bluuebunny/crossref_metadata_2025 huggingface dataset:
Diabetes Mellitus and Pregnancy: A seven‐year material of pregnant diabetics, where control during pregnancy was based on a centralized ambulant regime
Authors: Klebe Joachim G. , Espersen Thorkild , Allen Jim
Published: December 2009

A 7‐year survey of the outcome of pregnancy complicated by diabetes mellitus, carried out at the Aarhus center, is presented. The material comprised 344 diabetic pregnant women where the control was based mainly on a centralized ambulant regime. The latter half‐period was moreover based on self‐monitoring of the blood glucose level. This achieved a significantly better blood glucose regulation, with a reduction of the mean blood glucose level from 7.9 to 6.4 mmol/l. Furthermore, the introduction of self‐monitoring halved the number of hospitalizations necessary for blood glucose regulation.

Pregnancy was complicated in about 35%. The importance of screening for urinary tract infection is emphasized, since this, which was present in 20% of cases, might be a possible factor in ketoacidosis and/or intra‐uterine growth retardation. In 19% of the vaginal births it was deemed necessary to give instrumental assistance; 5% had shoulder dystocia. The cesarean section frequency was 31%. The antenatal mortality rate was 1.2% and the uncorrected perinatal mortality was 3.5%, half of the neonatal mortality was due to fatal congenital malformations. About half of the newborn babies required immediate intensive neonatal treatment. Because of the high frequency of complications in pregnant diabetics, during childbirth and in the neonatal period, centralized monitoring by a highly specialized team is necessary in order to maintain the present relatively low perinatal mortality and morbidity rates and the low number of cesarean sections, together with the most convenient control regimen for this highly pathological group. Furthermore, centralization will facilitate research which, together with prepregnancy consultation, may reduce the frequency of major fetal malformations.
Massive Ascites as a Complication to Subclinical Perihepatitis and Pelvic Inflammatory Disease
Authors: Urnes A. , Stray‐Pedersen B. , Raknerud N.
Published: December 2009

A case report is presented of a 16‐year old female who had a history of abdominal distention due to 5000 ml ascites as a serious complication of pelvic inflammatory disease. She made an uneventful recovery after exploratory laparotomy and removal of the right inflamed and dilated Fallopian tube.
Fetal Death in Early Pregnancy Due to Electric Current
Authors: Jaffe Richard , Fejgin Moshe , Aderet Noah Ben
Published: December 2009

Electric shock injuries in pregnant women are rare events. The uterus and amniotic fluid are thought to be excellent conductors of electric current which reaches the fetus causing cardiac arrest and fetal death. All cases except one reported in the literature occurred in the third trimester, and ended with the death of the fetus. We report a case of a woman struck by a high voltage electric current in the 13th week of her pregnancy, causing fetal death and abortion.
Infertility in women participating in a screening program for cervical cancer in helsinki
Authors: Rantala Maija‐Liisa , Koskimies Aarne I.
Published: December 2009

The purpose of the present study was to establish the occurrence of infertility in Finnish women aged 30, 35 and 40 years. The study is based on an interview by questionnaire carried out on women participating in screening for cancer by Pap smear. The participation rate is generally about 60%. A total of 4879 women were interviewed between May 1981 and April 1982. 149 incomplete replies were discarded and an additional 528 women not at risk of conception were excluded. The final analysis included 4202 women. Actual infertility, i.e., failure to establish pregnancy at the time of interview, occurred in 438 women (10.4%). The overall infertility rate was 15.4%. The primary infertility rate (5%) seems to be similar in all the age groups interviewed. Secondary infertility increased among women aged 30–40 years, from 4.1 to 9.9%. Actual infertility increased highly significantly between the age groups 30 and 40 years. A limited number of women are permanently infertile, but the percentage of those who at some point in their lives are involuntarily childless is higher.
Moderate alcohol consumption—need for intervention programs in pregnancy?
Authors: Meberg Alf , Halvorsen Bjørn , Holter Berit , Ek Inger Johanne , Askeland Astrid , Gaaserud Wenche , Steinsvåg Johnny
Published: December 2009

Consumption of alcohol was investigated in two groups of pregnant women: an intervention group (n = 58) (two structured interviews during pregnancy including counseling focused on reduction of alcohol consumption and potential benefits to the fetus, and interview after delivery), and a control group (n = 74) (interview after delivery). Prepregnancy 80% of the women were light or moderate alcohol consumers, and 20% teetotallers. Pregnancy considerably reduced alcohol consumption in both groups. 66% abstained from alcohol during pregnancy, and use of liquor nearly ceased. The changes in alcohol consumption occurred independently to the intervention program. Strategy for reducing alcohol consumption during pregnancy should include a structured alcohol anamnesis at the first ante‐natal visit, accompanied by counseling focused on reduction of alcohol consumption. More extensive intervention programs may be reserved for pregnancies at higher risk (high‐consumers, abusers).
Cesarean section and perinatal mortality in Sweden in 1981
Authors: Nielsen T. F. , Hökegård K‐H. , Ericson A.
Published: December 2009

