bluuebunny/crossref_metadata_2025 huggingface dataset:
A Demographic Study in Subgroups of Women Seeking Help for Premenstrual Syndrome
Authors: Hammarbäck Stefan , Bäckström Torbjörn
Published: November 2007

Eighty‐two consecutive cases of women who sought help for premenstrual syndrome (PMS) at the PMS clinic, University Hospital of Umeå, Sweden were studied. The presence of PMS was diagnosed by prospective daily rating of symptoms. The women also completed a modified Moos menstrual distress questionnaire (MDQ) and an Eysenck Personality Inventory (EPI). Two patients were excluded because of poor daily ratings. The remaining 80 women were divided after the diagnostic procedure into three groups: group I with pure PMS, group II called the premenstrual aggravation group and group III where cyclicity of symptoms could not be ascertained. Several demographic factors concerning marital status, education, employment, and previous medical, psychiatric and PMS history were studied, as well as menstrual problems per se. No significant differences betwsen the three subgroups were found in the analysis of the demographic factors. The only difference was that the pure PMS group contained a significantly smaller number of patients with pathologically high scores for neuroticism in the EPI, together with a smaller number of patients with a psychiatric history.
Gonadotropin—Releasing Hormone Agonist as an Adjunct in Conservative Surgery for Uterine Leiomyomas
Authors: Tanbo Tom , Åbyholm Thomas , Skjæraasen Julie
Published: November 2007

Preoperative treatment of a large uterine leiomyoma with a gonadotrop‐in‐releasing hormone agonist resulted in a volume reduction of 45%.
Emergency Embolectomy in a Patient with Massive Pulmonary Embolism during Second Trimester Pregnancy
Authors: Blegvad Susanne , Lund Ole , Nielsen Torsten Toftegaard , Guldholt Inger
Published: November 2007

Emergency pulmonary embolectomy was performed successfully on a patient in her second trimester of pregnancy. The patient had severe right ventricular failure due to obstruction of 85% of the pulmonary arterial circulation. Three months after embolectomy she was delivered of a normal infant. The problem of significant but misinterpreted or overlooked clinical and electrocardiographic signs of pulmonary embolism is discussed. Thrombolytic therapy during pregnancy imposes considerable risk of bleeding with deleterious effects on both mother and fetus. In our opinion, emergency embolectomy during extracorporeal circulation is the best treatment in case of massive emboli during pregnancy.
Squamous Cell Carcinoma of the Vulva with Cutaneous Metastases
Authors: Santala Markku , Syrjänen Kari , Saarikoski Seppo
Published: November 2007

Cutaneous metastases from squamous cell carcinoma of the vulva are extremely uncommon. A 72‐year old woman had undergone vulvectomy with bilateral inguinal lymphadenectomy. The operative specimen showed tumor infiltration in the resection borders to a considerable depth. Thereafter she received radiotherapy. Seven months after the primary operation, multiple non‐tender tumor metastases appeared on the lower abdomen. These metastases result from cross‐section and obstruction of lymphatic channels.
Fetal Growth And Fetal Glucose And C‐Peptide Levels In Relation To The Degree Of Anemia In Fetuses Affected By Rhesus Iso‐Immunization
Authors: Westgren Magnus , Selbing Anders , Stangenberg Magus
Published: November 2007

Fetal growth rate was determined by measuring the fetal biparietal diameter at 63 two‐week time points during the second trimester in 14 patients with severe Rhesus isoimmunization. Growth rate was found to be related to the fetal hemoglobin concentration which was determined at the end of each 2‐week period. Fetuses with a hemoglobin concentration of less than 30% of the normal value had a significantly decreased growth rate (p<0.01). These fetuses had also reduced C‐peptide (p<0.05) and increased glucose levels (p<0.1) compared with less anemic fetuses. The physiological background to impaired fetal growth in cases of severe fetal anamia at Rhesus iso‐immunization is discussed.
Relief Of Low Back Pain In Labor By Using Intracutaneous Nerve Stimulation (Ins) With Sterile Water Papules
Authors: Lytzen Tom , Cederberg Lennart , Möller‐Nielsen Jesper
Published: November 2007

Eighty‐three women experiencing low back pain in the 1st stage of labor were given intracutaneous nociceptive stimulation (INS) by means of sterile water papules injected intracutaneously over sacrum. There was instant and complete relief of the low back pain in all but 6 women, this effect lasting in many cases as long as 3h, after which INS could be repeated. A reduction in total pain‐score from 6.05 to 2.92 was seen after 1 hour with no further analgesia given, and half the women required no further analgesia during the 1st stage. The method was well tolerated and 67 of the 83 women said they would like to have INS analgesia for their next delivery. Possible mechanisms behind the analgesic effect of INS are discussed.
The Prevalence Of Prenatal Death In The Community Of Viborg, Denmark
Authors: Brandt Carsten A. , Holmskov Anni
Published: November 2007

In order to lower the perinatal mortality rate, it is necessary to acquire a specific fetal diagnosis in all late abortions and stillbirths. A uniform classification for the maternal/fetal diagnosis is needed for comparison of progress in maternity care program between the different countries. We have studied 86 consecutive cases of late abortion and stillbirth at Viborg Hospital, Denmark, and made a comparison with the modified Aberdeen classification of fetal death.
The Effects Of Serum From Women With Miscarriages On The In Vitro Development Of Mouse Preimplantation Embryos
Authors: Abir Ronit , Zusrnan Lgor , Hur Hertzel Ben , Yaffe Perhiya , Ornoy Asher
Published: November 2007

