bluuebunny/crossref_metadata_2025 huggingface dataset:
The Pregnant Population and A Fetal Crown‐Rump Length Screening Program
Authors: Selbing Anders
Published: December 2009

Abstract. Ultrasound screening for estimation of gestation‐al age is one of the most important advances made in obstetrics. In this study on the effects of our crown‐rump length (CRL) screening program, a most significant (25%) proportion of the pregnant women had a difference between menstrual age and gestational age estimated on the basis of crown‐rump length, exceeding 7 days. Regular menstrual cycles and reliable menstrual history could only reduce this frequency to 19%. Postmature deliveries (>294 days menstrual age) were reduced from one in fifteen to one in three hundred. A screening program with CRL is useless if the woman books in too late, since a CRL above 90 mm is unreliable because of differences in fetal bending of the spine. In our catchment area more than 78% of the women delivered booked early enough for a fetal CRL measurement. If this result can be expected in a population, CRL measurement should be used because of its better accuracy than biparietal diameter measurement for the estimation of gestational age.
The Diagnostic Value of Serum Copper/Zinc Ratio in Gynecological Tumors
Authors: Brandes Joseph M. , Lightman Abraham , Drugan Arie , Zinder Oren , Cohen Ayala , Itskovtiz Joseph
Published: December 2009

Abstract. Serum copper levels (SCu) and serum zinc levels (SZn) were determined on admission in 73 women hospitalized for suspected gynecological tumor. Twenty‐five of the women were subsequently found to have malignant tumor, while 48 had benign growths. The serum Cu/Zn ratio of the malignant group (2.13±0.53) was significantly (p<0.001) higher than that of the benign group (1.45±0.25). A good correlation was established between the Cu/Zn ratio and the stage of the malignant tumor. Serum copper level showed a linear correlation (R = 0.878) with serum ceruloplasmin values. These results indicate that the serum Cu/Zn ratio may be used as a valuable predictor of the presence of malignant gynecological tumor and its stage.
Obstetrical Paracervical block with Chloroprocaine or Bupivacaine
Authors: Belfrage Patrick , Floberg Jan
Published: December 2009

Abstract. Obstetrical paracervical block was randomly administered to 47 patients, using either 2% chloroprocaine or 0.25% bupivacaine. Analgesia and onset of analgesia were similar for both drugs, but the duration of chloroprocaine was only about half that of bupivacaine (35 min versus 66 min). Fetal bradycardia was encountered in one case after chloroprocaine and in two cases after bupivacaine. It is concluded that chloroprocaine plain is not very suitable for obstetrical paracervical block due to its short duration of action.
Early Diagnosis of Ectopic Pregnancy
Authors: Thorburn Jane E. K. , Janson Per O. , Lindstedt Goran
Published: December 2009

Abstract. An analysis was made of the records of 328 cases of ectopic pregnancy seen during a 5‐year period (1975‐79) with respect to history, clinical features, diagnostic tools and surgical procedures. Special attention was paid to the methods used to obtain an early diagnosis. The best methods in this respect were found to be laparoscopy and determination of serum chorionic gonadotropin. Ultrasonogra‐phy was performed in too few cases to permit an evaluation of the sensitivity of the method. However, 25% of the cases presented with a gestational time of 6 weeks or less, a period during which ultrasound is known to be uncertain in the diagnosis of pregnancy, and only 33% of the cases with a time of 9 weeks or more when ultrasound is considered to be highly reliable for this diagnosis.
A Comparison of Cesarean Section Frequencies in two Norwegian Hospitals
Authors: Nilsen Stein Tore , Bergsjö Per , Lökling Arnt , Skarsten Kjell W. , Johannessen Kristina H. , Blaas Harm‐Gerd
Published: December 2009

Abstract. The two largest Norwegian obstetrical departments, in the cities of Bergen and Stavanger, differ markedly with regard to the frequency of Cesarean section. During the 1970′s the proportions rose in both departments, but the Stavanger rate remained about half of that in Bergen, the latter following the national average. These differences were not reflected in the perinatal mortality, which had the same rates and fell equally in both hospitals.

To search for explanations, all records of Cesarean section cases from the years 1974 and 1979 were studied in both hospitals. We found that mechanical indications, meaning disproportion and prolonged labor, accounted for most of the difference, whereas there was no significant rise in the frequencies for the indication fetal asphyxia in either of the hospitals, these being numerically the most important indications.

In fact, there was no significant rise for mechanical indications in Stavanger between 1974 and 1979, whereas in Bergen the increased frequency for this indication gave the highest significance level for any of the seven subgroups of indications.

It is suggested that the chain of command may be an important cause of the observed differences between the two departments, although this is not reflected in any stated or conscious policy in either place.
Vaginal Administration of 15‐ Methyl ‐PGF2α‐ Methyl Ester Prior to Vacuum Aspiration
Authors: Nilsson S. , Johnell H. , Langhoff‐Roos J. , Nyberg R. , Green K.
Published: December 2009

