bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictive value of serum interleukin‐6 and ‐8 levels in preterm labor or rupture of the membranes
Authors: VON MINCKWITZ GUNTER , GRISCHKE EVA‐MARIA , SCHWAB STEFANIE , HETTINGER SUSANNE , LOIBL SIBYLLE , AULMANN MICHAEL , KAUFMANN MANFRED 
Published: March 2003

Background. The aim of this prospective study was to examine if serum concentrations of cytokines are of value in the identification of patients at risk for preterm delivery.Methods. Interleukin‐1β,2,4,6,8 and tumor necrosis factor α were determined between 25 and 37 weeks of gestation in the serum of 72 consecutive patients with preterm labor, 38 patients with preterm rupture of the membranes, and 24 healthy pregnant women as a control group. Material was collected within 18 hours after hospitalization and was immediately centrifuged and shock frozen.Results. Significantly increased serum levels were found for interleukin‐6 and ‐8 in patients with preterm labor or preterm rupture of the membranes when compared to the control group (p<0.001 and p<0.005, respectively). In patients with preterm rupture of the membranes and interleukin‐6 levels above the median of 4.0 pg/ml the delivery occurred significantly earlier than in patients with lower levels (1 versus 5.5 days; p=0.005). Patients of both pathology groups with detectable (>18 pg/ml). Interleukin‐8 levels had a shorter pregnancy duration when compared to other patients (p=0.05 for preterm labor and p=0.04 for preterm rupture of the membranes). Interleukin‐1β,2,4, and tumor necrosis factor α were not correlated with clinical outcome.Conclusions. Increased serum interleukin‐6 and ‐8 levels are associated with a shorter interval between onset of preterm rupture of the membranes and delivery and should therefore be further evaluated for their use in clinical practice.
Menstrual cycle symptom variation in a community sample of women using and not using oral contraceptives
Authors: SVEINSDÓTTIR HERDÍS , BÄCKSTRÖM TORBJÖRN 
Published: March 2003

Background. The prevalence of significant symptom change (symptom cyclicity) prospectively rated over multiple menstrual cycles has not been established in a non‐clinical population.Methods. Seventy‐three women charted 57 symptoms over 2–6 menstrual cycles each. Symptoms, and summarized symptom scores within seven symptom groups, were tested for changes between the follicular phase and the luteal phase of each cycle. Recurrent symptom cyclicity over multiple cycles within individuals was ascertained and the stability between cycles of mean symptom scores for both the follicular phase and the luteal phase.Results. Forty‐five percent of the participants experienced cyclicity over multiple cycles in at least one symptom and 23% in at least one symptom group. Eighteen percent of the participants consistently reported a higher symptom score during the luteal phase compared to the follicular phase (a PMS‐like pattern) in all symptoms in which they experienced a change. The remaining 27% experienced a varying direction of change in the same symptom between cycles, or consistently experienced a lower symptom score during the luteal phase (a reverse PMS‐like pattern) of the cycles they charted. Recurrent cyclicity was experienced by 16% of the participants in one symptom; in two symptoms by 15%; in 3–8 symptoms by 14%; in one symptom group by 19% and in two symptom groups by only 4% of participants. Average symptom severity did not vary significantly between cycles.Conclusion. Due to the varied direction of symptom severity change over multiple cycles, prospective daily ratings are necessary to achieve a true picture of menstrual related symptom cyclicity in the general population.
Changes in flow velocity, resistance indices, and cerebral perfusion pressure in the maternal middle cerebral artery distribution during normal pregnancy
Authors: Belfort Michael A. , Tooke‐Miller Cathy , Allen John C. , Saade George R. , Dildy Gary A. , Grunewald Charlotta , Nisell Henry , Herd J. Alan 
Published: March 2003