It is generally believed that some human miscarriages result from embryotoxic factors existing in the sera. To study the embryotoxicity of such sera, 3.5‐day‐old mouse blastocysts were cultured for 72 h on 80% sera from different groups of women. After 72 h there was no blastocystic development in 53.2% of the cases grown on sera from women after two or more miscarriages, and none in 33.6% of the blastocysts grown on sera from women after one miscarriage, as compared with 8.2% and 12% respectively on control sera. Sera from women with miscarriages were divided into ‘high risk’ (50% or more embryotoxicity) and ‘low risk’ (less than 50% embryotoxicity) sera. The ‘high risk’ sera from two or more miscarriages caused an average of 72.1% undevelopment, while the ‘low risk’ sera (less than 50% embryotoxicity) from the same group caused 33.6% undevelopment. The ‘high risk’ sera from one miscarriage were embryotoxic to 55.8% of the blastocysts and the ‘low risk’ sera from the same group caused only 8.7% undevelopment. No significant differences were found in the mean serum concentrations of folic acid, zinc and copper of many of the experimental groups, in comparison with controls. The embryotoxic factor/s which exist in the ‘high risk’ sera from women with miscarriages are still not known.
Long‐Term Effectiveness Of The Burch Colposuspension In Female Urinary Stress Incontinence
Authors: Eriksen Bjarne C. , Hagen Bjørn , Eik‐Nes Sturla H. , Molne Kåre , Mjølnererd Ove K. , Romslo Lnge
Published: November 2007

Of 91 women who underwent Burch colposuspension, 86 were available for clinical, urodynamic and isotope renographic follow‐up examinations 5 years after surgery for evaluation of late complications and long‐term effectiveness in urinary stress incontinence. A repeat urodynamic examination was accepted by 76 patients. Stress incontinence was cured in 71 % of the patients with a stable bladder preoperatively, and in 57% with stress incontinence and detrusor instability (non‐significant difference). Cure rate was not significantly related to age, hormonal status or previous anterior vaginal repair. The urodynamic measurements at follow‐up showed a significant increase in the functional urethral length in the cured group, as compared with the improved group. The mean maximum urethral closure pressure was reduced in both groups. Symptomatic detrusor instability was found in 18% of the preoperative stable bladders, while 67% of the unstable bladders had become stable. Only 29% of the patients with a preoperative unstable bladder had a normal lower urinary tract function at follow‐up. Late voiding difficulties were observed in 3% of the study group; enterocele, requiring surgical repair, developed in 7%. One patient suffered a damaged kidney due to undetected ureteral obstruction after surgery. Irritative bladder symptoms such as urgency, frequency, stranguria and nocturia represent a long‐term problem after colposuspension. At the 5‐year follow‐up, only 52% of the study group were completely dry and free of complications, and about 30% needed further incontinence therapy. This may be due to some neurogenic factor which is not corrected by surgery.
Stress Urinary Incontinence And Posterior Bladder Suspension Defects: Results Of Vaginal Repair Versus Burch Colposuspension
Authors: Thunedborg Per , Fischer‐Rasmussen Wiggo , Jensen Simone Bjerregaard
Published: November 2007

Vaginal repair has been recommended in cases of stress urinary incontinence and posterior bladder suspension defect diagnosed by colpocysto‐urethrography. Thirty‐eight women with stress urinary incontinence and posterior suspension defect have been treated. First, 19 women underwent a vaginal repair. In a second period, another 19 consecutive patients had a colposuspension a.m. Burch. The patients have been evaluated 6 months postoperatively and at a long‐term follow‐up. No significant difference was found postoperatively in the frequency of symptoms and signs of stress incontinence, either after 6 months or at the long‐term follow‐up. A significantly smaller frequency of genital prolapse was found in the colposuspension group at long‐term follow‐up. No side effects such as frequency, urgency or bacteriuria were evident in the group treated by colposuspension. With reservation to the non‐randomized allocation, it may be concluded that a radiographic distinction between anterior and posterior bladder suspension defects in choosing the surgical approach is unnecessary.
Psycho‐Social Factors In Pelvic Pain: A Controlled Study Of Women Living In Physically Abusive Relationships
Authors: Schei Berit
Published: November 2007

The study was designed to reveal possible associations between living in an abusive relationship and gynecological disturbances, including pelvic pain. 66 women living in or having lived in such a relationship the previous year were compared with 114 women, in a random sample of women from the same area not exposed to life in an abusive relationship. Data from both groups were obtained through personal interview. 32 women (48%) in the study group and 24 (21%) among controls had a history of pelvic pain (p<0.001). Eight (12%) women in the study‐group versus 2 (2%) of the controls had contacted a physician and reported a history of pelvic pain during the year prior to the interview (p < 0.05). The difference in the history of pelvic pain could not be explained by differences in psychosocial factors between the groups.
Influence Of Bupivacaine And Morphine On Human Umbilical Arteries And Veins In Vitro
Authors: Norén Håkan , Källfelt Björn , Lindblom Bo
Published: November 2007

Strips from human umbilical arteries and veins were prepared by micro‐dissection. The vessel strips were mounted in tissue baths for isometric recording of contractile activity. The local anesthetic drug bupivacaine induced a concentration‐dependent increase of tone in both artery and vein, whereas morphine had no effect. Nor did morphine influence the increase in vessel tone induced by bupivacaine. If applicable in vivo, the results suggest that morphine has little influence on umbilical vessel tone, whereas bupivacaine may reduce the umbilical blood flow, at least when the local concentration of bupivacaine exceeds a certain critical level. The addition of morphine to local anesthetics did not increase any adverse effects on the umbilical vessels in this study.
Rupture Of Uterus Treated With Suture
Authors: Klungsøryr Peter , Kiserud Torvid
Published: November 2007

