bluuebunny/crossref_metadata_2025 huggingface dataset:
Acid‐Base and Electrolyte Balance in Infants of Diabetic Mothers
Authors: Thalme B. , Edström K. , Broberger U. , Engström L. , Kretzschmar G.
Published: December 2009

Abstract. The acid‐base and electrolyte balance of 30 women was studied at delivery and in their infants during the first 48 h. 18 women were diabetics, 10 of these were delivered vaginally (DMvag) and 8 by elective caesarean section (DMcs). 12 healthy women were vaginally delivered (HMvag). The infants of diabetic mothers (IDM) received active infusion therapy. At birth the DMvag and their infants (IDMvag) had a more pronounced metabolic acidosis than the DMcs and their babies (IDMcs). The largest metabolic acidosis occurred, however, in the group of HMvag and their infants (IHMvag). After birth no significant differences were obtained in the acid‐base and electrolyte balance between IDMvag and IDMcs. The plasma potassium level remained lower in IDM than in IHM. The study stresses the importance of adequate management of diabetes in pregnancy in combination with active intravenous therapy during delivery and to the infant in the immediate neonatal period. The slightly larger metabolic acidosis seen in combination with vaginal delivery suggests that this mode of delivery should not be attempted uncritically in diabetic women.
Serum Levels of Oestradiol and Progesterone During Administration of Prostaglandin F2α for Induction of Abortion and Labour
Authors: Widholm O. , Kajanoja P. , Johansson E. D. B.
Published: December 2009

Abstract. Prostaglandin F2α was used to induce abortion or labour in 84 women between the 11th and 44th weeks of pregnancy. Three different routes of administration were used, intravenous, extra‐amniotic, and intra‐amniotic. The extra‐amniotic infusion of prostaglandin F2α produced a faster response than the other two routes. Less than one‐third of the dose used in the intra‐amniotic group was required in the extra‐amniotic group for a complete evacuation of the uterus. Vomiting and diarrhoea occurred in 40% of the women in the intra‐and extra‐amniotic group, while the frequency was 88% in the intravenous group. Serum levels of progesterone and oestradiol decreased in accordance with the pattern found during spontaneous deliveries. The effect of prostaglandin F2α on the myometrium does not appear to be mediated via changes in the blood levels of progesterone or oestradiol.
Urge Incontinence in Women
Authors: Ingelman‐Sundberg Axel
Published: December 2009

Abstract. A survey has been presented of the author's personal methods to treat urge incontinence in women caused by neurogenic disturbances or by urethritis. Denervation of the bladder by unilateral or bilateral resection of the inferior hypogastric plexus is used for neurogenic disturbances with uninhibited bladder contractions or hypertonic bladders and in cases of interstitial cystitis, if a preoperative blockade with local anaesthesia has given a favourable result. Urethral diverticula are extirpated. Urethritis is treated with careful dilatation of the urethra and massage in combination with local treatment of the mucosa with 1% solution of silver nitrate. In cases with a narrow urethral orifice a meatotomy is made. Women with wide external urethral orifice and recurrent urethritis following intercourse are operated upon. A structure similar to the frenulum of the prepuce in the male is constructed, which closes the orifice at the introduction of the penis.
Relationship Between Endometrial Arias‐Stella Phenomenon and Concentrations of Urinary Chorionic Gonadotropin and Serum Human Placental Lactogen
Authors: Ylikorkala Olavi , Korhonen Matti
Published: December 2009

Abstract. Serum placental lactogen (HPL) and urinary chorionic gonadotrophin (HCG) were measured in 14 patients with the endometrial Arias‐Stella phenomenon and in 35 comparable patients without this reaction in order to explore a possible causative relationship between the hormonal levels and the endometrial changes. The concentrations of HPL and HCG were similar in both groups of patients, indicating a lack of correlation between the levels of these two hormones and endometrial changes.
Studies in Cholestasis of Pregnancy
Authors: Johnson P.
Published: December 2009

Abstract. Pregnant women with pruritus and with cholestasis of pregnancy verified from the medical history and by the presence of lipoprotein‐X in serum have been studied. Thirty‐nine patients were investigated for serum lipids (cholesterol, phospholipids, and trigly‐cerides), serum lipoproteins (high‐density‐lipoproteins cholesterol and estimated low‐density‐lipoproteins cholesterol), and for hematological data (serum iron and serum iron binding capacity), in relation to duration of pruritus. In 28 patients the serum lecithin concentrations and fatty acid compositions were also analysed. Severity and duration of the disease appeared to influence the lipid/lipo‐protein metabolism. The results support the hypothesis of an abnormal reaction of liver metabolism to estrogens in the initial stage of cholestasis of pregnancy.
Quantitative Analysis of Radioisotopic Angiography in Trophoblastic Neoplasia
Authors: Tojo Shimpei , Yamashita Sumio , Tanaka Minoru , Matsuzoe Yasuyo , Mizuhata Koji
Published: December 2009

Abstract. The diagnostic significance of radioisotopic angiography in the clinical management of trophoblastic neoplasia was studied by analyzing the patterns of radioisotope (RI)‐dynamic curve obtained by processing sequential image with a computer, and an attempt was made to express numerically the size of tumors present in vivo. It was demonstrated that the total activities of RI in the abnormal phase of RI‐dynamic curves in trophoblastic neoplasia were closely correlated with the sizes of the intrauterine tumors actually resected.
Patterns of Free Fatty Acids, Glycerol, D‐β‐Hydroxybutyrate and Insulin in Pregnant Women and Their Newborn Infants
Authors: Edström Karin , Persson Bengt , Cerasi Erol , Luft Rolf
Published: December 2009

