bluuebunny/crossref_metadata_2025_split huggingface dataset:
Premenopausal women affected by sexual arousal disorder treated with sildenafil: a double‐blind, cross‐over, placebo‐controlled study
Authors: Caruso Salvatore , Intelisano Giorgia , Lupo Lorenzo , Agnello Carmela 
Published: December 2003

Objective
To verify whether sildenafil is effective in young premenopausal women affected by arousal disorder.Design
A double‐blind cross‐over study.Setting
Centre for Sexological Research, Department of Microbiological and Gynaecological Science, University of Catania, Italy.Sample
Fifty‐three volunteer women aged 22–28 years affected by arousal disorders.Methods
The study consisted of three 4‐week periods: sildenafil, washout, placebo, by six possible sequences. sildenafil was used at 25 mg or 50 mg.Main
outcome measures Efficacy was assessed at baseline and once monthly by the Personal Experiences Questionnaire based on the 5‐point Likert scale. The questionnaire quantified subjective arousal (primary endpoint), and orgasm, enjoyment, sexual frequency, and the number of sexual fantasies.Results
Fifty‐one women completed the study. Mean (SD) usage of sildenafil 25mg and 50mg was, respectively, 2.8 (0.8) and 2.7 (1.3) times weekly, while mean usage of placebo was 2.8 (1.6) times weekly. During both sildenafil dosages, arousal and orgasm improved with respect to placebo (P<0.001). Therapeutically significant differences were not noted during the treatment with both 50 mg and 25 mg of sildenafil for arousal and orgasm. The frequency of sexual fantasies and of sexual intercourse, and enjoyment, improved in the women treated with sildenafil (P<0.05).Conclusions
Our study suggests that sildenafil may improve sexual performance of women affected by sexual difficulties such as arousal disorder, and may indirectly improve other aspects of sexual life. Moreover, further studies need to define the use of PDE type 5 inhibitors in this sexual pathophysiology.
Fever in labour and neonatal encephalopathy: a prospective cohort study
Authors: Impey Lawrence , Greenwood Catherine , MacQuillan Kathryn , Reynolds Margaret , Sheil Orla 
Published: December 2003

Objective
To determine whether the reported association of maternal fever with neonatal encephalopathy is independent of other associated intrapartum risk factors.Design
Prospective cohort study.Setting
Dublin teaching hospital delivery ward.Population
4915 low risk women in labour at 36‐41 weeks of gestation.Methods
Using logistic regression with odds ratios and 95% confidence intervals, the incidence of neonatal encephalopathy and other neonatal outcomes of women who had an intrapartum fever >37.5° C was compared with those who did not.Results
The cohort comprised 33% of all deliveries during the study period. Neonatal encephalopathy was diagnosed in 3.25/1000 births. The incidence of intrapartum fever was 6.8%. Maternal fever was strongly associated with neonatal encephalopathy (crude OR 10.8, 95% CI 4.0‐29.3). Univariate analysis showed maternal fever was associated with epidural analgesia, nulliparity, induction, longer labour, oxytocin administration, greater fetal birthweight and gestational age and instrumental vaginal delivery, but not with prolonged (>24hours) prelabour rupture of the membranes. The association of fever with neonatal encephalopathy persisted having adjusting for these covariates (adjusted OR 4.72, 95% CI 1.28‐17.4).Conclusions
The relationship between maternal intrapartum fever and neonatal encephalopathy is independent of other known intrapartum risk factors. This provides further evidence for the role of inflammatory processes in the aetiology of neonatal neurological morbidity.
Beta‐3 versus beta‐2 adrenergic agonists and preterm labour: in vitro uterine relaxation effects
Authors: Dennedy Michael C. , Friel Anne M. , Gardeil Francois , Morrison John J. 
Published: December 2003

