bluuebunny/crossref_metadata_2025 huggingface dataset:
INGELMAN‐SUNDBERG OPERATION FOR URINARY INCONTINENCE
Authors: Da Silveira Gustavo Gomes , Piccoli Carlos Eduardo
Published: December 2009

Abstract. The authors analyse the indications for the Ingelman‐Sundberg operation considering pelvic anatomy, previous surgery and the age of the patient. The operation is described with pre‐ and postoperative management. Associated operations, such as perineorraphy and the amputation of the uterine cervix are mentioned. Finally, a study is made of the experience of the Gynecologic Clinic of the Catholic Faculty of Medicine presenting the postoperative problems that have arisen and the results obtained in the cure of urinary incontinence. The surgical treatment of urinary incontinence due to lesions of the pelvic floor, presents several difficulties, with a high incidence of recurrence of symptoms.
Immediate Post‐Partum Insertion of the Antigon
Authors: Wiese J. , Osier M.
Published: December 2009

Abstract. The results of intrauterine contraception using the Antigon inserted into 364 women immediately post partum are submitted. The patients were followed for 24 months, total number of woman months 5225. The follow‐up was 96.7% after 3 months, 92.9% after 12 months, and 89.7% after 24 months. Four types of Antigon were used, having surface areas from 785 to 2740 mm2. Type I and the wing model (type IV), which have the smallest surface area, proved best suited. The continuation rates for types I and IV after 12 and 24 months were 77.4–59.2 and 76.4–54.5 respectively. These rates are on a level with those for Antigon inserted 6–8 weeks post partum. It is notable that the expulsion rates (12.8 and 12.7 after 12 months) were no higher than those for Antigons inserted 6–8 weeks post partum. The incidence of puerperal complications was not increased, and no perforations occurred.
BIOAVAILABILITY OF NATURAL ESTROGENS IN YOUNG FEMALES WITH SECONDARY AMENORRHEA
Authors: Spona J. , Schneider W. H. F.
Published: December 2009

Abstract. The bioavailability of 17 ß‐estradiol valerate, free 17 ß‐estradiol and Premarin was studied in 24 subjects suffering from secondary amenorrhea. 17 ß‐estradiol and estrone were determined by specific radioimmunoassay systems. All estrogens were administered as single oraldoses. Theamounts applied were 2 and 10 mg of 17 ß‐estradiol valerate or equivalent amounts of the free estradiol and Premarin, respectively. No elevations of 17ß‐estradiol serum levels were recorded at the lower dosages, whereas the increases of estrone serum levels were approximately tenfold over basal levels. Similar data were recorded in a group of 3 women with normal cycles after the ingestion of 2 mg of 17ß‐estradiol valerate. All subjects responded to the higher doses of estrogens with a moderate increase of 17ß‐estradiol serum levels, but with much higher elevation of estrone levels. These data suggest a rapid conversion of 17ß‐estradiol into estrone. The biological activity of 2 mg 17ß‐estradiol valerate is discussed on grounds of a possible metabolism of estrone sulfate at the target tissues.
THE EFFECTS OF CYCLICAL OESTROGEN THERAPY AND SEQUENTIAL OESTROGEN/PROGESTOGEN THERAPY ON THE ENDOMETRIUM OF POST‐MENOPAUSAL WOMEN
Authors: Whitehead M. I. , McQueen J. , Beard R. J. , Minardi J. , Campbell S.
Published: December 2009

Abstract. In a prospective study, 127 patients attending a Menopause Clinic had uterine curettage performed prior to oestrogen therapy and at intervals during treatment with three different natural oestrogen regimes. At pre‐treatment curettage three patients (2%) were found to have carcinoma of the endometrium and nine patients (7%) were found to have endometrial hyperplasia. Thirty seven patients with normal endometrium at pre‐treatment curettage received cyclical natural oestrogen regimes or sequential oestrogen/progestogen regimes. Eleven (44%) of the 25 patients given cyclical high dose oestrogen regimes developed endometrial hyperplasia but only one (13%) of eight patients given cyclical low dose oestrogen regimes developed this condition. All four patients given sequential oestrogen/progestogen regimes continued to have normal endometrium during therapy. Four patients (33%) developed endometrial hyperplasia within seven months of the commencement of therapy but de novo development of hyperplasia could be delayed for as long as 24 months. Pre‐treatment hyperplasia was associated with elevated urinary total oestrogen excretion. During cyclical oestrogen therapy the urinary total oestrogen levels were high, in and above the range known to be associated with pre‐treatment hyperplasia. Eleven patients with endometrial hyperplasia, either pre‐treatment or oestrogen induced, were subsequently treated with sequential oestrogen/progestogen regimes; and in all cases there was a reversal from endometrial hyperplasia to normal endometrium. In one patient a reduction in exogenous oestrogens from a cyclical high dose to a cyclical low dose regime was not followed by a reversal in endometrial hyperplasia. Two patients with pre‐treatment endometrial hyperplasia developed adenocarcinoma of the endometrium during cyclical high dose oestrogen therapy. Five of the nine patients with endometrial hyperplasia at pre‐treatment curettage had experienced no abnormal vaginal bleeding. Of the patients with normal endometrium, both pre‐treatment and during cyclical oestrogen therapy, regular withdrawal bleeding was experienced by ten patients (53%) during therapy; withdrawal or breakthrough bleeding by 17 patients (90%) and two patients (10%) had no vaginal bleeding. Of the patients with normal endometrium at pre‐treatment curettage who developed endometrial hyperplasia during cyclical oestrogen therapy regular withdrawal bleeding was experienced by three patients (25%) during therapy; withdrawal or breakthrough bleeding by eight patients (67%) and four patients (33%) had no vaginal bleeding. In total, 15 patients received sequential oestrogen/progestogen regimes; 14 patients (93%) had regular withdrawal bleeding while one patient had breakthrough bleeding during sequential therapy.
The Significance of Human Chorionic Gonadotropin in Blood Serum for the Early Diagnosis of Ectopic Pregnancy
Authors: Milwidsky A. , Adoni A. , Palti Z. , Stark M. , Segal S.
Published: December 2009

