bluuebunny/crossref_metadata_2025_split huggingface dataset:
Randomized study on the effect of adding oxytocin to ethacridine lactate or misoprostol for second‐trimester termination of pregnancy
Authors: Kelekci Sefa , Erdemoglu Evrim , İnan İsmet 
Published: December 2009

AbstractObjective. To compare effectiveness of misoprostol and ethacridine lactate with or without oxytocin in second‐trimester medical abortions.Subjects and methods. A randomized prospective study. A total of 388 women with genetic indications for termination of pregnancy at 13–24 weeks of gestation were recruited. Group I (n=85) were treated with extra‐amniotic ethacridine lactate, 10 ml instilled per gestational week, to a maximum of 200 ml. Group II (n=93) were treated with misoprostol administered intravaginally (200 μg), followed by 100 μg of oral misoprostol 4 hourly for 24 h. Group III (n=102) were treated with a combination of ethacrine lactate and oxytocin. An initial dose of 6 mU/min oxytocin was given, followed by additional 6 mU/min doses every 20 min. Group IV (n=96) were treated with a combination of misoprostol and oxytocin administered in a similar way as in group III. The main outcome measures were time to induce abortion, side effects, and failure/success rates.Results. The mean time to induce abortion was 14.2±3.6, 13.2±3.4, 10.8±2.6, and 9.9±2.4 h in groups I, II, III, and IV, respectively (p<0.001). Addition of oxytocin to ethacridine lactate did not decrease the risk of prolongation of induction beyond 24 h but use of oxytocin with misoprostol did reduce the risk of induction beyond 24 h (OR: 0.46, 95%CI: 0.21–1, p<0.05). The occurrence of minor side effects was similar in all groups.Conclusion. Addition of oxytocin to ethacridine lactate or misoprostol significantly decreases the length of time to induce abortion without supplementary side effects.
Miniconization procedure with C‐LETZ conization electrode for treatment of cervical intraepithelial neoplasia: A Swedish study
Authors: MINTS MIRIAM , GABERI VERA , ANDERSSON SONIA 
Published: December 2009

AbstractBackground. Since 1989 large loop excision of the transformation zone (LLETZ) has become the treatment of choice for cervical intraepithelial neoplasia in many colposcopy clinics. This method has limitations however, in that the resection margins of the cone produced by LLETZ cannot give conclusive histological reassurance, because of thermal injury in 5–30% of the specimens. Furthermore, LLETZ are often taken in several sections, which makes the histopathological examination unnecessarily difficult. As a new and single treatment without these limitations, conization with the contoured loop excision of the transformation zone (C‐LETZ) electrode was investigated in the present study. Material and methods. One hundred and seventy‐four patients with CIN were treated with the C‐LETZ electrode during 12 months at the Gynaecological Department, Karolinska University Hospital, Huddinge. The inclusion criteria were a histological diagnosis of CIN II–III, or persistent CIN I. Results. Eighty‐six per cent of the patients had a complete excision according to histological findings, and 12% had an incomplete excision. The frequency of incomplete excisions increased with the severity of the CIN but were found in all groups of patients: 1 (3%) in CIN I, 5 (12%) in CIN II, and 12 (17%) in CIN III. The resection margins and histological diagnoses were certain in 98% of the cases. A cure rate of 90% was observed. Conclusions. Miniconization with the C‐LETZ electrode makes it possible to individualize the size of the minicones and produce the minicones as one‐piece specimens for histopathological assessment. Our findings confirm that this method is a reproducible, safe, and economical way to treat CIN with a low rate of morbidity in a hospital outpatient setting.
Term prediction with ultrasound: Evaluation of a new dating curve for biparietal diameter measurements
Authors: BACKE BJØRN , NAKLING JAKOB 
Published: December 2009

