bluuebunny/crossref_metadata_2025_split huggingface dataset:
A longitudinal study of pelvic inflammatory disease
Authors: STAGEY CAROLYN M. , MUNDAY PATRICIA E. , TAYLOR‐ROBINSON DAVID , THOMAS BRENDA J. , GILCHRIST CLIVE , RUCK FIONA , ISDN CATHERINE A. , BEARD RICHARD W. 
Published: August 2005

ABSTRACTObjective
To study the microbiology and long term prognosis of pelvic inflammatory disease (PID).Design
A prospective study of women with laparoscopically confirmed PID.Setting
Teaching hospital in central London.Subjects
23 women with PID.Outcome measures
Microbiological investigations at the time of diagnosis and at follow up; subsequent fertility and the occurrence of pelvic pain.Results
PID diagnosed by laparoscopy was regarded as moderate to severe in 15 cases. Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma hominis and Ureaplasma urealyticum or a combination of these micro‐organisms were detected most frequently in the cervix, less often in the endometrium and least in the tubes, C. trachomatis being the micro‐organism found most commonly in the tubes. There was serological evidence of acute chlamydial infection in 13 of 20 cases in which paired sera were available and a serological response to M. hominis in 9 of 12 cases in which it was possible to evaluate the results. On the basis of microbiological and serological results, C. trachomatis appeared to be the most important aetiological agent in 10 cases, N. gonorrhoeae in four cases, M. hominis in three cases and U. urealyticum in none; in five cases, two of these microrganisms appeared to be of equal importance. After 1 to 3 years, 33% of the women were having difficulty conceiving and 56% continued to complain of pelvic pain.Conclusion
It is difficult to be certain of the infectious cause of PID in any given case. However, the evidence that N. gonorrhoeae and C. trachomatis are pathogens is very strong. M. hominis may be responsible for a few cases on its own or together with other micro‐organisms.
Induction of abortion with mifepristone and misoprostol in early pregnancy
Authors: THONG K. JOO , BAIRD DAVID T. 
Published: August 2005

ABSTRACTObjective
To investigate the clinical efficacy of the combination of mifepristone and an orally active prostaglandin, misoprostol, for early medical termination.Design
Women with amenorrhoea ≤56 days were given 200 mg mifepristone. 48 h later, 600 μg misoprostol was given orally.Setting
Medical Termination Unit, Simpson Memorial Maternity Pavilion, Edinburgh.Subjects
100 women requesting medical termination of pregnancy.Interventions
Evacuation of uterus for incomplete abortion or on‐going pregnancies.Results
One woman had an incomplete abortion prior to administration of misoprostol. 92 (93%) out of 99 women had complete abortion following administration of misoprostol. There were three on‐going pregnancies (3.0%, 95% confidence limits (CL) 0.6‐8.6) and four incomplete abortions with this regimen (4.0%, 95% CL 1.1‐10.0). 24% women vomited and 7% had diarrrhoea following administration of misoprostol. 62% did not require any analgesia.Conclusions
The combination of misoprostol with mifepristone is inexpensive, simple, effective, noninvasive and an acceptable alternative to current regimens for medical termination.
Compliance with hormone replacement therapy (HRT) after screening for post menopausal osteoporosis
Authors: RYAN P. J. , HARRISON R. , BLAKE G. M. , FOGELMAN I. 
Published: August 2005

ABSTRACTObjective
To assess compliance with recommendations for hormone replacement therapy (HRT) in postmenopausal women following screening for osteoporosis.Design
A postal questionnaire sent to women an average of 8 months (range 6–12) following measurement of their bone mineral density (BMD), and recommendations regarding HRT given to the referring general practitioner.Setting
Referrals from local general practitioners. Mixed social class.Subjects
400 postmenopausal women aged 40–69 years (average age 52).Main outcome measures
Compliance with advice and if failing to comply, reasons for not doing so.Results
Replies were received from 352 women (88%) and 74% of respondents followed advice to start, continue, or refrain from starting or continuing HRT with regard to protecting their skeleton. Those who rejected advice to take HRT mostly had concern over side effects or the efficacy or safety of treatment. Of the women who started HRT 28% subsequently stopped, the principal reasons being withdrawal bleeding and weight gain. Of the women recommended to take HRT, 39% were not taking treatment by 8 months after referral, either because they ignored advice given (22%) or because of side effects (17%).Conclusions
Screening leads to increased usage of HRT among women at most risk for osteoporosis. However, almost 40% of women with low bone mineral density were not taking HRT 8 months after referral, and therefore until improved compliance has ben demonstrated screening cannot be widely recommended.
The epidemiology of hysterectomy: findings in a large cohort study
Authors: VESSEY MARTIN P. , VILLARD‐MACKINTOSH LAURENCE , MCPHERSON KLIM , COULTER ANGELA , YEATES DAVID 
Published: August 2005

