bluuebunny/crossref_metadata_2025_split huggingface dataset:
C‐reactive protein in preterm labour; association with outcome of tocolysis and placental histology
Authors: CAMMU H. , TEMMERMAN M. , FOULON W. , AMY J. J. , GOOSSENS A. , DERDE M. P. 
Published: August 2005

SummaryTocolytics were administered in 66 consecutive women in uncomplicated preterm labour with intact fetal membranes (53 singleton and 13 twin pregnancies). C‐reactive protein (CRP), a marker of infection, was determined daily and used retrospectively to investigate the role of subclinical infection in preterm labour and to predict the efficacy of tocolysis and the development of a clinical perinatal infection. CRP was also determined in 66 women in uncomplicated labour at term (53 singleton and 13 twin pregnancies). The placenta was examined for histological evidence of infection in all patients who were delivered bcfore 36 weeks (n=21) and in all women in the control group (n=66). Elevated CRP levels were more often found in patients who were refractory to tocolysis, suggesting an underlying infectious morbidity. Placental infection was found in 62% of the preterm delivery group and in 12% of the control group. There was an association between elevated CRP levels and histological evidence of placental infection. However, confounding factors such as urinary tract infections limit the usefulness of the CRP test. Because CRP cannot predict clinical perinatal infection accurately, its clinical relevance is very limited.
A randomized study of the sitting position for delivery using a newly designed obstetric chair
Authors: STEWART PETER , SPIBY HELEN 
Published: August 2005

SummaryA new obstetric chair has been designed to overcome some of the problems of those currently available commercially. The chair has been used to assess the effects of the sitting position in the second stage of labour on the outcome of delivery in 304 women randomly allocated to be delivered either in the chair or in the conventional dorsal position. Delivery in the chair conferred no benefits to mother or baby and resulted in greatcr mean blood loss and a higher rate of postpartum haemorrhage.
Plasma secretin concentrations during normal human pregnancy, delivery, and postpartum
Authors: HOLST N. , MALTAU J. M. , JENSSEN T. G. , BURHOL P. G. 
Published: August 2005

SummaryPlasma concentrations of secretin were measured at 4‐week intervals throughout eight normal pregnancies and again twice postpartum, and in another six women during parturition and the early postpartum period. Comparisons were made with levels in 16 normal non‐pregnant women. Plasma secretin concentrations increased during pregnancy with maximum levels at 36 weeks. The increase was statistically significant from week 28 to 36, compared with non‐pregnant levels. By 5 days after delivery plasma secretin levels were similar to the non‐pregnant levels. No significant changes in plasma secretin were observed during delivery and early postpartum. The altered secretin levels may be of importance for heartburn in pregnancy, calcium metabolism, and the changes in renal haemodynamics.
Changes in the connective tissue of corpus and cervix uteri during ripening and labour in term pregnancy
Authors: GRANSTRÖM L. , EKMAN G. , ULMSTEN U. , MALMSTRÖM A. 
Published: August 2005

SummaryThe composition of the connective tissue of human cervix and corpus uteri was studied in tissue specimens from seven nonpregnant women and 14 pregnant women, delivered at term by section, to examine spontaneous cervical ripening and labour‐induced changes in both the uterine and the cervical connective tissue. The main finding in both the cervix and the corpus was a large (40–60%) decrease of the collagen concentration. The collagen extractability, obtained by pepsin digestion, was increased twofold, suggesting a change of the organization of the collagen fibrils. This reorganization process could also be demonstrated by a large increase of the collagenolytic activity demonstrated with an artificial DNP‐peptide substrate. The concentrations of sulphated glycosaminoglycans was lower in pregnant women than in non‐pregnant women. The results show that both the cervix and the corpus uteri contain substantial amounts of connective tissue components (collagen, sulphated glycosaminoglycans and hyaluronic acid) and that during ripening, reconstruction of the connective tissue components occurs in both sites. This indicates that the cervical state reflects that of the myometrium.
Do raised serum luteinizing hormone levels during stimulation for in‐vitro fertilization predict outcome?
Authors: THOMAS A. , OKAMOTO S. , O'SHEA F. , MACLACHLAN V. , BESANKO M. , HEALY D. 
Published: August 2005

