bluuebunny/crossref_metadata_2025 huggingface dataset:
The outcome of labor at the University Teaching Hospital (CHU), Yaounde, Cameroon
Authors: Doh A.S. , Nasah B.T. , Kamdom‐Moyo J.
Published: April 2004

The University Teaching Hospital, Yaounde, Cameroon became operational in 1982. This retrospective study analyses the performance of the maternity unit during the first 5 years. Data was obtained from casenotes, annual reports, delivery and operation registers. The maternal mortality rate (MMR) is one of the lowest in Africa. The perinatal mortality is low but could be improved upon. The reasons for the low MMR is discussed. It is possible to reduce the appalling MMRs of developing countries without sophisticated technologies.
Early experience with in vitro fertilization‐embryo transfer and gamete intrafallopian transfer in a Nigerian hospital
Authors: Olatunbosun O.A. , Lokulo‐Sodipe O. , Okonofua F.E. , Oguntade O. , Armar N.A. , Ahuja K.
Published: April 2004

We present our early experience with in vitro fertilisation‐embryo transfer (IVF‐ET) and gamete intrafallopian transfer (GIFT) in a Nigerian Hospital. Twenty‐one patients were recruited, 11 patients for the IVF‐ET program and 10 for the GIFT program. In the IVF program the oocyte recovery rate was 100%, the fertilization rate was 66% and the cleavage rate was 97% but no live pregnancies were achieved. In contrast, one live delivery was achieved with GIFT. These results suggest that both IVT‐ET and GIFT are feasible in developing countries.
The relative significance of colposcopic descriptive appearances in the diagnosis of cervical intraepithelial neoplasia
Authors: Edebiri A.A.
Published: April 2004

Four hundred and seventy seven colposcopic appearances have been analysed in 252 patients to determine their histopathological correlation and clinical efficiency in the diagnosis of cervical intraepithelial neoplasia (CIN). Immature metaplasia, cervical ectopy and cervicitis produced a considerable quotient of abnormal colposcopic appearances. Acetowhite epithelium had the highest sensitivity (92%), lowest specificity (25%) and a positive predictive value of 61%. Mosaicism and punctation were less sensitive (30 and 38%), but more specific (89 and 85%), respectively and had superior positive predictive values.
Pruritic urticarial papules and plaques of pregnancy
Authors: Barrenetxea G. , Melchor J.C. , Barbazán M.J. , Aranguren G. , Rodriguez‐Escudero F.J.
Published: April 2004

The authors present a rare case of pruritic urticarial papules and plaques of pregnancy in a 25‐year‐old caucasian primigravida admitted to our department because of pruritus in the third trimester of gestation. Recommendations for management are discussed.
Vaginal delivery after one cesarean section
Authors: van der Walt W.A. , Cronjé H.S. , Bam R.H.
Published: April 2004

Objective: To determine the success rate and safety of vaginal delivery after a previous cesarean section in a South African teaching hospital serving a developing community. Method: One hundred eighty‐nine women with a history of one previous cesarean section were studied during a 10.5‐month period. Maternal morbidity was studied in 92 of these patients who had infants weighing 2500 g or more. During the study period 5044 women delivered at the hospital. Results: In the study group of 189 women, 85 (44.9%) delivered vaginally, 65 (34.4%) by cesarean section during labor and 39 (20.6%) had elective cesarean sections. One maternal and two perinatal deaths occurred. In the subgroup of 92 women with babies weighing 2500 g or more at birth, 10 women (10.9%) experienced morbidity related to trial of scar. Conclusion: Vaginal birth was accomplished less often in this population compared with reports from developed countries, but the procedure was equally safe.
Exercise during pregnancy and the postpartum period
Authors:   The American College of Obstetricians and Gynecologists
Published: April 2004

In the absence of either obstetric or medical complications, pregnant women can continue to exercise and derive related benefits. Women who have achieved cardiovascular fitness prior to pregnancy should be able to safely maintain that level of fitness throughout pregnancy and the postpartum period. Depending on the individual's needs and the physiologic changes associated with pregnancy, women may have to modify their specific exercise regimens. Despite findings that suggest lower birth weights among offspring of women who continue to exercise vigorously throughout pregnancy, there currently are no data to confirm that, with the specific exceptions mentioned here, exercise during pregnancy has any deleterious effects on the fetus. While maternal fitness and sense of well‐being may be enhanced by exercise, no level of exercise during pregnancy has been conclusively demonstrated to be beneficial in improving perinatal outcome.
A clinical model for enhancing adolescent ego identity
Authors: Enright Robert D. , Olson Leanne Marzocco , Ganiere Diane , Lapsley Daniel K. , Buss Ray R.
Published: April 2004

A model of identity formation based on the cognitive developmental stages of social perspective‐taking is described. The model assumes that identity can be achieved through cognitive strategies of considering the self in relation to one friend, one's family, the peer group, and society. Two studies were undertaken to test the model. In Study 1, 28 college students participated in a two week program in which the experimental students were asked to take the perspective of each social entity above and then to consider how the self was like and unlike these. The experimentals gained more than the controls on the identity subscale of Rasmussen's EIS. Fifty‐nine college students participated in Study 2 which used a more sensitive discrepancy score measure on a revised identity scale. Discrepancy scores in an analysis of covariance indicated that the experimentals were higher than the controls at post‐test and at a one month follow‐up.
Parental influence on adolescents' imagination
Authors: Rabinowitz A. , Engelberg D.
Published: April 2004

