bluuebunny/crossref_metadata_2025 huggingface dataset:
Immediate postpartum IUD insertions in a Chinese hospital — a two year follow‐up
Authors: Zhou S.‐W. , Chi I.‐C.
Published: April 2004

A data set consisting of 199 immediate postpartum IUD insertions performed at the Xuan Wu Hospital, Beijing, China was analysed in terms of insertion route, category of inserting personnel and device type. IUD expulsion and continuation of use were the outcome events of interest in this study. Based on our findings, the following hypotheses were derived for future confirmative studies: lower expulsion rates and hence, higher continuation rates of immediate postpartum IUD insertions are associated with (1) insertions through the abdominal incision wound for women who had a cesarean delivery as compared to immediate (< 10 min) vaginal insertions in women with vaginal delivery; (2) obstetrician insertions, as compared to midwife insertions, and (3) use of the Delta T, as compared to that of the Delta Loop. For the derivation of the latter two hypotheses, only the vaginal insertions were studied.
Prenatal diagnosis of recurrent Meckel Syndrome
Authors: Ramadani H.M. , Nasrat H.A.
Published: April 2004

We report a rare case of Meckel‐Gruber syndrome in a woman who had three affected offsprings in the past with similar condition. Ante‐natal ultrasonographic diagnosis and management are presented.
Acquired gynetresia in Eastern Nigeria
Authors: Ozumba B.C.
Published: April 2004

A retrospective analysis of 78 patients who presented with acquired vaginal stenosis between January 1980 and December 1989 at the University of Nigeria Teaching Hospital Enugu was carried out. Ritual circumcision was a leading cause of this condition, followed by birth injuries and postoperative injuries. Urinary symptoms such as dysuria and urinary retention, as well as coital difficulty presenting as dyspareunia and apareunia featured prominently amongst the patients. The modified Fenton's operation was used in treating a majority of the patients, with good results. Occasionally more extensive surgery such as the Mclndoe operation was used when the lesion was more severe. Recurrence rate was low and 11 women became pregnant during the period of follow up. The problem is of public health dimensions, and community based education to eliminate the etiological factors is recommended.
A randomized trial of penicillin and streptomycin in the prevention of post‐partum infection in Uganda
Authors: Kampikaho A. , Irwig L.M.
Published: April 2004

We report findings of a randomized trial of penicillin and streptomycin to prevent postpartum infection conducted on 737 women who delivered consecutively at Kawempe Maternity Centre (KMC) in Kampala from 1st October, 1989 to 31st May, 1990. The objectives were: (i) to identify clinical postpartum infection using at least two of its symptoms and signs (fever, lower abdominal pain, lower abdominal tenderness, vaginal discharge); (ii) to identify the causes of postpartum infection using laboratory methods; and (iii) evaluate the effectiveness of prophylactic fortified procaine penicillin (PPF) and streptomycin on postpartum infection. Clinical infection occurred in 36.4% of the group not given antibiotics, 23.3% in the PPF group and 20.3% in the streptomycin group. Laboratory‐confirmed infection occurred in 15.5% of the group not given antibiotics, 9.2% in the PPF group and 8.4% in the streptomycin group. However, severe laboratory‐confirmed infection (severe clinical infection plus positive laboratory findings) occurred in 4.9% of the group not given antibiotics, 6.1% in the PPF group and 6.6% in the streptomycin group. In general, the organisms isolated included enterobacteria (35.9%), yeast and protozoa (31.6%), staphylococci (23.9%), streptococci (69%) and Neisseria (1.7%). The advantage of PPF and streptomycin was evident in most subgroups defined by clinical characteristics or laboratory findings. In view of the findings in this study, we believe that prophylactic antibiotics given in labor may have a role to play at reducing the incidence of postpartum infection. However, as the cost of antibiotics in developing countries is significant, the development of resistant organisms due to indiscriminate antibiotic use is also a concern and health resources are best used when targeted at specific populations, we feel that antibiotic prophylaxis should not be used routinely and that a more realistic view can be obtained by studying high‐risk groups of women with more severe infection.
Poor glycemic control and antepartum obstetric complications in women with insulin‐dependent diabetes
Authors: Rosenn B. , Miodovnik M. , Combs C.A. , Khoury J. , Siddiqi T.A.
Published: April 2004

OBJECTIVE: The purpose of this study was to test the hypotheses that the rate of complications of pregnancy in women with insulin‐dependent diabetes is higher than in nondiabetic women and is associated with poor glycemic control and microvascular disease. METHOD: Women who enrolled in a multidisciplinary program of diabetes in pregnancy prior to 20 weeks' gestation were included in the study and matched 1:2 by age, race and parity to a control group of nondiabetic women. Complications of pregnancy were retrospectively analyzed and compared between groups. The association of complications with glycemic control and microvascular disease was analyzed within the diabetic group. RESULT: Women with diabetes had significantly higher rates of pregnancy‐induced hypertension (PIH), polyhydramnios, pyelonephritis, preterm delivery and meconium‐stained amniotic fluid. Poor glycemic control, particularly during the first and second trimesters of pregnancy, was associated with all complications, except pyelonephritis. Microvascular disease was associated with PIH and preterm delivery prior to 34 weeks. CONCLUSION: Women with insulin‐dependent diabetes are at high risk for complications of pregnancy. Glycemic control during the first and second trimesters may affect events later in pregnancy.
Ultrasound‐guided aspiration of ovarian endometriotic cysts
Authors: Giorlandino C. , Taramanni C. , Muzii L. , Santillo E. , Nanni C. , Vizzone A.
Published: April 2004

