bluuebunny/crossref_metadata_2025_split huggingface dataset:
Women's experiences of being screened for gestational diabetes mellitus
Authors: Rumbold Alice R , Crowther Caroline A 
Published: October 2004

ABSTRACTObjectiveTo assess if women screening positive for gestational diabetes mellitus (GDM) will experience a reduction in their quality of life.DesignProspective survey.SettingLevel III teaching hospital with a high‐risk pregnancy service and neonatal intensive care unit.PopulationPregnant women prior to being screened for GDM, after screening and late in pregnancy.MethodsWomen were surveyed using the six‐item short‐form of the Spielberger State‐Trait Anxiety Inventory, Edinburgh Postnatal Depression Scale and Short Form 36 Item Health Survey.Further questions asked about the mother's perception of health and the concern the mother felt for the health of her unborn child, the adequacy of information given about the screening tests and its results, adequacy of information about the results of the diagnostic OGTT and women's overall experiences of being screened.Main outcome measuresAnxiety, depression, health status, concerns about the health of the baby and perceived health.ResultsAfter screening, women screening positive for GDM had lower health perceptions (p < 0.05), were less likely to rate their health as ‘much better than one year ago’ (p < 0.05) and were more likely to only rate their health as ‘fair’ rather than ‘very good’ or ‘excellent’ when compared with women screening negative (p < 0.01). No differences were found in levels of anxiety, depression or the concern women felt about the health of their baby.ConclusionsScreening for GDM had an adverse impact on women's perceptions of their own health.
Antenatal and intrapartum antecedents of cerebral palsy: a case‐control study
Authors: Walstab Janet , Bell Robin , Reddihough Dinah , Brennecke Shaun , Bessell Christine , Beischer Norman 
Published: October 2004

ABSTRACTAimTo identify antenatal and intrapartum factors contributing to the aetiology of cerebral palsy (CP).MethodsA case‐control study using moderate/severe cases of cerebral palsy identified from the Victorian Cerebral Palsy Register and two controls per case identified through the Victorian Perinatal Data Collection Unit.ResultsA number of previously identified risk factors for CP were confirmed in our data. New observations were (in specific sub‐groups): protective effects of mother's negative Rhesus status, cigarette smoking at the first visit and episiotomy and an increased risk of CP associated with an abnormal antenatal cardiotocograph.ConclusionsAlthough the result of the deliberate investigation of specific aspects of the antenatal and intrapartum period identified from a pilot study, our new findings must be interpreted with caution as they were not all based on specific a priori hypotheses, although some had been examined by other investigators. We would encourage their evaluation in other data sets.
Contrasting views of staff and patients regarding psychosocial care for Australian women who miscarry: a hospital based study
Authors: Evans Louise , Lloyd Deborah , Considine Robyn , Hancock Lynne 
Published: October 2004

ABSTRACTObjectivesThe objectives of this study were to assess the psychosocial needs of women following miscarriage and to describe what changes should be made to improve their hospital care.MethodsOne hundred and nine women were asked to complete a survey within one month of discharge from hospital following a miscarriage. The women were asked to describe their psychosocial needs, satisfaction with hospital care and type of follow‐up care provided. The women also completed the Edinburgh Depression Scale and the General Health Questionnaire–12. Forty‐three staff were asked questions relating to the psychosocial effects of miscarriage on these women, how the hospital experience could be improved for women, and barriers to providing adequate psychosocial care.ResultsSeventy‐five per cent of the women felt that their hospital experience could have been improved, particularly by a more considerate and sensitive attitude from staff. While staff agreed that the hospital experience could be better for women, they considered this would be best achieved by the provision of counselling, more privacy and additional staff. Results of the Edinburgh Depression Scale indicated that 44% of the women were either possibly or probably depressed, while the General Health Questionnaire–12 indicated that 57% were suffering some psychological distress.ConclusionIt is clear that women and their hospital care givers want to see improvements in the care given to women who miscarry. However, disagreement exists as to how this improvement can be best achieved.
Laparoscopic entry: a literature review and analysis of techniques and complications of primary port entry
Authors: Molloy David , Kaloo Philip D , Cooper Michael , Nguyen Tuan V 
Published: October 2004