SummaryPrevious reports associating raised LH concentrations with reduced fertilization and pregnancy rates in women undergoing in‐vitro fertilization (IVF) have assumed a Gaussian distribution of LH values with IVF treatment. We have determined the serum LH range during ovarian stimulation for IVF with a single regimen of clomiphene citrate/ hMG from 102 consecutive IVF conception cycles. The results show a non‐Gaussian distribution of LH values. Application of this LH range to a consecutive series of 596 women undergoing IVF treated with this single regimen showed no difference in pregnancy rates, fertilization rates, median number of oocytes fertilized or retrieved when analysed with respect to serum LH concentrations above the 75th or 95th centile for ≥3 days of an IVF treatment cycle. We conclude that follicular‐phase LH concentrations do not predict IVF fertilization rates or clinical outcome and are not clinically useful in individual patient management.
Characteristics of persistent ovarian masses in asymptomatic women
Authors: BHAN V. , AMSO N. , WHITEHEAD M. I. , CAMPBELL S. , COLLINS W. P. , ROYSTON P. 
Published: August 2005

SummaryPersistent ovarian masses have been found in a substantial proportion of 5479 self‐selected asymptomatic women who were screened for early ovarian neoplasia. Each woman was scheduled to undergo three ultrasound screens (consisting of 1–12 scans) to detect regressing and non‐regressing masses. A total of 14,594 screens (15,977 scans) was performed. The average interval between successive screens was 595 days (range 214–1134 days). Overall, 650screens (4.4%; 10.1% of women) produced a positive result which became negative with successive scans (four times more frequently in pre‐than naturally postmenopausal women), and 338 screens (2.3%; 5.9% of women) had a final positive result (at least one ovary that was grossly abnormal or contained a persistent mass). Biopsies were taken from 336 ovaries (89% of total, 271 women). Overall, 134 tumour‐like conditions and 119 benign tumours were identified. The detection rate of tumour‐like conditions was 1.5 times higher in premenopausal than naturally postmenopausal women, whereas the proportion of tumours to normal ovaries was similar in both groups. Overall, 51% of tumour‐like conditions and 70% of all tumours were detected at screen 1. Four women had metastatic ovarian cancer (three at screen 1, one at screen 2; two were bilateral). Five women (0.1%) had a primary malignant tumour (two at screen 1, three at screen 2; four were stage la and one was stage Ib). All women are being monitored to obtain additional information about the significance of the findings.
Survey of attitudes to testing for human immunodeficiency virus infection in antenatal clinics in West Glamorgan
Authors: THOMAS J. , BOWEN‐SIMPKINS P. , STEWART G. , PATTERSON T. 
Published: August 2005

SummaryA total of 1023 women attending hospital antenatal clinics in West Glamorgan was surveyed by means of a self‐administered questionnaire, to determine their attitudes to HIV testing in pregnancy. The response rate was 98%. Of the responders, 94% had no objection to their antenatal blood specimen being tested for HIV infection. Of the non‐objectors, 55% wished their permission to be asked first, and 92% wished to be informed of the result, i.e. they wished for named testing. With regard to knowledge of other tests for infectious diseases performed on antenatal blood specimens, only 1·5% had totally correct knowledge, and only one in three knew that their blood was tested for syphilis. The implications of anonymous and named HIV testing are discussed, together with estimates of prevalence of HIV infection in women attending antental clinics, the rate of vertical transmission, and the prognosis for an infected baby.
Results with the EMA/CO (etoposide, methotrexate, actinomycin D, cyclophosphamide, vincristine) regimen in high risk gestational trophoblastic tumours, 1979 to 1989
Authors: NEWLANDS E. S. , BAGSHAWE K. D. , BEGENT R. H. J. , RUSTIN G. J. S. , HOLDEN L. 
Published: August 2005

