bluuebunny/crossref_metadata_2025 huggingface dataset:
Bilateral ovarian lipid cell hyperplasia in a young hirsute patient
Authors: Henriksen Henel Marie , Fischer Simon , Guttorm Eigil
Published: April 2004

Virilizing lipid cell ovarian hyperplasia occurrd in a 24‐year‐old woman referred with secondary amenorrhea, hirsutism, and weight gain. Hormone analyses revealed abnormal androgen production shown in a suppression test to be autonomic and of ovarian origin.

Ovarian vein catheterization revealed abnormally increased androgen levels in the left ovarian vein and in the caval vein where it was entered by the right ovarian vein. As the patient wanted to become pregnant, three‐quarters of her ovarian tissue was resected. Menstruation and ovulation returned. Two years after the operation the patient conceived.

Histopathological and electron microscopic examinations revealed bilateral lipid cell hyperplasia.
Carcinoma in situ of the cervix in the postmenopausal female
Authors: Rotmensch Jacob , Rosenshein Neil , Parmley Tim
Published: April 2004

Eleven cases of postmenopausal carcinoma in situ of the cervix (CIS) are reviewed. They comprised 7% of the 178 cases of CIS evaluated and treated at The Johns Hopkins Hospital between January 1, 1977 and June 30, 1980. The extensive involvement of the endocervical canal in the postmenopausal patient requires conization in addition to colposcopy and endocervical curettage in order to fully evaluate the cervical disease.
Conservative treatment of uterine leiomyoma with the antiestrogen antiprogesterone R‐2323
Authors: Coutinho Elsimar M.
Published: April 2004

The case reported here shows how adequate conservative therapy of the antiestrogen R‐2323 saved a uterus in a woman of childbearing age who suffered a uterine leiomyoma. The patient's fertility was restored, and a twin pregnancy is currently in progress.
Sperm migration at different stages of the menstrual cycle
Authors: Faúndes Aníbal , Montes de Oca Víctor , Brache Vivian , Alvarez‐Sánchez Francisco
Published: April 2004

Sperm migration to the upper genital tract was studied in 15 volunteers who were to be surgically sterilized to see if sperm migration to the upper genital tract is consistent during different stages of the menstrual cycle. Five subjects underwent surgery during the midproliferative phase, five during the periovulatory period and five during the secretory phase. The stage of the cycle was determined by endometrial and ovarian biopsy at the time of surgery. Volunteers had a single coitus 5–12 h before surgery, confirmed by Sims‐Huhner test. Sperm were found in the uterus and at least one oviduct in all five subjects studied during the periovulatory phase, and only in two of the five cases undergoing surgery during either of the other phases. A good correlation was also observed between presence and number of sperm in the upper genital tract and quality of Sims‐Huhner test. However, neither the cycle stage nor the postcoital test had an absolute prognostic value over sperm migration.
Accessory cervix: An unusual congenital malformation
Authors: Qualiarello John , Porges Robert , Weiss Gerson
Published: April 2004

A woman with a septate vagina and two cervices was observed. One of the cervices ended blindly. The other cervix communicated with a normal corpus and two normally positioned patent fallopian tubes. Two explanations for the origin of this accessory cervix are offered: (1) that it originated from a fusion failure of the lower portions of the müllerian ducts, and (2) that it arose from the urogenital sinus.
Massive edema of the ovary: Two case reports
Authors: Lotgering F.K. , Lammes F.B.
Published: April 2004

Clinical history and histological findings in two cases of massive edema of the ovary are presented. The etiology is discussed and literature is reviewed. Recognition of this clinico‐pathological entity may possibly prevent unnecessary oophorectomy in young women.
The economic implication in pregnancy outcome
Authors: Rodriguez‐Escudero F.J.
Published: April 2004

The economic implication in pregnancy outcome is evaluated in a Spanish homogeneous population. The potential risk is assessed for: prematurity, intrauterine growth retardation, perinatal mortality and major malformation. The husband's employment appears worthless as an economic parameter. The best estimators of economic level in our population are the total income per capita and the monthly food allowance per capita. Study results clearly support the relationship between poverty and prematurity, intrauterine growth retardation and major malformation. No correlation is found between perinatal mortality and lower economic conditions, which differs from previous reports. The author suggests that perinatal problems be differentiated from each other in studies of risk factors.
Maternal mortality at twelve teaching hospitals in Indonesia — an epidemiologic analysis
Authors: Chi I‐Cheng , Agoestina Tina , Harbin Joe
Published: April 2004

Records on 36,062 maternity cases admitted to 12 teaching hospitals throughout Indonesia between 1977 and 1980 were analyzed. A hospital maternal mortality rate of 37.4/10,000 cases (39.0/10,000 live births) was derived that was about ten times higher than rates reported from developed countries in the early seventies. Hemorrhage, infection and toxemia accounted for 91.2% of deaths resulting from direct obstetric causes and for 86.1% of total deaths. It is postulated that if all pregnant women received adequate antenatal care, and if all women wanting no additional children were sterilized, maternal mortality would be cut in half. It is recommended that maternal health services in Indonesia be integrated into its successful family planning program.
The roll‐over test to predict toxemia in pregnancy
Authors: Ujalambkar A.N. , Sutaria U.D.
Published: April 2004

