bluuebunny/crossref_metadata_2025 huggingface dataset:
Phospholipase C‐Sensitive Factor Vii Actiy in Normal Pregnancy
Authors: Dalaker Knut , Ingebretsen Ole C. , Rasrnussen Svein , Nordbø Berge Lillian , Prydz Hans
Published: November 2007

We have previously reported the existence of a phospholipase C‐sensitive form of factor VII‐probably a factor VII‐phospholipid complex in normal pregnancy. By bivariate regression analysis, the level of this complex shows highly significant positive correlations with serum triglycerides (r=0.90, p< 0.0001) and blood platelet count (r=0.67, p=0.0004). This high degree of correlation was verified by stepwise multiple regression analysis. It is presently not known how this factor VII complex forrnes.
Single High Dose of Intravenous Phenytoin Sodium for the Treatt of Eclampsia
Authors: Coyaji Kurus J. , Otiv Suhas R.
Published: November 2007

Phenytoin sodium was administered intravenously as a single 900 mg dose in 33 consecutive women with eclampsia immediately on admission. No untoward effects were observed either in the mother or subsequently in the neonate. Since the patient's level of consciousness is unaltered by the drug, it could be monitored serially as part of neurological assessment. The risks of pulmonary aspiration, respiratory depression and airway obstruction arising from deep sedation which occurs with standard regimens, were averted. Control of convulsions was adequate without the need for any complicated drug related patient monitoring.
Responsiveness of L‐S Ratio of the Amniotic Fluid To Intra‐Amniotic Administran of Thyroxine: Role of fetal age
Authors: Romaguera Josefina , Zorrilla Carmen , de la Vega Alberto , Fromm Ruth , Wallach Robert C. , Rodriguez‐Mariani Aixa , Adamsons Karlis
Published: November 2007

Since 1982 we have accelerated fetal maturation with intra‐amniotic thyr‐oxine (T4) in more than 140 patients. The purpose of this analysis was to determine the rate of change of the ratio of lecithin to sphingomyelin (LIS) after administration of T4 at different gestational ages, and to compare the responses to the first and the second administration of T4. Fifty‐nine cases in which administration of T4 was continued for 2 weeks or more, and in which at least 3 determinations of L/S had been performed, were identified. Gestational age of the fetus at the inititiation of treatment ranged from 26 to 31 weeks (mean 29.3 weeks). Thyroxine was administered weekly in 200 to 500 mcg doses.

Administration of T4 prior to the 27th week did not change the L/S. From the 27th and 31st week of gestation, the slope of the L/S, after the initial dose of T4 increased from 0.331wk to 1.05/wk. In contrast the slope of the untreated patients changed little reaching a maximum of 0.22 at the 33 week. L/S>2 was observed in 80% of cases after 2 weeks of therapy, when it had been initiated after the 26th week.

The response to the second dose was about twice that of the first in fetuses 5 30 weeks, but was similar to that seen after the initial dose in fetuses >30 weeks. Phosphatidylglycerol (PG) was detected in amniotic fluid in 51% of cases after 2 weeks of treatment, and in 6 instances as early as at the 30th week.

Responsiveness of L/S to T4 treatment of the fetus is a function of gestational age and of prior exposure to T4.
No Abortion‐Inducing Effect of Tht Ulcer‐Healing Dosf the Synthetic Prostaglandin E2 Analogue Enprostil In First Trimester
Authors: Jacobson Jan , Bergquist Christer , Rydnert Jan , Bokström Hans , Huovinen Kari
Published: November 2007

Milligram‐range doses of E2 prostaglandins have long been used to induce labor or abortion in the second and third trimesters of pregnancy. Enprostil, a synthetic dehydroprostaglandin E2 structural analogue, is administered in microgram doses for the treatment of acute duodenal ulcer and acute gastric ulcer. This study examined the effect of the ulcer‐healing dose and twice the ulcer‐healing dose upon women in the first trimester of pregnancy. Two hundred and seven women who had requested legal abortion in the first trimester participated in two randomized, double‐blind, placebo‐controlled, parallel studies. They received two doses of enprostil 35 μg (the recommended dose for the treatment of duodenal and gastric ulcer) (n=51), 70 μg (twice the recommended dose) (n=53), or placebo (n = 103) 12 h apart. No drug‐induced abortions occurred in any of the first‐trimester pregnancies. Vaginal bleeding occurred in 4% of volunteers receiving the lower dose and 4% receiving the higher dose of enprostil. Vaginal bleeding occurred in up to 2% of volunteers on placebo. Although not recommended for pregnant women, if enprostil is given inadvertently to pregnant women with ulcers, it is unlikely to endanger the pregnancy during the first trimester.
Diagnostic Value of An Abnormal Sr in Non‐Pregnant Women: Evaluation of Positive Smear from the Surface of the Portio Obtained by the Cottonswab Method or by the Dry Wooden Ayre Spatula and the Relevance of Positive Smear from the Endocervix and/or from the Surface of the Portio
Authors: Lundvall Lene , Hajgaard Lise Lotte , Hajgaard Knud , Lundvall Finn
Published: November 2007

During a 3‐4 year period, 324 women with a positive smear were registered consecutively and prospectively and divided into two groups according to the design of the investigation. In one group the smear was taken with an Ayre spatula and in the other group with a cotton swab. The purpose of this investigation has been to make a comparison between the endocervical smear and the smear taken from the surface of the portio and at the same time between the samples taken with a dry wooden Ayre spatula and with a cotton swab. No differences were found. The cytological findings have been registered and correlated both with the histological findings by colposcopically directed punch‐biopsies and endocervical curettings and with the final histological diagnosis obtained by punch‐biopsy, conization or hysterectomy.
Which Types of Perinatal Events are Predictable?:A Look at a Risk Score Model
Authors: Hoist Kirsten , Hilden Jorgen , Philip John , Andersen Else , Goldstein Henri , Henningsen Inge
Published: November 2007

