bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oral poliovirus vaccination and pregnancy complications
Authors: Harjulehto‐Mervaala Tina , Hovi Tapani , Aro Timo , Saxen Harri , Hiilesmaa Vilho K. 
Published: November 2007

Background. To determine whether the effect of live attenuated oral polio virus vaccine given to pregnant women increases pregnancy complications.Methods. A study of women who had been vaccinated against poliovirus during a national vaccination campaign and who had delivered by cesarean section in three obstetrical hospitals in southern Finland. One thousand seven hundred and forty‐seven vaccinated women (in three study cohorts), and their 2293 nonvaccinated controls (in two reference cohorts) were analyzed. Subjects are out of 22 000 deliveries evaluated earlier.Results. Vaccinated sectioned women did not show an excess of pregnancy complications. The mean rate of cesarean sections was 18.4% in the study cohorts and 18.9% in the reference cohorts counted from the 22 000 deliveries.Conclusions. Oral live attenuated polio virus vaccine does not increase pregnancy complications and is considered a safe alternative for vaccinating pregnant women.
Preventing the recurrence of atonic postpartum hemorrhage: a double‐blind trial
Authors: Van Selm Maria , Kanhai Humphrey H.H. , Keirse Marc J.N.C. 
Published: November 2007

Background. We conducted a double‐blind randomized controlled trial to compare a conventional regimen of oxytocin and ergometrine with administration of the prostaglandin E2 analogue, sulprostone, for prophylaxis of postpartum hemorrhage in high‐risk women.Methods. Women with a history of postpartum hemorrhage ≥1000 were assigned to two coded prophylactic regimens. Drugs, given respectively at delivery of the anterior shoulder and after delivery of the placenta, were oxytocin and ergometrine in the control group, and sulprostone and placebo in the experimental group. Eighty‐one women, 69 of whom actually participated in the trial, were investigated. Both the women and the caregivers were unaware of treatment allocation.Results. Although the trial was terminated prematurely there was a slight, but not statistically significant, preference for the sulprostone regimen in terms of blood loss and use of blood transfusion. No serious adverse effects were noted with either of the two regimens.Conclusion. Prostaglandins may be more effective for preventing recurrence of severe postpartum hemorrhage than the oxytocin and ergometrine combination, but they do not eliminate the risk entirely.
The influence of social class on parity and psychological reactions in women coming for induced abortion
Authors: Hamark Bengt , Uddenberg Nils , Forssman Lars 
Published: November 2007

Objective. To test the hypothesis that the correlation between legal abortion and socio‐economic conditions, known from the time when abortion was restricted, has current validity. To evaluate the effect of social class on network support and psychological reactions.Design. Consecutive sampling and semistructured personal interviewing.Subjects. 444 women living in the city of Gothenburg and applying for legal termination of pregnancy in the first trimester.Setting. The department of gynaecology at a university hospital with primary care responsibility for legal abortions.Results. The 667 health administration districts of Gothenburg were ranked into four groups according to the mean income. Women living in lower socio‐economic districts were younger. Irrespective of age, previous experience of induced abortion was more common among them (p<0.001). Unsatisfactory network response or support was common (37%), but equally shared between the social classes. Discontinuation of oral contraception during the previous six months was twice as common among teenagers (40.0%) as among other women (p<0.001) but without social differences. Pitman's permutation test was used for statistical analyses. Conclusion. Socio‐economic conditions have a strong and inverse correlation to previous experience of induced abortion. Psychological reactions and needs did not vary with class.
Cervical ripening and induction of delivery by local administration of prostaglandin E2 gel or vaginal tablets is equally effective
Authors: Rix Per , Ladehoff Poul , Møller Anna Margrethe , Tilma Karen Andersen , Zdravkovic Milica 
Published: November 2007

