bluuebunny/crossref_metadata_2025 huggingface dataset:
Poor prognostic value of the basal fetal heart rate as observed during antenatal monitoring
Authors: Odendaal H.J. , Kotze T.J.v.W.
Published: April 2004

The basal fetal heart rate, accelerations, decelerations and amplitude and frequency of variation were scored in positive stress tests of 146 and in suspicious recordings of 296 patients. Positive tests scored lower for accelerations, decelerations and amplitude and frequency of variation but not for the basal heart rate. When the outcome was poor, as characterized by low 5‐min Apgar score and intrauterine growth retardation, it was reflected by all parameters of the fetal heart rate pattern except for the basal heart rate.
Yugoslavian experience with the contraceptive sponge
Authors: Borko E. , Behlilovic B.
Published: April 2004

A trial of the contraceptive sponge was conducted at two clinics (403 subjects) in Yugoslavia. Women were periodically followed up for 1 year. The 1‐year method pregnancy rate (life‐table) was 5.6 per 100 women. Rates of other events leading to discontinuation of sponge use were similarly low. There were no serious complications. The results of the study show that the contraceptive sponge may be successfully used by a population of women with limited experience with the use of vaginal contraceptive methods.
Acute rupture of an ovarian pregnancy associated with a negative serum B‐HCG
Authors: Fejgin M. , Cohen I. , Ben‐nun I. , Siegal A. , Ben‐Aderet N.
Published: April 2004

A case of acute rupture of an ovarian pregnancy in which Beta Subunit of human chorionic gonadotropin was negative is presented. This is the first case known in the literature. Clinical and laboratory aspects of ovarian pregnancy are reviewed.
Tubal pregnancy with patent tube diagnosed by hysterosalpingography
Authors: Schwartz Z. , Katz Z. , Lancet M. , Bernstein D.
Published: April 2004

A demonstration of patent tube usually excludes the presence of tubal pregnancy. In the reported case tubal patency was demonstrated by hysterosalpingography in the presence of 6 weeks tubal pregnancy.
Re‐evaluation of the obstetrical risk for the older primipara
Authors: Blickstein I. , Lancet M. , Kessler I.
Published: April 2004

The obstetric data relating to 92 older primiparas (OP) treated as regular obstetric patients and data relating to 92 older multiparas (OM) are compared to a previous study of 98 OP, which led to the conclusion that OP should not be managed as high‐risk patients during gestation. No difference was found between the two periods regarding complications of pregnancy, gestational age and birth weight, onset of labor, perinatal morbidity and mortality. Nevertheless, cesarean deliveries were significantly higher in the study group. It seems that the conservative attitude towards OP during pregnancy is justified, but at labor, more rigid indications for cesarean section should be applied to establish objective patient care.
Hypergonadotropic amenorrhea ‐ etiology and outcome in 93 young women
Authors: Hague W.M. , Tan S.L. , Adams J. , Jacobs H.S.
Published: April 2004

Ninety‐three cases of amenorrheic women aged 40 years or less in whom serum FSH concentrations were found to be > 20 units/l have been reviewed. The etiology and diagnosis of this uncommon but serious condition and the potential for spontaneous recovery of ovarian follicular activity (17.1%) are discussed. Management is reviewed in the light of ultrasonic, karyotypic and immunological findings.
Sexually transmitted diseases in women with urethral syndrome
Authors: Vitoratos N. , Gregoriou O. , Papadias C. , Liapis A. , Zourlas P.A.
Published: April 2004

Frequency of micturition and dysuria were prominent symptoms in 135 (57%) of 237 women with urethral syndrome. Urea‐plasma urealyticum, Mycoplasma hominis and Chlamydia trachomatis were the principal organisms associated with the urethral syndrome (38.41%, 28.14% and 11.11%, respectively). Escherichia coli was cultured from four patients and Herepes genitalis and Neisseria gonorrhoea were isolated from five patients. Infections with more than one organism were frequent. Thirty‐one of 135 patients were infected by two organisms, 27 by three and 4 patients by four microorganisms. Vaginitis due to Garnerella vaginalis, Candida spp. and Trichomonas vaginalis was discovered in 52 (39%) of 135 patients.
Abnormal glucose screening in pregnancy in patients with normal oral glucose tolerance tests as a screening test for fetal macrosomia
Authors: Witter F.R. , Niebyl J.R.
Published: April 2004

Minor abnormalities of carbohydrate metabolism in pregnancy are a risk factor for delivery of a macrosomic infant. However, the 50‐g 1‐h oral glucose screen at 28 weeks is not a useful screening test for macrosomia in pregnant patients with normal glucose tolerance tests, because a positive screen does not raise the probability of delivering a macrosomic infant sufficiently to warrant intervention.
Ultrasonic assessment of ovulation in cyclofenil induced ovulatory cycles
Authors: Varma T.R. , Patel R.H. , Pillai U.
Published: April 2004

Graafian follicle growth was studied by ultrasound scanning during the peri‐ovulatory period in 64 ovulatory cycles in 32 infertile patients on cyclofenil treatment, and compared with a control group of 32 patients with confirmed ovulatory cycles assessed on the basis of serum progesterone levels in the middle of the second half of the cycle. The mean maximum diameters of the leading follicles before ovulation were 21.9 ± 0.6 (S.E.) mm and 24.4 ± 0.5 (S.E.) mm, respectively for the cyclofenil group and the normal control group (P > 0.05). In 79% of the cyclofenil stimulated group and 83% of the spontaneous ovulation group, ultrasonic evidence of ovulation was present between 12 and 36 h after the initial increase in urine LH levels. Ultrasound scanning was found to be simple, and a quick method of monitoring graafian follicle development and ovulation on cyclofenil therapy and the cycles were comparable to the spontaneous ovulatory cycles as assessed on the basis of graafian follicle diameter, and the time of ovulation. Cervical score was not found to be useful to assess ovulation time in the cyclofenil treated group since 31.3% achieved a score of 10 or more on day – 4, 93.8% within 24 h of ovulation and 24% on day 3 following the ovulation.
Hyperprolactinemic infertile men
Authors: Mbizvo M.T. , Chimbira T.H.K. , Mkwananzi J.B.
Published: April 2004