OBJECTIVE: To evaluate the outcome of ultrasound‐guided aspiration of ovarian endometriotic cysts. METHOD: Thirty‐four patients with ovarian endometriomas were submitted to transvaginal (28 patients) or transabdominal (6 patients) ultrasound‐guided aspiration of the cyst content, and then followed with serial ultrasonograms for a mean period of 12 months (range 6–20 months). RESULT: The procedure was successful in all cases, and no early complications occurred. The recurrence rate was 53%, and it was not influenced significantly by the preoperative or post‐operative administration of medical suppressive therapy. CONCLUSION: Ultrasound‐guided aspiration of ovarian endometriomas yields a relatively high recurrence rate, and can be proposed as an alternative treatment when surgery is undesired or contraindicated.
Uterine myxoid leiomyosarcoma and CYVADIC‐etoposide therapy
Authors: Fukunishi H. , Yukimura N. , Takeuchi S. , Kitazawa S.
Published: April 2004

Objectives: To conduct a pathological characterization of rare uterine myxoid leiomyosarcoma (MLS) and establish an effective chemotherapy for metastasis after hysterectomy. Methods: Histological and immunohistochemical methods were used to characterize the type of uterine MLS in a 39‐year‐old female. For multiple lung metastases found 3 months after operation, CYVADIC (400 mg cyclophosphamide, 1 mg vincristine, 50 mg epirubicin and 400 mg dacarbazine per body for one course) and oral etoposide (50 mg/body per day for 2 weeks) were applied. Results: The rapidly enlarging uterine tumors exhibited gelatinous cut surfaces, a high count of 30 mitotic cells per 10 hpf and mucinous stroma, indicating a rare high‐mitotic type of uterine MLS. The two‐course CYVADIC‐etoposide therapy was effective for disseminated pulmonary metastases. Conclusion: The present MLS was a rare high‐mitotic type. CYVADIC‐etoposide was an optional effective chemotherapy for lung metastasis in this case.
Management of patients with persistent β‐hCG values following laparoscopic surgical and local drug treatment for ectopic pregnancy
Authors: Bonatz G. , Lehmann‐Willenbrock E. , Kunstmann P. , Semm I. , Hedderich J. , Semm K.
Published: April 2004

Objectives: To show that the β‐human chorionic gonadotropin (hCG) decline following tubal‐preserving techniques for ectopic pregnancy (EP) can take a longer course than currently believed, indicating expectant management; and to define the indications for a second‐look laparoscopy if β‐hCG persists. Methods: Three hundred thirty‐seven patients treated for EP were retrospectively reviewed. In order to define the ‘normal’ β‐hCG decline following tubal‐preserving techniques we acquired a Kaplan‐Meier curve for 98 patients treated by laparoscopic linear salpingotomy, the main method performed for EP (253 patients). The Mann‐Whitney U‐test served as a statistical test. The patient population requiring a second‐look laparoscopy for proliferating trophoblastic remnants is described. Results: Twenty‐eight patients (8.3%) required a second‐look laparoscopy (acute abdominal pain and sonographically suspect findings combined with increasing β‐hCG values). The majority (15 patients) underwent a preceding laparoscopic linear salpingotomy (6.5% unresolved cases). The relative β‐hCG values differed significantly from the unresolved group compared to the group with resolved EP starting at postoperative day 2 (P < 0.01). A maximal β‐hCG decline period of 77 days postoperatively was observed. Conclusions: Patients with slowly declining β‐hCG levels following tubal‐preserving techniques for EP can be managed expectantly. Increasing β‐hCG values combined with abdominal pain and sonographically suspect observations indicate a second‐look laparoscopy.
Two patients with postpartum HELLP syndrome after a normotensive twin pregnancy
Authors: Tilstra J.H.
Published: April 2004

Two patients with postpartum HELLP syndrome after a normotensive twin pregnancy are presented. As seen in one of the patients, morbidity can be significant. These cases illustrate that even after uneventful pregnancies one should be on the alert for symptoms of HELLP syndrome. If symptoms exist laboratory investigations should be carried out.
Self‐report measures of obsessionality, depression and social anxiety in a school population of adolescents
Authors: Allsopp Mark , Williams Tim
Published: April 2004

The results are reported for a non‐clinical school population of 252 adolescent subjects, aged 13 to 15 years, responding to the Maudsley Obsessive‐Compulsive Inventory (MOCI), the Childrens Depression Inventory (CDI) and the List of Social Situation Problems (LSSP). The scales intercorrelated significantly but appear to measure different aspects of self perception. No significant age or gender effects emerged in any. The results obtained are compared with those of previous studies and the use of the MOCI in adolescent populations discussed.
Running groups for parents with schizophrenic adolescents: initial experiences and plans for the future
Authors: Sheridan Anne , Moore Lucy M.
Published: April 2004

Six‐session educational and support groups were held for two sets of parents (32 in all) who had an adolescent schizophrenic child. Results indicate no significant increases in knowledge about the disorder following the group (probably due to the relatively high scores obtained at the outset) but gains seem to have been made in ability to handle the teenage patient at home. All parents commented on how they had benefited from the supportive aspect of the group. Future developments of these groups are discussed.
Knowledge, attitudes and behaviors related to AIDS among youth in residential centers: results from an exploratory study
Authors: Slonim‐Nevo Vered , Ozawa Martha N. , Auslander Wendy F.
Published: April 2004

