bluuebunny/crossref_metadata_2025 huggingface dataset:
The Predictive values of single and combined urodynamic parameters
Authors: Riss Paul A. , Koelbl Heinz
Published: November 2007

We calculated the predictive values of single urodynamic parameters with regard to five urodynamic diagnoses: genuine stress incontinence, mixed incontinence, motor urge incontinence, sensory urge, and no incontinence demonstrable. We now constructed tree diagrams by using the parameters with the highest predictive values (recursive partitioning analysis) and calculated the predictive values of the combinations of parameters in each subset. The tree diagrams and the predictive values of the combined urodynamic parameters offer insights into the relevance of different urodynamic parameters and can be used in developing programs for computer‐assisted medical decision making in urodynamics.
Clinicopathologic considerations of fusobacteria chorioamnionitis
Authors: Altshuler Geoffrey , Hyde Scott
Published: November 2007

When sought by light microscopy in formalin‐fixed tissue, fusobacteria are apparent in 7–18% of chorioamnionitis cases. Brown and Hopps bacterial staining characteristically visualizes their long, slender and filamentous forms. Fusobacteria‐like organisms in placentae have previously been associated with prematurity. Our findings indicate that perinatal infection with fusobacteria may cause neonatal death from prematurity, rather than from sepsis. In a study of 586 placentae, 14 specimens with chorioamnionitis and fusobacteria‐like organisms were found. On the five occasions when microbiologic tests were made, fusobacteria were isolated. Prematurity of the newborns was associated with twelve of those placentae. Immunofluorescent labelling of the organisms is a helpful but incomplete means of diagnosis. Because fusobacteria antibodies are highly specific, they do not cross‐react with other members of the genus Fusobacterium. A typical case is reported, in detail.
Glycosaminoglycans in human breast cancer
Authors: Olsen Elith Bjarne , Trier Klaus , Eldov Kent , Ammitzbøll Thorkil
Published: November 2007

Abnormal concentrations of glycosaminoglycans (GAG) have been reported for various types of tumors, suggesting that they may play a role in neoplasia. The correlation between the content of individual GAGs was studied in breast tumor tissues. The total content of GAG was estimated by uronic acid analysis. The relative distributions of dermatan sulphate, heparan sulphate, hyaluronic acid and chondroitin sulphate were measured after cellulose acetate electrophoresis. Mammary tissue samples were obtained at the time of surgery from 11 women, 6 with fibroadenomata and 5 with carcinoma. From each patient, biopsies were obtained centrally in the tumor and perilesional areas adjacent to the tumor, and also from clinically uninvolved tissue in the same region. In the central areas, it was found that carcinoma had a significant increase in chondroitin sulphate and uronic acid content, and a significant decrease in dermatan sulphate content, as compared with fibroadenoma. The chondroitin sulphate content in perilesional carcinomatous tissue was significantly greater than in clinically uninvolved tissue.
Ovarian and intra‐uterine pregnancy combined
Authors: Nilsson B. G. , Gerdes U.
Published: November 2007

Combined ectopic and intra‐uterine gestations are uncommon, especially if the ectopic pregnancy is located in the ovary. A case of combined ovarian and intra‐uterine pregnancy that resulted in a full‐term delivery is reported.
Gamete Intrafallopian Transfer (GIFT): The Results Of 83 Consecutive Treatments
Authors: Henriksen Tore , Åbyholm Thomas , Tanbo Tom , Magnus øystein
Published: November 2007

Eighty‐two couples were treated with gamete intrafallopian transfer (GIFT) in 93 treatment cycles. Twenty‐three clinical pregnancies resulted. Pregnancies were obtained in 40% of the cases where 5 or more ova were placed in the Fallopian tubes. In the cases where 4 or fewer ova were transferred, the pregnancy rate was 12%. Three miscarriages and one ectopic pregnancy occurred. Sixteen of the pregnancies were singleton, there were 5 twins, 1 triplet and 1 quadruplet. According to the present material, GIFT seems to represent a significant improvement in selected groups of patients.
Mobiluncus and Cluecells as Predictors of PID After First‐Trimester Abortion
Authors: Larsson P‐G , Bergman B. , Forsum U. , Platz‐Christensen J‐J , Påhlson C.
Published: November 2007

Women attending our Department for a first‐trimester abortion were examined for the presence of Mobiluncus species, Ctrachomatis or clue cells in vaginal discharge in an attempt to identify risk groups for development of pelvic inflammatory disease (PID) after first‐trimester abortion. A correlation was found between the presence of Mobiluncus and clue cells in vaginal discharge and the incidence of PID after first‐trimester abortions. These women were also older than those in whom C. trachomatis was identified. Our study indicates that screening for C. trachomatis and clue cells in vaginal discharge will identify two different risk groups for developing PID after first‐trimester abortion.
Sexual Behavior, Contraception and Unintended Pregnancy Among Young Females
Authors: Wielandt Hanne , Hansen Unni Mølholm
Published: November 2007

Information about contraceptive usage and sexual experiences was sampled in 1985–86 from 16–20‐year‐old Danish females admitted for legally induced abortion on Funen (N = 140). In attempts to elucidatec the causal relations behind undesired pregnancy among teenagers, data were in the present context compared with answers to the same questions from a representative Danish sample of sexually experienced, non‐pregnant females of the same age (N = 201).

