bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dietary habits, prepregnancy weight, and weight gain during pregnancy: Risk of pre term rupture of amniotic sac membranes
Authors: Gosselink Carol A. , Ekwo Edem E. , Woolson Robert F. , Moawad Atef , Long Cynthia R. 
Published: November 2007

Background: Premature rupture of amniotic sac membranes (PROM) is associated with perinatal morbidity and mortality. A matched case‐control study was undertaken to determine whether dietary habits, prepregnancy weight, and weight gain during pregnancy were associated with increased risks for PROM.Methods: Three study groups were defined, consisting of women delivering pre term with PROM (PP), full term with PROM (FP), and pre term without PROM (PWP). Cases were singly matched by race, age, and parity with women having full term deliveries without PROM. Data were collected by face‐to‐face structured interviews with eligible subjects and by medical records abstraction.Results: Conditional multiple logistic regression indicated that during pregnancy, PP cases were significantly more likely to have gained < 21 pounds (9.5 kg) (OR = 2.7, CI = 1.146.36) and were only half as likely as controls to have improved their diet (OR = 0.43, CI = O.lRo.99) while controlling for cigarette smoking, urinary tract infection, chorioamnionitis, chlamydia, and a history of previous PROM. FP cases were significantly less likely than controls to have gained 31–40 pounds (1418 kg) while pregnant (OR = 0.56, CI = 0.33–0.94) and were significantly more likely than controls to have a somewhat inadequate pregnancy diet (OR = 2.05, C1 = 1.11–3.77) while controlling for a history of previous PROM. PWP cases were significantly less likely to have gained 31–40 pounds (1418 kg) (OR = 0.42, CI = 0.21–0.84) or > 40 pounds (18 kg) (OR = 0.37, CI = 0.17–0.80) while pregnant or to have had adequate dairy products intake (OR = 0.60, CI = 0.36–0.99) while controlling for cigarette usage.Conclusion: Maternal dietary habits, weight gain during pregnancy, and supplement intake are associated with the occurrence of both pre term and full term PROM and pre term delivery without PROM.
Organisation of obstetric ultrasound in Denmark 1990
Authors: Jørgensen Finn Stener 
Published: November 2007

To provide an overview of the current organisational status of obstetric ultrasound in Denmark, a questionnaire was sent in spring 1990 to all 59 departments responsible for the hospital antenatal care program and to the 25 imaging diagnostic departments providing ultrasound services for those of the 59 departments that had either insufficient or no ultrasound facilities. The response rate was 100%.Obstetric ultrasound was performed in 25 obstetric, 11 surgical, 22 radiology, 2 clinical physiology departments and 1 ultrasound laboratory (total 61). The departments had a total of 110 ultrasound scanners. The median year of purchase of these scanners was 1985 (range 1976–1990). 488 persons performed ultrasound examinations; the examiners were mainly doctors (72%).40% of the pregnant population was routinely offered an ultrasound scan in the 15–20th week of gestation. Of these 2/5 were offered screening for fetal malformations. One department offered examinations in both the 19th and 34th week. The scanning capacity, as judged by the departments themselves, was also assessed through the study.
Placental hstology and fetal blood flow in intrauterine growth retardation
Authors: Laurini Ricardo , Laurin Jan , Marsål Karel 
Published: November 2007

Objective. To define the histological lesions in the placenta associated with abnormal blood flow findings and to evaluate their possible clinical significance.Design. A prospective blind study.Setting. A clinical study at a teaching hospital, Malmö General Hospital, University of Lund, Sweden, morphological studies of placentas being performed at the Institute of Pathology, University of Lausanne, Switzerland.Material Thirty‐seven pregnancies where intrauterine growth retardation (IUGR) was suspected.Methods Blood velocimetry of the fetal descending aorta, umbilical artery and vein, and the maternal arcuate artery, using 2.5 MHz pulsed wave Doppler ultrasound. Histological examination of at least five random samples from each placenta.Main outcome measures. Frequency of small‐for‐gestational age (SGA) newborns (birth weight ≥ mean −2 s.d.) and of operative delivery for fetal distress.Results. Only the presence of placental infarction was significantly associated with IUGR and with intrauterine findings of abnormal blood velocity in the fetal descending aorta and umbilical artery.Conclusion. Placental infarction would seem to be a valuable morphological marker of uteroplacental vascular disease related to JUGR and impaired fetal and umbilical blood flow.
Experience of childbirth in birth center care
Authors: Waldenström Ulla , Nilsson Carl‐Axel 
Published: November 2007