Between August 1983 and August 1985, 63 patients in labor with uterine rupture were treated at Sidamo Regional Hospital, Yirgaalem, South Ethiopia, mainly by suture of the uterus. None of those operated on died. We recommend suturing as the treatment of choice. Hysterectomy is rarety indicated.
Outcome of Pregnancy in one Norwegian County 3 Years Prior to and 3 Years Subsequent to the Chernobyl Accident
Authors: Ulstein Magnar , Jensen Tone Skeie , Irgens Lorentz M. , Lie Rolv Terje , Sivertsen Erling
Published: November 2007

Pregnancy outcome was studied in a county in Norway 3 years prior to and 3 years subsequent to the Chernobyl nuclear plant accident on 26th April 1986. More detailed analyses have been performed for the 12 months prior to and subsequent to the accident. A significant increase in the spontaneous abortion rate the first year after the accident was followed by a slight decrease during the second and third years, but figures were still higher than the period prior to the accident. the rate of legal abortions was unchanged. During the entire observation period the number of births increased continuously, with the exception of a decrease in the last 2 months of 1986 and the first month of 1987. A higher incidence of spontaneous abortions was found for pregnancies conceived during the first 3 months after the accident. This increase in the spontaneous abortion rate is noteworthy, and more especially its long‐term persistence, which cannot be the result of external radiation. the internal radiation from food polluted by radioactive fallout is a possible explanation. Changes in nutrition in order to avoid polluted food may also be of importance.
When does External Cephalic Version Succeed?
Authors: Hellström Ann‐Cathrin , Nilsson Bo , Stånge Lars , Nylund Lars
Published: November 2007

From 1984 to 1987, 300 pregnant women with fetal representations underwent an attempt at external cephalic version (ECV) during the last trimester. A consecutive analysis of factors associated with successful version was performed during this period. the final version rate after one or more attempts was 58%, being lower in nulliparous (39%) than in parous women (80%). Multivariate analyses (logistic regression) identified only three significant variables out of 16 with independent power to explain successful version. the overall most important factor was parity (p < 0.001), followed by fetal presentation (p < 0.001) and amount of amniotic fluid (p = 0.019).
Perinatal and Neonatal Significance of Bacteria‐Related Placental Villous Edema
Authors: Ilagan Nestor B. , Elias Estela G. , Liang Keh‐Chyang , Kazzi George , Piligian John , Khatib Ghada
Published: November 2007

In a study of 82 cases of clinical chorioamnionitis in which no antibiotics were administered antenatally, significant villous edema was observed in 51 placentas (62%). Polymorphonuclear leukocyte invasion of the placental plate was found in 53 placentas (65%). the presence of SVE was significantly associated with placental bacterial recovery, occurrence of prolonged rupture of membranes, lower one minute Apgar score, the need for resuscitation and significant neonatal respiratory problems. Findings suggest that bacteria‐related placental villous edema can lead to significant perinatal and neonatal morbidities.
Altered Ciliary Substructure in the Endosalpinx in Women using an IUCD
Authors: Wollen Anne‐Lone , Flood Per R. , Sandvei Roar
Published: November 2007

Fallopian tube segments were removed from 20 women undergoing sterilization by laparoscopy or laparotomy. Ten of these patients used an intrauterine contraceptive device (IUCD). the other 10 had used neither IUCD nor oral contraceptives and served as controls. the ciliary ultrastructure was examined by light‐ and transmission electron microscopy. the IUCD users had a significantly reduced ciliary length and less well oriented cilia, as compared with the control group. Also, the proportion of cilia with a ciliary crown structure was significantly smaller in IUCD users than in the non‐users. the mechanism that may cause these alterations and their putative consequences are discussed.
BREAST IS BEST
Authors: Nesheim Britt—Ingjerd
Published: November 2007

Book reviewed in this article:

Breast is Best Lawrence, Ruth A.: Breastfeeding. A guide for the medical profession. 652 pp. illustrated. St. Louis: C. V. Mosby, 1989. £32.95.
An analysis of rapid pad testing and the history for the diagnosis of stress incontinence
Authors: Papa Petros P. E. , Ulmsten U.
Published: November 2007

Two rapid exercise pad tests, the vitamin B test, and the methylene blue test, are introduced for the diagnosis of urinary stress incontinence. The vitamin B test is entirely non‐invasive, takes only a few minutes to perform, and is especially useful as an office test. The methylene blue test has fewer variables, and fits easily into a urodynamic routine. With the methylene blue test, a direct correlation was noted between amount of urine lost and pressure generated by the tests. This conforms to the definition of stress incontinence as a passive process. The sensitivity of the test in a group with mainly mixed symptoms was 89.5%, and the specificity 100%. The test is useful where objective diagnosis of stress incontinence is important.