AbstractObjective— To assess the efficacy, toxicity and survival in patients with high risk GTT treated with the EMA/CO regimen (etoposide, methotrexate, actinomycin D, cyclophosphamide, vincristine/oncovine).Design— Open non‐randomized study of 148 consecutive patients referred to the Charing Cross Hospital between 1979 and 1989.Setting— Trophoblastic disease centre in a London teaching hospital.Subjects— 148 consecutive patients with high risk GTT were treated with the EMA/CO regimen. 76 patients had received no prior chemotherapy and 72 had received prior chemotherapy.Main outcome measures— Survival, causes of treatment failure and toxicity were analysed.Results— Of 76 patients who had received no prior chemotherapy, 62 (82%) are in remission, 72 patients had received prior chemotherapy and 64 (89%) are in remission; an overall survival of 85% for the 148 patients. Ten of the 76 patients without prior chemotherapy died from extensive disease within 3 weeks of starting chemotherapy. The complete and partial response rates to EMA/CO chemotherapy were 80% and 18% respectively. The addition of cisplatin salvaged 9 of 11 (82%) who developed drug resistance and did not require surgery. Salvage surgery alone resulted in 7 of 8 (87%) having complete remissions. Relapse after EMA/CO chemotherapy is uncommon (5.4%) but survival is still relatively good with further chemotherapy and/or surgery with 6 (75%) of 8 patients obtaining a further sustained remission. Complications from EMA/CO chemotherapy are acceptable with myelosuppression being dose‐limiting. Late sequelae are uncommon: menstruation usually returns with a few months, and no fetal abnormalities have been recorded in subsequent pregnancies. One patient developed what we presume to be a therapy‐induced acute myeloid leukaemia.Conclusion— At present EMA/CO chemotherapy is our treatment of choice for patients with high risk GTT. Its toxicity is predictable and reversible. In patients developing drug resistance, salvage surgery is important. Future developments may include further dose intensification with the addition of haemopoietic growth factors, earlier diagnosis and the separation of gestational from non‐gestational trophoblastic tumours.
Placental bed spiral arteries in the hypertensive disorders of pregnancy
Authors: PIJNENBORG ROBERT , ANTHONY JOHN , DAVEY DENNIS A. , REES ALEXANDRA , TILTMAN ANDREW , VERCRUYSSE LISBETH , VAN ASSCHE ANDRE 
Published: August 2005

AbstractObjective— The investigation of the histology of the placental bed spiral arteries in normal pregnancy and in pregnancies complicated by hypertension, with or without proteinura.Design— An observational study, based on women having caesarean sections for clinical reasons.Subjects— 17 normal pregnant women, 43 with gestational hypertension, of whom 39 had proteinuria, 17 with chronic hypertension, of whom 6 had proteinuria, and 5 with unclassified hypertension.Interventions— Placental bed biopsies obtained during caesarean section.Main outcome measures— Histological appearance of sections stained with haematoxylin and eosin PAS and Lendrum's MSB.Results— Biopsies containing spiral arteries were obtained from 6 normotensive and 44 hypertensive women. Trophoblastic invasion was present in 5 of the 6 normotensive biopsies but absent in the majority of those with hypertension. Subintimal proliferation was seen in all the normotensive biopsies but in only 8 of 28 from those with gestational hypertension and proteinuria. Other features seen predominantly or only in the hypertensive biopsies, in order of frequency, were medial hyperplasia, fibrin deposits, acute atherosis, endothelial vacuolation and thrombosis.Conclusion— Absence of physiological changes may not be peculiar to preeclampsia but may be associated or even a result of various forms of hypertension in pregnancy. Spiral arteries show a spectrum of changes in hypertensive pregnancies that do not appear to bear a clear‐cut relation to the clinical signs.
Increased plasma levels of vasoactive intestinal polypeptide in pre‐eclampsia
Authors: HOLST N. , ØIAN P. , AUNE B. , JENSSEN T. G. , BURHOL P. G. 
Published: August 2005

AbstractObjective— To investigate the plasma vasoactive peptide (VIP) levels in pregnancies complicated by pre‐eclampsia.Design— A prospective clinical study.Setting— University Department of Obstetrics, Tromso, Norway.Subjects— 18 women with untreated gestational proteinuric hypertension between 32 and 40 weeks gestation (13 primigravid) and 8 women with normal pregnancies of similar gestational age.Interventions— Fasting blood samples on two occasions, 10 min apart.Main outcome measures— Plasma VIP measured by radioimmunoassay.Results— Mean maternal plasma VIP was 13–9 (SEM 1–7) pmol/l in those with pre‐eclampsia and 4–4 (SEM 0–5) pmol/l in normal pregnancies (P<0.0001).Conclusion— The increased levels of VIP in pre‐eclampsia may represent a powerful compensatory mechanism to restore vascular perfusion of various organs, including the uterus and placenta.
Thyrotrophin‐releasing hormone—a lactation‐promoting agent?
Authors: PETERS F. , SCHULZE‐TOLLERT J. , SCHUTH W. 
Published: August 2005

