bluuebunny/crossref_metadata_2025_split huggingface dataset:
A comparative study of women with chronic pelvic pain, chronic nonpelvic pain and those with no history of pain attending general practitioners
Authors: Collett B. J. , Cordle C. J. , Stewart C. R. , Jagger Carol 
Published: August 2005

Objective
To investigate and compare the demographic and psychosocial profiles of women with chronic pelvic pain, chronic pain in a different site, and those with no history of pain with specific reference to a history of sexual abuse.Design
A prospective comparative study.Setting
Pelvic Pain Clinic at Leicester General Hospital NHS Trust, Pain Management Clinic at Leicester Royal Infirmary NHS Trust and two General Practices.Participants
Thirty women with chronic pelvic pain, 30 women with chronic pain in a different site and 30 women attending their general practitioner with no history of pain.Interventions
A specifically designed patient profile questionnaire to identify and explore incidents of sexual and physical abuse was administered to each woman by a research psychologist for confidential self‐completion. Data were also collected on other demographic, medical and psychosocial characteristics.Results
Women with chronic pelvic pain were found to have a higher lifetime prevalence of sexual abuse, involving penetration or other genital contact compared with the two comparison groups. The prevalence of physical abuse was the same in all groups. Women in the pelvic pain group were more likely to have approached their GP for symptoms not related to pelvic pain than women in the other two groups and the incidence of clinical anxiety was significantly higher in this group compared with the pain‐free group. The prevalence of sexual problems was much higher in the group with pelvic pain compared with the other two groups.Conclusion
These findings indicate that women with chronic pelvic pain have a higher incidence of past sexual abuse compared with women in a comparison pain group and with women with no pain.
Maternal serum inhibin A can predict pre‐eclampsia
Authors: Cuckle Howard , Sehmi Indera , Jones Richard 
Published: August 2005

Objective
To compare median levels of maternal serum inhibin A in the second trimester blood samples of women who subsequently develop pre‐eclampsia and those who do not.Design
Retrospective analysis of 13–18 week samples from a bank of serum stored at −40°C, originally taken for Down's syndrome screening.Setting
Antenatal clinics in a teaching hospital.Sample
Twenty‐eight pregnancies with pre‐eclampsia and 701 controls. Samples were taken, on average, 22 weeks before the diagnosis.Main outcome measure
Median inhibin A level.Results
The median inhibin A level in the cases was 2.01 multiples of the gestation‐specific median in the controls, a statistically significant elevation (P < 0.001). Twenty‐three (82%) had levels above the normal median; 19 (68%), 15 (54%), and 11 (39%) exceeded the normal 75th, 90th and 95th centiles, respectively.Conclusions
In pre‐eclampsia the maternal serum inhibin A level can be increased months before the onset of symptoms. This provides an opportunity to study the early natural history of the disease and possibly to conduct treatment trials.
Antibodies against copper‐oxidised and malondialdehyde‐modified low density lipoproteins in pre‐eclamptic pregnancies
Authors: Uotila Jukka , Solakivi Tiina , Jaakkola Olli , Tuimala Risto , Lehtimaki Terho 
Published: August 2005

Objective
To measure auto‐antibodies against oxidatively modified low density lipoprotein (LDL) in pre‐eclamptic pregnancies using two different techniques.Design
Clinical study comparing pre‐eclamptic and normal pregnancies.Setting
Tampere University Hospital, Finland.Population
Twenty‐one primigravidae with pre‐eclampsia and 13 healthy, normotensive primigravidae as controls.Methods
The serum titers of antibodies against both malondialdehyde‐modified and copper‐oxidised LDL (MDA‐LDL and copper‐ox LDL) were analysed and related to parameters reflecting the severity of pre‐eclampsia.Results
There was a positive correlation (r= 0.58) between antibodies against MDA‐LDL and copper‐ox LDL in women with pre‐eclampsia but not in healthy pregnant controls. The antibody levels against copper‐ox LDL, but not against MDA‐LDL, were higher in women with pre‐eclampsia than in women with a normal pregnancy (P < 0.01). While the antibody titers against copper‐ox LDL did not correlate with any parameter reflecting the severity of pre‐eclampsia, those against MDA‐LDL showed a positive correlation with the level of diastolic blood pressure (r= 0.54) and a negative correlation with platelet count (r= 461) in women with pre‐eclampsia.Conclusions
There are increased titers of serum autoantibodies against copper‐oxidised LDL in pre‐eclampsia, which may reflect enhanced lipid peroxidation involving circulating lipoproteins.
Perceptions of women on the impact of menorrhagia on their health using multi‐attribute utility assessment
Authors: Shaw R. W. , Brickley M. R. , Evans L. , Edwards M. J. 
Published: August 2005