A group of 38 patients with a history (questionnaire) of stress incontinence exhibited a total of 105 positive individual symptoms out of a possible 228 symptoms (6 × 38), comprising a history of leaking at sneezing, coughing, exercise, laughing, walking, or bending. The individual symptoms were analyzed for accuracy and predictability by comparing them with six graded provocative exercises comprising a trampoline test, star jumps, coughing, stepping, bending and hand washing. The symptoms were graded into a hierarchy from the results. A history of stress incontinence was found to be an accurate determinant of stress incontinence, even in patients with mixed symptoms. This allows the questionnaire as presented to be used as a semiquantitative index for assessment purposes.
Primary vulvar lymphoma presenting as a clitoral tumor
Authors: Ferrando‐Marco J. , Martorell M. A. , Carrato A. , Navarro J. T.
Published: November 2007

We report a case of malignant large cleaved cell vulvar lymphoma predominantly affecting the clitoris, in a 60 year‐old woman. In a review of the literature, female genital tract lymphomas of vulvar location are exceptional. Histologically, these tumors must be differentiated from pseudolymphomatous lesions. In the present case (Stage IE), response to chemotherapy was good and the patient remains asymptomatic after three years of follow‐up.
Acute hernia of Bochdalek during pregnancy Hyperemesis for the first time in a third pregnancy?
Authors: Toorians Arno W. F. T. , Drost‐Driessen Margaret A. , Snellen Jaap P. , Smeets Rene W. M. C.
Published: November 2007

A rare case of a patient with right‐sided diaphragmatic hernia during pregnancy is described. Knowledge of this disorder offers the possibility of early diagnosis on clinical, ultrasound, and radiographic criteria before serious complications develop. Operative correction must be performed, with timing dependent on clinical presentation and period of gestation.
Hormonal and biochemical profiles of premenstrual syndrome
Authors: Cerin Asta , Collins Aila , And Brut‐Marie Landgren , Eneroth Peter
Published: November 2007

Women diagnosed as suffering from premenstrual syndrome and symptom free controls were compared on hormonal parameters, glucose tolerance, mineralocorticoids, cholesterols, triglycerides, apolipoprotein (a), magnesium and calcium in the follicular and luteal phases of the menstrual cycle. The effect of treatment with essential fatty acids on the biochemical variables was also evaluated in a randomized, double‐blind crossover design. The results showed that the hormonal and biochemical profiles of women with PMS and symptom free controls were markedly similar, except for aldosterone which was lower in the follicular and luteal phases and cholesterol which was higher in the follicular phase in women with PMS. No effects of treatment with essential fatty acids were found for any of the biochemical variables studied.
Socio‐demographic characteristics of women requesting induced abortion
Authors: Soderberg Hanna , Andersson Christina , Janzon Lars , Sjoberg Nils‐Otto
Published: November 2007

The aim of this study in an urban population has been to describe socio‐demographic characteristics of women seeking an induced abortion. The 1,220 cases in the study correspond to an annual abortion rate of 26.0 per 1,000 women aged 15–44. There were substantial differences from 10.1 to 42.6 per 1,000 women in the 18 different urban areas. High rate areas had, in comparison with the municipal average, a higher percentage of people with low income, low education, foreign background, and people in need of social welfare. There was also a higher percentage of people living alone and a higher migration rate. Women applying for an induced abortion had similar socio‐demographic characteristics. It is concluded that these associations should be considered in future family planning programs and that preventive efforts probably can be made more cost effective by concentrating on areas and individuals with these socio‐demographic characteristics.
Gonadotropin releasing hormone agonist treatment before hysterectomy for menorrhagia and uterine leiomyomas
Authors: Vercellini Paolo , Bocciolone Luca , Colombo Alberto , Vendola Nicoletta , Meschia Mlchele , Bolis Giorgio
Published: November 2007

Objective. To investigate the effect of gonadotropin releasing hormone agonist (goserelin) treatment before hysterectomy for leiomyomata‐associated menorrhagia.

Design. Prospective, comparative, nonrandomized study.

Setting. A teaching hospital of Milano University.

Patients. Anemic women requiring hysterectomy for myoma‐associated menorrhagia.

Intervention. Six months' preoperative goserelin treatment (41 cases) or immediate surgery (92 controls).

Main outcome measures. Abdominal/vaginal hysterectomy rate, number of transfusions, operating time, blood loss, complications, febrile morbidity, and days in hospital.

Results. In the goserelin group mean hemoglobin rose (8.5 versus 13.3 g/dl) and mean uterine volume decreased (528 versus 251 ml). At preoperative pelvic exploration abdominal hysterectomy was indicated in 22 (54%) cases and 74 (80%) controls and vaginal hysterectomy in 19 (46%) and 18 (20%) (relative risk 3.6, 95% confidence interval 1.6 to 7.7; p = 0.001). No case required a transfusion whereas 51% of controls needed a total of 127 packed red cell units.

Conclusions. In anemic women with menorrhagia and leiomyomas, gonadotropin releasing hormone agonist treatment before hysterectomy limited transfusion requirements and increased the vaginal procedure rate.
Obstetric shoulder injury
Authors: Walle Tuna , Hartikainen‐Sorri Anna‐Liisa
Published: November 2007

A prospective case‐control study was made to estimate the incidence of clavicular fracture and brachial plexus palsy, to find out possible risk factors during pregnancy and labor associated with these injuries, and to ascertain the prognosis of injured infants. Clavicular fracture occurred in 165 (3.2%) and brachial plexus palsy in 10 (0.2%) of the 5082 infants born during the study period. From maternal characteristics the Body Mass Index (kg/m2) and pregnancy weight gain were significantly greater in the cases than in the controls. Symphysis‐to‐fundus height was, on average, higher in the case group. There were no more instrumental vaginal deliveries in cases than in controls. The shoulder injured infants were in every way bigger, but only in 30% of the cases macrosomic (birthweight over the 90th percentile), and they were more often males than in the controls. The prediction of shoulder injury by ultrasound was not successful in our study. The prognosis of injured infants was good, all children except one recovered soon after birth.
External cephalic version at term — using tocolysis
Authors: Shalev E. , Battino S. , Giladi Y. , Edelstein S.
Published: November 2007

