bluuebunny/crossref_metadata_2025 huggingface dataset:
Hormonal and Cytopathological Changes in Vaginal and Cervical Smears from women undergoing chemotherapy for extragenital Malignant Diseases
Authors: Schachter Alexander , Kopmar Alexander , Avram Erna , Gorodeski Israel G. , Segal Anita
Published: December 2009

Abstract. The effects of various chemotherapeutic drugs on the squamous epithelium of the cervicovaginal tissues were investigated in a test group of 74 and a control group of 44 women with advanced extragenital malignancy. The cyto‐logical findings were as follows

(A) cytohormonal changes reflecting estrogenic withdrawal in pre‐ and postmenopausal women

(B) reversible cytopathol'ogical changes reflecting a cytotox‐ic reaction, and

(C) absence of premalignant and malignant changes.
Severe Fetal Distress with Hydramnios due to Chorioangioma
Authors: Hurwitz Arye , Milwidsky Ariel , Yarkoni Shaul , Palti Zvi
Published: December 2009

Abstract. A case is described of antenatal detection of a placental mass by ultrasound in a patient with hydramnios due to chorioangioma and who had a sinusoidal‐like pattern and positive oxytocin challenge test (OCT). The importance of frequent fetal heart rate monitoring in cases of supected chorioangioma is emphasized.
Maternal Mortality in the Nordic countries 1970‐1979
Authors: Augensen Kåre , Bergsjø Per
Published: December 2009

Abstract. There are approximately 400000 births plus legal abortions in the five Nordic countries annually. During the 1970s the number of maternal deaths ranged from 14 to 33 per year, the overall mean rate being 7.2 per 100000 births. The rates declined somewhat from 1972 onwards, but otherwise there was no demonstrable change in frequency with time. Mortality rose steeply with increasing maternal age, with a rate of 28.5 for mothers over 35. The two most frequent causes of death were pre‐eclampsia/eclampsia and hemorrhage, comprising. 17.0 and 14.2% of the total, respectively. Legal abortion carried less risk of death than did pregnancy continuing to birth. Among the countries, Denmark and Sweden had the lowest average maternal mortality rates. The distribution of causes showed a predominance of abortion and thrombosis in Finland, and of hemorrhage and infection in Norway, but neither singular causes nor age‐specific birth distributions can explain inter‐country differences.
Acute Effects of Prostaglandins on the Biosynthesis of Connective Tissue Constituents in the Non‐Pregnant Human Cervix Uteri
Authors: Norström Anders
Published: December 2009

Abstract. Biochemical effects of prostaglandins (PGs) on the connective tissue of the human cervix uteri were studied by measuring the net incorporation of [3H] glycine and [3H] glucosamine into cervical specimens, incubated in vitro in the presence of PGE2 and PGF2α. The net radiolabelling with these isotopes, precursors of collagen and proteo‐glycans, was influenced by PGE2 and PGF2α in a similar manner. In the follicular phase of the menstrual cycle, both PGs induced a decreased radiolabelling with glycine but caused an increased labelling with glucosamine. In the luteal phase, the situation was reversed, i.e. the incorporation of glycine was augmented and that of glucosamine was reduced in tissue incubated with PGs. It is suggested that PGs can modulate the fibroblast biosynthesis activity in such a way that either the synthesis of fibrous structures (collagen) or that of ground substance constituents (proteoglycans) is favored.
Estimation of Fetal Weight by External Abdominal Measurements
Authors: Pschera Helmut , Söderberg GÖRan
Published: December 2009

Abstract. In 2108 pregnant women, external abdominal measurements were correlated to the weight of the newborn child. The product of girth and uterine height was more closely correlated to the infant weight than were any of these maternal variables alone or in other combinations, but the accuracy of this method was almost as low as of simple external palpation. For successive estimations of fetal growth the product of maternal girth and uterine height may be more adequate than either of these variables alone.
Menstrual Dysfunction in Norwegian Top Athletes
Authors: Øian Pål , Augestad Liv Berit , Molne KÅRe , Oseid Svein , Aakvaag Asbjørn
Published: December 2009

Abstract. Of 301 Norwegian female top athletes, all members of the national team in 27 different sports, who were approached with a questionnaire about menstrual function, 278 (92.4%) responded. Ninety‐nine of the respondents who used oral contraceptives were excluded. Of the remaining 179, 18 (10.1%) reported secondary amenorrhea (>4 months since the last period) and were chosen for further studies. Blood samples were drawn for hormonal analyses between 10 and 12 a.m. and at least 12 hours after the last training session. Their mean age was 20.8 years (range 18‐27), mean height 169.8 cm (160‐180), mean weight 58.5 kg (51‐67), and their mean age at menarche 14.6 years (13—16.5), significantly older than that of the other top athletes: 13.5 years (p <0.05). Their mean number of training hours per week was 16.1 (12—24). Hormonal changes were consistent with simple normoprolactinemic hypotha‐lamic suppression, characterized by low values of FSH, es‐tradiol—17β and prolactin. The androgen hormones demonstrated high levels of dihydrotestosterone. Testosterone levels were within normal limits, but in the upper part of the range, whereas sex hormone‐binding globulin was in the lower normal range.
External Endometriosis in 801 Operated Patients
Authors: Nikkanen V. , Punnonen R.
Published: December 2009