Background. There are few longitudinal data currently available detailing the normal changes in maternal cerebral hemodynamics during human pregnancy. This lack of information limits the study of pregnancy‐associated cerebrovascular adjustments and, in particular, preeclampsia, where the brain appears to be especially susceptible to ischemic and encephalopathic injury. Our objective was to define the hemodynamic changes, specifically velocity, resistance indices, and cerebral perfusion pressure, in the middle cerebral artery (MCA) distribution of the brain during normal pregnancy.Methods and materials. Transcranial Doppler ultrasound was used to determine the systolic, diastolic and mean blood velocities in the middle cerebral arteries in non‐laboring women studied longitudinally during normal gestation. The resistance index (RI), pulsatility index (PI), and cerebral perfusion pressure (CPP) were calculated using the velocity and blood pressure data. Data were analyzed using a longitudinal statistical model incorporating random patient effects and a homoscedastic (compound symmetric) variance‐covariance structure over time (gestational age). The predicted mean value (Least Squares Mean), and the 5th and 95th percentiles, were defined for normal pregnancy.Results. MCA systolic velocity decreased (24%) as did the mean velocity (17%). The diastolic velocity did not change significantly. The MCA RI decreased by 19% and the PI decreased by 25%. The MCA CPP increased by 52% between 12 and 40 weeks of gestation.Conclusions. The normative ranges for MCA velocity, RI, and CPP have been defined in normal human pregnancy using longitudinally collected data. By having a defined normal range, identification of abnormalities in cerebral hemodynamics during pregnancy is now possible, and this may help researchers and clinicians to elucidate etiologies and treatments for pregnancy‐related pathophysiologic states such as preeclampsia
Maternal risk factors for cause‐specific stillbirth and neonatal death
Authors: Winbo Ingrid , Serenius Fredrik , Dahlquist Gisela , Källén Bengt 
Published: March 2003

Background. To study specific effects of four maternal risk factors: age, parity, educational level, smoking, for specific causes of stillbirth and neonatal death according to a previously described hierarchic classification.Methods. The study is based on 9,785 stillbirths or neonatal deaths among infants born in Sweden, 1983–1995 (n=1,412,754) and identified with various Swedish health registers. Statistical analysis is performed using Mantel‐Haenszel analysis.Results. Some risk factors, known from the literature, were confirmed and could be quantified. In addition, high parity was shown to increase the risk for death associated with multiple births (OR=2.49, 95% CI 2.07–3.01) and low educational level seems to be protective for such death (OR=0.75, 95% CI 0.60–0.93). If the infant is SGA, the risk for death is higher at high than at low parity (1.70, 95% CI 1.19–2.43, and 1.0, 95% CI 1.06–1.15, respectively). Maternal smoking seems to aggravate the placental abruption because the death risk in the presence of abruption increases when the mother smoked (OR=1.74, 95% CI 45–2.08).Conclusions. The study shows that the groups of the classification system used (NICE) differ in their association with known risk factors for stillbirth and neonatal deaths and an analysis based on specific causes of death can therefore unravel risk factors hidden when total mortality is used. The computerized method of classification and the cause‐of‐death classification developed by us is clearly useful for such analyses which requires large materials.
Prevalence of depressive symptoms in late pregnancy and postpartum
Authors: Josefsson Ann , Berg Göran , Nordin Conny , Sydsjö Gunilla 
Published: March 2003

Background.Postnatal depression refers to a non‐psychotic depressive episode that begins in or extends into the postpartum period. The aims of this study were to examine the prevalence of depressive symptoms in a pregnant and later postnatal population, to determine the natural course of these symptoms and whether there is an association between antenatal and postnatal depressive symptomatology.Methods.A longitudinal study with a total population of 1,558 consecutively registered pregnant women in the southeast region of Sweden. Presence of depressive symptoms was measured with the Edinburgh Postnatal Depression Scale on four occasions namely in gestational week 35–36, in the maternity ward, 6–8 weeks and 6 months postpartum.Results.The prevalence of depressive symptoms during late pregnancy was 17%; in the maternity ward 18%; 6–8 weeks postnatally 13%; and 6 months postnatally, 13%. A correlation between antenatal and postnatal depressive symptoms was found (r=0.50,p<0.0001).Conclusion.Detection of women at risk for developing postnatal depressive symptoms can be done during late pregnancy. Antenatal care clinics constitute a natural and useful environment for recognition of women with depressive symptoms.
Feto‐maternal morbidity and mortality after cardiac valve replacement
Authors: Ayhan Ali , Yucel Aykan , Bildirici Ibrahim , Dogan Riza 
Published: March 2003

