bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic value of a malignancy grading system in treatment of recurrent cervical carcinoma
Authors: Sorbe B. , Lannes P.
Published: April 2004

A malignancy grading system (MGS) comprising 8 histopathological parameters has been used to evaluate the response rate and prognosis for patients receiving chemotherapy for recurrent cervical carcinoma. Seventy‐two women were treated with an adriamycin‐cyclophosamide‐vincristine (ACO) regimen or bleomycin‐adriamycin‐cisplatin (BAD) regimen. The mean value in the MGS was 16.7 for the primary tumors and 17.4 for the recurrences. Correlations between the individual parameters of the MGS when used on the primary tumors and on the recurrences were low. Only parameters 7 (vascular invasion) and 8 (lymphocytic response) were significantly higher in the recurrences.

Responders had significantly longer survival than non‐responders (P < 0.001), but the two groups did not differ regarding the malignancy scores for the 8 individual parameters nor for the MGS sums.

There was no correlation between the malignancy scores and survival in this selected series of recurrent cervical carcinomas.
Transient painful osteoporosis of the hip in pregnancy
Authors: Lose Gunnar , Lindholm Per
Published: April 2004

A 35‐year‐old paitent is presented with transient painful osteoporosis of the hip during the last trimester of pregnancy. This syndrome, which was first described in 1959, is characterized by mechanical pain in one or both hips and profund osteoporosis occurring shortly before or during the third trimester of pregnancy. The clinical course is spontaneous recovery within a few weeks to several months postpartum. There seem to be no specific laboratory findings. The treatment is symptomatic including bedrest.

Awareness of this syndrome should help to state the right diagnosis, to choose a proper treatment and to obviate unnecessary invasive investigations.
beta‐1‐Glycoprotein determination in normal and disturbed pregnancy
Authors: Sterzik K. , Wenske C. , Rossmanith W. , Benz R.
Published: April 2004

beta‐1‐Glycoprotein (SP1) concentration of 170 women with undisturbed pregnancy under 18th week were taken as reference. SP1 levels of 72 patients with threatening abortion but favorable outcome were compared with those of 70 patients with threatening abortion and subsequent miscarriage. Decreased SP1 levels were determined in most (88%) patients who aborted, whereas 88.8% of patients with favorable outcome had SP1 levels within normal range. The predictive value of SP1 determination in early pregnancies is emphasized.
The impact of early medical technology on maternal mortality in late 19th century Sweden
Authors: Högberg U. , Wall S. , Broström G.
Published: April 2004

The prevention of fatal complications of childbirth is a priority of health care in the developing countries. This historical study of maternal deaths in Sweden analyses the decline in mortality between 1751–1900 and during this years maternal mortality was reduced by 76% whereas the female mortality dropped only by 33% The decline was especially pronounced during the period 1861–1900, when maternal mortality declined from 567 to 227 per 100,000 live births. The potential impact of medical technology was analysed by epidemiological methods for the period 1861–1900. The introduction of antiseptic technique was estimated to reduce septic maternal mortality 25‐fold in lying‐in hospitals and 2.7‐fold in rural home deliveries, implying that 49% of the septic maternal deaths were thus “prevented”. In addition, licensed midwives assisting at home deliveries were estimated to reduce non‐septic mortality 5‐fold, thus “preventing” 46% of the non‐septic maternal deaths. This could be one explanation why Sweden had a lower maternal mortality than the U.S. and the U.K. in the beginning of the 20th century.
Preliminary experiment with computerized anamnesis in gynecology and reproductive health
Authors: Diaz J. , Miranda O.M.Z. , Faúndes A. , Pinotti J.A.
Published: April 2004

The Hospital of the Faculty of Medical Sciences of the State University of Campinas is implementing an Integrated Health Care Programme, whose objectives are early detection of risk factors of several diseases and the evaluation of the patient's reproductive health at the moment of the first visit to the Hospital.

The initial results of this program encouraged us to try to apply it all to our own clientele. The present lack of material resources and qualified manpower leads us to concentrate all our attention on the patient's immediate complaints. This situation indicated to us that the only way to implement the program should be by means of a computerized questionnaire able to detect diseases and risk factors early.

This paper presents the preliminary results of the application of computerized questionnaires to evaluate health risks.

The authors conclude:

(1) The application of a computerized questionnaire met with very favorable reception by the clientele;

(2) In some segments of the population, the questionnaire can be answered by the patients in direct interaction with the computer;

(3) Programmes which evaluate risk factors need to be carefully revised before being put to use;

(3) The system operates on a relatively low cost basis, which could bring undeniable benefits to primary health care.
Metabolic effects of depot‐medroxyprogesterone acetate in long‐term users: A cross‐sectional study
Authors: Virutamasen P. , Wongsrichanalai C. , Tangkeo P. , Nitichai Y. , Rienprayoon D.
Published: April 2004

Oral glucose tolerance test and determination of insulin, cholesterol, triglycerides, total bilirubin, serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), alkaline phosphatase and cortisol in blood were performed on 57 Thai women who had used depot‐medroxyprogesterone acetate (DMPA) for 5 years or more and 24 healthy non‐DMPA users. Plasma insulin, alkaline phosphatase and morning cortisol levels were significantly higher in the DMPA users than in the non‐users. There were no significant differences for other laboratory tests. The findings suggest some effects of DMPA on carbohydrate metabolism and liver function in long‐term users.
Ripening of the cervix with prostaglandin E2‐gel. A randomized study with a new ready‐to‐use compound of triacetin‐prostaglandin‐E2‐gel
Authors: Kristoffersen M. , Sande H.A. , Sande O.S.
Published: April 2004

