bluuebunny/crossref_metadata_2025_split huggingface dataset:
Premature rupture of the membranes (PROM) at term in nulliparous women with a ripe cervix
Authors: Hjertberg Ragnhild , Hammarström Margareta , Moberger Birgitta , Nordlander Elisabeth , Granström Lena 
Published: November 2007

Objective. To compare maternal and neonatal outcomes after 12 or 24 hours of expectant management in healthy nulliparous women with a ripe cervix and PROM at term.Design. A prospective, randomized study.Location. Karolinska Hospital, Stockholm. Sweden.Subjects. Two hundred and five healthy nulliparous women with singleton pregnancies, cephalic presentation, gestational duration 36 to 42 weeks, randomized to 12 or 24 hours of expectant management after evaluation of the cervical score (>5). If spontaneous labor did not occur, induction was performed with oxytocin after 12 or 24 hours, respectively. Main parameters. Maternal early morbidity and neonatal infections, obstetric intervention rate (cesarean section or instrumental delivery).Results. The cesarean section rate was 4% in each group. The vacuum extraction rate was 21% in each group. Induction of labor was performed in 47% of the women allocated to 12 hours of expectant management vs 17% of the women allocated to 24 hours of expectant management (p<0.05). The maternal morbidity rate was almost negligible. Only a few fetal infections occurred and no difference was noted between the groups.Conclusions. In healthy nulliparous women at term with a ripe cervix, expectant management over 24 hours vs 12 hours resulted in fewer inductions of labor and no increase in instrumental deliveries, without any increase in neonatal or maternal morbidity.
Intrauterine growth retardation at term: association between anthropometric and endocrine parameters
Authors: Nieto‐Diaz Anibal , Villar Jose , Matorras‐Weinig Roberto , Valenzuela‐Ruiz Pedro 
Published: November 2007

Objective. To investigate the endocrine profile of the intrauterine growth retardation newborns and its association with anthropometric parameters at birth.Study design. This is a case‐control study of 76 full term gestations, of which 31 were diagnosed as intrauterine growth retardation (IUGR) confirmed at birth, and 45 as normal births. Insulin, insulin‐like growth factor I (IGF‐I), growth hormone (GH), thyroid stimulating hormone (TSH), hydrocortisone, prolactin and 15 metabolic parameters were measured in maternal blood antepartum, amniotic fluid and umbilical cord blood at birth.Results. Blood taken from the umbilical cord in the IUGR group had statistically significant lower levels of IGF‐I, insulin and TSH, but higher levels of GH. In amniotic fluid and maternal blood, IUGR babies had lower levels of cortisol. The changes in GH and glucose levels in cord blood of IUGR babies were independently associated to birth weight variability (Adjusted regression coefficient‐squared=0.09 and 0.17 respectively). Ponderal index (weight/length3) among IUGR babies was independently associated with metabological changes in amniotic fluid (Adjusted regression coefficient‐squared=0.35).Conclusions. The endocrine profile of IUGR fetus would be: hypoinsulinemic, hypothyrotropinemic, hypoglycemic, hypoalbuminemic, hypocholesterolemic and hypermagnesemic with lower IGF‐I levels, yet higher than normal group GH levels at birth. Tryglicerides in amniotic fluid; GH, Glucose and Mg changes in cord blood of IUGR babies were independently associated with birth weight variability.
Assessment of fetal fibronectin in cervical secretion in cases of equivocal rupture of the membranes at term
Authors: Nisell Henry , Hagskog Katrin , Westgren Magnus 
Published: November 2007

Background. To evaluate if the presence of fibronectin in cervical secretion might provide information on the natural course of equivocal prelabor rupture of membranes (ROM) at term.Methods. One hundred and sixteen women with a history of prelabor ROM at term but without visible amniotic fluid leakage were included in the study. The presence of fetal fibronectin in cervical secretion was determined by a commercially available kit (ROM check® limit of detection 100 ng/ml). Women with (n=49) and without (n=67) a positive fibronectin test were compared with regard to time interval between presumed membrane rupture and delivery, mode of delivery and fetal distress rates.Results. There was no significant difference in the time interval between presumed ROM and delivery between those with a negative fibronectin test (median: 80 hours) and those with a positive test (median: 64 hours: p=0.28, Mann‐Whitney U‐test). Neither were there any differences in complicated delivery or fetal distress rates.Conclusion. Determination of fetal fibronectin in cervical secretion with the present method is of limited value in the clinical management of patients with equivocal rupture of the membranes.
Fetal pulse oximetry
Authors: Maesel Alf , Mårtensson Laila , Gudmundsson Saemundur , Maršål Karel 
Published: November 2007

