bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can 24‐hour ambulatory blood pressure measurement predict the development of hypertension in primigravidae?
Authors: Higgins John R. , Walshe Joseph J. , Halligan Aidan , O'Brien Eoin , Conroy Ronan , Darling Michael R. N. 
Published: August 2005

Objective
To assess the role of 24‐hour ambulatory blood pressure measurement in the mid‐second trimester as a predictive test for the development of hypertension in pregnancy.Design
Prospective intervention.Setting
The Rotunda Hospital, Dublin.Participants
One thousand one hundred and two healthy primigravid women.Intervention
24‐hour ambulatory blood pressure measurement at 18 to 24 weeks of gestation.Main outcome measures
The development of pre‐eclampsia or gestational hypertension.Results
A total of 1048 women had sufficient readings to be included in the final analysis. Of these, 23 (2.2%) developed pre‐eclampsia, 64 (6.1%) developed gestational hypertension and 961 (91.7%) remained normotensive. Significantly higher ambulatory blood pressures were recorded in both the pre‐eclamptic and gestational hypertensive group compared with the normotensive group. In addition, the gestational hypertensive group had significantly higher clinically measured blood pressure compared with the normotensive group. There were no differences between the pre‐eclamptic and the gestational hypertensive group for any of the blood pressure parameters analysed. The best overall predictor for pre‐eclampsia was 24‐hour mean diastolic pressure which using a cutoff level of 71 mmHg gave a test with a sensitivity of only 22% and a positive predictive value of 15%.Conclusion
Because the absolute differences are small and the overlap between the hypertensive and normotensive groups large, ambulatory blood pressure measurement, in a healthy primigravid population, between 18 and 24 weeks of gestation is not a useful predictor of hypertension.
Increased levels of intercellular adhesion molecules and vascular cell adhesion molecules in pre‐eclampsia
Authors: Djurovic Srdjan , Schjetlein Rune , Wislaff Finn , Haugen Guttorm , Berg Kare 
Published: August 2005

Objective
To investigate the correlation between soluble forms of the intercellular adhesion molecule (SICAM‐1) and vascular cell adhesion molecule (sVCAM‐1) and the severity of pre‐eclampsia or its possible consequences for fetal growth.Design
Prospective observational study.Setting
Institute of Medical Genetics, University of Oslo, Department of Medical Genetics and Haematological Research Laboratory, Ullevål University Hospital; and the Department of Obstetrics and Gynaecology, The National Hospital, Oslo, Norway.Participants
Seventy‐six women with normotensive pregnancies and 157 women with pre‐eclampsia divided into three subgroups: mild, severe and pre‐eclampsia with fetal growth retardation.Methods
ELISA‐measurements of plasma SICAM‐1 and sVCAM‐1 were performed in a group of healthy pregnant normotensive women and three groups of women with varying degrees of pre‐eclampsia.Results
SICAM‐1 concentrations were higher in the pre‐eclampsia group compared with the control group, but this difference was not statistically significant. Plasma concentrations of sVCAM‐1 were significantly greater (P < 0.0001) in all pre‐eclampsia subgroups (835.34, 855.25 and 964.05 ng/mL) compared with the control group (667.62 ng/mL). Within the pre‐eclampsia group, plasma concentration of sVCAM‐1 was significantly higher in the subgroup exhibiting fetal growth retardation (P= 0.03) compared with mild pre‐eclampsia.Conclusion
The observed increases in plasma concentrations of sVCAM‐1 suggest that measurements of this adhesion molecule may be useful in monitoring pregnancies with respect to the development of pre‐eclampsia or fetal growth retardation.
Elevated levels of serum nitrate, a stable end product of nitric oxide, in women with pre‐eclampsia
Authors: Smárason Alexander , Allman Keith G. , Young Duncan , Redman Christopher W. G. 
Published: August 2005

