bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intravaginal electrical stimulation: a randomized, double‐blind study on the treatment of mixed urinary incontinence
Authors: Amaro João L. , Gameiro Mônica O. , Kawano Paulo R. , Padovani Carlos R. 
Published: December 2009

AbstractBackground. The aim of this study was to compare effective and sham intravaginal electrical stimulation (IES) in treating mixed urinary incontinence.Methods. Between January 2001 and February 2002, 40 women were randomly distributed, in a double‐blind study, into two groups: group G1 (n=20), effective IES, and group G2 (n = 20), sham IES, with follow up at one month. Different parameters was studied: 1. clinical questionnaire; 2. body mass index; 3. 60‐min pad test; 4. urodynamic study. The protocol of IES consisted of three 20‐min sessions per week over a seven‐week period. The Dualpex Uro 996 used a frequency of 4 Hz.Results. There was no statistically significant difference in the demographic data of both groups. The number of micturitions per 24 h after treatment was reduced significantly in both groups. Urge incontinence was reduced to 15% in G1 and 31.5% in G2; there was no significant difference between the groups. In the analog wetness and discomfort sensation evaluations were reduced significantly in both groups. The pretreatment urodynamic study showed no statistical difference in urodynamic parameters between the groups. Ten percent of the women presented involuntary detrusor contractions. In the 60‐min pad test, there was a significant reduction in both groups. In regards to satisfaction level, after treatment, 80% of G1 patients and 65% of G2 patients were satisfied. There was no statistically significant difference between the groups.Conclusion. Significant improvement was provided by effective and sham electrostimulation, questioning the effectiveness of electrostimulation as a monotherapy.
Intrauterine pressure, ischemia markers, and experienced pain during administration of a vasopressin V1a receptor antagonist in spontaneous and vasopressin‐induced dysmenorrhea
Authors: LIEDMAN RAGNER , GRANT LEE , IGIDBASHIAN SARAH , JAMES IAN , MCLEOD ALISON , SKILLERN LAURENCE , ÅKERLUND MATS 
Published: December 2009

AbstractBackground. A model to study the effect of vasopressin V1a antagonist in dysmenorrhea. Methods. A double‐blind, randomized, placebo‐controlled, cross‐over trial was performed. Eight patients with primary dysmenorrhea and eight tubal‐ligated, healthy subjects participated on days 1–2 of two consecutive menstruations. At each menstruation a bolus injection of 10 pmol/kg of vasopressin was administered before and during infusion of either 300 μg/min of atosiban or placebo. Intrauterine pressure was measured as area under the curve throughout the experiments. Ischemia markers in plasma and pain recorded by a visual analog scale were measured before and after each vasopressin injection as well as before and after the start of either atosiban or placebo infusion. Results. Vasopressin injections elevated area under the curve in both healthy volunteers and dysmenorrhea subjects. The vasopressin‐induced rise in area under the curve was lower during atosiban administration than during infusion of placebo in both groups. None of the ischemia markers differed between or within groups at vasopressin injections or atosiban/placebo infusions. In subjects with dysmenorrhea the increase in pain following the administration of vasopressin was significantly lower during atosiban than during placebo infusion. Healthy volunteers experienced only slight discomfort after the vasopressin injections. Conclusions. Atosiban reduces vasopressin‐induced intrauterine pressure in both healthy volunteers and dysmenorrheics, and reported pain in subjects with dysmenorrhea. The ischemia markers are not a useful biomarker index in women with dysmenorrhea. The dysmenorrhea pain evoked by vasopressin correlated poorly with area under the curve, which may suggest that the effect is mediated by more than one V1a‐like receptor. We conclude that this model with recordings in healthy women is useful in the evaluation of drug candidates for primary dysmenorrhea.
The comparison of vessels in elective and spontaneous abortion decidua in first trimester pregnancies: importance of vascular changes in early pregnancy losses
Authors: GUN BANU DOGAN , NUMANOGLU GAMZE , OZDAMAR SUKRU OGUZ 
Published: December 2009