AbstractObjective— To study the lactational and hormonal responses to nasal administration of thyrotrophin‐releasing hormone (TRH) in puerperal women with inadequate lactation.Design— Prospective randomized double‐blind placebo‐controlled study.Subjects— 19 puerperal women with inadequate lactation (<50% of normal milk yield) on the 5th day postpartum.Interventions— 10 women were allocated to receive TRH administered by a nasal spray of 1 mg, four times daily, between suckling episodes, for 10 consecutive days starting on day 6 postpartum. Nine women were allocated to receive placebo sprays.Main outcome measures— Daily milk yield, serum levels of prolactin and thyroid hormones.Results— Before treatment all the women had significant prolactin responses to TRH and suckling stimuli. At the end of 10 days of treatment, milk yield increased significantly in the TRH group from a mean of 142–0 (SD 33.9) to 253–0 (SD 105.3) g/day (P = 0.014). There was no significant change in the placebo group. Basal prolactin levels increased from a mean of 117–4 μg/1(SD 45.2) to 173–3 μg/1 (SD 55.5) (P < 0.001) in the TRH group whereas in the placebo group prolactin levels decreased from 137–2 (SD 69.5) to 82–0 (SD 37.7) μg/1. A further rise in prolactin levels and milk yield was seen in seven women in the TRH group who received a second 10‐day course of TRH treatment at their own request. There was no significant change in levels of thyroid stimulating hormone, thyroxine and triiodothyronine during treatment in either of the two treatment groups and no signs of hyperthyroidism.Conclusion— Repeated nasal TRH administration between suckling episodes may improve defective lactation.
Haemorrhagic problems in obstetrics and gynaecology in patients with congenital coagulopathies
Authors: GREER I. A. , LOWE G. D. O. , WALKER J. J. , FORBES C. D. 
Published: August 2005

AbstractObjective— To review the obstetric and gynaecological problems in women with congenital coagulopathies.Design— Retrospective review.Setting— Regional Adult Haemophilia Unit, Glasgow Royal Infirmary.Subjects— All women in contact with the Unit over a period of 30 years, comprising eight with von Willebrand's disease, 18 obligate carriers of haemophilia A and five obligate carriers of Christmas disease. Each woman was interviewed and details of their obstetric and gynaecological histories were obtained and their case records were reviewed.Main outcome measures— Haemostatic changes associated with pregnancy and gynaecological problems.Results— In 14 pregnancies in seven patients with von Willebrand's disease, there were four primary and four secondary post‐partum haemorrhages and a large perineal haematoma complicating an episiotomy. These problems arose despite the endogenous rise in factor VIIIc seen with pregnancy. All women seen with von Willebrand's disease complained of menorrhagia and had been referred to gynaecologists. Treatment included danazol, tranexamic acid and the contraceptive pill. Diagnostic curettagc resulted in severe haemorrhage in one woman and two women with pelvic pain and dyspareunia were found to have spontaneous broad ligament haematomas, one requiring surgery. In 43 pregnancies in obligate carriers of haemophilia A and Christmas disease there were five post‐partum haemorrhages and a large perineal haematoma.Conclusion— In von Willebrand's disease it should be noted that adequate laboratory correction of factor VIIIc levels does not ensure clinical haemostasis; hence platelet function should also be measured. Patients with congenital coagulopathies pose particular problems for the obstetrician and gynaecologist and should be managed in close association with the local haemophilia centre.
Bilateral oophorectomy and hysterectomy in the treatment of intractable pelvic pain associated with pelvic congestion
Authors: BEARD R. W. , KENNEDY R. G. , GANGAR K. F. , STONES R. W. , ROGERS V. , REGINALD P. W. , ANDERSON M. 
Published: August 2005