ABSTRACTObjectiveTo obtain consensus as to the optimal form of entry technique for access to the peritoneal cavity.DesignA meta‐analysis of all relevant English language studies of laparoscopic entry complications.Main outcome measuresIncidence of bowel and major vascular injuries.ResultsBowel injuries occur in 0.7/1000 and major vascular injuries in 0.4/1000. The overall incidence of major injuries at time of entry is 1.1/1000. The direct entry technique is associated with a significantly reduced major injury incidence of 0.5/1000, when compared to both open and Veress entry produces (1.1 and 0.9/1000 respectively, p = 0.0005). Entry‐related bowel injuries are reported more often following general surgical laparoscopies than with gynaecological procedures (p = 0.001). No such difference is seen in the incidence of vascular injuries (p = 0.987). Open entry is statistically more likely to be associated with bowel injury than either Veress needle or direct entry. However, open entry appears to minimize vascular injury at time of entry.ConclusionsThere remains no clear evidence as to the optimal form of laparoscopic entry in the low‐risk patient. However, direct entry may be an under‐utilised and safe alternative to the Veress needle and open entry technique.
Changes in vesicourethral function following laparoscopic hysterectomy versus abdominal hysterectomy
Authors: Long CY , Jang MY , Chen SC , Chen YH , Su JH , Hsu SC 
Published: October 2004

ABSTRACTObjectiveTo assess whether total hysterectomy is associated with increased postoperative vesicourethral abnormalities.SampleForty‐five patients had a laparoscopic hysterectomy and 36 patients had a total abdominal hysterectomy.DesignBefore and after hysterectomy, patients underwent a urinalysis, a personal interview, and an urodynamic study.ResultsOf the laparoscopic hysterectomy group, 27 patients (60%) exhibited urinary symptoms preoperatively, and 22 patients (48.9%) remained symptomatic following surgery. There was no significant change in the number of women with one or more urinary symptoms, but the incidence of urinary frequency and stress incontinence decreased significantly following hysterectomy (p < 0.05). Of the total abdominal hysterectomy group, preoperative voiding symptoms were present in 22 patients (61.1%). After surgery, urinary symptoms were present in 19 patients (52.8%). Some patients did not complain of any urinary frequency or stress incontinence following hysterectomy, but this figure did not differ significantly (p > 0.05). Maximal urethral closure pressure and maximal cystometric capacity demonstrated significant increases for both groups following surgery.ConclusionsThe results indicated that total hysterectomy, either laparoscopic or total abdominal hysterectomy, did not significantly increase the subjective and objective incidence of vesicourethral dysfunction. On the contrary, some patients experience a substantial improvement of pre‐existing urinary frequency or stress incontinence, partly as a result of an increase in the maximal urethral closure pressure and total bladder capacity following hysterectomy.
A prospective randomised double‐blind placebo controlled trial to assess whether gas drains reduce shoulder pain following gynaecological laparoscopy
Authors: Swift Gary , Healey Martin , Varol Nesrin , Maher Peter , Hill David 
Published: October 2004

ABSTRACTObjectiveTo assess the effects on patient discomfort of an intraabdominal passive gas drain left for four hours postoperatively following gynaecologic laparoscopic surgery.DesignA prospective randomised double‐blinded placebo controlled trial.SettingUniversity tertiary hospital and private hospital.Population or sampleEighty women having a laparoscopic gynaecological procedure for benign disease.MethodsA drain was placed via the umbilical port at the conclusion of the surgical procedure and was removed four hours postoperatively. The researcher, assessor and patient were all blinded as to the patency or occlusion of the drain. Patients were asked to complete questionnaires at regular intervals up to five days postoperatively.Main outcome measuresVisual analogue scale (VAS) to assess overall pain, shoulder and chest pain, abdominal pain, bloating and energy prior to surgery and at intervals up to five days postoperatively.Results and conclusionsNo complications were attributed to the presence and withdrawal of the drain tube. Shoulder pain following operative or diagnostic laparoscopy was significantly reduced for 12, 24, 48 and 72 hours by the presence of a patent passive gas drain for the first four hours postoperatively. The drains were easy to use and had no associated morbidity. We recommend that in the absence of the need for an active drain, all patients undergoing laparoscopy should have a gas drain inserted for a period of four hours after the completion of the procedure.
Who remains undelivered more than seven days after a single course of prenatal corticosteroids and gives birth at less than 34 weeks?
Authors: McLaughlin KJ , Crowther CA , Vigneswaran P , Hancock E , Willson K 
Published: October 2004

