bluuebunny/crossref_metadata_2025_split huggingface dataset:
Color Doppler ultrasound in the preoperative assessment of adnexal masses
Authors: Zanetta Gerardo , Vergani Patrizia , Lissoni Andrea 
Published: November 2007

Objective. To differentiate benign from malignant ovarian tumors preoperatively by means of transhaginal color Doppler ultrasound and to compare the sensitivity and specificity of this technique with that of conventional transvaginal ultrasound and CA 125 serum levels.Methods. Different indicators of blood flow resistance (pulsatility index and resistance index) within intratunioral vessels were evaluated preoperatively in 80 adnexal masses by means of color Doppler ultrasound. Results were compared to CA 125 levels, conventional ultrasound and histopathologic findings.Results. Forty‐seven benign, 29 malignant and four borderline masses were studied. Mean PI and RI were significantly higher in benign than in malignant masses but an overlap was observed Sensitivity, specificity and accuracy of color Doppler in predicting malignancy were 85%, 91% and 89% by using a cut‐off value of 0.56 for resistance index and 97%, 87%, 91% by using a cut‐off value of 1.0 for pulsatility index. The accuracy of both indexes in differentiating benign from malignant tumors was superior to that obtained by using conventional ultruaound and CA 125. In eight of nine masses where disagreement existed between color Doppler ultrasound and conventional ultrasound, pathologic examination confirmed the nature suggested by color Doppler ultrasound.Conclusions. Compared to conventional ultrasound and CA 125, color Doppler ultrasound was more accurate in discriminating malignancies from benign tumors. The best use for this techniquc seems in giving further preoperative information about masses with uncertain sonographic characteristics. allowing better timing and tailoring of surgery.
Prognostic factors and long‐term results of the Burch colposuspension
Authors: Kjølhede Preben , Rydén Gunnar 
Published: November 2007

The purpose of this retrospective study was to evaluate the importance of different preoperative estimates and postoperative complications on the outcome of the Burch colposuspension with respect to urinary continence.During the period 1980‐1988 243 women were operated upon with the Burch colposuspension for stress incontinence or mixed incontinence. The patient records have been analysed with respect to preoperative assessments and postoperative complications. 236 patients were alive at the follow‐up, median 6 years after operation, and 232 (98%) answered a postal questionnaire about their present urinary symptoms.According to the postal questionnaire the overall cure‐rate was 63 per cent, another 27 per cent were improved. Prognostic factors for an unsuccessful outcome of the operation were previous urinary incontinence surgery, postoperative febrile morbidity, and immediate voiding difficulties (stranguria and difficulties emptying the urinary bladder). At the follow‐up the voiding difficulties were still significantly more often seen in patients not cured from incontinence than among women cured by the colposuspension. Among the patients with recurrent incontinence we also found a significantly higher rate of lower urinary tract infections (> 3 UTI per year). The continence rate was found to be almost constant between the second and tenth year postoperatively. No significant differences in preoperatively measured maximal urcthral closure pressure and functional urethral length were found between cured and not cured patients. Although not significant, the cure‐rate showed a tendency to decrease with age iit the operation. both in the short‐term result as well as the long‐term result.
Transvaginal sonography of myometrial invasion depth in endometrial cancer
Authors: Prömpeler Heinrich J. , Madjar Helmut , du Bois Andreas , Lattermann Ulrich , Wilhelm Christian , Kommoss Friedrich , Pfleiderer Albrecht 
Published: November 2007

The myometrial invasion depth of endometrial cancer is an important prognostic factor. The preoperative assessment is decisive for the appropriate surgical treatment. In 96 patients with endometrial cancer, the myometrial invasion depth (greater than 50% or less than 50%) was measured preoperatively using transvaginal sonography (TVS). The sonographic results were compared to the histopathological findings. A sensitivity of 93% was obtained for invasion depths greater than 50%. The predictive value of an invasion depth less than 50% was 93% as well. In 16% of the cases the invasion depth was overestimated while, in only 3% it was underestimated. The diagnostic accuracy was 81%. Forty‐five patients were examined preceding a diagnostic dilatation and curettage and fifty‐one were examined following a diagnostic dilatation and curettage. The diagnostic accuracy in both groups was equivalent. Using transvaginal sonography, the spread of cancer to the cervix was observed in five of the seven cases in which it was postoperatively confirmed.TVS is a valuable, non‐invasive diagnostic method for patients with endometrial cancer. When the TVS data are combined with results from other preoperative tests, the prognostic information obtained provides a useful basis in choosing the appropriate therapy.
Lack of association between Doppler velocimetry and synthesis of prostacyclin and thromboxane in umbilical cord vessels from growth retarded fetuses
Authors: Saldeen Pia , Olofsson Per , Marsál Karel 
Published: November 2007

