bluuebunny/crossref_metadata_2025_split huggingface dataset:
No Benefit From Conservative Management in Nulliparous Women with Premature Rupture of the Membranes (PROM) at Term: A Randomized Study
Authors: Rydhström Håkan , Ingemarsson Ingemar 
Published: November 2007

Objective. To compare maternal and fetal outcome in pregnancies with premature rupture of the membranes (PROM) at term with either early induction of labor or conservative management awaiting spontaneous labor.Design. A prospective randomized trial.Setting. The University Hospital of Lund, Sweden.Subjects. Altogether 369 women with singleton pregnancy, cephalic presentation, gestational duration 36–41 weeks, were randomized either to induction of labor (n = 139) or conservative management up to 3 days (n = 138). Those eligible but not participating in the study totalled 92.Main obstetric measures. Obstetric intervention rate (cesarean section or instrumental delivery) and short‐term neonatal morbidity.Results. No difference was found in the rate of obstetric intervention between the induction of labor group and the group with conservative management (12.2 vs. 18.8%; X2 = 2.3, p > 0.05). A slightly increased rate of neonatal infections was seen in the latter group (0.7 vs. 4.3%; X2 = 3.2, p < 0.05).Conclusions. We found no benefit from conservative management for up to 3 days in women with PROM at term, compared with immediate induction of labor. There was no difference in the number of obstetric interventions during labor. The neonatal infectious morbidity was slightly higher in conservatively managed cases.
Fetal heart rate response to acoustic stimulation in relation to fetal development and hearing impairment
Authors: Johansson Bertil , Wedenberg Erik , Westin Björn 
Published: November 2007

In twelve healthy pregnant women the fetal heart rate response to sound stimulation was tested every second week between the 22nd and the 34th week of the pregnancy. Habituation to the acoustic stimuli used was also investigated at the last examination. A high risk material for hearing impairment comprised 31 pregnant women.The stimuli were presented by a vibrator placed on the maternal abdomen over the fetal head. As stimuli pure tones were used in the form of pulses of one second at a frequency of 3000 Hz and with an onset and a decay time chosen not to cause audible clicks to a normal ear. The intensity of the tone pulse was set at a level calculated to correspond at the position of the fetal head to 110 dB sound pressure level in free field.Roughly 50% of the fetuses tested started to react with an increased heart rate in the 24th week of the development. Four weeks later all tested subjects responded to the test stimuli.Habituation of the motor ‘startle’ response was shown but the fetus heart rate change was consistent over 20 consecutive stimulations one min in between each.In 31 high risk subjects the responses from three fetuses must be considered as pathologic. These three children exhibited impaired auditory tests after birth and severe hearing impairment at the age of three years. All the others disclosed normal hearing at birth as well as at three years of age. Repeated significant increases in fetal heart rate following acoustic stimulation may appear as an indication of normal function of the hearing organ. Several consecutive acoustic stimulations without any fetal responses in heartbeat rate is an indication of a possible hearing impairment.
Uterine torsion in pregnancy
Authors: Jensen John Grønkjær 
Published: November 2007

Torsion of the pregnant uterus is defined as rotation more than 45° around the long axis of the uterus. Uterine torsion is observed in all age groups of the reproductive period, in all parity groups, and at all stages of pregnancy. Torsion from 60° to 720° has been described. It is not possible to clarify why uterine torsion occurs, but numerous abnormalities have appeared with uterine torsion; most often, abnormal fetal presentation, myoma uteri and uterine malformations. The most usual symptoms of uterine torsion are birth obstruction, abdominal pain, vaginal bleeding, shock, and urinary and intestinal symptoms. Elcvcn percent arc asymptomatic. The treatment in the earlier months of pregnancy is immediate laparotomy and detorsion of the uterus and, if practicable, adjunct surgery to climinatc the possible etiologic factors. Near term or during labor ccsarcan section is carried out, and elimination of the possible etiologic factors.The fetal and maternal mortality rates since 1976 arc 12% and 0% respectively.
Estrogen and progesterone receptors in vessel walls: Biochemical and immunochemical assays
Authors: Bergqvist Agneta , Bergqvist David , Fernö Mårten 
Published: November 2007