Background. The objective of the study was to compare women's use of obstetric analgesia, experience of pain in labor, and other aspects of the childbirth experience at an in‐hospital birth center and with standard maternity care. The birth center care was characterized by comprehensive antenatal, intrapartum and post partum care, on the same premises with a home‐like environment and the same team of midwives, restricted use of medical technology and pharmacological pain relief, and discharge within 24 h after birth.Methods Of 1,230 women interested in birth center care and meeting low‐risk medical criteria in early pregnancy, 617 were randomly allotted birth center care (EG) and 613 standard obstetric care (CG). Data were collected by questionnaires two months post partum, and hospital records.Results. EG women used less pharmacological pain relief than CG women, but no difference was observed concerning the retrospective attitude to pain, or among primiparas, to the intensity of pain experienced. EG multiparas experienced pain in labor as more intense, than did CG multiparas, probably because of a more negative prenatal attitude to labor pain. EG women experienced more support from the midwife, and a greater freedom in expressing their feelings during the birth than CG women. EG primiparas were more satisfied with their own achievement and felt more involved in the birth process than CG primiparas. No differences were observed between the groups regarding overall experience of childbirth, anxiety during the birth or support from husband.Conclusion Birth center care gave women interested in a natural childbirth, by avoiding pharmacological pain relief, greater opportunity to give birth according to their prenatal wishes, and it contributed to a slightly more positive birth experience.
The effect of labor on the normal values of umbilical blood acid‐base status
Authors: Yoon Bo Hyun , Kim Syng Wook 
Published: November 2007

Background. Although several investigators have attempted to define the normal values of umbilical cord blood pH and gases, there is considerable controversy about the optimal cutoff values to diagnosis intrauterine asphyxia. A possible reason for this might be that several studies have included data from fetuses born after different duration of labor.Objective To determine the effect of labor and the duration of second stage of labor on umbilical arterial acid‐base status at birth in healthy term infants.Methods Umbilical artery acid‐base status was determined in patients (n = 356) who met the following criteria: 1) singleton term pregnancy with no significant medical, obstetric, or neonatal complications; 2) vertex presentation if delivered vaginally; 3) neither regional nor general anesthesia applied if delivered vaginally; 4) no use of oxytocin; 5) normal fetal heart rate patterns; 6) clear amniotic fluid; 7) Apgar scores at 1 and 5 min ≥7; 8) appropriate fetal weight for gestational age. Patients were divided into three groups. A ‐ patients delivered by cesarean section (CS) in the absence of labor (n=135); B‐patients delivered by CS during first stage of labor (n = 62); C‐patients with vaginal birth (n=159). A Kruskal‐Wallis A YOVA with post‐hoc procedures and stepwise multiple regression analysis were performed.Results. 1) There were significant differences in cord arterial acid‐base values between study groups (pH: no labor CS. 7.27 ± 0.05 vs labor CS. 7.26 ± 0.05 vs vaginal birth, 7.24 ± 0.07, p < 0,0000 1). 2) There was a significant fall in cord arterial pH and bicarbonate concentrations with increased duration of second stage of labor in newborns born vaginally (pH: duration of second stage. 1‐30 min, 7.25 ± U.07 vs 31‐60 min, 7.22 ± 0.06 vs >61 min, 7.21±0.07. p<0.05). 3) Analysis of confounding variables which could influence the cord pH such as parity, usz of vacuum. gestational age, maternal age, and birth weight by stepwise multiple regression analysis indicated that only the duration of second stage of labor pain had a significant relationship with cord blood pH.Conclusion There is a significant fall in umbilical artery pH and bicarbonate with the presence of labor and increased duration of second stage of labor in healthy term neonates. This should br taken into consideration in evaluating neonatal well‐being by cord blood pH and acid‐base measurements.
Objectively measured tobacco exposure among pregnant women in Finland in 1986 and 1990
Authors: Bardy Ali Henri , Seppala Timo , Lillsunde Pirjo , Koskela Pentti , Gref Carl‐Gustav 
Published: November 2007