It was hypothesized that a permissive democratic parental attitude towards childrearing and favorable accepting attitude towards children's imagination are conducive to the development of their adolescent children's imaginative ability. It was also hypothesized that the mother's role is more crucial than that of the fathers. The subjects were 104 adolescent Israeli boys and girls and their parents. The subjects were administered four scales of the Imaginal Processes Inventory and the Children's Report of Parental Behavior Inventory. The parents filled out a questionnaire devised to study their attitude to children's imagination. The first two hypotheses were not confirmed. The data point in the opposite direction as regards the first hypothesis. There was partial conformation for the third hypothesis. The data were also discussed in relation to healthy and neurotic daydreaming.
Complex role experiences and personal differentiation: a real‐life experiment
Authors: Rapoport Tamar , Rosenhek Zeev
Published: April 2004

This paper analyses the relationship between the complexity of role experiences and personal differentiation. “Complex role experiences” are defined by high levels of voluntarism, multiplexity, quasi‐responsibility and trial‐and‐error behaviour. The ability to differentiate between diverse principles of role enactment and various criteria of interpersonal relations is conceptualized as “personal differentiation”. Our hypothesis is that a pre‐designed educational programme providing complex role experiences enhances personal differentiation This hypothesis was tested in an experimental study on Israeli adolescents participating in summer camps. The results show that the active exposure to and assumption of variegated roles in different settings on a voluntaristic basis, while performing meaningful and quasi‐responsible actions by means of trial‐and‐error behaviour, enhances role and interpersonal differentiation, and hence personal differentiation, among adolescents.
The AIDS awareness and sexual behaviour of young people in the South‐west of England
Authors: Ford Nicholas
Published: April 2004

A programme of surveys was undertaken in collaboration with District Health Authorities to assess the AIDS awareness and sexual behaviour of young people, in order to help the development and implementation of HIV/AIDS risk‐reduction strategies. Given that the patterns of findings were strongly replicated in the different districts, the data is presented in terms of a combined data set comprising 2955 respondents aged 16–24. The surveys indicate fairly reasonable levels of knowledge about HIV/AIDS but very low personally perceived vulnerability to infection. The sexual culture is one of fairly early ages of first intercourse, moderate levels of partner change and low (one third) levels of condom use. The findings are discussed in terms of their implications for HIV/AIDS risk‐reduction strategies.
Strong convergence of an iterative sequence for maximal monotone operators in a Banach space
Authors: Kohsaka Fumiaki , Takahashi Wataru
Published: April 2004

We first introduce a modified proximal point algorithm for
maximal monotone operators in a Banach space. Next, we obtain a
strong convergence theorem for resolvents of maximal monotone
operators in a Banach space which generalizes the previous result
by Kamimura and Takahashi in a Hilbert space. Using this result,
we deal with the convex minimization problem and the variational
inequality problem in a Banach space.
Invariant sets for nonlinear evolution equations, Cauchy problemsand periodic problems
Authors: Hirano Norimichi , Shioji Naoki
Published: April 2004

In the case of , we study Cauchy problems
and periodic problems for nonlinear evolution equation u(t) ∈ K, u′(t) + Au(t)∋f(t, u(t)), 0 ≤ t ≤ T, where A isa
maximal monotone operator on a Hilbert space H, K is a
closed, convex subset of H, V is a subspace of H, and f : [0, T] × (K∩V) → H is of Carathéodory
type.
Clinical features of pregnancies with fatal fetal abnormality
Authors: Kirkinen Pertti , Jouppila Pentti , Herva Riitta
Published: April 2004

Obstetrical features and antenatal findings in 68 pregnancies with fatal fetal abnormalities are evaluated. The course of the pregnancy was complicated in 81% of these cases, the most common complication being intrauterine fetal growth retardation (IUGR) which was typical for 18‐trisomies and multimalformed fetuses. The retardation in symphyseal‐fundal growth was manifested on the average on the 25th gestational week. Low‐profile type biparietal growth retardation was associated with 43% of the IUGR cases, and the brain‐sparing effect in growth was found in 29%. Polyhydramnios was a complication in 30% of the series. Premature labor was associated with 60% of the spontaneously initiated deliveries in the series, and was not due to the polyhydramniotic tendency only. Antenatal evaluation of the fetoplacental unit function revealed a normal capacity in 62% of the cases. The fatality of the fetal abnormality was not manifested in any special feature in the complications of the pregnancy. Antenatal etiological evaluation and search for fetal anomalies in all pregnancies complicated by early IUGR, polyhydramnios and imminent premature labor is stressed for the adequate assessment of perinatal care.
Pituitary‐ovarian hormones after low‐dose endometrial afterloading irradiation
Authors: Grönroos M. , Kauppila O. , Pulkkinen M. , Turunen S. , Salmi T. , Raekallio J.
Published: April 2004

Low‐dose endometrial after loading irradiation was used in 19 mentally retarded women for the induction of therapeutic amenorrhea. They were divided into two subgroups on the basis of age: 13 young patients (mean age 17 years, range 13–26 years) and six patients of middle age (mean age 42 years, range 34–44 years).