The purpose of the present investigation was to examine the estrogen and progesterone receptor status in arterial and vein walls in women and men. Biopsies from uterine arteries and veins were obtained from 14 fertile and six post menopausal women. Biopsies from saphenous veins were obtained from eight fertile women, 12 post menopausal women and 12 men. Comparative receptor assays were performed with ligand technique and monoclonal antibodies. Immunohistochemical localization of estrogen and progesterone receptors was performed using monoclonal antibodies.The ligand technique revealed estrogen and progesterone receptors in low frequency in the uterine vessels but the monoclonal antibodies showed low receptor level in all arterial and vein samples. There was no statistical difference between fertile and post menopausal women. In the few nuclear fractions examined, both estrogen and progesterone receptors were measurable.Estrogen receptors were found in all peripheral vein samples from fertile women but not in all samples from post menopausal women and men. Progesterone receptors were detected in almost all samples of peripheral veins. There were significant differences with higher levels of estrogen receptors in cytosol and nuclear fraction and of progesterone receptors in nuclear fraction, all assayed with monoclonal antibodies, in uterine veins from fertile women compared to peripheral veins from fertile women, post menopausal women and men, respectively. These data indicate that the hormonal regulation of peripheral vein walls is different than that of the uterine vessel.
Morphometric analysis of gap junction density in human myometrium at term
Authors: Kilarski Wincenty M. , Rezapour Masoumeh , Bäckström Torbjörn , Roomans Godfried M. , Ulmsten Ulf 
Published: November 2007

In the human myometrium. the formation of gap junctions in the various stages of labor and, in correlation with the concentration of progesterone in the maternal blood, has not been described adequately. The accepted hypothesis that raised concentrations of progesterone in maternal blood in animals prevent the formation of gap junctions was scrutinized in human niyometrium. Myometrial tissue was examined by electron microscopy for the presence of gap lunctions and analyzed morphometrically in 17 women who had an elective or emergency cesarean operation at the 38th or 39th week of pregnancy. The concentrations of progesterone and estradiol in the maternal and cord blood was measured by means of radioimiiiunoassay. The frequency and area of gap junctions varied in relation to the presence or absence of labor. In the myometrium of women in labor, gap junctions were most frequent (5.2/1000 μm of cell membrane), their area largest (0.32 μ2/1000 μm of cell membrane) and their fractional area greatest (0.20%). When the women were not in genuine labor or when contractions were weak, the percentage fractional areas of gap junctions were low (0.020‐0 090) and the gap junctions very small. In the pre‐ and active phases of labor, the concentration of progesterone in maternal blood was significantly higher (p <0.025 and 0.03 respectively) than in women who were not in labor.Hence, despite high concentrations of progesterone in the maternal and cord blood at term, the myometrium presented numerous gap junctions of relatively large area.
Predictive value of psychatric history, genital pain and menstrual symptoms for sexuality after hysterectomy
Authors: Helström Lotti , Weiner Erik , Sörbom Dag , Bäckström Torbjörn 
Published: November 2007

Objective. To study the predictive value of the history of genital pain, psychiatric complaints and menstrual symptoms on a woman's sexual life before and after subtotal hysterectomy.Material rind method. One hundred and four premenopausal women were interviewed one month before and one year after surgery. A latent variable for pre‐ and postoperative sexuality was constructed from the intercorrelation between the measured parameters of frequency of desire for sex, coital frequency, cyclicity of desire and existence of multiple orgasm, and other variables for genital pain, psychiatric morbidity and menstrual symptoms were compared to the latent factors for sexuality.Results. No difference was seen in postoperative sexuality in women with and without a history 01 psychiatric complaints. The regular use of analgetics, a need to stay home from work because of menstruation, and the occurrence of dyspareunia were positively correlated to the latent factors for sexuality before and after the operation. A history of the need to use psychopharmaceuticals, such as sedatives or antidepressants, had a negative influence on preoperative. but not on postoperative sexuality. Dysmenorrhea had a positive influence on postoperative, but not on preoperative, sexuality.Conclusion. Among variables studied, dysmenorrhea was the best predictor for postoperative sexuality. That is: women with dysmenorrhea do not only invariably experience relief from the pain, hut also have a chance to improve their sexual lives after removal of their malfunctioning uterus. Presence of psychiatric problems had, in general, little influence on sexuality.
Synergistic effects of carboxymethylcellulose and low molecular weight heparin in reducing adhesion formation in the rat uterine horn model
Authors: Sahin Yilmaz , Saglam Abdullah 
Published: November 2007

