bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physical abuse and low birthweight: a case‐control study
Authors: Grimstad Hilde , Schei Berit , Backe Bjørn , Jacobsen Geir 
Published: August 2005

Objective
To examine whether physical abuse of a woman by her partner was associated with low birthweight.Design
A case—control study.Setting
Department of Gynaecology and Obstetrics, University Hospital of Trondheim, Norway.Participants/sample
Eighty‐six women who were delivered of a low birthweight (< 2500 g) infant (cases) and 92 women who were delivered of an infant with birthweight 2500 g (controls).Methods
An in‐depth interview, either postpartum at the maternity ward or one year after delivery. Information about abuse was obtained by direct questioning and a modified version of the Conflict Tactics Scales.Results
A total of 17% of the women had experienced abuse by a partner. While 7% had been abused by their current partner before the index pregnancy only one woman reported abuse during pregnancy. Relatively more mothers of low birthweight infants were abused (20%) compared with controls (15%), but the association was not statistically significant (OR 1.37, 95% CI 0.63–2.99). Abused women reported a higher consumption of alcohol and cigarettes in pregnancy compared with nonabused women.Conclusion
Abuse was not found to be a risk factor for low birthweight in this study.
Perinatal mortality and route of delivery in term breech presentations
Authors: Lindqvist Anna , Nordén‐Lindeberg Solveig , Hanson Ulf 
Published: August 2005

Objective
To compare intrapartum related infant mortality in term (> 34 weeks) breech presentations in relation to vaginal delivery or delivery by caesarean section.Design
Register based nationwide study.Setting
Sweden from 1991 to 1992.Participants
6542 singleton fetuses born in the breech presentation.Main outcome measures
Intrapartum and early neonatal deaths, stillbirths and congenital malformations, low Apgar score < 7 at 5 min, mode of delivery.Results
After exclusion of antepartum stillbirths and congenital malformation, the intrapartum and early neonatal mortality rate was 2/2248 (0.09%) in the group delivered vaginally and 2/4029 (0.05%) in the group delivered by caesarean section. The relative risk was 1.81 (95% CI 0.26–12.84). Thus the difference was not statistically significant. This result was further supported after reviewing individual cases.Conclusions
The intrapartum related mortality in the group delivered vaginally was low and the result could not verify an increased mortality in term breech presentations delivered vaginally compared with those delivered by caesarean section.
Fetal fibronectin, endotoxin, bacterial vaginosis and cervical length as predictors of preterm birth and neonatal morbidity in twin pregnancies
Authors: Wennerholm U.‐B. , Holm B. , Mattsby‐Baltzer I. , Nielsen T. , Platz‐Christensen J. , Sundell G. , Hosseini N. , Hagberg H. 
Published: August 2005

Objective To evaluate the predictive values of fetal fibronectin, bacterial vaginosis, endotoxin and cervical length for preterm birth (< 35 and < 37 weeks) and neonatal morbidity in twin pregnancies.Participants One–hundred and twenty–one women with twin pregnancies recruited into a prospective longitudinal study at three antenatal clinics in the southwest of Sweden.Methods Cervical or vaginal fluid was sampled and determined for fetal fibronectin ( 0.05 μg/mL was used as cutoff), endotoxin ( 100 pg/mL) and bacterial vaginosis (presence of clue cells) at two week intervals from 24 to 34 weeks of gestation. The cervical length was measured with transvaginal sonography at the same time intervals.Main outcome measures Occurrence of preterm birth (< 35 and < 37 weeks of gestation) and neonatal morbidity.Results All positive fetal fibronectin samples obtained at screening between 24 and 34 weeks predicted birth < 35 weeks (RR 18.0; 95% CI2.2–145.9). A positive fetal fibronectin at 28 weeks of gestation predicted delivery < 35 weeks (RR 6.3; 95% CI 2.6–15.1) with a sensitivity, specificity, positive and negative predictive value of 50.0, 92.0, 62.5 and 87.3%, respectively. An independent association between fetal fibronectin at 28 weeks and preterm birth (< 35 weeks) was verified with logistic regression (P= 0.03). A positive fetal fibronectin at 28 weeks of gestation predicted neonatal morbidity (RR 5.1; 95% CI 2.4–11.0) and a longer period of care at the neonatal intensive care unit. The predictive power of cervical sonography was generally low but cervical length (cutoff 33 mm) measured at 28 weeks of gestation was significantly associated with birth < 37 weeks (RR 2.2; 95% CI 1.1–4.2). The presence of endotoxin correlated to bacterial vaginosis, but these tests were not significantly related to preterm birth or neonatal morbidity.Conclusions Fetal fibronectin predicted preterm birth and neonatal morbidity in twin pregnancies. The predictive value of cervical length determinations was low. Endotoxin and bacterial vaginosis had no predictive power for preterm delivery in this study.
Blood pressure and fetal heart rate changes with patient‐controlled combined spinal epidural analgesia while ambulating in labour
Authors: Al‐Mufti Raghad , Morey Richard , Shennan Andrew , Morgan Barbara 
Published: August 2005

