bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ultrasonographical and hormonal description of the normal ovulatory menstrual cycle
Authors: Bakos Oddvar , Lundkvist Örjan , Wide Leif , Bergh Torbjörn 
Published: November 2007

Objective. To describe the changes in uterine volume, endometrial thickness and follicular size during the normal menstrual cycle by use of transvaginal ultrasonography and to correlate these changes with the endocrine events in the same cycle.Methods. A group of 23 healthy women with normal body mass index and with a history of regular menstruations were monitored with repeated hormonal and vaginal ultrasonographical investigations during the menstrual cycle.Results. Sixteen of the women fulfilled the hormonal criteria for ovulation. The mean length of the cycles was 28 days (range 25–30 days) with a mean length of the follicular and the luteal phases of 14.4 days (range 12–17 days) and 13.5 days (range 12–16 days), respectively. The estradiol level in serum the day before the peak of the luteinizing hormone varied between 490 and 1710 pmol/1 (mean 1087 pmol/1). Ultrasonographically, the most clinically relevant changes were the increase in diameter of the dominant follicle and the growth of the endometrium. At ovulation the dominant follicle had a mean diameter of 21.4 mm (range 17.4–27.0), whereas the endometrium had a mean thickness of 12.8 mm (range 10.0–15.9). When analysed over the entire follicular phase, the serum estradiol concentration correlated both with the diameter of the dominant follicle (r = 0.93, p = 0.0001) and with the thickness of the endometrium (r = 0.79, p = 0.0001). However, no such correlations were found when only the last part of the follicular phase was analysed. In the luteal phase there was no correlation between the size of the corpus luteum and the serum concentration of progesterone.Conclusions. Vaginal ultrasonography is a practical and reliable method to monitor structural changes in the ovaries and the uterus during the menstrual cycle. The results are of clinical importance for a better understanding of the physiological changes and helpful when monitoring induction of ovulation in assisted reproduction.
Severely impaired fetal growth is preceded by maternal hemodynamic maladaptation in very early pregnancy
Authors: Duvekot Johannes J. , Cheriex Emile C. , Pieters Frans A. A. , Peeters Louis L. H. 
Published: November 2007

Objective. To test the hypothesis that in pregnancies complicated by intrauterine growth retardation (IUGR) maternal cardiovascular adaptation is already abnormal in the first weeks of pregnancy.Setting. University Hospital Maastricht, Maastricht, The Netherlands.Subjects. Fourteen healthy pregnant women, recruited from the subfertility clinic. Ten pregnancies were uneventful and four pregnancies resulted in the birth of growth retarded infants.Methods. Maternal cardiovascular status was followed longitudinally by combined M‐mode and Doppler echocardiography. Studies were performed weekly between the fifth and 10th week, at 14, 25 and 35 weeks and postpartum. Differences between the two groups were analyzed by nonparametric tests.Results. In early pregnancy, the IUGR group differed from the normal group by a consistently smaller left atrial diameter and a cardiac output that failed to increase. Postpartum the subjects in the IUGR group had a significantly smaller left atrial diameter and faster mean circumferential fiber shortening.Conclusion. Maternal hemodynamic adaptation in the first weeks of pregnancy is defective in IUGR pregnancies, presumably associated with a concomitant inadequacy of the vascular filling state.
The cervical smear record: Its relevance to the subsequent development of cervical neoplasia
Authors: Bertelsen B. , Hartveit F. 
Published: November 2007

Background. Our aim was to investigate the previous smear history in women with cervical intraepithelial neoplasia grade 1–3 or squamous carcinoma and define its relevance to the lesion present in 1989.Methods. All 850 women with a laboratory record of cervical intraepithelial neoplasia or cervical squamous carcinoma in 1989 were studied. We retrieved their cytological and histological cervical diagnoses for the period 1981 to 1992 from the laboratory files. On this basis we assessed their previous smear history and short term clinical outcome.Results. Half the women had a negative record prior to 1989, irrespective of the grade of their lesion in that year. Cervical intraepithelial neoplasia grade 1 had previously been found in 16%, grade 2 in 10%, and grade 3 in 7%. These levels were not related to the grade present in ′89, but as in those with a negative record, were proportional to the number of women examined, and thus reflect the frequency of such lesions in the screened population in general. In all, 310 were treated operatively for cervical intraepithelial neoplasia grade 3 following abnormal findings in 1989. In such cases abnormal findings were also common in ′88, although 45% of them still had a negative smear history. The group with no previous record, i.e. unscreened, contained significantly more invasive cases.Conclusions. In women with cervical intraepithelial neoplasia in 1989, their previous smear history did not indicate the grade of lesion present. The relevance of their previous abnormal slides to that lesion is thus questionable. The findings, however, suggest that progressive lesions may be acute in origin, superimposed in some cases on a history of similar morphological abnormalities.
Alloimmunization during pregnancy treated with high dose intravenous immunoglobulin
Authors: Gottvall Tomas , Selbing Anders 
Published: November 2007