Abstract. Twenty‐eight healthy women, 17 with high and 11 with low insulin response to glucose but with normal glucose tolerance, were followed throughout pregnancy. Plasma FFA, glycerol and D‐β‐hydroxybutyrate as well as plasma insulin and glucose in blood were determined before and during a glucose infusion test (GIT) in each trimester and after pregnancy. In 13 infants of high insulin responders (IHR) and 10 infants of low responders (ILR) an intravenous glucose tolerance test (IVGTT) was performed, and the above lipid parameters were studied at birth and during the IVGTT. The low responder group was postulated to consist mainly of prediabetic individuals (8). Their infants have previously been shown to have an increased glucose assimilation rate at IVGTT (12, 13), as has been shown for infants of diabetic mothers.

There was little difference between the two groups of mothers except for the insulin levels during the GIT in non‐pregnant and early pregnant subjects, which were considerably lower in the low responders. They all had decreased fasting levels of FFA, glycerol, and D‐β‐hydroxybutyrate in mid‐pregnancy and normal values in late pregnancy. The ILR showed the same changes in FFA and glycerol as the IHR, but their d‐β‐hydroxybutyrate levels were higher at birth than those of the IHR and lower after birth. Another difference found, was the correlation between birth weight and fasting insulin (and to some extent the insulin level at birth) in the ILR group, which was not found in the IHR. Apart from those differences the ILR and the IHR seemed to handle their fat metabolism in a similar way in the early neonatal perinatal period.
Phospholipids and Creatinine in Amniotic Fluid in Relation to Gestational Age: I. Normal Pregnancy
Authors: Fex Göran , Holmberg Nils‐Gunnar , Löfstrand Tord
Published: December 2009

Abstract. 185 samples of amniotic fluid were obtained from 174 healthy women with uncomplicated pregnancies in the 15th‐43rd week of pregnancy by abdominal amniocentesis or by puncture of the amniotic sac via an amnioscope. The concentrations of creatinine (183 cases), phospholipid phosphorus and the ratio of lecithin/sphingomyelin (L/S‐ratio, 130 cases) were determined. The treatment of the amniotic fluid samples (centrifugation, filtration and lipid extraction) and the methods for the determination of L/S‐ratio were examined and the accuracy and limitations of the latter method were defined and discussed. The relative amounts of lecithin and sphingomyelin as well as the L/S‐ratio and creatinine concentration were closely correlated to gestational age. A L/S‐ratio of ≥2.25 indicated all women to be ≥34th week of pregnancy; 64% of them had reached the 38th week. A creatinine concentration of ≥1.8 mg% corresponded to x ≥35th week of pregnancy, while 75% of the women had reached at least the 38th week. With a L/S‐ratio ≥2.25 and a creatinine concentration ≥1.8 mg% of all women were ≥ the 36th week. 71% of the women ≥ the 38th week fulfilled these critiera. A combination of the two parameters seems to be of a great value in discrimination between gestational ages < the 36th week and ≥ the 38th week.
On some Late Effects of Bilateral Oophorectomy in the Age Range 15–30 Years
Authors: Johansson B. W. , Kaij L. , Kullander S. , Lennér H.‐C. , Svanberg L. , Åstedt B.
Published: December 2009

Abstract. Between 1910 and 1940, 146 young females, aged 15–30 years, underwent bilateral salpingo‐oophorectomy as part of a radical operation for salpingo‐oophoritis. These women or their records were reviewed in 1971. 42 women had died in the meantime. More than half (22) of them had died from cardiovascular diseases, 5 from carcinoma of the uterus and 4 had committed suicide. None had died from carcinoma of the breast. Of 68 who were still alive, information by questionnaire was obtained and 32 were admitted to hospital for extensive examination. 32 age‐matched women to be operated on for prolapse but with no other known disease of the reproductive tract served as controls. A further control group was added as 11 of the 68 were found to have menstruated again after the operation which had evidently not completely removed the gonads. Complete oophorectomy was found to have been followed by: (a) an increased incidence of cardiac symptoms and nervous diseases as well as an increased use of drugs; (b) a significant increase in the frequency of coronary vascular diseases in ages up to 70 years; (c) an increase in the serum cholesterol and triglycerides, most significantly in the ages below 60‐65 years. Women with symptomatic coronary disease had a higher serum cholesterol level than women without and women with signs of peripheral vascular diseases had a significantly higher concentration of serum triglycerides: (d) an increased frequency of fractures (radius and femoral neck), increased osteoporosis and thinner cortical bone. The brittleness of the skeleton was correlated with low excretion of oestrogens in the urine. No vertebral compression or abnormal decrease in height was observed, (e) an increased adrenocortical activity with significantly increased excretion of 17‐ketosteroids, 17‐OH‐ketosteroids and low polar total oestrogens. This activity abated in women above 65 years. (f) a traumatic psychological experience of the accompanying sterility while sexuality seemed to be largely unaffected in many of them. Almost half of the women examined by the psychiatrist were unusually mentally active and agile and they had a lower excretion of estriol than the rest.
Progesterone Therapy in Pre‐Eclamptic Toxaemia
Authors: Sammour Mohamed B. , El‐Kabarity H. , Khalifa A. S.
Published: December 2009