We performed the roll‐over test on 98 primigravid and 107 multigravid patients at 28–32 weeks' gestation to predict pre‐eclamptic toxemia. Positive results from the roll‐over test correctly predicted preeclamptic toxemia in 71.4% of primigravidae and 23.3% of multigravidae. Negative results were associated with a normal pregnancy in 94.9% of primigravidae and in 98.9% of multi‐gravidae. A mean arterial pressure of 61 mmHg or more when recorded between 28 and 32 weeks' gestation accurately predicted preeclamptic toxemia in 96% of all patients.
Placenta accreta and percreta: A review of 5 cases
Authors: Oumachigui Asha , Rajagopalan Gita , Reddy Rani , Prabhavathy R. , Chakravarty A.
Published: April 2004

Five cases of placenta accreta and percreta are reviewed. Three cases, one a recurrence in the same patient, presented with acute abdominal pain; in one case perforation resulting from placenta percreta was discovered at laparotomy. In another case, placenta accreta was recognized during cesarean delivery. Total or subtotal hysterectomy was performed in three cases; piecemeal removal of placental tissue and closure of the tear was performed in two of the patients. There were no maternal deaths, but the infants were stillborn in three cases of perforation or uterine rupture.
The transcutaneous Po2 measurement as an additional evaluation index to the physiological and pathological conditions under delivery
Authors: Klink T. , Husstedt W. , Klitzing L.v. , Friedrich H. , Seoudy A. , Oberheuser F.
Published: April 2004

Transcutaneous Po2 was continuously recorded from 17 newborns sub partu by normal deliveries and four cases with umbilical cord complications. These data were correlated with the corresponding fetal heart rate alterations and the maximum of contraction directly and 30 s thereafter. During the course of delivery three stages are differentiated: first stage of labor, full cervix dilatation, second stage of labor. The statistical evaluation succeeded in the χ2‐test (P < 0.01). Deriving from this result the tcPo2 measurement is an additional aiding procedure beside the cardiotocographic control for subpartal supervision.
The effect of various oral contraceptive combinations on premenstrual symptoms
Authors: Andersch Björn
Published: April 2004

The influence of different oral contraceptives on premenstrual complaints was examined in 191 randomly selected women from an urban population. Premenstrual depression and abdominal swelling was significantly more common in women taking oral contraceptives containing the progestogen component lynestrenol than those containing norgestrel. The reason for this difference is discussed. A deficiency of pyridoxine which affects tryptophan metabolism can explain the difference in premenstrual depression. However, it should be emphasized that the system which controls neuro‐endocrine balance is extremely complicated and does not at the present time permit any definite conclusions regarding the influence of oral contraceptives on mental complaints.
Hypogammaglobulinaemia during pregnancy in identical twin sisters
Authors: Amarin Z.O. , Grant K.A.
Published: April 2004

The clinical histories and reaction to pregnancy is described in identical twin sisters with acquired hypogammaglobulinemia. Additional evidence for the genetic basis of this disorder is advanced. A possible association with myasthenia gravis is noted and the occurrence of fetal growth retardation is described. Replacement therapy should be given when the diagnosis is made, and high doses might be useful during pregnancy especially if fetal growth retardation seems to be present.
Effects of long‐term treatment with bromocriptine on pituitary prolactinoma in a male
Authors: Ayalon D. , Eckstein N. , Homonnai Z.T. , Paz G.F. , Eshel A. , Reider I.
Published: April 2004

Poor surgical results are obtained when operating on large prolactinomas, especially when an extrasellar growth is demonstrated. Several groups have reported tumor regression following bromocriptine treatment.

A case report is presented of a young hyperprolactinemic man with a large pituitary adenoma with suprasellar extension, normal visual fields, decreased libido, impotence, hypogonadism and azoospermia. This man was treated with high doses of bromocriptine for a period of 5 months. A significant improvement of potency libido and sperm concentration associated with radiological evidence of a marked reduction of tumor size was noted following suppressive treatment with this ergot alkaloid.
The echogenic endometrium and alterations during menstrual cycle
Authors: Sakamoto C. , Nakano H.
Published: April 2004

Endometrial echograms were obtained from 101 patients with a regular menses to investigate cyclic changes which occur during normal menstrual cycle.

After the mid‐secretory phase, a marked increase of the reflecting interfaces was evident within the endometrium and a thickened echogenic area was observed. Such were not evident during the proliferative phase.

As the increased interfaces within the endometrium represent the effects of progesterone, an assessment of the endocrinological milieu is made feasible.
Interrelationship of breast‐feeding and educational status in lactational amenorrhea
Authors: Sudarshan K. , Prabhakar A.K. , Gupta A. , Sharma N.L.
Published: April 2004

This report presents the results of a study of breast‐feeding practices in 552 women at Smt. Sucheta Kriplani Hospital, New Delhi. Both education status and breast‐feeding had a significant correlation with lactational amenorrhea, although the correlation coefficient was higher with breast‐feeding.
The rise in ectopic pregnancy ‐ exploration of possible reasons
Authors: Chavkin Wendy
Published: April 2004

The rate of ectopic pregnancies has been rising in the past decade and it is responsible for an increasing proportion of maternal deaths. A history of pelvic inflammatory disease is strongly associated with ectopic pregnancy. There is a higher rate of ectopic pregnancy among intrauterine device users than non‐users. A history of abdominal surgery has been associated with ectopic pregnancy and there is some evidence that women taking certain hormonal preparations experience excess ectopic pregnancies. Through a critical review of the literature, the author explores the evidence for these associations. The paper closes with recommendations for future research.
Experience with Lippes Loop and Copper‐T intrauterine devices in rural Bangladesh
Authors: Bhatia Shushum
Published: April 2004