Objective
To determine the effect of patient‐controlled combined spinal epidural analgesia (PCEA) on maternal pulse and blood pressure, and fetal heart rate in primigravid women, when adapting different positions in labour.Design
A prospective study.Setting
Queen Charlotte's and Chelsea hospital, London.Participants
Fifty‐five primigravid women in labour at 37 weeks of gestation; 40 women had supervised standing top‐ups given by an anaesthetist. A further 15 women had PCEA top‐ups given in each of standing, sitting and lying positions.Main outcome measures
Maternal pulse rate, blood pressure and fetal heart rate changes following epidural top‐ups.Results
In the first 40 women there was no clinically significant fall in their blood pressure (< 5 mmHg). The subsequent 15 women who had PCEA top‐ups had no fall in blood pressure in the standing and sitting positions, though the average blood pressure fell significantly when a top‐up was given in the lying position. Maternal heart rate increased significantly at 12 min post top‐up when the women were in the standing position (P= 0.0018). In the 15 women who had PCEA top‐ups, the CTG showed improvement in decelerations when women were in the standing position but deterioration when in the lying position (P < 0.01).Conclusion
Patient‐controlled epidural analgesia top‐ups with maternal mobility may be beneficial to the fetus possibly by reducing the hypotension normally associated with top‐ups in the lying position.
Randomised trial comparing the upright and supine positions for the second stage of labour
Authors: de Jong P. R. , Johanson R. B. , Baxen P. , Adrians V. D. , van der Westhuisen S. , Jones P. W. 
Published: August 2005

Objective
To assess the maternal and neonatal effects of upright compared with recumbent positions during delivery, in terms of defined outcome variables.Design
A randomised controlled trial.Setting
St Monica's Nursing Home, a midwife based maternity unit in Cape Town, South Africa.Participants
Five hundred and seventeen women of low obstetrical risk assigned to deliver at the nursing home.Results
The trial showed that women who adopted the upright posture for delivery experienced less pain, perineal trauma and fewer episiotomies than those who delivered in the supine position.Conclusion
The data suggest that in women of low obstetrical risk, choice of posture during delivery may be encouraged.
Randomised trial of immediate versus deferred treatment strategies for the management of minor cervical cytological abnormalities
Authors: Shafi M. I. , Luesley D. M. , Jordan J. A. , Dunn J. A. , Rollason T. P. , Yates M. 
Published: August 2005

Objective
To compare immediate and deferred treatment in women with cervical smears showing borderline nuclear abnormalities or mild dyskaryosis.Design
Prospective randomised trial.Setting
Colposcopy clinics at Birmingham and Midland Hospital for Women and the City Hospital NHS Trust, Dudley Road, Birmingham.Participants
Four hundred and thirty‐five women with minor cytological abnormality younger than 35 years of age, of whom 353 were randomised to immediate treatment or deferred treatment.Main outcome measures
Comparison of histologies in the subsequent two years in the immediate and deferred treatment groups.Results
Thirty‐six women (21%) defaulted from follow up. The percentage of high grade abnormalities (CIN II and III) in the deferred treatment arm at two years is similar to that in the immediate treated arm at first colposcopy (25%vs24%). Cytology failed to pick up two cases of CIN III and there was one case of early invasive carcinoma at the six month follow up. If treatment is deferred, the proportion with CIN I is almost halved (25%vs13%); the proportion with koilocytic atypia is slightly reduced (51%vs42%) and the proportion with no abnormality is substantially increased (0.6% vs 20%).Conclusion
Immediate referral and a select‐and‐treat management strategy of all women with any degree of dyskaryosis is recommended based on the case of invasive cervical cancer, high default rate and the failure of cytology to pick up two cases of CIN III.
A pragmatic randomised comparison of transcervical resection of the endometrium with endometrial laser ablation for the treatment of menorrhagia
Authors: Bhattacharya S. , Cameron I. M. , Parkin D. E. , Abramovich D. R. , Mollison J. , Pinion S. B. , Alexander D. A. , Grant A. , Kitchener H. C. 
Published: August 2005