AbstractBackground. To determine whether adequate trophoblastic migration and maternal placental perfusion occurs in cases of early pregnancy loss, we compared vessels in elective abortion decidua with those in spontaneous abortion decidua.Methods. Elective abortion decidua at 5–11 weeks (n=40) were compared with spontaneous abortion decidua at 5–12 weeks (n=25). Also normal late secretory endometrial biopsy specimens (n=10) were examined. The cross‐sections of veins and arteries were counted in 25 elective and 15 spontaneous abortion materials. The number of the veins that contain trophoblastic fragments and the number of the spiral arteries converted by trophoblasts were determined. Statistical significance by Mann–Whitney U and Spearman's correlation test was p<0.05.Results. All sets of decidua had dilated veins, but no secretory endometrium did. The ratio of converted spiral arteries to nonconverted arteries was much more in elective abortion decidua (113/938, 12.04%) than in spontaneous abortion decidua (11/511, 2.15%) (p<0.001).Conclusions. The presence of converted arteries, dilated veins, and intravenous trophoblastic fragments in decidual specimens were evidence of intervillous circulation and placental perfusion by maternal circulation in the first trimester. Also the insufficient conversion of the arteries in spontaneous abortions might be responsible for many cases of early pregnancy loss.
Impact of prepregnant body mass index and maternal weight gain on the risk of pregnancy complications in Japanese women
Authors: WATABA KOYA , MIZUTANI TAKAHIRO , WASADA KENSHI , MORINE MIKIO , SUGIYAMA TAKASHI , SUEHARA NORIYUKI 
Published: December 2009

AbstractBackground. To analyze the association of pregnancy complications with prepregnant body mass index and weight gain during pregnancy in Japanese women. Methods. A retrospective cohort study was conducted with 21,718 Japanese women with a singleton pregnancy. Pregnant women were grouped by prepregnant body mass index and evaluated for association with pregnancy complications using multivariate logistic regression analysis. The women in each body mass index group were then divided into groups by weight gain during pregnancy using intervals of 0.05 kg/week to analyze the relationship between the weight gain and pregnancy complications by multivariate logistic regression association analysis. Results. In both nulliparous and parous women, the least pregnancy complications were found among women with medium prepregnant body mass indexes (18–23.9). Significant risks of pregnancy complications were associated with low (<18) and high (≥24) prepregnant body mass indexes, particularly high prepregnant body mass indexes. In nulliparous women, the optimal weight gain was 0.25–0.4 kg/week for low (<18) prepregnant body mass index, 0.20–0.30 kg/week for medium (18–23.9) prepregnant body mass index, and ≥0.05 kg/week for high (≥24) prepregnant body mass index. In parous women, the corresponding values were ≥0.20, 0.20–0.30, and 0.05–0.30 kg/week. Conclusions. Japanese women with prepregnant body mass indexes from 18 to 23.9 are least associated with pregnancy complications, although there is a broad range of prepregnant body mass indexes associated with few pregnancy complications. Optimal weight gain is roughly inversely related to prepregnant body mass index.
If nuchal translucency screening is combined with first‐trimester serum screening the need for fetal karyotyping decreases
Authors: Marsk Anna , Grunewald Charlotta , Saltvedt Sissel , Valentin Lil , Almström Harald 
Published: December 2009

AbstractBackground. This case–control study was performed to evaluate whether adding first‐trimester maternal serum testing to nuchal translucency measurement would improve the antenatal detection of Down's syndrome and decrease the number of women offered fetal karyotyping. Methods. In the Swedish Nuchal Translucency Trial (the NUPP trial), 39,572 pregnant women were randomized to a routine scan at 12–14 gestational weeks including nuchal translucency screening for Down's syndrome, or a routine scan at 16–18 gestational weeks. From the early scan group 47 pregnancies with Down's syndrome were identified and for each case three controls were chosen. Of the 189 women asked to participate, 31 cases and 108 controls with a singleton pregnancy and frozen serum from 8–14 gestational weeks available for analysis accepted participation. Maternal sera were analyzed for free beta human chorionic gonadotrophin and pregnancy‐associated plasma protein A. The risk for Down's syndrome was calculated using combinations of maternal age, crown–rump length, nuchal translucency, and biochemistry. A risk ≥1/250 was considered increased and an indication for fetal karyotyping. Results. Risk calculated on the basis of maternal age alone would have identified 21 of the 31 Down's syndrome cases by karyotyping 61 of the 139 fetuses. Maternal age and nuchal translucency would have identified 29 cases by karyotyping 51 fetuses. Maternal age, nuchal translucency, and biochemistry would also have identified 29 cases by karyotyping 37 fetuses. Conclusions. By adding first trimester biochemistry to nuchal translucency measurement the detection rate of fetuses with Down's syndrome seems to remain unchanged whereas the antenatal risk group to be offered fetal karyotyping decreases.
Effect of a structured follow‐up visit to a midwife on women with early miscarriage: a randomized study
Authors: ADOLFSSON ANNSOFIE , BERTERÖ CARINA , LARSSON PER‐GÖRAN 
Published: December 2009