Background. High dose intravenous immunoglobulin has been reported to be advantageous in the treatment of alloimmunization during pregnancy. The mode of action is unknown.Method. High dose intravenous immunoglobulin was used as the sole prenatal treatment in six severely rhesus(D) sensitized pregnant women. Maternal and fetal anti‐D concentrations as well as fetal hemoglobin concentrations were studied. Seven pregnancies in rhesus(D) sensitized women served as controls. They received no treatment because they had milder forms of erythroblastosis fetalis or, in one case, a rhesus(D) negative fetus.Result. No obvious inhibitory effect of the treatment on maternal anti‐D production and transplacental anti‐D passage to the fetus was found. The fetal hemoglobin concentrations remained stable at about 80 g/L (hematocrit 27%) in five of six treated patients while there was a significant decrease in the control group.Conclusion. High dose intravenous immunoglobulin treatment seems to act mainly on fetal red cell destruction rate, possibly by blocking Fc receptor mediated macrophage phagocytosis. We claim that the treatment can successfully be used to prevent further deterioration of fetal anemia in rhesus(D) immunizations if started before severe fetal anemia (hemoglobin concentration < 70 g/L. hematocrit < 23%) and imminent hydrops fetalis arises.
Morphometric analysis of gap junctions in nonpregnant and term pregnant human myometrium
Authors: ÇLiray H. Nadir , Güner Haldun , Håkansson Hanna , Tekelioglu Meral , Roomans Godfried M. , Ulmsten Ulf 
Published: November 2007

Background and methods. Some structures in the human myometrium, namely; caveolae, extracellular space and gap junctions were quantified in tissues from nonpregnant women, women who were not in labor, and women in spontaneous labor or oxytocin‐induced labor, in order to reveal morphologic differences that would contribute to explaining the events leading to labor. Transmission electron micrographs taken from tissues from twenty‐four pregnant and ten nonpregnant women were studied.Results. Differences were observed in cell growth which was accompanied by enlargement of the extracellular space, and in gap junctions. Gap junctions were demonstrated in nonpregnant women, and even in one postmenopausal woman. Their frequency and size increased gradually between groups of pregnant women in the order of non‐labor, oxytocin‐induced labor and spontaneous labor. The increase in size of the junctions was less than the increase in number.Conclusions. Gap junctions are most frequently found in human myometrial cells in spontaneous labor, which strongly suggests a role for these structures in the termination of pregnancy. The effect of oxytocin on the appearance of gap junctions was negligible; hence, the contribution of oxytocin to establish myometrial contractile synchronicity is thought to be minor. Caveolae are probably not relevant for the initiation of labor as their distribution did not differ between the groups.
Standing and walking at work and birthweight
Authors: Henriksen Tine Brink , Hedegaard Morten , Secher Niels Jørgen 
Published: November 2007

Objectives. To study the influence of standing and walking at work on birthweight for gestational age.Methods. A prospective cohort of 8711 women with singleton pregnancies was established (1989‐91). Information about medical and obstetrical history, lifestyle factors and work related exposures were collected at 16 gestational weeks. The 4249 respondents who worked during pregnancy formed the basis of the analyses.Results. After adjustment for confounders and gestational age at delivery, infants of women standing >5 hours per workday had birthweights 49 g lower (95% confidence interval (CI): −108 to 10) than those of women standing ≤2 hours. Infants of women walking >2 but >5 hours per workday had higher birthweights (35 g, CI: 8‐63) than those of women with both shorter and longer hours of walking per day. Some women were unable to separate periods of standing from walking; a combined measure of these two exposures was created to reflect exposure intensity. Women who reported >5 hours of both standing and walking had infants with significantly lower birthweight (−119 g, CI: −230 to −8) compared to those of women who reported ≤2 hours on either of the exposures.Conclusions. Our study suggests that standing at work affects birthweight. Prolonged hours of walking and standing decrease birthweight for gestational age, whereas some degree of walking seems beneficial in terms of increased birthweight.
Iron deficiency among pregnant Pakistanis in Norway and the content of phytic acid in their diet
Authors: Brunvand Leif , Henriksen Christine , Larsson Marie , Sandberg Ann‐Sofie 
Published: November 2007

