bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Comparison of D & C and Vacuum Aspiration for Performing First Trimester Abortion
Authors: Lean T. H. , Vengadasalam D. , Pachauri Saroj , Miller Eva R. 
Published: January 2017

Lean, T. H., Vengadasalam, D., Pachauri, Saroj and Miller, Eva R. (Kandang Kerbau Hospital, Singapore and International Fertility Research Program, Research Triangle Park, North Carolina, USA). A comparison of D & C and vacuum aspiration for performing first trimester abortion.Int J Gynaecol Obstet 14:481–486, 1976.In a study of techniques for first trimester abortion conducted at Kandang Kerbau Hospital in Singapore from September 1973 to April 1975, 420 physically healthy gravidas were randomly assigned to one of two treatment groups either by D & C or vacuum aspiration. Half of the patients in each group were 6 to 10 menstrual weeks’ gestation and half were 11 to 12 weeks’ gestation. The numbers of women with one or more complications were the same for the two treatment groups, but were significantly less when termination was carried out at 11 to 12 weeks’ gestation. Estimated blood loss was significantly lower for patients treated by VA (32.3 ml) than for patients treated by D & C (39.0 ml) at 6 to 10 weeks’ gestation, but the difference in blood loss was not statistically significant at 11 to 12 weeks’ gestation. Time from insertion to removal of the speculum was significantly less with VA than D & C at 6 to 10 weeks’ gestation but not at 11 to 12 weeks’ gestation. Since vacuum aspiration is at least as safe as D & C, and appears to be more convenient and costeffective, it should on the basis of this experience be accepted over D & C as the standard method for treatment of first trimester abortion.
Transplacental Passage of Diazepam Following Intravenous Injection Immediately Prior to Operative Vaginal Delivery
Authors: Haram Kjell , Sagen Norvald , Brandt Roger D. 
Published: January 2017

Haram, K., Sagen, N. and Brandt, R. D. (Dept. of Obstetrics and Gynecology, University of Bergen, Norway and Dept. of Experimental Medicine, F. Hoffmann‐La Roche & Co. AG, Basel, Switzerland). Transplacental passage of diazepam following intravenous injection immediately prior to operative vaginal delivery.Int J Gynaecol Obstet 14: 545–549, 1976.The early phase of diaplacental transfer of diazepam was studied in 39 women given the drug as a basic anaesthetic for operative vaginal delivery indicated by prolonged second stage of labour (9 cases), breech delivery (19 cases) and intrauterine hypoxia (11 cases). A total dose of 30 mg diazepam (Valium Roche) was injected intravenously over a period of 15 sec and umbilical cord blood was collected immediately after delivery. Diazepam was extracted with diethyl ether and determined by gas chromatography. The concentration of diazepam in cord blood increased from >5–250 ng/ml at 57–60 seconds to 48–1861 ng/ml at 90–100 seconds after completion of the intravenous injection. Thereafter a plateau seemed to be reached but the interindividual variation was still great with values ranging from 45–3034 ng/ml up to 360 seconds. Judged by Apgar score and the clinical course the neonates seemed to be unaffected by the medication administered to the mother.
Ovarian Function in Tubectomized Women Studied by Vaginal Cytology
Authors: Mehta P. V. 
Published: January 2017

ABSTRACTThe present menstrual pattern of 450 tubectomized women was analysed in respect to flow, intensity and duration, 2 to 8 years after the operation. A control group, matched for age, parity and socio‐economic status, comprising of 100 women whose husbands had undergone vasectomy, was similarly analysed as to their menstrual pattern. The menstrual changes in both the groups were assessed by comparing them with the normal menstrual cycle. The ovarian function in a representative 250 tubectomized women of the original group of 450 women was studied by serial vaginal cytology. The smear pattern in 240 women was ovulatory and in the remaining 10 women, anovulatory with a mild estrogenic effect. In the present study, both the tubectomized and the control groups had mild menstrual changes. The changes in the tubectomized women were found statistically significant by χ2 test. The menstrual changes observed were decreased flow, shorter duration and shorter intervals.
Effect of Dexamethasone on Blood Levels of ACTH, Cortisol, Progesterone, Estradiol and Estriol during Late Pregnancy
Authors: Kauppila Antti , Jouppila Pentti , Karvonen Pentti , Tuimala Risto , Ylikorkala Olavi 
Published: January 2017