Abstract. Determination of human chorionic gonadotropin (HCG) values in the serum by the radioimmunoassay technique, was performed in 23 women with suspected ectopic pregnancies. in 16 cases the values of HCG were high and the diagnosis of ectopic pregnancy was verified by laparoscopy and laparotomy. in 7 cases low HCG values were found and ectopic pregnancy was excluded. the detection of HCG in the serum was found to be an excellent tool for the early diagnosis of ectopic pregnancy, thus helping to prevent the dangerous sequelae which follow the late diagnosis of this condition.
A Radioimmunological Method for Oestrone
Authors: Axelsson O. , Lindberg B. S. , Nilsson B. A. , Johansson E. D. B.
Published: December 2009

Abstract. A specific antiserum to oestrone1 has been used to develop a radioimmunoassay. No chromatographic separation step was included. A small amount of plasma (0.01–0.15 ml) was extracted once with diethyl ether. the method was used to estimate plasma levels of non‐conjugated oestrone in women during uncomplicated late pregnancy. the oestrone plasma concentrations showed a gradual increase from a mean of 4 ng/ml in the 22nd week to 11 ng/ml in the 41st week. Great individual variations were found. No systematic changes of unconjugated oestrone plasma concentrations were noticed during a 24‐hour period in late pregnancy. Short term studies revealed that large and rapid fluctuations may appear in the levels of unconjugated oestrone during pregnancy.
Heterologous Growth of Human Ovarian Cancer: A New in Vivo Testing System
Authors: Davy Margaret , Mossige Jeanne , Johannessen Jan V.
Published: December 2009

Abstract. Successful heterotransplantation of ovarian cancer in the mouse mutant, nude is described, with serial transmission, in one case to date. Light and electron microscopic examination of this tumour, a poorly differentiated adenocarcinoma, has not revealed any alteration in its morphology after six passages. Tumour‐bearing mice have been treated with ThioTEPA or 5‐Fluoro‐Uracil, in an attempt to see if they show a similar effect to that seen in the patient. ThioTEPA resulted in a marked regression, whilst there was no effect from 5‐Fluoro‐Uracil, on tumour growth—confirming the ThioTEPA effect seen in the patient.
Basic Levels of the Immuno Suppressive Serum Protein Pz in Women—Influence of Age, Parity, Gonadotrophins and Estrogens
Authors: Damber M. G. , von Schoultz B. , Stigbrand T. , Carlstrom K. , Furuhjelm M.
Published: December 2009

Abstract. The basic levels of the pregnancy zone protein (PZ) were measured by a radio‐immunoassay, in 270 women of various age. All women were apparently healthy taking no drugs. Values were correlated to age, parity, gonadotropins and estrogens. A significant age dependent increase was found for PZ while no influence could be attributed to the other factors studied. the present results emphasize that the age dependent variation of PZ concentration should be considered when clinical data of this protein are evaluated.
A Case of Massive, Unilateral Oedema of the Ovary Simulating Tumour
Authors: Teglbjærg P. Stubbe , Vetner M.
Published: December 2009

Abstract. This paper describes the first reported Scandinavian case of massive unilateral oedema of the ovary. It represents the tenth such case in the literature. the probable pathogenesis is partial torsion of the mes‐ovarium. If suspected clinically, such ovaries might be conserved.
Presence of Anti‐c in the Serum of 42 Women Giving Birth to c Positive Babies: Serological and Clinical Findings1
Authors: Astrup Jorunn , Kornstad Leif
Published: December 2009

Abstract. During routine ante‐natal testing during the period 1953–73 anti‐c was found in the serum of 63 women. Twenty‐four of them had received blood transfusion previously and of these 22 were multigravidae. In 39 women pregnancies alone were responsible for the immunization. The anti‐c titres of the 42 women giving birth to c positive babies showed that the probability of developing haemolytic disease increases with higher titres. But low titres by no means exclude the existence of such disease. Among the 42 c positive babies 32 had a positive direct antiglobulin test. Some of the affected infants had a serious degree of haemolytic disease.
Changes of Bone Mineral Content During Pregnancy and Lactation
Authors: Lamke Bertil , Brundin Jan , Moberg Peter
Published: December 2009

Abstract. In order to study changes in the calcium depots of the body during pregnancy and lactation, bone mineral determinations were performed on fourteen pregnant women and eighteen mothers post partum by X‐ray spectrophotomeyry. Pregnant women exhibited a loss in trabecular bone but not in cortical bone when measured once during late first or early second trimester and again one week post partum. Lactating women who nursed less than three months lost mineral during the first three months and than regained it while those who nursed for longer than three months had no losses during six months of study.
Effects of terbutaline on the pressure volume relationship in fetal rabbit lung
Authors: Bergman B. , Hedner T. , Lundborg P.
Published: December 2009