Of the reference sample, 83,6% were using contraceptives at the time of the interview—mostly oral contraceptives (O.C.). Of the abortion sample, 90.7% said they had used contraception earlier in their reproductive life. Approximately one third conceived in spite of contraception (most frequently the condoms). O.C. was the contraceptive method used most recently (by 43.6%). Thus, a pause in an effective contraceptive often precedes an unintended pregnancy, pointing to the need for follow‐up counselling when O.C. is prescribed to teenagers.

Only the minority could state the total number of times they had experienced sexual intercourse. Significantly more females in the abortion sample were in an alliance with a male partner with whom they had regular sexual intercourse. However, they also reported a higher average number of different sexual partners, indicating an association between changing sexual relationships and undesired pregnancy.

In the abortion sample significantly more pregnancies prior to the index pregnancy were reported during a corresponding period of risk of conception lasting only a few years. Taking the widespread use of contraception into account, it is possible that an increased fecundity might be a co‐factor behind unsuccessful contraception.
Bilateral Parametrial Mature Teratomas
Authors: Rasmussen Kirsten Cleemann , Baldur Birthe , Holten Iben Wulff
Published: November 2007

In a 21‐year‐old virgin suffering from increasing abdominal pain, laparotomy revealed two tumors arising from the parametria. Microscopic examination showed them to be mature teratomas. Teratomas located in the parametria have not been described in literature previously.
Uterine Rupture after Re‐Implantation of Fallopian Tubes
Authors: Brandt Carsten A. , Larsen Bjarne
Published: November 2007

Spontaneous uterine rupture in the second trimester of pregnancy with twins following a previous re‐fertilization is very rare. A case of spontaneous cornual uterine rupture following re‐implantation of the Fallopian tubes in a 35‐year‐old multigravid woman is described. The atypical clinical presentation and the findings at the operation are discussed.
Major Vascular Injury during Gynecologic Laparoscopy: Report of a case and review of published cases
Authors: Baadsgaard Sven Erik , Bille Sørren , Egeblad Klas
Published: November 2007

Serious complications following gynecologic laparoscopy are rare. We report a case of a 24‐year‐old woman who had a common iliac artery and vein injured by the trocar, resulting in deep shock. The arterial lesion was repaired with an allograft and the vein sutured. The patient recovered with light sequelae. The literature was reviewed and we found 15 cases described in varying detail. In most cases the injury was caused by the pneumoperitoneum‐needle and in only 2 by the trocar. Characteristically the terminal aorta and its major branches were injured. All the patients had a large retroperitoneal hematoma and only minimal free blood in the peritoneum. Signs of bleeding were nearly always acute. Most lesions could be treated by simple suture. Recovery is the rule, but 2 of the 15 died. Examiner's experience and correct technique are important to prevent this potentially lethal complication which is also probably underreported.
Testing And Training Of The Pelvic Floor Muscles After Childbirth
Authors: Jonasson Aino , Larsson Bertil , Pschera Helmut
Published: November 2007

In a prospective study of 83 women, two different physiotherapy methods for strengthening the pelvic floor muscles after childbirth were evaluated. The training program was carried out by the patients at home for 12 weeks, starting 8 weeks after spontaneous uneventful delivery. Forty‐two women did pelvic floor exercises in accordance with the method presented by Kegel (1). Forty‐one women used standard vaginal cones with weights increasing in 10 g stages from 20 to 100 g, to be retained in the vagina both when standing erect and moving. Pelvic floor muscle strength, defined as the weight in grams of the heaviest cone that could be retained in the vagina, was recorded before and after the 12‐week training period. Training with vaginal cones produced significantly better pelvic floor muscle strength than did exercise without cones.
Computation Of Fertility Rates Following A Defined Reproductive Risk Event, By The Life Table Method, With Ectopic Pregnancy Used As An Example
Authors: Sandvei Roar , Bergsja Per , Brun Oddny
Published: November 2007

We have adapted the life table for use in the observation study of subjects desirous of pregnancy following a well‐defined risk event in their reproductive lives. The construction of the table is described and illustrated, with the fertility after ectopic pregnancy given as the example.
Endobrush Sampling For Endometrial Cancer
Authors: Vuopala Salme , Klemi Pekka J. , Mäenpää Juhani , Salmi Tuula , Mäkäräinen Leo
Published: November 2007

The two intra‐uterine cytological sampling methods Endobrush and Pistolet were compared for clinical applicability in 66 premenopausal and 47 postmenopausal women. The taking of the specimens succeeded in 94% of the cases with the Endobrush method and in 99% with the Pistolet method. The two intra‐uterine sampling methods were both almost painless. The Endobrush and the Pistolet specimens were filtered and stained by the Papanicolaou method. The Endobrush specimens were also used to make smears, which were also stained by the Pap method. According to the separate evaluations of two cytologists the Endobrush smear yielded specimens with a large or moderate number of cells in 59.0 to 71.4%, the Endobrush filter method in 73.6 to 76.5% and the Pistolet filter method in 71.4 to 76.8%. Specimens with good or moderate quality were found in 83.3%, 86.8 to 89.6% and 93.7 to 99.1%, respectively. Unsatisfactory specimens accounted for only 2.8–0.9% of the cases. All four endometrial carcinomas were placed in Pap classes 3 to 5 on the basis of the Endobrush and Pistolet filter specimens. The diagnostic quality of the smears was inferior to that of the filter specimens. The results suggest that the Endobrush filter method yields cytological endometrial samples which are similar in cell number, quality and diagnostic value to those obtained by the Pistolet method. Endobrush method is also simple, quick and painless, and therefore well acceptable to patients and suitable for clinical use.
Effect Of β‐Receptor Blockers On Uterine Contractility In A Puerperal Model
Authors: Egarter Ch. , Meisner W. , Kroboth W. K. , Grünberger W.
Published: November 2007