ABSTRACTCorticosteroids are used to prevent the respiratory distress syndrome of the premature newborn. In order to evaluate the effect of such treatment on maternal and fetal endocrine functions the circulation levels of ACTH, Cortisol, progesterone, estradiol and estriol were measured in 13 patients before, during and after three days of intramuscular dexamethasone treatment. ACTH was significantly lower in the first day of the treatment and Cortisol in all three days, indicating a significant suppression of the pituitary‐adrenal axis. The treatment did not effect placental steroid genesis, as seen in the unchanged level of progesterone. Estradiol and estriol levels decreased significantly during the days of the treatment. This was supposedly the result of a decrease in the production of C‐19 estrogen precursors, caused by the suppression of both maternal and fetal adrenals. Clinically, it is important to notice that during dexamethasone treatment estriol is not a reliable indicator of fetoplacental function and the blocking of the pituitary‐adrenal system ought to be borne in mind when planning operative delivery during such treatment.
The Relationship of Amniotic Fluid Insulin Levels and the Lecithin‐Sphingomyelin Ratio
Authors: Newman Robert L. 
Published: January 2017

ABSTRACTAmniotic fluid insulin levels and the lecithin‐sphingomyelin ratio were determined in 62 samples of 33 insulin‐dependent diabetic patients from the 29th to the 44th week of gestation inclusive and in 42 samples of 38 gestational diabetic patients from the 35th to the 43rd week of gestation inclusive. (Gestational age was measured by ultrasonography.) The level of insulin in the amniotic fluid did not appear to affect the lecithin‐sphingomyelin ratio.
IgG, IgA, and IgM in the Serum of Latin American (Chilean) Women in the Course of Normal Gestation
Authors: Lizana Jorge , Ludwig Hella 
Published: January 2017

ABSTRACTThis paper reports the results of tests for the 3 major immunoglobulins (G, A, and M) in a homogeneous, low socioeconomic group of 81 pregnant women of different gestational ages and 20 postpartum and 20 nonpregnant women from a developing Latin American country (Chile). The serum total proteins and albumin values are also included. The single radial immunodiffusion assay used was standardized with the WHO Reference Immunoglobulin Preparation.Total proteins and albumin decreased throughout pregnancy by 12.5% and 20.2%, respectively, in the third trimester. IgG decreased during gestation in the first trimester; the fall was 18.0% below the IgG of the reference group. IgA decreased in the first trimester, declined by 25.0% during the second trimester, and recovered to its normal values in the third trimester. There was no noteworthy change in IgM, but 19.7% of the cases showed elevated serum IgM concentrations.In the postpartum sera, the total proteins, albumin, IgG, and IgM levels slowly returned to normal values, but the IgA level was elevated.The mechanisms causing the variations observed are not clear; but dilutional effects, alteration of the regulation mechanisms, race, environmental conditions, and transport across the placenta should be considered in looking for an explanation.
Psychological Sequelae of Sterilization in Women in Singapore
Authors: Cheng Mark C. E. , Cheong J. , Khew K. S. , Ratnam S. S. 
Published: January 2017

ABSTRACTThe Chinese in Singapore erroneously believe that there is an association between sterilization and castration. This belief has led to deep‐seated fears that sterilization may result in obesity, physical weakness, and impairment of sexual function. Beginning in 1969, Singapore authorities introduced increasingly stronger social policies to help reduce family size. Subsequently, there was a large increase in the number of tubal ligations. It was initially thought that this might result in a high incidence of psychological sequelae. A study of 150 women who had had culdoscopic ligations showed that 6.3% were dissatisfied at the end of 2 years. Women with fewer than 4 children and those with fewer than 2 sons tended to be more dissatisfied with sterilization.
Perspectives in Evaluating the Safety and Effectiveness of Steroidal Contraceptives in Different Parts of the World
Authors: Goldzieher Joseph W. 
Published: January 2017

ABSTRACTWhile differences in acceptability of steroidal contraceptives from nation to nation are generally recognized, variations in safety and effectiveness have been given little attention. Cardiovascular hazards such as thromboembolic disease, myocardial infarction, and stroke, which create such concern in developed countries, may be insignificant problems in other parts of the world where these diseases are rare in women of reproductive age. On the other hand, the influence of nutritional deficiencies, anemia, intestinal parasitism, malaria, and other widespread health problems on the effects and/or metabolism of steroids, which may be of major concern in developing countries, is just coming under study. Side effects also vary greatly among religiously and ethnically different populations, and significant differences in pregnancy protection and bleeding patterns among different populations have been reported—even with injectables. It is, therefore, important to examine and define intergroup differences and especially to recognize that safety concerns in one geographic setting cannot be automatically assumed to apply equally in other areas.
An Overview of IUD Research and Implications for the Future
Authors: Zipper J. , Edelman D. A. , Goldsmith A. 
Published: January 2017

