bluuebunny/crossref_metadata_2025_split huggingface dataset:
Second trimester ambulatory blood pressure in nulliparous pregnancy: a useful screening test for pre‐eclampsia?
Authors: Kyle P. M. , Clark S. J. , Buckley D. , Kissane J. , Coats A. J. S. , de Swiet M. , Redman C. W. G. 
Published: August 2005

ABSTRACTObjective
To assess the effectiveness of second trimester 24‐hour ambulatory blood pressure measurement as a screening test for pre‐eclampsia.Design
Prospective interventional study.Setting
John Radcliffe Maternity Hospital, Oxford, and Queen Charlotte's and Chelsea Hospital, London.Subjects
One hundred and sixty‐two normotensive nulliparous women recruited at hospital booking clinics.Intervention
Ambulatory blood pressure was measured at 18 and 28 weeks gestation using the TM2420 monitor.Main outcome measure
The development of pre‐eclampsia.Results
Awake systolic and mean arterial pressures were significantly increased (P<0.02) at 18 weeks in those who later developed pre‐eclampsia. Those differences were more apparent at 28 weeks at which time the diastolic pressure was also increased (P<0.01). At both stages of gestation the higher readings were sustained during sleep so that the awake‐sleep differences were similar in relation to each outcome. The group with incipient pre‐eclampsia had a significantly faster heart rate at both 18 and 28 weeks (P<0.002) The sensitivity in predicting pre‐eclampsia for a mean arterial pressure of 85 mmHg or greater at 28 weeks was 65%, with a positive predictive value of 31 %. The sensitivity and positive predictive value for a test combining a mean arterial pressure of 85 mmHg or greater and a heart rate of 90 bpm or greater were 53% and 45%, respectively.Conclusion
Although second trimester ambulatory blood pressure is significantly increased in women who later develop pre‐eclampsia, the predictive values for blood pressure alone are low. The efficiency of the test is increased by combining the awake ambulatory heart rate and blood pressure measurement together. If an effective method for preventing pre‐eclampsia becomes available (commencing at 28 weeks gestation), then awake ambulatory blood pressure and heart rate may have some clinical value as a screening test.
Can laparoscopic assisted hysterectomy safely replace abdominal hysterectomy?
Authors: Hunter R. W. , McCartney A. J. 
Published: August 2005

ABSTRACTObjective
To evaluate the feasibility, safety and advantages of laparoscopic hysterectomy.Design
Retrospective review.Setting
St. John of God Hospital, Perth, Australia.Subjects
Fifty‐four women scheduled to undergo laparoscopic hysterectomy for a variety of benign gynaecological conditions.Main outcome measures
Failure to complete the operation laparoscopically, time taken in theatre, incidence of febrile morbidity, incidence of major complications, duration of post‐operative stay in hospital, interval from operation to full activity and return to work.Results
Laparoscopic hysterectomy was attempted in 54 women. A total of 53 operations were completed laparoscopically with one conversion to laparotomy because of haemorrhage. Major complications occurred in two women, both of whom required further surgery. There were four cases of febrile morbidity. The average duration of post‐operative stay was four days (range 2–9), with return to normal activity in two and a half weeks and to work in three weeks.Conclusions
Laparoscopic hysterectomy can be successfully achieved in most women selected for the procedure. Serious complications are inherent to some of the techniques used, but these can be overcome by modifications. Proper training and supervision in laparoscopic surgery is essential during the learning phase of the technique. There are considerable advantages to eligible women in terms of a rapid return to normal activities and work.
A study of endometrial morphology in women who failed to conceive in a donor insemination programme
Authors: Li T. C. , Klentzeris L. , Barratt C. , Warren M. A. , Cooke S. , Cooke I. D. 
Published: August 2005