Experience with IUD use among rural Bangladeshi women within two programmatic efforts demonstrates that the Copper‐T IUD suited the needs of younger, lower‐parity women better than Lippes Loop. The differential performance by the device was especially marked within the program that offered a broad selection of contraceptive methods and occurred mainly because of lower rates of expulsion and lower rates of discontinuation for bleeding and pain among the Copper‐T users. Nevertheless, the easy availability of a wide choice of methods during the second program successfully encouraged dissatisfied IUD discontinuers to try other methods of contraception.
Hydatidiform mole following successful gonadotropin ovulation induction and donor artificial insemination
Authors: Portuondo JoséA. , Camarero María C. , Matia Juan C. , Roldan Manuel J.
Published: April 2004

A case of successful gonadotropins ovulation induction and donor artificial insemination (AID) followed by a complication of hydatidiform mole is presented. A review of the published papers related to this topic are commented. The organization of a world registry of AID depending on the World Health Organization is encouraged.
Automatic detection of fetal movement by Doppler ultrasound during non‐stress testing
Authors: Lauersen Niels H. , Hochberg Howard M.
Published: April 2004

A new external fetal monitor, using a defocused, wide‐area ultrasound transducer has been devised in order to obtain a more accurate representation of fetal movement during antepartum non‐stress testing. The fetal activity Doppler signal is easily distinguished from the fetal heart Doppler and provides an automatic record of fetal movement which is objective and reproducible. In several clinical tests, this new monitor was found to be more sensitive and reliable than either reports of fetal movement from the mother or from a physician palpating the abdomen. This method of automatic detection of fetal activity can improve the accuracy of the non‐stress test by providing an additional objective criteria.
Serum uric acid levels as an index of fetal prognosis in pregnancies complicated by pre‐existing hypertension and pre‐eclampsia of pregnancy
Authors: Varma Thankam R.
Published: April 2004

The relation of perinatal mortality to plasma‐urate concentration and blood pressure was studied in 200 patients with pre‐existing hypertension and 200 patients with pre‐eclampsia of pregnancy. Perinatal mortality was markedly increased when maternal plasma‐urate concentrations were raised, generally in association with severe pre‐eclampsia of early onset or superimposed on pre‐existing hypertension. Maternal hypertension, even severe, without hyperuricemia was associated with good prognosis for the fetus. When there was hyperuricemia, the prognosis for the fetus was poor irrespective of the level of blood pressure. Pre‐eclampsia of pregnancy was associated with high perinatal mortality rate when compared with the rate in pre‐existing hypertension. This study suggests that serum urate is a reliable index of fetal welfare when pregnancy is complicated by pre‐eclampsia and pre‐existing hypertension.
Surgical correction of a rectovaginal fistula
Authors: Rock J.A. , Woodruff J.D.
Published: April 2004

A modification of a transplantation procedure to repair congenital vaginal‐anus is described. This procedure may serve as an alternative to a primary closure when the rectum lies above the external sphincter muscle and little tissue is available to build a perineal body.
Chemotherapy in advanced primary and recurrent cervical carcinoma
Authors: Choo Yew Cheong
Published: April 2004

Chemotherapy in carcinoma of the cervix continues to be a therapeutic challenge. The diversified treatment programs from one institution and the factors affecting response are analyzed. It is concluded that until more active regimens are available, chemotherapy in advanced and recurrent cervical carcinoma should be confined to patients with good prognostic factors.
Induction of cervical compliance by balloon catheter in late pregnancy
Authors: Semchyshyn Stefan
Published: April 2004

Balloon catheter was used for pre‐induction cervical priming and in order to enhance induction of labor in 51 patients. This procedure was found to be a safe and effective adjunct to induction of labor in patients with unripe cervices (mean Bishop score 3.4) with induction of labor to delivery time of 6.5 h.
Malignancy grading and prognosis from a biopsy only in cases of electrocoagulated squamous cell carcinoma of the vulva, stages I and II
Authors: Frankman Olle , Kabulski Zbigniew
Published: April 2004

Histologic malignancy grading and prognosis from a biopsy only was retrospectively investigated in 92 cases of stages I and II of cancer of the vulva treated with electrocoagulation. A scoring was made of several histologic variables. The score proved to be a better predictor of survival than any other single factor analysed, including clinical staging. Depth of invasion did not significantly influence survival, thus indicating improper use of “microinvasion”, if defined only by depth of invasion.
The introduction of postpartum intrauterine devices in the People's Republic of China
Authors: Wen Zhou Su , Lin Lung , Laufe Leonard E. , Dixon Beth
Published: April 2004

In China, which has a commitment to family planning and, in particular, to the one‐child family, a postpartum IUD should be widely accepted and could have significant impact on the Chinese family planning program. This report presents the introduction of the Delta T and Delta Loop devices, with 200 immediate postpartum insertions. Fifty‐two deliveries were by cesarean section. The 6‐month expulsion rates were 13.3 and 17.2 for the Delta T and Delta Loop, respectively. There was one pregnancy reported. Analysis suggests that the two devices are suitable for use in the postpartum period for Chinese women.
Termination of second trimester pregnancy with a long‐acting vaginal pessary containing 15‐methyl‐PGF2α methyl ester
Authors:   The World Health Organization
Published: April 2004