During the years 1973–81, the cesarean section (CS) birth rate increased from 5.5% to 12.4% in Sweden. During the same time, perinatal mortality declined from 12 to 7.1 per thousand children. The rates of CS and perinatal mortality, however, cannot be presented as reciprocally dependent variables without taking into consideration many of the other factors that have been at work during the same decade, e.g. improved results of the neonatologists in the lower weight groups, electronic fetal monitoring, use of steroids, introduction of tocolytic agents. The present study revealed that the incidence of CS could vary between 8% and 19% between different obstetric departments in Sweden during 1981. Despite this great difference in CS rate, no difference was noted in the rates of asphyxia or perinatal mortality. It is concluded that in the present study we have seen no indication that a marked increase in the CS rate would improve our present perinatal survival data and furthermore it still remains unproven that CS and perinatal mortality rates necessarily have a reciprocal relationship.
Clinical Experience with a Low‐Dose Combination of Estradiol Valerate and Levonorgestrel: Double‐blind Comparative Study between SH D 386 F and Cyclabil. Effects on Symptoms, Lipids and Endometrial Condition*
Authors: Lagrelius A. , Fredricsson B. , Hirt M. , Weintraub L.
Published: December 2009

In a double blind study of the effects of hormone replacement therapy in climacteric women, two different dosages of estradiol—17β valerate and levonorgestrel, with the same ratio between the amounts of the two steroids (Cyclabil and the trial preparation having the code number SH D 386 F respectively), were compared. The differences in effects on symptoms, certain humoral parameters including serum lipids, and endometrial histology before and after 12 months of therapy were evaluated.

The study population consisted of 120 healthy women in the age range 41–63 years, many of whom had undergone previous estrogen treatment. All had typical climacteric symptoms and were peri‐ or postmenopausal.

There were no significant differences between the two preparations as regards the effects on symptoms—except for episodes of hot flushes and depression (loss of confidence), which were more frequent during treatment with the higher dosage.

One of the main objects of the study was to determine whether the lower dosage would be sufficient to prevent the development of endometrial hyperplasia. To this end, endometrial samples were collected before and after 12 months of treatment, using “Mi‐mark TM” disposable equipment for endometrial cytology/histology.

No significant endometrial hyperplasia was found in either of the groups during the period of investigation.

The serum lipid pattern was evidently more influenced in the group treated with Cyclabil.

The drop‐out rate was 20%, most of them being due to side effects of mild to moderate severity such as undesirable withdrawal bleedings or unsatisfactory relief of symptoms, which sometimes resulted in a wish to return to earlier treatment regimens.
Predictive Values of Diagnostic Tests in the Evaluation of Female Urinary Stress Incontinence
Authors: Fischer‐Rasmussen Wiggo , Hansen Rolf Iversen , Stage Poul
Published: December 2009

Preoperatively a collaboration between gynecologists, urologists and radiologists is essential for the diagnostic accuracy of urinary incontinence especially to isolate stress incontinence for surgical treatment. the aim of this study was to estimate the value of these combined efforts.

212 women referred for urinary incontinence were assessed by history of micturition, pelvic examination, cystoscopy, cystometry, stress test for urine loss, uroflowmetry and colpo‐cysto‐urethrography. a final diagnosis obtained on this basis classified the patients in stress incontinence (130), urgeincontinence (47), neuromuscular dysfunction (6), uncertain type (10), other disease (8) and no incontinence (11).

According to calculations of predictive values of positive and negative tests, respectively, each single test in the preoperative investigation programme was evaluated regarding the final diagnosis stress incontinence. It was assumed that the symptom stress incontinence, the pelvic examination and the colpo‐cysto‐urethrography were of minor or no importance for the diagnosis stress incontinence but might have been for the choice of surgical treatment. Cystoscopy and uroflowmetry had no place in daily routine. in contrast normal cystometry and especially the sign stress incontinence deserved consideration of refinements.
Relationship of Premorbid State of Nutrition to Endometrial Carcinoma
Authors: Jensen Helle
Published: December 2009

Women with endometrial cancer are often reported as being overweight. It is thus of some interest to examine a possible connection between body weight and development of cancer corporis uteri, since a positive result might be of significance in a preventive respect. a retrospective epidemiological study of 414 patients revealed a positive correlation between body weight and endometrial carcinoma. 73.4% of the patients were overweight and 55.8% were obese. the patients had a significantly greater absolute and relative weight than normal controls of corresponding age. There was a tendency for the patients to be taller than the controls. Endometrial carcinoma may have a hormonal etiology as a result of prolonged or increased estrogenic influence on the endometrium, possibly intensified by missing progesterone stimulation. As obesity contributes to an increased level of estrogen—androstenedione being converted into estrone in the fatty tissue—a hypothesis is advanced that the diet is of importance for the development of endometrial carcinoma, as dietary quantity and composition may influence the estrogen metabolism, and thus affect the endometrial mucosa.
Eclampsia in Sweden, 1976–1980
Authors: Möller Bo , Lindmark Gunilla
Published: December 2009

Among 480969 births in Sweden during the period 1976 to 1980, 74 parturients with eclampsia were identified. the clinical characteristics of women developing eclampsia before 37 completed weeks of gestation differed markedly from those with eclampsia at term. in the preterm group, subjective symptoms nearly always preceded the eclamptic attack, the newborns were generally small‐forgestational‐age, the perinatal mortality was high, and the mothers more frequently had complications related to eclampsia. the only maternal death occurred in this group.

In the term group the first convulsion often came unexpectedly without typical premonitory signs. the infants were with few exceptions within the average for gestational age. the general outcome for mothers and their babies was favorable and the length of hospital stay was on average 3 days longer than that of the overall obstetric population.

