bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnosing fetal urinary tract abnormalities: benefits of MRI compared to ultrasonography
Authors: POUTAMO JAANA , VANNINEN RITVA , PARTANEN KAARINA , KIRKINEN PERTTI 
Published: March 2003

Background. To compare antepartum ultrasonography with magnetic resonance imaging for prenatal diagnosis of malformations in the fetal urinary tract in high risk patients during the last trimester.Materials and methods. The study involved 22 women and 24 fetuses with either severe oligohydramnios or ultrasonographically or clinically suspected abnormality of urinary tract. Ultrasound examination was carried out with 5 MHz abdominal convex probe and magnetic resonance imaging with superconductive 1.5 T equipment. Postnatal findings were used as reference.Results. Correct diagnosis of urinary tract anomaly was done in 15 fetuses on ultrasound and in 20 fetuses on magnetic resonance imaging. Both methods enabled correct diagnosis in 12, only ultrasound in three and only magnetic resonance imaging in eight fetuses. Both methods imaged equivocally in one case. The additional information by magnetic resonance imaging was gained from five fetuses out of 12 pregnancies with oligohydramnios and from three fetuses out of ten pregnancies with normal amount of amniotic fluid.Conclusions. MRI is a valuable additional method to ultrasonography of fetal urinary tract if resolution of ultrasound is impaired for reason of oligohydramnios or technical deterioration.
The role of pretreatment squamous cell carcinoma antigen in predicting nodal metastasis in early stage cervical cancer
Authors: LIN HAO , CHANGCHIEN CHAN‐CHAO , HUANG ENG‐YEN , TSENG CHIH‐WEN , ENG HOCK‐LIEW , HUANG CHAO‐CHENG 
Published: March 2003

Purpose. To evaluate whether the presence of pelvic lymph node metastasis can be predicted by pretreatment squamous cell carcinoma antigen (SCC‐Ag) levels in early stage squamous cervical carcinoma.Materials and methods. Between 1994 and 1998, 284 patients with stage Ib and IIa cervical squamous cell carcinoma undergoing radical hysterectomy had preoperative SCC‐Ag determination. The correlation between clinicopathological findings on SCC‐Ag levels were examined. The Mann‐Whitney U test was used to statistically analyze differences between node positive and negative patients. Multiple regression analysis and a multiple logistic model were employed to examine the effect of clinicopathological findings on SCC‐Ag levels.Results. Of the 284 patients, 56 patients were found to have nodal metastasis. Median serum levels and 90% ranges of SCC‐Ag were 0.74 μg/l (0.5–7.8) in the 228 nodal negative patients and 4.33 μg/l (0.5–48.5) in the 56 nodal positive patients (p<0.001). Lymph node metastasis and tumor size were found to have a significant impact on SCC‐Ag levels. Around 86% of the patients with SCC‐Ag levels below 8 μg/l showed no nodal metastasis, while about 65% of the patients with serum levels above 8 μg/l exhibited nodal metastasis. Multivariate analyses confirmed that only lymph node metastasis had a significant impact on the SCC‐Ag levels exceeding 8 μg/l.Conclusion. For predicting nodal metastasis preoperatively, SCC‐Ag levels greater than 8 μg/l can be considered a high‐risk zone for nodal metastasis.
The pap‐smear history of women with invasive cervical squamous carcinoma
Authors: ANDERSSON‐ELLSTRÖM AGNETA , SEIDAL TOMAS , GRANNAS MARIANNE , HAGMAR BJÖRN 
Published: March 2003

