bluuebunny/crossref_metadata_2025_split huggingface dataset:
Measurement of cardiac stroke volume by impedance cardiography in the last trimester of pregnancy
Authors: Milsom I. , Forssman L. , Sivertsson R. , Dottori O. 
Published: December 2009

Abstract. Simultaneous determination of cardiac stroke volume by impedance cardiography and the dye dilution technique was compared in 10 women during the last trimester of pregnancy. Measurements were performed in different body positions to investigate the influence of body position on stroke volume.The correlation coefficient for all measurements was 0.87. Mean stroke volume determined by impedance cardiography was significantly (p<001) lower than mean stroke volume calculated by the dye dilution technique. There was no significant difference between the mean change in stroke volume determined by the two techniques during serial measurements. The reproducibility of individual impedance‐determined stroke volumes (6.1 ml) did not differ significantly from individual values obtained by dye dilution (9.3 ml).Maximum mean impedance‐determined stroke volume was recorded in the left lateral position (83.8 ±4.0 ml). Mean stroke volume was significantly (p<0.01) reduced in the supine position (17.9%). A smaller (14.4%) reduction was registered in the right lateral position. These changes in stroke volume according to body position were equally evident by both methods.Impedance cardiography is a safe, reliable, non‐invasive technique for the measurement of changes in stroke volume during late pregnancy. The ability of impedance cardiography to determine changes in stroke volume was unaffected by changes in body position.
Cytoplasmic Progestin Receptors in Myomal and Myometrial Tissues
Authors: Büchi K. A. , Keller P. J. 
Published: December 2009

Abstract. Cytoplasmic progestin receptors in human myo‐metrium and myomata of uteri, both with and without tumors, were determined. The same concentration was found in all tissues when expressed in terms of tissue weight or DNA content. However, tumors had slightly more receptors when calculated per mg of soluble protein. This was due to the fact that myomata contained considerably less soluble protein than the normal myometrium.The receptors present were dependent upon the serum concentration of estradiol. Increasing values were accompanied by an increase in the number of receptors. At estradiol levels exceeding 300 pmoles/1 their number reached a plateau and became independent of the hormone concentration. Progesterone had no influence except at very high levels where it depressed the number of receptors significantly.The investigation did not reveal any difference in the number of or the hormonal regulation of cytoplasmic progesterone receptors present in the various tissues. However, it showed that tumors contained considerably less soluble protein than normal myometrium.
Estriol Screening in Pregnancy
Authors: Nielsen Peter Vest 
Published: December 2009

Abstract. One thousand six hundred and sixty pregnancies were recorded in this investigation. In 1042 women with singleton pregnancies and known term, measurements of the total serum estriol (E3) were made exclusively for the present study. The study was prospective, and the clinicians had no knowledge of the E3 values.Within the screened group a low E3 value entailed a 42% risk of delivering an infant with perinatal complications and a 27% risk of an infant small for gestational age (SGA). 7% of the infants with perinatal complications and 19% of the SGA infants were detected at the screening. In a sub‐group of 800 pregnancies considered normal according to given criteria, a low E3 level involved a 27% risk of perinatal complications and a 15% risk of an SGA infant. Of these cases 4% and 14% respectively had been detected at the screening.It is concluded that the E3 level should be measured on wide indications, but that this test is of little value in pregnancies that are clinically quite normal. Thus, the benefit of screening all apparently normal pregnancies depends upon the extent and thoroughness of the clinical antenatal care.
Maternal and Fetal Serum Prolactin Levels in Cases of Premature Rupture of Membranes
Authors: Ron M. , Beller U. , Ori J. , Ben‐David M. , Palti Z. 
Published: December 2009

Abstract. Serum prolactin levels were measured in maternal and fetal sera immediately post delivery in 20 cases of premature rupture of the membranes and in 20 controls. Fetal serum prolactin levels were 781 ±265 ng/ml in cases of PRM and 737±314 ng/ml in controls. Maternal serum prolactin levels were 504±264 ng/ml in cases of PRM and 731±361 ng/ml in controls. This difference is statistically significant (t=1.81, p<0.05).A probable role of prolactin in maintaining fetal membrane integrity and the probable effect of the difference in maternal serum prolactin concentration in the two groups on the membrans' viscoelastic properties is discussed.
Fetal Activity Acceleration During Early Labor
Authors: Nyholm H. Chr. , Hansen T. , Neldam S. 
Published: December 2009