Abstract. The pressure‐volume relationship in preterm rabbit lung was studied at 28 days of gestation, Injection of 0.1 mg terbutaline, a selective β2‐receptor stimulating drug, significantly increased the volume of air at equivalent low transpulmonary pressures, compared to a saline treated group and an untreated group. These findings indicate an increased pulmonary distensibility of the fetal rabbit lung after terbutaline administration. The mechanism of action is discussed and surfactant mediated effects are suggested to be the probable explanation.
Pregnancy in a case of nelson's syndrome
Authors: Leiba Sara , Kaufman Haiuta , Winkelsberg Gideon , Bahary Charles M.
Published: December 2009

Abstract. A woman suffering from Cushing's disease from the age of 17 who had been treated consecutively with pituitary irradiation, bilateral partial adrenalectomy and o, p'‐DDD (Mitotane, USP) presented the clinical picture of Nelson's syndrome (hypoadrenalism with secondary hypersecretion of ACTH and MSH) at the age of 32. Under substitution therapy with corticoids she became pregnant for the first time at the age of 38. The course of the pregnancy was normal and at term she was delivered of a normal child by Cesarean section. The materno‐fetal relationship, the increased risk of pituitary infarction during pregnancy and the possible teratogenic effect of chemotherapy in such cases are discussed.
The landry‐guillain‐barré syndrome and pregnancy
Authors: Ahlberg Greger , Ahlmark Gösta
Published: December 2009

Abstract. The Landry‐Guillain‐Barré syndrome is considered rare in connection with pregnancy. In mild cases the course of the pregnancy is unaffected. In severe cases, with respiratory depression and bulbar symptoms, especially during late pregnancy, the syndrome entails an increased risk to both mother and foetus. Therapeutic abortion or cesarean section are not considered to be indicated. A pregnant woman developed the disease during the final trimester and gave birth to premature twins during respirator treatment. The mother and the infants survived.
ORGANIZATION OF AMNIOCENTESIS FOR ANTENATAL GENETIC DIAGNOSIS
Authors: Rothe Desider J. , Cederqvist Lars L. , Zervoudakis Ioannis A. , Fuchs Fritz
Published: December 2009

Abstract. In spite of the rapid development of amniocentesis for genetic diagnosis, it is still only a small fraction of the mothers at risk who are having the procedure performed. The medical and public health problems associated with genetic amniocentesis are discussed on the basis of the experience gathered in a major medical center.
CYCLIC AND STEROID‐INDUCED CHANGES IN ADRENERGIC NEUROTRANSMITTER LEVEL OF GUINEA‐PIG UTERUS
Authors: Thorbert G. , Aim P. , Rosengren E.
Published: December 2009

Abstract. The uterine neurotransmitter, noradrenaline, was examined histochemically and fluorometrically in guinea‐pigs during the estrous cycle and after pretreatment with sex steroids. In diestrous animals noradrenaline values were higher than in the estrous state. Treatment with estradiol or progesterone alone did not markedly influence the level of uterine adrenergic transmitter, whereas combined estradiol and progesterone administration caused a clear‐cut reduction in uterine noradrenaline. The quantitative changes in transmitter level did not reflect the marked alterations in weight during the various experimental conditions, and even inverse noradrenaline‐weight relationships were observed. The findings offer further support for the concept of a steroid‐mediated influence on uterine neurotransmission, where the uterine adrenergic nerves constitute a separate target for endocrine control, distinct from the rest of the uterus.
PREMALIGNANT AND MALIGNANT UTERINE CHANGES IN IMMUNOSUPPRESSED RENAL TRANSPLANT RECIPIENTS
Authors: Husslein Hugo , Breitenecker Gerhard , Tatra Gerhart
Published: December 2009

Abstract. 29 female immunosuppressed renal transplant recipients were examined gynecologically. In 2 cases the epithelium of the portio was found to be dysplastic, while endometrial carcinoma was present in 1 patient. A review of the literature suggests that immunosuppressed patients are more likely to develop tumors than others. The authors stress the need for gynecological and cytological examinations at short intervals, to identify premalignant and early malignant uterine changes at a time at which these can readily be treated without discontinuation of the immunosuppressive therapy.
Extremely low placental lactogen hormone (hpl) values in an otherwise uneventful pregnancy preceding delivery of a normal baby
Authors: Gaede Preben , Trolle Dyre , Pedersen Henning
Published: December 2009

Abstract. A case of a normal pregnancy and delivery with extremely low placental lactogen hormone (hPL) values in maternal blood is presented. The low hPL‐values were due to the fact that the placenta only produced about 1/25 of the normal estimated output, calculated on the basis of the hPL‐concentration in the invervillous spaces. The concentrations of progesterone, the placenta‐specific β1‐glycoprotein (SP1) and total estriol in serum were normal, while prolactin and chorionic gonadotropin (hCG) were considerably elevated. Glucose levels were normal. At the ultrastructural level the actual placenta under study did not differ from a normal term placenta. In spite of the very low concentrations of hPL there was a good milk secretion, and the mother was still breast‐feeding her baby 11 months after the delivery. Basal level of prolactin was at this time normal.
Intrauterine injection of vitamin k before the delivery during anticoagulant therapy of the mother
Authors: Larsen Jørgen Falck , Jacobsen Bo , Holm Hans Henrik , Pedersen Jan Fog , Mantoni Margit
Published: December 2009

