bluuebunny/crossref_metadata_2025_split huggingface dataset:
Maternal, Fetal and Neonatal Effects of Beta‐Adrenergic Stimulation in Connection with cesarean Section
Authors: Jouppila R. , Kauppila A. , Tuimala R. , Pakarinen A. , Moilanen K. 
Published: December 2009

To investigate the combined metabolic effects of beta‐mimetic therapy and general anesthesia on maternal and fetal/neonatal metabolism, 14 patients were treated with isotonic saline, 11 with intravenous fenoterol (3 μg/min) and 9 with intravenous isoxsuprine (150 μg/min) for 30 minutes prior to cesarean section. The maternal heart rate and blood pressure as well as the maternal and fetal acid‐base balance were followed. The neonatal glucose level was monitored for 36 hours after delivery.The heart rate and the diastolic and systolic blood pressure values increased during the operation in each group, without any marked differences between the groups. At delivery, the mean maternal BD (base‐deficit) value was higher in the fenoterol patients than in the control patients, indicating a trend towards metabolic acidosis. The other values of acid‐base balance in the maternal and umbilical arterial and venous blood did not reveal any differences between the groups. The neonatal glucose level at 2 hours after delivery was higher in the fenoterol group than in the control group. The other values recorded during 36 hours revealed no differences between the groups.Beta‐mimetic treatment preceding general anesthesia in cesarean section does not have unfavorable effects on the mother, the fetus or the newborn. Such therapy thus does not seem contraindicated when uterine contractions should be rapidly suppressed in cases of fetal distress before operation.
Gonorrheal Infection Followed by an Increased Frequency of Cervical Carcinoma
Authors: Furgyik Stefan , Åstedt Birger 
Published: December 2009

In a town with a fairly centralized health service and a well organized gynecologic health control, women who had had gonorrhea in 1954 or 1955 were reviewed for presence of cervical neoplasia and compared with age‐matched controls. Of 164 women studied, 29 (17.7 per cent) had 24 or 23 years later developed cancer in situ, compared with 7 (4.3 per cent) of the controls (p < 0.001), while 8 (4.3 per cent) had invasive cancer colli uteri against only one (0.6 per cent) of the controls (p < 0.02). Malignant disease of the portio proved at least four times as common among the women with gonorrhea in their history as among the controls. The findings corroborate the view that cervical carcinoma is a sexually transmitted disease.It may be assumed that at least every fourth woman who had had gonorrhea had been or is a carrier of the carcinogenic agent(s). It is probably easier to search for and detect such agents in association with gonorrhea than in patients with already manifest cancer of the uterine cervix.
Maternal Pulmonary Edema Occurring after Therapy with Ritodrine for Premature Uterine Contractions
Authors: Abramovici Haim , Lewin Aby , Lissak Arie , Palant Abraham 
Published: December 2009

Intravenous administration of beta‐sympathomimetic drugs in combination with betamethasone or dexamethasone is a treatment often used for the suppression of premature uterine contractions and for the stimulations of fetal lung maturity. It has been suggested that the combination of these drugs may be responsible for maternal pulmonary edema and five such cases have been reported in the literature (1, 2).We report a patient who developed pulmonary edema during ritodrine therapy. Corticosteroids were not given in this case.
Induction of Labor by Oxytocin or Prostaglandin E2
Authors: Bremme Katarina , Bygdeman Marc 
Published: December 2009

