bluuebunny/crossref_metadata_2025_split huggingface dataset:
Induction of Labor: A Prospective, Randomized Study into Amniotomy and Oxcytocin as Induction Methods in a Total Unselected Population
Authors: Bakos Oddvar , Bäckström Torbjörn 
Published: November 2007

All women (n =223) scheduled for induction of labor were randomized into start with oxcytocin infusion (O) or amniotomy (A). After 4 h an assessment of the progress and prognosis was made. If the progress was not acceptable O was added to A and A to O.Oxcytocin alone showed the lowest frequency of delivered patients. The “amniotomy only” group showed the shortest duration of delivery. The frequency of complications was low but somewhat higher when the initial step was oxcytocin.Oxcytocin alone is not a good method for induction. Early evaluation of the progress and prognosis of the induction is difficult. The combination of amniotomy and oxcytocin seem to be more essential than the choice of initial step. If, however, an infusion of oxcytocin is the first proceeding, amniotomy should be added on a routine basis and without delay.Bishop score is not a conclusive measure of the readyness of uterus to go into labor. Parity may partly be the explanation but other today unknown factors are probably involved in the inducability.
Sex Hormone Binding Globulin in Clinical Perspective
Authors: Bond Andrew , Davis Collin 
Published: November 2007

The plasma steroid‐binding proteins play a fundamental role in the modification and delivery of the steroid “signal” to its target tissue. While their precise function requires further evaluation, the measurement of these proteins, particularly of SHBG, provides clinically useful information.This article reviews the current theories of sex steroid transport and uptake, and documents the changes in SHBG status relevant to health, disease and drug therapy.
Ultrasound measurement of the ovarian volume
Authors: Andolf Ellika , Jörgensen Connie , Svalenius Elizabeth , Sundén Bertil , Andolf E. 
Published: November 2007

The ovaries of 377 women between the age of 40 and 70 years were measured by ultrasound. About one third of the patients were postmenopausal. Mean value, standard deviation and S.E.M. of the ovarian volume were calculated and related to age, parity and menstrual cycle. Ovarian size decreased with age in all women but bore no relation to parity and day of menstrual cycle in the menstruating group of women over 40 years of age. A diagram of the ovarian volume related to age is presented.In postmenopausal women the volume was related to estrogen treatment, age, parity and years since menopaus. In the group of women receiving orally administered estrogens for at least a year the p‐values for all parameters were >0.005. Furthermore, the ovarian volume of women under hormonal treatment did not decrease with age. On the other hand the most important factor for ovarian size in subjects not receiving estrogen treatment was age (p = 0.0056).The results presented here will serve as a prerequisite for sonar examination of the ovaries in women at high risk for developement of ovarian carcinoma.
The Effect Of Peroral Lynestrenol On Serum Lipids And Lipoproteins In Therapeutic Amenorrhea Of Mentally Retarded Women
Authors: Huovinen K. , Tikkanen M. J. , Varonen S. , Wilska M.‐L. , Westermarck T. , Vesterinen H. 
Published: November 2007

Serum concentrations of total cholesterol, high‐density lipoprotein cholesterol (HDL‐C), apolipoprotein A1 (Apo A1), apolipoprotein 6 (Apo B), and triglyceride (TG) were measured and that of low density lipoprotein cholesterol (LDL‐C) calculated in blood samples obtained from mentally handicapped women undergoing therapeutic amenorrhea (TA) induced by 5–10 mg of peroral lynestrenol, some receiving, some not receiving simultaneous anticonvulsant therapy Iphenytoin, carbamazepine or barbiturate, alone or in combination), In addition, these analyses were carried out in women receiving only anti‐convulsants and in controls (mentally handicapped women not receiving any of the above‐mentioned medications).Significantly lower HDL‐C, Apo A1, TG and cholesterol concentrations were measured in TA patients receiving lynestrenol only, than in those receiving anticonvulsants only, or in controls (p<0.001). With regard to HDL‐C and Apo A1, patients receiving both lynestrenol and anticonvulsants were intermediate between lynestrenol only patients and controls, but the HDL‐C/LDL‐C and Apo A1/Apo B ratios were similar to those observed in lynestrenol only patients.Addition of 8 or 12 mg of estriol succinate to the lynestrenol regimen was virtually without an effect. However, halving of the lynestrenol dose resulted in a significant increase in HDL‐C and in the HDL‐C/LDL‐C and Apo A1/Apo B ratios (p<0.001 or p<0.01), respectively. The lynestrenol dose was thus the most important determinant of lipoprotein pattern and should be kept as small as possible in order to reduce cardiovascular risk.
Effect of Cortisol on the secretion of testosterone and estradiol‐17β by human granulosa‐luteal cell cultures
Authors: Tsai Li , Pousette Åke , Johansson Christer , Carlström Kjell 
Published: November 2007