Abstract. In order to simplify the operative technique and lower the postoperative complication rate, 354 healthy primigravidae were treated with a vaginal suppository containing 1 mg of 15‐methyl‐prostaglandin F2α 12 hours prior to vacuum aspiration abortion in the first trimester. The mean cervical diameter found at the operation was 8.5 mm and in 38% of the women no further mechanical dilatation of the cervix was needed. The amount of bleeding during the operation was low (mean 30 ml, max. 300 ml). No perforations of the uterus or cervical lacerations occurred at operation. Side effects of the prostaglandin such as vomiting, diarrhea and lower abdominal pain occurred in 80% of the women and must be regarded as disturbing to the patient and seem to require that the women be hospitalized. The incidence of genital infection following the abortion was found to be 6.2%. In 8.2% of the women, the postoperative bleeding persisted for more than 14 days. It is concluded that if the frequency of side effects can be lowered by using new analogues of prostaglandins, pretreat‐ment with vaginal suppositories may be recommended before vacuum‐aspiration at legal abortion in the first trimester.
Late Complications of Laparoscopic Clip Sterilization
Authors: Punnonen R. , Erkkola R.
Published: December 2009

Abstract. Late sequelae after laparoscopic Hulka clip sterilization were investigated in 100 women, with a follow‐up time of 1½—3 years. Of the patients, 18% showed menstrual disorders, and one patient complained of climacteric symptoms. Increased libido was reported by 34% of the women and decreased libido by 8%. Of the husbands, libido had increased in 18% of cases, while none of them reported decreased libido. Sexual intercourse was felt to be more satisfactory after sterilization by 40% of the women, while the others did not find any change. All the patients were asked whether they would again choose laparoscopic sterilization as a contraceptive method and all answers were unhesitatingly in the affirmative.
Fetal Heart Rate Response to Controlled Sound Stimuli During the Third Trimester of Normal Pregnancy
Authors: Jensen Odd Harald
Published: December 2009

Abstract. Fetal Heart Rate (FHR) Responses to Controlled Sound Stimuli were Compared in the 32nd, 35th and 39th week of pregnancy. Though a tendency to a greater FHR response to sound was found as gestation advanced, this increase would seem to be so small that it may be ignored in practice. The earlier demonstrated influence of stimulus intensity and prestimulus heart rate level on the FHR response to sound were confirmed.
Evaluation of History and Simple Supine Cystometry as a Preoperative test in Stress Urinary Incontinence
Authors: Fall M. , Erlandson B. E. , Pettersson S.
Published: December 2009

Abstract. In a follow‐up study the accuracy of a simple pre‐operative screening including history, Bonney's test and supine cystometry was evaluated in patients with stress urinary incontinence. Based upon preoperative history alone, the patients were divided into two different groups, pure stress incontinence, and mixed stress and urge incontinence. All patients accepted had a normal supine cystometry at the preoperative work‐up. The results of the operation were good in pure stress incontinence. In patients with mixed stress and urge incontinence the results were unsatisfactory and most of them presented a variety of urodynamic abnormalities postoperatively. Thus, in patients with pure stress incontinence, acceptance for surgery may be based upon a careful history, a simple supine cystometry and Bonney's test, but in patients with mixed stress and urge incontinence a comprehensive clinical and urodynamic evaluation is mandatory. It seems that combination of detrusor instability and a history of pronounced urgency preoperatively calls for other therapeutic alternatives than operation.
CO2‐Laser Treatment of Condylomata Acuminata
Authors: Kryger‐Baggesen Niels , Larsen Jørgen Falck , Pedersen Poul Hjortkjær
Published: December 2009

Abstract. Fifty‐two consecutive patients with condylomata acuminata were treated with CO2‐laser under general anesthesia. In many of the cases, previous conventional treatment had failed. The effectiveness of the treatment was found to be between 75 and 87%. It caused few complication or complains. Eighty‐three percent of the patients expressed satisfaction with the treatment. Laser treatment of condylomata acuminata is an alternative to conventional treatment in tractable cases and in cases where conventional methods are contra‐indicated.
Copper and Zinc in Pre‐Eclampsia
Authors: Kiilholma P. , Paul R. , Pakarinen P. , Gränroos M.
Published: December 2009

Abstract. Twenty uncomplicated pregnancies, 10 parturients with mild and 10 parturients with severe preeclampsia, all with uncomplicated deliveries, were studied. Maternal and umbilical cord serum were checked for copper and zinc by the protoninduced X‐ray emission (PIXE) method; maternal serum protein, hemoglobin and estriol were determined as well. Maternal zinc and copper values were lower, whereas the umbilical cord serum copper level was higher in the group with severe preeclampsia as compared with the controls. Maternal zinc was also lower in mild preeclampsia than in the controls. The possible causes of these changes are discussed in view of the hormonal, metabolic and enzymatic changes in preeclampsia.
Acute Responses to Maternal Smoking of the Pulsatile Movements in Fetal Aorta
Authors: Eriksen Poul Sindberg , Gennser Gerhard
Published: December 2009

Abstract. In order to further characterize the acute cardiovascular responses of the human fetus to maternal smoking, 17 women in late pregnancy were studied after smoking a single cigarette. The pulsations of the fetal descending aorta were recorded by means of an ultrasound scanner connected to a phaselocked echotracking instrument; the fetal ECG was recorded from abdominal electrodes. Both the level and the waveform of the diameter pulse curve changed typically 3 25 min after the onset of smoking, concomitant with an increase in maternal and fetal heart rate. Apparent diastolic diameter and pulse amplitude increased, while the ascending part of the curve increased in slope and decreased in duration; the late decremental velocity was reduced. The propagation time from the onset of the fetal Q‐wave to the arrival of the pulse wave at the site of recording was reduced. This study demonstrates for the first time the acute effects of maternal smoking on the pulsatile dynamics of fetal vessel walls, and the method suggests the possibility of estimating changes in the contractility of the fetal heart and theafteroad in the fetal circulation.
Fetal Heart Rate Response to Sound Stimulation After Pethidine Injection in the Mother
Authors: Jensen Odd Harald
Published: December 2009

