bluuebunny/crossref_metadata_2025_split huggingface dataset:
Placebo‐controlled trial of active immunization with third party leukocytes in recurrent miscarriage
Authors: Christiansen Ole B. , Mathiesen Ole , Husth Merete , Lauritsen J. Glenn , Grunnet Niels 
Published: November 2007

Objective. To investigate whether active immunization with third party leukocytes improves pregnancy outcome in women with unexplained recurrent miscarriages.Design. A double‐blind prospective placebo‐randomized trial.Patients. Sixty‐six patients with unexplained recurrent miscarriages achieved pregnancy after having received active immunization or placebo.Interventions. Among the patients who achieved pregnancy, 43 were immunized with third party leukocytes and 23 received autologous leukocytes.Main outcome measures. Frequency of new miscarriages in actively immunized women compared with placebo.Results. In the total group of patients, 71% of the actively immunized patients had a successful pregnancy compared with 48% of the placebo treated patients (not significant, RR = 0.6; 95% confidence limits = 0.3–1.1). In a subgroup of patients with primary recurrent miscarriages the success rate was 76% compared with 38% in the placebo group (p<0.02, RR = 0.4; 95%) confidence limits = 0.2–0.9). In this subset of patients, median birthweight was also significantly higher in actively immunized patients than in placebo treated patients (3445 g versus 3000 g;p<0.05).Conclusions. Active immunization did not provide any benefit in the overall group of women with recurrent miscarriages. However, among women with primary recurrent miscarriages it may improve outcome with respect to the number of livebirths and birthweight.
Does the loop electrosurgical excision procedure adversely affect the histopathological interpretation of cervical conization specimens?
Authors: Chen Ruey‐Jien , Lee Evelyn Fung , Shih Jin‐Chung 
Published: November 2007

Objective. To assess the suitability of conized specimens obtained by loop electrosurgical excision procedure for histopathological interpretation.Methods. We evaluated the histological pictures of 215 tissue sections obtained by loop electrosurgical excision procedure. These sections came from 32 cases of patients with various degrees of cervical intraepithelial neoplasia. All women included in our study had a satisfactory colposcopy and no cytological or colposcopic evidence of invasive cancer. We quantified the thickness of thermal damage in the tissue sections using a stage‐mounted. calibrated grid microscope.Results. At its greatest extent, thermal damage occurring next to incision lines ranged from 160 to 520 μ (mean 762, SE 14 μ). Two different zones of thermal damage were produced by LEEP: the carbonization and coagulation zones. The carbonization zone was located at the outermost layer and was very thin. measuring from 10 to 30 μ in depth. The coagulation zone was adjacent to the carbonization zone, was eosinophilic, and was significantly deeper than the carbonization zone at its points of greatest thickness (150 to 500 μ; p<0.0001, Student's t‐test). The depth of the coagulation zone correlated significantly with the depth of the carbonization zone (p = 0.041. least linear correlation). Tissue distortion was present in 53% (17/32) of the cases, and appeared only in the coagulation zone.Conclusion. Tissue structure from the diseased portions of the conized specimens was generally veil preserved. The area of thermal damage was limited and thus did not result in diagnostic problems. We conclude that LEEP is a reliable method for obtaining tissue samples for histopathological examination.
Maternal health care program and markers for late fetal death
Authors: Walles Bengt , Tyden Tommy , Herbst Andreas , Ljungblad Ulf , Rydhstrøm HÅKan 
Published: November 2007

