bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ruptured uterus in Ibadan — A twelve year review
Authors: Konje J.C. , Odukoya O.A. , Ladipo O.A. 
Published: April 2004

AbstractMaternal mortality and morbidity have remained very high in the developing countries. A common cause is ruptured uterus. In this report of 227 cases of ruptured uterus, the incidence was found to be rising. About 71.4% of the cases lacked prenatal care while 48.4% had a previously scarred uterus with many of them laboring for more than 12 h. The most common etiological factor was prolonged labor. Maternal mortality was 7.5% while perinatal mortality was 62.0%. Labor in high risk patients outside hospital because of declining economy and the rising influence of religion were some of the predisposing factors implicated. Methods to reduce this obstetric catastrophe are discussed.
Some characteristics of labor in ethnic minorities in Amsterdam
Authors: van Enk A. , Doornbos H.P.R. , Nordbeck H.J. 
Published: April 2004

AbstractA retrospective study of labor in immigrants, subdivided into Blacks, Asians and Mediterraneans (Turks and Moroccans) and autochthonous Dutch in Amsterdam over a 10‐year period showed definite differences. The second stage was shortest in Blacks and Mediterraneans but they sustained perineal tears and episiotomies less frequently. Differences in positions at birth were small except for occipito‐posterior position which was very rare in Asians and Mediterraneans. The rate of cesarean section was highest and that of instrumental vaginal delivery lowest in Blacks, the latter being highest in Asians. Retained placenta occurred less often in immigrants than in Dutch.
A comparative randomized study of oral prostaglandin E2(PGE2) tablets and intravenous oxytocin in induction of labor in patients with premature rupture of membranes before 37 weeks of pregnancy
Authors: El‐Qarmalawi A.M. , Elmardi A.A. , Saddik M. , El‐Abdel Hadi F. , Shaker S.M.A. 
Published: April 2004

AbstractIn a randomized prospective study, we compared the use of intravenous oxytocin with oral PGE2tablets for stimulation of labor in cases of premature rupture of membranes (PROM) before term, where the onset of spontaneous labor did not occur within the first 3 h. This study represents the first of its kind in which oral PGE2and oxytocin have been directly compared as oxytocic agents for PROM before 37 weeks. Labor induction was successful in 96% of patients in the PGE2group compared with 84% in the oxytocin group. The incidence of cesarean section (CS) was 5% and 16% in the PGE2and the oxytocin groups, respectively. While 10% of the CS were performed due to fetal bradycardia in the oxytocin group, none was performed in the PGE2group despite the fact that the latter group had relatively lower Bishop scores. The data presented indicate that oral PGE2is safe and effective in initiating active labor in healthy women at pre‐term with PROM. Thus we recommend its use to induce labor 3 h after rupture of membranes before 37 weeks gestation.
Efficacy of second‐look laparotomy for patients with epithelial ovarian carcinoma
Authors: Kamura T. , Tsukamoto N. , Saito T. , Kaku T. , Matsuyama T. , Nakano H. 
Published: April 2004

AbstractSecond‐look laparotomies (SLL) were performed on 42 patients with ovarian carcinoma. Ten (24%) had residual disease. Serum CA 125 values before SLL predicted the presence of residual tumors, but its relatively high false negative rate made it unable to take place of SLL. Positive peritoneal cytology at initial surgery significantly influenced SLL results in patients with early disease. Residual pelvic lesions at initial surgery seemed to resist subsequent chemotherapy. Salvage therapy with external pelvic irradiation was effective on lesions confined to the pelvis without serious toxicity. Patients with advanced disease, undergoing SLL achieved better survival than without SLL. This study shows SLL is still the most accurate procedure in assessing the efficacy of treatment, and useful in selecting second‐line therapy.
Unusual presentations of genital tract tuberculosis
Authors: Carter J.R. 
Published: April 2004

AbstractThree cases of genital tract tuberculosis (GTB) are described. This disease is uncommon in developed countries. Patients may present with infertility, non‐specific menstrual disturbance, pain or abdominal distention. The genital tract is usually infected by hematogenous spread from a distant focus, with the fallopian tubes most commonly involved. Diagnosis is often made retrospectively, and once confirmed medical management is the mainstay of treatment. Future fertility is doubtful in these patients.
The effect of maternal age and socioeconomical background on neonatal outcome
Authors: Seidman D.S. , Samueloff A. , Mor‐Yosef S. , Schenker J.G. 
Published: April 2004

