bluuebunny/crossref_metadata_2025_split huggingface dataset:
A survey of knowledge, attitude and practice of malaria management among pregnant women from two health care facilities in Nigeria
Authors: ENATO EHIJIE F. O. , OKHAMAFE AUGUSTINE O. , OKPERE EUGENE E. 
Published: March 2007

AbstractBackground. Malaria remains one of the most important causes of maternal and child morbidity and mortality in sub‐Saharan Africa, despite the availability of effective interventions. The objective of this study was to assess the knowledge, attitude and practice of malaria management among pregnant women attending antenatal clinics in Nigeria. Methods. A cross‐sectional study was undertaken on a sample of 867 pregnant women attending antenatal clinics in 2 health care facilities in Edo State, Nigeria, using a self‐administered questionnaire. Results. Of the respondents, 87% said that they had undergone at least 1 episode of malaria during their current pregnancy. Most respondents (89%) attributed malaria to bites from infected mosquitoes, while 75% consider malaria an important health risk during pregnancy. However, knowledge of the consequences of malaria during pregnancy was poor, especially the risk posed to the fetus. Overall, the mean knowledge score on a scale of ‘0–7’ was 3.5 (median 4.0). Respondents had poor belief in the effectiveness and use of insecticide‐treated bed nets and intermittent preventive therapy, in preventing malaria during pregnancy. Conclusions. This study has revealed that malaria is perceived as a common health problem among pregnant women attending these 2 health care facilities, and that knowledge, attitude and practice of its management is poor. Efforts should be made to improve anti‐malarial intervention during pregnancy, to ensure that the goals of the Roll Back Malaria Initiative are achieved in Nigeria.
Maternal smoking does not affect fetal size as measured in the mid‐second trimester
Authors: BERGSJØ PER , BAKKETEIG LEIV S. , LINDMARK GUNILLA 
Published: March 2007

AbstractBackground. Cigarette smoking during pregnancy is causally related to birthweight, but we do not know whether fetal growth restriction is a continuous process or, if not, at what stage of pregnancy it affects weight gain. Material and methods. A random sample of para 1 and 2 mothers, drawn from the population of pregnant women in Bergen and Trondheim, Norway, and Uppsala, Sweden, were examined by a detailed questionnaire concerning smoking habits, menstrual history and pregnancy dating, and subjected to morphometric sonography of their fetuses in or around week 17. Of the 547 study participants, 31.9% were smokers. Gestational age was primarily determined by the last menstrual period [LMP], except in those with irregular cycles, and in 30 cases (6.6% of those with regular cycles) in whom the biparietal diameter [BPD]‐determined age deviated >14 days from the LMP‐based date. Results. The analysis did not reveal any statistically significant differences between the fetuses of non‐smokers, light smokers (0–9 cigarettes per day) and heavy (10+ cigarettes per day) smokers, regarding BPD, mean abdominal diameter [MAD] femur length [FL], and a ‘body contour index’: [BPD+FL]÷MAD. Conclusion. Tobacco‐induced fetal growth restriction probably begins after gestational week 17.
Impact of subclinical chorioamnionitis on maternal and neonatal outcomes
Authors: MIYAZAKI KEN , FURUHASHI MADOKA , MATSUO KEITARO , MINAMI KOJIRO , YOSHIDA KANA , KUNO NAOHIKO , ISHIKAWA KAORU 
Published: March 2007

AbstractBackground. Chorioamnionitis is considered to be one of the main causes of preterm labor and has been associated with an adverse perinatal outcome in preterm infants. The controversy about the benefits/risks of delaying labor is a critical issue concerning the management of chorioamnionitis. Methods. The database between July 2001 and March 2006 was reviewed for women with singleton pregnancies between 22 and 28 weeks of gestation and with chorioamnionitis diagnosed on admission by amniotic fluid neutrophil elastase level. Women were classified according to the severity of chorioamnionitis (group A, amniotic fluid neutrophil elastase level of 0.15–1 µg/ml; B, 1–10 µg/ml; and C, ≥10 µg/ml). During expectant management, serum C‐reactive protein levels monitored the remission and aggravation of chorioamnionitis. Following deliveries, placentas were examined for histologic chorioamnionitis. Results. One hundred women were enrolled (group A, 38; B, 34; C, 28). The latency period until delivery was significantly longer in group A than in groups B and C. C‐reactive protein levels just before delivery were higher than those on admission in 61% of the overall cases. Histologic chorioamnionitis and funisitis were manifested in 90.4% and 65.5%, respectively. Intrauterine fetal demise (4 cases) and neonatal and postneonatal deaths during admission (10 cases) were observed. Bronchopulmonary dysplasia was the most common major morbidity noted in groups B and C. Conclusion. Chorioamnionitis could be controlled but is hard to cure. Higher levels of amniotic fluid neutrophil elastase are associated with a shorter interval from admission to delivery in women with subclinical chorioamnionitis.
Characterization of surgically transposed ovaries in integrated PET/CT scan in patients with cervical cancer
Authors: HOON CHUNG HYUN , JUN KANG WON , WEON KIM JAE , PARK NOH‐HYUN , SONG YONG‐SANG , CHUNG JUNE‐KEY , KANG SOON‐BEOM , LEE HYO‐PYO 
Published: March 2007