This study describes the association of a risk factor model for complicated delivery, perinatal morbidity and perinatal mortality with each of various types of delivery complications, types of perinatal morbidity and causes of perinatal mortality. The material comprises a total cohort, 4,066 pregnant women with singletons in a Danish county, and their newborn infants, of whom 494 (12%) had clinical morbidity during the first 5 days of life; 28 (0.7%) died perinatally. A set of 20 risk factors, identifiable before pregnancy, at any time during the pregnancy or at term, was devised by joining existing models for prediction of complicated delivery and of perinatal morbidity and mortality. Metabolic and disproportion‐related events were well predicted by the model, inertia‐related ones less so, and placental conditions not at all, except for abruption. All types of neonatal morbidity (except sepsis) were well predicted, as were deaths. The strongest predictors of perinatal death were signs of hydramnios (RR=16.1) and growth retardation (RR=7.2). The 20 risk factors affected 43% of the population, predicting 57% of the unfavorable perinatal events.
Pregnancy Outcome after Female Infertility in Kuwait: Comparison of Medical and Surgical Treatment
Authors: El‐Ashnehi M. Salah , Ibrahim Mahoun E. , El‐Tamamy Hamdi , Murad Duaa
Published: November 2007

During a 4‐year period, 163 patients conceived after treatment of their infertility due solely to a female factor. They were divided into two groups, 108 patients treated medically (Group 1) and 55 treated surgically (Group 2). At the time of conception, the mean age in Group (1) was 24.9 ± 5.7 years while in Group (2) it was 31.2 + 6.1 years. The difference was statistically significant (p < 0.01). The duration of infertility prior to pregnancy and the treatment‐to‐pregnancy interval were both significantly longer in Group (2) (p<0.05). The rates of miscarriage, multiple pregnancy, and preterm labor were higher in Group (1), though the differences were statistically not significant. In contrast, the rate of ectopic pregnancy was significantly higher in Group (2) (p< 0.05), as was the need for elective cesarean section (p<0.01). Despite these differences, both groups had nearly the same perinatal outcome.
Hypertension as a Risk Factor in Pregnancies Complicated by Systemic Lupus Erythematosus
Authors: Kaaja Risto , Julkunen Heikki , Ammala Pirkko
Published: November 2007

To study the occurrence and significance of pregnancy‐associated hypertension and pre‐eclampsia in systemic lupus erythematosus (SLE), we studied retrospectively 34 pregnancies in 27 SLE patients in 1981‐87. Eleven pregnancies (32%) were hypertensive (group A). The remaining 18 patients during their 23 pregnancies had a normal blood pressure (group B). Previous nephritis was slightly more common in the hypertensive group (54.5% vs. 26.1%, NS). Preeclampsia was present in seven of the pregnancies (21%) and of whom four were superimposed. Flare‐ups of the disease were more common in the non‐hypertensive group (30.4%) than in group A (9.1%) (NS). Duration of pregnancy was the same in the two groups. Intra‐uterine growth retardation was present in 27.3% of the pregnancies in group A and in 13.0% of group B (NS). Fetal loss occurred only in 2 patients of the non‐hypertensive group; one patient had excacerbation of SLE and the other (with two stillbirths) high anticardiolipin antibodies. Our data suggest that pregnancy‐associated hypertension and pre‐eclampsia do not cause increased fetal loss in pregnancies affected by SLE. There seem to be other factors that are more important, such as antiphospholipid antibodies and flare‐ups of the disease.
Limited Transfer of Prostaglandin E2 Across the Fetal Membrane before and after Labor
Authors: Roseblade Christopher K. , Sullivan Mark H.F. , Khan Haroon , Lumb Michael R. , Elder Murdoch G.
Published: November 2007

The transfer of prostaglandin E2 (PGE2) across intact fetal membranes (amnion‐chorion‐decidua) obtained before and after the onset of labor was investigated using a novel system for in vitro fetal membrane culture. Studies using physiological concentrations of PGE2 showed that very little PGE2 will cross the membranes without being metabolised, before or after the onset of labor. It was only when pharmacological concentrations of PGE2 were used that the enzyme activity of the chorion was no longer able to prevent transfer of PGE2 without conversion to inactive metabolites. These results suggest that only small amounts of PGE2 from amnion are normally transferred across the chorio‐decidua before or after the onset of labor, but the metabolism of PGE2 subsequent to transfer across the fetal membranes requires further assessment.
Control of Fetal Membrane Prostaglandin E2 Production by Bacteria
Authors: Helmig Rikke , Roseblade Christopher K. , Uldbjerg Niels , Elder Murdoch G. , Sullivan Mark H. F.
Published: November 2007

The effect of bacteria on the production of prostaglandin E2 (PGE2) and PGE2 metabolites by fetal membranes has been investigated. Live bacteria stimulated a large increase in the levels of PGE2 metabolites, but only a small increase in the levels of PGE2 on the fetal side of the membranes. No significant changes in the levels of PGE2 or its metabolites were found on the maternal side. Bacteria may therefore stimulate PGE2 production by fetal membranes during short‐term incubations, but it seems that the metabolic capacity of the chorion was so high that no change in PGE2 levels was detectable on the maternal side of the fetal membranes. This was confirmed by the finding that < 1 % of 3H‐PGE2 added to the fetal side of the membrane reached the maternal side without being metabolized.
Does Physical Exercise Influence the Frequency of Postmenopausal Hot Flushes?
Authors: Hammar Mats , And Goran Berg , Lindgren Richard
Published: November 2007