ABSTRACTObjective
To examine patterns of hysterectomy in the Oxford‐Family Planning Association (Oxford‐FPA) study in relation to age, parity, social class and calendar period (–1974, 1975–79. 1980–84, 1985–89).Design
The Oxford‐FPA study is a large scale prospective study of 17 032 women recruited from 1968–74 and still under observation.Setting
Seventeen family planning centres throughout England and Scotland.Subjects
At recruitment the 17 032 women were all white, British, married, aged 25–39 and willing to co‐operate. In addition, they were using the pill or an intrauterine device or a diaphragm as their method of contraception. Main outcome measure Hysterectomy rates per 1000 woman‐years of observation in various subclasses of the data.Results
Up to the end of 1989, 1885 (11.1%) of the 17 032 women in the study were known to have undergone hysterectomy. Fibroids were the most common cause followed closely by menstrual disturbances in the absence of fibroids (hereafter referred to as ‘menstrual disturbances’). Social class had a modest influence on hysterectomy rates. Hysterectomy for fibroids, prolapse, endometriosis and ‘other reasons’ showed little trend with calendar period while hysterectomy for menstrual disturbances and for cancer showed a sharp increase with calendar time especially at ages 30–39. Hysterectomy generally tended to increase with age and showed a strong relation to parity; in particular, hysterectomy for fibroids fell with parity and hysterectomy for menstrual disturbances rose sharply with parity. Using lifetable methods, it was estimated that almost 20% of the women in the study would have had a hysterectomy by age 55.Conclusions
The results give insights into factors affecting hysterectomy rates. Of particular interest is the modest influence of social class, the strong influence of parity and the rise in rates with calendar time at ages 30–39 for those undergoing hysterectomy for menstrual disturbances or cancer, but since the cohort is not directly representative of the population, some caution is required in extrapolating these findings. The estimated hysterectomy rate of about 20% by age 55 is in line with other similar estimates for the United Kingdom.
Secondary amenorrhoea: prevalence and medical contact—a cross–sectional study from a Danish county
Authors: MÜNSTER KIRSTINE , HELM PETER , SCHMIDT LONE 
Published: August 2005

ABSTRACTObjective
To examine the prevalence of secondary amenorrhoea and the patterns of seeking medical advice for secondary amenorrhoea in an unselected population.Design
Cross‐sectional postal questionnaire study.Setting
County of Copenhagen, Denmark.Subjects
3743 women, aged 15–44, selected at random from a Danish county who were asked to provide information on menstrual patterns for the preceding year, 1988. The response rate was 78%. Information from non‐responders was obtained via telephone interviews.Results
One‐year period prevalence of secondary amenorrhoea of more than 3 months duration was 4.6% and was 7.6%, 3.0%, and 3.7% in women aged 15–24, 25–34, and 35–44 respectively. The duration of secondary amenorrhoea was 6 months or less in 75% aged 15–34 years, but longer than 6 months in 55% of those aged 35–44 years. A social gradient was found of the prevalence of secondary amenorrhoea (odds ratio 3.3, 95% CI 1.5–8.3) in the lowest social group compared with the highest social group; controlled by age. Only 39% of women with secondary amenorrhoea had contacted a doctor. Educational level or social status did not seem to influence the frequency of medical contact in women with amenorrhoea.Conclusion
Spontaneous return of the menstrual cycle occurs within 6 months in many amenorrheic women below the age of 35. The detailed investigation of secondary amenorrhoea in this age group can be postponed until it is of 6 months duration, unless there is clinical suspicion of disease. The relative infrequency with which women with secondary amenorrhoea seek medical advice constitutes an important source of selection bias in hospital‐based clinical research on this topic.
Detection of small‐for‐gestational‐age fetuses by ultrasound screening in a high risk population: a randomized controlled study
Authors: LARSEN TORBEN , LARSEN JØRGEN FALCK , PETERSEN STEN , GREISEN GORM 
Published: August 2005