Clinical descriptions of prolactin in states of oversecretion are presented in 49 patients that presented for infertility investigation. Radiological assessment did not reveal microadenomas in these patients. Erectile dysfunction or deficient semen parameters could be early manifestations of hyperprolactinemia in some infertile men.
The advantages and disadvantages of subspecialization
Authors: Jansen R.P.S.
Published: April 2004

Writing as a subspecialist I intend to show: (1) that subspecialization is as necessary in developing countries as it is in developed countries; (2) that there are universal principles of human nature likely to govern the process of subspecialization, independently of a country's political system or health care policies; and (3) that the pyramidal system of tertiary referrals to subspecialists is threatening to price doctors out of many people's reach.
Contribution of congenital malformation to perinatal mortality in Lagos, Nigeria
Authors: Abudu O.O. , Uguru V. , Olude O.
Published: April 2004

Over a 17‐month period we prospectively recorded identifiable congenital malformations at delivery in singleton births in our hospital. Despite the prevailing religious and cultural belief we carried out autopsies in 41% of the perinatal deaths that occurred during the study period. Out of a total of 63 (21/1000 singleton births) congenital malformations discovered, 21 (33%) were identified at autopsy only. About 16% of total perinatal deaths were due to congenital malformation. Cardiovascular malformations accounted for about 40% of perinatal deaths from congenital malformations followed by central nervous system malformation (23.3%), gastrointestinal malformations (20%), musculo‐skeletal malformations (6.7%); renal malformations (3.3%) and others (6.7%). No relationship between maternal age, parity and congenital malformation was found. The results from this study suggest that with the use of autopsy, teratology may contribute significantly to the prevailing high perinatal mortality in Lagos more than was previously thought.
Urinary estrone glucuronide, pregnanediol glucuronide and human chorionic gonadotrophin in threatened abortion
Authors: Ishwad P.C. , Chitlange S.M. , Joshi U.M. , Chowdhury V. , Mehta A.C.
Published: April 2004

Estimations of urinary estrone glucuronide, pregnanediol glucuronide and human chorionic gonadotrophin were carried out by ELISA to see their potential in predicting an abnormal outcome in cases with vaginal bleeding in early pregnancy. Reference values were set up with samples from women without bleeding in present or past pregnancies and with normal ultrasonic findings. None of the parameters were found to be sensitive enough to predict an abnormal outcome. However, predictability of an abnormal value was found to be 95% for estrone‐3‐glucuronide (E1G), 93% for pregnanediol glucuronide (PdG) and 87% for human chorionic gonadotrophin (hCG).
Serologic diagnosis of Chlamydia trachomatis infections
Authors: Hossain A.
Published: April 2004

The serology of various infections often caused by Chlamydia trachomatis including complications such as pelvic inflammatory disease (PID) and infertility was investigated comprehensively among diverse patient groups in a developing country using initially an indirect immunofluorescent antibody test (IFA). Any positives detected were further examined by a micro‐immunofluorescence (MIF) method for the presence of type specific anti‐chlamydial IgG/IgM antibodies. Conventional cell culture was carried out concurrently to compare culture results with serologic results. Among 416 patients (107 males and 309 females) C. trachomatis D‐K antibodies to IgG were identified in 87 (20.9%) and to type specific IgM were identified in 11(2.6%) patients. Cell culture identified C. trachomatis in 60 patients (14.4%). C. trachomatis IgG antibodies were detectable in 6.4% of chlamydia culture negative patients.
Histopathology of tubal pregnancy
Authors: Dietl J. , Buchholz F. , Kindler P.A.
Published: April 2004

The histopathological examination of several sections of tubal ectopic pregnancies shows that the growth of the trophoblast usually takes place in an extraluminal subperitoneal site and that dilation of the tube is caused by coagulated blood and not by the trophoblast. For conservative surgery of the tube it is necessary to keep in mind the histopathological findings of tubal pregnancies.
Massive ascites associated with endometriosis in a Nigerian African
Authors: Olubuyide I.O. , Adebajo A.O. , Adeleye J.A. , Solanke T.F.
Published: April 2004

A case of endometriosis with massive ascites in a 19‐year‐old Nigerian African is reported. This is an unusual combination and it is likely that most gynecologists and general physicians would never see such a case. The presentation and management of this entity is discussed.
Brenner tumor as encountered in a southern Nigerian Hospital
Authors: Briggs N.D. , Katchy K.C.
Published: April 2004

Brenner tumor is an uncommon ovarian tumor whose etiology and hormonal activity have aroused controversies. The salient features of three cases of this tumor seen at the University of Port Harcourt Teaching Hospital, Nigeria, between March 1981 and March 1987 are discussed.