This study assesses the level of knowledge about and attitudes toward AIDS among youth residing in residential centers. It also assesses the degree to which they engage in high risk behaviors related to AIDS. The study evaluates the impact of a short educational intervention on the youth's knowledge, attitudes, and behaviors related to AIDS. Findings suggest that the respondents are relatively knowledgeable about the disease and how to prevent it. However, a substantial proportion of them do not hold positive attitudes toward prevention and are actually engaging in unsafe behavior. The results also show that a short intervention that provides information about AIDS is ineffective in reducing engagement in high risk activities.
Glioblastoma cells block radiation‐induced programmed cell death of endothelial cells
Authors: Brown Charles K. , Khodarev Nikolai N. , Yu Jianqing , Moo-Young Tricia , Labay Edwardine , Darga Thomas E. , Posner Mitchell C. , Weichselbaum Ralph R. , Mauceri Helena J.
Published: April 2004

We demonstrate that human umbilical vein endothelial cells (HUVEC) grown in co‐culture (CC) with U87 glioblastoma cells transfected with green fluorescent protein (GFP‐U87) exhibit resistance to radiation‐mediated apoptosis. cDNA macroarray analysis reveals increases in the accumulation of RNAs for HUVEC genes encoding cell adhesion molecules, growth factor‐related proteins, and cell cycle regulatory/DNA repair proteins. An increase in protein expression of integrin αv, integrin β1, MAPK(p42), Rad51, DNA‐PKCS, and ataxia telangiectasia gene (ATM) was detected in HUVEC grown in CC with GFP‐U87 cells compared with HUVEC grown in mono‐culture. Treatment with anti‐VEGF antibody decreases the expression of integrin αv, integrin β1, DNA‐PKCS and ATM with a corresponding increase in ionizing radiation (IR)‐induced apoptosis. These data support the concept that endothelial cells growing in the tumor microenvironment may develop resistance to cytotoxic therapies due to the up‐regulation by tumor cells of endothelial cells genes associated with survival.
An efficient approach for solving a class of nonlinear 2D parabolic PDEs
Authors: Kim Dongjin , Proskurowski Wlodek
Published: April 2004

We consider a class of nonlinear 2D parabolic equations that allow for an efficient application of an operator splitting technique and a suitable linearization of the discretized problem. We apply our scheme to study the finite extinction phenomenon for the porous‐medium equation with strong absorption. A comparison of accuracy and computational efficiency of the resulting algorithms for several test problems is presented.
Conditions for global existence of solutions of ordinary differential, stochastic differential, and parabolic equations
Authors: Gliklikh Yuri E. , Morozova Lora A.
Published: April 2004

First, we prove a necessary and sufficient condition for global in time existence of all solutions of an ordinary differential equation (ODE). It is a condition of one‐sided estimate type that is formulated in terms of so‐called proper functions on extended phase space. A generalization of this idea to stochastic differential equations (SDE) and parabolic equations (PE) allows us to prove similar necessary and sufficient conditions for global in time existence of solutions of special sorts: L1‐complete solutions of SDE (this means that they belong to a certain functional space of L1 type) and the so‐called complete Feller evolution families giving solutions of PE. The general case of equations on noncompact smooth manifolds is under consideration.
Multiplicity of solutions for a class of quasilinear problem inexterior domains with Neumann conditions
Authors: Alves Claudianor O. , Carrião Paulo C. , Medeiros Everaldo S.
Published: April 2004

We study the existence and multiplicity of solutions for a class
of quasilinear elliptic problem in exterior domain with Neumann
boundary conditions.
Antepartum fetal evaluation by assessment of fetal heart rate and fetal movements
Authors: Sadovsky Eliahu , Weinstein Daniel , Even Yael
Published: April 2004

Three antenatal monitoring tests — fetal movement acceleration test (FMAC‐test), fetal heart rate‐non‐stress test (FHR‐NST), and daily fetal movement recording (DFMR) were evaluated in 212 high risk pregnant women. While in 196 cases all three tests were normal, in 16 patients one to three tests showed pathological results. In the latter group, there was a significantly higher incidence of perinatal mortality, low Apgar score and growth retardation. Since false positives are known to occur in these tests, at least two should be pathological to warrant delivery in an attempt to prevent fetal death in utero. The sequence in which the pathology appears in the deteriorating fetus is as follows: the first to become non‐reactive is the FMAC‐test, followed by decreased fetal movements till cessation, and, finally, severe changes in the FHR‐NST take place. The importance of this sequence of events is discussed.
Successful multiple pregnancy in renal transplant recipient
Authors: Boner Geoffrey , Bott‐Kanner Gustawa , Schweitzer Abraham , Danon Yehuda L. , Rosenfeld Joseph B.
Published: April 2004

Twin females were born by Caesarean section to a patient who had undergone a living donor renal transplant 2 years previously. These infants have been followed for 6 years and have been found to have normal development. Tests performed during the first year of life showed that both infants have normal immunologic responses.
Termination of second trimester pregnancy by intramuscular injection of 16‐phenoxy‐ω‐17,18,19,20‐tetranor‐PGE2 methyl sulphonylamide
Authors: Krishna U , Narone JN , Hingorani V , Karim S , Bydeman M , Herczeg J
Published: April 2004