ABSTRACTObjective
To examine the morphology of endometrium in women who failed to conceive after nine or more cycles of donor insemination treatment.Design
Prospective study.Setting
Jessop Hospital for Women, Sheffield.Subjects
Two groups: twenty‐six infertile women and a control group of eight fertile women.Intervention
Endometrial biopsy specimens were obtained in the mid‐luteal phase, timed precisely by the luteinising hormone surge.Main outcome measure
Morphological study of endometrial biopsy specimens by the use of traditional dating criteria and established morphometric techniques.Results
Twelve biopsy specimens (42%) were found to be retarded. In addition, morphometric analysis revealed significant differences in the glandular component of the endometrium between the infertile and fertile groups.Conclusion
Endometrial defect leading to implantation failure may be an important underlying cause of failure to conceive after repeated attempts at donor insemination. The endometrium should be investigated in this group of women, and further attempts at donor insemination treatment should be offered only in conjunction with attempts to restore the normality of the endometrium.
Changes in amniotic arachidonic acid metabolism associated with increased cyclo‐oxygenase gene expression
Authors: Bennett Phillip R. , Slater Donna , Sullivan Mark , Elder Murdoch G. , Moore Gudrun E. 
Published: August 2005

ABSTRACTObjectives
To study the differences in the metabolism of arachidonic acid, to prostaglandins and other eicosanoids, between amnion cells before and after labour. To study the changes in the expression of the type 1 cyclo‐oxygenase gene associated with the changes in arachidonic acid metabolism.Design
Amnion cells collected before labour, at elective caesarean section, and following spontaneous labour and delivery were established in mono‐layer culture. Intracellular arachidonic acid pools were radio‐labelled and the metabolic fate of endogenous archidonic acid was then studied using high performance liquid chromatography. RNA was extracted from the cell cultures and expression of the cyclooxygenase gene was studied using northern hybridisation to a sheep cyclo‐oxygenase cDNA.Results
Metabolism of endogenous arachidonic acid in amnion cells established in culture prior to labour is principally via lipoxygenase and epoxygenase enzyme pathways to di‐ and mono‐HETEs and EET with little cyclo‐oxygenase metabolism to prostaglandins. Following labour there is a large increase in arachidonic acid metabolism with a change in the cyclo‐oxygenase: lipoxygenase enzyme pathway ratio in favour synthesis of prostaglandin E2. Whilst synthesis of lipoxygenase metabolites doubles, the increase in prostaglandin E2 synthesis is ten fold. Expression of the cyclo‐oxygenase gene is significantly greater in cell cultures established following spontaneous labour and delivery than in those established following elective caesarean section prior to labour.Conclusions
In association with labour there is an increase in arachidonic acid metabolism in amnion cells and a change in the ratio of metabolism via cyclo‐oxygenase and lipoxygenase enzyme pathways to increase synthesis of prostaglandin E2. This change is associated with increased expression of the cyclooxygenase gene.
Changes in the concentration of alpha‐fetoprotein and placental hormones following two methods of medical abortion in early pregnancy
Authors: Thong K. Joo , Norman Jane E. , Baird David T. 
Published: August 2005

ABSTRACTObjective
Measurement of alpha‐fetoprotein (AFP) was used to investigate the occurrence of feto‐maternal haemorrhage in women undergoing medical abortion.Design
Three groups of women with amenorrhoea of 56 or less days were studied. A control and a mifepristone group had two blood samples taken 48 h apart. Women undergoing medical abortion with gemeprost had two blood samples taken 24 h apart.Setting
Medical Termination Unit, Simpson Memorial Maternity Pavilion, Edinburgh.Subjects
Three hundred and thirty‐five women requesting abortion.Interventions
Blood samples taken at 24 h or 48 h apart.Measurements and main results
The rise in concentration of AFP in plasma was much higher (P= 0.01) in the two groups of women in whom abortion was induced by gemeprost or mifepristone than in control women. Whereas only 5% of women in the control group had a significant rise in AFP, 27% and 33% of women in the mifepristone and gemeprost groups, respectively, had a rise in AFP level which exceeded the 95th centile (≥38%). The concentration of hCG rose by 48 h in both control and mifepristone groups. Progesterone remained unchanged, and oestradiol decreased (P<0.02) in the mifepristone group. By 24 h, there was a significant fall in the concentrations of hCG, progesterone and oestradiol in the group who had aborted after being given gemeprost.Conclusions
Anti‐D prophylaxis must be administered to rhesus negative women to avoid rhesus iso‐immunisation.
Memory loss during pregnancy
Authors: Sharp Katharine , Brindle Peter M. , Brown Malcolm W. , Turner Gillian M. 
Published: August 2005