AbstractBackground. Women's grief after miscarriage is substantial and important. Women who experience early miscarriage do not constitute a homogenous group. The aim of this study is to measure whether a structured follow‐up visit to a midwife (group 1) at 21–28 days after early miscarriage could reduce the women's grief, measured using the perinatal grief scale Swedish short version (PGS) after a further 3 months (i.e. 4 months after the miscarriage), compared to a regular follow‐up visit to a midwife (group 2). Methods. We performed an open randomized study of women who experienced early miscarriage (n = 88). The midwife's attitude in group 1 came from Swanson science theory of midwifery. In group 2, the women were offered only the ordinary type of consultation at a regular visit. A questionnaire with the PGS was used in both groups. Four months after the miscarriage, a second questionnaire with the same perinatal grief scale was sent by post. Results. There was a 30% greater reduction in grief in group 1 than that in group 2, when comparing the first and second measurements (not significant). The biggest differences were in the subscales active grief and difficulty in coping. Women with the subdiagnosis missed abortions had, as a group, significantly higher PGS scores at both visits, especially in active grief and difficulty in coping, regardless of the type of follow‐up visit. Conclusions. A structured follow‐up visit did not, in comparison with a regular follow‐up visit, imply any significant reduction in grief as measured using the PGS scale. However, the subgroup missed abortion had more extensive grief than the other women with miscarriage. Structured follow‐up visits are not imperative for all women with early miscarriage.
Pregnancy risk increases from 41 weeks of gestation
Authors: Nakling Jakob , Backe Bjørn 
Published: December 2009

AbstractBackground. The aim of this study was to evaluate the mortality and morbidity of conservatively managed post‐term pregnancies (gestation 294 days and beyond). Materials and methods. This is a population‐based prospective study. The sample was comprised of all women (N=17 493) with a singleton pregnancy in one Norwegian county from 1989 to 1999, with a second‐trimester ultrasound examination and delivery after 37 completed gestational weeks. Results. One thousand three hundred and thirty‐six (7.6%) of the deliveries were post‐term. In this group, the increase in perinatal mortality reached borderline significance [relative risk (RR) 2.0; 95% confidence interval 0.9–4.6]. Perinatal morbidity expressed as Apgar score <7 at 5min (RR 2.0; 95% confidence interval 1.2–3.3), and transferal to neonatal intensive care unit (RR 1.6; 95% confidence interval 1.3–2.0) were significantly more frequent. However, RR for perinatal death calculated per 1000 ongoing pregnancies increased significantly from 0.2 in week 37–3.7 in week 42, using perinatal mortality in gestational week 41 as a reference. Conclusions Our results indicate that expectant management of post‐term pregnancies allowing pregnancies to continue up to week 43 carries a risk for perinatal mortality and morbidity. The risk increases already from gestational week 41. The guidelines for management of post‐term pregnancies should be revised.
The relationship between psychosocial profile, health practices, and pregnancy outcomes
Authors: NEGGERS YASMIN , GOLDENBERG ROBERT , CLIVER SUZANNE , HAUTH JOHN 
Published: December 2009