Eclampsia cases in Sweden represent a small subfraction of parturients with hypertensive disorders of pregnancy. the incidence (29/100000) in our material is, to our knowledge, the lowest yet reported. Despite the very regular attendance at the antenatal clinic, weekly from 36 weeks onwards, fewer than half of the patients had hypertension diagnosed 4 days or more prior to the eclamptic convulsion. a shortening of the intervals between the antenatal visits therefore does not seem warranted.
Results of a Five‐Year Prospective Study Using a Feto‐Pelvic Scoring System For Term Singleton Breech Delivery After Uncomplicated Pregnancy
Authors: Barlöv Kjell , Larsson Göran
Published: December 2009

Two hundred and twenty‐six term singleton breech deliveries were managed prospectively during a 5‐year period according to Westin's feto‐pelvic scoring system based on X‐ray pelvimetry, estimated fetal weight, type of breech, and outcome of previous vaginal deliveries. the vaginal delivery rate was 45.1% and cesarean section rate 54.9%. 81.5% of cesarean sections could be planned in advance, based on the scoring system. Corrected neonatal mortality was nil and persistent morbidity was 0.4% for the whole material. Asphyxia, defined as 5 min Apgar score <7, occurred in only 1% of cases, evenly distributed among vaginal and planned cesarean deliveries. It was possible by means of the scoring system to identify a group of women who could give birth vaginally, without any mortality or persistent morbidity.
Plasminogen Activator and Fibrinogen/Fibrin Degradation Products At Conization of the Uterine Cervix
Authors: Larsson Göran , åstedt Birger
Published: December 2009

In women undergoing conization of the uterine cervix, peripheral blood samples and blood samples from the cone cavity were obtained and analysed for their concentration of plasminogen activator of tissue type (t‐PA) and of urokinase type (u‐PA) and the concentration of fibrinogen/fibrin degradation products (FDP). a significant increase was found for t‐PA (p<0.002) and u‐PA (p<0.0002) as well as for FDP (p<0.002) in blood from the cone cavity compared with peripheral blood. the finding of increased liberation of plasminogen activators strengthens the rationale for administration of synthetic inhibitors of fibrinolysis to reduce the frequency of bleeding complications at conization.
An Examination of the Relationship Between Fetal Movements and Infant Motor Activity
Authors: Shadmi Ariella , Homburg Roy , Insler Vaclav
Published: December 2009

Fifty‐one patients recorded fetal movement counts for several weeks, 29 while hospitalized for complications of pregnancy (group 1) and 22 with normal pregnancies and ambulant (group 2). the motor activity of group 1 neonates was examined 24–72 hours following delivery, using a partial Brazelton neonatal assessment scale. Group 2 infants were examined at age 10–12 months, using a method specially designed for this study to assess motor activity. No significant correlation was found between the mean number of fetal movements and the motor activity of neonates, versus those of one‐year‐old infants. These findings suggest that fetal movements are most probably influenced by numerous factors differing from those influencing the motor activity of the neonate and infant.
Venous Reactivity and Pregnancy Abnormalities
Authors: Goodlin Robert C.
Published: December 2009

An impedance plethysmograph recording was obtained on at least two occasions from 162 women between their 24 and 36th week of pregnancy; 29 while in labor and 21 at the time of their 6‐week postpartum visit. There was a significant increase in venous capacitance and a decline in venous capacitance index during apparently normal pregnancy. Those with pregnancy complications (hypertension, premature labor and fetal growth retardation) appeared to have significantly abnormal venous reactivity. It is proposed that equal consideration be given to abnormal venous activity in the mechanisms and therapy of pregnancy‐related cardiovascular abnormalities.
Fetal Surveillance in Diabetic Pregnancy: II. the Nonstress Test Versus the Oxytocin Challenge Test
Authors: Olofsson Per , Sjöberg Nils‐Otto , Solum Thore
Published: December 2009

At the Department of Obstetrics and Gynecology, University of Lund, it has been the routine management in diabetic pregnancy to use both nonstress test (NST) and oxytocin challenge test (OCT) for fetal surveillance. the study material reported comprised 61 pregnant diabetics, 1882 NSTs and 90 OCTs. Evaluations were made separately for the time interval 0–2 days antepartum, within 1 week antepartum, and all tests included. Predictive value, specificity and sensitivity were calculated for both the NSTs and the OCTs according to the following variables of neonatal outcome: Apgar scores at 1, 5 and 10 min, baby's first cry (or not) within 1 min of birth, pulmonary function, and metabolic balance. No perinatal deaths occured. There were no statistically significant differences between the NSTs and OCTs in the antepartum time intervals 0–2 days and 1 week regarding any variable. When all tests were included, the OCT proved superior in that there were fewer falsely pathological tests, though biased by the fact that most of the NSTs evaluated were older than the oldest OCT in this context. Nevertheless, it is concluded that the OCT does not favor the NST for routine fetal surveillance in diabetic pregnancy.
Leiomyomatosis Peritonealis Disseminata
Authors: Thejls Henning , Pettersson Birgitta , Nordlinder Hans
Published: December 2009

Leiomyomatosis peritonealis disseminata (LPD) is a rare condition characterized by multiple subperitoneal spread of nodules, giving the clinical impression of a widespread malignant tumor. the histopathology of LPD is that of a benign leiomyoma, probably originating from the multipotent subcoelomic mesenchymal cells. Two new case reports are presented here, suggesting that some cases of LPD are wrongly classified as metastasizing leiomyosarcoma. As the prognosis in LPD is favorable, it is of great importance to establish the correct diagnosis. When both the pathologist and the clinician become aware of the multipotentiality of the mesothelium and the adjacent stroma and thereby the multifocal character of the lesions, some of the diagnostic problems might be overcome.
Vaginitis Emphysematosa in a Renal Transplant Patient
Authors: Tjugum Jostein , Jonassen Fredrik , Olsson Jan‐Henrik
Published: December 2009