Background. The aim of this study is to evaluate the fetomaternal morbidity and mortality of the pregnancies of women who conceived after cardiac valve replacement.Methods. A consecutive series of one hundred and thirty‐six pregnancies of one hundred and one patients who conceived after cardiac valve replacement were retrospectively analyzed. Regarding the anticoagulation therapy, 101 patients were classified into three groups: A: patients on oral anticoagulants (n=68), B: patients on heparin (n=16) and C: patients who received no anticoagulation (n=17).Results. Three groups (patients on oral anticoagulants (A), on heparin (B), patients who received no anticoagulation (C)) were compared in terms of spontaneous abortion (19%, 11%, 5.6%), preterm delivery (14%, 22.3%, 16.6%), maternal mortality (3%, 11.1%, 0%), thromboembolic events (4%, 11.1%, 0%), cardiac failure (6%, 11.1%, 11.1%), atrial fibrillation (9%, 11.1%, 5.6%), antenatal bleeding (9%, 11.1%, 5.6%), delivery route and fetal malformation (5%, 0%, 0%) and no statistically significant differences were detected. In group B, hematoma formation rate (22.2%) (p=0.011) and transfusion rate (27.8%) (p=0.005) were significantly higher. Five cases of congenital anomalies were detected, all belonging to group A, but this tendency was not found to be statistically significant.Conclusions. Management of pregnancies with prosthetic heart valves require closely monitored anticoagulation, and an obstetrician should be familiar with the potential fetal and maternal adverse effects of any anticoagulant therapy during the course of pregnancy.
Influence of maternal magnesium sulphate and ritodrine treatment on cerebral blood flow velocity of the preterm newborn
Authors: Pezzati Marco , Giani Teresa , Gambi Beatrice , Dani Carlo , Bertini Giovanna , Biagiotti Roberto , Rubaltelli Firmino F. 
Published: March 2003

Background. To evaluate the effect of antenatal tocolytic administration of magnesium sulphate and ritodrine on the cerebral blood flow velocity and on the cerebral vascular resistance of preterm newborns in the first hours of life.Methods. Cerebral blood flow velocity, resistance index and relative vascular resistance were studied in 27 preterm infants (<34 weeks gestation) with antenatal exposure to maternal magnesium sulphate treatment and in 27 preterm infants (<34 weeks gestation) with antenatal exposure to maternal ritodrine treatment. Both antenatal magnesium sulphate or ritodrine were used for tocolysis. Cerebral blood flow was measured, using Doppler ultrasonography, in the anterior cerebral artery, in the left middle cerebral artery and in the right middle cerebral artery.Results. We did not find any significant difference in the blood flow velocity, resistance index or relative vascular resistance in the three cerebral arteries between the two treatment groups.Conclusions. Our study shows that maternal antenatal administration of magnesium sulphate to delay preterm delivery, compared to antenatal administration of ritodrine, does not induce any significant differences either in cerebral blood flow velocity or in cerebral vascular resistance of preterm infants in the first hours of life.
Do very sick neonates born at term have antenatal risks?
Authors: Sutton Lee , Sayer Geoffrey P. , Bajuk Barbara , Richardson Valerie , Berry Geoffrey , Henderson‐Smart David J. 
Published: March 2003

Aims. 1. Ascertain antenatal and intrapartum risk factors for term neonates ventilated primarily for ‘perinatal asphyxia’. 2. Describe the neonatal morbidity and mortality.Methods. Population‐based case control cohort study. Setting. Sydney and four large rural/urban health areas in New South Wales. Subjects. Singleton term infants, no major congenital anomaly: subset of 83 infants ventilated primarily for ‘asphyxia’ from 182 cases admitted to a tertiary neonatal intensive care unit (NICU) for mechanical ventilation, 550 randomly selected controls. Outcome. Risk factors for case status by maternal, antenatal, labor, delivery, and combined epochs, adjusted odds ratios (OR), 95 per cent confidence intervals (CI), p<0.05.Results. Predictors of case status by multivariate epochs: Primigravida (1.8 [1.1, 2.8]), thyroid disease (7.8 [1.1, 57.0]), any antenatal complication (5.1 [3.0, 8.6]), growth restriction (4.2 [1.7, 10.4]), male gender (2.1 [1.3, 3.5]), gestational age >40 weeks (1.9 (1.1, 3.3)), prolonged rupture of membranes (9.7 [1.3, 72.5]), complicated labor (6.6 [3.7, 11.9]), induced labor (2.2 [1.3, 3.9]), prostaglandins 2.46 [1.23, 4.91]), maternal pyrexia (10.8 [2.8, 42.7]), placental hemorrhage in labor (OR 4.24 [1.45, 12.42]), forceps delivery (4.1 [1.9, 8.5]), emergency cesarean section (4.7 [2.6, 8.7]). Twenty case infants (24%) and no control infants died.Conclusions. This study has shown maternal and antepartum risk factors for severe neonatal morbidity in term infants. More centers need to become interested in the term baby, so that a larger multicenter study can further elucidate the heterogeneous causal pathways to term neonatal morbidity.
Do very sick neonates born at term have antenatal risks?
Authors: Sutton Lee , Sayer Geoffrey P. , Bajuk Barbara , Richardson Valerie , Berry Geoffrey , Henderson‐Smart David J. 
Published: March 2003