In one case, the tumor was bilateral and was associated with secondry polycythemia. Another case was associated with a full term pregnancy and here the tumor contained luteinized stromal cells. Although such cells are usually associated with estrogenic activity, the full term pregnancy in this case will suggest at best a low level of hormonal activity. The last case was an incidental microscopic lesion in a postmenopausal woman.
Risk factors for low birthweight in Singapore: strategies for prevention
Authors: Viegas O.A.C. , Singh K. , Cheng E.L. , Ratnam S.S.
Published: April 2004

An analysis of 9399 consecutive singleton births delivered at this unit is presented. The incidence of low birthweight (< 2500 g) was 7.4%. Further analysis of the 698 low birth weight babies indicated that a variety of socio‐demographic risk factors are operational in the etiology of low birthweight. Many of these are preventable before pregnancy so that the implementation of preventive Public Health measures utilising appropriate technology at least in developing countries may be socially and economically preferable to continued financial investment in intensive perinatal services.
Serum complement levels in normal pregnancy and pregnancy‐induced hypertension
Authors: Jagadeesan V.
Published: April 2004

Serum complement assay (CH50) was carried out in urban low‐income women belonging to the following groups: (i) non‐pregnant and non‐lactating women; (ii) pregnant women in different periods of gestation; (iii) women suffering from pregnancy‐induced hypertension. Serum CH50 titers showed significant increase in the second and third trimester pregnancies as compared to non‐pregnant, non‐lactating women. There were no differences in CH50 levels between women suffering from pregnancy‐induced hypertension and those with normal pregnancy of comparable period of gestation. Nutritional status did not seem to have any influence on complement titers.
Perinatal mortality at King Fahd Hospital of The University Al‐Khobar, Saudi Arabia
Authors: El‐Zibdeh Mazen Y. , Al‐Suleiman Suleiman A. , Al‐Sibai Mohammad H.
Published: April 2004

The perinatal deaths of all singleton births that occurred at King Fahd Hospital of the University, Al‐Khobar, Saudi Arabia during a 4‐year period are analysed. The causes of death are classified into 12 groups using an extended modification of the Aberdeen classification. There were 165 perinatal deaths in 8057 singleton births, giving a perinatal mortality rate of 20.47 per 1000 total births. Fetal malformations occurred in 29 (17.57%) cases. Of the remaining 136 normal infants, 77 (56.6%) were stillbirths and 59 (43.4%) died within 1 week of delivery. Spontaneous premature labor was the commonest cause of death (23.52%) followed by birth trauma (11%) and maternal diseases (9.55%). The cause of death was not known in 22 (16.17%) cases. In conclusion, prevention of premature labor, better intrapartum fetal monitoring, early recognition of fetal distress and improvement of neonatal care should reduce the perinatal mortality rate.
Endocrine and morphological study of a case of ovarian sex‐cord tumor with annular tubules in a woman with Peutz‐Jeghers syndrome
Authors: Benagiano G. , Bigotti G. , D'Alessandro P. , Napolitano C.
Published: April 2004

A bilateral ovarian sex‐cord tumor with annular tubules (SCTAT) was incidentally discovered in an amenorrheic patient with Peutz‐Jeghers syndrome during conservative surgery in which a small non‐capsulated mass was removed from each ovary. Ovulation was then induced over two consecutive cycles with urinary gonadotropins; the couple did not conceive because of a male infertility factor. Hysterectomy and bilateral oophorectomy were performed to prevent recurrence and avoid the possibility of a cervical malignant adenoma. Immunohistochemistry of the SCTAT showed positivity for estradiol and testosterone similar to that of Sertoli and granulosa cell tumors; progesterone was not detected in any cellular component of the neoplasia. Electron microscopy showed that the neoplasm consisted of numerous solid cords of cells surrounded by fibrillary layers of basal lamina, as well as central hyaline bodies. Two types of cells, clear and dark, were noted; clear cells were predominant and intermixed with scattered dark cells. No crystalloids or Charchot‐Bottcher filaments were detectable in the tumors.
The perinatal survey of the South‐west Region in the United Kingdom
Authors: Dunn P.M.
Published: April 2004

The South Western Region of the United Kingdom (UK) has a population of over three million and approximately 38,000 births each year in 48 maternity units. During 1980–1982, a detailed survey, including site visits, was undertaken of the perinatal facilities, staffing, workload and outcome. During that period the perinatal mortality for the region fell faster than in any other region; at 9.1 per 1000 births in 1982, it was also the lowest for any region in the UK.
Developing professional responsibility in maternity care in Hong Kong
Authors: Wong V.C.W. , Leung P.M.K. , Li D.F.H.
Published: April 2004

A simple questionnaire was used to document basic information surrounding all perinatal deaths in Hong Kong. Coordinators were appointed for every maternity unit. Replies were sent by mail to the Obstetrical and Gynaecological Society. Using volunteer time and minimum budget, the data were collated and analyzed. The main causes of death were congenital anomalies, intrauterine death of unknown cause and prematurity. There was significant difference in performance when the University units were compared with the private and Government units. Changes in resource allocation and modification of clinical practice may be recommended as a result of such audit.
Oral versus local treatment of vaginal candidosis
Authors: Salem H.T. , Salah M. , Farid A. , Sabra A.M. , Makarem M.H.
Published: April 2004

A comparative study was conducted to compare the results of the use of oral and local vaginal therapy in the treatment of vaginal candidosis. Forty‐five patients with clinical and mycological evidence of vaginal candidosis were recruited and were randomly allocated to one of the treatment groups. Twenty‐four patients received ketoconazole orally (400 mg/day for 5 days) and 21 patients received nystatin vaginal pessaries (100,000 units twice/day for 7 days). Seven out of 20 rectal swabs (35%) were positive for Candida albicans. Both drugs were significantly effective in relieving patients symptoms and physical signs. The mycological cure rates were 87.5% and 81%, and the relapsing rates were 0% and 5.9% for the ketoconazole and nystatin groups, respectively. Ketoconazole oral therapy had generally slightly higher results than local nystatin therapy in the treatment of vaginal candidosis, yet the difference was statistically insignificant.
Transient blindness in pregnancy induced hypertension
Authors: Nalliah Sivalingam , Thavarashah A.S.
Published: April 2004

