bluuebunny/crossref_metadata_2025_split huggingface dataset:
In vitro fertilization following laparoscopic ovarian diathermy in patients with polycystic ovarian syndrome
Authors: Colacurci Nicola , Zullo Fulvio , De Franciscis Pasquale , Mollo Antonio , De Placido Giuseppe 
Published: March 2008

Background. To evaluate the in vitro fertilization outcome in patients with polycystic ovarian syndrome previously treated by laparoscopic ovarian diathermy.Methods. We designed a prospective study to compare in vitro fertilization stimulation parameters and pregnancy rate for two groups of women with polycystic ovarian syndrome. In the first group, we included 23 patients previously treated by laparoscopic ovarian electrodia‐thermy (group A), in the second group we included 36 women who did not undergo surgical treatment (group B). All patients underwent the same ovarian hyperstimulation protocol and a standard in vitro fertilization and embryo transfer technique. In a limited number of women (five in group A and eight in group B) we measured the levels of sex steroids in follicular fluid. Statistical analysis was performed by means of chi‐square test or Fisher's exact test to compare frequencies and by means of the Student's t‐test or ANOVA test to compare means. Significance was set at p<0.05.Results. In group A we found a significantly higher ongoing pregnancy rate (28.6% in group A vs 7.3% in group B), a significantly lower estradiol peak level (1722.73 ± 522.24 in group A vs 2314.48 ± 692.60 in group B), a trend for lower abortion rates and an improvement in the number of patients administered human chorionic gonadotropin than in group B. The levels of estradiol, testosterone and androstenedione in follicular fluid were significantly lower from small to intermediate and to large follicles in group A, while in group B only estradiol and androstenedione were different. Lower levels of androstenedione and testosterone were found in each follicular pool of group A, compared to the respective pool in group B.Conclusion. We report a significantly better ongoing pregnancy rate after in vitro fertilization and embryo transfer procedures in women pretreated by means of laparoscopic ovarian electrocautery. These results may be related to lower androgen levels in the follicular fluid.
The female pelvic floor: A dome‐not a basin
Authors: Hjartardóttir SigrúN , Nilsson Jan , Petersen Cecilia , Lingman Goran 
Published: March 2008

Background. Classically and based on necropsy observations, the muscles of the pelvic floor (the levator ani and coccygeus muscles) have been described as having the shape of a basin. In a previous study by Hugosson et al. (1991), magnetic resonance imaging revealed the dome shape of the pelvic floor in live subjects when muscular tonus is present.Methods. The normal anatomy and the dynamic movements of the female pelvis were examined with magnetic resonance imaging including conventional and fast sequences. Six nulliparous and six parous healthy women without signs or symptoms of pelvic relaxation were studied in the supine position at rest, during voluntary pelvic contractions and during bearing down.Results. The levator ani muscle was dome‐shaped at rest. During voluntary pelvic contractions the muscle straightened, becoming more horizontal and during bearing down it descended, becoming basin‐shaped. The width of the genital hiatus was the same in both groups at rest and it widened during bearing down in all but two 3‐para women. The bladder base was lifted upward and forward during voluntary pelvic contractions but during bearing down it descended.The rectum at rest had a posterior angle which decreased during voluntary pelvic contractions and increased during bearing down.Conclusions. MRI of the female pelvis is valuable in anatomic and dynamic analysis in healthy women and offers new information about the female pelvic floor. The female pelvic floor is shaped like a dome ‐ not like a basin.
Cisplatin‐induced nephrotoxicity and the protective effect of fosfomycin on it as demonstrated by using a crossover study of urinary metabolite levels
Authors: Hayashi Masatoshi , Numaguchi Masahide , Watabe Hideki , Enomoto Hideo , Yaoi Yoshimasa 
Published: March 2008

