bluuebunny/crossref_metadata_2025 huggingface dataset:
Intrauterine insemination as a treatment of infertility in women with antisperm antibodies
Authors: Gregoriou O. , Vitoratos N. , Papadias C. , Konidaris S. , Maragudakis A. , Zourlas P.A.
Published: April 2004

Twenty‐four women with infertility caused by antisperm antibodies were treated by homologous intrauterine insemination. Initially, all the women had timed intrauterine insemination by washed spermatozoa for three cycles. The pregnancy rate per couple was 4.20%. The remaining 23 patients received a combined treatment of chlomiphene citrate and intrauterine insemination for three cycles, which did not increase the pregnancy rate per couple and per cycle (4.3% and 1.4% respectively). Thereafter, the remaining 22 patients received a combined treatment of hMG and intrauterine insemination for another three cycles which resulted in a pregnancy rate per cycle (6.1%) and per couple (18.20%) that was significantly greater (P < 0.01). We conclude that infertile women with antisperm antibodies can benefit after a trial of induction of multiple follicular development with hMG in combination with intrauterine insemination.
General principles in delegation of maternity functions to community‐based health workers
Authors: Nasah B.T.
Published: April 2004

Following a review of the general principles in delegation of responsibility, the functions to be delegated are presented together with minimal criteria for training to acquire required skills. Problems arising from delegation are reviewed as well as possible solutions which include modification of some standard procedures. It is concluded, drawing from case summaries, that effective delegation needs strong leadership of maternal health teams buttressed with national political, professional, and community support.
Delegation of responsibility in maternity care in Karawa rural Health Zone, Zaire
Authors: Duale S.
Published: April 2004

Karawa Health Zone (KHZ) located in northwestern Zaire, comprises 19 000 km2 with about 340 000 inhabitants. As part of an expanding primary health care program, KHZ officials instituted an extensive outreach program to increase access of women to maternity care. General practitioner (GP) doctors, nurses, midwives, auxiliaries, and traditional birth attendants share responsibilities in delivering maternity care services. Nurses and midwives perform most of the obstetric functions at the Karawa Hospital Maternity Center. Data from 1988 to 1990 show that nurses and midwives attended 98% of normal deliveries and 81% of the complicated ones. Selected nurses performed cesarean section routinely. There was no significant difference in maternal and neonatal outcomes for cesarean section performed by nurses and GPs. Physicians on staff provided support through monitoring, supervision, training, and care for the most complicated cases.
Pregnancy in hemoglobin sickle cell patients at the University College Hospital, Ibadan
Authors: Idrisa A. , Omigbodun A.O. , Adeleye J.A.
Published: April 2004

A retrospective review of pregnancy outcome in hemoglobin (Hbsc) patients managed at the University College Hospital, Ibadan over a 5‐year period (1984–1988) was carried out. The main antenatal complications included anemia (51.2%), bacterial infection (22.0%), bone pain crisis (7.3%) and preeclampsia (2.4%). Intrapartum complications included anemia (29.2%), bone pain crisis (12.2%) and pseudotoxemia (4.9%). The maternal and perinatal mortality rate were 48 and 195 per 1000, respectively. The duration of labor and operative delivery rate were not different from the general population.
A randomized controlled trial of valethamate bromide in acceleration of labor
Authors: Kuruvila S. , Jasper P. , Peedicayil A. , Mathai M.
Published: April 2004

A randomized controlled study of valethamate bromide administered by intramuscular injection in acceleration of labor was done in 60 consecutive primigravidae and 60 consecutive multigravidae admitted in labor at 2–4 cm cervical dilatation. There was no difference observed in the rate of cervical dilatation between those who received valethamate bromide and those who received normal saline. However, maternal tachycardia was observed in significantly more women primigravida RR 1.97, 95% CI 1.3–3.0; multigravida RR 2.16, 95% CI 1.3–3.6) who had received valethamate bromide.
Ovarian function after conservational ovarian surgery: A long‐term follow‐up study
Authors: Sayegh R. , Garcia C.R.
Published: April 2004

OBJECTIVE: To determine the long‐term effects of conservational ovarian surgery on subsequent ovarian function. METHOD: Medical, surgical and menstrual records of 87 reproductive age women who have undergone pelvic surgery for indications including endometriosis, infertility, and pelvic pain between June 1982 and June 1989 were retrospectively reviewed. RESULTS: Sixty‐seven patients had ovarian surgery during their procedure; 26 ovarian cystectomies (OC), 19 partial ovarian resections (OR) and 22 ovariolyses (OL). Twenty patients had no ovarian surgery (NOS). The mean follow‐up period was comparable in all groups (OL 32 ± 15 months, OR 34 ± 26 months, OC 41 ± 30 months and NOS 37 ± 21 months). The mean time to onset of the first postoperative menses was not significantly different among the four groups (OL 24 ± 7 days, OR 24 ± 13 days, OC 29 ± 26 days and NOS 22 ± 6 days). The cumulative conception rates were not significantly different (OL 23%, OR 37%, OC 19% and NOS 25%). Menstrual disturbances, defined as perceived deviations from preoperative patterns, did not appear to be related to the type or extent of ovarian surgery and occurred in comparable frequencies among patients with or without ovarian surgery (OL 23%, OR 37%, OC 23% and NOS 20%). In the majority of cases, menstrual disturbances occurred either in the early postoperative months and were self‐limited, or much later in which case they were related to recurrent endometriosis. Premature ovarian failure has so far occurred in one patient suggesting an incidence comparable to that in the general population. CONCLUSIONS: It is concluded that in this group of patients, conservational ovarian surgery had no significant effects on ovulatory and menstrual function over a prolonged follow‐up period.
Usefulness of the urinary microalbumin/creatinine ratio in predicting pregnancy‐induced hypertension
Authors: Nakamura T. , Ito M. , Yoshimura T. , Mabe K. , Okamura H.
Published: April 2004