β‐receptor blockers are increasingly used in the treatment of pregnancy‐induced hypertension. Hitherto an oxytocic effect on the myometrium could not be excluded. We investigated the effect of 0.8 resp 1.6 mg pindolol on uterine activity in a double blind study in comparison with a placebo group, using a puerperal model. A “paradoxical” decline in uterine activity could be demonstrated, speaking in favor of a further propagation of β‐blockers in obstetric practice.
Heterophilic Antibodies Against Rabbit Serum Causing Falsely Elevated Gonadotropin Levels
Authors: Berglund Lars , Holmberg Nils‐Gunnar
Published: November 2007

Two cases are presented in which previously acquired antibodies against rabbits in the patient's serum caused falsely elevated hormonal levels in radio‐irnmuno assays (RIA) based on rabbit antibodies to follicle‐stimulating hormone (FSH) and human chorionic gonadotropin (hCG). The erroneous results led to unnecessary operative intervention and inconvenience for the patients.
Severe Complication To Phytomenadione After Intramuscular Injection In Woman In Labor: Case Report And Review Of Literature
Authors: Andersen Torben Houman , Hindsholm Karsten Bragger , Fallingborg Jan
Published: November 2007

A 28‐year‐old woman in labor developed a severe anaphylactoid reaction, necessitating acute cesarean section, with subsequent neonatal death, after receiving 10 mg of phytomenadione (Konakion®) by the intramuscular route. Allergologic investigations revealed no type I reaction against the drug, and the symptoms were considered to be caused by drug‐induced intolerance. Prophylactic administration of phytomenadione to the infant rather than to the parturient is recommended.
Postpartum Symptoms: Episiotomy Or Tear At Vaginal Delivery
Authors: Thranov Ingrid , Kringelbach Anne Mette , Melchior Emilie , Olsen Ole , Damsgaard Mogens Trab
Published: November 2007

The influence of episiotomy was evaluated in a quasi‐randomized follow‐up study. In 193 primiparas with spontaneous vaginal delivery, postpartum perineal pain and insufficiency symptoms and their duration were evaluated by means of a questionaire, 15–24 months post partum. Information about the birth and any complications was obtained from the medical records. On compairing the 85 primiparas delivered by midwives who had a low episiotomy rate (mean 21%) versus the 61 primiparas delivered by midwives with a medium episiotomy rate (mean 34%) and the 41 delivered by midwives with a high episiotomy rate (mean 70%), no differences were found regarding postpartum perineal pain and insufficiency symptoms. Postpartum perineal pain symptoms were significantly correlated to the duration of the second stage of labor, irrespective of the episiotomy rate of the midwife in charge, or of the use of episiotomy.
Combined Diagnostic Laparoscopy And Follicular Aspiration For Human In Vitro Fertilization
Authors: Shoham (Schwartz) Zeev , Barash Amichai , Yemini Matan , Borenstein Richard
Published: November 2007

Laparoscopic retrieval of oocytes from stimulated follicles for in vitro fertilization and embryo transfer (IVF‐ET) was performed at the time of diagnostic laparoscopy in 36 infertile women. Their mean rates of cleavage, embryo transfer and pregnancy did not differ from those obtained in 86 patients (101 cycles) who underwent ultrasonically guided transvaginal oocyte retrieval following diagnostic laparoscopy performed earlier as a separate procedure. In view of the advantages in terms of reduced patient morbidity, time and cost benefits, and the opportunity for oocyte‐sperm compatibility testing in vitro, the combined procedure appears to be the best method in patients scheduled to undergo diagnostic laparoscopy.
The Female Condom: A Pilot Study Of The Acceptability Of A New Female Barrier Method
Authors: Gregersen Erik , Gregersen Bente
Published: November 2007

The best available prevention against sexually transsmitted diseases is limited to a consistent and correct use of a condom by the male. A new barrier method has been developed for the female. As it can be inserted into the vagina before sexual intercourse starts, and as it covers the entrance of the vagina, the opening of the uretra and the root of the penis, it is presumed to give a high degree of protection against sexually transmitted diseases and unwanted pregnancy. The preliminary results concerning acceptability are promising, and futher investigations concerning acceptability and efficacy are in progress or completed in several countries. The method should be regarded as one aspect in the pattern of protection, particularly suitable for females with sexual risk behavior.
The Effect of Delayed Pushing in the Second Stage of Labor with Continuous Lumbar Epidural Analgesia
Authors: Manyonda Isaac T. , Shaw David E. , Drife James O.
Published: November 2007