Transplant surgery is now a widely established practice and the associated immunosuppressive treatment is followed by various complications. the present report on vaginitis emphysematosa in a woman with renal transplantation indicates that even this benign condition may have a connection with immunosuppressive therapy.
Surgical Correction of Female Infertility: An Analysis of Results and Failures in 101 Cases
Authors: Fredricsson Bengt , Rosenborg Lennart
Published: December 2009

During the 1970s, surgery undertaken to remedy infertility at Sabbatsberg Hospital in Stockholm involved macrosurgical techniques. the patients described here had the same pathology on either side. Sixty‐three underwent different procedures for the correction of tubal pathology at laparotomy, while 20 patients had lysis of adhesions performed at laparoscopy. a further 18 patients were operated on for ovarian endometriosis. the results in terms of conceptions (ranging from 43 to 60%, depending upon the type of operation) were similar to those reported from microsurgery, but the incidence of ectopic pregnancy was higher. Second‐look laparoscopy revealed the presence of adhesions and tubal block in a significant number of patients, though less often in those who ultimatively conceived. There was no difference in semen findings between patients who conceived and those who did not. Postoperative adhesions are responsible for many surgical failures, but refined methods of surgery may reduce the risk of future ectopic gestation. Only a limited number of cases remain where persistence of infertility may be due to minor anatomical or functional defects not amenable to present‐day clinical evaluation.
Copper and Zinc Levels in Serum From Patients with Abnormalities of the Uterine Cervix
Authors: Grail Ann , Norval Mary
Published: December 2009

Serum copper and zinc levels were determined by atomic absorption spectroscopy in 110 women with varying degrees of cervical dysplasia up to carcinoma‐in‐situ and in 9 women with invasive carcinoma of the cervix, and compared with levels in 21 women with no evidence of cervical dysplasia. the average serum copper and zinc levels in the control group were 1.25 mg/l and 1.02 mg/l (respectively). the mean serum copper level increased with dysplasia to 1.4 mg/l and with invasive carcinoma to 1.47 mg/l. the mean serum zinc levels were decreased in cervical intra‐epithelial neoplasia (CIN) grade 1 to 0.81 mg/l and in invasive carcinoma to 0.73 mg/l. the copper:zinc ratios varied significantly between controls, patients with cervical dysplasia and patients with invasive carcinoma (p<0.01). Measurement of serum ceruloplasmin revealed no significant differences among the control group and the groups of patients.
Nulliparity in Women with Double Primary Cancers in Both Breast and Endometrium
Authors: Silman Alan , Thomas Antony , Kandler Rosalind , Ashford Jane
Published: December 2009

A hospital‐based diagnostic index revealed 340 women with endometrial carcinoma diagnosed over the 5‐year period 1974 to 1979. on later review, 12 had histological evidence of a separate primary in the breast, developing either prior or subsequent to the endometrial primary. Fifty‐eight per cent (n = 7) of these women were nulliparous, which was significantly greater than the nulliparity rate of 23% observed in a sample of the remaining women with endometrial cancer. the results from this small study suggest that the association of nulliparity with double primary cancers is greater than with endometrial cancer alone, though the findings need confirmation from the study of a larger series of such patients.
Evaluation of New Serum and Urine Tests in Cases of Suspected Pathologic Early Pregnancy
Authors: Steier Johan Arnt , Myking Ole L.
Published: December 2009

Two pregnancy tests, ModEL serum hCG Assay and ModEL Urine hCG Assay, were evaluated using sera and urine from 46 patients suspected of pathologic early pregnancy, of whom 22 patients had spontaneous abortion and 9 an ectopic pregnancy. Model Serum hCG Assay had a 100% sensitivity and specificity, thus demonstrating its value in these cases. with a sensitivity of 94% and a specificity of 87%, ModEL Urine hCG Assay gave poorer results. Both tests have a relative high “detection limit” of 25 U/l (serum) and 50 U/l (urine) which may impair their ability to distinguish between presence and absence of pregnancy by very low levels of hCG.
Placental Grading with Ultrasound in Hypertensive and Normotensive Pregnancies: A Prospective, Consecutive Study
Authors: Montan Sven , Jörgensen Connie , Svalenius Elisabeth , Ingemarsson Ingemar
Published: December 2009

Placental grading was studied prospectively with real‐time ultrasound in 654 consecutive pregnancies. the placental maturation was clearly demonstrated in both unselected and hypertensive pregnancies. No differences in placental grading were found between normotensive and hypertensive pregnancies. Fetal outcome was not associated with different placental grades and a grade III placenta was not predictive of an adverse outcome. the value of antenatal placental grading in unselective and hypertensive pregnancies could not be demonstrated.
Induction of Labor by Intra‐Cervical Pge2 in Viscous Gel: Mechanism of Action and Clinical Treatment Routines
Authors: Wiqvist Ingrid , Norström Anders , Wiqvist Nils
Published: December 2009

Induction of labor in women with immature cervix was accomplished by four different treatment schedules. the case material included a total of 100 subjects, each treatment group having 25 cases:

Group A: Intravenous oxytocin;

Group B: Intracervical PGE2‐gel followed by intravenous oxytocin;

Group C: Intracervical PGE2‐gel twice with a 12‐hour interval;

Group D: Intracervical placebo gel twice with 12‐hour interval.

