bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hospital‐associated infections in obstetrics and gynecology
Authors: Evaldson George R. , Frederici Harriet , Jullig Claes , Mannerquist Kerstin , Nyström Bertil 
Published: November 2007

Study objective: To determine whether continuous surveillance of hospital‐associated infections with regular feed‐back to the staff reduces the infection rate in obstetrics and gynecology.Design: Two infection control nurses surveyed all patients over a 2‐year period for infections and potential risk factors. After an initial 9‐month period (period A), quarterly information to all doctors and nurses was introduced for the rest of the study (period B).Setting: A department of obstetrics and gynecology at a Swedish university hospital.Patients: All patients undergoing surgery, excluding vacuum aspiration abortions and dilatation and curettage.Main results: 2,334 patients were surveyed. In period A, 14.2% of all operations were followed by an infection, compared with 9.5% in period B (p < 0.001). For purulent wound infections and for endometritis, a significantly reduced rate was noted from period A to B. Several risk factors for infection were significantly more common in period B than in period A. Cesarean sections and hysterectomies were the most common operations also having among the highest infection rates. For both of these operations, infection rates were significantly reduced from period A to period B (from 15.1% to 9.0% and from 15.7% to 10.7%, respectively). The average length of hospitalization was 6 days longer for an infected than for an uninfected patient.Conclusions: Surveillance of hospital‐associated infections including regular feed‐back to the staff was accompanied by a significant reduction in infection rates. A quality surveillance program for departments of obstetrics and gynecology therefore seems to benefit from including such surveillance. Surveillance could possibly be limited to only a few common operations with high infection rates.
Oral contraceptives and cancer of the cervix uteri: A meta‐analysis
Authors: Delgado‐Rodriguez M. , Sillero‐Arenas M. , Martin‐Moreno J. M. , Galvez‐Vargas R. 
Published: November 2007

Aim and objective: Because the findings of epidemiologic studies of the relationship between oral contraceptive use and cervical cancer have not been consistent, we reanalyzed the relationship.Design: Meta‐analysis of studies published to date.Setting and subjects: Papers were located by searching the MEDLINE data base, supplemented by a hand search of all the references in the articles recovered.Measurements: Studies were graded as to quality. Two meta‐analyses were performed: one including all the studies gathered and one including methodologically acceptable studies only. The method of Woolf was used to combine relative risks. Heterogeneity of the effect was assessed.Main results: Fifty‐one published studies were collected: 21 case‐control, 18 cross‐sectional, and 12 cohort designs. Twenty‐one of these were considered as methodologically acceptable, but only 18 could be pooled. The main results observed were: relative risks was 1.52 (1.3–1.8) for dysplasia, 1.S2 (1.3–1.8) for carcinoma in situ, and 1.21 (1.1–1.4) for invasive cancer. A significant linear dose‐response effect was observed in dysplasia, carcinoma in situ, and invasive cervical cancer. Heterogeneity of the effect was present in some of the former estimates.Conclusions: Oral contraceptive use may be a risk factor for all stages of the natural history of cervical cancer, which may imply an initiator effect. Limitations to this research are discussed.
Expression of receptors for tumor necrosis factor in human placenta at term
Authors: Austgulen Rigmor , Espevik Terje , Mecsei Reidun , Scott Helge 
Published: November 2007

The biological effects of tumor necrosis factor (TNF) are mediated through its interaction with high affinity receptors on target cells. Secretion of soluble cytokine receptors has been suggested as a mechanism of regulating cytokine activity in vivo. In a previous study we detected soluble TNF receptors (TNFRs) in amniotic fluid and urine samples from pregnant women, suggesting that secretion of soluble TNFRs may provide a mechanism for protection of the fetus against TNF action during pregnancy.In the present study, TNFR containing cells in cryostat sections from normal placentas at term were evaluated by monoclonal antibodies against the 55kD ‐ and the 75kD TNFR in an indirect immunofluorescence technique. The 55kD TNFR was expressed by the villous syncytiotrophoblasts, by vascular endothelial cells, by some decidual cells and by occasional cells in the placental stroma. Staining for the 75kD TNFR was confined to the vascular endothelial cells, a relatively small number of stromal cells and decidual cells, whereas the villous syncytiotrophoblasts were negative.The abundant expression of TNFRs in placental tissue suggests 1.) That a considerable number of the placental cells are receptive to the regulatory activities of TNF; 2.) That placental cells may be the cellular origin of soluble TNFRs secreted during pregnancy.
Maternal smoking and age
Authors: Backe Bjørn 
Published: November 2007