Aims. 1. Ascertain antenatal and intrapartum risk factors for term neonates ventilated primarily for respiratory problems. 2. Describe the neonatal morbidity and mortality.Methods. Population‐based case control cohort study.Setting. Sydney and four large rural/urban Health Areas in New South Wales, 1996.Subjects. Singleton term infants, no major congenital anomaly: subset of 99 infants ventilated primarily for respiratory problems from 182 cases admitted to a tertiary neonatal intensive care unit (NICU) for mechanical ventilation, and 550 randomly selected controls.Outcome. Risk factors for case status by maternal, antenatal, labor, delivery, and combined epochs, adjusted Odds Ratios (OR), 95 per cent Confidence Intervals (CI), p<0.05.Results. Predictors of case status by multivariate epochs: mother’s age ≥35 years (1.9 (1.1, 3.2) p=0.03), primigravida (1.8 (1.1, 2.8) p=0.01), any antenatal complication (3.8 (2.4, 5.9) p=0.0001), birth weight <3rd percentile (3.7 (1.5, 9.1) p=0.006), gestational diabetes (2.9 (1.3, 6.9) p=0.01), maternal pyrexia (6.5 (1.6, 27.2) p=0.01), birth weight >90th percentile (1.8 (1.01, 3.2) p=0.047), gestation 37–38 weeks (2.3 (1.5, 3.6) p=0.0004), forceps (4.4 (2.1, 9.1) p=0.0001), elective cesarean section (3.7 (2.0, 6.5) p=0.0001), emergency cesarean section (4.5 (2.4, 8.4) p=0.0001). Case mortality rate was 5 per cent.Conclusion. The pathways to neonatal respiratory morbidity in term infants are multifactorial. Several areas which warrant more in‐depth study are: elective cesarean section at 37–38 weeks gestation, fetal growth restriction, macrosomia and the pattern of in‐utero growth, maternal weight gain during pregnancy, gestational diabetes, pyrexia in labor and the role of chorioamnionitis.
Do fertile women remember the onset of stress incontinence?
Authors: Viktrup Lars , Lose Gunnar 
Published: March 2003

Background. To evaluate fertile women’s ability to recall the onset of stress incontinence.Methods. In a prospective cohort study 305 primiparae were interviewed after 1st delivery and again 5 years later using a tested questionnaire. In 83 women with stress incontinence 5 years after 1st delivery history of onset was compared with data from the initial questionnaire by grouping women with onset before 1st pregnancy, during 1st pregnancy, during 1st puerperium or after 1st puerperium.Results. Five years after 1st delivery only 26% recalled the onset of stress incontinence precisely. The statistical agreement for each of the four groups of women with different recall of onset varied with a Kappa from 0.02 to 0.38.Conclusion. Five years after 1st delivery stress incontinent women seem to recall the onset of the symptom imprecisely.
Pain experience during transvaginal aspiration of immature oocytes
Authors: Hildebrandt Nan B. , Høst Erik , Mikkelsen Anne Lis 
Published: March 2003

