bluuebunny/crossref_metadata_2025 huggingface dataset:
Urethrovaginal and Vesicovaginal Fistula
Authors: Henriksson Christen , Kihl Björn , Pettersson Silas
Published: December 2009

Abstract. During an 11‐year period 29 women were treated for 6 urethrovaginal and 24 vesicovaginal fistulae. In all patients the urethrovaginal fistula was preceded by an operation for a benign lesion. Of the 24 patients with vesicovaginal fistulae 11 had a benign and 13 a malignant primary disease. Endoscopy, vaginal examination and IVP provided in most cases sufficient information with which to establish a diagnosis. The urethrovaginal fistulae were operated on either by a vaginal approach (3 patients) or by a combined suprapubic and vaginal approach (3 patients); two recurrences occurred but healed after reoperation. Of the 24 patients with vesicovaginal fistulae, 14 underwent a combined operation usually including omentum interposition, while 10 underwent primary diversion. Primary cure ensued after 9 of 14 combined operations; recurrences were operated on by a combined approach in 2 patients, vaginal in one and with fibrin occlusion in one. Eight of the 10 patients who underwent urinary diversion had a malignant disease. A vaginal approach is recommended at the primary reconstruction of urethrovaginal fistulae, whereas a combined suprapubic and vaginal approach is recommended in vesicovaginal fistulae as well as in recurrent urethrovaginal fistulae.
Clinical and Virological Features of Herpes Genitalis in Japanese Women
Authors: Ishiguro Tatsuya , Ozaki Yoshikatsu , Matsunami Mitsuyo , Funakoshi Shigeko
Published: December 2009

Abstract. We report herein clinical and virological findings in 35 Japanese women with a confirmed herpes genitalis. The frequency of herpes genitalis was 0.24% in our obstetrical and gynecological outpatient clinic, while that in cancer screening clinics was 0.01%. Eighty percent of all patients were between 20 and 49 years of age (median age of 38.5 years). Genital herpes was detected more frequently in summer and autumn. Virus isolations were carried out in 20 patients and 13 were positive (65.0%). Of 13 genital isolates with positive cultures, 7 (53.8%) were identified as herpes simplex virus type 1 (HSV‐1) and 6 (46.2%) as herpes simplex virus type 2 (HSV‐2). Two virgins were diagnosed virologically and cytologically as having progenital herpes, and in these 2 women, HSV‐1 was isolated by the virus isolations. Lack of antibodies to either virus was higher in HSV‐1 type infection. These studies together with previous findings show that both clinical and virological features of genital herpes differ between Japanese and Caucasian or black women. These differences are attributed to some extent to sexual patterns of behavior in the different races.
Predictive Value of a Single Unstressed Antepartum Cardiotocogram in Apparently Uncomplicated Pregnancy
Authors: Lenstrup C.
Published: December 2009

Abstract. Antepartum CTGs were recorded in 88 pregnant women in the 36th week of pregnancy, approximately. The CTGs were evaluated according to three different CTG scoring systems. A new CTG score is now presented. The three systems are compared according to their ability to predict retarded intra‐uterine growth. Nine infants were born small‐for‐date; 8 of these had s suspect CTG. In 7 of these cases reduced variability was present for more than 25% of the registration time. When variability is reduced for more than 25% of the registration time there is a statistically significantly higher rate of infants born small‐for‐date (p<0.001).

Fifty per cent of those fetuses that did not move spontaneously during registration were born small‐for‐date. When accelerations were present, 94% of the infants were born normal‐for‐date. Low estriol and/or low hPL levels were found in 5 of 9 cases where the infants were born small‐for‐date. Low estriol/hPL and/or suspect CTG were found in all cases of infants born small‐for‐date. When estriol, hPL and CTG were normal, no infants were born small‐for‐date.
Fetal Response to Voluntary Maternal Hyperventilation
Authors: Navot Danny , Donchin Yoel , Sadovsky Eliahu
Published: December 2009

Abstract. Maternal hyperventilation can cause transient reduction in fetal oxygen tension. Fifty women with normal and high‐risk pregnancies, between the 32nd and 43rd week, were voluntarily hyperventilated; in 33, fetal heart rate (FHR) acceleration or transient tachycardia were observed (reactive FHR). Of the 33 pregnancies the outcome was good in 30 (91%) as judged by the absence of perinatal death, no fetal distress in labor and no intrauterine growth retardation (IUGR). In 14 patients in whom there was no FHR response to maternal hyperventilation (non‐reactive FHR), the outcome of pregnancy was significantly worse; one infant died neonatally, 10 were either chronically (IUGR), or acutely distressed. Only in 3 was the outcome good (21%). The study showed that there is good correlation between a “reactiv” FHR and favorable neonatal outcome, and between a “non‐reactive” FHR and an unfavorable neonatal outcome.
Management of Pregnancies with Rare Blood Types
Authors: Biale Y. , Dvilansky A.
Published: December 2009

Abstract. Pregnant women with antibodies to high incidence blood group antigens should be diagnosed as early as possible and red blood cells should be stored frozen for future possible needs. Either autologous, compatible siblings' or unrelated individuals' red blood cells should be frozen. The application of such a program is described in three pregnant women with exceedingly rare antibodies to high incidence blood group antigens (anti‐Lutheranb, and PP1Pk, and anti c with blood type B CCddee Du negative).
Significance of Unstressed Antepartum Cardiotocography Performed Weekly in last Trimester of Apparently Normal Pregnancy
Authors: Lenstrup C.
Published: December 2009

