bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gestational Diabetes Mellitus. At What Time Should the Postprandial Glucose Level be Monitored?
Authors: G Moses Robert , M Luca Elizabeths , Knights Sallyanne 
Published: February 2008

Summary Objective: To compare selected pregnancy outcomes for women with gestational diabetes mellitus (GDM) with management based on testing either 1 hour or 2 hours postprandially according to the ADIPS recommendations. Methods: Prospective study of consecutive women referred for the medical management of their GDM. Women were allowed to select whether they would test either 1 hour postprandial with a target glucose of <8.0mmol/L or 2 hours postprandial with a target glucose of <7.0mmol/L. Changes to diet and the introduction and adjustment of insulin therapy were designed to maintain postprandial glucose levels below these targets. Results: 166 women elected to test 1 hour postprandial and 101 elected to test 2 hours postprandial. There were no significant demographic differences between these 2 groups. The fetal birth weight, percentage of women requiring insulin and the total daily dose of insulin were similar in both groups. Conclusions: For women with GDM, monitoring either 1 hour or 2 hours postprandially led to similar outcomes. This would suggest that the ADIPS recommendations are equivalent and therefore women can choose the most convenient time for their postprandial monitoring.
Development of a customised birthweight standard for ethnic Chinese subjects
Authors: Pang MW , Leung TN , Sahota DS , Lau TK , Chang Allan MZ 
Published: February 2008

Summary: A model to establish customised birthweight standards for the Chinese population was developed, using data from a cohort of 1564 Chinese women with normal singleton pregnancies. Multiple regression analysis was performed using maternal height, weight, parity, gestation at delivery and fetal sex as independent (predictor) variables. From this, a customised ideal birthweight for each baby can be estimated, and the normality of the actual birth‐ weight can be evaluated according to this, rather than from population standards.The results of this study show that birthweights are strongly influenced by maternal characteristics, confirming conclusions from similar studies in other ethnic populations. The overall mean birth‐ weight at 280 days of gestation was 3252 g, which was smaller than that of the Caucasian population. Birthweight increased with maternal height (5.1 g/cm), maternal booking weight (10.2 g/kg) and gestation at delivery (18.3 g/day from 280 days). Babies from women who had two previous deliveries weighed 145.2 g more than the nulliparous. Male babies were 84.8 g heavier than females. Adjustment using these results produces a customised ideal birthweight for each baby.When compared with population based standards, customised birthweight standards identified significantly fewer small for gestational age (SGA ‐ birth‐ weight below 10th centile, McNemar Chi square = 19.1, p c 0.01) and fewer large for gestational age (LGA ‐ birthweight above 90th centile, McNemar Chi square = 23.7, p < 0.01) cases.
Patterns of medication use during and prior to pregnancy: the M A P study
Authors: Henry Amanda , Crowther Caroline 
Published: February 2008

Summary: We interviewed 140 pregnant women of any gestational age attending antenatal clinics at the Women's and Children's Hospital in Adelaide during September‐October 1999 to elicit information about their patterns of medication use during and in the 3 months prior to their current pregnancy.Demographic information, information on women's prescribed, non‐prescribed, and non‐medicinal drug use during and in the 3 months prior to pregnancy, and information about both their general sources of information on medication use and their specific reasons for medication uptake/cessation during pregnancy were obtained.The women used an average of 0.7‐0.8 prescribed and 2.3‐2.6 non‐prescribed medications (total 3.1–3.3) in the 3 pregnancy trimesters, compared with 1.0 prescribed and 2.2 non‐prescribed prior to pregnancy. Use of a prescribed or non‐prescribed medication was 96–97% across trimesters.Simple analgesics, vitamin/mineral supplements, and antacids were the most commonly taken medications. Antibiotics were the most commonly prescribed medication. Use of class A medications increased during pregnancy while use of non‐class A medications decreased. Peri‐conceptional folate supplementation was 31%.Alcohol consumption and cigarette smoking decreased after diagnosis of pregnancy. Both prescribed and non‐prescribed medication use is common during all trimesters of pregnancy However, overall use changes little compared with pre‐pregnancy values. Rates of peri‐conceptional folate supplementation are low.
Endometrial adenocarcinoma ‐ presenting pathology is a poor guide to surgical management
Authors: Petersen Rodney W , Quinlivan Julie A , Casper Gabrielle R , Nicklin James L 
Published: February 2008

