bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prospective comparison of videopelviscopy with laparotomy for ectopic pregnancy
Authors: BAUMANN RALF , MAGOS ADAM L. , TURNBULL ALEXANDER 
Published: August 2005

AbstractObjective— To compare operativc laparoscopy with laparotomy for the management of ectopic pregnancy in haemodynamically stable women.Design— Non‐randomized prospective cohort study, treatment allocation depending on the surgical preference and experience of the on‐call medical team.Setting— Provincial undergraduate teaching hospital.Subjects— 87 consecutive and unselected haemodynamically stable women treated for ectopic pregnancy bctween 1 March 1988 and 31 August 1989.Interventions— Salpingotomy, salpingectomy, salpingo‐oophorectomy or simple extraction of the ectopic pregnancy depending on its site, size and nature performed under laparoscopic control or laparotomy.Main outcome measures— Operative outcome, duration of surgery, intra‐ and post‐operative complications, post‐operative hospital stay, return to normal domestic activities. return to work, changes in plasma β‐hCG concentrations, health and social service costs.Results— 60 women were treated by videopelviscopy on 65 occasions and the othcr 27 were treated by laparotomy. The two groups were similar for age, parity and gestation at presentation. Of the 65 operative laparoscopies 61 (94%) were successful and all 27 laparotomies were completed uneventfully. Whereas the operating time was similar in the two groups, 55.3 and 51.1 min for videopelviscopy and laparotomy respectively, operative laparoscopy was associated with significantly shorter post‐operative hospital stay (1.7 vs 5.2 days), faster return to domestic activitics (1.5 vs 3.3 weeks) and work (2.5 vs 5.7 weeks) (P<0.001 for all). In economic terms, successful vidcopelviscopy was associated with a reduction in hospital accommodation costs by 69% (£248 vs£808), drug costs by 52% (£8.38 vs£17.57) and statutory sickness payment by 51% (£130.25 vs£266.51), that is an overall saving to the health and social services of £701.47 or 50% per ectopic pregnancy (P<0.001).Conclusions— Operative laparoscopy can be used to successfully treat most cases of extrauterine pregnancy with advantages over laparoscopy in terms of reduced hospitalization, faster recovery and lower health service costs.
Direct antenatal fetal electrocardiographic waveform analysis
Authors: ARULKUMARAN S. , NICOLINI U. , FISK N. M. , TANNIRANDORN Y. , ROSEN K. G. , RODECK C. H. 
Published: August 2005

AbstractObjective— To establish a technique for continuous recording of fetal electrocardiograms (ECG) for waveform analysis in the antenatal period.Design— Prospective descriptive study.Setting— Fetal Medicine Unit, Queen Charlotte's and Chelsea Hospital, London, UK.Subjects— 35 women undergoing antenatal fetal blood sampling.Interventions— One end of an insulated Cooner wire was attached to the sampling needle and the other to an automatic ECG‐ST waveform analyser.Main outcome measures— ECG signals were obtained with the needle in the fetal abdomen during intrahepatic umbilical vein sampling or aspiration of fetal urine but not when it was in the placental cord insertion.Results— Continuous recording of the T/QRS ratio was obtained for a total of 166 min (mean 8 min per fetus) from 20 fetuses (16–38 weeks). The T/QRS ratio had no correlation with gestational age and fetal heart rate and was similar to values described in term fetuses in labour.Conclusions— The technique described can identify ST waveform changes and may be useful in the investigation of fetal cardiac arrhythmias, intrauterine growth retardation and in monitoring fetal transfusions.
United Kingdom Colposcopy Survey, British Society for Colposcopy and Cervical Pathology
Authors: KITCHENER H. C. 
Published: August 2005

