bluuebunny/crossref_metadata_2025_split huggingface dataset:
Face presentation at term: A forgotten issue
Authors: Tapisiz Omer L. , Aytan Hakan , Kiykac Altinbas Sadiman , Arman Feyza , Tuncay Gorkem , Besli Mustafa , Mollamahmutoglu Leyla , Danışman Nuri 
Published: June 2014

AbstractAimTo determine factors associated with face presentation of term fetuses delivered.MethodsOf 34 480 consecutive, term deliveries of uncomplicated pregnancies within a 3‐year period, all live, singleton term fetuses with cephalic presentation in which no lethal anomalies occurred that were diagnosed with a face presentation were studied. Factors that may have contributed to the etiology of the presentation including age, parity and fetal size were evaluated. Ultrasonographic evaluation was recorded.ResultsFifty cases were diagnosed with an incidence of 0.14%. Parity was not associated with face presentation. Birthweight of 4000 g or more indicated an increased risk of approximately 2.9‐fold, whereas fetuses weighing 3000–3499 g were found to have a relatively decreased risk of face presentation when compared with the general obstetrics group (P = 0.015 and 0.001, risk ratio = 2.948 and 0.450, respectively). With physical examination, only 70% were diagnosed correctly.ConclusionFace presentation is a rare event and birthweight more than 4000 g was found to be associated with face presentation. Parity is not an associated factor.
Disappearance of a uterine arteriovenous malformation following long‐term administration of oral norgestrel/ethinyl estradiol
Authors: Oride Aki , Kanasaki Haruhiko , Miyazaki Kohji 
Published: June 2014

AbstractUterine arteriovenous malformation (AVM) can cause sudden massive hemorrhage. We report a case of uterine AVM following curettage in a patient treated conservatively with an intermediate‐dose pill. An 18‐year‐old gravida 2 para 0 underwent curettage at 12 weeks of gestation and was examined for massive genital hemorrhage that occurred in postoperative month 4. Abundant blood flow in a mass within the uterine lumen was observed on color Doppler ultrasonography, and the patient was diagnosed with AVM. Six days after starting oral norgestrel/ethinyl estradiol, the hemorrhage ceased, and computed tomography on day 37 of administration showed disappearance of the abnormal vasculature. After 12 months, the patient's course remains favorable without relapse. Transarterial embolization for AVM can cause ovarian failure and subsequent placental malpositioning. Administration of oral norgestrel/ethinyl estradiol may be an alternative conservative treatment option for patients who wish to maintain fertility.
Preoperative evaluation of deep venous thrombosis in patients with pelvic organ prolapse
Authors: Kobayashi Yoichi , Kuroda Keiko , Shibuya Hiromi , Nishigaya Yoshiko , Momomura Mai , Matsumoto Hironori , Iwashita Mitsutoshi 
Published: June 2014

AbstractAimThe incidence of preoperative deep venous thrombosis (DVT) was examined in patients with pelvic organ prolapse (POP).Material and MethodsPreoperative screening for DVT was performed on the basis of D‐dimer levels; if D‐dimer levels were beyond the cut‐off limit (0.5 μg/mL), ultrasound examination of the lower extremities was performed. A total of 75 consecutive patients who were scheduled for POP operation in our department were examined retrospectively.ResultsD‐dimer levels were elevated in 24 patients (31.6%). Further, DVT was detected in 10 of the 75 patients, resulting in an incidence rate of 13.3% in the present study. D‐dimer levels were significantly higher in the patients with DVT (1.25 ± 0.52 μg/mL vs 0.41 ± 0.26 μg/mL). There was no significant difference in age, and although body mass index and the number of diabetes mellitus cases were relatively higher in the patients with DVT than in those without DVT, there were no statistically significant differences. According to a receiver–operator curve, the suggested cut‐off D‐dimer value was 0.71 μg/mL (sensitivity and specificity was 0.9 and 0.877, respectively).ConclusionsAlthough this was a preliminary study, to the best of our knowledge, this is the first report describing the incidence of preoperative DVT in patients with POP. Our study indicates that the incidence of DVT in patients with POP might have been underestimated thus far. Therefore, every surgeon should evaluate patients for DVT prior to any surgical procedure for POP, particularly in those patients with obesity or diabetes mellitus.
Primary retroperitoneal Müllerian adenocarcinoma arising from endometriosis
Authors: Tanaka Kei , Kobayashi Yoichi , Shibuya Hiromi , Nishigaya Yoshiko , Momomura Mai , Matsumoto Hironori , Iwashita Mitsutoshi 
Published: June 2014