Two doses of the prostaglandin analogue 16‐phenoxy‐ω‐17,18,19,20‐tetranor‐PGE2 methyl sulphonylamide were compared in a randomized multicentre trial in 6 centres for the termination of second trimester pregnancy. A total of 295 patients were treated with either 0.5 mg or 1.0 mg given by intramuscular injection every 4 h or 8 h, respectively. The 1‐mg dose was more effective in inducing an abortion than the lower dose but the difference was not statistically significant. Eighty‐four per cent of the patients aborted within 30 h from the onset of treatment. The induction‐abortion interval was approximately 15 h in both groups. The incidence of incomplete abortion, heavy blood loss and blood transfusion was similar for both treatments. Cervical lacerations occurred in 1.3% of patients given the smaller dose and 2.1% of the larger dose. In one patient belonging to the latter group an anterior rupture of the lower uterine segment was diagnosed necessitating hysterectomy. Fifty per cent of the patients had no vomiting and 90% no diarrhea. The frequency of gastrointestinal side effects was slightly higher with the 1‐mg dose. The major advantages of this treatment are the simplicity of administration and the low frequency of gastrointestinal side effects in comparison with prostaglandin F analogues.
Some important factors in the molding of the fetal head during vaginal delivery ‐ A photographic study
Authors: Sorbe B. , Dahlgren S.
Published: April 2004

The molding of the fetal head was studied in 319 vaginal deliveries. A photographic method was used to document the size and form of the infants' heads immediately postpartum and 3 days later. Six different diameters were measured but only three changed significantly during early neonatal restitution. A molding index was calculated and compared with the conventional occipitofrontal circumference. Infants born by primiparous women showed significantly higher degrees of molding of the head than those born by multiparous women. Oxytocin stimulation during labor as well as instrumental deliveries resulted in increased fetal head molding. The importance of fetal presentation at birth, the duration of labor, the age of the mother and birth weight of the infant was also analyzed with regard to the molding of the fetal skull during labor.
The prevention of preterm delivery through prenatal care: An intervention study in Martinique
Authors: Goujon H. , Papiernik E. , Maine D.
Published: April 2004

During 1976–1978, improvements were made in the free prenatal care provided by the maternal and child health authority (PMI) of Martinique. Central to these changes was implementation of a program of preventive prenatal care developed in France by one of the authors (EP). Data on all births during 1980–1982 show no significant difference in pregnancy outcomes between women receiving free prenatal care from the government and women receiving private care from obstetricians.
Placental transfer of ritodrine hydrochloride in sheep
Authors: Fujimoto Seiichiro , Akahane Masuo , Uzuki Katsuya , Inagawa Akira , Sakai Keiichiro , Sakai Akira
Published: April 2004

The purpose of this study was to examine the placental passage of ritodrine hydrochloride in relation to the drug's effects on the fetal circulation. Studies were carried out on nine nulliparous pregnant (120–140 days) ewes with chronically implanted cannulae for measurements of maternal and fetal arterial pressures and for blood sampling. One group of animals received sequential infusions of doses ranging from 0.1 to 30 μg/kg per min for 30 min (group 1). A second group was given a constant infusion of the drug at a dose of 3.0 μg/kg per min for 4 h (group 2). The peak concentrations of ritodrine in maternal and fetal blood were determined by radioimmunoassay. In group 1 they were 313.4 ± 24.1 ng/ml (mean ± S.E.) and 12.6 ± 3.7 ng/ml at the finish of 30.0 μg/kg per min infusion for maternal and fetal blood, respectively. In group 2, maternal drug levels were 81.3 ± 20.4 ng/ml after 30 min and 95.9 ± 17.1 ng/ml after 4 h of the infusion. Fetal plasma concentrations increased slowly from trace levels at 30 min to 3.3 ± 0.7 ng/ml at 4 h. Fetal blood pressure and heart rate did not show any significant changes during and after the infusion of ritodrine in both treatment groups. Our findings demonstrate the maternal administration of ritodrine produces no significant effects on the circulatory system of the fetal lamb because of the low transplacental passage of this drug.
Potassium and glucose concentrations in patients treated with oral tocolytic agents: A preliminary report
Authors: Rivera‐Alsina Manuel E. , Saldana Luis R. , Held Berel
Published: April 2004

Fifteen patients referred to the Division of Maternal‐Fetal Medicine with the diagnosis of cervical incompetence were placed in a study protocol where prophylactic oral beta mimetic agents were used in an attempt to prevent cervical dilatation between 20 and 36 weeks of gestation. Our study suggest that after the first week of therapy prolonged maternal oral tocolytic therapy has no significant effect on glucose or serum potassium levels and no deleterious effects on the immediate neonatal course.
Morphology of rabbit oviduct after reanostomosis with fibrin glue
Authors: Spernol R. , Riss P. , Shindler K. , Beck A. , Breitenecker G.
Published: April 2004

We examined the site of experimental reanastomosis with fibrin glue in rabbit oviducts 3 months after the operation with light and scanning electron microscopy. Local tissue reaction was minimal, no fibrin clots were seen and inflammatory reactions were almost absent. On scanning electron microscopy ciliated cells were reduced in number. Morphologic changes at the site of anastomosis after the use of fibrin glue appear comparable to the alterations seen after the use of microsutures.
The role of laparoscopy in the diagnosis of ectopic pregnancy: A plea for conservative management
Authors: Beck Paul , Broslovsky Lewis , Gal David , Tancer M. Leon
Published: April 2004