Abstract. Progesterone was the principal therapeutic agent used in 40 cases of pre‐eclamptic toxaemia. It was also given to 10 normal pregnant women who served as a control group. A significant fall in both the systolic and diastolic blood pressures was observed in 80% of the toxaemic patients. In all cases there was a marked increase in the 24‐hour urinary output with an apparent loss of weight. Serum uric acid showed a significant drop and the urea clearance values also improved. The serum sodium showed an apparent decline while the serum potassium did not show any marked variation. The serum uric acid, urea clearance, blood urea, serum sodium and serum potassium remained unchanged in the control group.
Dysmenorrhea in Industrial Workers
Authors: Bergsjø Per , Jenssen Helge , Vellar Odd D.
Published: December 2009

Abstract. In two Norwegian industrial companies 234 women of menstruating age were examined by the industrial nurse with regard to menstrual complaints. Every second woman experienced pain, 23% had consulted a doctor previously, about 30% had to stay in bed, and about 30% had been absent from work recently due to dysmenorrhea. Although pain was prevalent in all age groups, there were age‐specific differences in other complaints, such as headache and depression, which were more frequent among the older women. In a selected group of 32 women with severe complaints, the history and gynecological examination indicated secondary dysmenorrhea in only a few cases. Hormonal assays and endometrial biopsy indicated anovulatory cycles in 4 out of 12 women, in spite of dysmenorrhea.
Observer Error in Ultrasonic Fetal Cephalometry
Authors: Bergsjø Per , Bakke Trygve , Salamonsen Lois
Published: December 2009

Abstract. Although ultrasonic fetal cephalometry gives quite accurate results, a certain degree of observer error must be expected. In a series of duplicate measurements, the magnitude of this error has been assessed. The observer error was lowest when the fetal head was partly engaged in the pelvic inlet, when the midline echo was clearly observed, and when an obstetrician with experience in ultrasonography performed the examinations. The observer error should be taken into account when growth indices are evaluated in the individual patient.
Short Term Changes in Stillbirth Rates in Sweden, 1965–1971
Authors: Sandahl Björn
Published: December 2009

Abstract. An investigation was made of short time changes in stillbirth rates in Sweden 1965–1971. The data is based on official statistics from the whole of Sweden. The material has been divided into three maternal age groups: less than 30 years, 30–34 years, and 35 years or more. Division by parity was made in five groups, parity 1, 2, 3, 4, and 5 or higher (5+). The stillbirth rates in most groups show an approximately steady level or a very slight decrease during the years under study. However, the parae 1, 2, and 5+ in the age group 35 years or over, and para 5+ in age group 30–34 years, deviate from this pattern. There is a decrease to 1969, followed by an increase. To test the apparent increase in stillbirth risk during the period 1969–1971 for high‐risk groups a X2‐analysis was made. For parae 1, 4, and 5+, aged 35 years or more, a significant heterogeneity between years was found. This increase cannot be explained by a shift in age distribution within the age group ≥35 years. Exogenous factors may be involved, and further studies are planned in order to solve the problem.
The Effect of Norethindrone and Some Other Synthetic Gestagens Upon the Peripheral Plasma Levels of Progesterone and Estradiol During Early, Human Pregnancy
Authors: Nygren Karl‐Gösta , Johansson Elof D. B.
Published: December 2009

Abstract. Synthetic gestagens were given orally (norethindrone, d‐norgestrel, chlormadinone acetate) or intramuscularly (17α‐hydroxyprogesterone caproate) during 25 early, human pregnancies. The peripheral plasma levels of progesterone and estradiol were determined before, during and after the treatment. Norethindrone was most extensively used and in those women who received this gestagen the peripheral plasma levels of norethindrone were estimated by radioimmunoassay. No consistent effect upon the levels of progesterone or estradiol was observed. In 23 women no vaginal bleeding and no abortion occurred within about a week after the treatment. The pregnancies were terminated surgically. Histological examination of specimens from these abortions revealed no differences on comparison with 10 non‐treated controls. Two women aborted after the treatment, but judging from the hormonal levels these pregnancies were abnormal and would probably have aborted regardless of the treatment.
Studies in Cholestasis of Pregnancy
Authors: Johnson P. , Samsioe G. , Gustafson A.
Published: December 2009

Abstract. Fifty‐nine consecutive pregnant women complaining of pruritus without obvious dermatological cause were studied. In 57 women the presence in serum of an abnormal lipoprotein, LP‐X, characteristic conditions associated with cholestasis, was verified by an immunological technique. These 57 women were designated as having cholestasis of pregnancy. Clinical symptoms were related to liver function tests: serum bilirubin, alkaline phosphatase, SGOT and SGPT. Compared with women with uncomplicated pregnancy, these patients showed a high frequency (p<0.05) and long duration (p<0.001) of emesis, food‐ and drug idiosyncrasy (p<0.001) and gall bladder disease (p<0.05).