AbstractThis population‐based study examined whether the neonatal outcome of primiparae is determined by maternal age or by her socioeconomic background. Data on all births in Israel during a three‐month period was made available from a nation‐wide census. Primiparae 30 years of age or older had a significantly (P < 0.001) higher risk of low birthweight and prematurity. Perinatal mortality rates and low 5‐min Apgar scores were not associated with maternal age, but were significantly (P < 0.001) increased for the socioeconomically disadvantaged parturients. Our results suggest the growth retardation and short gestation among older primiparae may reflect biological aging of maternal tissues and the effect of diseases of pregnancy such as hypertension and preeclampsia, found significantly (P < 0.001) more common for these mothers. Excessive perinatal mortality, on the other hand, may be attributable to environmental disadvantage of socioeconomically deprived populations.
Role of microcolposcopy in the diagnostic evaluation of cervical pre‐invasive lesions
Authors: Pasetto N. , Piccione E. , Sesti F. 
Published: April 2004

AbstractThe present clinical study was undertaken to assess and compare the value of microcolposcopy and endocervical curettage in the diagnostic workup of patients with abnormal cervical lesions. Microcolposcopic findings were well correlated to histology both on directed biopsy and endocervical curettage specimens. Therefore, both microcolposcopy and endocervical curettage are useful procedures to explore the endocervical mucosa. Microcolposcopy should be mainly indicated in those cases where colposcopy has failed to show any lesion, or when colposcopy is unsatisfactory.
Doppler umbilical velocimetry in women with polydrug abuse including cocaine
Authors: Cohen L.S. , Sabbagha R.E. , Keith L.G. , Chasnoff I.J. 
Published: April 2004

AbstractDoppler umbilical artery velocimetry was performed in 40 chemically dependent women. The mean S/D ratio was 2.7 with 15/66 values ≥ 3.0. No cases of absent or reverse end‐diastolic flow were noted. The mean S/D ratio in women with positive toxicologies for cocaine use was not statistically elevated compared to women with negative screens (2.8 versus 2.7, P = 0.51). In this study an S/D ratio ≥ 3.0 had a sensitivity of 40% for identifying intrauterine growth retardation with a positive predictive value of 20%.
Maternal mortality: community‐based interventions
Authors: Rosenfield A. 
Published: April 2004

AbstractMaternal mortality is one of the great neglected problems of health care in developing countries. The World Health Organization estimates that approximately 500 000 women die each year from pregnancy‐related causes, over 98% of these deaths occurring in the developing world, where maternal mortality is as much as 100 times higher than rates seen in industrialized countries. The most common causes include obstructed labor and ruptured uterus, postpartum hemorrhage, eclampsia, postpartum infection and complications of illegal abortion. It is suggested that no new or costly technologies are needed; rather that appropriate priority setting and allocation of needed resources are essential to the solution of the problem. There are few interventions that hold much hope of success at the village level, although antibiotics, ergotrate, and sedatives might be productively utilized, after appropriate training. Overall, however, networks of maternity care facilities, trained personnel, and means of transport are necessary to provide needed emergency maternity care services.
Evaluation of maternal health programs: approaches, methods and indicators
Authors: Bobadilla J.L. 
Published: April 2004

AbstractEvaluation of maternal health services is an essential function of any health system. Single or multiple aspects of a program can be evaluated but they must be clearly defined. To assess success of a program the dimensions of coverage, equity, quality, women's satisfaction, efficiency and cost‐effectiveness must be considered. These can be measured according to some standard criteria, and various methods are described, including randomized clinical trials, randomized community trials, before and after studies, and observational studies, including the case‐control approach and confidential inquiries into maternal deaths. Indicators to assess effectiveness of a maternal health program may relate to structure, i.e., available resources or organizational arrangement; process, including changes in quantity of services provided; or outcome indicators that measure maternal mortality or morbidity.
Adjunctive antibiotic treatment of women with preterm rupture of membranes or preterm labor
Authors: McCaul J.F. , Perry K.G. , Moore J.L. , Martin R.W. , Bucovaz E.T. , Morrison J.C. 
Published: April 2004

