bluuebunny/crossref_metadata_2025_split huggingface dataset:
Methods for myometrium closure and other factors impacting effects on cesarean section scars of the uterine segment detected by the ultrasonography
Authors: HAYAKAWA HIROMI , ITAKURA ATSUO , MITSUI TAKASHI , OKADA MAYUMI , SUZUKI MASAKI , TAMAKOSHI KOJI , KIKKAWA FUMITAKA 
Published: December 2009

AbstractObjective. Ultrasound examination is an objective method for assessment of uterine scar defects. The present study was conducted to compare single‐layer interrupted sutures (Group A) with double‐layer interrupted sutures (Group B) and our new method (Group C) as well as other perioperative parameters in relation to risk of wedge defects in scars. Methods. We have introduced a new myometrium closure procedure consisting of continuous suture with decidual closure followed by interrupted myometrium suture. In this prospective study, women undergoing cesarean operation (n=137) were examined by transvaginal ultrasound one month after surgery to assess the appearance of lower uterine scars. Multivariate logistic regression analysis was performed to identify associations of perioperative parameters and methods for lower myometrium closure with abnormal wedge formation. Results. Wedge defects were observed in a total of 27 patients (19.7%). The analysis revealed Groups B and C to have reduced risks with odds ratios of 0.28 and 0.077, respectively, as compared to Group A. Furthermore, increasing gestational week at delivery, plural fetal pregnancies, premature rupture of membranes and pre‐eclampsia were also linked with an increased risk, with odds ratios of 1.4–8.9. Conclusion. The incidence of uterine scar defects 1 month after cesarean sections varies with the method applied for myometrial suture and perioperative variables. The data suggest that methods for myometrium closure as well as other factors influence the condition of myometrial healing.
Symphysis–fundus measurements for detection of small for gestational age pregnancies
Authors: BERGMAN EVA , KIELER HELLE , PETZOLD MAX G. , SONESSON CHRISTIAN , AXELSSON OVE 
Published: December 2009

AbstractBackground. In Sweden measurements of the symphysis–fundus (SF) distance are used to detect small for gestational age (SGA) pregnancies. The aim of this study was to evaluate the efficiency of Swedish ultrasound‐based SF reference curves in detecting SGA pregnancies.Methods. To assess the sensitivity for detection of SGA pregnancies we performed a case–control study. Through the Swedish Medical Birth Register we identified all singleton SGA infants born in Uppsala in 1993–1997 and randomly recruited non‐SGA singleton infants as controls. We included 169 term and 73 preterm SGA cases and 296 controls, all born at term. The reference curves constructed by Steingrimsdottir (S curve) and Kieler (K curve) were evaluated. Gestational age at the first alarm in the preterm SGA group was recorded.Results. In term pregnancies the S curve showed a sensitivity of 32% and specificity of 90% at a cut‐off of −2 SDs. The corresponding values for the K curve were 51% and 83%, respectively. In preterm SGA pregnancies the sensitivity of the S curve was 49% and of the K curve 58%. The first alarm below 2 SDs was noted before 32 weeks in 37% with the S curve and 43% with the K curve for preterm SGA pregnancies.Conclusions. Both tested Swedish SF reference curves had low sensitivities for term SGA pregnancies. Sensitivity was higher for the preterm group and SF measurements seem to be better for detecting the most severe cases of SGA.
Effectiveness of cervical cancer screening in Iceland, 1964–2002: a study on trends in incidence and mortality and the effect of risk factors
Authors: SIGURDSSON KRISTJAN , SIGVALDASON HELGI 
Published: December 2009