AbstractBackground. The purpose of this study was to determine the ovarian findings on integrated positron emission tomography/computed tomography scans during follow‐up in cervical cancer patients with ovarian transposition. Method. We retrospectively reviewed the clinical data and integrated 18F‐fluorodeoxyglucose positron emission tomography/computed tomography of women with ovarian transposition during radical hysterectomy for cervical cancer between December 2003 and March 2006. Results. Eighty‐four premenopausal women had ovarian transposition performed during the study period. Twelve positron emission tomography/computed tomography scans from 11 patients were registered for the current study and three women were diagnosed with metastasis: two in lung and one in pelvis. Two patients complained of menopausal symptoms during follow‐up, and the hormonal tests were consistent with it. In the current study, an integrated positron emission tomography/computed tomography scan detected one patient with right lower abdominal mass with increased 18F‐fluorodeoxyglucose uptake, which was identified as a transposed right ovary. Clinical information of ovarian transposition was helpful in interpretation of the lesion. In the patient, transposed ovary was associated with increased fluorodeoxyglucose uptake, with standard uptake values ranging from 3.7 to 5.5. Other positron emission tomography/computed tomography scans did not show abnormal uptake of 18F‐fluorodeoxyglucose. Conclusions. Transposed ovary in premenopausal women may appear on integrated positron emission tomography/computed tomography scan as a mass with increased 18F‐fluorodeoxyglucose uptake, which may be associated with preserved ovarian function. Clinical information regarding transposition should be noted in order not to interpret these as recurrent or metastatic lesions.
Accuracy of HPV testing of vaginal smear obtained with a novel self‐sampling device
Authors: STENVALL HARRIET , WIKSTRÖM INGRID , BACKLUND INGRID , WILANDER ERIK 
Published: March 2007

AbstractBackground. Most of women diagnosed as having cervical cancer have not participated in organized cytological screening. Aim. A study was conducted to evaluate the accuracy of human papilloma virus testing by self‐collected vaginal samples in comparison to regular cytological screening. The agreement of hybrid capture 2 assay and polymerase chain reaction assay for detection of human papilloma virus DNA in self‐collected vaginal samples and clinician‐obtained cervical smears was investigated. Method. Forty‐three women aged 23–58 years admitted for further examination due to previous positive cytology in the organized screening participated in self‐collecting of vaginal samples with a novel self‐sampling device. During the visit a clinician also collected a cervical smear using a cytobrush. The vaginal samples collected with the self‐sampling device were analyzed for high‐risk human papilloma virus with the hybrid capture 2 assay technique and the cervical smears were Pap‐stained, examined cytologically and after that reanalyzed for human papilloma virus DNA using a polymerase chain reaction assay. Result. The vaginal samples were positive for high‐risk human papilloma virus in 37% of the cases using hybrid capture 2 assay. Twelve of the 43 Pap smears showed positive cytology (ASCUS‐CIN 3), of which 4 showed CIN 2–3. When polymerase chain reaction assay was performed, human papilloma virus DNA was detected in 40% of the glass slides. The agreement between cytology and the two human papilloma virus testing techniques was 67–74% (kappa 0.27–0.45) and the agreement between the two human papilloma virus tests was 70% (kappa 0.36). Conclusion. Testing for high‐risk human papilloma virus can identify more women at risk of developing cervical cancer than cytology irrespective of the sampling method. Furthermore, offering a self‐sampling device for collection of vaginal smear seems to be a useful screening tool for cervical cancer among women not responding to an invitation for smear sampling.
Menstrual disorders and associated factors among adolescent girls visiting a youth clinic
Authors: WIKSTEN‐ALMSTRÖMER MARIANNE , LINDÉN HIRSCHBERG ANGELICA , HAGENFELDT KERSTIN 
Published: March 2007

