bluuebunny/crossref_metadata_2025 huggingface dataset:
Stress incontinence during pregnancy and in puerperium
Authors: Iosif Serafim
Published: April 2004

A retrospective follow‐up investigation dealing with the frequency of stress incontinence was carried out among maternities at the Women's Clinic in Lund over a period of 15 months. Of 1500 newly‐delivered women whose interviews were solicited, 1411 responded. Twenty‐two percent indicated symptoms of stress incontinence. These were examined gynecologically, including Bonney's test. The material may be divided into four groups according to the onset and type of stress incontinence: — Onset of stress incontinence prior to pregnancy in connection with puberty; 8.5% of the total number of stress incontinents (2% of the entire material).

— Permanent stress incontinence with onset during pregnancy; 23% of all stress incontinents (5% of the entire material).

— Temporary, mild, “physiological” stress incontinence, manifest only during the second part of the pregnancy and disappearing approximately 3 months after delivery. This type of incontinence represents 50% of all stress incontinents (11% of the entire material).

— Stress incontinence arising in conjunction with or following parturition; 19% of all cases of stress incontinence (4% of the entire material). Of the patients in this group 8% were temporarily incontinent. Eleven percent (2.3% of the entire material), represents women suffering from constant incontinence which first appeared in connection with childbirth.

It is more often the case that stress incontinence begins during the first pregnancy rather than during subsequent pregnancies (statistical significance P ⩽ 0.05).

The results indicate that the pregnancy itself and hereditary factors predispose more readily than the parturition trauma to the occurrence of stress incontinence.
Swyer syndrome with gonadoblastoma
Authors: Ashby Wendell B.
Published: April 2004

Any patient who has a portion of a Y chromosome present should have gonadal extirpation to avoid the risk of gonadal neoplasia, whether benign or malignant. The following case history is presented to illustrate this risk and to lay aside the misconception that such patients are free from risk in the absence of an adnexal mass.
Feedback effect of estradiol on follicle‐stimulating hormone and prolactin secretion during the puerperium
Authors: Canales Elías S. , Fonseca M.E. , Mason Macrina , Zárate Arturo
Published: April 2004

Injections of 3 mg of estradiol benzoate were given to seven lactating women during the second and third weeks postpartum to study its effects on secretion of follicle‐stimulating hormone (FSH) and prolactin during the subsequent 4 days. Administration of estradiol during the second week postpartum had no effect on serum levels of FSH and prolactin, however, 1 week later estradiol injection elicited a double effect: FSH levels decreased and prolactin concentrations increased. Early lactation seems to abolish the estrogen induced positive feedback effect on pituitary gonadotropin secretion. The negative effect of estrogen on FSH secretion and the positive effect on prolactin release became evident by the third week postpartum.
Cysts of the vulva and vagina: A comparative study
Authors: Junaid T.A. , Thomas Syamala Mary
Published: April 2004

Histologic and histochemical criteria were used to divide benign cystic lesions of the vulva and vagina into three subtypes in two centres of study. A disproportionately high number of epithelial inclusion cysts was found in Nigerian children aged 15 months to 10 years. Socio‐cultural practices provided an explanation for the difference observed between the American and Nigerian patients.
Genital manifestation of pulmonary tuberculosis
Authors: Tripathy S.N. , Tripathy S.N.
Published: April 2004

We studied 200 women with pulmonary tuberculosis to check for genital lesions; 13% of these women had genital tuberculosis. As clinical diagnosis was not possible, we relied on meticulous and repeated histopathologic studies. The occurrence of genital tuberculosis was more frequent in women who had pulmonary tuberculosis of shorter duration, but was not related to the severity of the disease. Pulmonary tuberculosis indirectly affects the female genital tract in almost all cases, giving rise to various gynecologic symptoms and signs. A review of the literature and further discussion about this subject are presented.
Verapamil to inhibit the cardiovascular side effects of ritodrine
Authors: Rodríguez‐Escudero F.J. , Aranguren G. , Benito J.A.
Published: April 2004

Side effects of β‐sympathomimetic drugs are of primary interest in the treatment of preterm labor. Incidence of side effects are dose‐dependent, as is the efficacy of the β‐agonist in uterine relaxation. The effect of verapamil (Ca2+ inhibitor with antiarrhythmic action) on ritodrine does not modify the value of ritodrine in prolonging pregnancy, but clearly diminishes the incidence of maternal tachycardia and hypotension. The authors suggest that in the treatment of preterm labor with ritodrine infusion above 200 μg/min, the addition of verapamil (dosage, 80–120 μg/min) is useful because it substantially reduces the cardiovascular side effects associated with ritodrine hydrochloride.
Comparative urodynamic studies of women with prolapse and stress incontinence before and after abdomino‐vaginal sling urethro‐plasty
Authors: Iosif Constantin S.
Published: April 2004

The effect of abdomino‐vaginal sling urethro‐plasty according to lyodura slings on the intravesical and intraurethral pressure was evaluated in 25 women with prolapse and stress incontinence. The investigations including a gynecological examination, urine and simultaneous urethro‐cystometry. Prior to the operation, all incontinent women had a negative urethral closure pressure at stress. After surgery all 25 patients reported continence, which was confirmed by positive urethral closure pressures. The urethral pressure at rest was significantly decreased in all patients 2 weeks after operation but returned to the same value 1 year after surgery as before surgery. The functional and the absolute urethral lengths increased minimally after the operation.
Discovery rate of dysplasia and carcinoma of the uterine cervix in an urban Medical Center serving patients at high risk
Authors: Chung Haingsub R , Riccio John A , Gerstung Roland A , Najem G. Reza , Chou Jean
Published: April 2004

