bluuebunny/crossref_metadata_2025 huggingface dataset:
Maximal electrical stimulation of patients with frequency, urgency and urge incontinence: Report of 38 cases
Authors: Zöllner‐Nielsen M. , Samuelsson S. M.
Published: November 2007

Thirty‐eight consecutive female patients with frequency, urgency or urge incontinence were treated with maximal electrical pelvic floor stimulation. Diagnostic cystometry was performed in 34 cases. Detrusor instability was found in 13 patients, sensory urgency in 13 and hyperreflexia in eight cases.

The effect of the treatment was evaluated by subjective assessment and micturition charts filled in for 48 hours.

63% were cured or improved. The success rate was the same among elderly and younger patients. Detrusor instability and hyperreflexia improved in about 75% of the cases. A good correlation was found between the subjective assessment and the micturition chart recordings.

Maximal electrical stimulation has a good effect on certain types of lower urinary tract dysfunction with few side‐effects. It is well tolerated even by elderly patients.
Lipid‐independent therapeutic properties of transdermal 17 B‐estradiol on cardiovascular diseases
Authors: Cagnacci Angelo , Soldani Renza , Puccini Enrico , Fioretti Piero , Melis Gian Benedetto
Published: November 2007

A low dose of transdermally administered 17 B‐estradiol promptly improved a severe, treatment‐unresponsive, cardiac arrhythmia initiated after the menopause in a woman with type‐II familial hyperlipoproteinemia. The same treatment normalized the hyper. tension initiated after ovariectomy, in a woman who was only poorly controlled by anti‐hypertensive drugs. These two cases are the first clear report of cardiovascular therapeutic properties of transdermal estradiol via mechanisms independent of lipopro‐tein modifications.
Improving placental blood flow in pre‐eclampsia with prostaglandin A1
Authors: Toppozada Mokhtar , Medhat Ibrahim , Sallam Hassan , Ismail Ahmed Abdel‐Aziz , El‐Badawy El‐Sayed , Rabbo Salah Abd
Published: November 2007

Prostaglandin A1 is a potent hypotensive, peripheral vasodilator, a weak oxytocic, antiplatelet aggregator. It improves the renal hemodynamics. Its effect on placental circulation was evaluated (expressed as systolic/diastolic ratio and umbilical artery resistance index) in 20 women with severe pre‐eclampsia and 10 normotensive pregnant women, by using the Doppler technique. Moreover, another 10 women with severe pre‐eclampsia received dextrose 5% as a placebo for comparative purposes. Significant improvements in both parameters studied were observed in the women with severe pre‐eclampsia. The beneficial changes differed significantly from the recorded values when using dextrose in pre‐eclampsia or prostaglandin A, in normotensive subjects. Such promising data add another important perspective to prostaglandin A, in severe pre‐eclampsia and may open up new avenues for its use in other situations with compromised placental flow.
Treatment of Bartholin's abscess
Authors: Andersen P. G. , Christensen S. , Detlefsen G. U. , Kern‐Hansen P.
Published: November 2007

Conventional marsupialization was compared with incision plus curettage and primary suture of the abscess cavity under antibiotic (Clindamycin) cover in a prospective, randomized study of 32 patients with Bartholin's abscess. The median time to healing was 5 days less after suture than after marsupialization alone. The difference was statistically significant. 29 patients were followed up for 6 months. Recurrence of abscesses tended not to be more frequent after suture, making suture an attractive, safe and convenient alternative treatment for Bartholin's abscess.
Metastasis from squamous carcinoma of the cervix stage IB to a borderline cystadenoma of the ovary
Authors: Rasmussen Roar Bruun , Rasmussen Birgitte Bruun , Knudsen Jens B.
Published: November 2007

A case of metastasis from squamous carcinoma stage 1B of the cervix to a borderline cystadenoma of the ovary is described. In addition, the patient had atypical endometrial hyperplasia. The patient underwent a radical hysterectomy with no adjuvant postoperative treatment and has resumed work, with no sign of recurrence one year postoperatively. The aspects of the metastasis to the ovary, multiple tumors in the genital tract and tumor‐to‐tumor metastasis are discussed. Reports on ovarian metastasis in low‐stage squamous carcinoma of the cervix are few and it still seems justified to spare the ovaries at surgery in the young patient.
Two cases of neonatal pneumococcal septicemia
Authors: Johnsson Hans , Bergström Staffan , Ewald Uwe , Schwan Anna
Published: November 2007

Pneumococci (Streptococcus pneumoniae) infrequently cause neonatal septicemia. An increased number of cases have been reported in recent years, but no increase in the relative incidence among neonatal infections has been noted. Two recent cases that occurred within a short period of time are described. They were found to exhibit most clinical characteristics, previously described, of Group B Streptococci (GBS) septicemia with an early onset, but appear to have a graver prognosis.
Right atrial myxoma presenting as post partum ascites and fever of unknown origin
Authors: Bakri Younes N. , Subhi Jamal , Fawzi Mohammed
Published: November 2007

A case is reported of right atrial myxoma presenting clinically as ascites and fever of unknown origin. An extensive work‐up, including laboratory investigations, X‐ray imaging, laparoscopy and laparotomy, failed to explain the clinical picture which was manifested post partum. Echocardiography was diagnostic and led to the curative treatment of surgical resection.
Antiphospholipid antibodies in pre‐eclamptic women: Relation to growth retardation and neonatal outcome
Authors: Sletnes Kari E. , Wisløff Finn , Moe Narve , Dale Per O.
Published: November 2007