Based on liver function tests two groups of patients with different degrees of severity of cholestasis of pregnancy were differentiated. Thirteen cases, characterized by serum bilirubin >1.2 mg/100 ml and/or SGOT and SGPT >50 units/1, were called hepatosis of pregnancy (HP), while 37 cases with pruritus gravidarum (PG) represented a milder degree of cholestasis.
Alpha‐Fetoprotein in Amniotic Fluid and Serum from Pregnant Women with Severe Rhesus Isoimmunization
Authors: Bock Johannes E. , Nørgaard‐Pedersen B. , Trolle Dyre
Published: December 2009

Abstract. In 12 pregnant women with severe rhesusisoimmunization the AFP concentration in amniotic fluid (50 samples), maternal serum (212 samples) and cord blood (5 samples) were determined by immuno‐electrophoresis. With surviving infants (9 patients) the initial values in amniotic fluid before intrauterine transfusion (IUT) lie evenly distributed within the 90% reference interval. In serum the initial values are within the 90% reference interval, but above the mean level for AFP concentration for gestational age. A similar pattern is seen in the period up to delivery. In 3 cases of intrauterine/neonatal death the initial concentrations of AFP in maternal serum were significantly above the upper limit of normal range, whereas all the initial amniotic fluid concentrations were close to 95% fractile. Intrauterine transfusions do not influence the AFP profiles in a uniform way. The AFP concentration in maternal serum may be used in evaluation of severe rhesus‐isoimmunized pregnancies.
A Follow‐Up Study on Infants Who Received Intra‐Uterine Transfusions Because of Severe Rhesus Haemolytic Disease
Authors: Bock Johannes E. , Winkel S.
Published: December 2009

Abstract. The developmental characteristics of infants surviving the neonatal period after the performance of prenatal intra‐uterine transfusions because of severe rhesus haemolytic disease were studied in 17 of 19 children, using the revised Denver Developmental Screening Test and a physical‐neurological examination. The children ranged in age from 5 to 91 months. Two cases are reported as having retarded psychomotor development. No cases of cerebral palsy were found. Among the minor abnormalities were squints, abdominal hernia and enamel defects. The results justify the use of intra‐uterine transfusions in appropriately selected fetuses when combined with treatment of hyperbilirubinaemia and respiratory distress during the neonatal period.
FOUR YEARS OVERALL EXPERIENCE WITH A NEW LOW ESTROGEN‐LOW PROGESTOGEN ORAL CONTRACEPTIVE
Authors: Brat Th.
Published: December 2009

Abstract. The reliability and the overall clinical acceptance of a new combined oral contraceptive, containing 30 mcg of ethinyl estradiol and 0.15 mg of D‐norgestrel, was studied in 102 patients over 1,731 cycles. The results have been accumulated over a period of four years, some of the subjects still using the presented formulation. No pregnancy occurred during the observation period. Out of the totally observed cycles, 94.3 per cent had a duration of 28 ± 2 days. In only 1.7 per cent of the cycles did withdrawal bleeding fail to appear. Spotting and breakthrough bleeding occurred in 3.6 and 3.8 per cent of the cycles respectively. The incidence of side‐effects reported by the users and commonly associated with oral contraceptive use was relatively low.
Serum Lipids and Fatty Acid Composition of Serum Lecithin in the Non‐Pregnant State in Patients with Previous Cholestasis of Pregnancy
Authors: Samsioe Göran
Published: December 2009

Abstract. Serum lipids and fatty acid composition of serum lecithin were studied 8‐21 months after delivery in 20 non‐pregnant women who during their latest pregnancy had presented signs of CP. These women were compared with normal non‐pregnant women (n = 18) and with patients with cholestasis of pregnancy (CP) (n = 28). In the non‐pregnant state women with previous cholestasis of pregnancy (CP) showed in serum lecithin a low relative content of palmitic (16:0) and linoleic (18:2) acids and a high portion of stearic acid (18:0). These findings indicate as a basic defect in CP, a reduction in liver lecithin synthesis via pathway I (Kennedy's pathway) in favour of an increased pathway II (Greenberg's pathway). These data further support the hypothesis of increased estrogen activity as an etiological factor in CP. The basic influence by pregnancy on serum lipids and serum lecithin fatty acid composition was the same in women with CP as in women with a normal pregnancy.
On Radiation‐Decreased Fibrinolytic Activity of Vessel Walls
Authors: Svanberg Lars , Åstedt Birger , Kullander Stig
Published: December 2009

Abstract. Fibrinolytic activity was histochemically determined in biopsy specimens of the walls of human veins (vv. epigastricae superficiales) obtained from 15 patients after irradiation of the lower abdomen because of malignant genital diseases and compared with non‐irradiated controls. The activity was significantly lower (p>0.001) after radiotherapy.
A New Technique for Measurements of the Urethra Pressure Profile
Authors: Asmussen M. , Ulmsten U.
Published: December 2009

Abstract. A new standardized technique for continuous recording of the urethral pressure profile simultaneously with intravesical pressure has been developed. The pressures were recorded using two micro‐transducers enclosed in a thin Dacron catheter. The catheter moved with a constant speed through the urethra with the aid of a specially designed instrument. This instrument is described. Twenty‐five healthy women were examined. The patients were divided into two groups: (A) 10 post‐menopausal women, and (B) 15 fertile women. The results of the recordings showed that the functional length and the absolute length of the urethra could be reproduced with an error of >1 mm. The maximal pressure amplitude was significantly less in group A.
Secondary Amenorrhoea and Oral Contraceptives
Authors: Ingerslev Mogens , Jeppesen Thomas , Ramsing Ellen‐Maria
Published: December 2009