Abstract. The coagulation factors PP% (Factors II+IV), factor IX and factor X were determinated in infants born by mothers receiving anticoagulants. The factors were very low when the mothers did not receive vitamin K before the delivery. No significant improvement in the factors was observed after an intravenous or intraamniotic injection of vitamin K two to four days before the delivery. Vitamin K was injected intramuscularly into four foetuses in utero using an ultrasonic multitransducer scanner. Three of these infants had normal coagulation factors at birth. In the fourth case the factor X was normal and factor IX was significantly better than in the infants of the other groups. The injection had no harmful effects to the infants.
Caesarean Section
Authors: Patek Eva , Larsson Bertil
Published: December 2009

Abstract. At Huddinge University Hospital 539 Caesarean Sections (C. S.) were made among 8415 deliveries from October 1972 to June 1976, corresponding to an over all C. S. rate of 6.4%. Over these years the rate has increased from 3.5% in 1972 to 9.7% in 1976. The main increase was due to a higher incidence of abdominal deliveries in cases of imminent fetal asphyxia. The maternal complication rate and the neonatal morbidity rate were both 6.5 times higher and the neonatal mortality rate was 4.1 times higher in emergency than in elective surgery. There was neither any mortality nor any morbidity in infants delivered by elective C. S. from healthy mothers at term.
Pregnancy and sarcoma
Authors: Jafari Kianoosh , Lash Abraham F. , Webster Augusta
Published: December 2009

Abstract. Six cases of pregnancy associated with sarcoma are presented. Among these six cases is one patient with vulvar sarcoma which was diagnosed during the 34th week of pregnancy. The literature was reviewed with reference to the effect which pregnancy may have on the growth of malignant tumors. Most authors believe that pregnancy has no deleterious effect on the course of cancer, however, this is not well supported through adequate data. Several reports to the contrary contain evidence that pregnancy may have a deleterious effect on the course of cancer. These discrepancies could be explained on the basis of differences in the natural history and biological behavior of different malignant tumors in relation to the pregnancy.
Operative treatment of rectal endometriosis
Authors: Ruponen S. , Taina E.
Published: December 2009

Abstract. 27 patients with rectal endometriosis were operated upon in Turku University Central Hospital in 1967–1976. The main symptom was defecation pain especially during menstruation. Eighteen patients had had previous surgery for endometriosis of the pelvic area. A palpable tumor was found on gynaecological examination in every patient. The tumors did not grow through the rectal wall. Three kinds of operative procedures were applied (a simple excision method, a so called “window” operation, and resection of rectum) and the results were good.
Plasma Levels of Non‐Conjugated Oestrone in High Risk Pregnancies
Authors: Axelsson O. , Lindberg B. S. , Nilsson B. A. , Johansson E. D. B.
Published: December 2009

Abstract. Plasma levels of non‐conjugated oestrone1 were measured with a radio‐immunological method in women with complicated pregnancies during the last trimester. A comparison was performed between values of normal pregnancies from a previous report (3) and those of pathological pregnancies. Women with severe pre‐eclampsia were found to have low values and to some extent the oestrone level could predict fetal outcome. In pregnant patients with long‐standing diabetes mellitus the plasma levels of oestrone seemed to be higher than those of uncomplicated pregnancy. In women with pregnancies complicated by Rh‐isoimmunization, oestrone plasma levels were similar to those found in normal pregnancies.
The Influence of Locally Administered Prostaglandin E2 and F2α on Uterine Motility in the Intact Non‐Pregnant Human Uterus
Authors: Martin J. N. , Bygdeman M. , Eneroth P.
Published: December 2009

Abstract. Clinical studies on the effect of locally administered prostaglandin E2 and F2α on the sensitivity and reactivity of the non‐pregnant human uterus were performed in 16 volunteers. With the use of the flaccid microballoon technique, uterine recordings were made at frequent intervals throughout the menstrual cycle. As little as 0.25 μg PGE2 or 1.0 μg PGFM2α effected an increase in uterine motility during most of the proliferative and secretory phases of the menstrual cycle. However, a marked decrease in sensitivity and suppression of reactivity to either prostaglandin compound was observed around ovulation. Moreover, an inhibition of uterine contractility in response to PGE2 but not to PGF2α was noted during active menstrual bleeding. Circulating levels of estrogen could be correlated generally with these uterine responses. Endogenous prostaglandins normally occur in the secretory endometrium in levels compatible with the amount of exogenously administered prostaglandins which elicited increased, decreased, or unchanged uterine activity in this study. These findings suggest that local prostaglandin E2 and F2α in concert with variable levels of circulating estrogen, may play important roles in the cyclic regulation of uterine motility during the menstrual cycle.
Postoperative Irradiation and Chemotherapy in Patients with Advanced Ovarian Cancer
Authors: Welander C. , Kjørstad K. E. , Kolstad P.
Published: December 2009

Abstract. Two groups of patients with stage III ovarian carcinoma were selected for a randomized clinical trial. The first group consisted of 157 patients who had radical surgery at their first laparotomy, the second group consisted of 145 patients with inoperable disease. The aim of the trial was to compare the results of maximum external megavoltage irradiation, 5 000 rads, to a large abdominal field, with the results of a reduced dose, 3 000 rads, immediately followed by chemotherapy with an alkylating agent (Thio‐tepa). In none of the groups, did maximum radiotherapy prove superior to the schedule of a reduced dose combined with chemotherapy. The less costly and time saving combined treatment was better tolerated than irradiation alone. Histological tumour type did not influence the prognosis in these advanced cases where spread was found outside the true pelvis.
Ripening of the Uterine Cervix and Induction of Labour at Term with Prostaglandin E2 in Viscous Gel
Authors: Wingerup L. , Andersson K. E. , Ulmsten U.
Published: December 2009

