g, respectively) of the tumors; a smooth‐surfaced tumor was, however, associated with a greater amount of peritoneal fluid. Varying degrees of calcification in some tumors are detectable on ultrasonography and occasionally on abdominal radiography. The classical Meig's Syndrome was seldom encountered. The histopathological features, diagnostic problems and management are discussed.
A large scale rooming‐in program in a developing country: The Dr. Jose Fabella Memorial Hospital Experience
Authors: Gonzales R.B.
Published: April 2004

This paper describes the successful expansion of a pilot rooming‐in project to rooming‐in for all mothers, whether they gave birth vaginally or by cesarean section. Babies in Intensive Care are also given breast milk as much as possible. This policy has resulted in reduced bleeding and hospital stays, and decreased costs, among other things. Objective indicators for different aspects of the program are currently being assessed. Four reasons are given for success: strong political will; persistent administrative determination; trained personnel; and an informed public.
Breastfeeding promotion in family planning programs
Authors: Jennings V.H.
Published: April 2004

Family planning programs serve large numbers of women of childbearing, and thus breastfeeding, age. Although these programs appear to have a number of characteristics which would be useful for promoting and supporting breastfeeding, most family planning programs have done very little in this area. The Agency for International Development (A.I.D.) and the Institute for International Studies in Natural Family Planning are working to find ways to remove barriers to family planning breastfeeding promotion efforts. Such barriers include lack of or conflicting measures of program success and lack of information on the breastfeeding/fertility relationship. The Institute is developing guidelines to help family planning programs promote breastfeeding.
Influence of suckling on plasma concentrations of somatostatin, insulin and gastrin in lactating women
Authors: Franceschini R. , Ragni N. , Cataldi A. , Venturini P.L. , Barreca T. , Rolandi E.
Published: April 2004

The effects of suckling on plasma somatostatin, insulin and gastrin values were evaluated in eight nursing women on the 3rd to 4th day postpartum. Plasma prolactin levels were also determined. Prolactin levels increased in response to suckling, as expected. Insulin levels also rose, whereas somatostatin and gastrin concentrations did not change after suckling. It is possible that the suckling‐induced hyperinsulinemia blunts the somatostatin response to suckling in humans.
Symphysis‐fundal height measurement — A reliable parameter for assessment of fetal growth
Authors: Indira R. , Oumachigui Asha , Narayan K.A. , Rajaram P. , Ramalingam G.
Published: April 2004

Intrauterine growth retardation (IUGR) is one of the major causes of perinatal mortality in countries like India. Fundal height traditionally measured in relation to umbilicus and xiphisternum is of little value in predicting the fetal growth. Some workers have found that symphysis fundal height (SFH) measurements could be useful in screening pregnancies for growth retardation. A prospective study was taken up in 109 pregnant women attending the antenatal clinic of our Institution. Serial measurements of SFH, abdominal girth, double abdominal wall thickness (DAWT) and maternal weight gain were recorded. SFH measurements obtained were arranged on the basis of 10th, 50th and 90th percentile and represented graphically. Statistical analysis showed that the coefficient of variation was smallest for SFH as compared to abdominal girth and maternal weight gain. The babies (single born) delivered were between 2600 g and 3700 g irrespective of whether the maternal weight gain was 143 g/week or 424 g/week. The abdominal wall thickness had no influence on the measurement of SFH. An attempt was made to develop a nomogram of SFH for our population. This is a simple, reliable and inexpensive method in the screening of pregnancies for IUGR.
Socio‐biological factors influencing infertility in a rural Nigerian community
Authors: Ebomoyi E. , Adetoro O.O.
Published: April 2004

An assessment of factors influencing infertility in a rural Nigerian community revealed a prevalence rate of 12.9% primary infertility. Secondary infertility among the subjects was 54.1%. Age, education and religion of respondents had statistically significant influence on infertility (P < 0.05) but not income (P > 0.05). The correlation between age of respondents and infertility was statistically significant (P < 0.05). Primary health care efforts aimed at implementing maternal and child health care should explore the traditional customs on infertility in rural areas of developing countries.
Magnetocardiographic patterns in complicated and uncomplicated pregnancies
Authors: Anninos Ph. , Anastasiadis P. , Sivridis E.
Published: April 2004