AbstractSubclinical infection is associated with pre‐term rupture of the membranes (PROM) and preterm labor (PTL) in many cases. It was hypothesized that antibiotic treatment might delay delivery and/or decrease infectious morbidity in those with PROM or PTL. Patients from 19 to 34 weeks with PROM and no labor or PTL with intact membranes (but not both) were separately randomized to receive ampicillin versus placebo in addition to usual therapy. There were 36 women with PTL (21 ampicillin/15 placebo) and 84 with preterm PROM (41 ampicillin/43 placebo). Demographically, the treatment and placebo groups were similar. Outcome variables analyzed included delivery delay after treatment, maternal chorioamnionitis/endometritis, Apgar score, neonatal infection, or respiratory distress, and hospital stay. There were no significant differences between the ampicillin and placebo groups in those with PTL or preterm PROM as it concerned outcome parameters. Adjunctive ampicillin used for treatment of idiopathic PTL or preterm PROM was not beneficial in this study.
Risk factors in extreme grand multiparity
Authors: Fayed H.M. , Abid S.F. , Stevens B. 
Published: April 2004

AbstractOBJECTIVE: To study the obstetric performance and outcome of patients of extreme multiparity (Para 10 or more) compared to controls of parity 2–5. METHOD: Records were reviewed for 228 cases and 3349 controls at Security Forces Hospital 1986 and 1991. RESULT: Hypertension and cesarean section rate were significantly higher in the study group opposed to the control. Instrumental vaginal deliveries were significantly lower in the study group. There was no difference in the perinatal outcome between both groups. CONCLUSION: We conclude that with high socioeconomic state and high standard of antenatal care extreme grand multiparity does not carry any added special obstetric or perinatal risk.
Maternal height as a predictor of vaginal delivery
Authors: Kwawukume E.Y. , Ghosh T.S. , Wilson J.B. 
Published: April 2004

AbstractOBJECTIVE: The purpose of the study was to establish a relationship between maternal height and vaginal delivery. METHOD: A prospective study of 900 primigravidas in labor in the Department of Obstetrics and Gynecology, Korle‐Bu Teaching Hospital was conducted. A questionnaire was developed and administered by research assistants. The results were analyzed using the χ2‐test. RESULT: Of the 900 patients who delivered, 538 were studied. The remaining patients were excluded from the study because of factors described under exclusion criteria. A critical height of 154 cm was chosen as the screening height for ‘at risk’ of cephalopelvic disproportion (CPD). This height would identify 71.1% of women who would develop CPD. CONCLUSION: Short women with heights up to 150 cm are at risk of failing spontaneous vaginal delivery and should be referred to hospitals where labor could be closely monitored and cesarean section performed if necessary.
Antenatal subdural hemorrhage causing fetal death before labor
Authors: Kawabata I. , Imai A. , Tamaya T. 
Published: April 2004

AbstractAntepartum intracranial hemorrhage, which can cause fetal death prior to the onset of labor, is a rare event. This report documents the clinical findings and magnetic resonance imaging (MRI) of an uncommon case of antenatal acute subdural hematoma. MRI was extremely accurate in delineating the possible extent and location of the lesion. This is the first report to demonstrate MRI of subdural hemorrhage resulting in fetal death in utero.
Can breech presentation at birth be predicted from ultrasound examinations during the second or third trimesters?
Authors: Tadmor O.P. , Rabinowitz R. , Alon L. , Mostoslavsky V. , Aboulafia Y. , Diamant Y.Z. 
Published: April 2004