Objective
To compare endometrial laser ablation (ELA) with transcervical resection of the endometrium (TCRE) in the treatment of menorrhagia.Design
Randomised controlled trial.Setting
Gynaecology department of a large teaching hospital.Participants
Women with menorrhagia due to dysfunctional uterine bleeding (n= 372) were randomly allocated to ELA (n= 188) or TCRE (n= 184).Main outcome measures
Operative complications, post‐operative recovery, relief of menstrual and other symptoms, need for further surgical treatment, satisfaction with treatment after 6 and 12 months, and differential resource use.Results
TCRE was significantly quicker, with lower rates of fluid overload. Perioperative morbidity was low and similar hi both groups. Outcome at 12 months was also similar: 72 women (45%) had either amenorrhoea or brown discharge in the ELA group compared with 71 (49%) in the TCRE group; 79 (49%) versus 68 (46%) had lighter periods. Thirty (16%) versus36 (20%) had received further surgical treatment: 9 (5%) compared with 25 (14%) had had a hysterectomy, and 21 (11%) versus 11 (6%) had received repeat ablation. Anxiety and depression, dysmenorrhoea and pre‐menstrual symptoms were improved by both procedures and bladder symptoms were affected by neither. At 12 months 148 (90%) women in the ELA group and 140 (91%) women in the TCRE group were satisfied with their treatment. The estimated additional cost of ELA was £145 per procedure.Conclusions
At one year there was no clear difference in clinical outcome between ELA and TCRE.Both procedures were associated with low morbidity. ELA was the more costly procedure. Despite the need for further surgery for about one in six women, satisfaction rates were high following both ELA and TCRE.
Radiofrequency induced endometrial ablation: an update
Authors: Thijssen R. F. A. 
Published: August 2005

Objective
To test the safety and efficiency of radiofrequency endometrial ablation as a nonhysteroscopic treatment of dysfunctional uterine bleeding.Design
A multicentre trial. Setting Nineteen clinics in six countries.Methods
From February 1990 to December 1994, 1280 women were treated with radiofrequency endometrial ablation. Inclusion criteria were: menorrhagia, age 30–55 years, a completed family, a wish to retain the uterus, no hypergonadotropic state indicating an approaching menopause, a normal sized uterus, normal cervical cytology, normal adnexa, no prolapse, no intrauterine abnormalities, and no history of a bleeding disorder. Treatment was performed according to a standard operating protocol.Results
Either amenorrhoea or a satisfactory improvement of menstruation was obtained in 78.5% of 944 women followed for six months or more. The design of the equipment has been thoroughly revised and improved during the last four years. The complications encountered were mostly related to the handling of radiofrequency and sometimes due to failures in following the safety protocol.Conclusions
Although the technology is complicated, the treatment is simple, fast and effective. The complications have often been unpredictable. Despite the improvements made during this period, safety must be further enhanced to develop the original concept into an established technique.
The levonorgestrel intrauterine system in the management of menorrhagia
Authors: Barrington J. W. , Bowen‐Simpkins P. 
Published: August 2005

