bluuebunny/crossref_metadata_2025_split huggingface dataset:
New score indicating placental vascular resistance
Authors: Gudmundsson Saemundur , Korszun Przemyslaw , Olofsson Per , Dubiel Mariusz 
Published: August 2003

Background.  Umbilical artery Doppler velocimetry is a routine method for fetal surveillance in high‐risk pregnancy. Uterine artery Doppler seems to give comparable information, but it can be difficult to interpret as there are two arteries, which might show notching and/or increased pulsatility index (PI) as signs of increased vascular impedance. Combining the information on vascular resistance on both sides in a new score might simplify and improve evaluation of placental circulation.Methods.  Uterine and umbilical artery Doppler velocimetry was evaluated in 633 high‐risk pregnancies. The managing clinician was informed only about the umbilical artery flow. The umbilical artery flow spectrum was semiquantitatively divided into four blood flow classes (BFC), expressing signs of increasing vascular resistance. The uterine artery Doppler flow spectrum was divided into five uterine artery scores (UAS), taking into account presence/absence of notching and/or increase in PI. By adding UAS to BFC, a new placental score (PLS) was constructed with values ranging from 0 to 7, indicating general placental vascular resistance. The scores were related to three outcome variables: small‐for‐gestational age (SGA), premature delivery (<37 weeks), and cesarean section.Results.  All three score systems showed a significant relationship between signs of increasing vascular resistance and outcome. The new PLS showed the best association to adverse outcomes, with optimal cut‐off at values exceeding score 3.Conclusion.  Doppler velocimetry on both sides of the placenta showed a strong relationship to an adverse outcome of pregnancy. The new PLS showed a better relationship to adverse perinatal outcome than the BFC and the UAS. The PLS can simplify evaluation of uteroplacental and fetoplacental Doppler velocimetry.
Maternal plasma levels of cytokines in normal and preeclamptic pregnancies and their relationship with diastolic blood pressure and fibronectin levels
Authors: Madazli Riza , Aydin Seval , Uludag Seyfettin , Vildan Ocak. , Tolun Necati 
Published: August 2003

Background.  To determine the plasma concentrations of placental growth factor (PLGF), vascular endothelial growth factor (VEGF), transforming growth factor‐β1 (TGF‐β1), soluble tumor necrosis factor α receptor (sTNFp55), interleukin‐2 receptor (IL‐2R), and interleukins 6 and 10 (IL‐6, IL‐10) in normotensive and preeclamptic women, and to evaluate the correlations between these cytokines and the diastolic blood pressure and fibronectin levels.Methods.  A prospective case–control study. Thirty‐five women with preeclampsia were compared with 34 healthy women with uncomplicated pregnancies. Peripheral venous blood samples were obtained and plasma levels of PLGF, VEGF, TGF‐β1, sTNFp55, IL‐2R, IL‐6 and IL‐10 were measured by an enzyme‐linked immunoassay and fibronectin by a radial immundiffusion technic.Results.  In preeclampsia PLGF and VEGF levels were significantly lower, and TGF‐β1, sTNFp55, IL‐2R, IL‐6 and IL‐10 levels were significantly higher than in normotensive pregnancy (p < 0.001). The plasma levels of PLGF and VEGF significantly decreased, whereas TGF‐β1, sTNFp55, IL‐2R, IL‐6 and IL‐10 levels significantly increased with the increments in diastolic blood pressure and fibronectin levels (p < 0.001).Conclusions.  Altered concentrations of various cytokines might explain the shallow placentation and endothelial cell dysfunction described in preeclampsia. The clinical severity of preeclampsia seems to correlate with the severity of the cytokine abnormalities.
Undiagnosed term breech: Impact on mode of delivery and neonatal outcome
Authors: Usta Ihab M. , Nassar Anwar H. , Khabbaz Antoun Y. , Abu Musa Antoine A. 
Published: August 2003