This report evaluates the role of laparoscopy in patients admitted with the diagnosis of “Rule Out Ectopic”. There were 186 patients admitted to the Brookdale Hospital Medical Center in the 6‐year period 1974–1979 inclusive with a diagnosis of “Rule Out Ectopic” or “Possible Unruptured Ectopic”. These patients were all laparoscoped. There were 157 satisfactory and 27 unsatisfactory laparoscopies. There were 71 ectopic pregnancies: 42 ruptured, 25 unruptured. Thirty‐six cysts were diagnosed. The value of early laparoscopy is clearly established. Particular emphasis is placed on the diagnosis of the unruptured ectopic so that appropriate conservative management of the tube can be instituted in order to preserve potential reproductive capacity.
The treatment of failed laparoscopy using open laparoscopy
Authors: Dodson Melvin G.
Published: April 2004

There are over 300,000 laparoscopies done each year in the United States, and about 60,000 in England. “Failed laparoscopies” in which the procedure cannot be accomplished, has variously been reported in 0.043–4.3/1000 cases. A reasonable estimate of failed laparoscopy of 0.75% suggest that up to 2250 cases of “failed laparoscopy” occurs each year in the USA and 450 in UK. The translation of such failures into the personal experience of patients and the overall cost is staggering despite the fact that failures are not common. Three cases of “failed laparoscopy” in which the procedure was easily completed by open laparoscopy are reported and discussed. Familiarity with the techniques of open laparoscopy could virtually eliminate the incidence of failed laparoscopies.
Group B streptococci colonization among Saudi women in labor and neonatal acquisition
Authors: Uduman S.A. , Chatterjee T.K. , Al‐mouzan M.I. , Al‐Suleiman Suleiman
Published: April 2004

Rates of high vaginal Group B Streptococcus colonization and the perinatal transmission were determined in 260 Saudi women admitted for delivery to the Obstetrical Unit of the King Fahd Hospital of the University, Al‐Khobar. Of these women, 24 mothers in labour had vaginal colonization (9.2%). Three neonates acquired. Group B Streptococci soon after birth on more than one body site and the perinatal transmission rate was 12.5%. Implication of these findings are reviewed.
The interrelationships between age, physical measurements and body composition at menarche in schoolgirls at Ilorin, Nigeria
Authors: Fakeye Olurotimi
Published: April 2004

A cross‐sectional study of age, physical size and body composition at menarche was made at Ilorin, Nigeria among 162 secondary school girls who reached menarche between March and June, 1983. The findings show that the mean age, height and weight are 13.7 ± 1.0 years, 156.2 ± 6.3 cm and 47.4 ± 6.7 kg, respectively. The estimated body composition is: total body water (TBW), 25.7 ± 2.31;lean body mass (LBM), 35.7 ± 3.3 kg; and fat content, 11.8 ± 3.8 kg. Whereas the coefficient of variation was highest for fat content (32.2), it was least for height (4.0). Menarcheal age has a weak correlation to all the variables, but strong correlation existed between weight and the parameters of body composition. The findings of body composition at menarche in Nigerian and North American schoolgirls are similar.
Definition and treatment of microcarcinoma of the cervix uteri
Authors: Iversen Torbjørn
Published: April 2004

Patients with tumors without vessel invasion have a better prognosis than patients with tumors of the same size with vessel invasion. The depth of stromal infiltration should be measured from the epithelial surface. In patients with an infiltration less than 1 mm, conization will be sufficient treatment, but hysterectomy is necessary when the disease is more advanced. When the tumor has infiltrated into vessels, additional treatment including pelvic lymphadenectomy or external irradiation should be performed.
The assessment of fetal pulmonary maturity by fluorescence polarization (FP‐value) of pooled vaginal amniotic fluid associated with ruptured membranes
Authors: Runowicz Carolyn D. , Beers Philip C.
Published: April 2004

This prospective study was undertaken to examine the reliability of fluorescence polarization (FP) readings on amniotic fluid collected from the posterior formix of the vagina after membranes have ruptured. This method was chosen because it is as accurate as the L/S ratio, but it is simpler, faster and requires only 0.5 ml of sample. Forty‐seven out of 55 patients were eligible for the study, for a success rate of 85%. Respiratory distress syndrome (RDS) occurred in one out of 29 neonates with FP in the mature or low risk group. In the high risk group for RDS, 7 out of 12 developed the syndrome. In 11 patients, FP‐values obtained from transabdominal amniocentesis were not significantly different from those obtained from pooled vagina amniotic fluid once membranes were ruptured. Analysis of pooled vaginal amniotic fluid is simple, non‐invasive and capable of being performed with a high rate of success. FP‐values from properly collected pooled vaginal amniotic fluid can be used in the assessment of functional fetal lung maturity.
White sponge nevus of the vulva
Authors: Búchholz Friedrich , Schubert Christoph , Lehmann‐Willenbrock Enrique
Published: April 2004

The white sponge nevus is a hereditary leukokerotosis localized preferably in the oral mucosa, but may simultaneously manifest itself in other regions, e.g. perianally.

