bluuebunny/crossref_metadata_2025_split huggingface dataset:
Longitudinal assessment of amniotic fluid index
Authors: Nwosu E. C. , Welch C. R. , Manasse P. R. , Walkinshaw S. A. 
Published: August 2005

ABSTRACTObjective
To derive a longitudinal gestational reference range for amniotic fluid index and to compare it with the established cross‐sectional reference range.Design
Longitudinal prospective study.Setting
Liverpool Maternity Hospital and Mill Road Maternity Hospital, both teaching hospitals in central Liverpool.Subjects
One hundred and fifteen pregnant women, in whom the expected date by the last menstrual period and ultrasound scan at 18 to 19 weeks were in agreement by seven days, were recruited. They were divided into two groups and scanned at four weekly intervals as follows: Group A: scanned at 20, 24, 28, 32, 36, 40; and Group B: scanned at 22, 26, 30, 34, 38, 42.Results
Amniotic fluid index varies with gestation, rising from early gestation to peak at 30 weeks and then falling from 36 to 42 weeks. Comparison of our reference range with that of Moore and Cayle (1990) shows obvious differences at the lower limit.Conclusion
We have established a normal longitudinal reference range for the amniotic fluid index. Our ranges, derived from longitudinal data, would seem a more appropriate reference than the established reference ranges derived from cross‐sectional data. In particular, the differences at the lower limits may have considerable clinical implication in the use of amniotic fluid index in the prediction of fetal compromise.
Antiphospholipid antibodies in pregnancy: prevalence and clinical associations
Authors: Pattison N. S. , Chamley L. W. , McKay E. J. , Liggins G. C. , Butler W. S. 
Published: August 2005

ABSTRACTObjective
To determine prevalence, clinical association and predictive power of antiphospholipid antibodies in pregnancy.Design
To test for the presence of anticardiolipin antibodies and lupus anticoagulant in order to confirm prevalence data which imply that each antibody has the same clinical significance. A detailed obstetric history and the outcome measures were obtained from each patient in the study.Setting
National Women's Hospital, Auckland, New Zealand.Subjects
Nine hundred and thirty‐three consecutively booked pregnant women.Main outcome measures
Prevalence of auto‐antibodies; perinatal morbidity and mortality; incidence of preeclampsia, growth retardation and fetal distress.Results
Nine women (1.0%) had anticardiolipin antibodies, 11 (1.2%) had lupus anticoagulant and two had both antibodies. The fetal mortality rate for women with antibodies was 167/1000. Pre‐eclampsia occurred significantly more often in women with auto‐antibodies.Conclusion
The presence of antiphospholipid antibodies is frequently associated with adverse pregnancy outcome (9/18 pregnancies). High titre anticardiolipin antibodies carry a poor prognosis.
Urine production rate is related to behavioural states in the near term human fetus
Authors: Oosterhof Henk , vd Stege Jolande G. , Lander Monique , Prechtl Heinz F. R. , Aarnoudse Jan G. 
Published: August 2005

ABSTRACTObjective
To investigate the relation between hourly fetal urine production rate (HFUPR) and behavioural states 1F and 2F (corresponding to quiet and active sleep, respectively) in normal near term fetuses.Design
An observational study.Setting
A clinic for antenatal care at a university hospital.Subjects
Nineteen healthy pregnant women examined at 37 to 40 weeks of gestation.Main outcome measures
Fetal behavioural states (1F and 2F) were assessed by means of fetal heart rate patterns (FHR A and FHR B). Using real time ultrasonography, HFUPR (ml/h) was estimated during behavioural states 1F and 2F.Results
During behavioural state 1F, HFUPR was significantly higher than during state 2F (P<0.01). HFUPR falls by 47% from 50.8 ± 24.4 ml/h in state 1F to 25.7 ± 15.0 ml/h in state 2F.Conclusions
During active sleep (state 2F) hourly fetal urine production rate is considerably reduced as compared to quiet sleep (state 1F).
The interrelationship of eclampsia, HELLP syndrome, and prematurity: cofactors for significant maternal and perinatal risk
Authors: Martin James N. , Perry Kenneth G. , Miles Johnny F. , Blake Pamela G. , Magann Everett F. , Roberts William E. , Martin Rick W. 
Published: August 2005

