bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intrapartum and postpartum care in Sweden: women's opinions and risk factors for not being satisfied
Authors: Waldenström Ulla , Rudman Ann , Hildingsson Ingegerd 
Published: December 2009

Background. The aim of this study was to investigate satisfaction with intrapartum and postpartum care, and the risk of not being satisfied in relation to 1) a woman's sociodemographic background, 2) physical and emotional well‐being in early pregnancy, 3) labor outcomes, 4) care organization, and 5) a woman's subjective assessment of aspects of care.Methods. All Swedish‐speaking women booked for antenatal care during 3 weeks spread over 1 year (1999–2000) were invited to participate in the study, and 2,686 (82% of those who consented to participate and 58% of those who were eligible) completed questionnaires in early pregnancy and 2 months postpartum. Women who were satisfied with overall intrapartum and postpartum care respectively were compared with those who were not regarding possible risk factors, and associations were tested by logistic regression analysis.Results. Ten percent of women were not satisfied with intrapartum care (ip) and 26% with postpartum care (pp). The following risk factors for not being satisfied were found: 1) age <25 years (ip), only elementary school (ip + pp), single status (pp), inconvenient timing of pregnancy (ip), lack of support from partner (ip); 2) suffering from many physical symptoms (ip + pp); 3) newborn transfer to neonatal clinic (ip + pp); 4) length of stay <1 day and ≥5 days (ip + pp), no “debriefing” after birth (ip), large hospital (pp); 5) lack of support by midwife (ip), little involvement in decision making (ip), dissatisfaction with birth environment (ip), insufficient time for breastfeeding support, encouragement and personal questions (pp).
Obstetrical factors related to nuchal cord
Authors: Ogueh Onome , Al‐Tarkait Aisha , Vallerand Danielle , Rouah Fabrice , Morin Lucie , Benjamin Alice , Usher Robert H. 
Published: December 2009

AbstractBackground. To investigate the intrapartum factors related to umbilical cord nuchal loops (nuchal cord) with particular reference to shoulder dystocia.Methods. We studied all singleton pregnancies with a vertex presentation and a birth weight of at least 2500 g from 1 January 1978 to 31 March 1997 and the 13,717 pregnancies with nuchal cord were compared to the 44,136 without nuchal cord.Results. When compared to pregnant women without nuchal cord, a greater proportion of pregnant women with nuchal cord underwent induction of labor (adjusted OR 1.09, 95% CI 1.04–1.15) and augmentation with oxytocin (adjusted OR 1.06, 95% CI 1.01–1.11). They had a longer second stage of labor (p=0.0013) and a greater proportion of primiparous women with tight nuchal cord had second stage of labor that lasted longer than two hours (adjusted OR 1.21, 95% CI 1.03–1.41). The proportion of abnormal fetal heart rate patterns was higher in the presence of nuchal cord (adjusted OR 1.61, 95% CI 1.55–1.68). Shoulder dystocia occurred more commonly in association with nuchal cord, especially when the nuchal cord was tight (adjusted OR 1.50, 95% CI 1.30–1.72 for all nuchal cord; adjusted OR 1.82, 95% CI 1.42–2.34 for tight nuchal cord).Conclusions. Umbilical cord nuchal loops are associated with induction of labor, slow progress of labor, and shoulder dystocia.
The role of C‐reactive protein in modern obstetric and gynecological practice
Authors: AZIZIA MOHAMMAD M. , IRVINE LAURIE M. , COKER MARCELLINA , SANUSI FATAI A. 
Published: December 2009

