bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increase in bone mass after one year of percutaneous oestradiol and testosterone implants in post‐menopausal women who have previously received long‐term oral oestrogens
Authors: SAVVAS M. , STUDD J. W. W. , NORMAN S. , LEATHER A. T. , GARNETT T. J. , FOGELMAN I. 
Published: August 2005

ABSTRACTObjective
To determine the effect on the bone density of the skeleton after changing from oral oestrogen to subcutaneous oestradiol and testosterone replacement.Design
Prospective non‐randomized single centre study.Subjects
Twenty women who were receiving long‐term oral oestrogen replacement. Ten changed to oestradiol and testosterone implants; the remaining ten continued with oral oestrogens.Main outcome measures
Bone density was measured using dual photon absorptiometry at the lumbar spine and neck of femur at the start of the study and after one year.Results
The bone density increased significantly by 5.7% at the spine and by 5.2% at the neck of femur in those women who changed to implant therapy but remained unchanged in those women who continued with oral therapy.Conclusion
Subcutaneous oestradiol and testosterone implants will result in an increase in bone mass even after many years of oral oestrogen replacement therapy.
Maternal and fetal atrial natriuretic peptide levels at delivery from normal and growth retarded pregnancies
Authors: KINGDOM J. C. P. , McQUEEN J. , CONNELL J. M. C. , WHITTLE M. J. 
Published: August 2005

ABSTRACTObjective
To determine whether circulating fetal levels of the vasodilator atrial natriuretic peptide (ANP) are reduced in pregnancies complicated by intrauterine growth retardation (IUGR).Design
Prospective observational study.Setting
University teaching hospital and research laboratory.Subjects
25 normal singleton pregnancies delivered at term by spontaneous vertex delivery (n = 16) or by elective caesarean section (n= 9), and a series of 14 singleton pregnancies complicated by IUGR.Intervention
Measurement of ANP by radio‐immunoassay in maternal venous, umbilical artery, and umbilical vein plasma from a series of normal, and IUGR pregnancies.Main outcome measures
Comparison of plasma ANP levels between the three groups; relation between fetal ANP, Po2 and pH.Results
Mode of delivery did not influence either maternal, umbilical artery or umbilical vein plasma ANP levels in normal term singleton pregnancies. Umbilical vein ANP levels were significantly higher in the IUGR group when compared with normal pregnancies at term (mean 66 95%, CI 36–122 vs mean 37, 95% CI 29–47 pg/ml, P= 0.03) and were inversely related to umbilical artery pH (R2 = 65%; P= 0.003).Conclusions
These data suggest that umbilical vein ANP levels are elevated in pregnancies complicated by IUGR, and rise appropriately in response to the stress of acidosis. In the absence of any receptor or second messenger defect within fetoplacental vascular smooth muscle, these data suggest that ANP is not directly implicated in the vascular pathophysiology of IUGR.
Increased whole blood platelet aggregation in normal pregnancy can be prevented in vitro by aspirin and dazmegrel (UK38485)
Authors: NORRIS LUCY A. , SHEPPARD BRIAN L. , BONNAR JOHN 
Published: August 2005

ABSTRACTObjective
To determine the effect of normal pregnancy and the early puerperium on whole blood platelet aggregation and to assess the role of thromboxane A2 (TXA2) in platelet aggregation in pregnancy.Design
A prospective descriptive study.Setting
TCD Medical School, St James's Hospital, Dublin.Subjects
Twenty healthy primigravidae who remained normotensive during pregnancy and the puerperium.Interventions
20 ml blood samples were obtained serially at 12, 20, 28, 32 and 36 weeks gestation, during established labour and at 1 h, 24 h, 48 h and 6 weeks after delivery.Main outcome measures
Whole blood platelet aggregation in response to aggregating agents ADP, PAF (platelet aggregating factor) collagen, adrenaline and arachidonic acid (AA) at each stage of pregnancy and peuerperium was measured using a particle counting technique. The in vitro effect of aspirin and dazmegrel (thromboxane synthetase inhibitor UK38485) on platelet aggregation in pregnancy was also investigated.Results
Platelet aggregation in response to collagen, adrenaline, ADP and AA were increased in the last trimester, during labour and at 1 h after delivery but decreased 24–48 h after delivery. Platelet aggregation in response to AA, collagen and adrenalin was reduced by both aspirin and dazmegrel.Conclusions
The earliest and most marked increases in platelet aggregation during normal pregnancy were found in response to AA and collagen. These platelet changes were prevented when whole blood was pre‐incubated with either aspirin or dazmegrel. This suggests that enhanced production of TXA2 is reponsible for increased platelet reactivity in normal pregnancy.
Abnormal fetal immunological development in Down's syndrome
Authors: Thilaganathan Baskaran , Tsakonas Dennis , Nicolaides Kypros 
Published: August 2005

