bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of maternal protein intake before conception and throughout pregnancy with birth weight
Authors: CUCÓ G. , ARIJA V. , IRANZO R. , VILÀ J. , PRIETO M. T. , FERNÁNDEZ‐BALLART J. 
Published: December 2009

AbstractBackground.The aim of this study is to analyze how the maternal intake of macronutrients before conception and in the 6th, 10th, 26th, and 38th weeks of pregnancy affects birth weight.Methods.A longitudinal study of food consumption to assess the nutritional status of 77 healthy female volunteers (age range: 24–36) who were planning immediate pregnancy was performed in Reus between 1992 and 1996. A seven‐consecutive‐day dietary record was used in order to evaluate the dietary intake. We fitted multiple linear regression models of macronutrients on birth weight adjusted for energy intake, maternal age, pre‐conceptional body mass index, sex of the newborn, length of pregnancy, parity, physical activity in leisure time, and smoking.Results.In the 6th, 10th, and 26th weeks of pregnancy, 7.2–12.7% of the variability of the birth weight can be explained by the intake of macronutrients. In the protein and fat model, a 1 g increase in maternal protein intake during preconception and in the 10th, 26th, and 38th weeks of pregnancy leads to a significant increase of 7.8–11.4 g in birth weight.Conclusions.The diet of well‐nourished women in the preconception period and throughout most of pregnancy has a significant effect on birth weight, and proteins are the macronutrient that has the greatest influence.
Predictions for the decision‐to‐delivery interval for emergency cesarean sections in Norway
Authors: Kolås Toril , Hofoss Dag , Øian Pål 
Published: December 2009

AbstractBackground. To explain the variation in decision‐to‐delivery intervals in emergency cesarean sections in Norway. Methods. A seven‐month prospective registration of all emergency cesareans provided by 24 maternity units. The clinician in charge filled in a predesigned form for each delivery that obtained detailed information about obstetric history, the pregnancy, indication, the date and time of delivery, decision‐to‐delivery interval, seniority of the surgeon, and neonatal outcome until hospital discharge. To take account of the clustered nature of our observations, data were analyzed by multilevel regression. Results. 1,511 singleton emergency cesarean sections with known decision‐to‐delivery interval were included. The average decision‐to‐delivery interval for all emergency cesarean sections was 52.4 min, for acute cesarean sections 58.7 min, and for urgent emergency operations 11.8 min. Most of the decision‐to‐delivery interval variation was at patient level, not between departments. Several significant decision‐to‐delivery interval predictors were identified: 1. abruptio placentae (−54 min), umbilical cord prolapse (−37 min), and fetal stress (−35 min); 2. general anesthesia (versus regional) (−15 min), 3. cesarean sections performed during night‐time (−10 min), 4. seniority of the surgeon (−6 min), and 5. cervical opening (for each cm: −6 min). Conclusions. The variance in the decision‐to‐delivery interval was mainly explained by the different nature of the cesarean sections. The most important predictors, which all acted to reduce decision‐to‐delivery interval, were the three indications abruptio placentae, cord prolapse, and fetal stress. Sections performed during night‐time had significantly reduced decision‐to‐delivery interval. The size of the maternal units as measured by number of deliveries per year was not a significant predictor.
Maternal smoking predicts the risk of spontaneous abortion
Authors: Nielsen Ann , Gerd Hannibal Charlotte , Eriksen Lindekilde Bodil , Tolstrup Janne , Frederiksen Kirsten , Munk Christian , Bergholt Thomas , Buss Lisbeth , Ottesen Bent , Grønbaek Morten , Krüger Kjaer Susanne 
Published: December 2009