Fifty‐five patients with non‐vertex presentation at 37 to 40 weeks' gestation were evaluated to determine which factors were associated with a successful external cephalic version (ECV). Maternal parity, obesity, amniotic fluid volume, placental location, type of breech and position of fetal spine were analyzed. Only amniotic fluid volume and fetal weight were significantly associated with a successful version (p<0.05), 40/55 (73%) were successfully converted, 36/55 (65%) were vertex at delivery, and 32/55 (58%) delivered vaginally. Version attempts were successful in six out of eight patients who had undergone a previous cesarean section. Two out of six of the successful version patients went on to have vaginal birth after cesarean section. We conclude that although ECV is a reasonable alternative in the management of pathological presentation near term it should be performed only when there is sufficient amniotic fluid volume.
Alterations of calcium and phosphate metabolism in primary hyperparathyroidism during pregnancy
Authors: Ammann Patrick , Irion Olivier , Gast Jacques , Bonjour Jean‐Philippe , Beguin François , Rizzoli René
Published: November 2007

Primary hyperparathyroidism (PHP) is rare during pregnancy and has been claimed to be associated with significant increase of neonatal morbidity and mortality, Whether the well recognized changes in calcium (Ca) and phosphate (Pi) homeostasis occurring in pregnancy might influence the biochemical expression of PHP is unclear. We evaluated biochemical parameters of calcium and phosphate metabolism in two cases of PHP in pregnancy diagnosed in the third trimester (patient 1) and in the second trimester (patient 2). Both patients displayed increase in protein‐adjusted plasma Ca, bone resorption evaluated by the fasting urinary Ca‐to‐creatinine ratio, renal tubular reabsorption of Ca, urinary cAMP excretion and decrease in renal tubular reabsorption of Pi. These alterations were identical to those found in 12 non‐pregnant women with PHP. The biochemical expression of PHP did not change after delivery in patient 1. This patient underwent the excision of a 1 g parathyroid adenoma on the 13th day after delivery, which led to normalization of all biochemical parameters. The lowest plasma Ca of the newborn of patient 1 was 2.02 mM 72 hours after birth. Thus, the results indicate that these two pregnant women with PHP displayed biochemical alterations of calcium and phosphate metabolism similar to those observed in nonpregnant women with primary hyperparathyroidism.
Pregnancy after surgical correction of tricuspid atresia
Authors: Carmona Francisco , Martinez Sergio , Periz Alberto , Cararach Vicente
Published: November 2007

Tricuspid atresia comprises 1–3% of congenital heart diseases and it is still uncommon in adult patients. We present a case of tricuspid atresia in a young woman who experienced a successful uncomplicated pregnancy after surgical correction of her disease.
Iron status in Danish women aged 35–65 years
Authors: Milman Nils , Rosdahl Nils , Lyhne Niels , Jørgensen Torben , Graudal Niels
Published: November 2007

Iron status was assessed by serum (S‐) ferritin and hemoglobin (Hb) in a population survey comprising 883 non‐gravid Danish women in age cohorts of 35, 45. 55, and 65 years. Premenopausal women (n = 676) had lower S‐ferritin, median 42 μg/1, than postmenopausal women (n = 207), median 80 μg/1 (p<0.0001). Of premenopausal women, 12.1% had S‐ferritin ≤ 20 μg/1 (i.e. depleted iron stores), and 35.6% S‐ferritin of 21–40 μg/1 (i.e. small iron stores). Corresponding figures in postmenopausal women were 0.5%, and 13.2%. Premenopausal blood donors (n = 88) had lower S‐ferritin than non‐donors (p<0.001). In premenopausal women, S‐ferritin levels were strongly dependent on the duration of menstrual bleeding (p < 0.0001). which in turn was related to the method of contraception. Women (n = 64) using hormonal contraceptives (the pill) had menstrual bleeding of shorter duration than those (n = 511) not using pills or intrauterine devices (IUD), who in turn had bleeding of shorter duration than those (n= 101) using IUD. Median S‐ferritin in pill users was 62 μg/L in those not using pills or IUD 42 μg/L and in IUD users 36 μg/l. S‐ferritin values < 40 μg/l (i.e. small and depleted iron stores) were seen in 25%) of pill users. in 48% of those not using pills nr IUD, and in 61% of IUD users. Hb values in premenopausal women were mean 134 ± 10 (SD) g/1 (8.3±0.6 mmol/l), median 132 g/l (8.2 mmol/l). being slightly lower than in postmenopausal women, mean 137 ± 10 g/l (8.5±0.6 mmol/1), median 135 g/l (8.4 mmol/ 1) (p<0.001). Iron deficiency anemia (i.e. S‐ferritin ≤20 μg/l and Hb < 121 g/l) was found in 3.0%) of premenopausal and in none of postmenopausal women.
Placental abruption
Authors: Raymond Elizabeth G. , Mills James L.
Published: November 2007

Objective. To investigate maternal risk factors and fetal conditions associated with abruption.

Methods. Prospective cohort study of 30,681 singleton pregnancies at least 28 weeks' gestation. Data collected by patient questionnaire at the first prenatal visit and by medical record review.