The combination of hypercortisolism and usually low androgen and estrogen levels is frequently observed in female long distance athletes. In order to find a useful model system for studying the underlying mechanisms, the following studies were performed. The effect of Cortisol on the secretion of testosterone (T) and estradiol‐17β (E2) by human granolosa‐luteal cells was studied in vitro in cultures of cells recovered from mature follicles of gonadotrophin stimulated women (participating in the IVF program). Following 24 hours of culture in tissue culture medium without hormonal additives, the granulosa‐luteal cells were incubated for 6 hours in media with addition of 4‐androstene‐3,17‐dione (A‐4) as precursor and hMG and Cortisol in different combinations. The secretion of T was significantly stimulated by Cortisol but not by human menopausal gonadotrophin (hMG). Cortisol, but not hMG, also increased the secretion of E2, although this effect was not statistically significant.These in vitro findings make a direct effect of Cortisol upon ovarian sex steroid secretion less likely as the mechanism behind the subnormal sex steroid levels in female long distance athletes. Instead, inadequate gonadotrophic stimulation, related to hypothalamic amenorrhea, and/or a selective decrease in the adrenal secretion of precursor steroids, may be an explanation.
Intervention during labor: risk factors associated with complete tear of the anal sphincter
Authors: Bek Karl Møller , Laurberg Søren 
Published: November 2007

Among 41,200 consecutive deliveries there were 152 cases of complete tear of the anal sphincter (complete tear). In a case‐control design, the association between interventions during labor (forceps, vacuum extraction, use of oxytocin and prostaglandins and mediolateral episiotomy) and complete tear, were evaluated by confounder control using multiple logistic regression analysis. Controls chosen were the patients delivering just before and after the index patient with complete tear.Use of Kielland forceps, mediolateral episiotomy, shoulder dystocia and nulliparity were significantly associated with complete tear. Maternal age, presentation in labor, duration of second stage of labor and the indication for instrumental deliveries and episiotomy had no significant association with complete tear.
Vaginismus ‐ iatrogenic precipitation and maintenance
Authors: Pedersen Beth Lilja , Møhl Bo 
Published: November 2007

Four cases of vaginismus are presented. Two of them illustrate an iatrogenic precipitation of vaginismus, one misdiagnosis of vaginismus, and one shows the use of unnecessary hymenectomy as the first choice of treatment of vaginismus.The etiology of vaginismus and the indications of first pelvic examinations are discussed.
Changing concepts of medical treatment of endometriosis
Authors: Kauppila Antti 
Published: November 2007