Objective
1. To investigate the effects of the selective beta‐3 adrenoreceptor agonist, BRL 37344, on human pregnant myometrial contractility in vitro. 2. to compare these effects with those of the beta‐2 adrenoreceptor agonist, ritodrine.Methods
Isometric tension recording was performed under physiological conditions in isolated myometrial strips from biopsies obtained at elective caesarean section. Following pre‐incubation with oxytocin (10‐9 M), the effects of cumulative additions of BRL 37344 or ritodrine (10‐8–10‐3.5 M) on myometrial contractility were investigated. Results were expressed as ‐log EC50 (pD2) and mean maximal inhibition achieved for both drug compounds.Results
BRL 37344 exerted a concentration dependant relaxant effect on myometrial contractions in all strips exposed [pD2, 7.26 (0.48) (SEM); mean maximal inhibition 61.98 (4.89%); n= 6]. Similarly, ritodrine exerted a concentration dependant inhibition of myometrial contractility in all strips exposed [pD2= 7.40 (0.28); mean maximal inhibition 59.49 (3.97%); n= 6]. There was no significant difference between calculated pD2 values (P= 0.65) or mean maximal inhibition achieved (P= 0.79).Conclusions
The beta‐3 adrenoreceptor agonist BRL 37344 induced relaxation of human myometrial contractions with similar potency to that of the most commonly used tocolytic agent ritodrine. This raises the possibility that the novel beta‐3 adrenoreceptor agonists may have potential as therapeutic agents for human preterm labour. In view of their reported reduced cardiovascular side effects their potential clinical use requires further evaluation.
Plasma P‐selectin is elevated in the first trimester in women who subsequently develop pre‐eclampsia
Authors: Bosio P.M. , Cannon S. , McKenna P.J. , O'Herlihy C. , Conroy R. , Brady H. 
Published: December 2003

Objective To report plasma concentrations of the adhesion cell molecule P‐selectin during pregnancy to determine the effect of subsequent development of hypertension and pre‐eclampsia.Design A longitudinal study.Methods A longitudinal study involving 70 women followed up from early pregnancy; 20 who subsequently developed pre‐eclampsia were compared with 24 who developed gestational hypertension and 26 normotensive women with normal obstetric outcome. The determination of citrate plasma soluble P‐selectin levels throughout pregnancy was performed using a commercial quantitative sandwich immunoassay kit. The temporal course of plasma P‐selectin in the three groups of subjects was analysed.Results There was no significant difference in mean plasma P‐selectin concentration between normotensive and gestational hypertensive subjects at any stage of pregnancy. Using a cutoff level of 60 ng/mL, P‐selectin concentration at 10–14 weeks had a negative predictive value for pre‐eclampsia of almost 99%. Mean plasma P‐selectin concentrations were significantly elevated by 10–14 weeks in women who later developed pre‐eclampsia (P<0.001).Conclusions Our data support an inflammatory model for pre‐eclampsia whereby endothelial cell activation may be secondary to a primary inflammatory response. Plasma P‐selectin has significant potential as a first trimester clinical marker of pre‐eclampsia.
Human chorionic gonadotrophin inhibition of pregnant human myometrial contractility
Authors: Slattery Michael M. , Brennan Cara , O'Leary Michael J. , Morrison John J. 
Published: December 2003

Objective To evaluate the effect of human chorionic gonadotrophin (hCG) on pregnant human myometrial contractility in vitro and to determine whether the hCG‐elicited effect was oestrogen dependant.Methods Isometric tension recording was performed under physiological conditions in isolated myometrial strips from biopsies obtained at elective caesarean section. The effect of cumulative additions of hCG (0.001, 0.01, 0.1, 1.0 and 10 iu/mL) on myometrial contractility was evaluated. Secondarily, the contractile activity of pregnant myometrium following hCG exposure was investigated in tissue pre‐treated with beta‐oestradiol.Results hCG exerted a statistically significant relaxant effect on pregnant human myometrial tissue. The relaxant effect increased with increasing concentrations of hCG from 8.96% (SEM 2.06) (0.001 iu/mL hCG; P<0.01) to a net cumulative total of 58.50% (SEM 3.74) (10 iu/mL hCG; P<0.01). The relaxant effect was also time‐dependant, increasing in magnitude throughout the duration of experiments. Beta‐oestradiol did not significantly affect the response of myometrial tissue to hCG.Conclusions These results clearly demonstrate that hCG exerts a significant concentration‐dependant relaxant effect on human myometrial tissue obtained rate in pregnancy. These findings outline an inhibitory physiological role of hCG on human myometrial contractility and raise the possibility of its potential use as a tocolytic.
Prevalence and features of pancreatic islet cell autoimmunity in women with gestational diabetes from different ethnic groups
Authors: Kousta E. , Lawrence N.J. , Anyaoku V. , Johnston D.G. , McCarthy M.I. 
Published: December 2003