The significance of antiphospholipid antibodies in pre‐eclamptic women has not been thoroughly elucidated. The purpose of this study was to determine the proportion of pre‐eclamptic women who were antiphospholipid antibody positive, and to elucidate the significance of these antibodies regarding growth retardation and neonatal outcome. Positive levels of anticephalin antibodies, which are antiphospholipid antibodies, were detected in 7 (19%) out of 37 pre‐eclamptic women, as compared with none of 40 in a control group of normotensive women at similar stage of pregnancy (p = 0.004). The birthweight percentiles of the neonates of anticephalin antibody positive women were significantly lower than those of the neonates of anticephalin antibody negative women (p = 0.018). Four of 7 infants of anticephalin antibody positive women were growth retarded (<2.5th percentile). This was a significantly larger proportion than that for anticephalin antibody negative women (3/30) (p = 0.004). The 95% confidence interval for the difference between the two proportions was 0.10 to 0.85. Two of the 7 neonates of anticephalin antibody positive women died during the neonatal period, compared with none of the 30 neonates of anticephalin antibody negative women (p = 0.003). Thus, our study suggests that positive levels of anticephalin antibodies in pre‐eclamptic women increase the risk for growth retardation and neonatal death.
Prepartum transabdominal amnio‐infusion for severe oligohydramnios
Authors: Mandelbrot Laurent , Dommergues Marc , Dumez Yves
Published: November 2007

Transabdominal amnio‐infusion preceding labor induction was evaluated as a means of avoiding fetal distress and cesarean delivery in patients with oligohydramnios. A preliminary study was performed in 8 consecutive term or post‐term pregnancies complicated by severe oligohydramnios (ammotic fluid index ≤ 1 cm) with unripe cervices (Bishop's score ≤ 3). Warm saline was injected through a spinal needle under ultrasound control. Vaginal delivery occurred in 7 cases; cesarean section was performed in one patient for failure to progress. There was no meconium aspiration and no sign of fetal distress.
Torsion of a mucocele of the appendix in a pregnant woman
Authors: Abu Zidan Fikri M. , Al‐Hilaly Moshriq A. , Al‐Atrabi Nabeel
Published: November 2007

A case of torsion of a large appendicular mucocele presenting as acute abdomen in a 38‐week pregnant woman is reported. Ultrasound showed a localized cystic lesion with internal echoes on the right side of the abdomen. It was diagnosed preoperatively as twisted ovarian cyst. The patient was treated surgically with cesarean section and curative appendectomy.
Fetal ponderal index as an instrument for further classification of intra‐uterine growth retardation
Authors: Vilbergsson Gudjon , Wennergren Margareta
Published: November 2007

Perinatal morbidity and mortality are still high in cases of intra‐uterine growth retardation. Present screening methods select large risk groups and have a low positive predictive value. Instruments which could be used as indicators for those cases within the risk group needing close fetal monitoring would be valuable. The aim of this prospective study was to evaluate fetal ponderal index with respect to signs of fetal distress and neonatal outcome. By means of a risk scoring system, 73 pregnancies with increased risks of intra‐uterine growth retardation were compared with 61 controls. By means of ultrasound, fetal weight was estimated and the fetal femur measured. The fetal ponderal index was calculated by dividing the estimated fetal weight in grams by the third power of the femur length. In the control group, 5/61 showed signs of distress and in the risk group, 43/73. The mean fetal ponderal index of the controls was 8.60 (SD 0.84) and in the risk group 7.72. The groups were compared with each other with respect to signs of distress. The fetuses showing signs of distress had a mean FePI of 7.45 (p<0.001). Those (30/73) in the risk group not showing signs of fetal distress had a mean value of 8.14 and differed significantly (p<0.001) from the distress group. Fetal ponderal index would seem to he B valuable adjunct for the differentiation of the more susceptible fetuses in an intra‐uterine growth retardation risk group.
Prolactin and amniotic fluid electrolytes
Authors: Demir Namik , Celiloglu Murat , Thomassen Peter A. B. , Onvural Ata , Erten Oktay
Published: November 2007

Prolactin (PRL) levels and Na+. K+, Cl−. Ca+ concentrations in maternal serum and amniotic fluid from 64 women in normal term pregnancy were measured by immunoenzymetric assay and flame photometry. The mean amniotic fluid PRL concentration was 597.7 (SE 31.5) ng/ml and the mean amniotic fluid Na+, K+, Cl− and Cd++ levels were 125.6 (SE 0.9) mmol/l, 4.5 (SE 0.1) mmol/l, 109.3 (SE 1.3) mmol/l and 2.0 (SE 7.5 E‐02) mmol/l, respectively. There was no correlation between PRL levels in maternal scrum and amniotic fluid. and the electrolyte concentrations in amniotic fluid. A close correlation was found between the concentrations of Na+ and Cl− in maternal serum and amniotic fluid. Thus, even though PRL may participate in the regulation of electrolytes in the amniotic fluid compartments, our findings provide indirect evidence for the existence of other regulatory mechanisms.
Induction of labor by vaginal prostaglandin E2: A randomized study comparing pessaries with vaginal tablets
Authors: Sørensen S. Stampe , Colov N. Palmgren , Andreasson B. , Bock J. E. , Berget A. , Schmidt T.
Published: November 2007