ABSTRACTObjective
To investigate the intrauterine development of the immune system in Down's syndrome.Design
Cross sectional study.Setting
Harris Birthright Research Centre for Fetal Medicine, London, UK.Subjects
16 fetuses with Down's syndrome and 104 fetuses with a normal karyotype at 17–24 weeks gestation.Main outcome measures
Flow cytometry was used to enumerate T (CD3+), B (CD19+) and NK (CD3– & CD16+/CD56+) lymphocyte subpopulations in fetal blood obtained by cordocentesis.Results
The median numbers of T, B and NK lymphocytes in fetuses with Down's syndrome (1.52 × 109/l, 0.08 × 109/l, and 0.10 × 109/l, respectively) were significantly lower than in the chromosomally normal fetuses (T lymphocytes: 1.98 × 109/l, z= 3.04, P<0.01; B lymphocytes: 0.50 × 109/l, z= 5.84, P<0.0001; and NK lymphocytes: 0.19 × 109/l, z= 3.14, P<0.01).Conclusion
These data demonstrate that in Down's syndrome, there is abnormal intra‐uterine development of the immune system.
The Royal College of Obstetricians and Gynaecologists micro‐invasive carcinoma of the cervix study: preliminary results
Authors: Morgan P. R. , Anderson M. C. , Buckley C. H. , Murdoch J. B. , Lopes A. , Duncan I. D. , Monaghan J. M. 
Published: August 2005

ABSTRACTObjectives
To determine how micro‐invasive carcinoma of the cervix is diagnosed and treated in the United Kingdom. To record the frequency of the various pathological features which comprise the histological diagnosis of micro‐invasion, and to assess their relevance to outcome.Design
Prospective observational study.Setting
Hospitals throughout the United Kingdom.Subjects
Two hundred and eighty‐six cases were submitted for entry into the study. Following independent review of the histological material 116 cases were excluded: 41 were not accompanied by histological slides for review, 55 had no evidence of invasive disease, 17 had invasive disease greater than FIGO Stage 1a, and three were adenocarcinomas. The remaining 170 cases were registered for the study but follow up was incomplete in 18. This report concerns the 152 women with complete follow up to 1991.Results
The age of the 152 women ranged from 22 to 65 years (median 36 years). In 116 women (76%) the diagnosis was made by cone biopsy (cold knife, loop diathermy, or laser) or wedge biopsy, in 9 women (6%) the diagnosis was made by hysterectomy, and in 27 women (18%) punch biopsy suggested an invasive lesion and subsequent excisional treatment (including radical hysterectomy with node dissection in three) demonstrated micro‐invasion. The depth of invasion was up to 3 mm in 142 women (93%) and 3.1 to 5 mm in 10 women (7%). Capillary‐like space involvement was present in 12 women (8%). Treatment methods used were local cervical surgery in 79 women (52%), simple hysterectomy in 63 (41%), and radical hysterectomy in 10 (7%). There was only one known recurrence and death due to cervical carcinoma.Conclusion
There is no uniformity in the management of micro‐invasive carcinoma of the cervix. The frequency of recurrence, lymph metastases, and death is low. Nonradical surgery appears to give satisfactory results.
Induction of second trimester abortion with mifepristone and gemeprost
Authors: Thong K. J. , Baird David T. 
Published: August 2005

ABSTRACTObjective
To determine the efficacy of a new regimen of the antiprogestogen mifepristone and gemeprost for midtrimester abortion.Design
Prospective study.Setting
Medical Termination Unit, Simpson Memorial Maternity Pavilion, Edinburgh.Subjects
One hundred women undergoing midtrimester abortion.Interventions
Women were pretreated with 200 mg mifepristone 36 h before prostaglandin; 1 mg gemeprost was administered every 6 h for the first 24 h. If abortion had not occurred, 1 mg gemeprost was administered 3 hourly over the next 12 h.Measurement and main results
Ninety‐six percent and 99% women aborted within 24 h and 48 h, respectively. The median prostaglandin‐abortion interval was significantly shorter in multigravidae compared to primigravida (6.6 vs 8.2 h, P<0.01). The median number of gemeprost pessaries to induce abortion was only two and 47% of women required one pessary. The incidence of vomiting and diarrhoea was 31% and 5%, respectively. Eighty‐four percent of women required intramuscular diamorphine for analgesia. Thirty‐three percent of women required an evacuation of the uterus following abortion.Conclusions
The shortened induction‐delivery interval following pretreatment with mifepristone makes it possible to conduct midtrimester abortion on a daycare basis.
Low levels of amniotic fluid placental alkaline phosphatase in Down's syndrome
Authors: Ind Thomas E. J. , Iles Ray K. , Wathen Neville C. , Murugan Poovanni , Campbell James , Macintosh Mary , Chard Tim 
Published: August 2005

