bluuebunny/crossref_metadata_2025 huggingface dataset:
Preinductive cervical ripening with prostaglandin E, in women with one previous cesarean section
Authors: Norman Margareta , Ekman Gunvor
Published: November 2007

Thirty term pregnant women with one previous cesarean section and with unripe cervices were given 0.5 mg prostaglandin E2 in gel strictly intracervically for cervical ripening and labor induction. Fifteen out of these 30 women (50%) were vaginally delivered within 24 hours. The cervical ripeningllabor induction was considered a failure in two women. In one woman, an episode of hypercontractility was registered. After tocolytic therapy the uterine activity was normalised and the woman had a normal vaginal delivery. The frequency of cesarean sections was 8/30 (27%). At the operations no insufficencies in the uterine scars were noted. Conclusively, strict intracervical application of 0.5 mg prostaglandin E2 in gel can be used for cervical ripening and labor induction also in women with one previous cesarean section.
Survey of the treatment of Chlamydia trachomatis infection of the female genital tract
Authors: Aavitsland Preben
Published: November 2007

A questionnaire was sent to every tenth (n = 302) general practitioner in Norway. The physicians were to indicate their choice of antibiotic regimen for the treatment of genital chlamydial infections in women. Sixty‐nine percent of the practitioners responded. The choice of treatment varied widely between the respondents. Forty‐two different regimens were used for chlamydial cervicitis, 34 for cervicitis in pregnancy and 63 for probable pelvic infection. Of the prescribed treatments for these three diagnoses 14%, 5% and 46%, respectively, were compatible with the advice of the World Health Organization or the Centers for Disease Control. For the three previously mentioned diagnoses 49%, 79% and 43%, respectively, of the practioners would prescribe an antibiotic in either smaller doses, fewer daily doses or shorter duration than recommended. There is an urgent need to improve and standardize Norwegian general practitioners' treatment of chlamydial infection in women.
Transvaginal sacrospinous colpopexy for vaginal vault and complete genital prolapse in aged women
Authors: Heinonen Pentti K.
Published: November 2007

Twenty‐five women (mean age 72.8 years) with massive eversion of the vagina were treated with transvaginal sacrospinous ligament colpopexy between 1986 and 1990. Nine of them had a posthysterectomy vaginal prolapse; 16 had complete genital prolapse and coincident vaginal hysterectomy was performed. The operation was performed under spinal anesthesia in all cases except one with general anesthesia. Simultaneous anterior colporrhaphy was done in 88%, repair of enterocele in 72% and posterior colpop‐erineorrhaphy in 88% of all cases. There were no intra‐ or post‐operative complications. Vaginal vault prolapse did not recur during a mean follow‐up period of 2.8 years in 22 cases. Three patients developed asymptomatic cystocele or enterocele, and 5 (23%) women had a curtailed vagina. Sacrospinous ligament colpopexy under regional anesthesia is an effective and suitable operation for aged women with vaginal vault and complete genital prolapse. The operation is also a safe and fairly simple procedure if the anatomic relationship of the nearby structures is known.
Fetal heart rate patterns preceding intrauterine death during labor
Authors: Nesheim Britt‐Ingjerd
Published: November 2007

A fetus of 37 weeks died in labor during recording of the fetal heart rate patterns. Five hours earlier a reactive non‐stress test had been obtained. No other cause of death than a tight nuchal cord was found.
Spurious elevation of follicle‐stimulating hormone
Authors: Cahill David J. , Fox Robert , Thomas Paul H.
Published: November 2007

Serum concentrations of follicle‐stimulating hormone (FSH) were measured in a 33‐year‐old eurnenorrhoeic woman with primary infertility. Postmenopausal levels were obtained. Using an alternative assay, the patient was found to have normal levels of FSH. The probable cause of the misleading result is discussed.
The coexistence of stromomyoma and uterine tumor resembling ovarian sex‐cord tumors: Report of a case and immunohistochemical study
Authors: Erhan Ylldlz , Baygün Mine , Özdemir Necmettin
Published: November 2007

The case of a 40‐year‐old female with a uterine tumor resembling an ovarian sex‐cord tumor, located within another neoplastic nodule having the histopathological features of a stromomyoma is reported. Light microscopic examination of the uterine sex‐cord‐like tumor revealed a highly cellular tumor tissue with no specific differentiation, consisting of solid nests and anastomosing cords and a few pseudo‐tubular structures. The vacuoleted cytoplasm of the lipid‐rich cells proved vimentin‐positive, but desmin‐ and keratin‐negative. The coexistence of the two variants of endometrial stromal tumor was interpreted as arising from endometrial stroma or multipotential uterine mesenchyme that showed a diverse differentiation toward ovarian sex‐cord stroma and uterine smooth muscle with interspersed stromal cell clusters.
Relapsing thymic carcinoma during pregnancy
Authors: Peleg David , Zabari Avinoam , Shalev Eliezer
Published: November 2007

A 23 year old woman, who was known to be in remission from thymic carcinoma, presented in her first trimester. She had previously been treated with radiation and chemotherapy. Her pregnancy was complicated by fevcr and contractions at 30 weeks and ended with the birth of a live preterm male infant. Subsequent investigation revealed a massive relapse of her mediastinal tumor. This case reinforces the devastating consequences that pregnancy has on thymic hyperplasia. Of nine previously reported cases, five of the women died either during pregnancy or within six months and only one was alive longer than five years. Therapeutic abortion should be considered in the pregnant woman with known thymic neoplasia.
Metastatic choriocarcinoma with coexistent term pregnancy following four recurrent consecutive moles
Authors: Bakri Younes N. , Pedersen Poul , Ezzat Adnan
Published: November 2007