AbstractBackground. Data on cervical cancer screening programs that have covered a whole nation over a prolonged time are scarce. The effectiveness of a 40‐year established nationwide cervical screening program has been evaluated to define optimal age limits and screening intervals. Methods. Trends in incidence and mortality by calendar time, age, histology, stage and attendance during 1964–2002 and the predictive power of calendar year, age, stage and histology on the cause‐specific mortality rate were analyzed. Results. The rate of squamous cell carcinoma decreased significantly, but the rate of adenocarcinoma increased. The age‐specific incidence and cause‐specific mortality decreased significantly for all age groups except those women aged 20–29 years. An increased age‐specific incidence rate, confined to stage I, was observed in the age group 20–39 years after 1980 and a positive correlation was observed between early attendance and the rate of microinvasive squamous (stage IA) cell carcinoma and adenocarcinoma in this age group. The cumulative incidence of invasive disease started to increase two years after the last negative smear. Stage was the strongest risk factor, followed by age and calendar time, and to a lesser degree histology. Conclusions. The results confirm the effectiveness of the screening program and support the recommendation that screening should commence below age 25 with a maximum of 3‐year initial screening intervals. The interval can then be extended after age 40 and stopped after age 65.
Performance of acupuncture as labor analgesia in the clinical setting
Authors: NESHEIM BRITT‐INGJERD , KINGE RAGNHILD 
Published: December 2009

AbstractBackground. Three randomized controlled trials have shown that acupuncture during labor can reduce the use of epidural analgesia and meperidine. To supplement these trials, we have designed an observational study to answer the research question: “Do laboring women in a normal hospital setting who receive acupuncture require less epidural analgesia than those who do not receive acupuncture?”Methods. Setting: Delivery ward of a tertiary care University hospital in Norway. Subjects: All attempted vaginal labors during the period 01.12.99–31.12.03 (n=17,741). Statistical analysis: Multivariate logistic regression analysis.Results. The dependent variable in the regression analysis was use of epidural analgesia. The independent variables were: use of acupuncture, use of nitrous oxide, use of meperidine, parity, ethnicity, age, duration of pregnancy, type of labor (induced or not), and duration of first stage of labor. In the multivariate analysis the odds ratio for having an epidural was 0.6 (95% CI 0.5–0.7) for the patients having acupuncture compared to those not having acupuncture.Conclusions. Women having acupuncture as labor analgesia in the clinical setting have a reduced use of epidural analgesia.
COX‐2 and preoperative CA‐125 level are strongly correlated with survival and clinical responsiveness to chemotherapy in ovarian cancer
Authors: RASPOLLINI MARIA ROSARIA , AMUNNI GIANNI , VILLANUCCI ALESSANDRO , BODDI VIERI , TADDEI GIAN LUIGI 
Published: December 2009

AbstractBackground. CA‐125 is elevated in the serum of the majority of ovarian carcinoma patients. Cyclooxygenase‐2 is an enzyme whose synthesis is upgraded by several cytokines, growth factors, and tumor promoters. Methods. We analyzed cyclooxygenase‐2, preoperative CA‐125 levels, and CA‐125 levels during chemotherapy in 41 FIGO stage III, grade 3, ovarian serous carcinoma patients in relation to survival with a logistic regression. The correlation of cyclooxygenase‐2 expression and CA‐125 preoperative level with clinical responsiveness to chemotherapy was studied according to Fisher's exact test. We compared 23 patients living with no evident disease five years after primary treatment to 18 patients who had died of progression of disease no later than two years after primary treatment. Results. Cyclooxygenase‐2 overexpression (p=0.014 and p=0.036) and preoperative CA‐125 level (p=0.012 and p=0.029) were found to be independent predictors of survival in univariate and multivariate analyses. Cyclooxygenase‐2 and CA‐125 level were correlated to responsiveness to chemotherapy (p=0.003 and p=0.036, respectively; Fisher's exact test). The patients with a CA‐125 level <35 U/ml after two cycles of chemotherapy showed a longer survival (p=0.008). The median preoperative CA‐125 was 195 in high survival patients and 650 in low survival patients (p=0.004, Wilcoxon Mann–Whitney test). Conclusions. Cyclooxygenase‐2 overexpression and CA‐125 levels may help the management of ovarian cancer patients, permitting the selection of more aggressive and tailored first‐line therapy.
Chronic hypertension as a risk factor for offspring to be born small for gestational age
Authors: Zetterström Karin , Nordén Lindeberg Solveig , Haglund Bengt , Hanson Ulf 
Published: December 2009