Summary: We aimed to evaluate the correlation between the histological grade of endometrial cancer diagnosed on endometrial biopsy or curettage, with the definitive grade and stage of lesion as determined by surgery and histopathological examination and to make recommendations about the suitability of conservative surgery based on preoperative determination of the grade of endometrial adenocarcinoma.A retrospective review of all patients with endometrial adenocarcinoma presenting to the Queensland Centre for Gynaecological Cancer from l January 1996 to 31 December 1998 was undertaken. Clinical and pathological data was abstracted from medical records and case notes of 460 patients. All histological specimens were prospectively reviewed by a panel consisting of gynaecologic pathologists, gynaecologic oncologists and other doctors involved in the treatment of patients with gynaecological malignancies. The percentage of patients whose management would have been optimised by full surgical staging at the time of initial surgery was calculated.Only 60%, 71%, and 84% of the patients with a presenting diagnosis of grade 1, 2 and 3 endometrial adenocarcinomas respectively had this confirmed on final histopathology. Furthermore, using established criteria, 30%, 46% and 100% of patients presenting with grade 1, 2 and 3 endometrial adenocarcinoma required full surgical staging at the time of their primary surgery.There is poor correlation between the pre‐operative grade of endometrial cancer and the grade as determined on analysis of the resected uterus. The correlation is poorest with grade 1 endometrial adenocarcinoma, where strongest consideration is given to conservative surgery and the avoidance of subspecialty referral. There is a strong argument that all patients with a diagnosis of endometrial cancer made on endometrial biopsy or curettage, regardless of grade of malignancy, should be offered surgery where the option to perform concurrent comprehensive surgical staging is available.
Changes in the plasma activities of protein C and protein S during pregnancy
Authors: Oruç Semra , Saruç Murat , Koyuncu Faik M , Özdemir Ertan 
Published: February 2008

Summary: The objective of the study was to determine the changes in the plasma activities of protein C and protein S that occur during normal pregnancy. In this prospective cross‐sectional study, plasma activities of protein C and protein S were measured in 32 normal pregnant women in the first, second and third trimester and 6 weeks after delivery. There was a significant fall in protein C and protein S activities during normal pregnancy compared with the post‐puerperal period. The activities of protein C and protein S also gradually decreased through‐out pregnancy (p < 0.01).Increasing plasma volume during normal pregnancy and its dilutional effect might play some role in the low activities of protein S observed. The normal falls in protein S and protein C activities make it difficult to diagnose protein S and C deficiency during pregnancy. Based on our findings, if a woman has a thromboembolic event during pregnancy, testing for a definitive diagnosis of protein C or protein S deficiency or functional failure should be delayed until at least 6 weeks postpartum.
Prevalence of gestational diabetes mellitus in polycystic ovarian syndrome (PCOS) patients pregnant after ovulation induction with gonadotrophins
Authors: Vollenhoven Beverley , Clark Suzanne , Kovacs Gabor , Burger Henry , Healy David 
Published: February 2008

SUMMARYOur aims were:1 To investigate if women with PCOS who become pregnant using gonadotrophins have a higher incidence of gestational diabetes mellitus (GDM) compared to spontaneously pregnant matched control women,2 To compare the prevalence of GDM in PCOS women with that in women with hypo/eugonadotrophic hypogonadism and in unexplained infertility and3 To investigate differences in pregnancy outcomes between the groups.This was a retrospective case‐control study. Women with PCOS were matched with a control by age, BMI, and ethnicity. There were 60 women with PCOS, 11 with hypogonadotrophic hypogonadism, 6 with eugonadotrophic hypogonadism, and 12 with unexplained infertility. Control women were those who attended a major public hospital for antenatal care and delivery. We found no difference in the prevalence of GDM between the PCOS (22%) and the controls (17%) or between the PCOS and other groups. Women with GDM (diet or insulin controlled) had a significantly higher BMI than women without GDM (p = 0.019). There was no difference in pregnancy outcomes between the groups. There was a significant dependence of babies' birth weight on mother's BMI (p <0.001).
Vaginal birth after Caesarean section: an Australian multicentre study
Authors: Appleton Bill , Targett Christopher , Rasmussen Michael , Readman Emma , Sale Fiona , Permezel Michael ,   the VBAC Study Group
Published: February 2008