A case is reported of a 38‐year‐old woman with metastatic choriocarcinoma which followed four recurrent consecutive hydatidiform moles occurring within the preceding S‐year period. She conceived while having pulmonary metastasis, had a coexistent normal pregnancy and delivercd a normal infant at term. Surgical resection of the lung lesion together with chemotherapy accomplished a sustained remission, with no evidence of disease after 20 months' follow‐up.
Leiomyomatosis peritonealis disseminata with adipocytic differentiation
Authors: Kitazawa Sohei , Shiraish Nobuyuki , Maeda Sakan
Published: November 2007

We report a rare autopsy case of leiomyomatosis peritonealis disseminata in a woman, who had been operated upon for ovarian granulosa cell tumor two years prior to her death. The deposits showed both myofibrohlastic and adipocytic differentiation.
Psychopharmaceuticals and perinatal deaths
Authors: Jong P. C. M. Pasker‐De , Ahlborg G. , Bodin L. , Zielhuis G. A.
Published: November 2007

Re.: Laegreid L, Conradi N, Hagberg G, Hedner T. Psychotropic drug use in pregnancy and perinatal death. Acta Obstet Gynecol Scand 1992; 71: 492–493.
Estrogen and progesterone receptors in vessel walls: Biochemical and immunochemical assays
Authors: Bergqvist Agneta , Bergqvist David , Fernö Mårten
Published: November 2007

The purpose of the present investigation was to examine the estrogen and progesterone receptor status in arterial and vein walls in women and men. Biopsies from uterine arteries and veins were obtained from 14 fertile and six post menopausal women. Biopsies from saphenous veins were obtained from eight fertile women, 12 post menopausal women and 12 men. Comparative receptor assays were performed with ligand technique and monoclonal antibodies. Immunohistochemical localization of estrogen and progesterone receptors was performed using monoclonal antibodies.

The ligand technique revealed estrogen and progesterone receptors in low frequency in the uterine vessels but the monoclonal antibodies showed low receptor level in all arterial and vein samples. There was no statistical difference between fertile and post menopausal women. In the few nuclear fractions examined, both estrogen and progesterone receptors were measurable.

Estrogen receptors were found in all peripheral vein samples from fertile women but not in all samples from post menopausal women and men. Progesterone receptors were detected in almost all samples of peripheral veins. There were significant differences with higher levels of estrogen receptors in cytosol and nuclear fraction and of progesterone receptors in nuclear fraction, all assayed with monoclonal antibodies, in uterine veins from fertile women compared to peripheral veins from fertile women, post menopausal women and men, respectively. These data indicate that the hormonal regulation of peripheral vein walls is different than that of the uterine vessel.
Embryonic losses after in vitro fertilization and embryo transfer
Authors: Mesrogli Mahmoud , Dieterle Stefan
Published: November 2007

Early loss of embryos is a major problem after in vitro fertilization (IVF) and embryo transfer (ET). Because implantation of the embryo is a precondition for an increasing serum β‐hCG level, the embryonic development cannot be evaluated during the pre‐ and peri‐implantation period. Early pregnancy factor (EPF) is a marker of the development of the embryo before and during implantation. Therefore serum samples of 82 patients were screened for EPF and β‐hCG after IVF/ET. 63% (52/82) of all patients were positive for EPF, 21% (17/82) showed elevated serum β‐hCG levels. Clinical pregnancies occurred in 12 patients (15%) resulting in nine deliveries. After difficult ET EPF turned negative more frequently in the peri‐implantation period compared to transfers without problems. Emphasis should be directed towards optimizing the placement of the embryos and towards minimizing the trauma of the uterus.
Characteristics of women choosing birth center care
Authors: Waldenström Ulla , Nilsson Carl‐Axel
Published: November 2007

The purpose of this study was to describe the characteristics of women choosing alternative maternity care compared with women who preferred conventional care. The former group of women had their antenatal, intrapartum and postpartum care at a birth center in Stockholm, Sweden. Characteristics of the birth center care were continuity of care, restriction of medical technology, parental responsibility and self care. Altogether 1086 women enrolled for birth center care were included in the Alternative Group (AG). A sample of 630 was selected from among pregnant women who preferred conventional care (CG). Both groups filled in a structured questionnaire, and the response rate was 100% (1086) in the AG and 70% (441) in the CG. Besides having a more critical attitude to conventional procedures of maternity care, women in the AG were older, better educated and had other professions than CG women. They were in better physical health, and tended to be less anxious when thinking of the approaching birth and motherhood. They had more positive expectations of the coming birth, and a greater interest in not being separated from the newborn and the rest of the family immediately after the birth. They were also more interested in being actively involved in their own care. Generally speaking, AG women were more concerned about the psychological aspects of childbirth. No differences were found between the groups regarding civil status, proportion of native Swedes, or parity. Women whose characteristics coincide with those of the AG may be a growing proportion of the female population, due to better education and a growing concern about the disease orientation of maternity care. Interest in alternatives, particularly so‐called natural childbirth, may therefore be expected to increase. Such developments ought to be considered in the planning of maternity care.
Morphometric analysis of gap junction density in human myometrium at term
Authors: Kilarski Wincenty M. , Rezapour Masoumeh , Bäckström Torbjörn , Roomans Godfried M. , Ulmsten Ulf
Published: November 2007