A prospective randomized study of 267 pregnant women was undertaken to compare the efficacy of a pharmacy‐prepared 3‐mg prostaglandin E2 (PGE2) vaginal suppository with a 3‐mg PGE2 vaginal tablet for induction of labor and cervical ripening. No statistically significant difference in success frequency was found between the two groups, either on the first day (72% and 74%, respectively; p > 0.05) or on the second day (89% in both groups). There was an equal proportion of women requiring oxytocin augmentation in the two groups, but the slower releasing properties of the vaginal tablet were reflected in a longer mean induction—delivery interval of about 4 h for this group. In both the pessary and the vaginal tablet groups, women who had not gone into labor on the First day showed a statistically significant increment in the Bishop score on the morning of the second day. The frequency of cesarean section was the same in both groups, but instrumental deliveries were more frequent in the vaginal tablet group. It is concluded that PGE, vaginal tablets—a chemically stable alternative to pharmacy prepared pessaries—appear to be effective as regards cervical ripening as well as for labor induction.
Semen quality of smoking and non‐smoking men in infertile couples in a Swedish population
Authors: Osser Stellan , Beckman‐Ramirez Anette , Liedholm Percy
Published: November 2007

A study of semen quality, using conventional semen analysis, was undertaken. 186 male smokers were compared with 164 non‐smoking men undergoing infertility investigation. The cigarette smokers were subdivided into three groups according to the number of cigarettes they smoked: < 10(n = 27), 10–19 (n = 84) and > 19 cigarettes per day (n = 7.5). No statistically significant effect of cigarette smoking on sperm density, motility or morphologic features of sperm was detected. Nor was any significant difference in sperm quality, except for semen volume and total sperm count, disclosed between men in the different smoking categories or between heavy smokers and non‐smoking men. Thus, the present study does not corroborate reports of detrimental effects of cigarette smoking alone on sperm concentration, motility or morphology on the bases of this population of Swedish men in infertile couples.
Indomethacin treatment for polyhydramnios: Effective but potentially dangerous?
Authors: Nordström Lennart , Westgren Magnus
Published: November 2007

A case of acute polyhydramnios for unknown reason was successfully treated with orally administrated indomethacin. The need for close supervision of the pregnancy, because of potential risk for oligohydramnios, is described.
Combined ovarian vein catheterization with ovarian stimulation in the diagnosis of androgen overproduction
Authors: Cohen Ilan , Cuperman Solomon , Altaras Marco M. , Ben‐Nun Isaac , Goldberg Emanuel , Beyth Yoram
Published: November 2007

A 28‐year‐old woman was evaluated for late onset secondary amenorrhea, progressive hirsutism and an elevated serum testosterone concentration. Her serum cortisol, androstenedione, dehydroepiandrosterone sulfate and 17‐hydroxyprogesterone levels were normal. Bilateral ovarian and adrenal vein catheterization demonstrated mild elevated testosterone and androstenedione levels in the right ovarian vein. Fifteen minutes after administering the intravenous injection of 5,000 IU human chorionic gonadotropin, there was a six and a half to sevenfold increase in the level of these two hormones in the right ovarian vein with no significant change in hormone levels from other sources. Based on the ovarian peripheral vein gradients obtained during venography following ovarian stimulation, the diagnosis of right ovarian hyperthecosis was made. This diagnosis could not have been reached without the combination of selective ovarian vein catheterization and ovarian stimulation. We recommend that this combined test, which may provide additional information on the source of the androgens in women with hyperandrogens, be performed in selected cases, when a virilizing tumor is suspected.
Maternal leukocyte metabolism during pregnancv and puerperium, and its relation to fetal growth
Authors: Carboné Pilar , Sobreviela Mercedes , Jimenez Dolores , Martinez Cristina , de Aguero Rafael Gonzalez , Pocovi Miguel
Published: November 2007

Changes of energy inctaholism in maternal leukocytes were studied longitudinally in 33 normal term pregnancies at 12, 20 and 36 weeks of gestation and 40 days post partum. Nutrient intakes were calculated from 3‐day weighed food records at the same periods. Women tended to decrease their mean dietary intakes of energy and of most nutrients from early to late pregnancy. Glucose‐6‐P dehydrogenase (G6P‐DH), pyruvic kinase (PK) and adenylate kinase (AK) activities rose significantly after the 12th week of pregnancy, reaching maximal values at week 20. The following period up to week 36 showed a significant decrease that continued in the puerperium, when their values were lowest. Adenine nucleotidc contents and protein/DNA ratio followed a different pattern. A significant increase was also observed from weeks 12 to 20, remaining without changes during the second half of gestation, and falling at puerperium. The PK and AK activities showed a positive correlation with energy intake at 36 weeks of gestation and AK activity was negatively correlated with folic acid intake in the middle of pregnancy. At week 20, PK activity showed a positive correlation with both head circumference and body mass index of the newborn. There was also a correlation between protein/DNA ratio and head circumference at the 36th week of gestation. These findings may suggest a relationship between the metabolism of maternal leukocytes, and fetal development in utero.
Allo‐immunization during pregnancy: Clinical results from 1983 to 1989 in a Scandinavian University Hospital
Authors: Belfrage Patrick , Thomassen Peter , Floberg Jan , Åkerblom Olof , Broberger Ulf
Published: November 2007

From 1983 to 1989, 147, 068 pregnancies were analyzed for allo‐immunization against erythrocyte antigens. Approximately half of the cases were due to immunization against factor D and the others were due to allo‐immunization against other antigens (K, c, E, etc.). In 61 cases exchange transfusion of the newborn was needed and in 115 cases diagnostic amniocentesis was done during pregnancy. Intrauterine transfusions were performed in 10 cases. Fetal and neonatal mortality was 4% in these moderate to severe cases, all due to immunization against D. Immunization against D was due to failure to give immunoglobulin anti‐D in about 2/3 of the cases. Systematic prophylactic treatment with anti‐D during pregnancy would probably not be cost‐effective in this population.
Spontaneous abortions and work in day nurseries
Authors: Göthe Carl‐Johan , Hillert Lena
Published: November 2007