AbstractBackground. The influence of psychosocial factors such as stress, anxiety, depression, and self‐esteem on birth weight is controversial. A prospective study was conducted to evaluate the relationship between pregnancy outcomes, psychosocial profile, and maternal health practices. Methods. 3,149 low‐income, predominantly African‐American pregnant women participated in this study. A 28‐item psychosocial scale measured the constructs of negative and positive affect, self esteem, mastery, worry, and stress. Maternal health practices were assessed with 11 questions dealing with diet, exercise, and the use of preventive medical and dental services. Results. A low score on either scale indicated “poor” psychosocial or health practices status. Low birth weight, preterm delivery, and intrauterine growth retardation occurred in 10.9, 10.1 and 7.3% of the pregnant women respectively. In women with low psychosocial scores, the risk of both low birth weight and preterm delivery was 40% higher and the mean birth weight of infants was 51 g (p=0.02) lower as compared to women with high scores. Negative affect (a measure of depression) was the only factor significantly associated with both infant birth weight (β= − 71.2, p=0.001) and low birth weight (AOR = 1.4, 95% CI = 1.1–1.7). When data were stratified by body mass index, the adverse effect of negative affect scores on birth weight and low birth weight was present only in thin women. Health practice scores were not associated with any of the pregnancy outcomes. Conclusion. Thin women with a poor psychosocial profile and who are depressed during pregnancy are at increased risk of giving birth to low birth weight and preterm infants.
Longitudinal reference ranges for estimated fetal weight
Authors: JOHNSEN SYNNØVE LIAN , RASMUSSEN SVEIN , WILSGAARD TOM , SOLLIEN RITA , KISERUD TORVID 
Published: December 2009

AbstractObjective. The aims of the present study were to establish reference ranges for the growth of estimated fetal weight (EFW) between gestational weeks 20 and 42 and to determine the effect of fetal and maternal factors. Methods. This prospective longitudinal study was based on 634 low‐risk pregnancies and a total of 1799 examinations. Gestational age was computed from last menstrual period. Head circumference, abdominal circumference, and femur length were measured using ultrasound, and EFW was calculated using the formula of Combs et al. The statistical analysis was based on regression analysis and multilevel modeling. Results. Intrauterine growth expressed by EFW showed a continuous pattern until term. Males were calculated to be 5% heavier than female fetuses at 20 gestational weeks and 3% at 40 weeks. Otherwise, the fetal and maternal effects on intrauterine growth correspond to a weight shift of 1.3% for breech/nonbreech, 2.5% for each increase in maternal height tertile, and −4% for smoking/nonsmoking. Maternal age higher than 34 years had a significant increased EFW of 4.5% compared with maternal age less than 24 years. Cephalic index in the third tertile had a 1.1% lower EFW compared with the first tertile. Maternal weight, body mass index, and parity did not influence the EFW. Terms for customization to individualize the growth patterns are presented. Conclusions. The present growth chart is recommended as robust reference ranges for assessing EFW and growth. Fetal and maternal variables can be added into the models to individualize the prediction of EFW.
Fetal gender and gestational‐age‐related incidence of pre‐eclampsia
Authors: ELSMÉN EMMA , Källén Karin , MARŠÁL KAREL , HELLSTRÖM‐WESTAS LENA 
Published: December 2009

AbstractBackground. Male fetal gender is associated with an overall increased risk of pre‐eclampsia. However, it was recently shown that the male: female birth ratio was decreased in pre‐eclampsia associated with preterm delivery. The reason for this discrepancy is not known. Objective. To investigate whether the fetal and newborn gender is associated with the incidence of antenatal maternal pregnancy complications, and to investigate if gender‐associated risk changes with gestational age at delivery. Methods. Population‐based study including 1,158,276 infants born in Sweden 1990–2001. Five maternal diagnosis groups (pre‐eclampsia, infection, preterm premature rupture of membranes, abruptio placentae, and polyhydramnios) were explored in relation to newborn infant gender and gestational age at delivery. Results. When all gestational ages were evaluated, male newborn gender was associated with increased odds ratios for all five diagnosis groups, and for preterm birth before 37 weeks gestation, M/F ratio 1.17. In very preterm births (gestational age below 32 weeks), male newborn gender was associated with a significantly lower risk for pre‐eclampsia (OR 0.88, 95%CI 0.80–0.97), and a marginally lower risk for polyhydramnios (OR 0.74, 95%CI 0.54–1.01). Conclusion. The fetal gender seems to affect the occurrence of pre‐eclampsia, and possibly also polyhydramnios. The finding could be due to an increased risk for spontaneous abortions in pregnancies with male fetuses, but could also be associated with the etiology of these conditions. Evaluation of antenatal pregnancy complications from a fetal/newborn gender perspective may contribute to new insights regarding their pathophysiological mechanisms.
Identifying hazardous alcohol consumption during pregnancy: implementing a research‐based model in real life
Authors: Göransson Mona , Magnusson Åsa , Heilig Markus 
Published: December 2009