File analysis based on 98,970 Pap tests on 58,053 patients from the Martland Medical Center of CMDNJ and its clinics was performed. Discovery rates, period prevalence and incidence rates were calculated for categories of mild to moderate dysplasia through invasive carcinoma. An incidence rate of 27/100,000 for invasive carcinoma was obtained, which is lower than the national average. Period prevalence and incidence rates of dysplasias are both high and similar. This indicates that epidemiologic parameters may need to be studied further. The mean age for the mild to moderate dysplasia was 25.7 years, for moderate to severe dysplasia, 29.29 years and for CIS, 33.25 years. These data may imply that younger women, especially in the urban areas, are at much higher risk than previously expected.
Ectopic pregnancy following tubal sterilization
Authors: Qvigstad Erik , Jerve Fridtjof
Published: April 2004

Over a 5‐year period 232 ectopic pregnancies were recorded, and in three cases tubal sterilization had been performed prior to the development of the extrauterine pregnancy (1.3%).

Subsequent to female sterilization both intra‐ and extrauterine pregnancies may occur. The ectopic pregnancy may be caused by luteal phase pregnancy, operative failure or technical failure; fistula formation is probably the most common. Pregnancies that result after sterilization due to fistula formation are most probably ectopic.
A new method for the induction of therapeutic amenorrhea: Low dose endometrial afterloading irradiation. Clinical and hormonal studies
Authors: Grönroos M. , Turunen S. , Salmi T. , Raekallio J. , Ruotsalainen P.
Published: April 2004

The authors present a new method for the induction of therapeutic amenorrhea: low dose endometrial afterloading irradiation. The problem with this method has been how to inactivate the endometrium while maintaining the physiological function of the ovaries.

In 5/29 young patients regular or irregular bleedings occurred after an endometrial dose of 11 ± 1 Gy. These subjects were given a repeat low dose intrauterine irradiation. Thereafter no bleedings were found in four out of five patients. Two to 9 years after the repeat irradiation the plasma levels of E2, E2. FSH and LH corresponded closely to those of healthy women in reproductive age in three out of five patients; some high plasma P levels indicated ovulation. In two patients the E1, E2 and P values were more likely postmenopausal but, on the other hand, FSH and LH values reproductive ones.

The endocrinological studies after one irradiation [5] and the medico‐legal [15] and neuropsychiatric [17] aspects relevant to the method are presented elsewhere.
Intestinal perforation during pregnancy
Authors: Holdt David G. , Jacobs Allan J. , Heidrick William
Published: April 2004

Three cases of bowel perforation were encountered in pregnant women in a community hospital. Two were associated with mechanical obstruction, and one was of unknown etiology. Displacement of abdominal contents by the gravid uterus may predispose pregnant patients to intestinal obstruction in the presence of an underlying bowel abnormality, such as adhesions or malrotation. Prompt diagnosis and appropriate therapy are necessary to avoid a fatal or a severely morbid outcome.
Pregnancy among schoolgirls in Nigeria
Authors: Oronsaye A.U. , Ogbeide O. , Unuigbe E.
Published: April 2004

A study was made of 127 cases of schoolgirls with pregnancy‐related problems who were admitted into three of the major hospitals in Benin City, Nigeria, over a 10‐month period. The findings suggest that schoolgirl pregnancy in Benin City is found chiefly among teenage girls during the early years of secondary school. Lack of experience in family life and knowledge about contraceptive methods, coupled with poor parental control, are the major factors that put the young adolescent at risk of unwanted pregnancy. School drop‐out and complications of illegally induced abortion are the most frequent and worst consequences of schoolgirl pregnancies. The provision of formal education on family life and effective and easily accessible family planning methods for the adolescent population are suggested as a means to reduce the rate of schoolgirl pregnancy.
Epidemiologic observations on the relationship between calcium intake and eclampsia
Authors: Villar Jose , Belizan Jose M. , Fischer Pamela J.
Published: April 2004

In Guatemala, the obstetric population has a very low incidence of eclampsia despite the presence of factors that would be expected to favor appearance of the disease. In this study, the eclampsia incidence and calcium intake for three countries, Guatemala (low eclampsia incidence, high calcium intake); Cali, Colombia (high eclampsia incidence, low calcium intake); and the USA (low eclampsia incidence, high calcium intake) have been compared. Crude rates for eclampsia incidence were adjusted to control the effects of well‐documented predisposing factors: age, parity, and prenatal care. Results of the study support an association between calcium intake and development of eclampsia.
Epidemiological observations of thrombo‐embolic disease during pregnancy and in the puerperium, in 56,022 women
Authors: Treffers P.E. , Huidekoper B.L. , Weenink G.H. , Kloosterman G.J.
Published: April 2004