Objectives
Nitric oxide released from vascular endothelial cells is a potent vasodilator and inhibits platelet adhesion. It has been suggested that decreased nitric oxide production from dysfunctional endothelial cells is implicated in the pathophysiology of pre‐eclampsia. In this study evidence was sought for abnormal production of nitric oxide in pre‐eclamptic women.Participants
Blood was collected from 20 women presenting with pre‐eclampsia, from 20 matched healthy pregnant controls and from 12 nonpregnant women of childbearing age.Methods
Serum nitrate, the stable end metabolite of nitric oxide, was measured by vanadium III chloride reduction and chemiluminescence.Results
Sera from women with pre‐eclampsia had significantly higher nitrate concentrations (mean 47.4 μmol/L [SD 13.6]) compared with healthy pregnant (mean 31.2 μmol/L [SD 9.14]) and nonpregnant (mean 32.1 μmol/L [SD 10.0]) controls.Conclusions
These results do not support the hypothesis that decreased endothelial cell nitric oxide production may be important in the pathophysiology of pre‐eclampsia. On the contrary, serum nitrate levels are increased which may reflect either increased production of nitric oxide from an unidentified source or decreased elimination through the kidneys.
Epidemiology of genital prolapse: observations from the Oxford Family Planning Association study
Authors: Mant Jonathan , Painter Rosemary , Vessey Martin 
Published: August 2005

Objective
To explore the epidemiology of uterovaginal and post‐hysterectomy prolapse.Design
Cohort study.Setting
Seventeen large family planning clinics in England and Scotland.Population
17,032 women who attended family planning clinics between 1968 and 1974, aged between 25 and 39 years at study entry.Methods
Annual follow up by interview, postal or telephone questionnaire until July 1994. Further details on all hospital admissions were obtained from the hospital discharge summaries. All women were flagged at time of recruitment in the NHS central registers.Main outcome measure
In‐patient admission with diagnosis of prolapse (ICD codes 8th Revision 623.0–623.9).Results
The incidence of hospital admission with prolapse is 2.04 per 1000 person‐years of risk. Age, parity, calendar period and weight were significantly associated with risk of an inpatient admission with prolapse after adjustment for principal confounding factors. Significant trends were observed with regard to smoking status and obesity (Quetelet Index) at entry to the study and risk of prolapse. Social class, oral contraceptive use and height were not significantly associated with risk of prolapse. The incidence of prolapse which required surgical correction following hysterectomy was 3.6 per 1000 person‐years of risk. The cumulative risk rises from 1% three years after a hysterectomy to 5% 15 years after hysterectomy. The risk of prolapse following hysterectomy is 5.5 times higher (95% CI 3.1–9.7) in women whose initial hysterectomy was for genital prolapse as opposed to other reasons.Conclusion
Among the potential risk factors that were investigated, parity shows much the strongest relation to prolapse.
Long term influence of different postmenopausal hormone replacement regimens on serum lipids and lipoprotein(a): a randomised study
Authors: Hänggi Willy , Lippuner Kurt , Riesen Walter , Jaeger Phillippe , Birkhauser Martin H. 
Published: August 2005

Objective
To assess the influence of three different postmenopausal hormone replacement therapies on levels of serum lipids and lipoprotein(a) [Lp(a)].Design
Open, randomised, controlled study.Participants
One hundred and forty healthy, early postmenopausal women.Interventions
The women were randomised to receive continuous 17β‐oestradiol, either orally (2 mg daily; n= 35) or transdermally (50 μg daily; n= 35), plus 10 mg dydrogesterone daily for 14 days of each 28‐day cycle; or 2.5 mg tibolone daily (n= 35). Thirty‐five untreated women acted as controls.Main outcome measures
Fasting blood samples were analysed at baseline, 6,12 and 24 months for low‐density lipoprotein (LDL)‐cholesterol, high‐density lipoprotein (HDL)‐cholesterol, very low density lipoprotein (VLDL), total cholesterol, triglycerides, lipoprotein(a) [Lp(a)], apolipoproteins A‐l, A‐2 and B, fibrinogen, and antithrombin factor III.Results
At 24 months oral oestradiol increased mean HDL cholesterol (7%; 95% CI 1–14), compared with no change in the transdermal group and a decrease of 26.8% in the tibolone group (95% CI 22.9–30.5); oral oestradiol decreased mean LDL cholesterol (11.8%; 95% CI 6.3–19), compared with no change in the tibolone group. Changes in apolipoprotein A‐1 and B showed a similar pattern to HDL and LDL cholesterol, respectively. Oral oestradiol increased serum triglycerides (30%; 95% CI 18–42) after 24 months, compared with no change in the tibolone and transdermal oestradiol groups. Tibolone decreased serum Lp(a) by 36.6% after 24 months (95% CI 8.3–56.2), oral oestradiol decreased levels by 29.4% (95% CI 2–51.1), compared with no change in the transdermal oestradiol group.Conclusions
Oral and to a lesser extent transdermal oestradiol when sequentially combined with dydrogesterone, showed a beneficial influence on serum lipids regarding the cardiovascular disease risk, which was not seen with tibolone. The significance of Lp(a) levels on cardiovascular disease risk remains to be determined.
A study of treatment failures following large loop excision of the transformation zone for the treatment of cervical intraepithelial neoplasia
Authors: Flannelly Grainne , Langhan Heather , Jandial Lata , Mann Evelyn , Campbell Marion , Kitchener Henry 
Published: August 2005

