bluuebunny/crossref_metadata_2025_split huggingface dataset:
Histological incomplete excision of CIN after large loop excision of the transformation zone (LLETZ) merits careful follow up, not retreatment
Authors: MURDOCH JOHN B. , MORGAN PHILIP R. , LOPES ALBERTO , MONAGHAN JOHN M. 
Published: August 2005

ABSTRACTObjective
To quantify and analyse the influence of a histological report of incomplete excision of CIN after LLETZ on frequency of detection of residual CIN.Design
Review of a computerised database of sequential women treated by LLETZ. Initial follow‐up was three months post‐treatment.Setting
The Colposcopy Clinic, Regional Department of Gynaecological Oncology, Queen Elizabeth Hospital, Gateshead, Tyne and Wear, UK.Subjects
721 women with CIN diagnosed histologically on LLETZ specimens.Results
In spite of a first time treatment success rate of 95% at 3 months, only 56% of the women were reported to have complete histological excision of CIN. A report suggesting incomplete excision was more likely with more severe CIN, extensive lesions and involvement of the endocervical canal. Furthermore, 21 % with residual CIN had apparent complete excision of CIN at LLETZ.Conclusions
A histological report of incomplete excision of CIN at LLETZ does not equate with residual disease. The high treatment success rate of LLETZ means that a report of incomplete excision should stimulate close colposcopic and cyt‐ologic follow‐up to identify the small number of women with residual CIN after therapy.
The effect of intrauterine growth retardation on the development of renal nephrons
Authors: HINCHLIFFE S. A. , LYNCH M. R. J. , SARGENT P. H. , HOWARD C. V. , VAN VELZEN D. 
Published: August 2005

ABSTRACTObjective
To investigate the effect of Type II (asymmetrical) intrauterine growth retardation (IUGR) on renal development.Design
A prospective descriptive study.Setting Department of Fetal and Infant Pathology, Liverpool Children's Hospital.Subjects
Six (severely) affected IUGR stillbirths of known gestational age with a control group of stillbirths with birthweight > 10th centile, and eight liveborn IUGR infants who died within a year of birth with a control group of appropriately grown infants who died within a year of birth (postnatal groups).Techniques
The kidneys from all the groups studied were analysed using unbiased, reproducible and objective design‐based stereological techniques.Main outcome measures
Total renal nephron (glomerular) numbers and average volumes of total nephron and cortical and medullary nephron segments.Results
Nephron number estimates lay below the control group's 5% prediction limit in five out of the six growth‐retarded stillbirths, and were significantly (P<0.005, IUGR at 65% of the control mean) reduced in the postnatal group. Estimates of nephron (segment) volume did not differ between control and IUGR groups.Conclusions
Type II intrauterine growth retardation may exert a profound effect on renal development. The reduced nephron number at birth, together with the lack of any early postnatal compensation in either nephron number or nephron size, emphasizes the need for vigorous antenatal surveillance for IUGR and consideration of elective preterm delivery of affected fetuses. A systematic review of other organs, which develop in a similarly rapid fashion during the late intrauterine period, is indicated by this work. With one exception, all birthweights in the growth‐retarded groups were below the third centile, thus the precise quantitative relation between progressive IUGR and renal function requires further assessment.
Endometrial responses in artificial cycles: a prospective, randomized study comparing three different progesterone dosages
Authors: LI T. C. , RAMSEWAK S. S. , LENTON E. A. , COOKE I. D. , WARREN M. A. , DOCKERY P. 
Published: August 2005

ABSTRACTObjective
To examine the endometrial response to three different regimens of progesterone.Design
A prospective, randomized study.Setting
The Jessop Hospital for Women, Sheffield.Subjects
14 women with premature ovarian failure divided into two equal groups.Interventions
Three different regimens of hormone replacement therapy containing standard, high and low progesterone dosages. One group received the standard regimen in one cycle and high dosage regimen in another cycle. The second group received the standard regimen in one cycle and low dosage regimen in another cycle. The order of the two dosage regimens was randomized by lottery.Main outcome measures
Ultrasonographic measurement of endometrial thickness and morphological study of endometrial biopsy specimens taken on day 19 of the cycle using the traditional dating criteria and morphometric techniques.Results
Compared with standard regimen cycles, the endometrial response in cycles treated with the low dosage regimen showed significant retardation of overall endometrial development and changes in a number of morphometric measurements. The response of endometrial glands to the high dosage regimen was similar to that of the standard regimen, although the stromal cell diameter was increased.Conclusions
In women receiving hormone replacement therapy normal endometrial development depends on an adequate dosage of progesterone, but increased dosage above our standard regimen does not produce any further change in the glandular component of the endometrium.
Intra‐operative blood loss during elective lower segment caesarean section
Authors: DUTHIE S. J. , GHOSH A. , NG A. , HO P. C. 
Published: August 2005