Background. Screening by cytology is a potentially highly effective procedure for preventing carcinoma of the uterine cervix. To elucidate any weaknesses in the screening procedure in a Swedish county where screening started many years ago, the detection of invasive cervical squamous cell carcinoma was compared to the prior cytological screening.Methods. On the basis of the complete Pathology data files, including cytology and histology, all 112 women with invasive cervical squamous carcinoma were compared to 112 matched controls from the Swedish Population Register, regarding attendance rate and results of Pap‐smears prior to the date of discovery of an invasive carcinoma in the case.Results. Almost as many cases as controls had a history of pap‐smear testing, but the cases had significantly more prior atypias registered. Only 16% of women with cervical carcinoma and younger than 60 years were lacking Pap‐smear tests prior to the carcinoma diagnosis, but 46% had former atypias registered. More than half of them presented, however, a negative Pap‐smear test less than three years before the diagnosis. Among the controls, 10% were lacking prior Pap‐smears and only 9% had former atypias registered.Conclusion. The policy for follow‐up and treatment of cervical dysplasias has to be improved in order to achieve a further reduction of the incidence of invasive carcinoma.
Comparison of usefulness of estradiol vaginal tablets and estriol vagitories for treatment of vaginal atrophy
Authors: DUGAL RANDI , HESLA KNUT , SØRDAL TERJE , AASE KATHE HELEN , LILLEEIDET ODDVAR , WICKSTRØM EGIL 
Published: March 2003

Background. Atrophic vaginitis is a common condition. This study compared the usefulness of estradiol vaginal tablets (EVT) and estriol vagitories (EV) in treatment of atrophic vaginitis.Methods. Ninety‐six postmenopausal women with symptoms of atrophic vaginitis were treated for 24 weeks with either EVT or with EV. Patients used the medication daily for the first 2 weeks of the study, and twice‐weekly thereafter.Results. Both EVT and EV were effective in treating vaginal atrophy and patients in both treatment groups experienced a significant improvement in vaginal symptoms such as itching, irritation, dryness, and dyspareunia. At the end of the study three (6%) EVT treated women reported leakage and none needed to use sanitary towels. Among the EV treated women 31 (65%) reported leakage and 14 (29%) required sanitary protection. Furthermore, 90% in the EVT group perceived the medication as hygienic compared to 79% in the EV group, and 49% in the EVT group indicated that the product was easy to use compared to 28% in the EV group. Endometrial thickness was increased (1.1 mm with EVT and 0.5 mm on EV) in both treatment groups during the first 2 weeks of the study, but returned to baseline levels when the frequency of drug application was reduced to twice‐weekly.Conclusions. Estradiol vaginal tablets provides an effective alternative to traditional forms of local estrogen therapy.
Infants' length at birth: an independent effect on perinatal mortality
Authors: MELVE KARI KLUNGSØYR , GJESSING HÅKON K. , SKJÆRVEN ROLV , ØYEN NINA 
Published: March 2003

Aim. To investigate whether variations in birth length (crown‐heel‐length) were associated with perinatal mortality rate independent of birth weight.Material. The study population was singleton live‐ and stillbirths from 16 weeks of gestation compiled in the Medical Birth Registry of Norway from 1967 to 1997, totaling 1,705,652 births.Method. The total population was analyzed using z‐scores for length at birth, birth weight and gestational age. Variation in perinatal mortality by length at birth was studied within birth weight strata (250 g) by logistic regression.Results. Perinatal mortality varied more by birth length than by birth weight or gestational age, especially for values above the population means. Within birth weight strata, the association between perinatal mortality and length was similar in all 250 g birth weight categories above 1500 grams: mortality was lowest at birth lengths 0–2 cm below average, with mortality rates increasing exponentially in either direction.Conclusion. Within all birth weight strata, and adjusted for gestational age, long infants had the higher risk of perinatal death, suggesting that length at birth may be a valuable predictor when assessing the risk of perinatal mortality.
Outcome of pregnancies subsequent to placental abruption: a risk assessment
Authors: RASMUSSEN SVEIN , IRGENS LORENTZ M. , DALAKER KNUT 
Published: March 2003