Background. To test the hypothesis that iron deficiency is more common among pregnant Pakistani than pregnant Norwegian women in Oslo; and to determine whether differences in the diet can explain some of the differences in stored iron.Methods. A cross sectional study in the 18th week of pregnancy. Thirty‐eight Pakistani women and 38 Norwegian women referred to routine ultrasound examination at Aker and Ullevål Hospitals in Oslo participated. Analysis was undertaken of phytate (inositol hexaphosphate) and its degradation products in bread and chapatti.Results. Twenty‐six (68%) of the Pakistani and six (17%) of the Norwegian women had ferritin levels below 12 ug/1 and a highly significant difference in serum ferritin was found between the groups (p<0.001). Only one of the Pakistani and seven of the Norwegian women were supplemented with iron and there were no significant differences in the dietary intake of hem iron, non‐hem iron, organic fiber, tea, ascorbic acid, meat or cereals. The content of inositol hexaphosphate (phytate) and inositol pentaphosphate, well known inhibitors of iron absorption, were measured in bread and chapatti and the estimated dietary intake was much higher in the Pakistani group, mean (95% CI) was 1175 umol/day (933‐1417) and 507 umol/day (417‐597) respectively, p<0.001.Conclusions. Iron deficiency seems to be far more common among pregnant Pakistanis in Norway than among pregnant Norwegians. We speculate that the main reasons for this are a combination of a higher parity and a less common use of iron supplementation in pregnancy in the Pakistani group, and a higher content of phytate in the Pakistani diet.
In vitro fertilization/embryo transfer in unexplained infertility and minimal peritoneal endometriosis
Authors: Tanbo Tom , Omland Anne , Dale Per Olav , Åbyholm Thomas 
Published: November 2007

Background. To compare the outcome of in vitro fertilization /embryo transfer (IVF‐ET) in unexplained infertility and infertility associated with minimal peritoneal endometriosis.Methods. A retrospective analysis comparing results of stimulation, sperm characteristics, cleavage, implantation and pregnancy rates in patients with unexplained infertility and peritoneal endometriosis associated infertility Couples with tubal infertility constituted a control group.Results. In the unexplained infertility and endometriosis groups similar response to stimulation. similar sperm characteristics and cleavage rates were observed. Compared with tubal infertility lower sperm motility was seen in the unexplained infertility group. Both non tubal infertility groups had lower cleavage rate than was seen in the control group. No differences in pregnancy rate were observed, but a significantly higher implantation rate was seen in unexplained infertility compared with tubal infertility.Conclusions. Couples with unexplained infertility and infertility associated with minimal peritoneal endometriosis have similar outcomes in an IVF‐ET set up. Significantly lower cleavage rates in these groups compared with tubal infertility indicate gamete defects as possible causes of infertility.
Circulating oxytocin and vasopressin is influenced by ovarian steroid replacement in women
Authors: Bossmar Thomas , Forsling Mary , Åkerlund M. 
Published: November 2007

