bluuebunny/crossref_metadata_2025_split huggingface dataset:
Marine n‐3 fatty acid and calcium intake in relation to pregnancy induced hypertension, intrauterine growth retardation, and preterm delivery: A case‐control study
Authors: Kesmodel Ulrik , Olsen Sjúrdur Frodi , Salvig Jannie Dalby 
Published: March 2008

Objective. To evaluate whether low intakes in pregnancy of marine n‐3 fatty acids or calcium increase the risk of preeclampsia, pregnancy induced hypertension, intrauterine growth retardation. or preterm delivery and whether high intakes of the above nutrients increase the risk of posuerm delivery.Design. A case‐control nested in cohort study.Subjects ami methods. Between 1989 and 1991 a cohort of 9.434 pregnant women was established. Horn ‐three preeclamptics. 179 women with pregnancy induced hypertension. 182 with intrauterine growth retardation. 153 delivering preterm, and 189 delivering postterm together with 256 controls were sampled for this study. Dietary information was obtained retrospectively between six months and 31/2 years after delivery using a semiquantitative food frequency questionnaire, whilst information on potential confounders was obtained from the cohort data base and analyzed by multiple logistic regression. Questions regarding marine n‐3 fatty acids and calcium intake provided the basis for categorization into three and five intake groups respectively.Results For all live pregnancy outcomes and both nutritional factors, none of the confoun‐der‐adjusted odds ratios comparing higher intake levels with the lowest intake level were significant. Neither were Z2‐tests for trend calculated for each pregnancy outcome statistically significant (p > 0.20). Odds ratios for highest versus lowest intake levels were for n‐3 fatty‐acids 0 79 ((0.27 to 2.34 (95%CI)) for pregnancy induced hypertension. 1.00 (0.34 to 2.95) for intrauterine growth retardation, and 0.99 (0.35 to 2.74) for preterm delivery; for calcium they were 0.92 (0.33 to 2.60) for pregnancy induced hypertension. 0.77 (0.25 to 2.42) for intrauterine growth retardation, and 1.05 (0.36 to 3.10) for preterm delivery. Conclusions No associations could be detected in these data between calcium or fish intake and adverse pregnancy outcome.
Obstetric outcome of natural and assisted conception twin pregnancies is similar
Authors: Ágústsson Thórhallur , Geirsson Reynir T. , Mires Gary 
Published: March 2008

Background. The risk of obstetric intervention and adverse fetal or neonatal outcome is considerably higher in multiple gestation than in singleton pregnancy. How assisted conception influences obstetric management and outcome in twin pregnancies has not been evaluated.Methods. A survey of all twin pregnancies in Iceland and the Tayside Region, Scotland for a four year period, 1990‐93 comparing twins after assisted fertilization with natural conception.Results. The total number of twin pregnancies was 522, of which 453 were natural conceptions and 69 assisted. The twin rate was 1:75 among natural conceptions, but 1:5 in women having assisted fertilization. Mean gestational age in both groups was 36 weeks. Elective Cesarean section was used more often in the assisted conception group (odds ratio 2.57; p = 0.003). Induction rates did not differ to any significant degree and once labor commenced, no difference was seen between assisted and natural conception twins in the mode of delivery or neonatal short term morbidity. Birthweight, gestational length and perinatal mortality rates by conventional and extended classification were not different.Conclusion. After allowing for more frequent elective Cesarean section in the obstetric care of the assisted conception pregnancies, there was no major difference in obstetric and neonatal management or outcome between twins resulting from natural and assisted conception.
Factors influencing the reliability of oral contraceptives
Authors: Hansen Torben Høiland , Lundvall Finn 
Published: March 2008