ABSTRACTObjective
To assess the value of fetal weight estimation during routine third trimester ultrasound examinations for the identification of small‐for‐gestational‐age (SGA) fetuses, to promote active pregnancy management and so reduce perinatal morbidity.Design
A prospective controlled randomized study.Setting
Outpatient clinic at the Department of Obstetrics, Herlev University Hospital, Denmark.Subjects
One thousand pregnant women considered at risk were selected consecutively from April 1985 to September 1987 and randomized to either a revealed‐results group or a withheld‐results group.Intervention
All the women had an early ultrasound examination for estimation of gestational age. Both groups had routine ultrasound estimates of fetal weight after 28 weeks and then every third week until delivery. The results were available for clinical use only in the revealed group.Main outcome measures
Number of interventions during pregnancy (admission to hospital, elective delivery), emergency intervention during labour, and fetal outcome.Results
Revealing the results of ultrasound estimates of fetal weight for gestational age during the third trimester resulted in statistically significantly increased diagnosis of SGA fetuses, of elective deliveries based on this diagnosis, and of healthy preterm babies admitted to the neonatal care unit, but no detectable overall improvement in weight for gestational age at birth, or in neonatal morbidity or mortality.Conclusion
This method of screening improved the diagnosis of SGA fetuses, but this was not followed by improved fetal outcome.
Prevalence of hepatitis B and C viruses and human immunodeficiency virus infections in women of reproductive age
Authors: PURO V. , GIRARDI E. , IPPOLITO G. , LO PRESTI E. , BENEDETTO A. , ZANIRATTI S. , GIANNINI V. , GIOIA C. , NATILI S. , TOSSINI G. , POMINI P. , RIZZI N. , TELLINI P. 
Published: August 2005

ABSTRACTObjective: To determine the prevalence of hepatitis B and C viruses, and human immunodeficiency virus infections in women of reproductive age attending a health care System.Design: Prospective cross‐sectional study.Setting: Public Obstetric Clinic and Service for Pre‐ and Perinatal Prevention of Infectious Diseases, Rome, Latium Region, Italy.Subjects: 1142 women attending our centres consecutively for delivery, miscarriage, voluntary Interruption of pregnancy or screening for pre‐ and perinatal prevention of infectious diseases.Interventions: Serum samples, collected after informed consent over a period of 2 months, were tested for hepatitis B virus markers (anti‐HBc and HBsAg) by enzyme linked immunosorbent assay (ELISA), for antibodies against hepatitis C virus (by ELISA and, if positive, by RIBA) and for human immunodeficiency virus antibodies (by ELISA and, if positive by Western blot).Results: The seroprevalence of hepatitis B virus was 144% (95% CI Poisson distribution 12.2–16.5) for anti‐HBc and 1.6% (95% CI, 0.9–2.5) for HBsAg. Antibodies against hepatitis C virus were detected by ELISA in 2.4% (CI 1.6–3.5) and by first generation RIB A in 0.9% (CI 0.4–1.6). Human immunodeficiency virus seroprevalence was 1.0% (CI 0.5–1.7). No significant differences were observed by age or by reason for attending.Conclusions: Women attending our centres have a higher prevalence of hepatitis B virus, hepatitis C virus and human immunodeficiency virus infection than those observed in our country in larger national surveys of newborn babies, in reproductive‐aged women or in other selected low‐risk groups such as blood donors. This could be due to the attendance of women at increased risk such as drug addicts. The Information has the additional value of emphasizing the need for adherence by health care personnel, to the recommendations issued for the prevention of occupational infections.
Experience with the Cardial inferior vena cava filter as prophylaxis against pulmonary embolism in pregnant women with extensive deep venous thrombosis
Authors: NARAYAN HARINI , CULLIMORE JOHN , KRARUP K. , THURSTON H. , MACVICAR JOHN , BOLIA A. 
Published: August 2005