Studies on the natural history of endometriosis have demonstrated that the majority of endometriosis implants tend to progress, a finding that indicates eradication of the lesions by medical and/or surgical approaches. Infertility and dysmenorrhea are other indications for medical therapy in this disease.In recent prospective and controlled studies, progestin (at high doses), gestrinone and GnRH agonist analogues have been equally effective as regards elimination of endometriosis and relief of endometriosis‐associated symptoms, compared to danazol, a standard treatment in endometriosis. These four classes of drugs differ, however, in their adverse effects and as regards compliance. Danazol is a steroid with androgenic and anabolic effects and it adversely affects lipid metabolism. Gestrinone and 17‐OH progestins are weaker, and GnRH agonist analogues and some progestins neutral in these respects. GnRH agonist analogues induce a hypo‐estrogenic state with associated climacteric symptoms and mineral loss from the bones. The clinical value of combinations of GnRH analogue and steroid(s), used to prevent these side‐effects, is so far unclear.Laparoscopic microsurgery has revolutionized the treatment of endometriosis lesions. Hence, hormone treatment as a supplement to microsurgical approaches may become a dominant form of medical therapy in endometriosis. The definitive value of pre‐ or post‐operative hormonal treatment in this disease should, however, be tested in controlled trials. Such studies have proved antiprostaglandins to be useful in the treatment of dysmenorrhea secondary to endometriosis.Because each of the four drugs was ineffective in the treatment of infertility associated with endometriosis it is a waste of time to expose patients desiring pregnancy to long‐term hormonal therapy. Ovarian hyperstimulation with IVF and other methods of assisted fertilisation are promising alternatives, but their definitive value is so far unproven in this disease. Conclusively, the significance of medical therapy in endometriosis is only partly resolved, and therefore, many therapeutic problems await prospective randomised trials and new innovations.
Iodine deficiency in pregnancy in Denmark
Authors: Nøhr Susanne B. , Laurberg Peter , Børlum Karl‐Gerhardt , Pedersen Klaus M. , Johannesen Peter L. , Damm Peter , Fuglsang Ebbe , Johansen Allan 
Published: November 2007

Iodine requirements are increased during pregnancy and lactation and adequate iodine intake is important for normal brain development of the fetus/newborn child.The aim of the present study was to evaluate the extent to which this increase in iodine requirement is met in pregnant women living in various regions of Denmark. One hundred and fifty‐two healthy pregnant women admitted to five different Danish departments of obstetrics participated in the study. Iodine status was evaluated by measurement of iodine in spot urine at day five after delivery and by careful history of the intake of iodine containing vitamin/mineral tablets.Approximately one third of the women had received tablets containing iodine. In women who had not received iodine supplementation urinary iodine was low with a median value of 39,7 μg/g creatinine (Aalborg 28, Randers 33, Ringkabing 34, Arhus 43 and Copenhagen 62 μg/g creatinine).These values are far below internationally recommended levels. The consequences remain to be evaluated and no firm recommendations can be given. It seems reasonable, however, to recommend a high intake of food containing iodine (e.g. milk products) during pregnancy and lactation. Since nearly all the women took some kind of vitamin/mineral supplementation it could be considered to advocate intake of vitamin/mineral tablets containing iodine.
Prehysterectomy curettage in women with uterine fibromyomata is not worthwhile
Authors: Møller Lars Mikael Alling , Berget Arne 
Published: November 2007

Objective: To study the value of prehysterectomy curettage in women referred on the suggestion of uterine fibroids.Design: A retrospective study.Setting: Gentofte Hospital, University of Copenhagen.Subjects: Four hundred and eleven patients with a curettage prior to hysterectomy on suspicion of uterine fibroids.Main outcome measure: Histological accuracy, frequency of (pre)malignancies and clinical consequences due to routine curettage.Results: Curettage disclosed two cases of endometrial cancer and four cases of ON. It missed two cases of CIN and one case of endometrial cancer in a postmenopausal women. In no case did the final histology disclose diseases that had not been taken care of during the laparotomy.Conclusion: Curettage in women with a preoperative diagnosis of uterine fibromyomata is not worthwhile.
Management of functional ovarian cysts after induction of ovulation
Authors: Ben‐Ami M. , Geslevich Y. , Battino S. , And M. Matilsky , Shalev E. 
Published: November 2007

To investigate the need for hormonal treatment in patients with functional ovarian cysts after induction of ovulation, a randomized prospective study was performed. Fifty‐four patients who were found to have ovarian cysts after induction of ovulation were randomly assigned to two groups:a) Treatment with estrogen /progesterone.b) Expectant management.The main outcome measure was resolution of ovarian cysts. There was no significant difference between the groups. We conclude that hormonal treatment is not necessary in cases with functional ovarian cysts after induction of ovulation.
Phenylethanolamine‐N‐methyl transferase and catechol‐O‐methyl transferase activity in rat uterus
Authors: Casimiri Viviane , Cohen Wayne R. , Parvez Simone , Hobel Calvin , Parvez Hasan 
Published: November 2007