AbstractBackground. Few studies have examined smoking prior to pregnancy and the occurrence of spontaneous abortion, as most studies have addressed the risk of spontaneous abortion in relation to smoking during pregnancy. However, results are not entirely consistent. The aim of the present study was to assess the risk of spontaneous abortion considering smoking prior to pregnancy. Methods. We performed a nested case–control study using prospective data from a population‐based cohort comprising 11,088 women aged 20–29 years. From this cohort, women who experienced either a spontaneous abortion (n=343) or who gave birth (n=1,578) during follow‐up were selected. Associations between self‐reported smoking at enrolment and subsequent spontaneous abortion were analyzed by means of multiple logistic regression. Results. The risk of spontaneous abortion in relation to pre‐pregnancy smoking showed a clear dose–response effect. The adjusted odds ratio (95% confidence interval) for spontaneous abortion among current smokers prior to conception was 1.20 (1.04–1.39) per every extra five cigarettes smoked per day. The increased risk was only present for current smokers. The duration of smoking prior to pregnancy was not a significant predictor for subsequent spontaneous abortion. Conclusions. The amount of daily smoking prior to pregnancy seems to be associated with an increased risk of spontaneous abortion, whereas the duration of smoking does not seem to be related to an increased risk of spontaneous abortion.
Oral misoprostol for induction of labor in prelabor rupture of membranes (PROM) at term: a randomized control trial
Authors: Cheung Peter C. , Yeo Evelyn L. K. , Sun Wong Kin , Tang Lawrence C. H. 
Published: December 2009

AbstractObjective. To compare the efficacy of two different dosages of oral misoprostol (50 and 100 μg) with control, in medical induction of labor for patients with prelabor rupture of membranes (PROM) at term. Methods. One hundred women with PROM at term were randomized to receive placebo (vitamin B6 50 mg, control), 50 μg (treatment group 1), or 100 μg (treatment group 2) of oral misoprostol every 4 h to a maximum of six doses. The main outcome measures included time interval from onset of PROM to delivery, duration of first stage of labor, and occurrence of vaginal delivery within 24 h from PROM. Results. The time intervals from PROM to delivery were significantly reduced in both treatment groups compared to control (control, 25.1±10.5 h; treatment group 1, 14.5±6.2 h; and treatment group 2, 13.0±6.1 h, p<0.0001 for both). The duration of the first stage of labor was significantly shortened only in treatment group 2 compared to control (3.3±2.5 versus 6.2±3.4 h, p=0.01). Of those who delivered vaginally (93% in treatment group 1 and 97% in treatment group 2), significantly more women delivered within 24 h of PROM in the treatment group compared to the control group (50%, p<0.05). Conclusions. Oral misoprostol 50 μg every 4 h is safe, cheap, and as effective as 100 μg in reducing the PROM to delivery time interval and labor duration in primiparous women. The same effect is not observed in a multiparous group.
Quality of life in relation to TVT procedure for the treatment of stress urinary incontinence
Authors: Bakas Panagiotis , Liapis Angelos , Giner Maria , Creatsas Georgios 
Published: December 2009

AbstractBackground. The aim of the study was to assess the impact of tension‐free vaginal tape (TVT) procedure as anti‐incontinence surgery on patients’ urinary symptoms and quality of life. Methods. Ninety‐eight patients participated in the study. All patients were operated for urodynamic stress incontinence with the TVT procedure. Patients with prolapse more than first degree according to International Continence Society classification, previous anti‐incontinence surgery, detrusor overactivity, or intrinsic sphincter deficiency were excluded from the study. Patients’ quality of life assessment was performed with the use of the short form of Incontinence Impact Questionnaire and short form of Urinary Distress Inventory (UDI‐6). Results. Mean follow‐up time was 12.4 ±4.2 months (range: 6–18 months). The cure rate for TVT procedure was 87.6%. There was a statistically significant improvement of quality of life postoperatively. In addition, the domains of UDI‐6 concerning irritative symptoms and stress urinary incontinence symptoms showed statistically significant improvement postoperatively, while the domain concerning obstructive symptoms did not show statistically significant difference. Conclusions. Tension‐free vaginal tape procedure as anti‐incontinence surgery significantly improves the quality of life in female patients with urodynamic stress incontinence.
Pregnancy, delivery, and neonatal complications after treatment with antiepileptic drugs
Authors: Pilo Christina , Wide Katarina , Winbladh Birger 
Published: December 2009