Objective
To examine the long term efficacy of large loop excision of the transformation zone (LLETZ) in the treatment of cervical intraepithelial neoplasia (CIN) and to evaluate the relative diagnostic merits of colposcopy and cytology in the follow up of these women.Design
A retrospective examination of cytology, colposcopy and histology records of the first 1000 women treated with LLETZ in Aberdeen from 1989 to 1991.Setting
Colposcopy Clinic Aberdeen Royal Infirmary, Grampian Region, Scotland.Results
Nine hundred and seventy‐seven women (97.7%) were seen for follow up at least once and 317 were followed for as long as four years. This comprises 2812 woman years of follow up. The incidence of recurrent CIN was 27/1000 woman years and the cumulative rate of recurrence at four years was 10.1 per 100 women. Twenty‐eight of the 59 women (47%) with abnormal colposcopy and proven CIN had a concurrent smear that did not show dyskaryosis.Conclusions
LLETZ is an effective form of treatment for CIN. Colposcopy was useful in the follow up of these women and expedited the treatment of persistent disease. We recommend that any follow up protocol should include a colposcopic assessment and cytological follow up for at least four years following treatment. Further data are required to determine the risk of recurrence beyond this time.
Sjögren's syndrome in women presenting with chronic dyspareunia
Authors: Mulherin Diarmuid M. , Sheeran Thomas P. , Kumararatne Dinakantha S. , Speculand Bernard , Luesley David , Situnayake R. Deva 
Published: August 2005

Objective
To identify cases of Sjögren's syndrome among women with chronic dyspareunia who did not already have a diagnosed rheumatological disorder.Design
Prospective recruitment over 12 months.Setting
Tertiary referral service for the assessment of vulval disease.Participants
Women with chronic dyspareunia who had musculoskeletal symptoms, Raynaud's phenomenon or symptoms of ocular or oral dryness.Methods
The women underwent a Schirmer tear test and a comprehensive auto‐antibody screen including latex fixation test for rheumatoid factor, antinuclear, anti‐Ro, anti‐La and anti‐salivary duct antibodies. A labial salivary gland biopsy and vaginal biopsy were taken for routine histological analysis.Main outcome measures
Cases of definite and probable Sjögren's syndrome were identified using the European criteria.Results
Eleven women were assessed for features of Sjögren's syndrome. Four had definite primary Sjögren's syndrome, two had probable primary Sjögren's syndrome and one had probable secondary Sjögren's syndrome. Among these seven women the median duration of vaginal symptoms was seven years (range 0.25–20), of ocular symptoms was one year (range 0.25–2) and of oral symptoms was 1.5 years (range 0–6). In all but one woman dyspareunia presented before ocular or oral symptoms, often by many years.Conclusions
Although well‐recognised as a feature of established Sjögren's syndrome, this study emphasises that chronic dyspareunia can be a presenting feature in these women, antedating the emergence of ocular or oral symptoms by many years. Symptoms of ocular or oral dryness, Raynaud's phenomenon or musculoskeletal symptoms should be sought in women with chronic dyspareunia to identify those who merit further investigation.
Extra‐amniotic saline infusion for induction of labour in antepartum fetal death: a cost effective method worthy of wider use
Authors: Mahomed Kassam , Jayaguru Alex S. 
Published: August 2005

Objective
To compare the effectiveness of extra‐amniotic saline with intra‐amniotic prostaglandin F2α in inducing labour in pregnancies with intrauterine fetal death.Design
A randomised controlled trial.Participants
One hundred and twenty‐one women in the extra‐amniotic saline group and 123 women in the intra‐amniotic prostaglandin group, performed at Harare Maternity Hospital, Zimbabwe during the period October 1994 to February 1996.Results
The two methods were equally effective in achieving delivery. The number of women not delivering within 48 hours of recruitment was 6% for the extra‐amniotic saline group compared with 11% for the intra‐amniotic prostaglandin group (relative risk [RR] 0.51, 95% CI 0.21–1.22). The extra‐amniotic saline group required augmentation with Syntocinon more frequently than the intra‐amniotic prostaglandin group: 22% compared with 7% (RR 3.1, 95% CI 1.5–6.2). There were more complications associated with the intra‐amniotic prostaglandin group: five women developed hypertonic contractions compared with none in the extra‐amniotic saline group. In addition 23% of women in the intra‐amniotic prostaglandin group developed acute vasovagal‐like symptoms lasting for about 10 to 15 minutes which were distressing for the women. There was no evidence of any increase in febrile morbidity from extra‐amniotic saline (RR 0.8,95% CI 0.75–1.1).Conclusion
Extra‐amniotic saline infusion is successful in inducing labour in antepartum fetal deaths after 20 weeks of gestation. This method has been shown to be safe and well tolerated by the women and should be considered in areas with limited resources. This method should be evaluated further for inductions of labour with a live fetus.
Fetal oxygen saturation during labour
Authors: Chua S. , Yeong S. M. , Razvi K. , Arulkumaran S. 
Published: August 2005