Abstract. Details of medical history, symptomatology, operative findings and certain other special features are reported for patients with external endometriosis treated ope‐ratively during the period 1969‐76. The incidence of endometriosis in this survey was 19% of all gynecological laparo‐tomies. The mean age of the patients at the time of the operation was 36.7 years. The most common sites of endometriosis were the retrocervix and the ovaries. Of the patients, 559 (70%) had complained of dysmenorrhea; the pain generally began before the bleeding. Also typical was the exacerbation of the pain with increasing age. Twenty‐seven per cent of the patients also complained of infertility. Surgery was performed because of acute abdominal symptoms in 6% of cases. The incidence of endometriosis in postmenopausal women was 2.5% and that in young women, 1%. Endometriosis recurred in 15% of the cases during the follow‐up period. Gestagen therapy after the operation had no effect on the recurrence rate.
T‐Tube Suction Drainage and/or Prophylactic Two‐Dose Metronidazole in Abdominal Hysterectomy
Authors: Poulsen Henning Kvist , Borel John
Published: December 2009

Abstract. The efficacy of a two‐dose perioperative course of rectally administered metronidazole and/or suction drainage of the vaginal vault in preventing febrile and infectious morbidity was evaluated in a randomized study of 198 patients undergoing abdominal hysterectomy. When compared with the control values, the incidence of febrile morbidity was significantly reduced (from 49% to 10%, 24.5%, and 10% respectively) in the groups treated with metronidazole, T‐tube suction drainage, and a combination of the two prophylactic measures. The incidence of infectious morbidity was significantly reduced by using prophylactic metronidazole alone or in combination with suction drainage, but the reduction was most significant in the group treated with metronidazole alone. In the group managed with suction drainage alone, no reduction in infectious morbidity was found. The rate of postoperative urinary tract infection was significantly lower in the group treated with metronidazole alone as compared with the control group. No side effects of metronidazole were encountered.
Controlled Study of Bromocriptine and Placebo for Induction of Ovulation in Normoprolactinemic Secondary Amenorrhea
Authors: Espersen Thorkild , Thomsen Anders C.
Published: December 2009

Abstract. In order to evaluate the effect of bromocriptine in the treatment of secondary amenorrhea, a double‐blind placebo‐controlled study including 30 women with normo‐prolactinemic normo‐hypogonadotropic hypogonadism was carried out. The patients were given either 5 mg bromocriptine or placebo every day for 12 weeks and observed during the following 3 months. A biphasic basal body temperature curve and serum progesterone levels exceeding 25 nmol/1 during the expected midluteal phase were considered an indication of ovulation. Restoration of ovulation was observed in 2 of 17 women given bromocriptine and 4 of 13 women given placebo. Bromocriptine was found to have no specific effect on the restoration of ovulation in women with secondary amenorrhea and normoprolactinemic normo‐hypogonadotropic hypogonadism.
Subjective Recording of Fetal Movements
Authors: Valentin L. , Löfgren O. , Mars˘ál K. , Gullberg B.
Published: December 2009

Abstract. Maternal counting of fetal movements is increasingly used as a clinical method for assessment of fetal health. The present study established normal limits for two methods of subjective fetal movement recording. Four hundred‐and‐seventeen randomly selected women with low‐risk pregnancies recorded the time necessary for 10 fetal movements every morning and also the number of fetal movements during 15 min every evening. The study was carried out between gestational week 34 and parturition. Two hundred‐and‐twenty‐two consecutive women answered a questionnaire after the end of the study. 70% of the women counted fetal movements every day; 66.5% preferred the evening to the morning recording. In a strictly selected normal group (n = 129), no significant change was found in the number of fetal movements or in the time for 10 fetal movements with advancing gestation or approaching parturition. The results of the evening sessions were not influenced by maternal parity, fetal weight, or fetal sex. The great interin‐dividual variation in the results does not allow the application of general normal limits. A method for establishing individual normal low limits for each pregnancy was designed.
Urinary Free Cortisol During Pregnancy
Authors: Mikkelsen Anne Lis , Felding Christine , Hasselbalch Hans
Published: December 2009

Abstract. Adrenocortical function was measured during early and late normal pregnancies by determining urinary free cortisol on three consecutive days. A marked intra‐indi‐vidual variation in urinary free cortisol excretion was found. This pattern did not differ in early and late pregnancy. No correlation was demonstrated between the excretion of free cortisol, estrogen levels and creatinine clearances.
Umbilical Cord Damage and Placental Abruption During Amniocentesis
Authors: Zakut Haim , Lotan Michael , Achiron Reuven
Published: December 2009

Abstract. A case of umbilical cord laceration and placental damage during amniocentesis for maturity studies is presented, with a review of the complications of amniocentesis.
Symphysis‐fundus Measurements and Intrauterine Growth Retardation
Authors: Cnattingius Sven , Axelsson Ove , Lindmark Gunilla
Published: December 2009

Abstract. A prospective study of the clinical value of the symphysis‐fundus (SF) distance was performed on 528 women, all at risk for developing intrauterine growth retardation (IUGR). Four different types of SF curves were observed and denoted as normal, static, catch‐up and low. A normal or static SF curve predicted a normal birthweight (specificity 92%), while a catch‐up or low SF curve identified 79% of the infants with a birthweight below 2 SD for length of gestation.

The differences in short‐term morbidity between infants delivered by mothers with normal and pathological SF curves were mainly due to prematurity.

