bluuebunny/crossref_metadata_2025_split huggingface dataset:
Obstetricians’ attitudes and opinions on sickness absence and benefits during pregnancy
Authors: LARSSON CAROLINE , SYDSJÖ ADAM , ALEXANDERSON KRISTINA , SYDSJÖ GUNILLA 
Published: December 2009

AbstractBackground. In Sweden, sick leave is taken more frequently by pregnant women than by nonpregnant women. This led us to ask if the taking of sick leave during pregnancy could possibly be explained by attitudes to sickness absence held among obstetricians working in antenatal care. Methods. All obstetricians (n=45) engaged in public antenatal care and at work in May 2001 in seven hospitals in South Eastern Sweden were asked to anonymously respond to questions/statements concerning their work; 87% participated. The results were presented as percent (the median value) on a visual analog scale. Results. In 60% of all contacts with pregnant women issues such as working conditions, sickness absence or benefit programs were discussed besides the actual pregnancy. In 46% the obstetricians stated that they could not exactly pinpoint a correct medical diagnosis motivating a sickness certificate asked for by the pregnant woman. As the majority of the obstetricians (74%) often did not like to conform to the pregnant women's wishes, unpleasant situations were not uncommon (56%). A conflict was experienced in the dual role that the obstetrician had as the patient's confidant on the one hand and as a representative or gatekeeper for the social security system on the other. Male and female obstetricians did not differ in their opinions on their handling of pregnant women with regard to taking sick leave but for one issue, back pain. Conclusions. The high degree of work dealing with sickness absence and social benefits at the Antenatal Care Centers seems to have a negative effect on the obstetrician's evaluation of their work environment. The obstetricians’ opinion is that pregnant women are sick‐listed too frequently, but obstetricians comply as a rule to the women's wishes in order to avoid conflict.
Fear of childbirth and history of abuse: implications for pregnancy and delivery
Authors: HEIMSTAD RUNA , DAHLOE RAIJA , LAACHE INGEBJORG , SKOGVOLL EIRIK , SCHEI BERIT 
Published: December 2009

AbstractBackground. The aim of this study was to assess the prevalence of fear of childbirth, and to find possible associations to selected sociodemographic factors and important life events. A secondary aim was to explore the relationship between these factors and pregnancy outcome. Methods. Questionnaire booklets were sent to 2680 women at 18 weeks of gestation, of whom 1452 women (54%) responded. The questionnaire included background factors (marital status, education, history of abuse, current pregnancy), W‐DEQ (measurement of fear of childbirth), and STAI (measurement of subjective anxiety). Pregnancy outcome information was recorded. Results. The prevalence of serious fear of childbirth (W‐DEQ > /100) was 5.5%. The W‐DEQ and STAI scores were positively correlated (r=/0.44, p</0.001). Among the anxious women, a trend towards more frequent operative vaginal delivery (12.1% versus 6.9%, p=/0.07) was noted, but not for emergency cesarean section (10.6% versus 7.6%, p=/0.34). Women who reported being exposed to physical or sexual abuse in childhood had a higher W‐DEQ score (71, SD 31 and 69, SD 27) than did the non‐abused (61, SD 23, p<0.01). Only half of women sexually or physically abused in childhood (54% and 57% respectively) had uncomplicated vaginal delivery at term versus 75% among non‐abused (p<0.001). Conclusion. The prevalence of serious fear of childbirth was 5.5%. Fear of childbirth was not associated with mode of delivery, whereas sexual or physical abuse in childhood influenced negatively mode of delivery.
Peritoneal fluid and serum levels of hepatocyte growth factor may predict the activity of endometriosis
Authors: KHAN KHALEQUE NEWAZ , MASUZAKI HIDEAKI , FUJISHITA AKIRA , KITAJIMA MICHIO , HIRAKI KOICHI , MIURA SEIYOU , SEKINE ICHIRO , ISHIMARU TADAYUKI 
Published: December 2009