Magnetocardiographic (MCG) patterns, produced by the electrical activity of the heart, were investigated in 38 full term pregnant women (17 pre‐eclamptic and 21 with uncomplicated pregnancies), by means of a superconducting quantum interference device (SQUID). The most important difference was noted in the waveform amplitudes of the MCG recordings; these were appreciably lower in women with pre‐eclampsia compared to those in the normal control series, although in both groups the emitted magnetic fields ranged at approximately the same frequency band. Electrocardiographic (ECG) QRS complexes were represented clearly only in the low MCG waveform amplitudes, and these were related to the presence of widespread obliterative endarteritis in the fetal vasculature of the placentae. The above MCG findings are consistent with an increased contractibility of the myocardium in pregnant women with hypertensive disease secondary to the increased peripheral resistance.
Perinatal outcome following intravascular transfusion in severely isoimmunized fetuses
Authors: Ney J.A , Socol M.L , Dooley S.L , MacGregor S.N , Silver R.K , Millard D.D
Published: April 2004

Twenty‐six severely isoimmunized pregnancies managed exclusively with ultrasonographically guided intravascular fetal transfusions are reported. The mean gestational age plus and minus one standard deviationy (±SD) was 26.3 ± 3.6 weeks and the mean hematocrit (±SD) prior to initial transfusion was 20.6 ± 6.7%. Four of seven hydropic fetuses and 9 of 19 without hydrops were ≤ 26 weeks gestation at the first transfusion. Overall survival was 85% (22/26). Survival was similar whether or not fetal hydrops was present (6/7 vs. 16/19) and whether or not the first transfusion was administered at ≤26 weeks gestation (10/13 vs. 12/13).
Safe epidural anesthesia performed during labor by an obstetrician
Authors: Lurie S. , Feinstein M. , Blickstein I. , Caspi B. , Matzkel A.
Published: April 2004

One thousand seven hundred eighty‐seven epidural anesthesias during labor were performed by obstetricians well trained in the technique by the anesthesiology department. The course of labor was accelerated compared to control group. Vacuum extraction rate was 11.9%. Fetal outcome was favorable. Incidence of major complications was 0.16%. We conclude that in countries where an anesthetist is not routinely available at delivery wards, a safe and efficient epidural anaesthesia could be performed by an obstetrician well trained in administration of epidural anesthesia.
Cesarean section and maternal age in low‐risk nulliparas
Authors: Delgado L.R. , Nieto F. , Diaz A.G. , Schwarcz R.
Published: April 2004

The relationship between maternal age and cesarean section in low‐risk nulliparas was analysed in 7454 perinatal clinical records selected from eleven databases of Latin American institutions obtained with a comprehensive perinatal information system. The risk of cesarean section in nulliparas between 29 and 49 years of age was found to be three times higher than that corresponding to pregnant women of lesser age. This clearly more aggressive obstetrical conduct could not be explained by the main indications for cesarean section.
Knowledge and attitudinal study of Kenyan women in relation to cervical carcinoma
Authors: Machoki J.M.N. , Rogo K.O.
Published: April 2004

Knowledge and attitude in relation to cervical carcinoma was studied in 85 cervical cancer patients and 177 matched controls. The mean age of the cases was 44.2 years and mean parity 6.5. The majority were illiterate. Statistically significant differences were seen in both mean age at marriage and at first coitus, being lower for cases than controls (P < 0.001). Basic knowledge of abnormalities of vaginal bleeding or discharge was characteristically poor in both groups. Over 90% had never attended any routine gynecological check up and did not deem it necessary. The few on regular check up were FP clinic attenders. Pap smear was totally unknown to most cases and controls. Against this background the vital role of public education in the control of cervical carcinoma is emphasized.
Contraception with subdermal levonorgestrel implants as an alternative to surgical contraception at Ilorin, Nigeria
Authors: Fakeye O.
Published: April 2004