Abstract. A method for electronic supervision of the human fetus based upon controlled sound stimulation of the fetus and the fetal heart rate response was used to evaluate the effect of pethidine on the fetus. Half an hour after intramuscular injection of 100 mg pethidine in the mother, the fetal heart rate response to sound stimulation was already depressed in 10 out of 20 cases. A general depression of the heart rate response to sound was found 2 and 3 hours after the injection. The fetal heart rate response to sound stimulation seems to constitute a sensitive record of pethidine's influence.
FETAL TACHYPNEA: PROGNOSTIC SIGNIFICANCE AND TREATMENT
Authors: D'elia A. , Di Maggio F. , Troncone M. G. , Pignata M. , Alvano G.
Published: December 2009

Abstract. We report the case of a pregnant woman with class B diabetes whose fetus, examined in utero by means of real‐time ultrasound, showed tachypneic breathing movements. Having considered the clinical course of this case and of those reported in literature, we put forward a hypothesis concerning the pathogenesis and the prognostic significance of fetal tachypnea.
Acute Effects of Maternal Smoking on Fetal Heart Beat Intervals
Authors: Eriksen Poul Sindberg , Gennser Gerhard , Lindvall Richard , Nilsson Karin
Published: December 2009

Abstract. The purpose of this study was to analyse the acute effects of maternal cigarette smoking on the fetal heart beat intervals and their variability during the last trimester of a normal gestation. The fetal heart beat intervals were monitored continuously by abdominal electrocardiography for 60 min before and 60 min after smoking in 10 pregnant women. The mean intervals, their long‐term variability (SD) and short‐term variability (standard deviation of interval differences (SDID)), calculated for 30‐sec periods, showed a steady state before smoking. During the control period, the mean beat interval was negatively correlated with daily cigarette consumption and the short‐term variability was positively correlated with the maternal plasma nicotine level. After smoking, the mean beat interval and the short‐term variability decreased transiently, the values of both these parameters being positively correlated with the maternal nicotine values before smoking. The acute response of fetal heart beat intervals and their variability to one cigarette is distinct but transient, and the results suggest that the effects are modified by the chronic smoking habits of the women.
Red Cell 2,3‐Diphosphoglycerate and Hemoglobin‐Oxygen Affinity During Diabetic Pregnancy
Authors: Madsen H. , Ditzel J.
Published: December 2009

Abstract. Factors involved in blood oxygen transport were measured serially in the first, second and third trimester of pregnancy in 23 insulin‐dependent diabetic women. Twenty‐six non‐pregnant diabetic patients served as a reference group. Diabetic pregnancy was associated with relative anemia, a significant increase in arterial pH, and hypocap‐nia. The concentration of red cell 2,3‐diphosphoglycerate was significantly higher in the first trimester of diabetic pregnancy compared with non‐pregnant diabetics (median value 16.4 vs. 15.0 μmol/g hemoglobin, p>0.02) and increased gradually from the first to the third trimester (16.4 to 17.2 μmol/g hemoglobin, p<0.01). The hemoglobin A1c concentration decreased simultaneously from 8.1% to 7.3% (p <0.01). The level of hemoglobin A1c in the first trimester was significantly lower than that in the non‐pregnant diabetic patients (8.1 vs. 9.3%, p>0.01). In spite of the increase in red cell 2,3‐diphosphoglycerate content and the decrease in hemoglobin A1c, factors known to reduce hemoglobin oxygen affinity, the position of the oxyhemoglobin dissociation curve remained unchanged during diabetic pregnancy: P50 at actual pH in the first trimester, was 26.0 mmHg; in the second trimester, 26.9 mmHg, and in the third trimester, 26.8 mmHg (NS). These values of P50 at actual pH were identical with the value in the non‐pregnant group (26.6 mmHg). Other factors influencing hemoglobin oxygen affinity, such as hemoglobin concentration, hydrogen ion concentration and arterial oxygen saturation remained unchanged during diabetic pregnancy. The observations suggest that an unknown factor which increases hemoglobin oxygen affinity and to which the increased level of red cell 2,3‐diphosphoglycerate may be compensatory, is operating in diabetic pregnancy.
An Epidemic‐Like Appearance of Congenital Cystic Hygroma
Authors: Zimmer Etan Z. , Divon Michael Y. , Raijman Alina , Timor‐Tritsch Ilan E. , Paldi Eitan , Peretz Bezalel A.
Published: December 2009

Abstract. Five fetuses with cystic hyroma were diagnosed in our department during a period of 5 months. Four of them were identified by an ultrasonic examination. No common causative factor was found to explain the appearance of such a rare anomaly in 5 cases over a very short period of time.
Sinusoidal Fetal Heart Rate Pattern
Authors: Sigurd Jorgen , Joelsson Ingemar
Published: December 2009

Abstract. Transient occurrence of sinusoidal fetal heart rate pattern is described in a case of Rh iso‐immunization in a twin pregnancy treated with plasmapheresis.
Effect of danazol on serum concentrations of pituitary gonadotropins in postmenopausal women
Authors: Döberl Anton , Jeppsson Sten , Rannevik Gunnar
Published: December 2009