AbstractAim. To study the risk for complications during pregnancy, delivery, and neonatal period after the use of antiepileptic drugs (AEDs) during pregnancy.Methods. Women treated with AEDs during pregnancy and with singleton deliveries were identified from the Swedish Medical Birth Registry during the period July 1 1995 to and including 2001 (n = 1350). Risk estimates were made using the Mantel‐Haenszel procedure and comparisons with all singleton births in Sweden during this period (n = 559 491). Stratification was made for year of birth, maternal age, parity, and smoking habits.Results. Most of the women (n = 1207, 89%) used AEDs in monotherapy. Carbamazepine was the most commonly used drug (n = 683), followed by valproic acid (n = 255). The rate of caesarean sections was significantly increased (OR = 1.64, 95% CI 1.43–1.89), but it was not possible to differentiate between elective and emergency sections. The risk for pre‐eclampsia (OR = 1.66, 95% CI 1.32–2.08) and for hemorrhage after vaginal delivery was increased (OR = 1.29, 95% CI 1.02–1.63). The neonates showed an increased risk for respiratory distress (OR = 2.06, 95% CI 1.62–2.63).Conclusion. The study demonstrates a slightly increased risk only for preeclampsia, vaginal hemorrhage after delivery, and respiratory distress in the newborn after the use of AEDs during pregnancy.
Variation in Doppler indices along the length of the cord from the intraabdominal to the placental insertion
Authors: Khare Manjiri , Paul Sanjoy , Konje Justin C. 
Published: December 2009

AbstractAim. The aim of this study was to assess the feasibility of obtaining umbilical artery Doppler waveforms from the intraabdominal portion (perivesical) of the umbilical arteries and to compare the indices from this site to those from the free loop (FL) of cord placental insertion (PL) and abdominal insertion (AI). Methods. A cross‐sectional study of 71 singleton fetuses of 24–38 weeks of gestation. Umbilical artery Doppler waveforms were obtained from four sites by a single operator and their resulting indices — i.e. resistance index, pulsatility index, and systolic/diastolic ratio — were compared. Waveforms were also obtained from the two perivesical (PVC) arteries and the mean was used for analysis. Statistical analyses were performed using appropriate non‐parametric tests. Results. Doppler waveforms acceptable for inclusion in the study were obtained in 100% of cases from the FL site. There were failures to obtain waveforms that met the inclusion criteria in three (4%) cases at the PL site, three (4.2%) cases at the PVC site, and 12 (16.9%) cases at the AI. The three indices fell progressively with gestation from the PVC to the PL sites. There were no significant differences between the two PVC arteries using non‐parametric test of mean difference for related samples using Wilcoxon signed‐rank test (P>0.05) for all the indices. The relation between the differences at the two ends of the cord was fairly consistent across gestation. Conclusions. Doppler velocimetry at PVC site of the umbilical artery is feasible and easy to perform. The indices obtained at this site are higher than those at the other three sites. There is a need for standardization of the site of sampling in order to ensure consistency for clinical application.
Maternal and anthropomorphic risk factors for shoulder dystocia
Authors: Mazouni Chafika , Porcu Géraldine , Cohen‐Solal Emmanuelle , Heckenroth Helene , Guidicelli Beatrice , Bonnier Pascal , Gamerre Marc 
Published: December 2009

AbstractObjective. To study maternal and anthropomorphic parameters as potential risk factors for shoulder dystocia. Material and method. From a series of 9667 vaginal deliveries between January 1998 and December 2003, a total of 138 cases complicated by shoulder dystocia were retrospectively identified and compared with a control group of 138 uncomplicated vaginal deliveries. In addition to maternal age, parity, diabetes, body mass index (BMI), and ethnicity, anthropometric factors including maternal height‐to‐infant weight ratio, characteristics of labor, management techniques, and outcome were evaluated as possible risk factors for shoulder dystocia. Results. The overall incidence of shoulder dystocia in this retrospective series of vaginal deliveries was 1.4%. In univariate analysis, maternal obesity (OR; 95% CI: 3.6; 2.1–6.3), diabetes (OR: 19.4; 2.5–145.7), parity greater than 2 (OR: 2.5; 1.4–4.4), maternal height‐to‐infant weight ratio (OR: 1.02; 1.01–1.04; P < 0.001), and infant weight‐to‐maternal BMI ratio (OR: 1.02; 1.01–1.03; P < 0.001) were predictive of shoulder dystocia. In multiple regression analysis, obesity and multiparity were the most significant maternal risk factors for shoulder dystocia. The only anthropometric factors associated with shoulder dystocia in multiple regression analysis were maternal height <1.55 m (OR: 6.6; 1.3–34.9) and maternal height‐to‐infant weight ratio (OR: 1.02; 1.01–1.05). Conclusion. Shoulder dystocia may be anticipated in cases involving short women and discrepancy between maternal height or weight and infant weight.
A novel method of ninth‐intercostal microlaparoscopic approach for patients with previous laparotomy
Authors: Kumakiri Jun , Takeuchi Hiroyuki , Sato Yuichi , Kitade Mari , Kikuchi Iwaho , Shimanuki Hiroto , Kinoshita Katsuyuki 
Published: December 2009