ABSTRACTMinimal information exists as to how women who give birth more than seven days after initial corticosteroid treatment, who may benefit from repeat prenatal corticosteroids, differ from women who give birth within seven days, at < 34 weeks gestation.OBJECTIVESTo examine the differences, if any, between women who received a single course of prenatal corticosteroids and remained undelivered more than seven days later and women who gave birth within seven days of treatment, at < 34 weeks gestation.DESIGNRetrospective cohort.SettingWomen's and Children's Hospital, Adelaide.PopulationWomen who gave birth at < 34 weeks gestation from 1 January 1994 to 31 December 1996.MethodsData were extracted from medical records and retrieved from the hospital's database.Main potential predictors collectedPrenatal corticosteroid exposure, reason for risk of preterm birth, maternal demographics and previous and current obstetric history.ResultsOf the 506 women, 122 (24%) remained undelivered more than seven days following prenatal corticosteroid therapy. Initial corticosteroid treatment was given on average 1.6 weeks earlier to women who remained undelivered more than seven days after treatment. Women who were given prenatal corticosteroids for placenta praevia (RR 6.03, 95% CI 2.67‐13.61, p < 0.01) or cervical incompetence (RR 3.40, 95% CI 1.06‐10.95, p = 0.04) were more likely to give birth more than seven days after corticosteroid treatment.ConclusionsWomen who give birth very preterm, who remain undelivered more than seven days after prenatal corticosteroids, differ in the reasons for and timing of their first course from women who give birth within seven days.
The changes of circulating lymphocyte sub‐populations in women with preterm labour: a case‐controlled study
Authors: Sendag Fatih , Itil Ismail Mete , Terek Mustafa Cosan , Yilmaz Huseyin 
Published: October 2004

ABSTRACTObjectiveThe aim of this study was to determine the changes in circulating T‐cell subpopulations, B cells and natural killer cells in patients with imminent preterm labour.MethodsThirty‐five pregnant patients with imminent preterm labour and 35 women with uncomplicated pregnancies were included in the study. The gestational ages of the patients ranged from 28 to 36 weeks in both groups. The specific lymphocyte antigens were detected using direct staining with monoclonal antibodies, and analysed by flow cytometry.ResultsWe observed no significant difference in the mean percentage of T cell subpopulations, natural killer cells and active T cells in the group of patients with preterm labor when compared to controls. The mean percentage of T CD3+ lymphocytes was significantly lower and that of B CD19+ cells higher in the study group when compared to controls.ConclusionThe alterations in maternal circulating lymphocyte subpopulations could be associated with the mechanisms mediating preterm labour.
Postpartum urinary retention: assessment of contributing factors and long‐term clinical impact
Authors: Ching‐Chung Liang , Shuenn‐Dhy Chang , Ling‐Hong Tseng , Ching‐Chang Hsieh , Chao‐Lun Chung , Po‐Jen Cheng 
Published: October 2004

ABSTRACTObjectivesTo investigate the relationships between various obstetric parameters and postpartum urinary retention, and to offer some clinical guidance for resolution of urinary retention problems.DesignAn observational prospective studySettingA private teaching hospital medical centre.PopulationA total of 2,866 vaginally delivered women were recruited with 114 women classified as urinary retention group and the remaining 2752 women categorised as control group.Main outcome measures and resultsWomen in the urinary retention and control groups did not differ significantly in terms of age, fetal head circumference and fetal birth weight. Women suffering from postpartum urinary retention demonstrated significantly longer labour duration, more nulliparity and epidural analgesia and higher percentages of instrument‐assisted delivery and vaginal or perineal damage.ConclusionNulliparity, longer labour course, instrumental delivery, extensive vaginal and perineal laceration and use of epidural analgesia were contributing obstetric factors to postpartum urinary retention. Long‐term follow‐up showed that the problems of all but three of the 114 women, who complained of persistent minor urinary symptoms, were eventually resolved.
The prevalence of recalled low back pain during and after pregnancy: a South Australian population survey
Authors: Stapleton David B , MacLennan Alastair H , Kristiansson Per 
Published: October 2004