AbstractC‐reactive protein is an acute phase protein widely used as an indicator of infectious or inflammatory conditions. Traditionally it has been used as an adjunctive test for inflammation and as a marker of disease activity. Though sensitive, its nonspecific nature imposes limitation on its clinical use. Currently C‐reactive protein is used in the management of chorioamnionitis, preterm premature rupture of membranes, pelvic inflammatory disease, and urinary tract infection. Interestingly, several obstetric conditions such as pre‐eclampsia and gestational diabetes are now known to have an underlying inflammatory basis and there is an emerging role of C‐reactive protein testing in managing these diseases. Additionally C‐reactive protein testing has an established place in management of several acute abdominal conditions. The aim of this paper is to review the place of C‐reactive protein in modern obstetric and gynecological practice.
Effect of presurgical local infiltration of levobupivacaine in the surgical field on postsurgical wound pain in laparoscopic gynecological surgery
Authors: Alessandri Franco , Lijoi Davide , Mistrangelo Emanuela , Nicoletti Annamaria , Ragni Nicola 
Published: December 2009

AbstractBackground. To maintain a high standard of patient care, it is essential to provide adequate pain management in patients who undergo laparoscopic surgery.Methods. We randomly enrolled 74 women who underwent laparoscopic surgery for gynecological benign diseases. Patients in the levobupivacaine group (n=37) were injected with 7 ml of 5 mg/ml levobupivacaine at all incisional areas patients in the control group (n=37) were injected with an equal volume of physiologic saline solution. In the postoperative period the following variables were assessed for each group: decline of hemoglobin concentration, consumption of analgesics, time of ambulation, length of postoperative ileus, length of postoperative hospital stay, and VAS scores at 6, 12, and 24 h after surgery.Results. Mean pain intensity at 6 and 12 h after surgery was significantly lower in the levobupivacaine group than in the control group (p<0.01). Analgesic requirement was significantly lower (p<0.01) in the levobupivacaine group (0.3 phial±0.2) than in the control group (2.1 phial±1.0). The mean time of ambulation was significantly lower (p<0.05) in the levobupivacaine group (16±4) than in the control group (22±6). No significant difference was observed between the two groups in mean pain intensity 24 h after surgery, decline of hemoglobin concentration, length of postoperative ileus, or length of postoperative hospital stay.Conclusions. Our results suggest that presurgical infiltration of levobupivacaine in addition to general anesthesia and standard analgesic therapy significantly decreases the intensity of postsurgical pain, especially for the first 12 h after surgery, and reduces analgesic consumption after surgery.
Management and course of histologically verified cervical carcinoma in situ during pregnancy
Authors: Ackermann S. , Gehrsitz C. , Mehlhorn G. , Beckmann M.W. 
Published: December 2009

AbstractBackground. To study the rate of regression and progression into invasive disease of patients with histologically proven carcinoma in situ of the uterine cervix during pregnancy. Methods. Prospective observation of all pregnant women with biopsy‐proven carcinoma in situ of the uterine cervix, gained by colposcopic guided biopsy from 1996 to 2004 and correlation with the route of delivery and cytologic and histologic postpartum findings. Results. Eighty‐three patients with histologically verified carcinoma in situ during pregnancy were treated conservatively. Two patients were lost to follow‐up, one patient had an abortion, and three are still pregnant. The study population of 77 patients were followed for a median of 140 days before delivery. Postpartum regression rate was 34.2%, two patients had a diagnosis of microinvasive cervical cancer on the postpartum cone biopsy, and persistent carcinoma in situ was found postpartum in 63.1% of patients. No difference was seen for the route of delivery. Both patients with microinvasive carcinoma were delivered by primary cesarean section and are disease‐free after 24 and 38 months, respectively. Conclusions. We recommend conservative management for women with carcinoma in situ of the uterine cervix. We found no difference for the route of delivery regarding postpartum regression and recommend a postpartum evaluation after the puerperium. Colposcopic guided biopsy should rule out an invasive process during pregnancy. Cesarean section as the mode of delivery should be considered, if invasion is suspected.
The effect of environmental tobacco smoke during pregnancy on birth weight
Authors: Hegaard Hanne K. , Kjærgaard Hanne , Møller Lars F. , Wachmann Henrik , Ottesen Bent 
Published: December 2009