Objective. To investigate the effect of sodium carboxymethylcellulose (SCMC) and the combination of low molecular weight heparin (LMWH) with SCMC in the prevention of intraperitoneal adhesion.Design. Thirty‐eight rats underwent bilateral surgical injury to the uterine horn and the parietal peritoneum. In 13 rats, a solution of SCMC was instilled at laparotomy. In 11 rats, LMWH was delivered on to serosal and peritoneal defects, and SCMC was instilled. As a control group 14 rats were included in the study.Setting. Surgical Research Laboratory, Erciyes University.Participants. Female Wistar‐Albino rats, weighing 200 to 250 g each.Main outcome measures. Adhesions between the uterine horn and the abdominal sidewall were scored for extent and severity two weeks after the initial surgery.Results. Although the mean adhesion score both in the SCMC group (2.8, s.d. 1.15) and in the SCMC with LMWH group (1.6, s.d 1.18) was found to be significantly lower than in the control group (3.4, s.d. 0.89) (p < 0.05 and p < 0.001, respectively), more favorable adhesion prophylaxis was achieved in the SCMC with LMWH group in comparison with the SCMC treatment group without any hemorrhagic complications (p < 0.001).Conclusion. We conclude that SCMC with LMWH are highly effective in reducing postoperative adhesions in this animal model. SCMC with LMWH appears promising in adhesion prophylaxis.
In situ characterization of leukocytes in the fallopian tube in women with or without an intrauterine contraceptice device
Authors: Wollen Anne‐Lone , Sandvei Roar , Mørk Sverre , Marandon Jean Louis , Matre Roald 
Published: November 2007

Histological evaluation of sections from the human fallopian tube revealed an inflammatory reaction in 21 of 31 women using an intrauterine contraceptive device (IUCD) and in four of 29 controls (non‐IUCD users). The inflammatory cells were mainly localized at the epithelium‐lamina propria interface and at the center of the mucosal folds.The immunohistochemical study revealed leukocytes (CD45+), T lymphocytes (CD3+), T helper cells (CD4+), T suppressor/cytotoxic cells (CD8+), B lymphocytes (CD22+, CD19+), granulocytes, monocytes and null cells (CDllb+) mainly localized at the lamina propria in both groups. T lymphocytes were the predominant cell type, and the ratio between T helper and T suppressor/cytotoxic cells was fairly close to one both in IUCD‐users and controls. B lymphocytes were the least frequent cell type identified. In IUCD users, the numbers of the different leukocytes were increased.In both groups, IgA‐, IgG‐ and IgM‐positive cells were demonstrated and were predominantly located at the lamina propria of the mucosal folds. The IgA‐positive cells dominated in both groups, whereas IgG‐ and IgM‐positive cells were less frequent. Cell positive for IgA, IgG or IgM were significantly increased in number in the IUCD users.The data confirm the presence of an immune system in the normal human fallopian tube and indicate that the IUCD can induce a prominent recruitment of inflammatory cells, with a tubal inflammation as the result. The IUCD may disturb the immunological function of the fallopian tube and its role in fertilization.
Term prediction in routine ultrasound practice
Authors: Backe Bjørn , Nakling Jakob 
Published: November 2007

Study objective. Evaluation of the precision of routine ultrasound term prediction.Design. Population based follow‐up without intervention.Setting. Ultrasound screening in routine clinical practice.Material. 1650 women residing in one Norwegian county giving birth during a 12‐month period. All pregnancies were singleton with spontaneous onset of labor, all records contained a term predicted with routine ultrasound in the second trimester.Outcome measure. Difference between actual and predicted day of delivery, and difference between ultrasound predicted term and term calculated from last menstrual period.Main results. More women delivered within two weeks of ultrasound term than two weeks of term calculated from the last menstrual period (87.5% and 79.3%, p<0.001). Deliveries were significantly closer to the ultrasound predicted term than the term calculated from the last menstrual period, with the exception of deliveries in the 39th week after LMP where no significant difference was found between ultrasound term and LMP‐term. No difference was found in the mean performance of 14 different ultrasound operators.Conclusions. In a population representative of deliveries in one county, routine ultrasound term prediction performed in three medium sized hospitals more accurately predicted day of delivery than term calculated from the date of last menstrual period.
Abortion ethics—women's post abortion assessments
Authors: Holmgren Kristina , Uddenberg Nils 
Published: November 2007