In 199 normotensive pregnant women at 20 and 30 weeks of gestation, a fasting urinary albumin/creatinine ratio (FU Alb/Cr) was evaluated to predict pregnancy‐induced hypertension (PIH). FU Alb/Cr in patients destined to develop PIH was significantly high compared to that in normotensive women. When FU Alb/Cr of more than 16 was considered to represent a positive test result, the negative predictive value was 94% and 96%, respectively. FU Alb/Cr is a useful screening tool for PIH.
CA‐125 in menstrual discharge in patients with chronic pelvic pain
Authors: Abu‐Musa A. , Takahashi K. , Nagata H. , Yamasaki H. , Mizoguchi S. , Kitao M.
Published: April 2004

CA‐125 levels in menstrual discharge were determined in 55 patients with chronic pelvic pain to evaluate whether this test would be useful in differentiating between pelvic pain due to endometriosis and other causes. Of the 28 women with endometriosis, 25 (89%) had CA‐125 concentration ≥ 72 000 units/ml. The frequencies of elevated levels in Stage I, Stage II and Stages III/IV were 85.7, 85.7 and 92.8%, respectively. When used for the detection of endometriosis, the test had a sensitivity of 89.3% and a specificity of 96.3%. These results suggest that CA‐125 in menstrual discharge may be helpful in the evaluation of women with chronic pelvic pain.
Insulin‐like growth factor binding protein‐1 in female reproductive functions
Authors: Rutanen E‐M. , Seppälä M.
Published: April 2004

Multiple lines of evidence suggest that growth factors and related proteins are involved in the regulation of reproductive functions. It appears that hormones and local regulators control each other's production and action. Thus, the same regulatory factor may have different effects depending on the context in which it acts. Insulin‐like growth factor‐binding protein‐1 (IGEBP‐1) is a member of the family of soluble proteins that bind insulin‐like growth factors (IGF‐I and IGF‐II) and modulate their biological actions at the cellular level. In the reproductive tract, endometrium and ovarian granulosa‐luteal cells express IGFBP‐1 mRNA and secrete the protein at a certain stage of differentiation. During pregnancy, IGFBP‐1 is a major secretory product of decidualized endometrium. This report summarizes the current views on IGFBP‐1 with special regard to its synthesis, regulation and potential role in female reproductive tissues.
Obstructed labor in Ibadan
Authors: Konje J.C. , Obisesan K.A. , Ladipo O.A.
Published: April 2004

Over a period of 13 years, 380 cases of obstructed labor were managed amongst 39 456 deliveries. Absent prenatal care and poor intrapartum care at peripheral hospitals were major contributing factors. The average duration of labor in those with obstruction was three times that in the normal obstetric population. About 82% of patients with obstruction had an emergency cesarean section while 10% had destructive operations. The main etiological factor was unrecognised positional disproportion. Common associated complications were ruptured uterus, genital and wound sepsis. Maternal and perinatal morbidity and mortality were high. Adequate health education, incorporation of traditional birth attendants into health care programs and the provision of more health care centers will reduce the occurrence of this complication.
Assessment of fetal well‐being: Fetal movement count versus non stress test
Authors: Wilailak S. , Suthutvoravut S. , Cherng‐sa‐ad P. , Herabutya Y. , Chaturachinda K.
Published: April 2004

In this prospective study, comparisons were made between the results of fetal movement count as performed by either the attending staff or by the patients using the non stress test (NST). A total of 283 NSTs were performed in 200 patients who had singleton pregnancy of at least 32 weeks gestation with indications for assessment of fetal well‐being. Fetal movement counts performed by the attending staff and by the patients were recorded on 241 and 170 occasions, respectively. The results showed that the best correlation between fetal movement count by the attending staff with NST was when the criteria of three or more fetal movements within 10 min was used. Likewise, the best correlation between fetal movement count by patients with NST was found when ten fetal movements within 2 h was used as a cut off point. The result of this study suggests the usefulness of fetal movement count performed either by attending staff or patients as a cheap and effective method of screening for good fetal well‐being in places where NST is not readily available and may also be used as a screening for patients prior to further evaluation.
Antenatal steroid therapy before 33 weeks' gestation
Authors: Silver R.K. , MacGregor S.N. , Farrell E.E. , Sholl J.S. , Hobart E.D.
Published: April 2004