In the young patients, during the 10‐month month follow‐up period, the plasma E2 levels did not decrease. HOwever, the FSH concentration increased. Later on, 2–9 years after treatment, the E2 levels were significantly higher than those of healthy postmenopausal women and did not differ from the values of healthy women in the sixth to seventh days of the menstrual cycle. At that time the FSH and LH levels were similar to reference values in reproductive age. The E2/E1 ratio was significantly higher than that of healthy women in the sixth to seventh days of the cycle and that of postmenopausal women. Most of the menstrual cycles were anovulatory but some ovulatory also occurred. The testosterone concentrations did not differ from reference values. The ovaries of the middle age patients were more sensitive to irradiation than those of the younger patients.
Placental protein 5 (PP5) in severe pre‐eclampsia and eclampsia
Authors: Lee J.N. , Salem H.T. , Huang S.C. , Ouyang P.C. , Seppälä M. , Chard T.
Published: April 2004

Circulating levels of placental protein 5 (PP5) were studied in patients with severe pre‐eclampsia and eclampsia. Elevated PP5 levels were frequently observed in the eclampsia group. This elevation may be due to disturbance in endogenous coagulation mechanisms at the placental site.
Circulating blood levels of gonadotropins and prolactin in the normal menstrual cycle
Authors: Dada O.A. , Ladipo O.A. , Osotimehin B.O. , Nduka E.U.
Published: April 2004

Circulating blood levels of luteinizing hormone, follicle‐stimulating hormone and prolactin are reported in 17 normally menstruating Nigerian women. The profiles of the secretion of these pituitary hormones are similar to those reported in other ethnic groups. A significant midcycle peak of prolactin, coinciding with the peaks of luteinizing hormone and follicle stimulating hormone was also observed.
On the use of α‐fetoprotein and prolactin in prenatal diagnosis of fetal abnormalities in early pregnancies
Authors: Bremme K. , Eneroth P. , Nilsson B.
Published: April 2004

In the search for laboratory tests to aid in the diagnosis of fetal malformation we have explored the usefulness of assaying prolactin in amniotic fluid. The results have been compared to those obtained with α‐fetoprotein analyses.
A five year experience with Laparoscopic Falope Ring sterilization
Authors: Meyer Julien H.
Published: April 2004

This report presents the results of a 5‐year series of Laparoscopic Falope Ring tubal sterilizations performed consecutively at a private hospital by the author. It was seen that no special requirements for patient selection were necessary and previous abdominal surgery was not a contraindication for the operation. Laparoscopic tubal occlusions were accomplished in all but one of the 447 cases and banding was not attempted in this case because of bilateral hydrosalpinges. After follow‐up of 6 months to 5.5 years, there have been no pregnancies other than one well documented luteal phase pregnancy. The few complications encountered were mostly of a technical nature and considered minor. With 90% of the patients available for follow‐up there has been no evidence of long‐term adverse effects such as menstrual dysfunction. Thus Laparoscopic tubal occlusion is seen to be a safe, simple and effective means of female sterilization which can be performed by gynecologists trained in laparoscopy.
Pelvic schistosomiasis and infertility
Authors: El‐Mahgoub S.
Published: April 2004

The use of laparoscopy allowed us to diagnose asymptomatic pelvic schistosomiasis in 13 infertile women. The lesion was associated with dense pelvic adhesions in all cases, a defective luteal phase in 23.1% of the women and anovulation in 15.4%. Atraumatic adnexolysis, antibilharzial treatment and correction of ovulatory defects were followed by intrauterine pregnancy in 46% of the patients.
Ectopic pregnancy early diagnosis limitations
Authors: Portuondo JoséA. , Remacha María J. , Llaguno Manuel Roldan
Published: April 2004

A series of 219 surgically and pathologic proven ectopic gestations are reviewed to emphasize the ectopic pregnancy early diagnosis limitations. A childbearing age, low parity woman is typical of having an ectopic pregnancy. Risk factors in their past history were absent in 52% of patients. Fertility investigations, IUD, PID, and abdominal surgery are often found in their past. Six per cent of patients had a previous ectopic pregnancy. Sixty‐one per cent of patients were admitted with a definite ruptured ectopic pregnancy and 37% were admitted to rule out this condition. At surgery 58% had ruptured ectopic pregnancy with intraabdominal hemorrhage. Only 12% were unruptured.

The obstetric outcome after surgery was available in 74 patients. Out of these, 40.5% had term pregnancies with live children, repeat ectopic pregnancy occurred in 8.2% spontaneous first trimester abortion in 4.1% and subsequent infertility in 16% Postoperative pelvic adhesions were more frequently seen, at laparoscopy, when the patients were diagnosed at the stage of ruptured ectopic pregnancy with intraabdominal hemorrhage. A diagnostic protocol based on the screening of the patients at risk, correct evaluation of symptom and signs, and liberal use of β‐hCG pregnancy test, culdocentesis, ultrasound and laparoscopy, is finally proposed.
Three neuroleptanalgesia schedules for laparoscopic sterilization by electrocoagulation
Authors: Koetsawang Suporn , Srisupandit Suwanee , Kiriwat Orawan , Apimas Supanee J. , Feldblum Paul
Published: April 2004

Women undergoing interval laparoscopic electrocoagulation sterilization were randomly assigned to one of three neuroleptanalgesia regimens. The 299 women received either morphine (10 mg)/droperidol (2.5 mg)/ atropine (0.3 mg) or pethidine (100 mg)/ droperidol (2.5 mg)/atropine (0.3 mg) or pethidine (100 mg)/droperidol (2.5 mg).

