bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mode of delivery in pregnancies with suspected fetal growth restriction following induction of labor with vaginal prostaglandin E2
Authors: Ben‐Haroush Avi , Yogev Yariv , Glickman Hagit , Kaplan Boris , Hod Moshe , Bar Jacob 
Published: December 2003

Background.  Many fetuses below the 10th percentile for gestational age are uncompromised. We aimed to evaluate the mode of delivery and immediate neonatal outcome in pregnancies with suspected fetal growth restriction (FGR) and normal antenatal assessment following induction of labor with vaginal application of prostaglandin E2 (PGE2).Methods.  Ninety women with suspected FGR (sonographic estimated fetal weight < 10th percentile) with normal oxytocin contraction test (OCT), biophysical profile (BPP) and reassuring fetal heart rate underwent induction of labor with vaginal application of PGE2 tablets. The findings were compared with 115 women admitted for induction of labor because of decreased fetal movement (group 2) and with 510 women with normal spontaneous onset of labor (group 3).Results.  There were no between‐group differences in mean maternal age, gravidity, parity, nulliparity rate, number of tablets used or rate of patients receiving more than one PGE2 application. The rate of cesarean section (CS) in the study group (8.9%) was similar to the rate in groups 2 and 3 (14.8% and 9.0%, respectively). The incidence of nonreassuring fetal heart rate pattern leading to cesarean delivery was higher in the study group, but the rate of low 5‐min Apgar scores (< 7) was similar in all groups. A logistic regression model and forward likelihood analysis yielded no single significant variable associated with increased risk of cesarean delivery.Conclusions.  In selected cases of suspected FGR with reassuring fetal heart rate and normal OCT and BPP, induction of labor with vaginal PGE2 may yield a similar immediate fetal outcome and CS rate as in uncomplicated, induced or spontaneous deliveries.
Second‐ and third‐trimester serum levels of placental proteins in preeclampsia and small‐for‐gestational age pregnancies
Authors: Bersinger Nick A. , Ødegård Rønnaug A. 
Published: December 2003

Background:  Poor placentation may perpetuate preeclampsia, but the presence of a major placental pathology has been questioned in cases of preeclampsia where the newborn has an appropriate birthweight for gestational age. On the other hand, poor placentation is also observed in the absence of preeclampsia, in pregnancies with small‐for‐gestational‐age (SGA) fetuses. In late gestation, maternal serum levels of placental protein hormones are changed in both preeclampsia and SGA, but no longitudinal preonset studies are available for pregnancy‐associated plasma protein A (PAPP‐A), pregnancy‐specific β1‐glycoprotein (SP1) or human placental lactogen (HPL).Methods:  In a nested case‐control study we compared maternal serum levels of PAPP‐A, SP1, HPL and placenta growth factor (PLGF) at 17, 25 and 33 weeks in pregnancies developing preeclampsia without fetal growth restriction (n = 28), or characterized by a growth‐retarded fetus (n = 25), with gestation‐matched controls (n = 65). The proteins were quantified using microplate enzyme immunometric assays and the serum levels at 17, 25 and 33 weeks compared between the three groups by nonparametric statistical tests.Results:  In pregnancies with subsequent preeclampsia PAPP‐A, SP1, HPL and PLGF were reduced at 17 weeks of gestation whereas at 25 and 33 weeks only PLGF remained below the controls. In growth‐restricted pregnancies PAPP‐A, SP1 and HPL were reduced at 17 weeks, and only HPL continued to be strongly affected thereafter.Conclusion:  The reduced serum levels of the placental proteins PAPP‐A, SP1 and HPL in the early second trimester (17 weeks) in pregnancies with subsequent preeclampsia or with fetal growth restriction involve an underlying role for the placenta in either pathology independent from the other.
Maternal risks and perinatal outcome in a Danish national cohort of 1005 twin pregnancies: the role of in vitro fertilization
Authors: Pinborg Anja , Loft Anne , Schmidt Lone , Langhoff‐Roos Jens , Andersen Anders Nyboe 
Published: December 2003