Abstract. Altogether 59 women (53 normal and 6 high‐risk pregnancies) underwent a fetal activity acceleration determination (FAD) during the first stage of labor. 52 FAD were considered reactive, while 5 were non‐reactive and 2 technically inadequate. Four of the 5 fetuses with a non‐reactive FAD showed signs of fetal compromise during labor and 1 died intra‐uterinely. There were significantly more normal births and non‐compromised fetuses in the FAD reactive group than in the non‐reactive (p< 0.002, χ2‐test), while there were significantly more acute cesarean sections in the non‐reactive group (p<0.001, χ2‐test). Of the 12 vacuum extractions (all in the FAD reactive group) 4 were performed because of prolonged 2nd stage and 8 because of suspected intra‐uterine asphyxia, but all infants did well after delivery, and the umbilical arterial pH was in all cases above 7.15.It is concluded that when a FAD test is reactive in the first stage of labor, one can expect a positive outcome of the birth, whereas a non‐reactive test arouses suspicion of fetal compromise and implies that one must carefully monitor the progress of the birth so that the fetus can be delivered promptly if any sign of late decelerations should appear. A reactive FAD is, on the other hand, rather reassuring for the fetal state.
Hormonal and Cytopathological Changes in Vaginal and Cervical Smears from women undergoing chemotherapy for extragenital Malignant Diseases
Authors: Schachter Alexander , Kopmar Alexander , Avram Erna , Gorodeski Israel G. , Segal Anita 
Published: December 2009

Abstract. The effects of various chemotherapeutic drugs on the squamous epithelium of the cervicovaginal tissues were investigated in a test group of 74 and a control group of 44 women with advanced extragenital malignancy. The cyto‐logical findings were as follows(A) cytohormonal changes reflecting estrogenic withdrawal in pre‐ and postmenopausal women(B) reversible cytopathol'ogical changes reflecting a cytotox‐ic reaction, and(C) absence of premalignant and malignant changes.
Symphysis‐fundus Measurements and Intrauterine Growth Retardation
Authors: Cnattingius Sven , Axelsson Ove , Lindmark Gunilla 
Published: December 2009

Abstract. A prospective study of the clinical value of the symphysis‐fundus (SF) distance was performed on 528 women, all at risk for developing intrauterine growth retardation (IUGR). Four different types of SF curves were observed and denoted as normal, static, catch‐up and low. A normal or static SF curve predicted a normal birthweight (specificity 92%), while a catch‐up or low SF curve identified 79% of the infants with a birthweight below 2 SD for length of gestation.The differences in short‐term morbidity between infants delivered by mothers with normal and pathological SF curves were mainly due to prematurity.We find the SF method to be a useful tool for detection of IUGR. Since correct estimation of gestational age is a prerequisite, we recommend an early ultrasonic measurement on all patients.
Fibrinopeptide a and Intravascular Coagulation in Normotensive and Hypertensive Pregnancy and Parturition
Authors: Wallmo L. , Karlsson K. , Teger‐Nilsson A. C. 
Published: December 2009

Abstract. Fibrinopeptide A (FpA), fibrin monomers, fibrinogen, fibrin degradation products (FDP) and platelets have been studied during pregnancy, parturition and during toxemia and compared with normal nonpregnant controls in order to evaluate thrombin activity under these conditions. We found a significant rise in fibrinopeptide A levels in late pregnancy and even more so during parturition with a maximum immediately after placental expulsion. We also found elevated FpA levels in toxemic patients, but no significant differences from normal pregnancies. Fibrin monomers were more often elevated during delivery and toxemia than during normal pregnancy.One case report concerning a patient with deficient thrombin activation and heavy postpartum bleeding is added.Our studies indicate an increased thrombin activity and fibrinogen turnover in both normal and toxemic pregnancies. During normal childbirth, coagulation activity seemed to reach a maximum immediately after placental separation.
Adenocarcinoma of the Endometrium Stage I
Authors: Philipsen Torben , Nørgård Mogens 
Published: December 2009