AbstractBackground. The suitable parameter in PF as well as in serum that may predict the activity of endometriosis is not well described. Therefore, we tried to examine the peritoneal fluid (PF) and serum concentrations of hepatocyte growth factor (HGF) in different revised American Society of Reproductive Medicine (r‐ASRM) staging and morphologic appearances of endometriosis in an attempt to determine whether HGF can be clinically useful to predict the activity of pelvic endometriosis.Methods. Peritoneal fluid was collected from 137 women with endometriosis and 57 women without endometriosis during laparoscopy and blood sampling was collected from 37 women with endometriosis and 21 women without endometriosis before laparoscopy. The concentration of HGF in PF and serum was measured by enzyme‐linked immunosorbent assay. The ability of isolated macrophages and stroma to secrete HGF in response to lipopolysaccharide (LPS) was evaluated.Results. A significantly increased concentration of HGF in PF was found in women with endometriosis (1451.75±/90.7 pg/mL) than that in non‐endometriosis (1120.5±/77.3 pg/mL, p < /0.01) without any remarkable difference in HGF levels between women with stage I–/II endometriosis and stage III–/IV endometriosis. When we distributed serum and PF levels of HGF according to different color appearances of endometriosis, we found a significantly higher serum and PF levels of HGF in women containing dominant red peritoneal lesions in pelvic cavity (740±/109.3 pg/mL for serum; 1685±/183.4 pg/mL for PF) than those having other pigmented lesions (649±/79.5 pg/mL, p < /0.05 for serum; 1224±/67.8 pg/mL, p < /0.05 for PF) or chocolate cysts (485±/43.1 pg/mL, p < /0.05 for serum; 1118±/ 83.1 pg/mL, p < /0.01 for PF). Exogenous stimulation with LPS significantly increased the production of HGF in the culture media by macrophages and stroma derived from women with endometriosis than that in women without endometriosis.Conclusions. These results suggest that women with early or advanced endometriosis as measured by r‐ASRM scoring system are not associated with an increase in either serum or PF concentrations of HGF. Rather HGF levels in serum and PF were significantly increased in women harboring blood‐filled red peritoneal lesions and may be clinically useful to predict the activity of pelvic endometriosis.
Effectiveness and safety of a new vaginal misoprostol product specifically labeled for cervical ripening and labor induction
Authors: Guilherme Cecatti José , Porto Tedesco Ricardo , Maria Besteti Pires Helaine , Matos Calderon Iracema , Faúndes Aníbal 
Published: December 2009

AbstractObjective. The purpose of this study was to evaluate the effectiveness and safety of misoprostol in two different formulations: vaginal tablets of 25 μg and one‐eighth of a 200‐μg oral tablet, also administered intravaginally, for cervical ripening and labor induction of term pregnancies with an indication for that. Methods. A single‐blind, randomized, controlled clinical trial was carried out in 120 pregnant women who randomly received one of the two formulations. The main dependent variables were mode of delivery, need for additional oxytocin, time between beginning of induction and delivery, perinatal results, complications, and maternal side effects. Student's t, Mann–Whitney, χ2, Fisher's Exact, Wilcoxon and Kolmogorov‐Smirnoff tests, as well as survival analysis, were used in the data analysis. Results. There were no significant differences between the groups in terms of general characteristics, uterine contractility, and fetal well‐being during labor, cesarean section rates, perinatal outcomes, or maternal adverse events. The mean time between the beginning of cervical ripening and delivery was 31.3 h in the vaginal tablet group and 30.1 h in the oral tablet group, a difference that was not statistically significant. Conclusion. The results showed that the 25‐μg vaginal tablets of misoprostol were as effective and safe for cervical ripening and labor induction as the dose‐equivalent fraction of 200‐μg oral tablets.
Risk factors for bacterial vaginosis in pregnancy: a population‐based study on Danish women
Authors: Thorsen Poul , Vogel Ida , Molsted Kirsten , Jacobsson Bo , Arpi Magnus , Møller Birger R. , Jeune Bernard 
Published: December 2009

AbstractBackground. No larger population‐based study of bacterial vaginosis in pregnancy has previously been available. The objective of this study was to examine risk factors for bacterial vaginosis in pregnancy. Design. From a prospective population‐based cohort of 3,596 eligible pregnant women, 2,927 (81.4%) completed the study. Methods. Women were asked to participate in this study at their first prenatal visit at 17 gestational weeks (range 7 + 3–24 + 0). Samples from the genital tract were taken at enrolment. Bacterial vaginosis was determined by Amsel's clinical criteria (3 out of 4: pH > 4.5, homogenous discharge, clue cells, and positive amine test). Data were collected from three questionnaires completed during the second and third trimesters and correlated with the diagnosis of bacterial vaginosis. Crude and adjusted relative risks (reproductive, medical, behavioral, sexual, and sociodemographic factors) were computed. Results. At enrolment, bacterial vaginosis was diagnosed in 13.7% of Danish pregnant women. Significant risk factors for bacterial vaginosis were: daily coitus (adjusted relative risk 2.09 [1.43–3.04]), being single (1.76 [1.21–2.56]), smoking more than 10 cigarettes daily at conception (1.59 [1.29–1.93]), previous genital infection with Chlamydia trachomatis or Neisseria gonorrhoeae (1.39 [1.07–1.79]), and consuming 2 or more drinks per week (1.33 [1.02–1.74]) after control for confounding factors. Conclusion. In pregnancy, women who have daily coitus, are single, smokers, with a previous sexually transmitted disease, or with high alcohol consumption in pregnancy are at increased risk for bacterial vaginosis. Information on these risk factors may be important when planning preventive and treatment strategies of bacterial vaginosis in pregnancy.
Obstetric outcome in post‐term pregnancies: time for reappraisal in clinical management
Authors: Hovi Minna , Raatikainen Kaisa , Heiskanen Nonna , Heinonen Seppo 
Published: December 2009