ABSTRACTObjective
To investigate possible impairment of memory during pregnancy.Design
The performance of pregnant women in a variety of tests of memory was compared to that of controls.Setting
The Bristol Maternity Hospital.Subjects
Forty‐eight volunteer pregnant women attending for routine antenatal checks were compared to 19 nonpregnant controls.Main outcome measures
Subjectively perceived rating of memory impairment, objective measures of recall, recognition and priming memory.Results
Pregnant and control groups were given a series of tests of memory at the end of which they were asked to rate their own memory at present compared to some weeks ago (when they were not pregnant). Of the pregnant women 39 out of 48 (81%) rated their current memory as being impaired; only three out of 19 (16%) of the control subjects did so. Objective tests revealed that the pregnant group was significantly impaired in the recall of lists of words, particularly when learning was incidental rather than explicit. The pregnant group was also significantly impaired in two measures of priming memory. No significant deficit was found in recognition. The deficits were found for both primigravid and multigravid women, and were present in all trimesters of pregnancy.Conclusions
The majority of women believe their memory to be impaired during pregnancy. Objectively, during pregnancy there is significant impairment of memory as tested by recall or by priming, but not by recognition. The pattern of memory loss differs from that of other amnesic conditions. Information imparted to pregnant patients may not be retained as well as might be expected.
Retrospective analysis of platelet numbers and volumes in normal pregnancy and in pre‐eclampsia
Authors: Ahmed Yusuf , van Iddekinge Basil , Paul Carolyn , Sullivan Mark H. F. , Elder Murdoch G. 
Published: August 2005

ABSTRACTObjective
To determine the distribution of platelet volumes and numbers through pregnancy, and to compare these to changes in platelet volumes and numbers in women with pre‐eclampsia.Subjects
Four hundred twenty‐eight women with normal pregnancy from whom four or more platelet measurements were available were identified. 74 women with pre‐eclampsia (blood pressure 140/90 mmHg, at least 0.5g protein/24 h urine collection) from whom platelet measurements were available between 27 and 30 weeks of gestation were identified.Results
Mean platelet volume and platelet number remained constant in normal pregnancies between the first trimester and the end of pregnancy. A persistent increase of 0.8 fl ( 90th centile) in mean platelet volume was found in 14 out of 15 pre‐eclamptic patients between 24 weeks and 38 weeks of gestation and in only 13 of 428 normal pregnant individuals. Platelet numbers were decreased by 50 × 109/l (i.e. to less than the 10th centile) in 12 of the 15 patients with pre‐eclampsia. 10% of the normal pregnant population showed a similar decline in platelet numbers showing that changes in platelet numbers may be a less accurate assessment of the development of pre‐eclampsia.Conclusion
We suggest that longitudinal determination of platelet volumes may be of use in identifying those women at risk of pre‐eclampsia.
Hypnosis: practical applications and theoretical considerations in normal labour
Authors: Jenkins Mary W. , Pritchard M. H. 
Published: August 2005

ABSTRACTObjective
To assess the effects of hypnotherapy on the first and second stages of labour in a large group of pregnant women.Design
A semi‐prospective case control study in which women attending antenatal clinics were invited to undergo hypnotherapy.Subjects
One hundred twenty‐six primigravid women with 300 age matched controls, and 136 parous women having their second baby with 300 age matched controls. Only women who had spontaneous deliveries were included.Setting
Aberdare District Maternity Unit, Mid Glamorgan, Wales.Intervention
Six sessions of hypnotherapy given by a trained medical hypnotherapist during pregnancy.Outcome measures
Analgesic requirements, duration of first and second stages of labour.Results
The mean lengths of the first stage of labour in the primigravid women was 6.4 h after hypnosis and 9.3 h in the control group (P<0.0001); the mean lengths of the second stage were 37 min and 50 min, respectively (P<0.001). In the parous women the corresponding values were 5.3 h and 6.2 h (P<0.01); and 24 and 22 min (ns). The use of analgesic agents was significantly reduced (P<0.001) in both hypnotised groups compared with their controls.Conclusion
In addition to demonstrating the benefits of hynotherapy, the study gives some insight into the relative proportions of mechanical and psychological components involved in the longer duration of labour in primigravid women.
The effect on fetal arteriolar oxygen saturation resulting from giving oxygen to the mother measured by pulse oximetry
Authors: McNamara H. , Johnson N. , Lilford R. 
Published: August 2005

