bluuebunny/crossref_metadata_2025_split huggingface dataset:
A new symphysis‐fundus height growth chart based on a well defined female population with ultrasound‐dated singleton pregnancies
Authors: Håkansson Anders , Áberg Anders , Nyberg Per , Scherstén Bengt 
Published: November 2007

Background. The aim was to construct a new symphysis‐fundus (SF) height growth chart, based on ultrasound‐dated singleton pregnancies.Methods. We made a population‐based study of all women, from the catchment areas of three district antenatal clinics, who registered for antenatal care during 1986. The growth of the SF height was measured on 403 women with singleton pregnancies.Results. During pregnancy each woman made on average 14.0 (s.d. 2.8) visits to the antenatal clinic, where the SF height was measured on average 10.4 (s.d. 2.6) times. All but two women had an ultrasound examination. Using proper longitudinal methods a new SF height growth chart was constructed.Conclusion. The mean values of the present curve, based on longitudinal data, were almost identical with the mean values of a recently presented curve based on stratified cross‐sectional data. Both these Swedish studies were population‐based and the pregnancies were ultrasound‐dated.
Recalled menarche in relation to infertility and adult weight and height
Authors: Helm Peter , Münster Kirstine , Schmidt Lone 
Published: November 2007

Background. Possible relationships between menarche and fertility and fecundity later in life have not been fully clarified.Methods. A cross‐sectional study was made in a random sample of 3743 women, aged 15–44 years, in the county of Copenhagen; 78% responded. Telephone interviews were made with a sample of the non‐respondents.Results. Associations were observed between early menarche and increased risk of pelvic inflammatory disease (odds ratio 2.4 (1.4–4.1)) and spontaneous abortion (OR 3.1 (1.6–5.7)) later in life. On the other hand, no association was found with irregular bleedings or amenor‐rhoea; nor was a significant relationship established with fertility or fecundity. Late menarche was associated with underweight (OR 3.1 (1.4–6.9)), and early menarche with excess weight (OR 5.0 (2.4–10.6)). A significant positive correlation (R=0.17) was found between menarcheal age and final body height.Conclusions. Menarche was not associated with fatuity or fecundity. Early menarche was associated with pelvic inflammatory disease and spontaneous abortion. Menarche showed relationships with weight and height.
Adjuvant chemotherapy in stage IB neuroendocrine small cell carcinoma of the cervix
Authors: Abulafia Ovadia , Sherer David M. 
Published: November 2007

Background. Neuroendocrine small cell carcinoma of the cervix is a very rare and aggressive tumor which tends to metastasize early. This tumor is similar histologically to small cell carcinoma of the lung. Conventional treatment with surgery and/or radiation therapy has not been successful and has prompted the use of adjuvant chemotherapy regimens similar to those used for small cell carcinoma of the lung.Methods. Three patients with Stage IB neuroendocrine small cell carcinoma of the cervix treated with postoperative adjuvant chemotherapy consisting of cisplatinum and VP‐16, were identified. Analysis of the outcome of these three patients and a review of the current literature were performed.Results. Median survival was 28 months. Two patients received pelvic radiation therapy, one due to positive surgical margins and the other due to recurrent disease. Currently two patients are alive and free of disease at 17 and 61 months. The third patient developed hepatic and pelvic recurrence and died 30 months after her presentation and 18 months after recurrence.Conclusion. The outcome of our three patients and eight similar cases in the literature suggest an improved survival rate with adjuvant chemotherapy compared to conventional treatment with surgery and or radiation therapy.
Book Review
Authors: Markestad Trond 
Published: November 2007

Clements R. V (editor). Safe practice in Obstetrics and Gynaecology. A medico‐legal handbook. 492 pages. Edinburgh‐London‐Madrid‐Melbourne‐New York: Churchill Livingstone 1994.Monif GRG: TORCH syndrome. 172 pages, 25 tables. Omaha: IDI Publications. Parthenon Publishing Group Ltd, 1993. Price GBP 27.00.
Chronological changes in subjective symptoms during pregnancy in nulliparous and multiparous women
Authors: Oga Masayuki , Shono Hideaki , Kohara Mayumi , Ito Yuji , Tanaka Tomomitsu , Sugimori Hajime 
Published: November 2007