We find the SF method to be a useful tool for detection of IUGR. Since correct estimation of gestational age is a prerequisite, we recommend an early ultrasonic measurement on all patients.
Supernumerary Ovary
Authors: Hahn‐Pedersen Jan , Larsen Pia Munkholm
Published: December 2009

Abstract. A case of supernumerary ovary is reported—the eleventh in the literature. The patient had two left‐sided ovaries, associated with contralateral hemiuterus.
Impaired Voiding Efficiency and Urinary Retention after Laparoscopic Ventrosuspension Ad Modum Steptoe
Authors: Lose Gunnar , Lindholm Per
Published: December 2009

Abstract. A case of impaired voiding efficiency and urinary retention after laparoscopic ventrosuspension a.m. Steptoe is presented. Symptomatic management was achieved by prescribing the a‐adrenergic blocking agent phenoxybenza‐mine hydrochloride, but curative management was not obtained until neutralization of the ventrosuspension. Patho‐physiological possibilities are discussed.
Conization of the Cervix Uteri
Authors: Holmskov Anni , Qvist Niels , Møller Axel
Published: December 2009

Abstract. During a retrospective study on postoperative complications in 213 patients who had undergone conization, a (nonsignificant) reduction in the bleeding rate from 27.9% to 18.6% was found when using silk sutures (102 patients) instead of plain catgut (111 patients) for adaption of the edges of the wound (0.1 <p<0.2). The reduction was most pronounced and significant in cases where bleeding had occurred during the first 4 days after surgery, the usual period for hospital stay under normal conditions. After discharge the bleeding rates were more comparable, 12.6% in the catgut group and 16.6% in the silk group. On the other hand, more cases of stenosis of the cervical canal were observed, i.e., 25.5% in the silk group and 8.1% in the catgut group (p< 0.001). The period of hospitalization was reduced on an average by 2 days when using silk (p< 0.001).
The Predictive Value of Total Estriol; HPL and HB on Perinatal Outcome in Severe Pre‐Eclampsia
Authors: Sagen Norvald , Nilsen Stein Tore , Kim Hyun Chan , Koller Oddmund , Bergjø Per
Published: December 2009

Abstract. The prognostic value of total maternal plasma estriol, human placental lactogen (HPL) and hemoglobin (Hb) with regard to perinatal outcome was compared in 74 cases of severe preeclampsia. No combination of the tests predicted all cases of fetal and newborn pathology. HPL was the most reliable single test in cases of intrauterine growth retardation, while Hb was the best predictor of severe fetal pathology and perinatal distress. In cases of severe fetal and neonatal pathology, the prognostic value of the combination of HPL and Hb was more reliable than the combination of all the three tests.
Natural Killer Cell Activity After Gynecologic Infections with Chlamydia
Authors: Onsrud Mathias , Qvigstad Erik
Published: December 2009

Abstract. The level of blood natural killer (NK) cell activity was determined in relation to chlamydial infections. A group of 10 women who had recovered from chlamydial salpingitis was compared with a similar group who had had chlamydial cervicitis. Ten healthy female blood donors with no history of chlamydial infections served as controls. The spontaneous cytotoxity of nonadherent blood lymphocytes was determined in a 3‐hour assay with radiolabelled K562 cells as targets. There were no significant differences in the NK cell activity of the three groups. No correlation between NK cell activity and chlamydial IgG antibody titer in serum could be found. The level of NK cell activity as determined in this system cannot explain why some patients get a more severe form of chlamydial infection than others do.
Effects of Naloxone on Newborn Infant Behavior After Maternal Analgesia with Pethidine During Labor
Authors: Welles B. , Belfrage P. , De Château P.
Published: December 2009

Abstract. Infants born to mothers receiving 100 mg of pethidine during labor, were randomly given either 100 μg of naloxone (n = 14) or 0.25 ml 0.9% NaCl (n = 13) one hour post partum. Infant behavior was assessed with the Brazelton Neonatal Behavioral Assessment Scale (BNBAS) and the Broussard Neonatal Perception Inventory (NPI). No differences in cluster scores on the BNBAS were found between the two groups. Both groups improved scores over time in 4 out of 7 clusters. On the NPI, mothers assessed naloxone infants as having less optimal behavior than did the control mothers. The results of this study on the effects of naloxone on infant behavior and maternal perception of newborn behavior do not warrant administration of naloxone after maternal analgesia with pethidine in the absence of clinical evidence of respiratory depression in the newborn.
Decrease in Menarcheal Age From 1966 to 1983 in Denmark
Authors: Helm Peter , Helm Sven
Published: December 2009

Abstract. Mean age at menarche was estimated by the status quo method in the same region of Denmark in 1965—66 and 1982‐83 in 983 and 1591 girls, respectively. During that period menarcheal age decreased by 4 months from 13.40 to 13.03 years, subsequent to a similar decrease from 1949‐50 (2) to 1965‐66. Comparison with recent data from the other Nordic countries; except Norway, indicates that age at menarche is now close to 13 years, and a halt in the trend towards earlier menarche is not evident.
Fibrinopeptide a and Intravascular Coagulation in Normotensive and Hypertensive Pregnancy and Parturition
Authors: Wallmo L. , Karlsson K. , Teger‐Nilsson A. C.
Published: December 2009

Abstract. Fibrinopeptide A (FpA), fibrin monomers, fibrinogen, fibrin degradation products (FDP) and platelets have been studied during pregnancy, parturition and during toxemia and compared with normal nonpregnant controls in order to evaluate thrombin activity under these conditions. We found a significant rise in fibrinopeptide A levels in late pregnancy and even more so during parturition with a maximum immediately after placental expulsion. We also found elevated FpA levels in toxemic patients, but no significant differences from normal pregnancies. Fibrin monomers were more often elevated during delivery and toxemia than during normal pregnancy.

