bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prenatal diagnosis of six major cardiac malformations in Europe – A population based study
Authors: Garne Ester ,   THE EUROCAT WORKING GROUP
Published: March 2003

Aim. To present data on prenatal diagnosis of six major cardiac malformations in low‐risk European populations.Methods. Data from 12 Eurocat registries on congenital malformations. All registries have multiple sources of information and use the same methods of data collection and coding. The six cardiac malformations included were hypoplastic left heart, tricuspid atresia, single ventricle, Tetralogy of Fallot, transposition of great arteries and common A‐V‐canal.Results. There were significant differences in the proportion of cases diagnosed prenatally, with the highest detection rate in France (91% for single ventricle in Paris) and the lowest detection rate in countries without prenatal ultrasound screening (no cases diagnosed prenatally in the Danish registry area). Prenatal detection rate was significantly higher for the three malformations affecting the size of the ventricles (hypoplastic left heart, tricuspid atresia, single ventricle) compared to the other three malformations (46% versus 24%, p<0.001). Time of diagnosis was late, with only one third diagnosed before 24 weeks of gestation. The risk of fetal death seems to be low.Conclusion. There are significant regional differences in prenatal detection rate of major cardiac malformations in Europe.
Correlation between serum testosterone levels and peripartal mood states
Authors: Hohlagschwandtner Maria , Husslein Peter , Klier Claudia , Ulm Barbara 
Published: March 2003

Background. We conducted a prospective study at the Department of Obstetrics and Gynecology, University Hospital of Vienna to investigate associations between serum testosterone levels and maternal peripartal mood states.Methods. Two hundred and fifty‐two pregnant women at term (38 to 40 weeks’ gestation) took part in the study. Blood samples for plasma testosterone levels and other biochemicals were obtained prepartum, and on the 1st and 3rd day postpartum. Mood was assessed with the McNair Profile of Mood States (POMS) at term pregnancy and daily from the first day after delivery until discharge from the hospital.Results. The final study population consisted of 193 women. Serum testosterone levels correlated significantly with maternal depression scores, both pre‐ and post partum (at term r=0.148, p=0.04; 1st day postpartum r=0.156, p=0.03; and 2nd day postpartum r=0.186, p=0.02, respectively). Testosterone concentrations also correlated with anger prepartum (r=0.164, p=0.02) and on the third day after delivery (r=0.188, p=0.02). No significant correlation between testosterone concentration and fatigue and vigor both pre‐ and post partum, respectively were found.Conclusion. Serum testosterone levels correlate with depression and anger in the first postpartum days.
Preimplantation genetic diagnosis (PGD): The Gothenburg experience
Authors: Hanson Charles , Jakobsson Ann‐Helene , Sjögren Anita , Lundin Kersti , Nilsson Lars , Wahlström Jan , Hardarson Thorir , Stevic Justina , Darnfors Catarina , Janson Per Olof , Wikland Matts , Hamberger Lars 
Published: March 2003

Background. A program for preimplantation genetic diagnosis of pre‐embryos from patients with hereditary disorders was set up in our unit at Sahlgrenska University Hospital in 1994. The majority of the patients were carriers of X‐chromosome linked disorders; a few patients were translocation carriers. In this paper we describe our experiences of our first 36 cycles, 30 gender determinations and six analyses of embryos with possible translocations.Methods. Conventional hormone replacement treatment with intracytoplasmic sperm injection to fertilize the eggs followed by blastomere biopsy and fluorescent in situ hybridization at the eight cell stage was used for sexing as well as detection of translocations.Results. Out of the 30 cycles in 13 patients for gender determination, blastomere biopsies could be carried out in 25 cycles. Transfer of normal female embryos (XX) was performed in 18 cycles, resulting in five pregnancies (pregnancy rate 27.8%) and an implantation rate of 20% per transfer. Three girls have been born. Hence the take home baby rate was 16.7% per transfer and 10% per started cycle. Six cycles (three patients) for detection of translocations in embryos were performed. Diagnosis was possible in four cycles. Transfer of normal embryos was carried out in one cycle. No pregnancy was achieved.Conclusion. Successful PGD in its clinical application demands close collaboration between a large group of specialists. Even so, the success rate is considerably lower than after conventional IVF or ICSI procedures. Taking into account the stress caused to the parents facing late interruption of pregnancy following conventional prenatal diagnosis we are convinced that this technique is well worthwhile continuing and refining.
Choice and chance: Determinants of short interpregnancy intervals in Denmark
Authors: Kaharuza Frank M. , Sabroe Svend , Basso Olga 
Published: March 2003