The efficacy and safety of oral PGE2 or intravenous infusion of oxytocin, in both cases combined with early amniotomy, for induction of labor on medical grounds, were compared in a randomized study of 200 women. After an initial dose of 0.5 mg, 1.0 mg of PGE2 was given at hourly intervals for up to 24 hours. Oxytocin was administered as an intravenous pump infusion, the dose being increased step wise up to 20 mIU/min. The two methods were equally effective. All patients went into labor and were delivered within approximately 24 hours. Of the total of 200 patients included in the study, 92 per cent were delivered vaginally and 8 per cent with Caesarean section. In 26 per cent the delivery was completed by vacuum extraction. The frequency of instrumental delivery was significantly lower in multiparous than in primiparous patients. If the patient was a multiparous woman and the modified Bishop score was 6 or more, the combined frequency of Caesarean section and instrumental delivery was for PGE2 2.5 per cent and for oxytocin 3.1 per cent.No difference was found in the health status of neonates following labor induction with PGE2 and oxytocin respectively.At the end of the 24‐hour observation period five patients were still in labor. These patients were delivered either by vacuum extraction (three patients) or by Caesarean section (two patients).The duration of labor was slightly longer (mean 1.1 hour) following oral PGE2 than following intravenous infusion of oxytocin, mainly due to a prolongation of stage I.The type of delivery following oral PGE2 or intravenous infusion of oxytocin in combination with early amniotomy was compared with that following spontaneous labor and following labor induction by oxytocin alone. The frequency of Caesarean section was the same but the frequency of instrumental delivery was lower in the former two groups of patients. The difference could at least partly be explained by a higher frequency of patients who obtained epidural analgesia in the randomized trial. Oral PGE2 or intravenous infusion of oxytocin combined with early amniotomy was obviously more effective than oxytocin alone for labor induction. With oxytocin alone, two days of infusion was required in 53.8 per cent and four or more days in 2.4 per cent of the patients.It may be concluded that oral PGE2 therapy combined with amniotomy is a valuable alternative to intravenous infusion of oxytocin for labor induction at or near term. The method is generally well accepted by the patient. The main advantage is the ease and simplicity of the treatment. Complications are rare, particularly in multiparous patients with good prospects of inducibility.
Treatment of pulmonary endometriosis with danazol
Authors: Rönnberg Lars , Ylöstalo Pekka 
Published: December 2009

A successful treatment of pulmonary endometriosis with Danazol is reported. A 25‐year‐old woman who suffered from hemoptysis during her menstrual periods was at first treated with lynestrenol, but the hemoptysis recurred immediately after treatment. Following 6 months' therapy with Danazol she has now been symptom‐free for 12 months.Danazol appears to have a more lasting effect on ectopic foci of endometriosis than has progestin.
PAIN RELIEF IN LABOR BY TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION
Authors: Bundsen Peter , Peterson Lars‐Erik , Selstam Urban 
Published: December 2009

Abstract. The study evaluated transcutaneous electrical nerve stimulation (TNS) for pain relief in labor, used in parallel with conventional methods. The investigation comprised 566 vaginally delivered women, 283 of whom were given TNS. Pain relief was evaluated with a questionnaire which the women answered shortly after delivery. With a statistical multivariate technique, it was concluded that TNS has a specific effect on pain localized to the back. Few women in either the TNS or the control group reported good relief of pain localized to the suprapubic region. Nitrous oxide‐oxygen mixture was used less often in the TNS group than in the controls. Duration of labor and maternal blood loss were comparable in the two groups. The babies borne by primiparae in the TNS group tended to have better Apgar scores. Fewer babies of primiparae in the TNS group required observation for two days or more on the neonatal ward than was the case with the controls. However, the electrical stimulation could not be used optimally as it interfered with monitoring of the fetal heart rate in half the cases.It is concluded that although TNS has a good effect on low‐back pain and seems to have no negative effects on the mother or child, it is only a complement to conventional methods.
PROGNOSTIC VALUE OF HUMAN PLACENTAL LACTOGEN (HPL) IN AN UNSELECTED OBSTETRICAL POPULATION
Authors: Nielsen Peter Vest , Egebo Kirsten , Find Claus , Olsen Carl Eli 
Published: December 2009

Abstract. A prospective study on the value of routine HPL determination as a supplement to clinical antenatal care is presented. The HPL values in the apparently normal pregnant woman were not known to the clinicians.The material comprised 1 660 pregnancies and deliveries, in 87% of which at least one HPL value was available.The results are expressed as the ability of a low HPL value to predict the birth of a distressed infant and/or an infant of low birth weight, a normal HPL value the birth of a non‐distressed infant and/or an infant of normal birth weight. Moreover, the results show how many of the distressed infants and infants of low birth weight were born to mothers with low HPL values.Like a number of other authors, we found that HPL screening increases the prognostic reliability in pregnancies with complications. On the other hand, its value in normal pregnancies could not be confirmed.
Medroxyprogesterone Acetate (MPA) Plasma Levels After Oral and Intramuscular Administration in A Long‐Term Study
Authors: Hesselius Inge , Johansson Elof D. B. 
Published: December 2009