Oxytocin did not influence the Bishop score (B.S.) unless in the presence of active labor contractions. in contrast, there was an increment in B.S. by 3.6 points on average within 12 hours following PGE2‐gel as calculated from data of subjects without signs of contractions. These results support the concept of a local action of PGE2‐gel. the increment in B.S. was larger in subjects with very immature cervices (B.S. 2) than in those with moderately immature scores (B.S. 4). a second PGE2‐gel instillation did not increase the B.S. above the level achieved by the first application, indicating that pharmacological ripening of the cervix by a single dose of PGE2 results in an effect approaching maximum.

The success rate was the same for oxytocin and PGE2‐gel treated women during the first 24 hours, when approximately 40% of the women had given birth. the oxytocin group remained at that level of success rate, whereas the PGE2‐gel‐oxytocin and PGE2‐gel × 2 series continued to improve their success rate up to 75%. An interesting finding in the study was that women given PGE2‐gel twice did not need intravenous oxytocin stimulation except in a few cases.
Colposcopy in Assessment of the Natural History of Prospectively Followed‐Up Human Papillomavirus (Hpv) Lesions in the Uterine Cervix
Authors: Väyrynen Martti
Published: December 2009

As a part of the long‐term prospective follow‐up study conducted in our clinic since 1981 for women with cervical HPV (Human papillomavirus) infections (either with or without cervical intra‐epithelial neoplasia, HPV‐CIN and HPV‐NCIN, respectively) the colposcopic data on 292 consecutive patients with a mean follow‐up of 16 months are reported. the results are based on 786 colposcopies performed at 6‐month intervals according to conventional methods. Colposcopic findings are categorized into one of the following patterns: normal, warty, punctate, mosaic, leukoplakia, and combination. Colposcopic pattern bore an excellent correlation to the natural history (clinical course) of the HPV lesions, in that colposcopy was normal in 75% of the regressing lesions, in 38% of the persistors, and in only 16% of the progressors. the percentage of regression increased parallel with the frequency of normal pattern during the follow‐up. Leukoplakia and combination were the two most frequent (55.7%) patterns in progressor lesions, as compared with only 12.9% in regressors and in 33.2% of the persistors. the same was true of the 15 lesions progressing into carcinoma in situ (CIS), and treated by cone. in the progressor lesions, an abnormal colposcopy pattern was disclosed in 65–100%, as compared with 14–35% only in the regressors. the present study provides evidence that colposcopy is an applicable and relatively accurate diagnostic method for assessing cervical HPV lesions. Colposcopy also seems to have some prognostic value in the follow‐up of these lesions, as shown by the fact that normal colposcopic pattern is frequently associated with regression, whereas leukoplakia and combination are encountered more frequently than others in HPV lesions with CIN, shown to be more prone to progress during the follow‐up
Accessory Ovary
Authors: Schultze Henrik , Fenger Claus
Published: December 2009

A case is reported of an accessory ovary in a 46‐year‐old woman. Accessory ovaries are frequently small and may therefore be overlooked at laparotomy. the present case was presumably discovered due to gonadotropic hyperstimulation caused by the menopause or the previous bilateral ovarian resection.
Polyhydramnios Caused by Giant Alveolar Granular Cell Myoblastoma
Authors: Schwartz Z.
Published: December 2009

Congenital granular cell myoblastoma of the newborn is a rare tumor. the combination of polyhydramnios caused by obstruction of the infant's mouth by this tumor is extremely rare, and this is the first published report of such a condition.
Sexual Function and Somatopsychic Reactions in Vulvectomy‐Operated Women and their Partners
Authors: Andreasson B. , Moth Inge , Jensen Søren Buus , Bock Johannes E.
Published: December 2009

Sexual function and somatopsychic reactions were examined in 25 women following vulvectomy and in 15 of their partners. More than half of the women had both sexual dysfunction and psychological problems. Their partners had no sexual dysfunction but almost half had psychological problems. An important reason for this seems to be insufficient information and advice both pre‐ and postope‐ratively and failure to recognize a developing stricture of the introitus vaginae. Frequent control and advice to both partners both pre‐ and postoperatively is desirable. Less extensive surgical procedures in selected cases should be considered.
Behavior of Preovulatory Markers in Normal and Abnormal Cycles
Authors: Loverro G. , Aventaggiato E. , Granata A. , Greco P. , Restaino A. , Selvaggi L.
Published: December 2009

Various ovulation markers in natural cycle (ultrasound measurement of follicular diameter, E2, progesterone, and LH assays) have been studied in 18 women. The patients were divided into two groups. Group 1: women who became pregnant during the same cycle; group 2: women who showed evidence of follicular growth, E2 and a LH midcycle rise, but low P levels in the luteal phase. A weaker increase in these parameters was found in group 2, especially the LH rise. Moreover, an asynchronicity between the en‐docrinological and morphological events has been observed in the suboptimal cycles. These findings suggest a process of follicular atresia at the end of the maturation phase, as is commonly found in otherwise normal women.
Obstetric Implications of Pregnancy in Adolescence
Authors: Khwaja Suraiya S. , Al‐Sibai M. Hisham , Al‐Suleiman Suleiman A. , El‐Zibdeh Mazen Y.
Published: December 2009