Objective. To identify markers for late fetal death, a multicenter study was performed, based on routinely obtained data from maternal health care units.Material and methods. Prospectively recorded data were obtained from maternal health care units belonging to five delivery units. In all, 233 consecutive cases of singleton pregnancy involving late fetal death (≥28 weeks) were identified between 1983 and 1989. As a control for each case, the next consecutive mother giving birth to a live infant at the same delivery unit was selected, the sole matching criterium being parity.Results. After exclusion of pregnancies with lethal malformations or trauma, 205 cases remained for the statistical analysis. Two main subgroups were identified: mothers with placen‐tal abruption (n = 44), and pregnancies with no obvious reason for fetal death (n = 101). An increased risk for late fetal death was evident in expectant mothers ≥40 years (10 vs 1; χ2 = 7.6, p < 0.01), and in smokers where an association was seen to placental abruption. A significantly increased risk was also seen in women with medical treatment for essential hypertension (8 vs 1; χ2=5.6, p < 0.05). On the other hand, we found no correlation between pro‐teinuria, glucosuria, decreasing symphysis‐fundal height, or changes in the Hb, on the one hand, and late fetal demise, on the other. There was no overrepresentation of post dated pregnancy (by ultrasound early in the second trimester) among the cases. Nor did post dated pregnancies (≥42 weeks) estimated from first day of last menstrual period (but not post dated by ultrasound) imply a higher rate of fetal death, as has been suggested in previous studies. Conclusion. In the present material, there was no sign of systematic error in the evaluation of data routinely obtained from the antenatal clinics and maternity units. Apart from placental abruption in smokers, a high maternal age, and medical treatment for essential hypertension, deviating data were recorded as often among controls as among cases. No correlation was evident between a post date pregnancy and fetal demise. A short symphysis‐fundal height was recorded as often among controls as among cases and the even distribution of fetal birthweight in case pregnancies around the standard curve for the normal population is noteworthy.
Psychological responses following medical abortion (using mifepristone and gemeprost) and surgical vacuum aspiration a patient‐centered, partially randomised prospective study
Authors: Henshaw Richard , Naji Simon , Russell Ian , Templeton Allan 
Published: November 2007

Background. A substantial body of objective data now exists to support the consensus view that induced abortion results in a low incidence of psychiatric morbidity. However, these data do not include more recent advances in abortion technology. Medical abortion entails a participatory role on the part of the woman, who may perceive more pain or see products of conception. The physical and psychological events experienced by women undergoing this procedure may lead to differences in psychopathology.Methods. 363 women undergoing legal induced abortion up to 63 days gestation were allocated by a prospective partially randomised design to undergo medical abortion (using mifepristone 600 mg followed 48 h later by gemeprost 1 mg vaginal pessary) or vacuum aspiration performed under general anesthesia. This study design allowed women with a preference for a particular method to undergo that method; women without preferences were allocated at random. Women completed sensitive and reliable psychometric instruments (the Hospital Anxiety and Depression Scale and a semantic differential rating scale designed to measure self‐esteem) prior to abortion and 16 days later.Results. There were no significant differences between women allocated at random to medical abortion or vacuum aspiration in post‐abortal anxiety, depression or low self‐esteem. Women with high levels of mood disturbance prior to abortion, who were smokers or who had medical complications following abortion were at highest risk of post‐abortal mood disorder. Conclusions. Medical abortion is as psychologically safe as surgical vacuum aspiration. The quantitative findings of the study support the consensus view that abortion is associated with high incidence of psychological benefit, whichever method is used.
The prevalence of red cell antibodies in pregnancy correlated to the outcome of the newborn:
Authors: Filbey Derek , Hanson Ulf , Wesström Góran 
Published: November 2007

Background All maternal red cell antibodies found during pregnancy in a 12 year period have been compiled. The efficacy of the current antenatal screening and management programme has been ascertained by reviewing the outcome of all newborns to these immunized mothers.Method. Patient selection was carried out by computerised searching for all known records of registered antibodies during the study period. Each mother's obstetric record and her baby's hospital file was studied and relevant clinical treatment and laboratory data on both mother and child was recorded and analysed.Results. Eight hundred and twenty‐one alloantibodies were detected in 629 immunized pregnant women with 753 fetuses. An overall antibody incidence of 0.57% was observed which included 373 clinically significant antibodies found in 261 mothers (0.24%). Multiple antibodies were present in 8.2% of all samples. Anti‐D, by itself or in combination with other Rh‐antibodies, caused more severe forms of hemolytic disease of the newborn (HDN) with 46% of all Rh‐positive babies having phototherapy and 29% having exchange transfusion. Three of 18 Fya‐positive infants required phototherapy and one required exchange transfusion and in the 16 Kell‐positive babies, three required phototherapy and one required exchange transfusions.Conclusions. Few antibodies to blood group antigens other than those in the Rhesus system were (bund to cause severe HDN. Antibodies that are generally considered non‐significant did not cause HDN in this study. All antibodies that induced HDN were delected in time so that adequate measures could be taken to reduce the effects in the newborn. The antenatal screening and management programme currently in use is considered to be reliable.
Diagnosis of pelvic masses with transabdominal color Doppler, CA 125 and ultrasonography
Authors: Franchi Massimo , Beretta Paolo , Ghezzi Fabio , Zanaboni Flavia , Goddi Alfredo , Salvatore Stefano 
Published: November 2007