AbstractObjective— To determine whether bilateral oophorectomy combined with hysterectomy is an effective treatment for chronic pelvic pain due to congestion. Design—Prospective non‐randomized single centre study.Setting— Tertiary referral centre to a specialist pelvic pain clinic in a teaching hospital.Subjects— 36 women, 33 of whom had failed to obtain long term relief of pain on medical therapy.Main outcome measures— Relief of pain, coital frequency, and effect on daily life. Histology of uterus and ovaries.Results— Median pain score on visual analogue scale fell from a prc‐operativc value of 10 to 0 at one year. Twelve of the 36 women had some residual pain at one year postoperativcly, but in only one woman was the pain affecting her daily life. Thirty women were noted to have pelvic tenderness pre‐opcratively, at one year, 26 had no tenderness and four minimal tenderness on pelvic examination. The median frequency of sexual intercourse increased from once per month preoperatively to eight times per month one year postoperatively. The uterus was histologically normal in 25 women, adenomyosis was present in eight of whom two had ovarian endometriosis. Fibroids were present in three and endometriosis was found confined to the ovaries in one woman. Multiple peripheral cysts were present in the ovaries of 25 women.Conclusion— Bilateral oophorectomy combined with hysterectomy and hormone replacement therapy is an effective treatment for chronic pelvic pain due to venous congestion, which has failed to respond to medical treatment and leads to restoration of normal coital function and daily life.
The management of prolonged pregnancy—an analysis of women's attitudes before and after term
Authors: ROBERTS LAWRENCE J. , YOUNG KEITH R. 
Published: August 2005

AbstractObjective— To determine the attitude of pregnant women to a proposal of con‐servative management of prolonged pregnancy.Design— A prospective questionnaire‐based survey.Setting— Louis Margaret Maternity Wing, Cambridge Military Hospital, Aldershot.Subjects— 500 pregnant women initially at 37 weeks gestation considered suitable for the potential conservative management of prolonged pregnancy.Results— Despite a stated obstetric preference for conservative management, only 45% of the women at 37 weeks gestation were agreeable to conservative management; of those undelivered by 41 weeks gestation 31% still desired conservative management. This significant decrease was unaffected by parity or certainty of gestational age.Conclusions— Most pregnant women are unwilling to accept the conservative management of prolonged pregnancy and become more reluctant to do so if undelivered by 41 weeks gestation. Women are not as favourably disposed towards the conservative management of pregnancy as has been suggested previously.
Episiotomy and perineal lesions in spontaneous vaginal deliveries
Authors: HENRIKSEN TINE BRINK , MØLLER BEK KARL , HEDEGAARD MORTEN , SECHER NIELS J. 
Published: August 2005

ABSTRACTObjective
To evaluate the influence of mediolateral episiotomy on the perineal state after spontaneous, singleton vaginal deliveries with fetus in the occiput anterior position.Design
The study was a population based, observational study. Two approaches were used in the analyses. Initially, we considered the parturients as quasi‐randomised to one of three equally sized groups of midwives with different attitudes towards episiotomy. Secondly, we studied the effect of episiotomy on the state of the anal sphincter, controlling for birthweight, parity, and duration of second stage of labour.Subjects
2188 pregnant women delivering consecutively.Main outcome measures
Perineal lacerations and tear of the anal sphincter.Results
Women allocated to the group of midwives with the lowest rate of episiotomy were more likely to have intact perineum after delivery (OR = l.8 (l.4–2.2)), had a slight tendency towards more perineal lacerations (OR = 1.3 (1.0–1.5)), but no increase risk of having tear of the anal sphincter, compared with the women allocated to the two groups of midwives with higher frequencies of episiotomy. The second approach showed that episiotomy was related to an increased risk of tear of the anal sphincter (OR = 2.3 (1.2–4.6)). However, this relation was not found among the group of parturients delivered by the midwives with the lowest rate of episiotomy (22%).Conclusions
Our results encourage a conservative approach to the use of mediolateral episiotomy, and in the light of previous findings, it seems reasonable to suggest that episiotomy should ideally be used in about one in five spontaneous vaginal deliveries.