AbstractBackground. Chronic hypertension during pregnancy is associated with an increased risk for birth of small for gestational age offspring. The aim of this study was to determine whether the risk remains after consideration of maternal characteristics and superimposed pre‐eclampsia. Method. A population‐based cohort study based on the Swedish Medical Birth Register 1992–98 and comprising 560 188 women aged 15–44 years with singleton pregnancies including 2,754 women with chronic hypertension. The register contains data of maternal characteristics besides maternal and fetal complications. Multiple logistic regression analysis was used. Small for gestational age was defined as birth weight less than −2SD adjusted for gestational age and sex. Results. Chronic hypertensive women have an independent risk for small for gestational age (OR 3.1; 95% CI 2.7–3.7) when controlling for confounding of maternal characteristics such as age, parity, BMI, smoking, and ethnical origin. After introducing superimposed pre‐eclampsia in the model the risk remains but decreases (OR 2.4; 95% CI 2.1–2.9). Conclusion. Chronic hypertension is an independent risk factor for birth of small for gestational age offspring. Pre‐eclampsia is a strong mediating factor.
Bishop score and the outcome of labor induction with misoprostol
Authors: Szczesny Witold , Kjøllesdal Møyfrid , Karlsson Bengt , Nielsen Sven 
Published: December 2009

AbstractBackground.The aim of the study was to retrospectively identify possible factors for predicting the outcome of induction with misoprostol.Methods.Fifty micrograms of misoprostol were administered intravaginally every 6 h during the first 2 days of induction, up to a maximum of 4 doses. The Bishop score, indication for induction, gestational length, maternal age, and parity were analyzed. The study involved 99 patients (47 primiparous and 52 multiparous) at term (>36 weeks of gestation) with unripe cervices.Results.Forty‐five per cent of the patients achieved ripening of cervix and went into labor after a single dose of misoprostol; a further 45% required 2 doses. Nine patients received more than 2 tablets. Ninety‐seven per cent of all vaginal deliveries occurred within the first 2 days of induction. Ninety‐five per cent of the patients delivered vaginally when the Bishop score was >3, compared with 75% of those with a Bishop score of ≤3 (p=0.003). Among factors creating the Bishop scoring system, in logistic regression analysis effacement of the cervix was the only independent, significant predictor of cesarean section (p=0.003, OR = 0.16) even after adjusting for maternal age, which also was a significant predictor in the regression analysis. Eleven patients had previously had a cesarean section; one of them had a uterine rupture with a fatal outcome for the fetus. All women with a previously scarred uterus are now excluded from misoprostol treatment.Conclusion.Misoprostol 50 μg administered intravaginally every 6 h according to this protocol is highly effective for inducing labor in carefully selected patients with unripe cervices.
Depression in women with endometriosis with and without chronic pelvic pain
Authors: LORENÇATTO CAROLINA , PETTA CARLOS ALBERTO , JOSÉ NAVARRO MARIA , BAHAMONDES LUIS , MATOS ALESSANDRA 
Published: December 2009

AbstractAim. The aim of the study is to compare the prevalence of depression in women surgically diagnosed with endometriosis according to the presence or absence of pelvic pain. Methods. This cross‐sectional prospective study evaluated 100 women receiving care at the Outpatients’ Clinic for Endometriosis, Department of Obstetrics and Gynecology, Universidade Estadual de Campinas (UNICAMP), Campinas, São Paulo, Brazil, equally divided into two groups: one suffering from chronic pelvic pain and the other pain‐free. The Beck Depression Inventory was used in order to measure depression. Results. Depression was detected in 86 and 38% of the women with and without chronic pelvic pain, respectively. Complaints of depression, such as somatic concerns, work inhibition, dissatisfaction, and sadness, were observed at a significantly higher rate in the group with pain. A sensation of failure was the only variable observed more frequently in the pain‐free group. Conclusions. Depression is highly prevalent in women with endometriosis, especially those with pelvic pain. Careful evaluation can identify women with depression who may benefit from treatment.
The Pregnancy Mobility Index: a mobility scale during and after pregnancy
Authors: van de Pol G. , de Leeuw J.R.J. , van Brummen H.J. , Bruinse H.W. , Heintz A.P.M. , van der Vaart C.H. 
Published: December 2009