Acceptability and social characteristics of a cohort of Norplant®, IUD, pill and depo‐medroxyprogesterone acetate (DMPA) acceptors who were seen at the University of Ilorin Family Planning Clinic over a 10‐week period of the pre‐introductory clinical trial of Norplant®, are compared. Findings indicate that Norplant® and DMPA are adopted as an alternative to sterilization by women advanced in reproductive age and of high parity. The pill and IUD are adopted mainly as birth‐spacing methods. Women's education, but not previous use of a contraceptive method, influenced the adoption of Norplant®. The continuation rate at 12 months, a measure of acceptability, was highest, 93.7 per 100 women, for Norplant® and 77.9, 46.7 and 27.7 per 100 women for the IUD, DMPA and the pill, respectively. The need to address the high family size norms in the African subregion is discussed.
Mid‐trimester termination of pregnancy with 16,16‐dimethyl‐trans‐Δ2 PGE1 vaginal pessaries: A comparison with intra‐ and extra‐amniotic prostaglandin E2 administration
Authors: Hill N.C.W. , Selinger M. , Ferguson J. , MacKenzie I.Z.
Published: April 2004

PGE1 analogue (gemeprost) vaginal pessaries administered three hourly for three doses has been compared with a single extra‐ or intra‐amniotic injection of PGE2 for mid‐trimester termination of pregnancy in 450 women between 13 and 20 weeks gestation. The mean (SD) induction‐abortion interval (IAI) in the vaginal pessary group of 19.5 (8.4) h was significantly longer than the respective intervals of 14.4 (9.3) and 16.1 (6.8) h in the patients treated extra‐ or intra‐amniotically (P < 0.001). Seventy‐three percent treated with gemeprost aborted within 24 h of initial treatment compared with 84% and 87%, respectively in the extra‐ and intra‐amniotic groups (P < 0.05). Patients treated with gemeprost were more likely to need further prostaglandin treatment and had an increased incidence of gastrointestinal side effects. Despite these differences vaginal gemeprost pessaries provide a safe, effective, easy to administer method for midtrimester termination of pregnancy.
Mozambique — delegation of responsibility in the area of maternal care
Authors: da Luz Vaz M. , Bergström S.
Published: April 2004

The shortage of physicians in Mozambique has necessitated the training and delegation of maternity care to other available health personnel, such as traditional birth attendants, midwives, and nurses. In addition, surgical technicians have been trained to perform major surgical procedures, including cesarean sections and hysterectomies.
Mullerian adenosarcoma of the uterus in adolescents
Authors: Andrade L.A.L.A. , Derchain S.F.M. , Vial J.S. , Alvarenga M.
Published: April 2004

A case of uterine Mullerian tumor in an adolescent is described. Surgical and clinical management is discussed, based on the experience gained by the analysis of cases described in the literature. A review of the different age groups, primary sites, surgical management and biological behavior of cases described in the literature is tabulated and analysed.
Declining mortality in international sterilization services
Authors: Khairullah Z. , Huber D.H. , Gonzales B.
Published: April 2004

Between 1973 and 1988, A VSC supported 1 516 478 female sterilizations and 401 856 vasectomies in 50 countries. Overall, 73 deaths were attributable to voluntary sterilization procedures (yielding mortality rates of 4.7 deaths per 100 000 female sterilizations and 0.5 per 100 000 vasectomies). Causes of death, in order of frequency, were anesthesia (22), intestinal injury (20), infection (19), intraabdominal hemorrhage (6) and other (6). The female sterilization mortality rate declined from 7.1 per 100 000 procedures in 1973–1981 to 3.7 per 100 000 in 1982–1988. Safer anesthesia practices and improved infection control contributed most to this decline. The mortality rate related to surgical errors declined proportionately less than the rates related to anesthesia and infection. Contraceptive sterilization has become a very safe procedure in these 50 countries, where anesthesia (local and general), surgical technique (minilaparotomy and laparoscopy) and timing of the procedure (interval and postpartum) vary substantially. Future deaths will probably be rare. However, expert surgeons should review each case because identifying the most likely cause of death is always complex and these analyses help shape surgical contraception practices.
The role of the village midwife in detection of high risk pregnancies and newborns
Authors: Ibrahim S.A. , Omer M.I.A. , Amin I.K. , Babiker A.G. , Rushwan H.
Published: April 2004