OBJECTIVE: The purpose of this study was to determine those factors influencing contemporary antenatal steroid use in pregnancies delivered prior to 33 weeks of gestation. METHOD: We analyzed the clinical circumstances of 86 consecutive patients who delivered prior to 33 weeks of gestation and compared the 20 women who received dexamethasone prior to delivery with the remaining 66 untreated cases. RESULT: Known risk factors for preterm delivery (e.g. prior preterm birth, n = 17; prior admission and tocolysis during the index pregnancy, n = 15) did not discriminate between treated and untreated subsets. Premature membrane rupture (3/20 vs. 34/66; P < 0.01) and documented preterm labor (1/20 vs. 23/66 P < 0.01) were more common in the untreated cohort and a shorter mean interval from admission to delivery was also observed (2.8 vs 11.2 days). However, a full course of steroids would have been possible in 22/66 untreated women, since delivery was delayed for at least 36 h in these patients. CONCLUSION: These observations reflect the fact that many preterm births cannot be anticipated, even among hospitalized patients. We would therefore suggest that universal steroid treatment be considered for all women with documented preterm labor prior to 33 weeks of gestation. Initiation of steroid therapy at the referral center, (prior to maternal transport) should also be considered. Since both premature membrane rupture and early gestational age (24–28 weeks') confounded many of these cases, steroid use in patients with these circumstances should be reevaluated.
Cytidine deaminase activity in abnormal pregnancy
Authors: Okamura T. , Kigasawa K. , Takeuchi T. , Ohta C.
Published: April 2004

OBJECTIVE: To determine the usefulness of cytidine deaminase (CTD) activity in the prediction of abnormal pregnancy and the prognosis of fetal outcome. METHOD: The CTD activities in 367 pregnant women and 17 placentas and their cord sera were determined. The CTD activity was estimated to determine the amount of ammonia liberated during conversion of cytidine into uridine. The Kruskal‐Wallis test and paired t‐test were employed for statistical comparisons. RESULT: The placentas contained extremely high levels of CTD activity, but the cord serum did not. The mean value of CTD activity in abnormal pregnancy women was significantly higher than in normal pregnancy women. The two cases with a CTD activity of 40 U or more had the worst infant prognosis. CONCLUSION: The CTD activity in abnormal pregnancies was excessively elevated due to a damaged placenta under progressive deterioration. This CTD assay was simple and had predictive value for the prognosis of an infant of an abnormal pregnancy.
The role of the gynecologist in the management of breast disease
Authors: Marchant D.J.
Published: April 2004

The breast is an organ of reproduction. The diagnosis and treatment of most benign breast conditions and a knowledge of the contemporary treatment of breast cancer are essential components of the current practice of obstetrics and gynecology.
A comparison of the nonstress test, oxytocin challenge test, Doppler velocimetry and biophysical profile in predicting umbilical vein pH in growth‐retarded fetuses
Authors: Shalev E. , Zalel Y. , Weiner E.
Published: April 2004

OBJECTIVE: To examine and compare the value of the nonstress test (NST), oxytocin challenge test (OCT), Doppler velocimetry (S/D ratio), and biophysical profile (BPP) in predicting fetal acidosis. METHOD: NST, OCT, S/D ratio and BPP were performed in 23 pregnancies with growth‐retarded fetuses. The value of each parameter in predicting fetal acidosis (umbilical vein pH obtained by cordocentesis) was examined. Result: The NST, OCT and BPP were found to have the same positive predictive value of 57.1% in predicting fetal acidosis. The S/D ratio was found to have a very low positive predictive value (14.3%). The only combination of two parameters that showed improved positive predictive value, was that of OCT and NST (66.7%). CONCLUSION: (1) The best indirect method in assesing fetal well‐being is the combination of NST and OCT. (2) Since the positive predictive value of the indirect methods is still low, direct assessment of the fetal metabolic status is recommended in premature growth‐retarded fetuses with an abnormal test.
Outcome of pregnancy in diabetic mothers
Authors: Nasrat H.A. , Salleh M. , Ardawi M. , Ghafouri H.
Published: April 2004

OBJECTIVE: To study complications seen among newborns of gestational diabetic mothers versus nondiabetics, and to compare the pattern of distribution of those complications to similar reports form Western populations. METHOD: Prospective case controlled study of 384 newborns, (191 of diabetic and 193 of nondiabetic mothers) delivered at the King Abdulaziz University Hospital, Jeddah. RESULTS: The overall rate of infant morbidity was greater among newborns of diabetic mothers, especially those who required insulin for metabolic control. The major complications were those associated with increased incidence of large birth weight infants. Complications such as congenital malformations, intrauterine growth retardation and other severe forms of morbidity often associated with insulin‐dependent diabetes were rarely seen. CONCLUSION: Fetal and neonatal risks associated with diabetes in pregnancy depend not only on the severity, but also on the type of diabetes. In modern societies fetal complications associat ed with diabetes are mainly those due to hyperglycemia in the second half of gestation. The results also emphasize the fact that perinatal morbidity rather than mortality should be the yardstick for the efficacy of management of diabetes in pregnancy.
Abdominal pregnancy
Authors: Attapattu J.A.F. , Menon S.
Published: April 2004

Two cases of Abdominal pregnancy are reported: one from the Castle Street Hospital for Women, Colombo, Sri‐Lanka and the other from the Queen Elizabeth Hospital, Barbados, West Indies. The clinical manifestations, diagnosis and management are described. A review of the literature is presented.
Operative hysteroscopy
Authors: Prevedourakis C. , Lekkas N. , Makris N. , Dachlythras M.
Published: April 2004