Background.  The purpose of this study was to compare delivery mode and neonatal outcome in breech pregnancies diagnosed antepartum (Dx group) with those diagnosed on admission for delivery or intrapartum (No‐Dx group).Methods.  During an 11‐year period, breech pregnancies ≥34 weeks' gestation with a live nonanomalous fetus were reviewed. The Dx group was matched for gestational age, parity, and maternal age to the No‐Dx group (n = 256) and compared using the χ2‐test, the Mc‐Nemar test, and the Wilcoxon rank test. A p‐value of < 0.05 was considered significant.Results.  Breech type and birthweights were similar in the two groups. In the No‐Dx group, 19.5% did not receive prenatal care. More patients in the No‐Dx group were admitted with cervical dilation > 4 cm (39.4% vs. 27.0%, p = 0.004), whereas 17.1% of patients in the Dx group were admitted for elective cesarean delivery at term. There was a higher cesarean delivery rate in the Dx group (64.1% vs. 50.8%, p = 0.003), specifically for arrest disorders (15.2% vs. 6.9%, p = 0.008). The neonatal outcome in the two groups was similar regarding Apgar scores, intensive care nursery admission, need for mechanical ventilation, neonatal death, and length of nursery stay.Conclusions.  Antepartum diagnosis of breech presentation decreases the threshold for cesarean delivery. Failure to diagnose breech antepartum does not compromise neonatal outcome.
Pitfalls in diagnosis of interstitial pregnancy
Authors: Chan Louis Yik‐Si , Fok Wing Yee , Yuen Pong Mo 
Published: August 2003

Background.  To determine the incidence and reasons for misdiagnosis in interstitial ectopic pregnancy.Methods.  We conducted a retrospective study from 1990 to 2001. Women with interstitial pregnancy were identified and their case records retrieved and reviewed. Reasons for delay in diagnosis and associated morbidity were recorded.Results.  Thirty‐six women were diagnosed as having interstitial pregnancy during the study period. Initial diagnosis was incorrect in 15 cases (41.7%). In 14 cases, the interstitial pregnancies were mistaken as intrauterine pregnancy. These misdiagnoses resulted in six inappropriate surgical procedures (evacuation of uterus) being performed and led to rupture of interstitial pregnancy in eight women. In two women, the interstitial pregnancy was mistaken as normal intrauterine pregnancy while the uterus itself was thought to be a cervical fibroid. In both cases, the interstitial pregnancies ruptured at 18–20 weeks of gestation.Conclusion.  Despite advances in sonographic skills and equipment and the availability of β‐human chorionic gonadotropin (hCG) monitoring, misdiagnosis of interstitial pregnancy still occurs frequently. Clinicians should be aware of the limitations of various investigations and maintain a high index of suspicion.
A randomized trial comparing changes in psychological well‐being and sexuality after laparoscopic and abdominal hysterectomy
Authors: Ellström Marie A. , Åström Monica , Möller Anders , Olsson Jan‐Henrik , Hahlin Mats 
Published: August 2003

Background.  To evaluate changes in psychological well‐being and sexuality 1 year after laparoscopic and abdominal hysterectomy.Material and methods.  Seventy‐four women scheduled for abdominal hysterectomy due to benign disorders and assessed as not suitable for vaginal hysterectomy were randomized to abdominal hysterectomy (n = 38) or laparoscopic hysterectomy (n = 36). The Psychological General Well‐Being (PGWB) Index was used to evaluate changes in psychological well‐being and the McCoy scale was used to evaluate changes in sexuality. The differences in outcome before and 1 year after the hysterectomy were calculated for each individual and the changes were compared within and between the two patient groups.Results.  There were no significant differences between the two patient groups with respect to changes in psychological well‐being and sexuality 1 year after surgery.Conclusions.  This study implies that psychological well‐being and sexuality after hysterectomy are not influenced by surgical technique.
Effect of antenatal corticosteroid administration on Doppler flow velocity parameters in pregnancies with absent or reverse end‐diastolic flow in the umbilical artery
Authors: Müller Thomas , Nanan Ralph , Dietl Johannes 
Published: August 2003

Objective.  Evaluation of alterations of Doppler flow velocity waveforms after antenatal corticosteroid therapy.Methods.  Pulsatility index of the umbilical artery, middle cerebral artery and ductus venosus waveforms was measured in high‐risk pregnancies complicated by umbilical AREDV directly prior to and within 24 or 48 hours after application of the first dose of a steroid treatment course.Results.  Return of a positive end‐diastolic flow after umbilical AREDV or conversion of REDV into zero‐flow was detected in 9 of 20 (45%) pregnancies after steroid application. Neither in the group which showed altered umbilical end‐diastolic flow nor in the total of patients investigated was there any significant change in the PI of the umbilical artery or the ductus venosus waveforms. In contrast, there was an overall drop of pulsatility in the middle cerebral artery.Conclusions.  Antenatal corticosteroid administration could increase cerebral perfusion but has no influence on umbilical and venous blood flow.
Multimodal intervention raises smoking cessation rate during pregnancy
Authors: Hegaard Hanne K. , KjÆrgaard Hanne , MØller Lars F. , Wachmann Henrik , Ottesen Bent 
Published: August 2003