AbstractBackground. In Norway, routine ultrasound examination with assessment of gestational age was included in the standard antenatal care program in 1985. Until presently, a dating chart introduced in 1983 has been used throughout the country. New national normal values are now developed. The aim of the study was to compare the performance of the two sets of normal values; both are based on measurement of fetal biparietal diameter in the second trimester. Material and method. We analyzed a cohort of 11,238 singleton deliveries with spontaneous onset of labor. All had reliable last menstrual period and all had a routine ultrasound examination in the second trimester with measurement of fetal biparietal diameter. We calculated the expected day of delivery both according to the old (method A) and the new (method B) reference values. Results. The prediction error (the difference between observed and expected day of delivery) for the last menstrual period method was −0.1 days, for method A −3.5 days, and for method B −0.7 days. The prediction error for method A increased up to 7 days when ultrasound measurements were obtained in gestational week 14–15. Conclusion. The old ultrasound method leads to a systematic underestimation of fetal age, and the prediction error increases notably when the ultrasound measurements are performed in the early second trimester. Gestational age is more precisely assessed with the new reference values.
The effect of accelerated rehabilitation on recovery after surgery for ovarian malignancy
Authors: MARX CHARLOTTE , RASMUSSEN TINA , JAKOBSEN DORTHE HJORT , OTTOSEN CHRISTIAN , LUNDVALL LENE , OTTESEN BENT , CALLESEN TORBEN , KEHLET HENRIK 
Published: December 2009

AbstractBackground. In patients undergoing colonic surgery the postoperative hospital stay has been reduced from 8–12 days to 2–4 days with multimodal rehabilitation programs. The aim of this study was to evaluate the postoperative outcome after surgery for ovarian malignancy with conventional care compared to fast‐track multimodal rehabilitation. Methods. Seventy‐two consecutive patients receiving conventional care (group 1) were compared with 69 consecutive patients receiving multimodal, fast‐track rehabilitation with a planned care program including continuous epidural analgesia, early oral feeding and mobilization (group 2) in the same department. Outcome was postoperative hospital stay and morbidity during the first postoperative month. Results. Median age was 63 years (group 1) and 62 years (group 2). Median postoperative hospital stay was reduced from 6 days in group 1 (mean 7.3) to 5 days in group 2 (mean 5.4) (p<0.05). There was no difference in the overall complication rate, although severe medical complications were reduced in group 2 (14% versus 2%; p<0.01). Readmission rate was 10% in group 1 and 3% in group 2 (p>0.05). Conclusions. The concept of fast‐track multimodal rehabilitation appears to be beneficial in patients operated for ovarian malignancy, as hospital stay and medical morbidity are reduced.
A population‐based study of Swedish gynecologists’ experiences of working in abortion care
Authors: HAMMARSTEDT META , LALOS ANN , WULFF MARIANNE 
Published: December 2009

AbstractBackground. Legal abortion is a recurrent part of gynecologists’ work. The aim of the study was to describe Swedish gynecologists’ clinical and emotional experiences when working in abortion care. Further aims were to elucidate their perception of women's motives for having an abortion as well as looking for possible demographic and gender differences. Methods. A questionnaire comprising both structured and semi‐structured questions was sent to a random sample of 269 Swedish gynecologists. The response rate was 85%. Results. The female gynecologists were younger (27–59 years) and more numerous than the males (33–66 years). Almost all believed that gynecologists should be involved in abortion care, and half were opposed to the privilege of refusing to work with termination of pregnancy. The gynecologists supported the shift from surgical to medical abortions but not to their being managed in primary healthcare. A few gynecologists (n=42) had considered changing their job because of termination of pregnancy being part of their work. Misgivings occurred sometimes in connection with surgical and late abortions (n=60 and n=108 respectively). Few gynecologists (n=33) had felt inadequate when encountering abortion patients and more than half thought that working with termination of pregnancy was a positive experience. The gynecologists believed that continuing professional development and ongoing guidance of termination of pregnancy matters were important. Conclusions. In general, Swedish gynecologists have no doubts about taking part in and performing termination of pregnancy. Their clinical and emotional experience, as expressed in this study, as well as their perception of women's motives for abortions, indicate that they have gained deep insights and developed their professionalism in their work with termination of pregnancy.
Pelvic girdle pain in pregnancy: The impact on function
Authors: ROBINSON HILDE STENDAL , ESKILD ANNE , HEIBERG ELI , EBERHARD‐GRAN MALIN 
Published: December 2009