A significantly higher proportion of anesthesia complications were recorded in the morphine group. The amount of pain experienced by the women was similar in the three groups, as were the rates of early follow‐up complications and complaints. The neuroleptanalgesia regimen containing pethidine/ droperidol/atropine appears to be the safest and most effective of the three considered here.
The safety and efficacy of tubal sterilization: An international overview
Authors: Peterson H.B. , Lubell I. , DeStefano F. , Ory H.W.
Published: April 2004

This article presents a synthesis of some of the major published studies on the efficacy and safety of tubal sterilization. The conclusions of this overview are that tubal sterilization is a safe operation, long‐term sequelae of tubal sterilization have not been well documented, and the risk of pregnancy following tubal sterilization is less than 1 in 100. Continued study is needed to determine how to make a safe and effective procedure even safer and more effective.
Prenatal diagnosis of triploidy
Authors: Chatterjee Molly S. , Tejani Nergesh A. , Verma Uma L. , Weiss Robert R.
Published: April 2004

Two cases of late midtrimester triploid gestation are presented. This unusual condition might be suspected in cases of first and second trimester bleeding when the uterus appears to be unusually large as estimated by the menstrual history. Early presence of gestational hypertension also points suggestively toward a triploid fetus. Ultrasound examination of the placenta typically shows multiple sonolucent areas. Confirmation of diagnosis is made by karyotyping cells obtained from amniotic fluid. The condition is incompatible with life and termination of pregnancy is indicated. It is considered prudent to follow HCG levels for evidence of persistent trophoblastic tissue.
Urinary culture and morbidity in gynecological surgery
Authors: Ohel Gonen , Bahari Charles M. , Edelstein Theodore , Cohen Joel S.
Published: April 2004

Three hundred women undergoing gynecological surgery were evaluated as regards post‐operative morbidity and its relationship to urinary tract infections. The incidence of pre‐operative positive urine cultures was 6.3%. This was almost trippled post‐operatively.

Post operative morbidity was found in 39% of the cases with the highest rate following vaginal surgery. Urinary tract infection was thought to be the cause in 20% of the cases, wound infection in 42% and unknown among 36% of the cases.

It was found that the pre‐ and post‐operative urine cultures were poorly related to morbidity and it was particularly noted that 41% of patients who had positive post‐operative cultures suffered no morbidity at all. It was concluded that the mere finding of positive pos‐operative urine cultures may not have accounted for the morbidity in some of the cases and the need for further search of the cause is discussed.
Determination of biparietal diameter in the second trimester as a predictor of intrauterine growth retardation
Authors: Lee J.N. , Chard T.
Published: April 2004

Fetal biparietal diameter (BPD) was measured by ultrasound at 18–21 weeks gestation in 1023 women. The results showed a clear relationship to birth weight at delivery (36 weeks or later): the sensitivity was 24.2%, the predictive value was 18.2%, and the specificity was 92.5%. We propose that BPD measured in the second trimester is a clinically useful predictor of intrauterine growth retardation.
Leucocyte metabolism in maternal and cord blood in intrauterine malnutrition (IUM)
Authors: Iyengar Leela R. , Vishwanathan M.K.
Published: April 2004

Leucocyte metabolism was studied in maternal and cord blood in normal term pregnancies with and without intrauterine malnutrition (IUM). It was observed that hexose monophosphate shunt activity was significantly reduced in the leucocytes of both the mothers and infants with IUM. Glycogen content in the cord leucocytes was also reduced, indicating a reduction in the defense mechanism in the infants. Protein/DNA ratio was significantly increased in both the maternal and cord leucocytes in IUM. It would appear that IUM, especially in a high‐risk population, can be predicted in early third trimester by using maternal leucocyte protein/DNA.
Intestinal injuries following induced abortion
Authors: Imoedemhe D.A.G. , Ezimokhai M. , Okpere E.E. , Aboh I.F.O.
Published: April 2004

Sixteen cases of intestinal injuries following illegally induced abortion are reviewed. They constituted 2% of all such cases in the study period. Ten were terminal ileal injuries while six were colonic. Colonic injuries were predominantly encountered in the first trimester. The relative fixity of the terminal ileum and pelvic colon may be a factor in the determination of the site of injury. Morbidity and mortality are related to both gestational age and site of injury.
The effect of oral contraceptive formulation and field‐workers: A cautionary tale
Authors: Miller Peter C. , Donaldson Peter J. , Basnayake Sriani , De Silva S. Victor
Published: April 2004

This paper examines oral contraceptive continuation rates and reported side effects in a large scale clinical research project conducted in Sri Lanka. The project evaluated standard‐ and low‐dose pills used with and without vitamin supplements. Differences in continuation rates and perception of side effects are used to illustrate the impact that family planning field‐workers can have on women's use of oral contraceptives.
A hyperprolactinemic woman with regular ovulatory menstrual cycles
Authors: Miyakawa Isao , Kawano Kyogo , Koike Hiroyuki , Taniyama Keiichi , Mori Norimasa
Published: April 2004

A hyperprolactinemic woman with regular menstrual cycles was presented. It may be suggested in this case that immunoassayable plasma prolactin (PRL) with big molecules made up a greater percentage of total PRL than the highly biologically‐active little molecules.
Fetal growth and perinatal mortality in twin pregnancy ‐ effect of sick leave and hospitalization
Authors: Erkkola R. , Ala‐Mello S. , Kero P. , Sillanpää M.
Published: April 2004

Fetal growth, birth weight specific mortality rates and effect of sick leave or hospitalization on the fetal growth were investigated in a material of 476 twin pregnancies managed at University Central Hospital of Turku in year 1970–1981. Birth weights of twin babies at any gestational age were slightly but not significantly higher than in earlier materials. When compared to growth curve of singleton fetuses, the growth rate of both twins is equal to singletons up to 30th week of pregnancy, being thereafter slower than in singleton pregnancies.