Objective To assess the prevalence and characteristics of islet cell autoimmunity amongst women with gestational diabetes selected from South Asian and Afro‐Caribbean as well as European populations.Design Cross‐sectional retrospective survey of subject cohort.Population Three hundred and twenty‐one women with a recent history of gestational diabetes (173 European, 86 South Asian and 62 Afro‐Caribbean), a median (range) of 22 (1‐150) months postpartum.Results Antibodies to Glutamic acid decarboxylase were found in 13 (4%) of these women. There was no difference in the prevalence of anti‐glutamic acid decarboxylase positivity between the three ethnic groups (European 4.6%, South Asian 3.5%, Afro‐Caribbean 3.2%). Anti‐glutamic acid decarboxylase positive women were leaner than anti‐glutamic acid decarboxylase negative women (body mass index, median (upper‐lower quartile) 23.9 (22.5–26.7) vs 26.6 (23.4‐30.5)kg/m2, P=0.03, P=0.049 allowing for ethnicity). There was no difference between glutamic acid decarboxylase‐positive and glutamic acid decarboxylase‐negative women for age, family history of diabetes, waist/hip ratio, prevalence of insulin treatment during pregnancy, postpartum glucose status, lipid profile and indices of insulin action and beta‐cell function.Conclusions Markers of islet cell autoimmunity are found as frequently in gestational diabetes women of South Asian and Afro‐Caribbean origin, as they are in European subjects. Identification of future risk of type 1 diabetes is relevant to the planning of clinical management and intervention strategies in women with gestational diabetes of all major ethnic groups.
Maternal height and newborn size relative to risk of intrapartum caesarean delivery and perinatal distress
Authors: Merchant Kathleen M. , Villar José , Kestler Edgar 
Published: December 2003

Objective To estimate the changes in risk of intrapartum caesarean delivery and perinatal distress that may be introduced through increased birth size, resulting from interventions such as improving nutrition of the mother; and to characterise delivery risk relative to maternal stature by birth size.Design Model these risks using data from the Guatemalan Perinatal Study.Setting The antenatal clinic of the Gynaecology and Obstetrics Hospital of the Guatemalan Social Security Institute in Guatemala City serving predominantly working class women.Population Women who had their first prenatal visit between April 1984 and January 1986.Methods Multivariate logistic regression models were developed to estimate incidence of intrapartum caesarean delivery and perinatal distress and used to calculate changes in risk associated with changes in size.Main outcome measures Incidences of intrapartum caesarean delivery and perinatal distress.Results A woman of 146cm height (‐1 SD) relative to another of 160cm (+1 SD) has a 2.5 times higher risk of intrapartum caesarean delivery. An increase in newborn head circumference and weight (from ‐1 SD to +1 SD) are each independently associated with an increase in risk of intrapartum caesarean delivery (2.0 times and 1.5 times, respectively). An increase in birthweight from 2,450 g to 2,550 g is associated with a decrease in risk of perinatal distress of 34/1000 cases and an increase in risk of intrapartum caesarean delivery of 8/1000 cases.Conclusions Increases in fetal growth comparable to those attributable to improved nutrition during pregnancy are associated with a larger decrease in risk of perinatal distress relative to the increase in risk of intrapartum caesarean delivery for the mother. Greater maternal stature is associated with lower risk of intrapartum caesarean delivery.
Does the increased risk of preterm delivery in teenagers persist in pregnancies after the teenage period?
Authors: Olausson Petra Otterblad , Cnattingius Sven , Haglund Bengt 
Published: December 2003

Objective To study the associations between low maternal age at first birth and the risks of very and moderately preterm birth, in first birth and in second successive birth in adulthood.Design Population‐based cohort study.Setting Sweden.Population Women aged less than 25 years at first birth (n=275,933), having two successive live single births from 1973 through 1993.Methods Odds ratios with 95 percent confidence intervals were calculated to estimate the effect of low maternal age at first birth. Analyses of first births were adjusted for year of first birth and maternal education and in second births also for previous pregnancy outcomes and interpregnancy interval.Main outcome measures Very preterm birth (less than 33 completed weeks) and moderately preterm birth (33‐36 completed weeks).Results Compared with women aged 20 to 24 years at first birth, mothers aged 13 to 15 years were at increased risk of very preterm birth (odds ratio=4.8). The corresponding risks among women aged 16 to 17 years at first birth were doubled (odds ratio=2.3). The influence of maternal age on risks of moderately preterm birth was similar, although the age‐related risks were lower. At second birth, risks of preterm birth were reduced in all age groups. However, mothers who were 17 years or less at first birth, faced, compared with mothers aged 20‐24 years, significantly larger reduction in risks of very and moderately preterm birth.Conclusions Our results suggest that there may be a biological effect of very young maternal age, affecting foremost very preterm birth.
Obstetric practice and faecal incontinence three months after delivery
Authors: MacArthur C. , Glazener C.M.A. , Wilson P.D. , Herbison G.P. , Gee H. , Lang G.D. , Lancashire R. 
Published: December 2003

