bluuebunny/crossref_metadata_2025_split huggingface dataset:
Maternal smoking during pregnancy and nicotine and cotinine concentrations in maternal and neonatal hair
Authors: Jacqz‐Aigrain E. , Zhang D. , Maillard G. , Luton D. , André J. , Oury J.F. 
Published: December 2003

Objective
Conflicting data have been reported in the association between maternal smoking and adverse effects during pregnancy and in neonates. Some studies, conducted on a limited number of patients have evaluated maternal consumption and fetal exposure by measuring nicotine and cotinine in the hair. Our aims were to evaluate the relationship among maternal cigarette consumption, fetal smoking exposure and outcome of pregnancy in a population of pregnant women who smoked.Design
Mothers smoking during pregnancy were included at their first prenatal visit and followed prospectively. Maternal data (demographic variables, obstetrical history and cigarette consumption), neonatal data and birth indicators (number of weeks of gestation, type of delivery, weight) were collected. Hair samples from the mothers and the babies were collected at birth.Setting
The present study was conducted in the Department of Obstetrics of the University Hospital Robert Debré in Paris.Population
A total of 254 women smokers were included in the study and 182 mother/neonate pairs were analyzed after exclusion of 50 babies whose hair samples were inadequate and 22 for various other reasons.Methods
Nicotine and cotinine concentrations in the maternal and neonatal hair were measured at birth by radio‐immunoassay.Main outcome measures
Cigarette consumption was based on self reporting and quantified each trimester. It was expressed more precisely during the third trimester by the mean number per cigarette per day. Nicotine and cotinine concentrations in the maternal and neonatal hair at birth were also analysed.Results
Nicotine and cotinine concentrations in maternal hair were associated with cigarette consumption during the third trimester of pregnancy (P < 0.003 and P < 0.01, respectively). In neonates, only cotinine concentrations were associated to maternal cigarette consumption (P < 0.0001). This association remained significant in a multivariate analysis, which included maternal cotinine hair concentrations and the ethnic group.Conclusions
Our results have shown a strong relationship between maternal cigarette consumption and fetal exposure to smoking measured by cotinine concentrations in neonatal hair. Further studies are required to look for associations between fetal exposure and adverse pregnancy outcome.
Absence of enhanced systemic inflammatory response at 18 weeks of gestation in women with subsequent pre‐eclampsia
Authors: Djurovic Srdjan , Clausen Torun , Wergeland Ragnhild , Brosstad Frank , Berg Kåre , Henriksen Tore 
Published: December 2003

Objective
To compare indicators of systemic inflammatory response in the second trimester in women who developed pre‐eclampsia with normal pregnancies.Design
Prospective nested case control study derived from a cohort of 2190 pregnant women. Blood samples were obtained at 18 weeks of gestation. The following inflammatory parameters were measured: tumour necrosis factor‐α (TNF‐α), plasminogen activator inhibitor‐1 (PAI‐1), interleukin‐1β (IL‐1β), IL‐6, IL‐10, microCRP and tissue factor (TF).Setting
Institute of Medical Genetics, University of Oslo, and Department of Medical Genetics, Ullevål University Hospital and Departments of Obstetrics and Gynecology, Aker University Hospital, Oslo, Norway.Sample
The cases were 71 women who subsequently developed pre‐eclampsia. The controls were 71 healthy, pregnant women matched for age, parity and first trimester body mass index (BMI).Methods
Venous blood was drawn from fasting subjects into 5 mL test tubes containing EDTA. Samples were analysed for inflammatory parameters : IL‐1‐β, IL‐6, IL‐10, TNF‐α, PAI‐1, TF (ELISA‐technique) and CRP (latex‐enhanced immunonephelometric assay), strictly according to the manufacturer's recommendation.Main outcome measures
The matched case and control subjects were compared by the paired two‐tailed Wilcoxon signed rank test. All P values were two‐tailed and P < 0.05 was deemed statistically significant.Results
We found no differences in plasma concentrations of PAI‐1, IL‐1β, IL‐6, IL‐10, microCRP, TNF‐α or TF at 18 weeks of gestation between women who subsequently developed pre‐eclampsia and matched control women.Conclusion
In contrast to findings from women with overt pre‐eclampsia, the present study indicates that there are no indications of intensified systemic inflammatory response at 18 weeks of gestation in women who later develop pre‐eclampsia.
The contribution of hysterectomy to the occurrence of urge and stress urinary incontinence symptoms
Authors: Van, der Vaart C.H. , Van, der Bom J.G. , de Leeuw J.R.J. , Roovers J.P.W.R. , Heintz A.P.M. 
Published: December 2003