We studied primigravid women in spontaneous labor at term and given epidural analgesia. Two hundred such women giving birth in 1983 were compared with similar groups who gave birth in 1985 and 1987 after the introduction of ‘delayed pushing’ into our labor ward protocol. Four hundred controls were obtained in 1983 and 1985 by selecting from the labor ward register the next normal primigravid woman in spontaneous labor without epidural analgesia. the assisted delivery rate was significantly higher in all three epidural groups than in the controls (p < 0.001). Among epidural labors, there was no significant difference between 1983 and 1987 in the incidence of rotational or non‐rotational forceps, or of cesarean section. In each epidural group, women who waited more than 60 min were less likely to experience a normal spontaneous delivery than were those who did not (p < 0.001 in 1983; p = 0.006 in 1985 p = 0.035 in 1987). We conclude that to delay pushing beyond 60 min confers no benefit regarding mode of delivery.
Acute Polyhydramnios in Twin Pregnancy a Retrospective Study with Special Reference to therapeutic Amniocentesis
Authors: Råidestad Arne , Thomassen Peter A.
Published: November 2007

Acute polyhydramnios in monozygotic twin pregnancy causes severe maternal discomfort and carries a high risk of premature labor. During the years 1980 to 1987, 36 patients with this complication were delivered in Sweden, giving an incidence of 1/20,000 births, or 1/200 twin births. In 18 patients (group A) who were treated with one or more amniotic taps, the delivery was postponed by 2 weeks, as compared with one week in 18 conservatively treated patients (group B). the peri‐ and neonatal death rate was 47% in group A and 58% in group B. Our own experience is that amniotic taps are safe if the amniotic fluid is removed slowly under prophylactic tocolysis. It gives symptomatic relief to the mother and may postpone labor until the gestational age of the twins is more compatible with survival.
Oxytocin and Prolactin Levels in Breast‐Feeding Women. Correlation with milk Yield and Duration of Breast‐feeding
Authors: Uvnäs‐Moberg Kerstin , Widström Ann‐Marie , Werner Sigbritt , Matthiesen Ann‐Sofie , Winberg Jan
Published: November 2007

The aim of the present study was to examine suckling‐related plasma levels of oxytocin and prolactin in early and established lactation and to correlate hormone profiles to success of lactation performance. Fifty‐five primiparous women participated in the study. From each, 18 blood samples were drawn in connection with breast‐feeding on day 4 post partum and after 3‐4 months. Oxytocin and prolactin levels were determined with radio‐immunoassay. Basal levels of both hormones were significantly higher 4 days post partum than 3‐4 months later and after weaning. Basal prolactin levels fell significantly within 24 h of weaning. Oxytocin and prolactin levels rose in response to breast‐feeding—an effect which persisted during the lactation period. the suckling‐induced release of prolactin—but not that of oxytocin—was related to basal hormone levels. Basal as well as stimulated oxytocin levels obtained 4 days and 3‐4 months post partum correlated significantly, indicating that each woman has an individual, characteristic level of this hormone. Milk yield did not correlate with oxytocin or prolactin levels, but prolactin levels recorded 3‐4 months post partum did correlate with the remaining period of breast‐feeding. In addition, mothers who breast‐fed exclusively 3‐4 months post partum had significantly higher oxytocin and prolactin levels than those who gave supplementary feed. there was a significant correlation between oxytocin levels at 4 days and birth weight of the infant.
Plasma Levels of Cholecystokinin and Gastrin During the Menstrual Cycle and Pregnancy
Authors: Frick Göran , Bremme Katarina , Sjögren Christer , Lindén Angelica , Uvnäs‐Moberg Kerstin
Published: November 2007

The objective of the present study was to measure plasma levels of cholecystokinin (CCK‐8 and CCK‐33,39) as well as of gastrin during the menstrual cycle and pregnancy. Cholecystokinin and gastrin levels were measured by radioimmunoassay. Before being assayed for cholecystokinin, plasma samples were submitted to HPLC which allowed separation of gastrin and cholecystokinin as well as between CCK‐8 and CCK‐33,39. Fasting CCK levels were 5.2 ± 0.6 and 7.1 ±0.9 pM during the follicular and luteal phases of the menstrual cycle, respectively. the difference was significant (P<0.05). CCK levels were 8.7±1.2, 10.1 ± 1.6 and 10.4 ± 1.2 pM during the first, second and third trimester, respectively. CCK levels during pregnancy were significantly higher than during the menstrual cycle. the ratio between CCK‐33,39 and CCK‐8 appeared to increase during pregnancy. Gastrin levels remained unchanged during the menstrual cycle and pregnancy. the role of the high levels of cholecystokinin may be to stimulate the exocrine and endocrine pancreatic function during pregnancy. Furthermore, since cholecystokinin inhibits gastric emptying, it may play a role in the sickness of early pregnancy.
The Effect of the Anti‐Progestin Mifepristone (RU 486) on Plasma Prostaglandin Metabolite levels in Early Pregnancy and its Influence on Pregnancy Termination
Authors: Hill Nicholas C. W. , Bernal Andres López , Ferguson Jane , Mackenzie Ian Z.
Published: November 2007

The effect of a single dose of RU 486 (600mg) on prostaglandin metabolite levels has been studied over a 48 h period in 20 women undergoing medical termination of early pregnancy. the results were compared with controls of similar gestation who were treated surgically. the mean (SD) PGEM levels at 0 and 48 h in the RU 486 group were 13.7 (2.7) and 13.2 (2.2) pg/ml respectively, which was not significantly different from the values of 11.7 (1.1) and 11.3 (0.4) pg/ml measured in the control patients. Similarly the mean (SD) PGFM values of 22.3 (14.7) and 17.0 (7.2) pg/ml at 0 and 48 h were not significantly different from the corresponding control values of 21.9 (13.8) and 23.8 (7.2) pg/ml. In 10 of the study patients, there were no significant changes in PGEM and PGFM concentrations prior to and at 4, 24 and 48 h after RU 486 administration. Although all pregnancies were successfully terminated with the combination of RU 486 and subsequently a vaginal pessary containing PGE1, no stimulation of prostaglandin production could be demonstrated.
Prostaglandins—a role in Adhesion Formation an Experimental Study
Authors: Golan A. , Stolik O. , Wexler S. , Langer R. , Ber A. , David M. P.
Published: November 2007