Abstract. Survival after treatment of stage 1 endometrial ad‐enocarcinoma was studied in a material of 111 patients, median follow‐up period 6 years.Routine treatment was preoperative intrauterine and vaginal radium followed, in 6 weeks, by total hysterectomy and bilateral salpingo‐oophorectomy.The 5‐year corrected survival after treatment by operation and/or irradiation was 93%, after irradiation alone 87%. A significantly better survival was found in stage la (95%) than in stage Ib (83%) and also in patients with grade 1 tumors (97%) than in those with grade 3 tumors (71%). 21% of the patients had a residual endometrial tumor after preoperative radium, and among them survival was signifi‐canctly lower than in patients without residual tumor. The recurrence rate was 11.7%. Vaginal metastases did not occur.Our routine treatment afforded satisfactory results in stage 1, grade 1 and 2. However, supplementary treatment must be recommended in the case of grade 3 tumors, of myometrial deep invasion, and of residual tumor following preoperative radium therapy.
Screening for Detection of Intra‐Uterine Growth Retardation by Means of Ultrasound
Authors: Selbing Anders , Wichman Klas , Rydén Gunnar 
Published: December 2009

Abstract. In a two‐stage ultrasound screening program the gestational age was assessed by measurement of the fetal crown‐rump length in early pregnancy. At an adjusted gestational age between 32 and 35 completed weeks the biparietal diameter, the abdominal circumference, the abdominal area and the ratio between fetal head area and abdominal area were estimated by means of ultrasound measurement. ‘Acute’ fetal weight was estimated by calculations from biparietal diameter and abdominal diameters. Percen‐tile curves were constructed for these parameters and cutoff limits were tested for the predictability of intra‐uterine growth retardation of the fetus.The abdominal circumference and area estimations were equally good for the detection of intra‐uterine growth retardation. The biparietal diameter alone is of limited value for the detection of intra‐uterine growth retardation but the combination with abdominal diameters in ‘acute’ fetal weight estimation can well be used. The ratio between the skull and abdominal areas seems to be of little use for the detection of intra‐uterine growth retardation of two reasons: difficulty in measurement and low sensitivity.We consider that the assessment of gestational age in early pregnancy is a necessity both for the identification of suspectedIUGR by means of ultrasound and the diagnosis of IUGR by measurement of fetal weight at birth. It is concluded that if the gestational age has been assessed by crown‐rump length measurment in early pregnancy, a single estimation of the fetal abdominal circumference between 32 and 35 completed gestational weeks and a cut‐off limit at the 15th percentile offers a detection rate of about 90% of the growth retarded infants.
Changes in the Renin‐Angiotensin‐Aldosterone and Kallikrein‐Kinin Systems During Normal and Hypertensive Pregnancy
Authors: Karlberg Bengt E. , Rydén Gunnar , Wichman Klas 
Published: December 2009

Abstract. We conducted a prospective and serial study of blood pressure (BP) and of the changes in the renin‐angiotension‐aldosterone system (RAAS) and of one factor in the kallikrein‐kinin system during normal pregnancy and in patients with pre‐existing or developing hypertension in pregnancy. Strict diagnostic criteria were used to define pre‐eclampsia (PE), essential hypertensives (EH) and other hypertension (OH) in pregnancy.In normotensive pregnant women (n = 26) there was a rise in all components of the RAAS measured: plasma renin activty (PRA), plasma aldosterone concentration (PAC) and urinary aldosterone excretion (tU‐Aldo), from week 12 to week 20 of pregnancy, compared with non‐pregnant control subjects (n = 24) of similar age. Peak values were observed at week 30, whereafter fairly constant levels were maintained. Plasma and urinary aldosterone levels were increased 6‐10 fold. Urinary kallikrein excretion (tU‐Kall) was increased at weeks 12‐20, but at weeks 30‐36 roughly the same mean values were observed as for non‐pregnant control subjects.On the other hand, different results were obtained in the hypertensive patients, especially those with PE (n = 18). PRA was depressed in the PE group to values about those observed in non‐pregnant control subjects. PRA was also significantly lower in the PE group than in EH (n = 8) or OH (n=16) groups. PAC and tU‐Ado were also much lower in PE patients than in normal pregnant women at comparable gestational ages, but not significantly different from EH patients, whereas those with OH had both PAC and tU‐Pldo values comparable to normal pregnant women.In the PE group, tU‐Kall was significantly lower than for all other groups, but tU‐Kall values for EH and OH groups did not differ from those of normal pregnant women at the same gestational age.We conclude that during normal pregnancy there is an early and very marked activation of the RAAS. Initially, the kallikrein‐kinin system also seems to be activated. With the development of or with pre‐existing hypertension, the activation of RAAS is diminished. The suppression of both renin and aldosterone is most obvious in PE. Concomitantly, tU‐Kall decreases in PE patients, which may contribute to the rise in BP due to diminished depressor activity of kinins.
The Acute Effects of A Non‐Selective β‐Adrenergic Blocking Agent in Hypertensive Pregnant Rats
Authors: Karlsson Kirsten , Lundgren Yen , Ljungblad Ulf 
Published: December 2009