Objective
To study the contribution of hysterectomy to the occurrence of urge‐or stress urinary incontinence symptomsDesign
A population‐based, cross‐sectional cohort study conducted in 1999Setting
A university medical centre in The NetherlandsPopulation
Random sample of 2322 women, between 35 and 70 years of age, from a suburban area in the central part of The NetherlandsMethods
Self‐report questionnaire with questions from the Urogenital Distress Inventory, sociodemographic variables and data on obstetric and gynaecological historyMain outcome measures
Multivariate logistic regression analysis was used to obtain odds ratios with 95% confidence interval of the type and bothersomeness of urinary incontinence for hysterectomyResults
One thousand, six hundred and twenty‐six women (70%) responded. The adjusted odds of urge (1.9, 1.4;2.6) and bothersome urge (2.6, 1.4;4.4) urinary incontinence were increased for women who had a hysterectomy. This association was not limited to the elderly but also occurred in women under 60 years of age. No increased odds of stress or bothersome stress incontinence were foundConclusions
Meta‐analysis has shown that hysterectomy increases the odds of urinary incontinence by 30%. However, a distinction between the different types of urinary incontinence symptoms has not been made. Such a distinction is of importance since urge incontinence gives a significantly greater reduction in health‐related quality of life as compared with stress incontinence. Therefore, our finding that women scheduled for hysterectomy have an increased risk of developing urge incontinence symptoms indicates that these women should be counselled about this particular consequence
Effects of tibolone and continuous combined hormone replacement therapy on bleeding rates, quality of life and tolerability in postmenopausal women
Authors: Huber J. , Palacios S. , Berglund L. , Hänggi W. , Sathanandan S.M. , Christau S. , Helmond F. 
Published: December 2003

Objective
To compare the effects of tibolone and conjugated equine oestrogens continuously combined with medroxyprogesterone acetate on bleeding rates, quality of life (QoL) and tolerability.Design
A double‐blind, randomised comparative trial.Setting
Thirty‐seven centres in six European countries.Population
Five hundred and one postmenopausal women, under 65 years of age with an intact uterus.Interventions
For 12 months, women received daily treatment with tibolone 2.5 mg (n= 250), or conjugated equine oestrogens 0.625 mg continuously combined with medroxyprogesterone acetate 5 mg (CEE–MPA, n= 251).Main outcome measures
The primary outcome was vaginal bleeding rate during cycles 4–6. The secondary outcomes were vaginal bleeding rate during cycles 1–3, 7–9 and 10–13, cumulative bleeding rate, QoL, wellbeing, climacteric symptoms, urogenital complaints and tolerability.Results
Treatment with tibolone led to a significantly lower bleeding rate during cycles 4–6 compared with CEE–MPA (15.0%vs 26.9%; P= 0.004); there was a similar difference during cycles 1–3. Both treatments improved QoL, wellbeing, climacteric symptoms and urogenital complaints. By intent‐to‐treat analysis, tibolone significantly improved sexual drive, interest and/or performance, compared with CEE–MPA at 12 months (P= 0.017). Although both treatments were well tolerated, there was a significantly lower incidence of breast tenderness with tibolone than CEE–MPA (2.4%vs 17.1%; P < 0.001).Conclusion
The vaginal bleeding rate during cycles 4–6 was significantly lower in women using tibolone. Both treatments improved QoL, wellbeing, climacteric symptoms and urogenital symptoms. Breast tenderness was significantly less frequent with tibolone.
The creation of twin centile curves for size
Authors: Ong Stephen , Lim Meh‐Noi , Fitzmaurice Ann , Campbell Doris , Smith Anne P. , Smith Norman 
Published: December 2003

