bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and validation of a questionnaire for the assessment of bowel and lower urinary tract symptoms in women
Authors: Hiller L. , Radley S. , Mann C.H. , Radley S.C. , Begum G. , Pretlove S.J. , Salaman J.H. 
Published: December 2003

Objective
To develop a simple but sensitive instrument to evaluate and document symptoms of both bowel and urinary dysfunction in women.Design
A 22‐item questionnaire covering a range of bowel and urinary symptoms was developed and underwent rigorous psychometric testing.Setting
The gynaecology departments of three hospitals, a urogynaecology clinic, a functional bowel clinic and a general practice.Population
Six hundred and thirty women, comprising four groups: 1. women awaiting hysterectomy (n= 379), 2. women following hysterectomy (n= 45), 3. women referred with functional bowel and/or urinary symptoms (n= 65), 4. asymptomatic controls (n= 141).Main outcome measures
The content, construct and criterion validity, internal consistency, reliability and responsiveness of the questionnaire were measured.Results
Peer and patient reports and missing data patterns supported face and content validity. Factor analysis showed a clinically relevant four‐factor structure with low content replication able to distinguish between patient groups, indicating good internal structure. Comparison with clinical, anorectal physiological, videoproctographic, transit time and urodynamic test results provide provisional indication of criterion validity. Key domain question analysis and Cronbach's alphas showed internal consistency. Kappa values demonstrated good test–retest reliability and key question correlation over time proved responsiveness.Conclusions
Our findings support the suitability, clinical validity, reliability and responsiveness of a simple questionnaire, which is sensitive to the constraints of clinical practice. The authors recommend its use in health care evaluation research assessing the effects of pelvic surgery and as a useful tool in comparing treatment efficacy.
Adhesion molecules expression in the placental bed of pregnancies with pre‐eclampsia
Authors: Tziotis John , Malamitsi‐Puchner Ariadne , Vlachos George , Creatsas George , Michalas Stylianos 
Published: December 2003

ObjectiveTo compare the expression of intercellular adhesion molecule‐1 (ICAM‐1), vascular cell adhesion molecule‐1 (VCAM‐1), platelet endothelial cell adhesion molecule‐1 (PECAM‐1) and E‐selectin in placental bed biopsies (endothelium of spiral arteries as well as trophoblastic cells) from normal and pre‐eclamptic pregnanciesDesignA prospective study.Setting1. First Department of Obstetrics and Gynaecology, Alexandra Hospital, University of Athens, Greece. 2. Laboratory of Pathophysiology, Laikon Hospital, University of AthensPopulationSixteen placental bed biopsies from women with pre‐eclampsia were compared with 20 placental bed biopsies from uncomplicated normotensive womenMain outcome measuresImmunocytochemical staining of the placental bed biopsies for ICAM‐1, VCAM‐1, PECAM‐1 and E‐selectinResultsNo statistically significant differences were found in the expression of the adhesion molecules ICAM‐1, VCAM‐1, PECAM‐1 and E‐selectin in the endothelium of the spiral arteries and the trophoblastic cells of the placental bed of the two studied groupsConclusionsAdhesion molecules ICAM‐1, VCAM‐1, PECAM‐1, but not E‐selectin, are expressed in the placental bed of normal and pre‐eclamptic pregnancies, but there are no differences between the two groups of women. It seems that the above molecules are not likely to be implicated in the aetiology of pre‐eclampsia
Effect of twin‐to‐twin delivery interval on umbilical cord blood gas in the second twins
Authors: Leung Tak‐Yeung , Tam Wing‐Hung , Leung Tse‐Ngong , Lok Ingrid Hung , Lau Tze‐Kin 
Published: December 2003