Abstract. It is generally accepted that hypertensive cardiovascular complications can be prevented by treatment. However, during pregnancy, antihypertensive drugs might be hazardous in view of their influence on the fetus. Nevertheless, in spite of the diverging published results, even β‐blockers have been used in the pregnant patient. As our basic knowledge concerning the circulatory and fetal effects is minimal, we decided to elucidate the influence of the non‐selective β‐blocker, propranolol, on the haemodynamic circumstances in hypertensive pregnant rats. Renal hypertension was induced by clamping both renal arteries 4 weeks before pregnancy. Shortly before term, cardiac output was determined with the dye‐dilution technique and utero‐placental blood flow was determined with the microsphere technique, both before and after propranolol injection. Mean arterial pressure and heart rate were registered continuously. The acute propranolol injection reduced mean arterial pressure by 26%. This was due mainly to a 32% decrease in cardiac output, which in turn was due to a 24% decrease in stroke volume and a 6% decrease in heart rate. Both myometrial and placental blood flow decreased significantly, by 45 and 50%, respectively. It was furthermore of interest to observe the significant increase in blood flow resistance in both myometrium and placenta.In conclusion, it can be stated that the non‐selective β‐blocker propranolol, which lacks intrinsic stimulating activity, reduces mean arterial pressure mainly by a cardiac output decrease. The present results further indicate that the influence on peripheral blood flow might be caused by cardiac output changes as well as by direct effects on the utero‐placental vascular bed.
ANALGESIA AND MATERNAL SIDE EFFECTS OF PUDENDAL BLOCK AT DELIVERY
Authors: Langhoff‐Roos Jens , Lindmark Gunilla 
Published: December 2009

Abstract. In a randomized double‐blind study, 1 048 women received pudendal block (PDB) at vaginal delivery, using three different local anesthetics: mepivacaine 1% plain, mepivacaine 1% with epinephrine, and bupivacaine 0.25% plain. The PDB was given transvaginally in doses of 8 ml × 2.Mepivacaine – epinephrine was found to be more effective than the other local anesthetics. Loss of bearing down reflex after PDB was found in 31.2% of the mothers and most commonly when mepivacaine – epinephrine was used. Inhibition of labor was slightly more pronounced with mepivacaine‐epinephrine. The different durations of the local anesthetics did not affect the analgetic effect in clinical use. It is concluded that as the adverse effects on labor are quite common, PDB should not be given as a routine before delivery, but may be offered liberally when pain in the pudendal area is a main part of the pain of childbirth.
CYCLICAL MOOD CHANGES AS IN THE PREMENSTRUAL TENSION SYNDROME DURING SEQUENTIAL ESTROGEN‐PROGESTAGEN POSTMENOPAUSAL REPLACEMENT THERAPY
Authors: Hammarbäck Stefan , Bäckström TorbjöRn , Hoist Juhani , von Schoultz Bo , Lyrenäs Sven 
Published: December 2009