Background. Cisplatin induces nephrotoxicity and this study evaluated the protective effect of fosfomycin on it in 11 gynecological cancer patients.Methods. The N‐acetyl‐β‐D‐glucosaminidase (NAG), β2‐microglobulin (β2MG), creatinine (uCr) and total protein (TP) levels in a 24‐hour urine specimen as well as the blood urea nitrogen (BUN) and serum creatinine (sCr) were measured before and after CAPF chemotherapy alone (control) or with fosfomycin.Results. The results were statistically analyzed by using the t‐test. NAG, β2MG, uCr and TP levels increased significantly after chemotherapy in the control patients, but BUN and sCr levels did not change significantly. The NAG level in the control group was twice as high as in the fosfomycin group 8 days after chemotherapy (p<0.01). The uCr and TP in control patients increased significantly after chemotherapy when compared to those in patients coadministered fosfomycin. There were no significant changes in β2MG, BUN and sCr levels. Conclusions. Cisplatin affected the levels of NAG, β2MG, uCr and TP without influencing BUN and sCr levels. Fosfomycin, therefore, may be useful as a supplemental treatment for reducing cisplatin nephrotoxicity, especially proximal tubular damage.
Can women with intrapartum rupture of anal sphincter still suffer after‐effects two decades later?
Authors: Haadem Knut , Gudmundsson Saemundur 
Published: March 2008

Background. Recent research has revealed that women who suffer anal sphincter rupture (ASR) during delivery can experience persisting complaints some time afterwards. Examinations have been made some years postpartum, but it would be of interest to know if women with anal sphincer rupture might still have complaints attributable to the tear, two decades later.Method and material. A questionnaire was mailed to women with recorded intrapartum anal sphincter rupture (n=66) and to matched controls without anal sphincter rupture (n=66), two decades after the event.Results. Forty‐one of the anal sphincter rupture women and 38 controls replied. Anal problems were more often experienced by the anal sphincter rupture subjects (n=18) than by the controls (n=7) (p<0.01). Complaints such as anal fissures, gas incontinence and leakage into lingerie were significantly more common in the sphincter rupture group. Four claimed the physic trauma had deterred them from further pregnancy; two had nevertheless given birth later on. Five (12%) of the women were unaware that they had sustained a sphincter tear.Conclusion. Women with intrapartum anal sphincter rupture can still suffer problems 20 years afterwards. In the follow‐up of these women, information and support are essential and active tracing of such women is to be recommended.
Early dating by ultrasound and perinatal outcome
Authors: Høgberg Ulf , Larsson Nils 
Published: March 2008

Background. This study aims to evaluate the impact of routine ultrasound in early pregnancy on pregnancy outcome and perinatal mortality.Methods. Using the Swedish Medical Birth Registry, a two‐stage study was designed. First, an ecological study that included data from 45 hospitals, with 1,280,746 children born during the years 1974‐1991, was designed by differentiating hospitals on the basis of ultrasound usage. Second, a historical cohort study (n=60,864) was designed for the years 1982‐84, including a treatment group (having had routine ultrasound in early pregnancy) and a reference group (having had no routine ultrasound).Results. In hospitals practicing early dating by ultrasound, post‐term births were reduced from 13.3% to 7.4%, while pre‐term births were increased from 5.7% to 6.8%. For the treatment group, the cohort study showed: 1) fewer post‐term births, RR 0.7 (95% CL 0.7‐0.8), 2) lower post‐term perinatal mortality, RR 0.3 (95% CL 0.1‐1.0), 3) fewer twin births post‐term, RR 0.1 (95%CL 0.1‐0.7), 4) fewer acute growth retarded among term, RR 0.7 (95% CL 0.6‐0.9) and post‐term, RR 0.3 (95% CL 0.1‐1.1), and 5) a tendency towards less asphyxia among post‐term births.Conclusion. The study shows that early dating with ultrasound increases the possibilities of clinical judgment at the end of the pregnancy and also indicates that the procedure could contribute to a positive perinatal outcome.
Transcranial assessment of maternal cerebral blood flow velocity in patients with pre‐eclampsia
Authors: Ohno Yasumasa , Kawai Michiyasu , Wakahara Yasunori , Kitagawa Takeshi , Kakihara Masaki , Arii Yoshitaro 
Published: March 2008