Abstract. Eighty‐seven cases of secondary amenorrhoea of more than 6 months' duration developing after treatment with oral contraceptives (group I) were compared with 227 cases of secondary amenorrhoea not preceded by treatment with combined tablets (group II). The two groups were collected during the same period. The average age of the patients was 4 years higher in group I than in group II. Oligomenorrhoea had previously occurred in 30% of group I and in 46% of group II. Pronounced predisposing factors, such as psychogenic trauma and stress with or without considerable change in body weight, were encountered in 26% in group I and 56% in group II. The incidence of increased urinary output of 17‐keto steroids, 17‐ketogenic steroids and of hirsutism was slightly higher in group II. The percentage of eosinophilic cells in vaginal scrapings was low in 20% in group I as compared with 46% in group II. Spontaneous return of pituitary‐ovarian function occurred in 40% in both groups. Patients recovering spontaneously in group I presented a maximum during the first few months, followed by a steady and fairly uniform decline. Spontaneous recovery in group II was more or less independent of time. It seems reasonable to believe that oral contraceptives did promote or contribute to the development of secondary amenorrhoea in about 50%, representing cases with various predisposing factors. A causal relation between oral contraceptives and secondary amenorrhoea was indicated in the remaining 50% because of perfectly normal ovarian function before treatment and absence of predisposing factors.
Prognosis, Recurrences and Metastases Correlated to Histologic Cell Type in Carcinoma of the Uterine Cervix
Authors: Johansson O. , Johnsson J. E. , Lindberg L. G. , Sydsjö A.
Published: December 2009

Abstract. An analysis of 230 patients treated with radiotherapy for cervical cancer stages I and II is presented. No positive correlation to cell type was found as regards the number of failures, recurrence rate or the frequency of regional or distant metastases. Although different biological behavior might be shown by cancers of varying cell types, adequate planning and staging before treatment seems to be of better prognostic value.
Survey Radiography of Abdomen Following Caesarean Section, with Particular Reference to Caecal Diameter and the Presence of Free Subdiaphragmatic Gas
Authors: Lawaetz O. , Jensen H. Kålund
Published: December 2009

Abstract. The literature concerning perforation and imminent perforation of the caecum is reviewed. The greatest importance is attached to 5 cases of perforation of the caecum associated with paralyticileus following Caesarean section. The caecal diameter was determined by radiography in 100 patients on the 3rd and 5th day after Caesarean section. At the same time the volume of subdiaphragmatic free gas was assessed. An average caecal diameter of 6.4 cm was found, which is not different from the findings in the normal population. Increasing caecal diameter during the puerperium gives rise to suspicion of the caecum. In 90% of the patients free subdiaphragmatic gas disappeared by the 5th day after Caesarean section.
Induction of the “Pregnancy Zone” Protein by Conjugated Oestrogens
Authors: Damber M. G. , von Schoultz B. , Stigbrand T.
Published: December 2009

Abstract. Treatment with conjugated oestrogens was found to increase significantly the serum concentration of the pregnancy zone protein (PZ) in a group of postmenopausal women. The basic level of PZ before treatment was comparatively high in this group of women and might be related to age and previous pregnancies. Naturally occurring conjugated oestrogens have a similar effect on the induction of PZ as synthetic oestrogens.
Tubal Sterilization: With Special Reference to Electrocoagulation through the Laparoscope
Authors: Nilsen Per Agnar , Jerve Fridtjof
Published: December 2009

Abstract. In the past 5 years 1168 tubal sterilizations have been performed. One thousand and twelve of these were performed by dividing the tube by diathermy through the laparoscope. Since the first cases, and with increasing experience, complications have been infrequent, at the most a slight bleeding from the mesosalpinx. So far we have had ten failures, probably due to lack of experience. In every failure it was found at re‐examination that the tube had not been divided—at least at one side. The method is quick and simple. The patient suffers little inconvenience, has a very small scar and is in hospital only a short time. It has been used in post‐partum cases, but is not suitable for patients who have had several abdominal operations.
Amniotic Fluid Lecithin Concentrations in Pregnancies Complicated by Hypertensive Disorders and Intrauterine Growth Retardation
Authors: Lindback T.
Published: December 2009

Abstract. Amniotic fluid lecithin has been measured in 92 samples from 75 patients with hypertensive disorders and in normotensive pregnancies complicated by intrauterine growth retardation (IUGR). For the group with hypertensive disorders the lecithin concentrations were not significantly different from a reference material at any stage in gestation. Pre‐eclampsia associated with moderately elevated blood pressure and complicated by IUGR showed significantly higher lecithin concentrations than any other diagnostic subgroup. The lecithin concentrations showed no relationship to maternal urinary estrogen excretion. The value of serial estrogen measurements in predicting IUGR has been emphasized. An evaluation of the amniotic fluid lecithin concentration in relation to respiratory function has been made. Respiratory distress syndrome may occur even in growth retarded babies.
Outcome of Pregnancy After Clomiphene Therapy
Authors: Ahlgren Mats , Källen Bengt , Rannevik Gunnar
Published: December 2009

Abstract. Of 159 pregnancies conceived after clomiphene therapy, 141 ended in childbirth, including seven sets of twins. There was a probable increase in the number of infants born with major malformations. These were exclusively to women who had not previously borne a normal infant. The incidence of malformed infants compares well with that published after gonadotropin therapy. The possibly higher incidence of malformations seen after drug‐induced ovulation would therefore seem to be due to the underlying subfertility state and thus not a direct drug effect.
The Value of Amniotic Fluid Lecithin/Sphingomyelin Determination in Prediction of Hyaline Membrane Disease
Authors: Löfstrand Tord , Fex Göran
Published: December 2009

