bluuebunny/crossref_metadata_2025 huggingface dataset:
QUINACRINE HYDROCHLORIDE
Authors: Patek Eva
Published: December 2009

Abstract.Quinacrine hydrochloride, mainly used as an antimalarial, has been used as a nontoxic chemosterilant in a transvaginal procedure in the human female. Clinical experiments indicate that Quinacrine acts as a powerful obstructive agent exclusively on the epithelium of the intramural portion of the tube without alterating the histology of the endometrium.

The precise mechanism of Quinacrine's obstructive action on the mucosa of the uterotubal junction is unknown.

Its possible mode of action is binding to epithelial DNA thus forming a clot of granulomatous tissue, as Quinacrine is known to form adhesions when used in the control of neoplastic effusions.

Zinc is known to inhibit Quinacrine‐DNA binding. The human endometrium, rich in Zinc is unaffected by Quinacrine, whereas the tubal cornua, with little Zinc promote the obstruction by Quinacrine DNA bondage.

The procedure is effective in 90 per cent of the cases with two instillations of Quinacrine. Further studies are essential to find agents that would potentiate the action of Quinacrine on the human Fallopian tube epithelium.
Fetal growth retardation associated with inadequate haemodilution in otherwise uncomplicated pregnancy
Authors: Koller O. , Sagen N. , Ulstein M. , Vaula D.
Published: December 2009

Abstract. The Hb level during pregnancy was followed in 113 non‐anaemic women with uncomplicated pregnancy and birth weight of the baby above the 2.5th percentile. There was an inverse correlation close to statistical significance between the birth weight of the baby and the lowest Hb level reached during pregnancy as well as the Hb level in late pregnancy (38th week). A group of seven non‐anaemic women with birth weight of the baby below the 2.5th percentile had a significantly higher (p<0.001) Hb level in late pregnancy than the normal group. Four of these cases had a statistically significant higher Hb level already in the second trimester. Trends in the reproductive history, complaints in the present pregnancy as well as results of hormone assays and the condition of the baby indicated that the seven cases represented a pathological group with fetal growth retardation. None of the women in the two groups were treated with diuretics. All had iron supplementation in high doses.
The routine use of oral prostaglandin e2 tablets for induction or augmentation of labour
Authors: Gordon‐Wright A. P. , Dutt T. P. , Elder M. G.
Published: December 2009

Abstract. The use of oral prostaglandin E2 (PGE2) tablets is an effective and safe adjunct to low amniotomy for the induction of labour at term. Routine use of this regimen and the use of oral PGE2 tablets for augmentation of spontaneous labour has shown that the method is very effective in multiparous patients, but much less so in primiparous patients. Success or failure could not be predicted by the pre‐induction Bishop score. The incidence of gastro‐intestinal side effects is dose dependent, but is low in multiparous patients.
Hyperthecosis syndrome: clinical, endocrinologic and histologic findings
Authors: Karam K. , Hajj S.
Published: December 2009

Abstract. Five patients were found to have hyperthecosis ovarii as evidenced by the presence of large lipid containing thecal cells in the ovarian stroma. The clinical picture was similar in all of them, featuring mild virilization, obesity and oligomenorrhea, with refractoriness to clomid therapy. Plasma FSH levels were low normal, while LH levels were slightly elevated. Urinary 17‐ketosteroids levels were elevated, and plasma testosterone concentrations were upper normal. The response to dexamethasone suppression and HCG stimulation is discussed. The effect of wedge resection on the clinical and endocrinologic pictures is evaluated.
Acid‐base balance during laparoscopy: the effects of intraperitoneal insufflation of carbon dioxide and nitrous oxide on acid‐base balance during controlled ventilation
Authors: Magno Ricardo , Medegård Alf , Bengtsson Rolf , Tronstad Sven‐Erik
Published: December 2009

Abstract. During laparoscopy the carbon dioxide used to achieve a pneumoperitoneum is absorbed from the peritoneal cavity into the blood. The object of the present study was to clarify certain aspects concerned with anesthetic and ventilatory techniques, mostly in connection with the comparison between the effects of insufflation of either carbon dioxide or nitrous oxide. Anesthesia included ventilation with a volume controlled ventilator in curarised patients. Respiratory volumes were calculated according to the patienťs body area. The results show a sharp rise in PaCO2 and a fall in pH after intraperitoneal insufflation with carbon dioxide, while no changes were observed when nitrous oxide was used. The clinical consequences of these Findings are discussed.
ADJUSTMENTS OF CIRCULATION INCLUDING BLOOD PRESSURE TO ORTHOSTATIC REACTION AND PHYSICAL EXERCISE DURING APPLICATION OF A LOW ESTROGEN DOSE STEROID ORAL CONTRACEPTIVE
Authors: Sandström Bo , Backman Christer , Dahlström Jan‐Anders , Zador Göran
Published: December 2009