Purpose. The activity of phenylethanolamine‐N‐melhyl‐transferase (PNMT) and catechol‐O‐methyl‐transferasc (COMT) was studied in uterine homogenates from adult female Wistar rats with normal cycles and that had been ovariectomized. adrenalectomized. and steroid‐treated.Results. Activities of the two enzymes changed significantly during the normal estrus cycle. Both peaked during metestrus. with COMT showing a secondary peak of activity at proestrus. Progesterone treatment significantly increased and estradiol decreased PNMT activity in comparison to untreated controls. Hydrocortisone administration had no effect on uterine PNMT activity. COMT activity was not affected significantly by any of the steroid treatments.Conclusion. The data confirm that uterine tissues possess the enzymatic machinery to synthesize epinephrine from norepincphrine. and suggest the activity of this pathway may be mediated by variations in the sex hormone environment of the uterus.
Continuous progesterone exposure associated with high contraction frequency in human term myometrial strips
Authors: Löfgren Mats , BÄckstrÖm TorbjÖrn 
Published: November 2007

It has been shown that progesterone slightly reduced the work of human term myometrial strips. In vitro 5α‐pregnane‐3,20‐dione and 3α‐hydroxy‐5α‐pregnan‐20‐one, two major extra‐hepatic metabolites of progesterone, had only minor effects or none at all. The myometrial strips were stored and superfused in a progestin‐free buffer until the onset of contractions when progestin superfusion was commenced. In vivo the human myometrium is never deprived of the influence of these steroids, either prior to or during labor. In the present investigation we studied whether progesterone and the two named progesterone metabolites would have a different effect when the myometrial strips were not deprived of steroid. Muscle biopsy samples from the lower uterine segment were immediately placed and stored in buffer containing progesterone, 5α‐pregnane‐3,20‐dione, or 3α‐hydroxy‐5α‐pregnan‐20‐one. The strips were then bisected; one half was superfused with progestin buffer, and the other half with plain buffer to serve for control purposes.In strips continuously exposed to progesterone, the onset of contractions was delayed, compared with their progesterone‐depleted controls. This was as expected, according to current opinion regarding progesterone and parturition. Once muscular contractions were established, the contraction frequency was significantly higher, due to a shorter muscular relaxation time, in the progesterone‐superfused strips than in the controls and strips treated with progesterone metabolite superfusion. This was unexpected and can be interpreted as if continuous presence of progesterone facilitates human myometrial contraction frequency once contractions have started. Conversely, the 5<x‐progesterone metabolites showed no effect or minor effects.
Low‐back pain of pregnancy
Authors: Orvieto Raoul , Achiron Anat , Ben‐Rafael Zion , Gelernter Ilana , Achiron Reuwen 
Published: November 2007

Background. Low‐back pain (LBP) is a commonly observed symptom during pregnancy. Despite its high frequency the extent of the problem is less well documented and detailed studies concerning related risk factors are scarce. Furthermore, efforts to address the problem are hampered by the inability to predict accurately which pregnancies are at risk. This study was conducted in order to assess the frequency, manifestations and the contribution of various factors to the development of LBP during pregnancy.Methods. The study included 449 pregnant women who were consecutively referred for an antenatal ultrasonographic examination for various reasons. A simple questionnaire which consisted of several items along with ultrasonographic measurements was devised to evaluate the incidence of and risk factors for LBP during pregnancy.Results. 246 (54.8%) women reported LBP in the present pregnancy. Factors which were found to be significantly associated with an increased risk to develop LBP during pregnancy included low socioeconomic class, existence of LBP before the first pregnancy, during previous pregnancy, and interim pregnancies. Moreover, in nulliparous women, body mass index (BMI) was found to be significantly higher in women suffering from LBP. A tendency was observed between posterior/fundal location of the placenta to the presence of LBP during pregnancy. This tendency was also observed among parous but not among nulliparous women. Among pregnant women with LBP, pain radiation correlated significantly to fetal weight. Moreover, this correlation was also of statistical significance in nulliparous women with anterior placental location. Back care advice given to women suffering from LBP was found to significantly reduce LBP. The age, number of prior pregnancies, gestational age, average maternal height, weight and BMI were not found to be risk factors in LBP. Furthermore, we found no influence of previous abortion/s, instrumental delivery, previous cesarean section, or a history of epidural anesthesia during a previous labor were risks to develop LBP in the subsequent pregnancy.Conclusions. In the present pregnancy, LBP during pregnancy was associated with a history of LBP various socioanthropometric measures, as well as several ultrasonographic and obstetrical data. Back care advice offered to pregnant women who are prone to develop LBP during pregnancy, as early in their pregnancy as possible, may prevent or result in less ‘troublesome’ and ‘severe’ LBP during pregnancy.
Smoking cessation in pregnancy: Intervention among heavy smokers
Authors: Valbös Annelill , Nylander Gro 
Published: November 2007