OBJECTIVE: Analysis of the obtained results after operative hysteroscopy for several intrauterine abnormalities. METHOD: Thirty women with uterine problems (7 polyps, 16 endometrial, 5 endocervical adhesions and 2 lost IUDs) were submitted to operative hysteroscopy under general anesthesia by using fine rigid auxiliary instruments at Lito Private Maternity Hospital and the 1st Department of Obstetrics and Gynecology of Athens University during 1991. RESULT: The adhesiolysis was successful in all the 21 cases with 5 subsequent pregnancies to date, the hysteroscopic excision of the 7 polyps was uneventful and the removal of the 2 lost IUDs was done by using a special forceps for foreign bodies. CONCLUSION: Operative hysteroscopy presented excellent results intra‐operatively, post‐operatively and in the routine follow‐up by diagnostic hysteroscopy 3 months after intervention.
Intravenous leiomyomatosis with intracardiac involvement
Authors: To W.W.K. , Ngan H.Y.S. , Collins R.J.
Published: April 2004

Intravenous leiomyomatosis is considered to be a rare neoplastic disease usually arising from uterine fibromyomata, but its true incidence may be under‐recognized. Mortalities from this condition are usually the result of intracardiac involvement. A case report of successful treatment of intravenous leiomyomatosis with intracardiac extension is presented, together with a review of the existing literature concerning this rare condition.
Calculation of plasma estradiol levels by analysis of number and size of follicles measured by ultrasound
Authors: Franco J.G. , Baruffi R.L.R. , Vagnini L. , Oliveira J.B.A.
Published: April 2004

OBJECTIVE: To determine the possibility of immediate estimation of plasma estradiol (E2) levels in stimulated ovarian cycles using a multiple regression equation (MRE) based on the analysis of the number and size of ovarian follicles measured by pelvic ultrasound. METHOD: E2 levels were measured by enzyme immunoassay (EIA) in 47 patients on the day of induction of ovulation with human chorionic gonadotropin (hCG). MRE was employed to calculate E2 levels after analysis of the number of follicles present, divided into three groups according to their greatest ultrasonic diameters A (10–14 mm), B (15–16 mm) and C (≥ 17 mm). The follicular lots were analyzed retrospectively and a MRE was determined. In a later prospective study, plasma E2 levels were measured by EIA and MRE in 36 patients on the day of induction of ovulation with hCG. RESULTS: The following MRE was obtained for plasma E2 levels as a function of follicular diameter: MRE of E2 (pg/ml) = 556 + 95 A + 98 B + 108 C. In the prospective study, the correlation coefficient for the measurements of E2 levels by the two methods (EIA versus MRE) was 0.70. CONCLUSION: The use of MRE based on the analysis of number and size of ovarian follicles measured by ultrasound permits a relatively precise indirect estimate of plasma E2 levels in stimulated ovarian cycles.
Evaluation of transvaginal color Doppler sonography, transvaginal sonography and CA 125 for prediction of ovarian malignancy
Authors: Sengoku K. , Satoh T. , Saitoh S. , Abe M. , Ishikawa M.
Published: April 2004

Objectives: To evaluate the efficacy of color Doppler ultrasonography as the predictor of malignant ovarian tumors and to compare the results with CA 125 levels and ultrasonographic morphological patterns. Methods: We compared color Doppler ultrasound with sonographic findings and serum CA 125 levels for predicting ovarian malignancy in 16 patients with malignant and 12 patients with benign ovarian tumors. Results: There was a significant difference in pulsatility index (PI) value of ovarian vessel between benign and malignant tumors (2.42 ± 0.67 for benign and 1.35 ± 0.78 for malignant, respectively, P < 0.01). The specificity of morphological findings and CA 125 was lower than that of PI measurements, but sensitivity was not different between the three methods. In addition, the combination of color Doppler and CA 125 or morphological assessments resulted in a sensitivity of 100% and a negative predictive value of 100%, respectively. Conclusion: PI measurements by transvaginal color Doppler ultrasound combined with CA 125 levels or morphological findings could be an accurate and appropriate screening method for ovarian tumors.
Cervical ripening in women with previous cesarean deliveries
Authors: Del Valle G.O. , Adair C.D. , Sanchez‐Ramos L. , Gaudier F.L. , McDyer D.C. , Delke I.
Published: April 2004

Objective: To evaluate the safety and efficacy of preinduction cervical ripening in women with previous cesarean deliveries undergoing induction of labor. Methods: Retrospective study of women with previous low transverse cesarean deliveries who underwent ripening of an unfavorable cervix prior to induction of labor (n = 89). Multiparas without previous cesarean deliveries undergoing ripening and induction of labor during the same time period were used for comparison (n = 61). Ripening was performed with prostaglandin E2 (PGE2) gel, or an osmotic dilator, or both. Induction of labor with oxytocin followed the American College of Obstetricians and Gynecologists' guidelines. Outcome data were analyzed using the unpaired Student's t‐test or χ2‐test as appropriate. Significance was established at P < 0.05. Results: The mean gestational age was 39.6 ± 2.6 and 38.2 ± 2.9 weeks for the study and comparison groups, respectively. There were no differences between the groups in Bishop score, duration of the first stage of labor, maximum dose of oxytocin, indications for cesarean delivery, puerperal morbidity, birthweight, Apgar scores or NICU admissions. Sixty‐four percent (57 of 89) of study women delivered vaginally compared with 82% (50 of 61) of women in the comparison group (P < 0.03). The data were analyzed separately for those women undergoing cervical ripening with PGE2 gel only. No differences were observed between the groups in any of the categories mentioned above. Conclusion: Cervical ripening appears to be safe and effective in women with previous low transverse cesarean deliveries undergoing induction of labor with an unfavorable cervix.
A model of psychological dependence in adolescent substance abusers
Authors: Birmingham W.Geoffrey , Sheehy Marina S.
Published: April 2004