Results. 307 women had abruption (1%). After adjustment, important maternal risk factors included age (in years; OR 1.03; 95% CL 1.00. 1.06; p = 0.04) and less than 12 years of education (OR 1.58; 95% CL 1.10, 2.25; p = 0.01). Each pack of cigarettes smoked per day increased the risk by approximately 40% (OR 1.39; 95% CL 1.09, 1.79; p = 0.009). If abruption occurred, the perinatal mortality rate was substantially higher in women who smoked at least one pack per day than in nonsmokers (RR 2.53; 95% CL I.14, 5.61; p = 0.02). Abruption was also significantly associated with intrauterine growth retardation and fetal malformations. The increased malformation rate was due entirely to nearly a five‐times increase in congenital heart defects (OR 4.63; 95% CL 2.49. 8.55; p = 0.00000014).

Conclusions: Heavier smoking increases the risk both of abruption and of perinatal death when abruption occurs. If the association between abruption and congenital heart defects is confirmed, early evaluation could lead to more prompt treatment of these malformations in infants delivered after abruption.
Cervical conization and preterm delivery/low birth weight
Authors: Kristensen J. , Langhoff‐Roos J. , Wittrup M. , Bock J. E.
Published: November 2007

Objective. Evaluate the effect of cervical conization on preterm birth/low birth weight (LBW).

Design. A systematic review of the literature using external or internal controls.

Results. The typical odds ratio for preterm delivery in women with prior cervical conization using external controls was 3.23 (95% confidence interval 2.29–4.55). Using internal controls the typical odds ratio for LBW was 2.97 (95% confidence interval 1.09 8.05). Using external controls the typical odds ratio for LBW was 2.31 (95% confidence interval 1.33‐3.99).

Conclusion. Women with cervical conization are at higher risk for preterm birth than external controls, and the surgical intervention as such is a major determining factor.
Plasma immunoglobulin, total protein and albumin levels during Norplant use by Nigerian women
Authors: Otolorin E. O. , Adeyefa I. , Konje J. C. , Ojengbede O. , Osotimehin B. , Ladipo O. A.
Published: November 2007

Objective. To determine the effect of Norplant on plasma immunoglobulins, albumin and total proteins.

Design A longitudinal prospective study of Norplant (six capsules) subdermal contraceptive implant acceptors.

Setting. Family Planning Clinic. University College Hospital, Ibadan, Nigeria.

Patients. 36 women volunteers aged 18–40 years on Norplant.

Main outcome measures. Serum immunoglobulins, albumin and total protein before, one, three and 12 months after Norplant insertion.

Results. No statistically significant changes were observed in plasma levels of IgA. IgM and total proteins hut plasma levels of IgG showed statistically significant increases after one, three and 12 months on Norplant.

Conclusion Norplant does not seem to alter IgM, IgA. albumin and total protein levels over a period of 12 months. It, however, induces significant changes in IgG levels at one. three and 12 months after insertion. These changes are less marked by the end of 12 months.
A Swedish version of the Women's Health Questionnaire
Authors: Wiklund Ingela , Karlberg Johan , Lindgren Rickard , Sandin Kristina , Mattsson Lars‐Åke
Published: November 2007

We wanted to provide details on the psychometric documentation of the Swedish version of the Women's Health Questionnaire (WHQ), a patient based measure of postmenopausal complaints. The results of two clinical trials in Sweden in which the WHQ had been used as one out of several measurement tools were used to document the reliability, the validity and the responsiveness to change of the WHO. More than 350 women suffering from postmenopausal complaints were included in the two trials.

A factor analysis, using the baseline values of all women in each study. showed that the Swedish version of the WHQ was very close to the English original. The internal consistency reliability was excellent. The clinical validity was confirmed by a significant correlation between change in E, levels and change in the WHQ during estrogen therapy. A high construct validity was established by the agreement between the WHQ and other quality of life scales. For use in clinical trials the WHQ was sensitive to treatment‐induced changes. and added important information to the clinical effect variables.
Human papillomavirus 16 and 18 DNA can solely induce oncogenic transformation of mammalian cells in primary culture
Authors: Iwasaka T. , Yokoyama M. , Hayashi Y. , Sugimori H.
Published: November 2007

To compare the tumorigenic activity of HPV 6, 11, 16, and 18 DNA in mammalian cells in primary culture, HPV DNAs were transfected to Syrian hamster embryo (SHE) cells. Morphologically transformed foci were observed in all the HPV DNA‐transfected cultures and cells propagated from these foci were immortalized. All these cell lines at early passages were not tumorigenic in nude mice. However, a cell line derived from HPV 16 transfection became tumorigenic after 25 passages and a cell line derived from HPV 18 transfection also revealed tumorigenicity after 48 passages. Overexpression of the Ha‐ras proto‐oncogene occurred in these transformed cell lines. No tumorigenic activity was observed in HPV 6 and HPV 11‐transfected cell lines. All these observations suggest that HPVs 16 and 18 have a higher transforming potential than do HPVs 6 and 11 and can solely induce tumorigenic transformation of cells in primary cultures, with continuous passage.
Culture of human endometrial cells: A new simple technique to completely separate epithelial glands
Authors: Viganó Paola , Di Blasio Anna Maria , Antonio Giacomo Dell' , Vignali Mario
Published: November 2007