Objective
To create twin centile charts for size.Design
Retrospective study.Setting
Aberdeen Maternity Hospital.Methods
Ultrasound measurements of abdominal circumference (AC), biparietal diameter (BPD) and femur length (FL) for 1011 twin pregnancies were extracted from a databank. The methodology is based on that described by Altman and Chitty [Br. J. Obstet. Gynaecol. 101 (1994) 29.]; only one measurement from each twin was used, polynomial regression models were fitted separately to the mean and standard deviation (SD) of the ultrasound parameter as functions of gestational age. The centiles were obtained assuming that at each gestation, the measurements had a normal distribution.Results
The growth pattern of AC for twins appear to follow closely that of singletons until 32 weeks. Thereafter, there is a gradual but definite fall off in growth away from singleton standards. The pattern of growth of FL is largely similar to that of singletons. From mid to early third trimester, the BPD of twin babies was larger than that of singletons.
What are the implications for the next delivery in primigravidae who have an elective caesarean section for breech presentation?
Authors: Coughlan Carol , Kearney Rohna , Turner Michael J. 
Published: December 2003

Objective
To determine the mode of the next delivery for primigravid women who have an elective caesarean section for breech presentation.Design
Retrospective cohort study.Setting
University teaching hospital.Population
All primigravid women who had an elective caesarean section for a singleton pregnancy in the years 1992 to 1997 and who delivered their next baby in the hospital before 1999.Methods
Review of hospital computerised records.Main outcome measures
Mode of delivery and fetal presentation at next delivery.Results
Of 194 women who had an elective caesarean section with a breech presentation as a primigravida, 19 (9.8%) had a breech presentation at the time of elective caesarean section for their next baby compared with only two (1.7%) in the 121 women who had an elective caesarean section with a cephalic presentation as a primigravida (RR 5.9 [95% CI 1.4–25.0]). Despite the increased likelihood of another breech presentation, the overall repeat section rate was 43.8% (n= 85) in women with a previous breech presentation (n= 194), compared with 61.2% (n= 74) in women with a previous cephalic presentation (n= 121) (RR 0.72 [95% CI 0.58–0.89]). Of those women allowed to labour after elective caesarean section as a primigravid, the vaginal birth rate was 109/130 (84%) if the presentation previously was breech compared with 47/69 (68%) if the presentation previously was cephalic (RR 1.2 [95% CI 1.03–1.50]).Conclusions
Women who have an elective caesarean section for a breech presentation in their first pregnancy have about a 1 in 10 chance of having an elective caesarean section for a breech presentation in their second pregnancy. Overall, the incidence of repeat caesarean section for their second baby was 43.8%, and of those allowed to labour, 84% achieved a vaginal delivery. These results compared favourably with women who had an elective caesarean section with a cephalic presentation in their first pregnancy. This information is important in advising primigravid women with a breech presentation about longer term implications of elective caesarean section. It also allows healthcare managers to anticipate the resource implications of any changes in clinical practice for women with a breech presentation in their first pregnancy.
Relationship between customised birthweight centiles and neonatal anthropometric features of growth restriction
Authors: Owen Philip , Farrell Tom , Hardwick J. Christopher R. , Khan Khalid S. 
Published: December 2003

Objective
To determine the relationship between customised birthweight centiles (adjusted for maternal and fetal physiological variables) and neonatal anthropometric features of intrauterine growth restriction (IUGR).Design
Observational study.Population
Two‐hundred and seventy women with low risk pregnancies participating in a cohort study of serial ultrasound biometry.Methods
Customised birthweight centiles were calculated following adjustment for maternal weight, height and ethnic origin, gestational age at delivery, birth order, and sex of the infant. Three separate neonatal anthropometric measures were used to define IUGR: subscapular or triceps skinfold thickness <10th centile; ponderal index <25th centile; and mid‐arm circumference to occipito‐frontal circumference ratio (MAC/OFC) <−1 standard deviation (SD). Relationship of the centiles to these outcomes was evaluated using likelihood ratios (LR) and kappa statistic. These approaches allowed us to examine the strength of the association: an LR of 5–10 would be expected to generate moderate changes in the pre‐test probability of IUGR, whereas a kappa value of 0.2–0.4 would reflect fair agreement between customised birthweight centiles and neonatal anthropometric measures.Results
Customised birthweight centile of 10 or less had the following LR values for the various anthropometric criteria for IUGR: 5.1 (95% CI 3–8.5) for low skinfold thickness; 4.3 (95% CI 2.5–7.1) for low ponderal index; and 3.9 (95% CI 2–6.6) for low MAC/OFC ratio. The kappa values were: 0.4 (95% CI 0.26–0.51) for low skinfold thickness; 0.33 (95% CI 0.21–0.46) for low ponderal index; and 0.13 (95% CI 0–0.26) for low MAC/OFC ratio.Conclusion
In a low risk population, customised birthweight centiles can only be moderately useful in the identification of neonates with low skinfold thickness and low ponderal index.
A randomised study comparing a low dose of mifepristone and the Yuzpe regimen for emergency contraception
Authors: Ashok Premila W. , Stalder Catriona , Wagaarachchi Prabhath T. , Flett Gillian M. , Melvin Louise , Templeton Allan 
Published: December 2003