The effect of intraperitoneal application of prostaglandins F2Alpha and E2 on adhesion formation was studied in the rat after traumatizing to the uterine serosa. Prostaglandins applied locally were found to increase intraperitoneal adhesion formation at the injury site, in comparison with controls. the effect of intraperitoneal application of prostaglandins F2Alpha and E2 on fibroblastic proliferation was examined in vitro, by fibroblastic cell culture of rat kidney, human kidney and human prepuce. No direct effect of prostaglandins on fibroblast proliferation could be demonstated. It is concluded that prostaglandins play an important role in the process of adhesion formation. This effect in not related to fibrobalast proliferation.
Vaginal Agenesis and Congenital Adrenal Hyperplasia Psychosocial Sequelae of Diagnosis and Neovagina Formation
Authors: Langer Martin , Grunberger Werner , Ringler Marianne
Published: November 2007

Eleven patients with Mayer‐Rokitansky‐Küster syndrome (MRK) and 7 patients with adrenogenital syndrome (CVAH) were interviewed and tested pre‐and postoperatively. MRK subjects were operated on with a modified Vecchietti procedure, CVAH subjects underwent genitoplastic and clitoroplastic operation. Psychosocial sequelae of and coping with malformation and treatment were assessed with semistructured interviews and the Giessen test. Anatomical and functional results of the vaginoplastic operation were excellent, and sexual satisfaction correlated with coping. 7/11 MRK patients were capable of good to fair adaptation to the malformation, whereas CVAH patients suffered severe distortions of body image. the malformation caused narcissistic damage in all cases. Circumstances of diagnosis, prevailing defense mechanism and consequences for counselling are discussed.
Normal Umbilical Artery Doppler Sonography does not Exclude Fetal Distress
Authors: Drogtrop Adrian P. , Bruinse Hein W. , Reuwer Paul J.H.M.
Published: November 2007

Umbilical artery Doppler sonography is advocated as a method for fetal surveillance. Two cases of fetal distress caused by fetal anemia of non‐immune origin are presented. In both cases a normal pulsatility index of the umbilical artery was found. It is emphasized that normal umbilical artery Doppler sonography does not exclude fetal distress.
An epidemiological study of obstetric ultrasound examinations in Denmark 1989–1990
Authors: Jørgensen Finn Stener
Published: November 2007

Objective: To provide an epidemiological description of the use of ultrasound in obstetrics in Denmark and to analyse whether screeningper sereduces the mean number of obstetric ultrasound examinations for all pregnant women.

Design: Questionnaire study based on hospital records and patient interviews.

Setting: AH Danish hospital departments with delivery services (n= 57).

Patients: 2268 women who gave birth to a child in a two week period February 1990.

Results: The main findings of the study are: 1) Women with an offer of screening had a significantly higher mean number of obstetric ultrasound examinations during pregnancy (1.8) than women without (1.3), no matter at which type of department they had antenatal care and their delivery; 2) 45% of the women without an offer of screening had an ultrasound examination on indication in the interval of 14–20 weeks of gestation ‐ at which time an examination may include what is performed at a screening examination and 3) The study shows great regional variations in the use of ultrasound in obstetrics.

Conclusion: The results question the presumption that screeningper sewill reduce the mean number of ultrasound examinations during pregnancy.
An unusual uterine tumor resembling sex‐cord‐tumor of the ovary with papillomatous features Immunohistochemical and electron microscopic observations
Authors: Moll Merete , Horn Thomas
Published: November 2007

An unusual uterine tumor resembling a sex‐cord‐tumor of the ovary with papillomatous features is described. The tumor was polypoid and attached to the endometrium. Light microscopical immunohistochemical‐ and ultrastructural examinations gave support to an endometrial origin.
Benign abdominal multicystic mesothelioma
Authors: Kampschoer Paul H. N. M. , Ubachs Hans M. H. , Theunissen Paul H. M. H.
Published: November 2007

The benign abdominal multicystic mesothelioma is a rare disease. Usually a malignancy of the ovary is suspected prior to and during surgery. The histological diagnosis and the clinical course however are benign. Three cases are reported. Diagnosis, treatment and follow up are discussed.
Comparison of actual and ultrasound estimated second trimester gestational length in in‐vitro fertilized pregnancies
Authors: Geirsson Reynir T. , Have Grethe
Published: November 2007

Objective. To compare actual and calculated gestational age in pregnancies conceived by in‐vitro fertilisation.

Methods. In 36 healthy women conceiving by in‐vitro fertilisation an equation described for use in a Nordic population was used for calculating gestational age from the biparietal diameter and femur length at a routine 18–19 week scan. This was compared to actual gestational length estimated from the day between oocyte retrieval and embryo transfer.

Results. The mean difference amounted to −0.86 days with a standard deviation of 2.86 days, a range of −5 to +6 days and a 95% confidence interval −0.11 to 1.83 (t=1.806, df = 35, p = 0.8). Correlation between the two methods was highly significant.