ABSTRACTObjective
To investigate amniotic fluid placental alkaline phosphatase (PLAP) levels in normal and trisomy 21 pregnancies.Design
Cross sectional study.Setting
A tertiary referral prenatal diagnostic service.Subjects
Three hundred and eleven women with singleton pregnancies of normal karyotype between 10 and 23 weeks gestation and 31 women with pregnancies associated with trisomy 21 Down's syndrome.Outcome measures
PLAP levels were measured by immunoradiometric assay in amniotic fluid obtained by amniocentesis.Results
Amniotic fluid PLAP was detectable from 12 weeks gestation and the median value rose to a peak of 4.57 iu/1 at 18 weeks. Pregnancies associated with Down's syndrome had significantly lower levels with a median multiple of median (MoM) of 0.638, (U = 3374, P= 0.0016, 95%CI = 0.50, 0.89). For the 20 women with trisomy 21 pregnancies detected at 16 to 18 weeks, the median MoM was 0.482, (U = 3694, P= 0.0011, 95%CI = 0.37, 0.85).Conclusion
These data demonstrates that PLAP levels are reduced in the amniotic fluid of women carrying a fetus with trisomy 21.
Fetal immunodeficiency: a consequence of placental insufficiency
Authors: Thilaganathan Baskaran , Plachouras Nicolaos , Makrydimas George , Nicolaides Kypros H. 
Published: August 2005

ABSTRACTObjective
To study the effect of placental insufficiency on fetal lymphocyte subpopulations.Study design
Cross sectional study of 19 growth retarded fetuses undergoing cordocentesis at 24 to 37 weeks gestation. Flow cytometry was used to enumerate fetal blood lymphocyte subpopulations.Results
The mean T (CD3+), B (CD19+), T‐helper (CD4+), T‐suppressor/cytotoxic (CD8+) cell counts and the CD4 to CD8 ratio in the growth retarded fetuses were significantly lower than the respective normal mean for gestation (CD3+: z = 3.66, P<0.001; CD19+: z = 2.18, P<0.05; CD4+: z = 3.76, P<0.001; CD8+: z = 2.26, P<0.05; and CD4/CD8: z = 2.27, P<0.05). There were significant associations between the decrease in the T lymphocyte subpopulations and the degree of fetal acidaemia.Conclusions
Growth retarded fetuses demonstrate immune abnormalities that could be attributed to intrauterine starvation.
Fetal cerebral Doppler in the recognition of fetal compromise
Authors: Chandran Ravi , Serra‐Serra Vicente , Sellers Susan M. , Redman Christopher W. G. 
Published: August 2005

ABSTRACTObjective
To establish reference ranges for the human fetal middle cerebral artery pulsatility index (MCA PI) for the local obstetric population, and to compare computerised antenatal fetal heart rate (FHR) analysis with the MCA PI as indicators of fetal compromise.Design
Prospective data collection for selected patients.Setting
High risk pregnancy unit of a teaching hospital.Subjects
Group 1 consisted of 18 healthy women with uncomplicated singleton pregnancies. Group 2 consisted of 27 women admitted to the high risk pregnancy unit over a 9 month period with intrauterine growth retardation and other related problems; all these women were delivered by prelabour caesarean section.Intervention
Serial Duplex sonography to determine fetal MCA PI in Groups 1 and 2. Serial FHR analysis using computerised numerical techniques in Group 2 only.Main outcome measures
Serial MCA PI values from 24 to 39 completed weeks of gestation in Group 1. Comparison of serial MCA PI values with FHR analysis in relation to fetal outcome in Group 2.Results
In Group 1 the MCA PI diminished significantly as gestation advanced from 1.73 (SD 0.25) at 24 weeks to 1.38 (SD 0.26) at 39 weeks (P<0.01). In Group 2 eleven babies were hypoxaemic at delivery: all had low MCA PI values while only nine had an abnormal FHR prior to delivery.Conclusion
In normal pregnancy, there is a fall in the fetal MCA PI with advancing gestation which probably reflects a decreasing vascular resistance to fetal cerebral blood flow. Hypoxaemia at delivery appeared to be better recognised by the fetal MCA flow velocity waveform than the FHR analysis. This increased sensitivity, however, was achieved at the expense of a reduced specificity. Larger studies are needed to confirm the findings of this preliminary investigation.
Chirality in the umbilical cord
Authors: Fletcher Stewart 
Published: August 2005