Abstract.The orthostatic circulatory reaction, the physical working capacity on a bicycle ergometer, the blood pressure reactions at rest both during and after the ergometer test, the total hemoglobin content and the heart volume in the supine position were all determined on four separate occasions in 34 nulligravidae who were taking a low estrogen dose steroid oral contraceptive consisting of 30 μg of ethinyl estradiol and 150 μg of levonorgestrel (known as Neovletta®, Schering AG). These examinations were performed once prior to the commencement of this medication, and 6, 12 and 24 months thereafter. the orthostatic pulse and blood pressure reactions taken on these subjects standing upright for a period of eight minutes were pronounced up to and including the 12 month control, but decreased thereafter. Physical working capacity at a pulse rate of 170 beats per minute on the different test occasions decreased up to and including the 12 month control, but thereafter seemed to increase almost to their initial levels. Blood pressure, heart volume and total amount of hemoglobin increased up to and including the 12 month control but thereafter seemed to return to the pre‐treatment level. These circulatory changes during the first year of the application of this contraceptive may be as the result of a marked sympathicotonic reaction induced by the steroids. Possibly because of some form of adaptive mechanism, this reaction seems to decrease (and almost to “normalize”) during the second year of use.
SUPPRESSION OF UTERINE ACTIVITY BY PROSTAGLANDIN SYNTHETASE INHIBITORS
Authors: Pulkkinen Martti O.
Published: December 2009

Abstract. During hypertonic saline induction, the evolution of intrauterine pressure, the oxytocin response and abortion were delayed in naproxen‐treated patients. The PG synthesis inhibitors naproxen, mefenamic acid and ibuprofen decreased the high uterine resting pressure (‘tone’), the frequency of contractions but not always the active pressure (‘amplitude’) in dysmenorrheic patients, with a coincident decrease in pain.

The naproxen‐sodium treatment decreased prostaglandins F and E in menstrual blood and uterine jet washings by 60–80 per cent.
DYSMENORRHEA DURING ADOLESCENCE
Authors: Widholm Olof
Published: December 2009

Abstract. Different aspects of the menstrual pattern including dysmenorrhea, premenstrual tension and working performance during menstruation was studied in three different investigations.

The first study includes 5458 adolescent girls aged 10 to 20. The incidence of invariably painful menstruation was 7.2 per cent during the first gynecological year and 26 per cent five years later. A correlation was found between mothers and daughters for dysmenorrhea as well as for premenstrual tension.

In a second study including 331 girls aged 13 to 20 years the overall absence from school due to pain was 23.4 per cent. The frequency of dysmenorrhea increased from 36 per cent to 56.5 per cent between 13‐14 years and 17‐20 years.

Socio‐medical aspects of menstrual pattern were studied in 865 adult women. Approximately 88 per cent had premenstrual tension and almost 45 per cent had menstrual pain. Thus the treatment of menstrual distress during adolescence is of great importance and the use of modern prostaglandin synthetase inhibitors may be very useful.
Granulosa‐cell and theca‐cell tumors: The clinical picture and long‐term outcome for the radiumhemmet series
Authors: Björkholm Elisabet , Pettersson Folke
Published: December 2009

Over the period 1923‐72 a total of 305 patients with granulosa‐cell, theca‐cell tumor and mixed tumor were seen at Radiumhemmet.

The commonest symptom was abnormal uterine bleeding. Twenty‐three per cent of married women were nulliparous. The menarche seems to have occurred earlier in this group than in the general population.

Eight of the granulosa‐cell tumor group gave birth to 12 children after treatment for the tumor.

Nineteen women with granulosa‐cell tumor and 4 with thecoma had received radiotherapy earlier in life for benign lesions.

The risk of endometrial cancer was approximately 10 times greater for the women with granulosa‐ or theca‐cell tumor than for the general population.

Two hundred and fifty‐two patients were given both surgical treatment and radiotherapy. Fifty‐three received only surgery (37 granulosa‐cell and 16 theca‐cell tumors).

None of the thecoma patients but 21 per cent of those with granulosa‐cell tumor died from their disease. The 5‐year survival for the latter group, all stages, was 85 per cent.
Risk of Spontaneous Abortion Following Legally Induced Abortion
Authors: Obel Erik B.
Published: December 2009

Using the registration of all pregnant women living within a particular geographical district of Copenhagen the risk of spontaneous abortion has been calculated by means of a decremental method. A total of 3 042 pregnancies were registered and the total risk of spontaneous abortion was calculated at 10 per cent. In 431 women the previous pregnancy had been terminated by a legally induced abortion. Increased risk of spontaneous abortion could not be demonstrated in this group, where the cumulative risk of spontaneous abortion was 12 per cent. In particular, the risk of late abortion was not seen to increase.
Effect of Estrogen/Progestogen Combinations on Polymorphonuclear Leucocyte Chemotaxis
Authors: Nilsson Bo , Damber Mats‐Göran , von Schoultz Bo
Published: December 2009

The effects on leucocyte chemotaxis and on the mixed lymphocyte culture reaction were studied in fourteen women taking estrogen/progestogen combinations. An increase in leucocyte chemotaxis was found during hormonal treatment and sera from these women were found to inhibit the mixed lymphocyte culture reaction.
Ultrasonic Measurement of Fetal Body Size: A Randomized Controlled Trial
Authors: Wladimiroff J. W. , Laar J.
Published: December 2009

A total of 745 Caucacian women were allocated at random between two groups, A and B, at the first antenatal visit. At the completion of the study, 341 patients in group A underwent a single ultrasonic measurement of fetal chest area between 32 and 36 weeks of gestation. The medical staff was not informed of these results. Three hundred and sixty‐four patients in group B acted as controls.

The percentage of clinically detected small‐for‐dates (S.F.D.'s) was low in both groups, A (36 per cent) and B (42 per cent). The ultrasonic detection rate of the clinically missed S.F.D.'s (group A) was 77 per cent.