Objective. To assess the risk of small for gestational age (SGA), preterm birth, pregnancy induced hypertension (PIH), and perinatal death in the pregnancy immediate subsequent to a placental abruption (PA) in the same mother.Design. A cohort study based on the Medical Birth Registry of Norway.Results. Odds ratios of SGA in subsequent PA‐ and non‐PA deliveries were 2.8 (absolute risk = 18.5%) and 2.0 (13.9%), respectively, compared with non‐PA deliveries without a history of previous PA among siblings (7.5%) after exclusion of cases with SGA in the immediate previous birth. After exclusion of cases with spontaneous preterm birth in the immediate previous delivery, odds ratios of spontaneous preterm birth in subsequent PA‐ and non‐PA deliveries were 17.0 (36.3%) and 2.1 (6.6%), compared with non‐PA deliveries without a history of previous PA among siblings (3.2%). After exclusion of cases with PIH in the immediate previous pregnancy, odds ratios of PIH in subsequent PA‐ and non‐PA pregnancies were 2.9 (6.3%) and 1.6 (3.4%), compared with non‐PA deliveries without a history of previous PA among siblings (2.3%). After adjustment for demographic variables and obstetrical complications, the increased risks persisted.Conclusion. A pregnancy following a PA must be considered a high risk pregnancy, not only in terms of excess risk of recurrence, but also due to excess risk of SGA, preterm birth, and PIH irrespective of recurrence of PA. Consequently, all pregnancies following a pregnancy with PA should be offered close antenatal surveillance and care.
Obstetric history and the risk of placenta previa
Authors: RASMUSSEN SVEIN , ALBRECHTSEN SUSANNE , DALAKER KNUT 
Published: March 2003

Objective. To evaluate secular trends in the occurrence of placenta previa and whether placenta previa is associated with the outcome of previous pregnancies, cesarean section, and sociodemographic factors.Design. A cohort study based on the Medical Birth Registry of Norway. Placenta previa in the second pregnancy was investigated for associations with outcomes in the first pregnancy and sociodemographic factors.Results. In birth orders 1 and 2 the occurrence of placenta previa was 1.2 and 2.2 per 1000, respectively, with no secular trend. The occurrence increased with maternal age and was lowest in women aged 20–29 years. The recurrence rate was 23 per 1000 (adjusted odds ratio (OR) of recurrence=9.7). In women with prior delivery at ≤25 gestational weeks the risk of placenta previa was 6.7 per 1000 (adjusted OR=3.0). In women with prior placental abruption the risk was 5.8 per 1000 (OR=2.6). In women with prior perinatal death the risk was 4.4 per 1000 (adjusted OR=1.8). No independent relationship emerged with socio‐economic factors, previous birthweight, and a history of pregnancy induced hypertension. Cesarean section was associated with subsequent development of placenta previa (adjusted OR=1.3).Conclusions. We found no secular trends in the occurrence of placenta previa. Placenta previa is associated with previously described risk factors for placental abruption. The increased risk of placenta previa subsequent to placental abruption supports the theory of a shared etiologic factor. However, placenta previa and placental abruption do not share a common etiology in relation to a history of pregnancy induced hypertension, fetal growth retardation, and socio‐economic factors.
Knowledge and attitudes of folate, and use of dietary supplements among women of reproductive age in Norway 1998
Authors: VOLLSET STEIN EMIL , LANDE BRITT 
Published: March 2003

Background. Authorities in many countries, including Norway from March 1998, recommend that women consume supplemental folate before and early in pregnancy to prevent neural tube defects. The aim of this survey was to establish Norwegian baseline data on knowledge, use and attitudes of folate and dietary supplements before implementing national campaigns on folate and pregnancy.Method. A telephone survey was carried out in late 1998 among 1146 Norwegian women of reproductive age. The women were recruited from a nationally representative stratified random sample.Results. Among the women aged 18–45 years, 50.4% had heard about folate, 32.9% knew about its role in pregnancy and 9.5% that it may prevent a malformation. Only 4.0% of the women knew that the critical period for folate supplementation to prevent a neural tube defect is before and early in pregnancy. The strongest determinants of knowledge were closeness to a pregnancy and educational level. Dietary supplements were used daily or almost daily by 53.3% of the women. The most commonly used types were multivitamin supplements and cod liver oil while only 0.9% of the women reported current use of supplemental folate. The women were also asked about use of folate and dietary supplements before or early in their last pregnancy: 44.3% reported that they had used a dietary supplement and 2.4% had used folate. Among the few women who had been pregnant within the last year of the interview, 10.3% reported use of a folate supplement. Overall, 56.0% of the women stated that they would use a folate supplement in a future pregnancy and 66.7% that they wanted more information about folate.Conclusions. Although about half of Norwegian women had heard about folate in 1998, just below 10% knew that it could prevent a malformation. Use of folate supplements was low in 1998, but more than half of the women stated that they would use folate supplements in a future pregnancy.
Risk assessment at the end of pregnancy is a poor predictor for complications at delivery
Authors: BERGLUND ANNA , LINDMARK GUNILLA 
Published: March 2003