AbstractBackground. Menstrual disturbances are common among teenagers and are often explained by immaturity of the hypothalamic‐pituitary‐gonadal axis. However, little is known about the underlying causes. The aim of this study was to evaluate endocrine mechanisms of menstrual disturbances and associated factors among adolescent girls visiting a Swedish youth clinic. Methods. All adolescent girls visiting the youth clinic during a five‐year period due to menstrual disturbances, except those with primary amenorrhea, were included in this retrospective study. These 203 girls were evaluated in a standardized manner by the same gynecologist. One third also met a psychologist and/or a dietician at the clinic. Results. Secondary amenorrhea was diagnosed in 117 girls (58%) and oligomenorrhea in 86 girls (42%). Menarcheal age was 13 in both groups. Hypothalamic inhibition of the gonadal axis was more frequent in the girls with secondary amenorrhea, whereas a hyperandrogenic hormonal pattern as a feature of polycystic ovary syndrome was more common in the oligomenorrheic girls. Different types of eating disorders were diagnosed in 68% of the amenorrheic girls and in 38% of the oligomenorrheic girls. Conclusions. We found hypothalamic amenorrhea and hyperandrogenism to be frequent endocrine mechanisms of menstrual disorders in teenagers. Concomitant eating disorder was highly frequent and secondary amenorrhea was associated with anorectic behavior. It is important to evaluate endocrine patterns and eating behavior in adolescents with menstrual disturbances to ensure adequate medical care and treatment.
A comparison of high‐ versus low‐intensity, high‐frequency transcutaneous electric nerve stimulation for painful postpartum uterine contractions
Authors: FAGEVIK OLSÉN MONIKA , ELDEN HELEN , DAHMÉN JANSON EVA , LILJA HÅKAN , STENER‐VICTORIN ELISABET 
Published: March 2007

AbstractBackground.Breast‐feeding in the postpartum period is known to induce intense uterine contractions with pain in the lower abdomen.Aims.The primary aim of this study was to compare the effects of high and low intensity, high frequency Transcutaneous Electric Nerve Stimulation (TENS) on pain and discomfort of postpartum uterine contractions. The secondary aim was to evaluate discomfort experienced from the stimulation itself.Methods.Twenty‐one newly delivered women participated in this single‐blind trial, 12 women received high intensity, high‐frequency TENS (HI TENS) and 9 women received low intensity, high‐frequency TENS (LI TENS). The electrodes were placed abdominally on each side of the uterus. Stimulation was done during one minute. Visual analogue scales were used to evaluate the intensity of the pain before and after stimulation. A verbal scale was used to estimate sensation of discomfort before, during and after stimulation.Results.The median decrease in pain ratings before and after treatment by VAS was larger in the HI TENS group −49mm (95% CI −66.5– − 33.2) than in the LI TENS group −21mm (95% CI −39.0– − 20.0). The reduction of pain was most pronounced in the HI TENS group (median difference 28 (95% CI was 14.0–53.0). Furthermore, the HI TENS group experienced significantly less discomfort of the uterine contractions after stimulation (p < 0.01) but they also experienced more discomfort of the stimulation than women in the LI TENS group (p < 0.01).Conclusion.The women treated with HI TENS, experienced significantly less postpartum pain and discomfort to those treated with LI TENS even though the discomfort from the stimulation with HI TENS was greater.
Emergency obstetric hysterectomy
Authors: DASKALAKIS GEORGE , ANASTASAKIS ELEFTHERIOS , PAPANTONIOU NIKOLAOS , MESOGITIS SPYROS , THEODORA MARIANA , ANTSAKLIS ARIS 
Published: March 2007