The clinical detection rate of large‐for‐dates (L.F.D.'s) was only 12 per cent in group A and 13 per cent in group B. The ultrasonic detection rate of the clinically unrecognized L.F.D.'s (group A) was 60 per cent.
Metabolic Effects of Intravenous Ritodrine Infusion in Pregnancy
Authors: Schreyer P. , Caspi E. , Arieli S. , Maor J. , Modai D.
Published: December 2009

The effects of intravenous administration of Ritodrine on blood glucose, insulin, electrolytes, plasma and red cell potassium and venous pH were investigated.

A highly significant increase in blood glucose and insulin occurred. A highly significant negative correlation between serum and red cell potassium concentration was registered (r=−0.96268).

No significant changes during Ritodrine infusion were recorded in serum levels of sodium, chloride, calcium, phosphorus and magnesium.

The pH did not seem to be influenced by intravenous Ritodrine administration.

No cardiac arrhythmias or electrocardiographic deteriorations occurred.

While intravenous Ritodrine administration seems to be safe in normal pregnancies, a risk may be present in diabetic and digitalized patients, and pregnant women being treated by diuretics.
Postcesarean Vesico‐Uterine Fistula
Authors: Kihl Björn , Nilson Arne E. , Pettersson Silas
Published: December 2009

A case of postcesarean vesico‐uterine fistula in conjunction with a fibrous cord joining the anterior and posterior wall of the bladder is reported. The symptoms of menouria and amenorrhoea in the absence of urinary incontinence are explained by reference to the pressure gradients which normally exist in the bladder and the uterine cavity. The etiology, diagnosis and therapy of this and other reported cases are reviewed.
Premature Rupture of the Membranes
Authors: Evaldson George , Lagrelius Anders , Winiarski Jacek
Published: December 2009

The etiology of premature rupture of the membranes (PROM) has been investigated in 30 consecutive cases and 30 matched controls. The significance of several possible factors predisposing to this condition is discussed and the obstetric and pediatric outcome reviewed. Significantly increased frequencies of previous genital operations, cervical operations and lacerations were found in the PROM group, which also contained significantly more heavy smokers. The relation between the length of the PROM delivery time interval and the risks of prematurity and infection are discussed. Patients delivered > 24 hours after PROM had significantly more puerperal infections than those with a latent period of > 24 hours. Maternal fever was found to be an unreliable prognostic indicator. The incidence of puerperal infection amounted to 27 per cent in the PROM group. A 12 per cent incidence of proven neonatal septicaemia contributed to a high perinatal mortality rate (17.6 per cent).
Results in the Operative Treatment of Pelvic Endometriosis
Authors: Puolakka Jukka , Kauppila Antti , Rönnberg Lars
Published: December 2009

Two hundred and eight patients treated surgically for endometriosis were reviewed one to four years later. The incidence of endometriosis in this survey was 17 per cent of all gynecological laparotomies. After operation, 30 per cent of the patients were symptomless, 60 per cent estimated the alleviation as good or moderate, and only 10 per cent had no benefit from the operation. In the 32 cases where infertility was the main indication for operation and other factors affecting fertility were excluded, 20 pregnancies of 19 women were achieved after operation.
Monozygotic Twins with Dissimilar Phenotypes and Chromosome Complements
Authors: Pedersen I. Krogh , Philip J. , Sele V. , Starup J.
Published: December 2009

A case history of monozygotic twins is presented. Twin A showed gonadal dysgenesis and chromosomal mosaicism (45, X0/46, XX). Twin B was a phenotypical normal female with the karyotype 46, XX. Fifteen previous reports of monozygotic twins with gonadal dysgenesis are reviewed. Dissimilar phenotypes seem to be the rule rather than the exception, and mosaicism is found in the majority of cases with dissimilar phenotype. The assumption is made that the chromosome disorder leading to gonadal dysgenesis arises postzygotically, either before or after the process leading to twinning.
Urinary Fibrinolysis in Toxemia of Pregnancy
Authors: Chen H. Fu , Nakabayashi M. , Satoh K. , Sakamoto S.
Published: December 2009

Serial determinations of urinary plasmin level by radiocaseinolytic assay were performed in 40 healthy women and 29 patients with various types of toxemia throughout pregnancy, labor and the puerperium.

The results indicate that

1. The urinary plasmin level in normal pregnancy increased significantly from the third trimester to the early puerperium.

2. In mild pre‐eclampsia, a significant rise in urinary plasmin level from 26 weeks of gestation to the 4th day postpartum.

3. In severe pre‐eclampsia, a progressive decrease in late pregnancy was found. After delivery, in the early puerperium, the urinary plasmin level of the patients with a rapid clinical was significantly higher than that of the patients with the sequelae of toxemia.

Our study showed that serial assays of urinary plasmin activity can provide a reliable and sensitive index of severity, progression and natural history of toxemia of pregnancy.
Evaluation by Serum Ferritin Assay of the Influence of Maternal Iron Stores on the Iron Status of Newborns and Infants
Authors: Puolakka J. , Jänne O. , Vihko R.
Published: December 2009

Serum ferritin concentration was measured in 47 paired maternal and newborn (umbilical cord sample) blood specimens during delivery. The serum ferritin concentration was also measured in 31 of the above babies at the age of six months. Serum ferritin concentration of the newborn babies (mean 222 μg/l) born to the mothers with a low serum ferritin content at term (mean 28 μg/l) was significantly lower (p < 0.05) than that for those (mean 324 μg/l) born to the mothers with a normal ferritin concentration (mean 102 μg/l). The difference between the two groups of infants persisted for at least the whole study period of 6 months (mean at 6 months of age 99 μg/l and 150 μg/l, respectively).
THE EVOLUTION OF CERVICAL MUCUS INFRASTRUCTURE IN NORMAL CYCLIC BABOONS (PAPI0 ANUBIS) AND CASTRATED FEMALES RECEIVING HORMONAL SUPPLIES
Authors: Chréeatien F. C.
Published: December 2009