ABSTRACTObjective
To measure intra‐operative blood loss at elective lower segment caesarean section and to compare estimated wtih measured blood loss.Design
Prospective observational study. Blood loss was measured in patients who underwent lower segment caesarean section in the course of routine hospital activity.Setting
Tsan Yuk Hospital (Hong Kong), which is affiliated to the University of Hong Kong, 1990–1991.Subjects
Forty women (mean age 29 years) with singleton pregnancies (mean gestation 38 weeks) delivered by elective lower segment caesarean section under general anaesthesia (mean birthweight 3177 g).Main outcome measure
Intra‐operative blood loss measured by the alkaline haematin method (intra‐assay co‐efficient of Variation 2.2%).Results
The mean measured blood loss was 487 ml (SE 40, range 164–1438). The mean estimated blood loss was 425 ml (SE 31) range 100–1300; mode 400). Observer error in estimating blood loss was higher if measured blood loss >600 ml. One patient received a blood transfusion and another had a post‐operative haemoglobin level <10.0g/dl.Conclusion
Blood loss at elective lower segment caesarean section was usually <500 ml and was estimated with reasonable accuracy. However, there was a tendency to under‐estimate blood loss when the measured loss exceeded 600 ml.
Thyroxine dosage during pregnancy in women with primary hypothyroidism
Authors: GIRLING JOANNA C. , de SWIET MICHAEL 
Published: August 2005

ABSTRACTObjective
To assess whether pregnancy changes the thyroxine requirements of hypothyroid women.Design
A retrospective, longitudinal study.Setting
Queen Charlotte's and Chelsea Hospital for Women.Subjects
32 women referred for antenatal care during 35 pregnancies.Main outcome measures
Changes in thyroid stimulating hormone (TSH) and free thyroxine (fT4) levels as pregnancy progresses.Results
In most of the pregnancies (80%), no change in thyroxine dose was required (mean dose 129 μg). The mean TSH levels in early (1.8 mU/1) and in late pregnancy (1.5 mU/1) were unchanged (P >0.5). In the remaining pregnancies, thyroxine dose was increased after the first antenatal clinic appointment, on the basis of thyroid function test results, from a mean of 104 μg to a mean of 172 μg (P<0.01). These women had a mean early pregnancy TSH of 12.3 mU/1, which decreased by 95% to 1.3mU/1(P<0.01).Conclusions
Most of the hypothyroid patients presenting to an antenatal booking clinic are well controlled in early pregnancy and will remain so throughout pregnancy. The dose of thyroxine does not need to be changed, and further assessments of thyroid function should not be necessary. It is unlikely that the patients were all ‘over‐treated’ before conception, since they were referred to us by a large number of independent doctors. Women who are under‐treated before the pregnancy are likely to require both increased thyroxine dose and further thyroid function assays. They can generally be easily detected, biochemically, at the first hospital visit.
Vaginosonographic velocimetry in uterine arteries before and after administration of beta‐mimetics
Authors: DEUTINGER JOSEF , RUDELSTORFER RUDOLF , PATTERMANN ANDREAS , BERNASCHEK GERHARD 
Published: August 2005