Abstract. The antigonadotropic action of danazol is still a subject Of COntrOVerSy. Danazol does not cause a consistent and significant suppression of basal gonadotropin concentrations in premenopausal women. In order to investigate the possible effects of danazol on circulating gonadotropin levels in the absence of gonadal feedback, postmenopausal women were studied. Twelve healthy women, at least 3 Years Past the menoPau% volunteered. Their mean age was 61.1253 (SD) years. Danazol in daily doses of 400, 600 or 800 mg was given randomized, to 4 patients each, for 4 weeks. Venous samples were drawn at −1, 0, +1, + 2, +4 weeks of medication. FSH and LH in serum were measured by means of double antibody radio‐immunoassay. There was no significant difference between any of the pre‐treatment means in the three dose groups. After 4 weeks of danazol treatment, FSH had decreased by 18%, 31%. and 32% in the 400, 600 and 800 mg groups, respectively. The corresponding decreases in LH were 14%. 24% and 21%. There was no significant dose response between any of the doses used. In the absence of significant differences between the pretreatment means and of significant dose response, data for all 12 patients were pooled for statistical evaluation. The mean decrease in FSH was significant only after 4 weeks (−4.8 pg/l; p<0.001). The mean decrease in LH was significant after 1, 2 and 4 weeks of treatment (−1.0 to − 1.13; p<0.01 or less). The results support the view that the pharmacodynamic spectrum of actions of danazol, even in the absence of gonadal feedback, includes a direct effect on gonadotropin secretion at hypothalamic‐pituitary level.
Changes in the shbg concentration during danazol treatment
Authors: Gershagen Sten , Dörberl Anton , Rannevik Gunnar
Published: December 2009

Abstract. Serum levels of sex hormone binding globulin (SHBG) were measured by radioelectro‐immunoassay before and during administration of danazol in daily doses varying between 200 and 800 mg for a period of 1–6 months. The patients consisted of different groups of regularly menstruating women (n = 76) and of postmenopausal women (n = 12). A rapid proportional decrease in SHBG was seen at all dose levels in both pre‐and postmenopausal women, starting within the first 24 hours and reaching statistical significance by 48 hours. The fractional rate of fall appeared to be determined by the metabolic half‐life of the protein itself. Plotting log concentrations of SHBG versus time and using the slope of the linear regression for calculations, the half‐life of SHBG appeared to be 15±5.7 (SD) days. After approximately one month of treatment, the SHBG concentrations began to approach a new steady state at a level of approximately 20–30% of the original concentration, depending on the dose of danazol. The proportional suppression of SHBG was significantly greater following 600 or 800 mg of danazol daily than following 200 or 400 mg. However, with all doses the SHBG levels after one month of treatment were well below the levels normally found in healthy males. The mean proportional reduction following a certain dose was almost identical in premenopausal and postmenopausal women. The findings of the present investigation suggest that danazol exerts a direct inhibitory effect on the hepatic synthesis of SHBG, which is dependent of the dose of danazol, independent of estrogen concentration, but possibly accentuated by endogenous androgens.
Neonatal Effects of Beta‐Blocking Drugs in Pregnancy
Authors: Finnström Orvar , Ezitis Janis , Rydén Gunnar , Wichman Klas
Published: December 2009

Abstract. A review is presented as regards the neonatal effects of beta‐blocking agents in hypertension during pregnancy. Experience points to low fetal and neonatal risks, but firmly based data concerning the neonates are very scanty. An on‐going double‐blind study is presented in which pregnant women with hypertension are randomly allocated to either metoprolol or placebo treatment. One of the aims is to study the postnatal adaptation of the infants. The following measurements, recordings and examinations are performed: anthropometric measurements, Apgar score, blood gases and acid‐base status in umbilical (venous and arterial) blood, lactate and hypoxanthine in umbilical venous blood, catecholamines in umbilical arterial blood, pulse rate, blood glucose and a quantitative neurobehavioral assessment in the neonatal period.
General Anaesthesia Versus Epidural Block for Caesarean Section in Patient with Pre‐Eclampsia
Authors: Willdeck‐Lund Gunilla
Published: December 2009

Abstract. To protect mother and fetus from the stress of vaginal delivery, caesarean section is to be chosen in severe cases of pre‐eclampsia. When general anaesthesia is used, attention must be paid to the increase in arterial pressure, pulmonary arterial pressure (PA) and pulmonary capillary wedge pressure (PCW), which occur during intubation, tracheal suction and extubation. In epidural block, on the other hand, hypotension is a common phenomenon if the hypovolaemia is not corrected before the anaesthesia. It is important for the anaesthesiologist to see these women early to be able to treat the hypovolaemia and hypertension prior to caesarean section.
SELF‐MONITORING OF BLOOD GLUCOSE IN PREGNANT DIABETICS
Authors: Espersen Thorkild , Klebe Joachim G.
Published: December 2009

Abstract. Sixty‐one pregnant patients with insulin‐dependent diabetes mellitus completed a self‐monitoring program consisting of five daily blood glucose tests at least twice weekly during the ambulatory periods of their pregnancies. Either a reflectometer method, Eyetone, glucometer re‐flectometer, or Haemoglucotest 1‐44 test strips were used. Of 1 834 glucose profiles, 45% were optimal, with all blood glucose values between 3.9 and 8.3 mmol/1. The 61 pregnancies were compared with 62 pregnancies where the diabetic control and therapy principles were identical, but where self‐monitoring blood glucose methods were not employed. The self‐monitoring regime resulted in a significant drop in mean blood glucose levels, from 7.8±1.3 to 6.4±1.0 mmol/1, compared with the period before the self‐monitoring program was introduced. Furthermore, a decline in the number of diabetes‐conditioned extra hospitalizations during pregnancy in the self‐test group could be registered.
ECTOPIC PREGNANCY AND SPONTANEOUS ABORTIONS FOLLOWING IN‐VITRO FERTILIZATION AND EMBRYO TRANSFER
Authors: Lindenberg S. , Lauritsen J. G. , Lenz S.
Published: December 2009