Objective
To derive oxygen saturation by pulse oximetry (SpO2) values at each cervical dilatation in labour in fetuses with normal neonatal outcome.Participants
One hundred and forty‐five women at term in established labour with ruptured membranes and cervical dilatation at least 2 cm who had normal delivery outcome. The infants had 5 minute Apgar scores 7, birthweight 2500 g, umbilical cord artery pH 7.15 and did not require assisted ventilation or admission to neonatal intensive care.Methods
Women were monitored continuously with cardiotocography and fetal pulse oximetry using the Nellcor N‐400 fetal pulse oximeter and FS‐14 fetal oxisensor till delivery. Labour was managed according to established protocol without recourse to SpO2 readings.Results
There was a wide range of SpO2 values during labour hi fetuses with normal outcome. Mean values averaged 50%±10% throughout the first stage of labour, with lower ranges of SpO2 values above 30%. There was no significant difference in SpO2 readings at different cervical dilatations in the first stage of labour. Mean SpO2 values in the last 10 minutes before delivery were also not significantly different from those in the first stage of labour.Conclusion
The range of SpO2 in 115 healthy fetuses during normal labour was wide, but always above 30%. There was no trend of SpO2values in this study of 115 fetuses with normal neonatal outcome.
A double‐blind randomised placebo controlled trial of postnatal norethisterone enanthate: the effect on postnatal depression and serum hormones
Authors: Lawrie Theresa A. , Justus Hofmeyr G. , De Jager Marinda , Berk Michael , Paiker Janice , Viljoen Esther 
Published: August 2005

Objectives
To determine the effect of postnatal administration of the long‐acting progestogen contraceptive, norethisterone enanthate, on postnatal depression and on serum hormone concentrations, and their association with depression.Design
Double‐blind randomised placebo‐controlled trial.Setting
A tertiary care hospital in Johannesburg, South Africa.Population
Postnatal women using a non‐hormonal method of contraception (n= 180).Methods
Random allocation within 48 hours of delivery to norethisterone enanthate by injection, or placebo.Main outcome measures
1. Depression scores in the three months postpartum as rated by the Montgomery‐Åsberg Depression Rating Scale (MADRS) and the Edinburgh Postnatal Depression Scale (EPDS); 2. serum 17β‐oestradiol, progesterone, testosterone and the 17β‐oestradiol: progesterone ratio at six weeks postpartum.Results
There was a chance excess of caesarean section deliveries in the progestogen group. Mean depression scores were significantly higher in the progestogen group than in the placebo group at six weeks postpartum (mean MADRS score 8.3 vs 4.9; P = 0.01 11; mean EPDS score 10.6 vs 7.5; P = 0.0022). Mean serum 17β‐oestradiol and progesterone concentrations were significantly lower in the progestogen group compared with the placebo group at six weeks postpartum. There were no correlations between any of the hormone parameters and depression at six weeks except in the formula feeding subgroup of the placebo group, where formula feeding and 17β‐oestradiol concentrations were positively associated with depression.Conclusions
Long‐acting norethisterone enanthate given within 48 hours of delivery is associated with an increased risk of developing postnatal depression and causes suppression of endogenous ovarian hormone secretion.
Intra‐amniotic inflammation in human gastroschisis: possible aetiology of postnatal bowel dysfunction
Authors: Morrison John J. , Klein Nigel , Chitty Lyn S. , Kocjan Gabriella , Walshe Denise , Goulding Mark , Geary Michael P. , Pierro Agostino , Rodeck Charles H. 
Published: August 2005