In the human myometrium. the formation of gap junctions in the various stages of labor and, in correlation with the concentration of progesterone in the maternal blood, has not been described adequately. The accepted hypothesis that raised concentrations of progesterone in maternal blood in animals prevent the formation of gap junctions was scrutinized in human niyometrium. Myometrial tissue was examined by electron microscopy for the presence of gap lunctions and analyzed morphometrically in 17 women who had an elective or emergency cesarean operation at the 38th or 39th week of pregnancy. The concentrations of progesterone and estradiol in the maternal and cord blood was measured by means of radioimiiiunoassay. The frequency and area of gap junctions varied in relation to the presence or absence of labor. In the myometrium of women in labor, gap junctions were most frequent (5.2/1000 μm of cell membrane), their area largest (0.32 μ2/1000 μm of cell membrane) and their fractional area greatest (0.20%). When the women were not in genuine labor or when contractions were weak, the percentage fractional areas of gap junctions were low (0.020‐0 090) and the gap junctions very small. In the pre‐ and active phases of labor, the concentration of progesterone in maternal blood was significantly higher (p <0.025 and 0.03 respectively) than in women who were not in labor.

Hence, despite high concentrations of progesterone in the maternal and cord blood at term, the myometrium presented numerous gap junctions of relatively large area.
Ovarian electrocautery in the treatment of women with polycystii ovary syndrome (PCOS): Factors affecting the results
Authors: Gjønnaess Halvard
Published: November 2007

During ihe years 1979‐91 252 women with polycystic ovarian syndrome (PCOS) have been treated with ovarian electrocautery through the laparoscope in Aker University Hospital. Ovulation was obtained in 92% of the total series, and pregnancy in 84% of the women with PCOS as the sole cause of their infertility. Additional treatment with clomiphene citrate to the non‐responders increased the pregnancy rate to 89% The response to ovarian electrocautery was inlluenced by body weight, with an ovulation rate of 96‐97% in the slim and moderately obese women decreasing to 70% in the really obese ones. When ovulation was established. the pregnancy rate per se was independent of body weight ‐ when ovulation was established. the pregnancy rates of slim and overweight women with PCOS being 92% and 95%, respectively. In the responders (who ovulated following ovarian electrocautery), the annual rate of cessation of ovulation was 3‐4% only. Even after a period of contraceptive use following the ovarian electrocautery, ovulation was resumed and pregnancy obtained within a few months. Therefore, ovarian electrocautery is proposed as the primary treatment in women with PCOS undergoing laparoscopy for any reason, infertility being a present, future oi hypothetical problem only. When, on the other hand, infertility is not an issue, PCOS per se constitutes no reason to perform laparoscopy.
A modified technique for correction of the complete septate uterus
Authors: Vercellini Paolo , Ragni Guido , Trespidi Laura , Oldani Sabina , Panazza Stefania , Giorgio Crosignani Pier
Published: November 2007

When correcting a complete uterine septum, it is recommended that one should spare the cervical portion to avoid the possible risk of cervical incompetence. However, it may be difficuh to create a communication between the uterine cavities above the internal os. In seven piitients with complete septate uterus we incised the cervical portion with Metzenbaum scissors and the corporal portion with microscissors under hysteroscopic guidance. The operating times were shorter and the distension fluid deficit smaller compared with nine historicill controls in whom the cervical septum was spared. No intraoperative or obstetric complications were associated with cervical septal section. This modified technique is simple, rapid, s'ire, inexpensive, and may be considered among the alternative treatments to correct a complete septate uterus.
Predictive value of psychatric history, genital pain and menstrual symptoms for sexuality after hysterectomy
Authors: Helström Lotti , Weiner Erik , Sörbom Dag , Bäckström Torbjörn
Published: November 2007

Objective. To study the predictive value of the history of genital pain, psychiatric complaints and menstrual symptoms on a woman's sexual life before and after subtotal hysterectomy.

Material rind method. One hundred and four premenopausal women were interviewed one month before and one year after surgery. A latent variable for pre‐ and postoperative sexuality was constructed from the intercorrelation between the measured parameters of frequency of desire for sex, coital frequency, cyclicity of desire and existence of multiple orgasm, and other variables for genital pain, psychiatric morbidity and menstrual symptoms were compared to the latent factors for sexuality.

Results. No difference was seen in postoperative sexuality in women with and without a history 01 psychiatric complaints. The regular use of analgetics, a need to stay home from work because of menstruation, and the occurrence of dyspareunia were positively correlated to the latent factors for sexuality before and after the operation. A history of the need to use psychopharmaceuticals, such as sedatives or antidepressants, had a negative influence on preoperative. but not on postoperative sexuality. Dysmenorrhea had a positive influence on postoperative, but not on preoperative, sexuality.