Abstract. In‐vitro fertilization and embryo transfer was performed in 25 patients with diseased oviducts. Three pregnancies were achieved, but all ended in early abortion. One patient had ectopic pregnancy, one spontaneous abortion having a severe autosomal chromosome abnormality, and one had a rise in serum hCG but vaginal bleeding started 18 days after embryo transfer. We conclude that repeated ultrasonic examinations of all pregnancies following in‐vitro fertilization and embryo transfer is recommendable until intra‐uterine implantation has been confirmed and that amniocentesis should be offered to all these patients.
15(S)‐15‐METHYL‐PROSTAGLANDIN F2α USED FOR INDUCTION OF DELIVERY IN THE CASE OF INTRA‐UTERINE FETAL DEATH
Authors: Osier Mogens , Lange Aksel P. , Moth Inge , Pedersen Gunnar Thomsen , Westergaard Jes G.
Published: December 2009

Abstract. 102 pregnant women with intra‐uterine fetal death after the 12th week of gestation were treated with 15(S)‐15‐methyl‐prostaglandin F2α intramuscularly with doses of 125‐250 μg at 2‐3 hourly intervals. In all cases abortion or delivery was completed within 30 hours. The average time in primigravidae was 9 hours 43 minutes, and in multi‐gravidae 9 hours 59 minutes. In approximately two‐thirds of the patients, mild or moderate gastrointestinal side effects were recorded in spiteof prophylactic treatment with Retar‐dinR or Loperamide + Diphenoxylate. The therapy was found to be effective, easy to administer and the side effects acceptable. No serious side effects were recorded.
AUDITORY EVOKED RESPONSES IN THE HUMAN FETUS
Authors: Luz Nilo Pereira
Published: December 2009

Abstract. The author presents his observations made on the behavior of an auditory evoked response of the human fetus during labor, elicited by a standardized sound stimulus at 1 500 cycles/second. The method was applied to 233 women during labor and the pattern of responses evoked by sound stimulation was studied in all clinical conditions present in this high‐risk population. A fair number of observations was made on vigorous/depressed newborns by Apgar rating, in the presence of definite cardiotocographic signals of fetal distress, in cases of intact or ruptured membranes, in cephalo‐pelvic disproportion, in the presence of maternal risk factors, in cases of cord entaglement, in cases of meco‐nium present in amniotic fluid, in intra‐uterine growth retardation, hypertensive disease of pregnancy, and in familial and class A diabetes. A significant decrease in the response to sound stimulation was observed in cases of fetuses born in a depressed condition, after more than 2 hours following membrane rupture, in the presence of maternal obstetric risk factors, and in cases of hypertension in pregnancy. Women with intra‐uterine growth retardation and cephalo‐pelvic disproportion presented smaller changes and in cases of umbilical cord entanglement, presence of meco‐nium in amniotic fluid and with history of familial or class A diabetes, no differences in the patterns of responses to sound stimulation as compared with normal could be observed. The author observed a good correlation between the auditory evoked response and fetal conditions during the course of labor and suggests that this method should be further developed as a simple method of evaluating the cerebral function of the unborn human fetus.

In the first published part of this study (19) we described the modifications in the auditory evoked response of the human fetus caused by the progress of labor. A closer scrutiny of our data revealed the influence of several other factors acting upon the pattern of fetal response to sound stimulation. The present paper describes studies on those factors influencing the behavior of the human fetus following sound stimulation.
CORRELATIONS BETWEEN PRL AND CHLORIDE, SODIUM, POTASSIUM AND CALCIUM IN AMNIOTIC FLUID
Authors: Andersen Jesper Rye , Weber Tom
Published: December 2009

Abstract. The concentration of prolactin in amniotic fluid from 91 pregnant women (Group I: 51 specimens obtained at 15th‐20th week of gestation; Group II: 40 specimens at term) has been correlated with the amniotic fluid concentrations of calcium, of the ions sodium, chloride, and potassium, and with the clinical data. When the week of gestation in multiple regression analyses was predetermined for inclusion in the first step, the amniotic prolactin concentration was found to be significantly correlated with sodium or chloride in both groups and the correlation coefficients in the two groups were alike. The correlation coefficients of potassium and of calcium differed between the two groups and no general pattern could be detected. The results indicate that the amniotic sodium and chloride concentrations could be of importance for the regulation of the amniotic prolactin concentration.
MALES BORN BY CESAREAN SECTION EXAMINED 18 YEARS AFTER DELIVERY
Authors: Nilsen Stein Tore , Bergsjø Per
Published: December 2009

Abstract. Forty‐seven boys born by cesarean section in 1962‐63 were re‐examined 18 years afterwards, at the military medical draft board. No significant increase in mortality or morbidity was found. The mean general intelligence was significantly lower when placenta praevia had been the reason for abdominal delivery. In these cases the infants had had a lower birthweight and placental weight, on average, than the other subgroups.
CARDIOTOCOGRAPHIC DISTORTION OF FETAL HEART RATE VARIABILITY
Authors: Sigurd JÖRgen , Löfgren Olof , Joelsson Ingemar
Published: December 2009