AbstractBackground. The objective of this study was to determine the outcome of pregnancy in post‐term cases compared with term cases in a well defined population receiving modern obstetric care. Methods. We utilized the population‐based birth registry data of the Kuopio University Hospital (1990–2000) to investigate pregnancy outcome in 1,678 post‐term singleton pregnancies. The general obstetric population (n=22,712) was used as a reference group in logistic regression analysis. Results. The overall frequency of post‐term pregnancies was 6.9% and the incidence of post‐term pregnancies was found to be increased in obese, primiparous, and smoking women, whereas in women with chronic diseases and obstetric risks deliveries were induced earlier. The risks of macrosomia, maternal complications, and operative deliveries were increased in post‐term pregnancies. Post‐term infants experienced meconium passage (21.2% versus 12.8%) (p<0.01) and intrapartum asphyxia (3.4% versus 2.1%) (p<0.01) significantly more often than the controls. However, the stillbirth rate was low, probably due to careful monitoring of these pregnancies. Conclusions. Although high‐risk pregnancies were not allowed to come post‐term, postmaturity per se is a moderate risk state compromising fetal well‐being with regard to meconium passage and acid–base status at birth. We conclude that simple antenatal monitoring beyond 42 weeks reduces perinatal mortality but is inefficient in reducing meconium‐stained liquor seen with increasing gestation.
Detection of fetal structural abnormalities by an 11–14‐week ultrasound dating scan in an unselected Swedish population
Authors: Cedergren Marie , Selbing Anders 
Published: December 2009

AbstractBackground. To determine the detection rate of fetal structural abnormalities by a routine 11–14‐week ultrasound scan for dating in an unselected pregnant population. Methods. A prospective observational cohort study of 2,708 unselected pregnant women attending an abdominal ultrasound examination at 11–14 weeks gestation. The number of major fetal structural abnormalities diagnosed after birth was obtained from a computerized database at the same unit. Results. Out of 2,708 pregnant women, 89 (3.3%) were found to have a missed abortion at the time of the ultrasound scan and 33 (1.2%) were diagnosed as twins. Thirteen major structural abnormalities were detected, three cases of anencephaly (one case also had a spina bifida), one case with hydranencephaly, one fetus with Dandy‐Walker syndrome, two cases with gastroschisis, one case with a bilateral hydronephrosis, one case with a generalized hydrops, one fetus with multiple malformations, and three cystic hygromas. An additional 19 major structural defects were detected at birth. Four cases of neural tube defects and nine fetuses with congenital heart defects were diagnosed. The antenatal ultrasound detection rate was 40.6% (13/32). Nine patients had a nuchal translucency greater than 3.0 mm (excluding cystic hygromas); two of them had chromosomal abnormalities (trisomy 21 and trisomy 18). Conclusions. Fetal structural abnormalities were detected in 41% (95%CI = 24–59) of the cases in an unselected pregnant population at a routine 11–14‐week ultrasound scan for dating purpose. Two out of nine fetuses with a nuchal translucency greater than 3.0 mm had a chromosomal abnormality.
Clinical presentation and risk factors of placental abruption
Authors: Tikkanen Minna , Nuutila Mika , Hiilesmaa Vilho , Paavonen Jorma , Ylikorkala Olavi 
Published: December 2009