Background: The posterior pituitary hormones appear to be involved in the etiology of primary dysmenorrhoea, but mechanisms regulating their release, particularly the influence of ovarian steroids, are not fully understood.Methods. The effect of 17β‐estradiol and medroxyprogesterone alone and in combination on oxytocin and vasopressin levels was therefore studied in 10 postmenopausal women.Results. Transdermal treatment with estradiol alone by means of patches in a dose of 100 ug/ 24 h for five days resulted in an elevation of the mean plasma concentration of this hormone from undetectable to 262 pmol/1 and increase in mean circulating levels of vasopressin from 0.82 to 1.22 pmol/1 and of oxytocin from 2.50 to 3.98 pmol/1. Oral administration of medroxyprogesterone in a dose of 10 mg per day for 5 days, which resulted in a mean plasma level of 4.3 nmol/I, suppressed vasopressin concentrations to 0.60 pmol/1. When given after five days of treatment with estradiol, medroxyprogesterone also antagonized the stimulatory effect of the estrogen on vasopressin secretion. Medroxyprogesterone alone increased the plasma oxytocin concentration to 3.26 pmol/1, but the progestogen did not significantly influence the stimulatory effect of estradiol on oxytocin secretion.Conclusions. It is concluded that posterior pituitary hormone secretion is influenced by estradiol and progestogens, and that this may be a mechanism for the involvement of ovarian hormones in the etiology of primary dysmenorrhoea.
Pudendal nerve damage increases the risk of fecal incontinence in women with anal sphincter rupture after childbirth
Authors: Tetzschner Tine , Sørensen Michael , Rasmussen Ole Ø. , Lose Gunnar , Christiansen John 
Published: November 2007

Aim. To evaluate anal function after childbirth in 94 women in whom sphincter rupture occurred and in 19 control women. The findings of anorectal physiological assessment and history of childbirth were related to the presence of fecal incontinence. Methods. Anal manometry and electromyography were performed the first days after childbirth and repeated 3 months post partum together with measurement of pudendal nerve terminal motor latency.Results. Eighteen patients (19%) presented with incontinence. None of the controls developed fecal incontinence after delivery. Anal manometry showed that both incontinent and continent patients had decreased resting and squeeze pressures compared to control subjects (p<0.005). No difference in anal electromyography was found between the three groups. Both anal manometry and electromyography showed a significant increase in pressure and activity respectively 3 months after delivery in patients and controls. Patients with pudendal nerve terminal motor latencies >2.0 milliseconds had an increased risk of having fecal incontinence compared to patients with pudendal nerve terminal motor latencies >2.0 milliseconds (odds ratio 2.18, p<0.05). Fecal incontinence could not be related to the weight or head circumference of the infant. The manometric and electromyographic findings, the use of pudendal nerve block, the length of the second stage of labor, the depth of rupture or the use of vacuumextraction could not be related to either fecal incontinence or pudendal nerve function.Conclusion. The manometric findings indicated damage to the anal sphincter apparatus in both continent and incontinent patients. Decreased pudendal nerve function characterized incontinent women. Accurate prediction of fecal incontinence in women with obstetric anal sphincter rupture is not possible.
Perceptions and satisfaction among Norplant users in Finland
Authors: Slhvo Sinikka , Ollila Eeva , Hemminki Elina 
Published: November 2007

Objective. This study was designed to assess users' perceptions of and satisfaction with the Norplant contraceptive implant.Methods. A questionnaire was mailed to all women having had Norplant inserted one or two years before the study initiation in seven public out‐patient family‐planning clinics in the capital area of Finland, of whom 82% responded (n = 207).Results. Practically all women (97%) had experienced some side‐effects and 72% considered at least one of them to be disruptive. Of these side‐effects, bleeding irregularities proved most often bothersome during the first 6 months of use, but depression and nervousness were relatively more important reasons for early removal. Regardless of the ubiquity of side‐effects, 78% were satisfied with Norplant. High satisfaction was common especially among older users with their second set of capsules. Dissatisfaction with the method was best explained by the experience of unexpected and disruptive side‐effects.Conclusions. Our results suggest that mental problems related to Norplant use have received too little attention and that satisfaction is highest in carefully selected users among older women.
Gonadal function and morphology in non‐cirrhotic female alcoholics:
Authors: Valimaki Matti J. , Laitinen Kalevi , Tiitinen Aila , Steman Ulf‐HÅKan , Ylöstalo Pekka 
Published: November 2007