Abstract. The error arising when evaluating FHR variability on CTG curves is demonstrated. Visual estimation is based on the appreciation of oscillation amplitude (O.A.) which is necessarily dependent on basic heart frequency and the changes therein. It reflects variability in a distorted way – the distortion can be as great as 33% even when the basic heart frequency remains within the normal range of 120‐ 160 beats per minute.
BIOCONVERSION OF ARACHIDONIC ACID IN HUMAN PREGNANT UTERINE CERVIX
Authors: Christensen N. J. , Belfrage P. , Bygdeman M. , Floberg J. , Miszuhashi N. , Gréen K.
Published: December 2009

Abstract. The in vitro conversion of [14C]arachidonic acid by endocervical mucosa and cervical tissue specimens obtained in first trimester (9‐12 w) and term pregnant patients (37–39 w) was studied in whole‐cell homogenates. All radiolabelled products of the arachidonic acid cascade were extracted, purified and separated utilizing silicic acid chromatography, thin‐layer chromatography and reversed phase partition chromatography and identified with radio‐gas chromatography and gas chromatography‐mass specto‐metry. Both types of tissue produced PGF2α and PGE2, as well as TxB2. In cervical tissue specimens there was a significant increase in the production of all these three prostaglan‐dins as the pregnancy progressed, whereas no such difference was seen in homogenates of endocervical mucosa. In both endocervical mucosa and cervical tissue specimens there was a highly significant increase in the production of a so‐far unknown compound(s), in samples from term patients as compared with samples from first‐trimester patients. The possible participation of this metabolite of [14C]arachidonic acid in the regulation of cervical ripening is discussed.
AN UNUSUAL CASE OF CERVICAL PREGNANCY
Authors: Cohen I. , Altaras M. , Cordoba M. , Aderet N. Ben
Published: December 2009

Abstract. A very rare case of an unruptured cervical pregnancy, diagnosed by vaginal examination is described.

An elective abdominal hysterectomy was performed. No complications related to this entity occurred during treatment. Clinical management and literature are discussed.
ANTENATAL DIAGNOSIS OF BILATERAL CONGENITAL CHYLOTHORAX WITH PERICARDIAL EFFUSION
Authors: Jaffa Ariel J. , Barak Shimon , Kaysar Nehemia , Peyser M. Reuben
Published: December 2009

Abstract. Many fetal anomalies can be detected by ultrasound examination. The antenatal diagnosis of pathological disorders in the fetus can complicate management plans.

We report here a case of bilateral chylothorax with pericardial effusion diagnosed antenataly.
CONCEPTUAL DATING BY ULTRASONIC MEASUREMENT OF THE FETAL BIPARIETAL DIAMETER IN EARLY PREGNANCY
Authors: Selbing Anders , Kjessler Berndt
Published: December 2009

Abstract. The accuracy and precision of gestational dating, based on single measurements of the fetal biparietal diameter (BPD), was estimated in a consecutive series of 970 apparently normal, singleton pregnancies. The BPD sizes used varied between 11 and 60 mm, corresponding to 9–22 postconceptional weeks. The ‘conceptual ages’, used for reference, were estimated by means of ultrasonic measurements of the fetal crown—rump lengths (CRL). The association between the estimated conceptual age (dependent variable) and BPD size (independent variable) was found to be well represented (R2 = 0.972) by a second order polynomial: conceptual age = 44.7 + 1.069 × BPD+ 0.01382 × BPD × BPD. To check the validity of the proposed equation, we used 23 fetuses conceived by artificial insemination with donor semen as controls. There was good agreement between the virtual conceptual ages of the control cases and their corresponding BPD‐estimated conceptual ages (0.5 days mean difference, 3.6 days SD) when the suggested regression equation was used. The estimated precision of BPD‐dating was minumum ±4.4 days (= ±2SD) at 9–10 completed postconceptional weeks. At 14 completed weeks the corresponding precision was found to be ±11 days (±2SD). At the end of the studied BPD size interval, i.e. 56–60 mm BPD corresponding to 22 conceptual weeks, the precision was ±15 days. From an obstetrical point of view it seems obvious that the imprecision of gestational dating associated with BPD measurements > 35 mm should call for ultrasonic dating procedures to be performed earlier in pregnancy. An optimal precision of dating, i.e. better than ±6 days (= ±2SD), will certainly be achieved by ultrasonic measurements of the BPD between the 9th and 12th completed postconceptional weeks.
FLOW CYTOMETRY IN THE ASSESSMENT OF HUMAN PLACENTAL GROWTH
Authors: Iversen Ole E. , Farsund Tore
Published: December 2009

Abstract. The purpose of this study was to investigate the applicability of flow cytometry to human placenta and to challenge the hypothesis that no cell division takes place in the last 4–6 weeks of pregnancy. Relative DNA content in individual placental cells was measured and high —resolution DNA histograms were obtained, based upon measurements of more than 10000 cells. The fraction of cells with S‐phase DNA content was lower in cases of intra‐uterine growth retardation. In contrast to the earlier concept based on measurements of total organ content of DNA, this study indicates that cell division in placenta takes place right up to parturition. Small amounts of tissue are sufficient for the analyses which may aid surveillance of both normal and risk pregnancies.
VULVAR HEMANGIOPERICYTOMA
Authors: Zakut H. , Lotan M. , Lipnitzky M.
Published: December 2009

Abstract. Hemangiopericytoma is a rare vascular tumor that can be found in almost every site or organ in the body. To our knowledge, however, this is only the third reported case of hemangiopericytoma of the vulva.
ESTROGEN‐PROGESTOGEN REPLACEMENT IN CLIMACTERIC WOMEN, PARTICULARLY AS REGARDS A NEW TYPE OF CONTINUOUS REGIMEN
Authors: Mattsson Lars‐Åke , Samsioe Göran
Published: December 2009

Abstract. Twenty‐six peri‐ and postmenopausal women were treated with daily dose of 2 mg 17‐β‐estradiol, 1 mg estriol and 1 mg norethisterone‐acetate in a continuous regimen for 12 months. Clinical parameters such as vasomotor symptoms, bleeding patterns and histopathology were recorded. Blood samples were collected before, after 3 months and after 12 months of treatment and were analysed for estradiol‐17‐β, estrone, androstenedione in serum and lipoprotein lipids.