A randomized study with a group of patients treated with a new ready‐to‐use triacetin‐prostaglandin E2‐gel compared to a non‐treated group was conducted. The gel‐treated group showed a distinct difference in cervical score after 12 h and ten patients were delivered during this period without further inductim attempt compared to none in the control group. There was a significantly lower need for oxytocinstimulation in the treated group (P < 0.0005), but there was no difference in the cesarean section rate or instrumental delivery rate. No side‐effects were seen. This new gel seems effective and safe.
Ectopic pregnancy presenting as intermittent rectal bleeding and anemia. A case report
Authors: de Boer C.N.
Published: April 2004

A case report is presented of a patient with anemia and intermittent rectal hemorrhage caused by a tubal pregnancy eroding into the rectum. A search through the clinical literature on ectopic gestation reveals the rarity of such an occurrence.
Emergency hysterectomy in obstetric practice: Five year review
Authors: Aboelmagd M.S. , Kasrawi R. , Hathout H.
Published: April 2004

From January 1980 to December 1984, there were 86 483 deliveries and 25 emergency obstetric hysterectomies at the Maternity Hospital, Kuwait. The indications for hysterectomy were placental disorders (64%), uterine rupture (28%), and extension of the lower uterine scar during cesarean section (8%). The incidence of emergency hysterectomy increased with age and parity. Post‐operative morbidity was higher with subtotal than with total hysterectomy. The commonest post‐operative complication was urinary tract infection. There was one maternal death from consumptive coagulopathy associated with intra‐uterine fetal death.
Plasma fibronectin levels in normal pregnancy and pre‐eclampsia: A preliminary report
Authors: Thurnau G.R. , Morgan M.A. , Brubaker D. , Romine M. , Blackshaw C. , Fishburne J.I. , Fishburne I.
Published: April 2004

Fibronectin, a major component of the extracellular matrix and basement membranes throughout the body, is thought to maintain the integrity of both the reticulo‐endothelial system and microvasculature. In this study, plasma fibronectin levels were assayed by nephelometry in nine pre‐eclamptic gravid women, nine normotensive gravid women and ten non‐gravid women. The mean plasma fibronectin level (±S.E.M.) in pre‐eclamptic gravidas (1687 ± 101 μg/ml) is significantly higher than that of either normotensive gravidae (1129 ± 99 μg/ml) or non‐gravid women (897 ± 60 μg/ml). Although the mechanism for elevated levels of plasma fibronectin in patients with pre‐eclampsia is not clear, it may serve as an early biochemical marker for this disorder.
Combined intrauterine and extrauterine gestation: A report of case history and review
Authors: Varma T.R. , Patel R.H.
Published: April 2004

Combined intrauterine and extrauterine gestation is very rare. There is a higher maternal morbidity and fetal loss, due to delayed or missed diagnosis. We present a patient who was treated for primary infertility with ovulation induction agents, who presented later with combined intra‐ and extra‐uterine gestation with successful outcome following delivery of a healthy male infant at 38 weeks gestation.
Endometriosis in the groin
Authors: Clausen I. , Nielsen K.T.
Published: April 2004

Recently we found one case of endometriosis in the extraperitoneal part of the round ligament (EERL). We found 30 cases previously described in the literature. A comparison showed that 90% were right‐sided and often associated with an inguinal hernia. Fertility seemed to be below normal. In four of the cases a laporotomy was done. All had intraperitoneal endometriosis. In cases of EERL and claimed sterility therefore, the presence of intraperitoneal endometriosis should also be considered.
Hepatitis B vaccine in pregnancy: Immunogenicity, safety and transfer of antibodies to infants
Authors: Ayoola E.A. , Johnson A.O.K.
Published: April 2004

To determine the safety and immunogenicity of hepatitis B vaccine in pregnancy, 72 pregnant Nigerians who were negative for markers of hepatitis B virus (HBV) were given two intramuscular doses of vaccine (Heptavax, Merck) in the third trimester. One month after the second dose (at T2), 84% were anti HBs positive. No significant effect was observed in the mothers or their newborns. Passive transfer of anti HBs occurred in 59% of the newborns. The antibodies disappeared rapidly in these infants and by 3 months only 23% had detectable antibodies. No HBsAg carrier status developed in this group. In contrast, the infants born to HbsAg positive mothers had a cummulative rate of HBV events of 20%. It is concluded that HBV vaccine is safe and immunogenic in pregnant females. The passive immunity conferred on the infants is of short duration. Therefore, infants in endemic areas should be vaccinated early, preferably within 3 months of birth. Vaccination of pregnant mothers may provide adequate protection before the child is vaccinated.
Birth patterns: are the Chinese in Guangzhou City different?
Authors: Wang Zhi Jin , Avard Denise , Abernathy Tom , Nimrod Carl
Published: April 2004