ABSTRACTObjective
To determine if pulse oximetry could detect any changes in fetal arteriolar oxygen saturation resulting from maternal administration of oxygen.Design
A prospective study comparing study comparing the fetal pulse oximetry reading before and after giving 27% and 100% oxygen to the mother. The data were collected using an experimental pulse oximeter and a sensor specifically adapted to cope with the problems of fetal pulse oximetry.Setting
Labour ward, St. James's University Hospital, Leeds University, UK.Subjects
Twelve fetuses presenting by the vertex in normal uncomplicated labour.Main outcome measures
The change in fetal arteriolar oxygen saturation recorded by the pulse oximeter in response to oxygen administration to the mother.Results
Twenty‐seven percent oxygen increased the average fetal arteriolar oxygen saturation by 7.5%, the effect being reversed when the oxygen was withdrawn. One hundred percent oxygen increased fetal arteriolar oxygen saturation by 11% and when the oxygen was withdrawn oxygen saturation dropped by 10%. One hundred percent inspired maternal oxygen was more effective than 27%. The gradient of the fetal oxygen regression slope is steeper with 100% oxygen than 27% and it is steeper when oxygen is given compared to when it is withdrawn. This suggests that the fetus responds to the new placental oxygen gradient by accepting oxygen more rapidly than it gives it up. Using a quadratic regression model, it took 9 min for fetal oxygen saturation to reach its maximum value after giving the mother oxygen.Conclusion
This study confirms that a pulse oximeter is able to measure an increase in fetal arteriolar oxygen saturation when oxygen is administered to the mother.
A randomised prospective study comparing the new vacuum extractor policy with forceps delivery
Authors: Johanson R. B. , Rice C. , Doyle M. , Arthur J. , Anyanwu L. , Ibrahim J. , Warwick A. , Redman C. W. E. , O'Brien P. M. S. 
Published: August 2005

ABSTRACTObjective
To compare assisted vaginal delivery by forceps with delivery by vacuum extractor, where a new vacuum extractor policy was employed which dictated the cup to be used in specific situations.Design
Multicentre randomised controlled trial.Setting
Four district general hospitals in the West Midlands.Subjects
Six hundred‐seven women requiring assisted vaginal delivery, of whom 296 were allocated to vacuum extractor delivery and 311 to forceps.Main outcome measures
Delivery success rate, maternal perineal and vaginal injuries, maternal anaesthetic requirements, neonatal scalp and facial injuries.Results
Of the vacuum extractor group, 85% were delivered by the allocated instrument compared to 90% in the forceps group (odds ratio (OR) 0.64; 95% confidence intervals (CI) 0.4–1.04). However, more women in the vacuum extractor group were delivered vaginally (98%) than in the forceps group (96%). There were significantly fewer women with anal sphincter damage or upper vaginal extensions in the vacuum extractor group (11%vs 17%, OR 0.6; 95% CI, 0.38–0.97). There were significantly fewer women in the vacuum extractor group requiring epidural or spinal anaesthetics (25.4%vs 32.7%, OR 0.69; 95% CI 0.49–0.99) or general anaesthetics (1%vs 4%, OR 0.17; 95% CI 0.04–0.76). Although there were significantly more babies in the vacuum extractor group with cephalhaematomata (9%vs 3%, OR 3.3; 95% CI 1.4–7.4) there were fewer babies in the vacuum extractor group with other facial injuries. There were three babies in the forceps group with unexplained neonatal convulsions.Conclusions
Assisted vaginal delivery using the new vacuum extractor policy is associated with significantly less maternal trauma than with forceps. Further studies are required to assess neonatal morbidity adequately.
Investigation of factors influencing folate status in women who have had a neural tube defect‐affected infant
Authors: Wild J. , Schorah C. J. , Sheldon T. A. , Smithells R. W. 
Published: August 2005