Objective. First, to study tobacco exposure among pregnant Finnish women in 1986 and 1990. Second, to study the objectively measured exposure in different socioeconomic classes and in different geographical regions. Third, to assess the value of serum thiocyanate concentrations in estimating fetal tobacco exposure.Design. Tobacco exposure was measured from maternal and umbilical serum samples by measuring the concentration of nicotine metabolite, cotinine. In addition, the concentrations of thiocyanate were measured from umbilical serum samples. The occupations of the mothers were obtained from the Finnish Birth Registry, and the area of residence from laboratory records.Setting. Finland.Subjects. 1323 infants born in late February‐early March in 1991, 1263 mothers of these infants during antenatal visits in Autumn 1990, and 976 pregnant mothers during antenatal visits in Autumn 1986. The mothers and infants studied represented all newborn infants and their mothers during one week in one country.Measurements and main results. In 1986, 21.3% of Finnish mothers and in 1990 21.2% were exposed to tobacco. In 1986, exposed mothers were on average 1.4 (95% confidence interval 0.9‐1.8) years younger than nonexposed mothers, and in 1990, exposed mothers were on average 1.6 years (95% confidence interval 1.1‐2.3) younger than nonexposed mothers. 28.5% of mothers classified as unskilled workers were exposed, but only 9.1% of those classified as upper white‐collar. There were no significant geographical differences in exposure. Although umbilical serum thiocyanate levels were always elevated in exposed infants, high serum thiocyanate concentrations were detected in infants not exposed to tobacco.Conclusions. More than 20% of pregnant Finnish mothers and their fetuses were exposed to tobacco in 1986 and 1990. Young women and women in low socioeconomic classes were the most seriously exposed. Measurement of serum thiocyanate concentrations did not yield reliable estimates of exposure.
Cervical incompetence and cerclage in Denmark 198O‐1990 A register based epidemiological survey
Authors: Lidegaard Øjvind 
Published: November 2007

Objective. To assess the incidence rate of cervical incompetence diagnoses in Denmark 1980‐1990 according to maternal age, to analyse regional variations, to investigate how often cerclage is applied, and finally to estimate abortion rates among women with cervical incompetence with and without cerclage.Design. A register‐based retrospective cross section study.Setting. All Danish gynecological departments.Material and methods. Since 1977, all hospitalized patients in Denmark have been centrally recorded by diagnosis according to the ICD classification and by operation codes in The National Patient Register. From this database, all women with cervical incompetence (CI) and cerclage in the period 1980‐1990 were identified. From the same database all cases of spontaneous abortions were registered.Results. A total of 2756 cases of cervical incompetence were registered in the period 1980‐1990, corresponding to an incidence rate of 4.6/1000 births. The risk of cervical incompetence increased from 2/1000 births among women 15‐19 years old to 7.5/1000 births among women 35‐39 years old. The incidence rate of the Cl‐diagnosis fell 44% from 1980 to 1990. The incidence rates in different counties ranged from 1.7/1000 births to 10.0/1000 births. The average length of stay in hospital among patients with cervical incompetence was three weeks. Among patients with cervical incompetence, 61% were treated with cerclage. This per cent increased from 29% among women 15‐19 years old to 68% among women 35‐39 years old. 13.5% of women with CI experienced spontaneous abortion. This percentage increased from 12% for women 15‐19 years old to 17% among women 40‐44 years old (p < 0.01). Among women with CI and cerclage, the abortion rate was 17.6%.Conclusion. In the period 1980‐1990 the incidence rate of cervical incompetence in Denmark was on the average 4.6/1000 births. The incidence rate of the Cl‐diagnoses has fallen significantly during the last decade, and it increases four‐fold with increasing age. Six out of ten patients with cervical incompetence were treated with cerclage.
Outcome of pregnancy and childbirth following laryngectomy
Authors: Albrechtsen Susanne , Julseth Eli , Olofsson Jan , Dalaker Knut 
Published: November 2007