Although duration of sick leave and hospitalization increased considerably during the study period, no change in the duration of pregnancy nor in the weight of twin babies occurred. Instead perinatal mortality decreased from 101/per thousand to 36.2/ per thousand. Birth weight specific mortality rates did not differ from those in singleton fetuses.
Induction of labor in postterm pregnant women
Authors: Ekman Gunvor , Persson P.‐H. , Ulmsten Ulf
Published: April 2004

We have studied the outcome of labor induction in 145 postterm pregnant women in whom gestational age was properly assessed by ultrasound scanning. The induction techniques were adapted to the cervical states of the patients. Seventy‐five patients (32 nulliparous and 43 multiparous) with favorable cervical states were successfully induced with intravenous oxytocin. In this group the frequency of Caesarean section was 2%.

Seventy patients (45 mulliparous and 25 multiparous) with unripe cervices received 0.5 mg PGE2 in viscous gel intracervically to prime the cervix and to induce labor; 38 (52%) were induced into labor after a single PGE2‐gel application whereas 26 (48%) needed labor augmentation with intravenous oxytocin after PGE2‐gel obtained cervical ripening. In 6 of the 20 patients the cervix did not ripen and the PGE2‐gel application had then to be repeated. The frequency of cesarean sections was 11%.

In 5 out of the 145 patients (4%) the fetuses had signs of intrauterine growth retardation (IUGR) as assessed by ultrasound scanning, and postmaturity as verified by pediatric examination at delivery. All these fetuses belonged to nulliparous women with unripe cervices and all had to be delivered instrumentally (3 by cesarean section and 2 by ventouse) indicating the fragility of these children. If postterm pregnancy is complicated by an unfavorable cervical state intracervical application of PGE2‐gel seems to be an efficient method to prime the cervix and to induce labor. In most patients an uncomplicated vaginal delivery can be achieved by this procedure. However, nulliparous women with unfavorable cervices and signs of IUGR constitute a high risk group of patients at labor induction.
Acute polyhydramnios and cord presentation — complication of chorioangioma of the placenta — a case report
Authors: Wong P.C. , Arulkumaran S. , Ratnam S.S. , Pang M.
Published: April 2004

Chorioangioma of the placenta is an uncommon benign tumor of the placenta. Large tumors are rare and they often cause increased maternal morbidity and fetal morbidity and mortality. A patient with continuous abdominal pain at 29 weeks gestation was clinically diagnosed to have acute polyhydramnios. Multiple pregnancy was suspected because of a tense uterus much larger than the dates and three palpable “fetal poles”. An ultrasound examination revealed the third pole to be a large chorioangioma. She went into premature labor and a cesarean section was performed because of a cord presentation. Both mother and infant had an uneventful recovery. The complications of chorioangioma is discussed.
The effect of an oral contraceptive containing ethinylestradiol and desogestrel on hair growth and hormonal parameters of hirsute women
Authors: Ruutiainen K.
Published: April 2004

A group of 22 hirsute women was treated with a combination of 0.030 mg of ethinylestradiol and 0.150 mg of desogestrel (EE‐DG) for 6 or 12 months. After 6 months the hair growth was decreased in 17 patients. There was a significant decrease in testosterone/sex hormone binding globulin (T/SHBG) ratio and serum dehydroepiandrosterone sulphate (DHEAS) levels. The changes in the hirsutism and the T/SHBG ratio showed correlation (rho 0.36, P < 0.05). The patient groups with the best and the poorest clinical response differed in terms of summed changes in the T/SHBG ratio and DHEAS. These findings suggest that the therapeutic effect of the EE‐DG is based on combined changes in the related hormone levels.
Serum ovarian steroids, prolactin and prostaglandin metabolites in women using the inert intrauterine device
Authors: Shalev E. , Harpaz‐Kerpel S. , Engelhard Y. , Weiner E. , Eran A. , Zuckerman H.
Published: April 2004

Serum levels of 17β estradiol, progesterone, prolactin and metabolites of prostaglandins E2 and F2a were investigated in 18 healthy women before and after insertion of a Saf‐T‐Coil intrauterine device. The results suggest that the presence of an intrauterine device may cause hormonal changes affecting the luteal phase of the menstrual cycle.
International colloquy on the management of intrauterine fetal death
Authors: Kuhn W. , Rath W. , Sciarra John J.
Published: April 2004

Management of intrauterine fetal death is a common medical problem. The risks of time‐related development of consumptive coagulopathy and intrauterine infection with speticemia force the clinician to terminate pregnancy as soon as possible while still taking into account the mental distress of the patients. Rapid surgical intervention (e.g. hysterotomy) is associated with a considerable risk of maternal morbidity and mortality. The following reports from international experts present a topical survey of current methods for the management of fetal demise. This background of clinical experience from different countries should serve to stimulate discussion on problems associated with intrauterine fetal death and ultimately lead to practical advice that will be of benefit to the patients.
Ectopic pregnancy without laparotomy: defining the incidence of manageable patients
Authors: Sauer M.V. , Rand T.C. , Buster J.E.
Published: April 2004

To assess the incidence of ectopic pregnancies meeting published criteria for laparoscopic or medical therapy, we retrospectively evaluated tubal pregnancies admitted during a 12‐month period. Because 41/121 (34%) were visible laparoscopically, unruptured, and ⩽3 centimeters in diameter, we conclude that substantial numbers of ectopics may be managed without laparotomy.
Ovarian function after the menarche and hormonal contraception
Authors: Borsos A. , Lampé L. , Balogh A. , Csoknyay J. , Ditrói F. , Székely P.
Published: April 2004