Objective. To evaluate the usefulness of prenatal risk assessment for prediction of need for obstetric interventions.Design. Area based retrospective study.Setting. Västerås Central Hospital, Sweden, with all antenatal care units in the area.Subjects. All women delivered at the only delivery ward in the area, after attending antenatal care at the affiliated
ANC‐units in 1990 (n=2008) and 1992 (n=1874).Main outcome measures. Obstetric interventions at delivery.Results. During the two years 81% and 83% of the study population delivered an infant in vertex presentation at term but 15% and 17% without risk factors or complications at the end of pregnancy had complications during delivery. The relative risk for interventions when risk factors were present was 2.2 and with spontaneous onset of labor 1.3/1.4. Low risk primiparae had unforeseen complications in 25% and multiparae in 10%. Relative risk for multiparae with risk factors and spontaneous labor was 2.2/1.8 and for primiparae 1.4/1.6.Conclusions. Individual prediction of obstetric emergencies has low accuracy, which should be included in the information to women as well as in discussions with health planners.
Knowledge of and attitudes towards infertility held by members of two county councils in Sweden
Authors: KJELLBERG SVANTE , SYDSJÖ GUNILLA , GLEBE KRISTINA , SUNDELID MAGDALENA 
Published: March 2003

Background. To investigate Swedish county council members knowledge of the laws regulating infertility treatment, their understanding of the suggestions put forward in the report ‘Priorities in Health Care’ and their attitudes towards infertility.Methods. All members (n=182) of the 1998 county councils of Linköping and Jönköping were asked to participate in the study. In total, 153 answered the questionnaire.Results. Different age groups did not show different levels of knowledge. Similarly, there was no significant difference between men and women concerning their knowledge of infertility laws. Furthermore, those committee members who were very positive towards infertility treatment did not have any better knowledge of such treatment than those who were less positive. The men and women who themselves had previously had or were dealing with infertility problems at the time of the survey (12 per cent) displayed the same level of knowledge as the other council members. They also expressed similar attitudes. The members showed very little familiarity with the priority groups suggested in the report from the Health Care Priority Committee. For example, only 18 per cent knew that this committee in priority group III placed infertility treatment and investigation. 31.3 per cent answered that infertility was placed in group V, a group that does not exist. The majority stated that they had a positive attitude towards the treatment of infertility. This is indicated, for example, by their rejection of the statement ‘it’s [infertility is] a luxury problem'.Conclusions. The relative lack of knowledge of Swedish law and of the report from the Health Care Priority Committee might lead to a lower level of commitment to dealing with the problems that infertile couples face than if the members were better informed. In other words, this lack of knowledge might influence the decisions of the county council members.
Apoptosis in human cumulus cells in relation to maturation stage and cleavage of the corresponding oocyte
Authors: HØST ERIK , MIKKELSEN ANNE LIS , LINDENBERG SVEND , SMIDT‐JENSEN STEEN 
Published: March 2003

