bluuebunny/crossref_metadata_2025 huggingface dataset:
Venous Muscle Pump Function During Pregnancy: Assessment by Ambulatory Strain‐gauge Plethysmography
Authors: Struckmann Jan R. , Meiland Hanne , Bagi Per , Juul‐Jørgensen Birgit
Published: November 2007

The venous muscle pump function was quantitatively assessed through pregnancy weeks 16, 30, 38 and 3 months (week 53) following delivery, in 24 pregnant women who completed a normal pregnancy. A statistically significant increase was found in the mean venous reflux (P<0 01), which was restored to initial values postpartum. Expelled calf volume remained stable throughout pregnancy but increased following delivery. Venous outflow from the legs was significantly reduced in the third trimester. Subjective symptoms of venous insufficiency increased trough pregnancy, but, these symptoms had virtually disappeared post partum, corresponding to the muscle pump normalization. No statistical correlation was found between venous muscle pump values and changes in hormone concentrations of estradiol, estriol and progesterone. It is suggested that venous insufficiency development in pregnancy is caused primarily by mechanical obstruction, or hormonal influence other than that of etradiol, estriol or progesterone.

17% (4.7–37%) of the women with a normal pregnancy developed a pathological venous muscle pump function.
Effects of Intravenous Terbutaline on Maternal Circulation and Fetal Heart Activity
Authors: Roth Anders Cson , Milsom Ian , Forssman Lars , Ekman Lars‐Goran , Hedner Thomas
Published: November 2007

The effects of terbutaline on maternal circulation and fetal heart activity were studied in 15 healthy pregnant women admitted for external cephalic version. The two‐step infusion of terbutaline (5–10 μg/min) resulted in increases in maternal heart rate (p< 0.001 1, cardiac output (p < 0.001), systolic arterial pressure (p < 0.001) and pulse pressure (p <0.001 1, while diastolic arterial pressure (p < 0.001) and total peripheral vascular resistance (p< 0.001) were reduced. Mean arterial pressure was unchanged after the infusion. Fetal heart activity assessed by cardiotocography showed a gradual increase in baseline fetal heart rate (p < 0.01) and an increased percentage acceleration time (p< 0.05). Fetal movements also increased during the infusion (p < 0.05). The terbutaline infusion had a positive inotropic effect and produced decreased systemic vascular resistance in the pregnant woman, and placental transfer of the drug resulted in increased fetal heart activity. The potential influence of the drug‐induced changes in maternal hemodynamics on utero‐placental perfusion require further investigation.
Prevention of Breast Pain and Milk Secretion with Bromocriptine After Second‐Trimester Abortion
Authors: Andersen Anders Nyboe , Damm Peter , Tabor Ann , Pedersen Inger Maria , Harring Mette
Published: November 2007

Within 24 hours after abortion, 62 patients with a mean gestational age of 19 weeks, who had either induced (n = 50) or spontaneous (n = 12) abortions were randomly allocated to three groups: Group 1, bromocriptine 2.5 mg twice daily for 2 weeks; Group 2, placebo tablets 1 tablet twice daily for 2 weeks; Group 3, o treatment. Fifty‐two patients completed the study (bromocriptine n = 18, placebo n = 18 and no treatment n = 16). Placebo had no apparent influence on breast symptoms. In both the placebo group and the untreated group, breast pain and milk secretion peaked on days 3 to 7, and milk secretion often continued for 3 weeks. Only 3/34 (9%) of untreated and placebo treated patients were free of breast symptoms. Compared with placebo, bromocriptine caused a significant reduction in the objective assessment score of breast tenderness (p < 0.05) and milk secretion (p < 0.011, in serum prolactin (PRL) (p < 0.001) and in the subjective assessment score of breast pain (p < 0.01) and milk secretion (p < 0.01). Alleviation of breast pain and prevention of milk secretion appears to be indicated after second‐trimester abortion, and treatment with bromocriptine is efficacious.
Ovarian Metastatic Carcinoma Presenting as A Primary Cervical Carcinoma
Authors: Danielian Peter J.
Published: November 2007

A case of an ovarian carcinoma presenting as a primary cervical carcinoma is described. Although a rare event, this must be considered whenever the clinical or histological findings are unusual. The importance of careful histological review of all specimens in cases such as this is emphasized.
Summary of Doctoral Thesis
Authors: Suikkari Anne‐Maria
Published: November 2007

Insulin‐like growth factors (IGF‐I and IGF‐II), or somatomedins, are small polypeptides structurally related to insulin. IGFs exert insulin‐like, differ‐entiative and mitogenic actions on their target tissues (1). Several, if not all, human fetal and adult tissues produce IGFs, as evidenced by studies on the IGF content of tissue extracts and expression of IGF messenger ribonucleic acid (mRNA) (2,3). Many tissues and cell lines possess IGF receptors, through which IGFs exert their biological actions (4). Serum and tissue contents of IGF‐I, and to a lesser extent IGF‐II, are regulated by GH, nutritional status, age and other factors (5). Thus IGFs are thought to act both in endocrine and locally in an autocrine or paracrine manner.
Perinatal Mortality in a Swedish County 1980–1984: Mortality Pattern and its Amenability
Authors: Högberg Ulf , Wall Stig , Wiklund Dan‐Erik
Published: November 2007