This report summarizes the results of three studies comprising 1147 second trimester patients admitted to 11 different centres for termination of pregnancy. In the first study, mainly early second trimester patients received one long‐acting vaginal pessary containing 3.0 mg 15‐methyl‐PGF2α methyl ester, in the second study the pessary was randomly compared with intraamniotic administration of 2.5 mg 15‐methyl‐PGF2α in late second trimester patients (after the 15th week of gestation), and in the third study the same type of patients received the long‐acting pessary complemented, if necessary at 24 h, with intramuscular injections of 15‐methyl‐PGF2α (0.2–0.4 mg every third hour) for up to 12 h. The efficacy of the long‐acting pessary was related to the duration of pregnancy. In patients 15 weeks or less pregnant, the frequency of abortion was 81.2% within 30 h; in pregnancies greater than 15 weeks duration the success was 73.3% (P < 0.05). Both vaginal administration of the long‐acting pessary containing 15‐methyl‐PGF2α methyl ester and intraamniotic administration of 15‐methyl‐PGF2α were equally effective during the first 24 h following start of therapy. However, within the next 6 h, the intraamniotic administration was found to be significantly superior, especially in patients with a more advanced pregnancy. To achieve an efficacy comparable to the intrauterine treatment, it was necessary to add intramuscular injections of 15‐methyl‐PGF2α. This combined treatment resulted, however, in an increased frequency of cervical laceration. The results of the present study indicate that a treatment with a long‐acting pessary is useful in second trimester pregnancy up to the 15th week of gestation, when puncture of the amniotic sac is difficult. After the 15th week of pregnancy, intraamniotic administration of 15‐methyl‐PGF2α appears to be a more effective method with less side effects despite the invasive route of administration. The long‐acting pessary in conjunction with intramuscular supplement is equally effective if appropriately given.
Variant of pseudo‐Meig's syndrome
Authors: Koutras A. , Fisher S.
Published: April 2004

A variant of pseudo‐Meig's syndrome is reported in an 8‐year‐old female patient. The unusual presentation of this new variant (persistent bronchorrhea and absence of hydrothorax) is emphasized. Meig's and pseudo‐Meig's syndromes are discussed with emphasis on the new variant of pseudo‐Meig's syndrome. Attention is directed at the pathophysiologic mechanism and the early surgical intervention to avoid further complications.
Clinicopathologic study of breast carcinoma occurring during pregnancy and lactation
Authors: Aghadiuno P.U. , Ibeziako P.A.
Published: April 2004

In a 16‐year study of 703 cases of female breast carcinomas seen at the University College Hospital, Ibadan, Nigeria, seven cases were found in pregnant women and another seven cases in lactating women. Thus, pregnancy and lactation complicated breast carcinoma about two times per 100 female breast carcinomas. During the same period there were 51,058 deliveries, for a rate of three breast carcinomas per 10,000 deliveries. When women in the most active reproductive age group (20–40 years) were considered, there were 309 cases of female breast carcinomas. Therefore, 5% of women with breast carcinoma in this age group had concurrent pregnancy or lactation. The patients presented late, and the prognosis was generally poor. While the clinical features of inflammatory carcinoma are similar in most countries, the characteristics of some of the histologic types of breast neoplasia encountered in pregnancy and lactation in Nigerian women appear to differ from those reported in most European and American studies.
Level 2 hospital delivery of low birth weight infants 1970–1979
Authors: Mootabar Hamid , Fox Harold E.
Published: April 2004

We have reviewed the outcome for low birth weight infants in a designated Level 2 hospital. In New York City, hospitals are classified as Level 1, Level 2 and Level 3; the latter being the large tertiary center. St. Luke's‐Roosevelt Hospital Center, Roosevelt Division is a Level 2 institution modified by components of Level 3 expertise. The data presented spans 10 years comparing results before (Level 2) and after (Level 2+) upgrading of services. The survival of very low birth weight infants improved as a result of the change and is comparable to the tertiary center. The factors are discussed. It is concluded that an institution can decide on the lowest gestational age and/or birth weight to be managed within its perinatal service.
Congenital cardiac fibroma associated with fetal arrhythmia
Authors: Gonen R. , Degani S. , Samberg I. , Sharf M. , Grishkan A. , Abend M.
Published: April 2004

A congenital cardiac fibroma presented itself, antenatally by bursts of extrasystoles which were detected by the cardiotocograph during labor. Congenital cardiac tumors are extremely rare. The symptomatology of such tumors consists mainly of hemodynamic disturbances and various arrhythmias. Most of the reported cases were diagnosed in neonates or infants, usually in autopsies, none were diagnosed in utero. It seems logical to assume that some of the arrhythmias may have been present but not diagnosed antepartum. To the best of our knowledge the association of congenital cardiac tumor and fetal arrhythmia (FA) has not been reported yet.
Induction of labor with vaginal prostaglandin E2 pessaries
Authors: Varma T.R. , Norman Jacqueline , Cowell Lynne
Published: April 2004