The frequency of moderate and severe hot flushes was investigated in a group of women (n=142) who took part in organized physical exercise on a regular basis, and a control group of all women 52 and 54 years old in the city of Linkoping, Sweden (n = 1,246). Only women with natural menopause and without a history of hormonal replacement treatment were statistically compared in the study. It appeared that moderate and severe vegetative symptoms with hot flushes and sweatings were only half as common among the physically active postmenopausal women (21.5%) as in the control group (43.8%). Although this could be due to a positive selection of these physically active women, it might also be due to the fact that exercise may affect the mechanisms that elicit hot flushes in peri‐ and postmenopausal women.
Choriocarcinoma Presenting with Cerebral Metastases After Full‐Term Pregnancy
Authors: Pihl Karin , Malmstrom Henric , Simonsen Ernst
Published: November 2007

Choriocarcinoma is a rare malignancy in Scandinavia. We present a case of a young primigravida who experienced an uneventful pregnancy and gave birth to a healthy baby. Six days after delivery she underwent neurosurgery for intracranial hemorrhage. Pathological examination of the evacuated hematoma revealed metastatic choriocarcinoma. Further work‐up exposed additional metastases in the lungs and liver. The initial serum level of human chorionic gonadotropin (fi‐HCG) was 350,000 IU/I. Chemotherapy was given both intravenously and intrathecally. At 10 weeks, p‐HCG had returned to normal. Treatment was continued for another 10 weeks. Two years after cessation of therapy the patient is still in complete remission. In the discussion we review a scoring system to be used in selecting the mode of treatment, and briefly mention diagnosis and prognosis.
Pneumothorax in Pregnancy
Authors: Wennergren Margareta , Jorgensen Connie , Bugge Mogens , Lepore Vincenzo , Gatzinsky Pantalei
Published: November 2007

Since 1957, only 15 cases of isolated spontaneous pneumothorax in pregnancy have to our knowledge been reported in the English literature (1, 2, 3). The treatment of pneumothorax in pregnancy is more difficult than in non‐pregnant patients. A case is reported and therapy discussed.
Leiomyoma of the Ovary
Authors: Vierhout M. E. , Pijpers L. , Tham M. Ng A. , Chadha‐Ajwani S.
Published: November 2007

Ovarian leiomyoma is a rarity. Usually it is not associated with any clinical symptoms. Macro‐ and microscopically it is indistinguishable from the uterine leiomyoma. Treatment consists of simple removal of the tumor. The possible histogenesis of this tumor is reviewed. It is concluded that the ovarian leiomyoma probably originates from the smooth muscle cells of the ovarian blood vessel or from the smooth muscle fibers near the attachment of the ovarian ligament.
Serum Levels Of 1,5‐Anhydro‐D‐Glucitol During The Normal And Diabetic Pregnancy And Puerperium
Authors: Tetsuo Masahiro , Hamada Teiji , Yoshimatsu Kiyotaka , Ishimatsu Junji , Matsunaga Takamoto , Tetsuo Masahiro
Published: November 2007

In 25 normally non‐pregnant women, 543 normally pregnent women and 75 pregnant women with diabetes mellitus or gestational diabetes mellitus, the relationship between the serum concentration of 1,5‐anhydro‐D‐glucitol (1‐deoxy‐glucose) and carbohydrate metabolism was studied. The concentration of 1,5‐anhydro‐D‐glucitol was estimated by means of gas‐liquid chromatography. In normally non‐pregnant women the concentration was found to be 18.6±5.2 mg/l (mean±SD). During the normal pregnancy, from 9 weeks of gestation, a steadily decreasing concentration was observed as the pregnancy progressed and the lowest value (10.214.6 mg/l) was found in the third trimester. After 5 days of puerperium the concentrations were found to be 10.8±3.7 mg/l. On the 30th day postpartum, the level was within the range for non‐pregnant subjects. The values in pregnant women with diabetes mellitus and gestational diabetes mellitus were mostly below 10 mg/l throughout the entire pregnant period. The 1, 5‐anhydro‐D‐glucitol concentration was not affected by meals or oral glucose loading. A concentration below 10 mg/l was found in 36% of the normally pregnant women, where oral glucose tolerance tests and measurement of glycohemoglobin were shown to be within the normal range. The present study suggests that a change of 1,5‐anhydro‐D‐glucitol level during pregnancy may reflect a mild alteration of carbohydrate metabolism that goes undetected by all the other diabetic indicators.
Single‐Dose Cefuroxime Prophylaxis In Non‐Elective Cesarean Section
Authors: Kristensen Gunnar Balle , Beiter Ellen‐Christine , Mather Ole
Published: November 2007

A prospective randomized study was undertaken to evaluate the efficacy of a single dose of cefuroxime in alleviating infectious complications following non‐elective cesarean section. One hundred and two women were allocated to receive 750 mg of cefuroxime after cord clamping and 99 were allocated to a control group not receiving any antibiotic prophylaxis. The incidence of febrile morbidity was 2.0% in the cefuroxime group and 19.2% in the control group (p<0.001). The incidence of endometritis in the two groups was 1.0% and 6.1%, respectively, the incidence of fever of unknown origin was 1.0% and 9.1 %, respectively. Single‐dose cefuroxime prophylaxis significantly reduced the incidence of febrile morbidity in patients undergoing non‐elective cesarean section, without producing any side effects.
An In Vitro Perfusion Method For Metabolic Studies On Human Postmenopausal Ovaries
Authors: Abrahamsson G. , Janson P. O. , Kullander S.
Published: November 2007

