bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lactobacilli in the female genital tract in relation to other genital microbes and vaginal pH
Authors: Daniel Johannes Rönnqvist Per , Birgitta Forsgren‐Brusk Ulla , Elisabeth Grahn‐Håkansson Eva 
Published: December 2009

AbstractBackground. The relationship between lactobacilli and other microbes and the association with vaginal pH in the female genital tract were examined. The study also included evaluation of the possibility of supplying probiotics to the genital tract by using panty liners impregnated with the probiotic strain Lactobacillus plantarum LB931. Methods. This was a randomized, placebo‐controlled, double‐blind, multicenter study involving 191 healthy fertile women. Specified microbes were counted and vaginal pH was measured once a month for five consecutive months. Results. Major individual variations in the genital microflora composition and the vaginal pH were found among the women. The number of lactobacilli was significantly related to vaginal pH (p<0.001) and ∼70% of the women were permanent carriers of individual lactobacilli strains. Women with high numbers of lactobacilli were less prevalent with Group B streptococci than women with low numbers (p=0.036), and these women had a lower mean vaginal pH. The number of lactobacilli also correlated with the prevalence of yeast. LB931 could be found in 86% of the labial samples and 54% of the vaginal samples. Conclusions. High numbers of lactobacilli may contribute to a low vaginal pH and seem to have a negative influence on Group B streptococci. LB931 could be transferred from the panty liners to both the vagina and the labial fold.
Alcohol use before and during pregnancy: a population‐based study
Authors: ALVIK ASTRID , HEYERDAHL SONJA , HALDORSEN TOR , LINDEMANN ROLF 
Published: December 2009

AbstractBackground. Few population‐based studies have estimated alcohol consumption and binge drinking before and during pregnancy. Methods. The study is a longitudinal questionnaire study. In Norway, virtually 100% attend an ultrasound screening at 17–18 weeks of pregnancy. In Oslo, a representative sample attending this between June 2000 and May 2001 were invited to join the study, accepted by 92%. Non‐Norwegian‐speaking and/or immigrants from non‐Western countries were not invited; 1,749 (93%) completed the first questionnaire. Measures: T‐ACE (screening for pregnancy risk drinking), frequency of alcohol use, Standard Units (SU) per occasion, SU/week, and binge drinking (≥5 SU per occasion). Binary logistic regression analyses, Student's t‐test and Pearson's chi square were used. Results. Alcohol use was reported by 89% pre‐pregnancy and by 23% after pregnancy week 12. Binge drinking was reported by 59% pre‐pregnancy and by 25% during weeks 0–6. Change of drinking pattern occurred at pregnancy recognition for 85%, although 78% had planned the pregnancy, fetal welfare being the main reason. Participants reporting alcohol use during pregnancy were older, smokers, with more SU/week pre‐pregnancy, had some elevated anxiety score, higher income, and a partner with higher education. However, mental health, high income, or education were not predictive of usually drinking 1 SU per occasion or more, and not of binge drinking. The latter was predicted mainly by smoking during pregnancy and being T‐ACE positive. Conclusions. The study shows a drinking pattern before pregnancy recognition that, according to other studies, in 25% or more may cause suboptimal fetal development.
Maternal cerebral Doppler velocimetry before, during, and after a normal pregnancy: a longitudinal study
Authors: LINDQVIST PELLE G. , MARŠÁL KAREL , PIRHONEN JOUKO P. 
Published: December 2009

AbstractObjective. Our purpose was to determine normative data for maternal cerebral blood flow indices. Study design. A prospective longitudinal study. Methods. The maternal middle cerebral artery was examined by transcranial Doppler ultrasound in 14 healthy women before (0–10 months prior to conception) and during pregnancy (at 8, 15, 22, 29, and 36 weeks of gestation), and twice after delivery (at 8 and 24 weeks). Middle cerebral artery blood flow velocities were recorded, and pulsatility index and cerebral perfusion pressure were calculated. Results and conclusion. Pulsatility index of middle cerebral artery peaked in mid‐pregnancy and was constantly increased between 8 and 29 weeks of gestation. The diastolic middle cerebral artery velocity remained fairly constant at about 40 cm/s during the study period, while the systolic velocity peaked at 15 weeks (mean 102 cm/s). Cerebral perfusion pressure dropped to its lowest levels in mid‐pregnancy and after delivery.
Practices and perceptions on intrauterine contraception among Latvian obstetrician–gynecologists
Authors: Viberga Ilze , Odlind Viveca , Zodzika Jana 
Published: December 2009