Objective
To assess amniotic fluid for evidence of an inflammatory exudate in association with fetal gastroschisis.Setting
University College Hospital, London and Institute of Child Health, London.Sample
Samples of amniotic fluid in the third trimester from pregnant women with a diagnosis of fetal gastroschisis (n = 10) and from a control group (n= 10) with a normal fetus.Methods
Cytological analysis of the fluid was performed. Flow cytometry was performed on the amniotic fluid using antibodies for the myeloid cell antigen CD 15, the leucocyte beta integrin CDI1b/CD18 and CD3, CD19, CD56 and CD25. Tumour necrosis factor alpha and interleukin‐8 levels were assayed in the amniotic fluid.Results
An acute inflammatory exudate, composed predominantly of neutrophil polymorphs and mononuclear cells, was found in the amniotic fluid in fetal gastroschisis but not in control cases. When amniotic fluid samples from cases of fetal gastroschisis were stained with CD 15, analysis by flow cytometry showed a clear positive population. This CD 15 population showed markedly elevated levels of CD 11b. No distinct population of CD 15 positive cells was seen in amniotic fluid samples examined from the control group. No staining was seen with antibodies to CD3, CD 19, CD56 or CD25 in amniotic fluid obtained from either group. There was no significant difference between tumour necrosis factor alpha levels measured in the amniotic fluid of cases of fetal gastroschisis (median 102 pg/mL; range 20–340) and those of the control group (140 pg/mL; range 20–548) (P= 0.1). The levels of interleukin‐8 were markedly elevated in the amniotic fluid of cases of fetal gastroschisis (median 6320 pg/mL; range 4732–13,800) compared with the control group (median 1738 pg/mL; range 623–2861;) (P < 0.01).Conclusion
Human fetal gastroschisis is associated with an inflammatory exudate in the amniotic fluid which may have implications for postnatal bowel function.
Renal reabsorption of inorganic phosphorus in pregnancy in relation to the calciotropic hormones
Authors: Weiss Mordechai , Eisenstein Zemach , Ramot Yoram , Lipitz Shlomo , Shulman Adrian , Frenkel Yair 
Published: August 2005

Objective
To measure renal reabsorption of inorganic phosphorus and the calciotropic hormones in earlyDesign
Prospective, cross‐sectional study.Setting
Endocrine Institute at Assaf Harofeh and E. Wolfson Medical Centers; the Deparment of Obstetrics and Gynaecology, Sheba Medical Centre and Tel Aviv University.Population
Three groups of healthy women were studied: pregnant women at the end of the first trimester (n= 20), pregnant women at the end of the third trimester (n= 22), and nonpregnant controls (n= 27).Methods and main outcome measures
The renal tubular maximal phosphorus reabsorption per decilitre of glomerular filtrate (TmP/GFR) was measured in all women. Circulating levels of intact parathyroid hormone, calcitriol (1,25‐dihydroxy vitamin D3) and insulin‐like growth factor I were assayed in part of the women (8.11 of each group).Results
TmP/GFR was elevated in the first trimester group (mean 0.263 mmol/L) compared with controls (95% CI 0.07–0.46, P= 0.003). Third trimester values did not differ fiom controls. Serum calcitriol in the first trimester group was higher (mean difference 17.68 pg/mL) compared with controls (95% CI 3.89–31.47, P= 0.006) and was higher still (mean difference 20.75 pg/mL) in the third trimester group (95% CI 1.01–40*49, P= 0.042). Serum parathyroid hormone in the first trimester group was lower than in controls or the third trimester group: mean differences were respectively. Parathyroid hormone levels correlated negatively to calcitriol levels in the combined control and first trimester groups (r= ‐0.54, P= 0.022) and negatively to TmP/GFR values in the combined three groups (r= ‐0.68, P= 0.042). First trimester levels of insulin‐like growth factor I were lower than those in controls or in the third trimester: mean differences were 10.24 nmol/L (95% CI 2.05–1 8.43, P= 0.007) and 13.57 nmol/L (95% CI 4.23–22.91, P= 0.003), respectively.Conclusions
The dominant change in mineral metabolism in pregnancy is a rise in calcitriol which most probably is responsible for the relative suppression of parathyroid hormone and thereby for the rise in TmP/GFR in early pregnancy. All the above support the transfer of minerals to the fetus without compromising maternal bone. The significance of circulating insulin‐like growth factor I remains and late pregnancy. 4.40 pg/mL (95% CI ‐1.40 to 10.15, P= 0.078) and 8.18 pg/mL (95% CI 0.51–15.85, P= 0.019) unclear.