Abstract. The scanning electron microscope was used to study the evolution of the infrastructure of cervical mucus in normal cyclic baboons and in castrated animals treated with ovarian hormones for establishing an artificial cycle. In both groups, the results make conspicuous the progressive enlargement of the filamentous woof, which attains a maximum at midcycle and then decreases by degrees in the second part of the cycle. It was shown that the evolution of the framework is very similar during normal and artificial cycle, with only variations of slight amplitude. Moreover, the variations in the baboon mucus infrastructure closely resemble those described in the human. The results are briefly discussed in the light of known data.
Neonatal depression after obstetrical analgesia with pethidine. the role of the injection‐delivery time interval and of the plasma concentrations of pethidine and norpethidine
Authors: Belfrage P. , Boréus L. O. , Hartvig P. , Irestedt L. , Raabe N.
Published: December 2009

Pethidine (100 mg) was administered i.m. to women in labor at different times before delivery. The interval before respiration in the newborn became sustained was shorter if pethidine was given less than one hour before delivery. The respiratory rate of the newborn increased after naloxone injection in 40 per cent of the cases, mostly when intrauterine exposure to pethidine exceeded one hour. The plasma concentrations of pethidine and norpethidine were measured in mother and newborn. The concentrations in the umbilical vein and artery indicated a continuous net transfer of pethidine from mother to fetus for approximately two hours. This correlates with the clinical finding of maximal neonatal depression 2–3 hours after maternal injection. The concentrations of norpethidine increased with a longer time interval between injection and delivery, but were probably too low to have any effect on the newborn. Neonatal depression seems to be related to the amount of unmetabolized pethidine that has been transferred from mother to fetus but not to norpethidine as had been suspected earlier.
Fibrinolytic activity of uterine fluid in iud‐users
Authors: Casslén B. , Åstedt B.
Published: December 2009

The influence of an IUD on the fibrinolytic activity of uterine fluid was measured by radial enzyme diffusion on fibrin plates.

In samples obtained from 48 women using Cu‐IUDs, the fibrinolytic activity in mid‐cycle phase was higher than that in the proliferative or the luteal phase. It increased in the premenstrual phase. Individual values before and after insertion of a Cu‐T were determined in the proliferative‐mid‐cycle phase and the luteal phase in a group of 11 women. In contrast to earlier reports on the endometrium, the fibrinolytic activity of uterine fluid was lower after, than before, insertion of an IUD. This may be due to a lower concentration of activators and/or to an increased concentration of inhibitors of plasminogen activation.
EFFECT OF SALBUTAMOL ON THE NON‐PREGNANT HUMAN UTERUS IN VIVO
Authors: Lalos Othon , Joelsson Ingemar
Published: December 2009

Abstract. Uterine tonicity has been determined by means of hysterometry on the first day of menstruation in 5 women with severe primary dysmenorrhea. The effect of intravenous infusion of salbutamol in a dose of 10 μg/min was evaluated. The results indicate that this β2‐receptor stimulating agent is capable of eliciting a marked decrease in uterine tonicity in dysmenorrheic women. The diminished uterine tonicity was closely associated with pain relief.
THE LACK OF SIGNIFICANT CHANGE IN PLASMA PROGESTERONE AND ESTRADIOL‐17β LEVELS BEFORE THE ONSET OF HUMAN LABOR
Authors: Hartikainen‐Sorri A.‐L. , Kauppila A. , Tuimala R. , Viinikka L. , Ylikorkala O.
Published: December 2009

Abstract. Maternal plasma levels of progesterone and estradiol‐17β were measured weekly by radioimmunoassay in 15 healthy women during the last trimester of normal pregnancy. There was a large individual variation for both hormones. The mean concentrations rose slightly with advancing gestational age but the ratio of progesterone to estradiol did not change. It is apparent that the onset of spontaneous labor cannot be predicted by measuring the levels of progesterone and estradiol‐17β in maternal peripheral plasma.
Steroid Receptors in Urological Malignancies
Authors: Ekman Peter
Published: December 2009

Within urological practice, three important types of cancer seem to be under endocrine influence or develop in endocrine‐dependent organs: prostate cancer, hypernephroma and testicular tumors. Endocrine therapy is not used in testicular cancer, its value in renal cell carcinoma is limited, whereas it is a dominant form of therapy for prostate cancer. There seems to be a definite relation between androgen receptor content in primary prostatic carcinoma and response to hormonal manipulations. The presence of estrogen receptors is not well documented and probably the major effect of estrogen therapy is indirect, being exerted via the hypothalamo‐pituitary axis. Progestin receptors are present in hyperplastic prostate as well as in prostate cancer and may indicate cases sensitive to progestin therapy. The assay method still needs considerable refinement before it can be introduced into clinical practice.
THE IMPLICATION OF A LOW IMPLANTATION OF THE PLACENTA DETECTED BY ULTRASONOGRAPHY IN EARLY PREGNANCY
Authors: Varma T. R.
Published: December 2009