ABSTRACTObjective
To determine if there are differences between mothers and fetuses in eclamptic pregnancies with or without concurrent HELLP syndrome.Design
Retrospective review.Setting
A single tertiary perinatal centre, the University of Mississippi Medical Center.Subjects
All eclamptic pregnancies treated during a 141 month period from 1980 until the end of 1991.Methods
Pregnancies were grouped according to the presence or absence of HELLP syndrome subclassified as class 1 = platelet nadir ≤50 000/μl, class 2 = platelet nadir >50 000 to ≤100 000/μl, and class 3 = platelet nadir >100 000 to ≤150 000/μl.Results
Among 49 782 live births, there were 117 women with eclampsia prior to delivery (incidence 1:425), 62 of which had HELLP syndrome. The group with HELLP syndrome were delivered significantly earlier (32.1 vs 36.4 weeks), and had lower birthweights (1821 vs 2550 grams) and higher perinatal mortality (113 vs 18:100). They were also transfused more frequently (65%vs 35%), and suffered greater overall serious maternal morbidity and mortality.Conclusion
Eclampsia is more likely to be associated with the HELLP syndrome at early gestations. Although eclamptic patients are already at risk, the presence of HELLP syndrome accentuates the risk for adverse maternal‐perinatal outcome.
Abnormal cervical cytology following large loop excision of the transformation zone: a case controlled study
Authors: Shafi M. I. , Dunn J. A. , Buxton E. J. , Finn C. B. , Jordan J. A. , Luesley D. M. 
Published: August 2005

ABSTRACTObjectives
To determine factors that may predict cytological outcome at 6 months following large loop excision of transformation zone (LLETZ) for cervical intra epithelial neoplasia (CIN) and to investigate the outcome in women with continuing cytological abnormality.Design
Case controlled retrospective study.Setting
Dudley Road Hospital, Birmingham and Midland Hospital for Women.Subjects
Fifty‐eight women with abnormal follow up cytology and a control group of 116 women.Main outcome measures
The relation between pretreatment and treatment factors and cytological outcome, and the relation between cytology and histology in women who had biopsies for persistent adnormal cytology.Results
Univariate and stepwise logistic regression analysis showed that the number of sectors of atypical transformation zone (lesion size) and the excision margin status of the large loop excision specimen are of prognostic importance for the prediction of cytological abnormality at the 6 month follow up visit. Sixteen women have undergone further cervical biopsy. Of the five cases of persistent CIN, four had cytological changes showing moderate or severe dyskaryosis. Of the 11 women with koilocytosis or normal histology, 10 had mild dyskaryosis or borderline changes on their follow up cytology.Conclusion
Lesion size and excision margin status are important correlates of follow up cytology when treating patients for CIN with LLETZ. All women with abnormal cervical cytology at follow up should undergo colposcopic assessment. Excision biopsy is indicated if follow up cytology shows moderate or severe dyskaryosis, especially if still present 12 months after treatment.
Adverse effects on sperm movement characteristics in women with minimal and mild endometriosis
Authors: Curtis P. , Lindsay P. , Jackson A. E. , Shaw R. W. 
Published: August 2005

ABSTRACTObjective
To test the effect of peritoneal fluid from infertile women with minimal or mild endometriosis on sperm movement characteristics in comparison with fertile and infertile women with no endometriosis.Design
A prospective observer‐blind trial.Setting
Academic infertility department.Subjects
57 women undergoing diagnostic laparoscopy or laparoscopic sterilisation.Main outcome measures
Changes in sperm movement characteristics in semen samples provided during routine infertility investigation or from sperm donors. Computer assisted semen analysis (CASA) performed using a Celltrack‐S system.Results
Significant reductions in linearity (P <0.05), amplitude of lateral head displacement (P <0.01), straight line velocity (P <0.01), and curvilinear velocity (P <0.01) (but not percentage motility) were observed.Conclusions
Peritoneal fluid from women with minimal or mild endometriosis adversely effects sperm movement characteristics in comparison to fertile women.
Cardiovascular autonomic reflexes in mid‐pregnancy
Authors: Ekholm E. M. K. , Piha S. J. , Antila K. J. , Erkkola R. U. 
Published: August 2005