Abstract. 246 samples of amniotic fluid were obtained from 245 women with normal or complicated pregnancy near or at parturition. the lecithin/sphingomyelin (L/S) ratio was determined and retrospectively correlated with the clinical course of the neonate. Ten neonates developed hyaline membrane disease (HMD). the highest L/S‐ratio in this group was 1.82. Cesarean section was not associated with HMD if L/S‐ratio indicated pulmonary maturity (L/S>2). with the exception of children born by women with toxemia or chronic hypertensive disease, where no case of HMD appeared among nine infants, children with birth weights <2 000 g developed HMD in about 50% (6/11 cases). the results show that the L/S‐ratio correlates well to the pulmonary maturity of the neonate. Determination of L/S‐ratio is therefore of great importance in cases of high risk pregnancy or doubtful gestational age prior to induction or Cesarean section.
Correlation of Maternal Physical Fitness During Pregnancy with Maternal and Fetal Ph and Lactic Acid at Delivery
Authors: Erkkola R. , Rauramo L.
Published: December 2009

Abstract. The physical fitness of 120 healthy primi‐gravidae was determined two weeks before term using first the standardized three‐stage submaximal work test and on the following day the voluntarily maximal pulse‐conducted work test on a bicycle ergometer. After the first test the level of lactic acid in the capillary circulation of 115 mothers was examined. Immediately after delivery the pH and the level of lactic acid in the maternal artery, umbilical vein and umbilical artery were determined. the level of lactic acid after the work test was negatively correlated with the physical performance of the mother. the level of lactic acid in the mother after the work test and the levels of lactic acid in the umbilical vessels were positively correlated. the mean pH value in physically fit women after delivery was almost significantly higher than in the women of below average performance. the pH level in the umbilical artery was also almost significantly higher in the mothers with above average performance. the physically fit women appear to work more during delivery than the less fit mothers, as the level of lactic acid after the delivery was as high as or higher than in mothers with a physical performance below average. the physical fitness of six mothers, who delivered an asphyxiated baby, was almost significantly lower than the performance of the mothers. Five mothers with an exceptionally high pH after delivery had a significantly higher performance than the other mothers.
Radioisotope Radical Operation for Cancer of the Cervix
Authors: Gitsch Eduard
Published: December 2009

Abstract. By performing the radioisotope radical operation (pre‐surgical labelling of the lymphatic tissue of the pelvis with colloidal 198Au) with the aid of a gamma camera, it was possible in 78 out of 93 cases to completely extirpate the regional lymphatic tissue of the pelvis. in eight out of 24 cases with positive findings on the lymph nodes we were also able to extirpate with this technique residues of carcinomatous lymphatic tissue during the course of a secondary isotope lymphadenectomy. This fact is likely to further improve the recovery rate—all the more so since even the scanner and eye probe technique already reduced the mortality rate due to recurrence by 16.4% after 5 years.
CHANGES IN SERUM LIPIDS DURING TREATMENT WITH NORGESTREL, OESTRADIOL‐VALERATE AND CYCLOPROGYNON®
Authors: Nielsen F. Hassing , Honoré E. , Kristoffersen K. , Secher N. J. , Pedersen G. Thomsen
Published: December 2009

Abstract. The serum concentrations of triglycerides, cholesterol, and free glycerol were determined in 23 climacteric women, before and after the administration of three different steroid drugs. Each drug was given within a period of 12 weeks (3 cycles). Period I: Norgestrel, 0.5 mg daily from the 12th to 21st day of each cycle. Period II: Oestradiol‐valerate (Progynon®) 2 mg daily from the 2nd to 21st day of each cycle. Period III: Oestradiol‐valerate 2 mg from the 1st to 11th day followed by oestradiol‐valerate 2 mg+0.5 mg dl‐norgestrel from day 12 to 21 of each cycle (Cycloprogynon®). A significant decrease in triglycerides was observed following the administration of norgestrel and Cycloprogynon®, whereas oestradiol‐valerate had no effect on the triglyceride levels. On the other hand, oestradiol‐valerate, following a period of norgestrel, produced an increase in serum cholesterol levels.
SOME METHODOLOGICAL ASPECTS IN THE PSYCHOSOMATIC GYNAECOLOGY
Authors: Fedor‐Freybergh Peter , Zador Goran
Published: December 2009

Abstract. Psychosomatic medicine—and thus psychosomatic gynaecology—is presented as an approach to be used by doctors when meeting the patient. At the same time it is a method, a technique, trying to elucidate the mechanisms in the most complicated interplay between the psychological, somatic and social “parts of the whole”. Some diagnostic methods which can be used in this connection are discussed. The basic aim of the paper is to show the necessity and the possibility for the gynaecologist to use new technique from the psychodiagnostic field in his daily practice in order to achieve a better understanding of his patienťs complaints and needs.
PUBOCOCCYGEAL REPAIR AD MODUM INGELMAN‐SUNDBERG
Authors: öbrink Anders
Published: December 2009

Abstract. Fifty‐one women operated on for stress incontinence with pubococcygeal repair ad modum Ingelman‐Sundberg between 1955 and 1965 were investigated urogynecologically. The time of observation was accordingly at least 10 years in every case. An evaluation was made of this operation method, the distribution of recurrences during the postoperative period and possible side effects. Eight women had symptoms of at least degree I stress incontinence and thirteen showed signs of incontinence at the examination. Only four had both symptoms and signs of incontinence. The cure rate from a symptomatic point of view was 84% and from the technical aspect 75%. Most of the severe recurrences occurred in the first postoperative year. Thereafter the recurrences were evenly distributed. The only side effect in the long run was a tendency to rectocele.
INFRAVESICAL NERVE RESECTION FOR DETRUSOR DYSSYNERGIA
Authors: Hodgkinson C. Paul , Drukker Bruce H.
Published: December 2009