A retrospective, community based study on perinatal mortality was performed in a sparsely populated county with decentralized antenatal and maternity care. Neither level of care nor domicile showed any relation to perinatal mortality. A substantial underreporting of perinatal deaths was revealed. Death causes were classified according to the modified Aberdeen classification. One child per 2,000 births is stillborn due to asphyxia during delivery. Maternal age outside the optimal age range for reproduction was a significant risk factor. A suboptimal standard of care was identified in 33% of the perinatal deaths.
Risk Determinants of Perinatal Mortality in A Swedish County, 1980‐1984
Authors: Högberg Ulf , Wall Stig , Wiklund Dan‐Erik
Published: November 2007

A retrospective case‐referent study was performed to analyse risk factors of perinatal mortality. Overweight defined by body mass index, smoking > 10 cigs/day, infertility, earlier low birth weight, earlier perinatal death were significant risk determinants of the obstetric history. Overweight and smoking, measured by the etiologic fractions, had the greatest impact on perinatal mortality. Significant risk factors of the present pregnancy were low weight gain, pre‐eclampsia, cervical incompetence, and late hemorrhage. Intra‐uterine growth retardation had the highest etiologic fraction. High risk assessment at the first antenatal visit had a sensitivity of 45%, increasing to 72% when adding supervening pregnancy complications. Although the positive predictive value of high‐risk classification was very low, % of the perinatal deaths occurred among high‐risk cases.
Can Pregnancy‐Associated Plasma Protein A (Papp‐A) Predict the Outcome of Pregnancy in Women with Threatened Abortion and Confirmed Fetal Viability?
Authors: Ruge Susanne , Pedersen Jan Fog , SøSrensen Steen , Lange Aksel P.
Published: November 2007

Depressed pregnancy‐associated plasma protein A (PAPP‐A) concentrations have been found in patients with threatened abortion, often weeks before spontaneous abortion while the fetus was still alive. In order to extend these findings we have developed a highly sensitive PAPP‐A radio‐immunoassay and have established a reference range in early pregnancy for PAPP‐A between week 7 and week 20 of pregnancy, based on blood samples from 240 pregnant women. The gestational age was determined by ultrasound.

PAPP‐A was measured in 128 women admitted to hospital because of vaginal bleeding in the 7th to 20th gestational week. The viability of the fetus was confirmed by ultrasonography. The serum values of PAPP‐A were significantly lower (p = 0.002) in the group of women with vaginal bleeding than in the group of normally pregnant women. However, with regard to abortion later on, the predictive value of an abnormal blood test on admission was only 18.7%. Serial determinations showed increased PAPP‐A values corresponding to the centile expected in the 12 women who aborted, as well as in the 116 women who gave birth. Consequently, the test is of no clinical value in the assessment of the prognosis in patients with symptoms of threatened abortion.
Changes in β‐Endorphin in Fetal Membranes and Placenta in Normal and Pathological Pregnancies
Authors: Facchinetti Fabio , Garuti Giancarlo , Petraglia Felice , Mercantini Franco , Genazzani Andrea R.
Published: November 2007

Several studies indicated that trophoblast tissue syntetizes pro‐opiome‐lanocortin‐related peptides. These peptides are also present in amniotic fluid, but their origin remains unknown. The present study evaluated the presence of and the possible changes in p‐endorphin (β‐EP) in amnion and chorion during pregnancy, at parturition and in spontaneous abortion. Amnion, chorion and placental tissues were isolated and homogenized from a total of 46 pregnant women between 4th and 42th week of pregnancy. fi‐EP was separated on a Sephadex G‐75 column and measured by RIA with specific antiserum. The identity of the endogenous opioid with its corresponding reference molecule was confirmed by high performance liquid chromatography. In all tissues, the concentration of β‐EP in the first trimester was significantly higher than in the second trimester. A negative correlation between opioid levels and gestational age was observed in the first two trimesters. At delivery, the β‐EP content of all tissues was greater than in the second trimester. In tissues collected at term, in the absence of labor, p‐EP levels were very low in comparison with those collected after vaginal delivery. Low β‐EP contents were found in membranes collected from spontaneous abortion in 1st trimester. From these data one can surmise the existence of a local endogenous opioid system in fetal adnexes. This system seems sensitive to the stress of vaginal delivery and could be involved in the mechanisms leading to spontaneous abortion.
A Case Report and Review of the Literature: Aortic Valve Replacement During Pregnancy
Authors: Ben‐Ami M. , Battino S. , Rosenfeld T. , Marin G. , Shalev E.
Published: November 2007

Aortic stenosis (AS) is an uncommon complication during pregnancy, but when it occurs it results in significant maternal and fetal morbidity and mortality. We present a gravida with severe AS in which aortic valve replacement was performed in the 3rd trimester of her pregnancy. She had severe AS with mild aortic regurgitation and severe congestive heart failure. Fetal heart rate and uterine activity were monitored and recorded during the operation. The pregnancy was carried uneventfully to term and the patient was delivered of a healthy baby. The literature is reviewed and recommendations are made for the management of AS during pregnancy.
Carcinoma of the Cervix in A Pregnant Woman with Negative Pap Smears and Colposcopic Examination
Authors: Bakri Younes N. , Akhtar Mohammed , Al‐Amri Aladin
Published: November 2007

A case is reported of squamous cell carcinoma of the cervix developing in a pregnant woman while manifesting five consecutive false‐negative Pap smears and colposcopic appearance suggestive of dysplasia. Pap smears and colposcopic examinations are helpful in diagnosing dysplastic and early cancerous lesions of the uterine cervix. We describe a case where both Pap smears and colposcopy failed to diagnose an early occult invasive lesion in the cervix of a pregnant woman who manifested only CINIII by colposcopy, while the Pap smear was falsely negative on five consecutive occasions.
Unexpected Survival After Conservative Management of Cord Prolapse in Two Very Preterm Babies
Authors: Jacobsen Thorkild , Madsen Hans
Published: November 2007