Background. To clarify the cerebral hemodynamics in pre‐eclamptic pregnant women, we investigated the blood flow velocity of the cerebral arteries.Methods. The mean blood flow velocity and pulsatility index (PI) of the middle cerebral artery (MCA) and internal carotid artery (ICA) in normal pregnant women (n=35) and preeclamptic patients (n=18) were examined transcranially using pulsed‐wave Doppler technique with a 2 MHz probe. In two pre‐eclamptic women with post‐partum visual disturbance, we examined the mean blood flow velocity and PI of the MCA and ICA every day.Results. The mean blood flow velocity of the MCA in the pre‐eclamptic patients (89.7±20.5 cm/s) was significantly higher than that in the normal pregnant women (53.6±16.9 cm/s) (p<0.05). PI of the MCA in the former group (0.67±0.13) was significantly lower than that in the latter (0.78±0.02) (p<0.05). There was no significant difference between these two groups in these variables of the ICA. In the two patients with visual disturbance, the mean blood flow velocity of the MCA was increased before the onset of visual disturbance and decreased gradually following the disappearance of this symptom. In these patients, spasm of the MCA was confirmed by magnetic resonance angiography.Conclusions. In pre‐eclamptic patients, we found increased MCA mean velocity before the onset of visual disturbance. Transcranial Doppler may be useful for the evaluation of cerebral hemodynamics and the prediction of eclampsia.
Intrapartum death of nonmalformed fetuses in Denmark and Sweden in 1991
Authors: Westergaard Hanne Brix , Langhoff‐Roos Jens , Larsen Steen , Borch‐Christensen Hanne , Lindmark Gunilla 
Published: March 2008

Background. In 1991 the rate of intrapartum death of non‐malformed fetuses was higher in Denmark than in Sweden (4.2 vs. 1.9 per 10,000, OR 2.24). However, it is not clear whether this difference reflects potentially avoidable cases and / or suboptimal care.Material and Methods. Short descriptions were made from medical records of all 50 intrapartum deaths in Denmark and Sweden in 1991. Ten obstetricians, two from each of the Nordic countries, reviewed the cases to determine whether (1) intra‐uterine death might have occurred before admission, (2) surveillance and intervention were insufficient, (3) fetal death was potentially avoidable by improved obstetric care; and, if so, to suggest ways of improved health care.Results. There was a statistically higher rate of insufficient care (surveillance and intervention) (high or less degree) in the Danish cases (66% vs. 55%). The proportion of potentially avoidable fetal deaths was also higher in Denmark (59% vs. 52%) although the difference was not statistically significant.Conclusion. The significantly higher rate of intrapartum death of non‐malformed infants in 1991 in Denmark compared to Sweden might be reduced by improved intrapartum surveillance and interventions.
Ability of intrauterine bacterial lipopolysaccharide to cause in situ uterine contractions in pregnant rabbits
Authors: Katsuki Yukio , Kaga Nobuhiko , Kakinuma Chihaya , Takagaki Kinya , Kajikawa Satoshi , Shibutani Yasunori 
Published: March 2008

Background. To investigate the ability of bacterial lipopolysaccharide delivered by the intrauterine route to cause uterine contractions in rabbits, and to assess the suppressive effect of urinar trypsin inhibitor on them.Methods. Both pregnant and non‐pregnant rabbits were chronically implanted with a force‐transducer to make it possible to record isometric uterine contractions under unanesthetized and unrestrained conditions. Lipopolysaccharide (10 mg/animal) was administered via a catheter to their uteri: and then, after confirmation of lipopolysaccharide‐induced uterine contractions. urinary trypsin inhibitor (3.000 or 10.000 units/animal/time) or saline solution was injected through the catheter, 5 times for pregnant animals or 3 times for non‐pregnant animals at 1‐hour intervals in both cases. Their uterine contractions were continuously recorded for 3 to 5 hours. Effects of lipopolysaccharide (10 ug/ml) and urinary trypsin inhibitor (100 and 1.000 units/ml) on the contraction of isolated uteri from pregnant mice were also measured, as was their production of prostaglandin E2 and prostaglandin F2α by an enzyme immunoassay method.Results. Lipopolysaccharide augmented the in situ uterine contractions in both pregnant and non‐pregnant rabbits, as well as the in vitro contractions of isolated uteri from pregnant mice. Lipopolysaccharide also increased the uterine prostaglandin production. Urinary trypsin inhibitor inhibited significantly the lipopolysaccharide‐induced uterine contractions and the prostaglandin production.Conclusions. Lipopolysaccharide enhanced uterine contractions through, at least partly, a direct mechanism via uterine prostaglandin production, which action could explain the onset of preterm delhery due to intrauterine bacterial infection. As urinary trypsin inhibitor suppressed the lipopolysaccharide‐induced uterine contractions, this inhibitor may be a hopeful candidate of a drug for prevention of preterm delivery.
Short stature: An obstetric risk factor?
Authors: MöLler Bo , Lindmark Gunilla 
Published: March 2008