Background. Prostaglandin E2 for local application has been widely used for preinduction cervical ripening in cases presenting with an unfavorable cervical state. The optimal way of administering prostaglandin E2, however, remains unclear. The aim of this study was to compare the effect of multiple application of 0.5 mg Minprostin® intracervical Gel to the effect of 3 mg Minprostin® vaginal tablets in priming the uterine cervix and inducing labor in an open, prospective, randomised study.Methods. PGE2 was applied up to three times a day for two days until ripening was obtained or labor induced. In case no progress took place amniotomy was performed and i.v. oxytocin stimulation one hour later if necessary. A total of 208 pregnant women, consecutively admitted for induction of delivery, with Bishop Scores 0‐5, were included.Results. Minprostin® gel (group I) and Minprostin® tablets (group II) were equally effective in ripening the cervix. Delivery within 48 hours was achieved in 59% and 63% respectively. The mean number of applications was 2.6 (s.d. 1.6) and 2.7 (s.d. 1.3) respectively. In case more than four doses were required no further effect was seen on delivery rates. Rates of cesarean section (performed in 15% and 18% respectively), labor induction (3%/1%), drop outs (14%/12%) and failed inductions (10%/5%) were comparable. Patients in group I had a significantly lower demand for analgesia. A significantly shorter induction‐delivery interval in group II was seen in patients with preinduction Bishop scores 3‐5 compared to patients with Bishop scores 0‐2. Side effects were few. Both procedures appear safe. Conclusions. Cervical ripening and induction of delivery by local administration of prostaglandin E2 gel or vaginal tablets in cases presenting with an unfavorable cervical state is equally effective.
Effect of vaginal misoprostol application for cervical softening in pregnancy interruption before ten weeks of gestation
Authors: Ficicioglu Cem , Taşdemir Murat , Taşdemir Seval 
Published: November 2007

Objective. To determine the effect of vaginal misoprostol application for cervical dilatation and to determine the lime taken for pregnancy interruption.Methods. 200 μg misoprostol and gyno‐flor vaginal tablet, employed to create acidic milieu, were applied into the posterior fornix of 40 women with gestational age of 5 to 10 weeks. Placebo was applied vaginally to 20 women who made up the control group. All cases were examined 5 hours later. The cervical dilatation, presence of fetoplacental material in the vagina, extrauterine cervical bleeding and the time necessary for dilatation and suction curettage were investigated.Results. In 33 (82.5%) of the cases cervical bleeding, in 21 (52.5 %) of the cases fetoplacental material on the cervix and or in the vagina were detected in women of misoprostol group, while neither cervical bleeding nor fetoplacental material on the cervix and/or in the vagina was detected in the placebo group. In the misoprostol group the time taken for the operation was significantly (p<0.005) shorter than that of the control group.Conclusion. Vaginal application of misoprostol shortens the time needed for the termination of the gestation by its facilitating effect on cervical dilatation.
Relaxant effect of nitric oxide and prostacyclin on serotonin‐induced vasocontraction of human umbilical artery
Authors: Okatani Yuji , Watanabe Kazushi , Nakano Yuji , Sagara Yusuke 
Published: November 2007

Background. We investigated the effect of nitric oxide and prostacyclin, which are endothelium‐derived vasodilators, on serotonin (5‐HT)‐induced vasocontraction, and 5‐HT1‐serotoninergic receptor mediated relaxation in the human umbilical artery. Methods. Serotonin‐stimulated vasocontraction was measured in umbilical artery segments treated with and without 1) L‐arginine (10−4 M∼10−2 M), a precursor of nitric oxide synthesis: 2) methylene blue (10−5 and L‐NG‐monomethyl arginine (LNMA, 2×10−4 M), which are specific inhibitors of nitric oxide action and nitric oxide synthesis, respectively; and 3) tranylcypromine (2× 10−7 M. 2×10−5 M), an inhibitor of prostacyclin synthesis. 4) Vessels were pretreated with M1. an inhibitor of 5‐HT2 serotoninegic receptors, and then prostaglandin F2 α (9.0×10−7 M). Finally, we measured the 5‐HT1 receptor‐mediated relaxation induced by 5‐HT.Results. Treatment with L‐arginine significantly inhibits 5‐HT‐induced contraction in a dose‐dependent manner. Treatment with methylene blue and LNMA significantly potentiated 5‐HT‐induced contraction. Tranylcypromine caused no significant changes in 5‐HT‐induced vasocontraction. 5‐HT1 serotoninetic receptor‐mediated relaxation was found at higher concentrations of 5‐HT (greater than 4.94× 10−5 M).Conclusions. Our results suggest that nitric oxide may exert a strong relaxant effect on 5‐HT‐induced vasocontraction compared with prostacyclin in human umbilical artery.
Local administration of prostaglandin E2 for cervical ripening and labor induction: the appropriate route and dose
Authors: Nuutila Mika , Kajanoja Pauli 
Published: November 2007