Two very preterm infants (24 and 25 weeks) were born vaginally in spite of prolapse of the umbilical cord. The prolapses lasted 45 min and 2 h, respectively, but though both babies were at first believed to be lost, they survived, only mild to moderate asphyxia, and both were discharged well. One of the babies later developed slight neurological sequelae. Even a very preterm baby has the possibility of surviving vaginal delivery complicated by cord prolapse.
Early Detection of Primary Carcinoma of the Fallopian Tube by Endovaginal Ultrasound
Authors: Granberg Seth , Jansson Inge
Published: November 2007

About 0.5% of all gynecological malignancies in Sweden are primary fallopian tube carcinomas. Early diagnosis is difficult due to the paucity of symptoms. However, the diagnosis should be entertained in the presence of abnormal vaginal bleeding not explained by gynaecological examination and biopsy of the cervix and endometrium. The possibility of tubal carcinoma should be considered in patients with persistent vaginal discharge and lower abdominal pain without apparent explanation. An early case of fallopian tube carcinoma detected by endovaginal ultrasound is described.
Evaluation of symphysis‐fundus measurements and weighing during pregnancy
Authors: Jensen Odd Harald , Larsen Stig
Published: November 2007

To evaluate the value of using symphysis‐fundus (SF) distance and maternal weight gain measurements in predicting an infant's birth weight, these measurements were analysed in 831 single‐birth deliveries at Aker University Hospital during a period of 3 months. Of the 96 babies with a birth weight below the 10th percentile for gestational age, 39 (41%) could be detected by a series of SF‐measurements. For every third correctly identified SGA (small for gestational age) baby, there were 7 false positive predictions. Only 13 (14%) of the mothers who gave birth to SGA babies demonstrated a weight gain at each medical check‐up during pregnancy, whereas 197 (30%) of the women giving birth to normal‐weight babies showed a weight gain each time(p= 0.02). However, for maternal weight gain, both predictive value (14%) and specificity (29%) were low. Hence, these two screening methods for the dectection of SGA babies remain imprecise in practice. Test procedures should be improved, and factors influencing fetal growth should be emphasized to detect fetuses at risk.
The impact of low back and pelvic pain in pregnancy on the pregnancy outcome
Authors: Oätgaard Hans C. , Andersson Gunnar B. J. , Wennergren Margareta
Published: November 2007

The prevalence and characteristics of back pain were recorded in 855 women on nine occasions during pregnancy from the 12th to the 36th week of gestation. Data on delivery and pain relief were recorded. At 12 months post partum the women were reassessed regarding the presence of back pain. Women with a history of back pain had more intense pain(p< 0.05). No correlation was observed between back pain (a) during pregnancy and (b) after pregnancy and delivery, nor between (a) the need for pain relief in labor and (b) birth weight, length and Apgar score. Back pain usually disappeared in the first 6 months post partum, except in women with recurrent back pain from previous pregnancies. Eighty‐two percent of these women continued to have back pain at 18 months post partum, compared with 45% of all other multi‐parous women (p< 0.001).
Maternal factors associated with high birth weight
Authors: Wikström Ingrid , Axelsson Ove , Bergström Reinhold
Published: November 2007

Maternal characteristics associated with high birth weight were studied in 473 mothers delivered of singleton infants at term with a birth weight of 4500 g or more. The controls were mothers who gave birth to singleton infants at term, with a normal birth weight ± 1 SD for Swedish newborns. In the multivariate analysis the maximum symphysis‐fundus height measurement and gestational duration were strongly significant (p < 0.001), after correction for other variables, for the probability of being delivered of an infant of high birth weight. Maternal height, weight at beginning of pregnancy, total gestational weight increase and previous live birth of an infant weighing ≥ 4500 g were also important (p < 0.05) for high birth weight. The maternal characteristics included were evaluated in a prognostic model. With symphysis‐fundus height measurement included, the sensitivity increased from 80.3 to 83.3% and specificity from 78.8 to 85.6%, compared with a model where symphysis‐fundus measurement was not available.
Treatment of candidal vaginitis: A prospective randomized investigator‐blind multicenter study comparing topically applied econazole with oral fluconazole
Authors: Osser S. , Haglund A. , Weström L. , Aspl L. , Beckman‐Ramirez L.A. , Colling‐Saltin A.S. , Hajman A. , Herbstman M. , Herman M. , Jäderling J. , Kjellberg S. , Krohn K. , Nilsson B. , Sjöoberg I. , Svensson I. , Wird L.K. , Zacco S. , Berg A‐Son
Published: November 2007

Twohundred and thirty‐five women with clinically and microbiologically proven candidal vaginitis were randomly allocated for treatment with either one topically applied vaginal tablet of 150 mg econazole (114 women) or one orally administered capsule of 150 mg fluconazole (121 women). The women returned for follow‐up visits 7–10, 28–35, and 80‐100 days after the recruitment visit. Women with clinical and/or mycological failures and/or a recurrence were successively excluded from the follow‐up. At the 28‐35‐day follow‐up visit, the women treated with fluconazole had a significantly higher clinical/microbiological cure rate than those given econazole (P=0.022; Fisher's exact 2‐tail test). No significant such differences were observed at the 7‐10 and the 80‐100‐day follow‐up visits, although fluconazole tended to be more efficacious. Nine women administered fluconazole, and 2 women given econazole reported minor systemic side effects of the treatment. Three women out of 4 preferred oral to local therapy of candidal vaginitis.
Survival of chlamydiae in human semen prepared for artificial insemination by donor
Authors: Thorsen Poul , Møller Birger R. , Halkier‐Sørensen Lars , From Ellis , Nielsen Niels Christian
Published: November 2007