AbstractPrimary retroperitoneal Müllerian adenocarcinoma (PRMA) is an extremely rare tumor and the cause remains unknown. We report a case of PRMA arising from endometriosis. A 52‐year‐old woman with a history of malignant lymphoma underwent a follow‐up computed tomography scan, which revealed a retroperitoneal tumor. Immunohistochemical analysis of tumor resected during laparoscopic surgery showed adenocarcinoma positive for cytokeratin 7 and negative for cytokeratin 20. The patient had undergone hysterectomy and bilateral salpingo‐oophorectomy 14 years ago for myoma uteri and endometrial cysts and was treated with estrogen‐replacement therapy. The size of the tumor increased and laparotomy was performed. Histopathological examination showed adenocarcinoma resembling endometrial adenocarcinoma, which stained positive for cancer antigen 125, cancer antigen 19‐9, estrogen receptor, and progesterone receptor immunohistochemically. The focus of the endometriosis was found at the edge of the tumor, and the stromal cells around the tumor cells were CD10 positive. The patient was diagnosed as having PRMA arising from endometriosis, and treated with adjuvant chemotherapy.
Argentophilic nucleolus organizer region as a proliferation marker in cervical intraepithelial neoplasia grade 1 of the uterine cervix
Authors: Guerra Fernando , Rocher Adriana Esther , Villacorta Hidalgo José , Díaz Lilí , Vighi Susana , Cardinal Lucía , Tatti Silvio , Cúneo Nicasio , Prat Gay Gonzalo , Camporeale Gabriela , Palaoro Luis Alberto 
Published: June 2014

AbstractAimp16INK4a and argentophilic nucleolus organizer region (AgNOR) can be used as markers for progression of cervical intraepithelial neoplasia grade 1 (CIN1) of the uterine cervix. Our objective was to study the predictive value of the AgNOR technique as a progression marker of CIN1 and its correlation with p16INK4A.Material and MethodsOne uterine cervix biopsy from each of 75 patients with diagnosis of CIN1 was selected. All of these patients underwent a second biopsy, and these were also used for the study.ResultsThe second biopsies showed: regression (20 patients), persistent CIN1 (38 patients), progression to CIN2 (10 patients) and progression to CIN3 (seven patients). p16INK4A showed reactivity in 67 of the 75 first CIN1 biopsies: 12 of the 20 cases that cleared the lesions and the 55 cases with persistent or progressive lesions were positive for p16INK4a (specificity: 40%; sensitivity: 100%; positive predictive value [PPV]: 82%; negative predictive value [NPV]: 100%). Samples with AgNOR areas less than 3.0 μ2 returned in all cases, but patients whose lesions persisted or progressed to CIN2/CIN3, showed AgNOR areas greater than 3.0 μ2 in 50/55 cases (specificity: 100%; sensitivity: 91%; PPV: 100%; NPV: 80%).Conclusionsp16INK4a is expressed in a high percentage of returning lesions. AgNOR might be a better marker of proliferation of CIN1 than p16INK4a (PPV = 100%), which means that a value greater than 3.0 μ2 indicates the persistence or progression of the lesion. As its NPV is 80%, a value of AgNOR area less than 3.0 μ2 in CIN1 leaves a margin of doubt about the future behavior of the lesion.
Therapeutic effect of laser vaporization for vaginal intraepithelial neoplasia following hysterectomy due to premalignant and malignant lesions
Authors: Wang Yan , Kong Wei‐Min , Wu Yu‐Mei , Wang Jian‐Dong , Zhang Wei‐Yuan 
Published: June 2014

AbstractAimThe aim of this study was to evaluate the therapeutic effect of laser vaporization for vaginal intraepithelial neoplasia (VAIN) after hysterectomy in Chinese women and to identify factors affecting persistence/recurrence.Material and MethodsTwenty‐eight VAIN patients after hysterectomy due to cervical intraepithelial neoplasia (group 1) and 11 VAIN patients due to cervical cancer (group 2) were reviewed retrospectively. All patients were treated with at least one episode of laser vaporization between 2010 and 2011, and then followed up every 3 months for at least 1 year. Cox regression analysis was used to identify independent factors predicting persistence/recurrence.ResultsAll VAIN patients achieved remission after two episodes of laser treatment, with 85.7% complete regression in group 1 and 54.5% in group 2. The first episode of the treatment had a significantly higher success rate in group 1 than in group 2 (46.2% vs 0.0%). All patients had no recurrence during a mean follow‐up time of 22.8–27.8 months (range 12–39 months). However, infection persisted in 21 (61.8%) of 34 human‐papillomavirus‐positive patients after laser vaporization. Severity of VAIN was the only significant independent predictor of persistence/recurrence after one episode of the treatment (adjusted odds ratio, 4.08; 95% confidence interval, 1.28–12.96; P = 0.017). Laser treatments were well tolerated with no major side‐effects.ConclusionLaser vaporization may be a useful option for the treatment of VAIN after hysterectomy. However, a follow‐up is required to assess the long‐term efficacy of laser treatment.
Frequency of hereditary thrombophilia in women with recurrent pregnancy loss in Northern Pakistan
Authors: Ali Nadir , Bhatti Farhat Abbas , Khan Saleem Ahmed 
Published: June 2014