ABSTRACTObjective
To study the physiological responses to noninvasive cardiovascular autonomic function tests in normal pregnancy.Design
Cardiovascular autonomic responses in 60 women at 22 to 29 weeks gestation and 62 nonpregnant women were investigated using the Valsalva manoeuvre as well as orthostatic, quiet breathing, deep breathing, and isometric handgrip tests.Results
Compared with nonpregnant women, those who were pregnant showed significantly lower heart rate variability during normal breathing and a blunted tachycardic reaction to blowing during the Valsalva manoeuvre. The vagally controlled biphasic heart rate response to standing was also attenuated in the pregnant group.Conclusions
The cardiovascular responses were blunted in mid‐pregnancy indicating a decrease in parasympathetic cardiovascular control.
A national survey to assess current use of computerised information systems in obstetrics
Authors: Yoong A. , Das S. , Carroll S. , Chard T. 
Published: August 2005

ABSTRACTObjective
To ascertain the number and type of obstetric computer systems (OCS) in Great Britain, and to ascertain user satisfaction with these systems.Design
A postal questionnaire was circulated to every consultant obstetrician in Great Britain at the beginning of 1992.Main outcome measures
Information was sought on the hardware, software and uses of obstetric computer systems. Satisfaction with, benefits and problems of the system were also assessed.Results
There was an 87.5% response rate. Of the 264 units questioned, 100 units reported that they had a computer system. Sixty‐five units used terminals connected to a mainframe or minicomputer and 17 used stand‐alone personal computers (PCs). Local area networks (LANs) were used in 19 units and wide area network (WANs) in 22 units. Software varied from commercial turnkey systems to in‐house systems. The quoted annual running cost ranged from £50 to £48 000. Most units were satisfied with their system. Problems included slow operating times, unreliability, user unfriendliness, deficiencies in training and inadequate customer support services.Conclusions
Obstetric computer systems are now coming into widespread use. Despite problems, the use of such systems is likely to increase. This survey establishes a database for those units who are considering acquiring or changing their computer system for the purpose of audit or research.
The effect of induced abortion on subsequent fertility
Authors: Frank Peter , Mcnamee Roseanne , Hannaford Philip C. , Kay Clifford R. , Hirsch Sybil 
Published: August 2005

ABSTRACTObjectiveTo investigate the effect of induced abortion on subsequent fertility.Design1. Prospective cohort study of women who had an unplanned pregnancy at recruitment. 2. Retrospective study of women who had a planned pregnancy at recruitment.SettingJoint Royal College of General Practitioners/Royal College of Obstetricians and Gynaecologists study based in general practice in England, Scotland and Wales, between 1976 and 1987.Subjects1. Prospective study: Four hundred and thirty‐three women with a recruitment unplanned pregnancy ending in induced abortion (abortion group) and 1035 women with a recruitment unplanned pregnancy which ended naturally (nonabortion group). All subsequently had a planned pregnancy, or were known to be trying to conceive at some point during the follow‐up2. Retrospective study: Nine thousand two hundred and ninety‐nine women who presented at recruitment with a planned pregnancy.Main outcome measureThe women's estimated length of planning time, expressed as a fertility rate ratio.ResultsInduced abortion was not related to future fertility. In the prospective study, the fertility rate ratio (FRR) of the abortion group relative to the nonabortion group was 0.94 (95% CI0.83 to 1.07,P= 0.37). This result was supported by the retrospective study, which again showed no important difference between the two groups.ConclusionInduced abortion does not appear to have an important effect on future fertility.
Structural characteristics of term human fetal membranes: a novel zone of extreme morphological alteration within the rupture site
Authors: Malak T. M. , Bell S. C. 
Published: August 2005