In vitro studies on dispersed human endometrial cells are still difficult to perform as the techniques employed do not allow an optimal separation of the cells. In particular, epithelial glands tend to maintain their tubular structure even after enzymatic dispersion. This could be a disadvantage when monolayers of single well dispersed cells are needed. In this paper we describe a new technique to establish monolayer cultures of isolated endometrial stromal and epithelial cell populations. After a first collagenase digestion, stromal and epithelial cells were separated by differential sedimentation at unity gravity. The epithelial glands obtained were further dispersed in single cells using a short incubation with low amount of trypsin. Morphologic characterization was performed using immunohistochemistry for vimentin and cytokeratins. Compared to previous described methods, this procedure is shorter and could better preserve cell surface structures. Thus, it could be successfully employed for in vitro studies of human endometrial pathophysiology.
Have the AIDS campaigns changed the pattern of contraceptive usage among adolescents?
Authors: Wielandt Hanne Benedicte
Published: November 2007

In 1984 ‐just before the extensive public information about prevention of HIV infection by the use of the condom (the AIDS campaigns) ‐ personal interviews about sexual experiences and use of contraception were obtained in random samples of 16‐20 year old Danes. The investigation was repeated in 1989 addressing the issue of whether the behavior of adolescents regarding sexual intercourse and use of contraception has changed. In 1984 in all 286 females (respondent rate = 75.3%) and 336 males (respondent rate = 77.8%) agreed to be interviewed. The second investigation in 1989 involved new cohorts of 16‐20 year olds and here 359 females (respondent rate = 77.9%) and 400 males (respondent rate=76.3%) participated. In 1984 approximately 20% and in 1989 approximately 10% reported no use of contraception at first sexual intercourse. In both investigations oral contraception (OC) and condom were by far the predominant methods mentioned. In 1984 38.1% of females and 34.4% of males used OC and 37.2% of females and 42.1% of males employed condom. In 1989 26.7% of females and 30.8% of males used OC and 64.8% of females and 62.1% of males employed condom. No sex difference in the distribution of the various contraceptive methods could be revealed. From 1984 to 1989 the prevalence of condom increased significantly. In the first investigation 15.9% of sexually experienced females reported no present use of contraception. The most frequently used device was OC (62.7%). The second investigation collected information about contraception employed at the most recent sexual intercourse from both females and males. Approximately 5% of both sexes mentioned no use of contraception. In all 56.7% of females and 49.1% of males reported OC. In conclusion, the AIDS campaigns in Denmark seem to have increased the use of condom at first sexual intercourse. The intention to have a condom handy has also improved among the 16‐20 year olds. In 1989 a total of 36.9% of females and 52.0% of males used condom at their most recent sexual intercourse.
Calcium homeostasis in pregnancy and lactation
Authors: Haram Kjell , Thordarson Hrafnkell , Hervig Tor
Published: November 2007

This paper discusses different aspects of calcium homeostasis in pregnancy: the calcium demands of the mother, regulation mechanisms and the risk factors for demineralization. Special care should be paid to patients lying in bed for long periods and patients given heparin prophylaxis. One to two grams of calcium and 400 IU of vitamin D daily should be given orally to patients who are being treated for deep vein thrombosis. In addition, bone density should be checked to detect osteoporosis. The period of heparin prophylaxis must be as short as possible and bed rest must not be unnecessarily prolonged.
The prognosis of hypertensive disease of pregnancy accompanied by intrauterine growth retardation in relation to parity
Authors: Hochner‐Celnikier D. , Shimonovitz S. , Bursztyn M. , Zcut D. , Yagel S. , Ron M.
Published: November 2007

Twenty‐two primiparous women with hypertensive disease of pregnancy (HDP) associated with intra uterine growth retardation (IUGR) were compared with 20 parous women in whom HDP associated with IUGR appeared for the first time in a second or a later pregnancy. Both groups of women were followed up for 10–13 years. The course of the disease among the parous women was more severe as compared to the primiparous women; the mean gestational age at the first increase in blood pressure and gestational age at delivery were significantly earlier in the parous group (33.3 weeks ± 3.5 v.s. 35.3 ± 3.2 weeks, p < 0.01, 36.2 weeks ± 2.2 v.s. 37.6 ± 1.9 p < 0.01 accordingly). Maternal indication for induction of labor because of uncontrollable hypertension was present in 77% of the cases in the parous group as compared to 31% in the primiparous group (<p < 0.05). These complications were present in 66% of subsequent pregnancies in the parous group as compared with 31% in the primiparous group (<p < 0.05). Chronic hypertension developed in 33% of the parous group as compared with 20% in the primiparous group. These differences show that the manifestation of HDP is more severe in women in whom HDP with IUGR occur for the first time in a second or a later pregnancy than in those in whom this complication occurs for the first time in their first pregnancy. The long term prognosis of the first group is also more severe than in the later group. These findings suggest that pregnant women who for the first time develop HDP associated with IUGR in a later pregnancy belong to a special high risk group which warrants a close follow up concerning recurrent complications in subsequent pregnancies and the risk for developing chronic hypertension in the future ARTICLE
Relationship between iron status in pregnant women and their newborn babies
Authors: Gaspar Maria Jesus , Ortega Rosa Maria , Moreiras Olga
Published: November 2007

We studied 157 pregnant women living in Merida, Spain, during their third trimester of pregnancy and their newborns at birth, analyzing the mother's and the umbilical cord's blood for hemoglobin, hematocrit, mean corpuscular hemoglobin concentration (MCHC), serum iron and serum ferritin. We observed statistically significant correlations between hemoglobin and hematocrit values of the mother with erythrocyte count, hemoglobin and hematocrit values of her child and between serum iron of mother and child. The blood levels in the umbilical cord did not decrease until the ferritin value of the mother was < 12 μg/1. Under these conditions the ferritin levels in the umbilical cord blood (80.4 μg/1) were significantly lower than in those newborn infants whose mother had adequate ferritin levels (123 μg/1). We deduce that maternal iron status seems to condition, at least partially, fetal iron status, specially when the mother has some deficiencies. We did not find a lower birth weight in children of anemic mothers. Actually, we found an inverse correlation between maternal hemoglobin values and infant birth weight (r =‐0.1731, p < 0.05). It is possible that the demands on the mother are increased in the case of a newborn infant of greater size.
The familial risk of endometriosis
Authors: Moen Mette H. , Magnus Per
Published: November 2007