Background. The objective of this study was to test the accuracy of transabdominal color Doppler imaging in the prediction of malignancy of adnexal tumors when integrated in combination with CA 125 levels and two‐dimensional ultrasound.Methods. We considered 129 consecutive patients with a suspected adnexal mass at clinical examination and transabdominal and transvaginal two‐dimensional ultrasound. Serum CA 125 was measured in all cases. All the patients underwent color Doppler imaging to measure the Resistance index of the tumor associated blood flow profile and then surgery and histologic diagnosis.Results. The median age of the patients was 44 years (range 12–91), 64.3% were premenopausal and the prevalence of malignancy was 28.7%. The sensitivity of color Doppler mapping was 75.7%, specificity 71.7%, positive predictive value 68.3% and negative predictive value 93.0%, compared with 75.7%, 68.5%, 49.1% and 87.5% for CA 125 and 83.8%, 83.7%, 67.4% and 92.8% for two‐dimensional ultrasound. Blood flow was undetectable by color Doppler imaging in 17 of the 129 cases (13.2%). In 55 patients with three concordant tests, the positive and negative predictive values were 100%. When CA 125 values and two dimensional ultrasound results were discordant (35 patients), the color Doppler diagnosis was correct in 88.6% of the cases (93% in premenopausal women).Conclusion. Color Doppler imaging alone is not better than two‐dimensional ultrasound in predicting malignancy of pelvic masses. Its use together with CA 125 and two‐dimensional ultrasound may improve the accuracy of predictions when the three tests are concordant or when the other two are discordant.
The female corpus spongiosum revisited
Authors: van turnhout Arjen A. W. M. , Hage J. Joris , van Diest Paul J. 
Published: November 2007

Background. The extension of the female corpus spongiosum is subject to controversy. The anterior continuation of the vestibular bulbs, or pars intermedia, is not commonly recognized as part of the corpus spongiosum. Some authors deny this part of the corpus spongiosum exists in females.Material and Methods. To investigate this controversy, anatomic and histologic studies were performed of the female corpus spongiosum. The specimens were taken from female‐to‐male transsexual surgical patients and from fresh female cadavers. They were compared to surgically amputated penises to establish the similarity in male and female anatomy.Results Conclusions. The female corpus spongiosum is proven to extend anteriorly from the bilateral vestibular bulbs to terminate as the enlarged glans clitoridis. This latter structure also consists of spongious tissue. The spongiosum is hypertrophied in hormonally treated female‐to‐male transsexuals. The cleft vulvar anatomy is homologue to its non‐cleft male counterpart.
Death rates from ischemic heart disease in women with a history of hypertension in pregnancy
Authors: Sjónsdóttir Lilja , Arngrimsson Reynir , Geirsson Reynir T. , Slgvaldason Helgi , Slgfússon Nlkulás 
Published: November 2007

Background. Evidence about the influence of hypertension in pregnancy on later health and in particular the risk of cardiovascular disorders is conflicting, although a link has been suggested. In a population‐based study with a long follow‐up time the potential association between hypertension in pregnancy, preeclampsia and eclampsia with increased death rates from ischemic heart disease (IHD) was investigated.Methods. All 7543 case records at the main maternity hospital in Iceland during 1931–1947 were reviewed to identify women with hypertension in pregnancy, subdivided by parity and severity of disease into those with eclampsia, preeclampsia and hypertension alone. Information on those who had died was obtained from death certificates, supplemented by autopsy reports and hospital records. Death rates from IHD were compared to population data from public health and census reports during corresponding periods and between study groups.Results. Of 374 hypertensive women 177 had died. The death rate was slightly higher among women with any hypertension in pregnancy than in the reference population (RR=1.20; 95% CI 1.01–1.42). About half of the increase was attributed to excess mortality from IHD with a relative risk of dying of 1.47 (95% CI 1.05–2.02). The relative risk of dying from IHD was significantly higher among eclamptic women (RR = 2.61; 95% CI 1.11–6.12) and those with preeclampsia (RR=1.90; 95% CI 1.02–3.52) than those with hypertension alone. Parous women at the index pregnancy had a twofold higher risk of dying from IHD than primigravid women (RR = 2.05; 95% CI 1.19–3.55; p = 0.01).Conclusion. There is an indication of increased death rates among women with a history of hypertension in pregnancy, where ischemic heart disease may be more common than in the general population.
Conjunctiva is an estrogen‐sensitive epithelium
Authors: Vavilis Dlmitrios , Maloutas Stefanos , Nasioutziki Maria , Boni Ekaterini , Bontis John 
Published: November 2007