ABSTRACTThe limitations of nonmedicated intrauterine devices (IUDs) and the potential for improving IUD performance through the addition of pharmacologic agents are discussed. The mechanisms of action of IUDs, particularly of the copper and the progesterone‐releasing devices, are reviewed. The development of improved intrauterine contraceptive devices will depend on an understanding of these mechanisms of action. In order to determine the optimal design of intrauterine contraceptives, the effects of the pharmacologic agents will also have to be evaluated, both separately and in combination with the carrier (vector).
IUD Insertions by Midwives: Five Years' Experience in Santiago, Chile
Authors: Pastene Laura , Rivera Mirtha , Zipper Jaime , Medel Mario , Thomas Michael 
Published: January 2017

ABSTRACTThis report includes data on insertions of Lippes Loop D, Copper‐7, and Copper‐T intrauterine devices (IUDs) performed by certified nurse‐midwives and physicians with comparable levels of training and experience in inserting IUDs. Net 1‐year pregnancy, expulsion, and removal rates were used to compare the experiences of the 2 groups. There were no significant differences between the groups in most of the event rates or in the overall method discontinuation rates. The authors conclude that, with adequate training and experience, nurse‐midwives can provide this family planning service with no additional risk to patients.
Alternatives to Female Sterilization
Authors: Ratnam S. S. , Rauff Mary , Chew S. C. 
Published: January 2017

ABSTRACTWith national policies aimed at reaching zero population growth in the shortest possible time, many countries have introduced restrictive legislation and disincentive programs in an attempt to decrease family size norms to 2 or 3 children. As a result, younger women of lower parity are being sterilized, with consequences that will be seen in the years to come. Although female sterilization is usually associated with minimal complications and side effects and is highly effective without continuing motivation or promotion, it has the disadvantage of causing permanent, essentially irreversible sterility. Therefore, it will not be readily acceptable to a large portion of the population. For many women, alternatives must be sought. Reversible methods of female or male sterilization, longacting systemic contraceptives, longacting implants, and immunization against implantation or sperm antigens are potential alternatives, but all are still in experimental stages of development. Intrauterine devices and injectables are the 2 most effective alternatives now available. The use of intrauterine devices with abortion as a backup in case of contraceptive failure ranks high as an alternative to female sterilization.
Induction of Abortion with 15(S)‐15‐MethylPGF2α (Tham) Vaginal Suppositories
Authors: Vengadasalam D. , Lean T. H. , Edelman D. A. 
Published: January 2017

ABSTRACTThe repeated administration of vaginal suppositories containing 1 mg 15(S)‐15‐methyl PGF2α (Tham) successfully induced abortions in 60 of 62 patients. Among patients who successfully aborted, the mean abortion time was 19.0 hours. The mean abortion time was not related to gestational age or parity. Sixty (96.8%) aborted within 48 hours, and 53 (85.5%) aborted within 24 hours. Gastrointestinal side effects occurred for 33.9% of the patients. Diarrhea was the most frequent side effect. The abortion was complete for 40.3% of the patients.
Mortality and Fertility Control
Authors: Tietze Christopher , Lewit Sarah 
Published: January 2017

ABSTRACTThe authors present a continuation of the thesis suggesting that the most rational procedure for regulating fertility is a perfectly safe, even though not completely effective, contraceptive method combined with safe methods for terminating pregnancy when the contraceptive fails. This analysis demonstrates that, compared with the risk of death from pregnancy and childbirth, major reversible methods of fertility control—the pill, IUDs, condoms, and diaphragms—and abortion are associated with very low levels of mortality. The exception to this statement is pill use after age 40 by women who smoke. This analysis also confirms the very low mortality associated with using the condom and diaphragm with early induced abortion as a backup to terminate pregnancies resulting from contraceptive failures.
Toxoplasma Antibodies and Spontaneous Abortion
Authors: Lolis D. , Tzigounis V. , Michalas S. , Koumentakou E. , Kaskarelis D. 
Published: January 2017