Objective
To examine the effect of twin‐to‐twin delivery interval on the umbilical cord blood gas status of the second twin following vaginal delivery.Design
A retrospective study.Setting
The department of obstetrics and gynaecology in a university teaching hospital.Population
Twin deliveries at or beyond 34 weeks of gestation over a period of five years, with the first twin delivered vaginally. Twins with any antepartum complications including discordant growth, intrauterine growth restriction, intrauterine death, fetal malformations and pre‐eclampsia were excluded.Methods
The correlation between the twin‐to‐twin delivery interval, and both the umbilical arterial and venous blood gas parameters of the second twin, including pH, partial pressure of CO2 and base excess, were studied.Results
A total of 118 cases were reviewed. The mean gestation at delivery was 37.1 weeks. The median twin‐to‐twin delivery interval was 16.5 minutes. There were significant negative correlations between twin‐to‐twin delivery interval and both the umbilical cord arterial and venous pH and base excess of the second twin (P <0.05). There were also significant positive correlations between both arterial and venous partial pressure of CO2 and the delivery interval (P <0.05). Similar changes were found even if the analyses were limited to those who had normal vaginal deliveries. The umbilical arterial pH of Twin 2 was <7.00 in none of the cases delivered within 15 minutes of the birth of Twin 1, 5.9% if within 16–30 minutes, and 27% if more than 30 minutes. Among those with an inter‐twin delivery interval of more than 30 minutes, 73% had cardiotocographic evidence of fetal distress which required operative delivery.Conclusions
Umbilical cord arterial and venous values of pH, partial pressure of CO2 and base excess of the second twin deteriorate with increasing twin‐to‐twin delivery interval. Risks of fetal distress and acidosis in the second twin are high when the twin‐to‐twin delivery interval is beyond 30 minutes.
Flow‐mediated dilatation of the brachial artery in pregnancy at high altitude
Authors: Kametas Nikos A. , Savvidou Makrina D. , Donald Ann E. , McAuliffe Fionnuala , Nicolaides Kypros H. 
Published: December 2003

Objective
Pregnancy at high altitude has been associated with increased prevalence of pre‐eclampsia and reduced maternal oestrogen levels, factors that have been associated with endothelial dysfunction. The aim of this study was to examine the effect of high altitude (4370 m above sea level) on endothelial function during pregnancy as assessed by a non‐invasive method.Design
Cross‐sectional study.Setting
Two maternity units providing routine antenatal care: one at high altitude (District General Hospital ‐ IPSS in Cerro de Pasco, Peru) and one at sea level (Instituto Materno‐Perinatal in Lima, Peru).Population
Sixty pregnant women at 6–42 weeks of gestation resident at high altitude (Cerro de Pasco, Peru, 4370 m above sea level) and 54 at sea level (Lima, Peru). Comparisons were performed also in 11 and 14 non‐pregnant women at each altitude, respectively.Methods
Endothelial function was assessed by flow‐mediated dilatation of the brachial artery using high‐resolution ultrasound.Main outcome measures
Differences in flow mediated dilatation of the brachial artery in two groups of pregnant women, one at high altitude and one at sea level.Results
Both at high altitude and sea level flow‐mediated dilatation of the brachial artery increased in the first two trimesters to levels 32% higher than non‐pregnant controls. However, in the third trimester, flow‐mediated dilatation of the brachial artery was lower than non‐pregnant levels. Resting vessel size increased during pregnancy by 15% compared with non‐pregnant controls at term, with no difference between the two populations at high and low altitude. Pregnancy at high altitude, compared with sea level, was associated with 59% lower baseline blood flow and 76% higher reactive hyperaemia. Similarly, non‐pregnant controls at high altitude compared with sea level demonstrated similar flow‐mediated dilatation of the brachial artery and 40% lower resting blood flow of the brachial artery. However, the difference in reactive hyperaemia did not reach statistical significance.Conclusion
These data suggest that, during pregnancy at high altitude, endothelial function, as assessed by flow‐mediated dilatation of the brachial artery, is not impaired.
Haemodynamic changes in the brain after vaginal delivery and caesarean section in healthy term infants
Authors: Dani C. , Martelli E. , Bertini G. , Pezzati M. , Rubaltelli F.F. 
Published: December 2003