Abstract. Ultrasonic scanning in the first and early in the second trimester of pregnancy showed a high incidence (18 per cent) of possible placenta previa. A placenta which reached onto the internal cervical 0s but did not cover it in early pregnancy was found to be in the upper segment at a repeat scanning in the third trimester. The placenta which covered the internal cervical 0s either partially or completely was associated with a higher incidence of bleeding, abortion and placenta previa which was confirmed at repeated ultrasonic examination and at delivery.
GLUCOSE TOLERANCE FOLLOWING ORAL SALBUTAMOL TREATMENT IN LATE PREGNANCY
Authors: Wager J. , Lunell N. O. , Nadal M. , Östman J.
Published: December 2009

Abstract. Previous studies in pregnancy have shown that in‐travenous infusion of beta‐sympathomimetic drugs, such as salbutamol, is followed by pronounced carbohydrate and lipid metabolic effects. Similar effects, though less pro‐nounced, have also been demonstrated after oral salbutamol administration.

Glucose elimination and insulin response after an intravenous glucose tolerance test (IVGTT) were analyzed in 12 women treated with oral salbutamol in the last trimester of pregnancy. IVGTT was performed without salbutamol and after at least 10 and up to 45 days of salbutamol treatment.

No significant difference in either glucose elimination or insulin response to the glucose load were observed as a consequence of the salbutamol medication. This is in agreement with previous studies of other beta2‐sympathomimetic drugs and indicates that the use of salbutamol in late pregnancy does not give rise to serious disturbances of carbohydrate metabolism in healthy women.
SYMPHYSIS‐FUNDUS MEASUREMENT IN PREDICTION OF FETAL GROWTH DISTURBANCES
Authors: Wallin A. , Gyllenswärd Å , Westin B.
Published: December 2009

Abstract. Graphic supervision of pregnancy by symphysis‐fundus (SF) tape measurement was introduced in an area of north Stockholm in 1972. Subsequently a considerable and persistent drop in perinatal mortality was seen. SF‐tape measurements reflect the fetal growth and correlate well with fetal crown‐rump length. Over a 2‐year period SF‐growth data were collected for all infants admitted to the neonatal unit in the area. In all, 812 singletons were studied. Maternal smoking habits in the first trimester were recorded. A group of 283 normal neonates served as controls. A highly significant statistical difference was found on comparing the mean birth weights of infants associated with high, “normal”, and low and/or static SF‐curves from 34 weeks of gestation and onwards. The sensitivity in detecting LGA infants by high SF‐curves was 74%, with a specificity of 84%. The proportion of mothers with uncertain expected dates of confinement (EDC) was high among those having “normal” SF‐curves, yet giving birth to SGA infants. After correction for gestational age, the SF‐curves adjusted for dates were in most cases low and/or static during the weeks prior to delivery. The sensitivity and specificity would thereby have increased to 95% and 93%, respectively, in detecting SGA infants had their dates been certain.

Maternal smoking showed an overall incidence of 37% in the first trimester. No increase in incidence was seen among mothers to preterm infants. There was as could be expected a highly increased ratio of smoking mothers to infants with birth weight less than 1 S.D., regardless of gestational age.

SF‐tape measurement is recommended as a graphic method of supervising pregnancy for the detection of accelerated and retarded fetal growth. Early and correct determination of gestational age, however, is a prerequisite.
HOW SWEDISH OBSTETRICIANS MANAGE HYPERTENSION IN PREGNANCY
Authors: Lindberg Bo S. , Sandström Bo
Published: December 2009

Abstract. One hundred and seventy‐nine obstetricians in Sweden answered a questionnaire on the management of pregnant women with hypertension. A similar study on English practice has been published earlier. In mild hypertension, 33% of the obstetricians did not prescribe medical treatment at all, while in more severe cases almost all of them would recommend a combination of hydralazine and diuretics or betablockers. There was a considerable unanimity in the replies about what treatment a patient with hypertension could use or should stop using during pregnancy. In comparison with English obstetricians the Swedish colleagues seldom consider termination of pregnancy in hypertension during early pregnancy.
ACCURACY OF FETAL SEX DETERMINATION BY ULTRASOUND
Authors: Weldner Britt‐Marie
Published: December 2009

Abstract. The accuracy of fetal sex determination was tested in 101 consecutive pregnancies routinely examined by ultrasound in the 32nd gestational week. Sex determination was done when penis/scrotum or vulva could be discerned between the thighs of the fetus. Fetal sex could be determined in 75 per cent of the male infants and in 73 per cent of the females. The wrong sex was determined in 3 per cent of all examinations. In 25 and 21 per cent of female and male fetuses respectively sex determination could not be accomplished. The results were better in the 32nd than in the 38th week. The significance of fetal sex determinations is discussed.
Ultrasonic Growth Pattern of Fetuses with Chromosomal Abberations
Authors: Kurjak Asim , Kirkinen Pertti
Published: December 2009

Abstract. A retrospective analysis of the ultrasonic growth patterns of two 13‐15 trisomies, two 18‐trisomies and eight 21‐trisomies is presented. The patterns were examined by serial cephalometry, abdominometry and head‐to‐abdomen circumference measurements. Early and symmetric growth retardation was revealed by ultrasonography and later confirmed by postnatal pediatric examinations in the 13‐15 trisomies and 18‐trisomies. In the 21‐trisomies, fetal growth was normal.
Hydramnios and Observations in Bartter's Syndrome
Authors: Pereira R. Rodrigues , Hasaart T.
Published: December 2009