One case report concerning a patient with deficient thrombin activation and heavy postpartum bleeding is added.

Our studies indicate an increased thrombin activity and fibrinogen turnover in both normal and toxemic pregnancies. During normal childbirth, coagulation activity seemed to reach a maximum immediately after placental separation.
The Course of Subsequent Pregnancies After Previous Cesarean Section
Authors: Nielsen Thorkild F. , Hökegård Klas‐Henry
Published: December 2009

Abstract. The course of pregnancies subsequent to cesarean section (CS) was studied. During the years 1970‐72, 543 women were delivered by CS at Borås Central Hospital. A questionnaire was sent to all 543 during the autumn of 1976 and the spring of 1977. The questions concerned further conceptions and the outcome of all subsequent pregnancies after CS. Of the 440 (81%) women who answered the questionnaire, 244 (55.5%) became pregnant, the total number of subsequent pregnancies being 306. The incidence of spontaneous abortion, extra‐uterine pregnancy and legal abortion was not significantly higher than the corresponding rate for the total material for our department during the same period. Among the 215 women who completed a new pregnancy, an elective CS was performed in 81 cases (38%). Trial of labor occurred in 143 patients, 91 of whom (68%) gave birth per vaginam, while 43 (32%) were delivered by acute CS. In nearly half of the acute CS cases the indication was a narrow pelvis not detected until labor had started. This indicates that roentgenologic pelvimetry should be considered in certain cases, when planning delivery after a previous CS.
Outcome of First Delivery after 2nd Trimester Two‐Stage Induced Abortion
Authors: Meirik Olav , Nygren Karl‐Gösta
Published: December 2009

Abstract. In a historical cohort study the outcome of the first birth after a legal 2nd trimester two‐stage abortion induced with saline or prostaglandin F2α was evaluated for 142 nulliparous and 65 parous women. The birth‐outcome was compared with that for 180 parity‐matched control women and for all women in Sweden 1975. No statistically significant differences were disclosed with regard to means of infants' birthweight and length of gestation, or to occurrence of low birthweight (LBW) infants and preterm deliveries. The nulliparous women with a previously induced abortion tended, however, to have more LBW‐infants than did the other nulliparae. More LBW‐infants were born to the 29 nulliparae with a previous abortion induced with prostaglandin than to the 113 nulliparae having abortions induced with saline (p = 0.11); otherwise no noteworthy differences were found in the birth‐outcome for the 39 women with a previous abortion induced by prostaglandin, compared with the 168 having abortions induced by saline.
Adenocarcinoma of the Endometrium Stage I
Authors: Philipsen Torben , Nørgård Mogens
Published: December 2009

Abstract. Survival after treatment of stage 1 endometrial ad‐enocarcinoma was studied in a material of 111 patients, median follow‐up period 6 years.

Routine treatment was preoperative intrauterine and vaginal radium followed, in 6 weeks, by total hysterectomy and bilateral salpingo‐oophorectomy.

The 5‐year corrected survival after treatment by operation and/or irradiation was 93%, after irradiation alone 87%. A significantly better survival was found in stage la (95%) than in stage Ib (83%) and also in patients with grade 1 tumors (97%) than in those with grade 3 tumors (71%). 21% of the patients had a residual endometrial tumor after preoperative radium, and among them survival was signifi‐canctly lower than in patients without residual tumor. The recurrence rate was 11.7%. Vaginal metastases did not occur.

Our routine treatment afforded satisfactory results in stage 1, grade 1 and 2. However, supplementary treatment must be recommended in the case of grade 3 tumors, of myometrial deep invasion, and of residual tumor following preoperative radium therapy.
Pseudogestational Sac in Ectopic Pregnancy
Authors: Wexler Shraga , Yedwab Gideon , Golan Abraham , David Menachem P.
Published: December 2009

Abstract. A case of tubal pregnancy demonstrated by sono‐graphy is presented. In addition to the true ectopic gestational sac, an intra‐uterine structure closely resembling a ge‐stational sac was detected simultaneously. Such a finding of a pseudogestational sac in the uterine cavity may mislead to the diagnosis of an intra‐uterine gestation. Thus, this sonographic finding is not sufficient to exclude the diagnosis of ectopic pregnancy. Clinicians should be aware of the possible finding of a pseudogestational sac in cases of ectopic pregnancy and the pathophysiological basis of this phenomenon is discussed.
Results of in vitro fertilization and culture of human ova
Authors: Lauritsen J. G. , Therkelsen A. J.
Published: December 2009

Abstract. Using a technique with different media for fertilization and subsequent culture, cleavage of at least one oocyte was achieved in 35 (83%) out of 42 consecutive patients. A total of 138 oocytes (74 pre‐ovulatory, 20 non‐ovu‐latory and 44 atretic) were inseminated in vitro. Fifty‐two (70%) of the pre‐ovulatory oocytes clove and of these 37 (72%) developed apparently normally to the morula or blas‐tocyst stage, while cleavage of the remaining 15 (28%) was characterized by an abnormal growth curve or abnormal morphology of the embryo. Only one (5%) of the 20 non‐ovulatory oocytes clove, and this embryo displayed an abnormal growth curve. None of the atretic oocytes clove. It is concluded that evaluation of morphology and growth curve seems to be of value in distinguishing between apparently normally and abnormally developing embryos in vitro.
Red Cell 2,3‐Diphosphoglycerate and Hemoglobin‐Oxygen Affinity During Normal Pregnancy
Authors: Madsen Hans , Ditzel Jøm
Published: December 2009