Semen specimens from 21 men with urethral infection with Chlamydia trachomatis were tested for the presence of the organism before and after cryopreservation for 3 weeks of storage at −196°C. Five specimens were chlamydia‐positive before preservation and four of them were still positive after storage when examined by enzyme immunoassay (Chlamydiazyme). When examined by cell culture, four proved chlamydia‐ positive before storage and two afterwards. The results indicate that testing for C. trachomatis has to be performed from the urethra of all donors of semen used for artificial insemination before the inoculation takes place.
Is diathermy safe in women with copper‐bearing IUDs?
Authors: Heick Alex , Espersen Thorkild , Pedersen Henrik Lauge , Raahauge Jytte
Published: November 2007

Ultrasound and short‐wave diathermy are widely used in physiotherapy to induce heating of deep tissues, since this causes a concomitant increase in local blood flow. A metallic implant in the treated field is generally regarded as a contra‐indication to diathermy because at the risk of thermodamage to surrounding tissues. It is not certain, however, if copperbearing IUDs contain sufficient metal as to constitute a risk. In order to exclude the possibility that diathermy might lead to intra‐uterine burns in women using copper‐bearing IUDs a technique was devised at measuring temperatures in the copper wire of an IUD in situ during short‐wave an ultrasonic therapy. The results indicate diathermy to be perfectly safe in women whit copper‐bearing IUDs.
Neither exogenous nor endogenous GnRH stimulation alters the bio/immuno ratio of serum LH in healthy women and in polycystic ovarian disease
Authors: Ding Ying‐Qing , Anttila Leena , Ruutiainen Kristiina , Erkkola Risto , Irjala Kerttu , Huhtaniemi Ilpo
Published: November 2007

The purpose of this study was to re‐evaluate the quantitative and qualitative responses of LH to exogenous and endogenous GnRH stimulation in normally cycling women and in polycystic ovarian disease (PCOD). Responses of serum LH to GnRH (100g i.v.) and the opioid antagonist naloxone (10 mg i.v.) were determined in healthy women in the early (n = 5) and late (n = 4) follicular phase, and in patients with PCOD (n = 20). Serum bioactive (B) LH was determined by a mouse interstitial cell in vitro bioassay, and immunoreactive LH by a conventional RIA (I‐LH) and a novel sensitive (0.05 IU/I) and specific immunofluorimetric assay (F‐LH). The B/I (2.4 ± 0.1) and B/F (2.7 ± 0.6) ratios in basal serum samples of the PCOD patients were significantly higher (p < 0.05) than the corresponding ratios (1.6‐1.8 and 1.8‐2.0) of the control women. GnRH stimulated the secretion of I‐LH (2‐4‐fold), F‐LH and B‐LH (3‐5‐fold each) in all groups studied. There were no apparent changes of the BII and BIF ratios in normal women during early follicular phase or in patients with PCOD. However, the normal women during late follicular phase displayed a significant (pCO.05) increase in the BII ratio, albeit no change was found in the BIF ratio. During naloxone‐induced endogenous GnRH responses, the control women during late follicular phase showed a %‐fold increase in B‐LH, I‐LH and F‐LH, with unchanged B/I and B/F ratios. No LH responses to naloxone were found in normal women during early follicular phase or in patients with PCOD. We conclude that, hy utilizing an immunofluorimetric assay, the basally elevated biohmmuno ratio of LH could be confirmed in PCOD patients. However, there were no qualitative changes in LH during the response to GnRH stimulation in normal women or in PCOD.
A case of hepatocellular carcinoma in pregnancy detected by routine screening of maternal alpha‐feto‐protein
Authors: Goldberg Isaac , Hod Moshe , Katz Ian , Friedman Shmuel , Ovadia Jardena
Published: November 2007

A rare case of hepatocellular carcinoma in a 31‐year‐old woman is reported. The diagnosis was made at 16 weeks of pregnancy when very high levels of alpha‐feto‐protein were found upon routine examination. The pregnancy was terminated and cytostatic therapy was given. The patient died one year later.
Differences in Vasomotor Responses Between Main Stem and Smaller Branches of the Human Uterine Artery
Authors: Ekström Per , Alm Per , Åkerlund Mats
Published: November 2007

Specimens of the human uterine artery and its branches were taken at hysterectomy. By microscopical dissection, three groups of arteries were obtained with respect to size ‐main stem, medium and small branches (inner diameters of >1, 0.6‐0.8 and <0.4 mm, respectively). The contractile effects of different vasoactive substances were studied and the responses expressed as percentages of that of K±‐depolarization calculated. The most potent vasoconstrictor (the lowest EC50 concentration) was arginine vasopressin (AVP) followed in order by endothelin, oxytocin, prostaglandin (PG)F2α, noradrenalin and dopamine. Angiotensin had inconsistent effects. Atrial natriuretic peptide (ANP) counteracted the contractile effects of endothelin. AVP, endothelin, oxytocin and noradrenalin were significantly more potent on the smallest branches than on the main stem of the artery. Since the former type of vessel represents resistance arteries, the present results suggest that AVP, endothelin, oxytocin and noradrenalin could be of specific importance in the regulation of uterine blood flow. PGF2α, dopamine and angiotensin appear to be of minor importance from this aspect but ANP could play a role by regulating the effects of endothelin.
International collaborative effort (ICE) on birth weight, plurality, perinatal, and infant mortality: IV. Differences in obstetrical delivery practice: Norway, Scotland and the United States
Authors: Notzon Francis C. , Bergsjø Per , Cole Susan , Irgens Lorentz M. , Daltveit Anne Kjersti
Published: November 2007