Abstract. The etiology of the cyclical mood changes seen in the premenstrual syndrome is still unknown. A close relation to the luteal phase has been shown. One of the differences between the follicular and the luteal phase is the higher plasma progesterone concentration during the luteal phase. The present investigation has been conducted to study the effect of exogenously administered estrogen/gestagen sequential postmenopausal replacement therapy on mood and physical signs.Twenty‐two women requiring postmenopausal estrogen treatment were recruited and divided into two groups. Eleven women were given estradiol treatment only (Oestro‐gelR creme 3 mg percutaneously/day) for 21 days with a subsequent break of 7 days. The other 11 women were in addition given progestagen (Lynestrenol, OrgametrilR 5 mg/‐day) during the last 11 days of treatment. The women were asked to keep a daily record of their mood, using a visual analogue scale earlier tested in women with premenstrual syndrome. They also kept a record of physical signs and sexual feelings. The records were kept for between one and 6 months.The group with estrogen treatment only did not show any cyclical worsening in mood or physical signs during the treatment. The women who in the latter stage of the estrogen treatment cycle also received progestagen, showed significant cyclicity in both moods and physical signs, with a maximum symptom degree during the final days of gestagen treatment. The negative mood change started 1–3 days after the progestagen was added to the treatment. The results suggest that progestagens are involved in the provocation of cyclical symptom changes seen in the premenstrual syndrome.
EFFECT OF PHARMACOLOGICALLY ACTIVE AGENTS UPON THE HUMAN MYOMETRIUM IN VIVO
Authors: Joelsson Ingemar , Rydnert Jan 
Published: December 2009

Abstract. Smooth muscle is capable of contracting in response to mechanical distension. Even though the structural basis for this phenomenon is not completely clear, a method has been designed by which the contractile response to mechanical distension of the human uterine muscle can be determined in vivo. The distension is enforced sinusoidally within the frequency range 0.006— 1 Hz, by filling and emptying a rubber balloon introduced into the uterine cavity. A tonometric index of the myometrium is defined using Hook's law after the approximate evaluation of a contratile modulus and the tangential stress and strain in the innermost layer of the uterine wall. The regression lines of tonometric indices upon frequency are determined and intercepts of the equations for basic conditions are compared with those obtained during the administration of pharmacologically active agents.In a pilot study, this system, now modified for the evaluation of drug effects during early pregnancy, has been tested and found reliable.
CRITICAL EVALUATION OF METHODS FOR ELECTRON MICROSCOPY OF CERVICAL MUCUS
Authors: Ulstein Magnar , Myklebust Reidar 
Published: December 2009

Abstract.the ultrastructure of cervical mucus has been studied by scanning (SEM) and transmission (TEM) electron microscopy. the images differ according to the methods used for preparation; different patterns were found in the same sample when the freeze‐drying and critical point‐drying methods were used for SEM.When using TEM, the specimen appeared more homogeneous, with fine fibrils and granules. This accords with the theory that the cervical mucus consists of a randomly entangled fibrillar network. Electron microscopy of cervical mucus requires preparation procedures which involve considerable risk of creating artefacts. in our experience the TEM technique produces fewer artefacts and therefore gives pictures more true to the in vivo situation.
Diabetes Mellitus and Pregnancy: A seven‐year material of pregnant diabetics, where control during pregnancy was based on a centralized ambulant regime
Authors: Klebe Joachim G. , Espersen Thorkild , Allen Jim 
Published: December 2009

A 7‐year survey of the outcome of pregnancy complicated by diabetes mellitus, carried out at the Aarhus center, is presented. The material comprised 344 diabetic pregnant women where the control was based mainly on a centralized ambulant regime. The latter half‐period was moreover based on self‐monitoring of the blood glucose level. This achieved a significantly better blood glucose regulation, with a reduction of the mean blood glucose level from 7.9 to 6.4 mmol/l. Furthermore, the introduction of self‐monitoring halved the number of hospitalizations necessary for blood glucose regulation.Pregnancy was complicated in about 35%. The importance of screening for urinary tract infection is emphasized, since this, which was present in 20% of cases, might be a possible factor in ketoacidosis and/or intra‐uterine growth retardation. In 19% of the vaginal births it was deemed necessary to give instrumental assistance; 5% had shoulder dystocia. The cesarean section frequency was 31%. The antenatal mortality rate was 1.2% and the uncorrected perinatal mortality was 3.5%, half of the neonatal mortality was due to fatal congenital malformations. About half of the newborn babies required immediate intensive neonatal treatment. Because of the high frequency of complications in pregnant diabetics, during childbirth and in the neonatal period, centralized monitoring by a highly specialized team is necessary in order to maintain the present relatively low perinatal mortality and morbidity rates and the low number of cesarean sections, together with the most convenient control regimen for this highly pathological group. Furthermore, centralization will facilitate research which, together with prepregnancy consultation, may reduce the frequency of major fetal malformations.