A marked reduction of hot flushes and sweatings was noted and the number of days with bleeding gradually decreased during treatment, especially in the postmenopausal group of women. No signs of hyperplasia of the endometrium were recorded. A decrease in the serum concentration of testosterone and androstenedione was found during treatment. The reduction in triglycerides in very low density lipoproteins after 3 months, concomitant with a decrease in the cholesterol content of high density lipoproteins, was interpreted as an effect mainly of the progestogen component in the preparation.

The present formulation of estrogen‐progestogen, continuously administered, may be an appropriate alternative treatment regimen for many women. One proposition of how to treat women with climacteric complaints around the menopause is presented.
INTRA‐UTERINE INFECTION DUE TO EIKENELLA CORRODENS
Authors: Sporken J. M. J. , Muytjens H. L. , Vemer H. M.
Published: December 2009

Abstract. Infections associated with Eikenella corrodens have become increasingly recognized in recent years. Although E. corrodens has been implicated in a wide variety of clinical infections (1), most of the reported infections involve the head and neck or the abdominal area (2, 3).

The microorganism is part of the resident flora of mucous membranes, including the human oral and intestinal flora. As we are not aware of any report of an obstetrical or gynecological infection associated with E. corrodens, we describe here a patient who developed an intra‐uterine infection during pregnancy due to this organism.
TYPHOID FEVER COMPLICATING PREGNANCY
Authors: Amster Reuben , Lessing Joseph B. , Jaffa Ariel J. , Peyser M. Reuben
Published: December 2009

Abstract. Typhoid fever in pregnancy may result in infection of the fetus, with consequent abortion. Currently, it is a rare complication of pregnancy in the industrially developed countries. This report documents a case of maternal typhoid fever with septic abortion, in which trans‐placental infection of the fetus caused its demise.
Psychosocial Stress and Obstetrical Complications: The need for a comprehensive model
Authors: Magni Guido , Rizzardo Renzo , Andreoli Cesare
Published: December 2009

The relationship between life events, anxiety, social support, coping style and obstetrical complications was studied in a series of 319 pregnant women; they were interviewed during the sixth month of pregnancy. To allow a prospective study, only obstetrical complications occurring after the interview were considered. 142 of the women proved to be complicated and the remaining 177 uncomplicated. Taken singly, none of the psychosocial variables considered significantly differentiated the two groups of women. However, when the combined effect of some psychosocial variables is considered, numerous significant interactions emerge. The variables which interact most frequently with each other and with the life events variables are: specific anxiety, coping style and general anxiety.
Fetal heart rate changes and uterine activity during coitus
Authors: Chayen Benjamin , Tejani Nergesh , Verma Uma L. , Gordon Gregory
Published: December 2009

Fetal heart rate and uterine activity were monitored during sexual intercourse in three otherwise normal gravid women at varying gestational ages. Increased uterine activity and a variety of fetal heart rate changes, some of which are traditionally identified as ominous, were seen in most instances immediately following orgasm. An increase in fetal activity was also commonly reported by the mothers. It is postulated that coitus is equivalent to an un‐monitored contraction stress test.
Reliability of Radiographic Pelvimetry: A Methodological Study
Authors: Lundh Christer , Lindmark Gunilla , Wilbrand Hermann
Published: December 2009

The purpose of this study was to assess the reliability of radiographic pelvimetry. 48 radiologists were asked to estimate the pelvic inlet and outlet diameters from copies of 20 pelvimetry radiographs. We found that every third patient will have the sum of her pelvic outlet over‐ or underestimated by at least 4 mm, and 3% by more than 10 mm. the random measurement error of the sum of the pelvic outlet is about four times greater than the systematic error. the random error of the sagittal outlet diameter contributes to almost half of the total measurement error of the pelvic outlet sum. the measurement values of radiographic pelvimetry are often expressed in mm, which may give an impression of exactness that is obviously not well founded. Only in a few cases where the measurements suggest a severe fetopelvic disproportion is it justified to do an elective cesarean section on the basis of radiographic pelvimetry only.
Fatal Course of Malignant Melanoma During Pregnancy with Dissemination to the Products of Conception
Authors: Møller Dan , Ipsen Leif , Asschenfeldt Pia
Published: December 2009

The first case in Denmark of malignant melanoma metastasizing to the placenta and the fetal circulation is presented. the fact that shortly before becoming pregnant the patient had been treated with wide excision and regional lymph node dissection for a cutaneous melanoma of the right calf, gives further support to suspicions about a possible adverse effect of pregnancy on melanoma. in view of the high mortality in babies during their first year of life in the few similar reports available in the world literature, the authors would recommend the avoidance of pregnancy within 5 years of treatment of melanoma of any stage.
Diagnostic Aspects of Primary Tubal Malignancy
Authors: Mäkinen J. , Grenman S. , Klemi P.
Published: December 2009