Diurnal birth patterns in the City of Guangzhou, China and the City of Calgary in Canada were compared. Chinese data were abstracted from the labor room log book of one large general hospital located in the Hai Zhu district of Guangzhou. Calgary birth data were abstracted from birth notification forms submitted to Calgary Health Services. Information included day of birth, time of delivery, type of delivery and parity. Calgary births are concentrated on Tuesdays to Fridays whereas in Guangzhou weekly patterns varied tremendously according to whether it was assisted or unassisted. Calgary births are below average at night and during evening shift. The time of birth in Guangzhou varied substantially with above average rates for non‐assisted births noted at 0800–2400 h, and above average rates for assisted births noted at 0800–1700 h. Differences in hour of birth appeared to be related to obstetric intervention practices. Knowledge of birthing patterns are useful for effective hospital management.
The implications of childbearing in postpubertal girls in Sokoto, Nigeria
Authors: Adetoro O.O. , Agah A.
Published: April 2004

A retrospective analysis of 337 young post‐pubertal delivered mothers was compared with other parturient women in Sokoto University Teaching Hospital (S.U.T.H.) during a 1‐year period. In this analysis, late booking was identified as the most important factor that directly affects the perinatal outcome in young postpubertal pregnant mothers. The problems of postpubertal pregnancy were highlighted in order to motivate individuals towards family planning.
Mitral valve prolapse and thromboembolic disease in pregnancy: a case report
Authors: Bergh P.A. , Hollander D. , Gregori C.A. , Breen J.L.
Published: April 2004

Mitral valve prolapse is usually a benign condition, however, serious complications have been reported to be associated with it. A report of retinal artery occlusion associated with mitral valve prolapse and pregnancy is presented.
Pelvic assessment and cephalo‐pelvic disproportion in Central Tanzania
Authors: Bauer O. , Kingu R. , Laussen T. , Mbwana K.
Published: April 2004

Among 201 primigravidae, pelvic assessment was analyzed prospectively during the third trimester to detect patients likely to suffer from cephalo‐pelvic disproportion (CPD). If the sacral promontory (SP) was reached by the index finger (9.0–9.5 cm true conjugate) the pelvis was regarded as “suspect”. All patients who later developed CPD were in this group. Of the screened primigravidas, 22% were advised to deliver in the hospital. Pelvic assessment is an important screening tool during antenatal care to detect high‐risk primigravidas.
Eclampsia and placental abruption: basic patterns, management and morbidity
Authors: López‐Llera M M. , de la Luz Espinosa M M. , Arratia S C.
Published: April 2004

The clinical analysis of 46 cases of abruptio placentae complicating eclampsia showed that, (1) the severity of the eclamptic symptoms influenced the extension of the placental separation, (2) older and multiparous women had more complications, larger placental separations and higher mortality, (3) there were ten maternal deaths due to the additive effects of various complications, (4) total perinatal mortality was 44.7% and it was 40.5% for fetuses above 1000 g, (5) optimum timing of delivery by cesarean operation offered slightly better prognosis, even in cases with antepartum fetal death, (6) the dominant factor for morbidity was the stage reached by the combined pathology before receiving qualified medical care, and (7) the wide variability of these cases suggested that the basis for the complete management should be a series of sound and individually tailored decisions to be carried out in a reasonably short time.
The incidence, sociobiological factors and obstetric complications associated with large infants at Ilorin, Nigeria
Authors: Fakeye O.
Published: April 2004

The study examined the incidence, sociobiological factors and obstetric complications related to the deliveries of 351 large infants, weighing 4000 g and above, and compared them to the findings among controls, comprising of 6563 full‐size term infants; all deliveries took place at the University of Ilorin Teaching Hospital, June–December, 1983. Large infants constituted 4.7% of singleton deliveries and the male/female ratio among large infants was significantly higher than among controls. Significant associations were found in the occurrence of large infants with increasing age, parity and weight, but not with height. Large infants occurred more frequently among the high social class women who could pay for health services. Rate of cesarean section and postpartum hemorrhage increased four‐fold with deliveries of large infants. Shoulder dystocia complicated six deliveries resulting in four stillbirths and two cases of Erb's palsy. It is advocated that prenatal screening for gestational diabetes be performed on mothers with advanced maternal age, high parity, overweight and particularly of high social class.
Complications associated with genital colonization in pregnancies with and without cerclage
Authors: Kessler I. , Shoham (Schwartz) Z. , Lancet M. , Blickstein I. , Yemini M. , Miskin A. , Mogilner B.M.
Published: April 2004

Cultures from the cervical milieu were taken from 24 antibiotic‐treated patients (group A) and from 25 patients with no antibiotic treatment (group B). Both groups had undergone cerclage and were compared to 30 randomly chosen pregnant patients without cerclage (group C). Positive cultures were obtained in 70.8% and 48% before cerclage and in 66.7% and 68% after cerclage in groups A and B, respectively. These were not significantly different from group C (56.7%). Escherichia coli was found in over 75% of positive cultures. The rate of premature deliveries and premature rupture of the membranes were significantly higher in the cerclage groups. Maternal morbidity was significantly higher in group A compared to B and C. Our data suggest that bacterial colonization of the cervix and the vagina is not influenced by cerclage and antibiotics. It is concluded that cervical cerclage is associated with increased morbidity, therefore it is indicated only for definite anatomic and/or functional defects.
Differential rates of carcinoma of cervix uteri among the Chagga and Pares of Kilimanjaro region, Tanzania
Authors: Kitinya J.N. , Lauren P.A. , Kajembe A.H.
Published: April 2004