420 pregnancies were recorded between 1962 and 1987 among 202 women working for at least one month in day nurseries during 1984. During that time 230 pregnant mothers had worked as childminders in day nurseries (‘exposed’ pregnancies). The remaining 190 pregnancies were classified as ‘unexposed’. 27 spontaneous abortions were exposed and 7 unexposed corresponding to abortion rates of 11.7% and 3.9%, respectively, which is a significant difference. Also ‘threatened’ abortions during the first trimester of pregnancies ending up in live‐born children were accumulated in exposed pregnancies, and the miscarriage rate was possibly increased in unexposed pregnancies of women with their own children in day nurseries. Significant differences were not observed with regard to premature birth, congenital malformations, number of live‐born children and sex ratio of live‐born children. The cause of the increased frequency of spontaneous and ‘threatened’ abortions in exposed pregnancies could he a contagious agent.
Histologic confirmation of endometriosis in different peritoneal lesions
Authors: Moen Mette H. , Halvorsen Tore B.
Published: November 2007

The aim of this study was to compare the macroscopic evaluation of peritoneal abnormalities suspected of endometriosis with the histologic examination of the tissue. Peritoneal biopsies from 152 patients investigated for gynecological problems (94) or undergoing tubal sterilization (58) were taken from macroscopically abnormal peritoneum, and examined for the presence of endometriosis. Endometriosis was histologically confirmed by the presence of both endometrioid glands and stroma. Endometriosis was confirmed in 78 of the patients (51%). If the diagnostic criteria were extended also to include endometrioid stroma lacking glands, but containing iron pigment and/or hemorrhage, 82 patients (54%) were positive for endometriosis. Endometriosis was histologically confirmed in 76% of pigmented lesions, in 57% of clear or red papules, in 12% of peritoneal pockets, and in 16% when only fibrosis or scarring was observed. Half of the samples with confirmed endometriosis exhibited cyclic activity. The reproducibility of the histologic evaluation was satisfactory. A high rate of negative biopsies emphasizes the need of taking biopsies from peritoneal lesions suspected of endometriosis for confirmation of the diagnosis.
Microalbuminuria as a predictor of preeclampsia
Authors: Konstantin‐Hansen Karen F. , Hesseldahl Hans , Pedersen Susanne Möller
Published: November 2007

Urinary albumin concentration (UA) and albuminlcreatinine ratio (UA/UC) in early morning specimens were assayed in 225 consecutive pregnant women at 20, 26, 28 and 30 weeks of gestation. 193 did not develop preeclampsia (control group), 14 developed preeclampsia later (preeclamptic group), Y were excluded and Y dropped out. Reference intervals of UA and UA/Uc of healthy pregnant women (wk 20–30) was obtained. A statistically significant increase in urinary albumin excretion was observed with increasing gestational age as a normal phenomenon. There was no significant difference in the values of UA and UA/UC in the preeclamptic group when compared with the control group at the same stage of gestation. This indicates that microalbuminuria cannot be used as a predictor of preeclampsia.
De novo detrusor instability after Burch colposuspension
Authors: Vierhout M. E. , Muler A. F. P.
Published: November 2007

After successful surgery for stress incontinence, detrusor instability can develop in a prcviously stablc bladder. A review of six studies with a total of 396 patients is presented. Sixty‐eight of these patients (17%) developed de now DI. The prevalence varied from 5 to 27% in the different studies. The highest cure rate was 98%; the lowest 64%. It is concluded that the prevalence of de novo DI may be dependent on the details of the cystometric and surgical technique as well as unknown patient characteristics. Since the exact pathophysiologic mechanism of this phenomenon is unknown, it is difficult to predict it preoperatively in the individual patient.
Dietary habits, prepregnancy weight, and weight gain during pregnancy: Risk of pre term rupture of amniotic sac membranes
Authors: Gosselink Carol A. , Ekwo Edem E. , Woolson Robert F. , Moawad Atef , Long Cynthia R.
Published: November 2007

Background: Premature rupture of amniotic sac membranes (PROM) is associated with perinatal morbidity and mortality. A matched case‐control study was undertaken to determine whether dietary habits, prepregnancy weight, and weight gain during pregnancy were associated with increased risks for PROM.

Methods: Three study groups were defined, consisting of women delivering pre term with PROM (PP), full term with PROM (FP), and pre term without PROM (PWP). Cases were singly matched by race, age, and parity with women having full term deliveries without PROM. Data were collected by face‐to‐face structured interviews with eligible subjects and by medical records abstraction.

Results: Conditional multiple logistic regression indicated that during pregnancy, PP cases were significantly more likely to have gained < 21 pounds (9.5 kg) (OR = 2.7, CI = 1.146.36) and were only half as likely as controls to have improved their diet (OR = 0.43, CI = O.lRo.99) while controlling for cigarette smoking, urinary tract infection, chorioamnionitis, chlamydia, and a history of previous PROM. FP cases were significantly less likely than controls to have gained 31–40 pounds (1418 kg) while pregnant (OR = 0.56, CI = 0.33–0.94) and were significantly more likely than controls to have a somewhat inadequate pregnancy diet (OR = 2.05, C1 = 1.11–3.77) while controlling for a history of previous PROM. PWP cases were significantly less likely to have gained 31–40 pounds (1418 kg) (OR = 0.42, CI = 0.21–0.84) or > 40 pounds (18 kg) (OR = 0.37, CI = 0.17–0.80) while pregnant or to have had adequate dairy products intake (OR = 0.60, CI = 0.36–0.99) while controlling for cigarette usage.

