bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of cordocentesis in assessment of mosaicism found in amniotic fluid cell culture
Authors: Shalev E. , Zalel Y. , Weiner E. , Cohen H. , Shneur Y. 
Published: November 2007

Chromosomal mosaicism presents one of the most difficult problems in prenatal cytogenetic diagnosis, requiring the differentiation of true mosaicism from pseudomosaicism. To overcome associated problems and to prevent termination of normal pregnancies, we investigated 23 pregnancies in which true mosaicism has been found in amniotic fluid cell culture. A fetal blood sample was obtained by cordocentesis for rapid karyotyping, and meticulous sonographic examinations were carried out for detecting fetal abnormalities. The 23 cases in which mosaicisms were found in amniocytes involved five cases with sex chromosomal abnormalities, twelve with autosomal trisomy, four with autosomal structural defects, one with a supernumerary marker and one with tetraploidy. The karyotype from fetal leukocytes confirmed the diagnosis of mosaicism in only three out of 23 cases. These three included: two autosomal trisomies (47,XY+ 13/47,XY + 21 and 46,XY/47,XY + 21) and one sex chromosome mosaicism (45,X/46,XY). These were all selected for elective termination of pregnancies by the parents’ request. Post abortion karyotype re‐confirmed previous karyotype. The other twenty lymphocyte karyotypes were normal, and of these, 19 patients gave birth at term, and one delivered prematurely due to premature rupture of membranes. All 20 born infants were found normal by both neonatal examination and re‐karyotypes.We conclude that finding of mosaicism in amniotic fluid culture requires further investigation. Furthermore, in the presence of amniotic fluid cell true mosaicism and normal karyotype in fetal blood, continuation of the pregnancy is safe and to be recommended.
Uro‐genital microbial colonization and threatening preterm delivery
Authors: Svare Jens , Andersen Lars F. , Langhoff‐Roos Jens , Madsen Hans , Jensen Elsebeth T. , Bruun Brita , Lind Inga 
Published: November 2007

Objective. To examine whether there is a relationship between the urogenital microbial colonization and threatening preterm delivery.Study design. The microflora in the urine and endocervix was studied in 43 women with preterm labor. 45 women with preterm premature rupture of the membranes (PPROM) and 80 normal pregnant women at 26‐34 weeks of gestation. Amniotic fluid was examined in 20 of the patients with preterm labor. Data were analyzed by Fisher's exact test (two‐tailed).Results. The microflora in the urine was not significantly different in patients with preterm labor. PPROM and normal pregnant women. Compared with normal pregnant women, patients with preterm labor had significantly lower prevalences of corynebacteria (p <0.05) and coagulase‐negative staphylococci (p <0.01) in the cervix, while patients with PPROM had significantly lower prevalences of lactobacilli (p, <0.05) and coagulase‐negative staphylococci (p <0.05) in the cervix. Positive amniotic fluid cultures were detected in three of the 20 patients with preterm labor who underwent transabdominal amniocentesis. Evidence of ending colonization was found in two of these cases.Conclusions. The microbial colonization of the urine was not associated with threatening preterm delivery. Reduced prevalences of lactobacilli. corynebacteria and coagulase‐negative staphylococci in the cervix were associated with threatening preterm delivery.
Falling population incidence of eclampsia; A case‐control study of short term outcome
Authors: Geirsson Reynir T. , Arngrimsson Reynir , Apalset Ellen , Einarsson Atli , Snædal Gunnlaugur 
Published: November 2007

Background Eclampsia remains a serious complication of pregnancy and childbirth and factors related to morbidity require continued evaluation.Design. Retrospective case‐control study on the incidence and outcome of eclampsia.Setting. A defined total island population over 20 years.Method. All centrally collected birth registration returns in Iceland for the years 1972‐1991 were reviewed to identify women with the diagnosis of eclampsia, selecting women delivering immediately before and after the eclamptic case as controls. Information from all places where women had delivered was obtained to ensure that no case was missed. Maternity records were reviewed to verify the diagnosis and obtain maternal and neonatal data.Results. Forty women had eclampsia (0.046′%1 of deliveries). The incidence diminished between the decades 1972‐81 and 1982‐91 (p <0.05). as did the incidence of eclamptic convulsions before delivery. Eclamptic women were more often primiparous. younger and delivered earlier than controls. Preterm delivery and a low ponderal index were more common among offspring of the eclamptic mothers and the male/female ratio was lower.Conclusion The incidence of eclampsia in the population is falling. Common features related to the condition were confirmed. Severe maternal illness is rare. but the babies often appear growth‐retarded and are delivered preterm.
Who uses norplant: A study from Finland
Authors: Sihvo Sinikka , Ollila Eevn , Hemminki Elina 
Published: November 2007