Background.  Twin pregnancies constitute 25% of all in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) pregnancies. There is a lack of knowledge on maternal risks and perinatal outcome of IVF/ICSI twin pregnancies.Methods.  National survey by questionnaire (n = 1769). The study population consisted of all IVF/ICSI twin mothers (n = 266) and the two control groups of all IVF/ICSI singleton mothers (n = 764) and non‐IVF/ICSI twin mothers (n = 739) who delivered in Denmark in 1997. The response rate was 89% among IVF twin mothers and overall 81%.Results.  In terms of maternal risks and perinatal outcome no significant differences were observed between IVF/ICSI twin and non‐IVF/ICSI twin pregnancies after stratification for maternal age and parity. Nevertheless, IVF/ICSI twin mothers were more frequently on sick leave (OR 2.5, 95% CI 1.5–4.0) and hospitalized (OR 1.9, 95% CI 1.3–2.8) during pregnancy. Compared with IVF/ICSI singleton pregnancies, IVF/ICSI twin pregnancies were characterized by a higher incidence of preeclampsia (OR 2.4, 95% CI 1.5–4.2) and a higher frequency of sick leave (OR 6.8, 95% CI 4.4–10.5) and hospitalizations during pregnancy (OR 3.5, (95% CI 2.5–4.9); moreover, mean birthweight (p < 0.001) and gestational age (p < 0.001) were lower. No differences were observed in the incidence of pregnancy‐induced hypertension and gestational diabetes between IVF/ICSI twin and singleton pregnancies.Conclusion.  Although this population study indicates that maternal risks in IVF/ICSI twin pregnancies are comparable with non‐IVF/ICSI twin pregnancies, the IVF/ICSI twin mothers were more likely to be on sick leave or hospitalized during pregnancy. Furthermore, maternal risks were higher and obstetric outcome poorer in IVF/ICSI twin vs. IVF/ICSI singleton pregnancies.
The influence of body mass index on the prevalence of complications after vaginal and abdominal hysterectomy
Authors: Rasmussen Kjeld Leisgaard , Neumann Gudrun , Ljungström Britt , Hansen Villy , Lauszus Finn Friis 
Published: December 2003

Aim of study.  To investigate the association between obesity and peri‐ or postoperative complications after hysterectomy for nonmalignant bleeding disorders.Material and methods.  Data from 444 vaginal hysterectomies and 503 abdominal hysterectomies indicated by benign bleeding disorders were drawn from a regional database. Data on peri‐ or postoperative complications and postoperative stay were related to preoperative body mass index (BMI).Results.  Obesity was related to longer operation time for vaginal as well as abdominal hysterectomy and to large perioperative blood loss for vaginal hysterectomy only. No association was found between BMI and serious complications such as ileus, infection or hematomas except for a higher prevalence of wound hematoma after abdominal hysterectomy in underweight and normal weight patients. Neither was any association found between BMI and use of blood transfusion, reoperation or prolonged postoperative stay.Conclusion.  Vaginal and abdominal hysterectomy have a significant risk of complications, but obese patients did not experience an increased risk of serious morbidity compared to normal weight women. Obesity per se is not a contraindication of vaginal or abdominal hysterectomy in otherwise healthy women.
Norepinephrine, adrenocorticotropin, cortisol and beta‐endorphin in women suffering from fear of labor: responses to the cold pressor test during and after pregnancy
Authors: Saisto Terhi , Kaaja Risto , Helske Satu , Ylikorkala Olavi , Halmesmäki Erja 
Published: December 2003

Background.  Women suffering from fear of labor have reduced pain tolerance during a cold pressor test (CPT) during and after pregnancy.Methods.  We compared levels of norepinephrine, adrenocorticotropin (ACTH), cortisol and beta‐endorphin before and during the CPT up to 60 min in 20 normotensive women with and 20 without fear of labor at 37.4 ± 0.2 (mean ± SE) gestational weeks and at 41.9 ± 1.6 weeks after delivery.Results.  Baseline levels of norepinephrine in the pregnant fear group (1.63 ± 0.18 nmol/L) were higher (p = 0.068) than in controls (1.38 ± 0.14 nmol/L) but after delivery they were lower in the fear group (1.75 ± 0.31 nmol/L vs. 2.31 ± 0.26 nmol/L, p = 0.064). ACTH, cortisol and beta‐endorphin did not differ between pregnant and nonpregnant groups. The CPT caused a 28.4% smaller response in norepinephrine in the pregnant fearful women than in controls, whereas the responses of ACTH and beta‐endorphin were similar between groups during and after pregnancy. The CPT caused no significant response in cortisol. Pregnant fearful women had higher diastolic blood pressure (85.6 ± 4.5 mmHg, mean ± SE) than the controls (74.9 ± 3.4 mmHg, p = 0.065).Conclusions.  Women with fear of labor were characterized by changes in norepinephrine but not in ACTH, cortisol or beta‐endorphin before and during the CPT, indicating a normal pituitary–adrenal axis function.
Inhibitory effects of SR 49059 on oxytocin‐and vasopressin‐induced uterine contractions in non‐pregnant women
Authors: Steinwall Margareta , Bossmar Thomas , Gaud Christine , Åkerlund MatS 
Published: December 2003