Abstract. Antepartum Cardiotocographs (CTGs) were obtained at weekly intervals from 28th − 30th week of pregnancy onwards in 111 apparently normal pregnancies. A new CTG score was used to assess the 1 196 CTGs obtained, 80 per cent of which proved normal. Minor pathology was seen in 19.1 per cent, while moderate or severe pathology was seen in only 0.9% of the CTGs. Of 16 babies born small‐for‐date, 15 had a pathological CTG on one or more occasions. There was a significantly greater incidence of small‐for‐date infants when two or more pathological CTGs were observed. Nineteen of 20 women whose babies developed late decelerations during labor had at least one pathological CTG. All infants with an Apgar score <5 and all acidemic fetuses had one or more pathological CTGs. All women who required cesarean section because of fetal distress during labor had pathological CTGs on two or more occasions. All cases in which accelerations of the fetal heart rate did not accompany movements (AFM) after the 36th week of pregnancy resulted in the birth of a small‐for‐date infant, while sporadic absence of AFM before the 36th week was of no importance.
Depressed Prolactin Levels in Diabetic women with anovulation
Authors: Djursing Henning , Nyholm Henrik Chr. , Hagen Claus , Mølsted‐Pedersen Lars
Published: December 2009

Abstract. The circulating levels of prolactin (PRL), luteinizing hormone (LH), follicle stimulating hormone (FSH) and estradiol‐17β were determined by radioimmunoassay in 76 normal healthy women in the follicular phase of the menstrual cycle, 54 consecutive anovulatory non‐diabetic women and 20 consecutive diabetic women with anovulation. An elevated plasma PRL concentration was found in 1/20 (5%) of the diabetic women and in 17/54 (32%) of the non‐diabetic anovulatory women (p<0.05). Plasma concentrations of estradiol‐17β and gonadotropins in diabetics did not differ (p > 0.05) from those found in non‐diabetic women with anovulation. Diabetic women with secondary amen‐orrhea had significantly (p<0.05) lower plasma concentrations of PRL and estradiol‐17β than non‐diabetic women with amenorrhea and normal controls. Furthermore, this group of diabetic women had lower median plasma LH concentrations than the non‐diabetics with secondary amenorrhea and normal controls, but this difference was not significant (p>0.05). These data indicate that diabetic patients with anovulation have hypothalamic and/or pituitary defects. Furthermore, the low prolactin and LH levels despite a low estradiol‐17β concentration may suggest an increased hypothalamic dopamine activity in patients with diabetes mellitus and secondary amenorrhea.
α2‐Antiplasmin and α2‐Macroglobulin—The main inhibitors of fibrinolysis—During the Menstrual Cycle, Pregnancy, Delivery, and Treatment with oral contraceptives
Authors: Wallmo L. , Gyzander E. , Karlsson K. , Lindstedt G. , Radberg T. , Teger‐Nilsson A. C.
Published: December 2009

Abstract. α2‐Antiplasmin and α2‐macroglobulin have been studied during the menstrual cycle, pregnancy and parturition in healthy women, and during use of various types of contraception in both healthy and diabetic women, and compared with a reference group of healthy men and women.

α2‐Antiplasmin showed a slight sex difference, with higher values in women. The luteal phase of the menstrual cycle showed slightly higher values than the other phases. α2‐Antiplasmin increased during pregnancy, decreased (probably due to consumption) during labor and increased again in the puerperium. Treatment with neither combined contraceptive pills nor low dose progestogen pills gave any changes in α2‐antiplasmin.

α2‐Macroglobulin showed low values during menstruation. The increase during pregnancy and treatment with combined contraceptive pills is in accordance with earlier findings.

It is concluded that synthesis and metabolism of α2‐antiplasmin are under hormonal influence. The role of α2‐antiplasmin in the decreased fibrinolysis in pregnancy is discussed.
Plasma FSH, LH and Prolactin Levels in Postmenopausal Women Undergoing Cyclofenil Treatment
Authors: Nencioni T. , Miragoli A. , Bertaglia M. G. , Parini J.
Published: December 2009

Abstract. Ten postmenopausal women were studied in an attempt to identify the mechanism of action of cyclofenil, a non‐steroidal anti‐estrogen which has proved to be effective in the climacteric syndrome. A double‐blind inter‐patient clinical investigation was undertaken, with patients assigned randomly to treatment for 10 days with cyclofenil, 400 mg/ day, or else conjugated estrogens, 1.25 mg/day, always given orally at 8 a.m. Serum FSH, LH and PRL levels were determined daily 2 days before, during and for 2 days after treatment. On the first and tenth day of treatment, five blood samples were drawn between 8 a.m. and 4 p.m. to ascertain if there was any drug‐induced variation in the hormonal secretory patterns. Furthermore, endometrial biopsies of all patients were taken before and immediately after the 10‐day treatment. In 5 patients, endometrial biopsies were repeated after 3—6 months of therapy with cyclofenil. The results indicate that cyclofenil has two opposing actions on the hypothalamic‐hypophyseal axis, one estrogen‐like, in that it depresses serum FSH levels, and the other antiestro‐gen‐like, in that it depresses serum PRL levels. They also show that at both the peripheral and the central level cyclofenil is a drug of first choice for postmenopausal women at risk for endometrial and mammary neoplastic pathology.
End‐Stage Chronic Renal Failure due to Total Uterine Prolapse
Authors: Nässberger L. , Larsson R.
Published: December 2009

Abstract. Upper urinary dilatation caused by a protracted total uterine prolapse and resulting in end‐stage chronic renal failure in a 66‐year‐old women is described. A gynecological examination is advised in females with renal insufficiency of unknown etiology.
Laparoscopic sterilization with the falope‐ring technique
Authors: Hertz Jens B.
Published: December 2009