The aim of the study was to determine the date of regular ovulation after the menarche to better understand the physiology of female adolescence, especially as it pertains to the use of hormonal contraception. Early morning urine samples were collected from 51 girls in the perimenarche for 9 weeks semi‐annually during 2 years. Estrone‐ and pregnanediol‐3‐glucuronide values were determined. Cycles lasting 35–40 days at the onset of menses shortened to 28 days after the 23rd–25th cycle. Menses reached a 5.0–5.5 day average length at about the same time. After the 20th cycle, ovulation could be demonstrated in more than 50% of the study patients. Using a scoring system, regular ovulation could be expected on the basis of somatic data with scores of > 16. Hormonal contraception may be prescribed 2 years after the menarche, based on scores of > 16 and ovulation proven by hormonal cytology and basal body temperature.
Pregnancy after hemipelvectomy: a case report and review of the literature
Authors: Bergh P.A. , Bonamo J. , Breen J.L.
Published: April 2004

Hemipelvectomy is a most radical attempt at cure of malignant tumors of the pelvis and the upper portion of the femur. Pregnancy following this severely mutilating operation is rare. Despite the considerable loss of pelvic support patients do remarkably well. A case of pregnancy following hemipelvectomy is presented and represents the 16th report in the English literature. The anatomic consequences of hemipelvectomy are described and a review of the past 61 years experience with pregnancy following this operation is presented.
Serum lactic dehydrogenase isoenzymes alteration in carcinoma cervix uteri
Authors: Kumar M. , Birdi A. , Gupta Y.N. , Gupta S.
Published: April 2004

Serum LDH‐isoenzyme studies revealed that in carcinoma cervix, the principal activity was confined to LDH‐2 and LDH‐3 with a significant rise in LDH‐2 fraction when compared with the control values (P < 0.001). Radiotherapy caused significant lowering of LDH‐2 and LDH‐3 (P < 0.001 in each case). There was no relation of LDH‐isoenzyme distribution in different clinical stages and morphological distribution within the tumor. Further, LDH‐2 and LDH‐3 were found to be lowered significantly in good and moderate clinical radiation response (CRR) groups (P < 0.001 in each case) but in poor CRR group no significant change in LDH‐2 and LDH‐3 was observed following radiotherapy. LDH‐isoenzyme determination in carcinoma cervix is very helpful in assessing the treatment response following radiotherapy and thus may be an important prognostic parameter.
Serum methotrexate and human chorionic gonadotropin concentrations during five‐day chemotherapy for low‐risk metastatic gestational trophoblastic neoplasia
Authors: Hilgers R.D. , Standefer J.C. , Bowling M.C. , Greeley P.
Published: April 2004

A recent report of serum methotrexate (MTX) levels measured during treatment of gestational trophoblastic neoplasia (GTN) led us to determine MTX and human chorionic gonadotropin (β‐hCG) levels in a patient with low‐risk metastatic GTN with a pulmonary metastasis. Peak MTX concentrations exceeded 10−6 mol/l considered by many investigators to be within the therapeutic range against many human tumors. Serum β‐hCG levels did not decline during MTX administration; however, after 5 days of MTX a steep dose‐response curve was observed which continued during 5 courses of chemotherapy.
How does pre‐eclampsia influence thermal conductivity of the skin?
Authors: Miyamoto S. , Shimokawa H. , Kurokawa T. , Nakano H.
Published: April 2004

To evaluate the thermal conductivity characteristics in relation to pre‐eclampsia, deep body temperature (DBT) was measured using the zero‐heat flow method in non‐pregnant healthy subjects, normal pregnant subjects, pregnant subjects with essential hypertension and in pre‐eclamptics. The duration of the initial rise in peripheral DBT was significantly prolonged in the pre‐eclamptics, as compared with findings in the other three groups. The results indicate that pre‐eclamptics have a decrease of thermal conductivity of the skin.
Ultrasonographic measurement of thoracic diameters of the early gestating fetus
Authors: Hata T. , Hata K. , Yamane Y. , Osamu T. , Kitao M.
Published: April 2004

Eighty‐two ultrasonographic examinations were performed on 60 of our pregnant patients with regular menstrual cycles and no complications. The pregnancies ranged from 7 to 13 weeks of gestation. Thoracic anteroposterior diameter (ETAPD), transverse diameter (ETTD), cross‐sectional area (ETA) and crown‐rump length (CRL) were measured on each ultrasonogram. A high correlation between CRL and gestational age was firstly confirmed in this study. ETAPD, ETTD and ETA correlated well with the gestational age and CRL, respectively. Correlations between ETAPD/CRL and ETTD/CRL ratios with the gestational age were negative. A positive correlation of ETA/CRL ratio with the gestational age was evident. Ultrasonographic measurement of the thoracic diameters of the fetus in utero should be a useful parameter to evaluate the gestational age and for early detection of growth retardation in utero.
Preventive effect of traditional herbal medicine, shosaiko‐to, on danazol‐induced hepatic damage
Authors: Yaginuma T. , Okamura T. , Takeuchi T. , Nishii O. , Fujimori R.
Published: April 2004