Background.  Compounds that block uterine oxytocin and vasopressin V1a receptors have a therapeutic potential in preterm labor and primary dysmenorrhoea. The orally active vasopressin V1a receptor antagonist, SR49059, inhibits the effect of vasopressin on human uterine activity in vivo, but the influence on the response to oxytocin is unknown.Methods.  In a placebo‐controlled, double‐blind, parallel‐group, four‐dose comparison, the inhibitory effect of SR 49059 on oxytocin‐ and vasopressin‐induced uterine contractions in humans was investigated. Sixteen healthy female subjects, who had previously undergone sterilization with tubal ligation, participated in intrauterine pressure recordings at one of the first 3 days of bleeding of two menstrual cycles. Intravenous bolus injections of 10 pmol/kg body weight of vasopressin (Period 1) and of 50 pmol/kg body weight of oxytocin (Period 2) were given 1 h before and 1 , 2 and 4 h after oral administration of 0  (placebo), 25 , 75  or 200 mg of SR 49059. The area between the recording curve and zero level of intrauterine pressure (AUC) was calculated. Vital signs as well as urine and plasma safety parameters were measured. The plasma concentrations of oxytocin, vasopressin and the study drug were also estimated.Results.  The plasma concentrations of SR 49059 appeared to be dose related, with mean maximal values of 62.0, 163.7 and 468.0 ng/ml in the 25, 75 and 200 mg dose groups, respectively, in Period 1 with vasopressin and 34.4, 116.7 and 418.0 ng/mL, respectively, in Period 2 with oxytocin. Tmax was observed at about 1 h. The cumulative AUC over 50 min after vasopressin injection per se was significantly higher than that after oxytocin in spite of a five times lower dose and lower plasma concentrations. Pretreatment by SR 49059 caused a dose‐related reduction in AUCs for vasopressin, whereas no such effect was seen for oxytocin. With vasopressin as an agonist, a lower diastolic blood pressure was observed in all SR 49059 treatment groups, but not with oxytocin.Conclusions.  The much higher potency of vasopressin compared with oxytocin on uterine activity in non‐pregnant women at menstruation was confirmed. SR 49059 dose‐dependently inhibits vasopressin‐induced contractions, whereas such an effect was not seen with the present doses of SR 49059 and oxytocin. A marked reduction by SR 49059 of diastolic blood pressure after vasopressin injection was observed, indicating an inhibition by this compound of vascular vasopressin receptors.
Dietary supplementation with l‐arginine or placebo in women with pre‐eclampsia
Authors: Staff Anne Cathrine , Berge Lillian , Haugen Guttorm , Lorentzen Bjorg , Mikkelsen Bente , Henriksen Tore 
Published: December 2003

Background.  To investigate the effect of dietary intake of the NO‐donor l‐arginine on the diastolic blood pressure in women with pre‐eclampsia.Methods.  A randomized double‐blind study was designed to compare the effect of l‐arginine and placebo in pre‐eclamptic women with gestational length ranging from 28+0 to 36+0 weeks. The women received orally 12 g of l‐arginine or placebo daily for up to 5 days. The primary end‐point was to identify a difference in diastolic blood pressure alteration between the two groups after 2 days of intervention. Secondary end‐points included the interval from study start to delivery, the proportion of women delivered after 2, 5 or 10 days from treatment start and mean birth weight.Results.  There was no statistically significant alteration in diastolic blood pressure in the l‐arginine group compared with the placebo group after 2 days of treatment (p = 0.4). No differences in the proportions of women delivered by day 2, 5 or 10 after study start, in the mean interval from study start to delivery, or in mean birth weight percentile were observed between the two groups.Conclusions.  Oral l‐arginine supplementation did not reduce mean diastolic blood pressure after 2 days of treatment compared with placebo in pre‐eclamptic patients with gestational length varying from 28 to 36 weeks. Whether l‐arginine treatment could be clinically beneficial for the mother or the fetus if started earlier in the disease process than for the women in our study remains to be seen.
Radiotherapy at a young age reduces uterine volume of childhood cancer survivors
Authors: Larsen Elisabeth C. , Schmiegelow Kjeld , Rechnitzer Catherine , Loft Anne , Müller Jørn , Nyboe Andersen Anders 
Published: December 2003