Abstract. One hundred and sixteen women were admitted to hospital for laparoscopic sterilization by the Falope‐ring technique. Up to the present, and with an average observation period of 20.8 months, no pregnancies have occurred. Bleeding from the distal site of puncture and tubal transection were the most common peroperative complications, occurring in 4.4 and 3.5% respectively. In 80 patients, hysterosalpingography was performed after 3 months as a control. Unilateral leakage was demonstrated in 6 patients; 5 of these were resterilized via a minilaparotomy. The Falopering technique is easy and quick to carry out and, when performed correctly, is encumbered with a low rate of complications and failures. The method is recommended as an alternative to sterilization via electrocautery of the tubes.
Delivery and long—term outcome of very low birth weight infants
Authors: Westgren Magnus , Ingemarsson Ingemar , Ahlström Hans , Lindroth Magnus , Svenningsen Niels W.
Published: December 2009

Abstract. The obstetric and the neonatal management of 72 infants weighing less than 1500 g at birth were evaluated. Sixty per cent of the mothers were delivered by cesarean section. The neonatal mortality (27%) was equal in the cesarean section and the vaginally delivered groups, but intraventricular hemorrhage was a more frequent autopsy finding in the latter group.

At follow‐up, 88% of all surviving infants are neurologically normal at two years of age. Of the vaginally delivered infants, three suffered from cerebral palsy, but none in the cesarean section group. The present results reveal that an active management including cesarean section in the delivery of very low birth weight infants is justified and leads to a favorable prognosis.
An Ominous Undulating Fetal Heart Rate Pattern
Authors: Ginsburg D. S. , Hernandez E. , Schwemlein G. A. , Daikoku N. H. , Johnson T. R. B.
Published: December 2009

Abstract. Three cases of severely compromised fetuses are reported in which a similar FHR tracing was observed: an undulating pattern describing a “sinusoidal” shape, a frequency of 0.5—1 cpm, amplitude of 10—15 bpm, and flattened baseline varying between 60—120 bpm. This pattern appears to differ significantly from the sinusoidal pattern described previously and appears to identify an agonal or pre‐agonal fetus that nonetheless may be salvageable and, therefore, requires maximal obstetric intervention.
The clinical significance of blood‐contaminated midtrimester amniocentesis
Authors: Ron M. , Cohen T. , Yaffe H. , Beyth Y.
Published: December 2009

Abstract. In 706 midtrimester amniocenteses, 180 (25.5%) samples yielded blood‐stained amniotic fluid (macroscopically and microscopically), 152 (21.5%) contained maternal blood, 28 (3.9%) fetal blood and 8 samples contained both maternal and fetal blood. In the 180 cases of bloody midtrimester amniocentesis, the abortion rate was 6.6% when maternal blood was found and 14.3% when fetal blood was aspirated, compared with 1.7% in controls. The amount of blood drawn did not alter pregnancy outcome. The percentage of bloody amniotic fluid in amniocenteses performed before the 16th week of pregnancy was much higher (36.7%) than during and after the 16th week of pregnancy (22%).

Midtrimester amniocentesis should therefore be avoided before the 16th week of pregnancy.
Prediction of fetal growth deviation by ultrasonic biometry: I. Methodology
Authors: Eik‐Nes Sturla H. , Gröttum Per , Persson Per‐Håkan , Maršál Karel
Published: December 2009

Abstract. Early information of impaired or accelerated fetal growth is of importance for antenatal care. The present study has produced a mathematical formula which in the 33rd week of pregnancy permits prediction of fetal weight deviation at birth. The prediction was based on two ultrasonic examinations: in the 17th week of pregnancy the biparietal diameter (BPD) was measured to assess the fetal gestational age; in the 33rd week of pregnancy, BPD and the abdominal diameter (AD) of the fetus were measured. Fetal growth deviation was then described by comparing the assessed BPD and AD with the expected mean values for the gestational age on the day of this measurement. For 872 fetuses the growth deviation found in the 33rd week was related to the fetal weight deviation at birth; multiple regression analyses were performed and a mathematical formula developed. For practical purposes this formula is expressed in a nomogram.
Antibiotic Treatment of Acute Salpingitis
Authors: Forslin Lars , Danielson Dan , Kjellander Jan , Falk Viking
Published: December 2009

Abstract. A group of 782 patients with a diagnosis of acute salpingitis (a few of the patients because of other infection in the pelvis) were treated with the recommended oral dose of doxycycline (200 mg the first day and 100 mg once daily for at least the following 9–12 days) in combination with 1 g benzyl penicillin and 0.6 g procaine penicillin twice daily intramuscularly for 5–7 days. The plasma concentrations of doxycycline were determined on the third day of treatment before the next dose was given. In 26.5% of the patients the concentrations were below 1 μg/ml plasma, considered as the minimum therapeutic level. The dose of doxycycline was increased to 200 mg a day in these patients and the plasma concentrations increased accordingly. In another group of 80 patients, 40 were treated with the standard doxycycline dose, and the other 40 patients with the standard lymecycline dose (300 mg twice a day). The plasma concentrations, determined before the dose on the third day, were below 1 μg/ml in 35% of the patients treated with doxycycline, and in 5% of those treated with lymecycline. Since acute salpingitis in most cases is a serious complication to a lower genital tract infection, often a sexually transmitted disease caused by tetracycline‐sensitive organisms, the importance of achieving and determining the therapeutic plasma concentrations of tetracyclines is stressed.
Acute Fatty Liver of Pregnancy with Complicating Disseminated Intravascular Coagulation
Authors: Laursen Benedicte , Frost Lars , Mortensen Jens Z. , Hansen Kjeld B. , Paulsen Stein M.
Published: December 2009