The incidence of the hepatic damage during treatment with danazol (D), indicated by increased serum GOT, GPT and LDH levels, has been shown to be high especially in Japan. Thus, the preventive effect of the traditional herbal medicine, shosaiko‐to (SS) was investigated in the administration of D and SS for 16 weeks (D + SS group, N = 9) and the pre‐administration of SS for about 4 weeks followed by D and SS for 16 weeks (SS → D + SS group, N = 15). The incidence of serum GOT, GPT and LDH levels of more than normal range during the administration of danazol in the D + SS group was similar to that in the previous study of the administration of D alone. But it was significantly lower in the SS → D + SS group than the D + SS group. The mean levels of serum GOT and GPT were much lower in the SS → D + SS group than the D + SS group throughout the administration of danazol and the difference was significant at 8, 10 and 12 weeks in serum GOT levels and at 4 weeks in serum GPT levels. These results indicate that the pre‐administration of SS has great efficacy in the prevention of danazol‐induced hepatic damage.
Topical testosterone for lichen sclerosus
Authors: Ayhan A. , Urman B. , Yüce K. , Ayhan A. , Gököz A.
Published: April 2004

Twenty‐three patients diagnosed as lichen sclerosus with colposcopic directed biopsy were given topical testosterone as a first line therapy. The overall remission rate was found to be 87.7%; 8.7% of the patients experienced undesirable androgenic side effects. Of the three patients who did not respond satisfactorily to testosterone treatment, two had alcohol injection to the vulva and one had vulvar denervation.
Testicular volume and seminal fluid profile in fertile and infertile males in Ilorin, Nigeria
Authors: Sobowale O.B. , Akiwumi O.
Published: April 2004

Total testicular volume (TTV) measured with a metric tape and vernier calliper in 20 men whose wives were 12–20 weeks gestation, and in 48 infertile men was correlated with the height, weight, Ponderal Index (PI), sperm density, and total sperm in the ejaculate. There was a good correlation between TTV by tape and calliper (r = 0.96, P < 0.001). there was a positive linear correlation between TTV and height but not with the other parameters. Giant head spermatozoa were more common in fertile Nigerian males than in fertile Asian or caucasian males (P < 0.001). Giant head sperm and sperm with tail defects occurred in 6.25%, 11.1% fertile and 37.1%, 47.4% infertile men respectively. Spontaneous abortion due to blighted ova were more prevalent in wives whose husbands has > 8% giant head sperm (P < 0.02).
Importance of echographic and endocrine monitoring for the assessment of ovulation by follicle stimulating hormone in polycystic ovarian disease
Authors: Caruso A. , Lanzone A. , Fulghesu A.M. , Apa R. , Guida C. , Mancuso S.
Published: April 2004

Sixteen patients with polycystic ovarian disease (PCOD) were treated for 39 cycles with pure follicle‐stimulating hormone (FSH) for the induction of ovulation. At ovulation time human chorionic gonadotropin (hCG) was administered. Twenty‐one cycles were ovulatory. Twenty‐three were classified as normostimulated (N): six pregnancies and three abortions were observed. In the remaining eight hyperstimulated (H) cycles there were four full‐term pregnancies. Dosage and length of treatment were greater in patients with excess body weight (P < 0.01). H cycles were characterized in respect to N cycles by: (1) higher baseline values of 17‐hydroxy progesterone (17‐OHP) plasma levels and LH/FSH ratios; (2) higher plasma concentrations and rate of increase of 17‐OHP periovulatory levels. E2 plasma levels did not permit a clear differentiation between H and N cycles, and it was not useful for the timely recognition of hyperstimulation. Our data show that a slight controlled degree of ovarian hyperstimulation is beneficial to pregnancy rate and outcome.
Pregnancy outcome in unmarried teenage nulligravidae in Singapore
Authors: Kurup A. , Viegas O. , Singh K. , Ratnam S.S.
Published: April 2004

Singapore, like other newly industralized countries, has seen a dramatic transformation in the social standards of its population in a particularly short space of time. Unfortunately, this period of development has been accompanied by an escalation in the number of pregnancies to unmarried teenage girls. This paper examines the obstetric and social implications of 150 such pregnancies in younger and older teenagers. Poor intrauterine growth in the younger teenager appears to be the most important adverse obstetric outcome in that mean birthweight was significantly reduced (2738 g compared to 3054 g; P < 0.02). We believe this to be an important explanation for the five‐fold increase in perinatal mortality seen in this group of mothers. Unlike some other reports, we found no significant increase in the incidence of cephalopelvic disproportion, anemia or pregnancy induced hypertension in these mothers. The social implications of teenage pregnancy in Singapore are also examined and recommendations made for methods to curb the problem
Ultrasonic prediction of growth discordancy by intertwin difference in abdominal circumference
Authors: Blickstein I. , Friedman A. , Caspi B. , Lancet M.
Published: April 2004

Intertwin abdominal circumference (AC) and femur length (FL) differences were studied in 24 growth‐discordant (⩾15% birth weight difference) and in 32‐growth concordant twin pairs delivered within 2 weeks of the last ultrasonic examination. Both groups were of similar gestational age but differed significantly in the mean twin birth weight and intertwin AC difference (P = 0.01 and P = 0.00009, respectively). A cutoff value (⩾18 mm) for AC difference was found to discriminate significantly (P < 0.0009) between concordant and discordant pairs with sensitivity, specificity, positive predictive value and negative predictive value of 66.7%, 78%, 69.5% and 75.7%, respectively. These data may suggest that an intertwin difference of 18 mm or more in AC effectively screens for the diagnosis of 15% or more birth weight difference in twin pregnancies.
Abruptio placentae as complication to acute appendicitis
Authors: Blaakaer J. , Wilken‐Jensen C. , Petersen K. , Møller B.R.
Published: April 2004

A case of abruptio placentae as complication to acute appendicitis is reported.
Supporting breastfeeding: What governments and health workers can do — European experiences
Authors: Helsing E.
Published: April 2004