During a 28‐year period the incidence of thrombosis and pulmonary embolism (TE) in pregnancy remained practically equal (0.7‰), the incidence of puerperal TE was higher (2.3‰) but decreased during the last 7 years. Puerperal TE was influenced by age, mode of delivery, hypertension and prophylactic anticoagulant therapy. TE during pregnancy was not noticeably correlated with age and hypertension. TE during pregnancy and in the puerperium are closely related diseases, but their epidemiological characteristics are apparently distinct. Both are associated with a high rate of preterm deliveries and a high perinatal mortality rate.
Treatment of premature labor contractions with combined ritodrine and indomethacine
Authors: Katz Z. , Lancet M. , Yemini M. , Mogilner B.M. , Feigl A. , Ben. Hur H.
Published: April 2004

The results of combined ritodrine and indomethacine treatment (RI) in premature labor contractions were compared with ritodrine alone (R). One hundred and twenty patients with threatened premature labor in weeks 26–34 were studied. Sixty RI women received 100 mg ritodrine in infusion followed by 60 mg daily orally until 35 weeks and indomethacine 200 mg on the first day of treatment only. The R group included 60 women with identical tocolysis indices, age of pregnancy and anamnestic parameters who received ritodrine only. The mean prolongation index (PI) was 18.2 in the RI group, against 11.5 in the R patients (P < 0.05). The mean prolongation of pregnancy was 5.6 weeks in the first and 3.6 in the control group (P < 0.05). Birthweight and Apgar scores were similar in the two groups. In order to examine the possible early closure of the ductus arteriosus due to the indomethacin therapy, echocardiograms were done on all newborn in the RI group: the pre‐ejection period and right ventricular ejection time ratio was 0.19–0.26 after delivery and 0.17–0.22 1 month later, which excludes pulmonary diastolic hypertension due to premature closure of the duct. The combined RI treatment is more effective that R alone and does not give rise to any complications in the mother or the fetus.
IUD induced bleeding and the way of therapy
Authors: Batár István
Published: April 2004

In a retrospective study containing 2404 cases of IUD induced bleeding problems, the type and timing of bleeding as well as the types of conservative therapy were evaluated. The non‐hormonal treatment (uterotonics, calcium, C‐ and K‐vitamin etc.) proved to be significantly less effective (P < 0.05) than the hormonal therapy (estrogen, gestagen and combined preparations). The rate of effectiveness was 80.1% and 86.7%, respectively. Because the effectiveness of the conservative therapy is 80%, even in the non‐hormonal group, the IUD should be removed only if this treatment proves to be ineffective. Attention is drawn to the importance of routine colposcopic and cytological screening.
Non‐puerperal traumatic vulvar hematoma
Authors: Vermesh Michael , Deppe Gunter , Zbella Edward
Published: April 2004

Two patients with non‐puerperal traumatic vulvar hematoma due to physical assault are presented. Based on a review of the literature and our experience, a protocol for treatment is described with individualization of therapy emphasized.
Importance of ultrasonography in the follow‐up of patients treated for ovarian carcinoma
Authors: Juhász B. , Hernádi Z. , Tóth Z. , Lampé L.
Published: April 2004

The importance of serial ultrasonography was studied in 28 patients with histologically verified ovarian tumors. The patients were receiving combined cytostatic treatment. By graphic illustration of tumor volume, sonography can be of help in the treatment and follow‐up of patients, as well as in the choice of appropriate therapy.
Sex hormones in women on hemodialysis
Authors: Mantouvalos H. , Metallinos C. , Makrygiannakis A. , Gouskos A.
Published: April 2004

The pituitary‐ovarian axis was studied in 12 women with a creatinine clearance of less than 5 ml/min per 17 m2, established on regular hemodialysis for at least 12 months. Follicle stimulating hormone (FSH) serum levels were found to be slightly lower than normal, luteinizing hormone (LH) plasma concentration generally elevated, while progesterone and estradiol values were extremely low. The major reproductive consequence of chronic renal failure in women on hemodialysis is a severe impairment in ovulatory function.
The sex ratio of Igbo births
Authors: Egwuatu V.E.
Published: April 2004

The study determined that the sex ratio of live‐born infants in the Igbo‐occupied area of Nigeria is about 1.04. This figure, although similar to the 1.03 reported for Zaire and for the black populations of the US and the Caribbean, is lower than the 1.05 to 1.07 accepted for most European populations, the 1.06 recorded for the Yorubas of western Nigeria, and the 1.07 reported for the Hausa people of one northern Nigerian province. Values ranging from 1.12 to 1.14 have been reported for Africans of Uganda and Cameroun. All these figures are lower than the 1.15 recorded for the Far Eastern peoples and support the widely held impression that the sex ratio at birth is influenced by, among other factors, geographical and genetic distribution. Results of the study of Igbo births also showed that the sex ratio within a homogeneous population varies with place of confinement, from a high in hospitals to a low in community health centers.
Maternal mortality in the American University of Beirut Medical Center (AUBMC) 1971–1982
Authors: Mashini Ibrahim , Mroueh Adnan , Hadi Hamid
Published: April 2004

Maternal deaths were reviewed at the American University of Beirut Medical Center (AUBMC) during an 11‐year period, 1971–1982. There were 35,058 live births and 45 deaths making a maternal mortality rate of 128 per 100,000 live births. Hemorrhage, sepsis and toxemia were the main direct obstetric causes of death. The most important indirect causes were cerebrovascular accidents and heart disease. In this review, an analytic discussion of the direct and indirect causes of maternal death in Lebanon are presented and preventive measures are discussed.
Fetal tissue pH‐continuous intrapartum monitoring
Authors: Chatterjee Molly S. , Hetzel Fred , Kaminetzky Harold A.
Published: April 2004