ABSTRACTObjective
To determine the structural characteristics of the rupture site of term fetal membranes (amniochorion and decidua) that rupture spontaneously after the onset of labour.Design
Fourteen term fetal membranes were examined immediately after delivery at the light microscope level. Multiple samples were taken along the whole rupture site and along an axis between this site and placental edge. Morphometric analysis of the thickness of the constituent layers of the fetal membranes was performed.Setting
Leicester Royal Infirmary Maternity Hospital.Results
A restricted zone of extreme altered morphology, characterised by marked swelling and disruption of the connective tissue, thinning of the trophoblast layer and thinning or absence of decidua, was identified in the rupture site of all patients. Morphometric analysis of the thickness of membrane layers showed that these changes and the ratio between the thickness of the connective tissue layers and that of the trophoblast and decidua (termed fetal membrane morphometric index) were significant between the zone of extreme altered morphology and the rest of the membranes.Conclusions
The morphological features of the zone of extreme altered morphology suggests that it represents an area of structural weakness of the membranes. Since this zone did not include the whole length of the rupture site, it is likely that it was present before membrane rupture and was generated during pregnancy. We hypothesise that the zone of extreme altered morphology represents the site of initial rupture after which the tear is transmitted through the membranes to produce the rupture site. It is possible that if these changes become more extreme, then prelabour membrane rupture may occur. Further characterisation of this zone may help to understand the mechanism of its genesis and its role in predisposing the fetal membranes to rupture.
Assessment of maternal mortality in Tanzania
Authors: Walraven G. E. L. , Mkanje R. J. B. , van Roosmalen J. , van Dongen P. W. J. , Dolmans W. M. V. 
Published: August 2005

ABSTRACTObjective
To assess maternal mortality.Design
Prospective community‐based survey, a sisterhood method survey and hospital data.Setting
The study was performed in communities in a rural area in Northwestern Tanzania and the local district hospital.Results
Four hundred and forty‐seven pregnant women in the community survey were followed up as far as six weeks after delivery; there were 2865 respondents in the sisterhood survey; the hospital study involved 7526 deliveries. Maternal morality ratios derived from the prospective community‐based survey, the sisterhood method survey and hospital data analysis were 241, 297, and 845 per 100000 live births, respectively.Conclusions
Hospital data tend to overestimate maternal mortality in these communities. The sisterhood method is easier and more convenient than a prospective community‐based study.
Circulating levels of placental protein 14 in ectopic pregnancy
Authors: Stabile I. , Olajide F. , Chard T. , Grudzinskas J. G. 
Published: August 2005

ABSTRACTObjective
To determine circulating levels of placental protein 14 (PP14) in complications of early pregnancy.Design
Biochemical monitoring of women presenting with vaginal bleeding and/or abdominal pain.Setting
An emergency gynaecological ultrasound clinic in a London teaching hospital.Subjects
Venous blood samples were obtained from 67 women with normal pregnancy (n= 9), ectopic pregnancy (n= 26) and failed intrauterine pregnancy (n= 32). This group included anembryonic pregnancy (n= 18), missed miscarriage (n= 2), spontaneous miscarriage of a previously demonstrated live fetus (n= 6), incomplete miscarriage (n= 4), complete miscarriage (n= 1) and molar pregnancy (n= 1).Main outcome measures
Serum PP14 levels in the group of women with a failed intrauterine pregnancy in relation to the normal range for PP14.Results
Eighty‐one percent of women who miscarried spontaneously had normal serum PP14 levels; 81% of women with ectopic pregnancy had depressed (< 5th centile) serum PP14 levels.Conclusion
Measurements of PP14 may be useful in distinguishing spontaneous miscarriage from ectopic pregnancy, but not in the management of threatened miscarriage.
Early abortion induction by a combination of mifepristone and oral misoprostol: a comparison between two dose regimens of misoprostol and their effect on blood pressure
Authors: El‐Refaey Hazem , Templeton Allan 
Published: August 2005