Objective To determine whether obstetric and maternal factors relate to faecal incontinence at three months postpartum.Setting Maternity units in Aberdeen (Scotland), Birmingham (England) and Dunedin (New Zealand).Population All women who delivered during one year in the three maternity units.Methods Postal questionnaire at three months postpartum, to obtain information on faecal incontinence, linked to obstetric casenote data.Main outcome measures Prevalence of faecal incontinence.Results 7879 questionnaires were returned, a 71.7% response rate. The prevalence of faecal incontinence was 9.6%, with 4.2% reporting this more often than rarely. Logistic regression, confined to primiparae, showed that forceps delivery was a predictor of an increased risk of symptoms (OR=1.94, 95% CI 1.30 to 2.89) while vacuum extraction was not associated. Caesarean section was marginally associated with a reduced risk (OR=0.58, 95% CI 0.35 to 0.97). Older maternal age, Indian sub‐continent ethnic origin and body mass index ‘not known’ also showed significant associations. No associations were found for induced labour, duration of second stage labour, episiotomy, laceration or birthweight.Conclusions Women delivered by forceps had almost twice the risk of developing faecal incontinence, whereas vacuum extraction was not associated with faecal incontinence at three months postpartum. Caesarean section appears to offer some protection.
Fetal lung volume measurement by magnetic resonance imaging in congenital diaphragmatic hernia
Authors: Mahieu‐Caputo D. , Sonigo P. , Dommergues M. , Fournet J.C. , Thalabard J.C. , Abarca C. , Benachi A. , Brunelle F. , Dumez Y. 
Published: December 2003

Objective
To study the potential for prenatal magnetic resonance imaging to predict pulmonary hypoplasia in congenital diaphragmatic hernia.Design
Prospective observational study.Setting
Tertiary care centre.Participants
Thirteen cases of congenital diaphragmatic hernia (11 left, 2 right) without associated anomalies and 74 controls.Methods
Measurements by magnetic resonance imaging of fetal lung volume were achieved. In the control fetuses, a regression analysis was performed to associate fetal lung volume with gestational age. This yielded a formula allowing calculation of the expected fetal lung volume as a function of gestational age. In the cases with congenital diaphragmatic hernia, the observed/expected fetal lung volume ratio was compared with perinatal outcome.Main
outcome measures Neonatal mortality and pulmonary hypoplasia, which was defined as lung/body weight ratios less than 0.012.Results
The expected fetal lung volume was derived from the following formula: Fetal lung volume (mL) = exp (1.24722 + 0.08939 × gestational age in weeks). The observed/expected fetal lung volume ratio was significantly lower in congenital diaphragmatic hernia (median: 0.31, range: 0.06–0.63), than in controls (median: 0.99, range: 0.42–1.94). This ratio was significantly less in the infants with congenital diaphragmatic hernia who died (median: 0.26, range: 0.06–0.63) compared with those who survived (median: 0.46, range: 0.35–0.56). The observed: expected fetal lung volume ratio was significantly correlated with the post mortem lung: body weight ratio.Conclusion
In isolated congenital diaphragmatic hernia, fetal lung volume measurement by magnetic resonance imaging is a potential predictor of pulmonary hypoplasia and postnatal outcome. Further studies are required to establish the clinical value of magnetic resonance imaging for the prenatal assessment of fetal lungs.
Chronological aspects of ultrasonic, hormonal, and other indirect indices of ovulation
Authors: Ecochard René , Boehringer Hans , Rabilloud Muriel , Marret Henri 
Published: December 2003