Background. The aim of this study was to investigate the possible association between Doppler velocimetry and synthesis of prostacyclin (PGI2) and thromboxane A2 (TxA2) in umbilical cord vessels. The hypothesis was that an altered balance between PGI2 and TxA2 production is associated with a change of artery flow resistance.Methods. 17 cases with a suspicion of intrauterine growth retardation and 21 normal pregnancies were studied. The umbilical artery pulsatility index (PI) and venous mean velocity were recorded in vivo by Doppler velocimetry. Cord vessel prostanoid synthesis was determined in vitro. The Mann‐Whitney U test and simple linear regression were used for statistical analyses. Results. The umbilical vessel synthesis of both PGI2 and TxA2 was in general lower in small‐for‐gestational age (SGA) cases (n=10) compared to appropriate‐for‐gestational age (AGA) (n=28). In the vein, the PGI2/TxA2 ratio was significantly lower in SGA cases. No certain correlations were found between umbilical artery PI and venous velocity, respectively, and PGI2 or TxA2, or their ratio.Conclusion. The prostanoid synthesis was in general lower in SGA cases, resulting in a significantly lower PGI2/TxA2 ratio in the umbilical vein. This indicates that fetal growth retardation might be associated with a disturbed endothelial function in this vessel. The synthesis of PGI2 and TxA2 in the juxtaplacental umbilical cord vessels was not correlated to the umbilical artery PI or venous flow velocity. It is possible that an altered release of prostanoids in the placental vasculature and tissue accounts for the rise of umbilical artery flow resistance instead.
Comparative study of three amniotic fluid markers in premature rupture of membranes
Authors: Gaucherand Pascal , Guibaud Suzanne , Awada Azzam , Rudigoz René C. 
Published: November 2007

Background. To study the comparative diagnostic value in premature rupture of membranes (PRM) of three amniotic components: fetal fibronectin (EN), alphafetoprotein (AFP), diamino‐oxydase (DAO).Methods. 131 pregnant women took part in our prospective study. Three samples were obtained successively for each patient in a random order. Two clinical situations were studied: group A of 68 women with clinical certain PRM and group B of 63 women with a highly unlikely PRM.Results. fFN is the best marker for diagnosis of PRM (sensitivity of 94% and specificity of 97%). AFP and DAO are complementary: the NPV is greater for AFP (87% against 84%) whereas the PPV is greater for DAO (95% against 86%).Conclusion. Apart from its value in predicting premature labor, vaginal fFN represents a diagnostic test of PRM with good specificity and sensitivity.
Paracervical Block‐A Viable Alternative for Labor Pain Relief?
Authors: Ranta P. , Jouppila P. , Spalding M. , Kangas‐Saarela T. , Jouppila R. 
Published: November 2007

Background. Two hundred and forty‐eight consecutive deliveries with a 0.25% bupivacaine paracervical block (PCB) using a superficial injection technique were studied prospectively during the progress of labor in the three month study period. Parturients with signs of fetal distress were excluded. Pain level and the maternal, fetal and neonatal effects related to PCB were evaluated.Methods. Pain intensity level was assessed on a visual scoring scale (0–10). The intrapartum fetal heart rate patterns were recorded and reviewed to correlate the incidence of paracervical fetal bradycardia.Results. Parturients with PCB were provided a significant reduction (p<0.001) in pain levels and the change in pain scores could be maintained until the beginning of the second stage. After the block, bradycardia patterns were noted in five (2.0 %) fetuses, a fetal heart rate ranged from 60 to 105 beats per minute with an onset time of 2–20 minutes after the block and a duration of 4–12 minutes. All newborns in the bradycardia group were delivered va‐ginally without signs of asphyxia.Conclusions. PCB in selected parturients with a low‐dose superficial technique has been shown to be an effective analgesic modality with minimal fetal and neonatal side‐effects, but post‐blockade fetal bradycardia cannot be wholly eliminated.
Quality of life during pelvic radiotherapy
Authors: Bye Asta , Ose Turid , Kaasa Stein 
Published: November 2007