We report the case of a 18‐year‐old patient with a primarily and exclusively extraorally located white sponge nevus of the vulva. The differential diagnosis and clinical as well as therapeutical problems of this extremely rare disease are discussed.
Antimicrobial properties of amniotic fluid from some Nigerian women
Authors: Ojo Vincent A. , Okpere Eugene E. , Obaseiki‐Ebor Emmanuel E.
Published: April 2004

Fifty‐one amniotic fluids were aspirated via the vaginal route from 51 pregnant Nigerian mothers. Their antimicrobial activity was tested against Staphylococcus aureus, Escherichia coli and Candida albicans. Inhibition rates were 39.2% for Staph, aureus 19.6% for E. coli and 41.2% for C. albicans. The overall inhibitory capacity was 64.7%. Sixteen fluids (31.4%) were active against one organism, three fluids (5.9%) were active against two organisms and one fluid (2%) was active against the three organisms. Age, parity and meconium‐staining of liquor had no correlation with antimicrobial properties. The possible explanations for these are given.
Broad spectrum antibiotics as short term prophylaxis for elective abdominal hysterectomy: Comparison of mezlocillin, cefazolin and placebo
Authors: Hakim M. , Gonen R. , Levitan Z. , Sharf M.
Published: April 2004

A prospective randomized placebo controlled double‐blind study was conducted in order to evaluate the effect of short term perioperative antibiotic prophylaxis on patients undergoing elective abdominal hysterectomy. Fifty‐two patients received 3 doses of 0.5 g cefazolin, 54 patients received 3 doses of 1 g mezlocillin and 53 patients received placebo.

Postoperative infectious morbidity and the rate of pelvic cellulitis were significantly lower in either antibiotic group in comparison to the placebo group, but neither drug proved to be superior in this respect. The fever index was significantly lower in the mezlocillin group in comparison to both cefazolin and placebo groups.

It was thus concluded that antibiotic prophylaxis has a beneficial effect on patients undergoing abdominal hysterectomy and both drugs ‐ cefazolin and mezlocillin ‐ seem to be equally effective.
Management of pregnancy‐induced hypertension with pindolol‐comparative study with methyldopa
Authors: Ellenbogen A. , Jaschevatzky O. , Davidson A. , Anderman S. , Grunstein S.
Published: April 2004

Thirty‐two consecutive women with pregnancy‐induced hypertension of early onset were randomly allocated to treatment with pindolol or methyldopa. There was no difference between the groups in regard to the average time of delivery (36.33 vs. 36.6 weeks) and weight of the newborn (2850 vs. 2870 g). A significant drop in systotic (P < 0.005) and diastolic (P < 0.05) blood pressure was observed in the group of patients treated with pindolol as compared with the methyldopa group. In the pindolol group an improvement in renal function was observed as determined by CCT and serum creatinine. There were no side effects from the drugs in the mother or in the newborn.
Surgical emergencies of the uterine adnexae during pregnancy
Authors: Johnson T.R.B. , Woodruff J.D.
Published: April 2004

During the 5‐year period 1976–1980, seven cases of emergent surgical disease of the adnexae during pregnancy were encountered. The incidence of 1:1832 deliveries approximated that of appendicitis (1 : 1603 deliveries) during the same period. There were three cases of adnexal torsion, two ruptured ovarian cysts with hemorrhage, one heterotopic pregnancy, and one ruptured endometrioma. The right side was more commonly the site of the pathology, and abdominal pain the only consistent presenting symptom. Fever, tachycardia, and leukocytosis were inconsistent findings. Culdocentesis was positive in two cases. Four desired pregnancies were carried successfully to term postoperatively.

Surgical emergencies of the adnexae will be encountered during pregnancy more commonly than is generally recognized. Aspects of obstetric management are described. If prompt surgical intervention is undertaken in pregnancy when the clinical picture suggests an acute abdomen, a satisfactory outcome can be expected.
Transcatheter embolization of pelvic arteries as the safest method for postpartum hemorrhage
Authors: Ito M. , Matsui K. , Mabe K. , Katabuchi H. , Fujisaki S.
Published: April 2004

Two cases of intractable postpartum hemorrhage could be controlled by Gelfoam embolization via an angiographic catheter. The data presented here indicate that transcatheter embolization for postpartum hemorrhage is a safe and effective method compared to surgical ligation of the injured artery.
Serum ferritin levels and their significance in normal full‐term pregnant women
Authors: Ho Chao‐Hung , Yuan Chiou‐Chung , Yeh Shin‐Hwa
Published: April 2004

Serum ferritin levels were determined by radioimmunoassay (RIA) method and then analysed in 240 normal full‐term pregnant women. Their hemoglobin concentrations were found to be normal in the first trimester. None of them had received any hematonic during their whole pregnancy period. Their mean age was 27.7 years and the mean pregnancy duration was 39.5 weeks. Mean hemoglobin concentration in these normal pregnant women was 12.6 g%. Mean serum ferritin was 23.1 ng/ml. It was significantly lower than the mean value of the normal non‐pregnant women of the same age. In this study, we found that even normal pregnant women, 15.42% (37 out of the 240) had subclinical iron deficiency and 12.92% (31 out of the 240) of the previously normal pregnant women had clinical anemia during their term of pregnancy. Multiparity was found to be a factor in the prevalence of iron deficiency but age and gravida number played no role in the occurrence of iron deficiency anemia.
Characteristics of maternal deaths following cesarean section in a developing country
Authors: Ojo V.A. , Adetoro O.O. , Okwerekwu F.E.O.
Published: April 2004

A retrospective analysis was made of 27 maternal deaths after cesarean section occurring over a 5‐year period. Sepsis was the single most important cause of maternal death (81.5%). The commonest indications for the cesarean sections were obstructed labor (59.3%) and cord prolapse (18.5%). The causes of maternal deaths were classified as avoidable and recommendations were made for their prevention.
Ultrastructure of endosalpingeal biopsies in infertile patients: correlation with reproductive success
Authors: Marchini M. , Baglioni A. , Zamberletti D. , Vercellini P. , Motta T. , Fedele L.
Published: April 2004