Abstract. A description is given of acute fatty liver of pregnancy in a 26‐year‐old primigravida who survived. Complicating disseminated intravascular coagulation was diagnosed at parturition, and the importance of early diagnosis of this is emphasized. A suggestion for treatment is given as a possible means of improving the prognosis in this mostly fatal disease.
Teenage deliveries in a swedish population in the 1970′s
Authors: Larsson Jan , Svanberg Lars
Published: December 2009

Abstract. The investigated material consists of all teenage deliveries in the city of Malmö, Sweden, during the 1970′s. For the years of 1972 and 1976, before and after the new abortion act in Sweden, a more detailed study of the pregnancy and delivery has been performed. The study shows that the frequency of adolescent deliveries decreases by about 30% during the 1970′s. However, the teenage proportion of the total number of pregnancies remains still unchanged. The investigation also confirms that there is an increased incidence of preterm delivery and low birth weight babies in teenagers, but in other respects there is no increased risk to mother or child in teenage pregnancy. 82% of the teenage mothers were primigravidae and during the first year after delivery, 10.5% of the teenagers fell pregnant again. This is higher than that in a contemporary abortion material, where the corresponding figure is 6.5%.
Serial Plasma Oxytocin Levels During Pregnancy and Labor
Authors: Otsuki Y. , Yamaji K. , Fujita M. , Takagi T. , Tanizawa O.
Published: December 2009

Abstract. Maternal plasma oxytocin levels during pregnancy and labor were measured by a sensitive and specific ra‐dio‐immunoassay.

The mean plasma oxytocin concentration in maternal peripheral plasma showed a gradual rise towards term, reaching 12.5 μU/ml in term subjects without labor contractions. This level was not significantly different from the mean value in the 1st stage of normal spontaneous labor (12.6 μU/ml).

Brief fluctuations in plasma oxytocin levels of considerable degree, and sometimes spurt release, were observed in labor and at term, but not in the mid‐trimester, in serial samples collected at short intervals (about 10 sec).

In normal spontaneous labor, no obvious relation was observed between the plasma oxytocin level and the uterine contraction period, and no significant difference was found between the mean value in uterine contraction periods (12.1 μU/ml) and that in relaxation periods (11.5 μU/ml).
133Xenon Clearance from Amniotic Fluid in Baboons During Administration of Oxytocin, Prostaglandin F2α and A β‐ Mimetic Agent
Authors: Einer‐Jensen N. , Lauersen N. H. , Wilson K. H.
Published: December 2009

Abstract. Amniotic fluid clearance of 133xenon was measured in pregnant baboons near term during a control period of spontaneous uterine activity and during induction of contractions with oxytocin or PGF2α and inhibition of activity by a β‐adrenergic agent, berotec. There was no significant change in the clearance of 133xenon from the amniotic fluid during moderate uterine activity induced by oxytocin or PGF2α. The clearance rate decreased five‐fold during infusion of berotec, compared with the control infusion periods, simultaneous with a decrease in uterine activity. When the berotec infusion was discontinued, the clearance of 133xenon immediately returned to the previous level, while the return of uterine activity was more gradual.
Progesterone Levels Before and After Laparoscopic Tubal Sterilization Using Endotherm Coagulation
Authors: Helm G. , Sjöberg N.‐O.
Published: December 2009

Abstract. Tubal sterilization can be performed by several surgical methods. It has often been reported that menstrual disorders appear after the operations, probably caused by hormonal disturbance. However, there is no published systematic study of the ovarian hormonal status after sterilization. In the present prospective study therefore, the plasma progesterone level has been determined during one menstrual cycle before and one after endotherm tubal laparoscopic coagulation. Plasma progesterone was chosen as normal levels of this hormone during the luteal phase reflect ovulation and an adequate corpus luteum. The endotherm coagulation method does not appear to cause any progesterone malfunction in the ovary.
Positional Factors of the Uterus Play a Contributing Part in Iud Failure
Authors: Kivijarvi Anneli , Grönroos Matti
Published: December 2009

Abstract. This study is based on a uniform material of 3 500 copper IUD insertions at the Family Planning Unit of Turku Health Center, including 72 cases resulting in pregnancy. Among the pregnant subjects there were significantly more women with a retroverted flexed or mid‐positioned uterus than in the control material. Repeat IUD pregnancies were rather common. These observations should be taken into account in practice, especially regarding great care with the insertion technique and a close follow‐up of these women. The predisposing factors and the outcome of accidental pregnancies are discussed.
Norethindrone in Serum After use of an oral Contraceptive Containing Norethindrone Acetate
Authors: Sarkar N. N. , Laumas V. , Agarwal N. , Hingorani V. , Laumas K. R.
Published: December 2009