Background. To investigate chronological changes of subjective symptoms during a normal pregnancy in nulliparous and multiparous women.Methods. Prospective data were collected using a 20‐item questionnaire (general fatigue, headache, palpitation, nausea/vomiting, fever, insomnia, edema, abnormal abdominal size, urinary frequency, lumbago, fetal descent, genital bleeding, watery discharge, high frequency of uterine contraction, increase in frequency of uterine contraction, strong intensity of uterine contraction, increase in intensity of uterine contraction, no change of uterine contraction at rest, high frequency of fetal movements, strong intensity of fetal movements) at Tsushima Izuhara Hospital in Nagasaki Prefecture, Japan. Seven hundred and twenty‐nine nulliparous and 588 multiparous normal pregnant women were questioned from 1988 to 1992. A simple (chi‐square test) analysis of appearance percentages in each item for every term of pregnancy was made.Results. Each symptom showed different chronological patterns. In the simple analysis, there were significant differences (p < 0.05) in 10 symptoms (headache, palpitation, fever, insomnia, lumbago, fetal descent, watery discharge, increase in frequency of uterine contraction, strong intensity of uterine contraction, strong intensity of fetal movements) between nulliparous and multiparous subjects. In the multiparous group, there was a higher severity in eight of the ten symptoms, except for fever and watery discharge.Conclusions. The multiparous group had more complaints than did the nulliparous subjects. These normal patterns are of practical clinical use concerning subjective symptoms of pregnancy.
Is misoprostol the drug of choice for induced cervical ripening in early pregnancy termination?
Authors: Platz‐Christensen Jens Jörgen , Nlelsen Sven , Hamberger Lars 
Published: November 2007

Background. To study the effectiveness of three different cervical ripening agents in terms of dilatation ability and patient discomfort in connection with legal first trimester abortion.Methods. Three randomized trials among unselected nulliparous women were performed 1: hygroscopic tent versus gemeprost, 2: misoprostol versus gemeprost and 3: misoprostol administered orally 17 versus 10 hours before vacuum curettage was performed.Main outcomes. Dilatation ability, frequent gastrointestinal side effects, severe pain (patients' perception).Results. In Trial 1, there was a tendency of a greater dilatation ability using the hygroscopic tent, while the experience of pain was a greater problem with gemeprost. In Trials 2 and 3, there were no significant differences in the dilatation abilities or gastrointestinal patient discomfort. There was a tendency towards a higher demand for narcotic analgesics in patients treated with gemeprost compared with all other groups.Conclusions. Gemeprost and misoprostol showed almost identical ability to dilate and caused patient‐experienced discomfort to the same degree. The use of misoprostol may be preferred as it has the advantage of being both less expensive and easier to administer.
Reasons for pregnancy termination: Negligence or failure of contraception?
Authors: Savonius Hannele , Pakarinen Päivi , Sjöberg Lena , Kajanoja Pauli 
Published: November 2007

Background. The aim of the study was to analyze the reasons for the failure of contraception and the reasons for not using any contraception among women seeking a legal abortion on social grounds. The women were also asked about their knowledge of contraception methods, including postcoital contraception.Methods. We interviewed 200 women applying for a legal abortion within the first trimester of pregnancy about contraception, the contraceptive methods used, and the possible reasons for failure of contraception.Results. Of all the women interviewed, 93% claimed to have adequate knowlegde of contraception. At the time of conception 11.5% used safe methods (OCs 8%, IUDs 3.5%), 63% used less safe methods, and 26% were without contraception. Only 25% of the pill users had no explanation for the failure. 76.7% of the condom users reported that the condom was broken, had slipped off or its use had been irregular. The concern about side effects was the most common reason for not using safe contraceptives (25%).Conclusions. The women claimed to have enough information about contraceptives, and post‐coital contraception was also familiar, but the knowledge on how to use them in practice was inadequate. Irregular use and breaks in contraception were common. Despite the data based on Pearl indices, pills failed twice as often as IUDs. Counseling about the proper use of contraceptives is important, although the concern about the side effects appeared to be a big, unsolved problem.
Carbon dioxide laser miniconization for treatment of human papillomavirus infection associated with cervical intraepithelial neoplasia
Authors: Békássy Zoltán , Ahlgren Mats , Eriksson Margareta , Lindh Elisabet 
Published: November 2007