Pregnancy in adolescence constitutes a high‐risk obstetric situation and there is an obvious need for improvement in obstetric care for this age group. A retrospective study of 94 mothers, 17 years of age and under, was carried out at the Teaching Hospital of King Faisal University in order to assess the obstetric implications of adolescent pregnancy. This study has shown a significant increase in the incidence of low birth weight infants, breech presentation and preterm delivery. A significantly smaller number of adolescent mothers were found to have given birth spontaneously, vaginally. Adolescent primigravidas were noted to run a greater risk. It is imperative to institute a medical and educational service with comprehensive prenatal care for adolescent mothers in order to improve the outcome of their pregnancies.
A Solution to the Problem of “Missing” Iud threads
Authors: de Pésteny Margareta Pap , Solheim Folke , Åkerlund Mats
Published: December 2009

A disposable, plastic, sterile instrument, RetrievetteR, for the retrieval of ‘missing’ threads of intra‐uterine contraceptive devices (IUD) at routine gynecological investigations was developed and tested in 80 patients. In 64 instances, the threads were found and easily drawn out through the cervical canal. In the remaining 16 cases, where the threads were not found, this was due to already expelled IUD in 6, too short threads in 5, inverted IUD in one, IUD which had partly perforated the uterine wall in one, unknown factors in 2 cases where the women chose to keep a correctly placed IUD in spite of missing threads and, finally, in only one case due to method failure. In the latter case, a correctly placed IUD with threads of normal length was later extracted under general anaesthesia. It is concluded that this instrument can help the physician avoid more complicated and unpleasant procedures with ultrasonic or X‐ray localization and subsequent IUD extraction under local or general anesthesia in women with missing IUD threads.
Influence of Clomiphene Citrate in Vivo On Subsequent Steroid Formation and Gonadotropic Responsiveness in Vitro of Isolated Human Follicular Cells
Authors: Olsson Jan‐Henrik , Dennefors Bo , Nilsson Lars
Published: December 2009

Granulosa and thecal cells from human preovula‐tory follicles, extirpated from the ovaries of women undergoing sterilization by minilaparotomy, were incubated for 2 hours in the presence or in the absence of human gonadotropin (hCG). the follicles were obtained from 16 women, 8 of whom had previously been treated with clomi‐phene citrate (CC) to induce follicular maturation. the tissue contents of cyclic AMP (cAMP) and the content of progesterone (P), testosterone (T) and estradiol‐17β (E2) in the incubation medium were measured. Granulosa and thecal cells from control and CC‐induced follicles all responded to hCG in vitro with increased formation of cAMP. Both granulosa and thecal cells from CC‐induced follicles produced larger amounts of P in vitro than cells from spontaneously matured follicles. There were no other differences in the patterns of steroid formation or reactivity to hCG between the cells from the two types of follicle. It is concluded that CC treatment in vivo induces the growth and maturation of preovulatory follicles with apparently normal biochemical characteristics, as far as the content of and capacity to form cyclic AMP, progesterone, testosterone and estradiol‐17β are concerned.
Intra‐Uterine Weight Curves Obtained by Ultrasound
Authors: Persson P H. , Weldner B M.
Published: December 2009

Using multiple regression analysis, a formula was evolved for estimating fetal weight in utero, based on fetal biparietal diameter (BPD), abdominal diameter (AD) (mean of two orthogonal readings), and femur length (FL), measured by ultrasound within 48 hours before delivery or legal abortion in a stratified sample of 89 pregnancies, approx. 10 in each 500‐g weight class up to 5000 g. Tested on 135 neonates of varying birth weights, the formula evolved, wt = BPD0.972 × AD1.743 × FL0.367 × 10−2.647, neither under‐nor over‐estimated weight in any weight class, the error in estimates having a standard deviation of 7.1%, and maximum error being 18%' of true weight. to establish an intra‐uterine growth curve, the formula was applied to 177 longitudinal measurements in 19 normal pregnancies; the estimated weight against gestational age (GA) curve so obtained best fitted a third‐degree equation, wt = 1443.4–32.32 × GA + 0.203 × GA2‐0.000215 × GA3 (r2 = 0.978), tallying closely with the birth weight curve obtained in the same population from 4 743 pregnancies where gestational age had been assessed by ultrasound in early pregnancy. the present two growth curves, based on fetometry and on birth weight, differ from previous curves used almost universally by pediatricians.
Effect Upon the Human Myometrium During Early Pregnancy of the Prostaglandin F2α and Its Analogue 15 (S)‐15‐Methyl‐Pgf2α
Authors: Rydnert Jan
Published: December 2009

The hysterometric technique has been designed to measure the pharmacological effect of active agents upon the human uterine muscle. the physiological background is the fact that smooth muscle contracts under the influence of mechanical stimulation. by applying hysterometry, the effects on the human myometrium in vivo during early pregnancy of the naturally occurring prostaglandin F2α and its analogue 15(S)‐15‐methyl‐PGF2α have now been evaluated. According to the analysis of the contractile responses, the effects of the agents have been determined quantitatively.