AbstractBackground. During pregnancy, every second woman will experience some degree of back or pelvic pain. While several validated instruments to assess back pain exist for the general population, these are not suitable for application in a pregnant population and have not been validated for this purpose. A pregnant population not only differs from the general population regarding the type of back pain – frequently a pelvic girdle component is added – but pregnant women also have different mobility patterns and expectations. We therefore present in this study a self‐report mobility scale specifically designed for a pregnant population: the Pregnancy Mobility Index. Methods. Longitudinal cohort study including 672 nulliparous women with a singleton low‐risk pregnancy. The Pregnancy Mobility Index consists of items concerning day‐to‐day activities selected through literature research and clinical experience. Participating women completed the questionnaire at 12 and 36 weeks’ gestation and one year after delivery. Reliability, construct and criterion validity were tested. Results. The internal consistency (Cronbach's alpha) was 0.8 or higher. The Pregnancy Mobility Index scales correlated best with the physical and pain scale of the RAND‐36, indicating a good construct validity. The assumptions that the Pregnancy Mobility Index scores increase during pregnancy and decrease after delivery and that women with back or pelvic problems scored higher on the Pregnancy Mobility Index domains than women without back or pelvic pain were confirmed, indicating a good criterion validation. Conclusion. The Pregnancy Mobility Index has been shown to be a reliable and valid questionnaire well suited for use during and after pregnancy.
Grandparents’ age and the risk of Down's syndrome in Norway
Authors: KAZAURA METHOD R. , LIE ROLV T. , SKJÆRVEN ROLV S. 
Published: December 2009

AbstractBackground. High maternal age is a well‐recognized risk factor for Down's syndrome. There are also several studies of a possible effect of paternal age, but no consistent evidence of an association is found. Less is known about any effects of the age of grandparents. Objective. To assess whether maternal or paternal grandparents’ age is associated with the risk of Down's syndrome. Methods. We used logistic regression analyses with data from the Medical Birth Registry of Norway, adjusting for possible confounding factors. Results. We found no evidence of an association with the risk of Down's syndrome either for a maternal grandmother's age (odds ratio 0.9, 95% confidence interval 0.6–1.5 per 10‐year increase in grandmother's age) or for any of the other grandparents’ age. Conclusions. High maternal age remains the only well‐established age‐related risk factor for Down's syndrome. There is little evidence that the increased risk represented by older mothers is passed on to offspring of her non‐affected daughters.
Correlations between umbilical and maternal serum resistin levels and neonatal birth weight
Authors: Cho Geum Joon , Yoo Sang Wook , Hong Soon Cheol , Oh Min‐Jeong , Kim Tak , Kim Hai Joong , Lee Kyu Wan , Kim Sun Haeng 
Published: December 2009

AbstractObjective. Resistin is a novel hormone secreted by human adipocytes and mononuclear cells. It is expressed in the human placenta, and has been postulated to play a role in the regulation of energy metabolism during pregnancy. However, correlations between umbilical and maternal serum resistin levels and neonatal birth weight remain poorly understood. The purpose of the study was to clarify the correlation between umbilical cord and maternal serum resistin levels and neonatal birth weight. Materials and methods. This study included 37 healthy mothers, neonates. Resistin levels were determined by ELISA, and compared for correlation between umbilical cord and maternal serum resistin levels and neonatal birth weight. Results. The ranges of resistin levels for umbilical and maternal sera were 10.61–40.81 and 1.14–25.54 ng/ml, respectively. Mean umbilical serum resistin level (21.34±1.07 ng/ml) was significantly higher than maternal serum resistin level (10.13±1.12) (p<0.001). Umbilical serum resistin levels were positively correlated with maternal serum resistin levels (r=0.607, p<0.001) and negatively with neonatal birth weight (r= − 0.345, p=0.037). No significant differences in resistin levels were discovered between the female and male neonates. In addition, there were no correlation between the umbilical resistin levels and maternal body mass indices, umbilical leptin levels, or insulin levels. Conclusions. It is suggested that resistin not only affects energy homeostasis by existing in high levels in the fetus, but may play an important role in controlling body weight through effective regulation of adipogenesis by negative feedback.
Pregnancy complications by overweight and residential area. A prospective study of an urban Norwegian cohort
Authors: Clausen Torun , Øyen Nina , Henriksen Tore 
Published: December 2009