Abstract. In order to achieve ripening of the uterine cervix or induce labour in patients at term with an unfavourable cervical state, 1 mg of prostaglandin E2 (PGE2), suspended in a viscous gel, was instilled into the cervical canal. In a pilot study, 41 patients received the PGE2‐gel. Twentythree of these, (56%), went into labour, and delivery occurred without further stimulation within 15 hours. In the remaining 18 patients, there was a marked improvement of the cervical state, which changed from an average (modified) Bishop score of 2.5 to 6.1 within 24 hours. In a double‐blind study comprising 20 nulliparae, 10 received gel containing PGE2 and 10 gel without prostaglandin. Cervical state did not change significantly (Bishop score 3.6 and 4.0) after 24 hours in patients receiving placebo gel. In those receiving PGE2 gel, 8 went into labour and were delivered without further induction within 13 hours. Two patients showed an increase in Bishop score from 3 to 6 and 7, respectively, after 24 hours. They were then induced by oxytocin and delivery occurred after 8 and 10 hours. The results suggest that administration of PGE2 intracervically can induce ripening of the cervix in patients at term with an unfavourable cervical state, and thus facilitate delivery.
Ultrastructural Features in Normal and Hyperplastic Postmenopausal Endometrium
Authors: Deligdisch Liane , Yedwab G. , Persitz A. , David M. P.
Published: December 2009

Abstract. Seven samples of postmenopausal endometrium were studied by electron microscopy. Four samples were diagnosed as adenomatous hyperplasia (2 of which were atypical) and 3 as normal postmenopausal endometrium. The most striking ultrastructural features of hyperplastic endometrium were: numerous nucleoli, deep nuclear membrane infoldings, increased nucleocytoplasmic ratio, prominent and enlarged RER closely associated with mitochondria and nuclear membrane, abundant free ribosomes and marked network microfilaments. In the case of atypical adenomatous hyperplasia, the protruded intraglandular proliferating epithelial cells exhibited more atypical features than the epithelial cells of the glandular lining, suggesting a more advanced degree of anaplastic change. The characteristic features of the normal postmenopausal endometrium were: paucity and random distribution of the cytoplasmic organelles, the presence of large cytoplasmic vacuoles and short, blunt microvilli. Secretory vacuoles opening into the lumen of the gland were found in one case of cystic atrophy of a normal postmenopausal endometrium. Collagenization was found in the stroma of both groups, although predominantly in the normal postmenopausal endometrium. In 2 cases of adenomatous hyperplasia stromal cells with vacuolar cytoplasm were found. The significance of these findings, as related to their importance as precursor stages of endometrial cancer (in the cases of adenomatous and atypical adenomatous hyperplasia); as involutional manifestations (in the cases of normal postmenopausal endometrium); and as related to the absence of cyclic activity (in both groups) is briefly discussed.
Obstetric Service and Perinatal Mortality in Norway
Authors: Bakketeig Leiv S. , Hoffman Howard J. , Sternthal Phyllis M.
Published: December 2009

Abstract. Information on personnel, equipment and care facilities at all maternity institutions has been related to the perinatal mortality among all single births in Norway, 1967ndash1973. There was a total of 454, 358 single births during this seven year period which comprised the study data set. An obstetric score based on personnel and equipment as defined in a previous study has been used to divide the country into three groups of counties, with low, medium and high obstetric scores. Perinatal, fetal and early neonatal (less than seven days) mortality rates specific to birth weight categories in 500 gram intervals have been compared between the county groups. Significant differences were found in the mortality rates between the group of counties with low obstetric score and the two other groups. There is both a relative and absolute increased difference in mortality for births weighing 3000 grams or more compared to births less than 3000 grams. The major component in the perinatal mortality difference is due to a difference between the low and higher obstetric score county groups in the early neonatal mortality rates. Time trends indicate that the relative differences in perinatal mortality are not decreasing over the seven year period, but rather, have increased slightly. Potential differences in the populations at risk in the three county groups are discusses. An adjustment was made to eliminate the effects of some potential confounding variables, namely high parity and maternal age and illegitimacy, without basically changing the results.
Normal Range Curves for the Intrauterine Growth of the Biparietal Diameter
Authors: Persson P.‐H. , Grennert L. , Gennser G. , Gullberg B.
Published: December 2009

Abstract. Normal range curves for the growth of the fetal biparietal diameter (BPD) measured by ultrasound were calculated in three different ways; I. 93 selected women examined longitudinally with three‐week intervals from the 16th gestational week to term. II. Measurements for each week compiled with only the first measurement from each patient. From the 20th to the 30th week, 3,243 BPD determinations obtained in a routine screening programme was used. III. 157 BPD measurements from 60 women with known date of ovulation.

The results revealed that the three growth curves obtained in different ways were almost identical. The daily BPD increase was 0.44 mm up to the 33rd week. Thereafter, the increment declined. The data were best explained by an equation of the third degree (98.9 %) for the whole investigated period (16‐40 weeks), and before the 33rd week, best fitted to a straight line. Reliability was assessed by the test‐retest method. The error introduced by the unreliability of measurements had a standard deviation of 0.9 mm. The mean difference between examinations performed with an interval of one day was equal to the BPD growth for one day: 0.44 mm. To assess accuracy, the ultrasonic BPD measurements were checked against caliper measurements of the fetal head, in the first half of pregnancy after hysterotomy, and at term after cesarean section. The mean difference was 0.44 mm and 1.3 mm, respectively (SD 1.5 and 1.3 mm). The variation of the normal curve obtained from longitudinal measurements was 3.4 mm (SD) and the variation of the curve obtained from patients with known date of ovulation was 2.2 mm (SD). By comparing the two curves (I and III), 52 % of the variance around the mean of the former curve could be explained by difference in gestational age; 11 % was due to lack of accuracy, 6 % to lack of reliability, and 31 % to individual difference.
Diagnosis of Intrauterine Growth Retardation by Serial Ultrasonic Cephalometry
Authors: Persson P.‐H. , Grennert L. , Gennser G.
Published: December 2009

Abstract. The ultrasonic technique has provided a new and sensitive method for the early detection of retarded intrauterine growth (IUGR).