AbstractObjective— To audit various aspects of colposcopy practice throughout the United Kingdom on behalf of BSCCP.Design— A postal questionnaire was circulated to those responsible for colposcopy services in all districts in the United Kingdom in 1988, followed by a smaller survey of 40 clinics in 1990 to detect any trends.Main outcome measures— Information was sought on colposcopy workload, referral criteria, treatment method and follow‐up, waiting times, staffing and training.Results— There was a 71% response to the national survey of 1988 practice which alone accounted for 80 000 new referrals for colposcopy. Cytological criteria for colposcopy referral were generally liberal. In 1988 laser ablation was the single most popular method, and waiting times for colposcopy varied, with 79% of patients being seen within 8 weeks of referral. Colposcopy clinies run by non‐gynaecologists, mainly genito‐urinary physicians, were reported by 32% of districts. Half the respondents did not have accurate statistics, only 17% being computerized, and dissatisfaction with clerical support was widespread. Resources are required to improve administration and data collection. The principal findings from the 1990 data subset were a 10% reduction for new patient referrals compared with 1988 and the use of diathermy loop excision by one‐third as their preferred treatment.Conclusions— This audit of colposcopy has provided useful information as well as a means of monitoring trends in colposcopy activity in the future.
Fast‐scan magnetic resonance imaging of fetal anomalies
Authors: GARDEN ANNE S. , WEINDLING A. M. , GRIFFITHS R. D. , MARTIN P. A. 
Published: August 2005

AbstractObjective— To identify those congenital fetal anomalies, previously identified by ultrasound scanning, in which fast‐scan magnetic resonance imaging (F‐SMRI) would give additional information for the perinatal management of the infants.Design— Observational clinical study.Setting— Hospital Department of Obstetrics and Gynaecology/Resonance Research Centre.Subjects— Seven women carrying eight fetuses in whom congenital abnormal‐ities had been identified using ultrasound scans. The duration of the pregnancies was 28 to 39 weeks gestation.Interventions— Fast‐scan magnetic resonance imaging at between 28 and 39 weeks gestation.Main outcome measures— Identification of fetal abnormalities.Results and conclusions— F‐SMRI was of limited value in the diagnosis of further assessment of fetuses with abnormalities of accumulation of tissue fluid. Renal anomalies were poorly identified unless associated with cystic formation of the kidney. Further study is required in the imaging of fetal central nervous system anomalies. Until echoplanar imaging is more widely available, MRI does not contribute to the diagnosis of cardiac anomalies. F‐SMRI appears to be most useful in the diagnosis and management of soft tissue gastro intestinal abnormalities.
Fetal heart rate and intrauterine growth
Authors: ROBINSON SIAN M. , WHEELER TIMOTHY , HAYES MATTHEW C. , BARKER DAVID J. P. , OSMOND CLIVE 
Published: August 2005

AbstractObjective— To assess whether fetal heart rate in early and late pregnancy relates to size at birth.Design— Prospective study of fetal heart rates in early and late pregnancy.Setting— Princess Anne Hospital, Southampton.Subjects— 63 primigravid women.Main outcome measures— Anthropometric measurements made on the newborn infant.Results— There were no differences in heart rate between the sexes at 18 weeks gestation but by 36 weeks the boys had rates which were 4.4 beats lower than those of the girls. Higher fetal heart rate at 18 weeks was associated with lower ponderal index, smaller head circumference and smaller mid‐arm circumference. There were no trends in fetal heart rate at 36 weeks with any birth measurements.Conclusion— Babies born at term who have a pattern of neonatal measurements which reflect growth retardation have raised heart rates in early pregnancy. Influences which impair fetal growth appear to take effect early in gestation.
Chromosome abnormalities detected in chorionic villus biopsies of failing pregnancies in a subfertile population
Authors: LOWER ADRIAN M. , MULCAHY MARIE T. , YOVICH JOHN L. 
Published: August 2005

AbstractObjective— To determine the range and prevalence of chromosomal abnormal‐ities occurring in failing pregnancies in subfertile women.Design— Prospective biochemical and ultrasound monitoring of all pregnancies conceived between 1988 and 1990 in a subfertile population.Setting— A single‐centre specialist fertility clinic in Perth, Western Australia.Subjects— Tissue from 50 early pregnancy losses was successfully cultured for chromosomal analysis from 46 pregnancies comprising 29 anembryonic preg‐nancies, 9 miscarriages and 8 ectopic pregnancies.Main outcome measures— Impending pregnancy loss was identified at an early stage. Chromosomal analysis was performed on chorionic villi obtained before the diagnosis became clinically evident.Results— Significant chromosomal abnormalities were identified in 54% (14/26) of early pregnancy losses where gamete manipulation was involved and 45% (9/20) of those following spontaneous conception. The most common abnormal‐ities were trisomies (12 pregnancies, mainly trisomy 16), triploidies (3 preg‐nancies) and monosomy X (3 pregnancies). An excess of female fetuses was noted with only 24% of conceptuses (11/46) bearing a Y chromosome.Conclusions— The data indicate a similar rate of chromosomal abnormalities underlying pregnancy losses at earlier stages of pregnancy and after infertility treatments as that reported from the general population. Gamete manipulation does not appear to confer a higher rate of chromosomal abnormalities in ensuing pregnancies.
The relation between bone mineral density and early pregnancy loss
Authors: HAMED HAMED M. , PURDIE DAVID W. , STEEL SUE A. , HOWEY SYD 
Published: August 2005