Five ovaries from four postmenopausal women undergoing bilateral oophorectomy for benign conditions were prepared for vascular perfusion for 1 to 5 hours in a recirculating system containing oxygenized (5% CO2 + 95% O2) synthethic bicarbonate buffered medium (Medium 199 + 4% bovine serum albumin + antibiotics). Two histologically normal ovaries released measurable amounts of progesterone into the medium. One ovary, containing a simple cyst, released progesterone into the perfusate, and this release was further increased after the addition of hCG at a concentration of 10 lU/ml. A perfused cystadeno‐fibroma released cAMP, progesterone, estradiol and testosterone into the perfusion medium with an augmented release of cAMP, estradiol and testosterone after the addition of hCG. hCG also had a stimulating effect on the release of prostanoids from this tumour. Fluid from tumour cysts, obtained prior to perfusion, contained measurable levels of gonadotrophins, steroids and prostanoids. The isolated perfused ovary model may provide a tool for futher exploration of endocrine and oncological aspects of the postmenopausal ovary.
Epidermal Growth Factor (Egf) Concentrations in Amniotic Fluid and Maternal Urine During Pregnancy
Authors: Hofmann Glen E. , Abramowicz Jacques S.
Published: November 2007

Epidermal growth factor (EGF) was measured in amniotic fluid and maternal urine from women undergoing amniocentesis for genetic studies (1 5‐weeks' gestation, n = 36) and lung maturational studies (35–39 weeks' gestation, = 20). Amniotic fluid EGF concentrations (mean ± SD) were higher near term (87 ± 71 pM) than mid‐gestation (35 ± 8 pM) (p < 0.0001 1. Urinary EGF concentrations were higher near mid‐gestation (53.9± 30.8 μg EGF/g creatinine) than near term (33.4f 14.1 μg EGWg creatinine) (p<0.006). There was no correlation between individual amniotic fluid and urinary EGF concentrations. The amniotic fluid EGF concentrations correlated with gestational age. However, there was no relationship between EGF concentrations and pulmonary maturity studies or placental weight from the pregnancies studied near term. We conclude that the concentration of EGF in amniotic fluid increases towards term. The lack of correlation between amniotic fluid and maternal urinary EGF concentrations suggests that there probably is a different source of EGF in the two compartments and that EGF does not cross the placenta to any great extent.
Fibroepithelial Polyp of the Ureter A Case History and Discussion
Authors: Schiøtz Hjalmar A.
Published: November 2007

A 46‐year‐old woman had a 13 cm long benign fibroepithelial polyp arising in the right lower ureter and prolapsing through the urethral meatus. She also had uterine fibromyomata. She made an uneventful recovery after laparotomy with supravaginal amputation of the uterus and resection of a 1‐cm segment of the ureter. Benign fibroepithelial polyps very rarely recur and may be treated with local resection.
Uterine Myoma in Pregnancy
Authors: Glavind Karin , Palvio Doris H. B. , Lauritsen Jørgen Glenn
Published: November 2007

A review was made of the medical records of 76 patients with uterine myomas during pregnancy with the aim of studying the time and method of diagnosis, symptomatology, treatment, and outcome of pregnancy. In 11 patients (15%) myomectomy was performed during pregnancy. The frequency of abortion was 18% in patients treated both conservatively and with myomectomy. Myomectomy during pregnancy is discouraged in the literature. In cases where conservative treatment cannot be practised it seeems that the risk of spontaneous abortion during pregnancy is not significantly increased when myomectomy is performed.
Lower Genital Tract Infection with Neisseria Gonorrhoeae and Chlamydia Trachomatis in Women Requesting Induced Abortion and in Their Sexual Partners
Authors: óSskarsson Thordur , Geirsson Reynir T. , Steingrimsson óAlafur , Thorarinsson Hannes
Published: November 2007

The prevalence and patterns of gonococcal and chlamydial infection were investigated in a prospective microbiological study on 3,395 women requesting abortion and the sexual partners of culture positive women (organism identified). Neisseria gonorrhoeae was found in only 1.8% of 3,395 women during the whole study period of 7 years, but Chlamydia trachomatis in 13.5% of 1,635 women in the last 3 years. Women with positive cultures were significantly younger (p<<0.001), and more frequently single (p<<0.001) than those with negative cultures. Single women had more partners (mean 1.5) than those in an established relationship (mean 1.1). Almost all women with gonorrhea were single. Of the males, 62.7% were examined, of whom 47.3% had positive cultures. Twenty per cent of culture positive males had gonorrhea. A high prevalence of positive cultures in the males was only found where chamydial cultures had been positive in the female. All women and men with positive culture results received antibiotic treatment before or after the abortion procedure. The incidence of laparoscop‐ically verified post‐abortion salpingitis was low, at 0.57%, while a clinical diagnosis of endometritis was made in 3.3%. Routine pre‐operative microbial screening for Chlamydiae trachomatis should be considered for all women requesting abortion. Tracing and screening for chlamydial and gonorrheal infection of sexual partners of culture‐positive women is necessary as a preventive measure.
Case Report: Uterus Didelphys Associated with Duplex Kidneys and Ureters
Authors: Fedder Jens
Published: November 2007