AbstractBackground. The aim of this study was to determine the prevalence of self‐reported pelvic girdle pain in pregnancy and study the impact on function, the use of crutches, and waking up at night, according to location of pain. Methods. A population‐based questionnaire study was performed among all women 18–40 years in two communities in Norway in 1998–99. A total of 1,817 women with a prior delivery constituted the study sample. Pelvic girdle pain was grouped into five categories: pain in anterior pelvis, in posterior pelvis, in anterior and unilateral posterior pelvis, in anterior and bilateral posterior pelvis (a complete pelvic girdle syndrome), and pelvic pain with no information on location. Results. A total of 46% (843/1,817) reported pelvic girdle pain in pregnancy at one location or more. Nineteen percent reported pain in anterior pelvis only, 14% in posterior pelvis only, 4% in anterior and unilateral posterior pelvis, and 5% reported a complete pelvic girdle syndrome. A total of 7% of all pregnant women used crutches during pregnancy and 15% reported waking up at night frequently due to pelvic girdle pain. A complete pelvic girdle syndrome, as compared to pain in the anterior pelvis only, was strongly associated with the use of crutches (adjusted odds ratio (OR) 4.3; 95% confidence interval (CI) 2.5–7.4) and with waking up at night due to pain (OR 4.6; 95% CI 2.7–7.2). Conclusion. Pain related to the pelvic joints is common among pregnant women in Norway and may cause serious functional problems.
Antioxidant protection during the menstrual cycle: the effects of estradiol on ascorbic–dehydroascorbic acid plasma levels and total antioxidant plasma status in eumenorrhoic women during the menstrual cycle
Authors: Michos Constantinos , Kiortsis Demetrios N. , Evangelou Angelos , Karkabounas Spyridon 
Published: December 2009

AbstractBackground. Estrogens, apart from their classic role as steroid hormones, also possess significant antioxidant properties. The present study was undertaken to assess the antioxidant potential of the female during the various menstrual phases and to investigate the correlation between ascorbic acid, dehydroascorbic acid plasma levels, total antioxidant plasma status, and estradiol levels. Design and methods. Thirteen eumenorrhoic women were studied. Ascorbic acid and dehydroascorbic acid plasma levels, total antioxidant plasma status, estradiol, progesterone, luteinizing hormone, and follicle‐stimulating hormone during time of menstruation, midfollicular phase, time of ovulation, and midluteal phase were determined. Ascorbic–dehydroascorbic acid ratio was also calculated. Results. A progressive significant rise in ascorbic acid plasma levels (p<0.01), ascorbic–dehydroascorbic acid ratio (p<0.001), and total antioxidant plasma status (p<0.05) from menstruation to ovulation was observed. Moreover, a significant decrease in dehydroascorbic acid was found at the same phases (p<0.05). Changes of estradiol levels during the menstrual cycle correlated positively with the changes of ascorbic acid levels and total antioxidant plasma status (p<0.05). Furthermore, estradiol levels correlated positively with ascorbic acid levels (p<0.05, r<0.5), ascorbic–dehydroascorbic acid ratio (p<0.05, r<0.5), and total antioxidant plasma status (p<0.05, r<0.8) in all menstrual phases. Conclusions. An elevated antioxidant protection during ovulation and the midluteal phase appears to be present in eumenorrhoic women. Moreover we observed a cyclic variation in the antioxidant parameters we assayed in the females in the present study, which could be due to cyclic changes in estradiol levels.
Cosmetic results of lower midline abdominal incision: Donati stitches versus a continuous intracutaneous suture in a randomized clinical trial
Authors: de Waard Judith , Trimbos Baptist , Peters Lex 
Published: December 2009