Cervical cancer is the commonest cancer among females in Northern Tanzania. Female Pares showed a higher age specific incidence rate especially in the older age groups (50–65 years) compared to Chagga females. The incidence per year per 100,000 women, corrected to the standard African population was 5.0 in Moshi and 9.6 in Pare, during the study period. Both of these ethnic groups live in a limited geographic region and are culturally similar. The higher rate of cervical cancer among the Pares seems to be due to their increased sexual activity which is usually with several male partners.
Family planning practice among Nigerian student midwives
Authors: Adetoro O.O. , Anate M.
Published: April 2004

An analysis of the various contraceptive methods practiced by a total of 462 student midwives from the Northern and Southern parts of Nigeria over a 3‐years period is presented. The differences in age distribution, the type of contraceptive agents used, the reasons for using them, and the side effects in the two groups are statistically significant. The need to provide acceptable contraceptive advice to the rural communities by the midwives is discussed.
The problem of grandmultiparity in current obstetric practice
Authors: Mwambingu F.T. , Al Meshari A.A. , Akiel A.
Published: April 2004

A retrospective analysis of 646 Arab grandmultiparas who booked for hospital confinement between 1983 and 1985 was carried out. The results were compared with that of non‐grandmultiparas during the same period. In the grandmultiparas, the incidences of gestational diabetes, hypertension rheumatic heart disease, antepartum, postpartum hemorrhage and macrosomic infants were increased. However, contrary to some previous reports the incidences of anemia, cesarean sections, induced labor, dysmaturity and perinatal deaths were decreased. This is thought to be due to the provision of modern specialist perinatal care and improved socio‐economic standards.
Pelvic fibromatoses — a rare gynecological entity
Authors: Buckshee K. , Mittal S. , Agarwal N. , Chellani M.
Published: April 2004

A rare case of pelvic fibromatoses is reported. This condition is rarely encountered in gynecological practice but when encountered, creates a diagnostic and therapeutic challenge. The reported patient highlights the difficulties encountered in surgical excision (done twice) and illustrates the local aggressive growth behavior of this entity.
Electronic fetal heart rate monitoring during cesarean section in cases of fetal distress
Authors: Petrikovsky B.M. , Cohen M. , Tancer M.L.
Published: April 2004

Twelve fetuses in whom the diagnosis of fetal distress was made during first stage of labor were included in the study. All 12 patients underwent urgent cesarean section during which fetal heart rate (FHR) was recorded continuously. In 50% of the cases, marked improvement of FHR was registered early in the course of the operation. Improvement in fetal status is attributed to adequate oxygenation and cessation of uterine activity.
Bari district birthweight study: Comparison with the Bristol perinatal growth chart
Authors: Diaferia A. , D'Agostino G. , Ceci O. , Locorotondo V. , Tartagni M. , Loizzi P.
Published: April 2004

We studied the neonatal weight distribution of 15,298 newborns from the Bari District at various gestational ages by the 10th, 50th, and 90th percentiles. After analysis, we constructed a growth chart following the method of Dunn. By comparing our results with those of Dunn's Bristol Perinatal Growth Chart, we found a weight difference of +4.5% in our population. This difference may be related to ethnic as well as socioeconomic factors.
Antenatal screening for syphilis at the University of Nigeria Teaching Hospital, Enugu, Nigeria — A six year survey
Authors: Gini P.C. , Chukudebelu W.O. , Njoku‐Obi A.N.
Published: April 2004

Between January 1979 and December 1984, 29,083 out of 42,515 antenatal patients booking at the Antenatal Clinic of the Department of Obstetrics and Gynaecology of the University of Nigeria Teaching Hospital, Enugu, underwent full screening for syphilis. The results showed that 890 patients (3.06%) had positive VDRL test. Of those that reacted positively in the VDRL test, 103 (11.6%) had positive TPHA test. A prevalence rate of sero‐positivity of 0.35% was obtained indicating a low incidence of syphilis in our pregnant women compared with results from other parts of Nigeria. A strong recommendation was made to treat all seropositive cases whether there was historical or clinical confirmation of syphilis or not.
Cervical ripening with intravaginal prostaglandin E2 gel
Authors: Curet L.B. , Gauger L.J.
Published: April 2004

Fifty‐four patients were randomized in a double blind fashion into either a placebo group or a group treated with a 3 mg dose of an intravaginal prostaglandin E2 gel. The group receiving the prostaglandin E2 gel had a mean change in cervical score of 2.7 while the patients in the placebo group had no significant change. Even though a significantly higher number of patients in the prostaglandin group went into spontaneous labor, the incidence of cesarean section was not different between the two groups. Upon comparing the conflicting reports of various studies on the subject, it is concluded that the method of product preparation, particularly the source of prostaglandin E2 utilized and the choice of drug vehicle, may be important variables in determining treatment success, as measured in terms of decreased cesarean section rate.
The relation of the true conjugate to maternal height and obstetric performance in Ghanaians
Authors: Adadevoh S.W.K. , Hobbs C. , Elkins T.E.
Published: April 2004