AbstractBackground. To investigate the professional activity and perceptions of intrauterine contraception among Latvian obstetrician–gynecologists. Methods. A questionnaire was completed by 122 Latvian obstetrician–gynecologists attending an annual meeting. Statistical analysis was done with the Epi‐Info 2002 statistical package. Results. Every day contraceptive consultancy was done by 91.8% of physicians and 98.4% reported ever having inserted intrauterine contraception. The majority of doctors reported careful selection of intrauterine contraception candidates, including screening for sexually transmitted infections before insertion. Intrauterine contraception insertion was definitely excluded in women without a stable monogamous relationship only by 9.8%. A causal relationship between intrauterine contraception and pelvic inflammatory disease was believed by 52.5%. Many doctors sometimes prescribed prophylactic antibiotics before or immediately after intrauterine contraception insertion. However, antibiotics were never prescribed before intrauterine contraception insertion by 50.8%. Younger doctors had significantly more often themselves used combined oral contraceptives than had older doctors, whereas older doctors more often had been intrauterine contraception users. Of current and former intrauterine contraception users, 93.4% were satisfied with this contraceptive method. Conclusions. Latvian obstetrician–gynecologists have wide experience in contraception counseling of intrauterine contraception, but some gaps in the theoretical knowledge of doctors about intrauterine contraception were identified. We could not find any significant differences in attitudes to and personal experience with contraceptive methods between older and younger generations, nor were there any differences between genders of obstetrician–gynecologists.
Audit of severe maternal morbidity in Uganda – implications for quality of obstetric care
Authors: Okong Pius , Byamugisha Josaphat , Mirembe Florence , Byaruhanga Romano , Bergstrom Staffan 
Published: December 2009

AbstractBackground. For every maternal death, there are probably 100 or more morbidities, but the quality of health care for these women who survive has rarely been an issue. The purpose of this study is to explore audit of severe obstetric morbidity and the concept of near miss in four referral hospitals in Uganda. Methods. This was an exploratory systematic enquiry into the care of a subset of women with severe morbidity designated as near miss cases by organ failure or dysfunction. Patient factors and environmental factors were also explored. Data were abstracted from clinical records and from interviews with patients, relatives, and health workers. Results. Records of 685 women with severe maternal morbidity were examined and 229 cases fulfilled the criteria for near miss cases. Obstetric hemorrhage, rupture of the uterus, puerperal sepsis, and abortion complications were the major conditions leading to the near miss state in more than three quarters of the patients. Nearly half the cases were at home when the events occurred. More than half the cases delayed to seek care, because the patients were unwilling, or relatives were not helpful. Similar proportion also experienced substandard care in the hospitals. Conclusions. A systemic analysis found substandard care and records, and patient‐related factors in more than half the cases of severe maternal morbidity. Audit of near miss cases might offer a non‐threatening stimulus for improving the quality of obstetric care.
A narrow pelvic outlet increases the risk for emergency cesarean section
Authors: Stålberg Karin , Bodestedt Åke , Lyrenås Sven , Axelsson Ove 
Published: December 2009

AbstractBackground. The rate of cesarean section (CS) is increasing in Sweden as well as in most of the industrialized world. One of the most common indications for emergency CS is protracted labor. To what extent fetal pelvic disproportion is a cause of protracted labor is unclear. The value of pelvimetry has been questioned. The purpose of this study was to investigate whether women delivered with emergency CS because of protracted labor had a narrower pelvis than women delivered vaginally did.Methods. Thirty women delivered with CS because of protracted labor comprised the study group. Thirty women vaginally delivered served as controls. The two groups were matched for gestational age, birth weight, and parity. The study group and the control group underwent an X‐ray pelvimetry within 1 month of delivery.Results. The study group and the control group did not differ in maternal age or body mass index. The mean birth weight was 3914 g in the study group and 3884 g in the control group. The mean pelvic outlet was 328 mm in the study group and 346 mm in the control group (P=0.0024). The mean pelvic inlet was 245 mm in the study group and 255 mm in the control group (P=0.0038).Conclusion. A narrow pelvic outlet is associated with an increased risk of emergency CS because of protracted labor. A postpartum pelvimetry is recommended and should be used when to decide on route of delivery in forthcoming pregnancies.
Are there second thoughts about the results of the WHI study?
Authors: HAIMOV‐KOCHMAN RONIT , HOCHNER‐CELNIKIER DRORITH 
Published: December 2009