ABSTRACTObjectives
1. To investigate the efficacy of 800 μg misoprostol (a PGE1 analogue) when administered to women pretreated with mifepristone for early pregnancy termination. 2. To establish means of minimising gastrointestinal side effects by comparing two different misoprostol regimens. The impact of these regimens on blood pressure was investigated in a subgroup of patients.Design
A randomised study of 150 women of 56 days gestation, or less, allocated to receive oral misoprostol either in a single dose of 800 μg or as two doses of 400 μg administered sequentially 2 h apart; in each case misoprostol was administered 36 to 48 h after receiving mifepristone 200 mg orally.Main outcomes
Complete abortion rates, the frequency and severity (patients' perception) of gastrointestinal side effects, and blood pressure changes in response to prostaglandin administration.Results
The overall success rate was 93%. Seventy‐one (95%) women who received a single dose of misoprostol and sixty‐nine (92%) who received the sequential dose aborted completely. There were two ongoing pregnancies in the first group (2.5%) and three (4%) in the second. The overall ongoing pregnancy rate was 3%. The incidence of diarrhoea was significantly lower for women receiving the sequential dose, and no significant differences were found in the incidence of the other gastrointestinal side effects. The only noted significant change in blood pressure was in diastolic pressure 4 h after the administration of the higher dose of prostaglandin, but this was slight.Conclusions
The combination of mifepristone and oral misoprostol provides an alternative method to inducing abortion of pregnancies of up to eight weeks gestation. Patients receiving the single dose of 800 μg were more troubled by diarrhoea than those on the sequential regimen. The ongoing pregnancy rate was higher than previously reported with vaginal or parenteral administration of prostaglandin.
Relation between frequency of uterine contractions and human fetal cerebral oxygen saturation studied during labour by near infrared spectroscopy
Authors: Peebles D. M. , Spencer J. A. D. , Edwards A. D. , Wyatt J. S. , Reynolds E. O. R. , Cope M. , Delpy D. T. 
Published: August 2005

ABSTRACTObjective
To investigate the effect of the frequency of uterine contractions on fetal cerebral oxygenation, using near infrared spectroscopy.Design
An observational study relating changes in the fetal cerebral concentrations of oxyhaemoglobin and deoxyhaemoglobin, measured from the start of one contraction to that of the next, to the time interval between contraction peaks observed by external tocography.Setting
A teaching hospital obstetric and neonatal unit.Subjects
Ten term fetuses during labour.Results
Changes in cerebral oxyhaemoglobin concentration were positively, and in deoxyhaemoglobin negatively, correlated with the time interval between contractions (P < 0.001). A mean contraction interval of 2.3 min was found below which the concentration of oxyhaemoglobin usually fell and that of deoxyhaemoglobin rose, indicating a fall in cerebral haemoglobin saturation. Conversely, longer contraction intervals were associated with findings indicative of a rise in cerebral haemoglobin saturation.Conclusion
Short contraction intervals (< 2.3 min) were associated with a decrease, and longer contraction intervals with an increase in fetal cerebral oxygen saturation. Contractions occurring repeatedly at intervals less than 2.3 min are likely to result in progressive cerebral desaturation.
Cigarette smoking and histological outcome in wom with mildly dyskaryotic cervical smears
Authors: Luesley David , Blomfield Penelope , Dunn Janet , Shafi Mahmood , Chenoy Rashna , Buxton John 
Published: August 2005

ABSTRACTObjective
To determine which patient related variables, available at the point of referral, predict the presence of high grade intraepithelial neoplasia when the smear result is mild dyskaryosis with or without co‐existent koilocytosis.Design
Multivariate analysis of prospective programme trial.Setting
Academic Department Colposcopy clinics at Dudley Road Hospital, Birmingham, UK.Subjects
One hundred and sixty‐seven women, whose worst ever cervical smear was mild dyskaryosis with or without koilocytosis, referred to colposcopy clinics. All the women had complete data sets, as determined by the format of an ongoing programme, and all were treated by diathermy loop excision of the cervical transformation zone.Main outcome measures
Age, parity, contraceptive practice, smoking habit, duration of abnormal cytology and the grade of histology in the excised transformation zone.Results
Forty‐seven out of 78 (60%) smokers, compared with 18 out of 73 (25%) nonsmokers, had high grade disease. The other variables considered in the analysis were not significant or very weakly associated with histological grade when analysed in a univariate analysis. Stepwise logistic regression identified cigarette smoking as a powerful independent predictor of high grade disease.Conclusion
These data suggest a strong association between smoking and high grade intraepithelial neoplasia in a population of women whose worst ever smear report was mild dyskaryosis. Smoking is a variable that could be built into models to facilitate referral for colposcopic assessment.