Conclusion: Maternal dietary habits, weight gain during pregnancy, and supplement intake are associated with the occurrence of both pre term and full term PROM and pre term delivery without PROM.
Organisation of obstetric ultrasound in Denmark 1990
Authors: Jørgensen Finn Stener
Published: November 2007

To provide an overview of the current organisational status of obstetric ultrasound in Denmark, a questionnaire was sent in spring 1990 to all 59 departments responsible for the hospital antenatal care program and to the 25 imaging diagnostic departments providing ultrasound services for those of the 59 departments that had either insufficient or no ultrasound facilities. The response rate was 100%.

Obstetric ultrasound was performed in 25 obstetric, 11 surgical, 22 radiology, 2 clinical physiology departments and 1 ultrasound laboratory (total 61). The departments had a total of 110 ultrasound scanners. The median year of purchase of these scanners was 1985 (range 1976–1990). 488 persons performed ultrasound examinations; the examiners were mainly doctors (72%).

40% of the pregnant population was routinely offered an ultrasound scan in the 15–20th week of gestation. Of these 2/5 were offered screening for fetal malformations. One department offered examinations in both the 19th and 34th week. The scanning capacity, as judged by the departments themselves, was also assessed through the study.
Benign mixed Müllerian tumor of the ovary
Authors: Flam Folke , Silfverswärd Claes
Published: November 2007

A case of benign Mullerian tumor of the ovary in a 53‐year old woman is reported. The stromal element consisted of rhabdomyoblasts which clearly indicate that this tumor belongs to the Mullerian family. She remains free of disease 12 months following an abdominal hysterectomy and bilateral salpingo‐oophorectomy.
Demonstration of Fey receptors in human endometrium
Authors: Ulstein Magnar , Jensen Tone Skeie , Matre Roald
Published: November 2007

Cryostat sections of human endometrium bound sheep erythrocytes (E) sensitized with rabbit IgG antibody (A), (EA). Unsensitized E were not bound. Native, heat‐aggregated IgG and Fc fragments of IgG inhibited the binding of EA, whereas IgM, IgA and F(ab’)2 fragments of IgG did not. The data indicate the presence of receptors for the Fc part of IgG (FcR). Using immune complexes of horseradish peroxidase (HRP) and rabbit IgG antibodies to HRP and monoclonal antibodies (mAbs), FcR were located to the glandular epithelial and endothelial cells, macrophages and predecidual cells of the stroma. These structures were also stained by mAbs against all three FcR classes and a 40‐kD low affinity placental FcR. Preliminary results indicate that the expression of FcR varies during different stages of the menstrual cycle. FcR in the endometrium may play a role in local immunoregulation necessary for nidation and development of the blastocyst.
Bacterial vaginosis in pregnancy treated with yoghurt
Authors: Neri Alexander , Sabah Gad , Samra Zmira
Published: November 2007

As various drugs might have an effect on the fetus during pregnancy, the use of drugs should be minimized in the pregnant woman. Since bacterial vaginosis (BV) can be associated with prematurity and postpartum complications, we searched for alternative therapy for its cure during pregnancy. Commercial yoghurt incorporates both factors necessary for maintaining the protective mechanism of the vagina, vaginal pH and lactobacilhis. A total of 32 women with BV in the first trimester of pregnancy were treated with intravaginal application of yoghurt. The result was favorable indicating that the continuous correction of vaginal pH and lactobaccillus flora is crucial for normal vaginal ecology. During pregnancy, a local treatment restoring the normal acidity and vaginal flora, without systemic effect, may be preferable to any other treatment.
Intrauterine intravascular transfusions in fetal erythroblastosis: The influence of net transfusion volume on fetal survival
Authors: Selbing Anders , Stangenberg Magnus , Westgren Magnus , Rahman Feryal
Published: November 2007

The intravascular volume load that an anemic fetus can tolerate was studied retrospectively in 124 consecutive intravascular transfusions in 35 erythroblastotic fetuses. The tolerated volume load correlated well to the estimated fetal weight. Transfusion volume loads above 20 ml/kg of the estimated fetal weight resulted in a lower fetal survival. We recommend an upper transfusion limit at 20 ml/kg corresponding to approximately 20% of the feto‐placental blood volume.
Ovulation induction with low‐dose follicle‐stimulating hormone in women with the polycystic ovary syndrome
Authors: Dale Per Olav , Tanbo Tom , Lunde Ottar , Åbyholm Thomas
Published: November 2007

Fifty infertile women with the polycystic ovary syndrome (PCOS) were treated for 66 cycles with low‐dose FSH stimulation starting with 75 IU FSH for two weeks before eventual stepwise increases in the gonadotropin dose occurred. An unifollicular response was observed in 35 (53%) cycles and in 20 (30%) cycles there were two‐three mature follicles. A multifollicular response (>3 mature follicles) resulted in 11 (17%) cycles. One of the 66 cycles was complicated with the ovarian hyperstimulation syndrome. Twelve (22%) pregnancies were obtained following 55 completed cycles. All ongoing pregnancies were singleton gestations. The obese PCOS women required a longer period of stimulation and a higher amount of gonadotropin to achieve follicular maturation. However, there was no difference in cycle cancellation or pregnancy rate between obese and non‐obese PCOS women. Thus low‐dose FSH administration seems a safe stimulation regimen with a satisfactory conception rate in PCOS women.
Asymptomatic amniotic fluid invasion with Candida albicans in preterm premature rupture of membranes: Implications for obstetric and neonatal management
Authors: Mazor M. , Chaim W. , Shinwell ES. , Glezerman M.
Published: November 2007