Background. It is still unclear whether short interpregnancy intervals are a marker for women at risk of poor pregnancy outcome or a direct risk factor for poor perinatal outcomes. The study objective was to identify risk factors associated with short interpregnancy intervals in Denmark.Methods. From a cohort of pregnant women in a geographically defined area in Denmark (n=11,288) and using register linkage, we identified 5756 multiparous mothers who completed a detailed interview on social behavior during pregnancy. We restricted our analysis to 2904 mothers who had an interpregnancy interval of less than 37 months. Multiple logistic regression was used to estimate the Odds Ratio (OR) of having a short interval as a function of a number of determinants.Results. About 4.8% of the mothers had an interpregnancy interval less than 9 months. Short interpregnancy intervals were more likely to occur in an unplanned pregnancy (OR=2.9, 95% CI: 2.2–3.9), to follow irregular menstruation (OR=1.7, 95% CI: 1.1, 2.5) and to occur in older (OR=1.7, 95% CI: 1.1, 2.5) and high parity mothers (OR=1.9, 95% CI: 1.1, 3.1). Poor housing, smoking and low social status were also associated with short interpregnancy intervalConclusion. Short interpregnancy intervals may be a marker for women at risk and these risk factors differ among populations. They also appear to be a result of choice (e.g. in older women). Biological factors also play a significant role in determining short interpregnancy intervals.
Preoperative treatment of anemic women with epoetin beta
Authors: Larson Barbro , Bremme Katarina , Clyne Naomi , Nordström Lars 
Published: March 2003

Aim. To compare the effects of preoperative treatment with recombinant human erythropoietin (EPO) and iron with iron only on hemoglobin levels (Hb) in anemic women prior to hysterectomy.Methods. The study was an open‐labelled randomized parallel study. Fifteen women scheduled for hysterectomy due to uterine myoma were given oral iron and EPO (NeoRecormon®) 4 weeks prior to surgery (group I) and 16 women were given oral iron only (group II).Results. Group I showed a significantly greater increase in mean Hb during the pre‐surgery study period compared with group II (p=0.007). Two weeks postoperatively, however, there was no significant difference in mean Hb between the two groups.Conclusion. We found that a significantly greater increase in Hb was achieved with iron in combination with EPO, although in most cases iron only seemed to be as efficacious as iron+EPO in correcting anemia in myoma patients pre‐operatively.
Perinatal complications in women with gestational diabetes mellitus
Authors: Svare Jens A. , Hansen Bent B. , Mølsted‐Pedersen Lars 
Published: March 2003

Background. The aim of the study was to examine the outcome of the pregnancy and neonatal period in 1) women with gestational diabetes mellitus and non‐diabetic pregnant women, and 2) in women with early and late diagnosis of gestational diabetes mellitus.Methods. Included were 327 women with gestational diabetes mellitus and 295 non‐diabetic women, who were screened with a 75 g oral glucose tolerance test because of risk factors for gestational diabetes. Women with gestational diabetes mellitus were treated with low‐caloric diet and insulin when appropriate, while women in the control group received routine antenatal care.Results. Gestational age at delivery was significantly lower in the group with gestational diabetes mellitus, both when considering all deliveries (39.1±1.7 weeks versus 39.8±2.0 weeks, p<0.05) and only those with spontaneous onset of labor (38.8±2.0 weeks versus 40.0±1.6 weeks, p<0.05). The frequency of macrosomia was increased, although not statistically significant (8% vs. 2%, p=0.07), and the rate of admission to the neonatal ward was significantly increased (18% vs. 9%, p<0.05) in the group with gestational diabetes. Women with early diagnosis of gestational diabetes mellitus had a significantly increased need for insulin treatment during pregnancy (36% vs. 9% p<0.05) and a significantly higher occurrence of diabetes mellitus at follow‐up from two months until three years postpartum.Conclusions. This study of women with gestational diabetes mellitus and non‐diabetic pregnant women showed that gestational diabetes mellitus was associated with a significantly lower gestational age at delivery and an increased rate of admission to the neonatal ward. Women diagnosed with GDM before 20 weeks of gestation had an increased need for insulin treatment during pregnancy and a high risk of subsequent overt DM, compared with women diagnosed with GDM later in pregnancy.
Pregnancy planning and acceptance among Danish pregnant women
Authors: Rasch Vibeke , Knudsen Lisbeth B. , Wielandt Hanne 
Published: March 2003