In 1959 a paper was published in Acta Obstet Gynecol Scand (38: 487, 1959) by Axel Ingelman‐Sundberg (1) entitled “Partial Denervation of the Bladder—a new operation for the treatment of Urge Incontinence and similar conditions in women”. The basis for the operation was stated in the initial sentence: “The function of an autonomous neurogenic bladder is usually superior to that of a neurogenic bladder, where higher centers are still partially in function.” His operation consisted of transection of the preganglionic pelvic nerves near the inferior surface of the bladder and involved division of both the sympathetic and the parasympathetic nerves.
Variations in Plasma Steroid and Prostaglandin Concentrations During Human Pregnancy
Authors: Coats P. , Walker E. , Youssefnejadian E. , Craft I. L.
Published: December 2009

Abstract. Radioimmunoassay of sex steroids and prostaglandins was performed on plasma obtained from 10 uncomplicated primigravid subjects at a stated time of the day at varying stages of gestation. Prostaglandin E2 (PGE2), prostaglandin F2α (PGF2α), oestrone and oestriol concentrations reached a peak a few weeks before term and then declined. Progesterone, 17‐hydroxyprogesterone and oestradiol increased during pregnancy particularly after 32 weeks. In two normal patients repeated blood samples were taken throughout the day at weekly intervals in late pregnancy for sex steroid assays to evaluate the variation of concentrations with the time of sampling and the significance of changes in mean concentrations of different steroids with approaching parturition. Marked variability was found in the levels of different steroids during the day. Plasma oestriol values were lowest at 8.00 a.m. in one patient sampled frequently. A marked decrease in oestriol, oestrone, oestradiol and 17‐hydroxyprogesterone was found in one patient prior to the onset of spontaneous labour. In another subject there was no decrease in concentrations of oestrogens or progestogens prior to induction of labour at term.
Scintigraphic Studies of Uterine and Placental Growth and Placental Migration During Pregnancy
Authors: Nordlander S. , Sundberg B. , Westin B. , åsard P. E.
Published: December 2009

Abstract. Placental scintigraphy with 113mIn (Indium) combined with cervical marking with a shielded 57Co (Cobalt) radioactive source was used to study uterine and placental growth in human pregnancy and placental location and migration in a total of 176 patients. Uterine length measurements can be used for selecting growth retarded fetuses. There was an approximately constant ratio between placental diameter and uterine length (0.68±0.03). When the placenta was located on the ventral uterine wall, low implantation occurred in 61%. The corresponding figure for low implantation when the placenta was located on the dorsal uterine wall was 30%. The difference was highly significant. Placental migration was studied in 20 patients. Significant migration occurred in 11 cases. The placental margin closest to the internal cervical os migrated outwards about 3 cm on average.
A Comparison Between the Lecithin/Sphingomyelin Ratio and the Nile Blue Sulphate Test in the Estimation of Fetal Maturity
Authors: Gilbert J. M. , Taylor N. F. , McFadyen I. R.
Published: December 2009

Abstract. Functional fetal maturity was assessed in 72 patients by measuring in amniotic fluid the lecithin/sphin‐gomyelin ratio and the differential cell count. The correlation between these two tests is presented. Only one fetus with a lecithin/sphingomyelin ratio of 2 or more developed the respiratory distress syndrome after delivery: that was the child of a diabetic mother. The technical limitations of the lecithin/sphingomyelin ratio meant that it could not be measured in 12% of samples obtained.
Intra‐Urethral and Intra‐Vesical Pressure in Continent Women
Authors: öbrink A. , Bunne G. , Ulmsten U.
Published: December 2009

Abstract. Two age‐groups of continent women were examined regarding the pressures in the urethra and the bladder, using a standardized recording technique with a microtransducer catheter elaborated in 1974 by Ulmsten‐ Asmussen. The two groups of women (mean age 28 and 54 years respectively) were examined concerning their urethral pressure profile at every 100 ml bladder filling until the maximal bladder capacity had been reached. The functional length of the urethra and the bladder pressure were the same for all women but the maximal urethral pressure decreased significantly with age (mean 61.5 and 39 mmHg in the two groups respectively). At increasing bladder filling only the younger group was able to respond with an increase in the maximal urethral pressure. The bladder volume at which severe tenesmi occurred was significantly higher in the elderly group.
CARBOHYDRATE METABOLISM AND HORMONAL REPLACEMENT THERAPY: PROBLEMS AND CLINICAL RESULTS
Authors: Lageder H.
Published: December 2009

Abstract. Substitution treatment with a biphasic hormone combination (Cyclacur®) was administered to twenty women in menopause. Nine of these had undergone hysterectomy and/or ovarectomy. The experimental cycle consisted of a daily dose of 2 mg estradiol valerianate as estrogen for 11 days, the identical dose of estrogen plus 0,5 mg dl‐norgestrel as gestagen for 10 days, and a 7‐day medication‐free period. An initial placebo cycle was administered, followed by 7 experimental cycles and one final placebo cycle. Laboratory tests were carried out regularly. There were no significant changes during the investigation in serum lipids, blood sugar values, or serum enzyme tests used as parameters of hepatic function. Of the hematological parameters a moderate rise in hematocrit was observed. There was no change in serum protein‐bound iodine.
THE PERCEPTION OF MENOPAUSEIN FIVE ETHNIC GROUPS IN ISRAEL
Authors: Maoz Benjamin , Antonovsky Aaron , Apter Alan , Wijsenbeek Henricus , Datan Nancy
Published: December 2009