Conclusion. Among variables studied, dysmenorrhea was the best predictor for postoperative sexuality. That is: women with dysmenorrhea do not only invariably experience relief from the pain, hut also have a chance to improve their sexual lives after removal of their malfunctioning uterus. Presence of psychiatric problems had, in general, little influence on sexuality.
Screening voided urine for Chlamydia trachomatis in asymptomatic adolescent females
Authors: Svensson L.‐O. , Mares I. , Mardh P.‐A. , Olsson S.‐E.
Published: November 2007

First catch urine (FCU) from 751 asymptomatic adolescent female high school students, with sexual debut, were screened for the presence of Chlamydia trachomatis (Group A). The prevalence of C. trachomatis infection in Group A was 2.1% (16/751). In Group B, 619 asymptomatic adolescent females attending a youth and a family planning clinic were screened for C. trachomatis by testing FCU and cervical specimens. An enzyme immunoassay (IDEIA‐III) was used to detect C. trachomatis vertified by fluorescein‐isothianate‐conjugated (FITC) monoclonal antibodies. Only samples positive in both tests were regarded as true positive. The cervical samples from the women in Group B were positive in 7.8% (48/619), while the FCU were positive in 6.0% (37/619). Detection of C. trachomatis by EIA in FCU samples was found useful for screening females for genital chlamydial infection. The prevalence of C. trachomatis in an unselected asymptomatic population was found to be lower than in age‐matched individuals seeking medical advice in the same coherent area.
Synergistic effects of carboxymethylcellulose and low molecular weight heparin in reducing adhesion formation in the rat uterine horn model
Authors: Sahin Yilmaz , Saglam Abdullah
Published: November 2007

Objective. To investigate the effect of sodium carboxymethylcellulose (SCMC) and the combination of low molecular weight heparin (LMWH) with SCMC in the prevention of intraperitoneal adhesion.

Design. Thirty‐eight rats underwent bilateral surgical injury to the uterine horn and the parietal peritoneum. In 13 rats, a solution of SCMC was instilled at laparotomy. In 11 rats, LMWH was delivered on to serosal and peritoneal defects, and SCMC was instilled. As a control group 14 rats were included in the study.

Setting. Surgical Research Laboratory, Erciyes University.

Participants. Female Wistar‐Albino rats, weighing 200 to 250 g each.

Main outcome measures. Adhesions between the uterine horn and the abdominal sidewall were scored for extent and severity two weeks after the initial surgery.

Results. Although the mean adhesion score both in the SCMC group (2.8, s.d. 1.15) and in the SCMC with LMWH group (1.6, s.d 1.18) was found to be significantly lower than in the control group (3.4, s.d. 0.89) (p < 0.05 and p < 0.001, respectively), more favorable adhesion prophylaxis was achieved in the SCMC with LMWH group in comparison with the SCMC treatment group without any hemorrhagic complications (p < 0.001).

Conclusion. We conclude that SCMC with LMWH are highly effective in reducing postoperative adhesions in this animal model. SCMC with LMWH appears promising in adhesion prophylaxis.
Leiomyomatosis peritonealis disseminata
Authors: Kökçü Arif , Alvur Yüksel , Bariş Y. Sancar , Kuşkonmaz Ibrahim
Published: November 2007

Leiomyomatosis peritonealis disseminata is a very rare disorder. The number of cases documented in the literature is only 44. Of these cases, only one was in the postmenopausal period. We report a new case of leiomyomatosis peritonealis disseminata in a postmenopausal woman.
In situ characterization of leukocytes in the fallopian tube in women with or without an intrauterine contraceptice device
Authors: Wollen Anne‐Lone , Sandvei Roar , Mørk Sverre , Marandon Jean Louis , Matre Roald
Published: November 2007

Histological evaluation of sections from the human fallopian tube revealed an inflammatory reaction in 21 of 31 women using an intrauterine contraceptive device (IUCD) and in four of 29 controls (non‐IUCD users). The inflammatory cells were mainly localized at the epithelium‐lamina propria interface and at the center of the mucosal folds.

The immunohistochemical study revealed leukocytes (CD45+), T lymphocytes (CD3+), T helper cells (CD4+), T suppressor/cytotoxic cells (CD8+), B lymphocytes (CD22+, CD19+), granulocytes, monocytes and null cells (CDllb+) mainly localized at the lamina propria in both groups. T lymphocytes were the predominant cell type, and the ratio between T helper and T suppressor/cytotoxic cells was fairly close to one both in IUCD‐users and controls. B lymphocytes were the least frequent cell type identified. In IUCD users, the numbers of the different leukocytes were increased.

In both groups, IgA‐, IgG‐ and IgM‐positive cells were demonstrated and were predominantly located at the lamina propria of the mucosal folds. The IgA‐positive cells dominated in both groups, whereas IgG‐ and IgM‐positive cells were less frequent. Cell positive for IgA, IgG or IgM were significantly increased in number in the IUCD users.

The data confirm the presence of an immune system in the normal human fallopian tube and indicate that the IUCD can induce a prominent recruitment of inflammatory cells, with a tubal inflammation as the result. The IUCD may disturb the immunological function of the fallopian tube and its role in fertilization.
Term prediction in routine ultrasound practice
Authors: Backe Bjørn , Nakling Jakob
Published: November 2007

Study objective. Evaluation of the precision of routine ultrasound term prediction.

Design. Population based follow‐up without intervention.

Setting. Ultrasound screening in routine clinical practice.

Material. 1650 women residing in one Norwegian county giving birth during a 12‐month period. All pregnancies were singleton with spontaneous onset of labor, all records contained a term predicted with routine ultrasound in the second trimester.

Outcome measure. Difference between actual and predicted day of delivery, and difference between ultrasound predicted term and term calculated from last menstrual period.