We have carried out a comparative study on differences in operative obstetrical practice during the 1970s and 1980s, in Norway, Scotland and the United States of America. It was based on information from official sources in each country. We compared rates of cesarean section (CS) and operative vaginal delivery according to maternal age, parity and gestational age at delivery, birthweight, fetal presentation, and other characteristics of the child, indications for operative delivery, and hospital size and teaching status. While all three countries had rising CS rates, the Scottish rates, which lay between those of the U.S.A. and Norway, rose more slowly than in the latter. In 1985, the rates were 22.8% in the U.S.A., 13.5% in Scotland and 12.0% in Norway. Use of forceps and vacuum extractor declined in the U.S.A. and Scotland, but increased in Norway. CS rates in mothers aged 35 and over were uniformly high in 1970 and rose relatively little. Specific CS rates for very low birthweight children, breech presentation and twins rose to 30‐50% in all three countries with some national trend differences. Rate ratios of operative delivery between large and small hospitals fell from about 2‐3 in the 1970s to approximately 1.5 in 1985, least markedly in Scotland. The impact of previous CS as an indication for CS cannot be resolved because of notification and recording differences.
Treatment of hyperthyroidism in pregnancy
Authors: Sherif Ibrahim H. , Oyan Win Tin , Bosairi Soad , Carrascal Sylvia Moran
Published: November 2007

One hundred and five consecutive pregnancies in 79 women affected by hyperthyroidism were observed during an 8‐year period. AH had received treatment either with carbimazole alone (Group I) or with the combination of carbimazole and propranolol (Group II). There were 72 pregnancies in Group I, 33 in Group II. Seventy‐five pregnancies occurred whilst the mother was receiving antithyroid therapy and in the other 30 the diagnosis of hyperthyroidism was made following conception. The total fetal loss was 17.1%, with a spontaneous abortion rate of 5.5% in Group I and 24.2% in Group II. No congenital malformation or maternal deaths occurred. Carbimazole is safe and effective during pregnancy. Adding propranolol offers no further advantage and may indeed be detrimental.
A circadian variation in the observed duration of labor
Authors: Backe Bjørn
Published: November 2007

The distribution of the duration of labor during the day was analyzed.

Material A one‐year material consisting of 1,881 deliveries at the Department of Obstetrics, Regional Hospital of Trondheim, Norway. Only singleton pregnancies with spontaneous onset of contractions and intended vaginal delivery were included. Duration of labor was routinely recorded by the midwife.

Methods Stepwise multiple regression. Logarithmic transformation of the dependant variable (duration measured in hours) was applied. Parity (0/1±) and hour of birth were the independent variables.

This reflects a clustering of cases with longer duration of labor, unfavourable progress and less good prognosis during the latter half of the day, which has practical implications for the obstetrical staff. This may explain the similiar circadian pattern in perinatal mortality which has been repeatedly documented, the etiology of which has remained enigmatic.
Vaginal bromocriptine in hyperprolactinemic patients and puerperal women
Authors: Jasonni Valerio Maria , Raffelli Roberta , De March Adelina , Frank Giorgio , Flamigni Carlo
Published: November 2007

Fifteen hyperprolactinemic and 7 puerperal women were treated with bromocriptine per vaginam (2.5‐5 mg) because of absolute intolerance to the oral administration of this drug. In both groups the prolactinemia was normalized without the typical side effects of bromocriptine. Three patients reported vaginal burning, but only one discontinued the therapy because of the intensity of the symptom. This study suggests that vaginal bromocriptine should be considered as a useful alternative for the treatment of hyperprolactinemia.
Failure to predict and attempts to explain urinary stress incontinence following vaginal repair in continent women by using a modified lateral urethrocystography
Authors: Borstad Ellen , Skrede Margit , Rud Torkel
Published: November 2007

Of continent women undergoing the Manchester procedure for genito‐urinary prolapse, about 25% develop urinary stress‐incontinence. In order to study whether this is due to pre‐existing anatomical factors or to the surgical procedure itself, a prospective study was set up. Fifty‐eight continent women operated on for genito‐urinary prolapse, underwent urethrocystography prior to and 3 months following surgery. Sixteen of the 58 (28%) developed stress‐incontinence following the operation. Radiological parameters preoperatively were of little help in distinguishing the patients developing incontinence from those remaining continent. The stress‐incontinence following a Manchester procedure for genital prolapse seems to depend on two surgical factors: an insufficient elevation of the bladder‐neck and a radical reduction of the cystocele. A parameter combining the two factors: the percentage reduction of the cystocele minus the percentage elevation of the bladder‐neck, was significantly lower in women remaining continent than in those who developed stress‐incontinence.
Endothelin—a potent constrictor of small myometrial arteries of term pregnant women
Authors: Lindblom Bo , Lundberg Jan M. , Lunell Nils‐Olov , Nisell Henry , Norén Hakan , Wolff Kerstin
Published: November 2007

This study was performed to evaluate the in vitro effects of a new polypeptide, endothelin‐1 (ET‐1) on small intramyometrial vessels in comparison with the action of noradrenalin (NA). In connection with cesarean section, myometrial biopsies were obtained and small arteries (100–500 um in diameter) were excised. Cylindrical segments of these vessels were used for registration of contractile activity after administration of ET‐1 and NA. ET produced vasoconstriction and was approximately three times as powerful and 70‐fold as potent as NA. It is suggested that ET may be involved in the regulation of human utero‐placental blood flow.
Prediction of fetal outcome by Doppler examination and by the non‐stress test
Authors: Rognerud Jensen Odd H. , Guimaraes Mirian S.
Published: November 2007