Objective
To assess the effect of a levonorgestrel releasing intrauterine system in the management of menorrhagia.Design
A prospective study.Setting
A district general hospital in South Wales.Methods
Fifty women with a failed trial of medical therapy and awaiting hysterectomy or transcervical resection of the endometrium (TCRE) were treated with a levonorgestrel intrauterine system. The menstrual loss was estimated using a modified pictorial chart together with a full blood count and ferritin measurement preinsertion and at three and six to nine months postinsertion.Results
The menstrual loss was reduced to acceptable levels in 37 women at three months and a further four by six to nine months. In all, 41 patients were taken off the waiting list for surgery, four of whom became amenorrhoeic. There was no significant change in full blood count nor ferritin measurement despite unscheduled bleeding for six to eight weeks postinsertion. Fifty‐six percent of patients noticed considerable improvement or cure of their premenstrual syndrome symptoms; 80% noted a reduction in dysmenorrhoea.Conclusion
The levonorgestrel releasing intrauterine system is an effective nonsurgical treatment for the management of menorrhagia and dysmenorrhoea that has additional benefit as a contraceptive and in relieving premenstrual syndrome.
The effects of transdermal oestradiol and oral progestogens on haemostasis variables
Authors: Kroon U.‐B. , Tengborn L. , Rita H. , Bäckstrom A.‐C. 
Published: August 2005

Objective
To evaluate the effects of 1 g (1 mg oestradiol) transdermal oestradiol gel continuously combined with 10 mg medroxyprogesterone acetate orally 12 days either monthly or every third month on haemo‐ stasis variables.Design
An open, parallel stratified study.Setting
Sahlgrenska University Hospital, Goteborg, SwedenParticipants
A total of 48 peri‐ and postmenopausal women less than 65 years of age participated in this study. Twenty‐seven women, who had from 2 months to 3 years since their last period were included in group I. Twenty‐one women, who were more than 3 years postmenopausal, comprised group II.Main outcome measures
The following parameters were determined: von Willebrand factor antigen, factor VII antigen, fibrinogen, antithrombin, protein C, protein S, plasminogen activator inhibitor activity, tissue plasminogen activator antigen, prothrombin fragment1+2, thrombin‐antithrombin complex and platelets.Results
Both regimens decreased fibrinogen, factor VII antigen as well as antithrombin.Conclusions
These changes were mainly ‘in an anti‐thrombotic direction’. The overall impression is that the transdermally administered oestrogen in combination with an oral progestogen induced favourable, although slight changes in the haemostatic system. The possible influence of these changes on the risk of cardiovascular disease remains yet to be studied.
Recto vaginal septum adenomyotic nodules: a series of 500 cases
Authors: Donnez Jacques , Nisolle Michelle , Gillerot Stephane , Smets Mireille , Bassil Salim , Casanas‐Roux Françoise 
Published: August 2005

Objective
Laparoscopic procedure with excision of deep fibrotic endometriotic nodules of the rectovaginal septum and histological study of the lesions.Setting
An academic teaching hospital.Participants
A series of 500 women undergoing laparoscopy for pelvic pain or infertility.Results
Laparoscopic (n= 497) and laparotomic (n= 3) excision of endometriotic nodules resulted in considerable pain relief. Histologically the rectovaginal nodule was similar to an adenomyoma as it was a circumscribed nodular aggregate of smooth muscle and endometrial glands and stroma. The variations in oestrogen receptor and progesterone receptor content suggested a regulatory mechanism different from that of eutopic endometrium.Conclusion
This form of disease should be considered as an entity distinct from peritoneal and ovarian endometriosis, and originating from the Miillerian rests present in the rectovaginal septum.
Conservative surgery for Stage I ovarian carcinoma in women of childbearing age
Authors: Zanetta Gerardo , Chiari Stefania , Rota Sonia , Bratina Giorgio , Maneo Andrea , Torri Valter , Mangioni Costantino 
Published: August 2005