Objective
To investigate whether the mode of delivery may affect neonatal cerebral haemodynamics during the first hour of life.Design
Prospective study.Sample
Healthy infants with gestational age ≥37 weeks and birthweight appropriate for gestational age, born after uncomplicated pregnancy by vaginal delivery or elective caesarean section, two to five hours after the delivery.Methods
Near infra‐red spectroscopy was used to measure changes of oxygenated haemoglobin, deoxygenated haemoglobin, oxidized‐reduced cytochrome aa3, and mean cerebral oxygen saturation (mixed cerebral oxygen saturation = oxygenated haemoglobin/total haemoglobin). Changes in cerebral blood volume were calculated.Results
Near infra‐red spectroscopy data did not show significant differences between infants born by vaginal delivery or by caesarean section. There was a significant decrease of oxygenated haemoglobin and change of cerebral blood volume values at 120 and 180 minutes in both the groups, while deoxygenated haemoglobin and oxidized‐reduced cytochrome aa3 were unchanged.Conclusions
A decrease of cerebral blood volume occurs after birth and this occurs both in infants born by vaginal delivery and by caesarean section.
Vitamin D deficiency in pregnant women from a non‐European ethnic minority population—an interventional study
Authors: Datta S. , Alfaham M. , Davies D.P. , Dunstan F. , Woodhead S. , Evans J. , Richards B. 
Published: December 2003

Objective
To determine the vitamin D status of pregnant women from non‐European ethnic minorities in South Wales.Design
Prospective study.Setting
Llandough Hospital, Cardiff, South Wales.Sample
One hundred and sixty pregnant women from a non‐European ethnic minority population in South Wales.Methods
Biochemical screening of vitamin D status was carried out at the first antenatal visit. Women found to be deficient in vitamin D were subsequently supplemented and vitamin D status was rechecked at delivery.Main outcome measure
Vitamin D status at delivery.Results
Eighty of 160 women had a vitamin D level below 8 ng/mL at their first antenatal visit and were treated with oral vitamin D. Factors that could influence vitamin D status such as religion, fluency in English and dressing habits did not appear to have any effect, although a higher proportion of women who had lived in Britain for longer than three years had subnormal vitamin D levels. In 58 of those checked at delivery, the mean plasma vitamin D level increased from 6 to 11 ng/mL although the mean parathyroid hormone level was unchanged.Conclusion
In view of the high incidence of subnormal vitamin D levels in women from ethnic minorities, we recommend biochemical screening of these women in early pregnancy, with subsequent supplementation where indicated.
Prediction of chorionicity in twin pregnancies at 10–14 weeks of gestation
Authors: Carroll Stephen G.M. , Soothill Peter W. , Abdel‐Fattah Sherif A. , Porter Helen , Montague Imogen , Kyle Phillipa M. 
Published: December 2003

Objective
To examine the accuracy of sonographic determination of chorionicity in twin pregnancies at 10–14 weeks of gestation.Design
Prospective study on the sonographic prediction of chorionicity at 10–14 weeks of gestation.Participants
During a 30 month period, from October 1997 to May 2000, 165 women attending the departments of fetal medicine or ultrasound.Methods
Sonographic criteria used in the diagnosis of chorionicity were the number of placental sites, the lambda (λ) and T signs and the thickness of the inter‐twin membrane. The diagnosis of chorionicity was made at the time of the ultrasound examination using all these features and subsequently compared with the postnatal diagnosis, confirmed either by placental histology or discordancy in infant sex.Results
In 150 cases with confirmation of chorionicity following delivery, 116 were postnatally classified as dichorionic and 34 monochorionic. Prenatal ultrasound examination correctly identified chorionicity in 149 (99.3%) cases. The most reliable indicator for dichorionicity was a combination using the λ sign or two separate placentae with a sensitivity and specificity of 97.4% and 100%, respectively. The most useful test in predicting monochorionicity was the T sign with a sensitivity of 100% and specificity of 98.2%. Measurement of the inter‐twin membrane thickness was a less reliable indicator where the sensitivity for dichorionicity and specificity for monochorionicity was only 92.6%.Conclusions
Ultrasound examination of twin pregnancies at 10–14 weeks of gestation predicts chorionicity with a high degree of accuracy using a combination of the number of placentae, λ and T signs and inter‐twin membrane thickness. All hospitals should encourage departments providing ultrasound services to undertake chorionicity determination when examining women with twin pregnancies at this gestation.
Short term complications of the tension free vaginal tape operation for stress urinary incontinence in women
Authors: Bodelsson Gunilla , Henriksson Lars , Osser Stellan , Stjernquist Martin 
Published: December 2003