Background. The reliability of oral contraceptives (OC) is high but several known factors can potentially induce failures. The dose of estrogen (EE) has been reduced through the years. Interaction with concomitant use of other medicine is wellknown and gastroenteritis can reduce the uptake of EE. To further characterize and quantify these factors we have performed this study.Methods. Among patients admitted for legal abortion we selected those who had taken OC (only combined preparations; gestagen‐only preparations were excluded) according to the prescription but nevertheless became pregnant. Various parameters were noted. Results. Among 8058 women 70 women were found. Twenty‐nine used three‐phased and 25 used low‐dose OC while the rest used high‐dose, two‐phased or unknown OC (four, five and seven patients respectively). Five patients used other medicine concurrently (salbutamol, astemizol, mianserin, chlorcyclizin, paradryl, carbamazepin, lithium, chlorprotoxin and imip‐ramin). Sixteen patients had symptoms of gastroenteritis at the time of conception. Forty‐nine patients had failure without any known influencing factors. There was no significant difference between the various OC used by the patients compared to sales of them in Denmark. About two‐thirds of the patients wanted to continue with OC as future prevention. Conclusions. Failure of OC is a rare event but can occur in case of concurrent gastroenteritis or use of other medicine but in many cases, however, no definite cause can be determined. The EE‐content of the various OC was not found to have any influence. Although OC‐failure had occurred two‐thirds of the patients wanted to continue the use of OC.
Cytobrush and endocervical curettage in the diagnosis of dysplasia and malignancy of the uterine cervix
Authors: Mogensen Susanne Theil , Bak Martin , Dueholm Margit , Frost Lars , Knoblauch Niels Ole , Præst Jørgen , Svanholm Hans 
Published: March 2008

Background. The validity of cytobrush and endocervical curettage combined with colposcop‐ically directed biopsies in the diagnosis of cervical dysplasia and malignancy has not been evaluated in randomized trials. We aimed to elucidate the diagnostic validity of the two methods.Methods. A prospective, randomized study of 180 consecutive patients. All patients were examined without anesthesia by colposcopically directed biopsies of the ectocervix and randomly assigned to either cytobrush or endocervical curettage. Patients with CIN 1 were investigated with the alternative method three months later. Patients with CIN 2 had a cone biopsy.Results. One hundred and thirty‐one patients were evaluable. The sensitivity of cytobrush and endocervical curettage combined with colposcopically directed biopsies of the ectocervix was 96% and 84% (p = 0.08), respectively. The specificities of the two investigations were 95% and 88%, respectively (p=0.78). All cytobrush specimens were evaluable but because of a low recovery of endocervical material a diagnosis could not be made in 12%) of the patients examined by endocervical curettage.Conclusion. The sensitivity of the combined use of cytobrush and biopsies of the ectocervix was equal to or higher than the sensitivity of endocervical curettage and ectocervical biopsies. The specificities of the two investigations were much alike. All cytobrush specimens were evaluable but a diagnosis could not be performed in 12% of the endocervical curettage specimens because of too little endocervical material. Furthermore, cytobrush is less inconvenient to the patient. Therefore, in the follow‐up of patients with cervical dysplasia endocervical curettage may be replaced with cytobrush.
A population study of urinary incontinence and nocturia among women aged 20‐59 years
Authors: Samuelsson Eva , Victor Arne , Tibblin Gösta 
Published: March 2008

Background. The aim was to study urinary incontinence (UI) and nocturia in a female population: prevalence, effect on well‐being, wish for treatment and result of treatment in primary health care.Methods. A postal questionnaire was sent to all women aged 20‐59 years who were scheduled for gynecological health examination by midwives in a primary health care district during one year. Questions concerning well‐being were based on the Gothenburg QOL instrument. All women with incontinence were offered treatment by a midwife and a family doctor. Results. Of the included 641 women. 491 (77%) answered the questionnaire. The prevalence of urinary incontinence was 27.7%, 3.5% having daily leakage. Nocturia occurred in 32 women (6.5%). 12 of whom were also incontinent. Self‐assessed health, sleep, fitness and satisfaction with work situation decreased significantly with increased frequency of incontinence. Well‐being was not correlated to type of incontinence. Nocturia correlated to poor health and sleep. About a quarter of the incontinent women started treatment when offered and 80% of those who completed the treatment program were subjectively improved. Wish for treatment was directly correlated to frequency of incontinence but not to type. Conclusions. Urinary incontinence and nocturia affect well‐being in a negative way. Well‐being and wish for treatment correlate to frequency of incontinence but not to type of incontinence. Most women with UI accept it; only about a quarter of incontinent women, or 6‐7% of all women in the studied age group, want treatment. Treatment of female urinary incontinence in primary health care is successful.
Hernias in trocar ports following abdominal laparoscopy
Authors: Lajer Henrik , Widecrantz Steven , Heisterberg Lars 
Published: March 2008