Study objective. To analyse the information on maternal smoking routinely recorded during antenatal care by general practitioners, with emphasis on the impact of smoking on birth weight and risk for small‐for‐gestational age (SGA) births. Design. Geographically based cohort study.Setting. Evaluation of information recorded by general practitioners in antenatal records, in routine clinical practice without intervention.Material. Women residing in one Norwegian county delivering during a 12 month period 1988/1989.Main results. 1908 women gave birth. 30 % were recorded as smokers at first antenatal visit, 4% lacked information on smoking. The recording of smoking habits in week 36 was deficient as data were missing in 75% of the women who smoked at first antenatal visit. Smokers experienced a mean birthweight impairment of 182 grams (adjusted for parity and age). A dose‐response effect on birth weight of the number of cigarettes smoked per day at first visit was found. Also, a synergistic effect of increasing maternal age and smoking with regard to risk for SGA was demonstrated. The relative risk for SGA for smokers below 25 years was not significant, whereas women of 35 years and more had a relative risk of 3.8 for SGA. 18% of the SGA‐cases among the study subjects were attributable to smoking. Conclusions. Using the routinely collected information on smoking at first antenatal visit, the well known effects of smoking on birthweight are reproduced. The routine recording of smoking habits in week 36 is insufficient. Information on smoking registered in the antenatal records should be recorded in the Medical Birth Registry. Smoking in pregnancy appears not to be equally harmful for all women. The highest risk for SGA is found in the age group where smoking is most infrequent. The question of a more differentiated approach to the problem of smoking cessation in pregnancy, is raised.
Risk factors for multiple births
Authors: Parazzini Fabio , Tozzi Luca , Ferraroni Monica , Bocciolone Luca , Molteni Elena , Moreschi Cristina , Fedele Luigi 
Published: November 2007

Study objective: To analyze risk factors for multiple births.Design: A case‐control study. Cases were 103 women (median age 31 years, range 20‐44) who delivered multiple births not related with treatment for infertility at the ‘Clinica Luigi Mangiagalli’ of Milan. A total of 27 women delivered monozygotic twins and 76 dizygotic ones. Controls were 308 women (median age 30, range 17‐45) admitted for normal delivery on selected days to the same clinic where cases had been identified.Results: Cases tended to be less educated than controls and the relative risk of multiple pregnancy, compared with women reporting seven years of schooling or less, was 0.4 in those reporting 7‐11 and 12 or more years of education. When the analysis was done separately for dizygotic and monozygotic multiple pregnancies, this relationship was restricted to dizygotic multiple pregnancies (χ21 trend for dizygotic pregnancies=3.82, p = 0.05). A family history of multiple pregnancies was reported in 36 women (48%) with dizygotic multiple pregnancy and 13 (52%) monozygotic ones and 88 (30%) controls. The corresponding relative risks (RR) were 2.2 and 2.5 respectively for dizygotic and monozygotic pregnancies. Compared with nulliparae, the estimated RR of dizygotic multiple pregnancies was 0.5 in women reporting two or more births, but the trend in risk with number of births was not statistically significant. No relationship emerged with spontaneous or induced abortions, body mass index, oral contraceptive or IUD use, age at menarche and risk of multiple pregnancies. Conclusions: This study confirms the role of familiarity in the risk of multiple pregnancies and suggests some different epidemiological characteristics in dizygotic and monozygotic multiple pregnancies.
Treatment of unexplained infertility: Fallopian tube sperm perfusion (FSP)
Authors: Kahn Jarl A. , Sunde Arne , von Düring Vidar , Sørdal Terje , Molne Kåre 
Published: November 2007