SUMMARYRetrospective analysis of medical records and individual case review was undertaken at 11 major obstetric hospitals for a 5 year period from July 1992 to June 1997 to investigate rates of vaginal birth after Caesarean section (VBAC), the occurrences of uterine rupture, and the outcomes for mother and infant following rupture.Total deliveries were 234,015, of which 21,452 or 9.2% were associated with one or more previous Caesarean sections. Within this scar group, 5419 patients or 25.3% were delivered vaginally.There were 62 cases of significant uterine rupture with no maternal deaths. Perinatal mortality with rupture was 25% and serious maternal complications (usually hysterectomy) occurred in 25% of those with uterine rupture. In women attempting vaginal delivery after a previous lower segment Caesarean section, the uterine rupture rate was estimated at 0.3%, with 0.05% experiencing a perinatal death and 0.05% requiring a hysterectomy.Although VBAC rates in Australia remain lower than many overseas reported series, rates are increasing. While rupture continues to be associated with serious adverse outcomes, the incidence of rupture during trial of labour is low and appears to be associated with a better outcome than rupture of an unscarred uterus.
Misoprostol versus dinoprostone for cervical priming prior to induction of labour in term pregnancy: a randomised controlled trial
Authors: Rowlands Shelley , Bell Robin , Donath Sue , Morrow Sarah , Trudinger Brian J 
Published: February 2008

Summary: A prospective randomised controlled trial was performed to compare the efficacy and safety of intrav‐aginal misoprostol to that of intravaginal dinoprostone when used for cervical priming prior to the induction of labour; 126 women were recruited to the study and randomised to receive either intravaginal dinoprostone (n = 63) or misoprostol (n = 63) for cervical priming prior to induction of labour. The mean time from insertion of the priming agent to vaginal delivery was significantly shorter in the misoprostol group (925.8 versus 1577.6 minutes), the mean duration of the active length of labour was significantly shorter in the misoprostol group (353.7 versus 496.8 minutes) and more women in the misoprostol group delivered in less than 12 hours (92% versus 76.5%).Women in the misoprostol group were less likely to require a repeated dose of prostaglandin for cervical priming and less likely to require oxytocin for augmentation of labour. There was no difference in the number of women who were delivered vaginally or by Caesarean section between the two groups. More women developed hyperstimulation during labour in the misoprostol group; however there was no difference between the groups in neonatal outcome in respect to low cord pH or Apgar score at delivery or admission to the neonatal special care nursery.
Amoebic liver abscess in pregnancy
Authors: Read Kerry M , Kennedy‐Andrews Sue , Gordon David L 
Published: February 2008

Summary: We describe the case of an amoebic liver abscess (ALA) presenting in the third trimester of pregnancy which raised both diagnostic and treatment dilemmas as well as being associated with preterm labour.Amoebic liver abscess is caused by the protozoan organism Entamoeba histolytica which is endemic in many parts of the developing world. Invasion of the colonic mucosa results in the clinical syndrome of amoebic dysentery and in some cases dissemination to the liver or other organs occurs resulting in abscess formation.1Amoebic liver abscess is a rare complication of pregnancy and there are few reports in the world literature, these being mostly from endemic areas.2‐3‐4‐5 We present here the case of a Caucasian female who presented with an amoebic liver abscess in the third trimester of pregnancy, thirteen months after returning to Australia from a short holiday in Bali.
The management of extremely premature infants and the perceptions of viability and parental counselling practices of Australian obstetricians
Authors: Mulvey Sheila , Partridge J Colin , Martinez Alma M , Yu Victor YH , Wallace Euan M 
Published: February 2008