This prospective study investigated the incidence and the intrauterine development of fetuses with retarded growth of the biparietal diameter (BPD). The accordance between retarded BPD growth and IUGR, judged from endpoint observation (reduced fetal size at birth) was established. In a routine screening programme, 1317 pregnant women were examined by ultrasound twice for cephalometry. The BPD determinations were performed in the 19th and 32nd post‐menstrual weeks. Normal increment of the BPD during the interval between the 19th and the 32nd week was 40 mm (90 % confidence limits; 37 and 43 mm). Retarded BPD growth was defined as an increase less than 37 mm, which is equal to the growth of less than 5 % of the fetuses. In the examined 1317 pregnancies, 6.3 % of the fetuses had a retarded BPD growth. The further development of this group (Group S) was carefully monitored: The risk of preterm delivery was increased (26 %) as was the perinatal mortality (5.9 %). Infant weight, length, and head circumference at birth were below the 10th centile for dates in 45, 44, and 36 %, respectively. The mean birth‐weight of Group S was 750 g less than normal. Group S did not reveal any correlation between the degree of the BPD deviation and the outcome of pregnancy or the infant size.

The growth retardations detectable at the 32nd week were in general uniform; that is, head and body dimensions were equally small. This was true also for the placental weight in those pregnancies that were terminated before the 38th week, but thereafter, there was a tendency for the fetus to have outgrown its placenta.

The investigation demonstrates that, by only two measurements of the BPD, it is possible to diagnose a large risk group of pregnancies with not only a high proportion of pre‐term deliveries, but also infants with low birth weight. The new approach to fetal growth not only takes birth‐weight into consideration but also, to some extent, the time of onset of the growth retardation.
Serum prolactin and thyroid stimulating hormone levels following thyreotropin releasing hormone stimulation in preeclamptic patients
Authors: Kulseng‐Hanssen S. , Torjesen P. A. , Hanssen K. F.
Published: December 2009

Abstract. Serum prolactin and thyroid stimulating hormone (TSH) levels were measured following administration of thyreotropin releasing hormone (THR) in 17 preeclamptic patients and 18 normal pregnant controls.

31st to the 35th pregnancy week the preeclamptic patients showed increased basal serum prolactin and TSH levels compared to controls, but later in pregnancy the differences disappeared. Following TRH stimulation, the serum prolactin and TSH responses were similar in women with and without preeclampsia. A possible role of prolactin in the development of preeclampsia is discussed.
Pregnancy complications following conization of the uterine cervix (i)
Authors: Weber Torn , Obel Erik
Published: December 2009

Abstract. The literature on the course of pregnancies following conization of the uterine cervix has been studied. It is demonstrated that an evaluation of the possible effect of conization upon subsequent pregnancy should be based upon a comparison of either pregnancies before and after conization or upon a comparison between pregnancies in women with a previous conization and in a control group of women without conization. In both cases the possible influence of conization can be evaluated only if the patient material is described as regards age, parity, number of previous pregnancies, smoking habits, etc., factors which may all influence the course of pregnancy. None of the previous publications have described the patient material sufficiently, and most studies have not tried to set up control groups.

Due to these deficiencies we do not find it justified that conization leads to reduced fertility, increased frequency of spontaneous abortion, nor to increased perinatal mortality. An increased prematurity rate may not be rejected, however, but this point has not been adequately evaluated in the previous papers.
Biological fate of methenamine in man
Authors: Allgén Lars‐Göran , Holmberg Göran , Persson Birgitta , Sörbo Bo
Published: December 2009

Abstract. Methenamine hippurate was administered orally as tablets or granules to healthy volunteers. Plasma concentrations of methenamine reached a maximum 1‐2 hours after a single dose and then declined with a half‐life of about 4 hours. The apparent distribution volume was similar to that of total body water. Renal clearance of methenamine was somewhat lower than that of creatinine. In cross‐over experiments over six days, methenamine recovered in the urine corresponded to about 80 per cent of the dose given per 12 hours, slightly lower values being obtained from granules than from tablets. The efficient renal elimination of methenamine was confirmed in similar studies on patients post‐operatively.

Methenamine hippurate was also given to healthy pregnant women during labor, a few hours before expected delivery. Methenamine was found to pass the placental barrier. The concentration of methenamine in umbilical cord plasma was low but reached the level in maternal plasma after about 4 hours. In amniotic fluid the methenamine concentration was low and varying. No correlation was obtained to the maternal or umbilical cord plasma levels.