ABSTRACTOne hundred and fifty‐two women with spontaneous abortion were investigated by hemagglutination (HA) and immunofluorescence antibody (IFA) tests for toxoplasmosis. In 48 cases, quantitive immunoglobulin (Ig) studies and mouse inoculation with gestational material were performed. Positive toxoplasma antibody titers were observed in 62 cases (40.8%) using HA and in 52 cases (38.2%) using IFA. This prevalence was significantly higher than that observed in 80 normal women who served as controls. Toxoplasma gondii was isolated in two cases. No correlation was found between antibody titers and IgG, IgM or IgA levels. We conclude that toxoplasmosis should be considered as the cause of abortion when a patient's antibody titer exceeds 1:256.
Advances in Sterilization Equipment
Authors: McCann Margaret F. , Morrow Margaret M. , Goldsmith Alfredo 
Published: January 2017

ABSTRACTFrom the array of sterilization procedures that are safe, simple and effective, the service provider must select procedures that fit his or her logistical criteria, which include the cost and maintenance of equipment, availability of supplies, and training of the requisite personnel. In this paper, these criteria are discussed for each of the various sterilization procedures. Information about female sterilization equipment for conventional postpartum laparotomy, minilaparotomy, colpotomy, laparoscopy, and culdoscopy is presented, together with facts about the related tubal occlusion techniques. The standard ligation techniques for male sterilization are compared with the newer electrocoagulation and thermocoagulation methods. A variety of methods for both female and male sterilization that are in the research stage are also mentioned. It is concluded that, from a programmatic point of view, vasectomy and postpartum ligation via laparotomy are the optimal sterilization procedures. For women who have not recently been pregnant, minilaparotomy with a standard tubal ligation technique is recommended, except in large teaching hospitals where laparoscopy can be performed efficiently.
Fetal‐Maternal Hemorrhage after Amniocentesis: Incidence, Degree and Ramifications
Authors: Goldstein Arthur I. , Pezzlo Frank 
Published: January 2017

ABSTRACTA review of the literature indicates a small but significant incidence of fetal‐maternal hemorrhage following amniocentesis. In these studies, consideration has not been given to the frequency with which erythrocytes containing hemoglobin F are to be found in the maternal circulation in the absence of amniocentesis. In this investigation, Kleihauer‐Betke analysis was carried out before and after amniocentesis. This study confirms previous reports that spontaneous fetal‐maternal hemorrhage is not uncommon during normal intrauterine gestation and that amniocentesis is probably only an occasional cause of fetal‐maternal hemorrhage. This impression is based on the findings that most Kleihauer‐positive maternal blood samples after amniocentesis were also positive before amniocentesis. In spite of these findings, and since Rh‐immune serum globulin is apparently harmless to the fetus and mother, its use is still advocated in nonsensitized Rh‐negative mothers after amniocentesis.
Aerobic and Anaerobic Cervical Flora of Healthy Thai Women
Authors: Jayanetra Panida , Kongmuang Urirat , Vorachit Malai , Benchakan Vilai 
Published: January 2017

ABSTRACTThe bacteriologic study of the cervical flora in 50 healthy women revealed that 70% harbored mixed aerobic and anaerobic organisms. Aerobic organisms alone were recovered in 15 women (30%). Polymicrobial organisms were found in all but five women (in these only one aerobe was isolated per patient). The majority of patients had 1–2 anaerobes, with more than two aerobes. The common aerobes were α‐hemolytic streptococci, Staphylococcus epidermidis and lactobacilli. The most common anaerobes were Peptococcus asaccharolyticus isolated in 21 women (42%), P prevotii in 13 (26%) and Bacteroides in 10 (20%). These organisms are frequently found in pelvic infection, suggesting the pathogenic potential of the normal flora of the cervix.
Rheumatic Heart Disease Diagnosed During Pregnancy: A 30‐Year Follow‐up
Authors: Gleicher Norbert , Knutzen Victor K. , Elkayam Uri , Loew Saul , Kerenyi Thomas D. 
Published: January 2017