Background. To investigate whether the conjunctival epithelium shows cyclical maturation changes during the ovarian cycle and to study the cytological appearance of the conjunctiva in postmenopausal and pregnant women.Patients. Fifteen menstruating women with ovulatory cycles, ten postmenopausal women. and twelve pregnant women in the second or the third trimester of their pregnancy.Interventions. Conjunctival and vaginal smears were taken on a near‐daily basis.Main outcome measures. The percentage of the parabasal, the intermediate and the superficial cells (Maturation Index) in each specimen was determined.Results. In the conjunctival smears of the menstruating women cyclical maturation changes were noted. These changes were parallel to those of the vaginal smears, but to a minor degree. No cyclical changes were found in either the postmenopausal women or in the pregnant women, showing an extreme shift to the left in the Maturation Index.Conclusion. Conjunctiva appears to be a relatively estrogen‐sensitive epithelium.
Treatment of premenstrual syndrome by spironolactone: A double‐blind, placebo‐controlled study
Authors: Wang Mingde , Hammarbäck Stefan , Lindhe Bengt‐Åke , Bäckström Torbjörn 
Published: November 2007

Background. To reevaluate whether spironolactone, a steroid receptor antagonist, is effective in improving premenstrual syndrome (PMS) in a double‐blind, placebo‐controlled cross over study.Methods. Thirty‐five women with PMS were given one tablet of 100 mg spironolactone or placebo daily from day 14 of the menstrual cycle until the first day of the following menstruation. Two pretreatment cycles were observed for diagnosis in each woman, followed by 6 treatment cycles with spironolactone and placebo applied in either the first or second 3 months. The assessment of symptoms and diagnosis of PMS were based on prospective daily self‐ratings made by the women using a validated visual analogue scale.Results. The treatment with spironolactone was associated with an improvement in PMS symptoms compared to placebo as judged by significant decrease in negative mood symptom scores (p < 0.001) and somatic symptom scores (p < 0.001). Of the individual symptoms, spironolactone significantly improved irritability, depression, feeling of swelling, breast tenderness and food craving in comparison to placebo. A lasting effect of spironolactone was observed in women started with spironolactone after cross over to placebo.Conclusions. Spironolactone appears to be an effective therapy for the negative mood changes and somatic symptoms in PMS.
Human placental lactogen and pregnancy‐associated plasma protein A in first trimester and subsequent fetal growth
Authors: Pedersen Jan Fog , Sørensen Steen , Ruge Susanne 
Published: November 2007

Objective. To study in an optimized design the possible relation between serum levels in weeks 8‐14 of human placental lactogen and pregnancy‐associated plasma protein A and fetal size at delivery.Methods. Analysis of data from 93 normal singleton pregnancies. Gestational age was assessed from a sonographic crown‐rump length measurement. Serum levels of human placental lactogen and pregnancy‐associated plasma protein A were determined by radioimmunoassay, and were expressed in multiples of mean. The relative birth weight was used as an index of fetal growth.Results. Serum levels of human placental lactogen and pregnancy‐associated plasma protein A showed a negative correlation to gestational age at delivery (p<0.01 andp<0.05, respectively), and there was a positive correlation between the serum level of pregnancy‐associated plasma protein A and relative birth weight (p<0.02).Conclusions. Higher levels of human placental lactogen and pregnancy‐associated plasma protein A predicted earlier delivery, maybe because of better fetal growth, and higher levels of pregnancy‐associated plasma protein A predicted better fetal growth.
Elevation of oxytocin levels early post partum in women
Authors: Nissen Eva , Lilja Gunilla , Widström Ann‐Marie , Uvnás‐Moberg Kerstin 
Published: November 2007