Patients and methods. Fifty‐one couples with unexplained infertility were enrolled in the fallopian tube sperm perfusion (FSP) program. FSP is in short a combination of ovarian hyperstimulation, ovulation induction and intrauterine and intrafallopian tube insemination using a sperm suspension of 4 ml volume.Results. One hundred cycles were started; 93 of these were completed, resulting in 27 pregnancies (29.0% per cycle). The pregnancy rate in the first treatment cycle (41.2%) was significantly higher than in the subsequent treatment cycles (14.3%, p<0.01). Total pregnancy loss was 22.2% (2 ectopic pregnancies and 4 spontaneous abortions). The multiple birth rate was 14.2% (two sets of twins and one set of triplets).Twenty‐two couples not conceiving following a maximum of three FSP treatments, were offered IVF treatment. Forty‐three IVF cycles were started resulting in 27 embryo replacements in 15 patients. Seven pregnancies occurred in six couples. In 11 of the couples treated, IVF treatment revealed a possible explanation for the infertility; development of multiple small follicles following ovarian hyperstimulation, empty follicle syndrome and partial or total fertilization failure. Only in five of the couples who did not conceive, no cause for the infertility could be found.Conclusion. In the treatment of couples with unexplained infertility, the FSP procedure seems to give a birth rate of about 40% in less than two treatment cycles. FSP is less invasive and less expensive than alternative procedures such as GIFT, ZIFT and IVF and does not require the expertise and facilities for culturing of human oocytes and embryos.
Establishment of a tissue bank for fetal stem cell transplantation
Authors: Westgren Magnus , Ek Sverker , Bui The‐Hung , Hagenfeldt Lars , Markling Lola , Pschera Helmut , Seiger Åke , Sundström Erik , Ringden Olle 
Published: November 2007

Study Objective. To analyse the yield of fetal liver tissue in first trimester abortions and to evaluate the number of nucleated cells obtained from each fetal liver during the sixth to twelfth week of gestation.Design. Prospective descriptive studyLocation University Hospital.Material Women seeking abortion during a 12 month period 1992/1993.Results. Out of 1271 women seeking abortion, 152 were asked whether they were willing to donate fetal tissue for fetal transplantation. Of these women, 105 (69%) accepted the proposal and undcrwent a modified low suction vacuum curettage. Fetal liver tissue was obtained in 61 (58%) of these procedures. The frequency at which tissue was retrieved was strongly related to gestational age and rose from 29% in week 6 to 79% in the tenth to twelfth week of gestation. The mean number of nucleated cells obtained from each fetal liver demonstrated a conconiitant increase with gestational age, rising from 16 to 43 × 106 per liver during these weeks of gestation. Of the 61 cases in which fetal liver was obtained. four subjects were shown to be abnormal by laboratory analyses and 11 did not alter the mandatory follow‐up appointment. This left 46 cases for use in the program of fetal to fetal transplantations.Conclusions. Most women seeking abortion seem to be in favor of the idea of fetal tissue donation lor the treatment of other fetuses. The possibility of obtaining fetal liver tissue and the number of fetal stem cells retrieved are closely correlated to gestational age. A tissue bank appears to facilitate the operation of a fetal to fetal stem cell transplantation program.
Pregnancy outcome in renal allograft recipients in Nor
Authors: Haugen Guttorm , Fauchald Per , Sødal Gunnar , Leivestad Torbjørn , Moe Narve 
Published: November 2007