Objective
To assess the prevalence of intra‐ and post‐operative complications with the tension free vaginal tape operation for female urinary incontinence.Design
Non‐control case series.Setting
University Hospital.Population
One hundred and seventy‐seven operations on women who were diagnosed urodynamically to have genuine stress incontinence. In 26 cases (15%) there was symptomatic urge incontinence.Main outcome measures
Intra‐ and post‐operative complications in relation to individual surgeons and mode of anaesthesia (local or spinal), and continence at short term follow up.Results
Bladder or urethral perforation occurred in 26 cases (15%) and three operations were abandoned for these reasons. A failure to void after the first 24 hours was registered in 35 (20%); 21 (12%) had to undergo urethral dilatation while five patients (2.8%) had persistent urinary retention which required excision of the sling. These problems were significantly associated to the experience of surgeon. In seven cases (4%) haemorrhage required intravaginal tamponade. In three (1.7%) sling rejection occurred post‐operatively. When followed up six to eight weeks post‐operatively, 154 patients (88%) reported subjective cure, 21 (11%) significant improvement and two (1%) no improvement. The use of spinal anaesthesia increased the frequency of peroperative bladder perforation but affected neither the incidence of post‐operative bladder obstruction nor the outcome at follow up.Conclusions
This study identifies short term complications which relate partly to the experience of the individual surgeon. Nevertheless the 88% subjective cure rate was independent of these factors.
The risk of preterm delivery in women from different ethnic groups
Authors: Aveyard Paul , Cheng K.K. , Manaseki Semira , Gardosi Jason 
Published: December 2003

Objective
To examine whether routinely measured variables explained the increased risk of preterm delivery in some UK ethnic groups.Design
Cross sectional study of deliveries recorded in the Child Health Record System.Setting
North Birmingham, UK.Population
All North Birmingham women delivering singletons, 1994–1997 inclusive.Method
Logistic regression.Main outcome measures
Odds ratio (OR) and 95% confidence interval (CI) for preterm delivery, defined as less than 37 weeks, less than 34 weeks and less than 28 weeks, unadjusted and adjusted for maternal age, an area‐based socio‐economic status measure, and marital status, year of birth, fetal sex and past obstetric history.Results
For Afro‐Caribbean women, the ORs (95% CIs) were: for delivery less than 37 weeks, 1.44 (1.26–1.64) unadjusted and 1.22 (1.07–1.41) adjusted; for delivery less than 34 weeks, 1.55 (1.25–1.92) unadjusted and 1.29 (1.02–1.61) adjusted; for delivery less than 28 weeks, 1.66 (1.08–2.55) unadjusted and 1.32 (0.84–2.06) adjusted. For African women, the risk of delivery less than 37 weeks was not significantly raised; for delivery less than 34 weeks, the OR (95% CI) was 1.88 (0.99–3.58) unadjusted and 1.78 (0.93–3.40) adjusted; for delivery less than 28 weeks, the OR (95% CI) was 4.02 (1.60–10.12) unadjusted and 4.10 (1.66–10.16) adjusted. In Afro‐Caribbeans, deprivation and marital status explained the differences between the unadjusted and adjusted ORs. There was a linear relation between deprivation and preterm delivery for all ethnic groups, except for Asians.Conclusions
Factors associated with deprivation and marital status explain about half of the excess of preterm births in Afro‐Caribbeans, but not Africans. The risk of preterm delivery might not be related to deprivation in Asians.
Does a traumatic birth experience have an impact on future reproduction?
Authors: Gottvall Karin , Waldenström Ulla 
Published: December 2003