Objective. To investigate the effects of a low cost multicomponent intervention program among pregnant heavy smokers.Design. A randomized controlled experimental trial.Setting. The National Hospital, Oslo, Norway.Subjects. 104 pregnant women smoking 10 cigarettes or more daily at the time of routine ultrasound screening around the 18th week of pregnancy.Intervention. Around the 18th week of gestation the women received information about the dangers of smoking in pregnancy together with a self‐help manual. The manual was developed especially for pregnant women to aid smoking cessation during a 10 day program. A control ultrasound was performed around the 32nd week of pregnancy. Two encouraging reminders were mailed to them before and after the control ultrasound.Main outcome measures. Changes in smoking pattern were investigated at delivery time. Smoking cessation, reduction, increase and no change in smoking consumption was registered.Results. 20% stopped smoking and 65% reduced their smoking in the intervention group compared to 4% and 38% respectively in the control group. 11% in the intervention group did not change their smoking habit and 4% increased their consumption compared to 36% and 22% respectively in the control group. The differences were highly significant.Conclusion. This low cost multiple intervention model seems more effective than other intervention models investigated in Norway. The resources invested are probably within the limits of the common pregnancy health care.
Epidural analgesia in active management of labor
Authors: Cammu Hendrik , Verlaenen Hilde , Amy Jean‐Ja cques , De Koster Katelijne , Derde Marie‐Paule , Buekens Pierre 
Published: November 2007

Objectives. To examine the determinants of epidural analgesia in the active management of labor. To examine the association of epidural with instrumental delivery and cesarean section. Study Design. Observational study in a teaching hospital with a uniform active labor management and availability of epidural analgesia on demand. A thousand consecutive nulliparous women at term, were assessed.Results. Requests for epidural anesthesia were predominantly expressed at the time the patient was notified that spontaneous labor was going to be augmented by the administration of oxytocin, or later, when this latter treatment caused labor to be subjectively more arduous. In induced labor, the same observation applied to a greater degree, still. Operative delivery was significantly more frequent in patients with epidural. However, when the incidence of operative delivery was adjusted for the use of oxytocin, the significance between patients with epidural versus the others abated.Conclusion. The use of oxytocin in active management of labor results in a high demand for epidural when this is available on demand. This, however, need not be associated with an increased incidence of operative delivery.
Relative macrosomia identified by the individualised birthweight ratio (IBR): A better method of identifying the at risk fetus
Authors: Sanderson David A. , Wilcox and Mark A. , Johnson Ian R. 
Published: November 2007

Objective. To assess the effectiveness of a newly developed individualised birthweight ratio (IBR), which corrects for physiological birthweight determinants, in identifying infants at risk from the complications of macrosomia.Design. Prospective observational study.Setting. Obstetric unit, Nottingham City Hospital.Subjects. 2835 women delivered between December 1991 and July 1992 and the infants of 624 of these, selected by virtue of their birthweight for gestation and IBR centile positions.Main outcome measures. Skinfold thickness and ponderai index measurements, operative delivery, shoulder dystocia, fetal trauma, impaired glucose tolerance.Results. Using an IBR above the 90th centile as a cut off results in 2.4% of infants being reclassified as normally grown and 3.1% are reclassified as large. The IBR des not result in the identification of any more infants with abnormal ponderai indices or skinfold thicknesses than birthweight for gestation. It does, however, identify more of the infants at risk of operative delivery, shoulder dystocia, fetal trauma and impaired glucose tolerance.Conclusion. The IBR significantly improves upon birthweight for gestation in identifying infants who suffer from the complications of relative macrosomia.