Background. We wanted to determine the pain conception prior to, during, and after transvaginal recovery of immature oocytes for in vitro maturation (IVM).Material and methods. Fifty women received 1 g Paracetamol and 0.125 mg Halcion as preanalgesics. During the oocyte pick‐up para‐cervical blockage (PCB) with 5 ml Citanest ×2 was given, in addition to 1.5–2 ml Raphiphene intravenously. The pain was measured by using a visual analog scale (VAS). The expected pain was recorded just before the oocyte pick‐up. Right after the oocyte pick‐up the actual pain was measured and again 1/2 hour, and 1–11/2 hour later. Furthermore, the pain was recorded every second hour after discharge and every third hour the next day.Results. Forty‐three women experienced less pain than expected (p=0.003). The pain conception was correlated to the number of punctures through the vagina (p=0.012). Fifteen patients received analgesics postoperatively, and all patients were discharged less than 2 hours after the procedure without complaints. None noted any discomfort or pain after 30 hours following the oocyte pick‐up.Conclusion. Although the IVM oocyte pick‐up procedure involved puncture of very small follicles that required numerous punctures through the vagina, the experienced pain was significantly less than the expected pain, and the procedure was well accepted.
The impact of frozen embryos on emotional reactions during in vitro fertilization
Authors: Svanberg Agneta Skoog , Boivin Jacky , Hjelmstedt Anna , Bergh Lena Andersson , Collins Aila , Bergh Torbjörn 
Published: March 2003

Background. Emotional reactions of couples were investigated during in vitro fertilization (IVF) at a private clinic in Sweden. The purpose was to compare such reactions between couples who obtained supernumerary embryos that could be cryopreserved and couples without such embryos.Methods. Forty women and men undergoing IVF treatment monitored individually their emotional reactions daily for one complete treatment cycle from the first day of down‐regulation until the outcome of treatment was known. Ratings were extracted and analyzed from two separate days; the very first day of treatment and the day of embryo transfer.Results. The group of women (n=16; 40%) with supernumerary embryos suitable for cryopreservation reported a greater increase in optimism than the group (n=24; 60%) without such embryos (p=0.024). Correspondingly, women with supernumerary embryos reported less pessimism than women without such embryos (p=0.014). Among men there was no difference in optimism or pessimism between the groups. The women and men with supernumerary embryos did not differ in distress reactions compared to those women and men without such embryos. There was no correlation between optimism and distress on the day of embryo transfer in women; r=−0.167 and men; r=−0.135 respectively.Conclusion. The presence of frozen embryos increased optimistic and reduced pessimistic feelings about pregnancy among women undergoing IVF treatment. However, the couples’ increased optimism on the day of embryo transfer did not seem to reduce their experience of distress.
Expression of cadherins and CD44 isoforms in human endometrium and peritoneal endometriosis
Authors: Poncelet Christophe , Leblanc Marc , Walker‐Combrouze Francine , Soriano David , Feldmann Gérard , Madelenat Patrick , Scoazec Jean‐Yves , Daraï Emile 
Published: March 2003

Background.  To evaluate (a) cadherins and CD44 expression in normal endometrium and in peritoneal endometriosis, and (b) to correlate, their expressions with clinicopathological parameters.Methods.  E‐ and N‐cadherin, CD44 isoforms, CD44v3 and CD44v6 expressions were evaluated: (a) by immunoblotting in endometrium (n = 6) and in peritoneal endometriotic samples (n = 7) and, (b) by immunohistochemistry in endometrium (n = 15) and in peritoneal endometriotic samples (n = 23).Results.  By immunoblotting, endometrium expressed E‐ and N‐cadherin, CD44 isoforms, CD44v3 and CD44v6. Similar results were observed in peritoneal endometriosis. By immunohistochemistry, in endometrium, E‐cadherin was restricted to epithelial cells. Its expression remained constant throughout the menstrual cycle. N‐cadherin was detected in both epithelial and stromal cells in the proliferative phase but was restricted to epithelial cells in the secretory phase. CD44 immunostaining was detected in the secretory but not in the proliferative phase. Decreased expression of E‐cadherin (p < 0.01) and CD44 (p < 0.01) in epithelial cells was found in peritoneal endometriosis as compared with normal endometrium. In endometriotic stromal cells, decreased CD44 expression was found. In peritoneal endometriosis, we observed a decreased expression of E‐cadherin in advanced stages of the disease (p < 0.01).Conclusion.  Our results suggest that E‐cadherin and CD44 proteins could be involved in the development of endometriotic lesions. Investigation of the mechanisms of altered adhesion molecule expression may contribute to the understanding of the behavior of endometriotic cells.