Main results. More women delivered within two weeks of ultrasound term than two weeks of term calculated from the last menstrual period (87.5% and 79.3%, p<0.001). Deliveries were significantly closer to the ultrasound predicted term than the term calculated from the last menstrual period, with the exception of deliveries in the 39th week after LMP where no significant difference was found between ultrasound term and LMP‐term. No difference was found in the mean performance of 14 different ultrasound operators.

Conclusions. In a population representative of deliveries in one county, routine ultrasound term prediction performed in three medium sized hospitals more accurately predicted day of delivery than term calculated from the date of last menstrual period.
Sonographic diagnosis of a urachal cyst in utero
Authors: Awwad Johnny , Azar Ghassan , Soubra Maher
Published: November 2007

With improvements in fetal screening techniques, urachal anomalies can now be detected antenatally. Characteristic sonographic features of a urachal cyst in utero are described.
Abortion ethics—women's post abortion assessments
Authors: Holmgren Kristina , Uddenberg Nils
Published: November 2007

Background. Induced abortion is often discussed in terms of ethics. The aim of the present report is to describe the abortion ethics as it was expressed by women undergoing a legal abortion.

Objective. Moral considerations expressed during semistructured interviews by 128 women two weeks after a first trimester abortion in Stockholm 1987‐90 are reported.

Result. The women had faced a choice between abortion and parenthood. At the time of the abortion many of them were living under conditions that meant they were unable to offer a child the security they regarded as a child's right. The conflict the women spontaneously described as their main moral dilemma was not a conflict between the woman and the fetus, but a conflict between several close relationships, also concerning the prospective father. The ethics that the women applied to the problems of abortion was founded on a long‐term responsibility to care for persons in their relationships.

Conclusion. The women interviewed had three levels of moral reasoning simultaneously present. I. A theoretical level ‐ most of all concerning other women ‐ a liberal view of rights: abortion should be a freely obtainable option. 2. A theoretical level ‐ above all, concerning themselves ‐ a restrictive deontological view: the extinction of life is morally wrong and should he avoided. 3. A practical level ‐ when the problem was a reality: a consequentialist ethics of care. According to this ethics of care it was important that the abortion could be performed as early as possible during pregnancy.
Two‐year infant neurodevelopmental outcome after expectant management and indicated preterm delivery in hypertensive pregnancies
Authors: Spinillo Arsenio , Iasci Angela , Capuzzo Ezlo , Egbe Thomas O. , Colonna Laura , Fazzi Elsa
Published: November 2007

Background. To evaluate the impact of the expectant management of hypertensive disorders of pregniiiicy on infant neurodevelopmental outcome.

Methods. The two‐year neurodevelopmental outcome of infants delivered prematurely because of complications of maternal hypertension after expectant management was compared with thal of infants of uncomplicated age‐matched pregnancies delivered after spontaneous preterm labor or premature rupture of membranes.

Results. The rate of cerebral palsy was similar between the two groups. Conditional logistic regression analysis of the matched sets showed an increased risk of minor neurodevelopmental impairment among infants delivered after severe hypertension (odds ratio (OR) = 4.0, 95% confidence interval (CI) 1.34‐12.1) or preeclampsia (OR = 4.0, 95% CI = 1.61‐10.2). Fetal growth rciardation was not associated with increasing infant neurodevelopmental morbidity.

Conclusions. Infants delivered prematurely because of preeclampsia or severe hypertension are at incicased risk of later minor neurodevelopmental problems.
Evaluation of standard parameters to predict exchange transfusions in the erythroblastotic newborn
Authors: Gottvall Tomas , Hllden Jan‐Olof , Selbing Anders
Published: November 2007

During the time period 1983‐90, 91,300 consecutive pregnancies were monitored for red cell alloimmunization. Once revealed, the immunizations were followed by means of repeated maternal antibody titers, maternal anti‐D quantitation in D‐immunized women, amniotic fluid bilirubin levels and fetal hemoglobin concentrations. High dose intravenous immunoglobulin and/or intrauterine intravascular transfusion was given to prevent or treat fetal anemia. Delivery was induced for all before term when antibody titers were ≥16. Nevertheless, exchange transfusions were performed in 41 newborns with mothers alloimmunized to Rh(D), Rh(c), Rh(E) and Kell antigens. Eight of the mothers were Rh(D) positive. Phototherapy alone was given to 35 newborns. Both maternal antibody titers and amniotic fluid bilirubin levels were found to be unreliable to predict the need of exchange transfusions in the newborns. Quantitation of maternal anti‐D concentration was found to be significantly better predicting 62% at a cut‐off level of 0.7 μg/mL. Analysis of fetal hemoglobin concentration by cordocentesis is the only direct method to evaluate the degree of fetal affection, and should probably be performed when maternal antibody titers are ≥64, anti‐D concentration is ≥0,7 μg/mL and data indicate an aggravation of the immunization.
Puerperal endometritis after abdominal twin delivery
Authors: Suonio Sakari , Huttunen Marjatta
Published: November 2007