Methods. A total of 563 patients with endometriosis were interviewed about endometriosis or adenomyosis in their mothers or sisters. Five hundred and twenty‐eight patients (94%) gave information about their relatives. Six patients were adopted and had no knowledge about their relatives. Among 522 patients were seven pairs of sisters, of which only one was included, giving a total of 515 cases. The control group consisted of 149 women without endometriosis documented at a recently diagnostic laparoscopy performed in connection with sterilization. The controls were likewise interviewed about their relatives, and none refused to give information. If a gynecological operation in a relative was reported, medical records were obtained (68%) or a description of the medical history was given by the proband. Results Endometriosis or adenomyosis was disclosed in 3.9% of mothers of cases and in 0.7% of mothers of controls, in 4.8% of sisters of cases and in 0.6% of sisters of controls. The relative risk of endometriosis in a first‐degree relative (expressed as odds ratio), was 7.2 (95% confidence interval 2.1, 24.3). Severe manifestations of endometriosis were found more often among patients with a positive family history than among those without (26% versus 12%, p < 0.01).

Conclusion. The study demonstrates a seven fold increased risk of endometriosis in mothers and sisters of patients with endometriosis. It is assumed that daughters of patients with endometriosis have a similar risk of developing endometriosis.
Complications after hysterectomy
Authors: Andersen Tavs Folmer , Loft Anne , Brønnum‐Hansen Henrik , Roepstorff Christian , Madsen Mette
Published: November 2007

We studied complications after hysterectomy among all women in the Danish population who had a simple hysterectomy in the period 1978‐81 based on data obtained from the Danish National Hospital Registry. Among patients, with neither diagnosed cancer nor major co‐surgery (n = 23,386), we identified all the complications which occurred during hospital admission from the time of surgery up to six years from that point. Within 30 days of hysterectomy 2.6% of the patients had been diagnosed in hospitals as having complications according to our definition. The corresponding figures at 90 days and two years after the operation were 3.7% and 9.4%. The most frequently observed complications were post operative wound infections and bleeding, each affecting about 2% of all operated women. Logistic regression and Cox regression were used to identify prognostic indicators of readmission with complications. The probability of readmission with complications within six years after hysterectomy was estimated at 8% among low risk patients. The most pronounced increase in risk of readmission with complication occurred among women who had been admitted to psychiatric or somatic hospitals 0–12 months before they had their uterus removed (OR in the range 1.59 to 1.83). We discuss the prevailing difficulties of comparing observational evidence from different clinical settings reported in the literature, and emphasize the importance of developing a coordinated international strategy for non‐experimental assessment of medical technology.
Metastasis from breast lobular carcinoma to an endometrial polyp
Authors: Aranda F. Ignacio , Laforga Juan B. , Martinez M. Angeles
Published: November 2007

A case of lobular carcinoma of the breast metastatic to an endometrial polyp is described. The patient underwent a simple mastectomy and axillary lymphadenectomy because of infiltrating lobular carcinoma diagnosed three years before. Abdominal ultrasound revealed an endometrial polyp. An endometrial biopsy was performed but only scanty material insufficient for diagnosis was obtained. A total hysterectomy and bilateral salpingo‐oophorectomy was made. The uterus contained a large polyp which microscopically showed sheets and ribbons of small atypical cells infiltrating the stroma. Immunohistochemical stains were positive for epithelial cell markers. To our knowledge this is the first case of an infiltrating lobular carcinoma metastasizing to an endometrial polyp.
Pregnancy in lupus nephropathy
Authors: Julkunen Heikki , Kaaja Risto , Palosuo Timo , Grønhagen‐Riska Carola , Teramo Kari
Published: November 2007

The purpose of this study was to obtain information about the fetal and maternal outcome of pregnancy in patients with pre‐existing lupus nephritis and to evaluate risk factors for poor fetal outcome. Twenty‐six pregnancies in 16 patients were retrospectively analyzed. Induced abortions were performed in two patients and one patient had a spontaneous abortion. Of the 23 completed pregnancies, all clinically established on inactive lupus nephritis with normal renal function, seven (30%) were complicated by pre‐eclampsia. Two of the three patients with severe pre‐eclampsia had increased levels of antiphospholipid antibodies (aPL). Of the 23 newborns, seven (30%) were premature (> 37 weeks) and seven (30%) had neonatal complications. Six of the seven pregnancies associated with neonatal complications were hypertensive. There was one early neonatal death. Four newborns (16%) were severely growth retarded (>— 2 SD). The presence of hypertension before pregnancy tended to correlate with low relative birth weight in the newborns (p = 0.079). Flares of systemic lupus erythematosus (SLE) during pregnancy and six months post partum occurred in two (9%) of the 23 completed pregnancies. Renal function was not affected irreversibly in any patient. Thus, the outlook for pregnancy in patients with stable lupus nephritis at conception is good. However, the risk of obstetric complications is greater and fetal morbidity, especially in hypertensive pregnancies, is common.