Objective
To assess patient preferences regarding the treatment of menorrhagia using the multi‐attribute utility methodologies, to produce a clinically applicable scale, and to assess health outcomes following treatment of menorrhagia.Methods
Women referred to the gynaecology department for the treatment of menorrhagia were interviewed regarding the effects of menorrhagia on different aspects of their life. Their concerns were categorised into main components of health (domains). The relative importance of each domain was rated by the women using importance points which were distributed to represent the perceived importance of each domain. A series of statements (intra‐domain statements) was developed for each domain, which described various possible conditions of that component of health. These were also rated using a one metre visual analogue scale with numerical anchor points at zero (worst) and 100 (best).Results
The components of health considered most important were, in order of impact, family life, followed by physical health, work life, psychological health, practical difficulties and social life. The scores for the intra‐domain statements were combined into a scale to allow the calculation of a final health state utility for a particular outcome based upon the statements the patient chooses within each domain.Discussion
In planning treatment for menorrhagia clinicians can assess a woman's current perception of their health, using a simple to administer clinical scale.
Circulating markers of oxidative stress are raised in normal pregnancy and pre‐eclampsia
Authors: Morris Jonathan M. , Gopaul Nitin K. , Endresen Marit J. R. , Knight Marian , Linton Elizabeth A. , Dhir Suman , Ängård Eric E. , Redman Christopher W. G. 
Published: August 2005

Objective
To determine whether circulating markers of oxidative stress are elevated in pre‐eclampsia when appropriate precautions are taken to prevent in vitro oxidationDesign
A prospective study.Setting
Nuffield Department of Obstetrics and Gynaecology, Oxford and The William Harvey Institute, London.Sample
Three groups of women: those with pre‐eclampsia (n = 19), control pregnant (n = 19) matched for gestation, age and parity and a group of non pregnant individuals reproductive age (n = 7).Methods
Citrated plasma was stored at −80°C with 20 μmol β hydroxytoluene to prevent auto‐oxidation. Plasma samples were assayed for levels of 8 epi‐prostaglandin F2α, lipid hydroperoxides, malondialdehyde and also the lipid soluble antioxidant vitamin E.Results
There were no differences in 8 epi‐prostaglandin F2α lipid peroxide or malondialdehyde levels between the groups of women with pre‐eclampsia and those acting as pregnant controls. However, lipid hydroperoxides and malondialdehyde were significantly raised in both pre‐eclampsia and normal pregnancy, compared with nonpregnant women. Vitamin E levels were similar in women with pre‐eclampsia and those with a normal pregnancy, but in both groups levels were significantly higher than in nonpregnant women.Conclusion
Circulating markers of oxidative stress are raised in normal pregnancy and pre‐eclampsia.
Pregnancy in women with von Willebrand's disease or factor XI deficiency
Authors: Kadir Rezan A. , Lee Christine A. , Sabin Caroline A. , Pollard Debra , Economides Demetrios L. 
Published: August 2005