Background. During recent years fetal pulse oximetry has been under development for use in monitoring fetal oxygenation during labor. In a methodological study we have tested the practical applicability of one type of sensor (FS‐10 Oxisensor, Nellcor®). Both obstetricians and midwives took active part in sensor placement. The readings of fetal arterial oxygen saturation (SpO2) were not taken into account when managing the patients.Methods. Oxygenation was monitored during labor in 96 singleton pregnancies. Mean SpO2 levels were calculated when cervical dilatation was 4‐7 cm and 8‐10 cm, and in the second stage of labor. Student's t‐test was used for paired comparisons. A p‐value<0.05 was considered significant.Results. Of the 96 oxisensors. 91 (95%) were successfully placed. One mother felt pain which disappeared when the sensor was removed. Two of the newborns manifested an impression mark caused by the sensor, which disappeared completely within a day. No infection or increased bleeding was noted. The mean recording time was 134 minutes. SpO2‐values were obtainable during 69% of the recording time. A significant fall of mean SpO2 occurred between the first and second stages of labor.Conclusions. The method seems to be harmless for mother and child, and allows SpO2‐values to be obtained during two thirds of the recording period. Further research is needed to evaluate the possible clinical value of the method.
Does hyperandrogenism explain lower in vitro fertilization (IVF) success rates in smokers?
Authors: Gustafson Owe , Nylund Lars , Carlström Kjell 
Published: November 2007

Background. Our aims were to elucidate whether a decreased fertility in smoking women treated by in vitro fertilization (IVF) could be related to a divergent hormonal response to the controlled stimulation prior to IVF, to study the effect of smoking on the ovarian endocrine milieu and to possibly identify factors that might be detrimental to oocyte fertilization.Methods. Serum and follicular fluid concentrations of estradiol‐17β (E2), progesterone (P), testosterone (T), 4‐androstene‐3,17‐dione (A‐4), dehydroepiandrosterone (DHA), DHA sulfate (DHAS), sex hormone‐binding globulin (SHBG) and serum Cortisol were studied in 50 non‐smoking and 50 smoking women in an IVF program. Follicular fluid concentrations were also compared in follicles which gave rise to cleaved oocytes (TYPE I) and follicles which failed to yield fertilized oocytes (TYPE II) in the same woman.Results. The fertilization rate did not differ significantly between the two groups, but the live birth rate was 30% in non‐smokers and 4% in smokers. During treatment, serum A‐4, DHAS and the T/SHBG‐ratio were significantly higher in smokers than in non‐smokers. In the TYPE I follicles, smokers had higher follicular fluid concentrations of A‐4 and DHA and a higher E2/P ratio. The TYPE II follicles in smokers had higher A‐4 and T and lower E2 levels.Conclusions. Smoking women have a relative hyperandrogenism of ovarian origin, which may contribute to the lower pregnancy rate at IVF in this group.
The Influence of Glucose Tolerance tests on Subsequent Carbohydrate Metabolism in Pregnancy
Authors: Mei Fung Hedy Yun , Wong Shu Pong , Rogers Michael 
Published: November 2007