The true conjugate was determined intraoperatively with a caliper in 114 Ghanaian women and was correlated with their height, obstetric performance and fetal dimensions. Those patients undergoing cesarean section for cephalopelvic disproportion (Group Ia) were found to have a significantly shorter mean true conjugate (9.54 cm ± 0.63 S.D.) and mean body height (152.68 cm ± 5.46 S.D.) and a smaller true conjugate — fetal biparietal diameter difference (10.93 mm) than those who had no cephalopelvic disproportion (Group Ib) and whose mean measurements were 10.61 cm ± 0.81 S.D., 157.20 cm ± 5.69 S.D. and 21.50 mm, respectively (P = 0.0001). Recommendations for appropriate referral of rural clinic patients and for selection of patients for repeat cesarean sections are based on the above findings.
Endometriosis: incidence among the Igbos of Nigeria
Authors: Osefo N.J. , Okeke B.C.
Published: April 2004

A retrospective study of the incidence of endometriosis among the Igbos was undertaken. The incidence was 4.3% in patients with pelvic operations. This is the highest incidence ever reported for Nigeria. Differences in educational standards, ethnic habits and improved diagnostic resources of this hospital were the possible influencing factors; 90.8% of the cases were not diagnosed before operation, demonstrating the lack of awareness. Differential diagnostic considerations for menstrual disorders should include endometriosis in this environment.
Psychosexual aspects of virilization syndrome
Authors: Chavis W.M. , LaFerla J.J. , Brown J.C. , Keith R.B.
Published: April 2004

A case is reported of a 35‐year‐old black woman with marked hirsuitism. The focus is on the psychosexual aspects of her illness. Physicians must attend to the potentially devastating effects of virilization syndrome on their female patients.
Obstetric outcome among Vietnamese refugees in Hong Kong: an age‐matched case‐controlled study
Authors: King P.A. , Duthie S.J. , Li D.F.H. , Ma H.K.
Published: April 2004

The obstetric performance of 308 Vietnamese refugees is compared with that of 308 age‐matched Hong Kong Chinese patients. Vietnamese women were of higher parity and had an increased incidence of late booking and unreliable dates. Significant differences were found in the incidence of previous termination of pregnancy, iron‐deficiency anemia, parasitic infestation, tuberculosis (TB) and syphilis. There was no significant difference in the mean birthweight between the two groups. However, there were twice as many low birthweight (< 2500 g) infants amongst the Vietnamese whereas the Chinese patients had a higher incidence of macrosomic (> 4 kg) infants. There were no perinatal deaths and no significant perinatal morbidity.
A multifactorial study of birth place options: improving health care delivery in Saudi Arabia
Authors: Rasheed P. , Khan A.
Published: April 2004

Although consumer demands may dictate a review of the highly mechanized and sophisticated technology of obstetric care provided in some parts of the western world, problems in Saudi Arabia revolve around under‐utilization of health care facilities for maternity care and the consequences of this circumstance. A multifactorial analysis was performed to study the association of certain social correlates with options for birth settings in a rural region of the Kingdom. Age and educational level of the mother were found to be highly significant (P < 0.005) variables influencing the choice for place of delivery, whereas economic status (P > 0.1) and housing conditions (NS) tailed to make an equally impressive contribution. Within the constraints of available health care manpower at the local level, suggestions are made for the best strategy to successfully educate mothers for safer options in birth.
Obstetric anesthetic outpatient clinics: an international survey
Authors: Hamar O. , Garamvölgyi G.
Published: April 2004

An international investigation was undertaken into practices of pre‐anesthetic evaluation provided for obstetrical patients in outpatient clinics. A questionnaire was completed by 21/36 (58%) obstetric units. Only 5 (23%) had an outpatient clinic for pre‐anesthetic evaluation of the obstetric patient, but in 10 (37%) anesthetists take part in the prenatal examinations and give advice in cases of complicated pregnancy.
Maternal ECG recorded by internal monitoring closely mimicking fetal heart rate in a recent fetal death
Authors: Herman A. , Ron‐El R. , Arieli S. , Schreyer P. , Caspi E.
Published: April 2004

A case of intrapartum fetal death in which the maternal heart rate was recorded by internal fetal monitoring is presented. The electrical activity of the maternal heart was transmitted via the fetal body and the recording mimicked a “normal” fetal heart rate (FHR). The patient was referred because of sudden abdominal pain and bleeding; doppler fetal heart tones were not heard. Because internal monitoring was synchronous with the maternal pulse, ultrasonography was performed and established the diagnosis of fetal demise. Awareness and usage of simple modalities are mandatory for proper diagnosis in such cases.
Professional education and training for trainers
Authors: Naylor A.
Published: April 2004

There is a worldwide need for health professionals knowledgeable in lactation physiology and breastfeeding management. The seven step Wellstart education program is aimed at physician‐nurse teams from teaching hospitals in developing nations. In its 6 years of operation, it has taught 64 such teams, whose members have in turn taught others in their own countries. This success demonstrates the possibility for a major contribution to promoting breastfeeding.
The mothers' support group role in the health care system
Authors: Kyenkya‐Isabirye M. , Magalheas R.
Published: April 2004

Women have a need for one‐to‐one information and support from the health care system about breastfeeding and often they do not get it. Many experienced breastfeeding mothers have formed mothers' support groups to fill that need. As a necessity these groups train their members and ensure they are updated with scientific and other knowledge related to infant health and breastfeeding. In many places, these voluntary groups are working within health care systems and have proved an invaluable adjunct to the professional staff. They should have a role worldwide in counseling new mothers within health care, training health workers and mothers to be leaders and counselors, and helping in planning breastfeeding material and conferences.
Breastfeeding promotion: Training of mid‐level and outreach health workers
Authors: Armstrong H.C.
Published: April 2004