Prostaglandin E2 vaginal pessaries (3 mg) were compared with conventional amniotomy and oxytocin infusion as a method of induction of labor in 160 patients in the study group compared with 160 in the control group. Each group consisted of 100 primigravidae and 60 multigravidae. When the features of labor, delivery and fetal status were analyzed for the study and the control groups, the patients who received PGE2 pessaries had a better outcome. The difference was more significant for those patients with a low Bishop score. Compared with controls, the PGE2‐treated patients had fewer cesarean sections either for failed induction or fetal distress (P < 0.01); the incidence of infants with low Apgar score was significantly less (P < 0.05) and there were fewer postpartum haemorrhages (P < 0.01)
Induction of labor with oral prostaglandin E2 tablets in high‐parity patients
Authors: Rahman M.S. , Rahman J. , Farrag O.A.M.
Published: April 2004

Labor was induced with two low‐dose regimens of prostaglandin E2 (PGE2) tablets in 46 high‐parity women at term who had singleton pregnancies with a success rate of 97.8%. Of the successfully induced patients, 42 had vaginal delivery and three were dilivered by cesarean section for cephalopelvic disproportion. There was one failure of induction. Both dose regimens (0.5 mg and 0.75 mg hourly) were equally effective in inducing labor. The pattern of labor and mean induction‐delivery interval of 5.8 h was similar to a comparable group of high‐parity patients with spontaneous labor. It appears from this study that induction of labor with PGE2 tablets is safe in high‐parity patients.
Fetal pulmonary maturity: Relationship between optical density (650 nm) to the lecithin/sphingomyelin ratio and phosphatidylglycerol in amniotic fluid
Authors: Moodley Sangithan , Liu James H. , Cherkis Richard C. , Miller Richard K. , Allen Merritt T. , Whalen Lorraine E.
Published: April 2004

An optical density value ⩾0.15 at A650 nm of amniotic fluid obtained through transabdominal amniocentesis from a high risk obstetrical population, which excluded diabetes mellitus, isoimmunization, and amniotic fluid infection, correlated 98.6% with a mature lecithin to sphingomyelin ratio (L/S) ⩾ 2.0% and 41.6% with the presence of phosphatidylglycerol (PG). The corresponding false positive rates were 1.4% and 16.8%, respectively. In 30 infants delivered within 48 h of testing, A650 nm ⩾0.15 correlated 100% with absence of respiratory distress syndrome. A650 nm is not recommended for Rhesus immunized gestations, diabetic pregnancies and amniotic fluid infection due to a high false positive rate with A650 nm compared to L/S and PG.
Contractile responses of uterine smooth muscle to acetylcholine and marihuana extract
Authors: Murthy N.V.A. , Melville G.N. , Wynter Hugh H.
Published: April 2004

Marihuana extract (ME) is known to influence smooth muscle activity. This study was designed to investigate the effect of crude ME on rat uterine muscle and to explain the mechanism of action using antagonists such as atropine, ergometrine and propranolol. The contractions and the electrical activity were recorded on isolated superfused rat uteri. It is speculated that ME by its uterine stimulatory action compromise uterine blood and may affect oxygen/nutrient transfer. The implication of this to the fetus is discussed.
Aerobic urethral flora of women with infertility and gynecologic problems
Authors: Elegbe I.A. , Adefioye A.A. , Elegbe I.
Published: April 2004

One hundred eighty‐five urine specimens were collected from an unselected group of non‐gravid Nigerian women patients attending the infertility and gynaecologic clinics in Ile‐Ife, Nigeria to investigate the aerobic urethral microflora. The specimens revealed that 25.9% of the total collected and processed contained bacteria flora. The most common aerobes isolated were Escherichia coli, P. mirabilis and S. epidermidis, in that order. The study has shown that there are changes in the urethral microflora from one physiologic age group to the other and that colonization of the urethral and urinogenital tract is important in the development of urinary tract infections.
Epidemiologic analysis of fetal death in utero in Singapore
Authors: Tan K.C. , Karim S.M.M. , Ratnam S.S. , Kottegoda S.R.
Published: April 2004

Records on 1777 cases of missed abortion and 1001 cases of intrauterine fetal death in three major maternity hospitals in Singapore between 1976 and 1980 were analyzed. The overall incidence of these two conditions was 10.35 and 5.82 per 1000 births, respectively. During the 5‐year period, the incidence of missed abortion increased consistently, from 8.05 to 12.76 per 1000 births. In contrast, during the same period, the incidence of intrauterine fetal death declined steadily from 6.44 to 4.68 per 1000 births. Missed abortions occurred more frequently in the early part of the year, especially in the months of March, April and May. The incidence of missed abortion and its correlation with possible environmental factors are discussed.
Previous experience of induced abortion as a risk factor for fetal death and preterm delivery
Authors: Park Tai Keun , Strauss Lilo T. , Hogue Carol J. Rowland , Kim Il Soon
Published: April 2004

As part of a community‐based study in Korea to evaluate the effects of previous induced abortion on length of gestation and pregnancy outcome of subsequent pregnancies, we analyzed data obtained from January 1979 to December 1981 on pregnancies reported to family health workers in Kang Hwa Island, Korea. The preterm, live‐birth rates were not significantly associated with previous induced abortion. Overall, the life table‐estimated fetal death rate for women enrolled at the eighth or earlier weeks of gestation was 13.7%, 10.2% for women with no previous induced abortion and 28.9% for women with previous induced abortion. The relative risk for fetal death for women who had undergone a previous abortion was 2.8; relative risk for parous women compared to nulliparous women was 3.4. After controlling for parity, previous induced abortion was not a significant variable for fetal death rate.
Blood viscosity and erythrocyte deformability in gestational diabetes
Authors: Kaibara Manabu , Marumoto Yuriko , Kobayashi Takuro
Published: April 2004