Objective
To assess the obstetric outcome in women with von Willebrand's disease or factor XI deficiency.Setting
Haemophilia Centre and Haemostasis Unit, The Royal Free Hospital.Population
Women with von Willebrand's disease (n= 31) and with factor XI deficiency (n= 11) registered at the Royal Free Hospital Haemophilia Centre who had had a pregnancy within the previous 17 years (1980–1996), including 84 in women with von Willebrand's disease and 28 in women with factor XI deficiency.Methods
Women were interviewed and details of the obstetric history were obtained. The records of the Haemophilia Centre and the women's maternity records were also reviewed.Results
Threatened miscarriage occurred in 33% and 14% of pregnancies with von Willebrand's disease and factor XI deficiency, respectively. Excluding recurrent miscarriages, 14/68 (21%) of pregnancies with von Willebrand's disease and one pregnancy with factor XI deficiency miscarried spontaneously. There was an increased incidence of primary and secondary post‐abortal bleeding complications. Factor VIJI and von Willebrand factor antigen and activity levels increased significantly in pregnancy in all women apart from those with severe von Willebrand's disease. Factor XI, however, did not show any significant change. No neonatal haemorrhagic complications in association with the birth process were reported, although ventouse and difficult forceps deliveries were avoided. Extensive perineal bruising and haematoma was reported in three women with von Willebrand's disease; two of these were associated with forceps delivery. The incidence of primary postpartum haemorrhage was 185% in von Willebrand's disease and 16% in factor XI deficiency. Blood transfusion was required in six cases of von Willebrand's disease and two cases of factor XI deficiency. Ten of fourteen instances of primary postpartum haemorrhage occurred when maternal factor levels were < 50 IU/dL with no prophylactic treatment for labour. The incidence of secondary postpartum haemorrhage was 20% in von Willebrand's disease and 24% in factor XI deficiency. None of the women who had prophylactic treatment during labour or the puerperium suffered any significant bleeding complications. There were three neonatal bleeding complications.Conclusion
Pregnancy, labour and the puerperium are associated with significant bleeding problems in women with von Willebrand's disease or factor XI deficiency, but these are largely preventable. Specialist obstetric care in close liaison with the haemophilia centre is essential to minimise maternal deficiency. and neonatal complications.
Incidence of urinary incontinence and constipation during pregnancy and postpartum: survey of current findings at the Rotunda Lying‐in Hospital
Authors: Marshall Kathleen , Thompson Kate A. , Walsh Deirdre M. , Baxter George D. 
Published: August 2005

Objective
To assess the impact of pregnancy upon continence and constipation.Design
A questionnaire survey.Setting
Maternity wards in the Rotunda Lying In Hospital, Dublin, Republic of Ireland.Population
7771 women who were delivered of liveborn infants.Methods
Questionnaires were delivered and collected by physiotherapy staff as part of routine postnatal care.Results
Analysis of data using χ2 tests showed significant differences between three parity groups [primigravidae, multigravidae (2–4) and multigravidae (5+)] for symptoms of both urinary incontinence (χ2= 119.54, df = 2, P = 0.000) and constipation (χ2= 12.53, df = 3, P = 0.002); the incidence of both constipation and urinary incontinence increased with parity.Conclusion
The results of this survey have emphasised the relation between parity and postpartum incontinence which stresses the importance of early diagnosis and intervention.
Prediction of pre‐eclampsia, low birthweight for gestation and prematurity by uterine artery blood flow velocity waveforms analysis in low risk nulliparous women
Authors: Irion Olivier , Massé Jacques , Forest Jean‐Claude , Moutquin Jean‐Marie 
Published: August 2005

Objective
To assess the performance of four previously reported Doppler abnormalities of uterine artery velocity waveforms (presence of a protodiastolic notch, peak systolic over protodiastolic velocities (A:C ratio) > 2.5, peak systolic over end diastolic velocities (A:B ratio) > 90th centile, resistance index (RI) ([A‐B]/A) ≥0.58) in predicting pre‐eclampsia, low birthweight and prematurity.Design
Prospective cohort study.Setting
Tertiary care university hospital in Quebec City.Population
1311 nulliparous women.Methods
Evaluation of pulsed Doppler abnormalities of uterine artery velocity waveforms was carried out in 1000 and 1 194 of women at 18.3 (SD 0.9) or 26.7 (SD 0.9) weeks of pregnancy.Main outcome measures
Pre‐eclampsia, birthweight below the 10th centile for gestational age and spontaneous preterm birth (< 37 completed gestation weeks).Results
Pre‐eclampsia, low birthweight for gestation and prematurity occured in 4%, 11% and 7% of the pregnancies, respectively. At 26 weeks all the abnormalities of the studied Doppler indices were significantly associated with pre‐eclampsia and low birthweight for gestation as reflected by the 95% confidence intervals of the positive likelihood ratios which did not include the value 1. However, sensitivities (26% to 34%) and positive predictive values (7% to 28%) were low. No Doppler indices performed significantly better than the others. The abnormalities of the Doppler indices were not associated with spontaneous prematurity. The performance of the Doppler measurements performed at 18 weeks was poor.Conclusions
Uterine artery Doppler velocimetry waveform analysis does not qualify as a reliable screening test for pre‐eclampsia or low birthweight for gestation in low risk pregnancies but may be useful in selected high risk populations.
Can women at risk of cervical abnormality be identified?
Authors: Blomfield P. I. , Lancashire R. J. , Woodman C. B. J. 
Published: August 2005