Conclusion. The equation used allows prediction of term with sufficient accuracy for general use in our population.
Pad weighing tests with 50% or 75% bladder filling: Does it matter?
Authors: Jakobsen Henrik , Kromann‐Andersen Bjarne , Nielsen Kurt Kroyer , Maegaard Elsemarie
Published: November 2007

In order to evaluate the influence of bladder filling at the beginning of a 40 minutes pad test, 71 women completed this study. Thirty‐six patients were randomized to pretest filling of the bladder to 50% of the bladder capacity, and 35 patients to 75% pretest filling. In all patients, a retest was performed approximately fourteen days later. The leakage in the two groups was equal. Median leakage during the first test was 3 g in both groups (p = 0.97). The leakage was numerically larger during the second test, median 6.5 g and median 13 g, respectively (p = 0.69). The test‐retest variation was calculated in both groups. In patients with 50% bladder filling test‐retest variation (mean 2 S.D.) was −28.4%+ 206.8%. In patients with 75% bladder filling mean variation was −58.0% + 203.0%. The difference in test‐retest variation between groups was not statistically significant (p = 0A7). Only the subjective evaluation by the patients revealed a preference in favor of the test with 50% bladder filling. Significantly more patients in the 50% group reported that the results of the first test and the retest corresponded well with the daily urinary leakage (p=0.04). The most striking finding of this study was that, despite filling to either 50%. or 75% of the bladder capacity at the beginning of the test, the fluid load during the test, i.e. the initial volume instilled into the bladder plus the diuresis during the test, was equal in the two groups. The diuresis during the test in patients with 50% bladder filling was median 116 ml at the first test vs. median 64 ml in patients with 75% bladder filling (p = 0.01). These results were highly reproducible during the second test, where the diuresis in the two groups was median 115 ml and 63 ml, respectively (p = 0.01). The theoretical background for this phenomenon is discussed.
A second thought on second look laparotomy
Authors: Bar‐Am Amiram , Kovner Felix , Lessing Joseph B. , Inbar Moshe , Chaitchik Samario , Azem Foad , Brenner Steven H. , Peyser M. Reuben
Published: November 2007

Between 1982 and 1987, 43 patients with epithelial ovarian carcinoma, identified as International Federation of Gynaecology and Obstetrics Stages I‐IV, underwent second‐look laparotomy as a part of their treatment protocol. Twenty‐nine patients (67%) had no evidence of residual disease, five (11.6%) had residual disease 1 cm, and nine patients (20%) had residual disease 1 cm at re‐exploration. Persistent disease at the second operation was positively correlated with the initial clinical stage, and negatively correlated with the extent of the original cytoreductive surgery. Fifteen of 29 patients with negative findings (52%) developed recurrent disease within two years. All recurrences were limited to the abdominal cavity only. Three and five years survival, for the patients with negative findings, was 62% and 48% respectively. No documented benefit to the patients could be demonstrated by adopting second‐look laparotomy as a routine procedure in the management of patients with epithelial ovarian carcinoma. In view of our data, as well as that of others, such operations cannot be considered a valuable routine procedure. At this point, second‐look laparotomy may have a role in evaluating the efficacy of a post‐surgical new chemotherapy treatment regimen.
Effect of gynecological operations on the serum concentration of the aminoterminal propeptide of type III procollagen
Authors: Tomas Candido , Puistola Ulla , Risteli Leila , Risteli Juha , Kauppila Antti
Published: November 2007

Serum concentration of PIIINP (aminoterminal propeptide of type III procollagen), an indicator of connective tissue metabolism, is often increased in advanced gynecological carcinoma and correlates with the tumor growth. Because the healing wound also affects collagen metabolism we measured the serum PIIINP concentration in 15 patients operated on for endometrial carcinoma and in 28 patients operated on for benign gynecological diseases. Serial serum samples were collected for 35–51 days after surgery. In endometrial carcinoma, serum PIIINP level was increased in 53% of the patients before the operation. Postoperatively, the mean PIIINP concentration increased further, remaining at a pathological level throughout the study and with a peak at one week after the operation. In relative terms an abdominal operation for benign disease increased the serum PIIINP concentration as much as in endometrial carcinoma, but the mean level remained within the reference interval. After vaginal operation the increase in PIIINP concentration was not significant. The initially increased PIIINP concentration in endometrial carcinoma is probably caused by the effects of the malignancy on collagen metabolism. Because the relative response of PIIINP to abdominal operation was similar in both groups, the PIIINP response to surgical trauma in patients with malignant disease seems to depend only on the extent of the operation. In this group the transient increase in serum PIIINP concentration does not prevent the use of PIIINP as a tumor marker, since the follow‐up examinations for malignancy do not start earlier than two months after operation.
Fetomaternal blood flow measurements and management of combined coarctation and aneurysm of the thoracic aorta in pregnancy
Authors: Kupferminc Michael J. , Lessing Joseph B. , Jaffa Ariel , Vidne Bernardo A. , Peyser M. Reuben
Published: November 2007