AbstractBackground. To study the risk factors of placental abruption during the index pregnancy. Methods. One hundred and ninety‐eight women with placental abruption and 396 control women were identified among 46,742 women who delivered at a tertiary referral university hospital between 1997 and 2001. Clinical variables were compared between the groups. Multivariate logistic regression analysis was applied to identify independent risk factors. The clinical manifestations of placental abruption were also studied. Results. The overall incidence of placental abruption was 0.42%. The independent risk factors were maternal (adjusted OR 1.8; 95% CI 1.1, 2.9) and paternal smoking (2.2; 1.3, 3.6), use of alcohol (2.2; 1.1, 4.4), placenta previa (5.7; 1.4, 23.1), pre‐eclampsia (2.7; 1.3, 5.6), and chorioamnionitis (3.3; 1.0, 10.0). Vaginal bleeding (70%), abdominal pain (51%), bloody amniotic fluid (50%), and fetal heart rate abnormalities (69%) were the most common manifestations. Neither bleeding nor pain was present in 19% of the cases. Overall, 59% had preterm labor (OR 12.9; 95% CI 8.3, 19.8), and 91% were delivered by cesarean section (34.7; 20.0, 60.1). Of the newborns, 25% were growth restricted. The perinatal mortality rate was 9.2% (OR 10.1; 95% CI 3.4, 30.1). Retroplacental blood clot was seen by ultrasound in 15% of the cases. Conclusions. Maternal alcohol consumption and smoking, and smoking by the partner turned out to be independent risk factors for placental abruption. Smoking by both partners multiplied the risk. The liberal use of ultrasound examination contributed little to the management of women with placental abruption.
Elevated amniotic fluid leptin levels in pregnant women who are destined to develop preeclampsia
Authors: CHAN TE‐FU , SU JINU‐HUANG , CHUNG YUEH‐FANG , HSU YU‐HSIN , YEH YAO‐TSUNG , YUAN SHYNG‐SHIOU F. 
Published: December 2009

AbstractObjective. To analyze whether leptin levels of the amniotic fluid elevate during early pregnancy in women destined to develop preeclampsia and to evaluate the relationship between amniotic fluid leptin levels and gestational age, maternal body mass index, and fetal sex. Study design. Leptin levels of the amniotic fluid were compared in two groups of women, preeclamptic (n=20) and normotensive pregnant (n=40), matched for fetal sex, maternal body mass index at sampling, gravidity and fetal gestational age at sampling. Furthermore, amniotic leptin levels in 400 normotensive pregnant women were analyzed for their correlation with gestational age, maternal body mass index, and fetal sex. Results. Median leptin concentrations were significantly higher (p<0.001) in the women with preeclampsia (7.3±0.7 ng/ml) than in the normotensive pregnant women (4.1±0.3 ng/ml), independent of fetal sex. The leptin levels in the amniotic fluid decreased with advanced gestational age (r=0.24, p<0.001). Amniotic fluid leptin levels in the pregnant women carrying a female fetus (5.6±0.3 ng/ml) were significantly higher than those carrying a male fetus (4.7±0.2 ng/ml) (p = 0.004). Conclusion. Higher amniotic fluid leptin levels were observed in the preeclamptic pregnant women, and they decreased as gestational age advanced. Furthermore, the women with a female fetus were noted to have higher amniotic fluid leptin levels.
Can pelvic floor muscle training prevent and treat pelvic organ prolapse?
Authors: BØ KARI 
Published: December 2009

AbstractBackground and methods. Pelvic floor muscle dysfunction may cause urinary and fecal incontinence, pelvic organ prolapse (POP), pain, and sexual disturbances. The aim of the present study is to review the literature on the effectiveness of pelvic floor muscle training (PFMT) to prevent and treat POP, and the possible theories and mechanisms on how PFMT could prevent or reverse prolapse. Results. No studies were found on prevention of POP. One uncontrolled study and one low‐quality RCT were found in the treatment of prolapse. The results showed a positive effect of PFMT in severe, but not in mild prolapse. A review is presented of the main hypothesis of mechanisms on how PFMT may be effective. The two mechanisms are morphological changes occurring after strength training and use of a conscious contraction during increase in abdominal pressure in daily activities. Conclusions. In addition to the theory of functional anatomy and exercise science, one randomized controlled trial (RCT) is supportive for a positive effect of PFMT in the treatment of POP. There is an urgent need for more RCT with high methodological quality, use of valid and reproducible methods to assess degree of prolapse, and appropriate training protocols to evaluate the effect of PFMT in the prevention and treatment of POP.
Distension of painful structures in the treatment for chronic pelvic pain in women
Authors: Heyman J. , Öhrvik J. , Leppert J. 
Published: December 2009