AbstractAimHereditary thrombophilia (HT) screening is performed as routine work‐up of recurrent pregnancy loss (RPL) in Pakistan. In Northern Pakistan the prevalence of HT is not known. HT is not detected in the majority of RPL cases, especially in patients with ≤3 pregnancy losses (PL). The aim of this study was to determine the frequency of HT in women with RPL, and to find the prevalence of HT in patients with ≤3 PL and >3 PL.Material and MethodsLupus‐anticoagulant‐negative patients with unexplained RPL were screened for protein C, protein S, antithrombin, and factor V Leiden.ResultsA total of 315 patients with RPL were screened and 13 (4%) had evidence of HT. Protein C and protein S deficiency were detected in 6/140 (4.3%) women with >3 PL and in 2/175 (1.1%) women with ≤3 PL. Antithrombin deficiency was detected in 2/140 (0.75%) women with >3 PL and in no patients with ≤3 PL. Factor V Leiden was detected in 3/26 (12%) women with >3 PL and in no patients with ≤3 PL. The prevalence of HT in patients with >3 PL was significantly higher than in patients with ≤3 PL (P = 0.002). We detected a strong association between HT and >3 PL (odds ratio 7.3; 95% confidence interval: 1.60–33.85) as compared to ≤3 PL.ConclusionHT was detected in 4% of patients with RPL. The prevalence of HT in patients with >3 PL is significantly higher than in patients with ≤3 PL.
Major causes of impractical brachytherapy in elderly patients with uterine cervical cancer
Authors: Yanazume Yumi , Yanazume Shintaro , Iio Kazuto , Yonekura Ryuji , Kojima Nobuko , Uchida Natsuko , Koriyama Chihaya , Douchi Tsutomu 
Published: June 2014

AbstractAimIncomplete brachytherapy is a major risk factor for recurrence. However, high‐dose‐rate intracavitary brachytherapy has not been assessed adequately in elderly patients with invasive cervical cancer. The present study investigated the clinical importance of intracavitary brachytherapy and risk factors of incomplete intracavitary brachytherapy in elderly patients with cervical cancer.Material and MethodsSubjects were 76 patients aged 70–89 years old with invasive cervical cancer. All subjects were recruited between January 1997 and September 2010, and were planning to receive external beam radiation therapy followed by high‐dose‐rate intracavitary brachytherapy. Survival rates and the incidence of complications were compared between the 70s and 80s age groups. Risk factors for recurrence in elderly patients were evaluated using multivariate analysis, and risk factors for impractical intracavitary brachytherapy were also estimated.ResultsNo significant differences were observed in 3‐year progression‐free survival rates or the incidence of complications in the two age groups. Cox multivariate analysis showed that histology (non‐squamous cell carcinoma), incomplete intracavitary brachytherapy, and lymph node swelling were significant prognostic factors for recurrence. Impractical application was the major reason for incomplete treatment. Multiple logistic regression analysis revealed that a previous history without vaginal births (P = 0.016) was an independent risk factor for the impractical application, independent of tumor diameter ≥4 cm (P = 0.007).ConclusionsIncomplete intracavitary brachytherapy decreased the survival rates of elderly patients. Larger tumors and patients without a history of vaginal births were the two major causes of impractical intracavitary brachytherapy, which may be fatal, especially in elderly patients with bulky tumors.
Clinicopathological study on para‐aortic lymph node metastasis without pelvic lymph node metastasis in endometrial cancer
Authors: Tomisato Shoko , Yamagami Wataru , Susumu Nobuyuki , Kuwahata Michiko , Takigawa Aya , Nomura Hiroyuki , Kataoka Fumio , Hirasawa Akira , Banno Kouji , Aoki Daisuke 
Published: June 2014