AbstractThe publication of the Women's Health Initiative (WHI) study had significant impact on the attitude of physicians and patients towards the use of hormones in the menopause. It has been estimated that 40–83% of patients using hormones ceased treatment on their own initiative following publication of the WHI results. While in the pre‐WHI period, use of hormones in the menopause was termed ‘hormone‐replacement therapy’ (HRT) with an emphasis on replacement; ‘HRT’ has now been replaced with the term ‘hormone therapy’ (HT), focusing on the therapy's status as a treatment with defined risks and benefits. Following the publication of the WHI study, many caregivers concluded that HT had absolutely no role in clinical practice. However, the decision to begin HT for the symptomatic, healthy, newly postmenopausal woman should be based on whether the WHI study addresses all the issues that must be taken into consideration before initiation of HT, whether there are effective alternatives available to relieve climacteric symptoms, and also whether HT is better able to prevent cardiovascular disease (CVD) and Alzheimer's disease (AD) than to halt atherosclerotic lesions. Every postmenopausal woman should have an individual risk‐benefit evaluation to determine whether HT suits her needs. Until the effectiveness of HT for primary prevention of CVD and AD is established or disproved, there is no justification for HT use in the asymptomatic postmenopausal woman. However, symptomatic newly menopausal women might experience relief of their climacteric symptoms following HT use without exposing themselves to unreasonable risks.
A prospective, randomized trial comparing immediate versus delayed catheter removal following hysterectomy
Authors: Alessandri Franco , Mistrangelo Emanuela , Lijoi Davide , Ferrero Simone , Ragni Nicola 
Published: December 2009

AbstractBackground. A prospective, randomized study was used to assess whether the immediate removal of an in‐dwelling catheter after hysterectomy affects the rate of recatheterization, symptomatic urinary tract infections, time of ambulation, and hospital stay.Methods. We randomly assigned 96 women who underwent hysterectomy [44 vaginal hysterectomy (VH), 37 abdominal hysterectomy, and 15 laparoscopic assisted VH) to three groups. The in‐dwelling catheter was removed immediately (group A), at 6 hr (group B), or at 12 hr (group C) after the operation. The association between clinical variables and the length of catheterization was assessed by Chi‐square analysis.Results. Recatheterization occurred in six patients (18.8%) of group A, all after VH under spinal anesthesia. All patients in the groups B and C could spontaneously void the bladder after catheter removal. Symptomatic urinary tract infection occurred in one patient in group A, compared with four patients in group B, and five in group C. The mean time to ambulation was 4.3 hr in group A, 6.5 hr in group B, and 9.4 hr in group C. Patients with immediate removal of urinary catheter had a shorter hospital stay.Conclusions. There could be an association between necessity of recatheterization and the type of surgery (VH) or the type of anesthesia (spinal). Despite recatheterization rate, early removal of in‐dwelling catheters immediately after uncomplicated hysterectomy seems to decrease first ambulation time and hospital stay.
Perforated appendicitis during near‐term pregnancy causing necrotizing fasciitis of the lower extremity: a rare complication of a common disease
Authors: Penninga Luit , Wettergren André 
Published: December 2009

AbstractA 33‐year‐old woman presented with pain in the right side of the abdomen at 35 weeks of gestation. She was treated for cystitis. A few days later, her abdominal pain had disappeared; however, she had developed pain in the right thigh and fever. She delivered a healthy child, but postpartum her leg symptoms deteriorated. She was found to have a necrotizing fasciitis, which necessitated disarticulation of the hip. The source of the infection was a perforated appendix.
Colpoperineoplasty in women with a sensation of a wide vagina
Authors: Pardo Jack S. , Solà Vicente D. , Ricci Paolo A. , Guiloff Enrique F. , Freundlich Odette K. 
Published: December 2009