Background. The effect of the carbon dioxide laser miniconization for treatment of cervical intraepithelial neoplasia with concomitant human papillomavirus infection was evaluated.Material and methods. One hundred and eighteen women with cytologically proven cervical intraepithelial neoplasia stage 1 and/or 2 were investigated with repeat vaginal smear, colposcopy and human papillomavirus DNA sampling. Seventy‐five out of 118 women were subjected to laser miniconization or punch biopsy and cervical curettage.Results. Out of 118 patients 37 proved to have positive human papillomavirus DNA with one or more oncogenic types (31.4%). Of these, 32 women were miniconized and five subjected to punch biopsy or cervical curettage. On the first follow‐up after miniconization all 32 patients were HPV negative. With follow‐up up to five years no recurrences of HPV or dysplasia were seen.Conclusion. A miniconization procedure with carbon dioxide laser for treatment of cervical intraepithelial neoplasia proved useful also for simultaneous therapy of concomitant human papillomavirus infection of the uterine cervix.
Magnetic resonance imaging (MRI) in endometrial carcinoma; preoperative estimation of depth of myometrial invasion
Authors: Minderhoud‐Bassie Willy , Treurniet Frank E. E. , Koops Wim , Chadha‐Ajwani Sawi , Hage Jacobus C. , Huikeshoven Frans J. M. 
Published: November 2007

Background The incidence of pelvic and aortic lymph node involvement in endometrial carcinoma depends on both tumor differentiation grade and myometrial invasion depth. It was evaluated whether magnetic resonance imaging (MRI) provides a preoperative technique to assess the depth of myometrial invasion.Methods. The study includes 34 patients with an endometrial carcinoma. MRI (T5 Gyroscan. Philips) was made a few days before operation. Myometrial invasion was divided in four categories. Cervical invasion was classified as absent, superficial or deep. For comparison an in vitro MRI of the uterus was made directly after the operation. Histo‐pathological examination of the uterus was used as a golden standard of the depth of myometrial invasion.Results. The estimation by MRI of the myometrial invasion depth was correct in 25 out of 31 patients. In three patients estimation was not possible, because of bad image quality. In four patients the MRI underestimated the cervical invasion.Conclusions. Preoperative MRI in patients with an endometrial carcinoma can be used to estimate myometrial and cervical invasion. Therefore, in combination with the histological grading of the tumor, a preoperative MRI can be used to select patients at high risk of nodal involvement.
Umbilical artery velocimetry may influence clinical interpretation of intrapartum cardiotocograms
Authors: Almstrom Harald , Axelssön Ove , Ekman Gunvor , Ingemarsson Ingemar , Maesel Alf , Årström Kjell , Maršál Karel 
Published: November 2007

Background. In a previous prospective randomised trial on pregnancies complicated by small‐for‐gestational‐age fetuses fewer operative deliveries for fetal distress were found after antenatal surveillance with umbilical artery Doppler velocimetry (Doppler group) than after surveillance with cardiotocography (CTG group). Despite that, the neonatal outcome was similar in both groups. This raised the question whether the knowledge of the antenatal Doppler results had influenced the obstetric management of labor.Methods. In this retrospective study 242 intrapartum cardiotocogram tracings, obtained from the above mentioned prospective trial, were re‐interpreted by an expert without knowledge of the results in the original study. The re‐interpretation was then compared to the original interpretation.Results. The expert interpreted 18 intrapartum tracings in the Doppler group and 18 in the CTG group as abnormal, whereas the clinicians interpreted only 8 tracings as abnormal in the Doppler group and 18 tracings in the CTG group.Conclusions. The results of this retrospective study lend support to our hypothesis that the obstetricians in clinical practice are influenced by the knowledge of a normal umbilical Doppler velocimetry when interpreting an intrapartum CTG. This finding may partly explain why there were fewer emergency cesarean sections for fetal distress in the Doppler group than in the CTG group in the original prospective study.
Complications after radiotherapy and radical hysterectomy in early‐stage cervical carcinoma
Authors: Gerdin Eva , Cnattingius Sven , Johnson Per 
Published: November 2007