Background.  In contrast to chemotherapy, previous irradiation of the uterus carries an increased risk of an adverse pregnancy outcome. Conflicting results exist as regards the ability of the uterus to increase in volume following radiotherapy‐induced damage. We measured uterine volume in a cohort of childhood cancer survivors, and assessed uterine response to a high‐dose estrogen replacement regimen.Methods.  Uterine volume was assessed by transvaginal sonography in 100 childhood cancer survivors. Three patients with ovarian failure and severely reduced uterine volume following abdominal or pelvic irradiation were treated with percutaneous estradiol 150 µg/24 h for three cycles, and transvaginal uterine sonography was repeated monthly.Results.  Uterine volume was significantly reduced in nulliparous patients who had received direct uterine irradiation (n = 13; median 13 mL, range 1–52 mL) compared with nulliparous patients who had received chemotherapy only (n = 37; 47 mL, 22–88), radiotherapy above the diaphragm (n = 17; 40 mL, 24–61), or radiotherapy below the diaphragm not directly involving the uterus (n = 13; 34 mL, 8–77) (p < 0.02 in all comparisons). Among nulliparous patients a significant correlation was found between age at direct uterine irradiation and uterine volume (r = 0.78, p = 0.002). No significant improvement in uterine volume, endometrial thickness or uterine artery blood flow was observed in three hypogonadal patients in response to high‐dose estrogen replacement therapy.Conclusions.  Our results indicate that cytotoxic treatment in childhood does not affect adult uterine size. In contrast, uterine irradiation at a young age reduces adult uterine volume. The radiotherapy‐induced damage is probably irreversible.
The Kola Birth Registry and perinatal mortality in Mončegorsk, Russia
Authors: Vaktskjold Arild , Talykova Ljudmila , Chashchin Valerij , Nieboer Evert , Odland Jon Øyvind 
Published: December 2003

Background. A population‐based birth registry has been set up for the Arctic town of Mončegorsk in north‐western Russia. In this investigation, the quality and the content of the registry are assessed and the perinatal mortality (PM) rates in the period 1973–97 estimated.Material and method. Enrollment in the Kola Birth Registry (KBR) involved the retrospective inclusion of all births with at least 28 weeks of gestation in Mončegorsk in the period 1973–97. The data in the registry were assessed for data entry errors, completeness of data and population coverage. The annual PM rates were estimated for live‐ and stillborns with at least 28 weeks of gestation.Results. The KBR contains detailed information about the newborn, delivery, pregnancy and mother for 21 214 births by women from Mončegorsk, covering at least 96% of all the births by the population in the period studied. No records were missing data for gender and birth date of the newborn, and more than 99.9% of the records contained data about gestational age and birthweight. Data concerning the mothers' employment were missing in 0.4% of the records. The annual PM rate fell from more than 20 to less than 10 deaths per 1000 births during this period.Conclusion. The KBR provides an extensive data source useful for case‐control and register‐based prospective studies, and constitutes the first such compilation in Russia. The homogeneity of the population in Mončegorsk makes it advantageous for epidemiological investigations. The PM rate in Mončegorsk was lower than the overall rate in Russia.
Obstetric outcomes after cervical ripening by multiple doses of vaginal prostaglandin E2
Authors: Chan Louis Yik‐Si , Fu Lucille , Leung Tse Ngong , Wong Shell Fean , Lau Tze Kin 
Published: December 2003

Aim.  The study was designed to investigate the delivery outcome in women who required vaginal prostaglandin E2 for cervical priming prior to labor induction.Materials and methods.  This retrospective cohort study included all singleton term deliveries that required labor induction over a 3‐year period. Incidence and indications of obstetric interventions were compared among women who required different doses of vaginal prostaglandin E2 for cervical priming and who had induction by amniotomy and oxytocin infusion.Results.  Of 706 deliveries, 411 had favorable Bishop's scores and no vaginal prostaglandin E2 for cervical priming was required (group A); 268 required one or two doses of vaginal prostaglandin E2 for cervical priming (group B); and 27 required three or more doses (group C). The incidence of cesarean section was significantly higher in group C (48.1%) than in group A (19.0%) and group B (16.4%). The difference remained statistically significant when primiparous and multiparous women were analyzed separately. The risk of obstetric intervention was particularly high in primiparous women in group C (58.8% required emergency cesarean section and 23.5% had instrumental delivery). There was an increased frequency of all major indications for cesarean section in group C.Conclusion.  The risk of emergency cesarean section was higher in women who required more than two doses of vaginal prostaglandin E2 for cervical priming compared to induction by one or two doses of vaginal prostaglandin E2 or by amniotomy and oxytocin infusion. These women should be informed regarding the high risk of intrapartum cesarean section, and the option of alternative methods of induction or elective cesarean section should be made available.
Management of postmenopausal bleeding in Sweden: a need for increased use of hydrosonography and hysteroscopy
Authors: Epstein Elisabeth 
Published: December 2003