The infectious complications of 122 consecutive abdominal twin deliveries over the period 1984‐1989 were analyzed in a prospective clinical study, comparing them with 761 singleton abdominal deliveries over the period 1984‐1986. The incidence of endometritis was nearly three‐fold after twin deliveries and the incidence of abdominal wound infections nearly twofold compared with singleton abdominal pregnancies (13.1/4.7% and 5.6/3.0%). The risk of amnionitis was increased ten‐fold, 6 hours after rupture of the membranes in abdominal twin delivery, but no connection was found between amnionitis and endometritis, as in singleton abdominal deliveries. Multiple regression analysis indicated only two risk factors as regards puerperal endometritis after abdominal twin delivery: age under 25 years (odds ratio 6.9, 95% confidence limits 1.9‐24.8), an association also seen in singleton abdominal deliveries, and a period of more than 6 hours from rupture of membranes to delivery (odds ratio 7.8, 95% confidence limits 2.1‐28.5). Multiple pregnancy appears to be associated with an increased risk of endometritis. The etiological factors remain unknown, but a large placental bed and/or immunological factors may be implicated.
Estrogen and progesterone receptor content of enucleated uterine myomata after luteinizing hormone‐releasing hormone: Analogue depot therapy
Authors: Cirkel Ulrich , Ochs Heike , Roehl Alexandra , Schneider Hermann P. G.
Published: November 2007

We wanted to correlate the degree of myoma shrinkage after luteinizing hormone‐releasing hormone (LHRH)‐analogue depot therapy to the estrogen and progesterone receptor content of the enucleated fibroids. Twenty premenopausal, regularly menstruating women wishing to preserve their childbearing capacity were treated for three to six months with 3.75 mg of leuprorelin acetate depot subcutaneously. Four weeks after the last injection, all fibroids were enucleated and investigated immunohistochemically by using monoclonal (rat) antibodies to human estrogen and progesterone receptors. The localization and distribution of nuclear staining was visualized through a light microscope and scored semiquantitative by multiplying the staining intensity with the percentage of positive cells. Although LHRH‐analogue depot therapy led to almost the same degree of ovarian suppression in all of the women, extent of myoma shrinkage varied from 0% to 87%. On the other hand the extent of myoma regression correlated significantly to the estrogen receptor content of the enucleated fibroid, while diminution of myoma size seemed to be independent of the progesterone receptor. This indicates an association between myoma shrinkage and the estrogen receptor status of the enucleated fibroid. It remains to be proved that pretreatment receptor analysis may predict the myomata that are sensitive to endocrine treatment.
Sebaceous carcinoma arising in a benign dermoid cyst of the ovary
Authors: Changchien Chan‐Chao , Chen Leung , Eng Hock‐Liew
Published: November 2007

Sebaceous carcinoma in a ovarian dermoid cyst is a rare entity. The present patient has survived 54 months and has no evidence of recurrence after total abdominal hysterectomy, bilateral salpingoophorectomy and adjuvant chemotherapy with cisplatin, vinblastin, and bleomycin.
Effects of cadmium on myometrial activity of the nonpregnant human. Interactions with calcium and oxytocin
Authors: Sipowicz Marek , Kostrzewska Anna , Laudanski Tadeusz , Åkerlund Mats
Published: November 2007

With respect to recent reports suggesting an involvement of cadmium in preterm labor, the effects of this ion on the activity of myometrial strips from term pregnant women were examined. The interactions of cadmium with calcium and oxytocin on myometrial activity were also studied. Cadmium alone inhibited spontaneous contractile activity already in a concentration of 10−9 M and in 10−3 M myometrial contractions were almost completely abolished. Responses to Ca2+ and oxytocin were significantly increased by exposure to cadmium in low concentration (10−9 M‐10−8 M), whereas higher concentration of Cd2+ had inhibitory action. These results suggest that cadmium not only blocks Ca2+ channels in the human my‐ometrium. but also interferes with intracellular mechanisms involved in excitation‐contraction coupling. The increased responses to Ca2+ and oxytocin in the presence of low amounts of Cd2+ support a role of cadmium in mechanisms of preterm labor.
Sixty‐six cases of intrauterine fetal death
Authors: Ahlenius Inger , Floberg Jan , Thomassen Peter
Published: November 2007

Background. A prospective study was performed to elucidate the etiology of intrauterine fetal death and to evaluate diagnostic procedures.

Methods. Sixty‐six stillbirth cases with a gestational age of more than 25 complete weeks were studied. using an extensive test protocol. The validity of the cause of death was classified as certain. probable, possible and unexplained. The extent to which the diagnostic measures had been performed was classified: patients in whom none or only a few tests were performed, patients partially tested and patients completely tested.

Results. The cause of death was certain in 57%, probable in 20%, and possible in 11% of the cases. In only 12% of the cases did the cause of death remain entirely unexplained. The principal causes of IUFD were infections, including premature rupture of the membranes (15%). anomalies (11%), preeclampsia‐associated conditions (9%) and intrauterine growth retardation of unknown etiology (8%). In this series, less well‐known conditions, such as circulating maternal autoantibodies and feto‐maternal transfusion, also appeared to play an important role in causing intra‐uterine fetal death.