Hemorheological properties were investigated in 15 gestational diabetics and compared with those in 20 normal pregnant patients at 37 weeks gestation. Whole blood viscosity in gestational diabetes was increased significantly. Erythrocyte deformability measured by a filtration method was decreased significantly in gestational diabetes. A hypothesis that placental hypertrophy observed in gestational diabetes might be produced as a compensatory reaction to hypoxia caused by intervillous microcirculatory disturbance due to the abnormal hemorheology was proposed.
Meperidine and normeperidine metabolism in the rhesus monkey
Authors: Morrison John C. , Douvas Stavros G. , Rhodes Philip G. , Christie Russell J. , Bucovaz Edsel T. , Wiser Winfred L.
Published: April 2004

Meperidine and its principle metabolite, normeperidine, were given intravenously to four non‐human primates prior to cesarean delivery in an equivalent dose for human parturients. The status of the infants regarding neonatal depression was assessed at delivery. Repeated blood samples from both the mother and the neonate were obtained over a period of 4 days. The levels of meperidine and normeperidine were analyzed. The results showed that the metabolism of meperidine and normeperidine in the non‐human primate was essentially the same as that observed in the human parturient. In addition, normeperidine appeared to be more toxic than meperidine to the neonate. Finally, there does not appear to be an evidence for neonatal metabolism of meperidine to normeperidine.
Use of in vitro method to predict response of human ovarian carcinoma cells to chemotherapeutic agents
Authors: Buckshee K. , Roy P.K. , Chapekar T.N.
Published: April 2004

In vitro tissue culture and sensitivity tests were carried out on 16 cases of ovarian cancer to select the right anticancer drug(s) on an individual basis. The predictive accuracy of the in vitro drug sensitivity tests were 81.8%. The drug(s) suggested by in vitro tests did not reveal any correlation to the type of ovarian cancer. The drug sensitivity of cells from primary growth was different from that of secondary growth. The in vitro screening test also provided the choice of the next best drug(s), once the tumor had become resistant to a particular drug(s). Thus, the overall prognosis of patients at an advanced stage of malignancy could be improved with the help of in vitro predictive tests.
A misplaced intrauterine device: A case report
Authors: Nguma Monganza , Ntabona Bagalwa C. , Rahma‐Tozin Rachid , Lusanga Nkwey
Published: April 2004

A 26‐year‐old woman consulted our Family Planning Unit because she could not locate the thread of her intrauterine device (IUD), which was placed 16 months earlier. Attempts to remove the IUD under fluoroscopy failed. A hysterography showed the IUD to be in the pelvis away from the uterus. At laparotomy, the IUD was found hidden in the omentum and its removal was done by resection of a piece of the omentum. The patient became pregnant three months later and gave birth to a healthy baby at term.
Therapeutic insemination with fresh semen
Authors: Pereira De Carvalho Waldemar Diniz
Published: April 2004

Int J Gynaecol Obstet 22: 281–285, 1984 were studied. Every female patient presented normal ovulation, tubal patency and morphologic and functional integrity of her genital tract. Their husbands presented normal spermogram in 45 cases (23.4%), oligospermy in 145 (75.5%) and azoospermy in 2 (0.96%). The number of the inseminations ranged from 1 to 10 series, in each of which a daily trial was attempted, three times every other day in the ovulatory period. The insemination technique included vaginal, intracervical and intra‐uterine deposition of homologous fresh semen. The results expressed in terms of pregnancy achieved rates of 28.12% with 24.07% abortions.
Sexually transmitted diseases and infertility
Authors: Kramer Dorine G. , Brown Stuart T.
Published: April 2004

In the past decade, involuntary childlessness has become a major problem in many areas of the world. At the same time evidence confirms a link between sexually transmitted diseases (STDs) and the burgeoning infertility problem. STDs can adversely affect fertility by three primary mechanisms: (1) pregnancy wastage; (2) neonatal deaths; and (3) obstruction of either male or female reporductive ducts. STD control programs have been effective in preventing sequelae of disease, including infertility. The first step in developing such a program is to identify the magnitude and distribution of the problem, and to identify the specific agents most commonly involved. Subsequently, an STD control program emphasizing the prevention of infertility, can be incorporated into the existing health care system whenever STDs are an important cause of infertility.
Ambulatory removal of cervical polyps under colposcopy
Authors: Abramovici Haim , Bornstein Jacob , Pascal Bruno
Published: April 2004

Hospitalization, polypectomy, and D&C under general anesthesia, are the usual way to treat a cervical polyp. This article describes a simple, ambulatory way of performing polypectomy under colposcopic vision, with no need for hospitalization and general anesthesia. The paper summarizes our experience with this method in 96 patients. Our conclusion is that this simple procedure spares the patient general anesthesia, D&C, and unnecessary hospitalization with attendant expense.
Sterilization‐associated deaths: A global survey
Authors: Strauss Lilo T. , Huezo Carlos M. , Kramer Dorine G. , Rochat Roger W. , Senanayake Pramilla , Rubin George L.
Published: April 2004