Summary: The attitudes of Australian obstetricians to the resuscitation of extremely premature infants are reported. A structured questionnaire including questions regarding antenatal parent counselling, resuscitation practices, survival rates and personal attitudes about life support was distributed to obstetricians working in Australian hospitals with a Level 3 nursery. Eighty‐nine (48 % response rate) replies were received from 12 units located in seven major cities.Obstetricians are more likely to discuss resuscitation with prospective parents with increasing gestation with a major shift occurring at 23–24 weeks' gestation. They strive for consensus with parents regarding resuscitation options and they act upon the opinion of both the prospective parents and their paediatric colleagues. Threat of litigation rarely influences the decision to limit resuscitation of an extremely preterm infant. Obstetricians may underestimate the prognosis for extremely preterm infants. The data presented offer useful insights into current attitudes and practice of tertiary hospital obstetricians.
Screening for gestational diabetes mellitus: can we be more efficient?
Authors: Kyle CV , Cundy TF 
Published: February 2008

Summary: In a retrospective review of 471 patients screened for gestational diabetes mellitus (GDM) in a community laboratory, we compared 50g polycose screening test results with those of the 75g oral glucose tolerance test (GTT). The rate of GDM diagnosis was compared using criteria promulgated by the New Zealand Society for Study of Diabetes (NZSSD), Australian Diabetes in Pregnancy Society (ADIPS) and World Health Organisation (WHO).In those with borderline screening results (7.8‐8 mmol/L) the rate of GDM diagnosis using NZSSD criteria was low (2.8%) compared with higher screening test results (≥8.1 mmol/L), where the rate was 7.4%. Corresponding rates were 7.5% and 13.5% using ADIPS criteria and 5.6% and 12.4% using WHO criteria.The predictive value of a positive 50 g screening test is therefore low, especially for the higher New Zealand criteria. In women with borderline screening results no subject had a two‐hour plasma glucose of 9.0 mmol/L or more on oral GTT. This suggests that the current screening cut‐off of 7.8 mmol/L might be raised to 8.1 mmol/L, resulting in a 25% reduction in the number of glucose tolerance tests. Those with significant risk factors such as macrosomia, however, still warrant greater clinical suspicion and closer follow‐up.
Variation in cervical cancer screening by region, socio‐economic, migrant and Indigenous status in women in New South Wales
Authors: Wain Gerard , Morrell Stephen , Taylor Richard , Mamoon Hassan , Bodkin Nora 
Published: February 2008

Summary: The purpose of this study was to estimate the extent of association of cervical screening in NSW women with socio‐economic status (SES), rurality, and proportions of non‐English speaking background (NESB) and Indigenous status.Data on women who had at least one Pap test over two years (January 1998‐December 1999) were obtained from the NSW Pap test Register. Each local government area (LGA) was allocated to categories of population proportions of NESB and Indigenous status, a rurality classification based on population density and remoteness, and to an SES quintile. The odds ratios (OR) of having a Pap test were estimated and confounding adjusted by multiple logistic regression analysis. Implied Pap test rates in urban NESB and in rural Indigenous women were estimated from the modelled estimates.The adjusted OR for a Pap test in large rural centres (1.14) was significantly higher than those for metropolitan or capital city residents (0.9 and 1.0 respectively). Adjusted OR for a Pap test in other rural centres (0.73) and other remote areas (0.64) were significantly lower than those for metropolitan or capital city residents. In urban populations the lowest OR were in areas with both low SES and high proportion of NESB. The lowest OR for Pap screening in rural populations occurred in the most remote areas with the highest proportion of Indigenous women. For urban NESB women the biennial Pap test rate was estimated as 50oo and for rural Indigenous women 29%, compared with the NSW average of 59oo.
Differences and trends in obstetric interventions at term among urban and rural women in New South Wales: 1990–1997
Authors: Roberts Christine L , Algert Charles S , Peat Brian , Henderson‐Smart David 
Published: February 2008