Background. The aim of this study was to determine plasma levels of oxytocin in women immediately after delivery.Methods. Oxytocin was measured in 18 healthy women at 15 minute intervals after normal vaginal deliveries with healthy infants. The mothers had their infants put skin‐to‐skin on their chests immediately after birth. The infants stayed there up to two hours post partum. Results. There were significant elevations of oxytocin 15, 30 and 45 minutes after delivery (p=0.007, 0.02 and 0.02 respectively) when compared with average pre partum levels sampled approximately 7‐15 minutes before partus. This elevation of oxytocin coincided with the expulsion of placenta. In most women this first elevation was followed by repeated elevations of oxytocin. Oxytocin levels returned to pre partum levels at 60 minutes post partum.Conclusions. Oxytocin is known to play a role in maternal bonding in animals. Earlier studies indicate that there is a sensitive period for bonding the first hour after giving birth even in women. Our study demonstrates a coincidence of this putative ‘sensitive period’ and high levels of oxytocin.
Human chorionic gonadotropin patterns in early pregnancy after assisted reproduction
Authors: Fridström Margareta , Garoff Leena , Sjöblom Peter , Hillensjö TorbjÖRn 
Published: November 2007

Background. Assisted reproduction implies increased risks of pathological pregnancy, necessitating close follow up of early pregnancy. The use of serum hCG levels two and three weeks after embryo transfer for prediction of pregnancy outcome after in vitro fertilization‐embryo transfer (IVF/ET) or gamete intrafallopian transfer (GIFT) was evaluated.Methods. Three hundred and twenty‐nine treatment cycles were included. Serum samples were obtained on days 14 and 21 after ET and hCG was determined by fluoroimmunoassay. Receiver operating characteristic (ROC) curves were analyzed to find cut‐off levels of hCG giving maximal sensitivity and specificity, identifying a low risk group and a high risk group with regard to pathological pregnancy.Results. The group of patients carrying a viable pregnancy had significantly higher hCG levels two and three weeks after ET than the group of patients carrying a pathological pregnancy. Furthermore, the daily increase in hCG was higher. In multiple gestations, the levels of hCG were significantly higher compared to singleton pregnancies. Ninety per cent of the patients with an hCG level ≥150 IU/L 13‐15 days after ET carried a pregnancy to term (the low risk group). Conversely, 50% of the patients with hCG < 150 IU/L carried a pathological pregnancy (the high risk group).Conclusion. A single determination of the hCG level two weeks after ET, combined with transvaginal ultrasound two to three weeks later, is a reliable follow‐up. In cases of subnormal hCG levels (< 150 IU/L), a second hCG determination one week later followed by sonography is recommended.
Book Reviews
Authors: Bergsjo Per 
Published: November 2007

James D, Pillai M. Colour Guide Obstetrics. 147 pages. Illustrations. Edinburgh: Churchill Living stone, 1994. Price GBP 8.50.Studd J. Progress in Obstetrics & Gynaecology, Volume 11. 467 pages, figures, tables. Edinburgh: Churchill Livingstone 1994. Price: GBP 33.00.
Effects of hydralazine on placental and renal circulation in pre‐eclampsia
Authors: Gudmundsson Saemundur , Gennser Gerhard , Marsal Karel 
Published: November 2007

Background. Although hydralazine has been the drug of choice for treating pregnancy‐induced hypertension for some time owing to its effect on peripheral vascular tonus, its effects on utero‐ and feto‐placental circulation are less well understood.Methods. To evaluate the effect of hydralazine on placental circulation in cases of pre‐eclampsia, Doppler ultrasonography was used to record blood velocity in the arcuate and umbilical arteries in 12 pregnancies complicated by pre‐eclampsia, blood velocity in the maternal renal artery also being examined. The gravidae underwent Doppler ultrasonography after 24 hours bedrest in hospital (baseline values), and again 24 and 72 hours after starting oral hydralazine treatment at doses of 50 mg twice daily.Results. The gravidae showed increased heart rate and decreased blood pressure in response to treatment, but neither placental nor maternal renal blood velocity waveforms were affected.Conclusion. The results suggest that at recommended oral doses hydralazine has no effect on placental or maternal renal vascular resistance.