Background.  The aim was to study the effect of a multimodal smoking cessation intervention regimen on a number of pregnant smokers.Methods.  A prospective intervention study was designed where participants were allocated to intervention or control based on their birth date. The study included 647 pregnant smokers. The intervention group (n = 327) received initial individual smoking cessation counseling supplemented by an invitation to join, individually or in a group, a smoking cessation program with nicotine replacement therapy as a voluntary option. Intervention was designed as an integral part of the midwives' prenatal care. All pregnant smokers in the usual care group (n = 320) received standard counseling from a midwife. Outcome was self‐reported smoking cessation in the 37th week of pregnancy and the reported cessation was validated by cotinine saliva concentration.Results.  Self‐reported cessation rates during pregnancy were significantly higher in the intervention group (14%) than in the group receiving usual care (5.0%) (p < 0.0001) (Fisher's exact test). Cotinine‐validated cessation rates during pregnancy were significantly higher among the former (7%) than the latter (2%) (p = 0.003). The adjusted odds ratio (OR) for smoking cessation was 4.20 (95% CI 2.13–8.03). Logistic regression analysis showed a significant positive association of smoking cessation with low caffeine consumption in pregnancy, many years in school, no exposure to passive smoking outside the home, and previous attempts to stop smoking.Conclusions.  A multimodal intervention regimen with initial individual counseling supplemented by an invitation to join a smoking cessation program with nicotine replacement therapy as a voluntary option markedly increased cessation rates during pregnancy.
Obstetric and neonatal risk of pregnancies after assisted reproductive technology: a matched control study
Authors: Kozinszky Zoltán , Zádori János , Orvos Hajnalka , Katona Márta , Pál Attila , Kovács László 
Published: August 2003

Background.  The aim of the study was to evaluate the obstetric and neonatal outcome of pregnancies after assisted reproduction technology (ART) in comparison with matched controls from spontaneous pregnancies.Methods.  A total of 12 920 deliveries at the Department of Obstetrics and Gynecology, University of Szeged, from 1 January 1995 to 31 December 2001 were subjected to retrospective analysis. Two hundred and eighty‐four singleton, 75 twin and 17 triplet pregnancies after ovulation induction (n = 114; 30.3%), intrauterine insemination (n = 33; 8.8%) and in vitro fertilization (n = 229; 60.9%) were evaluated. The pregnancy outcome of the singleton and twin pregnancies was compared with that for controls matched with regard to age, gravidity and parity and previous obstetric outcome after spontaneous pregnancies.Results.  Twenty‐four percent of the assisted reproductive pregnancies were multiple pregnancies. The incidences of singleton intrauterine growth retardation (IUGR) and preterm birth were reasonably similar to those among the controls (IUGR: 6.3% vs. 4.2%; preterm births: 13.0% vs. 9.9%, for the cases and the controls, respectively). As compared with the controls, there was an increased incidence of cesarean section among the singleton (41.2% vs. 34.5%, p = 0.12; OR 1.33; 95% CI 0.95–1.87) and twin assisted reproduction pregnancies (66.7% vs. 60.0%), but without significant differences.Conclusions.  Increased obstetric risk could be observed concerning threatened preterm delivery and cesarean section rate in the study group. The perinatal outcome of singleton and twin pregnancies following assisted reproductive techniques is comparable with that of spontaneously conceived, matched pregnancies.
Relationship between bone mineral density changes in pregnancy and maternal and pregnancy characteristics: a longitudinal study
Authors: To William W. K. , Wong Margaret W. N. , Leung Tsin‐Wah 
Published: August 2003