ABSTRACTOne hundred one patients originally diagnosed as having rheumatic heart disease (RHD) during the years 1945–1948 were reevaluated in 1975 to determine the natural history of the disease. Twenty patients (19.8%) showed no sign of RHD. Of the patients with confirmed RHD, 56 (70.0%) had their original lesion confirmed, while 23 (28.8%) had developed additional valvular involvement. Pure mitral stenosis resulted in significantly lower mortality than all other valvular lesions, and congestive heart failure was the leading cause of death. Nineteen patients underwent cardiac surgery; the mortality in this group (52.6%) was not significantly higher than that in the overall RHD group (38.8%). False diagnosis of RHD during pregnancy is common. A more thorough evaluation of the “cardiac murmur of pregnancy” is advocated.
Viral Hepatitis Complicating Pregnancy: Mortality Trends in Saudi Arabia
Authors: Gelpi A. P. 
Published: January 2017

ABSTRACTThe striking mortality in viral hepatitis associated with pregnancy, regularly observed in developing countries, has shown a significant decrease in Saudi Arabia during a period of unprecedented economic growth. However, the risk of fatal hepatitis in the pregnant Saudi woman remains approximately four times that for the nonpregnant woman. The explanation for the observed mortality trend is not apparent, but is unlikely to be the result of improved nutritional status of the population alone, or because of treatment of severe hepatitis with adrenal corticosteroids. Disseminated intravascular coagulation may be one factor that decisively influences the outcome of hepatitis in the pregnant woman.
The Significance of Adrenal and Ovarian Catheterization in Patients with Polycystic Ovary Syndrome
Authors: Tzingounis Vassilios A. , Aksu M. Feridun , Natrajan Puthugramam K. , Greenblatt Robert B. 
Published: January 2017

ABSTRACTA previously unreported series of 15 anovulatory hirsute women with polycystic ovaries made up this study. Each underwent left adrenal and left ovarian vein catherization. Blood samples were obtained from the ovarian, adrenal and peripheral veins to test the levels of testosterone, Δ4 androstenedione (Δ4A), dehydroepiandrosterone (DHEA), estradiol and/or total estrogens, before and after administration of human chorionic gonadotropin (ten cases) and adrenocorticotropic hormone (ACTH) (five cases). Following intravenous human chorionic gonadotropin administration, the only response seen was a slight rise in ovarian levels of Δ4A and DHEA; after intravenous adrenocorticotropic hormone stimulation, the adrenal levels of Δ4A, testosterone and DHEA rose significantly. Peripheral concentrations of testosterone and Δ4A were in the high normal range and DHEA levels were high normal or slightly above normal range.
Ultrasound Diagnosis of Hematocervix Following Gynatresia in a Case of Uterus Bicornis Bicollis
Authors: Szöke Bela , Kiss Dezsö 
Published: January 2017

ABSTRACTThe authors describe the ultrasound findings of a hematocervix associated with cervical atresia. They emphasize the diagnostic difficulties and the important role of ultrasound in such cases.
A Survey of Sterilization Acceptors in a Family Planning Program in Rural Bangladesh
Authors: Bhatia Shushum , Osteria Trinidad , Chakraborty J. , Faruque A. S. G. 
Published: January 2017

ABSTRACTThe results of a survey of 275 Bangladeshi women who were sterilized at a rural family planning clinic are presented. The survey comprised two interviews of each woman: one conducted immediately prior to the sterilization procedure and the second conducted one month after each woman was sterilized. Sociodemographic data were gathered for the survey from the patients' clinic records. Reasons for the choice of sterilization and sociodemographic impact of the procedure are discussed, as are implications of the results on other rural family planning programs.
α‐Fetoprotein: A Marker for Threatened Abortion
Authors: Sande H. A. , Fagerhol M. , Molnar O. , Foss O. P. , Torjesen P. 
Published: January 2017

ABSTRACTThe role of α‐fetoprotein (AFP) as a marker for threatened abortion was investigated in 50 patients and compared with the roles of serum human chorionic somatomammotropin (HCS) or human placental lactogen (HPL) and human chorionic gonadotropin (HCG). Of the 50 patients admitted to the hospital with threatened abortion, 30 patients aborted and 20 gave birth to live‐born babies. Twenty women aborted within seven days of admission. Eighty‐two percent (82%) of the 20 had abnormal AFP values: one third were above the 97.5 percentile and two thirds were below the 2.5 percentile. The AFP values were normal in almost all cases in the group who aborted after seven days. The HCG level in serum was found to be the best indicator of threatened abortion. The AFP and HCS levels were equal indicators of threatened abortion, but were not as reliable as the HCG levels. The AFP values are of more diagnostic use than the HCS values, however, because both abnormally low and high AFP levels can indicate an unfavorable course in pregnancy.