A pregnant patient presented at 21 weeks of gestation with severe coarctation of the aorta and a large aneurysm (5.4 cm) of the ascending aorta. The patient developed hypertension at gestation week 17. Continuous Doppler wave velocimetry showed a low systolic/diastolic (S/D) ratio in the uterine arteries indicating reduced blood flow to the placenta. The presence of a severe coarctation, aneurysm of the ascending aorta, and hypertension associated with the hemodynamic changes of pregnancy, increases maternal and fetal risk. The literature reviewed disclosed that aneurysm expansion and dissection or rupture on the one hand, and fetal demise on the other, are the greatest risks. The challenge of treating both the patient and the fetus was managed successfully by correction of the coarctation at week 22. Blood pressure normalized a few weeks after the operation, and no expansion in aneurysm diameter was noticed. A normal S/D ratio in the uterine arteries indicated increased blood flow in the uterine arteries. A healthy female was born. Pregnant patients with coarctation of the aorta should have surgical correction preferably in the first or second trimesters.
The bleeding time in women
Authors: Berge Lillian Nordbø , Lyngmo Vegard , Svensson Birgit , Nordøy Arne
Published: November 2007

A sex difference in the bleeding time has been reported. To investigate the effects of the different sex hormones, the bleeding time (BT) and hemostatic factors related to it were measured in 209 healthy women: 50 pregnant, 113 menstruating and 46 post‐menopausal. The serum levels of estrogens, progesterone and testosterone were distributed as expected for the different groups. There were no significant differences in the BT between any of the groups. No correlations between the BT and female or male sex hormones were found. The findings indicate that although sex hormone mediated effects on platelet/endothelial cell interactions may exist, they do not become evident within the physiological variations in the BT of healthy women.
Adequacy of prenatal care and risk of pre term rupture of amniotic sac membranes
Authors: Gosselink Carol A. , Ekwo Edem E. , Woolson Robert F. , Moawad Atef , Long Cynthia R.
Published: November 2007

Premature rupture of amniotic membranes (PROM) is associated with perinatal morbidity and mortality. A matched case‐control study was undertaken to determine whether adequacy of prenatal care was associated with increased risk for PROM. Three study groups were defined, consisting of women delivering pre term with PROM, full term with PROM, and pre term without PROM. Cases were singly matched by race, age, and parity with women having full term deliveries without PROM. Data were collected by face‐to‐face structured interviews with eligible subjects and by medical records abstraction. Conditional multiple logistic regression indicated that among women with inadequate levels of prenatal care during pregnancy the risk for pre term PROM was 3.11 (CI = 1.10‐8.78) and for pre term without PROM 2.18 (CI= 1.05–4.53) times higher than for their matched controls, even when adjusted for other sociodemographic, behavioral, index pregnancy, and medical history factors. We conclude that inadequate prenatal care may be a marker for less healthy behaviors, lifestyles, and environmental factors among women at increased risk for pre term delivery.
Anti‐cardiolipin antibodies (IgG and IgA) in women with recurrent fetal loss correlate to clinical and serological characteristics of SLE
Authors: Bagger Peter Valdemar , Andersen Vagn , Baslund Bo , Beck Bjarne , Hove Hanne , Høier‐Madsen Mimi , Petersen Jørgen , Philip John , Schaadt Ole , Skouby Sven Olav , Starup Jørgen , Thorsen Sixtus , Wiik Allan
Published: November 2007

Aim of study. We investigated to which degree IgG, IgA and IgM anti‐cardiolipin antibodies (aCL) are associated in recurrent abortion or late fetal death with other signs of autoimmune disease and in particular SLE.

Material and methods. Serological variables typical of SLE and of the anti‐phospholipid antibody syndrome were measured once eight to 16 weeks after the last fetal loss in 158 women with recurrent abortion or late fetal death; women with manifest autoimmune rheumatic disease were excluded.

Results. (1) Positive values, i.e. above the 99th percentile of reference material, of IgG aCL and IgA aCL were observed in 4% and 7%, respectively, whereas 26% had positive values of IgM aCL. (2) IgG aCL and IgA aCL but not IgM aCL correlated to anti‐nuclear antibodies and to anti‐double stranded DNA. (3) Anti‐double stranded DNA, IgG aCL and IgA aCL but not IgM aCL correlated to previous occurrence of thrombosis. (4) ANA correlated to lower blood platelet concentrations and higher erythrocyte sedimentation rates

Conclusions. Women with recurrent abortion or late fetal death who have higher but not necessarily abnormally high levels of IgG aCL or IgA aCL constitute a group with increased occurrence of clinical and serological characteristics of SLE. We suggest that these women be kept under surveillance for future development of autoimmune disease especially SLE. The women with high IgM aCL constitute another group without these characteristics.
Lipid and lipoprotein profiles in postmenopausal women
Authors: Jensen Jytte
Published: November 2007

Coronary heart disease (CHD) increases in women after the menopause, and there is evidence to suggest that estrogen‐deficiency may have impact on the cardiovascular risk. Lipid and lipoprotein profiles are important cardiovascular risk factors, and the possibility has been advanced that the loss of relative cardioprotection at the menopause might be mediated through an effect on lipids and lipoproteins.
Ambivalence towards parenthood among pregnant women and their men
Authors: Wikman Marianne , Jacobsson Lars , Joelsson Ingemar , von Schoultz Bo
Published: November 2007