Objective. To study the occurrence and mechanisms of gonadal dysfunction in women with alcohol abuse.Design. Prospective study.Setting. Helsinki University Central Hospital.Subjects. Fifteen consecutive chronic female alcoholics without liver cirrhosis, admitted for withdrawal treatment, were studied after cessation of alcohol intake. Twelve women had regular menstrual cycles, two appeared to be menopausal and one had hypothalamic amenorrhoea. The women with regular cycles were compared with eleven healthy controls.Intervention. Blood was sampled for hormone measurements three times on cycle days 5 to 7, 11 to 14, and 19 to 22, and ultrasonography was performed on the same days as the first two hormonal studies.Main outcome measures. Serum LH, FSH, prolactin, estrone, estradiol, progesterone, testosterone, androstenedione, dehydroepiandrosterone sulfate (DHEAS), sex hormone‐binding globulin (SHBG). the ovarian volume, the follicular diameter, the endometrial thickness.Results. During the luteal phase of the menstrual cycle the serum concentration of testosterone was 65% (p<0.01) higher and that of progesterone 23% (p>0.05) lower in patients than in controls. During the follicular phase serum DHEAS level was decreased by 39%) (p<0.05) in patients. Otherwise the serum concentrations of the hormones studied were similar in patients and in controls. As assessed by ultrasonography, patients and controls did not differ with regard to size of the ovaries, follicle development, or the endometrial thickness. Conclusions. Even heavy alcohol use has only minor permanent effects on ovarian function, at least until development of liver cirrhosis.
Is MRI helpful in evaluating the response of cervical cancer to neoadjuvant chemotherapy?
Authors: Vives A. , Castelo‐Branco C. , Iglesias X. , Tomás X. , Palombo H. , Pahisa J. , Lejárcegui J. A. , Salvador A. , Puig‐Tintoré Li 
Published: November 2007

Background. To assess the potential role of magnetic resonance imaging (MRI) in evaluating the response of cervical tumor to neoadjuvant chemotherapy.Methods. We studied 14 patients with locally advanced carcinoma of the cervix. MRI was performed before and after each cycle. All patients underwent laparotomy four weeks after the last cycle. MR images after chemotherapy were compared with surgical‐pathologic findings.Results. Related to parametrial state after chemotherapy, surgical examination correlated with MRI in nine patients (nine true negative). In three cases parametrial invasion was overestimated (three false‐positive) and in two it was underestimated, so that tumor resection was not possible once laparotomy was performed (two false‐negative). MRI estimation of tumor size was confirmed at pathologic examination in only eight patients, whilst it was overestimated in the other four ones.Conclusions. These initial results suggest that MRI could not be as precise for cervix cancer staging and evaluation of response to chemotherapy as has recently been postulated. This is especially important since a false negative result may induce the surgeon to perform laparotomy in error in cases of unresectable tumors.
Book Review
Authors: Hordnes Knut 
Published: November 2007

Martin DC, editor. Atlas of endometriosis. London: Gower Medical Publishing, 1993. 90 pages, figures, tables, charts. Price, May 1993: GBP 40.00.Rowe PJ, Comhaire FH, Hargreave TB and Mellows HJ. WHO manual for the standardized investigation and diagnosis of the infertile couple. 83 pages, figures, tables. World Health Organization, New York: Cambridge University Press 1993. Price: USD 24.95.
Umbilical artery Doppler ultrasound predicts low birth weight and fetal death in hypertensive pregnancies
Authors: Torres Pere‐Joan , Gratacós Eduard , Alonso Pedro L. 
Published: November 2007

Background. Doppler ultrasound is nowadays common in the management of pregnancies complicated with hypertension, as an indirect assessment of fetal well‐being. However, the value of abnormal umbilical artery Doppler results in predicting poor fetal outcome in hypertensive pregnancies has been studied in only a small number of patients. We designed a study to investigate the relation between abnormal umbilical artery Doppler velocimetry and fetal outcome in hypertensive pregnancies.Design. A prospective observational study over a 2‐year period was performed at the Hospital Clinic, University of Barcelona. Pulsed Doppler examinations of the umbilical artery were performed in one hundred and seventy‐two hypertensive pregnant women. The physicians managing the case were not aware of the Doppler results. The incidence of low birth weight and fetal death were considered as the main outcome measures.Results. When low birth weight was used as an end‐point, abnormal resistance index showed a high specificity (95.16%), positive predictive value (83.33%), and negative predictive value (86.76%). Sensitivity was 62.5%. The absence of end‐diastolic velocity predicted low birth weight in 100% of pregnancies and fetal death in 66.66%. All stillbirths had absence of end‐diastolic velocity (sensitivity 100%).Conclusion. This study demonstrates that umbilical artery Doppler velocimetry is a useful tool to assess fetal well being in hypertensive pregnancies.