Objective
To determine if use of a detailed risk factor profile accurately predicts the presence of cytological abnormality of the cervix or improves the appropriateness of referral for colposcopic assessment when women are found to have these abnormalities.Design
Cross‐sectional survey.Setting
Family planning clinic.Population
1219 consecutive women, aged between 15 and 19 years, attending for contraceptive advice. Variables included age, social class, educational status, hormonal and obstetric history, smoking and alcohol habits, history of sexually transmitted diseases, the age of first intercourse, number of sexual partners, duration of each relationship, frequency of intercourse, contraception used and the age of each partner.Main outcome measures
Presence or absence of cytological abnormality and the presence or absence of histological abnormality in those with cytological abnormality referred for colposcopic assessment.Results
Univariate analysis confirmed many of the known associations of cervical abnormality. Discriminant analysis identified five independent significant predictors of cytological abnormality and four independent predictors of dyskaryotic cytology. At best models, derived from identified variables correctly predicted 10.1 % of individuals with cytological abnormality and 13.5% of those with dyskaryotic cytology. Of those referred for colposcopic assessment because of abnormal cytology, models were able to predict 23.5% of those with histological evidence of cervical intraepithelial neoplasia.Conclusions
Despite the availability of detailed information regarding the known correlates of cervical neoplasia in this age group, it was not possible to identify the majority of women with cervical abnormality. It is concluded that the strength of these associations is not sufficient to allow useful prediction of membership of a high risk group.
A comparative study of pre‐operative procedures to assess cervical invasion by endometrial carcinoma
Authors: Toki Toshihiko , Oka Kenji , Nakayama Kuniaki , Oguchi Osamu , Fujii Shingo 
Published: August 2005

Objective
To compare the accuracy of different diagnostic procedures currently used to assess cervical involvement in endometrial carcinoma.Design
Retrospective observational study.Setting
Department of Obstetrics and Gynecology, Shinshu University Hospital, Matsumoto, Japan.Participants
Sixty‐four patients with endometrial carcinoma were evaluated pre‐operatively for cervical involvement by six different diagnostic procedures: cervical cytology, endocervical curettage, transvaginal ultrasonography, hysteroscopy, magnetic resonance imaging, and serum levels of CA125. The number of positive and negative diagnoses of cervical invasion by each of these procedures were correlated with the actual invasion determined by histological examination.Results
Cervical invasion was confirmed in 12 (18.8%). Endocervical curettage showed high sensitivity (91%), the highest negative predictive value (96%), and the lowest negative likelihood ratio (0.14). Hysteroscopy showed high positive likelihood ratio (8.2) and low negative likelihood ratio (0.20). Magnetic resonance imaging showed the highest positive predictive value (75%) and the highest positive likelihood ratio (12.5). Magnetic resonance imaging was excellent for predicting stromal invasion, whereas hysteroscopy was superior for assessing mucosal involvement to magnetic resonance imaging.Conclusion
Endocervical curettage is a good test for excluding cervical involvement by endometrial carcinoma. Hysteroscopy is a good test in making both positive and negative diagnoses for cervical involvement. Magnetic resonance imaging is an excellent test for detecting cervical involvement, especially when the stroma is invaded.
Antenatal glucocorticoid administration increases corticotrophin‐releasing hormone in maternal plasma
Authors: Korebrits C. , Yu D. H. T. , Ramirez M. M. , Marinoni E. , Bocking A. D. , Challis J. R. G. 
Published: August 2005