Eleven cases of primary tubal malignancy are reported to characterize clinical symptoms and diagnostic procedures. the importance of a yellow vaginal discharge is emphasized as being a diagnostic sign.
Histopathological Findings in 226 Women with Post‐Menopausal Uterine Bleeding
Authors: (Baruch) Lidor A. , Ismajovich B. , Confino E. , David M. P.
Published: December 2009

Histopathological findings in 226 post‐meno‐pausal bleeding women were reviewed retrospectively. Ade‐nocarcinoma of the endometrium was diagnosed in 7% and hyperplastic endometrium in 15%. The incidence of malignancy showed a definite rise with advancing age, increasing amount and duration of bleeding, prolonged time interval between the menopause and onset of bleeding, and enlarged uterus. Adenocarcinoma of the endometrium was associated in 40% of the patients with either obesity, diabetes mellitus, or hypertension. The most frequent histopathological finding was atrophic endometrium (45%).
Growth in Breech Presentation: Ultrasound and Post‐Partal Assessment of Growth in 225 Fetuses Presenting by the Breech in the 33rd Gestational Week
Authors: Luterkort Marie , Polberger Staffan , Weldner Britt‐Marie , Persson Per Håkan , Bjerre Ingrid
Published: December 2009

225 fetuses with ultrasonically determined gestational age were shown by ultrasound to be in breech presentation in the 33rd gestational week. the biparietal diameter (BPD) and the mean of two perpendicular abdominal diameters (AD) were measured ultrasonically in gestational weeks 33, 35, and 38. Based on these measurements, fetal weight was estimated and compared with weight, length, and head circumference at birth and at 18 months of age. 42% of the fetuses were born in breech presentation (breech group) and 58% in vertex presentation (vertex group). the mean birth weight corrected for gestational age was 4.9% lower in the breech group than in the vertex group, which corresponds to the lower intra‐uterine values of BPD and AD found in the breech group. the weight differences at birth still persisted at 18 months of age. There were no differences between the groups regarding head circumference or length, either at birth or at 18 months of age.
Maternal Deaths in Sweden, 1971–1980
Authors: Högberg Ulf
Published: December 2009

Sixty‐eight deaths during pregnancy, parturition and puerperium were recorded in Sweden during the years 1971–80, giving a maternal mortality of 6.6 per 100 000 live births. the figurese for abdominal delivery and vaginal were 45.0 and 2.5 per 100000 live births respectively. Am‐niotic fluid embolism, pulmonary embolism and hemorrhage were the main causes of death within 24 hours after delivery, while pre‐eclampsia/eclampsia and sepsis were predominant during the rest of the puerperium. Age and parity are highly important risk factors. Presumed avoidable factors were identified in 19% of the cases. 9% of the deaths were related to unwanted pregnancy.
Urinary Unconjugated Cortisol in Normally Menstruating Women and During Estrogen–Gestagen Treatment
Authors: Felding Christine , Mikkelsen Anne Lis , Birch Carsten D.
Published: December 2009

Changes in 24‐hour excretion of unconjugated urinary cortisol and creatinine clearance were determined in 9 normally menstruating women and in 9 women undergoing estrogen–gestagen treatment on 3 consecutive days. A correlation between the cortisol excretion and the creatinine clearance was found only in the luteal phase of the menstrual cycle. the cortisol excretion increased neither during the menstrual cycle nor during the estrogen–gestagen treatment. A marked intra‐individual variation in the excretion of unconjugated urinary cortisol was demonstrated in both groups.
Blood Pressure and Renal Function During Normal Pregnancy
Authors: Wichman Klas , Rydén Gunnar
Published: December 2009

In order to obtain reference values during normal pregnancy 24 women with strict criteria for health and normal pregnancy were studied. Greatest interest was focused on blood pressure (BP) measurements and renal function tests. Investigations were made in early second trimester and in the 30th, 33rd and 36th gestational weeks. Gestational age was estimated by ultrasound measurement of crown‐rump length before the 14th gestational week. Both systolic and diastolic BP measured in the right arm were about 10 mmHg lower in the left lateral position than when supine or standing. the difference is suggested to be dependent on hydrostatic factors. Diastolic BP should be defined at the fourth phase of the Korotkoff sounds in order to be reliable because of the common phenomenon of late or non‐disappearance of the sounds during pregnancy. Diastolic BP in phase IV increased in up to 25% of the cases with 15 mmHg or more from early second trimester to the 36th gestational week in all three positions. Serum creatinine concentration was low in early second trimester and did not change during pregnancy, while serum urea decreased and serum urate increased during pregnancy. the results emphasize the importance of using reference values from a normal pregnant population obtained at different gestational weeks for comparison in studies on certain pathological conditions during pregnancy, especially pre‐eclampsia.
Normal Range Growth Curves for Fetal Biparietal Diameter, Occipito Frontal Diameter, Mean Abdominal Diameters and Femur Length
Authors: Persson P‐H. , Weldner B‐M.
Published: December 2009

Normal range curves for the growth of fetal biparietal diameter (BPD), occipitofrontal diameter (OFD), mean abdominal diameter (AD), and femur length (FL) were obtained in a longitudinal series of ultrasound measurements in 19 normal pregnancies. Regression analysis was used to fit the data to equations. The best equations for BPD and AD on gestational are close to similar longitudinally obtained regression curves from other Scandinavian countries.