ABSTRACTObjective
To investigate folate intake and blood levels of vitamins in women with and without a history of neural tube defect (NTD)‐affected infant and to explore the relation between red cell and serum folate in those women.Subjects
Twenty‐nine women with a history of NTD‐affected infant, who had taken periconceptional vitamin supplements one year or more prior to the study and twenty‐nine controls with no such history.Main outcome measures
Dietary intake of folate was assessed by questionnaire and blood levels of folate, vitamin B12 and vitamin C were measured.Results
Neither dietary intake of folate nor any of the blood vitamins measured were lower in the women with a history of NTD infant. The majority of women who had received periconceptional vitamin supplementation subsequently had adequate folate intakes and red blood cell folates greater than 160 ug/l. Smokers had lower plasma Vitamin C levels than nonsmokers. Multiple regression analysis suggested that the relation between red blood cell (RBC) and serum folate may differ between women with and without a history of NTD.Conclusions
Women with a history of NTD‐affected infants may have different folate metabolism from those who have not.
Maternal nutritional status in pregnancy and blood pressure in childhood
Authors: Godfrey K. M. , Forrester T. , Barker D. J. P. , Jackson A. A. , Landman J. P. , Hall J. St. E. , Cox V. , Osmond C. 
Published: August 2005

ABSTRACTObjective
To examine the relation between indices of maternal nutrition during pregnancy, including haemoglobin concentration, skinfold thickness and body weight, and the child's blood pressure at 10 to 12 years of age.Design
Follow up study of children whose mothers had haemoglobin estimations, weights and skinfold thicknesses recorded during pregnancy.Setting
Kingston, Jamaica.Subjects
Seventy‐seven children whose mothers took part in a prospective study of nutrition during pregnancy in relation to fetal growth.Main outcome measure
Blood pressure at 10 to 12 years of age.Results
The child's mean systolic pressure adjusted for current weight rose by 2.6 mmHg (95 % CI 0.5–4.6, P= 0.01) for each 1 g/dl fall in the mother's lowest haemoglobin during pregnancy. Mothers with a lower haemoglobin had thinner skinfold thicknesses, especially over the triceps (P= 0.005). In multiple regression analyses, taking account of the child's sex and current weight, there was a strong association between thin maternal triceps skinfold thickness at 15 weeks of gestation and raised blood pressure in the offspring. Taking account of the mother's triceps skinfold thickness abolished the relation between lower haemoglobin and raised blood pressure in the child. Lower weight gain between 15 and 35 weeks of gestation was independently associated with raised children's blood pressure. Systolic pressure rose by 10.7 mmHg (95 % CI 5.7 to 15.6, P= 0.0001) for each log mm decrease in the mother's triceps skinfold thickness, and by 0.6 mmHg (95% CI 0.1 to 1.0, P= 0.02) for each 1 kg decrease in the mother's weight gain during pregnancy.Conclusions
These results parallel animal experiments suggesting that impaired maternal nutrition may underlie the programming of adult hypertension during fetal life.
Endometrial sex steroid receptor expression in women with menorrhagia
Authors: Critchley Hilary O. D. , Abberton Keren M. , Taylor Nancy H. , Healy David L. , Rogers Peter A. W. 
Published: August 2005

ABSTRACTObjective
To investigate the oestrogen and progesterone receptor distribution in endometrium from reproductive age and perimenopausal women with and without menorrhagia.Design
A comparative observational study.Subjects
Forty‐five women with objective menorrhagia (27 categorised as reproductive age and 18 as perimenopausal) and a control group of 44 women (31 reproductive age and 13 perimenopausal) with menstrual blood loss of less than 80 ml per period.Main outcome measures
Oestrogen receptor and progesterone receptor semi‐quantitative immunostaining scores.Results
Comparison of control and menorrhagic endometrium in this study (whether from reproductive age or perimenopausal subjects) failed to demonstrate any major differences in either sex steroid receptor mean immunostaining score. The results demonstrated a great degree of variability in sex steroid receptor immunoreactivity between individuals. Irrespective of clinical group, significant increases in immunostaining were demonstrated in the proliferative phase of the cycle for immunoreactivity of oestrogen receptor in glands (P < 0.0005), and stromal (P= 0.002) compartments of endometrium and progesterone receptor immunoreactivity in glands (P= 0.009). Progesterone receptor immunostaining in the stromal compartments did not significantly decline (P= 0.06) in the secretory phase.Conclusions
Endometrium from women with objective evidence of menorrhagia is indistinguishable in terms of sex steroid immunoreactivity from endometrium of women with normal monthly blood loss. This pattern of sex steroid receptor immunostaining pattern was maintained into the perimenopausal years.