ABSTRACTObject
To determine the chiral varieties of the vascular helix of the umbilical cord and find their normal proportions.Design
Differences between the sexes were tested by a χ2 test and the hypothesis that left‐handed types occur in 50% of cases was tested using the binomial distribution.Setting
United Arab Emirates.Subject
Gulf Arab singletons from consecutive normal births, 100 male and 100 female.Results
Left‐handed helices predominate at 76.5%; right‐handed contribute 15.5%; mixed forms, where both chiralities co‐exist, were found in 6.5%; indeterminable chirality due to poor helix formation, or varices, reached 1.5%. A significant sex difference could not be established. Chiral generation, on genetic and mechanical‐rotational hypotheses, is discussed.Conclusion
The chirality of the cord is easily determined and is the sole distinguishing feature of the cord. Chirality should be entered in the birth record and in pathological descriptions for whatever value it may have in relation to fetal, or postnatal, characteristics and morbidity.
Morbidity following pelvic inflammatory disease
Authors: Buchan H. , Vessey M. , Goldacre M. , Fairweather J. 
Published: August 2005

ABSTRACTObjective
To examine patterns of morbidity following hospitalisation for pelvic inflammatory disease (PID).Design
Cohort study using Oxford Record Linkage Study data.Setting
Oxfordshire and West Berkshire.Subjects
One thousand three hundred fifty‐five women discharged from hospital for the first time with a diagnosis of pelvic inflammatory disease during the interval 1970–1985, together with 10 507 control women discharged with various other diagnoses.Main outcome measures
Hospital admission for abdominal pain, gynaecological pain, endometriosis, hysterectomy, and ectopic pregnancy. Data were not available in this analysis on pregnancies other than ectopic pregnancy.Results
In comparison with the controls, women with a diagnosis of PID were ten times more likely to be admitted for abdominal pain, four times more likely to be admitted for gynaecological pain, six times more likely to be admitted for endometriosis, eight times more likely to be admitted for hysterectomy and ten times more likely to be admitted for ectopic pregnancy.Conclusions
Serious sequelae of PID are common, even in a study unable to examine the effects of the disease on fertility. The data on hysterectomy are particularly interesting; the operation in women with pelvic inflammatory disease is most often a consequence of the inflammatory process itself.
The effect of neuromuscular blockade on human fetal heart rate and its variation
Authors: Spencer John A. D. , Ryan Greg , Ronderos‐Dumit Daniel , Nicolini Umberto , Rodeck Charles H. 
Published: August 2005

ABSTRACTObjective
To determine the effect of neuromuscular blockade on fetal heart rate and its variation.Design
Case control study.Setting
Tertiary referral fetal medicine unit in a London teaching hospital.Subject
Forty women with rhesus iso‐immunisation requiring an intravascular fetal blood transfusion between 28 and 34 weeks gestation.Intervention
Intravascular injection of pancuronium to the fetus prior to fetal blood transfusion in 20 cases.Main outcome measures
Comparison between the group receiving pancuronium and the control group with regard to differences in perceived fetal activity and computer derived numerical indices of fetal heart rate and fetal heart rate variation after fetal blood transfusion.Results
After transfusion in the control group, there were fewer perceived fetal movements, a small reduction in fetal heart rate but no differences in number of fetal heart rate accelerations or measures of fetal heart rate variation. In the study group, pancuronium produced no change in fetal heart rate despite a virtual abolition of perceived fetal movements and fetal heart rate accelerations. Measures of fetal heart rate variation were reduced by 60%. Comparison of the pre‐ to post‐transfusion changes between the two groups showed significant differences for all fetal heart rate indices.Conclusion
Fetal activity accounts for more than half the measured variation of the human fetal heart rate.
Serum ferritin and cobalamin in growth retarded fetuses
Authors: Abbas Anthony , Snijders Rosalinde J. M. , Nicolaides Kypros H. 
Published: August 2005