5 September 1995Background. This present study was designed to prospectively confirm a previous observational finding that a 75g glucose load exerts an influence on the results of a subsequent 50g glucose tolerance test performed after an interval of one week.Methods. Pregnant Chinese patients were given both 50g 3‐hour and 75g 2‐hour oral glucose tolerance test (OGTT) in random order, 7 days apart, between 28 and 32 weeks of gestation. Patients were divided according to whether they received 50g test first (group 1) or 75g test first (group 2). Student's t‐test for independent samples and for paired samples were used for between group comparisons and within patient comparisons respectively using SPSS for Windows software.Results. Significant decrease in fasting glucose levels (p<0.0001) between paired 50g and 75g OGTT was found when 75g test was performed first. The mean difference in 2‐hour values was also 35% lower. Similar results were also found when individual timed glucose levels were compared between groups.Conclusions. Differences in the blood glucose levels between OGTTs were confirmed to be related to which glucose load was given first. The 75g test exerts a significant effect on the fasting glucose and the response to a 50g glucose load up to one week later. These effects are consistent with improvement in glucose utilization. The differences observed will not significantly alter current clinical practice but may necessitate modification in the diagnostic criteria of mild abnormal glucose tolerance in pregnancy. We postulate that in some cases of mild glucose intolerance, the response to diet may not be due to caloric reduction but rather stimulation of a previously inadequate insulin response since a proportion of our local pregnant women consistently have caloric intakes significantly below the 1800 kcal per day.
Smoking habits among pregnant women in a Norwegian county 1987‐1994
Authors: Eriksson Kjerstin M. , Salvesen Kjell Å. , Haug Kjell , Eik‐Nes Sturla H. 
Published: November 2007

Background. The aim of the study was to investigate changes in smoking habits among pregnant women in the city of Trondheim and its surroundings. We also wanted to register the effect of a national campaign against smoking in pregnancy introduced in December 1989.Material and methods. From 1987‐1994 midwives interviewed 21 348 women in a non‐selected population during a routine ultrasound examination at 18 weeks of pregnancy. Smoking habits and cigarette consumption were recorded.Results. The point prevalence smoking rate among pregnant women decreased from 34% in 1987 to 22% in 1994 (p<0.001). A stratified analysis indicated that the reduction was not confounded by changes in age and parity over time. The mean number of cigarettes per pregnant smoker decreased from 8.6 cigarettes per day to 7.0 cigarettes per day during the study period (p<0.001). In 1987, 49% of the pregnant smokers consumed >10 cigarettes per day compared with 35% in 1994 (p<0.001). The national campaign may have reinforced the on‐going decline in smoking rate, but no significant effect was observed.Conclusions. The study demonstrated a statistically significant reduction in smoking prevalence among pregnant women in the study area. A similar decrease was not observed among women in the general population. No significant effect of the national campaign against smoking during pregnancy was observed.
Maternal risk factors for preterm birth and low birthweight in Cape Verde
Authors: Wessel Hans , Cnattingius Sven , Bergstrom Staffan , Dupret Alice , Reitmaier Pitt 
Published: November 2007

Background. Fifteen years after the implementation of an antenatal risk screening program in Cape Verde, the first assessment of an association between maternal obstetric characteristics and preterm birth or low birthweight (LBW) infants was undertaken.Methods. A cohort of 353 systematically selected antenatal clinic attenders in the county of Praia. Cape Verde, was studied prospectively during the period October 1991 through December 1992, The cohort was followed past the perinatal period and information was obtained according to a pretested structured questionnaire. In the analysis of preterm birth and LBW, multiple logistic regression was listed to estimate the relative risks of 11 background variables.Results. The prevalence of preterm birth (<37 gestational weeks) was 12%, and the prevalence of LBW infants was 8%. Low birthweight (<2500 grams) was significantly associated with low maternal age (<19 years. RR=3.7); nulliparity (RR=5.2) and obstetric history of previous LBW infant (RR=6.5). The risk for preterm birth was significantly increased if the woman had an obstetric history of hypertension or convulsions (RR=2.6).Conclusions. In the setting studied, teenage women and women with previous pregnancy hypertension should be given selective attention in antenatal care to achieve improved pregnancy outcome. Primary prevention is needed to lower the prevalence of teenage pregnancies.
Possible influence of expatriation on perinatal outcome
Authors: Kuvacic Ivan , Skrablin Snjezana , Hodzic Damir , Milkovic Gorana 
Published: November 2007