AbstractObjectives: To determine at which gestational age the ultrasound finding of a breech presentation should compel us to follow the pregnancy more closely with repeat ultrasound examinations. Methods: A retrospective longitudinal investigation of ultrasound examinations in the second and third trimesters is reported. The study group consisted of 157 breech deliveries and a control group of 1325 vertex deliveries. Results: In the study population (breech delivery) 63.2% were presenting as breech during the 15th–19th weeks of pregnancy ‐ almost the same percentage as in the vertex‐born group (of which 55.2% were breech presentation). In the interval between 20 and 24 weeks the same relationship was observed (50.8% and 42.9%, respectively). From 25 weeks until delivery a statistically significant difference appeared between the breech‐delivered group and the vertex‐delivered group: during weeks 25–29 in the breech‐delivered group, 70.6% were breech presentation compared with 28.9% in the vertex‐born group (P < 0.0001). That difference increased as the pregnancy progressed. Conclusions: Patients found sonographically to be a breech presentation at 25 weeks' gestation or later are at high risk for malpresentation at delivery.
Effects of a maternity waiting home on adverse maternal outcomes and the validity of antenatal risk screening
Authors: Chandramohan D. , Cutts F. , Chandra R. 
Published: April 2004

AbstractObjectives: To evaluate the effect of a maternity waiting home (MWH) on adverse maternal outcomes and the validity of antenatal risk criteria in predicting dystocia. Method: A hospital‐based cohort study was conducted at a district hospital in Zimbabwe. Information on the presence of antenatal risk factors, stay at an MWH, and mode and outcome of delivery was collected for each woman delivering at the hospital during 1989–1991. Results: The risk of obstructed labor was 16 times higher for those not attending an MWH (n = 2915) than for those who did attend an MWH (n = 1573) (1 vs. 0.06%, P < 0.005). Among the non‐users, 0.3% suffered a ruptured uterus compared with none of the MWH users. The presence of any one of the antenatal risk criteria used in Zimbabwe had a sensitivity of 78%, a specificity of 51% and positive predictive value of 25% for predicting dystocia. Conclusion: MWHs and antenatal risk screening are policy options for safe motherhood programs in settings where emergency obstetric services are not easily accessible.
Umbilical cord venous progesterone at term delivery in relation to mode of delivery
Authors: Aisien A.O. , Towobola O.A. , Otubu J.A.M. , Imade G.E. 
Published: April 2004

AbstractObjective: To determine whether the umbilical cord venous progesterone at term delivery is related to the mode of delivery. Methods: Thirty‐nine pregnant patients at term were divided into three groups: elective cesarean section (control), spontaneous vaginal delivery, and emergency cesarean section. Umbilical cord venous and maternal serum progesterone were measured by radioimmunoassay. Statistical analysis was carried out using Student's t‐test, with the level of significance set at P < 0.05. Results: Umbilical cord venous progesterone was significantly higher in babies delivered by emergency cesarean section (P < 0.001) and in those who had spontaneous vaginal delivery (P < 0.02), compared with the control group. Maternal serum progesterone concentrations showed no significant differences between the three groups. The Apgar scores of the stressed group of babies were significantly lower (P < 0.001). Conclusion: The findings demonstrate that the fetuses exposed to stress during labor produce higher progesterone secretion. This could be one possible way the fetus protects itself against the sequelae of hypoxia.
Significance of serum iron levels as a biochemical marker in pregnancy‐induced hypertension
Authors: Das S.S. , Dhall G.I. , Dhall K. , Dash S. 
Published: April 2004

AbstractOBJECTIVE: To determine the changes in serum iron levels, if any, as a biochemical marker of pregnancy‐induced hypertension (PIH). METHOD: Fifty‐four primigravidas with PIH formed the study group and 20 normotensive primigravidas comprised the control group in a prospective study. Serum iron levels were estimated at diagnosis of PIH, at termination of pregnancy and in the postpartum period. Data was analyzed using Student's t‐test, the X2‐test and regression analysis. RESULTS: Subjects with PIH were found to have higher serum iron levels at diagnosis of PIH (recruitment value) and at termination of pregnancy than the controls (P < 0.001). Serum iron levels in the PIH subjects decreased markedly in the postpartum period simultaneously with the clinical recovery from PIH. Serum iron values of ≥ 110 gg/dl was found to differentiate PIH from normotensive pregnancies with a sensitivity and specificity of 89% and 90%, respectively. CONCLUSIONS: Changes in serum iron levels correlated with the clinical course of PIH and appeared to be a uniform and specific biochemical marker of PIH although its correlation with the severity of PIH was found to be poor.
Construction of an artificial vagina with sigmoid colon in vaginal agenesis
Authors: Ghosh T.S. , Kwawukume E.Y. 
Published: April 2004