Objective. To evaluate the overall complications, major as well as minor, in patients treated for early‐stage cervical carcinoma as related to treatment parameters.Methods. In this retrospective study, 167 consecutive patients with early‐stage cervical carcinoma treated with preoperative radiotherapy and radical hysterectomy were investigated. Clinical data were collected from the medical files.Results. Transient or permanent complications appeared in up to half of all patients. Seven percent exhibited intraoperative complications and 35% suffered from early postoperative urinary tract problems; most frequently urinary tract infection. After one year, the urinary tract complications dominated; voidance difficulties and incontinence being most common. Gastrointestinal complications occurred in 15% of patients. Lymphedema appeared during the first year in 21% of the patients but several of the mild or moderate cases improved after the first year. The relative risk of lymphedema was increased with shorter duration of surgery, extensive preoperative irradiation to the bladder and after external postoperative irradiation. Some form of late sequelae remained in every fifth patient, and every fourth patient, aged 24‐44 years, periodically suffered from vasomotor symptoms despite estrogen replacement therapy.Conclusion. The complications after radiotherapy and radical hysterectomy in early stage cervical carcinoma suggest that attempts should be made to evaluate effective treatments designed to minimize risk to the patients.
Expression of mRNA for keratinocyte growth factor and its receptor in human endometrium
Authors: Siegfried Sari , Pekonen Fredrika , Nyman Tuulikki , Ämmälä Martti 
Published: November 2007

Background. The aim of the present study was to evaluate the expression of mRNA for the keratinocyte growth factor and the keratinocyte growth factor receptor in human endometrium at different stages of the menstrual cycle. The role of estrogen and progesterone in regulating the expression of the mRNAs encoding keratinocyte growth factor and its receptor was further examined by studying the effect of continuous progestin (endometrium exposed to levonorgestrel releasing intrauterine contraceptive device), and continuous estrogen (endometrium hyperplasia) on the endometrium.Methods. The expression of mRNA in endometrial samples was evaluated using reverse transcriptase polymerase chain reaction.Results. The expression of KGF mRNA was found to vary during the menstrual cycle, with the highest levels in the progesterone‐dominated late‐secretory stage endometrium. Keratinocyte growth factor mRNA expression was low in both the endometrium that had been under the influence of continuous progestin (atrophic endometrium) and continuous estrogen (hyperplastic endometrium). The highest level of keratinocyte growth factor receptor mRNA expression was seen in late‐proliferative stage of the menstrual cycle and in hyperplasia when the estrogen exposure to endometrium is high. A low receptor mRNA level was found in endometrium exposed to continuous progestin.Conclusion. The results suggest that keratinocyte growth factor mRNA expression is progesterone dependent, whereas keratinocyte growth factor receptor mRNA expression seems to be more estrogen than progesterone dependent.
Relationship between acute fetal distress and maternal‐placental‐fetal circulations in severe preeclampsia
Authors: Yang Jenn‐Ming , Wang Kuo‐Gon 
Published: November 2007