Background. In order to test the hypothesis of possible influence of environmental stress on the length of gestation the data on deliveries in the Maternity Unit, Zagreb University School of Medicine in three six months periods: May‐October 1991 (active war in Croatia), May‐October 1990 (pre‐war period), and the same period in 1992 are analysed.Methods. Deliveries of 7845 women from free areas of Croatia (non‐displaced population) and deliveries from 712 women from occupied areas of Croatia, as well of 593 Croatian refugees from Bosnia and Herzegovina and Serbia (expatriated population) were compared. The duration of pregnancy, fetal weight, immediate neonatal condition, mode of delivery and perinatal outcome in non‐displaced and expatriated population were compared using chi‐square test in statistical analysis.Results. During 1992 and 1991, there was a slight increase in total number of deliveries in comparison to 1990. The number of deliveries by displaced women more than doubled. The incidence of major pregnancy complications was almost the same for both groups in all three time periods. The two populations were comparable regarding their age, parity and previous obstetric history. Slight increase in preterm delivery rate (7.7% in 1990, 8.7% in 1991 and 9.4% in 1992), and a subsequent slight decrease in birth weight was found in all women. There was no significant change in the proportion of growth‐retarded newborns. Expatriated women both in 1990 and in 1991 delivered twice as often prematurely in comparison to non‐displaced women (17.5% and 14.3% deliveries), respectively. Birth weight of their infants was significantly more often under 2500 grams. Slight increase in overall perinatal mortality was observed. Perinatal mortality in the experiated population was significantly higher than in the non‐displaced population. Increase in perinatal mortality could be attributed exclusively to increase in prematurity rate.Conclusions. Our results support the concept of possible influence of stress, fear, exile and inadequate antenatal surveillance on the length of gestation.
A placebo‐controlled trial of oral ergometrine to reduce postpartum hemorrhage
Authors: de Groot Akosua NJA , van Roosmalen Jos , van Dongen Pieter W. , Borm George F. 
Published: November 2007

Background. Active management with oral ergometrine 0.4 mg was compared with expectant management for the control of blood loss in the third stage of labor in women at low risk of postpartum hemorrhage (PPH).Methods. A three‐arms randomized trial in which 0.4 mg ergometrine (2 tablets of 0.2 mg) was set off against placebo, both groups allowing comparison with a standard oxytocin regimen of 5 IU.Women at low risk for PPH. Of 367 parturients, 146 were randomised to ergometrine 0.4 mg, 143 to placebo and 78 to intramuscular oxytocin in a 2:2:1 design.Results. Compared with placebo, ergometrine reduced blood loss with 5% (‐5%; Confidence interval: −20% to +13%). Oxytocin reduced blood loss with 9% (−9%; Confidence interval: −26% to +12%) versus placebo.Conclusion. Oral ergometrine has too little effect on blood loss after childbirth in order to be a good alternative to parenteral prophylactic management.
Surgical management of tubal infertility
Authors: Mosgaard Berit , Hertz Jens , Steenstrup Birgit Ravn , Sorensen Søren Stampe , Lindhard Anette , Andersen Anders Nyboe 
Published: November 2007

Objective. To investigate an unselected group of patients in a regional area undergoing tubal surgery for infertility and to identify those women who would benefit from surgery and those who should be referred directly to in vitro fertilization (IVF). Design. A retrospective study based on medical records and questionnaires. Setting. The Departments of Obstetrics and Gynecology, Gentofte, Glostrup and Herlev Hospitals, University of Copenhagen, Denmark.Subjects. Two hundred and thirty‐six women with primary or secondary infertility undergoing tubal surgery or adhesiolysis during a five year period from 1985 to 1989 with a follow‐up period of minimum of 24 months.Results. Ninety‐four women (40%) became pregnant at least once and accounted for the total number of 144 pregnancies. One hundred and forty‐two patients (60%) did not become pregnant. The delivery rate was 25%, and 37 women (16%) had at least one ectopic pregnancy. There were no significant differences in the delivery rates of the operations in between, but the risk of ectopic pregnancy was significantly lower after adhesiolysis only than after tubal surgery (p<0.05). The initial laparoscopic findings could not be used to predict the probability of intrauterine pregnancy.Conclusion. There is still a place for surgical treatment of tubal infertility, but the risk of ectopic pregnancy should be taken into account before a decision concerning line of treatment is made.
Age of sexual debut related to life‐style and reproductive health factors in a group of Swedish teenage girls
Authors: Andersson‐Ellström Agneta , Forssman Lars , Milsom Ian 
Published: November 2007