Objective. To study how living conditions influence pregnancy planning and acceptance among Danish women.Method. A cross‐sectional questionnaire study performed among 3516 pregnant women attending Odense University Hospital, Denmark. The study population consisted of women with spontaneous abortion, women with ectopic pregnancies, women attending antenatal care and women with induced abortion. They were divided into four groups: women with planned and accepted pregnancies (accepting planners, n=2137), women who accepted an initially unplanned pregnancy (accepting non‐planners, n=1006), women who rejected an initially planned pregnancy (rejecting planners, n=31), and women with unplanned and rejected pregnancies (rejecting non‐planners, n=342). The association between socio‐economic characteristics and pregnancy planning and acceptance was evaluated by comparing accepting non‐planners with accepting planners and by comparing rejecting planners with rejecting non‐planners. The variables studied comprise age, number of children, partner relationship, education, occupation, economic situation and contraceptives.Results. The characteristics of accepting non‐planners and accepting planners were in accordance and in contrast to those of rejecting planners and in particular of rejecting non‐planners. The contraceptive prevalence rate among accepting non‐planners was 15%. Among rejecting non‐planners the same figure was 51%.Conclusion. Accepting non‐planners seemed to be in a situation which could be considered appropriate for childbirth. The contraceptive prevalence rate among accepting non‐planners was low and might reflect that these women were not entirely against the thought of having a child, although they did not actively plan to have one.
Urinary heparan sulfate proteoglycan excretion in black African women with pre‐eclampsia
Authors: Khedun Shaun M. , Naicker Thajasvarie , Moodley Jagdisea , Gathiram Prem 
Published: March 2003

Background.  The heparan sulfate proteoglycan of the glomerular basement membrane is considered to be mainly responsible for the charge selectivity of the glomerular basement membrane. Decreased heparan sulfate proteoglycan results in a decreased anionic charge of the glomerular basement membrane with increased heparan sulfate proteoglycan in the urine, and is believed to be responsible for the proteinuria in pre‐eclampsia.Aim.  To determine the urinary heparan and chondroitin sulfate proteoglycan levels in women with pre‐eclampsia.Materials and methods.  Eighty‐four patients were studied: 28 were normotensive pregnant, 28 were nonproteinuric hypertensive, and 28 were pre‐eclamptic. Urine samples were obtained and urinary glycosaminoglycan concentrations were determined using the dimethyl‐methylene blue assay. Plotting absorbance against the concentrations of heparan and chondroitin sulfate proteoglycans drew a standard curve. The concentration of heparan and chondroitin sulfate proteoglycans was read‐off from the linear portion of the standard curve. The standard solutions contained 25, 50, 100 and 200 mg/l heparan or chondroitin sulfate. The Mann–Whitney U‐test was used to detect differences between the three groups, and the Pearson's correlation coefficient was calculated for clinical data correlation of the pre‐eclamptic group.Results.  Urinary excretion of heparan sulfate proteoglycan (123.1 ± 22.1 mg/l) was significantly increased in the pre‐eclamptic group compared with the normotensive pregnant group (60.5 ± 5.1 mg/l; p < 0.0001) and the hypertensive nonproteinuric group (63. 2 ± 3.7 mg/l; p < 0.0001). Urinary chondroitin sulfate proteoglycan excretion followed a similar pattern, being significantly increased in the pre‐eclamptic group (88.86 ± 9.79 mg/l) compared with the normotensive pregnant group (49.1 ± 8.49 mg/l; p < 0.0001) and the hypertensive nonproteinuric group (43. 9 ± 5.7 mg/l; p < 0.0001). A significant Pearson's correlation between 24‐h urine output vs. 24‐h protein excretion (r = 0.51; p < 0.001), and between loss of HSPG versus 24‐h urinary protein excretion (r = 0.72; p < 0.0001) was obtained in the pre‐eclamptic group.Conclusion.  This study demonstrates a reduction of glomerular charge in pre‐eclampsia. The strong correlation between the severity of proteinuria and the loss of charge supports the hypothesis that the loss of glomerular charge induces structural changes of the filtration barrier, and may be the mechanism responsible for the proteinuria in pre‐eclampsia. Furthermore, the elevated levels of urinary proteoglycan (heparan and chondroitin sulfate proteoglycans) in this disorder show a loss into the urine rather than a neutralization of these macromolecules.
Maternal and fetal morbidity in pregnancies of Norwegian and Swedish women with cystic fibrosis
Authors: ØDegaard Inger , Stray‐Pedersen Babill , Hallberg Karin , Haanaes Ole Christen , Storrøsten Olav Trond , Johannesson Marie 
Published: March 2003