Ninety‐tour women with high‐risk pregnancies were referred to the Aker University Hospital, Department of Obstetrics, and monitored by Doppler velocimetry and conventional cardiotocography. The peak systolic/end diastolic (A/B) ratio was measured in the velocity waveform obtained in the umbilical artery blood flow. The non‐stress test (NST) was classified according to the Fischer scores. In this mixed group of high‐risk pregnancies, the sensitivity of the A/B ratio to predict fetal growth retardation was 71%, predictive value 57% and specificity 77%. The corresponding values for NST were 39%, 65% and 90%. It is concluded that Doppler velocimetry is more sensitive than cardiotocography for identifying fetal growth retardation. In an attempt to further improve the detection rate of fetal pathology, the cases with abnormal NST scores were added to those with high A/B ratios and collectively defined as abnormal. In consequence, only an insignificant improvement in sensitivity (79%) could be achieved. When the A/B ratio is normal, there seems little justification for expending time, effort and resources in routine use of cardiotocography.
Evaluation of fetal and neonatal mortality at the University Hospital of Tromsø, Norway, from 1976 to 1989
Authors: Berge Lillian Nordbø , Rasmussen Svein , Dahl Lauritz Bredrup
Published: November 2007

To investigate developments in perinatal care, all fetal and neonatal deaths among those born after at least 24 weeks of gestation at the University Hospital of Tromsø, Norway from 1976 to 1989, were subjected to medical audit. A decrease in total mortality rate was found when based on maturity (≥24 weeks; 19.9–13.4%; p<0.01), and/or birth weight (≥500 g; 19.2–13.4%; p<0.05). This was mainly due to a decrease in fetal deaths (14.8–6.6%; p<0.0001). Deaths during labor (5.4–1.1%; p<0.001), and deaths before the onset of labour (9.4–5.5%; p<0.05) declined. The neonatal death rate remained virtually constant (5.2–6.8%). The incidence of conditions affecting the placenta and the umbilical cord, causing asphyxia and intra‐uterine growth retardation, declined, from 9.2 to 5.0% (p<0.01), as did that caused by immaturity (2.8–1.3%; p<0.05). The rates of death caused by cerebral hemorrhage, respiratory distress syndrome, infections, and malformations did not change. There was no significant proportional change in the causes of death from the first to the last period. The rate of fetal death following suboptimal care declined (2.4–0.4%; p<0.01), while the corresponding neonatal death rate remained unchanged (0.9–1.1%). The proportions of both fetal and neonatal deaths occurring after suboptimal care were low (fetal: 16.2, 8.8, and 5.6%; neonatal: 17.1, 23.5, and 16.2%). These differences did not reach statistical significance. The ratio of neonatal to fetal deaths increased from the first (26.1%) to the last period (50.7%; p<0.01), due mainly to a significant shift from fetal to neonatal death among those weighing 500–999 g (19.6–56.0%; p<0.01). It is concluded that prophylactic efforts to avoid preterm birth and IUGR, and further therapeutic efforts in neonatal intensive care are needed to bring down mortality rates at our hospital in the future.
Smoking cessation in pregnancy Mode of intervention and effect
Authors: Valbo Annelill , Schioldborg Per
Published: November 2007

Three groups (n = 50 each) of pregnant smokers wanting to quit the habit were assigned to three different intervention programs around their 18th week in pregnancy. Group 1 participated in a smoking cessation program offering several self‐help methods; group 2 attended a doctor's information meeting at the hospital; and group 3 received a pamphlet on the deleterious effects of smoking in pregnancy. For Group 4, the control group, there was no intervention. In all three intervention groups, more than one‐third reduced their smoking to almost half, while 38% quit altogether in group 1, compared with less than 10% in groups 2 and 3. Twelve months later, 16%, 6% and 8% respectively, remained abstinent in the three groups. In groups 2 and 3, abstinence proved to be of the same magnitude as in the control group. We conclude that smoking in pregnancy, being one of the few amenable to risk factors affecting the perinatal death statistics, demands an active smoking cessation program during pregnancy led by specially trained health professionals.
Oxytocin or saline injected intra‐umbilically did not influence the third stage of labor
Authors: Bider David , Zolti Mati , Menashe Yehezkeal , Dulitzky Mordechai , Mashiach Shlomo , Ben‐Rafael Zion
Published: November 2007

The injection of varying volumes of normal saline solution, alone or with oxytocin, into the umbilical vein immediately after delivery was studied in 125 normal women delivered at term. Thirty seconds after cord clamping, either 20 ml (group 1, n = 25 women), 30 ml (group 2, n = 25) or 40 ml (group 3, n = 25) of normal saline solution alone, or oxytocin 10 units in 20 ml saline solution (group 4, n = 25) or ozytoxin 10 units in 40 ml saline solution (group 5, n = 25) were injected into the umbilical vein 1 cm from the introitus just proximal to the umbilical clamp. The mean (± SD) duration of placental expulsion was similar in the five study groups. We conclude that neither the volume of the solution nor the oxytocin injected intra‐mumbilically has any effect on the duration of the third stage of normal labor.
Ultrasonically guided retrieval of occult IUD in early pregnancy
Authors: Sviggum Oddvar , Skjeldestad Finn Egil , Tuveng Jon Morten
Published: November 2007