In a patient with uterus didelphys, four kidneys and four ureters were detected. The sister too has a didelphic uterus.
Investigations into a possible immunological origin of idiopathic non‐immune hydrops fetalis and initial results of prophylactic immune treatment of subsequent pregnancies
Authors: Mallmann Peter , Gembruch Ulrich , Mallmann Rolf , Hansmann Manfred
Published: November 2007

The cause of the non‐immune hydrops fetalis (NIHF) remains unsettled despite all efforts. From the immunological point of view of pregnancy as a successful course of an allograft, it would seem possible that the idiopathic NIHF can be caused by an immunologic disorder in the meaning of a host‐versus‐graft reaction. Of 324 cases of prenatally diagnosed NIHF, 49 (15,1%) could be classified after exclusion of all other causes as idiopathic and in 38 patients, as well as in 38 age‐ and parity‐paired controls, a differentiation of HLA‐antigens and a determination of lymphocytotoxic antibodies using the NIH Prolonged Incubations and Cold‐Complement‐Dependent Cytotoxicity Test (CoCoCy Test) were performed. In cases of idiopathic NIHF, the proportion of parents sharing 4 or 5 HLA antigens was increased significantly (p<0.05) compared with the control group. In women with idiopathic NIHF, the incidence of lymphocytotoxic antibodies was decreased, due to the test system used; between 28 and 68% in the NIHF group and 24‐80% in the control group. The proportion of women without lymphocytotoxic antibodies was increased in the NIHF group by 72% to 52%, whereas in the control group, in none of the patients could a higher cytotoxicity with a lysing rate of more than 75% be detected. In 8 cases of idiopathic NIHF, where an increased paternal histocompatibility and a decreased incidence and percentage of lymphocytotoxic antibodies were determined, an immunotherapy was performed in order to induce maternal blocking antibodies. Treatment was given as an intradermal injection of paternal lymphocytes before and from the 6th‐8th week of pregnancy every 4 weeks until the 26th week. In all patients, an induction of lymphocytotoxic antibodies could be achieved, giving six successful pregnancies so far. These results fulfilled the requirement of an immunologic diagnosis in all patients with an “idiopathic” NIHF and the carrying out of immunotherapy on appropriate indications.
Psychosocial indications for cesarean section: A retrospective study of 43 cases
Authors: Ryding Elsa Lena
Published: November 2007

At Helsingborg Maternity Clinic the rate of elective cesarean section on psychosocial indications has increased. The purpose of this study was to identify and characterize those women requiring cesarean section despite the absence of obstetrical complications of pregnancy and childbirth and their reasons for doing so. Hospital case records from 1983 to 1987 were examined retrospectively. Nine women (20%) were primiparae, who for different reasons refused vaginal delivery; 34 (80%) were multiparae, half of whom (n=17) had been delivered previously by an unanticipated cesarean section and 4 women by elective cesarean. Seven women had experienced obstetrical complications during vaginal delivery. Five had a diagnosis of other serious medical conditions during the previous or the present pregnancy. The final parous woman demanded a cesarean in spite of perfect health and a normal previous delivery. The patients' reasons for demanding a cesarean, as understood from hospital records, were primarily a very serious fear of childbirth. A psychotherapeutically trained member of the obstetrical staff is well equipped to offer help. The impact of previous complicated birth is obvious in this study. Hopefully, we can avoid some future cesarean sections by means of better care for patients in crisis resulting from complicated childbirth.
A health care program for the investigation and treatment of elderly women with urinary incontinence and related urogenital symptoms
Authors: Molander Ulla , Milsom Ian , Ekelund Peter , Arvidsson Leif , Eriksson Olle
Published: November 2007

The assessment and treatment of urinary incontinence and related urogenital symptoms using an algorithm model was evaluated in 364 elderly women complaining of urinary incontinence. The women (age 72.1 ±1.5 years, range 65‐84 years) were assessed by a 48‐hour pad test, a cough provocation test, micturition lists and a gynecological examination which included a smear test, measurement of vaginal pH and bacterial cultures. The diagnosis of urinary incontinence was confirmed in 346 women (stress 26.3%; urge: 32.7%; mixed: 41.0%). Women suffering from stress incontinence were younger (p < 0.05) and had experienced a larger number of deliveries (p < 0.05) than women with urge incontinence. All the women were treated with oral estriol, 3 mg daily for 4 weeks followed by 1‐2 mg daily. The total urinary leakage per 48 hours (p < 0.01) and maximum single leakage (p < 0.05) were reduced in women with mixed incontinence, while the frequency of micturition decreased (p< 0.05) in women with urge incontinence after 12 weeks treatment with oral estriol. There were no significant changes in any of the objective micturition parameters in women with stress incontinence following treatment. Karyopyknotic index and the presence of lactobacilli were increased (p < 0.001), and vaginal pH decreased (p< 0.001) following treatment in women with all types of incontinence. More than 70% of all the women treated in this algorithm model judged themselves to be improved, much improved or cured.
Mechanical knot performance of a new generation polydioxanon suture (PDS‐2)
Authors: Trimbos J. Baptis , Booster Maurits , Peters Alexander A. W.
Published: November 2007