Objective. Although Norplant implantable contraceptives were introduced first in Finland, their use has been infrequent. The objective of this study was to investigate what kind of women use Norplant in Finland, who suggested its use. and from what source women get their information on Norplant.Methods. A questionnaire was mailed to all women having had Norplant inserted one to two years before the study initiation (June 1992) in seven family‐planning clinics in the Helsinki city area (n = 262). After one reminder, the response rate was 82%.Results. Most of the users were 25–34 years old, and many of them had had a previous abortion. Half of the women were still considering a (subsequent) child. All the women had used some birth control method before Norplant and reported several problems with it. Women reported that they themselves had chosen Norplant. but physicians and nursing staff in the family‐planning clinic were their most important information sources. Most women considered that they had received sufficient information before insertion regarding both the good and bad aspects of the method.Conclusion. Women with previous abortions are a special users' group for Norplant. even though most users are in no way exceptional women.
Birth in standing position: A high frequency of third degree tears
Authors: Gareberg Britta , Magnusson Brltt , Sultan Bo , Wennerholm Ulla‐Britt , Wennergren Margareta , Hagberg Henrik 
Published: November 2007

Background. During the past years a major change in the use of delivery position has occurred in Sweden. Recumbent delivery positions have been replaced by a variety of positions: squatting, standing, lateral, kneeling and quadruped. The consequences of this shift in obstetrical practice for development of perineal lacerations are largely unknown.Method. Retrospective comparison of uncomplicated deliveries in standing (n = 650) and sitting (n = 264) position with respect to third degree lacerations.Results. The standing and sitting delivery group were similar with respect to maternal, infant and delivery characteristics. The frequency of third degree tears was 2.50% in standing and 0.38% in sitting birth position (p<0.05). In nulliparous women, third degree tears occurred in 4.2% in standing and 1.0% in sitting position.Conclusion. The present data implies that the risk of third degree lacerations is considerably higher (7x) in standing than in sitting birth positions.
Diagnostic accuracy of cytology and colposcopy in cervical squamous intraepithelial lesions
Authors: Kierkegaard Ole , Byrjalsen Carsten , Frandsen Kristian H. , Hansen Kristen C. , Frydenberg Morten 
Published: November 2007

Objective. To evaluate the diagnostic accuracy of cytology and colposcopy in women with an abnormal cervical smear using histology as the ‘gold standard’.Design. Survey of consecutively referred women with abnormal smear.Setting. The out‐patient colposcopical clinic of Herning Hospital, Denmark.Patients. 813 women with a median age of 29.0 years (range 15‐71 years) with their first abnormal smear.Results. For detecting cervical high‐grade lesions (HGL) the sensitivity of cytology was 41% (36‐47%). oS colposcopy 67% (62‐72%) and in combination 75% (70‐80%) so at least 25% of HGL were underestimated. Colposcopy underestimated more CIN‐2 than CIN‐3 lesions and more small lesions and lesions in smaller transformation zones. Cytology underestimated more CIN‐2 lesions but equal numbers of small and large lesions and transformation zones.Conclusion. Colposcopy was a better tool for diagnosing HGL than cytology. but even in combination too many HGL were missed. All women with abnormal cytology should thereUore have colposcopical and histological investigation and prospective studies of the natural history of cervical squamous lesions should include histological evidence.
Prenatal diagnosis of urinary tract anomalies: The value of two ultrasound examinations
Authors: Fugelseth Drude , Lindemann Rolf , Sande Hans Andreas , Refsum Sigvald , Nordshus Tore 
Published: November 2007