Abstract. The availability of norethindrone (NET) in serum was studied in 8 women after daily administration of a combination oral contraceptive pill (MinovlarR) containing 1 mg norethindrone acetate (NETA) and 50 μg ethinyl estradiol (EE2) from day 5 to day 25 of the menstrual cycle. The pill was taken daily at 9.30 a.m. after a light breakfast and blood samples were collected at 3 hr on alternate days and at 24 hr on other days after ingestion of the pill. On day 12 or day 15 of the first treatment cycle, serial blood samples were also collected at 1/2, 1, 2, 4, 6, 8 and 24 hr after taking the pill. Serum NET levels were estimated by the radioimmuno‐assay (RIA) technique. The plot of serum NET concentration versus time (0 — 24 hr) profile showed a rapid absorption of steroid and a peak NET concentration (18.3±4.8 ng/ml) reached at 2 hr after ingestion of the pill. By linear regression analysis of data (y = 0.27 + 0.12x; r=0.95), it was observed that the serum NET level was initially about 1 ng/ml. Thereafter, it increased by 0.12 ng/ml per day up to 3.5 ng/ml by the end of 21 days' treatment with oral pills. The serum NET concentration decay slope fitted a two‐compartment open model with an initial rapid decay (half‐life of 1.2±0.1 hr) followed by a slower β‐phase with a half‐life of 8.5±1.5 hr. The study revealed that there was an accumulation of norethindrone in plasma during the treatment period and this suggests the possibility of exploring a reduction in the dose of this preparation so as to achieve the optimum NET concentration for contraception, and thereby avoiding unwanted steroid accumulation in the plasma of women.
Prediction of Fetal Growth Deviation by Ultrasonic Biometry
Authors: Eik‐Nes S. H. , Persson P.‐H. , Gröttum P. , Marsál K.
Published: December 2009

Abstract. A previously developed mathematical formula for prediction of fetal growth deviation at birth by means of ultrasonic fetometry was applied to 505 unselected singleton pregnancies. The gestational age was assessed by measuring the fetal biparietal diameter (BPD) in the 17th week of pregnancy. In the 33rd and 38th week of pregnancy, BPD and the abdominal diameters (AD) were measured. In detecting fetuses small‐for‐gestational age (SGA) in the 33rd week, the ultrasonic diagnostic test had a nosological sensitivity of 77% and a nosological specificity of 78%. The nosological sensitivity and specificity for detecting fetuses large‐for‐gestational age (LGA) were 75% and 82%, respectively. The result was not improved significantly when the formula was applied to the total group in the 38th week. At the 33rd week examination risk groups with high prevalence of SGA and LGA fetuses were identified. When these groups were submitted to an additional examination in the 38th week, the prevalence of SGA and LGA fetuses in the new risk groups increased to 50%. At the 33rd week examination the predictive value of a negative test for SGA and LGA was 98%. Thus, the procedure described is well suited for general screening of pregnant women with ultrasound, and, combined with other biochemical and biophysical tests, makes possible a close clinical surveillance of the fetus at risk.
Verrucous Carcinoma of the Vulval Region
Authors: Andreasson B. , Bock J. E. , Strøm K. V. , Visfeldt J.
Published: December 2009

Abstract. Verrucous carcinoma is a variant of epidermoid carcinoma with distinctive clinical and pathological features. The diagnosis is often difficult. To date, 20 verrucous carcinomas involving the vulva have been reported in the literature. Metastases to the inguino‐femoral lymph nodes have not been described. The treatment of choice is wide local excision. Clinical features, histological findings, and therapy are discussed.
Evidence of a Possible Direct Action of Danazol on the Human Ovary
Authors: Milwidsky Ariel , Besch Norma F. , Besch Paige K. , Kaufman Raymond H.
Published: December 2009

Abstract. Strong evidence is presented that Danazol might exert a direct action on the human ovary by binding to receptor‐like receptors for progesterone and testosterone, in concentrations well within the pharmacological range of the treated patient. The possible significance of this finding in understanding Danazol's mode of action is discussed.
The Fluid Bridge Test for Urethral Incompetence
Authors: Sutherst John , Brown Malcolm
Published: December 2009

Abstract. A new urodynamic test which detects the entry of fluid into the proximal urethra has been used in the investigation of women with urinary incontinence. The test is positive if a “fluid bridge” is established between the bladder and a test point in the urethra. The test results from 30 incontinent patients were compared with those from 30 women with normal urinary control who had been matched for age and parity. Twenty‐four of the incontinent women had a positive fluid bridge test (FBT) at 0.5 cm from the bladder neck compared with 6 of the women in the control group. The difference between the test results in the two groups was highly significant (X2 = 19.27, p<0.001). In the incontinent patients a diagnosis was made after full clinical examination (which included an attempt to demonstrate stress leakage), cystometry and urethral closure pressure profile measurement. In a number of cases (23%) the only evidence of urethral incompetence was a positive FBT. We conclude that the FBT is a more sensitive index of sphincter weakness than are other non‐radiological urodynamic tests.
Campylobacter Enteritis Associated with Recurrent abortions in Agammaglobulinemia
Authors: Pines Amos , Goldhammer Ehud , Bregman Josef , Kaplinsky Naomi , Frankl Otto
Published: December 2009

Abstract. Campylobacter enteritis and habitual abortions occurred in a 28‐year‐old patient suffering from agamma‐globulinemia. Campylobacter jejuni has been recently recognized to be a common treatable cause of diarrhea in man. Since bacterial overgrowth of the small intestine is increased in hypo‐ or agammaglobulinemia, Campylobacter is expected to be found in those patients. As this patient's abortions might have been due to the same infection, Campylobacter should be considered in the differential diagnosis of habitual abortions, especially if associated with diarrheal disease. This treatable disease must be sought in every case of agammaglobulinemia and gastro‐intestinal complaints, before complicated diagnostic procedures are performed or potentially toxic drugs are administered.
Characteristics of Estrogen‐Treated Women
Authors: Persson I. , Adami H. O. , Lindberg B. S. , Johansson E. D. B. , Manell P.
Published: December 2009