In a long‐term study (1 year) the plasma concentration of medroxyprogesterone acetate (MPA, Depo‐Provera, Provera, Upjohn) was measured in 30 patients with endometrial carcinoma treated with MPA in the following dosages:

MPA 1 000 mg i.m. weekly
MPA 1 000 mg i.m. once every second week, and
MPA 100 mg orally twice daily.

In the orally treated group the blood samples were taken just before the next tablet. The plasma concentration in the orally treated group rapidly reached steady state, while the i.m. treated group showed gradually increasing levels that had a tendency to level off after 6 months. The mean concentration at the end of the year was about three times higher for MPA 1 000 mg i.m. weekly than for MPA 100 mg orally twice daily. This does not take into consideration the peak MPA level that occurs 2‐4 hours after each tablet. MPA i.m. has a very good depot effect, with release of MPA from the injection site for up to 9 months. The steady initial increase in MPA plasma concentration seen in the i.m. treated groups is probably due to the additions of new depots rather than accumulation in the body generally.
PLASMA AND RED BLOOD CELL FOLATE DURING NORMAL PREGNANCIES
Authors: Ek Johan , Magnus Erik M. 
Published: December 2009

Abstract. Plasma and red cell folate concentrations (Lactobacillus casei activity) have been studied in 43 women during pregnancy. Iron, but no folic acid supplement was given. The plasma folate concentrations decreased significantly during pregnancy and were lower than in the reference cases at term. The red cell folate concentrations were compatible with the reference material during early pregnancy, and significantly higher than the reference material at term. A significant decrease was observed during the last two months of pregnancy. The plasma folate and the red cell folate concentrations at different stages of pregnancy were correlated and a relationship was demonstrated between these parameters at different stages of pregnancy. The hemoglobin concentrations were compatible with the reference material during early pregnancy and at term.One hundred and sixty‐six women were also studied at term to evaluate the effect of repeated pregnancies on the folate status. Repeated pregnancies did not influence the plasma and red cell folate concentrations at term.We conclude that the folate intake is adequate to meet the increased requirements during pregnancy, and folic acid supplementation is therefore not recommended as a routine in normal pregnancies in this population.
Metabolic and Circulatory Effects of Intravenous and Oral Salbutamol in Late Pregnancy in Diabetic and Non‐Diabetic Women
Authors: Wager Jan , Fredholm Bertil , Lunell Nils‐Olov , Persson Bengt 
Published: December 2009

Abstract.The present study investigated the cardiovascular and metabolic “side‐effects” of the β2‐adrenoceptor stimulating drug salbutamol in the third trimester of pregnancy in diabetic and non‐diabetic women.Salbutamol was administered either orally or as an intravenous infusion. Blood samples were collected for analyses of plasma cyclic AMP, insulin, C‐peptide, and carbohydrate and lipid metabolites. Fetal heart rate, maternal heart rate, and blood pressure were registered simultaneously.After both intravenous and oral salbutamol, there was a statistically significant decrease in diastolic blood pressure, increase in maternal heart rate, plasma levels of cyclic AMP, insulin, and carbohydrate and lipid metabolites showing stimulation of glycogenolysis, lipolysis, and insulin secretion. The increase in fetal heart rate was slight. In diabetic women, the glycogenolytic and lipolytic effects of salbutamol were significantly more pronounced than in non‐diabetics.The acute maternal circulatory and metabolic effects after salbutamol are probably too slight to have any clinical significance in healthy women. However, in diabetics, due to their impaired insulin function, a serious metabolic deterioration after salbutamol might occur.
Development of Tolerance to the Metabolic Actions of β2‐Adrenoceptor Stimulating Drugs
Authors: Fredholm Bertil B. , Lunell Nils‐Olov , Persson Bengt , Wager Jan 
Published: December 2009