Objective
To assess the results of a policy of tailored conservative surgical management for young women with stage I ovarian carcinomas.Design
Retrospective study.Participants
Ninety‐nine women aged 40 years or younger who underwent either primary surgery in our department or were referred after primary surgery performed elsewhere.Methods
Of the 99 women in our study, 56 underwent fertility‐sparing surgery and 43 more radical surgery. Minimal requirements for conservative management were adequate staging and complete information about the therapeutic options. Factors important in the choice of the treatment were, age, wish to preserve fertility, histologic type and grade, and the stage of the tumour.Results
Conservative treatment was conducted in 84% of nulliparous and in 33% of parous women; 62% of grade 1 tumours, 48% of grade 2, and 50% of grade 3 were treated conservatively. With a median follow up of seven years, we observed five recurrences (9%) of carcinoma in women treated conservatively and five (12%) in those treated more radically. Two women (one in each treatment arm) were saved after recurrence. Two recurrences after conservative surgery involved the residual ovary (3.6%). Two women developed borderline tumour in the contralateral ovary and both were treated by surgery.Conclusion
After adequate staging and accurate information is given to the patient, conservative treatment may be safe in some women with early ovarian cancer. The risk of recurrence in the contralateral ovary is low. Conservative surgery may be also considered in some Stage I grade 3 tumours and in some women with stage IC tumours.
A longitudinal study of maternal bloodflow in normal pregnancy and the puerperium: analysis of Doppler waveforms using Laplace transform techniques
Authors: Brackley Karen J. , Ramsay Margaret M. , Pipkin Fiona Broughton , Rubin Peter C. 
Published: August 2005

Objective
To describe changes in the maternal cerebral circulation and the external iliac arteries throughout pregnancy and the puerperium using the Laplace transform analysis of Doppler waveforms.Design
A prospective longitudinal study.Setting
Department of Obstetrics and Gynaecology, Nottingham University Hospital.Sample
A cohort of 17 healthy women studied every four weeks from early pregnancy until term and up to three months postpartum. Pre‐conception data were available for 10 subjects.Methods
Doppler signals were recorded from the internal carotid, middle cerebral and external iliac arteries. The waveforms were analysed using two different techniques: standard indices (systolic: diastolic ratio, pulsatility and resistance indices) and Laplace transform analysis, an alternative method of waveform shape analysis which may provide additional haemodynamic information.Results
Vessel wall tone decreased at an early stage in pregnancy in the cerebral circulation and in the external iliac artery, but this rose again following delivery. The Laplace transform analysis techniques suggest dramatic eight‐fold increases in downstream resistance within the external iliac artery in the second half of pregnancy. An increase in downstream resistance to flow also occurred in the internal carotid artery whereas more stable conditions were noted in the middle cerebral artery.Conclusions
Having a preliminary idea of the normal ranges for the Laplace transform analysis variables during pregnancy in a variety of maternal vessels, haemodynamic changes in pregnancies complicated by conditions, such as pre‐eclampsia, can now be studied.
Age and basal follicle stimulating hormone as predictors of in vitro fertilisation outcome
Authors: Sharif Khaldoun , Elgendy Manal , Lashen Hany , Afnan Masoud 
Published: August 2005

Objective
To examine the relative effect of basal follicle stimulating hormone (FSH) concentration and the woman's age on predicting the ovarian response to gonadotrophin stimulation, normal fertilisation rate and pregnancy rate in in vitro fertilisation (IVF) treatment following pituitary desensitisation.Design
Descriptive cohort study.Participants
Three hundred and forty‐four women undergoing their first IVF cycle.Methods
Basal (menstrual‐day 3) FSH concentration was measured and the woman's age calculated before she underwent pituitary desensitisation followed by gonadotrophin ovarian stimulation and IVF treatment.Main outcome measures
Cancellation rate due to poor ovarian response, total dose of gonadotrophin required to achieve follicular maturity, number of oocytes collected, normal fertilisation rate and pregnancy rate were compared between banded values of the variables studied.Results
Increasing basal FSH concentration was associated significantly with increased cancellation rate, but increasing age was not. Both increasing basal FSH and age were associated significantly with increased total gonadotrophin dose, and reduced number of oocytes collected and pregnancy rate. Analysis of variance showed that the association for basal FSH with the number of oocytes was significant, independent of, and stronger than the effects of age. Logistic regression analysis showed that age, but not basal FSH, was independently associated with pregnancy rate. Neither basal FSH, nor age had significant association with normal fertilisation rate.Conclusion
Basal FSH concentration is a better predictor of cancellation rate and of the number of oocytes collected in IVF treatment than age, but age is a stronger predictor of pregnancy rate.