Background. A short maternal stature is associated with an increased risk of obstructed labor due to cephalopelvic disproportion and most antenatal programs, including that of Tanzania. designate short women as “at risk”.Objective. To determine mean maternal height in two obstetric populations and the effect, if any. of maternity care practices pertaining to maternal height, on interventions and outcome of pregnancy and delivery.Methods. A community based study of pregnancy outcome for women in two villages in rural Tanzania of different profiles and ethnicity.Results. In fiula 54% of cesarean sections were in the 4% of women under 150 cm and 39% of short women delivered in hospital. In Ikwiriri 23% of parturients were under 150 cm and height did not correlate to the duration of labor, referral patterns or Cesarean section rates. There are indications that fertility rate is reduced in short women in Hula but not in Ikwiriri. a result of the problems and risks of Cesarean section for women living in rural areas.Conclusions. The distribution of maternal height in the population should be considered when the cut‐off height for the ‘at risk’ designation is chosen. The implications of attaching an ‘at risk’ label is discussed and a call is made for regional specific and agreed risk criteria.
Risk of retained placenta: Multivariate approach
Authors: Adelusi Babatunde , Soltan Mohamed H. , Chowdhury Noori , Kangave Dustan 
Published: March 2008

Background. To identify important covariates related to retained placenta using logistic regression analysis.Methods. The study was carried out in the King Khalid University Hospital, Saudi Arabia, and involved 114 women who had retained placenta, and 116 women with normal deliveries. Chi‐square test and logistic regression analysis were used for analysis of data. Adequacy of predictor variables was examined using indices of sensitivity and specificity and plots of probability histograms for prediction of retained placenta among patients and controls.Results. Logistic regression analysis highlighted multiparity, induced labor, small placenta, and large amount of blood loss to be significantly associated with retained placenta. In addition. high pregnancy number, previous injury to uterus, and pre‐term labor related significantly to retained placenta. Predictor variables had sensitivity of 65.5% and 87.9% specificity and achieved 77% overall correct classification.Conclusions. These findings could be used to develop a predictive procedure for identifying high‐risk cases of retained placenta.
An analysis of the factors involved in the diagnostic accuracy of colposcopically directed biopsy
Authors: Baldauf Jean‐Jacques , Dreyfus Michel , Ritter Jean , Philippe Emile 
Published: March 2008

Objective. To compare the results of colposcopically directed biopsy with the final diagnosis established by the analysis of the surgical specimen, and to determine the clinical and colposcopy factors on which the reliability of biopsy is based.Material and methods. Five hundred and sixty‐seven women were seen by the same colposcopist who also performed the directed biopsies and/or the endocervical curettage. The final histological diagnosis identified 29 normal aspects (5.2%), 58 low‐grade cervical intraepithelial neoplasias (CIN) (10.2%). 448 high‐grade CINs (79.0%), 16 microinvasive cancers (2.8%) and 16 occult invasive cancers (2.8%). The influence of several factors ‐ such as age, parity, menopause, pregnancy, history of cervical treatment, site of the squamocolumnar junction, localization, size and severity of the lesions ‐ on the pertinence of the biopsy was studied in a uni‐ and multifactorial analysis.Results. Colposcopy was satisfactory in 399 patients (70.4%) in whom the colposcopic aspect was consistent with the final histological diagnosis in 81.2% of cases. The global agreement between biopsy diagnosis and final diagnosis was observed in 89.6% of cases. It was 84.2% for low‐grade CINs. 95.8% for high‐grade CINs, 31.2% for microinvasive cancers and 81.2% for imasive cancers. No clinical or colposcopic factor could be identified as independent factor associated with the diagnostic agreement with the directed biopsy. Conversely, concordance of biopsy was related to the final diagnosis since the only independent risk factors were a high‐grade CIN (adjusted risk ratio (ARR)=1.52, 95% CI= 1.11–2.08: p=0.006) and a microinvasive or invasive cancer (ARR = 0.56, 95% CI = 0.39–0.81; p=0.002).Conclusion. To ensure that a microinvasive cancer has not been overlooked, the excision of high‐grade CINs seems to be justified, whatever the clinical status and the colposcopic aspect.
Effect of arginine vasopressin on breathing movements of chronically instrumented fetal lambs
Authors: Bessho Takefumi , Murata Yuji , Ninomiya Yuko , Ibara Satoshi , Yamamoto Tatsuo , Miyake Yoshiaki , Tyner James G. 
Published: March 2008