Abstract. An investigation was made into the menopausal symptoms and attitudes of 1, 148 Israeli women of five different ethnic origins. The results show that, while some of the somatic menopausal symptoms are independent of ethnic origin, psychic and psychosomatic symptoms are more closely associated with this variable. Similarly, attitudes to the climacteric vary across cultural origins, especially with regard to husband‐wife relationships. This study underlines the necessity of a multi‐factorial, biological, sociological, psychological and anthropological approach to problems of menopause.
Intraamniotic and Intramuscular Administration of 15‐Methyl Prostaglandin F2α for Midtrimester Abortion
Authors: Bergquist Christer , Nyberg Rune
Published: December 2009

Abstract. Two series of midtrimester abortion inductions are compared. In one series of 68 cases of midtrimester pregnancies (12–24 weeks), legal abortion was induced by one intraamniotic injection of 2.5 mg 15‐methyl prostaglandin F2α. Fetus was expelled in 67 cases (98.5%) after a mean time of 18.4 hours. One case with duplex failed to abort (1.5%). Abortion was complete in 54% of the aborted cases.

In the second series of 93 cases abortion was induced by intramuscular injection of 300 μg 15‐methyl PGF2α every third hour (the first dose was 200 μg) during 30 hours. Fetus was expelled in 79 cases (85%) after a mean time of 16.7 hours. Failure occurred in 14 cases (15%). Abortion was complete in 57% of the aborted cases.

Side effects (vomiting and diarrhea) were more frequent in the intramuscular series and very inconvenient to many of the patients.

Excessive bleeding occurred more often in the intraamniotic series. A small rupture of the cervix was noted once (primigravida) in the intramuscular group.

It is concluded that the intramuscular way of administration is a simple method of second trimester pregnancy termination with small bleedings but that otherwise it is inferior to the intraamniotic route.
Pregnancy in the Young Teenage Woman
Authors: Sandström Bo
Published: December 2009

Abstract. Since 1967 the number of delivered young teenage women has gradually decreased. During the same period the number of therapeutic abortions among these young women has increased, probably to a sufficient extent to explain the decreased nativity. There is no evidence in this study of any effect of more extended sex and contraceptive education in schools.
Antenatal Diagnosis of Congenital Nephrosis of the Finnish Type
Authors: Kjessler B. , Hultquist G. , Johansson S. G. O. , Sherman M. S. , Gustavson K. H.
Published: December 2009

Abstract. Congenital nephrosis of the Finnish type (CN) is an hereditary, autosomal recessive disease which invariably leads to death in early infancy. We have found certain ultrastructural morphologic changes of the same type as in manifest CN to be present in kidney‐ and placental tissue specimens as early as in the 17th‐19th week post last menstrual period (LMP) in two affected fetuses. The placental structures appeared in some respects immature in relation to gestational age. The morphological alterations were found to be associated with renal, and possibly placental functional failure, resulting in extensive elevation of alpha‐fetoprotein (AFP) levels in amniotic fluid and maternal serum from the 16th and 12th week post LMP, respectively. Morphological structures of a similar type were absent, or only rarely observed, in eight control fetuses of comparable gestational age. Both mothers who previously had affected children as well as affected fetuses, have now given birth to healthy infants after pregnancies characterized by repeatedly normal levels of AFP in maternal serum and amniotic fluid. Antenatal diagnosis of CN therefore seems feasible between the 12th‐19th postmenstrual weeks by means of AFP‐determinations in maternal serum and amniotic fluid.
Simple Hysterectomy in the Presence of Invasive Cervical Cancer
Authors: Davy Margaret , Bentzen Helge , Jahren Ragnar
Published: December 2009

Abstract. During the years 1956–69, 74 cases of invasive cervical carcinoma treated by simple hysterectomy were referred to the Norwegian Radium Hospital. the 5 year survival for those with free operative borders was 77.1% as compared with 30.7% for those cases in which the tumour was transected during operation. Before operation for a supposed benign condition, cancer should always be ruled out. If simple hysterectomy is performed and cervical cancer found in the specimen, immediate postoperative megavoltage radiotherapy affords the best chance of cure.
Spontaneous Rupture of the Uterus in the Third Trimester with a Living Fetus Expelled into the Abdominal Cavity
Authors: Lalos Othon , Lundström Per , Probst Franz Paul
Published: December 2009

Abstract. A case of rupture of the uterus during pregnancy with the living fetus expelled intra‐abdominally is reported. the main symptoms were slowly increasing abdominal colicky pains. During the first five days of the hospital stay the woman's condition deteriorated and a paralytic ileus developed. the fetal lie changed between the second and third day from longitudinal to transverse and the fetus became situated at the umbilical level. At the same time the fetal heart sounds could no longer be detected and the tense uterine wall grew soft. the changed fetal lie and the paralytic ileus were radiologically substantiated. in spite of a delayed diagnosis the child and the mother were both saved. the etiology was possibly damage to the fundal wall at an earlier curettage carried out because of a spontaneous abortion. the differential diagnosis is discussed from the obstetrical as well as from the radiological and other methodological points of view.