ABSTRACTObjective
To report the use of the Cardial inferior vena caval filter as prophylaxis against pulmonary embolism in pregnant women with extensive iliofemoral thrombosis.Setting
Leicester Royal Infirmary.Subjects
Four pregnant women with extensive iliofemoral thrombosis, deemed to be at high risk of pulmonary embolism, managed over a period of one year.Technique
In addition to standard full anticoagulation with heparin, the Cardial inferior vena cava filter was introduced percutaneously under local anaesthesia through the unaffected contralateral femoral vein and positioned in the inferior cava below the renal veins.Results
The procedure was uncomplicated and did not compromise feto‐maternal condition. There was no evidence of pulmonary embolism after filter insertion.Conclusion
The use of inferior vena cava filters should be considered as an adjunct to intravenous anticoagulation in pregnant women with extensive deep vein thrombosis of the lower limbs.
A case‐control study of unexplained antepartum stillbirths
Authors: ALESSANDRI LOUISA M. , STANLEY FIONA J. , GARNER J. BARRY , NEWNHAM JOHN , WALTERS BARRY N. J. 
Published: August 2005

ABSTRACTObjective
To ascertain factors that will identify women who are at increased risk of unexplained antepartum stillbirth.Design
Matched case‐control study. The cases and controls were initially analysed as a whole group and again after dichotomizing into those of low birthweight (<2500 g) and those of normal birthweight (<=2500 g).Setting
Western Australia 1980–1983.Subjects
Unexplained antepartum stillbirths of ≥ 1000 g birthweight (cases) and liveborn infants individually matched for year of birth, plurality, sex and birthweight of infant and race of mother (controls).Results
The case pregnancies had more polyhydramnios (OR 10.83, 95% CI 2.41–48.69) and cord problems (OR 6.57 95% CI 1.36–31.75) than the controls but, paradoxically, other obstetric and medical complications were less common in the cases. The association with polyhydramnios persisted when the analysis was confined to those with low birthweight. With normal birthweight fetal distress was more frequent in the cases (OR 3.65 95% CI 1.36–9.80) but there were few other differences.Conclusions
The clinical and diagnostic systems currently in use are unable to identify many fetuses at risk of death. Decreases in the rate of unexplained antepartum stillbirths await the discovery of new preventable causes, or of innovations in clinical or laboratory aspects of obstetric care.
Do fetal pulse oximetry readings at delivery correlate with cord blood oxygenation and acidaemia?
Authors: McNAMARA HELEN , CHUNG D. CHRISTOPER , LILFORD RICHARD , JOHNSON NICHOLAS 
Published: August 2005

ABSTRACTObjective
To assess the accuracy of a pulse oximeter in the fetus.Design
A prospective descriptive study, comparing oxygenation and acidaemia of cord blood with oxygen saturation in the arteries of the fetal scalp measured by a pulse oximeter just before delivery. The data were collected using an experimental pulse oximeter and a sensor specifically adapted to cope with the problems of fetal pulse oximetry.Setting
The labour ward in a teaching hospital.Subjects
Thirty seven Caucasian fetuses presenting by the vertex in normal uncomplicated labour.Main outcome measure
Fetal pulse oximetry reading shortly before birth, umbilical cord oxygenation and pH, and Apgar scores.Results
Data of sufficient quality were obtained from 28 fetuses. There was a highly significant correlation between pulse oximetry reading and umbilical vein oxygen saturation r= 0.59, P= <0.001). There was also a significant correlation between the pulse oximeter reading and cord blood pH (vein: r= 0.57, P= 0.002, artery: r= 0.63, P= 0.001). Apgar scores were not related to the oximetry results.Conclusion
Pulse oximetry readings reflect fetal oxygenation at birth.
Does admission to hospital for bed rest prevent disease progression or improve fetal outcome in pregnancy complicated by non‐proteinuric hypertension?
Authors: CROWTHER C. A. , BOUWMEESTER A. M. , ASHURST H. M. 
Published: August 2005