Abstract. A cohort of 23 233 women who had received estrogen prescriptions was recruited for a prospective study of estrogen therapy and the associated risk of endometrial cancer. For a detailed study, a comprehensive questionnaire was mailed to 735 randomly sampled cohort members, and 89 per cent of them responded. Estrogen exposure and its implications were described in a preceding paper (part I). The present paper reports the distribution in the cohort sample of personal features known to be risk factors for endometrial cancer. A comparison with results from various materials derived from population‐based surveys and case‐control studies implied that the cohort members might have a lower proportion of nulliparity (infertility) and a somewhat higher prevalence of hypertension. Differences in the distributions of age at menarche or menopause, weight, height and prevalence of diabetes were according to these comparisons slight and probably without clinical significance. It was concluded that the prevalence of risk factors for endometrial cancer other than estrogen exposure was not higher in the cohort than in the background population. Moreover, approximately one‐fifth of the estrogen takers had been freed of their risk through hysterectomies.
Diagnosis in Utero of Congenital Hydrocephalus by Sonography and Computerized Tomography
Authors: Ölund Anders , Troell Staffan , Bistoletti Peter , Kraspelien Thomas , Somell Christina
Published: December 2009

Abstract. Four patients with suspected fetal hydrocephalus in utero were examined by means of sonography and computerized tomography (CT). The diagnosis was confirmed in 3 cases, while the fourth was found to be normal. The mean radiation dose absorbed by the maternal ovaries was estimated by phantom measurements.
Fetal Muscle Biopsy
Authors: Gustavii Björn , Löfberg Lars , Henriksson Karl Gösta
Published: December 2009

Abstract. Fetal muscle specimens suitable for histological and histochemical studies were obtained under fetoscopic visualization by removing a small piece of skin, thereby exposing the underlying muscle. The procedure was carried out in 7 cases prior to second‐trimester abortion. Muscle specimens so obtained may become useful in the prenatal diagnosis of Duchenne muscular dystrophy.
Actinomyces Israelii in the Genital Tract of Women with and Without Intra‐Uterine Contraceptive Devices
Authors: Persson E. , Holmberg K. , Dahlgren S. , Nilsson L.
Published: December 2009

Abstract. Actinomycosis involving the female genital tract is more common among IUD users than others. The diagnosis is difficult and often delayed. It has been suggested that the finding of Actinomyces‐like organisms or A. israelii in cervical smears indicates a risk of developing actinomycosis. A. israelii has not been regarded as a part of the indigenous genital flora.

A group of IUD users without symptoms of genital tract infections were compared with a control group without IUDs. No Actinomyces‐like organisms were found on cyto‐logical examination of cervical smears. Immunofluorescent staining and cultures identified A. israelii in 4% of the IUD users and in 3% of the non‐users. Serologic precipitin tests for actinomycosis were negative in all women. None developed actinomycosis on follow‐up of positive cases. The study indicates that A. israelli is a commensal of the female genital tract. The identification of A. israelii alone does not indicate that the patient risks developing actinomycosis. Other methods such as a serology test should be useful in defining the clinical significance of the findings.
HLA‐Dr‐Expressing Langerhans'‐Like Cells in Vaginal and Cervical Epithelium
Authors: Bjercke S. , Scott H. , Braathen L. R. , Thorsby E.
Published: December 2009

Abstract. Sections of ethanol‐fixed, paraffin‐embedded tissue specimens from human vagina and exocervix were stained by an indirect immunofluorescence method with a rabbit antiserum to HLA‐DR antigens. A specific staining of cells having a dendritic appearance were seen. The cells were randomly distributed, mainly in the parabasal cell‐layer of the stratified squamous epithelium. The number of dendritic cells was 1‐3% of all cells in the cervical epithelium and 1‐5% of the cells in the vaginal epithelium. Most probably these cells are Langerhans' cells.
Neuropeptides in the Regulation of Female Genital Smooth Muscle Contractility
Authors: Ottesen Bent , Söndergaard Finn , Fahrenkrug Jan
Published: December 2009

Abstract. The mammalian female genital tract is innervated with nerve fibers containing vasoactive intestinal polypep‐tide (VIP), substance P, enkephalins and somatostatin. The effect of these peptides has been studied by in vitro tension recordings on smooth muscle preparations from the uterine body, cervix and Fallopian tube of eighteen women. Substance P (10510−6 mol/1) had a dose‐dependent stimulatory effect. VIP displayed a dose‐dependently inhibitory effect on the substance P evoked contractions. Somatostatin, met‐enkephalin and leu‐enkephalin had neither stimulatory nor inhibitory effect. The findings suggest that substance P and VIP may participate in a dual nervous control of genital smooth muscle contractions.
Parturition and Pelvic Fracture
Authors: Madsen Lis Vinge , Jensen Jörn , Christensen Sören T.
Published: December 2009

Abstract. Thirty‐four women with a history of pelvic fracture gave birth. Ten had experienced increasing or recurrent pain during the course of their pregnancy. Twenty‐seven women gave birth without complications, including 13 patients with displaced pelvis.

In only one patient was cesarean section carried out on suspicion of disproportion. Cesarean section was carried out in another case because of resymphysiolysis and in one because of other complications to the pregnancy. Two underwent vacuum extraction because of secondary inertia, but subsequently they gave birth by the vaginal route without complications. In connection with pregnancy and birth, 2 patients had resymphysiolysis. They were the only patients of 8 with symphysiolysis who had undergone osteosynthesis, and both had had the material removed before pregnancy.