Adolescent substance abuse appears to have its foundations in a distortion of perceived events at an age prior to involvement with substances. Substances are used as a compromise in an attempt to establish a lifestyle which has meaning to the individual. Because the individual's involvement with a substance has taken place during the crucial developmental phase of adolescence, and because the use of drugs alters one's perception of one's social, emotional and cognitive state, any experience during this time must, by necessity, be distorted. At the same time, other experiences, necessary for natural development into adulthood, are forsaken. Thus, certain learned skills are replaced by those learned whilst under the influence of substances or as a reaction to the substance abusing lifestyle. The latter two often being inappropriate in drug‐free situations. As the abuse of substances severely hampers the individual's natural development, a model of Developmental Habilitation is the essence of change.
Dilemmas of adolescents with developmental retardation: a review
Authors: Dossetor D.R. , Nicol A.R.
Published: April 2004

Adolescence is highlighted in this review as the age of crisis and concern for those with developmental retardation. The complexities of this stage of life are considered from the perspectives of the individual's development and the commitment required by the family, school, professional services and society. These issues, illustrated with a case vignette, are critically examined using the evidence available in the literature.
Reasons for admission to an adolescent unit
Authors: Jaffa Tony , Dezsery Anna Maria
Published: April 2004

Three years admissions to a regional adolescent unit are analyzed to obtain information on the referral, the adolescent and family, and the behaviours leading to admission. The findings are discussed with particular relevance to the N.H.S. Health Advisory Service report on services for disturbed adolescents. Possible implications of the report which are not described by the H.A.S. are described.
Ethnic differences in adolescents' identity status and associated behavior problems
Authors: Rotheram‐Borus Mary Jane
Published: April 2004

The relationships between ethnicity and identity status and between identity status and behavior problems, social competence, and self‐esteem were examined among 330 White, Black, Puerto Rican and Filipino students in an integrated high school. Identity status (i.e., achieved, moratorium, foreclosed, or diffuse) was defined on the basis of a 24‐item self‐report inventory on which students rated their explorations of options and/or commitments to choices in their occupational, political, and religious domains. Ethnic status was also assessed in an 8‐item questionnaire which assessed exploration and commitment to one's ethnic role. White students in the upper grades reported significantly higher moratorium scale scores and perceived themselves as more likely to have explored and be committed to their ethnic role than minority youth. There were no significant ethnic differences in the relationships of identity status to behavior problems, social competence or self‐esteem. Adolescent boys were significantly more likely to be in moratorium regarding their ethnic role than girls. Grade and sex differences in identity status were consistent with those predicted by developmental researchers. Across all ethnic groups, ratings of moratorium status were associated with significantly more behavior problems, less social competence, and lower self‐esteem.
Adaptive regression and ego identity
Authors: Bilsker Dan , Marcia James E.
Published: April 2004

An inventory of adaptively regressive experiences (Taft Ego Permissiveness Inventory) and the Identity Status Interview were administered to 71 college students (35 female, 36 male). As hypothesized, Moratorium status individuals (actively engaged in identity formation) showed a greater disposition to adaptive regression than did individuals in other statuses. This supports the view that adaptive regression may serve an important function in the identity formation process.

Contrary to hypothesis, Achievement status individuals did not show greater disposition to adaptive regression than those in Foreclosure status. Females showed substantially greater disposition to adaptive regression than did males.
Preference for outdoor play during early adolescence
Authors: Pellegrini A.D.
Published: April 2004

The present study examined the extent to which boys' and girls' preference for outdoor, vigorous activity changed as they became socialized to middle school. A sample of 133 boys and girls were studied for one year: those just beginning middle school (sixth graders) and those with one year experience (seventh grade). Measures of children's preference for the playground, the duration of their stay outdoors, and behaviors while outdoors were obtained through direct observational methods. Additionally, teachers' rated children's level of achievement, physical attractiveness, and facility in games. Children also rated each other in terms of dominance status. Results indicated that boys', compared to girls', preference to play outdoors existed only in sixth grade. Factor analyses indicated that three factors described these children: Teachers' Choice, Active Female Oriented, and Outdoor Male Oriented. All three factors varied as children progressed through middle school. Results are discussed in terms of life course developmental theory.
Chronic self‐destructive behavior in normative and delinquent adolescents
Authors: Dolin Ira H. , Kelly David B. , Beasley T.Mark
Published: April 2004

The Chronic Self‐Destructiveness Scale (CSDS) and the Psychopathic Deviate and Hypomania scales of the MMPI were administered to 112 delinquent adolescents and to 141 high‐school students. Both male and female delinquents reported significantly higher levels of chronic self‐destructiveness. Significant positive correlations between the CSDS and the MMPI scales were found for all groups. The results indicate that delinquent males have high levels of chronic self‐destructiveness attributable to these personality variables; however, other cultural variables may intervene. The results for delinquent females were similar to those of high‐school males. Thus, these findings raise questions about societal influences and the definitions of delinquent behavior.
The social context of adolescent sexuality: safe sex implications
Authors: Moore Susan , Rosenthal Doreen
Published: April 2004