Background. In hypoxic conditions, fetal breathing movements (FBM) are reportedly inhibited with simultaneous elevation of the plasma level of catecholamines and arginine vasopressin (AVP). Although some kinds of catecholamines are reported to inhibit FBM, the effects of AVP on FBM are still unknown. The present study was undertaken to elucidate whether or not AVP has an inhibitory effect on FBM and electrocortical activities in chronically instrumented fetal lambs.Methods. Arginine vasopressin was injected slowly into the fetal external jugular vein via a catheter over a 30 minute period at an infusion rate of 4.9–10.0 mlU/minute/body. In 15 fetuses (36 estimations) the mean fetal age, mean estimated fetal body weight, and mean infusion dose were 132.4×4.5days, 3.4×0.3kg and 1.7×0.3 mlU/kg/min.Results. The infusion caused a persistent decrease in the fetal heart rate and an increase in the fetal arterial pressure during the 30 minute period. The infusion of AVP resulted in a significant decrease in the incidence of FBM from 36.1 × 14.8% to 12.4×14.9% (p > 0.01). However, there were no significant differences in the incidence of the low voltage fast (LVF) activity before and during infusion of AVP.Conclusion. AVP has an inhibitory effect on FBM. The mechanism of this inhibition was not a direct suppression of the CNS as there was a dissociation between FBM and the electrocortical activity during infusion of AVP.
Transvaginal sonographic assessment of cervical dynamics during the third trimester of normal pregnancy
Authors: Brieger Geoffrey M. , Ning Xie Hong , Dawkins Robert R. , Ying Kong Qiu , Weng Cai , Chang Allan M. Z. , Haines Christopher J. 
Published: March 2008

Background. To obtain a normogram of measurements of the uterine cervix by transvaginal sonography during the third trimester of normal primiparous pregnancies and to relate these measurements to the events surrounding labor.Methods. A prospective observational study, set in Guangzhou, Peoples Republic of China, was undertaken. Fifty‐five normal nulliparous Chinese women with singleton pregnancies were studied from 30 weeks gestation until delivery. Serial transvaginal ultrasound examinations were performed at 30. 32. 34 and 36 weeks gestation and weekly thereafter. Results. There was a significant correlation between gestational age and cervical length and width. Funnelling of the internal os was present in 25% of cases, and its earliest appearance was at 36 weeks. There was no consistent relationship between funnel length and width and gestational age. The duration of the first stage of labor was inversely correlated with the last ultrasound measurement of cervical length, but there was no relationship with either cervical width nor the presence of funnelling. The cervical changes in this population differed from those found in Caucasians.Conclusions. There is a direct relationship between both cervical width and length and gestational age and an inverse relationship with cervical length and the duration of labor. Funnelling of i he internal os was not a predictor of the early onset of labor. The dimensions and features of the Asian cervix differ from those of the Europeans, and this should be considered when conducting further studies of a similar nature.
Transvaginal color Doppler ultrasound for monitoring the response to neoadjuvant chemotherapy in advanced cervical cancer
Authors: Greco Pantaleo , Cormio Gennaro , Vimercati Antonella , Nacci Grazia , di Vagno Giovanni , Loverro Giuseppe , Selvaggi Luigi 
Published: March 2008

Background. To evaluate the role of transvaginal color Doppler ultrasound in monitoring the response to neoadjuvant chemotherapy in patients with locally‐advanced cervical cancer.Methods. Fourteen patients with locally‐advanced cervical cancer, scheduled for neoadjuvant chemotherapy, were investigated with transvaginal color Doppler ultrasonography before and at the completion of chemotherapy in order to study hemodynamic changes in cervical and intratumoral vessels. Twenty healthy women matched for age and parity served as a control group. Statistical analysis was performed with Student's t test for paired data.Results. Statistically different blood flow recording between patients with cervical cancer and healthy controls could be observed only in intratumoral vessels. A significant increase of RI and PI values, recorded in both cervical artery and intratumoral vessels, have been observed in the group of patients responding to neoadjuvant chemotherapy. In patients with stable disease at the completion of chemotherapy, flow characteristics did not change significantly.Conclusion. Preliminary results of our study suggest that transvaginal color Doppler ultrasound evaluation of flow characteristics in the cervical and intratumoral vessels might be useful in monitoring the response to neoadjuvant chemotherapy in patients with invasive cervical cancer.