A case of asymptomatic intraamniotic infection with Candida albicans in a woman presenting with preterm premature rupture of membranes is reported. Active prenatal diagnostic procedures and prompt and accurate neonatal treatment (Amphotericin B) improved significantly the usually poor outcome of these pregnancies.
Intravenous immunoglobulin treatment of Dregnant patients with recurrent pregnancy osses associated with antiphospholipid antibodies
Authors: Kaaja Risto , Julkunen Heikki , Ammala Pirkko , Palosuo Timo , Kurki Pekka
Published: November 2007

The effects of high dose iv‐immunoglobulin on antiphospholipid antibody levels and on pregnancy outcome was studied in one patient with secondary (SLE) and two patients with primary antiphospholipid syndrome during their four pregnancies. These three women had had two pulmonary embolies related to pregnancy and estrogen containing pills, 13 miscarriages and only one liveborn after pre‐eclamptic pregnancy. During the four pregnancies the patients also received 75 mg of aspirin per day. Progressive depression of IgG‐anticardioli‐pin antibody titer was observed after repetitive high dose iv‐immunoglobulin (1 g/kg body‐weight) infusions. The effects on lupus anticoagulant were variable. Three pregnancies ended in a delivery of healthy child after 36‐38 weeks of gestation and one preterm child (34 weeks), with slight respiratory distress syndrome, was born. Our results support the idea that the addition of iv‐immunoglobulin to aspirin prophylaxis is worth considering when the patient has a severe antiphospholipid syndrome and/or is refractory to usual treatments.
Changes of peripheral blood lymphocyte subsets before and after operation of patients with endometriosis
Authors: Kikuchi Yoshihiro , Ishikawa Naoaki , Hirata Unko , Imaizumi Eiji , Sasa Hidenori , Nagata Ichiro
Published: November 2007

This study was performed to elucidate whether endometriotic lesions can affect peripheral blood lymphocyte‐subsets. Changes of lymphocyte‐subsets of normal healthy women and patients with uterine myoma or endometriosis before and after operation were also examined by using two‐color assay methods. The percentage and absolute number of CD57+CD16+ cells [moderately differentiated natural killer (NK) cells] of NK cell subsets in peripheral blood from patients with endometriosis were signficantly lower than values from normal healthy women and patients with uterine myoma, while there was no difference in CD4+ and CD8+ lymphocyte‐subsets between normal healthy women and patients with uterine myoma or endometriosis. In patients with endometriosis the percentage and absolute number of CD8+CD11+ cells (suppressor T‐cells) was significantly increased after operation, while those in patients with uterine myoma did not change. On the other hand, resection of endometriotic lesions resulted in a significant decrease of the percentage of CD57+CD16+ cells (immature NK cells) and a significant increase of not only the percentage but also the absolute number of CD57+CD16+ cells (moderately differentiated NK cells), suggesting that existence of endometriotic lesions disturbs differentiation of the NK cells. Furthermore, suppressor inducer T‐cells as shown by measuring CD4+2H4+ and CD4+4B4− cells were significantly increased after operation of endometriosis. These results suggest that endometriotic lesions can affect differentiation of NK cells and such functional changes of the NK cells may be involved with progression or development of endometriosis.
Uterine artery flow velocity waveforms and color flow imaging in women with perimenopausal and postmenopausal bleeding
Authors: Weiner Zeev , Beck Dan , Rottem Shraga , Brandes Joseph M. , Thaler Israel
Published: November 2007

We performed Doppler studies of the uterine artery in 85 women with postmenopausal and perimenopausal bleeding. Sixty‐six women had non‐malignant changes and 19 women had malignant changes on histologic examination of the endometrium. Uterine fibroids were detected in 30 women. When malignant changes were detected in the endometrium, uterine artery resistance index was always below 0.83. The mean uterine artery resistance index was significantly lower in the group of women with pathologic changes of the endometrium (RI = 0.77±0.03) compared to the group with non pathologic changes (RI=0.85±0.08 p<0.01), excluding the women with uterine fibroids. The lowest mean resistance index in the uterine artery was observed in the group of women with uterine fibroids (RI = 0.60 ± 0.09 p< 0.001). In five of six patients with endometrial carcinoma blood vessels were detected around the myometrium by using color flow imaging. Their RI was always less than 0.5. In five patients, blood vessels were detected in uterine fibroids but their RI was always more than 0.5. All six women with endometrial carcinoma but only seven of 13 women with endometrial hyperplasia, had endometrial thickness greater than 5 mm. Doppler velocimetry of the uterine artery carries a high sensitivity (100%) in detecting pathological changes of the endometrium in patients presenting with postmenopausal or perimenopausal bleeding. The presence of high resistance in this vessel, may allow a more conservative approach in this group of patients.
Absent or reversed end‐diastolic flow in umbilical artery and severe intrauterine growth retardation
Authors: Battaglia C. , Artini P. G. , Galli P. A. , D'ambrogio G. , Droghini F. , Genazzani A. R.
Published: November 2007