Abstract. The concentration of red cell 2,3‐diphosphoglyce‐rate (2,3‐DPG), hemoglobin‐oxygen affinity and other oxygen transport variables were determined during first, second and third trimester of normal pregnancy as well as 3 months post partum in 18 healthy women. The median concentration of red cell 2,3‐DPG increased significantly from the first to the third trimester (16.1 to 17.0 μmol/gHb, p>0.01), whereas 2,3‐DPG decreased significantly post partum (p>0.01). Normal pregnancy was also associated with relative anemia, a significant increase in arterial pH, hypocapnia and hypophosphatemia. The difference in hemoglobin concentration from the first trimester to 3 months post partum was correlated inversely with the difference in red cell 2,3‐DPG content (r= 0.52, p>0.05). In spite of the variations in red cell 2,3‐DPG, hemoglobin‐oxygen affinity expressed as p50 at actual pH remained unchanged during pregnancy and post partum. The study suggests that the increased level of 2,3‐DPG during pregnancy may in part represent compensation for physiologic anemia and also compensate for a factor leading to increased hemoglobin‐oxygen affinity during pregnancy.
The Infrequent Occurrence of Mycoplasmas in Amniotic Fluid from Women with Intact Fetal Membranes
Authors: Thomsen A. C. , Taylor‐Robinson D. , Hansen K. Brogaaru , Furr P. M. , Ross J. M. , Milton P. J. , Hare M. J.
Published: December 2009

Abstract. As human genital mycoplasmas have been associated with various forms of reproductive failure, the present study was undertaken to investigate whether M. homi‐nis and U. urealyticum organisms (ureaplasmas) are capable of crossing intact fetal membranes. Nearly 300 women in Denmark and England were investigated. Most of them were seen at about the fourth month of gestation and the remainder towards or at the time of birth, all with unruptured membranes. A swab was taken from the uterine cervix or vagina and M. hominis was isolated from 9% of the women and ureaplasmas from half of them. The presence of these mycoplasmas was not associated with an abnormal outcome of pregnancy. In contrast to the frequent presence of mycoplasmas in the lower genital tract, amniotic fluids obtained by transabdominal amniocentesis or at cesarean section did not contain M. hominis and ureaplasmas were isolated from only one of them. This was associated with the same urea‐plasmal serotype being recovered from the cervix and also from the blood of both infant and mother, whose case differed from the others as labor had already started when the amniotic fluid was obtained. Thus, in our populations, we have no evidence that mycoplasmal invasion of the amniotic fluid occurs before the onset of labor. During labor, despite intact membranes, it seems that genital mycoplasmas may occasionally invade the fetal placental unit, probably by the hematogenous route after strong uterine contractions, or otherwise directly after membrane rupture. Since both these events are followed usually by immediate delivery, there would seem to be insufficient time for the genital mycoplasmas to cause fetal damage.
Changing Panorama of Perinatal and Infant Mortality in Diabetic Pregnancy
Authors: Olofsson Per , Sjöberg Nils‐Otto , Solum Thore , Svenningsen Niels W.
Published: December 2009

Abstract. In a 21‐year study covering 1960 to 1980, perinatal and infant mortality in 237 infants of diabetic mothers were analysed. The study was divided into three 7‐year periods related to changes in management. In period I (1960‐66) the perinatal mortality was 24.3%, decreasing to 5.0% in period II (1967‐73) and to 1.1 % in period III (1974‐80). The corresponding figures for infant mortality were 31.4%, 7.5% and 4.6% respectively. Today the difference between the perinatal mortality rate in diabetic vs. non‐diabetic pregnancies is almost negligible. However, perinatal mortality may give a false impression of pregnancy outcome, since owing to the high rate of lethal malformations in period III, infant mortality was still twice that of the non‐diabetic population. During the 21‐year period studied, complications of diabetic pregnancies such as severity and duration according to the White classification, hypertension and pyelonephritis in pregnancy and preterm delivery all decreased. Consequently the influence of these complicating factors on the overall outcome of diabetic pregnancies has declined.
Thanatophoric Dwarfism
Authors: Bækmark Ulla Britt , Bliddal Bodil , Lorentzen Martin
Published: December 2009

Abstract. Thanatophoric dwarfism was distinguished as a separate entity in 1967. A report is presented of the first case of thanatophoric dwarfism in Scandinavia. A literature survey is given of the clinical, radiological, ultrasonic and his‐tological findings. The mode of inheritance is still not known, but is presumed to be autosomal recessive and the imperic risk of recurrence is 1:50. There is no possibility of prenatal diagnosis, for eugenic reasons, but the condition can be detected by means of ultrasonic scanning and radiology around the 34th week of pregnancy. The value of diagnosis at this time is that the mother can be protected from excessive obstetrical procedures on fetal indications, as the condition always leads to the death of the infant.
Estradiol and Progesterone Receptors in Normal Ovary and Ovarian Tumors
Authors: Lantta Marja
Published: December 2009