ABSTRACTObjective
To investigate the effect of surgical procedures at 15 weeks gestation (amniocentesis or cervical cerclage), with or without post‐operative ritodrine prophylaxis, on uterine blood flow velocity waveforms and maternal heart rate.Design
A quasi‐randomized observational study.Setting
University Department of Obstetrics and Gynaecology, Vienna.Subjects
Sixty women having a genetic amniocentesis for advanced maternal age and 57 women having elective cervical cerclage for previous preterm labour or recurrent miscarriage.Interventions
The women in each group were allocated either to receive prophylactic ritodrine postoperatively or to receive no ritodrine treatment. Allocation used the year of birth of the woman (odd years received ritodrine, even years received no treatment). All the women had vaginal ultrasound velocimetry studies in both mainstem uterine arteries through the parametrium before the surgical procedure and again after the procedure. The ritodrine‐treated women in the cerclage group received intraveneous ritodrine hydrochloride (0.2 mg/min) and those in the amniocentesis group received 60 mg ritodrine/day orally.Main outcome measures
Uterine artery blood flow velocity waveform indices: A/B ratio and pulsatility index (PI) and maternal heart rate before and after the surgical procedure.Results
The only statistically significant difference in haemodynamic values between those obtained before the procedure and those obtained after the procedure with or without prophylactic ritodrine was seen in the women who had cervical cerclage with postoperative intravenous ritodrine. The mean A/B ratio decreased from 2.69 (SD 1.17) to 2.11 (SD 0.44), and the mean PI from 1.62 (SD 0.47) to 1.21 (SD 0.3) and the mean maternal heart rate increased from 82.6 (SD 11.1) to 99.4 (SD 15.7). There were no other statistically significant differences between before and after haemodynamic values.Conclusions
There are no clinically relevant effects of amniocentesis and cervical cerclage on uterine blood flow velocity waveforms.
A double‐blind randomized study of the effect of erythromycin in preventing pelvic inflammatory disease after first trimester abortion
Authors: SØRENSEN JETTE L. , THRANOV INGRID , HOFF GERDI , DIRACH JøRGEN , DAMSGAARD MOGEN T. 
Published: August 2005

ABSTRACTObjective
To assess the prophylactic use of erythromycin in prevention of post‐abortal pelvic inflammation disease (PID) in first trimester abortion.Design
Double‐blind, randomized controlled trial.Setting
Department of Surgery, County Hospital, Denmark.Subjects
Four hundred and thirty two women who were to undergo induced abortion before 12 weeks gestation were randomized to be treated either with prophylactic erythromycin or a placebo.Intervention
The women were randomized to receive a placebo or erythromycin, 500 mg twice a day for 71/2 days starting the evening before the abortion. All the women were investigated for Chlamydia trachomatis and Neisseria gonorrhoea before the abortion.Main outcome measures
Frequency of cervical C. trachomatis and N. gonorrhoea and frequency of PID after abortion.Results
Fifty four women were excluded after randomization. The frequency of PID was 11% (20/189) in the erythromycin group and 16% (30/189) in the placebo group (P= 0.13, χ2‐test). The prevalence of C. trachomatis was 19% (15/78) in women ≤ 20 years of age, 13% (14/109) in women between 21 and 25 years and 2% (5/241) in women ≤ 26 years of age. In women positive for C. trachomatis erythromycin prophylaxis significantly reduced the frequency of PID to 8% (l/13) compared with 43% (6/14) in the placebo group (P= 0.051, logistic regression analysis). Erythromycin had no effect on other potential high risk groups (first pregnancy, nulliparous, <20 years of age, and women with previous PID).Conclusion
Prophylactic erythromycin is not warranted for all women having an abortion. Cervical C. trachomatis is a risk factor for postabortal PID, and prophylaxis with erythromycin significantly reduces the frequency of PID. However, only a few women with PID had cervical C. trachomatis, and the prevention of post‐abortal PID remains a major challenge requiring further studies.
Detection of fetal DNA in trans‐cervical swabs from first trimester pregnancies by gene amplification: a new route to prenatal diagnosis?
Authors: GRIFFITH‐JONES MARTIN D. , MILLER DAVID , LILFORD RICHARD J. , SCOTT JANETTE , BULMER JUDITH 
Published: August 2005