The preliminary findings of a prospective study of perinatal, neonatal and maternal mortality carried out in a rural community of Sudan are reported. Out of 6275 deliveries monitored over a period of 3 years, 150 stillbirths, 167 neonatal deaths and 27 maternal deaths were observed. An intervention program to upgrade the skills of the village midwives started in the middle of the second year. There was a 25% reduction in the risk of unfavorable outcome of pregnancy (i.e. stillbirth and neonatal death) in the third year relative to the first 2 years. Peer review of the 40 village midwives who took part in the study revealed their tremendous potentials in mobilization of mothers as well as participation in primary health care. Their role in detection of high risk pregnancies and newborns cannot be overemphasized.
Comparison of four antiemetic regimens for the treatment of cisplatin‐induced vomiting
Authors: Póka R. , Hernádi Z. , Juhász B. , Lampé L.
Published: April 2004

OBJECTIVE: To improve the treatment of cisplatin‐induced acute emesis and vomiting, the adjuvant effect of two different doses of metoclopramide and metoclopramide plus droperidol was compared to a defined standard antiemetic regiment. METHOD: One‐hundred and twenty‐one consecutive cisplatin‐based chemotherapy treatments for ovarian carcinoma were randomly assigned to receive standard plus no adjuvant (control, n = 24), high‐dose metoclopramide (HDM, n = 33), very high dose metoclopramide (VHDM, n = 50) and very high dose metoclopramide plus droperidol (VHDM + DP, n = 14) antiemetic treatment. The number of vomiting episodes up to 4 h after the treatment were recorded and compared in the four different antiemetic groups. The effect of the number of previous chemotherapy cycles, the strength of previous antiemetic treatments, age and stage of disease on the number of vomiting episodes was also assessed. RESULT: The mean number of vomiting episodes during the first 4 h after the chemotherapy was 9, 6.4, 6.2 and 2.7 among patients receiving the standard HDM, VHDM and VHDM + DP antiemetic regimens, respectively. Analysis of variance of vomiting episodes confirmed significant differences between the groups (P < 0.001, F = 406.5, df = 120). The number of previous chemotherapy cycles and, to a lesser extent, the stage of disease, the strength of previous antiemetic regimens and the age showed significant correlation with the number of vomiting episodes (r = 0.443, −0.159, −0.14 and −0.009 respectively). CONCLUSION: Substantial improvement in the control of cisplating‐induced vomiting can be achieved by adding high‐dose metoclopramide and droperidol to a basic antiemetic regimen consisting prochlorperazine, dexamethasone and thiethylperazine.
Neonatal survival after preterm premature rupture of membranes secondary to first trimester chorionic villus sampling
Authors: Vernet M. , Pérez Picañol E. , Armengol R. , Gamissans O. , Coroleu W. , Roca A.
Published: April 2004

A case of preterm premature rupture of membranes (PROM) secondary to first trimester chorial biopsy is described. The newborn survived and physical and psychological development was normal at 1 year of age. On review of the literature, different attitudes may be found with regard to the treatment of PROM: some authors prefer expectant management while others defend extraction of the fetus when reasonable maturity is reached. In both cases the outcome is usually poor for the fetus.
Adolescents with obsessive‐compulsive disorder: a case note review of consecutive patients referred to a provincial regional adolescent psychiatry unit
Authors: Allsopp Mark , Verduyn Chrissie
Published: April 2004

A number of clinical descriptions of Obsessive‐Compulsive Disorder (OCD) in adolescence are available but are often of small numbers of cases with highly selective recruitment methods. We describe the findings of a systematic case note review of 44 consecutive OCD patients referred to Oxford Regional Adolescent Unit between 1974 and 1984. The relative frequencies of previously described features of the condition in this age group are presented. Many patients had problems with peer relationships and social isolation, which often preceded the onset of other symptoms by many years. The management of the cases and outcome at discharge are outlined.
Factors underlying suicidal ideation among college studients: a test of Teicher and Jacobs' model
Authors: Strang Scott P. , Orlofsky Jacob L.
Published: April 2004