Transient blindness associated with pregnancy induced hypertension without neurological symptoms is a rare phenomenon. The blindness in these cases is postulated to be of “cortical blindness”. Two such cases occurring immediately after childbirth are presented. The ophthalmic manifestations of this complication of pregnancy induced hypertension and the importance of an urgent evaluation are discussed.
Primary hyperparathyroidism and pregnancy
Authors: Hill N.C.W. , Lloyd‐Davies S.V. , Bishop A. , Goodman J.D.S.
Published: April 2004

Two cases of hyperparathyroidism during pregnancy are reported.
Angiogenic activity and neovascularization in adenocarcinoma of endometrium
Authors: Palczak R. , Splawinski J.
Published: April 2004

Angiogenic activity of adenocarcinoma of endometrium was evaluated by qualitative and quantitative assays that measure vessel growth in chorioallantoic membrane (CAM) of chick embryo and incorporation of [3H] thymidine to DNA of CAM, respectively. In addition, histological specimens of adenocarcinoma with the vascular system filled with contrasting medium, were examined for the presence of neovascularization. Both qualitative and quantitative assays on CAM indicated that adenocarcinoma of endometrium possessed angiogenic activity. Histological analysis suggested that neovascularization took place during development of adenocarcinoma. It is therefore possible that neovascularization in this tumor is stimulated by its angiogenic activity
Cervical prostaglandin injection: a novel method of administration for ripening the cervix and induction of labor
Authors: Shaala S. , Darwish E. , Anwar M. , Rocca M. , Ismail A.A.A.
Published: April 2004

Twenty pregnant women with ⩾36 weeks gestation and Bishop score of ⩽4 were subjected to either intracervical injection of PGE2 (0.25 mg) every 4 h to ripen the cervix and induce labor (study group n = 10) or injection of only the diluent (control group n = 10). PGE2 cases showed significant increase in Bishop score and were successfully induced. The mean induction‐establishment and induction‐delivery intervals were 4.3 ± 0.1 min and 6.07 ± 1.7 h, respectively. The control group showed no response. PGE2 cervical injection is a safe and effective method for cervical ripening and labor induction.
Prevalence of genital herpes simplex infection and abnormal vaginal cytology in late pregnancy in asymptomatic patients
Authors: Rimdusit P. , Yoosook C. , Srivanboon S. , Sirimongkolkasem R. , Pumeechockchai W.
Published: April 2004

A study was undertaken to determine the prevalence of genital herpes simplex virus (HSV) infection in 809 asymptomatic, late pregnant women attending the antenatal clinic (ANC) at Ramathibodi Hospital. There was only one case where the cervico‐vaginal swab specimen was positive for HSV by cultivation and the biotin‐streptavidin enzyme‐linked immunosorbent assay (B‐SA ELISA), for detection of viral antigens. This gave a prevalence rate of 0.12%. The anti‐HSV IgM in cord blood of the infant born to this mother was negative. The Papanicoulaou (Pap) smear was performed in 554 cases, including the above patient, but none showed evidence of HSV infection. The high prevalence of lower genital tract infection in these subjects was noted in both Pap smear (31.05%) and wet preparation of the cervico‐vaginal discharge (46.72%). Thus, examination of the cervico‐vaginal discharge during late pregnancy should be of benefit to the patients, in revealing asymptomatic infections of the lower genital tract.
Pelvic inflammatory disease and the intrauterine contraceptive device
Authors: Wright E.A. , Aisien A.O.
Published: April 2004

The relationship between the use of intrauterine contraceptive device (IUD) and pelvic inflammatory disease (PID) was examined in 1054 patients who were seen at the Family Planning Clinic of Jos University Teaching Hospital and were followed up. The overall risk of PID developing in women wearing the IUD was minimal: 62 out of 1054 (5.9%). The rates, however, varied for the 6‐month periods studied. The incidence of PID decreased as the period of usage increased. The greater number of patients developed PID less than 3 months from the date of IUD insertion. When PID occurred it was usually of mild or moderate intensity and the response to antibiotic therapy was very encouraging. There was no relationship between the parity of the patients and the development of PID. Even though there is a definite link between the use of IUD and the development of PID it does not obliterate the benefits which the use of IUD provide for the majority of its patrons; and so the use of IUD should continue.
Celo‐intestinal fistulae complicating advanced extra‐uterine pregnancy
Authors: Emembolu J.O.
Published: April 2004

Multiple celo‐intestinal fistulae with the passage of fetal bones per rectum as a rare complication of advanced extra‐uterine pregnancy is presented. This was further complicated by a recent intra‐uterine pregnancy which culminated in obstructed labor and uterine rupture. The subsequent peritonitis was of etiological significance in the formation of the peritoneo‐ or celo‐intestinal fistulae.
Accuracy of prediction of gestational age by ultrasound measurement of biparietal diameter in Nigerian women
Authors: Okonofua F.E. , Atoyebi F.A.
Published: April 2004