Background. Hypoxic complications are thought to be the result of vascular lesions in the maternal‐placental or fetal‐placental circulation, with a resultant decrease in blood flow. This study was designed 1) to explore what kind of pathophysiological changes occur in the maternal‐placental‐fetal circulations associated with acute fetal distress, and 2) to determine whether umbilical velocimetry can be used as a predictor of acute hypoxia in severe preeclampsia.Methods. Eighty‐nine cases of severe preeclampsia, who had Doppler ultrasonography, maternal blood chemistry and hematogram examinations all performed within two days of delivery or fetal death, were studied.Results. According to the absence or presence of acute fetal distress as determined by the fetal heart rate pattern, patients were divided into two groups: distress group and non‐distress group. There was no significant difference between the two groups in maternal general status. However, patients in the distress group had a significantly shorter gestation age on admission and at delivery (p<0.00001). In the distress group, the perinatal outcome was poor. Newborns in the distress group had, significantly, a lower birthweight, and a higher incidence of SGA, 1‐min Apgar scores of less than 7, and fetal acidosis (pH<7.2) (p<0.001). Doppler ultrasonography also showed a significantly higher incidence of abnormal umbilical artery Doppler waveforms in the distress group (p<0.05). However, there was no difference between the two groups in the uterine arter Doppler velocimetry. Maternal blood chemistry and hematogram examinations revealed significantly higher blood levels of hemoglobin, hematocrit, blood urea nitrogen, and creatinine but lower levels of total protein and albumin in the distress group. An abnormal umbilical artery SD ratio (>95th centile) as a predictor of acute fetal compromise, judged by the incidence of abnormal fetal heart tracing mandating emergency delivery, 1‐minute Apgar scores of less than 7, 5‐minute Apgar scores of less than 7, and a pH value for the umbilical arterial blood of less than 7.2, had a sensitivity of 40.5‐75%, specificity of 71.8‐80%, positive predictive value of 12.5‐75%, and negative predictive value of 64.5‐98.4%.Conclusion. In severe preeclampsia, early onset of disease superimposed with maternal hemoconcentration might initiate an acute insult and predispose the fetus to acute hypoxia.
The success rate in a Swedish in‐vitro fertilization unit: a cohort study
Authors: Bergh Christina , Josefsson Birgitta , Nilsson Lars , Hamberger Lars 
Published: November 2007

Objective. To evaluate the cumulative childbirth rate after completion of in vitro fertilization (IVF) treatment including three or, in a few cases, four stimulated cycles. Design. A cohort of 398 couples starting their first IVF treatment between January 1990 and December 1992 were followed until completion of their treatment.Results. Of 826 started cycles, embryo transfer was performed in 793 cycles, giving a mean of 2.0 completed cycles per couple. In addition, cryopreserved embryos were transferred in 228 cycles (0.57 cycles per couple). 204 couples completed their treatment with delivery or with an ongoing pregnancy, 95 couples underwent three stimulated cycles without achieving an ongoing pregnancy and 66 couples cancelled their treatment after one or two cycles because of varying reasons. In seven women no transfer took place. Twenty‐six women have not yet completed their planned cycles. Of 398 couples, where the vast majority had completed their IVF treatment, 51% (204) delivered as a result of the treatment.Conclusion. IVF treatment combined with freezing of surplus embryos, is a highly effective procedure giving a ‘take home baby rate’ on a cumulative basis of more than 50% within 1 to 3 cycles.
Are Israeli women in a low risk group for developing squamous cell carcinoma of the uterine cervix?
Authors: Bar‐Am Amiram , Niv Jacob , Yavetz Haim , Jaffa Ariel J. , Peyser Reuven M. 
Published: November 2007

Objective. Invasive cervical squamous cell carcinoma is not a common disease among Jewish women. In the present study an attempt was made to find what is the distribution of the known risk factors in this population.Methods. Three hundred and ninety‐one patients with various cervical cytological abnormalities comprised the study group. They were compared to 350 Israeli women with negative cytology. The risk factors were extracted from an anonymous questionnaire. The results were statistically analyzed and compared to the equivalent figures published in the literature pertaining to non‐Jewish women.Results. The prevalence of abnormal cytology among the Israeli women was almost the same as that of the non‐Jewish group: 24/1000 and 26/1000, respectively. Significant statistical differences were found between the following risk factors: number of sexual partners, age at first intercourse, age at first pregnancy. Women in the study group were younger when they became sexually active and at first pregnancy, they had a larger number of sexual partners, fewer of them were married and fewer of them were observant of Jewish ritual practices. In addition, they had achieved higher academic levels than the women in the control group.Conclusions. It was found that the distribution of the known risk factors among the study group was practically the same as those in the non‐Jewish population. Moreover, it was found that there was an increase of 29.2% (from 17/1000 to 24/1000) in the prevalence of cervical premalignant lesions among the Israeli women. We believe that this population can no longer be considered as being at low risk for this disease.