The risk of spontaneous abortion and intra‐uterine infections in pregnancies associated with an intra‐uterine conceptive device (IUD) is well documented. There is a general agreement regarding the desirability of removing the IUD as soon as the pregnancy is diagnosed. When the string is not visible, the proper management is controversial. This study reports the successful retrieval of occult IUD in early pregnancy under ultrasonic guidance in 8 out of 9 women. In the one case where we failed to remove the IUD, the women chose to terminate the pregnancy by legal abortion. Seven women completed their pregnancy, while one experienced a spontaneous abortion. We consider the removal of the occult IUD in pregnancy under ultrasonic guidance to be a useful procedure.
Psychotic exacerbation attributed to low‐dose bromocriptine treatment of galactorrhea and hyperprolactinemia
Authors: Dorevitch Abraham , Aronzon Rami , Stark Michael
Published: November 2007

Low‐dose bromocriptine administered for antipsychotic drug‐induced hyperprolactinemia and galactorrhea precipitated an acute psychotic state in a female patient. Discontinuation of the bromocriptine and increase in antipsychotic dosage resulted in complete remission. We advise caution in the use of bromocriptine especially in patients with a pre‐existing psychiatric history and recommend monitoring for changes in mental status when bromocriptine is prescribed.
Doppler Ultrasound Assessment of Endometrial Pathology
Authors: Mercé L. T. , Garcia G. Lopez , De la Fuente F.
Published: November 2007

In forty‐five metrorrhagic patients, transvaginal Doppler ultrasound examinations were performed in order to test the correlation between the modified resistance index (RI) of the uterine and intramyometrial arteries and the histopathologic findings. Uterine volume (UV) and endometrial thickness (ET) were studied. The results were compared with 19 otherwise normal patients. UV and ET were found increased in metrorrhagic patients with abnormal histopathology. These showed a significant decrease in intramyometrial RI (66.7 ± 15.9) and uterine RI (79.6 ± 9.4) compared with a control group (intramyometrial RI: 78.8 ± 16; uterine RI: 87.8 ± 9.4). Uterine resistance was significantly greater in patients with normal histopathology (intramyometrial RI: 94.2 ± 13.2; uterine RI: 89.1 ± 9.3). Only three false‐positive and three false‐negative results were found upon analysing the predictive accuracy of intramyometrial Doppler examinations. However, the uterine resistance index was less specific. Although transvaginal Doppler velocimetry cannot replace histopathologic diagnosis, it does provide a high prognostic precision in cases of metrorrhagia.
Pregnancy Complications and Short‐Term Follow‐Up of Infants Born After in Vitro Fertilization and Embryo Transfer (IVF/ET)
Authors: Wennerholm U.‐B. , Janson P. O. , Wennergren M. , Kjellmer I.
Published: November 2007

Two hundred and six pregnancies occurring after in vitro fertilization (IVF) and embryo transfer (ET) during a 7‐year period in Goteborg were analysed with respect to pregnancy outcome. The clinical abortion rate was 26%, the rate of ectopic pregnancy was 10%, the rate of ongoing pregnancies beyond 24 weeks was 15%, and the rate of deliveries was 49% (n = 100). The hospital records of 98 women with the 100 deliveries resulting in 131 infants were studied. Multiple pregnancy occurred in 27%, including one quadruplet and two triplet pregnancies. Preterm birth occurred in 30% of all pregnancies and in 20% of singleton pregnancies. Thirty‐four percent of the infants had a birth weight of less than 2500 g. The perinatal mortality was 46/1000, as estimated from the 24th week of pregnancy. The incidence of major malformation, 2.3%, was similar to that reported from studies in the general population. The first 100 infants born were followed up for 18 months to 8 years. Long‐term sequelae were associated with immaturity and low birth weight. No problems during follow‐up were disclosed in children who had had an uneventful neonatal period. It is concluded that IVF pregnancies are an obstetric risk group requiring special attention
Risk Factors in Ectopic Pregnancy Results of A Population‐Based Case‐Control Study
Authors: Nordenskjöld Fredrik , Ahlgren Mats
Published: November 2007

In a population‐based case‐control study, possible risk factors for ectopic pregnancy were compared in 119 patients with ectopic pregnancy and in 119 age‐matched controls with intra‐uterine pregnancy from each of the following categories: deliveries, spontaneous abortions and induced abortions. The following factors were found significantly more often in cases of ectopic pregnancy: a history of earlier ectopic pregnancy, a history of salpingitis, a history of earlier operation on the Fallopian tubes, a history of infertility, and a pregnancy that had occurred in spite of an intra‐uterine contraceptive device. A history of appendectomy was also found significantly more often among the cases. There was no significant correlation between ectopic pregnancy and a history of no earlier pregnancy, earlier deliveries, earlier spontaneous or induced abortions or a history of other gynecological operations and increased risk of ectopic pregnancy. One or more of the risk factors were found in 76.5% of cases and 23% of controls.
Appendectomy and Carcinoma Ovarii Cytoreduction, Palliation, or Simple Tradition?
Authors: Corfitsen Mogens Thyge , Pedersen Inga R. , Lebech Anne Mette , Kaae Hans‐Henrik
Published: November 2007