ABSTRACTObjective
To test whether a policy of admission to hospital for rest is of value in the management of women with non‐proteinuric hypertension during pregnancy.Design
A randomized controlled trial. Setting Harare Maternity Hospital, Zimbabwe.Subjects
218 (28 first pregnancies) women with non‐proteinuric hypertension and a singleton pregnancy at between 28 and 38 weeks gestation allocated to rest in hospital or routine outpatient care.Intervention
Admission to hospital for rest. Encouraged to rest in bed although voluntary ambulation around the ward was allowed. The women in the control group were encouraged to continue normal activity at home, to check urine each day for proteinuria. All the women were reviewed weekly.Main outcome measures
Disease progression was assessed by the development of severe hypertension (≥160/110 mmHg), development of proteinuria, need for induction of labour and number of infants born preterm (≤37 weeks). Fetal outcome was assessed by birthweight, number of infants small‐for‐gestational age (SGA), and the number of infants requiring admission to the neonatal unit and their length of stay.Results
The hospital rest group had a decreased risk of developing severe hypertension (blood pressure ≥160/110 mmHg [odds ratio 0.47, 95% CI 0.26–0.83]). No differences were found in fetal growth or neonatal morbidity. The mean antenatal stay in hospital was 22.2 (SD 16.5), and 6.5 (SD 7.9) days in the rest and control groups, respectively.Conclusions
Hospital admission for bed rest decreased the risk of developing severe hypertension but no improvement in fetal growth or neonatal morbidity was observed. Fetal monitoring at home and continued outpatient antenatal care provided a safe, alternative policy to hospital admission.
Transvaginal sonography for fetal measurement in early pregnancy
Authors: KUSTERMANN ALESSANDRA , ZORZOLI ALESSANDRO , SPAGNOLO DANIELE , NICOLINI UMBERTO 
Published: August 2005

ABSTRACTObjective
To establish reference ranges for fetal size by gestation in the first trimester as indicated by cephalic, abdominal and limb measurements using trans‐vaginal sonography.Design
A prospective descriptive study.Setting
Two antenatal clinics in Milan, Italy.Subjects
270 women with normal singleton pregnancies at 42–108 days gestation. All had regular cycles and certain dates.Interventions
Vaginal ultrasound examination including inspection of fetal structures and lasting 5–15 min.Main outcome measures
As many of the following fetal measurements as possible according to gestational age and ease: crown‐rump length (CRL), biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), femur and foot lengths.Results
CRL was measured in 183 fetuses, BPD in 201, HC in 162, AC in 160, femur length in 133 and foot length in 62. The best description of the relation of CRL to gestational age was achieved by a quadratic function (y =−3.98 − 0.308×+ 0.0117×2). Mean values thus derived were virtually identical to those obtained by Robinson & Fleming in 1975 with transabdominal static scanning. Fetal BPD, HC, AC and femur length correlated more closely with CRL than gestational age. Reference ranges (mean and 95% data intervals) were constructed for each biometrical measurement in relation to gestational age and CRL. The HC/AC and femur/foot length ratios did not show any significant variation with gestational age or CRL.Conclusions
These data may be useful in the early detection of genetic disorders affecting the growth of fetal head, trunk and limbs. Genetic and/or environmental variables play an appreciable role in the modulation of early fetal growth.
Diagnosis of bacterial vaginosis in a gynaecology clinic
Authors: HAY P. E. , TAYLOR‐ROBINSON D. , LAMONT R. F. 
Published: August 2005

ABSTRACTObjective
To estimate the prevalence of bacterial vaginosis in women referred to a gynaecology clinic, and to compare two methods of diagnosing bacterial vaginosis.Setting
Gynaecology Clinic at Northwick Park HospitalSubjects
114 women aged 16 to 65 referred consecutively to the gynaecology clinic of one consultant.Main outcome measures
Detection of bacterial vaginosis by standard compound criteria and by examination of a Gram stained smear of fluid from the posterior vaginal fornix.Results
Bacterial vaginosis was detected by both the Gram stain and the compound criteria in 13 women. There was no correlation between the symptom of vaginal discharge and the diagnosis of bacterial vaginosis in this population, but the presence of discharge noted by the clinician was associated with bacterial vaginosis.Conclusions
The prevalence of bacterial vaginosis was 11%. The Gram stain provides a simple and inexpensive method for laboratory confirmation of bacterial vaginosis where facilities for using the compound criteria are not available.