AbstractBackground. The objective of this study was to compare the cosmetic outcome of two different closing techniques for lower midline abdominal incisions: a continuous intracutaneous suture versus interrupted Donati stitches.Methods. Eighty patients undergoing gynecological surgery through a lower midline abdominal incision were randomized. The cosmetic outcome of the scar was assessed by independent observers and the patients at 8 days and 4–6 months after the operation using visual analog scales and a validated scoring system for hypertrophy, width, color, and cross‐hatching. Patients also completed a visual analog scale for postoperative pain on both occasions. The accumulated data were statistically evaluated using two‐sided χ2, Student's t, or Mann–Whitney tests with a confidence interval of 95%. Results. Closing a lower midline abdominal laparotomy wound with an absorbable intracutaneous suture did not take more time than using Donati stitches. Laparotomy scores were only significantly better in the intracutaneous group at the first assessment, one week after the operation. The cosmetic visual analog scale scores by both independent observers and patients were slightly better in the intracutaneous group but the difference was not statistically significant. There was also no significant difference between visual analog scale scores for pain felt around the scar. Conclusions. This study shows that in the opinion of both independent observers and patients, scar cosmetics are not significantly different when using Donati skin sutures or an intracutaneous suture to close a lower midline laparotomy wound. The two methods do not differ either in time‐consuming aspects or postoperative pain perception.
The joint effect of vaginal Ureaplasma urealyticum and bacterial vaginosis on adverse pregnancy outcomes
Authors: Vogel Ida , Thorsen Poul , Hogan Vijaya K. , Schieve Laura A. , Jacobsson Bo , Ferre Cynthia D. 
Published: December 2009

AbstractObjective. To examine associations of vaginal Ureaplasma urealyticum (UU) and bacterial vaginosis (BV) with preterm delivery (PTD), small for gestational age (SGA), and low birth weight (LBW). Material and methods. A population‐based, prospective cohort study of 2,927 pregnancies. After exclusion of multiples and antibiotic use sample size was 2,662. BV (Amsel's criteria) and UU (culture) were assessed in week 17. Gestational age was determined by last menstrual period, confirmed by ultrasound measurement in 97.5%. SGA infants were calculated from intrauterine fetal growth measurements. Results. There was no increased risk for spontaneous PTD among women with BV only (crude odds ratio 1.0, 95% CI 0.4–2.7), among women with UU only (1.3, 0.8–2.0), nor among women with UU + BV (0.9, 0.4–2.3) compared to women without UU and BV. However, there was a threefold increased risk of a LBW birth in women with UU + BV (3.1, 1.8–5.4), a twofold risk of a LBW birth among women with UU only (1.9, 1.3–2.9), but no increased risk among women with BV only (0.8, 0.3–2.2). Similarly, women with UU + BV had over a twofold increased risk of an SGA birth (2.3, 1.3–4.0), women with UU only had a 70% increase (1.7, 1.1–2.5), whereas a nonsignificant increase was found in women with BV only (1.3, 0.6–2.9). Adjustment by established confounders (smoking, previous PTD, previous LBW, and Escherichia coli) did not affect risk estimates. Conclusion. This analysis suggests that UU is independently associated with fetal growth and LBW and that BV with UU may enhance the risk of these outcomes.
Placement of probes in electrostimulation and biofeedback training in pelvic floor dysfunction
Authors: Voorham‐van der Zalm Petra J. , Pelger Rob C. M. , van Heeswijk‐Faase Ingrid C. , Elzevier Henk W. , Ouwerkerk Theo J. , Verhoef John , Lycklama à Nijeholt Guus A. B. 
Published: December 2009

AbstractBackground. We examined the positioning of five commonly used probes in electrostimulation and biofeedback training.Materials and methods. Ultrasound and MRI were used to evaluate the position of these probes in two multiparous women, in reference to pelvic floor anatomy.Results. From caudal to cranial we identified the anal external sphincter, puborectal muscle, and levator group. Positioning of probes varied considerably: the recording plates are situated from 1 cm caudal to 6 cm cranial of the puborectal muscle. Most probes stretched, due to a relatively large diameter, the vagina wall, anal external sphincter, or puborectal muscle beyond physiological proportions. On straining, all probes were pushed upwards into the rectum.Conclusion. The positioning of all examined probes varied considerably. Hence it is not likely that these probes give a reliable and uniform registration of muscular activity of the pelvic floor function or are all optimal for electrostimulation.
Estrogens are potentially the only steroids with an antioxidant role in pregnancy: in vitro evidence
Authors: Reyes Miguel R. , Sifuentes‐Alvarez Antonio , Lazalde Brissia 
Published: December 2009