AbstractBackground. There is a lack of established treatment for Chronic pelvic pain (CPP), defined as acyclic pain of at least six months duration. We decided to study the pain‐alleviating effects of stretching on defined structures in women with CPP, and the treatment's impact on quality of life variables.Design of study. An open, randomized study.Setting. Primary Health Care Centre, Kolbäck, Sweden.Methods. Fifty women, median age 33 years (range 19–54), complaining of CPP for a median duration of 25.5 months (range 6–264) were randomly assigned to either a treatment or a control group. A short questionnaire containing 17 questions was administered before randomization and two to three weeks after a second treatment of distension of pelvic structures. Visual analog scales were used for questions concerning intensity of pain and quality of life. Five‐point scales were used for questions dealing with duration and frequency of pain.Results. Intensity, frequency and duration of pelvic pain, painful intercourse, lower back pain, sleep disturbance, sleep quality, mental fatigue, depression, mood and anger improved significantly more in the treatment group than in the control group. Treatment proved more effective than counseling as reflected by self‐rating scales: pain intensity (OR 18.37, 95% CI 3.39–99.64) and pain during intercourse (OR 8.59, 95% CI 1.57–46.68).Conclusion. In this open, randomized study, distension of painful pelvic structures in women with CPP resulted in significant relief of pain and improvement in quality of life measures.
Hysterectomy and incontinence: a study from the Swedish national register for gynecological surgery
Authors: Ellström Engh Marie A. , Otterlind Lena , Stjerndahl Jan‐Henrik , Löfgren Mats 
Published: December 2009

AbstractBackground. Hysterectomy is one factor that has been suggested to be a risk factor for developing stress incontinence. In Sweden, with a population of 8.86 million, a national register was set up in 1997 in order to have data for assessing the quality of gynecological surgery for benign disorders. Methods. Data in the Swedish national register for gynecological surgery during the period 1997–2002 were investigated. Surgical methods compared during this time period were: total hysterectomy (abdominal/laparoscopic, n=198/116), subtotal hysterectomy (abdominal/laparoscopic, n=163/86), and total hysterectomy (vaginal/laparoscopic assisted vaginal, n=265/7). Patients who underwent endometrial destruction (endometrial ablation, endometrial balloon treatment, n=187) were used as a control group. Only patients with no preoperative complaints were included. Outcome measures were answers to subjective questions asked pre‐ and postoperatively regarding urinary problems and incontinence. Results. De novo symptoms of stress incontinence, urgency and urgency incontinence, and/or mixed incontinence were noted in all groups. No differences were found among the groups. Conclusion. Factors other than hysterectomy should be discussed causing stress incontinence in women.
Prevalence and impact of premenstrual syndrome in adolescent schoolgirls in the United Arab Emirates
Authors: Rizk Diaa E.E , Mosallam Moza , Alyan Syfian , Nagelkerke Nico 
Published: December 2009

AbstractBackground. Our objective was to determine the prevalence, sociodemographics, and impact of premenstrual syndrome in adolescent schoolgirls in the United Arab Emirates, as there are no national data on this subject.Methods. Adolescent girls aged 12–18 years who were at least 1 year postmenarchal were selected from five private and five public schools (n=70×10 = 700) in Al‐Ain city using a multistage stratified cluster‐sampling technique. Subjects were interviewed about cyclic and recurrent behavioral and somatic premenstrual symptoms during the last 3 months based on the American College of Obstetricians and Gynecologists’ criteria and their impact on quality of life using a structured and validated questionnaire.Results. The prevalence of premenstrual syndrome was 16.4% (n=115). On logistic regression analysis, premenstrual syndrome was significantly associated with Emirati nationality (p=0.001), presence of the condition in sister(s) (p=0.002), and dysmenorrhea (p<0.001). Only 52 affected subjects (45.2%) were currently taking treatment for premenstrual syndrome and the majority (60%) used pharmacological therapy. Premenstrual syndrome had a moderate but significant negative impact (p<0.001) on the quality of life of affected girls, particularly school performance, social interactions, lifestyle, and emotional well‐being. Difficulty in performing school functions and decrease in stigma were the two most adversely affected parameters.Conclusion. Premenstrual syndrome is a prevalent, yet undertreated, disorder in adolescent schoolgirls in the United Arab Emirates, which adversely affects their emotional well‐being and educational performance, representing a significant public health problem. Premenstrual syndrome is significantly associated with ethnicity, family history, and dysmenorrhea in this group.