ABSTRACTObjective
To determine if women who suffer from early pregnancy loss are at increased risk of osteoporosis later in life.Design
Part of a Community screening project for bone mineral density (BMD).Subjects
392 women aged 50–54 who had had from 0 to 6 miscarriages out of 0 to 8 term pregnancies.Technique
BMD measured using dual energy X‐ray absorptiometry at both the lumbar spine and the proximal femur.Results
The mean BMD in nulligravid women was not significantly different from those whose only pregnancies ended in early loss. There was no significant correlation between the BMD at either the lumbar spine or the proximal femur and the number of miscarriages (r= 0.03 and 0.01, respectively). The BMD of the lumbar spine and femoral neck were not affected by parity (P= 0.08 and P= 0.87, respectively).Conclusion
The risk of osteoporosis was not influenced by parity or the number of previous miscarriages.
The usage of pregnancy tests in one health district
Authors: VOSS SIMON 
Published: August 2005

ABSTRACTObjective
To investigate the total number of pregnancy tests performed and the proportion that are repeated in one health district. To relate these results to the number of conceptions.Design
Collection of data related to the numbers of pregnancy tests performed from all sources. Surveys of women booking for antenatal care or undergoing non‐routine obstetric ultrasound examination.Setting
One health district in the south of England.Results
About five pregnancy tests were performed for each proven pregnancy. Nearly two‐thirds of tests were purchased over the counter, the remainder being carried out by hospital laboratories and pregnancy advisory services. Very few women had their pregnancy diagnosed on clinical grounds alone and a small number of ultrasound examinations were apparently performed in lieu of chemical tests. Repeated testing was more likely in primiparous women (P<0.005).Conclusions
Chemical pregnancy tests appear to be trusted more than clinical examination for the diagnosis of pregnancy by women and doctors. When there is no medical urgency, women who want formal confirmation of pregnancy should be advised that home testing kits will provide the quickest results.
Endometrial phospholipases A2, polycystic ovaries and pelvic pain
Authors: BONNEY R. C. , WATSON H. , BEESLEY J. S. , HIGHAM J. M. , ROGERS V. , FRANKS S. 
Published: August 2005

ABSTRACTObjective
To compare the activity of calcium independent phospholipase A2 in the endometrium of women with polycystic ovaries and in women with normal ovaries, and to investigate the influence of chronic pelvic pain on phospholipase A2 activity.Design
A prospective descriptive study.Setting
The Samaritan Hospital for Women and the Unit of Metabolic Medicine, St Mary's Hospital Medical School, London.Subjects
73 women attending the Samaritan Hospital for Women for clip sterilization, infertility, early recurrent miscarriage or pelvic venous congestion. 45 of these women had no pelvic pain, 22 had normal ovaries and 23 had polycystic ovaries diagnosed by ultrasound. The other 28 women had chronic pelvic pain, 14 of them had normal ovaries and 14 polycystic ovaries.Interventions
Endometrial tissue was obtained at curettage or from the excised uterus in the proliferative or secretory phase of the menstrual cycle. The activities of calcium dependent (type 1) and calcium independent (type 2) phospholipase A2 isoenzymes were measured in all endometrial samples.Results
In all the women phospholipase A2 type 1 activity, was significantly higher in the secretory phase than in the proliferative phase (P > 0.001). There was no difference between women with normal ovaries and those with polycystic ovaries at either stage of the cycle irrespective of whether or not chronic pelvic venous congestion was present. In women with normal ovaries, both with and without chronic pelvic pain, phospholipase A2 type 2 activity was significantly higher in the secretory phase than in the proliferative phase (P > 0.02 and P > 0.05 respectively) but in women with polycystic ovaries, with and without chronic pelvic pain, there was no significant differene in activity between the two phases of the cycle. Women with polycystic ovaries had markedly higher proliferative phase type 2 activity than women with normal ovaries (P > 0.001). Secretory phase type 2 activity was similar in all the women investigated.Conclusion
These data suggest that phospholipase A, type 2 activity is increased in proliferative phase endometrium of women with polycystic ovaries but that the increase is not associated with chronic pelvic venous congestion.
Cord insulin and C‐peptide—distribution in an unselected population
Authors: STANLEY K. P. , FRASER R. B. , MILNER M. , BRUCE C. 
Published: August 2005