AbstractAimOne of the important risk factors for recurrence of endometrial cancer is lymph node metastasis. The regional lymph nodes are pelvic lymph nodes (PLN) and para‐aortic lymph nodes (PAN). PAN metastasis was often detected in the cases with PLN metastasis. However, PAN metastasis not associated with PLN metastasis was identified in a few cases. We focused on nine cases with PAN metastasis and without PLN metastasis.Material and MethodsThe subjects of this study were 260 cases that were diagnosed with endometrial cancer. The initial treatments were surgery, including pelvic and para‐aortic lymphadenectomy. Nine of these cases had PAN metastasis but did not have PLN metastasis. We retrospectively analyzed the clinicopathological factors and prognosis in cases with PLN–PAN+ cases.ResultsA total of 91 (35%) cases were identified as positive for either PLN or PAN. PAN metastases were detected in 62.6% of the cases that had some regional lymph node metastases and 3.5% of all cases were PLN– and PAN+. In all PLN–PAN+ cases, PAN swelling was not detected by preoperative chest‐abdominal computed tomography scan. There were no clear trends among risk factors of regional lymph node metastasis. The 5‐year progression‐free survival was 87.1% for PLN−PAN− cases, 67.5% for PLN+PAN− cases, 44.4% for PLN−PAN+ cases, and 33.2% for PLN+PAN+ cases.ConclusionDuring diagnosis and treatment for endometrial cancer, PLN−PAN+ cases should also be considered because the prognosis in PLN–PAN+ cases tended to be lower than that in PLN–PAN– cases and PLN+PAN− cases.
Preterm birth trend in Taiwan from 2001 to 2009
Authors: Wang Liang‐Kai , Chen Wan‐Ming , Chen Chie‐Pein 
Published: June 2014

AbstractAimThe aim of this study was to analyze the trends and risk factors of preterm birth from all the women who delivered during 2001–2009 in Taiwan.Material and MethodsWe analyzed the preterm birth rates, the proportions of obstetric antecedents and risk factors in the population of pregnant women and neonatal Apgar scores according to the National Medical Birth Register database from 2001 to 2009. Adjusted odds ratios (OR) with 95% confidence intervals for risk factors of preterm birth were assessed using multivariable logistic regression models. The obstetric antecedents of preterm birth for singletons were stratified by spontaneous preterm labor and indicated preterm delivery (labor induction or elective cesarean delivery).ResultsThe preterm birth rate was 8.56% with the majority (89.76%) delivered between 32 and 37 weeks of gestation. A 0.07% annual increase (P < 0.001) in preterm delivery was observed. The greatest risk factors were multiple pregnancies (OR > 20), followed by medical complications (OR > 2.8), congenital malformations (OR > 2), teen pregnancies (OR > 1), and advanced maternal age (OR > 1). Specifically, singleton preterm births comprised 57.3% spontaneous labor and 42.7% indicated delivery. There was a 0.5% annual increase (P < 0.001) in indicated delivery. Incidence of neonates with poor Apgar scores (<7) was significantly different between those with and without medical complications (P < 0.001).ConclusionsThe preterm birth rate increased significantly from 2001 to 2009 and multiple pregnancies were the most important contributing factor. Most of the singleton preterm births resulted from spontaneous labor, but the proportion of indicated deliveries increased.
Spontaneous rupture of uterine varicose veins: A rare cause for obstetric shock
Authors: Lim Pei Shan , Ng Soon Pheng , Shafiee Mohammad Nasir , Kampan Nirmala , Jamil Muhammad Abdul 
Published: June 2014

AbstractSpontaneous rupture of uterine surface varicose veins is rare but may result in serious complication of pregnancy, as it is associated with high perinatal and maternal mortality. We report a 24‐year‐old primigravida who presented with this rare condition mimicking placenta abruption, which was successfully managed. A review of reported cases was performed.
Validity for assisted hatching on pregnancy rate in assisted reproductive technology: Analysis based on results of Japan Assisted Reproductive Technology Registry System 2010
Authors: Nakasuji Takashi , Saito Hidekazu , Araki Ryuichiro , Nakaza Aritoshi , Kuwahara Akira , Ishihara Osamu , Irahara Minoru , Kubota Toshiro , Yoshimura Yasunori , Sakumoto Tetsuro 
Published: June 2014