To improve the handling characteristics of synthetic resorbable monofilament PDS (polydioxanon), a second‐generation (PDS‐2) suture has been developed. The mechanical knot performance of this suture was tested in square knots and sliding knots and compared with other monofilament suture materials. Knot performance was defined by the loop holding capacity (LHC) and expressed in Newton's(N). Maxon (polyglycolid‐three‐methylene carbonate) had significantly better knot performance than the other sutures. Knot performance of Prolene (polypropylene) was significantly poorer than that of the other sutures. Ordinary PDS (polydioxanon) and PDS‐2 (polydioxanon) showed intermediate results. Knot performance of PDS‐2 was similar to (square knots) or poorer than (sliding knots) that of ordinary PDS. It was concluded that knot performance of ordinary PDS is not improved by the introduction of PDS‐2. It is emphasized that surgeons should be aware of the mechanical properties of newly developed suture meterials. Underlying factors and clinical implications of the mechanical performance of PDS‐2 are discussed.
Catechol‐O‐methyltransferase activity in red blood cells in threatened preterm labor; effect of indomethacin and nylidrin
Authors: Kurki Tapio , Schultz Eija , Lindé Inge‐Britt , Ylikorkala Olavi
Published: November 2007

Catecholamines that are released in excess during human labor are inactivated mainly by catechol‐0‐methyltransferase (COMT). To ascertain whether uterine contractions are associated with changes in COMT activity in red blood cells (RBCs), we studied 25 women with established threat of preterm labor between 25 and 33 weeks of gestation, 25 gestational age‐matched control women not experiencing uterine contractions, 25 women who were in term labor, and 25 non‐pregnant healthy women. COMT activity in pregnant women without uterine contractions (median 0.3, range 0.1–0.8 pmoUmg/min) was lower (p< 0.05) than that in non‐pregnant control series (median 0.5, range 0.3–0.7 pmoUmg/min). RBCs' COMT activity in women with preterm labor (median 0.6, range 0.2–1.1 pmoUmg/min) was greater (p<0.05) than that in pregnant and non‐pregnant control women, but similar to that during term labor (median 0.5, range 0.2–1.7 pmoU mg/min). Women with preterm labor were treated with indomethacin (12 women) or nylidrin (13 women). Nylidrin treatment was accompanied by a 35% rise in COMT activity 3 h later, whereas indomethacin caused no significant change. Apart from cessation of uterine contractions during tocolysis, 13 women went into labor before the 37th gestational week, but their pretreatment COMT activity (median 0.7, range 0.2–1.1 pmol/mg/min) did not differ from COMT activity in women whose pregnancy proceeded to term (median 0.5, range 0.3–1.0 pmoUmg/min). We conclude that 1) uterine contractions, no matter whether preterm or term, were associated with elevated COMT activity in RBCs;, 2) COMT assay was of no help in predicting the outcome of premature contractions;, 3) nylidrin led to a short‐term increase in COMT activity.
The use of antiprogestin (RU 486) for termination of second trimester pregnancy
Authors: Goitlieb Claes , Bygdeman Marc
Published: November 2007

Pretreatment with laminaria tent is often used in prostaglandin‐induced second‐trimester abortion to increase efficacy and shorten induction‐to‐abortion time. In the present study, two alternatives to soften the cervix and dilate the cervical canal, the antiprogestin RU 486 and intra‐cervical application of PGE2, were studied. The study included 71 women requesting legal abortion in the 15th to 23rd week of pregnancy who were treated with repeated vaginal applications of 9‐methylene PGE, in a hydrophilic gel (5 mg every 4th hour) following pretreatment with 200 mg of RU 486 and/or intracervical administration of 0.5 mg of PGE2 gel. The mean interval from start of vaginal prostaglandin treatment to abortion was 13.2 h after intracervical PG‐treatment, 10.0 h after antiprogestin and 6.6 h after the combined pretreatment. Patients who received pretreatment with RU 486 alone or in combination with intracervical PGE, experienced the lowest frequency of episodes of vomiting. Of these two pretreatment alternatives, RU 486 alone has the advantage of a shorter hospital stay. It can be concluded that vaginal administration of 9‐methylene PGE2 after pretreatment with RU 486 was a highly effective, safe and rapid procedure for termination of mid‐trimester pregnancy, was well tolerated by the patients and was associated with few side effects.
Unsupplemented breastfeeding in the maternity ward Positive long‐term effects
Authors: Nylander Gro , Lindemann Rolf , Helsing Elisabet , Bendvold Erik
Published: November 2007

Feeding routines in the maternity ward were investigated in 204 mother‐infant pairs before and in 203 after a change towards earlier, more frequent breastfeeding and elimination of routine substitute feeds. In the intervention group, the volume of breast‐milk increased, while the use of formula and sugar solution decreased correspondingly. The infants in the intervention group lost more weight during the first 2‐3 days (6.4% versus 4.6%), but regained their birth weight faster than the supplemented control group. The incidence of hyperbilirubinemia was not significantly different in the two groups. No cases of hypoglycemia were diagnosed. At 6 months, 87% of the infants in the intervention group were still fed at the breast, compared with 66% in the control group. The weight curves were comparable up to 9 months, when intervention group infants were found to weigh slightly less. These follow‐up results must be interpreted with some caution due to the low but comparable response rate of the two groups. Thus the intervention study demonstrated that healthy, full‐term infants usually have no need for supplements to their mothers' milk provided they have had a satisfactory start in life with early and frequent feeds at the breast. The follow‐up study indicated that a more “physiological” start of breastfeeding may have had a positive long term effect on the overall duration of the lactational period.
Sexual behavior and sexually transmitted diseases among Swedish university students
Authors: Tydén Tanja , Björkelund Cecilia , Olsson Sven‐Eric
Published: November 2007