Objects. Pregnancy and delivery in two laryngectomized women.Results. One woman had a pregnancy complicated by hypothyroidism and stenosis of the tracheostoma, she was delivered by cesarean section. The other had an uneventful pregnancy and a spontaneous vaginal delivery.Conclusions. Individualized handling of the delivery. By modifying the technique of bearing down spontaneous vaginal delivery is possible.
Cesarean section in twin pregnancies in two Danish counties with different cesarean section rates
Authors: Henriksen Tine B. , Sperling Lene , Hedegaard Morten , Ulrichsen Helle , Øvlisen Bjarni , Secher Niels Jørgen 
Published: November 2007

Objective. Based on a comparison of the clinical indications for cesarean section (CS) in two Danish counties and a review of the literature regarding this issue the aim of this study was to discuss possible explanations for variations in CS rates in twin pregnancies. The comparison of indications for CS in twin pregnancies was made between two Danish counties, one with a high and one with a low overall CS rate in twin deliveries, taking into account the distribution of parity, mother's age, gestational age at birth, and birth weight.Design. A population based, historic follow‐up study based on antecedent data.Setting. Two Danish counties, with a CS rate in twin pregnancies of 57% and 28%, respectively.Subjects. All women with twin pregnancies who delivered in 1989 in the two counties.Main outcome measures. Comparison of the CS rates in the two counties according to indications and fetal presentation.Secondary measures. Perinatal and maternal outcome.Results. The difference in CS rates between the two counties could not be explained by different distributions of background characteristics. Different attitudes were found towards CS in cases with previous CS, with twin A in breech presentation and in cases with vertex‐breech deliveries. These differences could explain less than two thirds of the overall 29% (CI: 12‐46%) difference in risk of CS between the two counties, indicating more subtle reasons for the discrepancy. No difference between the two counties in perinatal morbidity and mortality was seen.Conclusion. In order to understand and discuss regional variations in the use of CSs in twin deliveries the subjects must be addressed in different ways: the unequivocal indications related to fetal presentations and previous CS can be subjected to randomised controlled trials or large scaled follow‐up studies regarding maternal and perinatal morbidity and mortality. Other more subtle determinants of the physicians’ and the pregnant women's attitude towards CS, however, seem quantitatively important, and these can only be evaluated in observational studies and through discussions.
‘To bathe or not to bathe’ during the first stage of labor
Authors: Cammu Hendrik , Clasen Koen , Van Wettere Lut , Derde Marie‐Paule 
Published: November 2007

Objective. Does a warm tub bath relieve labor pain? How is it experienced by the parturient?Methods. Design: prospective randomised trial.Setting: Labor ward of a teaching hospital with a uniform active labor management.Participants: one hundred and ten nulliparous low risk women, at term, in true spontaneous labor. Fifty‐four women had a bath. 56 women served as controls. Mean outcome measures: labor pain (assessed by means of a visual analogue scale) and post partum patients' bathing experience (by means of a self‐made questionnaire).Results. The study group and the control group were comparable with respect to maternal age. weight, length, duration of gestation. cervical status and labor pain sensation before randomisation. Absolute values of labor pain were not statistically different between the two groups. yet this latter progressed differently: in the bathing group the initial pain sensation (V.A.S.) was 6.8. and this remained stable during the first 25 minutes (V.A.S. = 6.7) and then rose to 8.2 after a mean of 53 minutes. In the control group, labor pain rose progressively from 6.3 to 7.3 after 25 min and to 8.7 after a mean of 52 min (p <0.O1, Student t‐test). There was no difference in the use of epidural analgesia. There were no differences in labor duration nor in the frequencies of either operative deliveries or neonatal complications. Eighty percent of the bathers experienced soothing of the pain and all but one reported body relaxation. Ninety percent wanted to bathe again during a next labor.Conclusion. Bathing provided no objective pain relief. It had, however, a temporal pain stabilizing effect possibly mediated through the improved ability to relax in between contractions. No side effects were found. It gives great satisfaction to users. Bathing, in conjunction with other forms of analgesia, is recommended.
Microcurettage sampling of the endometrium for histopathological examination—simpler but not safe?: Comparison of endometrial histopathology in samples obtained by a disposable mechanical curette and by traditional curettage
Authors: Schei Berit , Bang Torill Floa , Halgunset Jostein , Haugen Olav A. , Haarstad Ivar , Onsrud Mathias 
Published: November 2007