Objective
To improve prediction of ovulation in normal cycles.Design
Collection of women's characteristics and their menstrual cycles. Monitoring and analysis of time relationships between several indicators of ovulation: transvaginal ultrasonography, cervical mucus, basal body temperature, urinary luteinising hormone, and ratio of urinary oestrogen to progesterone metabolites.Setting
Each of eight natural family planning clinics was to study 12 women for at least three cycles.Population
One hundred and seven normally fertile and cycling women aged 18 to 45.Methods
Daily measurements of urinary luteinising hormone, follicle stimulating hormone, oestrone‐3‐glucuronide and pregnanediol‐3α‐glucuronide. Basal body temperature recording and cervical mucus checking. Transvaginal ultrasound examination of the ovaries.Main
outcome measures Delays between the expected day of ovulation according to the luteinising hormone peak or to ultrasound evidence and the expected days according to the other indices of ovulation.Results
Ultrasonography was able to show evidence of ovulation in 283 out of 326 cycles. The average time lag between luteinising hormone peak and ultrasound evidence was less than one day (+0.46) but premature and late luteinising hormone‐expected date of ovulation were observed in nearly 10% and 23% of cycles, respectively. Basal body temperature rise was observed in 98% of cycles. Cervical mucus peak symptom, rapid drop in the ratio of urinary metabolites, and luteinising hormone initial rise were all close to ultrasonographic evidence in more than 72% of cycles.Conclusions
For accuracy and practical reasons, the cervical mucus peak symptom, the ratio of urinary metabolites and luteinising hormone initial rise might be better indices of ovulation than the luteinising hormone peak.
Computerised analysis of the fetal heart rate and relation to acidaemia at delivery
Authors: Strachan Bryony K. , Sahota Daljit S. , van Wijngaarden Willem J. , James David K. , Chang Allan M.Z. 
Published: December 2003

Objective
To identify the individual features of the computerised analysis of the cardiotocograph that relate to arterial pH and base deficit at delivery.Design
Retrospective observational study.Setting
Teaching hospital labour wards.Participants
679 women requiring continuous intrapartum fetal monitoring.Methods
Fetal heart and uterine contraction data were obtained using the Nottingham Fetal ECG monitor. Fetal heart rate patterns for the last half‐hour preceding delivery were analysed using a computer algorithm developed for intrapartum application. The significance of the areas under receiver operator characteristic curves were calculated.Main
outcome measures Umbilical arterial pH and base deficit at delivery.Results
Three parameters, fetal bradycardia, total deceleration area and the deceleration area after a contraction had receiver operator characteristic curves that significantly predict a low umbilical arterial pH and base deficit at delivery (areas under receiver‐operator characteristic curves =0.53, SD 0.01 P= 0.03; 0.60, SD 0.03 P= 0.002; 0.62 SD 0.04 P<0.001, respectively). Tachycardia, accelerations and variability did not.Conclusions
The individual components of the computerised analysis of the fetal heart rate that predict acidaemia at delivery are identified.
Computerised antenatal fetal heart rate recordings between 24 and 28 weeks of gestation
Authors: Roberts Devender , Kumar Bidyut , Tincello Douglas G. , Walkinshaw Stephen A. 
Published: December 2003

Objective
To assess computerised fetal heart rate recordings between 24 and 28 weeks of gestation for gestation related differences.Design
Prospective, cross sectional observational study.Setting
Liverpool Women's Hospital.Population
112 women: 28 at 27 weeks, 30 at 26 weeks, 27 at 25 weeks and 27 at 24 weeks of gestation, respectively.Methods
Fetal heart recordings of 60 minutes duration were performed once in each pregnancy using the System 8000 fetal heart rate programme (System 8000, Oxford Sonicaid Ltd, Chichester, UK). For each gestational age, records were analysed for short term variation, basal heart rate, accelerations and time spent in high episodes.Results
The mean short term variation increased with gestation (P=0.05). No record had a short term variation <4 msecs. There was no relationship between heart rate and increasing gestation. The mean number of accelerations per record increased with increasing gestation (P<0.01). 20% of recordings showed no accelerations >15 bpm. The mean duration spent in episodes of high variation increased with gestation (P=0.05). 13% of recordings showed no time spent in high episodes. All fetuses had normal outcomes at delivery.Conclusions
Absence of episodes of high variation or absence of accelerations is not an abnormal finding at lower gestations. The standard threshold of 4 msecs for short term variation appears to remain valid at lower gestations. These differences should be considered when using computerised CTG analysis at early gestations.