The drug effects have been characterized by changes in myometrial response between registrations under basic conditions and during the infusion of the active agent, respectively. It was found that when these drugs were given in the doses usually employed in clinical practice, the effect on contractility of the PGF2α compound was more pronounced than that of the analogue. However, when describing the results on a microgram basis, the 15‐methyl‐PGF2α was confirmed to be 10–20 times more potent than PGF2α.
Quantitative Comparison of Circulating Immune Complexes in Normal Pregnancy and Pregnancy Related Hypertension
Authors: Westergaard Jes G. , Svehag Sven‐Erik , Hau Jann , Teisner Børge
Published: December 2009

Using two different Clq‐dependent assays for quantification of circulating immune complexes (CIC), the levels were compared in sera from 32 women with pregnancy‐related hypertension and in sera of 32 matched controls. No difference in the CIC levels was observed. the levels of CIC in the hypertensive patients were not correlated to pla‐cental weight, fetal weight, or diastolic blood pressure.
Twins Discordant for Vater Associationobstructed Labor of the Second Twin Due to Ascites and Persistent Cloaca Without Communication to the Exterior
Authors: Knudtzon Jørgen , Jordheim Odd , Smedsrud Baard
Published: December 2009

The unusual delivery of a dead second twin with rare malformations is presented. the first twin, born live following a normal labor, had no malformations. the birth of the second twin was obstructed by massive ascites, and its abdomen had to be perforated before delivery. the sex could not be determined due to lack of the internal genitalia and the fetal appearance of the external genitals. the left kidney and ureter were hypoplastic. the right ureter and distal part of the colon were dilated and opened into a large primitive cystic cloaca without communication to the exterior. the ascites was probably caused by the urinary obstruction. These malformations probably represent one of the earliest arrested developments of the embryonic hind‐gut. the presence of a tracheo‐esophageal fistula and a single umbilical artery, together with the anal atresia and the renal anomalies, could indicate that the anomalies formed part of the VATER association.
Increased Serum Ca 125 Levels During the First Trimester of Pregnancy
Authors: Seki K. , Kikuchi Y. , Uesato T. , Kato K.
Published: December 2009

An immunoradiometric assay for an ovarian tumor associated antigen (CA 125) has recently been developed. the CA 125 assay was reported to be fairly sensitive for ovarian cancer. However, elevated CA 125 levels were reportedly observed in 1% of healthy controls, 6% of patients with miscellaneous diseases and 29% of patients with non‐gynecological cancer. Therefore, the specificity of the CA 125 assay must be evaluated before its wide clinical application. Furthermore, data on the CA 125 levels in pregnant women have not heretofore been reported. in the present study, CA 125 levels were determined in sera randomly obtained from normal, pregnant women at various weeks of pregnancy and in sera serially collected from women who achieved pregnancy after ovulation induction. When compared with the normal, non‐pregnant state, CA 125 levels in pregnant women were significantly higher during the first trimester, but not during the second and third trimesters. Although CA 125 levels in women during the first trimester of pregnancy were significantly lower than those in patients with ovarian cancer, there was a considerable overlap between them. CA 125 levels were undetectable before pregnancy in all of the 8 patients who achieved pregnancy after ovulation induction. They rose during the first trimester of pregnancy in 7 of the 8 patients, and they decreased thereafter to undetectable levels by the end of the first trimester. the increased CA 125 level in the early pregnancy provides an important information for the clinical application of the CA 125 assay. Pregnancy should be ruled out when increased CA 125 levels are found in women during the childbearing years.
Premature Rupture of the Membranes at Term: Obstetric Outcome with Oxytocin Stimulation in Relation to Parity and Cervical Dilatation at Admission
Authors: Rydström H. , Arulkumaran S. , Ingemarsson I. , Kumar K. Jothi , Ratnam S. S.
Published: December 2009

The obstetric outcome in women with premature rupture of the membranes (PROM) at term (> 36 weeks gestation) without spontaneous onset of labor (within 2 h after admission) was evaluated prospectively in a joint study at the University Hospital of Lund, Sweden and Kandang Kerbau Hospital, National University of Singapore. After 2 h of observation without uterine contractions, labor was stimulated with oxytocin infusion. 303 patients participated and were classified according to parity (nulliparae–multiparae) and cervical dilatation at admission (<2 cm dilated; 2 cm dilated). No significant race‐related differences could be found, except for birthweight. Nulliparae with unfavorable cervix at admission had a high rate of ominous fetal heart rate findings in labor and a high cesarean section rate (19.4%), particularly for failed stimulation of labor. the high cesarean section rate after routine stimulation of labor in nulliparae with unfavorable cervix suggests that a non‐intervention approach may be justified in this group. in contrast, the cesarean section rate after stimulation of labor was 3.6% in nulliparae with the cervix dilated 2 cm or more at admission and 4.2% in multiparae and ominous fetal heart rate changes were much less common.
Release of β‐Endorphin in Response to Physical Exercise in Non‐Pregnant and Pregnant Women
Authors: Rauramo Ilkka , Salminen Katariina , Laatikainen Timo
Published: December 2009

The effect of physical exercise on β‐endorphin (β‐E) concentration in plasma was studied in 8 non‐pregnant and in 8 pregnant women in their last trimester of pregnancy, using a 10‐min bicycle ergometer test. in the nonpregnant women the mean β‐E levels were 2.4±0.7 (S.E.) pmol/l before the test, 4.3±0.9 pmol/l at the end of the test, and 4.3±0.6 and 5.0±2.0 pmol/l 15 and 30 min after the test, respectively, declining thereafter. in the pregnant women the mean β‐E values were 5.1±2.0 pmol/l before the test, 7.3±1.7 pmol/l at the end of the test, 6.7±2.0 pmol/l 15 min after the test, and 12.6±4.1 pmol/l 60 min after the test, declining thereafter. Thus β‐E secretion increased in response to exercise both in non‐pregnant and in pregnant women, the response lasting longer in pregnant women.
Suppressive Effect of Monocytes in Vitro in Patients with Carcinoma of the Uterine Cervix
Authors: Bjercke Sverre , Onsrud Mathias , Gaudernack Gustav
Published: December 2009