The International Baby Food Action Network Africa Regional Office (IBFAN Africa) has given thirteen courses in lactation management to subSaharan health workers. The aims of training, the process of running national courses in collaboration with local organizers, and the content of one‐ to two‐week courses are described. Available teaching resources include books, abstracts, films and slide sets. Forty topics are suggested for mid‐level training, with a sample exercise teaching observation of a breastfeed. A two‐week course leads participants through four stages of attitude change. Obstacles to training are listed and solutions recommended.
Technical working group A report: Breastfeeding promotion and support in hospitals and maternity care institutions
Authors: Greiner Ted , Baumslag Naomi , Winikoff Beverly
Published: April 2004

The purpose of this workshop was to design a general strategy for the development of activities to promote and support breastfeeding in hospitals and maternity care institutions. Several components were proposed for the success of the strategy: a strong commitment by a person with power; administrative backing; trained personnel; and consumer support. Designing a plan of action for a particular institution therefore requires the identification of allies within the institution; the identification of the agents for change; an assessment of what the institution is doing to promote or thwart breastfeeding; and an assessment of the forces that promote or thwart change.
Maternal sickle cell trait is not a cause of low birthweight in Nigerian neonates
Authors: Okonofua F.E. , Odutayo R. , Onwudiegwu U.
Published: April 2004

As a result of reports of reduced birthweight in neonates of mothers with hemoglobin AS (Hb‐AS) in other populations, we compared birthweights in 57 Hb‐AS primigravidas in Nigeria with 60 controls who were sickle negative. There was no statistically significant difference in mean birthweight or placental weight between the groups. This finding may be due to development of resistance against malaria infection by Hb‐AS women in this population.
Neonatal neurological morbidity in relation to obstetrical and social conditions in Grenada (Caribbean)
Authors: Atsma A.W. , Berntsen S.F. , Scheenstra R. , Hadders‐Algra M. , Boersma E.R. , Huisjes H.J. , Touwen B.C.L.
Published: April 2004

Neonatal morbidity, in particular neurological morbidity is a more relevant measure of the effectiveness of obstetrical care than perinatal mortality. Neurological morbidity was assessed in a birth cohort in Grenada, and appeared to be lower than in a reference group examined in Groningen, the Netherlands, in 1975–1978. Perinatal mortality, however, was higher. The results support the thesis that some children may have died who, if they would have survived, would have been neurologically abnormal. It is concluded that whereas a decrease in perinatal deaths is an essential goal in Grenada, a concomitant increase in morbidity should be carefully avoided.
Nuclear magnetic resonance in obstetrics and gynecology
Authors: Klimek R.
Published: April 2004

The modern gynecologist has access to real time nuclear magnetic resonance (NMR) images. This approach leads to an appreciation of the structure and function of an organ at the atomic level. The combination of NMR imaging and spectroscopy leads to images of female pelvic organs whose appearance is dependent not only on the reproductive and hormonal status of these structures, but also on the physical specifications of the scanner, the main magnetic field and the radiofrequency pulses as well as the time elapsed between them. The basis of gynecological diagnosis is at its optimum with NMR local coils in a time of only 20–25 ms with a resolution and penetration depth that has never before been achieved. Many obstetric and gynecologic investigations are best interpreted by a gynecologist's personal experience with USG, CT or angio‐, veno‐ and lymphography. Such an individual can best evaluate NMR findings with three‐dimensional pictures, in real‐time, of fetal heart beat, on the one hand, to tumor staging on the other.
Uterine rupture — an analysis of 81 cases in Conakry/Guinea
Authors: Balde M.D. , Breitbach G.P. , Bastert G.
Published: April 2004

Eighty‐one cases of uterine rupture in Conakry/Guinea are analyzed. With an incidence of 0.84%, i.e. 1 per 119 deliveries, uterine rupture is still a common problem in this region. In this analysis fetal mortality was found to be 75.3% and maternal mortality 20.9%. Mortality rates were statistically higher after hysterectomy than after repair. Other etiologic factors were extreme multiparity and an inadequate transfer system to the obstetric centers. A reduction of uterine rupture rates can be achieved by prevention of extreme multiparity (more than 4 deliveries) and of home deliveries and decentralization of obstetric services into peripheral units and villages.
Induction of ovulation and pregnancy following lateral oophoropexy for Hodgkin's disease
Authors: Damewood M.D. , Hesla H.S. , Lowen M. , Schultz M.J.
Published: April 2004

Present therapy for Hodgkin's disease which primarily affects young patients may produce long term remissions in more than 50% of cases. Potential injuries to the reproductive system from radiation or chemotherapy are significant considerations in therapeutic planning. Assessment of the effects of infradiaphragmatic radiation on germ cells may avoid ovarian ablation in women of reproductive age. This report addresses ovarian function and fertility following lateral oophoropexy and repositioning for Hodgkin's disease.
Tumor marker CA 125 level and ovarian volume at different cycle day periods and in postmenopause
Authors: Granberg S. , Wikland M. , Friberg L.‐G.
Published: April 2004