Abstract. Specific estradiol (ER) and progesterone receptors (PR) in the tumor cytosol of 54 patients with primary ovarian cancer were examined. Also 30 benign ovarian neoplasms and 19 normal ovaries were analysed. Of the malignant tumors, 46% contained ER and 41% PR. The ER content of most malignant tumors was 3–30 fmoles/mg protein; three tumors revealed an ER content over 30 fmoles/mg protein. The PR content of most malignant tumors was 8–80 fmoleslmg protein. Three endometrioid adenocarcinomas and three serous cystadenocarcinomas had a PR level over 100 fmoles/mg protein. ER and PR were simultaneously detected in 26% of the malignancies, whereas 39% of them were receptor negative. No significant differences were found between premenopausal and post‐menopausal women, as regards the presence of steroid receptors. Carcinomas were significantly more often ER‐positive than were benign tumors. The ER content of both the benign neoplasms and the normal ovary was low, 5 1 5 fmoles/mg protein, whereas higher PR levels were found in these two groups. The presence of steroid receptors in malignant ovarian tumors can possibly be used as an indicator of hormone dependency of these malignancies.
Estradiol and Progesterone Receptors in Gynecologic Sarcomas
Authors: Lantta Marja , Kärkkäinen Jorma , Wahlström Torsten , Widholm Olof
Published: December 2009

Abstract. We report the concentrations of estradiol and progesterone receptors found in the tumor tissue of 5 patients with leiomyosarcoma, 4 of uterine and one of ventricular origin, and of 5 patients with uterine or ovarian carcinosarcoma. Steroid receptor positive and negative tumors were present in both groups of sarcoma. One uterine leiomyosarcoma had a high concentration of estradiol and progesterone receptors, 37 fmoles/mg protein and 156 fmoles/mg protein, respectively. We suggest that steroid receptors should be analysed in all gynecologic sarcomas.
Improved Lung‐Thorax Compliance in the Premature Rabbit Neonate After Treatment With Dibuturyladenosine‐3′:5′‐Cyclic Monophosphate
Authors: Cosmi Ermelando V. , Lachmann Burkhard , Grossmann Gertie , Marzano Cristina , Orezzi Claudio , Saitto Carlo , Robertson Bengt
Published: December 2009

Abstract. Premature rabbit neonates, delivered on day 28 of gestation, were treated with a single dose of dibuturylade‐nosine‐3′:5′‐cyclic monophosphate (cyclic AMP), 300 mg/kg, immediately after delivery, saline‐injected litter‐mates serving as controls. All animals were kept in body ple‐thysmographs and ventilated artificially with 100% oxygen for 1 h, with a maximal tidal volume of 10 ml/kg body weight. Lung‐thorax compliance was significantly improved in animals treated with cyclic AMP, both 30 and 60 min after onset of ventilation (0.92±0.09 vs. 0.59±0.08 ml/cm H20.kg and 0.96±0.09 vs. 0.53±0.08, p>0.005), but there was no improvement in alveolar air expansion, evaluated histologically. Phosphatidylglycerol was absent in alveolar wash from all control animals, but present in 3 of the 8 pooled samples from the animals treated with cyclic AMP; this difference was not statistically significant, however.
Neurodevelopmental Outcome and Electronic Fetal Heart Rate Monitoring in a Neonatal Intensive Care Population
Authors: Holmqvist P. , Svenningsen N. W. , Ingemarsson I.
Published: December 2009

Abstract. In a one‐year population, 1977, of newborn infants admitted to the Neonatal Intensive Care Unit (NICU) the incidence of persistent neurodevelopmental handicaps was 3%, i.e. 13 of 427 survivors at 2 years of age. Transient abnormalities during the first 6 months of life were found in 63 infants, but after 6 months of age they were all normal at follow‐up examinations. Most mothers with infants showing transient abnormalities or persistent handicaps had a high‐risk pregnancy but one‐third (35.5%) had a low‐risk pregnancy and in this group 4 out of 7 cases with persistent major neurodevelopmental handicaps were found. In the total one‐year population, 6% showed ominous fetal heart rate patterns (FHR) in labor compared with 31% of infants with later abnormalities and handicaps. Furthermore, all 13 infants with persistent handicaps had a normal Apgar score at 5 min, indicating that Apgar scoring was less predictive than FHR for neurodevelopmental outcome. Altogether 54 infants born in 1977 were small for gestational age (SGA): 33 NICU‐treated and 21 not NICU‐treated. Seven (6 NICU‐treated, 1 not NICU‐treated) had transient abnormalities (12.9%). No SGA infant developed persistent handicaps. The results suggest an improved obstetric and neonatal care of these infants.
Orcadian Rhythm of Fetal Movements
Authors: Ehrström Christman
Published: December 2009

Abstract. Intra‐uterine fetal movements indicate the wellbeing of the fetus and can be used in the detection of chronic fetal asphyxia. The daily variations in fetal activity follow an irregular pattern, though showing a peak of activity in the evening. The pattern of nocturnal activity is not known. In this study, fetal movements were monitored by maternal subjective recordings in 116 women with a normal pregnancy. In gestational weeks 31‐40, fetal movements were recorded intermittently for at least 3 hours, both in the daytime and at night. In the daytime, fetal activity was moderate. A maximum occurred in the evening between 9 and 10 p.m. At night there was a period of minimum activity between 1 and 5 a.m. A minor peak in fetal activity was seen between 7 and 8 a.m. The frequency of fetal movements followed a pattern of a circadian rhythm, which was influenced by exogenous factors.
Screening for Detection of Intra‐Uterine Growth Retardation by Means of Ultrasound
Authors: Selbing Anders , Wichman Klas , Rydén Gunnar
Published: December 2009

Abstract. In a two‐stage ultrasound screening program the gestational age was assessed by measurement of the fetal crown‐rump length in early pregnancy. At an adjusted gestational age between 32 and 35 completed weeks the biparietal diameter, the abdominal circumference, the abdominal area and the ratio between fetal head area and abdominal area were estimated by means of ultrasound measurement. ‘Acute’ fetal weight was estimated by calculations from biparietal diameter and abdominal diameters. Percen‐tile curves were constructed for these parameters and cutoff limits were tested for the predictability of intra‐uterine growth retardation of the fetus.