The adherent cell fraction (AdC) of human peripheral blood mononuclear cells (PBM) contains two cell types of opposing function in vitro. Dendritic cells (DC) act as antigen‐presenting cells (APC) in vitro, while monocytes (Mo) have a suppressive effect on antigen activation of T cells. in this report we show that patients with cervical carcinoma have a significantly increased number of suppressive Mo compared with healthy controls. the T cell response to Herpes Simplex Virus (HSV‐1) and PPD was about the same in the two groups, but after removal of Mo by adherence a significantly higher T cell response was seen among the patients with advanced stage (Figo stage IIb–IVa) compared with patients in early stage (Figo stage Ia–IIa) and healthy controls. These observations indicate that patients with cervical carcinoma have 1) an increased number of T cells reactive with HSV, and 2) normal DC function. the relative suppression expressed on a per Mo basis was the same in all groups, which indicates that the increased suppression in the patients was caused by an increased number of Mo, and not by changes in their activation state.
Maternal Smoking Reduces Prostacyclin Formation in Human Umbilical Arteries: A Study on Strictly Selected Pregnancies
Authors: Ahlsten Gunnar , Ewald Uwe , Tuvemo Torsten
Published: December 2009

Production of prostacyclin(PGI2)‐like activity in umbilical arteries in vitro was evaluated in 38 selected newborn infants. Nineteen of the mothers of these infants were habitual smokers and the remaining 19 were non‐smokers. to rule out the possibility of disturbing effects of drugs or other factors, the newborn infants and their mothers fulfilled strict criteria regarding normality and control of drug intake. the infants of habitual smokers (>5 cigarettes/day) (n = 19) were compared with a control group (n = 19) with non‐smoking mothers. Smokers' babies had lower birth weights than the controls (3 500±440 vs 3 900±420 g, p<0.01). Production of PGI2‐like activity was estimated by a bioassay technique. Umbilical arteries of smokers' infants produced significantly less PGI2‐like activity (139±78 ng/g arterial tissue) than those of the controls (201±87 ng/g) (p<0.05). As expected, the two groups differed highly significantly regarding serum levels of markers for exposure to cigarette smoke, but these levels did not correlate to formation of PGI2. Decreased production of PGI2‐like activity in umbilical vessels might have an impact on nutritive blood flow and oxygen transport, especially in situations of asphyxia.
Surveillance of the Cervix by Ultrasonography at Cervical Incompetence
Authors: Westgren Magnus , Sjöberg Nils‐Otto
Published: December 2009

Three patients with cervical incompetence were followed by repeated ultrasonic examination of the cervix in the second and third trimesters. Cervical incompetence can be easily guided according to the ultrasonic appearance of the cervix, thereby avoiding vaginal palpation.
Fundal Height Growth in Rural Africa
Authors: Kiserud T.
Published: December 2009

Gestational age was assessed by ultrasound examination before the 22nd week of pregnancy in 118 Ethiopian women. Their pregnancies were monitored by taking symphysis‐fundus measurements. 114 gave birth in the 37th week or later and their record were incorporated in the project. The average gestational age of this group was 39.7 weeks with an average birth weight of 3256 g. The uterine growth pattern was the same as for Swedish women, althought the mothers' average height was 156 cm (10 cm below the Swedish standard).
Hemostasis in Cold‐Knife Conization: Effects and side effects of glypressinR, a long‐acting analogue of lysine‐vasopressin
Authors: Irestedt L. , Thomassen P. A. , Vilhardt H.
Published: December 2009

In a double‐blind, randomized study, 50 patients undergoing conization were treated with either lysine‐vasopressin (LVP) or its longer‐acting analogue GlypressinR. Bleeding during the operation and side effects were studied. The hemostatic effect appeared better with LVP than with Glypressin. One postoperative bleeding occurred in the whole series, in a patient treated with Glypressin. The effect on the general circulation, especially with respect to pallor of the skin, was less prominent with Glypressin than with LVP (with the concentrations used in this study).
An Evaluation of Automated Indirect Blood Pressure Measurement During Pregnancy
Authors: Milsom I. , Svahn S.‐Ö. , Forssman L. , Sivertsson R.
Published: December 2009

An automatic microcomputer‐assisted instrument (DinamapR) for indirect determination of blood pressure was evaluated in 10 healthy women in the last trimester of pregnancy. Blood pressure determined intra‐arterially was significantly (p<0.001) higher than indirect blood pressure determined with the Dinamap instrument or by manual sphygmomanometry. However, there was no significant difference in the mean change in blood pressure determined by the three techniques under investigation. A close correlation was recorded between systolic and diastolic blood pressure determined intra‐arterially and with the Dinamap instrument (r = 0.92, r = 0.90), and between blood pressure determined intra‐arterially and indirectly by auscultation (r = 0.93, r = 0.81). There was no significant difference in the reproducability of individual blood pressure values determined intra‐arterially (systolic, 2.4 mmHg, diastolic, 3.7 mmHg) or by the Dinamap instrument (systolic, 2.8 mmHg, diastolic, 3.4 mmHg) or by auscultation (systolic, 5.0 mmHg, diastolic, 4.9 mm Hg). The Dinamap instrument proved reliable for the measurement of changes in blood pressure during late pregnancy. The technique eliminates the problem of inter‐observer error which otherwise becomes evident when checking blood pressure antenatally.