SUMMARYThe aim of this study was to compare the management of term births among rural and urban women, including the effect of indigenous status and out‐of‐area‐birth for rural women. Data were obtained from the NSW Midwives Data Collection (MDC), on 619,298 women who gave birth to a live, singleton infant at term (37–45 weeks gestation) from 1 January 1990 to 31 December 1997. Compared with urban non‐indigenous women, rural women and indigenous women had lower rates of obstetric interventions both before birth (induction of labour, planned Caesarean section and epidural) and at the time of birth (Caesarean after labour, instrumental delivery and episiotomy). This was especially true for rural women giving birth in the their local area. The differing pregnancy risk profile of rural women did not explain the differences in intervention rates but differences were partly explained by higher rates of epidural anaesthesia in urban areas.
Induction policy and missed post‐term pregnancies: a mathematical model
Authors: Mongelli Max , Wong Yee Chee , Venkat Annapoorna , Chua Tsei Meng 
Published: February 2008

SUMMARYThe aim of this study was to compare the clinical performance of ultrasound dates and ultrasound dates combined with menstrual dates for the detection of post‐maturity.A computer model was designed which uses the statistical distributions of the duration of normal pregnancy, day of ovulation in relation to the menstrual cycle and ultrasound error for estimating gestational age. The clinical performance of the different dating methods was then analysed from these variables, on simulations of 30,000 cases. The efficacy of different dating methods for detecting post‐maturity was determined by generating receiver‐operator characteristics (ROC) curves.The proportion of post‐term pregnancies (294 days and over) predicted by the model (3.5%) agrees with published values. There is a steep rise in missed cases if induction is delayed beyond 10 days from the expected date of delivery, reaching 20% on day 294. Elective delivery on day 290 will detect 98.9% of cases destined to deliver post‐term, with an induction rate of 10%; the respective figures for induction on day 294 are 79% and 3.8%. The ROC curves for the detection of post‐maturity suggest that use of the mid‐trimester biparietal diameter (BPD) is better than a 7‐day or 10‐day rule.Timing of elective delivery is the most important variable affecting the detection rate for post maturity. There is no advantage in using menstrual dates when ultrasound biometry is available.
A review of 165 cases of transvaginal sacrospinous colpopexy performed by the Endo Stitch technique
Authors: Rogers Anna , Barker Glen , Viggers John , Mason Terry , Swan James , Mayall Peter 
Published: February 2008

SUMMARYThe Endo Stitch technique has been in use in Geelong since 1994 as the method of performing transvaginal sacrospinous colpopexy (TSC). This article looks at the outcome of 165 of these procedures as assessed by a questionnaire. As the operation is technically easy, has a low complication rate and a high level of patient satisfaction we suggest that the Endo Stitch technique may be the method of choice for TSC.
Whole blood mercury concentrations in sub‐fertile men in Hong Kong
Authors: Leung Tak Yeung , Choy Christine Ming Yan , Yim So‐Fan , Lam Christopher Wai Kei , Haines Christopher John 
Published: February 2008

SUMMARYWe aimed to investigate the association between whole blood mercury concentrations and semen quality in sub‐fertile men. Fifty‐nine male partners of infertile couples attending the Assisted Reproduction Unit of the Chinese University of Hong Kong between 1997 and 1998 were recruited into our study. Blood was taken from each subject for whole blood mercury concentration and hormone profile. Semen samples were obtained for computer assisted semen analysis using the Hobson sperm tracker. The semen parameters and hormone profile were compared between subjects with normal and those with elevated mercury concentrations.Twenty‐one subjects (35.6%) had a whole blood mercury concentration higher than the normal range (0–50 nmol/1). All parameters of the semen analysis including the concentration of sperm, percentage of morphologically normal sperm, percentage of motile sperm, curvilinear velocity, straight‐line velocity, average path velocity, and amplitude of lateral head displacement, were reduced in those with elevated blood mercury concentrations, although the difference was not statistically significant.We failed to demonstrate a statistically significant effect on the measurement of semen quality, but other adverse effects cannot be excluded. From a public heath perspective, these findings confirm that mercury toxicity is a potentially serious problem affecting the local community.