The glass tissue pH electrode was evaluated in 42 parturients. The results and technical difficulties are discussed. The fiberoptic tissue pH probe designed like an internal scalp electrode was evaluated in vitro and the results were found to be encouraging.
Hormones and electrolytes in premenstrual syndrome
Authors: Varma T.R.
Published: April 2004

We studied 10 normal and asymptomatic patients with ovulatory cycles and measured serum sodium, potassium, FSH, LH, prolactin, estradiol, progesterone and cortisol. The findings were compared with the levels in 25 patients with ovulatory cycles with premenstrual symptoms (PMS) lasting for 7–14 days prior to the onset of menstrual flow. We found no significant difference in serum sodium and potassium levels between the asymptomatic (control) group and the PMS group, or between the follicular and luteal phases of the menstrual cycle. We found no difference in hormone levels other than an altered estrogen/progesterone ratio in the second half of the luteal phase in seven out of 12 PMS patients with severe symptoms and a higher level of cortisol in the luteal phase in six out of 12 patients with severe PMS symptoms. However, the level of serum cortisol was still within the normal range. There was no significant alteration in the levels of electrolytes or hormones during treatment with Navidrex K (cyclopenthiazide, diuretic) pyridoxine (Vitamin B‐6), dydrogesterone (Duphaston) alone, or all the three drugs combined.
Perinatal mortality in the Maltese Islands
Authors: Ventura C. Savona , Grech E.S.
Published: April 2004

This study analyzes the perinatal mortality statistics for the Maltese Islands since 1950 and compares them to those of other European countries. The mortality rate has taken a variable downward trend which can be correlated to important events during this period. Hospital perinatal mortality statistics are reviewed in the light of the national statistics.
Effect of venipuncture stress on plasma prolactin levels
Authors: Ferriani Rui Alberto , Silva De Sá Marcos Felipe
Published: April 2004

Venipuncture for blood collection is postulated to be a stress factor that can increase circulating prolactin (PRL) and therefore produce false results. Seven normal non‐pregnant women and 44 gravidae were submitted to venipuncture with a butterfly needle connected to a syringe for vein maintenance. Blood was collected immediately (zero time) and 15 and 30 min after venipuncture. After the last collection, a vein in the contralateral arm was punctured in the non‐pregnant women only and a new blood sample was collected. PRL, measured by immunoassay, varied from 7 to 13.2 ng/ml in the non‐pregnant women and from 7 to 300 ng/ml in the gravidae. No significant difference in PRL values was detected at any of the collection times. It is concluded that the stress or pain caused by venipuncture is not sufficient to alter plasma PRL levels in normal (non‐pregnant) or hyperprolactinemic (gravidae) women.
Serum ferritin values in Nigerian pregnant women
Authors: Nnatu S.N.N. , Oluboyede O.A.
Published: April 2004

Serum ferritin values have been studied in 28 indigenous Nigerian pregnant women during the second and third trimesters of pregnancy. The mean serum ferritin value in the second trimester is higher than that in the third trimester, however, the difference is not statistically significant. When our results are related to those of Fenton and co‐workers in 1977 (Fenton V, Cavill I, Fisher J: Iron stores in pregnancy. Br J Haem 37: 145, 1977) it appears that serum ferritin decreases in early pregnancy and that this decrease is maintained through the second and third trimesters and towards term, irrespective of adequate iron supplementation. It also seems that the pre‐pregnancy serum ferritin level is achieved 5–8 weeks post‐delivery.

Our results also underline the sensitivity of serum ferritin evaluation in pregnancy, and reinforce the concept that fetal requirement for iron occurs significantly during the later half of pregnancy.
Ultrasonic and endocrinologic investigation of ovarian follicle and free fluid in cul‐de‐sac for monitoring follicular development and ovulation
Authors: Sengoku K. , Ishikawa M. , Kasamo M. , Yamashita K. , Shimizu T.
Published: April 2004

The accuracy of ultrasound as a means of monitoring follicular development and ovulation detection was studied in 31 infertile women. The follicular diameter measured by ultrasound correlated well actual diameter found during laparotomy (r = 0.88), and estradiol‐17β (E2) and progesterone in follicular fluid aspirated from large follicles (≧ 16 mm) indicated high levels. Furthermore, in 23 out of the 55 cycle, ultrasound examinations demonstrated free fluid in cul‐de‐sac at ovulation, and concentrations of E2 and progesterone (P) in peritoneal fluid by the puncture of cul‐de‐sac dramatically increased after ovulation. We suggested that ultrasound monitoring provided a reliable measure of follicular growth and prediction of ovulation, and a combined use of ultrasound and puncture of cul‐de‐sac could be developed into a new tool for the study of the mechanism of human ovulation.
Normal growth of the fetal biparietal diameter in an African population
Authors: Ayangade S.O. , Okonofua F.E.
Published: April 2004

The fetal biparietal diameter (BPD) was measured by ultrasound during normal pregnancy in 558 Nigerian women. The range of BPD values for each week of pregnancy from 12 weeks until term (713 measurements) was computed from cross‐sectional data. The data were used to illustrate the variation in weekly growth rate according to fetal maturity and head size.