We calculated the percentage of ciliated cells (PCC) in salpingeal microbiopsies of 41 patients with tubal infertility and ampullary microbiopsies of 36 fertile women, using the planimetric method at 500–1000x at the scanning electron microscope. No relation was found between PCC and fertility after surgery. Thus normal ciliation does not seem to be essential for reproductive success and other factors such as the state of preservation of the tubal wall may be important.
Coupling of uterine contractions during labor: a pilot study
Authors: Cronjé H.S. , van der Westhuizen A.
Published: April 2004

A review of 2167 cardiotocograms revealed 53 (2.5%) with coupling of contractions. The data of these patients was compared to the data of 53 patients with cardiotocograms without coupling. In the coupling group there were more primigravidas (45 vs. 18), and a lower incidence of normal vaginal deliveries (11.3% vs. 83.0%). Vacuum and forceps deliveries occurred in 49.1% in the coupling group and cesarean births in 39.6%. The corresponding figures in the control group were 9.4% and 7.5%, respectively. Coupling seems to be a sign of dysfunctional labor associated with a high incidence of abnormal deliveries, but several confounding variables could not be ruled out.
Postmenopausal endometrial patterns and serum estradiol concentrations
Authors: Ismail A.A.A. , Ramadan M. , Soliman A. , Rahmy A. , Rizk A.
Published: April 2004

Eighty postmenopausal women were subjected to endometrial biopsy. Inadequate biopsy was recorded in 30 cases. In the remaining cases (n = 50) the correlation between endometrial patterns and serum estradiol (E2) was performed. These cases were presenting with uterine bleeding (n = 38) or minor gynecological symptoms (n = 12). Proliferative endometrium was the predominant endometrial pattern whereas endometrial malignancy was only present in 15.8% of the bleeding cases. Serum E2 was significantly elevated in cases having malignant endometrium or adenomatous hyperplasia compared to cases having other endometrial patterns. Serum E2 measurement is recommended as a simple screening test for the detection of postmenopausal endometrial hyperplasia and/or malignancy.
Comparative study of single layer and conventional closure of uterine incision in cesarean section
Authors: Lal K. , Tsomo P.
Published: April 2004

Single layer interrupted suture closure of uterine wound incisions represent a viable choice over conventional closure since the operation not only has benefits in case of performance but also possesses a rational basis for the avoidance of ischemia of the wound, infection and hematoma formation. There is a distinct advantage of single interrupted suture closure over conventional closure because there is a substantially higher number of normal hysterograms in this group showing good integrity of the scar in the uterus.
The impact of diagnostic ultrasound on the prediction of intrauterine growth retardation in developing countries
Authors: Mahran M. , Omram M.
Published: April 2004

The purpose of this report is to throw light on the problem of intrauterine growth retardation in our society, and to show how this situation could be affected by the introduction of diagnostic ultrasound in our antenatal service. A series of 828 pregnant women were serially examined by ultrasound during the course of pregnancy. Among the whole series (no. 828) there were 98 growth retarded neonates (11.8%). Antenatal ultrasonic evaluation could predict 89.7% of these cases, while only 34.7% of cases could have been predicted by fundal palpation. Among the different etiological factors, maternal anemia was the most common (25%).
Homozygous sickle cell anemia at the University College Hospital, Ibadan, revisited
Authors: Osinusi B.O. , Adeleye J.A.
Published: April 2004

The outcome of 78 pregnancies in 47 patients with homozygous sickle cell anemia managed at the University College Hospital, Ibadan between January 1, 1975 to December 31, 1984 is reviewed. There were two maternal deaths giving a maternal mortality rate of 25 per thousand. Abortion rate was 155 per thousand. The overall perinatal mortality rate was 188 per thousand. Forty‐five percent of the babies were of low birthweight and 29% were preterm. Anemia was the commonest antenatal complication and the highest indication for hospitalization. The data were compared with previous ones from this hospital and with similar reports by other investigators outside Nigeria. A need for meticulous antenatal care and prenatal diagnosis to eliminate the homozygous sickle cell anemia is stressed.
Successful pregnancy in a renal transplant recipient taking cyclosporin A: hormonal and immunological studies
Authors: Salamalekis E.E. , Mortakis A.E. , Phocas I. , Dalamanga N. , Zourlas P.A.
Published: April 2004

A successful pregnancy following renal allotransplantation is reported. Until now azathioprine has been used as the standard immunosuppressive agent in such cases. Because of the potential teratogenicity of azathioprine, low doses of cyclosporin A, a new immunosuppressive drug, was used in our pregnant recipient. We present the management and the outcome of the pregnancy, as well as the hormonal and immunological follow‐up.
Mortality in acute gynecology: a developing country perspective
Authors: Rogo K.O.
Published: April 2004

Over a 20‐month period 109 deaths were recorded in the Acute Gynecology Ward, Kenyatta National Hospital, Nairobi; a rate of 5 deaths per month. Forty‐one percent of the deaths were directly attributable to pregnancy and 46% were due to malignancy (mainly cervical carcinoma). Of the dead, 12.4% were teenagers and 63% below 35 years in age. They were generally of low parity. A tragic picture is presented of death of young women in their prime from almost entirely preventable causes. The need for improved maternal care, including family planning and cytological screening for cervical carcinoma is discussed and emphasized.
Malignant degeneration of a mature ovarian teratoma
Authors: Christopherson W.A. , Councell R.B.
Published: April 2004