Background. To study the influence of pre‐conceptional health status and immunosuppressive drug regimen on pregnancy outcome in renal allograft recipients.Methods. The study includes all pregnancies in renal allograft recipients in Norway in the period 1973‐1991. The data were collected from the patient records. Serum‐creatinine values, proteinuria. blood pressure, recent graft rejection, and immunosuppressive drug regimen before pregnancy as well as the interval from transplantation until pregnancy were related to the frequency of deliveries at term, preterm deliveries, and of induced and spontaneous abortionsResults. 54 pregnancies in 37 renal allograft recipients resulted in 31 term deliveries, 12 preterm deliveries, four spontaneous, and seven induced abortions. One induced abortion due to psychosocial reasons was excluded from the calculations. Post‐transplant intervals less than two years as compared to longer intervals were associated with an increased frequency of spontaneous and induced abortions (6/13 vs 4/40. p < 0.01) and a non‐significant increase in the relation between preterm and term deliveries (3/4 vs 9/27). The few women with proteinuria, elevated serum‐creatinine values, and hypertension before pregnancy had an increased number of adverse pregnancy results. The women receiving cyclosporine A experienced a larger frequency of spontaneous and induced abortions (7/18 vs 3/35, p< 0.05) and an increase in the relation between preterm and term deliveries (714 vs 5/27, p<0.01) as compared to the women who received prednisolone and azathioprine only.Conclusions. The results demonstrate the importance of pre‐conceptional consultation and may indicate a harmful effect of cyclosporine A on pregnancy outcome.
A prospective study of fertility and outcome of pregnancy after discontinuation of oral contraception in relation to elective orthopedic surgery
Authors: Dale O. , Skjeldestad F. E. , Rossvoll I. 
Published: November 2007

Objective. To evaluate the risk of unwanted pregnancies, their outcome and the rate of resuming contraception after discontinuation of oral contraception (OC) prior to elective surgery.Design. A six months prospective follow‐up study.Setting. Orthopedic unit, operating on a total of 897 women during a period of 24 months.Subjects. Seventy‐eight healthy women in whom OC was stopped prior to elective orthopedic surgery.Outcome. Pregnancy rate, pregnancy outcome and reinstitution rate of OC.Results. Complete outcome data are available for 73 (93.5%) of 78 women who were asked to participate in the study. Five pregnancies were reported, giving a cumulated six month pregnancy rate of 6.8%. Three pregnancies were completed to term, one was ectopic and one terminated by induced abortion. Within six months after the operation the cumulative user rate of oral contraceptives was 74.2%. None of the women were readmitted to hospitals for severe illness during the study period.Conclusions. The women resumed oral contraceptives relatively soon after their first postoperative menstrual cycle. This may explain why the pregnancy rate during the first six postoperative months appears low.
Bacterial vaginosis and cervical intraepithelial neoplasia
Authors: Platz‐Christensen Jens Jörgen , Sundström Eva , Larsson Per‐Göran 
Published: November 2007

Methods. In an attempt to investigate an association between the finding of clue cells in Papanicolaou‐stained (PAP) smears and cervical intraepithelial neoplasia (CIN), a total of 6I50 smears from 1976 were re‐investigated.Results. Clue cells representing bacterial vaginosis were present in 10% of the PAP‐smears. CIN II and III alone, as well as all CIN cases, were more common in women with bacterial vaginosis (p< 0.001). Histologically CIN III/carcinoma in situ was found in nine patients with and in 16 patients without bacterial vaginosis. The relative risk of having CIN III/ carcinoma in situ if the women had bacterial vaginosis was 5.0 with 95% confidence interval of 2.2‐11.6.Conclusions. The possibility exists that bacterial vaginosis is in some way associated with the development of cervical intraepithelial neoplasia, i.e. as a cofactor to human papilloma virus. Therefore. bacterial vaginosis must be taken in consideration in future studies on CIN.
Renin gene restriction fragment length polymorphisms do not show linkage with preeclampsia and eclampsia
Authors: Arngrimsson Reynir , Geirsson Reynir T. , Cooke Alexander , Connor Michael , Bjornsson Steingrimur , Walker James J. 
Published: November 2007

Objective. To investigate linkage between the renin gene restriction fragment length polymorphisms in families with a history of preeclampsia/eclampsia.Methods. Nine Icelandic families with at least three affected females in two or three generations were investigated. DNA from lymphocytes was digested with the endonuclease restriction enzyme Bgl I and restriction fragments were transferred by Southern Blotting. Hybridisation was effected with the 32P‐oligonucleotide‐labeled diallelic genomic probe pHRnX 0.8. LOD scores were calculated by the Liped program for two forms of inheritance patterns. Affected sib pairs were analysed.Results. Frequencies of the 9.0 kb and 5.0 kb alleles were 0.67 and 0.33, with no significant differences between affected females and spouses and combined LOD scores of −2 for recombination values of 3%. Allele sharing in affected sibs was not different from the expected random assortment.Conclusion. The linkage analysis provides evidence to exclude alteration of the renin gene in pregnancy as being directly responsible for the manifestations of preeclampsia or eclampsia in these families.
Atrial natriuretic peptide, blood volume, aldosterone, and sodium excretion during twin pregnancy
Authors: Thomsen Jørn Kvist , Fogh‐Andersen Niels , Jaszczak Poul 
Published: November 2007