The results revealed a curve similar to those reported from Caucasian populations but with much less flexion in the later weeks of pregnancy. The BPD values per week were also less in this study group. The reasons for these differences are discussed.
A review of ten years' experience with surgical equipment in international health programs
Authors: Castadot Robert G. , Magarick Ronald H. , Sheppard Lianne , Burkman Ronald T.
Published: April 2004

The Johns Hopkins Program for International Education in Gynecology and Obstetrics (JHPIEGO) began in June of 1973 with financial assistance from the Agency for International Development (AID). The purpose of the organization was to provide training and medical equipment to physicians in developing countries to update their education in reproductive health. JHPIEGO began by offering courses in the United States and shortly thereafter began training at centers in the developing countries themselves.

Because of its important contributions to gynecological diagnosis in addition to its use in fertility management, laparoscopic equipment has been a major item in JHPIEGO reproductive health training. This paper details the development and role of laparoscopic training in JHPIEGO's program.

Laparoscopic training begins with selection of trainees from appropriate institutions. Training itself begins with a didactic session at Baltimore or an in‐country center. Trainees then receive clinical training and perform a minimum number of procedures, after which the practitioner, if he or she has successfully completed the clinical practice, can be named eligible to receive medical equipment to be donated to his or her institution. When equipment is installed, a field visit is made by a JHPIEGO consultant to insure the proper use and upkeep of equipment, and the understanding and implementation of standards and procedures.

JHPIEGO has trained almost 3000 physicians in laparoscopy techniques between 1973 and 1984.
Labor patterns in grand multiparas
Authors: Petrikovsky B. , Cohen M. , Moy F. , Tancer M.L.
Published: April 2004

Five hundred consecutive normal, term, grand multiparous labors were the subject of retrospective computer analysis. The purpose of the present study is to describe a labor curve applicable to the grand multipara.

Computer analysis revealed the following features of the “grand multipara” labor curve. The following deviations from the “classical” curve were observed: (1) The active phase of labor begins at 5–6 cm of cervical dilatation. (2) There is no deceleration phase. (3) Descent of the presenting part begins at 7–8 cm of cervical dilatation.

Knowledge of the labor pattern may be helpful in the clinical management of labor in the grand multiparous patient.
Decreased fetal activity in complications of pregnancy
Authors: Sadovsky E. , Ohel G. , Simon A. , Aboulafia Y.
Published: April 2004

Fetal activity expresses the fetal condition in utero. Absence of fetal movements may signify fetal distress. The reduction in fetal movements (FM) to 3 or less or their cessation for at least 12 h with audible heart beats was referred to by us as movement alarm signla (MAS). The rate of MAS in 662 complicated pregnancies was studied. There were 43 patients (6.5%) with MAS mainly in cases of fetal malformations and conditions associated with reduced utero‐placental blood flow. In 13 cases a non‐intervention approach was undertaken and all the fetuses died in utero. The remaining 30 cases with MAS were delivered promptly, mainly by Cesarean section and live births resulted. Eight of these died neonatally.

It is suggested that in cases of MAS the diagnosis of fetal distress should be verified by additional tests. Should fetal distress be confirmed, especially in cases of polyhydramnios, oligohydramnios and symmetrical growth retardation, every effort should be made to exclude fetal malformations before delivery is undertaken especially by Cesarean section.
Clinical evaluation of steroid receptors in ovarian neoplasms
Authors: Agarwal N. , Rao D.L. , Murgeshan K. , Verma U. , Mittal S. , Buckshee K. , Chapeker T.N.
Published: April 2004

Estrogen and progesterone receptors were estimated in a total of 25 ovarian neoplasms. None of the benign tumors showed steroid receptors. In malignant tumors serous tumors were more often receptor positive than the mucinous. Receptor levels were correlated with the staging of the disease, menstrual status and the resectability of the tumor. The response to chemotherapeutic drugs was better in patients with low estrogen and progesterone receptors as compared to those with high levels. The latter group showed a definite response to progesterone treatment in vitro. These are the group of patients who may benefit by combination of hormones and chemotherapeutic drugs.
Genital amebiasis
Authors: Veliath A.J. , Bansal R. , Sankaran V. , Rajaram P. , Parkash S.
Published: April 2004

Five cases of amebiasis of the genital tract involving the cervix, vulva and penis are described. All presented as an ulcerating mass and were clinically suspected to have a tumor. In two cases the amebiasis co‐existed with a carcinoma, an association which is extremely rare. The spouse of a patient with penile amebiasis was found to have amebiasis of the cervix suggesting a sexually transmitted mode of infection. The need for histopathological confirmation of all suspected genital malignancies is emphasised due to the striking resemblance of genital amebiasis to a carcinoma. The co‐existence of amebiasis with carcinoma is of interest and suggests a possible etiological relationship.
The value of computed tomography in staging cervical carcinoma
Authors: Botsis D. , Gregoriou O. , Kalovidouris A. , Tsarouchis K. , Zourias P.A.
Published: April 2004