Uteroplacental insufficiency is a major cause of perinatal mortality and postnatal morbidity. Doppler velocimetry has been used to assess well‐being of the fetus for several years. In the present study we evaluated the perinatal outcome of growth retarded fetuses with presence or absence of diastolic flow in umbilical artery at Doppler analysis. Forty‐six pregnant women with intra‐uterine‐growth‐retardation were studied. Ultrasound assessment of amniotic fluid was performed on alternate days until parturition. A weekly ultrasound measurement of fetal abdominal circumference was done. Doppler analysis of fetal/maternal circulation was performed upon arrival of the patient in hospital and thereafter on alternate days until delivery. Fetal blood was sampled by cordocentesis for immediate blood‐gas analysis. In the group (/i = 26) with absent or reversed diastolic flow in the umbilical artery, we observed a correspondingly worse blood‐gas analysis; a reduced time interposed between the diagnosis and the delivery; a reduced birth weight associated with an increased fetal risk and with a perinatal mortality approaching 60%. Our data suggest that absent or reversed diastolic flow in umbilical artery of growth‐retarded fetuses, associated with alterations in other vessels, are ominous signs of serious fetal compromise.
Eclampsia in Enugu, Eastern Nigeria
Authors: Chukwuma Benjamin , Ozumbia  , Ibe Anthony I.
Published: November 2007

A retrospective analysis of 83 cases of eclampsia managed at the University of Nigeria Teaching Hospital over a ten year period was carried out. Incidence of eclampsia was 1.7/ 1000 deliveries. Antepartum eclampsia constituted 84% of the cases managed. The incidence of eclampsia among unbooked cases was 14.3/1000 births and of these, the maternal mortality was 15.6% while the incidence of eclampsia for the booked patients was 1.1/1000 births of which the maternal mortality was 7.8%. Selection of high risk cases for hospital confinement, early referral of cases of eclampsia and careful use of drugs to control eclamptic fits are recommended to reduce morbidity and mortality from eclampsia.
Anastomosis of uterine serosa with cyanoacrylate versus suture in rats
Authors: Caballero‐Gómez J. M. , Ortega‐Moreno J.
Published: November 2007

Experimental end‐to‐end uterine horn anastomosis was performed in 20 Wistar rats with the conventional technique of microsurgery, with n‐butyl‐cyanoacrylate and with cyanoacrylate with the addition of one or two microsutures. Only in the case of conventional anastomosis and of cyanoacrylate in combination with two microsutures, was the patency rate 100%, whereas in the case of uterine horns anastomosed with cyanoacrylate alone, the patency rate was 80%. Histologic findings revealed the presence of tissue adhesive encysted in the serosa with a moderate inflammatory reaction around it, remaining two months after surgery. On the 60th day, the muscularis layer was only continuous in the conventional and cyanoacrylate with two microsutures groups. Our findings indicate that tissue adhesive and two sutures used together may offer a viable alternative to sutures for genital duct anastomosis.
Psoas abscess related to spontaneous abortion, intra‐uterine contraceptive device and curettage
Authors: Scheepers Norbert J. B. , van Bommel Peter F. J. , Bleker Otto P.
Published: November 2007

This case report presents a patient with a psoas abscess related to a dilatation and (aspiration) curettage for an incomplete abortion with an IUD. Psoas abscess is extremely rare in obstetrics and gynecology and a life threatening condition. It is important to recognize the clinical presentation. Psoas abscess should be suspected in patients presenting with fever, pain in the leg, thigh, or low back region. Whether antibiotic prophylaxis in abortion curettage may prevent this and other complications is discussed.
Transvaginal sonography and hysteroscopy in postmenopausal bleeding
Authors: Cacciatore Bruno , Ramsay Tiina , Lehtovirta Pentti , Ylostalo Pekka
Published: November 2007

We compared transvaginal sonography and hysteroscopy with dilatation and curettage findings in 45 women with atypical postmenopausal bleedings. The histological diagnosis was atrophy in eight (17.8%) women. hormonal effects in 14 (31.1%), endometrial polyp in 19 (42.2%) xnd adenocarcinoma in four (8.8%). Hysteroscopy detected 16 (78.9%) of the 19 cases wirh polyps and two of the four with carcinoma. Sensitivity and specificity for endometrial pathology were 86.9% and 91.7% respectively. A polyp was directly diagnosed by transvaginal sonography in 13 (57.9%) women and an infiltrative endometrial cancer in two. Sensitivily and specificity for endometrial pathology were 73.9%) and 95.7% respectively. All but one case of endometrial pathology were found when the endometrium (both layers) was thicker than 5 mm. Thus, an endometrial thickness of ≥ 5 mm had a sensitivity of 95.7%, a specificity of 45.5% and a positive predictive value of 64.7% for endometrial pathology. This study shows that transvaginal scanning allows detection of an endometrial pathology in the vast majority of cases and it may be used as the first diagnostic step in the investigation of women with atypical postmenopausal bleeding.
Uterine rupture. A seat belt hazard
Authors: VAN Enk A. , VAN Zwam W.
Published: November 2007

A case is described of a uterine rupture resulting from a car accident occurring in a woman who was wearing a seat belt as generally recommended. The rupture was initially not recognised and only became apparent after attempts to induce labor which led to expulsion of the fetus into the abdominal cavity.
Placental hstology and fetal blood flow in intrauterine growth retardation
Authors: Laurini Ricardo , Laurin Jan , Marsål Karel
Published: November 2007

Objective. To define the histological lesions in the placenta associated with abnormal blood flow findings and to evaluate their possible clinical significance.

Design. A prospective blind study.