Background.  The survival of patients with cystic fibrosis has increased. More women with cystic fibrosis reach reproductive age and wish to become pregnant. The aim of this work was to study the outcome of completed pregnancies in women with cystic fibrosis in Norway and Sweden.Methods.  A retrospective audit from medical records was performed for 33 successful pregnancies in 23 women from the cystic fibrosis center in Norway and two cystic fibrosis centers in Sweden. Lung function, body weight and use of antibiotics together with other medical data were related to the complications and outcomes of the pregnancies.Results.  The most frequent complication of the pregnancies was preterm delivery, which occurred in 24% of cases. The lung function of the women was significantly lower in the preterm group than in those delivering at term. Those who went on to deliver preterm were more likely to have other cystic fibrosis complications including diabetes, asthma or liver disease. The weight gain of the women with cystic fibrosis delivering preterm was less than in the term group (corrected for gestation), but the frequency of pulmonary infections did not differ. As for the total group, lung function did not deteriorate during pregnancy, even though the need for intravenous antibiotics was doubled compared with the year before and after pregnancy. Weight gain in pregnancy was on average 10.3 kg, and almost half of the women needed supplementary nutrition. Gestational diabetes developed in four of the 23 patients. Caesarean sections were performed in eight of the 33 deliveries (24%), and 26 of the babies (79%) were breast‐fed. None of the 33 children suffered from cystic fibrosis.Conclusion.  Women with cystic fibrosis with mild to moderate disease may safely go through pregnancy. In those with severe disease, preterm delivery is common. A team approach is necessary to provide the best medical care for pregnant women with cystic fibrosis.
New rapid bed‐side test to predict preterm delivery: phosphorylated insulin‐like growth factor binding protein‐1 in cervical secretions
Authors: Lembet Arda , Eroglu Derya , Ergin Tolga , Kuscu Esra , Zeyneloglu Hulusi , Batioglu Sertaç , Haberal Ali 
Published: March 2003

Background.  Phosphorylated insulin‐like growth factor binding protein‐1 (phIGFBP‐1) is secreted by decidual cells and leaks into cervical secretions when fetal membranes detach from decidua. Our aim was to assess whether detection of phIGFBP‐1 in cervical secretions by a rapid bed‐side test could be used to predict preterm delivery in patients with regular uterine contractions.Study design.  In our prospective study, 36 women between 20 and 36 weeks of gestation with regular, persistent contractions (> 10/h) and 18 women between 20 and 36 weeks gestation without symptoms of preterm labor were assessed for the presence of cervical phIGFBP‐1. Dacron swabs were applied to the cervix and assayed in 5 min by using immunochromotography, a new rapid bed‐side test (actim partus test, Medix Biochemica, Kauniainen, Finland). Data analysis included one‐way variance analysis (ANOVA), Student's t‐test, chi‐square and Fisher's exact test.Results.  Of the 36 patients with regular uterine contractions, 18 had a positive actim partus test and 18 had a negative test. Among the 18 patients with a positive test, only one delivered term and the other 17 patients delivered preterm (< 37 weeks). Among the 18 women with a negative test, only two delivered preterm (p < 0.05). Mean gestational age at delivery for patients with a positive and a negative test was 34.4 ± 3.0 and 37.9 ± 2.3 weeks, respectively (p < 0.05). Sensitivity, specificity, positive and negative predictive values of the rapid phIGFBP‐1 test for preterm delivery was 89.5, 94.1, 94.4 and 88.9%, respectively. For delivery < 37 weeks, positive likelihood ratio was 15.2 (± 95% CI; range 2.6–102.5). When cervical phIGBP‐1 assay was used to predict delivery within 7 days, sensitivity, specificity, positive and negative predictive values were 93.8, 85%, 83.3 and 94.1%, respectively. Positive likelihood ratio with ± 95% CI was 6.25 (range 2.2–17.8). When patients were categorized according to cervical dilatation, the positive likelihood ratio of the test when the cervix was closed at ≤ 1, ≤ 2 and > 2 cm were 8.3 (1.3–55.3), 13.6 (2–91.4), 15.8 (2.3–106.3) and 1.5 (0.2–11.5), respectively,Conclusion.  The presence of cervical phIGFBP‐1 is predictive of preterm delivery < 37 weeks of gestation. Our study shows that cervical detection of phIGFBP‐1 by immunochromotography is a rapid and easily applicable test that highly anticipates preterm delivery in patients at risk.
Major postpartum hemorrhage: survey of maternity units in the United Kingdom
Authors: Mousa Hatem A. , Alfirevic Zarko 
Published: March 2003