The accuracy of assessment of gestational age by ultrasound measurement of biparietal diameter (BPD) was evaluated in 84 Nigerian women. Ultrasound and menstrual delivery dates were compared in these women who had no complications of pregnancy and delivered infants whose birthweights were appropriate for 40 weeks. The results showed that ultrasound dating was more accurate than menstrual dating as evident from the number of women who delivered on and within 1 or 2 weeks of predicted delivery dates. It is concluded that (1) our locally produced BPD normogram is as accurate as those from elsewhere and (2) the normogram is recommended for use in Nigerian women for accurate pregnancy dating.
A 3‐year evaluation of the TCu380Ag and the Cu‐7
Authors: Apelo R.A. , Ramos R.M. , Bernardo E. , Champion C.B.
Published: April 2004

The TCu380Ag and the Cu‐7 intrauterine devices (IUDs) were evaluated in a randomized comparative clinical trial. A total of 198 women who had not recently been pregnant entered the trial in Manila, Philippines and were followed‐up through 3 years postinsertion. The 36‐month follow‐up rates were impressively high at 80.3 for TCu 380A users and 76.7 for users of the Cu‐7. Although the two IUDs demonstrated statistically similar termination rates, the findings suggest a higher efficacy for the TCu380Ag. Gross cumulative life‐table pregnancy rates were 0.0 and 4.5 for the TCu380Ag and Cu‐7, respectively, at 3 years. Overall 3‐year continuation rates were 74.3 and 64.9 for users of the respective devices.
Rudimentary horn pregnancy associated with pre‐eclampsia
Authors: Emembolu J.O.
Published: April 2004

The unusual association of pre‐eclampsia with a pregnancy in the rudimentary horn of the uterus in a multigravid patient is reported. The infrequent development of rudimentary horn pregnancy beyond the twentieth week of gestation may explain the rarity of this complication. The possible effect of rapid distension of the rudimentary horn with exposure of the myometrial surface to overwhelming fetal antigenic proteins may be of relevance in the development of pre‐eclampsia in this case.
Haemophilus influenzae bacteremia following first trimester abortion
Authors: Foldes J. , Eilam O.
Published: April 2004

While genital tract infections with Haemophilus influenza (H. influenzae) are recognized with increasing frequency, this organism still remains an uncommon cause of maternal infection. The association of this pathogen with spontaneous abortion is extremely rare and has been described only in cases of midtrimester abortion. We report a case of H. influenzae bacteremia following first trimester spontaneous abortion and review the literature.
Comparison of copper T‐200 with Lippes loop as a contraceptive device
Authors: Wright E.A. , Aisien O.A.
Published: April 2004

A comparison has been made between Lippes loop and T Cu 200 intra‐uterine contraceptive device with respect to their acceptability and effectiveness in a developing country. A total of 1054 patients were studied; 697 with Lippes loop and 357 with T Cu 200. The ages of the patients ranged between 14 and 44 years, with a peak age of 21–25 years for T Cu 200 and 26–30 for Lippes loop. The event rates were similar but T Cu 200 displayed lower expulsion rate, lower intermenstrual bleeding rate and a lower incidence of pelvic inflammatory disease. The Lippes loop had lower event rate for the other parameters considered, pregnancy and pelvic pain. The continuation rate was similar for both devices. Both devices are useful for women who wish to space out their children but for those who wish to achieve effective contraception for more than 5 years, Lippes loop should be the IUD of choice.
Intrauterine growth retardation: characteristics, risk factors and gestational age
Authors: Callan N.A. , Witter F.R.
Published: April 2004

Maternal, obstetrical, and neonatal factors were studied in 1604 pregnancies complicated by intrauterine growth retardation and 1604 non‐IUGR controls. These were examined in the overall IUGR group and at various gestational ages. Eighty‐six percent of perinatal deaths were found in the IUGR group with 57.4% occurring prior to labor. Maternal smoking, low weight gain, low prepregnancy weight, and hypertension were found more frequently in the IUGR population. In addition, maternal hypertension was found to be significant in the IUGR infants delivered prematurely.
Effects of oral contraceptive pills on serum lipoproteins and triglycerides
Authors: Towobola O.A. , Otubu J.A.M. , Uguru V.E.
Published: April 2004

Possible effects of a combined oral contraceptive (femenal) on blood triglycerides and high‐density‐lipoprotein‐cholesterol (HDL‐Chol) were studied in 25 women who had opted for hormonal contraception. Total serum triglycerides of 64.60 ± 12.39 mg/dl (mean ± SD) obtained prior to the commencement of hormonal contraception, did not reveal any statistical difference from the value of 65.49 ± 7.96 mg/dl obtained after 9 months contraception. Similarly, precontraception HDL‐Chol value of 58.05 ± 6.58 mg/dl was also not statistically different from the treatment value of 58.82 ± 5.42 mg/dl. Regression analysis of the values between control (precontraception) and treatment (9 months contraception) showed high correlation coefficients: (1) serum triglycerides, R2 = 0.5201; P < 0.001; (2) serum HDL‐Chol, R2 = 0.6590; P < 0.001. Both the mean body weight and blood pressure of the study subjects remained unchanged after 9 months continuous use of femenal for contraception.
Breastfeeding promotion: Feeding the low birth weight infant
Authors: Musoke R.N.
Published: April 2004

Though there is still some reluctance to use human milk for low birth weight infants, we have shown that it is possible exclusively to feed these infants on milk from their own mothers. The infants have adequate weight gain and are less likely to get infections, especially gastrointestinal and respiratory. It is possible to sustain lactation through manual expression during the period that the mother is not nursing her infant directly on the breast. A cup rather than a bottle can be used to feed these small infants. The mothers are thus encouraged because the infant does not suffer nipple confusion with a bottle and they continue breastfeeding after discharge from the hospital.
Breastfeeding promotion efforts: Why some do not work
Authors: Stokamer C.L.
Published: April 2004