369 pregnant women and 345 expectant fathers visiting antenatal clinics were examined by a questionnaire concerning attitudes towards pregnancy and parenthood. Data were processed by factor analysis and the degree of agreement to important factors was estimated. Attitudes were dominated by two conflicting views: children mean existential satisfaction and children mean restriction of freedom for women as well as for men. There was a tendency to deny the items concerning the disadvantages of having children. An important factor in the women's as well as in the men's analysis was the importance of own parents as models in parenthood. The findings from this unselected population of pregnant women and their men are consistent with earlier in‐depth interviews. It can be concluded that ambivalence should be regarded as a normal constituent of the adaptation to pregnancy and parenthood. Experiences of own parents play an important role in the transition to parenthood. An important task for the medical profession should be to inform about ambivalence as a normal phenomenon as it. left unaccepted, may cause unnecessary anxiety and feelings of guilt.
Management of prelabor rupture of membranes at term
Authors: Sperling Lene S. , Schantz Anne L. , Wahlin Anne , Duun Susanne , Jaszczak Poul , Scherling Brigitte , Carstensen Anne A. , Frese Susanne , Hvilsom Elsebeth , Ploug‐Jensen Birgit
Published: November 2007

Objective. To compare the rate of obstetric interventions, length of labor, and maternal morbidity in pregnancies with prelabor rupture of membranes at term after either early or late induction of labor in both primiparous and pluriparous women.

Design. Prospective. randomized study.

Subjects. 362 women with singleton pregnancies, cephalic presentations, gestational age of 36 completed weeks or more were allocated at random to induction with oxytocin either 6 hours after PROM (n = 62) (early) or 24 hours (n = 62) (late). Those eligible, but not participating in the study, totalled 238 women.

Main obstetric measures. Time of spontaneous labor in the late induction group. length of labor. obstetric intervention rate, maternal morbidity. and the degree of histologic chorioamnionitis.

Results. The length of labor was longer in the late induction group than in the early induction group in both primiparous and pluriparous (p<0.05). There were no overall differences in the rate of obstetric interventions or maternal morbidity, but there were marked differences between primiparous and pluriparous women. Increasing time span between the period from rupture of membranes to delivery increased the degree of histologic chorioamnionitis.

Conclusion. If a woman wants a short labor, she will benefit from early induction. We did not find statistical differences in the rate of obstetric intervention or in the maternal morbidity, but there was a tendency towards adverse effects of late induction.
Is sexual life influenced by transdermal estrogen therapy?
Authors: Nathorst‐Böös Jörgen , Wiklund Ingela , Mattsson Lars‐Åke , Sandin Kristina , von Schoultz Bo
Published: November 2007

Two hundred and forty‐two postmenopausal women between 35 and 65 years of age requiring hormone replacement therapy for climacteric symptoms were blindly and randomly allocated to treatment either with transdermal estradiol therapy (Estraderm* 50 μg/24 h) (E) or placebo (P). The patches were changed twice a week and treatment continued for 12 weeks. No progestogen supplement therapy was given during the study. No previous hormone replacement therapy had been given for the last six months and the women had had their last menstruation more than sin months ago. As a part of a larger study assessing women's quality of life, a Swedish version of ‘McCoy's Sex Scale Questionnaire’ was administered at the start of treatment and after 12 weeks. This questionnaire contains nine items regarding different aspects of sexual life. The difference between the scorings at the start of treatment and after 12 weeks were calculated for each item and the values of the E and the P groups were compared. Items regarding ‘satisfaction with frequency of sexual activity, sexual fantasies. degree of enjoyment. vaginal lubrication and pain during intercourse’ were positively influenced in the E group compared to the P group. Items not affected were ‘frequency of orgasm and sexual arousal’. A correlation between improved sexual life and quality of life was also found when the results from the McCoy scale were compared with a battery of quality of life questionnaires.
Immunohistochemical localization of pituitary gonadotropins and estrogen in human postmenopausal ovaries
Authors: Kobayashi Mitsuko , Nakano Ryosuke , Shima Kazuo
Published: November 2007

Immunohistochemical localization of pituitary gonadotropins (FSH, LH) and estrogen was investigated in 17 ovaries from ten postmenopausal women. Positive immunostaining for 17β‐estradiol was demonstrated in the cortical stroma of 14 postmenopausal ovaries. Positive immunostaining for FSH was localized in the cortical stroma of 12 postmenopausal ovaries, and positive immunostaining for LH was also localized in 12 ovaries. Immunohistochemical localization for pituitary gonadotropins (FSH and/ or LH) and 17β‐estradiol was identified in the same hypertrophic cortical stroma of 13 postmenopausal ovaries. The ultrastructural study suggested steroidogenic activity in the cortical stromal cells of the postmenopausal ovary. In addition, peripheral and ovarian venous concentrations of 17β‐estradiol were measured in 13 postmenopausal subjects, and significant concentration gradient for serum 17β‐estradiol was noted. The ovarian/peripheral concentration gradient for 17β‐estradiol had a tendency to be higher in the subjects with positive immunostaining for 17β‐estradiol compared with that in the subjects with negative immunostaining. The present results suggest that the human ovary secretes estrogen in response to pituitary gonadotropins even after the menopause.
A case of retroperitoneal liposarcoma in pregnancy: Case Report
Authors: De Jaco Plerandrea , Giorgio Mario , Zantedeschi Bruna , Mazzoleni Guido , Marabini Alberto
Published: November 2007

Retroperitoneal liposarcoma is a rare malignancy. We report a case of retroperitoneal myxoid liposarcoma in pregnancy. The patient died of the disease eight months after surgery.