AbstractBackground. All cases of obstetric hysterectomies that were performed in our hospital during a seven‐year study period were reviewed in order to evaluate the incidence, indications, risk factors, and complications associated with emergency obstetric hysterectomy. Methods. Medical records of 45 patients who had undergone emergency hysterectomy were scrutinized and evaluated retrospectively. Maternal age, parity, gestational age, indication for hysterectomy, the type of operation performed, estimated blood loss, amount of blood transfused, complications, and hospitalization period were noted and evaluated. The main outcome measures were the factors associated with obstetric hysterectomy as well as the indications for the procedure. Results. During the study period there were 32,338 deliveries and 9,601 of them (29.7%) were by cesarean section. In this period, 45 emergency hysterectomies were performed, with an incidence of 1 in 2,526 vaginal deliveries and 1 in 267 cesarean sections. All of them were due to massive postpartum hemorrhage. The most common underlying pathologies was placenta accreta (51.1%) and placenta previa (26.7%). There was no maternal mortality. Conclusions. Obstetric hysterectomy is a necessary life‐saving procedure. Abnormal placentation is the leading cause of emergency hysterectomy when obstetric practice is characterized by a high cesarean section rate. Therefore, every attempt should be made to reduce the cesarean section rate by performing this procedure only for valid clinical indications.
Obstetric brachial plexus palsy: a prospective study on risk factors related to manual assistance during the second stage of labor
Authors: MOLLBERG MARGARETA , WENNERGREN MARGARETA , BAGER BÖRJE , LADFORS LARS , HAGBERG HENRIK 
Published: March 2007

AbstractBackground. To evaluate the association between obstetric brachial plexus palsy and obstetrical maneuvers during the second stage of delivery. Methods. Prospective population‐based case control study. Cases of obstetric brachial plexus palsy were compared with a randomly selected control group with regard to obstetric management. Results. Five or more obstetrical maneuvers were used to deliver the infants in 82% in the obstetric brachial plexus palsy group versus 1.8% in the controls. Risk factors independently associated with obstetric brachial plexus palsy were force applied when downward traction was imposed on the fetal head (odds ratio 15.2; 95% confidence interval 8.4–27.7). The incidence of obstetric brachial plexus palsy in the infants in the population was 3.3‰. At 18 months of age 16.1% (incidence of 0.05%) of children had residual functional deficits and downward traction with substantial force was applied in all these cases. Conclusions. Forceful downward traction applied to the head after the fetal third rotation represents an important risk factor of obstetric brachial plexus palsy in vaginal deliveries in cephalic presentation.
Where is the aorta? Is it worth palpating the aorta prior to laparoscopy?
Authors: POLYZOS DIMITRIOS , PAPADOPOULOS NIKOLAOS , CHAPMAN LYNNE , PAPALAMPROS PANOS , VARELA VASILIKI , GAMBADAURO PIETRO , MAGOS ADAM 
Published: March 2007

AbstractBackground. Injury to major retroperitoneal vessels is the most catastrophic complication of laparoscopy. Knowledge of the site of the aortic bifurcation prior to inserting the umbilical port would be expected to reduce the risk of this type of injury. The aim of the study is to determine the feasibility of identifying the aortic bifurcation by palpation prior to the operation. Methods. We studied 100 patients undergoing laparoscopic surgery or laparotomy. After prepping and draping, the operating surgeon felt for the aortic bifurcation to determine its position in relation to the umbilicus. We then related our findings to the height, weight, and body mass index of the patient. Results. The aorta could not be palpated in 15% of cases, including almost 2/3 of women who were obese (body mass index >30). In the remaining 85% cases, where the aorta was palpable, the bifurcation was above the level of the umbilicus in 30 (35%) cases, at the umbilicus in 45 (53%) cases, and below in 10 (12%) cases. We did not find any significant effect of body mass index, height, or weight on the level of the aortic bifurcation by palpation. No vascular injury occurred in the laparoscopic cases during the study. Conclusions. The aortic bifurcation is palpable in the majority of women undergoing surgery, including 93% of those with a low or normal body mass index who are at higher risk of vascular injury. We recommend the routine palpation for the aortic bifurcation as a simple means to reduce the risk of injury to a major retroperitoneal vessel.
N‐Acetyl cysteine and clomiphene citrate for induction of ovulation in polycystic ovary syndrome: a cross‐over trial
Authors: BADAWY AHMED , STATE OMNIA , ABDELGAWAD SOMA 
Published: March 2007