AbstractBackground. To evaluate the availability of a primary laparoscopic approach for a patient with previous laparotomy and to assess postoperative adhesion to the abdominal wall. Methods. A total of 172 patients with a history of laparotomy who were undergoing laparoscopic surgery in our hospital were evaluated. The primary trocar insertion was performed via the ninth‐intercostal microlaparoscopic approach for these patients. Results. This procedure could be performed on all patients and there were no complications. Postoperative abdominal wall adhesion was found in 53 (30.8%) of 172 patients, and periumbilical adhesion was found in 16 patients (9.3%). Among the 172 patients, 150, 19, and three patients had undergone laparotomy once, twice, and thrice, respectively, prior to this study. Considering the number of previous laparotomies, the frequency of periumbilical adhesion was 5.3% (eight of 150 patients), 36.8% (seven of 19 patients), and 33.3% (one of three patients), respectively. Among 150 patients who had undergone laparotomy once, the type of laparotomy was an obstetric‐and‐gynecologic surgery in 126 patients and other surgeries in 24 patients. There was no significance in the frequency of adhesion between types of previous laparotomies. Surgical incisions were classified as median infra‐umbilical incision (94 patients), median supra‐umbilical incision (three patients), Pfannenstiel's incision (33 patients), para‐rectal incision (15 patients), and peri‐rectal incision (five patients). A high frequency of periumbilical adhesion was recognized in the all three median supra‐umbilical incisions. Conclusion. Ninth‐intercostal microlaparoscopic approach is safe for laparoscopic surgery in patients who have undergone laparotomy previously, and this procedure could prevent the risk of bowel injury.
Recurrence rate of endometriomas following a laparoscopic cystectomy
Authors: Kikuchi Iwaho , Takeuchi Hiroyuki , Kitade Mari , Shimanuki Hiroto , Kumakiri Jun , Kinoshita Katsuyuki 
Published: December 2009

AbstractBackground. The objectives were to observe the clinical course of patients who underwent laparoscopic cystectomy (LC) using transvaginal ultrasonography. Method. The definition of “recurrence” was to detect a diffuse, hypoechoic area whose long axis was at least 2 centimeters (cm) on the transvaginal ultrasonogram during the postoperative follow‐up period. Using the Cox regression test, we analyzed each patient's background variables, namely, patient's age, the revised American Society of Reproductive Medicine score (r‐ASRM score), use of gonadotropin releasing hormone analogues (GnRHa), and pregnancy during the observation period. Next, cyst size and multi‐lobularity of each of the 417 cysts were also analyzed as recurrence risk factors per cyst. Results. The mean postoperative observation period was 21.4±16.8 months. During the observation period, 50 (15.9%) out of 315 patients experienced recurrence and 51 (16.2%) out of 315 patients became pregnant. The cumulative recurrence rate per patient was 31.7% over 60 months. Among prognostic factors per patient, age and showed negative and r‐ASRM scores positive correlations with cyst recurrence. On the other hand, we did not identify any cyst factors associated with recurrence. The patients who underwent hemilateral LC showed a 5.2% cyst recurrence rate in the ovary that appeared to be normal at the time of the initial surgery. Conclusion. Young age and severe endometriosis appeared to be the factors associated with high recurrence risk. Recurring ovarian endometrimas probably include cysts occurring spontaneously and those recurring from the cyst residues in the lesions where cystectomy has been performed.
New ultrasonographic criteria for the prenatal diagnosis of Chiari type 2 malformation
Authors: FUJISAWA HIDETOSHI , KITAWAKI JO , IWASA KOICHI , HONJO HIDEO 
Published: December 2009