Except for data from several geographically limited studies, little is known globally about the number and causes of death associated with surgical sterilization. To identify clinical characteristics and problems leading to deaths related to the procedures, the International Planned Parenthood Federation (IPPF) and the Centers for Disease Control (CDC) in the United States collaborated in a global mail survey of 4642 physicians. Usable responses were received from 1298 physicians (28%) in 80 countries. Fifty‐five sterilization‐associated deaths which occurred from January 1, 1980 to June 30, 1982 were reported. The most frequently reported causes of death were infection, anesthetic complications, and hemorrhage. There were some regional differences in the relative frequencies of these causes. Most cases did not involve surgical accident. The characteristics most frequently associated with the reported fatal procedures were: interval sterilizations, minilaparotomy incision, tubal ligation and general anesthesia. Most deaths were attributable to the surgical sterilization procedure.
Ovarian melanoma. An interesting case
Authors: Ben David M. , Feldberg D. , Dicker D. , Kessler H. , Goldman Jack A.
Published: April 2004

A rare case of metastatic melanoma of the ovary and extension to the omentum is reported. The tumor was discovered 25 years following enucleation of one eye for malignant melanoma of the choroid.
Sonographic criteria of phasic changes in human endometrial tissue
Authors: Sakamoto C.
Published: April 2004

Sonographic criteria of endometrial tissue were obtained following serial observations in normally ovulating women, and a prospective identification of a specific phase was made in those with regular menstrual cycles. This may be the first report of endometrial tissue characterization. Clinical management of infertility and monitoring of follicular growth will thus be faciliated.
Complications of combined surgery and radiation therapy for carcinoma of the endometrium
Authors: Remy Jean Claude , Fruchter Rachel G. , Boyce John , Macasaet Milagros , Choi Kwang , Rotman Marvin
Published: April 2004

Long‐term gastrointestinal (GI) and urinary tract (UT) complications were evaluated in 133 women with carcinoma of the endometrium who were treated by both radiotherapy and hysterectomy. Major complications developed in 8% of patients who received external pelvic radiation but in none with intracavitary radiation. GI complications were more frequent and more severe in patients receiving external pelvic radiation than in those who received only intracavitary radiotherapy, irrespective of the sequence of treatment. UT complications were more frequent with prehysterectomy external radiotherapy (N = 39) than with posthysterectomy external radiotherapy (N = 21).
Pregnancy despite continued elevation of prolactin levels while on bromergocryptine
Authors: Corson Stephen L. , Batzer Frances R.
Published: April 2004

A case of long standing secondary amenorrhea with hyperprolactinemia and pregnancy success despite inability to normalize prolactin levels with high doses of bromergocryptine is presented.
Management of puerperal separation of the symphysis pubis
Authors: Schwartz Z. , Katz Z. , Lancet M.
Published: April 2004

Thirteen post‐partum patients with symphysiolysis were treated by intra‐symphysial injection of a combination of hydrocortisone, chymotrypsin and lidocain. The injection was given once a day and the full treatment consisted of between three to seven injections according to the severity of the symptoms. No other medication was given. Immediate relief was obtained in all cases after the first injection and all symptoms disappeared after the completion of treatment. The average time of hospitalization was 9.8 days. No complications were seen as a result of the treatment and the patients resumed their normal activities after being discharged from hospital. In comparison with other modes of treatment, the intra‐symphysial injection of the above drug combination shortened the time of morbidity and effected complete recovery.
Prostaglandins in the fetal circulation following maternal ingestion of a prostaglandin synthetase inhibitor during mid‐pregnancy
Authors: MacKenzie I.Z. , Graf A.K. , Mitchell M.D.
Published: April 2004

To assess the possible effect upon the fetus of maternal ingestion of the prostaglandin synthetase inhibitor, mefenamic acid, taken during mid‐pregnancy (15–22 weeks) to prevent spontaneous abortion, samples of fetal blood were collected at fetoscopy from 13 treated and 14 untreated control cases. Mefenamic acid levels in the fetus were 32–54% of those in the mothers in the treated group, while prostaglandins E2 (PGE2), 6‐oxo‐PGF1α and PGFM were all slightly but not significantly lower in those patients given 500 mg mefenamic acid 40–180 min prior to sampling than in untreated controls. Results indicate that the prostaglandin synthetase inhibitor crosses the placenta at this early gestation and may possibly suppress fetal prostaglandin production.
Cyclophosphamide and cisplatinum combination chemotherapy for the treatment of epithelial ovarian carcinoma
Authors: Hahn Karla , Magrina Javier F. , Masterson Byron J.
Published: April 2004

A review of 18 patients with Stage III epithelial ovarian carcinoma treated by surgery and followed by cyclophosphamide and cisplatinum combination chemotherapy is presented. At the end of 12 months from the initiation of chemotherapy, 88.9% of the patients were alive and 77.8% remained free of tumor progression. At the end of 2 years 77.8% of the patients were alive and 44.4% of the patients were free of tumor progression. The combination of cyclophosphamide and cisplatinum has low toxicity, a simple pattern of administration, and has provided satisfactory results.
Neutral mucosubstances as a prognostic indicator in serous and endometrioid carcinomas of the ovary. A morphometrical analysis of saliva‐periodic acid‐Schiff stain
Authors: Aalto M.‐L.
Published: April 2004