The International Code of Marketing of Breast‐Milk Substitutes provides health workers with a framework for action in breastfeeding promotion. Countries are to report their efforts to the World Health Organization (WHO). The European Regional WHO Office finds a diversity of practices within its countries. Therefore in 1986, they convened a meeting of health workers' organizations to draw up a strategy for implementation. This paper outlines the elements in the strategy, the reasons why some countries have seen increases in breastfeeding, and the possible ways international organizations can help.
Fetal macrosomia — maternal risks and fetal outcome
Authors: Meshari A.A. , De Silva S. , Rahman I.
Published: April 2004

Two hundred eighty‐four macrosomic babies of 4000 g or over at birth were compared with an equal number of appropriate weight term infants, to identify maternal risk factors and fetal outcome. Maternal obesity, grand multiparity, diabetes mellitus and post‐maturity were the major maternal risks. Prolonged labor, shoulder dystocia and injury to infant following instrumental delivery for mid‐cavity arrest were the major fetal risks. A protocol for management of fetal macrosomia is proposed.
Computerization of data: a person‐based medical record system
Authors: Savona‐Ventura C. , Grech E.S. , Grech A. , Fenech‐Gonzi P.
Published: April 2004

The collection and evaluation of obstetric data is essential for assessing the effectiveness of the health and social services in a country. A computerized system in use on a national level is described. The person‐based system aims to include all patients who encounter government medical services, including obstetric and infant data. The scope of the service is to make individual patient records easily available to the practitioner, but is designed to allow statistical analysis of the data.
Study of Norplant® implants in Shanghai: Three‐year experience
Authors: Du M.K. , Zheng H.M. , Chen H.C. , Chow L.P.
Published: April 2004

A clinical follow‐up study conducted in Shanghai, China confirmed earlier reports that the Norplant® implants, Norplant®‐1 and Norplant®‐2, are both highly effective with high continuation rates. The implants, however, tend to cause menstrual disturbance, spotting and bleeding. The mean hemoglobin value, however, did not change and the blood pressure remained stable. The report of 8 cases of thrombocytopenia among 301 Norplant®‐2 users is a source of concern.
Schmidt's syndrome: A rare cause of puberty menorrhagia
Authors: Sharma J.B. , Tiwari S. , Gulati N. , Sharma S.
Published: April 2004

Schmidt's syndrome, also known as polyglandular deficiency syndrome, is the presence of Addison's disease and hypothyrodism in a single patient. It is usually associated with other autoimmune disorders like vitiligo, diabetes mellitus, myasthenia gravis. A rare case of an 18‐year‐old girl having Schmidt's syndrome and vitiligo who presented with puberty menorrhagia is reported. A brief review of the literature is also given.
Elevated peritoneal fluid luteinizing hormone and prolactin concentrations in infertile women with endometriosis
Authors: Chew P.C.T. , Peh K.L. , Loganath A. , Gunasegaram R. , Ratnam S.S.
Published: April 2004

In this study, we compared (Mann‐Whitney U‐test) the peritoneal fluid FSH, LH and PRL levels, measured by RIA, at the follicular and luteal phases of the menstrual cycle in women with (n = 43; age 25–44 years) and with no evidence of endometriosis (n = 35; age 25–39 years) who were considered as controls. Both follicular and luteal phase FSH concentrations of women with endometriosis were not statistically different (n = 22 vs 18; 0.32–5.8 vs 0.50–8.2 IU/l, P = 0.247; n = 13 vs 14; 0.6–6.5 vs 0.66–6.7 IU/l, P = 0.604) compared to their respective controls. In contrast to FSH, the concentrations of LH at follicular (n = 19 vs 17; 3.1–34.2 vs 2.3–12.2 IU/l, P = 0.01) and luteal (n = 17 vs 15; 2.1–95.4 vs 1.3–17.9 IU/l, P = 0.02) phases of the test group was significantly elevated at both phases of the cycle. With respect to differences in PRL concentrations at follicular phase no significant change (n = 21 vs 16; 1030–5800 vs 1305–4650 mIU/l; P = 0.255) was observed. The greatest difference in luteal PRL concentrations (P = 0.007) was obtained between the women with endometriosis and controls (n = 17 vs 17; 1895–8600 vs 1041–5000 mIU/l). The results suggest that disordered synchronization of neuroendocrine mechanisms controlling LH and PRL may be the underlying abnormality causing infertility in our group of patients with endometriosis
Surviving child from tubal pregnancy
Authors: Hjortdal V.E. , Børlum K.G. , Søgaard H.
Published: April 2004

A case report of a 1150 g child surviving from a tubal pregnancy in the 30th week of gestation, delivered by cesarean laparotomy, is described. A review of the literature disclosed nine other cases.
Unicornuate uterus
Authors: Crowther M.E.
Published: April 2004

True unicornuate uterus is a rare anomaly which is often associated with renal tract anomalies, and may predispose to infertility and pregnancy complications. Three additional cases are reported here. One of the women had associated bony and cardiac anomalies, although there was no good evidence that these were part of a syndrome. The diagnosis in each case was made incidentally during the surgical investigation of abdominal pain, which in one case was caused by an ectopic pregnancy, itself a rare occurrence with unicornuate uterus.
Ritodrine‐induced agranulocytosis
Authors: Muro M. , Shono H. , Oga M. , Ito Y. , Hirai M. , Sugimori H.
Published: April 2004

This is the first reported case of development of agranulocytosis induced by continuous intravenous infusion of a large quantity of ritodrine hydrochloride for tocolysis. It is suspected that the pathophysiological mechanism is a dose‐related toxic reaction and a cell loss maturation process of myelocytes.