Abstract. Considerable evidence exists that treatment with β‐receptor stimulating drugs causes desensitization in several different tissues in vitro. There is also evidence that the administration of β‐receptor stimulating drugs during asthma therapy leads to the development of tolerance of at least some actions of β‐stimulating drugs.The present communication presents data from experiments in animals, including humans, suggesting that treatment with an oral salbutamol leads to the development of tolerance of metabolic actions of β‐adrenergic stimulating drugs. Rats given salbutamol, 20 mg/kg/day, showed a decreased lipolytic response to salbutamol and to noradrenaline. By contrast, rats subjected to adrenal demedullation showed an increased lipolytic response. These results suggested that β2‐adrenoceptor‐stimulating drugs may cause desensitization and also that the normal circulating levels of catecholamines may be sufficient to regulate the responsiveness of the adipose tissue.The effect of a single oral dose of salbutamol was compared in 10 women not previously given salbutamol and in 13 women treated with oral salbutamol in a dose of 4 mg 4 times/day for 12–33 days preceding study. The salbutamol‐induced increase in the levels of insulin, C‐peptide, glucose, and glycerol were significantly reduced in those exposed to salbutamol before the test. The rise in cyclic AMP and non‐esterified fatty acids was not significantly affected. There were also differences in the salbutamol‐induced fall in diastolic blood pressure and in heart rate. These differences in cardiovascular responsiveness could be accounted for by a difference in the values of these parameters before the test.Our results suggest that women receiving 16 mg/day of salbutamol, i.e. a normal clinical dose of the drug sufficient to achieve relaxation of the uterus, develop tolerance to some metabolic side effects. This, and the development of tolerance to the tremorogenic effect of β‐adrenoceptor‐stimulating drugs, may be clinically advantageous, but the possibility exists that tolerance may develop also to some of the therapeutic actions. The literature concerning the development of tolerance to β2adrenoceptor‐stimulating drugs is briefly reviewed, and some possible explanations for what appears to be an organ‐selective development of tolerance is discussed.
Desogestrel, a New Progestational Compound
Authors: Cullberg Göran , Eriksson Olof , Knutsson Folke , Steffensen Kjeld 
Published: December 2009

Abstract. A new progestational compound, desogestrel, was given orally to four otherwise healthy, ovariectomized volunteers who had first been treated for two cycles with ethinylestradiol and lynestrenol (given sequentially) and then primed with ethinylestradiol. The effects of decreasing doses of desogestrel (250 to 15 μg) in combination with 50 μg ethinylestradiol were compared with those of 1 mg lynestrenol plus 50 μg ethinylestradiol. Variables studied were basal body temperature, vaginal cytology (karyopyknotic index), cervical mucus (including Spinnbarkeit and ferning) and endometrial biopsies. In addition, body weight, blood pressure and selected biochemical variables were monitored.No side effects attributable to the treatment were noted. Progestational effects were observed on all variables in volunteers with adequate priming. Basal body temperature rose in all volunteers on desogestrel at doses down to 60 μg to the same extent as those with I mg lynestrenol. The karyopyknotic index did not react to estrogen priming in 2 volunteers, and the results with the 2 other volunteers were inconclusive. Cervical mucus became thick and scanty with reduced Spinnbarkeit at doses of desogestrel down to 60 μg as well as with 1 mg lynestrenol. Crystallization of mucus (ferning) ceased at a dose of 30 pg desogestrel and endometrial biopsies showed marked secretion at doses of desogestrel down to 30 μg; 60 μg was considered to be equipotent to 1 mg lynestrenol. The ovariectomized woman with her uterus intact appears to be a good model for the initial testing of progestational compounds.
Hilus cells from human postmenopausal ovaries: Gonadotrophin sensitivity, steroid and cyclic amp production
Authors: Dennefors B. L. , Janson P. O. , Hamberger L. , Knutsson F. 
Published: December 2009