AbstractAimThe aim of this study was to assess the efficacy of assisted hatching (AH) in assisted reproductive technology (ART) treatment.Material and MethodsIn this retrospective observational study, the data of patients who were registered in the National ART Registry System of Japan between January and December 2010 were analyzed. The descriptive statistics and validity of AH in fresh embryo transfer (ET) and frozen–thawed ET were assessed by using multiple logistic regression analyses.ResultsFrom a total of 105 450 single ET, 46 029 (43.7%) cycles underwent AH. A total of 9737 (21.3%) and 36 292 (60.9%) cycles underwent AH from 45 818 fresh single ET and 59 632 frozen–thawed single ET, respectively. In the fresh ET patients that underwent AH, the clinical pregnancy and live birth rate were significantly decreased in patients of all ages compared with that of the non‐AH group. In the frozen–thawed ET patients, there was no significant difference in pregnancy and live birth rate between the AH group and the non‐AH group.ConclusionAH treatment was more frequently performed in frozen–thawed ET patients than in fresh ET patients, and in the blastocyst stage than in the early cleavage stage. A significantly decreased pregnancy and live birth rate was observed in the fresh ET patients who underwent AH. In the frozen–thawed ET patients who underwent AH, improvement in the clinical pregnancy and live birth rate was not observed. Further studies on the indication and application of AH in ART treatment are required.
Measurement of endometrial and uterine vascularity by transvaginal ultrasonography in predicting pregnancy outcome during frozen–thawed embryo transfer cycles
Authors: Son Jung Bin , Jeong Ju Eun , Joo Jong Kil , Na Yong Jin , Kim Chang Woon , Lee Kyu Sup 
Published: June 2014

AbstractAimAn appropriate endometrial condition and vascular supply are usually considered essential for implantation of an embryo. This study was performed to assess the role of endometrial and uterine vascularity status measurement in predicting pregnancy outcome during frozen–thawed embryo transfer cycles.Material and MethodsA total of 70 infertile women were recruited with controlled ovarian stimulation followed by oocyte retrieval. After in vitro fertilization or intracytoplasmic sperm injection, embryos were cultured to blastocysts and blastocysts with good quality were selected for cryopreservation. After endometrial preparation, vitrified blastocysts were thawed and assisted hatching by zona dissection was performed. On the day of embryo transfer, endometrial thickness (EMT), resistance index (RI) and pulsatility index (PI) of sub‐endometrial artery (SEA) and uterine artery (UA) were obtained by transvaginal sonography. The women were divided into the pregnant and non‐pregnant groups, and these variables were compared between the two groups.ResultsPatients' general demographic characteristics were not statistically different between the pregnant and non‐pregnant groups. The overall implantation rate, clinical pregnancy rate, and ongoing pregnancy rate were 31.1%, 41.4% and 28.6%, respectively. Twenty‐nine patients who conceived had average EMT, RI of SEA, PI of SEA, RI of UA, and PI of UA values of 9.15 mm, 0.91, 2.42, 0.95, and 3.37, respectively. Forty‐one patients who did not conceive had average EMT, RI of SEA, PI of SEA, RI of UA, and PI of UA values of 9.31 mm, 1.01, 2.56, 0.94, and 3.00, respectively. In the two groups, none of the variables was statistically different (P > 0.05).ConclusionsEMT and blood flow index of endometrium and uterus measured by transvaginal sonography are not an effective predictor of pregnancy outcome in frozen–thawed embryo transfer cycles.
Results of tension‐free vaginal tape for recurrent stress urinary incontinence after unsuccessful transobturator tape surgery
Authors: Simsek Abdulmuttalip , Ozgor Faruk , Kirecci Sinan Levent , Akbulut Mehmet Fatih , Sonmezay Erkan , Yuksel Bahar , Kucuktopcu Onur , Gurbuz Zafer Gokhan 
Published: June 2014

AbstractAimThe aim of this study was to evaluate cure rate and mid‐term results of tension‐free vaginal tape for recurrent stress urinary incontinence after failed transobturator tape surgery.Material and MethodsBetween January 2006 and December 2011, 42 women were enrolled in this study. Patient characteristics and operating parameters were recorded, and any complications were noted. All patients were followed up for at least 24 months after the second surgery. The Incontinence Impact Questionnaire and the Urinary Distress Inventory were used to identify satisfaction level.ResultsThe mean age of the patients was 49.07 ± 8.6 years, and median period between transobturator surgery and the tension‐free vaginal tape procedure was 12.8 (range 9.2–17.8) months. The cure rate was 83.3% and 76.2% at the first‐ and second‐year follow‐up visits, respectively. Intraoperative complications were transient and slight. Bladder injury in five patients and subcutaneous hematoma above the pubis in two patients were the most serious complications, but they were managed conservatively. We found the scores of the Incontinence Impact Questionnaire and Urinary Distress Inventory to be significantly lower at follow‐up, compared to the preoperative assessment. De novo urgency was the most common complaint at follow‐up and occurred in 11.9% of the women.ConclusionsWe suggest that tension‐free vaginal tape is a feasible surgical option for recurrent stress urinary incontinence. Further studies with larger patient numbers and longer follow‐up periods are needed to support this finding.