Aim. To compare life‐style and reproductive health care factors in girls with a coitus debut < 15 years of age and girls with a later debut.Methods: Girls resident in the municipality of Karlstad, Sweden, starting their upper secondary school education were invited to attend the teenage clinic during two years (five visits). Gynecological examinations were performed and questions were asked about possible symptoms, sexual activity, contraception and sexually transmitted diseases.Results: Ninety‐eight girls accepted the invitation to participate and 88 girls completed all visits (mean age on admission 16 years). Median age for coitarche was 16 years. A sexual debut <15 years was reported by 17 girls (19.3%), 54 (61.4%) had their debut $15 years and 17 girls (19.3%) had not had their sexual debut on completion of this study. Girls with an early sexual debut had a greater number of sexually transmitted diseases (p<0.05) and more cervical atypias (p<0.05), and more often had a menarcheal age <13 years (p<0.05), >two brothers and/or sisters (p<0.01), were more often not living with their parents (p<0.01) and reported a greater number of life‐time partners (p<0.06) than the remainder. Girls with a sexual debut <15 years started drinking alcohol earlier than others (p<0.01). There was a greater proportion of smokers among girls with an early sex debut compared to the remainder (p<0.05).Conclusions. Early sexual debut is associated with an earlier menarche and a more premature adult life‐style and is an important indicator for continued risk behavior regarding reproductive health.
Antibiotic prophylaxis in cesarean section
Authors: Pedersen Trine Kølby , Blaakær Jan 
Published: November 2007

Background. To investigate the guidelines for patient selection and drug regimens for application of antibiotic prophylaxis in relation to cesarean section in the maternity clinics in Denmark.Methods. A questionnaire to all the Danish maternity clinics that perform cesarean section, concerning indications for application of antibiotic prophylaxis and antibiotic regimens to patients undergoing acute and elective cesarean section.Results. All departments (n=48) returned the questionnaire. Twenty departments (46%) provided written guidelines for antibiotic prophylaxis. Four departments (8%) used antibiotic prophylaxis to elective cesarean sections, 25 departments (52%) applied antibiotics to all emergency sections. In the presence of the rupture of membranes or prolongation of labor (>12hrs) 58% and 63% of the departments applied antibiotic prophylaxis, respectively. The most frequent first choice drug was cefuroxim, employed by 27 departments (56%). Concerning timing, 21 departments (44%) applied antibiotics after cord clamping and 13 departments (27%) before incision.Conclusion. We propose a nation‐wide prospective investigation on the rate of infections associated with cesarean section to set up rational guidelines for antibiotic prophylaxis.
Endometrial stromal sarcoma of twenty cases
Authors: Huang Kuang‐Ta , Chen Chi‐An , Tseng Guan‐Chin , Chen Tzer‐Ming , Cheng Wen‐Fang , Hsieh Chang‐Yao 
Published: November 2007

Background. Endometrial stromal sarcoma is a rare neoplasm. We reviewed twenty cases to study the characteristics of this disease.Methods. Twenty cases of endometrial stromal sarcoma were treated at our hospital. The clinical stage, treatment and outcome were retrospectively analyzed.Results. Endometrial stromal sarcoma comprised 4.3% of corpus cancers and 46.4% of uterine sarcomas at our hospital. Seven cases were stage I, one was stage II, ten were stage III, and two were stage IV at the time of diagnosis. Histopathologically, seventeen cases were classified as low‐grade sarcoma and three were high‐grade sarcoma. Seven patients had recurrence and five of them had already died of disease. Among these recurrent patients, one was stage II and six were stage III. All three patients with high‐grade sarcoma and four with low‐grade sarcoma had recurrence.Conclusions. We think mitotic count is an important prognostic factor in low‐grade endometrial stromal sarcoma and high‐grade endometrial stromal sarcoma has a poor prognosis even with post‐operative adjuvant treatment.
Effect of serum from fertile and infertile patients with endometriosis on the development of mouse embryos
Authors: Abu‐musa Antoine , Takahashi Kentaro , Kitao Manabu 
Published: November 2007

Objective. To evaluate the effect of serum from infertile and fertile patients with endometriosis on the development of 2‐cell mouse embryos.Patients. Serum was obtained from 26 infertile patients and 8 fertile patients with endometriosis. Mouse embryo development in serum samples was compared using χ2 analysis.Results. In the infertile group 23% of the embryos reached blastocyst stage, whereas 22 of the 26 samples were embryo toxic. In the fertile group significantly more embryos (45%) developed to blastocysts and only one serum sample was embryo toxic.Conclusion. The embryo toxicity of serum samples from patients with endometriosis is related to the infertility associated with the disease and not with the disease per se.