ABSTRACTObjective
To determine whether fetal sex can be predicted from fetal DNA retrieved transcervically from the lower part of the uterine cavity in the first trimester of pregnancy.Design
Prospective observational study.Setting
St James's University Hospital, Leeds.Subjects
33 women undergoing legal termination of pregnancy at 9 to 13 weeks gestational age.Interventions
Before termination of pregnancy samples for DNA analysis were obtained with cotton wool swabs from the vagina, cervix and transcervically in 26 women. In the other seven women samples were obtained using a transcervical cell retrieval (TraCeR) procedure involving flushing the lower uterine cavity with 5 ml saline.Main outcome measures
Detection of Y‐chromosome specific DNA sequences by the polymerase chain reaction (PCR) in cotton wool swabs taken from the lower uterus in the first trimester of pregnancy to predict fetal sex in comparison with standard cytogenetic analysis. Histological and immunohistochemical analysis of samples obtained by flushing of the lower uterine cavity (TraCeR) to confirm the presence of trophoblast.Results
Fetal sex was predicted accurately in 25 of the 26 pregnancies investigated. Immunohistochemical analysis identified syncytial trophoblast fragments in all seven pregnancies investigated by TraCeR.Conclusion
Trophoblast may be retrieved from the lower uterus in the first trimester by swabs or TraCeR. When purification of these syncytial fragments can be achieved using immuno‐magnetic technology, this test will enable prenatal diagnosis of single gene defects in the fetus by the polymerase chain reaction.
Clinical and histopathological features of parvovirus B19 infection in the human fetus
Authors: MOREY A. L. , KEELING J. W. , PORTER H. J. , FLEMING K. A. 
Published: August 2005

ABSTRACTObjective
To provide a comprehensive description of the clinical and histopathological features associated with parvovirus B19 infection of the human fetus.Subjects
All cases of parvovirus B19‐related fetal death presenting to the John Radcliffe Hospital, Oxford, over a 16 year period. Diagnosis was confirmed retrospectively by non‐isotopic in situ hybridization for parvovirus B19 DNA.Results
The ten cases occurred in two clusters (1979–80 and 1988–89) and presented between 15 and 29 weeks gestation. In at least three cases maternal infection was asymptomatic. Nine fetuses were grossly hydropic at necropsy. Histological features common to all cases included the presence of typical intranuclear inclusions in erythroid precursor cells and evidence of vasculitis within placental villi. Inflammatory changes were also present in the myocardium of four cases, with evidence of sub‐endocardial fibroelastosis in three.Conclusions
Histological features of fetal parvovirus B19 infection are similar across a range of gestational ages. The heart failure and hydropic state associated with fetal parvovirus infection may be of multifactorial aetiology, and not due to fetal anaemia alone.
In‐vivo studies of uterine electrosurgery
Authors: DUFFY S. , REID P. C. , SHARP F. 
Published: August 2005

ABSTRACTObjective
To study the effects of electrosurgery on the living human uterus.Design
Prospective observational study.Subjects
Nine women with recurrent refractory dysfunctional uterine bleeding, listed for hysterectomy.Intervention
Experimental endometrial resection on patients immediately prior to hysterectomy.Main outcome
measures The influence of power output, duration of exposure and repetition of consecutive surgical applications on the size of the zone of thermal necrosis in uterine tissue.Results
Resection of the endometrium was associated with a narrow zone of thermal necrosis of between 0.69 and 0.76 mm which was not dependent on power output. Duration of exposure, however, was directly related to tissue necrosis (1.44 vs 1.88 mm for Is and 5s, respectively). Coagulation by pin‐point desiccation caused a zone of thermal necrosis of 3.30–3.77 mm that was independent of either power or duration of exposure to electrical energy. Thermal transmission through the uterus in situ, during electrosurgery was minimal, the maximum recorded rise in temperature from the baseline was 0.4°C. The differences between the in vitro and in vivo effects of electrosurgery are highlighted and the possible reasons for these differences explored.Conclusions
The potential for unwanted thermally‐induced damage to the uterus is small.
Laparoscopic treatment of infiltrative rectosigmoid colon and rectovaginal septum endometriosis by the technique of videolaparoscopy and the CO2 laser
Authors: NEZHAT CAMRAN , NEZHAT FARR , PENNINGTON EARL 
Published: August 2005