Objective. To determine when fetal urinary tract anomalies were detected by ultrasound screening during pregnancy and to discuss the possible consequences if only one early ultrasound examination is performed.Design. A retrospective study of 47 cases where fetal urinary tract malformations were diagnosed in a two‐stage screening program (17th and 32nd week of gestation) covering 22,310 women over ten years, 1982‐91.Setting. Ullevål University Hospital in Oslo which serves as a referral center for obstetric and neonatal diseases.Results. Urinary tract anomalies were diagnosed in 0.18% of the pregnancies. Of these, 61.7% were found at the second routine ultrasound screening. The most difficult differential diagnoses were those of hydronephrosis without megaureter and a multicystic kidney. Hydronephrosis was found in 51% and a multicystic kidney in 21% of the cases. The tentative prenatal diagnoses were confirmed postnatally in 83% of the cases.Six of the fetuses had anomalies regarded as incompatible with postnatal life. These pregnancies were terminated, and the diagnoses verified by autopsy. Two other infants died perinatally, one of them as a result of the urinary tract anomalies.Conclusion. If only one ultrasound scanning had been performed in the 17th week, approximately two‐thirds of the cases would not have been detected. Early intervention and follow‐up after delivery would only have been performed if the infants had developed symptoms or complications related to the urinary tract anomalies.
Acute volume expansion in normal pregnancy and preeclampsia: Effects on plasma atrial natriuretic peptide (ANP) and cyclic guanosine monophosphate (cGMP) concentrations and feto‐maternal circulation
Authors: Grunewald Charlotta , Nisell Henry , Carlstrom Kjell , Kublickas Marius , Randmaa Ivar , Nylund Lars 
Published: November 2007

Objective. To compare normal pregnancy with pregnancy‐induced hypertension (PIH)/preec‐lampsia with respect to the effects of acute volume expansion on plasma atrial natriuretic peptide (ANP), cyclic guanosine monophosphate (cGMP) and fetal‐maternal circulation. Design. Observational study.Setting. University hospital.Subjects. Fifteen women with PIH/ preeclampsia and 15 healthy pregnant controls. Interventions. Before and after 30 minutes' infusion of a crystalloid solution (15 ml/kg), maternal venous blood was sampled for ANP and cGMP analysis and echocardiography and Doppler investigations were performed.Results. Basal median (range) ANP and cGMP levels were significantly higher in the PIH/ preeclampsia group compared to the controls: 6.5 (3.8‐30.4) compared to 3.9 (2.0‐6.7) pmol/1, p≤0.01 and 5.8 (2.4‐11.6) compared to 4.0 (2.3‐10.8) nmol/1, p≤0.05. The response to volume load was enhanced: 4.6 (‐4.5‐21.8) compared to 0.7 (‐4.1‐8.8), p≤0.05 and 2.9 (0.1‐10.9) compared to 1.2 (‐ 5.0‐6.0), p≤0.05, respectively. Systemic vascular resistance was initially higher in the patient group, 22.3 (14.1‐36.7) compared to 15.6 (10.0‐25.5) peripheral resistance units, p≤ 0.01 but the response to volume load was similar in both groups (12‐13% decrease). The pulsatility index of the uterine artery, 0.85 (0.46‐1.38) compared to 0.72 (0.49‐1.26) and umbilical artery 0.89 (0.66‐1.57) compared to 0.97 (0.74‐1.31) did not differ between the groups. Volume expansion did not affect any of these variables.Conclusions. The pulsatility index of the uterine artery remained unaffected in both preeclamptic patients and healthy controls despite an increase of ANP and cGMP concentration and a systemic vasodilatation during acute volume expansion. This finding may indicate the absence of a vasodilatation of the uteroplacental vascular bed.
An open prospective randomized study of dinoproston and gemeprost in second trimester legal abortions
Authors: Kjølhede Preben , Dahle Lars Olav , Matthiesen Leif , Ryden Gunnar , Ottosen Christian 
Published: November 2007

The aim of this open prospective randomized study was to compare two non‐invasive methods for second trimester abortion using gemeprost pessaries (Cervagem®) and dinoproston gel (Cerviprost®) concerning effectiveness, time for abortion, consumption of analgesics, infection‐rate and side‐effects.Forty women admitted for second trimester legal abortion were allocated to treatment with either gemeprost (20) intravaginally or dinoproston (20) intracervically. All patients were pre‐treated with a 3 mm in diameter Lamicel® tent applied intracervically for about four hours. The success‐rate was 95% for gemeprost and 75% for dinoproston within approximately 48 hours. The median abortion time calculated from the insertion of the Lamicel® tent for the successful cases was 22 h 0 min for gemeprost and 24 h 5min for dinoproston (not significant). The shortest abortion time was found among parous women in the Cervagem® group. The difference between Cerviprost® and Cervagem® in parous women was statistically significant. For nonparous women there were no significant differences in abortion time between the two regimes.No significant difference was found in the demand of Pethidin® and the infection‐rate between the two groups. No major side effects of the treatment were found.Even if no significant difference in successful abortions was found, probably due to the small patient material, Cervagem® seems to be the most appropriate of the two non‐invasive methods, because of a 95 per cent success‐rate within 48 hours, but also due to its simplicity in design.
Reactive sacroiliitis as late sequela after severe 3elvic inflammatory disease verified by aparoscopy or laparotomy
Authors: Mozas Juan , Castilla José A. , Alarcón José L. , López José M. , Garcia José L. , Herruzo Alfonso J. 
Published: November 2007