ABSTRACTObjectiveTo determine the prevalence of low back pain during pregnancy (LBPP) in an Australian Results population.DesignA representative population‐based survey of women aged 15 years and older.Setting and sampleFour thousand four hundred randomly selected South Australian households were visited by trained surveyors who interviewed 1531 women (69.7% response rate) using pre‐tested questions.MethodsThe South Australian Health Omnibus survey was utilised.Main outcome measuresDemographic data were collected along with details of previous pregnancies, and degree of back pain during pregnancy, treatment regimens, and persistence of back pain.ResultsThirty‐five and a half per cent of women recall having at least moderately severe back pain during pregnancy. Women who reported such back pain were younger, were more likely to report ill health and be unemployed. Increasing parity was not associated with current back pain. The most commonly used treatments were bed rest, pain killing medication, physiotherapy, and chiropractic treatment. Half of those with symptoms were untreated. Sixtyeight per cent of women who experienced moderate or worse low back pain during pregnancy continued to experience recurring low back pain with a self reported reduction in their health.ConclusionsChronic low back pain is commonly associated with an onset in pregnancy subjectively contributing to long‐term morbidity. The high prevalence may be an underestimate in view of the potential for recall bias in older women.
Epidemiology and predictive values of risk factors for neonatal group B streptococcal sepsis
Authors: Gilbert GL , Hewitt MC , Turner CM , Leeder SR 
Published: October 2004

ABSTRACTObjectivesTo determine the incidence of and factors affecting risk factors for neonatal group B streptococcal (GBS) sepsis and their predictive values for intrapartum GBS carriage; to calculate the proportions of women eligible for intrapartum antibiotic prophylaxis (IAP) using different selection protocols.DesignCohort study.SettingAntenatal clinics and labour wards of a community hospital and a tertiary referral centre in western Sydney.PopulationWomen attending antenatal clinics during the study periods were invited to participate.MethodsApproximately 500 women attending antenatal clinics were screened for GBS carriage at 26–32 weeks gestation and at delivery, using several screening methods. Clinical risk factors for neonatal sepsis were recorded during labour.Main outcome measuresIncidence of antenatal anovaginal GBS carriage and clinical risk factors during labour, their predictive values for intra‐partum GBS carriage and their relationship, if any, to demographic and obstetric factors.ResultsAntenatal and intra‐partum GBS carriage rates were similar but varied from 18% to 27%, depending on screening methods. The best positive and negative predictive values of antenatal GBS culture, for intra‐partum carriage, were 69% (95% confidence interval (CI) 64–74) and 92% (95% CI 50–94) respectively. Clinical risk factors occurred in similar proportions of GBS carriers and non‐carriers.ConclusionsNeither early antenatal screening nor clinical risk factors are reliable predictors of intra‐partum GBS carriage. Intra‐partum antibiotic prophylaxis based on GBS carriage or risk factors when carrier status is unknown would involve ∼35% of women, compared with ∼16% if based on risk factors only. Both strategies would prevent similar proportions of neonatal deaths from GBS sepsis. Compliance with a preventive protocol is the most likely determinant of its overall effectiveness.
Uterine artery embolisation for the treatment of symptomatic uterine fibroids: short‐term results of work in progress
Authors: Bapuraj Jayapalli Rajiv , Suri Sudha , Sidhu Ravinder , Nadh Ojili Vijay , Vasistha Kala 
Published: October 2004

ABSTRACTBilateral uterine artery embolisation (UAE) was used to treat 11 women with symptomatic uterine fibroids. Uterine volume and dominant fibroid volume were assessed quantitatively by ultrasonography both before and at two and six months post procedure. Both uterine arteries were occluded effectively in all of the women, and the procedure was well tolerated, with hospital stays limited to 24–48 hours in all cases. An improvement of symptoms occurred in 10 of the 11 women. There were no significant complications.The mean percentage reductions in uterine volume and dominant fibroid volume at six months following the procedure were 45.32% and 56.34%, respectively.Bilateral uterine artery embolisation for the treatment of uterine fibroids is a minimally invasive technique with very good clinical results. This procedure may be considered as an alternative to hysterectomy, or myomectomy in properly selected cases.
Randomised controlled trial of glove perforation in single and double‐gloving methods in gynaecologic surgery
Authors: Kovavisarach Ekachai , Seedadee Charoon 
Published: October 2004