Background. With increasing numbers of laparoscopics in gynecologic surgery as well as the use of larger trocars more post‐operative hernias can be expected. Most hernias occur as Richter' hernias without peritoneal lining and contain small or large intestines or omentum. The incidence is around 1%, but rising with increasing size of trocars. About one fourth of hernias are umbilical, the rest located extraumbilical.Results. The diagnosis is typically based on the presence of vomiting or nausea with an extended and painful abdomen within two weeks of surgery and can be established by a small bowel series. However, the course can be prolonged and ileus can occur up to one year following laparoscopy. In the majority of cases the hernial content was small intestines or omentum.Conclusions. In order to reduce the frequency of trocar hernias it is recommended to apply small trocars. Fascial closure must be done when trocars of 10 mm or larger have been employed and the surgeon must ensure that peritoneal tissue is not drawn into the trocar canals when removing the probes. Also, umbilical hernias must be ruled out and, if found, closure must include the complete fascial defect. There are several techniques available for fascial closure. It is concluded that all precautions including fascial suturing must be taken to reduce the 1% incidence of post‐laparoscopy hernias.
The behavior of amidolytic factor VII in smoking and non‐smoking pregnant women in relation to their gestational age
Authors: Devies Ingrid E. C. , Ubachs Hans M. H. , van Wersch Jan W. J. 
Published: March 2008

Objective. Aim of the study was to assess the behavior of factor VII by commercial amidolytic assay in smoking and non‐smoking pregnant women, and to compare this with the earlier reported factor VII: C levels during pregnancy and to discuss the role of F VII: Am with regard to thromboembolic complication in smoking pregnant women.Methods. Blood samples were obtained for 75 non‐smoking pregnant women and 109 smoking pregnant women. For the chromogenic determination of F VIFAm a COA‐Set F VII test kit from Kabi Vitrum was used. Correlations were calculated by the Spearman rank method. The Mann‐Whitney‐U test was used for the statistical comparison of the median values of the smoking and non‐smoking groups.Results. Both the smoking and non‐smoking group displayed a significant increase of F VII: ‐Am with gestational age (r=0.53; p<0.0001 for smokers and r=0.55; p=0.005 for non‐smokers). The median concentration of F VII: Am was significantly higher in stage 3 (226%‐211%) and stage 4 (262%‐230%) in the smoking group.Conclusion. As elevated F VII: C levels have been described to be a risk factor for thrombotic events, the even higher than normally already enhanced plasma levels of FVII: Am in smoking pregnant women may indicate an additional risk for both thrombosis in the pregnant and for an increased fetal morbidity and even mortality caused by thrombotic processes in the uteroplacental vasculature. The results from the present study might be an extra argument to advise pregnant women not to smoke or to quit smoking during pregnancy.
Umbilical cord blood sampling — a tool for delivery quality control?
Authors: Bulkmans Nicole , Lyrenas Sven , Hallberg Gunilla , Niklasson Frank 
Published: March 2008

Background. Regular cord blood analysis post partum is regarded by many as one of the most accurate and objective methods of auditing intrapartum care. Emergency cesarean sections and ventouse deliveries, due to the threat of asphyxia, are examples where post partum acid base data from the umbilical artery ought to be a must. The possibility of having cord blood analyses as a routine at all deliveries was investigated in this study.Methods. During a two month period blood samples were drawn from both the umbilical artery and vein at all vaginal deliveries and cesarean sections between 8 am and 4 pm. Samples were analysed for a complete acid base status and lactate concentration.Results. True paired artery‐venous samples for acid base data and lactate concentrations were obtained from 48% of the women. Sampling was especially difficult after emergency cesarean section and vaginal twin deliveries. Lactate analyses gave the same information about the metabolic state of the newborn as did BEecf.Conclusions. Cord blood acid base data are a superior method of retrospective analyses of CTG‐tracings and partographs within a quality control program relating to intra partum care. However, routines for cord blood sampling must be well established in both the delivery room and in the operating theater to obtain samples from the umbilical artery in cases of threatening intrapartum asphyxia. A graph for easy post partum documentation and interpretation of acid base data is introduced.
Psychological adjustment of infertile women entering IVF treatment: Differentiating aspects and influencing factors
Authors: Bringhenti Franco , Martinelli Franca , Ardenti Rossella , Battista La Sala Giovanni 
Published: March 2008