Abstract. A boy was born after a pregnancy complicated by a hydramnios. He appeared to suffer from Banter's syndrome, a disease characterized by hyperreninemia, hyperal‐dosteronism and excess prostaglandin production resulting in hypokalemia, normotension, impaired urine concentration ability, polyuria and renal sodium loss. Other children with Banter's syndrome, and also a different syndrome characterized by polyuria and hydramnios, are reviewed. In the evaluation of gross hydramnios of unknown etiology, Banter's syndrome might also be considered.
Infertility and Uterine Colonization with uReaplasma Urealyticum
Authors: Stray‐Pedersen Babill , Bruu Anne‐Lise , Molne Kaare
Published: December 2009

Abstract. Samples of cervical mucus and endometrial tissue from 379 women who were infertile for various reasons were examined for the presence of Ureaplasma urealyticum, and the results were compared with those obtained in 40 fertile women.

In the cervical samples U. urealyticum was present in about half of the women in both groups, whereas positive cultures from the endometrium were obtained significantly more often among the infertile patients (26%) than among the controls (7.5%). Between the different infertility subgroups (unaccountable infertility, infertility caused by tubal abnormalities, husband infertility and other known causes) no significant differences were found.

The presence of U. urealyticum in the endometrium was asymptomatic and was not related to prior pelvic inflammatory disease. In 14% of the Ureaplasma‐positive endometria, aerobic or anaerobic bacteria were demonstrated.

A treatment trial was also included in the study, but did not arrive at any definite conclusion as to the specific role of endometrial Ureaplasma colonization in infertility.
Human Fetal Breathing and Gross Body Activity Relative to Maternal Meals During insulin‐dependent pregnancy
Authors: Wladimiroff J. W. , Roodenburg P. J.
Published: December 2009

Abstract. Measurement of the percentage incidence of fetal breathing and gross body movements as well as of maternal blood glucose concentration was carried out in 12 insulin‐dependent diabetic pregnant women and 12 normal controls between 33 and 37 weeks of gestation. The observation period was related to the three meal times.

In diabetics no diurnal variation in pre‐prandial fetal breathing activity was observed whereas in normal controls fetal breathing incidence was significantly higher before evening dinner than before breakfast. Immediately following lunch and dinner, fetal breathing demonstrated a significantly lower incidence in diabetics than in normals. Since no significant difference in maternal blood glucose concentration was found between the two groups, it is suggested that other factors relative to carbohydrate metabolism may also be involved in the regulation of fetal breathing in diabetes. Fetal gross body activity in diabetics vs. normals did not differ essentially and demonstrated no correlation with the maternal blood glucose levels.
Estrogenic Potency of Oral Replacement Therapy Estimated by the Induction of Pregnancy Zone Protein
Authors: Helgason S. , Damber M.‐G. , von Schoultz B. , Stigbrand T.
Published: December 2009

Abstract. The induction of a highly estrogen‐inducible plasma protein, the pregnancy zone protein/pregnancy associated α2‐globulin (PZP/PAα2G), was used to design a sensitive method to quantify and compare the potency of various estrogens commonly used in clinical practice. Serum PZP levels were followed in 100 post‐menopausal women during 6 months' estrogen replacement therapy. Ethinyl estradiol caused more marked changes than the natural estrogens. Conjugated estrogens were more potent than estrone sulphate and estradiol‐17β which had similar values. Estriol, irrespective of daily dosage, exerted a negative effect. The following sequence of equipotency was calculated: ethinyl estradiol = 100 × conjugated estrogens = 450 × estrone sulphate = 500 × estradiol‐17β = 650 × estradiol valerate. These data were compared with other estimates of estrogenic potency from the literature. Compared with other clinical methods, PZP induction offers several advantages. Factors such as intestinal absorption, protein binding and intracellular metabolism are included in the net result of an increased protein synthesis which is easily followed in patients' sera during therapy.
Vaginal absorption of two estriol preparations
Authors: Mattsson Lars‐ÅKe , Cullberg GÖRan
Published: December 2009

Abstract. In a comparative randomized cross‐over study the absorption of a single dose of 0.5 mg estriol from a vaginal cream or a vaginal suppository (OvestinR, Organon, The Netherlands) was studied. Eight healthy postmenopausal women participated and the preparations were given with an interval of 14 days. Blood sampling was performed twice before application and then after 1/4, 1/2, 1, 2, 4, 6, 8, 24 and 48 hours. Serum was analysed for unconjugated and conjugated estriol (E3), FSH and LH by radio‐immunoas‐say. Considerable interindividual variations in serum levels of unconjugated E3 were found but mean values were about equal throughout the study for the two preparations. Peak levels of 0.5 — 0.6 nmol/1 were achieved 1 — 2 hours after application of the preparations and after 24 hours no unconjugated E3 was measurable. Conjugated E3 rose rapidly but within 48 hours serum concentrations reached baseline levels. A maximum decrease in serum LH levels of about 40% was obtained with both preparations after 6 hours and the return to baseline within 24 hours indicates a relationship to unconjugated E3. FSH in serum was maximally suppressed 6—12%. Estriol is thus readily absorbed by the vaginal route and peak levels of unconjugated E3 after insertion of 0.5 mg estriol seem to be comparable to those obtained after 8‐12 mg estriol given orally.
A clinical evaluation of treatment with estriol vaginal cream versus suppository in postmenopausal women
Authors: Mattsson Lars‐ÅKe , Cullberg GÖRan
Published: December 2009

Abstract. Thirty postmenopausal women with vaginal atrophy were treated with a vaginal cream or vaginal suppositories containing 0.5 rag estriol (OvestinR, Organon, The Netherlands). The preparations were given daily for 14 days and then during the next 6 weeks a maintenance dose was applied twice a week.