Background. A randomized clinical trial was carried out to evaluate the effect of a diet low in fat and lactose to prevent acute radiation‐induced diarrhea. The effect of the diet treatment on the patients' health related quality of life was studied.Methods. 143 women with gynecological malignancies were included. The daily number and consistency of stools, use of antidiarrheal agents and quality of life measured by using the EORTC Core Quality of life Questionnaire 36 item version, were recorded before therapy, in the last week of treatment, six weeks after end of radiotherapy and every eight weeks during one year's follow up.Results. Fourteen patients (23%) in the intervention group reported diarrhea during radiotherapy, compared to 32 (48%) in the control group (p<0.01). This difference was not seen with the EORTC questionnaire. The diet intervention did not interfere with emotional and social well‐being. Within the control group diarrhea was associated with higher scores on the physical functioning scale (p<0.01), and fatigue and malaise scale (p<0.01) indicating more pronounced dysfunction of symptoms.Conclusion. When measuring specific phenomena such as diarrhea in a clinical trial, the EORTC questionnaire does not seem to be as sensitive as specific trial‐related instruments. Diet intervention during radiotherapy might influence the patients' ability to cope with diarrhea by giving them more control over their own situation.
Prediction of fetal weights in twins
Authors: Jensen Odd H. Rognerud , Jenssen Helge 
Published: November 2007

Objective. To determine the accuracy of sonographic weight estimation of twin fetuses. Methods In 73 twin‐pregnancies, fetal weight estimation by ultrasound was performed within 7 days prior to delivery. Fetal head biparietal diameter and abdominal circumference were measured. The coefficient of correlation (r), and the ratio between estimated weight and actual weight were calculated.Results. The coefficient of correlation was r=0.954 between estimated weight and actual birth weight. The ratio between the two parameters was 1.025, the standard deviation 0.089. In our study, 41% of the antenatal estimated weights deviated less than 5% from the actual birth weight. For 72% of all estimated weights, the deviation was less than 10%. Ultrasonographic prediction of actual weight below the 10th percentile level showed a sensitivity of 85%, predictive value of 80% and specificity of 87%. In detecting inter‐twin discordance 2200, the respective values were 64%, 64% and 91%.Conclusions. Antenatal estimation of birth weight by ultrasound correlates well with the actual weights of twin fetuses. Prediction of individual fetal weight seems to be more accurate than prediction of inter‐twin discordance.
Vaginal misoprostol as an alternative to oxytocin for induction of labor in women with late fetal death
Authors: Bugalho Antonio , Bique Cassimo , Machungo Fernanda , Bergström Staffan 
Published: November 2007

Background. Induction of labor in women with late fetal death is often difficult in settings with scarce resources. The purpose of this study was to assess the value of vaginal misoprostol for induction of labor in women with such fetal death.Methods. In Maputo 156 women with late fetal death were allotted in a non‐randomised way to either vaginal misoprostol or intravenous infusion of oxytocin. Treatment outcomes were compared as to cost‐effectiveness and safety. In the misoprostol group none received more than 800 µg. Oxytocin infusion followed an established routine. Statistical analyses were performed by EPI Info software.Results. In cases with Bishop's score <6 the induction‐to‐delivery interval averaged 14.8 hours in the misoprostol group and 31.0 hours in the oxytocin group (p=0.001). The corresponding values for women with Bishop's score <6 were 6.6 and 8.7 hours, respectively (p=0.4). Women with intact membranes had an induction‐to‐delivery interval of 13.8 hours in the misoprostol group and 26.9 hours in the oxytocin group (p=0.002). The corresponding values in women with ruptured membranes were 7.8 and 10.5 hours, respectively (p=0.6). Successful induction was achieved in 81% of misoprostol‐treated women at a dose of 100 pg or less.Conclusions. Vaginal misoprostol is a safe, low‐cost drug particularly suitable in women of high average parity having late, fetal death.
Declining an alpha‐fetoprotein test in pregnancy, why and who?
Authors: Jørgensen Finn Stener 
Published: November 2007