Background.  The objective was to determine how postmenopausal bleeding (PMB) is managed in Sweden today, and to relate the findings to a new evidence‐based algorithm for the management of PMB.Methods.  A questionnaire regarding the role of ultrasound and the use of different endometrial biopsy methods in the management of PMB was sent to all 61 gynecologic departments in Sweden.Results.  Fifty‐nine of the 61 departments (97%) satisfactorily answered the questionnaire. Ultrasound was either always (n = 54, 92%) or most commonly (n = 5, 8%) used in the diagnostic work‐up of PMB. In women with endometrial thickness ≤4 mm, 18 of the departments (31%) routinely sampled the endometrium; 12 (15%) followed the women with ultrasound; three (5%) did both sampling and follow‐up with ultrasound; and the remaining 29 (49%) used expectant management (i.e. no biopsy or routine follow‐up). In women with endometrium ≥5 mm, hydrosonography was performed routinely in two departments (3%), occasionally in 37 departments (63%), and never in 20 departments (34%). In women with endometrium ≥5 mm, endometrial biopsy was obtained routinely by Endorette®/Pipelle® in 39 departments (66%), while in 26 departments (44%) operative hysteroscopy was never performed.Conclusion.  More than one‐third of the gynecologic departments in Sweden never perform hydrosonography to rule out focal lesions or operative hysteroscopy for the removal of such lesions. Hydrosonography and hysteroscopy have a central role in the new guidelines for the management of PMB. Therefore, a need exists to broaden the use of hydrosonography and hysteroscopy.
The Importance of Photodissociative Trichloromethanol for Atmospheric Chemistry
Authors: Mühlhäuser Max , Schnell Melanie , Peyerimhoff Sigrid D. 
Published: December 2003

Multireference configuration interaction calculations are carried out for ground and excited states of trichloromethanol to investigate two important photofragmentation processes relevant to atmospheric chemistry. For CCl3OH five low-lying excited states in the energy range between 6.1 and 7.1 eV are found to be highly repulsive for C-Cl elongation leading to Cl2COH (X2A') and Cl (X2P). Photodissociation along C-O cleavage resulting in Cl3C (X2A') and OH (X2Π) has to overcome a barrier of about 0.8 eV (13A'', 11A'') and 1.2 eV (13A') because the low-lying excited states 11A'', 13A' and 13A'' become repulsive only after elongating the C-O bond by about 0.3 Å.
A Combined ab initio and Density Functional Study of the Electronic Structure of Thymine and 2-Thiothymine Radicals
Authors: Vianello Robert , Maksić Zvonimir B. 
Published: December 2003

The electronic and energetic properties of thymine (1) and 2-thiothymine (2) and their neutral and positively charged radicals are considered by a combined ab initio and density functional theory approach. It is conclusively shown that ionization of 1 and 2 greatly facilitates deprotonation of the formed radical cations thus making the proton transfer between charged and neutral precursor species thermodynamically favourable. The adiabatic ionization potential of 1 and 2 are analysed. It appears that ADIP(1) is larger than ADIP(2) by 10 kcal/mol, because of greater stability of the highest occupied molecular orbital (HOMO) of the former. It is also shown beyond any doubt that the spin density in neutral and cationic radical of 2 is almost exclusively placed on the σ-3p AO of sulfur implying that these two systems represent rather rare sigma-radicals. In contrast, the spin density of radicals of 1 is distributed over their π-network.
On the Stability of Hydroxo-Dilead(II) Complex Cations
Authors: Breza Martin , Biskupič Stanislav 
Published: December 2003

Using Hartree-Fock, B3LYP and MP2 treatments, the optimal geometries and corresponding electronic structures of various isomers of [Pb2(OH)n]q complex cations with total charges q = 4 - n, n = 1, 2, 3, are investigated. [Pb(μ-OH)Pb]3+ seems to be the most stable whereas [Pb(μ-OH)Pb(OH)]2+ and [Pb(μ-OH)Pb(OH)2]+ are unstable (because additional non-bridging hydroxyl weakens the neighboring Pb-Oμ and Oμ-Hμ bonds). Direct Pb-Pb and Oμ-Oμ interactions are weakly antibonding in all the systems under study. The clusters are held together exclusively by relatively weak Pb-O bonds. Non-measurable concentrations of [Pb(μ-OH)Pb]3+ in aqueous solutions might be explained by its reaction with OH- yielding preferably unstable [Pb(μ-OH)Pb(OH)]2+ species.