Background.  To determine current clinical practice among different maternity units in the United Kingdom for the management of major postpartum hemorrhage.Methods.  A postal questionnaire was sent to 258 maternity units in the UK. It was developed to identify the definition of major postpartum hemorrhage, and to identify the medical and surgical interventions used for postpartum hemorrhage, as considered by each unit, and the type and use of thromboprophylaxis following surgery for major hemorrhage after delivery.Results.  A total of 212 (82%) returned the questionnaire, but 13 units indicated that the questionnaire was not applicable to them, leaving 199 (82%) for analysis. There was a lack of agreement between the different units regarding the definition and interventions for major postpartum hemorrhage. The majority of the units use oxytocin, ergometrine and carboprost as a ‘first‐line’ for the treatment of postpartum hemorrhage. Hysterectomy was the most common surgical procedure (89% of units had performed at least one hysterectomy for major hemorrhage in the last 5 years). There was a lack of agreement regarding the use and choice of thromboprophylaxis following surgery for major hemorrhage.Conclusions.  Current management of major postpartum hemorrhage varies considerably. There is an urgent need to identify protocols that will reduce the need for hysterectomy in women with major hemorrhage who are unresponsive to conventional medical therapy.
Relationship between umbilical cord morphology and nuchal cord entanglement
Authors: Rogers Michael S. , Ip Yim W. , Qin Yun , Rogers Sean M. , Sahota Daljit 
Published: March 2003

Acta Obstet Gynecol Scand 2002; 82: 32–37. © Acta Obstet Gynecol Scand 2003Objective.  To determine whether tightening of nuchal cord entanglement is more likely to occur where normal cord coiling is absent and there is deficient Wharton's jelly. The study was carried out in the delivery suite of a university teaching hospital, using a prospective matched controlled‐pairs survey.Methods.  Midwives identified index cases with nuchal cord entanglement at the time of delivery. The next delivery of equivalent gestation (± 1 week) without cord entanglement was taken as the control. Only singleton pregnancies with cephalic presentation undergoing spontaneous labor were studied. Placental insertion, nuchal entanglement (tight or loose), length, presence of knots, umbilical coiling index (UCI), and the amount of Wharton's jelly were recorded.Results.  Longer cords were more frequent amongst male infants and were predisposed towards entanglement. There were no significant differences in the amount of Wharton's jelly, or in the UCI between tight and loose nuchal cord groups. The only measurement that differed significantly was the total cord length, with shorter cords predisposed towards tightening.Conclusion.  Whilst nuchal cord entanglement amongst male babies is frequently associated with long and straight umbilical cords, tightening is more likely to occur if the cord is of short or normal length. Neither low UCI nor low percentage of Wharton's jelly are predisposed towards tightening of cord entanglement.
Comparative evaluation of early vs. deferred vitrectomy in Eales' Disease
Authors: Kumar Atul , Tiwari Hem Kumar , Singh R. P. , Verma Lalit , Prasad Nagendra 
Published: March 2003

ABSTRACT.Methods: 40 cases of vitreous haemorrhage secondary to Eales' disease were taken up for vitrectomy. Depending upon duration of vitreous haemorrhage patients were divided into two groups: Group I (20 eyes); early vitrectomy group with duration between 3–6 months; Group II (20 eyes); deferred vitrectomy group with duration of more than 6 months. All patients were followed up for a minimum period of 3 months following vitrectomy.Results: Eyes in Group I showing a preoperative ultrasonic picture of complete posterior vitreous detachment, less mobility of organised vitreous haemorrhage and mid vitreous organisation on kinetic echography achieved a final visual acuity of 6/9 or better in 13 (65%) eyes as compared to 4 (20%) eyes in Group II (p<0.01). Poor visual outcome in the deferred group was secondary to cystoid macular oedema, macular scar, macular pucker formation and macular degeneration.Conclusion: Improved visual outcome in the early vitrectomy group was probably because the haemorrhagic blood and its toxic products had less time to damage the macula, a lesser incidence of macular traction and cystoid macular oedema.