Objective
To compare 100 mg mifepristone with the standard Yuzpe regimen for emergency contraception.Design
Randomised controlled trial.Setting
Family Planning Clinic, Aberdeen.Sample
One thousand women seeking emergency contraception within 72 hours after an episode of unprotected sexual intercourse.Methods
Women were randomised to receive either 100 mg (half tablet) of mifepristone as a single dose or the Yuzpe regimen (two tablets each with 50 μg ethinyloestradiol and 0.25 mg levonorgestrel, to be repeated 12 hours later).Outcome measures
Crude pregnancy rates, proportion of pregnancies prevented, side effects and patient acceptability.Results
The crude pregnancy rates (95% CI) for the Yuzpe regimen and mifepristone were 3.6% (2.3–5.7) and 0.6% (0.2–1.8), respectively, with a significant difference between the two groups (RR 6.04; 95% CI 1.75–20.75). Mifepristone prevented 92% of pregnancies and the Yuzpe regimen preventing 56%. An increasing coitus to treatment interval was associated with contraceptive failure in the Yuzpe group (P= 0.03) with no association seen with mifepristone. Following administration of mifepristone 24.5% and 13.1% given the Yuzpe regimen had a delayed period (RR 2.14; 95% CI 1.46–3.15). Overall, mifepristone was better tolerated than the Yuzpe regimen with significantly fewer side effects. More women were satisfied (P < 0.0001) with mifepristone as an emergency contraceptive and would recommend it to a friend (P= 0.02).Conclusion
Mifepristone administered in a 100 mg dose is a highly effective post‐coital contraceptive with high patient acceptability and fewer side effects compared with the standard Yuzpe regimen. Delay in the onset of menstruation did not decrease patient acceptability.
Few women wish to be delivered by caesarean section
Authors: Hildingsson Ingegerd , Rådestad Ingela , Rubertsson Christine , Waldenström Ulla 
Published: December 2003

Objective
To investigate how many women wish to have a caesarean section when asked in early pregnancy, and to identify background variables associated with such a wish.Design
National survey.Setting
Swedish antenatal clinics.Population
3283 Swedish‐speaking women booked for antenatal care, at approximately 600 Swedish antenatal clinics, during three weeks spread over one year (1999–2000).Methods
A questionnaire was mailed shortly after the first antenatal visit.Main outcome measures
Women's preferences for mode of delivery.Results
3061 women completed the first questionnaire, corresponding to 94% of those who consented to participate after exclusion of reported miscarriages. The background characteristics of the study sample were very similar to a one‐year cohort of women giving birth in Sweden during 1999. The result showed that 8.2% of the women would prefer to have a caesarean section. A wish for caesarean section was associated with parity, age, civil status, residential area and obstetric history. Women preferring caesarean section were more depressed and worried, not only about giving birth, but also about other things in life. A multivariate logistic regression model showed three factors being statistically associated with a wish for caesarean section: a previous caesarean section, fear of giving birth and a previous negative birth experience.Conclusions
Relatively few women wish to have a caesarean section when asked in early pregnancy, and these women seem to be a vulnerable group.
The effect of fundal pressure manoeuvre on intrauterine pressure in the second stage of labour
Authors: Buhimschi Catalin S. , Buhimschi Irina A. , Malinow Andrew M. , Kopelman Jerome N. , Weiner Carl P. 
Published: December 2003