AbstractAims. It has been repeatedly demonstrated that hazardous alcohol use during pregnancy is rarely detected in regular antenatal care, and that detection can be markedly improved using systematic screening. A major challenge is to translate research‐based strategies into regular antenatal care. Here, we examined whether a screening strategy using the Alcohol Use Disorder Test (AUDIT) and time‐line follow‐back (TLFB) could be implemented under naturalistic conditions and within available resources; and whether it would improve detection to the extent previously shown in a research context. Methods. Regular midwives at a large antenatal care clinic were randomized to receive brief training and then implement AUDIT and TLFB (“intervention”); or to a waiting‐list control group continuing to deliver regular care (“control”). In the intervention‐condition, AUDIT was used to collect data about alcohol use during the year preceding pregnancy, and TLFB to assess actual consumption during the first trimester. Data were collected from new admissions over 6 months. Results. Drop out was higher among patients of the intervention group than control midwives, 14% (23/162) versus 0% (0/153), and p<0.0001. A one‐day training session combined with continuous expert support was sufficient to implement systematic screening with AUDIT and TLFB largely within resources of regular antenatal care. The use of these instruments identified patients with hazardous consumption during the year preceding pregnancy i.e. AUDIT score 6 or higher (17%, 23/139), and patients with ongoing consumption exceeding 70 g/week and/or binge consumption according to TLFB (17%, 24/139), to a significantly higher degree than regular antenatal screening (0/162). The AUDIT‐ and TLFB‐positive populations overlapped partially, with 36/139 subjects screening positive with either of the instrument and 11/139 were positive for both. Conclusions. We confirm previous findings that alcohol use during pregnancy is more extensive in Sweden than has generally been realized. Systematic screening using AUDIT and TLFB detects hazardous use in a manner which regular antenatal care does not. This remains true under naturalistic conditions, following minimal training of regular antenatal care staff, and can be achieved with minimal resources. The proposed strategy appears attractive for broad implementation.
Use of pH/whiff test or QuickVue Advanced® pH and Amines test for the diagnosis of bacterial vaginosis and prevention of postabortion pelvic inflammatory disease
Authors: Charonis Georgios , Larsson P.‐G. 
Published: December 2009

AbstractBackground. Untreated bacterial vaginosis (BV) is a risk factor for postabortion pelvic inflammatory disease (PID). Methods. Eight hundred and eight women who requested therapeutic abortion were consecutively examined for the presence of BV, using either pH/whiff test or QuickVue Advanced® pH and Amines test. All patients who tested positive to BV were treated with clindamycin or metronidazole prior to abortion. Results. Based on the wet smear examination, the incidence of BV was 21.6%. Positive pH and whiff test had a sensitivity of 53%, specificity of 98% and Kappa index 0.59 (n=239). Values for QuickVue Advanced® pH and Amines test were 53%, 97%, and 0.58 respectively (n=508). The incidence of PID among all patients was 2.4% after pharmacological abortion and 4.9% after surgical abortion. Among the patients with microscopic presence of BV diagnosed positive by the pH/whiff test or QuickVue Advanced® pH and Amines test and treated with antibiotics, no PID occurred. Patients with negative pH/whiff test or QuickVue pH and amines test who consequently did not receive preoperative antibiotics, but who later demonstrated microscopic presence of BV, had an incidence of 14.3% (5/35) postoperative PID compared to women with normal lactobacilli flora 4.3% (10/234) (OR 3.73; 95% CI 1.21–9.21). Conclusions. Although the pH/whiff test and QuickVue pH and Amines test failed to ascertain BV in almost half of the participants later found to have BV, we found that preabortal screening and subsequent treatment of those who test clinically positive does lower the incidence of postabortion PID.