Background. The reports on plasma concentrations and physiological function of atrial natriuretic peptide (ANP) during pregnancy are conflicting. In a recent prospective study, including 40 healthy primigravidae, we found a highly significant decrease in the plasma concentration of ANP (p‐ANP) during the third trimester and the results indicated that ANP takes part in regulation of blood volume and renal function during pregnancy as in the nonpregnant state. In order to test these results, a study was performed in primigravidae with twin pregnancy to test if the accentuated physiological changes here were followed by a corresponding greater decrease in p‐ANP.Methods. Ten healthy primigravidae with twin pregnancy were examined four times during pregnancy plus 12 weeks after delivery. Each time the following were measured: p‐ANP, aldosterone, renin, blood volume (carbon monoxide), cardiac output (Doppler), blood pressure and sodium excretion. Interdependence of the changes in ANP and in the other parameters was tested using Spearman's rank correlation test on the delta (Δ)‐values (the differences in measurements between investigations). The results were compared to the results obtained during singleton pregnancy using the Mann‐Whitney rank sum test.Results. All pregnant values of p‐ANP during twin pregnancy were lower than 12 weeks after delivery, p < 0.01. In the 20th, 28th, and 32nd week p‐ANP was lower in twin pregnancy than in singleton pregnancy, p < 0.05. There was a negative correlation between changes in p‐ANP and changes in: a) blood volume, R=‐0.8, p < 0.0001, b) aldosterone, R=‐0.66, p < 0.0001, c) renin, R=‐0.52, p < 0.01, d) cardiac output, R=‐0.68, p < 0.0001. There was a positive correlation between changes in p‐ANP and changes in: a) fractional excretion of sodium, R = 0.73, p < 0.0001, and b) total peripheral resistance, R = 0.61, p < 0.0001.Conclusion. The results suggest that the competitive relationship between ANP and the renin‐aldosterone system in regulating sodium balance and fluid volume is preserved during pregnancy. The vasodilatation during pregnancy is not mediated by ANP.
Choice of contraceptive modality by women in Norway
Authors: Skjeldestad Finn Egil 
Published: November 2007

Study objective. To investigate the use of contraception in a representative sample of Norwegian women.Outcome measures. Frequency distribution of contraceptive methods by age, marital status and parity strata.Material. A sample of 4,933 women were selected at random from the Central Population Register as participants in the second Norwegian fertility study (1988). The response rate was 81% (n=4,019) and personal interviews of contraceptive use were carried out among 2,782 women who were fecund, sexually active and not pregnant. These women comprise the study population.Results. 2,782 women were sexually active during the last month prior to the interview and thus in potential need of contraception. More than 50% of the women used either oral contraceptives (21%) or IUDs (30%). The use of oral contraceptives decreased linearly with age from a user rate of 60% among women 20‐24 years old to 1.5% among women 40‐44 years of age. The use of IUDs increased from 6% in the youngest age group to nearly 40% among women aged 30‐39 years of age. Oral contraceptives were preferentially used by childless women or those with only one child, while IUDs were most often used by women with two or more children. The sterilisation rate increased by age and in the 40‐44 age group one out of every three women was sterilised. Non‐use was most frequent among the subgroups of women who planned children in the future. Use of condoms and other coitus‐dependent contraceptives varied less with age, marital status and parity than did the use of OC, IUDs or sterilisation.Conclusion. The user pattern concerning different contraceptive methods reflects the general guidelines for contraceptives in Norway. The fact that nearly 70% of the women were in one of the three categories ‐ OC or IUD users, or one of the partners was sterilised ‐ reveals that the awareness and knowledge of modern contraception is high in Norwegian society.