ABSTRACTObjective
To assess the distribution of cord blood insulin in an unselected population, and examine its relation to birthweight centiles.Setting
District General Hospital in Nottinghamshire.Subjects
209 unselected singleton births.Mean Outcome Measure
Cord blood insulin; cord blood C‐peptide; birthweight centiles.Results
Hyperinsulinaemic babies (> 97th centile for cord insulin) were found at all birthweight centiles. 15% of high birthweight babies were hyperinsulinaemic. For low birthweight babies, the distribution of cord insulin/C‐peptide was skewed indicating a high number of low values. Hypoinsulinaemic babies were present up to the 50th centile for birthweight.Conclusions
Abnormalities of fetal insulinisation may be found in babies of all birthweights.
The role of abnormal fetal heart rate in scheduling chorionic villus sampling
Authors: YAGEL SIMCHA , ANTEBY EYAL , RON MOSHE , HOCHNER‐CELNIKIER DRORITH , ACHIRON REUVEN 
Published: August 2005

ABSTRACTObjective
To assess the value of fetal heart rate (FHR) measurements in predicting spontaneous fetal loss in pregnancies scheduled for chorionic villus sampling (CVS).Design
A prospective descriptive study.Setting
Two hospital departments of obstetrics and gynaecology in Israel.Subjects
114 women between 9 and 11 weeks gestation scheduled for chorionic villus sampling (CVS).Interventions
Fetal heart rate was measured by transvaginal Doppler ultrasound and compared with a monogram established from 75 fetuses. Whenever a normal FHR was recorded, CVS was performed immediately.Results
106 women had a normal FHR and underwent CVS; two of these pregnancies ended in miscarriage. In five pregnancies no fetal heart beats could be identified and fetal death was diagnosed. In three pregnancies an abnormal FHR was recorded and CVS was postponed; all three pregnancies ended in miscarriage within 2 weeks.Conclusion
Determination of FHR correlated with crown‐rump length could be useful in predicting spontaneous miscarriage before performing any invasive procedure late in the first trimester.
Plasma endothelin, atrial natriuretic peptide (ANP) and uterine and umbilical artery flow velocity waveforms in hypertensive pregnancies
Authors: LUMME RIITTA , LAATIKAINEN TIMO , VUOLTEENAHO OLLI , LEPPÄLUOTO JUHANI 
Published: August 2005

ABSTRACTObjective
To investigate the relation between concentrations of endothelin and atrial natriuretic peptide (ANP) in maternal plasma and vasospasm in the uterine and umbilical arteries as detected by duplex pulsed colour Doppler ultrasonography in hypertensive pregnancies.Design
An observational study.Subjects
32 women admitted consecutively to hospital with pregnancy induced hypertension (seven without proteinuria and 25 with proteinuria) and 78 healthy pregnant women examined at 28–0 weeks gestation.Main outcome measures
Systolic/diastolic (S/D) ratio in flow velocity waveforms (FVWs) and plasma concentrations of endothelin and ANP in the 32 women with pregnancy induced hypertension; plasma concentrations of endothelin and ANP in 78 healthy pregnant women (controls).Results
Pathological FVWs suggesting vasospasm in the uterine or umbilical artery, or both arteries, were found in 12 women with hypertension. Plasma ANP was significantly higher (P= 0.03) in the women with hypertension and pathological FVWs (median 23.0, range 10.1–52.8 pmol/1) than in those with hypertension and normal FVWs, (median 13.8, range 5.3–42.3 pmol/1) but corresponding plasma endothelin levels did not show any significant difference (median 1.63, range 0.51–3.33 pmol/1 and median 1.38, range 0.51–3.51 pmol/1, respectively).Conclusion
Local release of endothelin from the vascular endothelium is thought to cause vasospasm in pregnancy induced hypertension but this does not seem to increase the concentration of endothelin in the maternal peripheral plasma, probably because of its rapid disappearance from the blood circulation. As ANP dilates the blood vessels, the increase of its release in hypertensive pregnancies may be a compensatory mechanism against vasospasm.
Intergenerational studies of human birthweight from the 1958 birth cohort.
Authors: EMANUEL IRVIN , FILAKTI HAROULLA , ALBERMAN EVA , EVANS STEPHEN J. W. 
Published: August 2005