Conclusions. An extensive and relevant test protocol provides information as to the cause of death in the majority of cases. Future protocols should include tests for autoimmune antibodies and feto‐maternal transfusion.
Antibodies to ureaplasma urealyticum in women with intraamniotic infection and adverse pregnancy outcome
Authors: Horowitz Shulamith , Mazor Moshe , Horowitz Jacob , Porath Avl , Glezerman Marek
Published: November 2007

Objective. To determine the association between antibody response to Ureaplasma urealyticum and pregnancy outcome in women with ureaplasmal invasion of the amniotic cavity. Methods. A cross section study was performed in our high risk pregnancy unit. Three groups of pregnant women were identified: 1) 271 women at the midtrimester of pregnancy (16–20 weeks), who underwent transabdominal amniocentesis for genetic indications 2) 161 consecutive women admitted with preterm labor and intact membranes. 3) 118 consecutive patients with preterm premature rupture of membranes. Amniotic fluids were cultured for Ureaplasma urealyticum, Mycoplasma hominis and also for other aerobic and anaerobic bacteria. Serum antibodies to Uu were measured by a specific enzyme‐linked‐immunosorbent‐assay. Results. The prevalence of positive AF cultures with Uu in the 3 study groups was 2.9%, 4.3% and 17.8%, and the prevalence of antibodies to Uu in the AF‐colonized patients was 50%, 86% and 57%, respectively. Adverse pregnancy outcome (preterm birth, low birth weight or fetal death) among all AF colonized women, was significantly higher in patients with antibodies to Uu than in those without antibodies; preterm delivery 90% vs. 43%, and low birth weight infants or fetal death 85% vs. 28%, p=0.006 and 0.001 respectively. Conclusion. Women with intraamniotic infection with Uu and elevated levels of antibodies to Uu, had a higher rate of preterm delivery, and low birthweight infantdfetal death than those without antibody to Uu.
Gigantomastia complicating pregnancy
Authors: Wolf Yoram , Pauzner David , Groutz Asnat , Walman Igal , David Menachem P.
Published: November 2007

Gigantomastia, or Gravidic macromastia, during pregnancy is a diffuse increase in size of the breasts over and above their physiologic size. It is a rare disorder of undertermined etiology, that may be due to hormonal excess or to hypersensitivity of the target organ. The histologic appearance is of glandular hyperplasia with an increase in connective tissue. Treatment during pregnancy is supportive and pharmacologic; once the patient has delivered surgical treatment is usually indicated.

We present herewith a case report of gigantomastia during pregnancy, with a discussion of the treatment and a review of the literature.
Distribution of NADPH diaphorase‐reactive nerves in the human female genital organ
Authors: Yoshida Yoshinobu , Yoshida Kazuhide , Kimura Toshio , Toda Noboru
Published: November 2007

Objective. This study was designed to histochemically clarify the presence of nerves containing NADPH diaphorase, representing the catalytic activity of nitric oxide synthase, in the human female genital organ.

Study design. Female genital organs were isolated for NADPH diaphorase staining by extensive or simple hysterectomy from ten patients.

Results. Paracervical ganglia contained many nerve cells intensely stained. The nerve from the ganglia contained many axons intensely stained, which selectively innervated blood vessels distributing to the whole genital organ. NADPH diaphorase‐reactive nerve fibers around the vascular wall distributed in the adventitia, closely contacting to the medial layer. The distribution of the axons was much denser in the arterial wall than in the venous wall.

Conclusion. The NADPH diaphorase‐reactive nerve fibers, possibly originated from paracervical ganglia. appear to play an important role in the regulation of uterine vascular tone by liberating nitric oxide, and such a neurogenic control may be predominant in the artery over the Lein.
Ovarian volume in postmenopausal women‐suggestions to an ovarian sue. nomogram for menopausal age
Authors: Tepper R. , Zalel Y. , Markov S. , Cohen I. , Beyth Y.
Published: November 2007

Background. Transvaginal ultrasonography is an accurate and reliable technique for measuring ovarian size. However, there is no consensus as to the normal ovarian size in postmenopausal women. The purpose of this study was to establish normal values for ovarian volume in postmenopausal age.

Methods. A prospective study was undertaken, in which the ovaries of 311 healthy postmenopausal women were examined by transvaginal ultrasonography. Menopausal age ranged from one to more than 15 years. Three dimensions of each ovary were measured and ovarian volume of every menopausal year was calculated.

Results. Curvilinear relationships were found between ovarian volume and menopausal age. Ovarian volume (as plotted on the nomogram) shows a progressive decrease from 8.6±2.3 cm3 in the first menopausal year, to 2.2±1.4 cm3 after more than 15 years after the menopause.

Conclusions. These data represent a comprehensive characterization of normal ovarian volumes related to postmenopausal age.

These baseline values provide the data which will assist the physician to obtain the sono‐graphic diagnosis of abnormal ovarian size, thus eventually establishing early diagnosis of ovarian tumors.
Serum levels of hPL, PAPP‐A and PP14 in patients with early pregnancy bleeding and subchorionic hemorrhage
Authors: Pedersen Jan Fog , Ruge Susanne , Sørensen Steen
Published: November 2007

Objective. To investigate possible endocrine changes in patients with early pregnancy bleeding and subchorionic hemorrhage.

Design. Prospective study in first trimester of pregnancy comparing circulating levels of human placental lactogen (hPL), pregnancy‐associated plasma protein A (PAPP‐A) and endo‐metrial secretory protein PP14 (PP14) in women with and without subchorionic hemorrhage. Subjects. Sixty‐nine women with early pregnancy bleeding, who in week 7–14 had a blood sample and an ultrasound study with both determination of fetal crown‐rump length and a search for subchorionic hemorrhage.

Results. There was no difference between serum levels of hPL, PAPP‐A and PP14 in 29 women with and 40 women without subchorionic hemorrhage, and no correlation between serum levels and the size of the hematoma.