Objective
To examine fetal and maternal serum cobalamin and ferritin concentrations in pregnancies complicated by fetal growth retardation.Setting
Harris Birthright Research Centre for Fetal Medicine, King's College Hospital Medical School, London.Design
Cross sectional study.Subject
Fetal blood samples obtained by cordocentesis from 20 growth retarded fetuses at 26 to 36 weeks of gestation. Maternal venous blood was also collected and serum ferritin and cobalamin concentrations were measured by radio‐immunoassay in the fetal and maternal samples.Results
In the growth retarded group, the mean fetal serum concentration of cobalamin was higher than the normal mean for gestation (t= 3.27, P < 0.01), and this increase was significantly associated with fetal acidaemia (r=−0.686, P < 0.001) and erythroblastosis (r= 0.731, P < 0.001). In contrast, the fetal to maternal ferritin ratio was significantly reduced; there was a nonsignificant decrease in fetal serum and an increase in maternal serum ferritin concentration. There was an association between fetal serum ferritin concentration and erythrocyte count (r=–0.612, P < 0.01).Conclusions
In placental insufficiency, as in postnatal starvation and Kwashiorkor syndrome, uptake and storage of cobalamin by the fetal liver may be impaired. The decrease in fetal to maternal ratio of ferritin could be the consequence of impaired placental perfusion.
Lack of association between maternal phosphoglucomutase‐1 phenotype and fetal macrosomia in diabetic pregnancy
Authors: Johnstone Frank D. , West John D. , Steel Judith , Whitehouse David B. , Drago Guido A. , Greer Ian A. , Prescott Robin J. 
Published: August 2005

ABSTRACTObjective
To assess the reports that maternal phosphoglucomutase‐1 (PGM 1) phenotype is highly related to macrosomia in diabetic pregnancy. This could be either a direct metabolic phenomenon, or the PGM1 locus could be a marker for a tightly linked gene involved in the maternal control of fetal growth.Design
A comparative biochemical genetic study.Setting
A large diabetic pregnancy clinic.Subject
One hundred and fifty‐two women who had diabetes during pregnancy, 136 being insulin dependent before pregnancy. Two hundred and thirty‐six women without pre‐existing medical or pregnancy complications who functioned as a control group.Measures
PGM1 phenotype was assessed by conventional electrophoresis and subgroups were examined using iso‐electric focusing.Outcome
Standardised birthweight was corrected for sex, maternal parity and gestation confirmed in every case by early pregnancy ultrasound. Maternal diabetes control was assessed by glycosylated haemoglobin.Results
No differences were found in the observed phenotype frequencies for diabetics and control pregnant women. No association between PGM1 phenotype and macrosomia in diabetic pregnancy was found. PGM1 did not make a significant contribution to birthweight, standardised birthweight, length or ponderal index of the baby as assessed by multiple regression.Conclusions
Our study of a larger number of insulin dependent diabetics in Scotland makes the claim that macrosomia in diabetic pregnancy is associated with PGM1 phenotype unlikely to be of general significance.
Rapid detection of chromosome aneuploidies in fetal blood and chorionic villi by fluorescence in situ hybridisation
Authors: Pandya P. P. , Kuhn P. , Brizot M. , Cardy D. L. , Nicolaides K. H. 
Published: August 2005

ABSTRACTObjective
Evaluation of fluorescence in situ hybridisation in the detection of numerical aberrations involving chromosomes X, Y, 13, 18 and 21.Setting
Harris Birthright Research Centre for Fetal Medicine.Subjects and methods
Chorionic villi (n= 45) or fetal blood (n= 34) were obtained from 79 pregnancies undergoing fetal karyotyping at 10 to 39 weeks of gestation because of ultrasonographic markers of fetal chromosomal abnormality. Karyotyping was performed by both traditional cytogenetics and fluorescence in situ hybridisation, using commercially available kits which utilise a heterochromatic Y probe and the alpha satellite repeat probes for chromosomes X, 18, and 13/21. The frequency distributions of the number of signals obtained by fluorescence in situ hybridisation in the chromosomally normal and abnormal fetuses were compared.Results
Traditional cytogenetic analysis demonstrated that the fetal karyotype was normal in 47 cases and abnormal in 32 (including 24 with trisomies 21, 18 or 13, three with triploidy, one with Turners syndrome and four with translocations, deletions or mosaicism). With fluorescence in situ hybridisation it was possible to obtain accurate diagnosis of trisomy 18, Turners or triploidy within six hours of sampling; signal distributions with these chromosomal abnormalities were very different from those of normals. However, for trisomies 21 and 13 there was an overlap in values with those from normals.Conclusions
In detection of fetal numerical chromosomal abnormalities the use of the combined 13/21 probe cannot provide sufficiently accurate results to justify abandonment of traditional cytogenetics in favour of fluorescence in situ hybridisation.