The value of using CA 125 for screening of ovarian carcinoma is still under debate. It is important to be aware of possible physiological variation in serum levels of this antigen. This study aimed at finding out whether there were any differences in CA 125 levels in serum at different cycle day periods of fertile women and postmenopausal women. In 106 women, CA 125 and ovarian volume were measured at different cycle day periods and in postmenopausal women. The highest levels were found in cycle day (CD) 1–9, i.e. 22 units/ml and the lowest in postmenopausal women i.e. 6.7 units/ml. No correlation could be found between the CA 125 levels and ovarian volume as measured by vaginal sonography.
Sickle trait and its association with birthweight and urinary tract infections in pregnancy
Authors: Baill I.C. , Witter F.R.
Published: April 2004

The objective of this retrospective case control study was to compare pregnant women with sickle trait hemoglobin to their normal hemoglobin counterparts. Sickle trait was associated with a significant increase in bacteriuria (13.0% vs 9.0%) and pyelonephritis (2.1% vs 1.4%). No difference was seen in birthweight between the two groups.
Changes in the circulating levels of hemoglobin, hematocrit, serum iron and total iron binding capacity after four methods of surgical tubal sterilization
Authors: El Sahwi S. , Kamel M. , Abd Rabou S. , Haiba N. , Anwar M.
Published: April 2004

One‐hundred women requesting voluntary surgical sterilization were included and enrolled into four groups (each n = 25). Four sterilization modalities were used namely: Falope ring, electrocoagulation, clip and Pomeroy ligation. The circulating levels of hemoglobin, hematocrit, serum iron and total iron binding capacity were studied before sterilization and at 3, 6 and 12 months thereafter. No significant changes were observed at 3 and 6 months post‐sterilization. At 12 months a significant increase in the hemoglobin and serum iron was observed with a significant decrease in total iron binding capacity. Falope ring, clip and Pomeroy ligation were of a higher rank in this context versus electrocoagulation.
Mycoplasmas among clients attending a family planning clinic in Zaria, Nigeria
Authors: Nsofor B.I. , Bello C.S.S. , Ekwempu C.C.
Published: April 2004

The effect of contraception in the incidence of genital tract mycoplasma infection was studied in 150 women practicing contraception and another 50 women attending a gynecological clinic, using no contraception. Using the chi‐squared method, there was no statistically significant difference between total mycoplasma recovery in family planning clients versus the controls. The only statistically significant difference was between total positive mycoplasma in the oral contraceptive group versus IUD users.
Ultrasonographically observed preterm grade III placenta and perinatal outcome
Authors: Chitlange S.M. , Hazari K.T. , Joshi J.V. , Shah R.K. , Mehta A.C.
Published: April 2004

Ultrasound studies of placenta were conducted in 270 singleton normal pregnancies. Women were enrolled between 31 and 34 weeks of gestation and were followed up for the outcome of pregnancy. Women with grade III placental maturity comprised the study group (n = 64) and those with grade I placenta were enrolled as control group (n = 206). Another 100 normal women were enrolled to note the prevalence of grade III placenta at term. There was an increased incidence of intrauterine growth retardation (6.20%) and fetal distress (7.8%) in the study group compared with the control group (nil), which was statistically significant. The incidence of low birth weight was also higher (34.37%) in the study group compared with the control group (22.33%). Three women in the study group developed preeclampsia at subsequent follow up visit but none in control group (P < 0.01). Prevalence rate of grade III placenta at term was 28%. In view of these findings preterm grade III placenta is found to be a sensitive predictor of poor perinatal outcome.
Progestin and antiprogestin interactions with progesterone receptors in human myomas
Authors: Vij U. , Murugesan K. , Laumas K.R. , Farooq A.
Published: April 2004

Progesterone receptors (PRs) in human fibromyomata (myomas) and normal myometrium were characterized by gel filtration, sucrose gradient sedimentation analysis, isoelectrofocusing and ligand specificity. The PR population in myoma tissues, 1242 ± 505 fmol/mg protein, was 3‐fold higher than normal myometrial tissues under similar hormonal milieu. The increased PR concentration in myomas appears to be of potential importance in physiopathology of fibromyoma.
Sonographic diagnosis of combined intrauterine and extrauterine pregnancy
Authors: Sepúlveda W.H.
Published: April 2004

A case of combined intrauterine and extrauterine pregnancy diagnosed by sonography is reported. Both viable intrauterine and ectopic fetuses were demonstrated by real‐time sonography. The importance of careful sonographic examination of adnexal region in all symptomatic patients with first trimester pregnancy or with some predisposing factors for combined pregnancy is emphasized.
Copper and zinc levels in maternal and fetal cord blood
Authors: Veena R. , Narang A.P.S. , Banday A.W. , Bhan V.K.
Published: April 2004

Serum copper and zinc were estimated in 44 mothers and their cord blood at term. The results were compared with 40 age‐matched non‐pregnant females and 67 males. The mean serum copper in the nonpregnant female group and in males was 114.6 (SD 30.43) and 111.3 (SD 30.79) μg/dl, whereas in mothers immediately after delivery it was 135.3 (±26.26) μg/dl, which was significantly higher than the female control group (P < 0.01). In fetal cord blood, it was 35% as compared to maternal blood. Serum zinc in control females and males was 112.8 (±11.94) and 109.9 (±15.69) μg/dl, respectively. In mothers it was 102.9 (±17.04) μg/dl which was significantly lower than the female controls. In fetal cord blood, it was 98.6 (±12.10) μg/dl. No significant difference could be obtained between maternal serum zinc and cord blood levels.
Sexual activity and attitudes toward contraception among women seeking termination of pregnancy in Zaria, Northern Nigeria
Authors: Ujah I.A.O.
Published: April 2004