Objective.  The study aims to verify whether a progressive fall in bone mineral density (BMD) values can be demonstrated using quantitative ultrasound measurements of the os calcis. The BMD change during the pregnancy was then correlated with other maternal and pregnancy characteristics to identify any high‐risk factors for bone loss in pregnancy.Methods.  Consecutive patients were recruited from a low‐risk obstetric clinic over a period of 9 months. BMD measurements were performed at the os calcis before 18 weeks, between 28 and 32 weeks, and at 36–38 weeks using a Hologic Sahara Clinical Bone Sonometer system. A computer‐derived BMD value was obtained with each measurement. Body fat composition was also measured using a Tanita 501 bioimpedance assay system.Results.  In a cohort of 780 patients, a mean fall in BMD of 0.040 g/cm2 was demonstrable across the trimesters. The difference in BMD across the three serial measurements was highly significant (p < 0.001). Univariate analysis showed that those with a low initial BMD, glucose intolerance and high body fat accumulation weight gain during the pregnancy had lower BMD loss, while gestational hypertension and obesity had no impact on the degree of BMD loss. Entering these parameters in a logistic regression analysis showed that the impact of glucose intolerance was lost, but that the other factors remained significant. A linear regression model of quantitative variables showed that only fat accumulation (p = 0.03) and early pregnancy BMD values (p < 0.001) remained significant factors associated with BMD loss.Conclusion.  A gradual fall in BMD was demonstrable using ultrasound measurement of the os calcis from early to late pregnancy. Of the various parameters identified as significant factors affecting BMD loss in pregnancy, a low initial BMD in early pregnancy and high body fat accumulation during pregnancy appeared to be related to lower BMD loss.
Detection of cervical intraepithelial neoplasia in women with atypical squamous or glandular cells of undetermined significance cytology: A prospective study
Authors: Wensveen Celesta , Kagie Marjolein , Veldhuizen Roel , Groot Christianne De , Denny Lynette , Zwinderman Koos , Trimbos Baptist 
Published: August 2003

Background.  (1) To assess the prevalence of histologically confirmed cervical intraepithelial neoplasia in patients with cervical smears diagnosed as atypical squamous or glandular cells of undetermined significance. (2) To evaluate the role of colposcopy and the presence of human papillomavirus in detecting underlying cervical intraepithelial neoplasia.Materials and methods.  In this prospective cohort, 148 women with atypical squamous or glandular cells of undetermined significance were evaluated by colposcopy, histological sampling, and human papillomavirus deoxyribonucleic acid testing.Results.  Histological diagnosis of ≥ cervical intraepithelial neoplasia II was found in 10/148 women. Women with a histological ≥ cervical intraepithelial neoplasia II had a higher prevalence of ≥ two abnormal quadrants (90% vs. 38%≤ cervical intraepithelial neoplasia I, p = 0.002) and of high/intermediate‐risk human papillomavirus (90% vs. 42% ≤ cervical intraepithelial neoplasia I, p = 0.005).Conclusion.  Our study shows that premalignant lesions of the cervix were present in 7% of the patients with a cytological diagnosis of atypical squamous or glandular cells of undetermined significance. Colposcopy and human papillomavirus deoxyribonucleic acid testing are both important parameters in detecting ≥ cervical intraepithelial neoplasia II.
Human Seminal Plasma Antibody‐Binding Proteins
Authors: Chiu W. W. C. , Chamley L. W. 
Published: August 2003

Problem: The physiological role of antibody‐binding proteins in human seminal plasma and the potential role of these proteins in infertility is relatively unknown.Method of study: Literature on antibody‐binding proteins.Results: Human seminal plasma has a diverse effect on immune function of the reproductive tracts. This review describes (1) the presence of receptors like proteins that can react with monoclonal antibodies against Fcγ receptors III (Fcγ RIII) but are distinctly different from Fcγ RIII; (2) IgG binding factors (IgGBF), a group of low molecular weight proteins that are capable of binding human IgG; (3) other proteins that can bind antibodies, such as prolactin‐inducible protein and three other novel proteins that we have discovered. These proteins potentially all have the ability to reduce the interactions between antisperm antibodies and effector components of the immune system, such as phagocytic cells.Conclusions: Human seminal plasma contains proteins that can bind antibodies. However, to date our knowledge of these proteins especially, whether they have a physiological role in either the male and female reproductive tracts is limited.
Anti‐annexin A5 Antibodies in Reproductive Failures in Relation to Antiphospholipid Antibodies and Phosphatidylserine
Authors: Arai T. , Matsubayashi H. , Sugi T. , Kondo A. , Shida M. , Suzuki T. , Izumi S.‐I. , McIntyre J. A. , Makino T. 
Published: August 2003

Problem: The presence of IgG anti‐annexin A5 (IgGαA5) and/or antiphospholipid antibodies (aPL) are risk factors associated with recurrent spontaneous abortion. Problems are whether IgA anti‐annexin A5 (IgAαA5) is pathogenic, and how IgGαA5 works.Method of study: Blood samples from 238 patients with early recurrent spontaneous abortion, 48 patients with recurrent in vitro fertilization‐embryo transfer failure, 179 non‐pregnant women and 120 pregnant controls were tested for IgAαA5 by enzyme‐linked immunosorbent assay. We also determined if IgGαA5 appeared coincident with aPL. The antigenic epitope(s) recognized by IgGαA5 was investigated.Results: We observed no difference between patients and controls for IgAαA5. The prevalence of IgGαA5 was not different statistically between patient samples with or without aPL. Patient IgGαA5 bound annexin A5 when the latter was free/unbound but not when annexin A5 was associated with phospholipid.Conclusions: The IgAαA5 does not appear to be pathogenic. IgGαA5 works to make a complex with annexin A5 without relation to aPLs, which may reduce annexin A5 available for binding to trophoblast.
Expression of Leptin Receptor Isoforms in vitro: Lack of Effects of Leptin on Endometrial Cytokine and MMP Production
Authors: Quinton N. D. , Laird S. M. , Tuckerman E. M. , Cork B. A. , Li T. C. , Blakemore A. I. F. 
Published: August 2003