ABSTRACTObjective
To ascertain whether maternal twinning influences the previously described association between the birthweight of singleton mothers and their infants.Design and subjects
The association between the birthweight of singleton parents and their offspring and that between twin parents and their offspring was compared using data from the 23‐year‐old sample of the 1958 British national birth cohort. The numbers available for full comparison were 1027 female and 611 male singleton cohort members, and 26 female and 17 male twin cohort members and their first singleton livebirths.Results
Of the mothers who had been twins, half had been of low birthweight, and overall their mean weight was 700 g less than that of their singleton counterparts. Nevertheless, the mean birthweight of babies of twin mothers was 133 g, and of twin fathers 94 g, greater than of babies of corresponding singletons. For female, but not male, parents this difference persisted after adjustment for confounding variables.Conclusions
We suggest two possible reasons for the difference between the weight of babies of twin and singleton mothers. Firstly, the growth of twins becomes retarded late in pregnancy, possibly after a period critical in determining long‐term reproductive effects. Secondly, the twin survivors were of higher birthweight than the original twin cohort, whilst the singleton survivors were more representative of all singleton births, thus introducing a possible bias.
Prepregnancy counselling: experience from 1 075 cases
Authors: COX M. , WHITTLE M. J. , BYRNE A. , KINGDOM J. C. P. , RYAN G. 
Published: August 2005

ABSTRACTObjective To assess the activity of a prepregnancy counselling clinic in terms of investigations, counselling, treatment and subsequent pregnancy outcome.Design
Review of 1 075 couples attending over a nine year period.Setting
University Hospital offering a tertiary referral service for fetal medicine.Subjects
Couples referred to the clinic from a variety of sources.Main outcome measures
Categories of referral, value of diagnostic tests, and subsequent pregnancy outcome.Results
The main categories of referral were: previous miscarriage (44.4%); previous fetal abnormality (19.6%); chronic maternal disease (22.3%); and others (13.7%). Routine investigations produced a low yield of abnoramality (1 %), in contrast to investigations selected for specific reasons (12%). Subsequent pregnancy outcome, which was unaltered in either the previous miscarriage or fetal abnormality groups, did improve in the chronic maternal disease group.Conclusions
This study does not prove the value of prepregnancy counselling. However, it does illustrate the importance of making an accurate assessment of previous problems and current health as a means of determining both maternal and fetal risks in a subsequent pregnancy, a process which seems to lead to an improved outcome within selected groups. The importance of continuity of care in all couples, especially when there has been a previous adverse pregnancy outcome is emphasized.
The importance of serial biophysical assessment of fetal wellbeing in gastroschisis
Authors: CRAWFORD R. A. F. , RYAN G. , WRIGHT V. M. , RODECK C. H. 
Published: August 2005

ABSTRACTObjective
To review antenatal and intrapartum assessment of pregnancies complicated by gastroschisis.Design
Retrospective descriptive study.Setting
University College Hospital, London.Subjects
24 consecutive cases of gastroschisis between 1986 and 1991.Results
The gestational age at sonographic diagnosis was 20.3 weeks (SD 6.77) and at birth was 36.5 weeks (SD 2.06). There were 21 live births, all with good surgical outcome. There were 16 vaginal deliveries and eight caesarean sections. The elective sections were for oligohydramnios and dilated bowel (1) and clinically suspected growth retardation (1); the intrapartum caesarean sections were for fetal distress (4) and premature breech presentation (2). There were six with dilated gut on ultrasound; one of these ended in a stillbirth. There was a significant association between gut dilatation and caesarean section for fetal distress (P= 0.004). There was also a significant association between meconium staining and fetal distress (P= 0.021). Of these babies, 46% were ≤ third centile for corrected birth weight.Conclusions
While half of the babies with gastroschisis were small for gestational age at birth, reliable antenatal prediction of birth weight is difficult. Gut dilatation may be an indicator of either antenatal or intrapartum fetal distress, but does not correlate with poor neonatal surgical outcome. We suggest close antenatal surveillance of fetal wellbeing in all cases of gastroschisis because, in addition to growth retardation, many show some evidence of fetal distress and 12.5% end in stillbirth, even when appropriately grown.