ABSTRACTObjectiveTo assess the value of double‐gloving in gynaecological surgery.DesignA prospective randomised controlled trial of glove perforation in single‐ and double‐gloving methods.SettingRajavithi Hospital between 1 September 1999 to 31 August 2000.SampleEighty‐eight (88) and 82 primary surgeons were selected at random to make up single‐ and doublegloving groups, respectively, while performing total abdominal hysterectomy (TAH) with or without bilateral salpingo‐oophorectomy (BSO).MethodsThe gloves were tested by immersion in water.ResultsThe glove perforation rate was 6.09% and 22.73% in double‐inner and single gloves, respectively, with this difference being statistically different (p < 0.05). There was no significant difference between the glove perforation rates in single gloves (22.73%) and in double‐outer gloves (19.51%). There was matched perforation of the same finger of both outer and inner gloves in 1.22% of total double‐inner gloves.ConclusionsThe double‐gloving methods significantly reduced the risk of surgeons' hands contacting blood, when compared with the single‐gloving method, in TAH with/or without BSO.
Vaginal childbirth and bladder neck mobility
Authors: Dietz HP , Clarke B , Vancaillie TG 
Published: October 2004

ABSTRACTObjectiveHypermobility of the bladder base is a predictor of stress urinary incontinence (SUI) in the female and at least partly due to pregnancy and vaginal childbirth. The purpose of this study was to quantify the effect of vaginal parity and birthweight on anterior compartment relaxation.DesignRetrospective observational study.SettingOutpatient uroynaecological clinics.PopulationFive hundred and seventy three women seen for primary urogynaecological assessment.MethodsFiles of patients seen by the first author for assessment and translabial ultrasound imaging at urogynaecological units in Brisbane and Sydney, Australia, were reviewed for routinely‐collected obstetric data and imaging results.Main outcome measuresUltrasound parameters of anterior vaginal wall descent such as urethral rotation on Valsalva manoeuvre, bladder neck position on Valsalva, bladder neck descent and maximal descent of a cystocele on Valsalva.ResultsANOVA analysis demonstrated a highly significant relationship between vaginal childbirth and bladder neck position on Valsalva (p < 0.001), bladder neck descent (p = 0.002) and maximal descent of a cystocele (p = 0.001). A large part of this effect was seen after one vaginal delivery. There was a trend towards increased bladder neck mobility (p = 0.065) with vaginal operative deliveries. Maximal recorded birth‐weight did not correlate with parameters of hyper‐mobility.ConclusionVaginal childbirth is strongly associated with increased anterior vaginal wall descent, with most of this effect being due to the first vaginal delivery.
An ultrastructural study of cellular response to variation in porosity in phase‐pure hydroxyapatite
Authors: ANNAZ B. , HING K. A. , KAYSER M. , BUCKLAND T. , DI SILVIO L. 
Published: October 2004

SummaryHydroxyapatite has been shown to be biocompatible and bioactive. Incorporation of porosity has been shown to enhance osteointegration; however, difficulty in controlling the extent and type of porosity has limited investigation into determining the role of both macro‐ and microporosity. The current investigation reports on the synthesis of four types of phase‐pure hydroxyapatite with varying levels of porosity (HA1–HA4), and with defined levels of macro‐ and microporosities. Transmission electron microscopy was used to evaluate qualitatively the effect of these two parameters on cell–material interactions following a 30‐day incubation period. Biological mineralization was observed within vesicles and the needle‐like minerals were confirmed as hydroxyapatite using X‐ray microanalysis. This demonstrated the suitability of primary human osteoblast‐like cells as a tool to assess the extent of mineralization. Furthermore, internalization of hydroxyapatite particles was observed. Our findings show that the variation in macro‐ and microporosity does not affect the extent of cell–material interaction, with collagen synthesis evident in all samples.