AbstractBackground. This study explores whether pregnant nonsmokers’ exposure to environmental tobacco smoke (ETS) affects the average birth weight at term.Methods. The population studied consists of pregnant nonsmokers participating in a study called Smoke‐free Newborn Study. The participants (n = 1612) answered a questionnaire during 12th to 16th gestational week about their exposure to ETS at home and outside the home.Results. Pregnant nonsmokers exposed to ETS both at home and outside the home gave birth to children with a birth weight of 78.9 g (95% CI −143.7 to −14.1) (P=0.02) lower than the weight of children born to women unexposed to ETS. There was no significant reduction in birth weight among women exposed to ETS at home only or outside the home only. A nonsignificant dose–response association was seen between increasing daily exposure to ETS and reduction in birth weight.Conclusion. Nonsmoking pregnant women who were exposed to ETS at home as well as outside the home gave birth to children with a 79 g reduction in birth weight compared to children of unexposed women. The fact that exposure to ETS has an effect on the birth weight is regarded as essential. The authors recommend that pregnant women should not be exposed to passive smoking, and that it should be considered whether workplace legislation should be instituted in order to protect pregnant women against the adverse effects of passive smoking.
The effects of time on pH and gas values in the blood contained in the umbilical cord
Authors: VALENZUELA P. , GUIJARRO R. 
Published: December 2009

AbstractBackground. The pH and gas analysis of umbilical cord blood is an accepted practice in most maternity hospitals. The data that is obtained after a latency period in processing the cord blood samples is evaluated to determine whether it is useful for the clinic. Methods. The umbilical cords from 50 term infants were clamped immediately after delivery. Samples of artery and vein blood were drawn 5, 60, and 120 min postpartum and pH, pO2, and pCO2 levels were measured. Results. No significant differences were found after 60 min in the average values for pH in the arterial and venous paired samples, though the arterial and venous pCO2 values declined significantly. The arterial pO2 values increased significantly. After 120 min, no significant differences in the average values for the venous pH and pO2 paired samples were found. The arterial pH values increased significantly, however, and the arterial and venous pCO2 values declined significantly. The arterial pO2 values increased significantly. Conclusions. Though statistically significant differences occurred over time, these changes were so modest clinically that the data could still be used even when an immediate analysis of the umbilical cord was not possible.
Women with hypogonadotropic hypogonadism: cycle characteristics and results of assisted reproductive techniques
Authors: KUMBAK BANU , KAHRAMAN SEMRA 
Published: December 2009

AbstractObjective. To present cycle characteristics and results of in vitro fertilization in 27 patients with hypogonadotropic hypogonadism. Further, to demonstrate the consequences of advanced age (≥35 years). Methods. Data from 27 hypogonadotropic hypogonadism patients treated with in vitro fertilization in the period from 2000 to 2004 were analyzed and compared with treatment results from 39 patients with unexplained infertility. Moreover, data from hypogonadotropic hypogonadism patients were analyzed according to the age factor. Mann–Whitney U, Chi‐square, and Student's t‐tests were used for statistical analysis. p<0.05 was considered significant. Results. Higher gonadotropin consumption and a longer stimulation period were observed in the hypogonadotropic hypogonadism group. Peak E2 levels, and the total number of oocytes and metaphase II oocytes were higher in the unexplained infertility group. Although a higher number of grade I embryos were transferred in the unexplained infertility group, the implantation rate was found to be better in the hypogonadotropic hypogonadism group (36.5% versus 13%; p<0.0001). Pregnancy rates were similar. When hypogonadotropic hypogonadism patients were evaluated according to the age factor, no significant difference was found with regard to cycle and outcome parameters, except higher gonadotropin consumption in aged patients. In aged hypogonadotropic hypogonadism patients, a pregnancy rate of 50% was achieved. Conclusion. Hypogonadotropic hypogonadism women undergoing in vitro fertilization were found to be good responders. In the presence of advanced age, management of these patients becomes challenging. However, even these patients still have a good chance of pregnancy.
EMG biofeedback versus topical lidocaine gel: a randomized study for the treatment of women with vulvar vestibulitis
Authors: DANIELSSON INGELA , TORSTENSSON THOMAS , BRODDA‐JANSEN GUNILLA , BOHM‐STARKE NINA 
Published: December 2009