It is concluded that separation of the symphysis in a pelvic fracture is a more serious complication in subsequent parturition than is displacement of the bony birth canal.
Neonatal Fetal Death Following Cesarean Section Secondary to Hyperextended Head in Breech Presentation
Authors: Weinstein D. , Margalioth E. J. , Navot D. , Mor‐Yosef S. , Eyal F.
Published: December 2009

Abstract. There is a general agreement that infants with hy‐perextension in breech presentation should be delivered by Cesarean section in order to prevent spinal cord injuries and neonatal deaths. The following case report illustrates complete spinal cord transection in a fetus with hyperextended head in breech presentation delivered by Cesarean section who died 8 days after delivery.
The Incidence of Acute Neonatal Respiratory Disorders in Relation to Mode Of Delivery
Authors: Nielsen Thorkild F. , Hökegård Klas‐Henry
Published: December 2009

Abstract. Over a 3‐year period all infants (n = 7401) born at the Department of Obstetrics and Gynecology, Central Hospital, Borås Sweden, were studied for signs of respiratory disease. For all infants who developed signs of respiratory disorders the mode of delivery and the type of anesthesia used in cesarean section (CS) were analysed. The incidence of respiratory disorders in the whole material was 3.0% (n = 220) and the‐mortality rate for these disorders was 0.24%. There was a significantly higher incidence (p< 0.001) of respiratory disorders in infants weighing ≥ 2 500 g born by CS vis‐à‐vis infants born by the vaginal route. The group born by elective CS under maternal general anesthesia had a higher (p<0.05) rate of respiratory disorders than those born by elective CS under maternal epi‐dural anesthesia. It is concluded that the risk of respiratory disorders in infants delivered by CS is related to the mode of delivery per se. Consequently, a reduction in the proportion of such interventions ought to reduce the overall number of infants developing respiratory disease, as indicated in the present study.
Avoiding Prematurity in Elective Repeat Cesarean Section
Authors: Gross Thomas L. , Sokol Robert J. , Kwong Melinda S. , Wilson Margaret V. , Kuhnert Paul M.
Published: December 2009

Abstract. A prospective study was undertaken in 107 elective repeat cesarean deliveries in which the lecithin/sphingo‐myelin (L/S) ratio was positive. The frequency of neonatal complications in 87 of these women having positive amniotic fluid (AF) phosphatidylglycerol (PG) was compared with the frequency in the remaining 20 patients exhibiting a negative PG. Hyaline membrane disease (HMD) did not occur in either group. However, neonatal complications and related clinical procedures were significantly increased in the PG‐negative patients. These neonatal complications included increased frequency of admissions to the neonatal intensive care unit, physiologic jaundice, poor feeding, transient tachypnea, prolonged oxygen therapy, arterial blood gas determinations, chest X‐ray and placement of a peripheral intravenous line. The cause of this increased frequency in neonatal complications appears to be mild prematurity in patients exhibiting a positive AF L/S with a negative PG. This study suggests that, in hospitals where PG determinations are available, neonatal complications could be reduced further by awaiting the AF PG result before electively performing a repeat cesarean section.
A Longitudinal Study of Actinomyces Israelii in the Female Genital Tract
Authors: Persson Elisabeth , Holmberg Kenneth
Published: December 2009

Abstract. A prospective longitudinal investigation was performed to study variations in the occurence of Actinomyces israeliiwith reference to four microorganisms, staphylococ‐ci, E. coli, P. acnesand C. albicans, in the female genital tract. Fifteen healthy women were studied during all phases of the menstrual cycle. Sampling was made from the cervix, vagina and perineal area three times a week during two consecutive menstrual periods and during menstruation from napkins and tampons. Altogether 1 108 samples were taken on 349 sampling occasions for different cultural procedures. A. israelii was identified in all women, in varying frequencies (range 4 to 74% of sampling occasions). As a mean, A. israeliiwas recovered in 24% of the perineal samples, 13% of the vaginal and 6% of the cervical samples. The occurence of A. israelii was related neither to the recovery of reference microorganisms nor to the phase of the menstrual cycle, the amount of bleeding or discharge, the pH of the vaginal specimens, the contraceptive method used, or to the use of different sanitary products. It is our conclusion that A. israelii appears to be a part of the indigenous genital flora of healthy women.
Clinical Experience with a Triphasic Oral Contraceptive
Authors: Ulstein M. , Svendsen E. , Steier A. , Bratt H. , Fylling P. , Lie S. , Schiefloe A. , Aaserud J.
Published: December 2009

Abstract.A triphasic combined oral contraceptive containing fluctuating amounts of ethinylestradiol and levonorge‐strel was tested clinically in a multicenter trial at six hospitals in Norway. 367 women were included in the study, 3 588 cycles were studied, and the follow up period was 12 months. The one year continuation rate was 67%. Five pregnancies occurred during the study period. All of them had to be considered as patient failures. The causes for stopping medication were side effects in about 50% and the rest for personal reasons. The cycle control taking into account duration of bleeding, amount of flow, and intermenstrual bleeding was good and comparable to the low‐dose monophasic combined pills. The incidence of side effects was low. One woman had an increase in systolic blood pressure to more than 140 mmHg. Thrombophlebitis was not registered. In conclusion the triphasic oral contraceptive was effective and had a good cycle control and low incidence of side effects.
Low Maternal but Normal Fetal Prolactin Levels in Cigarette Smoking Pregnant Women
Authors: Andersen A. Nyboe , Rønn B. , Tjønneland A. , Djursing H. , Schiøler V.
Published: December 2009