AbstractBackground. Health varies in residential areas of different socioeconomic status in the capital of Norway. This study compares risks of pregnancy complications in Oslo according to prevalence of overweight and areas of residency. Methods. Prospective cohort study of 3,677 pregnancies. Pregnancy outcomes were retrieved from medical records after delivery. Statistics were performed by logistic regression analyses. Results. Pregnant women from areas of lower socioeconomic status (Oslo East) had higher prevalence of overweight than women from areas of higher status (Oslo West). Dose–response relationships were found between body mass index and increased risk of pregnancy complications (pre‐eclampsia, gestational hypertension, gestational diabetes mellitus, macrosomia, cesarean deliveries, acute cesarean deliveries, transfer of the newborn to neonatal intensive care unit). Comparing Oslo East with Oslo West the relative risks of pregnancy complications were 1.8 for pre‐eclampsia, 1.6 for gestational diabetes, 1.4 for acute cesarean deliveries, 1.6 for low birth weight (≤2,500 g) and 1.5 for transfer to neonatal intensive care. Adjustment for body mass index did not change the increased risks of pre‐eclampsia, acute cesarean deliveries, low birth weight, or transfer to neonatal intensive care among Oslo East women. Only the increased risk of gestational diabetes could partially be explained by higher body mass index. Conclusions. Residential areas of lower socioeconomic status had higher risk of pregnancy complications. Overweight was a strong independent predictor of pregnancy complications. The higher prevalence of overweight in Oslo East could, however, not explain the increased risk of pregnancy complications.
Randomized study on removable PGE2 vaginal insert versus PGE2 cervical gel for cervical priming and labor induction in low‐Bishop‐score pregnancy
Authors: STROBELT NICOLA , MEREGALLI VIRGINIO , RATTI MARTA , MARIANI SILVIA , ZANI GIULIA , MORANA SERENELLA 
Published: December 2009

AbstractBackground. Dinoprostone vaginal insert has been compared to Dinoprostone cervical gel in few studies, whose cases presented different Bishop scores and gestational ages at admission, and various treatment strategies in control arms. The present study compares the vaginal insert to the cervical gel in patients with low Bishop score at term. Methods. Prospective multicenter randomized trial, with parity‐based randomization. Admission criteria: single pregnancy with Bishop score of 0–4, gestational age of 37–41 weeks, intact membranes, no previous cesarean section, no bleeding or abnormal cardiotocography at admission. Results. Vaginal prostaglandins were required as a second‐line induction procedure in 25% of study patients versus 47.1% of controls (p<0.03, κ2). Study patients experienced shorter induction‐to‐delivery time (920±428 versus 1,266±740 min, p<0,01), with a mean difference of 5 h and 46 min between the groups. Even though patients that received vaginal insert showed a trend of increased incidence of abnormal cardiotocography during labor (12% versus 6.3%) and hyperkinetic labor (11.8% versus 2.1%), the incidence of cesarean sections (21.4% versus 21.6%), cesareans for fetal distress (12.5% versus 11.8%), and umbilical artery pH < 7.10 (4.9% versus 2.5%) was comparable between the two groups. Conclusions. Dinoprostone vaginal insert is more efficient than cervical gel in promoting cervical priming and labor induction in low‐Bishop‐score patients at term. The vaginal insert placement seems to be safe for the mother and the newborn, although larger studies are required to investigate uterine hyperstimulation incidence.
Childbearing and the desire to have children among university students in Finland
Authors: VIRTALA AIRA , KUNTTU KRISTINA , HUTTUNEN TEPPO , VIRJO IRMA 
Published: December 2009

AbstractBackground. The fertility rate in Europe is low and there is concern over the low birth rate in relation to the aging population. The age of childbearing women has increased and infertility is a growing problem. Highly educated women in Finland suffer from childlessness more often than less educated women. The aim of this study was to establish Finnish university students’ actual and desired number of children, and compare the economic and educational situations of students with and without children. Methods. The study population consisted of Finnish undergraduate students under 35 years of age. The randomly selected sample was 5,030 subjects. The data were collected by postal questionnaire, the response rate being 62.7%. Frequency distributions, cross‐tabulations, and descriptive statistics were used. Categorical variables were tested by the Cochran‐Mantel‐Haenzel test. Results. 7.5% of students had children. Almost 90% desired to have children. Parenthood did not correlate negatively with satisfaction with financial situation or completed studies. Conclusion. University students are seldom parents, though they are at the ideal age for childbearing and the majority desire to have children. The risk of unintended childlessness exists, when pregnancies are postponed because of unfinished studies.