AbstractBackground. In women complaining of a wide vagina and decreased sexual satisfaction we performed colporrhaphy – including perineoplasty in most cases. Methods. Between November 2003 and October 2004, a total of 53 patients were selected for operation at the Urogynecology and Vaginal Surgery Unit, Las Condes Clinic, Chile. The patients were requested to assess the results of surgery in terms of experienced vaginal tightening and regained or enhanced sexual satisfaction. Results. Six months after surgery, 94% experienced a tighter vagina and said they were able to achieve orgasm. Expectations were fulfilled in 74%, partially fulfilled in 21%, and not met in 5%. Only two patients (4%) regretted surgery, and two patients had minor surgical complications. Conclusion. In a selected group of women with acquired sensation of a wide vagina, colporrhaphy seems to improve symptoms and enhance sexual gratification in a majority of the women. A controlled trial with a longer follow‐up is needed for a proper evaluation.
Women's preference on mode of delivery in Southern Italy
Authors: Mancuso Alfredo , De Vivo Antonio , Fanara Giusi , Settineri Salvatore , Triolo Onofrio , Giacobbe Annamaria 
Published: December 2009

AbstractBackground. Rates of cesarean section are rising worldwide and maternal requests for this kind of delivery contribute to the increase in this trend. The purpose of this study was to analyze the factors influencing maternal demand in our region and the profile of women preferring this mode of delivery. Methods. Six obstetricians (3 male and 3 female) were asked to give out a questionnaire to their patients with an uncomplicated pregnancy. Demographic data, obstetrical history, lifestyle, and physician–patient relationship were analyzed. Patients who would have preferred abdominal delivery were asked to report the motivations for their choice. A psychiatric evaluation, using the Hamilton Anxiety Scale and the Montgomery–Åsberg Depression Rating Scale, was conducted. Results. 16.9% of 390 patients enrolled preferred cesarean section. This wish was correlated with patients’ age ≥ 35 years (OR 2.43; p=0.0065), high level of education (OR 4.28, p=0.019), previous infertility (OR 3.91, p=0.0045), smoking (OR 4.25, p=0.0008), quality of information (OR 29.08, p=0.0013), and desire for more comprehension (OR 8.25, p=0.00001). The most frequent motivation for this choice was a safer childbirth (90.9%). No difference was found for the Hamilton scale's score, while the Montgomery‐Asberg Scale showed a lower mean score for the cesarean section group (7.2±3.3 versus 9.4±7.3, p=0.0002). Conclusions. A high rate of women wish to give birth by cesarean section. This is probably an expression of the changes in society's attitudes. However, more careful attention to the psychological aspects and more personalized information about pregnancy and delivery could reduce this maternal demand.
Severe anemia in pregnancy in rural Ghana: a case–control study of causes and management
Authors: GEELHOED DIEDERIKE , AGADZI FLORENCE , VISSER LUCIA , ABLORDEPPEY EMELIA , ASARE KOFI , O'Rourke Peter , VAN LEEUWEN JULES SCHAGEN , VAN ROOSMALEN JOS 
Published: December 2009