The abdominal circumference and area estimations were equally good for the detection of intra‐uterine growth retardation. The biparietal diameter alone is of limited value for the detection of intra‐uterine growth retardation but the combination with abdominal diameters in ‘acute’ fetal weight estimation can well be used. The ratio between the skull and abdominal areas seems to be of little use for the detection of intra‐uterine growth retardation of two reasons: difficulty in measurement and low sensitivity.

We consider that the assessment of gestational age in early pregnancy is a necessity both for the identification of suspectedIUGR by means of ultrasound and the diagnosis of IUGR by measurement of fetal weight at birth. It is concluded that if the gestational age has been assessed by crown‐rump length measurment in early pregnancy, a single estimation of the fetal abdominal circumference between 32 and 35 completed gestational weeks and a cut‐off limit at the 15th percentile offers a detection rate of about 90% of the growth retarded infants.
Histochemical localization of specific estrogen and progesterone binding in human endometrium and endometriotic tissue
Authors: Bergqvist Agneta , Carlström Kjell , Jeppsson Sten , Ljungberg Otto
Published: December 2009

Abstract. A histochemical method for the detection of steroid‐binding sites in very small tissue specimens was evaluated. Competitive binding experiments proved the method to be sufficiently specific. When applied to endometrium and endometriotic tissue obtained simultaneously from the same patient, a distinct binding was found both in the epithelial structures and in the stroma. The binding pattern in endometriotic glands resembled that in the endometrium. The study seems thus to support the conclusion that endometriotic lesions contain specific binding sites for estrogen and progesterone and that their distribution seems to be similar to that found in the endometrium from the same patient.
Peritoneal fluid 6‐keto‐prostaglandin FLα, thromboxane B2 in endometriosis and unexplained infertility
Authors: Koskimies Aarne I. , Tenhunen Anssi , Mikorkala Olavi
Published: December 2009

Abstract. To study peritoneal fluid (PF) prostaglandin (PG) in infertile women, 6‐keto‐PGFla (a breakdown product of prostacyclin) and thromboxane B2 (T × B2) (a metabolite of T × A2) were assayed with radio‐immunoassays from PF samples collected at laparascopy from patients with endo‐metriosis (n = 29), unexplained infertility (n = 13) and from women with normal pelvic organs (n = 25). The concentrations of 6‐keto‐PGFla and T×82 in PF were increased (p<0.05) in endometriosis and unexplained infertility, as compared with the corresponding levels in the controls. In patients with endometriosis, both 6‐keto‐PGFla and T × B2 increases were related to the severity of the disease. There was no relationship between 6‐keto‐PGF1α × B2 in PF, and day of menstrual cycle. It is suggested that endometriotic tissue and peritoneal macrophages may contribute to these prostanoids in PF. The smooth muscle activities of PF prostacyclin and T × A2 may be involved in infertility by interfering with tuba1 function.
Distribution of HLA‐antigens among patients with endometriosis
Authors: Moen Mette , Bratlie Anne , Moen Torols
Published: December 2009

Abstract. Previous studies have demonstrated a hereditary tendency to develop endometriosis and the incidence of the disease varies in different ethnic groups. The genetic background to these differences has not been clearly explained. The present investigation was performed to seek a possible association between certain HLA antigens and endometriosis. One hundred patients were typed for HLA‐A, ‐B and ‐C, and of these 24 were also typed for HLA‐DR. No significant deviations from the antigen frequencies in a normal population were found. We conclude that the development of endometriosis does not seem to be associated with HLA‐A, ‐B, ‐C or ‐DR antigens.
Short‐term effects of danazol on endometrial histology
Authors: Jeppsson Sten , Mellquist Peter , Rannevik Gunnar
Published: December 2009

Abstract. The synthetic steroid danazol has rapidly become the drug most commonly used in the hormonal treatment of endometriosis and its clinical and endocrine properties in women have been investigated extensively. However, little is known about the early effects of danazol on the endometrium. This study was performed in order to discover how soon after institution of danazol therapy atrophic changes can be observed in the endometrium. Ten patients with fibromyoma of the uterus and menorrhagia were treated with danazol at a dosage of 600 mg a day. During treatment, plasma estradiol values corresponded to those of the early follicular phase of a normal menstrual cycle. In 5 of the patients, endometrial biopsies were obtained after 8 weeks of therapy. Four of them had a thin endometrium of atrophic histological appearance. In view of these findings, biopsies were taken from a further 5 patients after only 4 weeks' treatment. All of these biopsies revealed a reduced endometrium and 3 of the 5 endometria were histologically clearly atrophic. Even if total resorption of endometriotic tissue usually takes a considerable time, the finding of atrophy of the uterine endometrium induced by danazol after only 4 weeks of treatment is consistent with the rapid improvement in clinical symptoms in patients with endometriosis.
Cytosol estrogen and progestin receptor concentrations and 17β‐hydroxysteroid dehydrogenase activities in the endometrium and endometriotic tissue
Authors: Kauppila Antti , Vierikko Pirkko , Isotalo Hannu , Rönnberg Lars , Vihko Reijo
Published: December 2009