AbstractOBJECTIVES: The study of 15 cases of colonic reconstruction for absent vagina. The outcome in cases of reconstruction of an artificial vagina using the colon is evaluated. METHODS: Fifteen female patients with congenital absence of vagina who were evaluated and treated with sigmoid colonic reconstruction at the Korle‐Bu Teaching Hospital in Accra, Ghana were studied. RESULTS: This reconstructive method is successful in patients having a functioning vagina without progressive shrinkage or other symptoms. Disfigurement of the thighs and labia are avoided as is the need for active manipulation. CONCLUSION: Sigmoid colonic reconstruction for vaginal agenesis is an acceptable method especially in the developing world.
Adolescents and their experience of parental divorce
Authors: Mcloughlin David , Whitfield Richard 
Published: April 2004

AbstractThis paper describes the results of an interview‐based study of the reactions of 64 adolescents to the separation and divorce of their parents.The results of the interviews suggest that parental divorce does not necessarily interfere with adolescent development. They also suggest that adolescents would prefer to live in a one‐parent home than a two‐parent home which is fraught with conflict, and that it is preferable for parents who are unable to resolve such conflict in any other way to separate rather than allow it to persist.Further, the results of the interviews provide some suggestions as to the way divorcing parents should behave if they are to facilitate the adjustment of their adolescent children to the divorce process. In particular, attention is drawn to the extent to which they need to keep their children informed about their intentions, their conduct towards each other following the separation and their conduct in forming and maintaining new relationships.
Muslim traditions and attitudes to female education
Authors: Siann Gerda , Khalid Ruhi 
Published: April 2004

AbstractIt has been suggested that girls and women coming from a Muslim background in the Asian sub‐continent are disadvantaged in the educational sphere. In this study two particular aspects of this suggested disadvantage are investigated. First, the importance of educating males rather than females and secondly, the issue of parental and husband's control over the rights of women to education and work. Twenty‐six Muslim females living in a large Scottish town but of a Pakistani Punjabi background were interviewed in depth. The findings, that these women considered that it is as important to educate girls as it is to educate boys, and that they acquiesced in parental and husband's control over the rights of females to be educated and work, are discussed within a cross‐cultural perspective. It is concluded that such issues cannot be isolated from traditional values about the importance of upholding family honour.
Resistance in psychotherapy with adolescents
Authors: Graafsma T. , Anbeek M. 
Published: April 2004

AbstractResistances are of considerable significance in psychotherapy with adolescents. In this article, that significance is investigated further, because the way in which resistances are valued is very important in treatment.The forms in which it appears and, the source and intention of resistances are discussed. It is proposed that the investigation of resistances should not be aimed primarily at their removal.
Democratic consensus and the young: a cross national comparison of Britain and America
Authors: Ranade Wendy , Norris Pippa 
Published: April 2004

AbstractIn previous decades research has suggested that the young, especially those in higher education, were increasingly cynical, distrustful and disenchanted with the democratic process in Britain and America. The aim of this paper is to see how far this is still the case by assessing democratic attitudes amongst college students in a sample from Britain and America, using scales developed by McClosky (1964). The paper concludes that the responses from the American and British sample were fairly similar across a number of scales on the rules of the game, free speech and equality. On all these both groups of students displayed relatively high support for democratic attitudes. The main contrast was found on feelings of trust and efficacy, with the British sample showing much lower feelings that government was honest and responsive to their needs. The paper concludes with some suggestions about how these responses can be explained.
Adolescent images of adolescence
Authors: Falchikov Nancy 
Published: April 2004

AbstractThis study examines the extent to which a group of Scottish adolescents are influenced by negative images of adolescence present in our culture, and investigates their self‐image by means of a Q sort. Forty 15‐ and 16‐year‐old school students took part in the study, half of whom were female. Half of the sample were staying on at school to take higher examinations, the other half being school leavers. Eleven factors emerged from the analysis, the first six of which met the criterion that distinguishes common factors. Participants defining common factors were re‐interviewed, and their responses to factor interpretations noted. Little evidence was found to suggest that adolescents are influenced by newspaper images. Some descriptions hint at conflict, while others do not. If the results of the present study were to be replicated, a more pluralistic view of adolescence may be required.