The study examined three factors thought to be involved in the etiology of suicidal ideation in adolescents: an absence or disruption of interpersonal attachments, a conviction of personal helplessness, and a sense of hopelessness regarding the future. Subjects, 191 college students age 21 or less, completed questionnaires assessing suicidal ideation, parent and peer attachments, locus of control, and hopelessness. Nearly 61 per cent of the subjects reported at least some degree of suicidal ideation, and 21 per cent reported moderate or high levels of ideation. Both low‐level and moderate‐ to high‐level ideators reported poorer relationships with their parents than non‐ideators. In addition, compared to non‐ideator and low‐ideator subjects, moderate to high ideators reported poorer relationships with peers and greater convictions of helplessness and hopelessness about the future. No gender differences were found other than a suggestion that insecure attachment to parents may be a more important factor in the genesis of suicidal ideation in college women than men.
Perceived parental rearing, personality and mental status in Japanese adolescents
Authors: Furukawa Toshiaki
Published: April 2004

As a part of a prospective study on the psychological adjustment of Japanese teenagers enrolled in a foreign exchange student program, the Parental Bonding Instrument (PBI), the Maudsley Personality Inventory and the General Health Questionnaire (GHQ) were administered to 130 females and 47 males aged 17 through 19 before departure. Parental practices were found to influence personality features, which in turn contribute to the mental health status, but no direct significant relationship was found between the PBI and GHQ measures. The last finding is in contradistinction to the previous reports which report low care and high overprotection in unipolar depressives and anxiety disorder patients but in accordance with a recent finding which failed to replicate them in general population. It is possible that the earlier findings in clinical populations were a case of Berkson bias.
Friendship and personal adjustment during adolescence
Authors: Claes Michel E.
Published: April 2004

A questionnaire evaluating the friendship network, the expectations towards friends, the level of intimacy and attachment with friends, as well as the presence of conflicts with friends, was administered to 349 adolescents. The sample consisted of both males and females, age ranging from 12 to 18 years. Subjects were also given various personal adjustment indices that were obtained from the Offer Self Image Questionnaire. The results demonstrate that there are small differences in the friendship network across age and gender. Analysis of the qualitative aspects of friendship are generally constant with respect to age, but demonstrate marked differences with respect to gender: girls expect more from their friends than boys and their level of attachment and intimacy with friends is greater. The results also indicate that the number of friends in the network is not significantly correlated with the personal adjustment variables. Multiple regression analyses revealed that the quality of attachment maintained with friends and the absence of conflict experiences in friendship account for a low but significant proportion of the score variance obtained from the personal adjustment scale. The possibility to confer personal problems and the preoccupations to friends seems beneficial for the acquisition of adaptive behavior. Deficiences in communication with friends or confrontation experiences and feelings of alienation are related to some forms of maladaptive behavior.
Mycoplasma hominis, ureaplasma urealyticum, and corynebacterium genitalium recovered from the lower genital tracts of adolescent women
Authors: Russo Joseph F. , Coppola Karen , Furness Geoffrey
Published: April 2004

The lower genital tracts of 137 adolescent women were examined for the presence of Mycoplasma hominis, Ureaplasma urealyticum, and Corynebacterium genitalium in relation to sexual activity, previous pregnancy, presence of vaginal discharge and oral contraceptive use. None of the sexually inactive and 10% of the sexually active adolescent females were colonized with U. urealyticum. None of the sexually inactive and 4% of the sexually active adolescent females were colonized with C. genitalium. Nineteen percent of the sexually inactive and 36% of the sexually active adolescent females were colonized with M. hominis.

The presence of M. hominis in the lower genital tract was not associated with any clinically identifiable vaginal discharge or inflammatory changes in exfoliated cervical and vaginal epithelial cells. The presence of M. hominis in the lower genital tract did not appear to be related to the use of oral contraceptives or antecedent pregnancy. There was no significant difference in the recovery rates of these microorganisms when we compared women who had non‐specific vaginitis with those who did not. There is no evidence from this study that any of these microorganisms is responsible for non‐specific vaginitis.