AbstractObjective. To compare clomiphene citrate plus N‐acetyl cysteine versus clomiphene citrate for inducing ovulation in patients with polycystic ovary syndrome. Design. Prospective cross‐over trial. Setting. University teaching hospital and a private practice setting. Patients. Five hundred and seventy‐three patients were treated with clomiphene citrate for one menstrual cycle among which 470 patients were treated with clomiphene citrate plus N‐acetyl cysteine for another cycle. All women suffered from polycystic ovary syndrome. Interventions. Patients had clomiphene citrate 50‐mg tablets twice daily alone or with N‐acetyl cysteine 1,200 mg/day orally for 5 days starting on day 3 of the menstrual cycle. Outcome measures. Primary outcomes were number of mature follicles, serum E2, serum progesterone, and endometrial thickness. Secondary outcome was the occurrence of pregnancy. Results. Ovulation rate improved significantly after the addition of N‐acetyl cysteine (17.9% versus 52.1%). Although the number of mature follicles was more in the N‐acetyl cysteine group (2.1±0.88 versus 3.2±0.93), the difference was not statistically significant. The mean E2 levels (pg/ml) at the time of human chorionic gonadotropine injection, serum progesterone levels (ng/ml) on days 21–23 of the cycle, and the endometrial thickness were significantly improved in the N‐acetyl cysteine group. The overall pregnancy rate was 11.5% in the N‐acetyl cysteine group. Insulin resistance occurred in 260 patients (55.4%). There was no significant difference between the insulin resistance group (n = 260) and non‐insulin resistance group (n = 210) as regards ovulation rate, number of follicles, serum E2 (pg/ml), serum progesterone (ng/ml), endometrial thickness (mm), or pregnancy rate. Conclusion. N‐Acetyl cysteine is proved effective in inducing or augmenting ovulation in polycystic ovary patients.
Treatment of vulvovaginal erosive and stenosing lichen planus by surgical dilatation and methotrexate
Authors: KORTEKANGAS‐SAVOLAINEN OUTI , KIILHOLMA PENTTI 
Published: March 2007

AbstractWe treated five patients with stenosing lichen planus [LP] of the vulvovaginal region with methotrexate supplemented with ultrapotent corticosteroid cream and tacrolimus, in combination with surgical dilatation. All patients experienced long‐term symptom relief, and there was only minimal or moderate re‐stenosing of the vagina on follow‐up for 2–41 months.
Childbearing or induced abortion: the impact of education and ethnic background. Population study of Norwegian and Pakistani women in Oslo, Norway
Authors: ESKILD ANNE , NESHEIM BRITT‐INGJERD , BUSUND BJØRN , VATTEN LARS , VANGEN SIRI 
Published: March 2007

AbstractObjective. To study patterns of induced abortion versus childbirth related to education among Norwegian and Pakistani women. Design and setting. Population‐based study in Oslo, Norway. Population. All women 15–50 years of age of Norwegian (n = 94,428) or Pakistani (n = 5,390) descent living in Oslo. Main outcome measures. Induced abortion or child delivery. Results. In Norwegian women with a university education, 15.3% delivered a child and 2.9% had an induced abortion between 2000 and 2002. In women with less than high school education, the figures were 5.3% and 4.3%. Pregnant women with less than high school education were twice as likely to have an induced abortion as women with a university education (odds ratio, 2.0; 95% confidence interval, 1.7–2.5), after adjustment for age, parity, marital status, and residential area. Among Pakistani women with a university education, 23.0% gave birth and 2.9% had an induced abortion. In Pakistani women with less than high school education, the figures were 20.8% and 2.8%. Among pregnant Pakistani women, those with less than high school education were less likely to have an induced abortion compared to women with a university education (odds ratio, 0.5; 95% confidence interval, 0.2–1.1). Conclusions. Childbirth was substantially more common in Pakistani than in Norwegian women living in Oslo. In Norwegian women, low education was associated with lower frequency of child delivery but higher frequency of induced abortion. In Pakistani women, child delivery was not related to education, but induced abortion tended to be more frequent in those with a university education.
Peritoneal fluid as an unrecognised vector between female reproductive tissues
Authors: HUNTER R.H.F. , CICINELLI E. , EINER‐JENSEN N. 
Published: March 2007

AbstractThis essay discusses the potential contribution of peritoneal fluid to the regulation of reproductive processes in female mammals. After noting the relatively high concentrations of diverse hormones in peritoneal fluid, and accepting that it bathes the surface of all the internal reproductive organs, peritoneal fluid is then proposed as a means of communication between the two ovaries. It could act to influence both the hierarchy of Graafian follicles and the rate and extent of development of a newly‐formed corpus luteum. Cytokines in peritoneal fluid are considered in this context, as are the differing populations of leukocytes. Circumstantial evidence is offered for entry of peritoneal fluid into the Fallopian tubes, especially close to the time of ovulation, with the suggestion that such entry could modify the nature of endosalpingeal secretion and transudation. Thereafter, the spectrum of gonadal hormones in peritoneal fluid could be influencing uterine tissues in a local manner. Finally, reference is made to regional differences in the concentration of steroid hormones in the peritoneal fluid of women, likewise to regional differences in domestic animals.