This study was an examination of the sexual worlds of 153 adolescents aged 15 to 18 years through the content analysis of interviews on the topics of love, romance, relationships between the sexes, sexual values and sexual behaviors. The aim was to develop more detailed descriptions of the dimension of adolescent sexuality and related these dimensions to sexual risk, that is, the tendency to engage in unprotected intercourse, an activity which increases vulnerability to AIDS and other sexually transmitted diseases. To this end, seven themes were isolated from the interview scripts, these being permissiveness, double standards, belief about sexual control (the Id Factor), romance, regrets about permissiveness, sexual aggression, and questioning. Measures of four of these themes were constructed, and sex and sub‐group differences explored, as were the relationships between themes and sexual risk. The implications of different “pathways” to sexual risk‐taking were discussed.
Racial differences in the etiology of abruptio placentae
Authors: Omu A.E. , Diejomaoh F.M.E.
Published: April 2004

Of 13,500 deliveries in a 6‐year period, 326 cases of antepartum hemorrhage (2.4%) were encountered. Fifty‐six (0.42%) of these patients had abruptio placentae while 130 (0.96%) had placenta previa. An inverse ratio of placenta previa and abruptio placentae was observed in this study, which may be due to a racial difference — probably a result of the late onset of preeclampsia among Nigerians. A high perinatal mortality of 643/1000, influenced mainly by the high prematurity rate, was observed; cesarean section resulted in the lowest perinatal mortality (154/1000). There was one maternal death, giving a maternal mortality rate of 18/1000.
Pictorial maternal and neonatal records for illiterate traditional birth attendants
Authors: Kumar Vijay , Walia Inderjeet
Published: April 2004

A pictorial card was devised for illiterate traditional birth attendants to record the important events during pregnancy, childbirth and the neonatal period. Between October 1979 and July 1980, traditional birth attendants from 15 villages completed 88 pictorial records. The card has served successfully as a prompting device to ensure continuing maternal and newborn care.
Seizures in the Nigerian neonate: Perinatal factors
Authors: Omene J.A. , Longe A.C. , Okolo A.A.
Published: April 2004

A prospective study of 55 infants with neonatal seizures admitted to the Special Care Baby Unit of the University of Benin Teaching Hospital over a 5.5‐year period revealed that perinatal asphyxia and hypoglycemia were the principal aetiologic factors in about 71% of the cases. The most frequently encountered seizure types were unilateral clonic (51.5%). Generalized clonic and massive generalized myoclonic seizures were found in 14 (25.5%) and seven (12.7%) cases, respectively, and subtle seizures in three.

The overall incidence was 3.5/1000 live births, with a preponderance of male infants in the seizure population, among whom preterm infants were significantly more common.

The mortality, (34.5%) was closely related to the etiology. Since the associated adverse perinatal events are largely preventable, improved prenatal and perinatal health care delivery should lead to a decline in the frequency of neonatal seizures.
Monitoring perinatal mortality by birth weight specific mortality rates
Authors: Erkkola R. , Kero P. , Seppälä A. , Grönroos M. , Rauramo L.
Published: April 2004

The perinatal mortality at University Central Hospital of Turku, Finland decreased significantly from 15.7/1000 in years 1970–1975 to 8.9/1000 in years 1976–1978. The main decrease has occurred in weight groups of 1000 g and more. In years 1976–1978 the perinatal mortality of non‐malformed babies in the weight group 1500–1999 g was 93/1000, in the group 2000–2499 g 21/1000 and in the group of 2500 g and over 1.7/1000. The early neonatal mortality of non‐malformed infants has decreased significantly only in the weight group of 1500–1999 g. The 1‐week survival rate has been 48% in the weight group 500–999 g, but 77% in the weight group 1000–1499 g. The birth weight specific mortality rates are greatly required when the quality of obstetrical care is assessed. Birth weight specific neonatal mortality rates are essential when guidelines for elective termination of third trimester pregnancy are designed.
Effect of oestrogen replacement therapy on blood coagulation factors in postmenopausal women
Authors: Varma T.R.
Published: April 2004

Natural oestrogens “Premarin”, (Ayerst, conjugated equine oestrogens) “Harmogen”, (Abbott, piperazine oestrone sulphate) and “Progynova” (Schering, oestradiol valerate) alone and in combination with proestational agents such as “Primolut N”, (Schering, norethisterone) “Neogest”, (Schering, norgestrel), “Norgeston”, (Schering, levonorgestrel), “Duphaston” (Duphar, dydrogesterone) did not have adverse effects on clotting factors. One patient developed deep vein thrombosis following treatment using “Progynova” (oestradiol valerate) alone and a second patient suffered from mild myocardial infarction following the use of “Premarin” (conjugated equine oestrogens) alone.
The clinical management of congenital absence of the uterine cervix
Authors: Rock John A. , Schlaff William D. , Zacur Howard A. , Jones Howard W.
Published: April 2004