Objective. To investigate the frequency of lumbosacral pains and sacroiliitis as late sequela of severe pelvic inflammatory disease (PID) confirmed by laparoscopy or laparotomy.Design. The sacroiliac joints were examined radiographically and scintigraphically to search for signs of reactive sacroiliitis.Setting. Department of Obstetrics and Gynecology, Hospital General Virgen de las Nieves, Granada, Spain.Patients. Thirty‐five out of 70 women admitted with severe clinical symptoms of PID during a five‐year period. PID was confirmed by laparoscopy or laparotomy.Measurements. The sacroiliac joints were examined radiographically, and bone scintigraphic studies of the pelvic girdle were performed with technetium labelled pyrophosphate.Results. Twenty out of 35 patients reported lumbosacral pain. The bone scintigraphic findings were positive for sacroiliitis in 18 out of 33 patients (54.6%), and the radiographic findings were positive in 11 women (33.3%).Conclusions. Patients with previous severe clinical PID complaining of lumbosacral pains may be offered a bone scintigraphy, a sensitive procedure using low‐dose radiation, to search for early signs of reactive sacroiliitis.
Effects of labor on serum levels of insulin and insulin‐like growth factor‐binding proteins at the time of delivery
Authors: Wang Hsin‐Shih , Lee Jing‐Der , Soong Yung‐Kuei 
Published: November 2007

Background. The purposes of this study were to explore whether serum levels of insulin, insulin‐like growth factor‐I (IGF‐I), insulin‐like growth factor‐binding protein‐1 (IGFBP‐1) and IGFBP‐3 in both maternal and fetal compartments were affected by the stress of labor, and to investigate the relationship between the fetal birthweight and serum levels of insulin, IGF‐I and IGFBPs.Methods. Blood samples were collected at the time of delivery from 147 parturients with vaginal delivery and 128 cases of Cesarean section (112 cases without labor and 16 cases with arrest of cervical dilatation during the active phase of labor). Serum concentrations of insulin, IGF‐I, IGFBP‐1 and IGFBP‐3 were determined by radioimmunoassays (insulin, IGFBP‐I and IGFBP‐3) and immunoradiometric assay (IGF‐I).Results. Maternal circulating IGFBP‐1 levels in parturients with normal spontaneous delivery (NSD) and in subjects receiving Cesarean section (CS) due to arrest of cervical dilatation during active phase of labor were higher than those undergoing scheduled CS without labor. By contrast, insulin levels in both maternal and umbilical cord serum were higher in parturients with CS without labor than those with NSD. No difference in maternal serum IGFBP‐3 levels was observed between NSD and CS at the time of delivery. As for all measurements (insulin, IGF‐I, IGFBP‐1 and IGFBP‐3), serum levels in pregnant women (from both NSD and CS) were strikingly higher than those in the fetus. Serum levels of IGFBP‐I in umbilical cords from both groups of NSD (p<0.02) and scheduled CS (p<0.01) were inversely correlated with birthweight (BW). By contrast, serum concentration of insulin and IGF‐I in umbilical cords from NSD (p<0.005 and p<0.01; respectively) and scheduled CS (p<0.001 and P&<0.05; respectively) were positively related to BW.Conclusions. From the present results, we conclude that insulin appears to be a regulator for circulating IGFBP‐1 during pregnancy. The fetal growth may not be well reflected by maternal serum IGFBP‐I levels, nor by IGFBP‐3. By contrast, cord serum IGFBP‐1 from CS group without labor may preeminently reflect fetal weight. In additional, serum concentration of insulin and IGF‐I in umbilical cord may also be good indicators to reflect the result of neonatal birthweight.
Couples' willingness to pay for IVF/ET
Authors: Granberg Maria , Wikland Matts , Nilsson Lars , Hamberger Lars 
Published: November 2007