The failure of a breastfeeding promotion effort to take root is traced to lack of administrative support and its consequences. For example, although staff training sessions were held, they were not mandatory and attendance was poor. There was no supervisory reprimand for staff who did not implement breastfeeding policies and practices. The program followed the steps for instituting change but failed and the lessons of its failure suggest that administrative backing is particularly important.
Basic and clinical aspects of GnRH‐agonists in reproduction
Authors: Schmutzler R.K. , Diedrich K.
Published: April 2004

Within recent years GnRH agonists have gained increasing importance in the treatment of reproductive failure. Their use as a pretreatment for in vitro fertilization increases the pregnancy rate at least under certain conditions. In cases of endometriosis and uterus myomatosus, GnRH agonists achieve high remission rates and may avoid or at least postpone the need for surgical intervention. The physiological basis and current clinical strategies are discussed.
Hydatidiform mole: clinicopathologic associations with the development of postevacuation trophoblastic disease
Authors: Murad T.M. , Longley J.V. , Lurain J.R. , Brewer J.I.
Published: April 2004

Clinical information and histopathologic material for 165 patients with hydatidiform mole referred to the John I. Brewer Trophoblastic Disease Center of Northwestern University Medical School during one year were reviewed in order to identify characteristics more likely to be associated with the development of gestational trophoblastic tumors. Twenty‐nine patients (18%) required chemotherapy for invasive mole or choriocarcinoma. Patients with uterine enlargement beyond that expected for dates and patients with ovarian theca‐lutein cysts were much more likely to require treatment after molar evacuation (47% vs. 18% and 40% vs. 16%, respectively). There was no correlation between the initial human chorionic gonadotropin level, gestational age, uterine size per se, maternal age or gravidity and the subsequent clinical course. Histologically, the following factors were associated with an increased incidence of postmolar gestational trophoblastic tumor: (1) progressive nuclear atypia (26.7% if atypia present vs. 4% if absent); (2) necrosis and hemorrhage (39.1% if extensive vs. 12.8% if limited); (3) decreased trophoblast maturation (48% if < 20% mature vs. 8.7% if ≥20% mature); (4) trophoblast proliferation (50% if marked vs. 13.9% if limited); (5) increased ratio of cytotrophoblast to syncytium (33.3% if > 1 vs. 6.4% if < 1); and (6) absence of Nitabuch's layer (21.4% if absent vs. 11.6% if present). Hydatidiform moles which demonstrate clinical or histopathologic evidence of excessively abnormal proliferative activity, as indicated by these features, are more likely to develop invasive mole or choriocarcinoma and should be considered for prophylactic chemotherapy.
Respiratory distress syndrome: differential effects of prenatal steroid therapy and prolonged rupture of the membranes
Authors: Suidan J.S. , Baassiri G.
Published: April 2004

We studied the incidences of respiratory distress syndrome (RDS) and of severe RDS and the survival rate in premature newborns who received a complete prenatal course of betamethasone (N = 49) and in those who did not receive the steroid (N = 546). We also studied the same parameters in steroid‐untreated prematures who had prolonged rupture of the membranes (⩾24 h, N = 91), and in those who did not (N = 448). We found that the incidences of RDS and severe RDS were significantly lower and the survival rate significantly higher in steroid‐treated babies than in untreated babies at 28–32 weeks of gestation (29% vs. 58%, P < 0.01; 21% vs. 46%, P < 0.03; and 83% vs. 49%, P < 0.01, respectively). We also found that untreated babies born after prolonged rupture of the membranes at 28–32 weeks had significantly lower incidences of RDS and severe RDS than untreated babies without prolonged rupture (43% vs. 64%, P < 0.02; 30% vs. 51% P < 0.02, respectively). Between 28 and 32 weeks, steroid‐treated babies did not have significantly lower incidences of RDS and severe RDS than untreated babies born after prolonged rupture of the membranes (29% vs. 43%, P > 0.2; 21% vs. 30%, P > 0.3, respectively). The data indicate that between 28 and 32 weeks gestation, the protection against RDS that is provided by prenatal treatment with betamethasone is not superior to that provided by prolonged rupture of the membranes alone.
Breech delivery of infants weighing more than 2000 grams: a case controlled retrospective analysis of 751 patients
Authors: Mahomed K. , Seeras R. , Coulson R.
Published: April 2004

This is a case controlled study of 385 women with breech presentation and 357 with cephalic presentation. Unlike many recent studies, vaginal breech delivery was associated with a significantly worse outcome for the infant. The reasons for these are discussed particularly in relation to developing countries and a protocol for management of these women is suggested to attempt to reduce the unacceptably poor outcome. Selective external cephalic version is advocated.
Arterio‐venous fistulas involving the uterus and lung
Authors: Kaku T. , Tsukamoto N. , Matsukuma T. , Matsuyama T. , Kamura T. , Nakano H.
Published: April 2004

A case of arterio‐venous fistulas (AVF) involving the uterus and lungs is described. A 57‐year‐old Japanese woman developed profuse uterine bleeding during endometrial curettage, and underwent emergency abdominal hysterectomy. Postoperatively, she complained of exertional dyspnea and palpitation. Pulmonary angiography revealed multiple AVFs in both lungs. The surgical resections of the lung lesions were performed and her pulmonary symptoms improved.
Fundal height in normal pregnant Nigerian women: Anthropometric gravidogram
Authors: Ogunranti J.O.
Published: April 2004