Abstract. Strips of ovarian hilar tissue taken from 11 post‐menopausal women were examined histologically and found to contain clusters of hilus cells in contiguity with non‐mye‐linated nerve fibers. No other steroidogenically active structures were found. Specimens from these strips were incubated for 30 and 240 minutes in Krebs bicarbonate buffer containing 5.5 mM glucose and 1% bovine serum albumin. The specimens produced measureable amounts of androstene‐dione, estradiol‐17β and progesterone in vitro. The major steroid formed was androstenedione, and this pattern of steroidogenesis appeared similar to that of postmenopausal ovarian stroma. However, the amounts of steroids formed were considerably higher than in stromal tissue. This implies that the hilus cells possibly may be of greater importance, qualitatively, than the stroma cells for steroidogenesis in the postmenopausal ovary.Addition of hCG to the incubated specimens elicited increase in both cyclic AMP formation and steroid synthesis, especially of estradiol‐17β, indicating a preserved responsiveness to gonadotrophin in hilus cells from postmeno‐pasual ovaries.
Outcome of Pregnancy After Conization
Authors: Larsson Göran , Grundsell Hans , Gullberg Bo , Svennerud Sven 
Published: December 2009

Abstract. The outcome of 635 pregnancies in 197 women before and after conization is reported. After conization a significant increase in premature deliveries occurred in young women (age 21‐25), nulliparae representing the highest risk. The rate of premature deliveries in this age group was 4.4% before conization and 30.6% after conization. No such increase could be found in any other age group.Labor was notably short in non‐parous women and in parous women it started with rupture of the membranes significantly more often after conization. In addition, a significant increase in the frequency of cervical stenosis was observed, but this was of clinical significance in only one case.Treatment in the form of prophylactic cerclage did not reduce the incidence of either premature delivery or of late spontaneous abortion.
Malignant Cervical Teratoma of the Fetus
Authors: Shoenfeld A. , Ovadia J. , Edelstein T. , Liban E. 
Published: December 2009

Abstract. Cervical teratomas have been defined and one new case is now added to the 116 cases previously reported. We have been able to find only six reports of malignant teratoma in the literature so far. The problems of diagnosis and obstetrtic management are discussed briefly. The incidence of appearance of the tumor is described and the likelihood of hydramnios or of acute obstructive symptoms of the trachea and esophagus at birth ar discussed. The differential diagnosis includes cystic hygroma, congenital goitre, bronchial cyst, lymphangioma, neuroblastoma, parotid tumor and carcinoma of the thyroid.The object of this review is to present a synoptic description of these tumors, their clinical manifestations, management, treatment and prognosis, so that it may afford the attending obstetrician a guideline in understanding this rare entity.
The Tendency to Repeat Gestational Age and Birth Weight in Successive Births, Related to Perinatal Survival
Authors: Bakketeig Leiv S. , Hoffman Howard J. 
Published: December 2009

Abstract. The risk of perinatal death was studied in relation to the tendency for mothers to carry their fetuses to similar gestational ages and birth weights in successive pregnancies. The data for this study are derived from all 635 140 births in Norway during a 10‐year period (1967‐76). The findings demonstrate that those babies that were born similar in age and size to their elder siblings ran the lowest risk of perinatal death. For example', the perinatal mortality rate (PMR) for second‐birth babies weighing between 2501 and 3000 g is 9.1 per 1 000 births if the first baby weighed 3000 grams or less. But the PMR is 50% higher, 13.3 per 1 000 births, when the first baby weighed between 3001 and 3 500 g. If the first baby weighed more than 3 500 g, then the PMR is 3 1/2 times greater, 32.1 per 1000 births.In addition to gestational age and birth weight, the Medical Birth Registry of Norway also records measurements of crown‐heel length. The length data show that babies at greatest risk for perinatal mortality tend to be relative long and thin rather than symmetrically developed. For example, the PMR for second babies weighing between 2501 and 3000 grams who were disproportionately long (>46 cm) was 4.6 times greater than the PMR for the average length babies of the same birth weight. The investigation of cause‐specific mortality rates showed that most categories were increased for the higher risk babies. However, congenital malformation was the principal contributor to deaths of the relatively short babies. Conversely, placenta praevia, abruptio placentae, and complications of the umbilical cord were the principal contributors to the mortality of the relatively long babies. These results suggest that any deviation from the expected growth pattern for a fetus of a multiparoiis mother should raise concern about an increased risk for the remainder of her pregnancy and delivery.