Background. Although there are many comparative studies concerning the local administration of prostaglandin E2 gel for cervical ripening and labor induction, the safety, efficacy and the appropriate route and dose of the gel are still debated.Patients and methods. One hundred and ten women with high‐risk pregnancy and unripe cervix received prostaglandin E2 gel 1 mg intravaginally (n=35), 2 mg intravaginally (n=36) and 0.5 mg intracervically (n=39), maximally three times at 6‐hour intervals for cervical ripening prior to labor induction. The safety, efficacy and optimal dose were assessed. Results. The 2 mg intravaginal gel and the 0.5 mg intracervical gel were equally effective and more effective than the 1 mg intravaginal gel in labor characteristics such as ripening time and cesarean section rate, but not in labor time. However, the failure rate (labor could not be induced) was highest in the intracervical group (10.3%) compared to the intravaginal groups (2.9% and 2.8%), although the differences were not statistically significant. In the two intravaginal groups three and five patients received the third gel application and one patient in both groups could not be induced. In the intracervical group the ripening of the cervix failed in all patients, who received the third gel. The neonatal outcome was uneventful in all groups. There were two cases of uterine hypertonus associated with fetal bradycardia, one in the intracervical and one in the 2 mg intravaginal group. Thus careful fetal monitoring is necessary. Furthermore, the vaginal route has the advantage of an easier technique of administration and obviously lower risk for inadvertent extraamnial instillation.Conclusion. We recommend the use of multiple applications of 2 mg intravaginal prostaglandin E2 gel as a safe, effective and easy method for preinduction cervical ripening in high‐risk pregnancies. More than three gel applications hardly increase the efficacy.
Reduction of bone mineral density by gonadotropin‐releasing hormone agonist, nafarelin, is not completely reversible at 6 months after the cessation of administration
Authors: Taga Michiyoshi , Minaguchi Hiroshi 
Published: November 2007

Study Objective. To determine the reversibilty of bone mineral density after the cessation of GnRH agonist treatment for endometriosis.Design. Longitudinal trial with 6‐month treatment period and 6‐month follow‐up.Patients. 28 Japanese premenopausal women with endometriosis.Interventions. Daily dose of 400 μg nafarelin was administered for 6 months. Measurement and main results. The spine bone mineral density was measured by dual energy X‐ray absorptiometry, and blood and urinary bone metabolic parameters were analyzed. The decrease of lumbar bone mineral density, which took place during treatment, continued during the first 3 months after the cessation of treatment and did not return to the initial baseline level even at 6 months after the withdrawal of treatment. The biochemical parameters, which showed a state of enhanced bone turnover during nafarelin treatment, almost returned to the pretreatment level 6 months after the termination of treatment.Conclusion. These results indicate that relatively long period of bone metabolic change might be required to alter the actual bone mineral density after GnRH analog administration.
Management of urinary bladder injuries in laparoscopic assisted vaginal hysterectomy
Authors: Lee Chyi‐Long , Lai Ying‐Ming , Soong Yung‐Kuei 
Published: November 2007

Background. To illustrate our experience and evolution in management of urinary bladder injury in laparoscopically assisted vaginal hysterectomy.Methods. Four hundred and twenty‐two women underwent laparoscopically assisted vaginal hysterestomy with or without adnexectomy during the period March 1991‐September 1994. The indicators for hysterectomy included adenomyosis myoma uteri, intractable menorrhagia, endometriosis and severe pelvic adhesion. There are six cases of urinary bladder injuries resulting from our 422 cases of laparoscopically assisted vaginal hysterectomy.Results. The first two cases of urinary bladder injuries were repaired through exploratory laparotomy. The third case was repaired through laparoscopic intracorporeal suture. The technique of the automatic linear stapler through laparoscopy was used in case 4. The last two cases were repaired vaginally. All these patients recovered well after primary repair with an indwelling catheter for five to seven days regardless of the method of repair. The operation time for repairing the injuries is shortest in vaginal approach.Conclusions. The urinary bladder injury is one of the most common complications associated with laparoscopically assisted vaginal hysterectomy. Early detection and treatment enable complications to be overcome easily. As the laparoscopist acquires further experience in dealing with these complications, the urinary bladder injury may be managed laparoscopically. However, vaginal approach may be an easier way in dealing with this complication. Thus most laparotomy or high technique laparoscopically repair could be avoided.
A prospective study of antibodies against parvovirus B19 in pregnancy
Authors: Skjöldebrand‐Sparre Lottie , Fridell Eva , Nyman Margareta , Wahren Britta 
Published: November 2007