Background. Induced abortion is often discussed in terms of ethics. The aim of the present report is to describe the abortion ethics as it was expressed by women undergoing a legal abortion.Objective. Moral considerations expressed during semistructured interviews by 128 women two weeks after a first trimester abortion in Stockholm 1987‐90 are reported.Result. The women had faced a choice between abortion and parenthood. At the time of the abortion many of them were living under conditions that meant they were unable to offer a child the security they regarded as a child's right. The conflict the women spontaneously described as their main moral dilemma was not a conflict between the woman and the fetus, but a conflict between several close relationships, also concerning the prospective father. The ethics that the women applied to the problems of abortion was founded on a long‐term responsibility to care for persons in their relationships.Conclusion. The women interviewed had three levels of moral reasoning simultaneously present. I. A theoretical level ‐ most of all concerning other women ‐ a liberal view of rights: abortion should be a freely obtainable option. 2. A theoretical level ‐ above all, concerning themselves ‐ a restrictive deontological view: the extinction of life is morally wrong and should he avoided. 3. A practical level ‐ when the problem was a reality: a consequentialist ethics of care. According to this ethics of care it was important that the abortion could be performed as early as possible during pregnancy.
Two‐year infant neurodevelopmental outcome after expectant management and indicated preterm delivery in hypertensive pregnancies
Authors: Spinillo Arsenio , Iasci Angela , Capuzzo Ezlo , Egbe Thomas O. , Colonna Laura , Fazzi Elsa 
Published: November 2007

Background. To evaluate the impact of the expectant management of hypertensive disorders of pregniiiicy on infant neurodevelopmental outcome.Methods. The two‐year neurodevelopmental outcome of infants delivered prematurely because of complications of maternal hypertension after expectant management was compared with thal of infants of uncomplicated age‐matched pregnancies delivered after spontaneous preterm labor or premature rupture of membranes.Results. The rate of cerebral palsy was similar between the two groups. Conditional logistic regression analysis of the matched sets showed an increased risk of minor neurodevelopmental impairment among infants delivered after severe hypertension (odds ratio (OR) = 4.0, 95% confidence interval (CI) 1.34‐12.1) or preeclampsia (OR = 4.0, 95% CI = 1.61‐10.2). Fetal growth rciardation was not associated with increasing infant neurodevelopmental morbidity.Conclusions. Infants delivered prematurely because of preeclampsia or severe hypertension are at incicased risk of later minor neurodevelopmental problems.
Sixty‐six cases of intrauterine fetal death
Authors: Ahlenius Inger , Floberg Jan , Thomassen Peter 
Published: November 2007

Background. A prospective study was performed to elucidate the etiology of intrauterine fetal death and to evaluate diagnostic procedures.Methods. Sixty‐six stillbirth cases with a gestational age of more than 25 complete weeks were studied. using an extensive test protocol. The validity of the cause of death was classified as certain. probable, possible and unexplained. The extent to which the diagnostic measures had been performed was classified: patients in whom none or only a few tests were performed, patients partially tested and patients completely tested.Results. The cause of death was certain in 57%, probable in 20%, and possible in 11% of the cases. In only 12% of the cases did the cause of death remain entirely unexplained. The principal causes of IUFD were infections, including premature rupture of the membranes (15%). anomalies (11%), preeclampsia‐associated conditions (9%) and intrauterine growth retardation of unknown etiology (8%). In this series, less well‐known conditions, such as circulating maternal autoantibodies and feto‐maternal transfusion, also appeared to play an important role in causing intra‐uterine fetal death.Conclusions. An extensive and relevant test protocol provides information as to the cause of death in the majority of cases. Future protocols should include tests for autoimmune antibodies and feto‐maternal transfusion.
Gigantomastia complicating pregnancy
Authors: Wolf Yoram , Pauzner David , Groutz Asnat , Walman Igal , David Menachem P. 
Published: November 2007