Fundal height measurements in centimeters (FH) have always been an objective method of evaluating fetal growth in pregnancy. The popular Mcdonald's rule refers mainly to caucasians unfortunately. Since FH may actually vary in an anthropological sense it was considered necessary to apply Mcdonald's rule to African subjects. Pregnant Nigerian women were studied to observe how their fundal height values compared with those obtained for caucasian women in western communities. A gravidogram was derived for the 10th, 50th and 90th centiles. Values outside the range of 10–90th centiles are to be used for the prediction of small‐for‐dates and large‐for‐dates babies accordingly. Prediction formulae for the various centiles derived from regression analysis were obtained and their usefulness in clinical anthropological practice using fundal height measurement highlighted. A simple universal formula for African subjects is presented. Normal values of pregnant women for somatotype, height, and abdominal girth are also presented. The result of this survey demonstrates a significant difference in fundal height values of African women from those of the hitherto utilized standards derived from the study of caucasian women, especially in early pregnancy. This report suggests an early intra‐uterine growth retardation in the African pregnancies which is corrected in the third trimester.
Multiple diagnoses and procedures during hysterectomy
Authors: Ranney B.
Published: April 2004

Seldom does a gynecologic patient, who needs a hysterectomy, have a single diagnosis. Among 2892 gynecologic patients who needed a hysterectomy, only 127 had a single diagnosis. The rest had two to ten separate diagnoses. Therefore, 96.4% also needed other gynecologic procedures at the time of hysterectomy — 4842 other operative procedures during 1925 abdominal hysterectomies, and 2356 associated operative procedures during 864 vaginal hysterectomies. Prior to the time of hysterectomy, 15.07% of these patients had had major gynecologic operations, but after hysterectomy (+ +) only 2.9% needed any subsequent gynecologic operations. We conclude that among gynecologic patients, chart reviews or coding systems which are based only on a single diagnosis, or computer systems which are limited to 2, 3, or 4 diagnoses, will usually be incomplete, inaccurate, and misleading.
Combined intrauterine and tubal pregnancy after in vitro fertilization and embryo transfer
Authors: Tani H. , Oda K. , Schichiri K. , Arakawa O. , Sato Y.
Published: April 2004

A case of combined intrauterine and tubal pregnancy after in vitro fertilization and embryo transfer is reported. As soon as the diagnosis was made at 9 weeks gestation, the fetal heart movement of the tubal pregnancy disappeared, and the patient was managed without surgery throughout the pregnancy course. After an infant was delivered, a right salpingectomy was performed and the diagnosis was histologically confirmed. Risk factors and treatments of combined pregnancy are discussed.
Bilateral tubal and twin pregnancies in Ile‐Ife, Nigeria
Authors: Makinde O.O. , Ogunniyi S.O.
Published: April 2004

Three cases of unilateral tubal twin pregnancies and four cases of simultaneous bilateral tubal pregnancy recorded in a Nigerian University Teaching Hospital were reviewed. The incidences were 1 in 68 and 1 in 51 ectopic pregnancies respectively. High twinning rates within the environment and tubal damage from pelvic infections were considered as possible etiologic factors.
Immunological studies on pre‐eclampsia in Nigerian women
Authors: Okerengwo A.A. , Williams A.I.O. , Ibeziako P.A.
Published: April 2004

Circulating immune complexes, C3b inactivator, C3 activator, C3c, C4 and C‐reactive protein were assayed in 49 patients with pre‐eclampsia and 35 apparently healthy pregnant Nigerian women. Pre‐eclamptic women had significantly higher mean levels of circulating immune complexes, C3c and C‐reactive protein. C3 activator mean level was also higher in pre‐eclampsia than in normal pregnancy. C3b inactivator concentrations were greatly depressed and the mean level was also significantly lower in the pre‐eclamptic group (P < 0.001). However, C4 mean levels were the same in both groups. From the results, it is postulated that in pre‐eclamptic conditions the significantly depressed levels of C3b inactivator could predispose to the persistence of deposited immune complexes in the kidneys, resulting in tissue damage. The findings also generally indicate an immunologic pathogenesis for the renal lesions in pre‐eclampsia in Nigerian women.
A centile chart for weight gain in pregnancy for the urban population of the Western Cape, South Africa
Authors: Theron G.B. , Thompson M.L.
Published: April 2004

Weight gain during pregnancy was studied. Women with low body mass index (BMI) gained significantly more weight than women with high BMI. Older women gained significantly less weight than younger women. Centile charts were constructed using a maximum likelihood procedure. The centile charts for patients who are ⩽25 years or with a BMI = ⩽ 24 kg/m2 cannot be regarded as differing significantly, however the chart for patients > 25 years with a BMI > 24 kg/m2 does lie significantly below the others. For practical purposes the process of weight gain can be regarded as independent of gestational age These charts can thus be used without knowledge of gestational age.
Trends in selected obstetric complications from University Hospital, Kuala Lumper, Malaysia
Authors: Zulkifli S.N. , Paine L.L. , Greener D.L. , Subramaniam R.
Published: April 2004

Trends in selected pregnancy complications from 1969 to 1987 in a tertiary hospital in Malaysia are presented. Complications reviewed were abortion, ectopic pregnancy, anemia, hypertension, hyperemesis, antepartum and postpartum hemorrhage. Possible explanations for the observed trends were discussed, including the role of improved obstetric care and changes in the characteristics of the childbearing population. The data presented give some indication of maternal morbidity in the childbearing population served by this tertiary center and should lead to improvements in provision of services as well as in health data collection in the future.
Extrauterine pregnancy in Mozambique
Authors: Bugalho A. , Strolego F. , Pregazzi R. , Osman N. , Ching C.
Published: April 2004