Malignant components are present in 1–2% of mature teratomas (dermoid cysts) and historically have been associated with a very poor prognosis. Patients with malignant mature cystic teratomas typically are postmenopausal and may present with a rapidly enlarging tumor or systemic symptoms suggestive of malignancy. However, the diagnosis is rarely made pre‐operatively and, if the tumor is not metastatic, may not be made until the tumor is examined microscopically. Squamous cell carcinoma is the most common malignancy found in mature cystic teratomas. We present a 26‐year‐old woman with this cancer in whom the disease proved fatal. A surgical approach to patients with malignant mature teratomas is suggested. Prognostic factors and adjuvant therapy are discussed.
The need for action
Authors: Savage F.
Published: April 2004

Nutrition workers speculated about why poor mothers should decide to bottle feed, when their community in the past had apparently always breastfed effortlessly and successfully. Surveys cross‐tabulated feeding methods against socioeconomic variables, but it was difficult to make use of the results. Few thought that there was anything we needed to learn about HOW to make breastfeeding succeed. There was also a tacit assumption that if you had the resources — for example if you were yourself an employed health worker — you could bottle feed safely, so there was no need to worry.
Breastfeeding as an intervention within diarrheal diseases control programs: WHO/CDD activities
Authors: Hogan R. , Martinez J.
Published: April 2004

The Control of Diarrhoeal Diseases Programme (CDD) at the World Health Organization (WHO) is looking at ways to prevent diarrhea and has identified breastfeeding as an important factor. CDD is studying the protective effects of exclusive breastfeeding and the morbidity and mortality risks for infants exclusively, partially, or not breastfed. CDD has identified trials of interventions for breastfeeding promotion and the evaluation of approaches for the implementation of tested interventions among its research priorities. CDD also has included breastfeeding promotion information in modules in its two management training courses. The Programme plans to monitor the effectiveness of the training and develop future activities based on that feedback.
Reliability of the patient's history in the diagnosis of urinary incontinence
Authors: Bergman A. , Bader K.
Published: April 2004

The reliability of a patient's history has been challenged in the preoperative evaluation of stress urinary incontinence. In this study, 122 consecutive patients referred to our Gynecology/Urology clinic were evaluated and an additional 32 control patients (continent women with no urinary symptoms) were evaluated. All patients answered a detailed 64‐item questionnaire, and all patients received a complete urodynamic evaluation. Our detailed questionnaire provided a mean positive predictive value of 80% for genuine stress incontinence and 25% for detrusor instability. The conditions leading to a false positive history suggestive of genuine stress incontinence were detrusor instability and urethral diverticulum. The conditions leading to a false positive history suggestive of detrusor instability were urethritis, unstable urethra, vaginitis and polyuria. History alone can be misleading in diagnosing urinary incontinence.
Delayed abdominal pain after outpatient endometrial biopsy in the luteal phase
Authors: Li T.C. , Cooke I.D.
Published: April 2004

Outpatient endometrial biopsy was followed by delayed abdominal discomfort in 50% of cases. The pain started 2–3 h after the procedure, lasted for about 2 h and was described in most cases as similar to dysmenorrhoea of a moderate degree. Appropriate explanation and the use of a simple analgesic may reduce the discomfort and the anxiety with which it is associated.
Mechanism of action of gestagens
Authors: Landgren B.‐M.
Published: April 2004

In the mid‐1950s it was shown that ovulation can be inhibited by oral administration of progesterone or of synthetic progestogens such as norethynodrel. The idea that progestogens may interfere with fertility even when administered in doses so small, that they do not invariably inhibit ovulation was launched in the mid‐1960s by a group of Mexican investigators. Since then a large number of studies have been conducted on the mechanism of action of gestagens when used as contraceptives. The objective of this communication is to review the information collected so far on this topic.
Birth asphyxia and obstetric care in Curaçao Netherlands Antilles
Authors: Wildschut H.I.J. , Wiedijk V. , Tutein Nolthenius‐Puylaert M.
Published: April 2004

Out of the 223 fetal and neonatal deaths that occurred on the island of Curaçao in a 2‐year period (1984–1985), 35 were due to birth asphyxia (15.7%). In order to evaluate the quality of obstetric care, the circumstances surrounding each asphyxiated death were scrutinized. On the whole, patients' compliance with antenatal care was satisfactory. However, when the woman presented in labor the attending physician or midwife often lacked information on maternal antecedents and the course of pregnancy. Inadequate intrapartum surveillance together with failure to respond appropriately to abnormalities in labor constituted the principle factors which were associated with asphyxiated deaths. In addition, asphyxial conditions during labor were often preceded by inappropriate administration of oxytocic agents.
Successful ultrasound‐guided intrauterine blood transfusion in severe non‐immune hydrops fetalis
Authors: Buckshee K. , Bhatla N. , Paul V.K.
Published: April 2004

Non‐immune hydrops fetalis has varied etiology, high mortality and few known successful treatment modalities. A rare case of non‐immune fetal hydrops with severe anemia diagnosed prenatally and treated successfully by repeated ultrasound‐guided intrauterine blood transfusions is presented.
Associated leukemia and mixed gem cell tumor in a patient with gonadal dysgenesis
Authors: Kaplan S.S. , Bornstein S.G. , Christopherson W.A. , Surti U.
Published: April 2004

A 16‐year‐old phenotypic female developed acute myeloblastic leukemia with a fulminant course very shortly after surgery and chemotherapy for a mixed germ cell tumor of the ovary. The karyotype (46, XY, 47, XY + 8) suggested de novo rather than therapy‐associated leukemia. The relationship between germ cell tumors and leukemia, their common yolk sac derivation and the role of the Y chromosome are discussed. The idea that XY gonadal dysgenesis may be familial also is discussed.