The methenamine concentration in breast milk was of the same magnitude as in maternal plasma. It is concluded that methenamine may be safely given to pregnant and lactating women with respect to the wellbeing of the child.
RATIO OF AMNIOTIC FLUID CORTISOL AND MATERNAL SERUM CORTISOL (AFC/MSC) AS AN INDEX OF FETAL LUNG MATURITY
Authors: Varma K. , Heine M. W. , Haller W. S. , Row A. D. , Railsback K. , Varma S. K.
Published: December 2009

Abstract. Fifty‐eight samples of amniotic fluid from pregnant women between the gestation period of 34‐42 weeks were analyzed for total cortisol levels. Thirty‐four simultaneous maternal serum total cortisol levels were also measured. Amniotic fluid cortisol (AFC), maternal serum cortisol (MSC) and the ratio of AFC/MSC were correlated with L/S ratio. AFC alone and AFC/MSC ratios correlate with L/S ratios (r=0.36, p <0.01, and r=0.46, p <0.01, respectively). MSC and L/S ratios had no correlation. AFC/MSC had less individual variation as compared to AFC alone. The AFC/MSC had less individual variation as compared to AFC alone. The AFC/MSC could be divided by an arbitrary line at 0.1 and values less than 0.1 signify immature fetal lungs. Values of 0.1 and greater signify mature fetal lungs.
INTRAMUSCULAR ACTH OR PLACEBO IN THE TREATMENT OF HYPEREMESIS GRAVIDARUM
Authors: Ylikorkala Olavi , Kauppila Antti , Ollanketo Maija‐Liisa
Published: December 2009

Abstract. Thirty‐two women with hyperemesis gravidarum were treated with intramuscular ACTH (0.5 mg) or placebo for 4 days in a randomized double‐blind trial. The two treatments were equally effective in relieving hyperemesis, although the function of the adrenal cortex was stimulated only during the ACTH therapy. The administration of ACTH thus appears useless for the treatment of severe vomiting in early pregnancy.
DELAYED REPRODUCTIVE COMPLICATIONS AFTER INDUCED ABORTION
Authors: Dalaker Knut , Lichtenberg Sissel Moe , Økland Gunnar
Published: December 2009

Abstract. An investigation was undertaken regarding subsequent pregnancy in 619 women who had their preceding pregnancy terminated by legal abortion, compared with an age‐ and parity‐matched group of 619 women who continued with the pregnancy to delivery. The groups were compared for complications such as first and second trimester abortion, cervical incompetence, pre‐term delivery, ectopic pregnancy and sterility. The total complication rate was 24.3 per cent in the abortion group, and 20.2 per cent in the controls. No significant difference was found between the two groups for any of the parameters examined, except for a significantly higher rate of complications amongst women who had not had a previous delivery: 25.5 per cent as opposed to 13.2 per cent in the control group.
IN‐SITU CARCINOMA OF THE UTERINE CERVIX SHOWING SUPERFICIAL ENDOMETRIAL SPREAD
Authors: Gupta S. , Gupta I. M. , Tiwari P. V.
Published: December 2009

Abstract. Superficial spread of invasive carcinoma cervix over the endometrial surface is extremely rare and may follow radiation therapy (3, 5). Ferenczy et al. (1) have reported an instance of carcinoma in situ of ecto cervix spreading on the endometrial surface via the endo‐cervical canal. This paper reports another in situ lesion of the cervix showing superficial endometrial spread.
Duration of Labour with Spontaneous Onset
Authors: Bergsjø P. , Bakketeig L. , Eikhom S. N.
Published: December 2009

Abstract. Among 2242 women with spontaneous onset of labour, the median duration of labour for those delivered vaginally was 81/4 hours in para 0, 5 1/2 hours in para 1 and 43/4 hours in para 2+ mothers. In the parity groups 0, 1 and 2+ 90% had delivered within 16 1/4 hours, 10 1/2 hours and 103/4 hours, respectively, while 10% of para 0 labours lasted less than 4 hours, 10%ofpara 1 labours less than 2 1/4 hours and finally 10% of para 2+ labours less than 2 hours. In the first stage of labour the latent phase (cervical dilatation less than 4 cm), was nearly 2.5 times as long as the active phase (cervical dilatation 4–10 cm). The second stage (cervical dilatation 10 cm—birth) had a median duration of 16 min in para 0 and approximately 10 min in para 1+ mothers. The length of the latent and active phases and the second stage for para 1+ mothers was 60‐70% of that of para 0 mothers. In individual mothers there were weak correlations between the length of the phases and stages. For example, the length of the latent phase appeared to be a relatively poor predictor of the length of the active phase of labour. However, selection bias may have weakened these correlations somewhat.
Ultrasound Diagnosis of Fetal Abnormalities in Multiple Pregnancy
Authors: Kurjak A. , Latin V.
Published: December 2009

Abstract. Over a period of four years, 41 cases of abnormal multiple pregnancies were diagnosed successfully by ultrasound. These include several rare combinations of abnormalities. The most frequent was a normal pregnancy and a synchronous blighted ovum. Others were twin blighted ova, blighted ovum and missed abortion, missed abortion in both gestational sacs, two embryonic echoes with the development of only one baby, normal fetus and an anencephalic twin, normal fetus and fetus papyraceous, and triplets with two fetuses papyraceous. The results suggest that one or more gestational sacs may be resorbed during pregnancy without any adverse effect on the coexisting normal fetus. From a practical point of view, it is important to be aware of these possibilities before giving the final diagnosis of multiple pregnancy to the patient. The more diagnostic ultrasound is used in obstetrics, the more rare abnormalities associated with multiple pregnancies will be revealed.
Treatment of Vulval Epithelial Lesions by Pulsed High‐Frequency Therapy
Authors: Grönroos M. , Liukko P. , Rauramo L. , Punnonen R.
Published: December 2009