Background. Parvovirus infection during pregnancy has been reported to be associated with spontaneous abortion and fetal loss.Objective. To show the incidence of antibodies against Parvovirus B19 early in pregnancy and sero‐reactivities during and after pregnancy.Study design. In a prospective study during a non‐epidemic period, 457 women admitted to an antenatal care center were included. Serum samples were collected at 7‐13, 21, and 33 weeks of gestation, and 7‐9 weeks after delivery.Method. Samples were evaluated for parvovirus specific IgG and IgM against two different parvovirus antigens.Results and conclusion. Parvovirus specific antibodies were present in 81% of the women in the first sample. Six women (six of 88 susceptible, 6.8%) seroconverted and 28 women (28/ 369. 7.6%) boosted their antibody response during or after pregnancy. All gave birth to healthy infants.One woman free of symptoms experienced an intrauterine fetal death at 37 weeks of gestation. She had no rise in B19 antibodies during pregnancy, but parvovirus DNA was found in maternal serum samples and in the placenta.
Prospective study of incidence and predisposing factors for clavicular fracture in the newborn
Authors: Many Ariel , Brenner Steven H. , Yaron Yuval , Lusky Ayala , Peyser M. Reuben , Lessing Joseph B. 
Published: November 2007

Objective. To determine the incidence of clavicular fractures, associated fetal and maternal risk factors and its connection with quality care control.Results. Forty‐six (1.5%) newborns were found to have clavicular fractures. When compared to the control group, they were found to have a higher birthweight (3710±352gm vs 3235±405gm) an older maternal age (30.5±5 vs 27.7±6), a longer second stage of labor (34 min vs 23 min). higher rate of instrumental deliveries (13/46 vs 6/52) and shoulder dystocia (6/46 vs 1/52). Nearly 80% of newborns with clavicular fractures weighed less than 4000 gm. Multivariate analysis demonstrated two independent variables; birthweight over 3500 gm and maternal age >29.Conclusion. Clavicular fractures are associated with higher birthweight, older maternal age, longer second stage of labor, instrumental deliveries and shoulder dystocia. However, in most cases this injury cannot be predicted prior to delivery and thus cannot be an indicator of quality control.Subjects and methods. A total of 3030 newborns delivered vaginally were evaluated for clavicular fractures by three separate physicians. The study group included all newborns with fractured clavicle. A control group consisted of 52 newborns delivered vaginallly with no history of fractures. Maternal records were evaluated for possible predisposing factors.
The effect of post‐natal exercises to strengthen the pelvic floor muscles
Authors: Mordved Siv , Bo Kari 
Published: November 2007

Background. The purpose of the present study was to evaluate the effect of post‐natal pelvic floor muscle exercise.Methods. A prospective comparison design comprising 66 matched pairs (n=132) of mothers, divided into a training group (TG) and a control group (CG) was used. The TG attended an eight week special pelvic floor muscle exercise course, training in groups led by a physiotherapist 45 minutes once per week. In addition they exercised at home at least three times per week. The CG followed the ordinary written postnatal instructions provided by the hospital. Pelvic floor muscle strength was measured at the 8th and the 16th week after delivery using a vaginal balloon catheter connected to a pressure transducer. Vaginal palpation and observation of inward movement of the balloon catheter during contraction, were used to control the ability to perform correct pelvic floor muscle contraction. In addition the women were interviewed about breast feeding, menstruation, general physical activity and pelvic floor muscle exercise during pregnancy, between birth and test 1, and between test 1 and test 2. Wilcoxon‐Signed‐Ranks‐Test for matched pairs was performed to compare change in pelvic floor muscle strength within and between groups.Results. While a statistically significant change in pelvic floor muscle strength was found in both the TG and the CG. the improvement for the training group was significantly greater.Conclusions. It was concluded that a specially devised pelvic floor muscle strength training programme can add significantly to physical recovery after childbirth.
Effects of endothelin‐1 and the ETA receptor antagonist BQ‐123 on resistance arteries from normal pregnant and preeclamptic women
Authors: Wolff Kerstin , Kublickiene Karolina‐Rasa , Kublickas Marius , Lindblom Bo , Lunell Nils‐Olov , Nisell Henry 
Published: November 2007