The present article is based on a review of 187 patients with an ovarian cancer who had a “second‐look” or debulking operation performed. Seventy‐nine patients underwent appendectomy prior to or in connection with the primary cytoreductive surgery and were observed for a average of 16.6 months before secondary oncologic surgery was performed. The remaining 108 patients had their appendix in situ during the same period and were observed for an average of 14.7 months and 1 patient developed acute appendicitis. A total of 125 appendectomies were performed in patients with cancer of the ovary and 14 (1 1%) showed metastatic growth. The two groups were similar as regards age, period of observation, tumor type and stage. The risk of developing acuteappendicitis did not exceed the incidence in healthy women and no surgical problems were experienced in observing either of the two groups during the total period of 2,900 months. The need for surgical surveillance, however, was significantly greater for those who kept their appendix during the medical oncologic treatment. it is concluded that the cytoreductive effect of an appendectomy is limited, but that the appendix should be extirpated if possible as part of the primary staging effort. Leaving an appendix in situ at primary cytoreductive surgery does not expose the patient to any significantly increased risk, but an appendectomy prevents the patient from experiencing the additional burden of an acute appendicitis during medical oncologic treatment.
Prenatal Diagnosis of Autosomal Recessive Polycystic Kidney Disease by Ultrasonography and Magnetic Resonance Imaging
Authors: Nishi Takenori , Iwasaki Masafumi , Yamoto Mareo , Nakano Ryosuke
Published: November 2007

Autosomal recessive polycystic kidney disease is a relatively rare congenital disease affecting the kidneys and liver. We noticed the kidney abnormality at 22 weeks gestation and observed the patient till the delivery at 36 weeks of gestation. The ultrasonographic features consisted of bilaterally enlarged hyperechogenic kidneys, oligohydramnios, lack of distention and difficulty in identifing the fetal urinary bladder. The serial sonographic features of the kidneys changed as pregnancy progressed. The kidney cysts gradually changed in size, shape and renal texture, but the umbilical velocimetry and the kidney circumference/abdominal circumference ratio did not change. Magnetic resonance imaging also showed similar characteristic features as observed by ultrasonography.
Endometrial Squamous Cell Carcinoma
Authors: Gedikolu Gökhan , Demirel Dilaver , Günhan ömer , Finci Rifki
Published: November 2007

Endometrial squamous cell carcinoma is an extremely rare female genital malignancy. Only 26 cases which fulfil the Fluhmann criteria have been reported in the literature. In this report, 2 cases of endometrial squamous cell carcinoma are presented, with a review of related current knowledge.
A Case of Vesical Leukoplakia
Authors: Højgaard Astrid Ditte , Jessen Anne Lene
Published: November 2007

A 54‐year‐old woman who had earlier been treated for cervical dysplasia complained of recurrent cystitis, urgency and frequency, but without signs of genital prolapse. At cystoscopy with biopsies, leukoplakia of the bladder was diagnosed. We describe how the condition is distinguished from squamous metaplasia of the trigone as seen in normal premenopausal women. An association between leukoplakia and cancer is widely accepted. Against this background, a follow‐up program is outlined. The possibility of leukoplakia as a multicentric disorder of the genito‐urinary tract is briefly discussed.
Cutaneous Involvement by an Ovarian Serous Tumor of Low Malignant Potential
Authors: Dugan Theresa , Balsara Gulnar , Dunton Charles J. , Hernandez Enrique
Published: November 2007

The case presented is of a 67‐year‐old woman with multifocal ovarian serous tumor of low malignant potential with skin involvement. To our knowledge this is the first such case not preceded by abdominal surgery. The pathogenesis of her cutaneous lesions is discussed. We propose neoplastic transformation of cutaneous endosalpingosis as a possible explanation.
Polycystic ovary syndrome and risk for myocardial infarction: Evaluated from a risk factor model based on a prospective population study of women
Authors: Dahlgren E. , Janson P. O. , Johansson S. , Lapidus L. , Odén A.
Published: November 2007

In order to estimate whether women with polycystic ovary syndrome (PCOS) have an increased risk of developing myocardial infdrction, a risk factor model was applied on 33 women with PCOS and 132 age matched referents.

The risk factor model was established from independent risk factors for myocardial infarction in a prospective population study of 1462 women in Goteborg, Sweden. The independent risk factors were age. manifest hypertension, manifest diabetes mellitus, central obesity measured as increased waist to hip circumference ratio and serum trigly‐ceride concentration.

A considerably increased risk (relative risk of 7.4) of developing myocardial infarction was observed for women with PCOS compared to age‐matched referents.

Since the risk factors include variables correlated to obesity, the results indicate that advice on dietary restriction is an important part of the treatment once the diagnosis is established.
Women's evaluation of three early abortion methods
Authors: Holmgren Kristina
Published: November 2007

Today several very early abortion methods are available; effective and safe, medical as well as surgical. The aim of the present study is to estimate women's attitudes towards three early abortion methods, to see if one or several of these methods are preferable ‐ or best avoided ‐ for psychological reasons, and to assess if women of a certain social or psychological background would benefit from a specific abortion method. Three groups of women were interviewed two weeks after a first trimester abortion; 1/43 women having an ‘ordinary abortion’ with preoperative ripening of the cervix followed by a vacuum aspiration under heavy sedation, 2/40 women having a modified Karman exeresis with a paracervical block, 3/45 women having a medical abortion with RU 486 and prostaglandin.

There was a noticeable difference in the effect the three abortion methods had on the women taking part in the study. Women with a medical abortion reported more bleeding and somewhat more pain and moral considerations than the other women, but also a relief to be spared a surgical procedure. Most of the women said they preferred the abortion method they had just experienced. A short waiting time appeared to be more important than whether a surgical or a medical method was used. Which abortion method is the best in each case is dependent on a variety of personal reasons, and can only be decided by each woman, in consultation with her doctor.