Abstract. The effect of pulsed high‐frequency therapy has been investigated in 25 patients, who had various chronic vulval lesions resulting in continuous, annoying pruritus, smarting or pain, resistant to conventional therapy. The beneficial effect of pulsed high‐frequency therapy was either definite or good in 80% of all the cases.
Effect of Alkoxyglycerols on the Frequency of Fistulas Following Radiation Therapy for Carcinoma of the Uterine Cervix
Authors: Brohult Astrid , Brohult Johan , Brohult Sven , Joelsson Ingemar
Published: December 2009

Abstract. The incidence of injuries following radiation therapy for carcinoma of the uterine cervix is markedly decreased by the administration of alkoxyglycerols. This is the case for less harmful injuries as well as for the more severe ones, i.e. the fistulas. Recto‐vaginal and vesico‐vaginal fistulas are reduced with 47 per cent when alkoxyglycerols are administered prior to to radiation treatment.
FOLIC ACID SUPPLEMENT AND INTRAUTERINE GROWTH
Authors: Rolschau J. , Date J. , Kristoffersen K.
Published: December 2009

Abstract. The effect of a folic acid supplement on birth weight and placental weight in women delivering in the early summer in Denmark was investigated.

Thirty‐six women with normal pregnancy and expected delivery in the first half of June were selected consecutively. They were paired two and two, and allotted to two groups, one of which was supplied daily with 5 mg folic acid, and the second with tablets without folic acid, from the 23rd week of pregnancy. A significant correlation was found between erythrocyte folic acid and birth weight. The infants in the folic acid group were 12.7 per cent heavier than those in the control group (p < 0.01). A similar difference was found with regard to placental weight and the number of placental cells.
UTERINE AND OVARIAN ESTROGEN RECEPTOR LEVELS IN CLIMACTERIC WOMEN
Authors: Punnonen R. , Kouvonen I. , Lövgren T. , Rauramo L.
Published: December 2009

Abstract. High affinity cytoplasmic estrogen receptors in the endometrium, myometrium and ovary of 15 climacteric women were studied. In addition, the concurrent serum estradiol and progesterone level of each woman was estimated and the endometrium examined histologically. The cytoplasmic estrogen receptor level of the endometrium and myometrium had remained extremely high in some cases several years after the menopause and in the presence of a completely atrophied endometrium. The lowest endometrial and myometrial estrogen receptor levels in premenopausal women were measured towards the end of the menstrual cycle. The endometrial estrogen receptor level was roughly 2‐3 times the comparable myometrial level. Estrogen receptors were also encountered in all cases in the cervical myometrium. The estrogen receptor levels of the ovary were low in all cases.
VULVAL EOSINOPHILIC GRANULOMA
Authors: Miodovnik M. , Adatto R. , Adoni A. , Palti Z. , Dollberg L.
Published: December 2009

Abstract. A case of Eosinophilic Granuloma of the vulva, associated with Diabetes Insipidus, is presented.

There is neither specific nor adequate treatment for the vulval lesions. Treatment with local steroids should first be tried, if this does not help Roentgen‐ray irradiation should be given. Simple vulvectomy is a last resort with poor results.
Maternal alcohol and tobacco consumption and their association with nausea and vomiting during pregnancy
Authors: Little Ruth E. , Hook Ernest B.
Published: December 2009

Abstract. Nausea and vomiting during pregnancy (NVP) has been associated with favorable pregnancy outcome, though little is known about factors influencing its occurrence. In this study, information on NVP in 210 patients at a west coast health maintenance organization was obtained. Smoking and alcohol consumption before and during pregnancy were also estimated in two personal interviews during gestation. In all, 72% of the subjects had NVP in the first 4 months of pregnancy. Smokers had significantly less NVP than non‐smokers (52% vs. 79%). Furthermore, NVP in smokers was negatively associated with alcohol consumption before and during pregnancy, with the stronger relation being for alcohol reported in the 6 months before pregnancy; only 46% of smokers drinking more than 1 fl. oz. of absolute alcohol daily in this period reported NVP, while 68% of smokers drinking less had NVP. For non‐smokers, there was no relation between alcohol use in any period and NVP. The risk of NVP associated with pre‐pregnancy drinking was not related to any change in alcohol consumption after conception. These results suggest an interaction between NVP, smoking, and reported alcohol consumption. The association of favorable pregnancy outcome with NVP may be in part a reflection of moderation in maternal alcohol and tobacco use.
Early successful pregnancy following tuberculous endometritis
Authors: O'herlihy Colm
Published: December 2009

Abstract. Successful pregnancy following proven endometrial tuberculosis is rare. Such a case is reported where conception occurred within three months of finishing treatment. It is suggested that rifampin may offer a better prospect of subsequent fertility than other chemo‐therapeutic agents.
ASPECTS ON RIPENING OF THE CERVIX AND INDUCTION OF LABOR BY INTRACERVICAL APPLICATION OF PGE2 IN VISCOUS GEL
Authors: Ulmsten Ulf
Published: December 2009

Abstract. In this survey the effect of intracervically applied prostaglandin E2 (PGE2) on the pregnant uterus is outlined. It is concluded that PGE2 decreases cervical resistance and stimulates the myometrium to contract. In small doses (0.25 mg and 0.5 mg) PGE2 produces a rapid and prominent ripening of the cervix without systemic side effects and independent of prominent uterine contractions. Prostaglandin E2 applied intracervically in viscous gel seems to be superior to previously used methods for treatment of patients with an unfavorable cervical state.