AbstractBackground. During prenatal ultrasonography, characteristic malformations including the lemon sign, the banana sign, and obliteration of the cisterna magna are widely used for diagnosis of Chiari type 2 malformation (Arnold Chiari malformation). However, these signs are often obscured by 25 weeks’ gestation. Here, we report an investigation of ultrasonographic markers of Chiari type 2 malformation for diagnosis after 24 weeks’ gestation. Methods. Twenty‐two cases of 24–37 weeks’ gestation referred as fetal ventriculomegaly were analyzed prospectively. Fetuses were examined with ultrasonography by axial section of the head to detect conventional signs, and then by coronary section of the posterior horn of the lateral ventricle to detect two prospective new signs: bilateral downward‐triangle shape (triangle sign) and quadrilateral angular shape (square sign). Results. From the axial sections, three cases were diagnosed with holoprosencephaly, but the remaining 19 cases did not show the lemon sign. In the coronar sections, the eight cases that showed the triangle sign were associated with open spina bifida at the lower vertebral site. The four cases that displayed the square sign showed upper spinal lesions. Chiari type 2 malformation was suspected in these 12 cases. Four of the other seven cases were suspected to be agenesis of the corpus callosum, and the remaining three were normal. All ultrasonographic findings were consistent with the subsequent MRI and postpartum definitive diagnoses. Conclusions. At 24 weeks’ gestation or later, Chiari type 2 malformation can be precisely and efficiently diagnosed by two new characteristics detected during ultrasonography: triangular shape and quadrilateral angular shape.
Using Veronikis ligature carrier to simplify transvaginal sacrospinous colpopexy
Authors: Chang Wen‐chun , Huang Su‐cheng , Sheu Bor‐ching , Hsu Wen‐chiung , Torng Pao‐ling , Chow Song‐nan , Chang Daw‐yuan 
Published: December 2009

AbstractBackground. Pelvic organ prolapse is a common problem in women and often requires surgical management. Sacrospinous colpopexy (SSC) requires significant expertise, especially in placement of the suture into sacrospinous ligament (SSL).Methods. Veronikis ligature carrier (VLC) designed for SSC was used to facilitate suture placement and retrieval under direct visualization within the confines of the pararectal space. From December 2003 through March 2004, SSC was performed in 20 patients with VLC as part of their site‐specific reconstructive pelvic surgery (group A). The historic control group (group B) included 15 patients who underwent SSC with a straight needle holder between March 1999 and March 2001.Results. There was no significant difference in age, gravity, parity, body mass index, blood loss, and hospital stay in both groups with the diagnosis of uterovaginal prolapse or posthysterectomy vaginal vault prolapse. The median operation time for group A and group B was 35min (range 25–40min) and 75min (range 45–128min), respectively (P<0.001). It took less than 5min to introduce two sutures through the SSL by VLC in group A but 20–40 min by straight needle holder in group B. There was no injury to the bladder, rectum, pudendal nerve, or major pelvic vessels.Conclusions. VLC allows rapid and safe introduction of the suspending suture through the SSL and makes SSC easy to perform.
Ultrasound screening for fetal anomalies in Southern Sweden: a population‐based study
Authors: Nikkilä Annamari , Rydhstroem Hakan , Nikkilä Annamari , Rydhstroem Hakan , Källén Bengt , Jörgensen Connie 
Published: December 2009

AbstractBackground. The accuracy of ultrasound in the diagnosis of congenital malformations has been the subject of many studies. Most of these are hospital‐based studies over a limited period of years presenting high detection rates and also relatively high incidence of major malformations. We present here a large population‐based study over a long period of years. Methods. The prenatal diagnoses are compared with the diagnoses of the newborns and aborted fetuses, including autopsy results. The detection rate of some common structural malformations is studied. Results. The overall detection rate of malformations in our study was 28.4%. We noticed an improved detection rate of heart defects and cleft lip during the study period. The prevalence of malformations in the population was 2.6%. The false positive diagnoses were few, 54 cases, and mainly of a mild nature. Conclusions. Ultrasound screening of fetal malformations in our population has a low false positive rate and even though the overall sensitivity is low, 28.4%, the detection rate for many common structural malformations is relatively good.