The purpose of our study was to determine the value of computed tomography (CT) in relation to the local extension of cervical carcinoma and the possible spread in the peritoneal and the retroperitoneal space. Sixty‐five patients treated for cervical carcinoma during the period 1980–1986 were included in the study. Histologic diagnosis of the disease was done by punch cervical biopsy and diagnostic curettage. The investigation of all patients included intravenous pyelography, barium enema, bone and liver scanning and CT. Our results demonstrate a correlation between CT and pathologic data in 75–78.5% depending on stage. CT may be considered as a dependable method for staging of cervical carcinoma.
Adrenal response to adrenocorticotropin stimulation in unexplained infertile women
Authors: Cohen I. , Blanstein J. , Ben‐Michael R. , Lunenfeld B. , Eshkol A.
Published: April 2004

The response to a rapid intravenous administration of adrenocorticotropin (ACTH, cortrosyn) was compared in 24 unexplained infertile women and 13 fertile women. There was no significant difference in the response to a rapid ACTH stimulation as expressed by the slope of testosterone (T) response in both groups. However, the individual and mean T values prior and following the stimulation were significantly higher in the infertile group (P < 0.001; P < 0.005, respectively). There was no significant difference in individual values as well as in mean basal values or in mean values of 17‐hydroxyprogesterone (17‐OHP) after the stimulation between the two study groups (P < 0.3; P < 0.9, respectively). There was no significant difference in individual values as well as in mean values of dehydroepiadnrosterone (DHEA) before or 90 min after the stimulation between the two study groups (P < 0.1; P < 0.2, respectively). It can therefore be concluded that the elevated basal testosterone values in the infertile group originated from the ovary. Despite the fact that no attempt was made to reduce androgen values 7 (46.66%) of 15 infertile women who were available for follow‐up and treatment conceived following ovulation induction therapy.
Menstrual regulation in Bangladesh: an evaluation of training and service programs
Authors: Amin R. , Kamal G.M. , Mariam A.G.
Published: April 2004

This article evaluates the performance of three urban menstrual regulation (MR) training and service programs in Bangladesh. Virtually all of the MR providers including physicians and paramedics in the three centers received training in various MR procedures by means of demonstration or class lectures. However, a significant proportion of the trained MR providers were unable to render proper MR services due to the lack of clinical facilities and lack of equipment. Analysis of follow‐up data for MR clients revealed that those women who utilized MR procedures offered through the centers had an average of about three live births. Physician providers were more likely to serve clients from a higher socioeconomic strata, while paramedical providers were more likely to serve MR clients from lower socioeconomic strata or agricultural background. Most of the clients receiving MR services were ever and current users of contraceptives and developed fewer complications from MR procedures than those served by untrained traditional herbalists, healers or birth attendants.
Ultrasound measurement of fetal abdominal circumference and the ratio of biparietal diameter to transverse abdominal diameter in a mixed Nigerian population
Authors: Okonofua F.E. , Ayangade S.O. , Ajibulu O.A.
Published: April 2004

The fetal adbominal circumference (FAC) and biparietal diameter to transverse abdominal diameter ratio (BPD/TAD) were measured by ultrasound in 219 normal pregnant Nigerian women from 20 weeks until term using the cross‐sectional method. There was a progressive linear growth of the FAC and a consistent standard deviation throughout the study period. When compared to caucasian growth curves, the curve shapes were identical but the FAC values were consistently less for each week of gestation in our Nigerian sample. The BPD/TAD ratio showed a progressive fall from 20 weeks until term similar to that previously noted for fetal head circumference to abdominal circumference ratio, indicating that this parameter may also be useful for predicting abnormal fetal growth.
Apgar scores and umbilical cord arterial pH in the breech neonate
Authors: Socol M.L. , Cohen L. , Depp R. , Dooley S.L. , Tamura R.K.
Published: April 2004

Apgar scores and umbilical cord arterial pH measurements of 449 singleton breech deliveries are compared retrospectively to those of 1425 singleton vertex neonates. In the vaginal deliveries the Apgar scores and umbilical arterial pH were higher for the vertex neonates. There were no differences in either Apgar scores or umbilical arterial pH between the breech and vertex neonates delivered by cesarean section. Whereas Apgar scores in the < 1000 g and ⩾ 2500 g weight groups were lower in the breech neonates delivered vaginally compared to cesarean section, umbilical arterial pH measurements were similar. The data suggest that liberal use of cesarean section may improve the Apgar scores but will probably not appreciably improve the acid‐base status of the breech neonate.
The relationship of increased amniotic fluid volume to perinatal outcome
Authors: Varma T.R. , Bateman S. , Patel R.H. , Chamberlain G.V.P. , Pillai U.
Published: April 2004

We studied a group of 135 patients with polyhydramnios diagnosed on the basis of ultrasonic findings (greatest vertical diameter of the liquor column ⩾8.0 cm) between 32 and 36 weeks gestation (study group). We compared the obstetric characteristics and perinatal outcome of the study group with a similar number who constituted our control group. The incidence of women aged 20 years or less was higher in the study group (8.9%) compared with 4.5% in the control group. Of the 135 patients who were diagnosed to have polyhydramnios ultrasonically, the clinical diagnoses prior to referral for ultrasonic scanning, were, suspected large for date fetuses in 34 patients (25.2%), clinically suspected polyhydramnios in 28 (20.7%), gestational diabetes in 21 (15.6%) and insulin dependent diabetes in 6 (4.4%) compared with 13.3%, 5.2%, 3.0% and 0.7%, respectively in the control group (P < 0.05). Preterm delivery occurred in 11.1% in the study group compared with the incidence of 6.7% in the control group. The incidence of fetal distress, low Apgar Score, macrosomic infants, major fetal anomalies, gross and corrected perinatal mortality rate and admission to special/intensive care nursery was significantly higher in the study group compared with that of the control (P < 0.01). We found ultrasonic examination is a reliable technique to assess the amount of amniotic fluid volume and it alerts the clinician to possible future problems in pregnancy, labor and neonatal period.
Ectopic pregnancy: Analysis of 100 cases
Authors: Lindow S.W. , Moore P.J.
Published: April 2004