Abstract. In the 36th week of pregnancy, levels of serum prolactin (PRL) (p <0.01) and estriol (p <0.05) were significantly lower in 101 consecutive women smoking 10 cigarettes or more per day, compared with a control group of 104 non‐smoking pregnant women. Cord serum PRL was not related to maternal smoking habits, whereas estriol was significantly (p <0.05) lower in the infants of smokers, compared with the control group. The lower PRL levels in cigarette‐smoking pregnant women may be due either to a direct effect of nicotine or secondary to lower estrogen levels, and the finding may be of clinical importance in relation to lactation.
Omentum Presenting at the Vulva After a Normal Labor and Delivery
Authors: Marsden Donald E.
Published: December 2009

Abstract. A case is described where omentum prolapsed through a uterine fenestration and presented at the vulva after a normal vaginal delivery. The patient had been aborted three times in the past, and it is postulated that the uterus had been perforated on one of these occasions.
Pregnancy‐Specific β1‐Glycoprotein (Spo Levels Measured by Nephelometry in Serum from Women with Vaginal Bleeding in the First Half of Pregnancy
Authors: Tamsen L.
Published: December 2009

Abstract. Pregnancy‐specific β1‐glycoprotein (SP1) levels were measured by nephelometry in sera from 107 women admitted to hospital because of vaginal bleeding in weeks 8 to 20 of pregnancy. The SP1 results were compared with those in single samples from 655 women and serial samples from 9 women with uncomplicated single pregnancies in the same period. The possibility of predicting the outcome of a pregnancy complicated by vaginal bleeding was calculated on the basis of the SP1 level on admission to hospital. In 65 % a normal SP1 value predicted continuation of pregnancy, whereas a low SP1 value invariably predicted spontaneous abortion.
Effects of Two Estradiol/Norgestrel Combinations on the Ovulatory Pattern and on Sex Hormone Binding Globulin Capacity in Women Around Forty Years of Age
Authors: Hagstad Anita , Damber Jan‐Erik , Janson Per Olof , Samsioe Göran , Södergård Ragnar
Published: December 2009

Abstract. Thirteen women aged 36—46 years (mean 43) who were seeking contraceptive advice, were monitored for 3 months with basal body temperature (BBT) and were then treated for 3 months with CyclabilR (11 tablets of 2 mg es‐tradiol valerate (E2) followed by 10 tablets of 2 mg E2 + 0.5 mg norgestrel). This treatment was immediately followed by another 3 months with CyclabilR + 2 mg E2. BBT revealed a spontaneous ovulatory rate of 89%. Cyclabil reduced the ovulatory rate, as measured with repeated serum progesterone analyses, to 37%, and Cyclabil + 2 mg E2 resulted in a marked reduction in the number of ovulations (3 %). Both types of hormonal combination resulted in relatively small changes in Sex Hormone Binding Globulin Capacity. It is concluded that the addition of 2 mg E2 to CyclabilR causes a decrease in ovulation rate to such an extent that women using this combination run a relatively small risk of conceiving. One advantage over contraceptive steroids may be that the present combination contains a natural estrogen at a relatively low concentration.
Serum IGE and Smooth Muscle Antibodies in Pre‐Eclampsia
Authors: Alanen Anna
Published: December 2009

Abstract. The serum IgE concentrations and the occurrence of autoantibodies were measured in 20 women with preeclampsia and in 17 women with normal pregnancy. All women studied were primigravid and matched according to the age and the duration of pregnancy. The serum IgE concentration was higher in preeclampsia. Antinuclear and antimitochondrial antibodies were found only occasionally, whereas smooth muscle antibodies were found in preeclamptic women more often than in normal pregnancy. These results are in agreement with the findings of disturbed immune function in preeclampsia, but do not clarify the etiology of this disorder.
A Comparison of Three Dosages of Prostaglandin E2 Pessaries for Ripening the Unfavourable Cervix Prior to Induction of Labor
Authors: Varma T. R. , Norman J.
Published: December 2009

Abstract. A study was planned to evaluate the effect of Prostaglandin E2 pessaries in three different dosages in ripening the unfavourable cervix prior to the induction of labor.

A single dose of PGE2 as pessary in the three different dosages was administered into the posterior vaginal fornix to ripen an unfavourable cervix with a Bishop score ≤4 in 101 primigravid and 79 multigravid patients.

The pessary containing 2 mgm was as effective as 3 mgm and 5 mgm PGE2 pessary in ripening the cervix, and the outcome of labor and fetal status were similar with the different dosages of PGE2. However, two multigravid patients who received 5 mg of PGEs pessary and one multigravid patient who received 3 mg of PGE2 pessary developed hyper‐tonic uterine activity. None of the patients who received 2 mg PGE2 pessary developed any adverse effect on uterine activity.
The Incidence of Candida Albicans in the Vagina of “Healthy Young Women”
Authors: Leegaard Merete
Published: December 2009

Abstract. The frequency of vaginal Candida albicans was investigated in 603 healthy women at a “Contraceptive Clinic”. Swabs were taken from the rectum, which is thought to be the reservoir and thereby the cause of reinfection of the vagina with Candida albicans. A neat correlation exists. Women who have received antibiotics within 3 months prior to the investigation have significantly more frequent bouts of candidosis. The same is true of with users of “the pill” and women using sanitary towels only for menstrual protection, compared with women using tampons only. The women were asked about bathing facilities and the frequency with which they use soap and water for washing of the external genitalia. The latter showed no difference, while there was an apparently increased frequency of positive swabs for Candida albicans in women who were “spot” washing, compared with those who took a shower and those who took a bath. This difference was not significant, however.