Objective
This study was designed to determine whether maternal corticotrophin‐releasing hormone (CRH) concentrations are altered after maternal betamethasone administration for fetal lung maturity in women with threatened pretenn labour and whether these effects are dependent on gestational age.Methods
Our study included 49 women with threatened preterm labour who received prenatal betamethasone for fetal lung maturity between 24 and 31 weeks of gestational age and 11 women who did not. Maternal blood was taken before and after glucocorticoid administration or at 24 hours after initial sampling. Plasma CRH, adrenocorticotrophin (ACTH) and cortisol concentrations were determined by radioimmunoassays. The women were stratified into 24–25 weeks, 26–27 weeks, 28–29 weeks, and 30–31 weeks completed gestation.Results
At each gestational age, maternal cortisol concentrations decreased by approximately 85% after glucocorticoid administration. Overall mean cortisol values fell from 580.0 (SD, 351.8) to 89.7 (96.6) nmol/L (n= 40, P < 0.001). Overall mean ACTH values decreased from 9.9 (4.7) to 5.0 (3.4) pmol/L (n= 43, P < 0*001), and the approximate 50% decrease was similar at each gestational age. In marked contrast, overall mean CRH values increased from 58.0 (37.0) to 87.8 (68.6) pmol/L (n= 49, P < 0.001) after betamethasone administration. There was no change in maternal cortisol, ACTH or CRH values over 24 hours in women who did not receive betamethasone.Conclusions
We conclude that maternal betamethasone administration increases maternal plasma CRH values between 24 and 31 completed weeks of gestation.
A randomised comparison of strategies for reducing infective complications of induced abortion
Authors: Penney Gillian C. , Thomson Margaret , Norman Jane , McKenzie Hamish , Vale Luke , Smith Robert , Imrie Moira 
Published: August 2005

Objectives
To determine lower genital tract carriage rates of C. trachomatis, N. gonorrhoeae and bacterial vaginosis among women seeking termination of pregnancy. To compare two clinical management strategies for minimising the risks of infective morbidity after induced abortion.Design
Prevalence of infections was assessed by screening women undergoing abortion. Clinical management strategies were compared by a randomised trial.Setting
The gynaecology departments of four hospitals in Scotland.Participants
1672 women undergoing induced abortion.Interventions
Women randomised to prophylaxis received metronidazole 1 g rectally before abortion plus doxycycline 100 mg twice daily for seven days. Women randomised to screen‐and‐treat received appropriate antibiotics only if screening proved positive for one or more infection.Main outcome measures
Prevalences of infections; morbidity in the eight weeks following abortion as assessed by reported symptoms, general practitioner consultation and prescription rates and hospital re‐attendances; costs to the NHS of alternative managements.Results
Prevalence rates: C. trachomatis 5.6%; N. gonorrhoeae 0.19%; bacterial vaginosis 17.5%. Overall, women allocated to receive prophylaxis had lower rates of measures of short term infective morbidity than those allocated to screen‐and‐treat. These differences only reached statistical significance for women who were reported negative on screening. The direct costs to the NHS of prophylaxis and screen‐and‐treat were calculated to be £8.17 and £18.34 per woman, respectively.Conclusions
Prevalences of lower genital tract infections which have been implicated in increased rates of infective morbidity after abortion are similar to those reported elsewhere. Universal antibiotic prophylaxis is at least as effective as a policy of screen‐and‐treat in minimising the risk of short term infective morbidity and is far more cost efficient.
Effect of dexamethasone and betamethasone on fetal heart rate variability in preterm labour: a randomised study
Authors: Senat M. V. , Minoui S. , Multon O. , Fernandez H. , Frydman R. , Ville Y. 
Published: August 2005

Objective
To compare the effects of betamethasone and dexamethasone on fetal heart rate in appropriately grown fetuses.Methods
Eighty‐two pregnant women (97 fetuses) with preterm labour were randomly allocated to receive betamethasone (n= 42) or dexamethasone (n= 40) for fetal lung maturation in a nonblinded fashion. Computerised cardiotocogram (CTG) parameters were compared before, during and after treatment.Results
A decrease in fetal heart rate variability was found with betamethasone but no significant changes were found with dexamethasone. Fetal heart rate variability returned to pre‐treatment values within a week after cessation of treatment with betamethasone. Neonatal outcome was similar in the two groups.Conclusions
These findings might prove useful in the management of compromised fetuses with decreased fetal heart rate variability in which the CTG should be used together with other parameters to assess fetal wellbeing during corticosteroid treatment. Dexamethasone may be preferable as the drug of choice since it was associated with significantly less alteration in fetal heart rate variability compared with betamethasone.