Objective. To evaluate the psychological adjustment of infertile women compared with a control group of mothers and to determine which personal or marital factors influence the amount of emotional disorders in the infertile group.Design. Cross‐sectional questionnaire study with a group of infertile women and a group of mothers attending a routine gynecological examination.Setting. Infertile women and mothers received the questionnaires after a psychological or medical examination respectively, at a Sterility Center in a Department of Obstetrics and Gynaecology.Participants. One hundred and twenty‐two infertile women, entering an IVF program, and 57 mothers attending a routine care visit.Main outcome measures. Stressful events, self‐esteem, job and marital satisfaction, care and control measures of intimate bond, state‐trait anxiety, depression, psychophysiological symptoms and global emotional factor scores.Results. The organic infertile group was higher than mothers on satisfaction with their relationship with their husbands, perception of care and state‐anxiety. The emotional factor scores of infertile women, controlled for stressful events, were influenced by a) number of IVF‐cycles and availability for adoption, b) job position, job satisfaction and self‐esteem, c) personality dimensions. State and trait anxiety scores were influenced by the level of global marital satisfaction.Conclusions. Infertile women, entering an IVF treatment program, do not necessarily show signs of psychological maladjustment. Their level of state‐anxiety can be considered a situational response to the treatment stress. The infertility condition and its treatment can be effectively dealt with by women having a good personality disposition, a high level of self‐esteem, who are satisfied with their job and relationship with their husband, and who are willing to adopt a child as a last solution for their maternal need.
The prevalence and severity of climacteric symptoms and the use of different treatment regimens in a Swedish population
Authors: Stadberg Elisabeth , Mattsson Lars‐Åke , Milsom Ian 
Published: March 2008

Objectives. To determine (i) the prevalence and severity of climacteric symptoms, and (ii) the prevalence of treatment for climacteric complaints, in a population based, random sample of Swedish women aged 46–62 years.Material and methods. A random sample of 5990 women from the birth cohorts 1946 1942 1938 1934 and 1930. resident in the city of Göteborg, was obtained from the population register. The women were invited by letter to complete a questionnaire concerning general health, reproductive history, climacteric symptoms (severity graded on a scale 0,1,2,3) and the treatment of climacteric complaints. The overall response rate was 76%.Results. The prevalence of climacteric symptoms was as follows: vasomotor symptoms 53%, depression irritability 57%. sleeping disturbance 52%, muscle/joint pain 57%, loss of libido 37”, and vaginal dryness 21%. Hormone replacement therapy (HRT) with medium potency estrogens was currently being used by 13.4% and 7.7% were using low potency estrogens. Medium potency estrogens had previously been used by 14% and 6% had used low potency estrogens. HRT was reported to be effective against the most common climacteric complaints in 70%‐90%. Non‐hormonal treatment regimens had been used by 45% of the women and 31–63%. reported a positive effect on climacteric symptoms.Conclusions. Although the majority of peri‐ and postmenopausal women reported suffering from climacteric complaints only 21% were current users of estrogens. Non‐hormonal treatment modalities had been used by 45% of the women and were reported to have a good effect on climacteric symptoms in 45% compared to up to 90% of the HRT users.
Intrauterine administration of levonorgestrel 5 and 10 μg/24 hours in perimenopausal hormone replacement therapy
Authors: Wollter‐Svensson Lars‐Olof , Stadberg Elisabeth , Andersson Kerstin , Mattsson Lars‐Åke , Odlind Viveca , Persson Ingemar 
Published: March 2008

Objective. To investigate the clinical effects especially with regard to histopathology and bleeding patterns by levonorgestrel (5‐ or 10 ug/24 h) released from an intrauterine system (IUS) in combination with estradiol valerate (2 mg) given daily or transdermal estradiol (50 μg/24 h) in perimenopausal women.Design. A prospective randomized single blind comparison during twelve months.Subjects. One hundred and twelve perimenopausal women with vaso‐motor symptoms. Outcome measures. Histopathological assessment of the endometrium, ultrasonographic measurement of endometrial thickness, bleeding patterns, and acceptability.Results. A total of 108 women started the study and 12 discontinued. The most common reason for discontinuation was frequent bleeding (six women). Thus, 96 (89%) women were followed for twelve months. In both the 5‐ and 10 ug levonorgestrel IUS groups the endometrium in all women but one was non‐proliferative after twelve months and no case of hyperplasia was found. Irregular bleeding was reported during the first months of treatment but decreased after six months. At the end of the study 62% in the 5 μg‐ and 61% in the 10 μg group were amenorrhoic. The effects on bleeding patterns did not differ between the two levonorgestrel dosages.Conclusion. Continuous combined HRT was well accepted in perimenopausal women when the progestogen was given in an IUS. IUS's releasing 5‐ or 10 μg/24 h levonorgestrel seemed to minimize the progestogenic side effects and proved to be sufficient for effective prevention of endometrial stimulation by estrogen treatment in HRT in perimenopausal women.
Pelvic floor findings in urinary incontinence results of conditioning using vaginal cones
Authors: Fischer Wolfgang , Linde Astrid 
Published: March 2008