Students at Uppsala University. Sweden, were interviewed about their sexual behavior, their knowledge of and attitudes to sexually transmitted diseases (STDs) and related issues. The purpose of the study was to ascertain trends in behavior and attitudes as an indication of the likely risk of the spread of STDs, in particular AIDS, among students. Results revealed that change of partner was commonplace. A significant number of students had suffered from an STD. Students' claims that their own sexual practices, and those of others, had changed as a result of the AIDS epidemic, proved to be unsubstantiated in their behavior. Although contraceptive use was high, condom use with change of partner was infrequent. Alcohol played a significant role in impairing judgement. Despite a reasonably sound knowledge of STDs, the students exhibited a high degree of risk‐taking behavior. The study has highlighted the dichotomy between knowledge and practice in student sexual behavior. Notable was the lack of perception among university students of their own risk of contracting STDs.
An enzyme (β‐D‐N‐acetylglucosaminidase) released from the decidua to maternal plasma prior to the onset of labor
Authors: Takenaka Akira , Soga Hiroshi , Miyamoto Katsunori , Kasahara Kazuhiko , Yoshida Yoshinobu
Published: November 2007

Changes in the activity of β‐N‐acetylglucosaminidase (E.C. 3.2.1.30; NAG), a lysosomal marker enzyme, in the maternal plasma and utero‐placental tissues during late pregnancy and parturition were examined in order to determine if lysosomal enzymes participate in the cervical ripening. NAG activity in the plasma gradually increased as gestation advanced, to reach a miximum 3‐4 days before the spontaneous onset of labor, and remaining at this level until the second stage. The activity measured in decidua and amnion obtained from the women who had undergone routine repeat cesarean section after labor onset was lower than in those before the onset. Since the decidua was much heavier than the amnion, it was concluded that NAG was released to the maternal circulation mainly from the decidua and only partly from the amnion. Our data revealed that lysosomal enzyme release occurs prior to the onset of labor, and that NAG may play a role primarily in the ripening of the cervix rather than in the onset of labor, by hydrolysing GAGs in the uterine cervix.
Reference intervals for serum sex steroids and gonadotropins in regularly menstruating women
Authors: Anttila Leena , Koskinen Perth , Irjala Kerttu , Kaihola Hanna‐Leena
Published: November 2007

Reference intervals for novel fluoro‐immunoassays for serum luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol (E2) and progesterone (P) were established in 40 healthy regularly menstruating women. Serum samples for sex steroids, including testosterone (T), androstenedione (A) and dehydroepiandrosterone sulphate (DHEAS), as well as sex hormone binding globulin (SHBG) and gonadotropins, were collected in the early follicular and mid‐luteal phases of the menstrual cycle. The need for the timing of androgen and gonadotropin samples was also determinated. Serum E2 and P were measured by radio‐immuno‐ and time‐resolved fluoro‐immunoassays. Various assay methods correlated closely, but the reference intervals varied considerably from one method to another. In the early follicular phase the LH/FSH ratio only ranged between 0.2 and 1.7 (mean ± S.D.; 0.8 ± 0.3); the variation was greater (from 0.3 to 3.5) in the luteal phase, when the mean was also significantly higher (1.5 ± 0.9, p = 0.0001). Similarly the mean values of T and SHBG were higher in the luteal phase, while the other androgen concentrations and calculated androgen indexes were equal, compared with the follicular phase values. Thus the timing of hormone determinations is warranted in the investigation of the gonadotropin and androgen status in normally menstruating women. Moreover, the upper limit of the LH/FSH ratio examined with new, sensitive methods is lower than that previously stated. The use of an intra‐uterine contraceptive device (IUD) had no effect on hormone levels.
Duplex Doppler ultrasound in the evaluation of pregnancies complicated by pregnancy‐induced hypertension
Authors: Ben‐Ami M. , Battino S. , Weiner E. , Shalev E.
Published: November 2007

Umbilical artery velocimetry using pulsed Doppler technique was carried out in 49 pregnancies complicated by pregnancy‐induced hypertension (PIH). Outcome of the pregnancies was evaluated after delivery. We found the systolic to diastolic ratio of the umbilical artery to be highly sensitive and specific in predicting abnormal outcome in pregnancies complicated by PIH. In our opinion, the pulsed Doppler technique can be a useful adjunct to other methods for evaluation of fetal well‐being in patients with PIH.
Pericardial effusion in normal pregnant women
Authors: Abduuabbar Hassan S.O. , Marzouki Khalid M.H. , Zawawi Tarif H. , Khan Ahmed S.
Published: November 2007

Fifty‐two normally pregnant women underwent echocardiography to examine their pericardium in the first, second and third trimester. Pericardial effusion was noted in 15.3% of the women (n=8) in the first trimester, 19.2% (n=10) in the second trimester and 44.2% (n=23) in the third trimester of pregnancy. Pericardial effusion during pregnancy was found to be completely resolved in all patients who underwent an echocardiogram 6 weeks post delivery (n=U). There was no statistically significant difference in age, hemoglobin, total protein, albumin/globulin ratio or mean blood pressure during pregnancy between those who developed pericardial effusion and those who did not. The frequency of occurrence of pericardial effusion in primigravidas at 69.2% (9/13) was higher than that in multigravidas, with a ratio of 35.9% (14/39), the difference being statistically significant (p < 0.025). The frequency of occurrence of pericardial effusion in patients who gained more than 12 kg during pregnancy at 67.7% (11/17) was higher than in patients who gained less than 12 kg, with a ratio of 34.3% (12/35), the difference being statistically significant (p < 0.025).
The relationship between alcohol consumption during pregnancy and infant birthweight: An epidemiologic study
Authors: Virji S. K.
Published: November 2007