This study of 100 consecutive ectopic pregnancies in Zulu patients emphasises the role of less sophisticated diagnostic methods such as colpopuncture when beta human chorionic gonadotrophin (beta HCG) assay is not available. Infertility (61%) and previous pelvic infection (32%) were associated factors. The ectopic gestation was ruptured in 93% of cases.
Pelveo‐peritoneal schistosomiasis as a cause of primary infertility
Authors: Harouny A. , Pedersen H.
Published: April 2004

An unusual case of bilharziosis apparently leading to anatomic infertility in a Kuwaiti woman is reported.
Abortion‐related morbidity and mortality in Benin City, Nigeria: 1973–1985
Authors: Unuigbe J.A. , Oronsaye A.U. , Orhue A.A.E.
Published: April 2004

In a 13‐year review of maternal deaths at the University of Benin Teaching Hospital, Benin City, abortion was one of the three major causes of death, accounting for 37 (22.4%) out of the 165 deaths. Induced abortion was responsible for 34 (91.9%) of these deaths. The usual victim is the teenage, inexperienced school girl who has no ready access to contraceptive practice. Death was mainly due to sepsis (including tetanus), hemorrhage and trauma to vital organs, complications directly attributable to faulty techniques by unskilled abortion providers, a by‐product of the present restrictive abortion laws. Total overhaul of maternal child health services and the family health education system, as well as integration of planned parenthood at primary health care level into the health care delivery system, are suggested. Contraceptive practice should be made available to all categories of women at risk, and the cost subsidised by governmental and institutional bodies. Where unwanted pregnancies occur, the authors advocate termination in appropriate health institutions where lethal and sometimes fatal complications are unlikely to occur. In effect, from the results of this study and a review of studies on abortion deaths in Nigeria and other developing countries, it is obvious that a revision of abortion laws as they operate, notably in the African continent, is overdue.
Medical audit by peer review and competitive self‐appraisal as tools for promoting efficiency: A case study in Lahore, Pakistan
Authors: Awan A.K. , Awan A.H. , Akhtar R.
Published: April 2004

A pilot maternal and child health and family planning service project in urban and rural areas of Lahore, Pakistan, was evaluated after 4 years (1984–1988). In this time the birth rate declined from 41.0 to 19.2, infant mortality from 119.0 to 70.2, and maternal mortality from 560 to 220 per 100,000 live births. Success was attributed to medical audit of services through peer review of performance.
Hyperreactio luteinalis in normal singleton pregnancy
Authors: Okadome M. , Kaku T. , Tsukamoto N. , Saito T. , Matsukuma K. , Uehira K. , Hirakawa T. , Nakano H.
Published: April 2004

A case of hyperreactio luteinalis in a patient with normal singleton pregnancy is reported. The course of pregnancy had been normal until the 24th week of gestation, when the mother developed lower abdominal pain and signs of virilization. She delivered of a normal female infant at 39 weeks' gestation. The baby did not show any signs of masculinization. Serum testosterone, Δ4‐androstenedione, and 5α‐dihydrotestosterone of the mother were markedly elevated. They remained high after the delivery but returned to the normal ranges soon after the partial resection of the enlarged ovaries. Reported cases of hyperreactio luteinalis are reviewed. Their maternal serum androgen levels were compared with cases of luteoma of pregnancy.
Update on delivery following prior cesarean section: a 15‐year review 1972–1987
Authors: Meehan F.P. , Burke G. , Kehoe J.T.
Published: April 2004

Fear of true rupture remains the main indication for repeat section. Between 1972 and 1987 there were 2434 patients with one or more prior section and 1350 (55%) were permitted trial of labor, the remainder, having had two or more previous sections (maximum number, 10), had repeat surgery. Induction was employed in 31% and oxytocin for induction or acceleration in 32% patients. The first period (1972–1982) had 844 and the second period (1982–1987) had 506 trial of labor patients. Improved management resulted in the true rupture rate falling from 0.6% (1 : 169) to 0.2% (1 : 506) and the elimination of procedure‐related perinatal death. There were two maternal deaths with repeat section and none with trial of labor. We have achieved a plateau for cesarean section (10–11%) and a continuing fall in the uncorrected hospital perinatal mortality, which has averaged 10.6/1000 for the years 1982–1986 inclusive.
The effect of hypertension in pregnancy on fetal and neonatal condition
Authors: Martikainen A.M. , Heinonen K.M. , Saarikoski S.V.
Published: April 2004