Objective. The aim of the study was to elucidate the questions: 1) Why are some women declining an alpha‐fetoprotein (AFP)‐test? and 2) Do women who decline an AFP‐test differ in background and in attitudes towards abortion issues from women who accept the test? Furthermore the study was aimed at clarifying some aspects of the decision process.Design. Questionnaire study over a one‐year period from October 1, 1988 to September 30, 1989.Setting. Hvidovre University Hospital, Copenhagen, and the county hospitals of Sønderjyl‐land. Denmark.Subjects. 336 women who declined the AFP‐test and 3331 women who had the test performed.Main outcome measures. Main questions concerned reasons for declining AFP‐testing, attitudes to abortion issues and how the decision was made.Results. The main reasons for declining were found to be ethicalireligious reasons or the view that the test was not reliable enough. The frequencies of women with a high school degree (46.4% versus 30.8%) and of women who had had a previous spontaneous abortion (24.1% versus 14.8%) were both significantly higher in the declining group. Regarding abortion issues, women who declined the test were significantly more restrictive in their acceptance of abortion than women who had taken the AFP‐test. 5.7% of the women who declined reported that they had perceived pressure to accept the offer to have the test.Conclusion. The study has clarified the questions as to who declines the AFP‐test and why. It is discussed whether the AFP‐programme and its consequences are, in fact, too difficult for some women to grasp and understand in detail. From the Health Service's point of view, it is noteworthy that a considerable number of women who declined the test offer might make a different choice if the AFP‐programme were improved.
Use of antenatal care services in a controlled ultrasound screening trial
Authors: Saari‐Kemppainen Aulikki 
Published: November 2007

Background. The purpose of the present study was to evaluate whether systematically organized ultrasound screening would have an effect on the uptake of antenatal care services. Methods. A total of 9310 women were randomised to an ultrasound screening (4691) or to a control (4619) group. The screening group had an ultrasound examination between the 16th and 20th week of gestation, but otherwise both groups had identical antenatal care. Results. Antenatal outpatient clinic visits were significantly fewer (2.3 compared to 2.6, p<0.0001) in the screening group. On the other hand women in the screening group had more visits to maternal health centers than those in the control group (12.9 compared to 12.6, p<0.0001). No difference was noted between the groups with respect to days in hospital, rest at home on sick leave and visits for medical check‐ups.Conclusion. Ultrasound screening reduced the need for specialist services and increased the use of basic maternal health care services.
Evaluation of breast stimulation for induction of labor in women with a prior cesarean section and in grandmultiparas
Authors: Segal Shmuel , Gemer Ofer , Zohav Efraim , Siani Moshe , Sassoon Essi 
Published: November 2007

Background. Information on the efficacy of breast stimulation for inducing labor in grandmultiparas and in women with a previous cesarean section with or without premature rupture of membranes is limited.Methods. Retrospective study of labor data from 135 women of grand multiparity or those with a previous section with or without premature rupture of the membranes in whom labor was induced by breast stimulation.Results. The success rate in achieving vaginal delivery was 84%. The duration of breast stimulation, length of labor, vaginal delivery rate, and Apgar score did not differ significantly among the four groups studied.Conclusion. Breast stimulation in grandmultiparas and in women with a previous cesarean section is efficacious and safe.
Fertility, miscarriage and pregnancy after vertical banded gastroplasty operation for morbid obesity
Authors: Bilenka Boris , Ben‐Shlomo Izhar , Cozacov Carlos , Gold Clive H. , Zohar Shlfra 
Published: November 2007

Vertical banded gastroplasty (VBG) is today the most widely performed bariatric operation. The procedures used previously for the same purpose resulted in metabolic derangements and other pathologies during pregnancy. In a retrospective study we compared the reproductive performance of nine women prior to VBG and after it.Of eighteen pregnancies prior to the operation, seven ended with miscarriage, while only one of fourteen pregnancies conceived after the operation was aborted. The rate of spontaneous conception was greatly increased after the operation and there were fewer complications in the course of the pregnancies. From the obstetrician and gynecologist's point of view VBG seems to be a good treatment for morbid obesity.
Psychosocial aspects of donor insemination
Authors: Nielsen Anders Faurskov , Pedersen Bjørn , Lauritsen Jørgen Glenn 
Published: November 2007