The routine use of dilatation and curettage (D&C) is questioned as a standard procedure for endometrial sampling. Instruments have been developed in order to simplify the procedure. The aim of the present study was to estimate the sensitivity to detect malignancy/premalignancy by histological exmination of endometrial samples obtained by microcurettage using a disposable plastic curette. Gynoscannk. The histological examination of the combined microcurettage and D&C material was defined as the true diagnosis.All patients undergoing diagnostic D&C at the two participating hospitals were included in the study. The endometrial samples were evaluated at the Department of Pathology as part of their routine work. The microcurettage samples were re‐examined independently by two pathologists (observer 1 and observer 2) who did not have access to the rest of the tissue material nor the diagnosis given previously. A total of 902 patients were enrolled in the study. Endometrial cancer was found in four women below SO years of age. None of these were detected by histological examination of the Gynoscannk obtained sample. Among women aged 50 and above, samples from 16 women turned out to have endometrial cancer. The microcurettage samples were correctly classified as malignant/premalignant by observer 1 in 13 casts bind by observer 2 in 14 cases. We conclude that diagnostic D&C among women 50 years aid below cannot be replaced by histological examination of Gynoscannk samples without the risk of overlooking significant pathology.
Is differentiation of benign and malignant cystic adnexal masses possible by evaluation of cysts fluids with respect to color, cytology, steroid hormones, and tumor markers?
Authors: Gaetje R. , Popp L. W. 
Published: November 2007

Objective. Differentiation of benign and malignant cystic adnexal masses by analysis of cyst fluid was investigated.Study design. Eighty‐one cystic adnexal lesions of 80 patients were punctured intraoperatively or after surgical removal. Color of the cyst fluid, cytology, concentrations of steroid hormones (estradiol. progesterone, testosterone), and tumor markers (CEA, CA 125, CA 15‐3) were correlated to histology.Results. Color or cyst fluid was not reliable in the differential diagnosis of cystic adnexal masses. Cytology missed four out of seven malignant tumors. One mucinous cystadenoma was cytologically suspicious for malignancy. The combination of negative cytology, low tumor marker levels. and estradiol levels higher than 1000 pg/ml may support the diagnosis of a ‘functional’ cyst. Elevated CEA levels may be suspicious for all mucinous and malignant lesions.Conclusions: Analysis of cyst fluid could not accurately discriminate between benign or malignant tumors.
Serum testosterone, androstenedione and luteinizing hormone levels after short‐term medroxyprogesterone acetate treatment in women with polycystic ovarian disease
Authors: Anttila Leena , Koskinen Pertti , Erkkola Risto , Irjala Kerttu , Ruutiainen Kristiina 
Published: November 2007

Background. Medroxyprogesterone acetate (MPA) ‐treatment suppresses serum gonadotropin and androgen concentrations in women with polycystic ovarian disease (PCOD). This study ws designed to determine serum testosterone (T), androstenedione (A) and luteinizing hormone (LH) patterns in a group of oligomenorrheic PCOD patients after MPA‐treatment.Methods. The study group consisted of 11 women with ultrasonographically diagnosed PCOD. Blood samples were drawn in the morning in fasting conditions first during oligomenorrhea and then within one week after MPA‐induced bleeding. After that the sampling was repealed four times at one week intervals. Student's paired t‐test was used for statistical calculations.Results. The levels of T, A and LH decreased significantly after MPA‐treatment. During the follow‐up the T and A concentrations increased significantly till the third sampling week, after which no further increases were found.Conclusions. Our results show that T and A secretion return to levels characteristic of PCOD after discontinuation of MPA‐treatment within a few weeks in women with PCOD.