Eight women with cervical atresia were evaluated and treated for symptoms of pelvic pain. Two distinct anatomic variations of cervical atresia were observed among these patients. A fibrous cord, with islands of endocervical glands, was noted in two patients surgically treated with the creation of a cervico‐vaginal fistula through the fibrous cord. Alternatively, a complete absence of the cervical stroma required a uterovaginal anastomosis in two women. One of the two women with the cervicovaginal fistula continues to menstruate. Both women, after the anastomosis, required additional surgery to maintain menstrual flow and ultimately received hysterectomy. Subsequently, four women with complete congenital absence of the cervical stroma were treated primarily with the removal of the uterine fundus. Although menstrual function may be maintained in patients with some cervical stroma, no pregnancies have occurred. Thus, removal of the uterine fundus remains the treatment of choice, relieving symptoms and avoiding additional surgery to maintain uterovaginal patency.
Left‐sided hydrothorax in connection with severe pre‐eclampsia case reports
Authors: Suonio S. , Saaranen M. , Saarikoski S.
Published: April 2004

Four cases of left‐sided pleural hydrothorax in connection with severe pre‐eclampsia are reported. In addition an increased formation of ascitic fluid was observed in the patients. A long‐lasting bed rest in the left lateral recumbent position preceded the discovery of the roentgenologically verified pleural changes. Hypoproteinemia caused by the excretion of large amounts of protein in the urine seems to be a partial etiological factor aggravated by the renal retention of sodium and water. Pleural transudate disappeared spontaneously within two weeks from the delivery. In such cases, immediate diagnostic procedures, e.g. the exclusion of tuberculosis, are unnecessary. The authors think that the phenomenon is common in similar cases but usually remains undiagnosed.
Cesarean versus vaginal delivery in abruptio placentae associated with live fetuses
Authors: Okonofua F.E. , Olatunbosun O.A.
Published: April 2004

In order to test the relative effectiveness of cesarean section and vaginal delivery in mild abruptio placentae associated with live fetuses, 23 consecutive patients were delivered vaginally and 18 by cesarean section over an 18‐month period at the University of Ife Hospital in Nigeria. The perinatal mortality of the vaginal delivery group (52.2%) was significantly greater than that of those delivered by cesarean section (16.7%) (P > 0.02; <0.05; χ2 test). The 1‐min Apgar score test was also significantly greater than that of those delivered by cesarean section (P > 0.001). These differences have been attributed to the admission‐to‐delivery interval, which was significantly longer in the vaginal delivery group (12 h vs. 2 h). It is concluded that cesarean section is clearly superior to vaginal delivery in the management of abruptio placentae associated with live fetuses.
Factors influencing maternal survival in ruptured uterus
Authors: Megafu Uche
Published: April 2004

Ruptured uterus continues to be a common obstetric hazard in under developed countries. The commonest cause is spontaneous rupture from obstructed labor in the multipara. There was not a single rupture in the primipara. Rupture following previous cesarean section scar is also common. The most effective way of management is to correct fluid and blood loss followed by laparotomy and subtotal hysterectomy. This method gave a lower mortality than either repair and sterilization or total hysterectomy. Adequate pre‐operative resuscitation and time interval between rupture and operation also influences mortality rate. The experience of the surgeon is another vital factor in determining mortality rate.
Luteal phase defects in repeated abortion
Authors: Vanrell Juan A. , Balasch Juan
Published: April 2004

Fifty women with 2 or more previous first‐trimester abortions and 300 infertile patients underwent a luteal phase evaluation by basal body temperature, plasma progesterone, estradiol and prolactin determination, and endometrial biopsy (repeated in a later cycle when the first was defective).

An endometrial luteal phase deficiency was detected in 15 (30%) of aborting patients. In 13 (26%) of these women the endometrial defect was associated to normal hormonal levels. This condition was only present in 36 (12%) of the infertility cases (P < 0.01).

We conclude that the possible etiologic role of luteal phase defects in repeated abortion, is by a secretory insufficiency in the endometrial pattern despite normal plasma hormonal levels.
A case of single umbilical artery with various fetal anomalies: Correlations between prenatal ultrasonographic diagnosis and autopsy
Authors: Hata Toshiyuki , Hata Kohkichi , Kitao Manabu , Tanaka Osamu
Published: April 2004

We report a case of a single umbilical artery with various fetal anomalies, and a comparative study between prenatal ultrasonographic diagnosis and autopsy was done. The prenatal ultrasonographic diagnosis included, atrial septal defect (ASD), ventricular septal defect (VSD), mitral atresia or stenosis and a single great vessel. At autopsy, ASD, VSD, mitral atresia, overriding aorta and pulmonary atresia were evident. In case of other anomalies, the findings in the prenatal diagnosis and at autopsy were encephalocele, adrenal hypoplasia and a single umbilical artery. The ultrasonic detection of these anomalies is discussed and the limitations of this diagnostic method are given attention.
Sequential radiation changes in cytology of vaginal smears in carcinoma of cervix uteri during radiotherapy
Authors: Gupta S. , Mukherjee K. , Gupta Y.N. , Kumar M.
Published: April 2004

The study deals with acute/immediate radiation changes in 2020 sequential vaginal smears in 101 patients of carcinoma of the cervix uteri, 97 were of squamous cell carcinoma and 4 of adenocarcinoma. The smears were collected after 12–14 days, 15–24 days and 25 days to 6 weeks following radiotherapy. The pretreatment vaginal smears were collected and examined for percentage of cancer cells. Subsequent smears were studied for radiation changes in benign and malignant cells, such as cell size, vacuolation of cytoplasm, multinucleation and nuclear changes, etc. A gradual and linear decline in cancer cells was observed until the end of therapy; 41.6% of patients had less than 10% cancer cells within 12–14 days of therapy, 63.4% of patients between 15 and 24 days and 74.6% after 25 days to 6 weeks following radiation. Eighty three percent of the patients attained zero level at the end of therapy.
Recurrent uterine myomata in three sisters — an uncommon occurrence
Authors: Kulenthran A. , Sivanesaratnam V.
Published: April 2004