Background. The purpose of this study was to evaluate the attitudes and opinions among donor insemination recipient couples with respect to the informing of offspring and relatives, the effects of donor insemination on sexual life and marital status, and their concerns about the risk of getting a sexually transmitted disease.Methods. A questionnaire study design. Three hundred and sixteen (194 Danish and 122 Swedish) couples were included.Results. Answering rate among the Danish couples was 89% and among the Swedes 75%, (p<0.01).Fifty percent of the Danish couples and 66% of the Swedes were of the opinion that the treatments should be kept secret from good friends, (p<0.05). Sixty‐seven percent of the Danes and 87% of the Swedes found it important that knowledge about the inseminations was not made common knowledge to all interested parties, (p<0.005).Parameters in which there were no differences between Danes and Swedes: Fifty‐one percent of the couples would withhold information about the insemination from the child even when it was old enough to understand this information.Seventy percent of the couples would prefer not to know themselves, whether they had been conceived by donor insemination.Nineteen percent of the Danish couples would not have accepted donor insemination if the legislation guaranteeing donor anonymity had not been in existence.Eighty percent thought that their sexual life was unaffected during the course of the treatment. When asked, 95% were still married to the same partner with whom they began the treatment. Eighty‐five percent of the couples were worried about getting a sexually transmitted disease through the treatment.Conclusion. The results suggest that secrecy about the treatment and donor anonymity have a high priority among Danish and Swedish recipient couples, irrespective of the different legislation in the two countries.
Intracranial blood flow during laparoscopic hysterectomy
Authors: Kirkinen Perti , Hirvonen Eila , Kauko Minna , Purhonen Slnlkka , Nuutinen Lauri 
Published: November 2007

Aim of the study. To examine intracranial blood flow during major laparoscopic gynecologic operation and the effects of a deep Trendelenburg position and pneumoperitoneum on the flow.Material. Fifteen patients scheduled for laparoscopic hysterectomy.Methods. Trans‐cranial Doppler examination of blood flow velocity waveforms in the middle cerebral artery during operation.Results. Trendelenburg position and pneumoperitoneum were followed by a decrease in cardiac output and an increase of central venous pressure and pulmonary capillary wedge pressure. No significant changes in the pulsatility index or maximal or mean blood flow velocities in the middle cerebral artery occurred during operations. A negative correlation between percentual changes in the pulsatility index and mean arterial pressure existed.Conclusions. Uncomplicated laparoscopic hysterectomy is not associated with harmful changes in intracranial circulation in spite of a Trendelenburg position, pneumoperitoneum and changes in the patient's extracranial hemodynamics.
Influence of fatty fish intake during pregnancy in the polyunsaturated fatty acids of erythrocyte phospholipids in the mother at labor and newborn infant
Authors: Sanjurjo Pablo , Matorras Roberto , Perteagudo Lourdes 
Published: November 2007

Background. Assessing the relationship between fatty fish intake, the main source of N‐3 polyunsaturated fatty acids and maternal and fetal levels in erythrocytes at labor.Methods. The fatty acid composition was studied in 64 mother‐newborn infant pairs by means of capillar gas chromatography. Following a nutritional inquiry our population was classified as follows: superior intake group (SIG) (> 4 times fatty fish per month; 54.4±20.5 g/day), medium intake group (MIG) (2–4 per month; 16.5±4 g/day) and inferior intake group (IIG) (< 2 times per month; 4.3±4 g/day).Results. In erythrocyte phospholipids higher levels were observed in SIG in relation to IIG in mothers regarding eicosapentaenoic (0.56±0.3% and 0.39±0.2%; p=0.02) and docosahexaenoic acids (6.14±1.16% and 5.4±0.98%; p=0.02) and in newborn infants regarding eicosapentaenoic acid (0.32±0.24% and 0.17±0.09%; p < 0.01). On the other hand, SIG had lower values of arachidonic acid than IIG in mother (11.15±1.61% vs 12.83±1.86%; p < 0.01) and newborn infants (16.08 ± 3.42% vs 17.89±2.57%; p=0.05).Conclusions. From a biochemical point of view, and taking into account the pre‐existing literature, it is suggested that a minimum fatty fish intake of twice per month should be recommended (edible portion 85 g.) in order to reach the N‐6/N‐3 quotient usually proposed.