ABSTRACTObjective
To present the technique and results of videolaparoscopy and the CO, laser as a treatment for deep, infiltrative endometriosis of the rectovaginal septum, uterosacral ligaments, pouch of Douglas and anterior wall of the rectosigmoid colon.Design
Observational study with 1–5 year follow up.Setting
Sub‐specialty practice: Endometriosis clinic and centre for special pelvic surgery.Subjects
185 women, ages 25–41 years. All had pelvic endometriosis and were referred because of the failure of previous medical and/or surgical treatment.Interventions
Vaporization and excision of endometriotic implants and nodules, ureterolysis, ureteric stents, laparoscopic anterior rectal wall resection and reanastomosis, presacral neurectomy, laparoscopic hysterectomy, salpingo‐oophorectomy and appendicectomy using the CO2 laser.Main outcome measures
174 patients were followed for 1–5 years after surgery by office visit questionnaire or telephone interview. Eleven were lost to follow‐up.Results
175 patients were discharged within 24 h. Nine with bowel perforations and one with a partial bowel resection were discharged 2–4 days postoperatively. Two patients required ureteric stents, which were removed 6 weeks postoperatively without sequelae. 162 women reported moderate to complete pain relief (145 after one procedure, 13 after two and four after three). 12 reported persistent or worse pain following the surgery. Seven eventually underwent total hysterectomy, four had bowel resections and one had a salpingo‐oophorectomy. Of 61 with infertility, 25 achieved pregnancy. Postoperative complications included shoulder pain, anterior abdominal wall ecchymosis, urine retention and dyschezia for one to two weeks.Conclusions
Our experience suggests that rectosigmoid colon and infiltrative rectovaginal septum endometriosis can be effectively treated via videolaparoscopy in the hands of experienced endoscopic gynaecologists.
Stimulation of vasopressin release in women with primary dysmenorrhoea and after oral contraceptive treatment—effect on uterine contractility
Authors: EKSTRÖM PER , ÅKERLUND MATS , FORSLING MARY , KINDAHL HANS , LAUDANSKI TADEUSZ , MRUGACZ GRZEGORZ 
Published: August 2005

ABSTRACTObjective
To study aspects of the aetiology of primary dysmenorrhoea and mechanisms underlying the therapeutic effect in this condition of an oral contraceptive.Intervention
Intrauterine pressure was recorded before and during infusion of hypertonic saline (5% NaCl, 0.06 ml/kg/min) over 75 min on the first day of bleeding in women with dysmenorrhoea and after 3 weeks of oral contraceptive treatment. Plasma sampling every 15 min of ongoing infusion for the estimation of osmolality, arginine vasopressin, oxytocin and the prostaglandin (PG) F‐metabolito, 15‐keto‐13, 14‐dihydro‐PGF2α.Subjects
Ten healthy nulliparous women with moderate to severe primary dysmenorrhoea.Main outcome measures
Plasma levels of posterior pituitary hormones and the PGF‐metabolite. Total pressure area (TPA) of the recording curve.Results
In dysmenorrhoea before infusion the plasma concentration of vasopressin was in mean 2.18, oxytocin 5.05 and the PGF‐metabolite 321.5 pmol/1, and the TPA 3.8 kPa ≥ 10 min. After oral contraceptive treatment the vasopressin level and the TPA were significantly reduced. At both sessions apart from intensifying the pain, the saline infusion increased vasopressin and oxytocin levels as well as the TPA, whereas the concentration of the PGF‐metabolite at both sessions decreased.Conclusion
Confirmation is provided of the elevated secretion of arginine vasopressin and PGF2α, as well as increased uterine activity in primary dysmenorrhoea. The observations are in agreement with the concept that a lowered level of vasopressin and a decreased uterine activity contributes to the beneficial effect of OCs in the condition. Stimulation of the secretion of vasopressin increases the uterine activity and symptoms of primary dysmenorrhoea, but results suggest that this effect does not involve a mechanism of increased PGF‐synthesis. The role of oxytocin in dysmenorrhoea can not yet be defined.
A four‐year follow‐up of hearing and development in children exposed in utero to vibro‐acoustic stimulation
Authors: NYMAN MARGARETA , BARR MATS , WESTGREN MAGNUS 
Published: August 2005

ABSTRACTObjective
To obtain information of hearing and neuro‐development in children exposed to vibro‐acoustic stimulation in utero.Design
Information collected from Swedish child care programmes.Setting
Department of Obstetrics and Gynaecology, Karolinska Institutet, Danderyd University Hospital, Sweden.Subjects
Children of 460 mothers exposed to vibro‐acoustic stimulation for the assessment of fetal well‐being during high‐ and low‐risk pregnancies during 1985–1987.Main outcome measures
Auditory test (20–25 dB at eight frequencies between 500 and 8000 Hz) and general neurological examination at four years of age.Results
No hearing damage or neuro‐developmental abnormalities that could be connected to the vibro‐acoustic stimulation were found.Conclusions
Vibro‐acoustic stimulation, as applied in clinical practice, did not endanger either neurological developement or hearing in children exposed in utero.