Cervical mucus, vaginal cytology and the endometrium were studied. Blood samples were analysed for unconjugat‐ed and conjugated estriol, FSH, LH, prolactin and sex hormone binding globulin capacity, before and after 2 weeks of treatment. Subjective relief of vaginal symptoms was reported by all patients. Restoration of vaginal mucosa was confirmed by colposcopy. Some women noted a feeling of transient “vaginal heat” during the first days of treatment; otherwise no side effects were reported.

Higher values for Spinnbarkeit, ferning and karyopyk‐notic index were found for the cream group on day 14. No endometrial stimulation was detected as judged by light microscopy in any of the samples. No significant differences between the preparations were found for any of the hormone variables, or sex hormone binding globulin capacity, except for prolactin levels after 2 weeks of treatment. Possible reasons for the disparity between the two preparations regarding peripheral variables are discussed.
The Definition and the Significance of Decreased Fetal Movements
Authors: Sadovsky E. , Ohel G. , Havazeleth H. , Steinwell A. , Penchas S.
Published: December 2009

Abstract. The ability to diagnose severe chronic fetal distress‐impending death utilizing the six different definitions of decreased fetal movement (DFM) currently in use, was evaluated retrospectively in 616 high‐risk pregnant women. The study reveals the superiority of two definitions as prognostic tools: The “movements alarm signal” (MAS), i.e. no fetal movements (FM) for at least 12 hours with audible fetal heart beats, and “ten and less FM” (≤ 10 FM), i.e. ten or fewer FM in 12 hours. The application of these definitions distinguished two groups of patients which included significantly more poor outcomes than were contained by the groups of patients based on the other definitions. MAS was the definition also selecting the group with fewest false‐positive cases. The monitoring of FM while utilizing one of the above two definitions of DFM as cut‐off points for suspected impending fetal death is a useful adjunct in high‐risk pregnancy management.
Prognostic Importance of Ascites in Ovarian Carcinoma
Authors: Sorbe Bengt , Frankendal Bo
Published: December 2009

Abstract. In a well‐controlled series of 501 ovarian carcinomas the prognostic importance of peritoneal effusion (ascites) at the time of diagnosis was analysed by the life table technique (survival curves) and log‐rank resting. Ascites was present in 44.1% (221/501) of the new cases in the complete series but in 74.7% with stage III tumors and 55.5% with seropapillary adenocarcinomas. The histology and degree of differentiation were of no importance for the frequency of ascites within each individual tumor stage. In stage I tumors the occurrence of ascites is of prognostic significance per se, regardless of histology and grade, probably owing to the facilitation of tumor cell spread. In higher stages, tumor volume and spread are of the utmost importance and the presence or absence of peritoneal fluid does not affect the probability of survival.
Cardiovascular effects of terbutalin in pregnant women
Authors: Schwarz Reinhold , Retzke Ulrich
Published: December 2009

Abstract. Terbutalin, a β‐mimetic drug, appears to have a favorable β2: β1 ratio. It is suitable for uterine relaxation. Ten normotensive pregnant women with imminent premature labor were studied during intravenous infusion of terbutalin with the non‐invasive method of quantitative sphyg‐mometry. Cardiac output increased and total peripheral resistance decreased. As there was only slight variation in the arterial blood pressure, terbutalin is indicated especially in cases with hypotension.
New Cases of Irregular Blood Group Antibodies Other Than Anti‐D in Pregnancy
Authors: Kornstad Leif
Published: December 2009

Abstract. The frequency of irregular blood group antibodies detected for the first time in pregnant women during the period 1975‐80 has been examined. Whereas Rh(D)‐negative gravidae in Norway are examined immuno‐hema‐tologically three times during pregnancy, Rh(D)‐positive women are tested once only, usually early in pregnancy. Nevertheless, about one‐third of the new cases of immunization within the Rh system were found in the Rh‐positive women. In the latter, anti‐E and anti‐c were the Rh antibodies most frequently encountered. Among other irregular antibodies which can cause hemolytic disease of the newborn (HDN), those of the Kell and Duffy systems are the ones second in frequency and clinical significance to the Rh antibodies. In the present series about 40% of the new cases of immunization within the Rh, Kell and Duffy systems were found in Rh‐positive women. This proportion would undoubtedly have been greater if also the Rh‐positive women had been retested for the presence of irregular blood group antibodies towards the end of the gestation. Such a retesting of Rh‐positive gravidae is desirable both for a better prediction and early diagnosis of HDN and to facilitate the procurement of compatible blood if the woman should need an emergency blood transfusion.
Pregnancy and Venous Thrombo‐Embolism
Authors: Bergqvist D. , Hedner U.
Published: December 2009

Abstract. In 30 patients with objectively diagnosed and 13 with clinically diagnosed venous thrombosis during pregnancy the extension and localization of the thrombotic process was analysed in relation to the coagulation and fibrino‐lytic status at least 6 months after thrombosis. Left‐sided thrombi pre‐dominated, being more extensive and proximal on the left side. Most thrombi started during the last two trimesters. Few changes were found in the coagulation system. Nineteen per cent of the patients showed a defective fibrino‐lytic system, as diagnosed by a reduced release capacity and/or a reduced fibrinolytic activity in the vessel wall. No great differences were found between patients with clinical vs. objective diagnosis.
Variations in the effect of epidural morphine in gynecological and obstetric patients
Authors: Niv David , Rudick Valery , Chayen Mark S. , David Menachem P.
Published: December 2009