Background. Conservative treatment of urinary incontinence (UI) may be more reliable if it is associated with improved testing of pelvic floor function. The results of cone training in patients and healthy controls are compared.Methods. Voluntary contractions of pelvic floor muscles in 16 women with genuine stress incontinence, 14 with mixed stress/urge incontinence, and eight healthy controls were assessed by digital transvaginal palpation, manometry, and inspection using the so‐called speculum‐lift test. In addition, the capability to hold vaginal cones was investigated. All examinations were done before and after four‐week cone training (Femcon® 20–70 g).Results. Prior to cone training, no pelvic floor response was recordable from eight women (27%) by palpation and from seven women (23%) by inspection. After training, contractions were restored in all women. The best post‐training results were obtained by palpation (27 positive responses), followed by manometry (25 women, 83%), and speculum‐lift test (13 women, 43%). The capability to hold vaginal cones was also improved. Initial weights in 15 UI patients (50%) were lower (cone No. 1–2) than in eight healthy women (cone No. 5). Average contractility increased from 5 to 9.7 mmHg in patients and from 17.5 to 23.1 mmHg in healthy women. Twenty‐four patients (80%) were cured (57%>) or improved (23%). Twenty‐six asked for continuation of cone training.Conclusions. Pelvic floor conditioning with vaginal cones is a good alternative to poor acceptance or insufficient availability of conventional exercises.
Immunohistochemical analysis of insulin‐like growth factor I, insulin‐like growth factor I receptor and insulin‐like growth factor II in endometriotic tissue and endometrium
Authors: Chang Shiuh Y. , Ho Yat‐Sen 
Published: March 2008

Background. The purpose of this study was to investigate unprecedentedly immunohistochemical localization of insulin‐like growth factor I, insulin‐like growth factor I receptor and insulin‐like growth factor II in endometriotic tissue, and to compare staining intensity with that of endometrium obtained simultaneously.Methods. Endometriotic and corresponding endometrial tissue samples were obtained during operative laparoscopy from eighteen infertile patients for the problem of infertility. Semiquantitative scoring was used for analysis of results.Results. It was demonstrated that insulin‐like growth factor I and insulin‐like growth factor I receptor were present in both endometriotic and endometrial tissues. In contrast, there was little insulin‐like growth factor II present in either ectopic or eutopic endometrial tissue. For insulin‐like growth factor I and insulin‐like growth factor I receptor, the immunostaining score was similar between ectopic and eutopic endometrial tissues. There was no significant difference in immunostaining score between glandular epithelium and stromal cells. Conclusions, insulin‐like growth factor I and insulin‐like growth factor I receptor could be demonstrated immunohistochemically in both endometriotic and endometrial tissues.
Conservative management of twin pregnancies with one dead fetus: is it safe?
Authors: Zorlu C. Gürkan , Yalçin Hakan R. , Claglar Turhan , Gökmen Oya 
Published: March 2008

Background. Fetal death in one of the twins is unusual and the management issue of such a condition is not straightforward.Methods. We reviewed the outcomes of nine twin pregnancies with one dead fetus in whom follow‐up period exceeded 3 weeks.Results. The twinning frequency was 8.9 per thousand deliveries and the frequency of subsequent antepartum death of one fetus was found to be 3.8%. The preterm birth rate was 45.5%and the survival rate was 90.1%. The perinatal mortality rate was 12%. Maternal clotting disorder was observed in one patient and treated successfully with heparin. Conclusions. We suggest that these patients are best managed conservatively unless further hazard to the fetus or mother appears.