Forty‐four serous and 17 endometrioid carcinomas of the ovary were classified on hematoxylin‐eosin stained tissue sections using the criteria of World Health Organization (WHO). The amount of saliva‐periodic acid‐Schiff (SPAS) staining positivity, indicating presence of neutral mucosubstances, was quantitated morphometrically and compared with survival of the patients. The 5‐year survival of patients who had SPAS positive serous carcinoma was 36% whereas that of patients with SPAS negative serous carcinomas was only 7%. Among the patients who had endometrioid carcinoma showing SPAS positivity over the median, the 5‐year survival was 47%. All patients with SPAS positivity less than the median had died in 3 years after the diagnosis. The differences in survivals were statistically significant (P < 0.001). This study shows that neutral mucosubstances as quantitated morphometrically is a good prognostic indicator of serous and endometrioid carcinomas of the ovary.
Evaluation of a needle pH electrode for continuous tissue‐pH monitoring during labor. Characteristics during acidosis in the rat
Authors: Nickelsen C. , Weber T. , Hansen A.J. , Hansen A. , Zeuthen T.
Published: April 2004

A prototype of a needle tissue‐pH (t‐pH) electrode designed for continuous t‐pH monitoring of the human fetus during labor is described and evaluated in vitro and in vivo in the rat. Respiratory acidosis was induced by ventilation with 5% carbon dioxide, and t‐pH measured by the needle electrode compared to simultaneous t‐pH measured by the Kontron‐Roche electrode and to arterial blood pH. A close correlation between the two t‐pH electrodes was demonstrated (r = 0.80, P < 0.001).

Furthermore, a close correlation was found between t‐pH and arterial blood pH during the first 15 min of acidosis (r = 0.82, P < 0.001). It is concluded that the needle electrode fulfils nearly all theoretical demands to a t‐pH electrode for clinical use.
Expression of HLA class I and class II antigens in human choriocarcinoma cell lines
Authors: Yamashita K. , Nakamura T. , Shimizu T. , Katagiri M. , Ikeda H.
Published: April 2004

Eight choriocarcinoma cell lines (6:gestational origin, 2:non‐gestational origin) were studied by a radioimmune inhibition test using monoclonal antibodies for the expression of HLA class I and class II antigens. Levels of HLA class I antigens were very slight or nil. On the other hand, no HLA class II antigen was detected in any choriocarcinoma cell lines examined.
Continuous extraovular prostaglandin F2 alpha instillation for late pregnancy termination in patients with previous cesarean section delivery
Authors: Atad J. , Lissak A. , Calderon I. , Sorokin T. , Abramovici H.
Published: April 2004

Late pregnancy termination by continuous extraovular instillation of prostaglandin F2α (PGF2α) was successfully performed in 13 patients with previous cesarian section (CS) delivery. The indications for pregnancy termination were intrauterine fetal demise in nine patients, social indications in two patients, Down's Syndrome in one patient and quadruplets pregnancy in one patient. One patient had a previous classical vertical cesarian section, two had two previous and one three previous low segment transverse (LST) cesarian sections. The other nine patients had one previous low segment transverse cesarian section. The instillation of prostaglandin solution was obtained by using a new double balloon catheter designed for extraovular pregnancy terminations. All patients aborted following the procedure with no complications. The instillation abortion time ranged from 1/2 to 20 h (mean 13.3 h).
Determination of trace and bulk elements in plasma and erythrocytes of healthy pregnant women by pixe method
Authors: Gödény Sándor , Borbély‐Kiss Ilkikó , Koltay Ede , László Sándor , Szabó Gyula
Published: April 2004

Particle Induced X‐ray Emission (PIXE) analysis of blood samples from healthy pregnant women was carried out. Elements S, Ca, P, K, Cl, Fe, Zn, Cu, Rb and Br were detected in red blood cells while S, Ca, P, K, Cl, Fe, Zn, Cu, Ni, Br in the plasma. The concentrations of Ca, K and Br were found to be stable throughout pregnancy, others exhibited significant alterations. The importance of macro‐ and microelement metabolisms during pregnancy and their role in the intrauterine development is summarized.
Hospital deaths in a high risk obstetric population: Karawa, Zaire
Authors: Smith Jason B. , Burton Nadine F. , Nelson Grace , Fortney Judith A. , Duale Sambe
Published: April 2004

Three thousand four hundred thirteen consecutive deliveries at a rural hospital in Zaire are examined. 85% of patients had goiters and 5% were cretins. Twenty maternal deaths occurred, or 5.9 per 1000 deliveries. Risk factors for maternal death included late presentation, advanced age (⩾ 35 years), no education and presence of goiter or cretinism. Ninety percent of women who died were in critical condition at admission, 45% had labored ⩾48 h and 70% had uterine rupture.
Selective screening for carcinoma cervix in south Indian women
Authors: Shrivastav P. , Jairaj P. , Balasubramaniam N. , Krishnaswami H.
Published: April 2004

In India, the need exists for a scheme of selective screening for women at high risk of developing cervical carcinoma. In this study, the incidence of abnormal cervical cytology amongst 500 pregnant south Indian women (gravida 3, para 2 or more) who were booked under the Post Partum Programme of the Government of India was compared to that of 200 primi and second gravidas from the same out patient clinic population. Abnormal cytology was detected in 3.6% of the women in the study group which was significantly higher (P < 0.05) than that in the control (0.5%), indicating that the former are at higher risk of developing cervical cancer.

Within the study group, abnormal cytology was not found to correlate with increasing age and gravidity or with any clinical parameter. The study and follow up could be carried out using existing facilities and manpower. Using existing personnel involved in the Post Partum Programme, a follow up rate of 67% could be achieved from among women with abnormal cervical cytology. The cost‐effectiveness of this scheme of selective screening is borne out by the extremely modest additional cost incurred.