Three sisters who developed recurrent uterine myomata from a very young age are presented. Despite repeated attempts at myomectomy, all three cases had hysterectomies ultimately. Complications encountered during surgery were severe hemorrhage, inadvertent injury to bladder and bowel in two patients and a rare complication of colonicuteric‐cutaneous fistula occurring post‐operatively in one patient. Histology of the final hysterectomy specimens in two cases showed low grade leiomyosarcoma and cellular myoma, respectively.
Experience with a new flexible hysteroscope
Authors: Marty R.
Published: April 2004

This is a report of our experience with a new flexible fibroscope, the CHF P 10. We performed more than 50 diagnostic endoscopies and 28 operative procedures. It is extremely practical to perform diagnostic and operative procedures at the same time if necessary. The major advantages of the new fibroscope are its diameter (4.9 mm), flexibility and bendable tip (260° range). This permits a substantial decrease in cervical dilatation and use of anesthesia. Because of this, hospitalization costs decrease and the safety of surgical procedures is increased.
Serum lipids and lipoproteins in women with polycystic ovarian disease with different body mass index
Authors: Rojanasakul A. , Chailurkit L. , Sirimongkolkasem R. , Chaturachinda K.
Published: April 2004

A study to determine serum lipids and lipoproteins in 54 women with polycystic ovarian disease (PCOD) who had varying body mass index (BMI) compared to the normal regular menstruating women was carried out. All patients had similar hormonal profiles of PCOD and differed from the control group. The significant observations were high level of triglyceride and low percentage of alpha lipoprotein in obese PCOD. The BMI was positively correlated with serum triglyceride level, beta and prebeta lipoproteins but inversely correlated with high density lipoprotein (HDL) cholesterol, the low density lipoprotein (LDL) cholesterol/HDL cholesterol ratio and alpha lipoprotein. No significant correlation between lipids, lipoproteins and testosterone levels was observed. It appeared that the alteration of serum lipids and lipoproteins in PCOD is due to the effect of obesity.
Infertility in Central Africa: Infection is the cause
Authors: Collet M. , Reniers J. , Frost E. , Gass R. , Yvert F. , Leclerc A. , Roth‐Meyer C. , Ivanoff B. , Meheus A.
Published: April 2004

Determinants of infertility were studied in 340 women in Eastern Gabon, an area situated in the “infertility belt” of Central Africa. Fallopian tube occlusion was diagnosed in 82.8% of cases, showing the importance of infection‐related causes. Women with tubal occlusion did not differ significantly from women with normal tubes in obstetrical history or prevalence of Neisseria gonorrhoeae or Chlamydia trachomatis on endocervical culture. Antecedents of pelvic inflammatory disease or a pelvic mass were significantly more common in the group with tubal occlusion. This group also had a significantly higher prevalence of serum chlamydial antibodies at a titer of 1/64 or higher. Hormonal factors were found in 31.7% of women, a cervical factor in 29.0% and mechanical factors in 5.6%. No diagnosis could be made in 12.2% of cases. During the investigation, 4.4% of women became pregnant. The predominance of infectious related causes of infertility makes it imperative to focus resources on prevention programs of upper genital tract infections in women.
Professional responsibility in maternity care: Role of medical audit
Authors: Bhatt R.V.
Published: April 2004

In 1965, Baroda Medical College initiated a process of medical audit of maternal and perinatal deaths occurring at this institution, and consultation in peripheral medical facilities providing antenatal and obstetric care. By 1984 maternal and perinatal mortality had declined and clinical judgment in maternity care had improved.
Fentanyl‐midazolam‐flumazenil anesthesia for induced abortion
Authors: Hamar O. , Garamvölgyi Gy. , Kálmán A.
Published: April 2004

A new anesthetic method (fentanyl‐midazolam‐flumazenil) was compared with a previously administered anesthetic regimen (pethidine‐diazepam‐ketamine) in two groups of 25 women, each of whom underwent termination of pregnancy. No significant difference was found between the two groups in quality of anesthesia. Recovery was assessed by means of the Aldrete score and a visual analog scale. The recovery time was significantly shorter in patients who received the fentanyl‐midazolam‐flumazenil.
Observations on molar pregnancy in Enugu, Nigeria
Authors: Egwuatu V.E. , Ozumba B.C.
Published: April 2004

Forty‐one molar pregnancies seen at the University Teaching Hospital Enugu, Nigeria during the 10‐year period 1976–1985 are analyzed. The incidence of hydatidiform mole was 0.82 per 1000 pregnancies. The incidence of molar pregnancy was lowest among teenage women and increased markedly with advancing age over 35 years. Hyperemesis gravidarum, a relatively uncommon finding in Nigerian women during normal pregnancy was a prominent feature of molar pregnancy in the women. The incidence of postmolar gestational trophoblastic disease was 17%; choriocarcinoma occurred in 7% of the subjects. Molar pregnancy and postmolar malignant trophoblastic disease occurred much less frequently among the Igbo women of Enugbu than the Yorubas of western Nigeria. Earlier and better recognition and treatment of hydatidiform mole will probably result in a decrease in the high rate of complications found during this study.