The aim of this prospective study was to determine the effect of hypertension in pregnancy (PH) on fetal and neonatal condition via other mechanisms than retarded intrauterine growth and preterm delivery. Sixty‐six preterm and 175 full‐term babies born to PH mothers were compared, respectively, with 183 preterm and 220 full‐term babies born to non‐hypertensive (non‐PH) mothers over a 22‐month period in 1984–1986. Small‐forgestational‐age (SGA) children were examined separately from appropriate‐forgestational‐age (AGA) children. Percentages of preterm babies and of both preterm and full‐term SGA babies born to hypertensive mothers were twice as great as the percentages of such babies born to non‐hypertensive mothers. Hypertension in pregnancy directly increased neonatal morbidity, but the effect was minor. In preterm babies it was related to intrauterine growth retardation and to preeclampsia. In full‐term babies the effect was unrelated to the severity of hypertension.
Characteristics of traditional midwives and their beliefs and practices in rural Bangladesh
Authors: Amin R. , Khan A.H.
Published: April 2004

This study has analyzed the characteristics, beliefs and practices of midwives in rural Bangladesh. The midwives were mainly above age 30, married or widowed, and illiterate. Most of them learned their midwifery from informal sources such as female relatives or neighbours. Often, during pregnancy, childbirth, and post‐partum period, midwives imposed dietary restriction on the mothers. Similarly, devices used in the cutting of the umbilical cord and placenta were not properly sterilized and potentially dangerous substances were applied at the navel after cutting the umbilical cord or placenta. There was a practice of withholding breast‐feeding up to 3 days after the birth of a child. However, there were also some beliefs or practices among the midwives that could be regarded as based on scientific understanding such as the practice of cutting the umbilical cord by boiled razor blade or the belief that child death could occur from tetanus caused by the unsterilized device used in the cutting of the umbilical cord.
Abdominal hysterectomies at area hospital, Point Fortin, Trinidad, West Indies
Authors: Santha Ram N.V. , Murthy N.V.A.
Published: April 2004

A retrospective analysis of abdominal hysterectomies (3.08% of major operations) at the Area Hospital (52 beds), over a 5‐year period revealed that the majority of the patients were multiparous in the reproductive age group. Menstrual irregularity is the most frequent indication, however, hysterectomy in these cases is not justified. High febrile morbidity (38%), blood transfusions and prolonged hospitalization were observed. Peer review, prophylactic antibiotics and survey of the Island hospitals are recommended to make hysterectomy appropriate, safe and to explain any racial variation.
The effect of postplacental insertion of the spiked and the standard Lippes loop on uterine involution
Authors: Younis M.N. , Hamed A.F. , Aref I. , Elmasry G. , Sultan M.
Published: April 2004

The spiked Lippes loop was inserted in 53 women and the standard loop in 55 women immediately following the delivery of the placenta after normal vaginal delivery. A group of 50 recently delivered women with no IUD was studied as a control. The cases were followed up for 1 year. Ultrasonic scanning was performed during the 6th week after insertion for 47 cases with the spiked loop and 43 cases with the standard loop. All loops were correctly positioned within the uterine cavity except in two cases; one using the spiked and the other using the standard loop. The loops were found displaced down wards and as there was excessive bleeding, the devices were removed. Regarding the effect of the IUD on uterine involution, it was found that the fundus to internal os length for the cases with IUDs was shorter than that among the controls, also this length among the standard loop users was significantly shorter than that of the controls (P < 0.01). Postplacental IUD insertion did not delay uterine involution, on the contrary, it helped involution. Regarding the effect of lactation, the fundus to internal os length for the fully lactating women either using a loop or not, was found to be significantly shorter than that of the non‐lactating cases (P < 0.002).
Breastfeeding and return to ovulation in Bangkok
Authors: Israngkura B. , Kennedy K.I. , Leelapatana B. , Cohen H.S.
Published: April 2004

Twenty‐seven breastfeeding mothers and nine non‐breastfeeding postpartum comparison mothers in Bangkok, Thailand were followed longitudinally until ovulation resumed. A simple set of guidelines is described involving three obvious milestones for the breastfeeding mother to safely use the natural contraceptive benefit of breastfeeding. Those milestones are the first menses, the initiation of supplementation and the child's monthly birthday. In the absence of menses and supplementation, 93% of breastfeeding mothers remained anovular for 3 months postpartum and 88–89% for up to 6 months. Further, the work of other investigators suggests that the proportion ovulatory provides an overestimate of those at risk of pregnancy. The guidelines suggest a way to estimate the period of lactational infertility and may be most useful on a programmatic level.
Adhesion formation associated with the use of absorbable staples in comparison to other types of peritoneal injury
Authors: Ling F.W. , Stovall T.G. , Meyer N.L. , Elkins T.E. , Muram D.
Published: April 2004

Adhesion formation was assessed after inducing peritoneal injury with absorbable staples, absorbable suture, surgical excision or thermal injury. In addition, adhesion formation was assessed in the presence of Hyskon. Absorbable staples were associated with increased adhesion formation when compared to the other methods of injury. Hyskon appears to significantly reduce the formation of peritoneal adhesions at sites of peritoneal suturing, excision, and thermal injury, but did not reduce adhesion formation in the area of stapling.
Perforated adenocarcinoma of the colon during pregnancy
Authors: Jaffe R. , Schwartz I. , Freund U. , Cohen I. , Rosen D. , Fejgin M.
Published: April 2004

Performated carcinoma of the colon in pregnant women is a rare event. Only six cases have been reported in the literature, all except one in the recto‐sigmoid. We present a case of perforated adenocarcinoma of the colon located above the peritoneal reflection and discuss the problem of diagnosis and management.