Abstract. A prospective study was performed on the effect of epidural morphine (2 mg in 10 ml of saline) in three groups of patients: (1) following gynecological operations, 60; (2) following cesarean section, 120; (3) patients in active labor, 30. Pain relief in the first group was uniformly and almost invariably complete for up to 24 hours. In the second group spasmodic visceral pain was felt after about 10 hours, relieved by light analgesics. The wound was not painful. In the third group only hypoalgesia was obtained during labor, but if an episiotomy was done, the pain in the perineum was relieved. Few side effects were observed: urinary retention, vomiting, and non‐segmental itching. Neither motor nor sympathetic block were noted. The somatic effect of epidural morphine was reliable and uniform, whereas visceral pain was poorly affected. The side effects cause relatively little disturbance at the dose used.
Peripheral Hormone Levels and the Endometrial Condition in Postmenopausal Women
Authors: Brody S. , Carlström K. , von Uexküll A.‐K. , Lagrelius A. , Lunell N.‐O. , Rosenborg L.
Published: December 2009

Abstract. Thirteen postmenopausal women with benign endometrial changes including proliferative, secretory and polypous endometrium, endometrial hyperplasia and atypia (group I) and 13 randomly selected age‐matched controls with normal atrophic endometrium (group II) were studied with respect to serum levels of dehydroepiandrosterone (DHA) and its sulfate (DHAS), testosterone, total estrone, estradiol‐17β, progesterone, FSH and prolactin. Serum levels of DHA, DHAS, testosterone and total estrone were significantly higher in group I than in group II; otherwise no significant differences Were found. Mean values for body weight and for Broca's index, respectively, were almost identical in the two groups.

It is speculated that the adrenal androgens may affect the endometrium in two ways, viz. via peripheral conversion to estrogens and/or via direct interaction with endometrial steroid receptors. The results give further support to the hypothesis of an association between adrenocortical hyper‐activity and endometrial abnormalities including endometrial carcinoma.
The 24‐Hour Rhythmicity of birth
Authors: Glattre Eystein , Bjerkedal Tor
Published: December 2009

Abstract. The incidence of birth has been determined for each hour of the day for all births in Norway in 1968–1977 of fetuses of 16 weeks of gestation or older, with resident mothers. The 24‐hour incidence variations of births (A) with spontaneous onset and parturition, (B) with spontaneous onset, but delivery intervention, (C) with induced onset, but spontaneous birth, and (D) with induced onset and delivery intervention, are all different.

It is shown that the curve for the hourly incidence of birth category A coincides very well with previous results of other workers. When multiple births are excluded and category A is split into first and later births in Northern and Southern Norway, dissimilarities arise between the respective 24‐hour incidence curves.

The results indicate that the 24‐hour birth incidence variation has an underlying endogenous, circadian rhythmicity ‐possibly synchronized by the sun.

The 24‐hour rhythmicities of birth categories B, C and D seem to be purely exogenous ‐ reflecting the working activity rhythms of hospital obstetricians and midwives.
Intra‐Uterine Growth and Fatal Fetal Abnormality
Authors: Kirkinen Pertti , Jouppila Pentti , Herva Riitta
Published: December 2009

Abstract. To study intra‐uterine growth in pregnancies complicated by fatal abnormality of the fetus, 73 pregnancies involving fetal or neonatal death caused by malformation, chromosomal aberration or Mendelian disease were evaluated. Small‐for‐gestational age newborns were found in 45% of the patients, and this finding was typical of 18‐trisomies, amnion adhesion syndrome fetuses and multimalformed fetuses. Pregnancies affected by a Mendelian disease or a single fetal malformation mostly presented normal intra‐uterine growth. In 25% of the patients, the symphyseal‐fun‐dal growth was retarded; this retardation started on average in the 25th gestational week. Polyhydramnios was present in 30% of the patients and was expressed in growth acceleration of the symphyseal‐fundal measurement from the 28th gestational week. In 45% of the small‐for‐gestational‐age fetuses the biparietal growth showed low profile type retardation. The brain‐sparing phenomenon in growth was found in 21%. To assess the prospects of the conceivable modes of treatment, the need for an exact diagnostic evaluation of all pregnancies complicated by intra‐uterine growth retardation and a consideration of the need for diagnostic amniocentesis in cases of early growth retardation is emphasized. This also applies to the time after legal abortion.
Ultrasound Demonstration of the Amniotic Membrane
Authors: Mantoni Margit , Pedersen Jan Fog
Published: December 2009

Abstract. Ultrasound scanning in the first trimester of pregnancy occasionally revealed a thin linear echo in the gestational sac. A total of 360 examinations, which had shown a live fetus with a crown‐rump length of 7–82 mm, equivalent to a menstrual age of 6–14 weeks, were reviewed. The linear echo was seen in 51 of the examinations, at an ultrasound age of 6–12 weeks. Most frequently it was seen in the 9th week, where it was recorded in 28 of 61 (46%) of the examinations. The origin of the linear echo is believed to be the very thin amniotic membrane, which from the 8th to the 12th week is lined by fluid on both sides. Other intra‐uterine membranes which all give stronger echo reflections are listed.