Objective
To investigate the relationship between intrauterine pressure and the application of a standardised fundal pressure manoeuvre, and to determine the maternal, fetal and labour characteristics that modulate the relationship.Design
Prospective measurement of intrauterine pressure during the second stage of labour.Setting
North American university hospital.Population
Forty full‐term women in spontaneous labour were studied during the second stage. Each woman acted as her own control. All women laboured with requested epidural analgesia.Methods
A fundal pressure manoeuvre was performed so as to standardise the level of force and the surface area of application. Intrauterine pressure was measured using a sensor–tip catheter. Five interventions were analysed: 1. valsalva during a uterine contraction; 2. fundal pressure and valsalva during a contraction; 3. fundal pressure during a contraction without valsalva; 4. fundal pressure in the absence of uterine contractions; and 5. valsalva in the absence of uterine contractions.Results
Women in the second stage of labour transiently increased their expulsive force (as reflected by intrauterine pressure) by 86% of their baseline contraction using valsalva and fundal pressure simultaneously. The efficiency by which both contraction‐enhancing manoeuvres increased intrauterine pressure was directly related to gestational age and inversely related to myometrial thickness.Conclusion
Fundal pressure applied under controlled conditions significantly increases intrauterine pressure in some, but not all women. Simultaneous measurement of intrauterine pressure, to maintain feedback during application will create a ‘controlled environment’ for the obstetrician and reassurance that this manoeuvre can be applied in a controlled fashion. Future delineation of the group of women that could benefit from fundal pressure, as well as the group that is refractory is essential to avoid unnecessary or delayed operative interventions.
Maternal morbidity and pregnancy outcome in a cohort of mothers transferred out of perinatal centres during a national census
Authors: Bennett Charlotte C. , Lal Mithilesh K. , Field David J. , Wilkinson Andrew R. 
Published: December 2003

Objective
To record the maternal morbidity and pregnancy outcome in this cohort.Design
Retrospective data collection from a prospectively defined cohort.Setting
The 37 largest perinatal centres in the UK.Population
258 in utero transfers recorded during a three‐month census (1/4/99–30/6/99).Methods
A questionnaire regarding the outcome of each mother was sent to the perinatal centre and receiving hospital.Results
Data were returned on 242/258 (94%) mothers. Fifty‐eight percent were transferred out of their perinatal centre in preterm labour and 38% had coexisting disease necessitating early delivery. The median gestational age at transfer was 32 weeks (range 23–41). Sixty‐one percent delivered at the receiving hospital; 12% were transferred on to a third hospital and 29% ultimately returned to deliver at the original perinatal centre. Fifty‐two percent of mothers received postnatal care in hospitals other than those defined as a major perinatal centre. One mother delivered during transfer and a further nine within one hour of arrival. One mother received intensive care after delivery and later died, a further 7% required high dependency care postnatally. Data were available on 273/333 (82%) babies. The median gestational age at delivery was 34 weeks (range 24–41). Six infants were stillborn and 187/264 (71%) infants were admitted to a neonatal unit.Conclusions
This study has documented the maternal morbidity, potential risks and pregnancy outcome of a cohort of mothers transferred out of the largest perinatal centres in the UK because of a shortage of neonatal cots. A national standard for the delivery of high risk perinatal services is needed to uphold good clinical practice guidelines in the care of high risk mothers and their infants.
Is outpatient diagnostic hysteroscopy more useful than endometrial biopsy alone for the investigation of abnormal uterine bleeding in unselected premenopausal women?
Authors: Bain Christine , Parkin David E. , Cooper Kevin G. 
Published: December 2003

Objective
To formally evaluate the clinical benefit of additional outpatient hysteroscopy over traditional vaginal examination and endometrial biopsy.Design
A prospective randomised controlled trial.Setting
A large teaching hospital in the northeast of Scotland.Sample
Premenopausal women with abnormal uterine bleeding referred to the general gynaecologic clinic and requiring endometrial biopsy.Methods
Women were randomised to either outpatient hysteroscopy and endometrial biopsy or endometrial biopsy alone.Main outcome measures
Primary outcome: initial surgical intervention rates. Secondary outcomes: procedural success and acceptability, intrauterine pathology identified and changes in management.Results
Three hundred and seventy women were recruited to the study. Initial trends in clinical management were comparable in both groups. No woman was advised to have removal of a localised lesion found at outpatient hysteroscopy and a normal uterine cavity at hysteroscopy did not influence the hysterectomy rate, which was similar in both groups. Outpatient hysteroscopy was found to be as acceptable as an outpatient endometrial biopsy and successfully completed in 85% compared with 91% of women who underwent endometrial biopsy alone. No cases of endometrial malignancy were identified.Conclusions
Outpatient diagnostic hysteroscopy is an acceptable procedure and may give more reassurance. It did not influence clinical management, especially with respect to hysterectomy rate. Outpatient hysteroscopy may be useful in selected cases, but when performed in a non‐selective manner, it has little influence on clinical management and increases costs.