Acta Ohstet Gynecol Scand 1995; 74: 199–202. © Acta Obstet Gynecol Scand 1995Background. Many politicians and decision‐makers in health care consider assisted reproduction an expensive and exclusive treatment despite the results of in vitro fertilizationiembryo transfer (IVF/ET) treatments having improved considerably during the last few years. With the improved results the costs in relation to successful outcome are decreasing.Aim and Methods. The aim of this study was to evaluate the cost‐benefit of IVF/ET treatments in a group of infertile couples. The benefit was measured as willingness to pay (WTP) for IVF/ET treatment and was related to the cost of IVF/ET. For the calculation of costs, data from one private and one public IVF clinic in Sweden during the period from January 1992 to March 1993 were used.Results and conclusions. The cost analysis showed a direct cost for IVF/ET of $3,170 per started treatment and $9,410 per delivery. Including the indirect cost, the total cost was $3,880 per started IVFIET treatment and $11,490 per delivery. The survey of the WTP showed that the infertile couples gave high economic priority to infertility treatment. A majority of the couples were willing to pay more for a child than the calculated direct cost.
Serum tetranectin in patients with acute pelvic inflammatory disease (PID): Correlation to clinical and laboratory findings
Authors: Høgdall Claw K. , Christiansen Michael , Brihmer Christina 
Published: November 2007

Aim of study. To clarify the impact of the presence of pelvic inflammatory disease (PID) and activation of the acute phase response on the serum level of tetranectin (Se‐TN), a potential new tumor marker for ovarian cancer.Material and methods. The study group consisted of 70 patients with a laparoscopically verified PID and 47 healthy female controls.Results. Lower Se‐TN levels were found for the PID group compared to the control group (p<0.0001). It was not possible to relate the decreases in Se‐TN levels to any distinct bacterial strain. Neither was it possible to find any correlation between Se‐TN and severity of PID (p=0.5). A significant positive correlation was found between Se‐TN and ALB (p<0.001). A just significant negative correlation was found between Se‐TN and C‐reactive protein (CRP) (p= 0.04). while no correlation was found with any of the other acute phase reactants. Highly significant correlations were found between all the acute phase reactants and grade of PID.Conclusions. A slight, but significant reduction in Se‐TN was found in PID patients. The decrease was minor compared to the reported findings of very low Se‐TN levels for ovarian cancer patients. However, the finding is important in the assessment of TN used as a potential screening marker for ovarian cancer, or as a diagnostic tool for pelvic tumors. Furthermore, Se‐TN does not seem to behave as a negative acute phase reactant.
Sonographc assessment of the vaginal vault following hysterectomy
Authors: Haines Christopher J. , Shan Yuen Oi , Hung Tam Wing , Chung Tony K. H. , Leung Denis H.Y. 
Published: November 2007

Objective. A prospective study to determine the sonographic appearance of the vaginal vault following hysterectomy.Methods. A transvaginal sonographic examination of the vaginal vault on the third postoperative day. Follow‐up to determine the incidence of postoperative morbidity.Results. An accurate sonographic examination of the vaginal vault was possible in 66/71 cases (92.9%). Fluid collections were visible in 28/66 cases (42.4%), and measured up to 41.1 cm2 in the transverse plane and 30.2 cm2 in the sagittal plane. There was no correlation between the presence of a collection and indices of postoperative morbidity.Conclusion. Collections of fluid at the vaginal vault are common after hysterectomy, but do not usually contribute to postoperative morbidity.
Impetigo herpetiformis during pregnancy: case report and review of the literature
Authors: Wolf Yoram , Groutz Asnat , Walman Igal , Luxman Dov , David Menachem P. 
Published: November 2007

A case of impetigo herpetiformis in pregnancy is reported together with a review of the literature.The patient was a 25‐year‐old primigravida with pregnancy‐induced hypertension (PIH). At 35 weeks' gestation, the patient developed a severely pruritic pustular rash with fever and leukocytosis. The skin of the affected areas was biopsied and showed intraepidermal pustules with a neutrophilic infiltrate.Treatment commenced with intravenous fluids, oral prednisone, and steroid creams. Labor was induced. and a normal delivery of a healthy infant was effected, following which the patient's condition improved rapidly.The clinical and laboratory features were typical of impetigo herpetiformis as described in the literature. Impetigo herpetiformis is a rare, potentially serious skin disorder occurring particularly during pregnancy, and must be diagnosed early to allow prompt, aggressive treatment.