AbstractBackground. Various factors contribute to severe anemia in pregnancy in low‐income countries. This study assesses which of these are of importance in rural Ghana, and evaluates management.Methods. Prospective case–control study in two (sub)district hospitals in rural Ghana among 175 severely anemic pregnant women (Hb < 8.0 g/dl), receiving a comprehensive treatment package; and 152 non‐anemic pregnant women (Hb ≥ 10.9 g/dl), giving birth at the study hospitals, matched for age and parity. Evaluated characteristics were need for treatment for urinary tract infection and schistosomiasis; sickle cell and HIV status; antenatal care characteristics; and Hb increase after treatment. Statistical analysis included Chi square test and general linear modeling.Results. Associated with severe anemia were multiple pregnancy (OR 8.9; 95%CI 1.1–71.0), urinary tract infection (OR 6.2; 95%CI 3.5–11.0), residence outside study (sub)district (OR 2.7; 95%CI 1.7–4.3), body mass index < 20.0 (OR 2.0; 95%CI 1.2–3.4), and less than 4 antenatal clinic visits (OR 1.9; 95%CI 1.2–3.0). No association was found with sickle cell or HIV status, schistosomiasis treatment, blood loss in pregnancy, or gestational age at antenatal care registration. After treatment, mean Hb in the severe anemia group increased by 3.2 g/dl, significantly more than in the control group (0.2 g/dl; p<0.001). Modeling showed that the number of antenatal visits and the lowest Hb together explained approximately 25% of the variability in Hb prior to childbirth among women with severe anemia.Conclusions. Treatable causes contribute considerably to severe anemia in pregnancy in low‐income countries. Even with limited resources, a substantial increase of Hb can be achieved.
Geographical variation in relationships between parental body size and offspring phenotype at birth
Authors: Leary Sam , Fall Caroline , Osmond Clive , Lovel Hermione , Campbell Doris , Eriksson Johan , Forrester Terrence , Godfrey Keith , Hill Jacqui , Jie Mi , Law Catherine , Newby Rachel , Robinson Sian , Yajnik Chittaranjan 
Published: December 2009

AbstractBackground. Size and body proportions at birth are partly determined by maternal body composition, but most studies of mother–baby relationships have only considered the effects of maternal height and weight on offspring birth weight, and few have examined the size of effects. Paternal size and body composition also play a role, primarily through the fetal genome, although few studies have investigated relationships with neonatal phenotype. Methods. Data from the UK, Finland, India, Sri Lanka, China, DR Congo, Nigeria and Jamaica were used to investigate the effects of maternal measures (derived at 30 weeks’ gestation, n=16,418), and also paternal size (n=3,733) on neonatal phenotype, for singleton, live‐born, term births. Results. After accounting for variation in maternal size and shape across populations, differences in neonatal phenotype were markedly reduced. Mother–baby relationships were similar across populations, although some were stronger in developing countries. Maternal height was generally the strongest predictor of neonatal length, maternal head circumference of neonatal head and maternal skinfold thickness of neonatal skinfolds. Relationships with maternal arm muscle area were generally weak. Effects of paternal height and body mass index were weaker than the equivalent maternal measurements in most studies. Conclusions. Differences in maternal body composition account for a large part of the geographical variation in neonatal phenotype. The size of the effects of all maternal measures on neonatal phenotype suggests that nutrition at every stage of the mother's life cycle may influence fetal growth. Further research is needed into father–baby relationships and the genetic mechanisms that influence fetal growth.
Randomized controlled trial on prevention of postcesarean infection using penicillin and cephalothin in Brazil
Authors: Vieira Cunha Rudge Marilza , Nagib Atallah Álvaro , Carlos Peraçoli José , da Rocha Tristão Andréa , Mendonça Neto Moisés 
Published: December 2009

AbstractBackground. There is a need to assess the effects of different antibiotic administration models on infectious complications among women from low‐income populations who undergo cesarean delivery, and the cost benefit. Design. Randomized, blinded controlled clinical trial study of a single preoperative dose of cephalothin, versus a postcesarean scheme for infection prophylaxis, versus no antibiotics. Methods. The setting was a tertiary Brazilian center with 1,500 deliveries annually. Pregnant women (n=600) with an indication for emergency or elective cesarean section were randomly allocated consecutively to one of three groups and treated as follows: Group 1 (n=200), no antibiotics; Group 2 (n=200), the standard antibiotics scheme followed at this center; Group 3 (n=200), a single dose of intravenous cephalothin 2 g, intraoperatively. Main outcome measurements. Prevalences of wound infection, puerperal and postcesarean infections, and costs of antibiotics used. Results. Antibiotics reduced the incidence of puerperal infection, but did not change the percentages of wound and postcesarean infections and no use of antibiotics increased the puerperal infection risk sixfold. Cephalothin reduced the relative risk of puerperal infection by 89% (95% confidence interval: 7–87%). Penicillin reduced it by 78%, but this was not statistically significant. No deaths occurred. The costs of the two schemes were similar (almost US$1.00). Conclusions. Prophylactic cephalothin use was associated with decreased postcesarean puerperal infection and presented a cost benefit.