One hundred and eight (108) women seeking termination of pregnancy in Zaria were studied during a period of 3 months (October to December 1985). The mean age was 21.8 years (range 15–38); 35.6% were below the age of 20 years and 57% were students. The three major tribes engage in illegal termination of pregnancy and Yorubas were in the majority; 53.3% had history of previous induced abortion. Sixty‐three percent had had sexual experience by the age of 18 years. The major reasons for seeking termination of pregnancy were “still in school” and “not married.” Although 88.8% had knowledge of contraception, less than half actually used any method. Of the 60 patients who volunteered information on their views on legalization of abortion, 21 (35%) were against legalization of abortion for various reasons. Family health education in schools and contraceptive counseling among the adolescents will reduce the prevalence of illegal abortions and its disastrous consequences.
Oral cavity metastasis from carcinoma of the cervix
Authors: Davidson N.G.P. , Moyo C.
Published: April 2004

A case report of a patient with carcinoma of the cervix with metastasis to the oral cavity clinically mimicking a primary oral cavity neoplasm is described. The patient presented one year after completing radiotherapy followed by radical hysterectomy and pelvic lymphadenectomy for carcinoma of the cervix. Excellent palliation was produced with radiotherapy. We are not aware of any reported case of oral cavity metastasis from carcinoma of the cervix.
Prevention of osteoporosis by medroxyprogesterone acetate in postmenopausal women
Authors: McNeeley S.G. , Schinfeld J.S. , Stovall T.G. , Ling F.W. , Buxton B.H.
Published: April 2004

The effect of medroxyprogesterone acetate 10 mg BID alone, conjugated estrogens alone or in a combination regimen for the prevention of osteoporosis was determined in 36 postmenopausal women using single photon densitometry. No significant differences in cortical or trabecular bone mass over time were detected in women between the three treatment groups, although a slight increase in bone mass was noted in women with the combined therapy. Medroxyprogesterone acetate appears efficacious in preventing postmenopausal osteoporosis, and may be especially useful in women with contraindications to estrogen replacement therapy.
An unusual cause and treatment of decelerations in fetal heart rate
Authors: Brotanek V. , Lopez J.S.
Published: April 2004

Decelerations of severe degree were detected during the monitoring of fetal heart rate at term. Decelerations continued despite the usual maneuvers in patient's position. Examination by ultrasound revealed that a loop of umbilical cord was held and squeezed in the fetal fist. The oxytocin infusion stimulated strong and frequent fetal movements which caused the fetal grip on umbilical cord to release and FHR decelerations to disappear. Induced labor progressed rapidly and within 5 h a healthy term infant was delivered.
Uterine leiomyomata in pregnancy
Authors: Hasan F. , Arumugam K. , Sivanesaratnam V.
Published: April 2004

Sixty cases with uterine leiomyomata in pregnancy are presented. The incidence was 1 in 1033 deliveries. The median age of the patients was 33.4 years. The majority were primigravidae (60%). A significant number of patients gave a history of infertility (43%) and spontaneous abortions (25%). The commonest antenatal complication was malpresentation and in all these patients the myomata were larger than 6 cm. Typical features of red degeneration occurred in 10% of cases. The cesarean section rate was 73%, the commonest indication being obstructed labor. Severe hemorrhage was encountered at cesarean section in 10 patients, 3 of whom needed hysterectomy. There were no perinatal deaths.
Short stature and cephalopelvic disproportion in Burkina Faso, West Africa
Authors: Sokal D. , Sawadogo L. , Adjibade A.
Published: April 2004

In order to reduce maternal mortality due to cephalopelvic disproportion (CPD), it is important to screen women for short stature, especially in rural areas of developing countries. We measured the height of 1733 women as they left the maternity services in Ouagadougou and recorded the type of delivery. Women less than 155 cm tall were 4.9 times more likely to have a cesarean section delivery. We propose simplified screening criteria for use by traditional birth attendants.
The use of ammiotic fluid viscosity measurements to establish fetal lung maturity
Authors: Rosati P. , Pola P. , Riccardi P. , Flore R. , Tondi P. , Bellati U.
Published: April 2004

A Haake viscosimeter was used to determine the viscosity of amniotic fluid and this value correlated with fetal lung maturity. The results were evaluated along the weeks of pregnancy and compared to those obtained using Gluck's method (lecithin/sphingomyelin ratio (L/S)). Using 91 separate amniotic fluid samples, free of meconium and blood contamination, we found that the new method was quick and easy to perform. Thirty‐one neonates were delivered within 48 h of the amniotic fluid sampling and the percentage of correct prediction of respiratory distress syndrome (RDS) was 71% with a mature L/S ratio and 83% with viscosity < 1.17 cP. In cases with an immature L/S ratio (value below 2) the correct prediction of RDS was 64%; with the fluorescence polarization (FP) technique it was 91%. We conclude that the amniotic fluid FP value is a reliable index of fetal lung maturity and risk for developing RDS and has also specific technical and diagnostic advantages over the L/S ratio.