AbstractBackground. Pregnancy is a condition that favors oxidative stress by reactive oxygen species. Oxidative stress is involved in the etiopathogenesis of disorders of pregnancy such as pre‐eclampsia. An antioxidant effect of estrogens has been described and a putative role of them as antioxidants has been proposed. The aim of this work was to evaluate in vitro the antioxidant properties of dehydroepiandrosterone sulfate, estradiol, estriol, progesterone, and testosterone, five steroid hormones present in the maternofetal circulation. Methods. The antioxidant properties of the hormones were evaluated by two methods: 1. their antioxidant effect on the auto‐oxidation of linoeic acid, a hydrogen atom transfer reaction; 2. diphenylpicrylhydrazil‐scavenging capacity, a single electron transfer reaction. Results. Of the five hormones tested, only estradiol and estriol at 10 μM concentration exerted a strong antioxidant effect of 81.73 and 70.97% respectively on linoleic acid auto‐oxidation, at the end‐point of the reaction. Likewise, only these two hormones showed radical‐scavenging activity on diphenylpicrylhydrazil, noticeable only at supraphysiological concentrations of 1 mM. Conclusions. Estradiol and estriol could play a role as antioxidants for maternofetal autoprotection in addition to their hormonal activity, but this role could be preferentially exerted by estriol due to its higher concentrations exhibited during pregnancy. In vivo studies are necessary to shed light on this issue.
Satisfying parents’ preferences with regard to various models of postnatal care is cost‐minimizing
Authors: ELLBERG LOTTA , HÖGBERG ULF , LUNDMAN BERIT , LINDHOLM LARS 
Published: December 2009

AbstractBackground. This study describes three options for postnatal care in Sweden and contains a cost analysis of the options in various combinations. The aim of the study was to calculate the cost of a postnatal care model according to new parents’ preferences. Methods. Staff costs were calculated for various models of postnatal care, comprising the maternity ward, the family suite, and/or the early discharge program. One of the models was based on answers from 342 parents who specified their preferences with regard to postnatal care in the event of another birth. Results. Comparing costs for five different models of postnatal care showed that the proportion of mothers receiving care at the maternity ward crucially influences the total costs. The staff costs differed significantly between the models, ranging from US$448 000 to US$778 000 per 1500 mother‐child dyads. Main outcome measures Cost calculation of various care models and parents’ preferences for postnatal care. Conclusions. Because the parents’ preferences with regard to postnatal care created one of the most cost‐minimizing care models in the study, it would be possible to better meet parent's desires and, at the same time, reduce costs, without increasing risks in comparison with the early discharge program.
Spontaneous abortion: A prospective cohort study of younger women from the general population in Denmark. Validation, occurrence and risk determinants
Authors: BUSS L. , TOLSTRUP J. , MUNK C. , BERGHOLT T. , OTTESEN B. , GRØNBÆK M. , KJAER S.K. 
Published: December 2009

AbstractObjective. To assess the occurrence of spontaneous abortion, comparing two different data sources. To estimate the rate of spontaneous abortion over a 2‐year period, and examine potential predictors of the risk for incident spontaneous abortion. Methods. We used interview data from a population‐based prospective cohort study comprising 11,088 women and data from a linkage of the cohort with the Hospital Discharge Register to compare spontaneous abortions as reported in the interview with those identified in the register. Based on interview data, we estimated the rate of spontaneous abortion during the two‐year follow‐up. Finally, risk determinants for incident spontaneous abortion were analyzed by means of logistic regression. Results. A total of 654 spontaneous abortions before enrolment in the study were reported by the women compared to 531 abortions found in the register. More than 80% of the spontaneous abortions identified from both sources were recorded in the same year. During follow‐up a total of 20.9% of pregnancies intended to be carried to term ended as a spontaneous abortion. In the risk factor analysis, we found that previous spontaneous abortion, being single, never having used oral contraceptives, and use of intrauterine device were associated with increased risk of subsequent spontaneous abortion. In addition, it was indicated that a short interpregnancy interval following a spontaneous abortion may confer an increased risk of abortion in the subsequent pregnancy. Conclusion. We found a high rate of spontaneous abortion in the present study and an acceptable agreement between information obtained by interview and register information. More than 25% of the spontaneous abortions were only reported by the women, and this could not be explained by erroneously reported induced abortions, and may be early, nonhospitalized abortions. We confirm that number of previous spontaneous abortions is a strong determinant, and our data may also indicate a role of previous contraceptive habits. A role of the length of interpregnancy interval in the risk of spontaneous abortion cannot be ruled out.