Conclusion. Judged from the serum levels of the studied substances there were no indications of an impaired function of the trophoblast or the decidua that could explain the development of subchorionic hemorrhage.
Regression of hepatic tumors during transdermal estradiol replacement therapy
Authors: Gdansky Efraim , Beller Uzlel , Neuman Menachem , Halevy Jonathan , Lebensart Pinchas D.
Published: November 2007

A 39 year‐old patient with long‐standing diagnosis of pelvic endometriosis had been treated for over twenty years with oral contraceptives (OCs). A year prior to admission to the gynecological ward. an ultrasonographic examination revealed three hepatic lesions, which were not reported in previous liver sonography. These lesions progressed during OC use, over the next six months. Liver function tests were normal. Liver scan, CT and ultrasound imaging techniques supported the diagnosis of solid hepatic tumors. These lesions developed concomitantly to long‐term use of OCs, therefore discontinuation of therapy was mandatory. Six months later, the patient was hospitalized due to pelvic pain. She underwent total abdominal hysterectomy and left salpingo‐oophorectomy (the right adnexa had been removed years before). Due to the patient's young age, hormone replacement therapy was indicated. The preferred preparation was transdermal estradiol due to the fact that systemic absorption has no hepatic first‐pass effect and therefore exerts minimal influence on liver enzymes and functions. Serial ultrasonographic examinations, performed while under treatment with transdermal estradiol, showed complete regression of the hepatic lesions over a period of two years. Our report demonstrates regression of multifocal hepatic tumors despite transdermal estradiol replacement therapy.
Effects Of Vip And Phm In Human Intracervical Arteries
Authors: Hansen Villy , Ottesen Bent , Allen Jim , Maigaard Svend , Forman Axel
Published: November 2007

The relaxing effects of vasoactive intestinal polypeptide (VIP) and peptide histidine methionine (PHM) on human intracervical arteries were studied. Cervical tissue specimens were excised after hysterectomy at various phases of the menstrual cycle (n = 12) and small intracervical arteries were dissected free by microtechnique. Ring preparations of the vessels were prepared and mounted in organ baths, and isometric circular tension was recorded. None of the compounds showed any effects in unstimulated cervical arterial preparations. In vessels precontracted by noradrenalin 10−5 M, VIP lo−8 −10 −6 M and PHM 10−8 −10 −6 M induced similar, concentration‐dependent relaxation with a maximum effect of 73.2±12.7% relaxation for VIP 10−6 M and 79.6±11.8% for PHM 10−6 M, as compared to 10.7±3.1% decrease in tension for control preparations treated with solvent (mean ± SE, n = 6). Simultaneous addition of VIP 5 × 10−7 M and PHM 5−10−7 M produced additive effects. Pretreatment with indometacin 10−6 M, atropine 10−6 M or propranolol 10−6 M did not significantly influence these responses. Both peptides might be involved in regulation of blood flow in the human cervix.
Plasma Atrial Natriuretic Peptide (Anp) And Maternal Hemodynamic Changes During Normal Pregnancy
Authors: Milsom Ian , Hedner Jan , Hedner Thomas
Published: November 2007

Peripheral venous plasma concentrations of immunoreactive atrial natriuretic peptide (irANP) were studied longitudinally in 12 women at the 12th, 24th, and 36th week of pregnancy as well as 3–5 days and 3 months post partum. Serial measurements of maternal hemodynamics were performed simultaneously with blood sampling for irANP determination. With advancing pregnancy there were significant increases (p < 0.001) in cardiac output, stroke volume and heart rate, while total peripheral vascular resistance decreased (p < 0.001). All these changes were normalized 3 months post partum. Plasma irANP increased (p < 0.05) from 23.2±1.3 pM/1 at week 12 to 25.9±1.5 pM/1 at week 36 of pregnancy, and fell significantly (p < 0.01) to 20.5±1.1 pM/1 3 months post partum. Changes in plasma irANP appear to be related to changes in maternal central hemodynamics. The changes in ANP release probably represent one of several mechanisms that maintain circulatory and volume homeostasis during normal pregnancy.
Patterns of Cigarette Use Among Black and White Adolescents
Authors: Feigelman William , Lee Julia A.
Published: November 2007

The authors compared peer and familial correlates of smoking among black and non‐Hispanic white teenagers. Some earlier school‐based studies suggested that black teens are predominately peer‐driven smokers and not especially influenced by parental smoking behavior. Using national and California‐based survey data, the authors applied logistic regression analysis to corroborate earlier research indicating, among both samples of black teens, that smoking was significantly associated with having best friends and siblings who smoke, and parental smoking did not correlate significantly with smoking. For the non‐Hispanic white sub‐samples, the evidence was less clear. Logistic regression data also showed adolescent smoking primarily as a peer‐ and sibling‐influenced activity.
Validity of Assessing Treatment Readiness in Patients With Substance Use Disorders
Authors: Gastfriend David R. , Filstead William J. , Reif Sharon , Najavits Lisa M. , Parrella David P.
Published: November 2007

The Recovery Attitude and Treatment Evaluator–Clinical Evaluation (RAATE–CE) assesses resistance and impediments to addiction treatment participation. The authors conducted a preliminary test of the RAATE–CE's predictive validity. Addiction counselors conducted RAATE–CE assessments on 220 adults who were newly admitted to a hospital detoxification unit. Relationships between scores and disposition were examined using analysis of variance. All RAATE–CE dimensions show significant associations with subsequent treatment placements in the expected directions. Preliminary findings of predictive validity warrant further research on the RAATE–CE for clinical research and treatment planning.