AbstractBackground. To evaluate the efficacy of electromyographic biofeedback and topical lidocaine treatment for women with vulvar vestibulitis. Methods. A prospective randomized study where 46 women with vulvar vestibulitis were randomized to receive either electromyographic biofeedback or topical lidocaine treatment for four months. Assessments with vulvar pressure pain thresholds and questionnaires regarding quality of life, psychosocial adjustments, and sexual functioning were made before treatment, after treatment, and at six‐ and 12‐month follow‐ups. Nonparametric statistical methods were used to analyze differences in outcomes. Results. Nine women (9/46) dropped out during the treatment period. Both treatments showed significantly improved values for vestibular pressure pain thresholds, quality of life measurements, and sexual functioning at the 12‐month follow‐up. No differences were found between the two treatment groups. No severe side effects were reported. Conclusions. Four months’ treatment with electromyographic biofeedback and topical lidocaine gave statistically significant improvements on vestibular pain measurements, sexual functioning, and psychosocial adjustments at the 12‐month follow‐up. No differences in outcome between the two treatments were observed but a larger sample may be needed to obtain significance. The treatments were well tolerated but the compliance to the electromyographic biofeedback training program was low. A combination of both treatments could potentially benefit many women with vulvar vestibulitis.
Maternal deaths after elective cesarean section for breech presentation in the Netherlands
Authors: SCHUTTE JOKE M. , STEEGERS ERIC A.P. , SANTEMA JOB G. , SCHUITEMAKER NICO W.E. , VAN ROOSMALEN JOS ,   on behalf of the Maternal Mortality Committee of the Netherlands Society of Obstetrics and Gynaecology
Published: December 2009

AbstractBackground and methods. The cesarean section rate for term singleton breech babies in the Netherlands rose from 57 to 81% after the Term Breech Trial in 2000. The Dutch Maternal Mortality Committee registered and evaluated maternal mortality due to elective cesarean section for breech. Results. Four maternal deaths after elective cesarean section for breech presentation, from 2000 to 2002 inclusive, were registered, 7% of total direct maternal mortality in that period. Two women died due to massive pulmonary embolism, both were obese, and thromboprophylaxis was not adjusted to their weight. The other two women died from sepsis, one had not receive perioperative prophylactic antibiotics. The case fatality rate for elective cesarean section for breech presentation was 0.47/1,000 operations. No death after emergency cesarean section for breech presentation was registered at the committee. Conclusions. Elective cesarean section does not guarantee the improved outcome of the child, but may increase risks for the mother, compared to vaginal delivery.
Can we Reduce the Burden of Depression? The Australian experience with Beyondblue: The National Depression Initiative
Authors: Hickie Ian 
Published: December 2009

Objective: Throughout the Asia Pacific region, there is an urgent need to reduce the burden of depression by increasing depression awareness, reducing stigma and dismantling those social barriers that prevent full participation by people with depression. This paper describes the development and early achievements of the Australian depression initiative, beyondblue Methods: A review of the key priorities of beyondblue and their impacts during the first three years of operation (2001–2003). Results: Key achievements include: the degree of national recognition of beyondblue; size and scope of media impact; growth in website utilisation; increased reporting of the community's recognition of people with depression; genuine reforms in life insurance and income protection; development of a new national consumer and carer organisation; establishment of major population-based preventative and early intervention programs; system-wide reform of primary care-based mental health services; national educational program uptake by general practitioners; and, development of key awareness and intervention programs for use in schools and the workplace. Conclusions: In its first three years of operation, beyondblue has had a major impact on depression awareness in Australia and demonstrable gains have been made in reducing stigma and major social barriers. A pre-existing national mental health policy and implementation plan, a substantial funding base and participation by key political, media and community leaders have been essential elements of its short-term success. Its longer-term impact will now depend on more sustainable community and business partnerships as well as the growth of a more influential consumer and carer voice.
A Review of the Legislative Mechanisms Available to Protect the Social Participation Rights of People with Depression in the Asia Pacific Region
Authors: Ricci Cristina , Lee Ming-Been , Chiu Chen-huan 
Published: December 2009