Objective, To compare the effect of endothelin on isolated resistance arteries from different vascular beds in normal and preeclamptic women before and after pretreatment with the ETA receptor antagonist BQ‐123.Materials and methods. Resistance arteries from myometrial and omental biopsies obtained at cesarean section of normal pregnant and preeclamptic women were dissected and mounted in organ baths for recording of isometric tension. The contractile response to endothelin‐1 in presence and absence of BQ‐123 was recorded.Results. Endothelin‐1 induced similar concentration‐dependent contractions in all arteries investigated. In women with preeclampsia the contractile response induced by endothelin‐1 was significantly higher in omental as compared to myometrial vessels. Pretreatment with BQ‐123 significantly shifted the concentration‐response curve to the right but only reduced the maximum contractile response in omental vessels.Conclusion. Endothelin‐1 is a potent constrictor of resistance arteries from different vascular beds in normal pregnancy and preeclampsia. The contractile effect is at least in part mediated by ETA receptors, since it was significantly reduced after pretreatment with BQ‐123. In preeclamptic but not in normal pregnant women the response to endothelin‐1 was reduced in myometrial as compared to omental arteries, possibly secondary to receptor down regulation.
A comparative study of obstetric outcome of patients with pregnancy induced hypertension: economic considerations
Authors: Omu Alexander E. , Al‐Othman Saed , Al‐Qattan Fawzia , Al‐Falah Fatma Z. , Sharma Prem 
Published: November 2007

Background. Hypertension in pregnancy is associated with increased maternal and fetal morbidity and mortality. The aim of this prospective study was to evaluate the obstetric outcome of patients with pregnancy induced hypertension (PIH) that delivered at the Maternity Hospital Kuwait within a period of six months and evaluate the economic implications of present management strategies.Methods. This was a comparative study with age and parity, as matching variables, in 224 pregnant hypertensive women and 224 normotensive controls.Results. During the study period, the incidence of PIH was 4.9 percent. They were more associated with diabetes mellitus and multiple pregnancy than controls (p<0.02). About 43 percent of the hypertensive parturients used antihypertensive therapy. More of them had induction of labor (p<0.001), preterm delivery (p<0.002) and cesarean section (p<0.001), and babies with low birthweight (p<0.01). In the linear regression analysis, hypertension in pregnancy gave rise to more hospitalisation, intrauterine growth retardation and operative deliveries than the normotensive controls. The perinatal mortality was higher (p<0.001).Conclusion. Despite the economic expenditure of about five times more for hypertensive women in pregnancy than in controls, both obstetric and neonatal outcome, are still significantly worse in the former. This study therefore advocates more research into the prevention, prediction and management, including neonatal care, of hypertensive disorders of pregnancy.
Maternal and perinatal implications of the use of human recombinant erythropoietin
Authors: Braga Jorge , Marques Ricardo , Branco Anabela , Gonçalves Joaquim , Lobato Luísa , Pimentel Joao Pedro , Flores Maria Manuel , Gonçalves Eduardo , Jorge Carlos Santos 
Published: November 2007

Background. The use of human recombinant erythropoietin (rHuEPO) in pregnant patients has been limited by the fear of eventual maternal and fetal repercussions (either direct or indirect).Methods. The authors present their experience with the use of rHuEPO during pregnancy, with two pregnant women with kidney transplants and in three others with chronic renal insufficiency (one with diabetic nephropathy, another dialysis dependent), all with hematocrit below 30% and adequate iron reserves.Results. Three of the patients had needed blood transfusions before beginning therapy, and another needed transfusion after significant metrorrhagia. The length of the treatment varied between 2 and 23 weeks and the hematocrit at delivery varied between 26% and 36%. Secondary effects (appearance or worsening of hypertension and seizures) were nil. There was one fetal death at 23 weeks of pregnancy (following an abruptio placentce), two neonates weighing between the 5th and the 10th percentiles, and three needing phototherapy (1 to 2 days). One year after birth, all showed a normal ponderal and neurologic development.Conclusions. Among the cases presented, no maternal and perinatal complications attributable to rHuEPO were registered. It is important that institutions report their experiences with the use of rHuEPO, given its restrictive indications and the limited experience of each institution.