Objective
To investigate whether women's experiences of their first birth affects future reproduction.Design
Prospective cohort study.Setting
South Hospital, Stockholm, Sweden.Population
Six hundred and seventeen women who gave birth to their first child 1989–1992.Methods
A global measure of women's experiences of their first birth, assessed two months postpartum, was available from a birth centre trial, together with information on a range of background variables. This information was linked to the Swedish Medical Birth Register, which included information on the number of subsequent births during the following 8–10 years.Main Outcome Measures
Number of births (0 or ≥1) following the first birth.Results
Women with a negative experience of their first birth had fewer subsequent children and a longer interval to the second baby (RR 1.7, 95% CI 1.3–2.3). Being 35 years and older (RR 2.6, 95% CI 1.6–3.7), or single (RR 2.6, 95% CI 1.7–3.9) was also associated with subsequent infertility.Conclusion
A negative birth experience was associated with subsequent infertility, and women's experiences should therefore be considered seriously in the provision of maternity care.
Glucocorticoid treatment in an ischaemic‐like excitotoxic model of periventricular leucomalacia in mice
Authors: Arquié Cyrille , Leroux Philippe , Bodenant Corinne , Laquerrière Annie , Marpeau Loıuml;c , Marret Stéphane 
Published: December 2003

Objective
To determine the effects of fluorinated glucocorticoids on the occurrence and extent of ischaemic‐like excitotoxic grey and white matter cerebral injuries in an animal model.Design
A study of the influence of single or repeated doses of glucocorticoids when creating excitotoxic lesions in mice pups, mimicking some aspects of periventricular leucomalacia and cortical–subcortical stroke as observed in human neonates.Sample
Four hundred and sixty‐seven mouse pups out of more than 30 liters.Methods
An excitotoxic lesion was created by intracerebral injection of ibotenate, a glutamatergic agonist, in day five postnatal mice pups. A single dose of betamethasone or dexamethasone was administered, in a dose of 0.006–6 and 0.001–1 mg/kg, respectively, 24 hours before or 15 minutes after each ibotenate injection. Repeated doses of dexamethasone (0.01 mg/kg per day) or betamethasone (0.006 mg/kg) were given for five days before or after ibotenate injections. The measurement of white matter and grey matter lesions and the occurrence of cysts were assessed under light microscope on cresyl violet‐stained brain sections.Main outcome measures
Size of white matter cystic lesions.Results
A single injection of betamethasone or dexamethasone had a significant neuroprotective effect when administered after the excitotoxin. Betamethasone injected once prior to ibotenate also had a protective effect. Repeated administration of each steroid before or after excitotoxin injection provided more protection than a single injection.Conclusion
Fluorinated glucocorticoids reduced neonatal brain lesions observed in a mouse model treated by excitotoxin injection.
Minimally invasive surgery for obstructed labour: a review of symphysiotomy during the twentieth century (including 5000 cases)
Authors: Björklund Kenneth 
Published: December 2003

Objective
To compile and make available essential data on symphysiotomy for evaluation in the struggle against maternal and fetal mortality and morbidity from obstructed labour, which causes the death of 50,000 women each year in low‐resourced countries.Design
Retrospective review of literature.Sample
Five thousand symphysiotomies and 1200 caesarean sections from 28 countries on four continents.Methods
The review is based on original papers published 1900 to 1999, stepwise traced through reference lists. Inclusion criteria were: firstly, that the cases reported be consecutive, secondly the presence of an acceptable description of methodology and thirdly, the study size was set at a minimum of 25 cases for analysis of maternal and fetal mortality. Papers comprising only five to 24 cases were included in other analyses. All studies were retrospective, except the follow up studies.Main Outcome Measures
Maternal and fetal mortality; causes of maternal death; fetal mortality in previous deliveries; mode of delivery in subsequent pregnancies; symphyseal width after symphysiotomy; immediate, short and long term complications; maternal and fetal mortality comparing symphysiotomy and caesarean section.Results
Symphysiotomy has been extensively studied, modified and refined over the last century, and the scientific documentation is substantial. The results indicate that symphysiotomy is safe for the mother from a vital perspective, confers a permanent enlargement of the pelvis and facilitates vaginal delivery in future pregnancies, and is a life saving operation for the child. Severe complications are rare. Symphysiotomy compares favourably with caesarean section in terms of risk for the mother's life.Conclusion
If valid conclusions can be drawn from one hundred years of retrospective studies, there is considerable evidence to support a reinstatement of symphysiotomy in the obstetric arsenal, for the benefit of women in obstructed labour and their offspring.