Setting. A clinical study at a teaching hospital, Malmö General Hospital, University of Lund, Sweden, morphological studies of placentas being performed at the Institute of Pathology, University of Lausanne, Switzerland.

Material Thirty‐seven pregnancies where intrauterine growth retardation (IUGR) was suspected.

Methods Blood velocimetry of the fetal descending aorta, umbilical artery and vein, and the maternal arcuate artery, using 2.5 MHz pulsed wave Doppler ultrasound. Histological examination of at least five random samples from each placenta.

Main outcome measures. Frequency of small‐for‐gestational age (SGA) newborns (birth weight ≥ mean −2 s.d.) and of operative delivery for fetal distress.

Results. Only the presence of placental infarction was significantly associated with IUGR and with intrauterine findings of abnormal blood velocity in the fetal descending aorta and umbilical artery.

Conclusion. Placental infarction would seem to be a valuable morphological marker of uteroplacental vascular disease related to JUGR and impaired fetal and umbilical blood flow.
Experience of childbirth in birth center care
Authors: Waldenström Ulla , Nilsson Carl‐Axel
Published: November 2007

Background. The objective of the study was to compare women's use of obstetric analgesia, experience of pain in labor, and other aspects of the childbirth experience at an in‐hospital birth center and with standard maternity care. The birth center care was characterized by comprehensive antenatal, intrapartum and post partum care, on the same premises with a home‐like environment and the same team of midwives, restricted use of medical technology and pharmacological pain relief, and discharge within 24 h after birth.

Methods Of 1,230 women interested in birth center care and meeting low‐risk medical criteria in early pregnancy, 617 were randomly allotted birth center care (EG) and 613 standard obstetric care (CG). Data were collected by questionnaires two months post partum, and hospital records.

Results. EG women used less pharmacological pain relief than CG women, but no difference was observed concerning the retrospective attitude to pain, or among primiparas, to the intensity of pain experienced. EG multiparas experienced pain in labor as more intense, than did CG multiparas, probably because of a more negative prenatal attitude to labor pain. EG women experienced more support from the midwife, and a greater freedom in expressing their feelings during the birth than CG women. EG primiparas were more satisfied with their own achievement and felt more involved in the birth process than CG primiparas. No differences were observed between the groups regarding overall experience of childbirth, anxiety during the birth or support from husband.

Conclusion Birth center care gave women interested in a natural childbirth, by avoiding pharmacological pain relief, greater opportunity to give birth according to their prenatal wishes, and it contributed to a slightly more positive birth experience.
The effect of labor on the normal values of umbilical blood acid‐base status
Authors: Yoon Bo Hyun , Kim Syng Wook
Published: November 2007

Background. Although several investigators have attempted to define the normal values of umbilical cord blood pH and gases, there is considerable controversy about the optimal cutoff values to diagnosis intrauterine asphyxia. A possible reason for this might be that several studies have included data from fetuses born after different duration of labor.

Objective To determine the effect of labor and the duration of second stage of labor on umbilical arterial acid‐base status at birth in healthy term infants.

Methods Umbilical artery acid‐base status was determined in patients (n = 356) who met the following criteria: 1) singleton term pregnancy with no significant medical, obstetric, or neonatal complications; 2) vertex presentation if delivered vaginally; 3) neither regional nor general anesthesia applied if delivered vaginally; 4) no use of oxytocin; 5) normal fetal heart rate patterns; 6) clear amniotic fluid; 7) Apgar scores at 1 and 5 min ≥7; 8) appropriate fetal weight for gestational age. Patients were divided into three groups. A ‐ patients delivered by cesarean section (CS) in the absence of labor (n=135); B‐patients delivered by CS during first stage of labor (n = 62); C‐patients with vaginal birth (n=159). A Kruskal‐Wallis A YOVA with post‐hoc procedures and stepwise multiple regression analysis were performed.

Results. 1) There were significant differences in cord arterial acid‐base values between study groups (pH: no labor CS. 7.27 ± 0.05 vs labor CS. 7.26 ± 0.05 vs vaginal birth, 7.24 ± 0.07, p < 0,0000 1). 2) There was a significant fall in cord arterial pH and bicarbonate concentrations with increased duration of second stage of labor in newborns born vaginally (pH: duration of second stage. 1‐30 min, 7.25 ± U.07 vs 31‐60 min, 7.22 ± 0.06 vs >61 min, 7.21±0.07. p<0.05). 3) Analysis of confounding variables which could influence the cord pH such as parity, usz of vacuum. gestational age, maternal age, and birth weight by stepwise multiple regression analysis indicated that only the duration of second stage of labor pain had a significant relationship with cord blood pH.

Conclusion There is a significant fall in umbilical artery pH and bicarbonate with the presence of labor and increased duration of second stage of labor in healthy term neonates. This should br taken into consideration in evaluating neonatal well‐being by cord blood pH and acid‐base measurements.
Spontaneous closure of enterovaginal fistula caused by a neglected foreign body
Authors: Haddad Bassem R. , Usta Ihab M. , Khalil Ali , Mufarrij Ibrahim
Published: November 2007

The problem of a foreign body left in the operative field is rarely discussed in the medical literature despite the multiple complications it might cause. The purpose of this article is to report on a patient who developed an enterovaginal fistula secondary to a pack left in the pelvis to temponade post‐hysterectomy bleeding. The fistula closed spontaneously after three months of expectant management. Expectant management of enterovaginal fistulae is feasible. Adequate reporting of the operative procedures performed and the use of tagged sponges is a must.