Abstract. Concentrations of cytosol estrogen (ERC) and progestin (PRc) receptors and the activities of 17β‐hydroxysteroid dehydrogenase (17‐HSD) were measured in 80 untreated and 23 danazol‐treated endometriotic tissue specimens. The results were compared with those obtained from endometrium specimens prior to or following danazol or medroxyprogesterone acetate (MPA) treatment. The concentrations of ERc and PRc in the endometriotic tissue were lower than corresponding values in the endometrium. Cytosol female sex steroid receptors were always present in the normal endometrium, whereas only 70% of the endometriotic lesions were simultaneously ERc‐and PRc‐positive (receptor concentration ≥3 and ≥6 fmol/mg cytosol protein respectively), 24% PRc‐positive, and 6% receptor‐negative. In the endometriotic tissue, the mean concentrations of PRc during the luteal phase of the cycle (90±23, SE, fmol/mg protein) were lower (p<0.05) than during the follicular phase (177±32 fmol/mg protein), while the ERc concentrations and 17‐HSD activities did not show any cyclic variations. Danazol and MPA had similar effects on the endometrium, both inducing a decrease in concentration of the female sex steroid receptors and an increase in activity of 17‐HSD during short‐term treatment (one week), and a decrease in activity of the enzyme during long‐term treatment (3 weeks). The effect of danazol on the endometriotic tissue differed from that found in the endometrium. Danazol did not alter the activity of 17‐HSD or the concentration of PRc but tended to increase the concentration of ERc in endometriotic tissue when given for 7–30 days. The present results suggest that endometriotic tissue is under the control of steroid hormones, but that this hormonal regulation does not seem to be identical with that found in the endometrium.
Influence of danazol on uterine activity
Authors: Åkerlund Mats
Published: December 2009

Abstract. The influence of danazol treatment on uterine activity was studied by means of repeated intra‐uterine pressure recordings in two women with laparoscopically diagnosed endometriosis. During a control cycle the women had normal plasma levels of FSH, LH, estradiol and progesterone and repeated recordings showed a varying uterine activity, with irregular small contractions in the follicular phase and regular ones with maximal amplitude and duration at the onset of menstruation. Treatment with danazol inhibited the fluctuations in circulating gonadotropins and invariably caused low levels of ovarian hormones. Between 2 and 3 weeks after starting treatment there was a period of increased myometrial activity and increased reactivity of the uterus, but thereafter a marked inhibition of the contractions was seen. It is suggested that danazol could be of value in the treatment of painful conditions with excessive uterine activity, such as primary—and to some extent also secondary—dysmenorrhea.
Inhibition of steroid sulfatase activity by danazol
Authors: Carlström Kjell , Döberl Anton , Pousette Åke , Rannevik Gunnar , Wilking Nils
Published: December 2009

Abstract. The hydrolysis of dehydroepiandrosterone sulfate (DHAS) by human liver cells in culture and the hydrolysis of and formation of estradiol‐17β (E2) from estrone sulfate PIS) by human breast tumor preparations in vitro were studies in the presence and absence of danazol. In the latter tissue the effects of medroxyprogesterone acetate (MPA), trilostane, aminoglutethimide (AG) and tamoxifen were tested for comparison. Danazol at concentrations of 1.4 × M strongly inhibited the hydrolysis of DHAS as well as the hydrolysis of and formation of E2 from E1S. With the exception of a slight inhibitory effect of trilostane upon E1S hydrolysis, the other four drugs did not inhibit the metabolism of E1S. Danazol, at concentrations corresponding to those occurring in vivo during therapy, is a potent inhibitor of steroid sulfatase activity. This may be one of the ways in which the drug affects peripheral and target tissue levels of steroid hormones.
Peripheral levels of dehydroepiandrosterone sulfate, dehydroepiandrosterone, androstenedione, and testosterone following different doses of danazol
Authors: Carlström Kjell , Döberl Anton , Gershagen Sten , Rannevik Gunnar
Published: December 2009

Abstract. Peripheral serum levels of dehydroepiandrosterone sulfate (DHAS), dehydroepiandrosterone (DHA), an‐drostenedione (A4) and testosterone (T) were measured in two groups of premenopausal women with fibrocystic breast disease, given 200 and 400 mg of danazol a day respectively for 6 months. During treatment, DHAS levels increased and DHA, DHA/DHAS ratio, A4, and T decreased. A tendency towards dose dependency was observed. The changes in DHAS, DHA and DHA/DHAS ratio were interpreted as resulting from inhibition of liver sulfatase activity by danazol. The decreased A4 and T levels probably reflect a suppression of ovarian steroidogenesis due to enzyme inhibition by danazol, and for the latter steroid also an increased metabolism due to interaction of the drug with sex hormone‐binding globulin.
A Brief History of Intrauterine Pressure Measurement
Authors: Smith Roger P.
Published: December 2009

In 1861 the development of obstetrical forceps to measure the degree of uterine expulsive forces gave impetus to investigations of uterine physiology. Although many methods were devised, the intrauterine balloon, used in the first successful attempt to evaluate activity of the gravid uterus in 1872, remained the standard by which other methods were judged. Alternate methods (such as the open catheter technique, hystero‐salpingography, electrouterography, and external hysterography) were limited by cumbersome equipment, inaccurate gauges, difficulty in construction, excessive uterine irritation, and restriction of patient movement. A century of technological improvements in the intrauterine balloon and transducers made possible pioneering work in understanding the activity of the nongravid uterus, the concept of the rhythm method of birth control, carbon dioxide in the determination of tuba1 patency, and hormonal effects on reproduction and ovulation. Finally, understanding uterine contractile malfunction has given rise to the rational treatment of patients with dysmenorrhea.