Objective: To conduct a review of the legislative mechanisms potentially available to protect the social participation rights of people with depression in the Asia Pacific region. Methods: Questions were sent to the SEBoD International Advisory Board and Internet and legal database searches were conducted to supplement responses from advisors. Results: While it cannot be said that comprehensive antidiscrimination legislation in relation to disability exists in all countries in the Asia Pacific region, most countries have commenced the process. Many have implemented either human rights or antidiscrimination legislation and most have set up a Human Rights Commission to protect social participation rights and allow complaints to be lodged. Conclusions: This review highlighted the difference between legislation and practice. While many countries have enacted laws, insufficient resources have been committed to support the objectives to realise the protection of rights enshrined in legislation. Additionally, many people may not know that the laws exist or do not have the money or social supports to fight for their rights. Many countries, however, have commenced a concerted approach to tackling the larger issues and have developed comprehensive action plans to address the social participation rights of people with disability.
First Report of Tobacco rattle virus in Spinach in California
Authors: Koike S. T. , Tian T. , Liu H.-Y. 
Published: December 2009

In 2009 in coastal California (Santa Barbara County), commercially grown spinach (Spinacia oleracea) in two nearby fields exhibited symptoms of a previously unrecognized virus-like disease. Symptoms consisted of general chlorosis and bright yellow blotches and spots. Necrotic spots were also associated with the disease. In affected fields, disease occurred in limited, irregularly shaped patches that ranged from one to several meters in diameter. Symptomatic plants were unmarketable and these small patches of spinach were not harvested. With a transmission electron microscope, rigid, rod-shaped particles with a clear central canal were observed from plant sap of the symptomatic spinach. Analysis by a double-antibody sandwich-ELISA assay (Agdia Inc., Elkhart, IN) for Tobacco rattle virus (TRV) showed that the symptomatic plants were positive. Symptomatic spinach from the field was used for mechanical transmission to Chenopodium quinoa, C. murale, C. capitatum, spinach, and sugar beet (Beta vulgaris). All inoculated plants showed chlorotic local lesions and sugar beet showed chlorotic local lesions with rings. To further confirm the presence of TRV, reverse transcription (RT)-PCR was conducted. Total RNA was extracted from the mechanically inoculated symptomatic spinach plants using an RNeasy Plant Kit (Qiagen Inc., Valencia, CA) and used as a template in RT-PCR with forward (5′-TACATCACATCTGCCTGC-3′) and reverse (5′-CTTCATTCACACAACCCTTG-3′) primers specific to the movement protein gene from the spinach isolate of TRV (GenBank Accession No. AJ007294). Amplicons of the expected size (approximately 562 bp) were obtained. The RT-PCR products were sequenced (GenBank Accession No. GU002156) and compared with TRV sequences in GenBank to confirm the identity of the products. Sequences obtained had 96% nucleotide identity and 97% amino acid identity with TRV sequences available under the GenBank Accession Nos. FJ357571 and AJ007294. On the basis of the data from electron microscopy and serological and molecular analyses, the virus was identified as TRV. Soil samples collected from one of the fields were assayed for nematodes; however, Paratrichodorus or Trichodorus species were not recovered. To our knowledge, this is the first report of TRV in spinach in California. TRV has also been reported in spinach in England (1) and Germany (2). References: (1) A. Kurppa et al. Ann. Appl. Biol. 98:243, 1981. (2) K. Schmidt and R. Koenig. Arch. Virol. 144:503, 1999.