Heavy alcohol consumption during pregnancy has been consistently associated with inhibited intra‐uterine growth; however, the effect of social drinking is not yet clear. The relationship between moderate drinking and low birth weight (< 2,500 g) among a nationally representative sample of white married mothers who gave birth to singletons infants in the National Natality Survey (1980) is analysed here. Alcohol consumption during pregnancy was significantly associated with birth weight (p <0.02). Moreover, there was a gradient of risk in low birth weight associated with increasing amount of alcohol ingestion during pregnancy. There was a significant association between the mean birth weight of the singletons across different categories of alcohol intake (p< 0.0001). The difference between the mean birth weight of the singletons among moderate drinkers compared with nondrinkers was also statistically significant (p< 0.005). These relationships remained after simultaneously adjusting effects of the confounding variables gestational age, parity, smoking, weight gain, maternal age and education in multiple regression analyses. These findings confirm earlier reports of a relationship between alcohol use during pregnancy and decreased birth weight. Additionally, it is shown here that for moderate alcohol use during pregnancy, there is an adverse effect on the birth weight.
The influence of epidural blockade and pethidine administered during delivery on neonatal myocardial performance
Authors: Lichtenstein M. , Mellander M. , Milsom I. , Westling F.
Published: November 2007

The aim of the present study was to investigate whether obstetric analgesia with an epidural blockade (Marcaine*, bupivacaine hydrochloride, 141.5 ± 56.8 mg) and pethidine (95.0 ± 30.7 mg) influenced neonatal myocardial function following vaginal delivery. Left ventricular output and other left ventricular function indices were measured 5.6 ± 4.3 h postpartum with Doppler and M‐mode echocardiography in a group of healthy, full‐term, appropriate‐for‐gestational‐age infants (n = 10) whose mothers had received both bupivacaine and pethidine during delivery, and in a similar group of newborn infants (n = 10) whose mothers had received only nitrous oxide/oxygen analgesia. In 7 of the 10 infants in each groups, a second assessment of myocardial function was performed 21.7 ± 4.6 h post partum. There were no significant differences in any of the variables used to assess left ventricular function at either of the measurement points between the group of infants whose mothers had received bupivacaine/pethidine during delivery, and the group of infants whose mothers had received nitrous oxide/oxygen analgesia only.
Treatment of tubal pregnancy by laparoscopic laser surgery
Authors: Langebrekke Anton , Kirschner Rolf , Skår Oskar Johan , Sørnes Torgrim , Urnes Arne
Published: November 2007

We present 150 consecutive cases of tubal pregnancy treated by laparoscopic techniques. A three‐puncture technique was used. 74 cases were treated conservatively by linear salpingotomy with carbon dioxide laser laparoscopy and 76 cases were treated non‐conservatively through the laparoscope by salpingectomy or tubal resection. Contraindications to laparoscopic surgery were haemodynamically unstable patient and interstitial pregnancy. Seventy‐five per cent of all tubal pregnancies were treated by laparoscopy in the period studied. No complications were encountered during the laparoscopic operations. Two patients needed a second laparoscopy, while 2 others unverwent a subsequent laparotomy. This study has shown that tubal ectopic pregnancies can in most cases be effectively managed by laparoscopic techniques.
Serum lipids and lipoproteins during therapeutic amenorrhea induced by lynestrenol and depot‐medroxyprogesterone acetate
Authors: Huovinen K. , Tikkanen M. J. , Autio S. , Härkonen T. , Lommi L. , Varonen S. , Wilska M.‐L.
Published: November 2007

Serum concentrations of total cholesterol, low‐density lipoprotein cholesterol (LDL‐C), high‐density lipoprotein cholesterol (HDL‐C), triglyceride (TG), apolipoprotein A1 (Apo A1), and apolipoprotein B (Apo B) were determined in mentally handicapped subjects (n = 87). 33 women were on lynestrenol 5–10 mg for therapeutic amenorrhea (TA). 18 of them were randomly allocated to continue on lynestrenol and 15 were switched to intramuscular administration of medrozyprogesterone (DMPA). The switch to DMPA resulted in significant increases in HDL‐C (33%), Apo A1 (12%), as well as in the HDL‐C/LDL‐C (48%) and Apo Ai/Apo B (22%) ratios. The concentrations of HDL‐C and Apo A1 were significantly greater in patients receiving DMPA, than in patients continuing with lynestrenol therapy. The amenorrhea incidence, however, did not differ between the two therapy groups. It is concluded that therapy with DMPA may be associated with smaller atherosclerosis risk than with peroral lynestrenol, because of its weaker effect on HDL‐C and A1 levels.
Concomitant endocervical curettage and cervical conization
Authors: Vierhout M. E. , de Planque P. M.
Published: November 2007

We present a series of 94 endocervical curettages (ECC) performed directly after cutting a cervical cone specimen. In 7 patients the ECC gave insufficient material for a histological diagnosis, but in 9 patients it contained CIN. The top of the cone contained CIN in 17 cases. The correlation between the histological results from the top of the cone and the ECC was poor. The presence of persistent disease after conization was studied in relation to both the status of the top of the cone and to the ECC. For the latter we found a sensitivity of 0.50 and a specificity of 0.95. The top of the cone showed a sensitivity of 0.80 and a specificity of 0.88. It is concluded that ECC is of little additional value in predicting persisting disease.