Epidemiologic, clinical and management information was collected from the case histories of 103 women operated on for an extrauterine pregnancy at the Department of Obstetrics and Gynaecology of the Central Hospital in Maputo (Mozambique) from April 1st, 1987 to March 31st, 1988. We observed a decline in extrauterine pregnancies (9.76%), an association of pelvic schistosomiasis (3.9%), and a high percentage of women with ruptured tubes and subsequent hemoperitoneum (75.7%).
Percutaneous ultrasound‐guided fetal skin biopsy: A new approach
Authors: Buckshee K. , Parveen S. , Mittal S. , Verma K. , Singh M.
Published: April 2004

Our preliminary experience with this unreported percutaneous ultrasound guided method using a fine needle system showed 100% success (seven cases) in obtaining fetal skin biopsies. The fetal scalp was chosen for biopsy. This technique is easy, less invasive, simple, has minimum procedural difficulties and complications and thus it may replace fetoscopy for obtaining fetal skin biopsy.
Perinatal mortality and cesarean section in Jos University Teaching Hospital, Nigeria
Authors: Wright E.A. , Kapu M.M. , Onwuhafua H.I.
Published: April 2004

The experience on perinatal mortality among 757 patients who underwent cesarean section in Jos University Teaching Hospital serving a high risk urban and rural population in Jos, Plateau State of Nigeria is presented. During the 2 years of study the cesarean section rate was found to be 4.4%. There were 69 stillbirths, 107 deaths during the first week of life giving a perinatal mortality rate of 235 per 1000. The possible factors responsible for this high rate are discussed and suggestions made to improve on this figure. These results were also compared with figures from studies carried out in other parts of Nigeria, and in other countries.
Relation between the birthweight and cord, maternal serum and amniotic fluid growth hormone levels
Authors: Ayhan A. , Yüce K. , Bilgin T. , Yüce A. , Koray Z. , Duyar O. , Erdem G.
Published: April 2004

Maternal and cord serum and amniotic fluid growth hormone (GH) levels were measured in 55 term pregnancies in order to evaluate the role of GH in prenatal fetal somatic growth. The study group consisted of patients who had small, large, and average for gestational age infants. The difference in mean maternal and cord serum and amniotic fluid GH levels between the three weight groups were found to be insignificant. It is concluded that GH does not influence fetal somatic growth.
Cytohistology, colposcopy and in situ hybridization in cervical preneoplastic lesions: A correlative study
Authors: Pasetto N. , Piccione E. , Mantenuto L. , Sesti F.
Published: April 2004

Formalin‐fixed, paraffin‐embedded cervical tissues from 106 patients which exhibited a colposcopically atypical transformation zone, were examined for the presence of HPV DNA by in situ hybridization using biotin‐labeled HPV 6/11 and 16/18 DNA probes. From the comparative study between histologic, cytologic, colposcopic findings and virologic results it is confirmed that HPV 6/11 DNA is detected more frequently in the less severe lesions, whereas HPV 16/18 DNA is predominantly found in the most severe dysplastic lesions.
An elevated maternal serum α‐fetoprotein leading to the diagnosis of an immature teratoma
Authors: Frederiksen M.C. , Casanova L. , Schink J.C.
Published: April 2004

A case report is presented of a woman with a maternal serum α‐fetoprotein 17.46 multiples of the median (MOM), who was found to have an ovarian immature teratoma. It is suggested that patients who present with a maternal serum α‐fetoprotein value greater than 9 multiples of the median receive a more comprehensive evaluation remembering that the α‐fetoprotein in the adult can be a tumor marker.
Recommendations for the management of low risk obstetric patients
Authors: Davis L. , Riedmann G.
Published: April 2004

Specific interventional procedures have enjoyed widespread popularity in the United States in the routine management of low risk obstetric patients without the benefit of clinical studies attesting to their utility. A review of the literature was conducted to survey obstetric practice with regard to amniotomy, intravenous fluids, third stage administration of oxytocics, episiotomy and continuous fetal monitoring.
McRoberts maneuver for shoulder dystocia: a survey
Authors: O'Leary J.A. , Pollack N.B.
Published: April 2004

A survey of 108 major teaching institutions in the United States regarding the utilization of the McRoberts maneuver for shoulder dystocia was conducted. Only 40% taught the procedure but 64% reported being familiar with its use. Among users, only 32% used it as the initial step. Surprisingly, only 40% thought it reduced fetal trauma.
Fetal intracranial arterial hemodynamics assessed by color and pulsed Doppler ultrasound
Authors: Hata K. , Hata T. , Makihara K. , Aoki S. , Takamiya O. , Kitao M.
Published: April 2004

Fetal intracranial arterial velocimetries were serially performed on 31 pregnant women with regular menstrual cycle, at 28–40 weeks of gestation, using color and pulsed Doppler ultrasound. The change in fetal intracranial arterial hemodynamics was based on the calculation of resistance index (RI). There was no significant difference between the RI values in the anterior cerebral artery (ACA) and middle cerebral artery (MCA) from 28 weeks to term. The RI in the posterior cerebral artery (PCA) was significantly lower than that in the ACA and MCA, respectively, from 28 weeks to term (P < 0.001). The PI values in both the ACA and MCA remained unchanged from 28 to 33 weeks, became significantly lower from 34 to 35 weeks (P < 0.05), and the values were fairly constant thereafter. The RI seen in the PCA showed no significant change from 28 weeks to term. This color and pulsed Doppler ultrasound assessment of fetal intracranial arterial blood flow provides a useful foundation for elucidating normal intracranial hemodynamics and will aid in avoiding misinterpretations of the different intracranial arteries.