Problem: Leptin has a key role to play in human female reproduction. Its receptor is expressed highly throughout the reproductive tract. Cytokines have an important role in preparing the endometrium for implantation and leptin is known to modulate cytokine production in other tissues. We, therefore, investigated the possible role of leptin in endometrial growth and function.Method of Study: Reverse transcriptase polymerase chain reaction and immunocytochemistry were used to determine the pattern of expression of leptin receptor isoforms in primary human endometrial epithelial and stromal cells in culture. The effect of leptin on cell growth and on the production of cytokines [Leukaemia Inhibitory Factor (LIF), interleukin 6 and tumour necrosis factor‐α] and matrix metalloproteinases (MMP) (MMP2 and MMP‐9) was also investigated.Results: Expression of the long form of the leptin was restricted to the cultured endometrial, epithelial cells. Both cultured endometrial stromal and epithelial cells expressed the short and variant isoforms of the receptor. Incubation of epithelial and stromal cell cultures with varying concentrations of leptin (0–1000 ng/mL) had no significant effect on cell growth or levels of MMP‐2 or MMP‐9 production. Leptin also had no significant effect on cytokine production by epithelial cells.Conclusions: This study shows for the first time, the presence of leptin receptor isoforms on endometrial, epithelial and stromal cells in culture. Leptin had no effect on cytokine and MMP production by these cells. However, it is possible that leptin affects other factors within the endometrium not investigated here.
Enhancement of Immunogenicity of Jeg3 Cells by Ectopic Expression of HLA‐A*0201 and CD80
Authors: Koc Serpil , Kather Angela , Markert Udo R. , Dürst Matthias , Schneider Achim , Kaufmann Andreas M. 
Published: August 2003

Problem: The choriocarcinoma cell line Jeg3 suppresses immunity in vitro by secretion of soluble factors like leukemia inhibitory factor suppressing leukocyte activation. The cells lack expression of classical human leukocyte antigen (HLA)‐A and ‐B alleles but express some HLA‐C, and non‐classical HLA‐G and ‐E. Upon binding to killing inhibitory receptor on natural killer (NK) cells, HLA‐G prevents activation of cytolytic activity. We investigated whether Jeg3 cells are capable of immune stimulation after complementation with classical HLA and T cell costimulatory signal CD80.Method of study: Jeg3 cells were transduced to express HLA‐A*0201 and/or CD80. Parental Jeg3 or transfectants Jeg3‐A2, Jeg3‐CD80 or Jeg3‐CD80‐A2 were used to stimulate allogeneic resting and activated peripheral blood lymphocytes (PBL). The different cell lines were loaded with a HLA‐A2‐restricted Epstein‐Barr virus (EBV) recall antigen peptide epitope and antigen presenting ability was examined. T cell lines specific for Jeg3 and transfectants were generated from HLA‐A2 matched and nonmatched donors and compared for expansion, phenotypes and cytolytic activity.Results: While all Jeg3 cell lines induced only marginal proliferation of resting T cells, phytohemagglutinin (PHA)‐activated T cells were stimulated by CD80 or CD80‐A2 expressing Jeg3. Only the transfectant Jeg3‐CD80‐A2 was capable of specific T cell stimulation by EBV recall antigen presentation. T cell lines of HLA‐A2 non‐matched donors stimulated with the Jeg3 transfectants showed significant expansion only when HLA‐A2 and the costimulus CD80 were present. T cells from HLA‐A2 positive donors did not expand significantly or differentially. No NK cells grew under any condition. In Jeg3‐CD80‐A2 stimulated T cells lines CD8+ cells expanded preferentially. These T cells exerted cytolytic activity toward all Jeg3 cell lines.Conclusion: Our data suggest that, in spite of immunosuppressive mechanisms, proliferative and cytolytic T cell responses are induced by Jeg3 cells when classical HLA‐ and/or costimulatory signals are present on the cells.