Gigantomastia, or Gravidic macromastia, during pregnancy is a diffuse increase in size of the breasts over and above their physiologic size. It is a rare disorder of undertermined etiology, that may be due to hormonal excess or to hypersensitivity of the target organ. The histologic appearance is of glandular hyperplasia with an increase in connective tissue. Treatment during pregnancy is supportive and pharmacologic; once the patient has delivered surgical treatment is usually indicated.We present herewith a case report of gigantomastia during pregnancy, with a discussion of the treatment and a review of the literature.
Distribution of NADPH diaphorase‐reactive nerves in the human female genital organ
Authors: Yoshida Yoshinobu , Yoshida Kazuhide , Kimura Toshio , Toda Noboru 
Published: November 2007

Objective. This study was designed to histochemically clarify the presence of nerves containing NADPH diaphorase, representing the catalytic activity of nitric oxide synthase, in the human female genital organ.Study design. Female genital organs were isolated for NADPH diaphorase staining by extensive or simple hysterectomy from ten patients.Results. Paracervical ganglia contained many nerve cells intensely stained. The nerve from the ganglia contained many axons intensely stained, which selectively innervated blood vessels distributing to the whole genital organ. NADPH diaphorase‐reactive nerve fibers around the vascular wall distributed in the adventitia, closely contacting to the medial layer. The distribution of the axons was much denser in the arterial wall than in the venous wall.Conclusion. The NADPH diaphorase‐reactive nerve fibers, possibly originated from paracervical ganglia. appear to play an important role in the regulation of uterine vascular tone by liberating nitric oxide, and such a neurogenic control may be predominant in the artery over the Lein.
Ovarian volume in postmenopausal women‐suggestions to an ovarian sue. nomogram for menopausal age
Authors: Tepper R. , Zalel Y. , Markov S. , Cohen I. , Beyth Y. 
Published: November 2007

Background. Transvaginal ultrasonography is an accurate and reliable technique for measuring ovarian size. However, there is no consensus as to the normal ovarian size in postmenopausal women. The purpose of this study was to establish normal values for ovarian volume in postmenopausal age.Methods. A prospective study was undertaken, in which the ovaries of 311 healthy postmenopausal women were examined by transvaginal ultrasonography. Menopausal age ranged from one to more than 15 years. Three dimensions of each ovary were measured and ovarian volume of every menopausal year was calculated.Results. Curvilinear relationships were found between ovarian volume and menopausal age. Ovarian volume (as plotted on the nomogram) shows a progressive decrease from 8.6±2.3 cm3 in the first menopausal year, to 2.2±1.4 cm3 after more than 15 years after the menopause.Conclusions. These data represent a comprehensive characterization of normal ovarian volumes related to postmenopausal age.These baseline values provide the data which will assist the physician to obtain the sono‐graphic diagnosis of abnormal ovarian size, thus eventually establishing early diagnosis of ovarian tumors.
Serum levels of hPL, PAPP‐A and PP14 in patients with early pregnancy bleeding and subchorionic hemorrhage
Authors: Pedersen Jan Fog , Ruge Susanne , Sørensen Steen 
Published: November 2007

Objective. To investigate possible endocrine changes in patients with early pregnancy bleeding and subchorionic hemorrhage.Design. Prospective study in first trimester of pregnancy comparing circulating levels of human placental lactogen (hPL), pregnancy‐associated plasma protein A (PAPP‐A) and endo‐metrial secretory protein PP14 (PP14) in women with and without subchorionic hemorrhage. Subjects. Sixty‐nine women with early pregnancy bleeding, who in week 7–14 had a blood sample and an ultrasound study with both determination of fetal crown‐rump length and a search for subchorionic hemorrhage.Results. There was no difference between serum levels of hPL, PAPP‐A and PP14 in 29 women with and 40 women without subchorionic hemorrhage, and no correlation between serum levels and the size of the hematoma.Conclusion. Judged from the serum levels of the studied substances there were no indications of an impaired function of the trophoblast or the decidua that could explain the development of subchorionic hemorrhage.