Background. The purpose of this study was to determine the incidence of apoptosis in cumulus cells, and correlate these findings with the maturation stage, fertilization rate and embryo score of the corresponding oocyte, in couples undergoing ICSI due to a male factor.Methods. The study group consisted of 21 couples where
ICSI was performed. The total number of oocyte‐cumulus complexes retrieved was 164. Sperm samples were assessed according to the WHO manual, morphology according to the strict criteria and for the presence of apoptosis. The degree of apoptotic
DNA fragmentation was determined using the free 3'OH
DNA termini in situ with chemically labeled and unlabeled nucleotides. The study was blinded for the technician involved in the assessments of apoptosis in the cumulus cells, apoptosis and morphology in spermatozoa. Ovarian hyperstimulation was carried out according to a long down regulation protocol using GnRH, rec FSH and hCG. A maximum of 3 embryos were transferred on day 2 after ICSI.Results. This study demonstrated that the incidence of apoptosis was significantly higher in cumulus cells from germinal vesicle and metaphase I oocytes compared to cumulus cells from metaphase II oocytes (p<0.0001). Non‐fertilized metaphase II oocytes showed significantly higher incidence of apoptosis in cumulus cells compared to fertilized metaphase II oocytes (p=0.0082). Furthermore, apoptosis in spermatozoa had an impact on the embryo score (p=0.0087).Conclusion. Comparing apoptosis in cumulus cells with maturity of the corresponding oocytes, a significantly higher degree was found related to immature oocytes. Apoptosis in cumulus cells from human metaphase II oocytes impaired the fertilization rate. The degree of fragmentation in the embryo might be correlated to apoptosis in the spermatozoa.
The influence of cotinine on interleukin 6 expression in smokers with cervical preneoplasia
Authors: EPPEL WOLFGANG , WORDA CHRISTOF , FRIGO PETER , MANAVI MAMOOD , CZERWENKA KLAUS 
Published: March 2003

Background. Several epidemiological investigations have shown that cigarette smoking leads to increased serum IL‐6 levels and is a risk factor for cervical cancer.Methods. We examined the levels of interleukin 6 (IL‐6) and the amount of cotinine in the cervical fluid of 78 women and compared the presence of human papillomavirus (HPV) in smokers and nonsmokers.Results. The results of our study showed that IL‐6 levels were higher in the cervical mucus of smokers than in nonsmokers. Fourteen percent of smokers were in the category with highest IL‐6 levels compared to 6% of nonsmokers. However, our IL‐6 results were not significant as they were probably influenced by the higher rates of HPV infection in smokers (17 cases) than in nonsmokers (4 cases). Significant findings showed that smokers had a higher prevalence of squamous intraepithelial lesions (SILs) than nonsmokers. Smokers' cotinine levels also exceeded those of nonsmokers: 13.95 ng/ml compared with 5.00 ng/ml. However, less IL‐6 activity was evident in smokers with high‐grade SILs and HPV infection of high‐risk types.Conclusion. Our results suggest that smoking has a stimulatory effect on the production of IL‐6 in the cervix. Furthermore, smokers show a higher genital HPV infection rate and a higher prevalence of SILs.
Changes in molecular weight of hyaluronan and hyaluronidase activity in uterine cervical mucus in cervical ripening
Authors: Obara Mikitaka , Hirano Hideto , Ogawa Masaki , Tsubaki Hiromitsu , Hosoya Naoko , Yoshida Yuko , Miyauchi Satoshi , Tanaka Toshinobu 
Published: March 2003

Background. This study was undertaken to investigate changes in the forms of hyaluronan and hyaluronidase activity in cervical mucus during cervical ripening.Methods. Uterine cervical mucus was obtained from 57 pregnant women (25 at preterm gestation, ten at term gestation, 11 within 1 week before labor, and 11 during the first stage of labor). We determined 1) concentration of hyaluronan, 2) hyaluronidase activity, and 3) molecular weight of hyaluronan in cervical mucus. Data are presented as mean and range.Results. The hyaluronan concentration in mucus in the 1st stage of labor (1.58 μg/ml, 0.46–23.96) was significantly (p<0.05) higher than that in all other groups (preterm: 0.29, 0.10–0.88; term: 0.24, 0.11–0.80; within 1 week before labor: 0.30, 0.18–0.62). Hyaluronidase activity both within 1 week before labor group (3.03 min., 1.12–3.95) and in 1st stage of labor group (3.52, 0.43–5.15) was significantly (p<0.05) higher than that in preterm group (1.70, 0.00–5.47). The molecular weight of hyaluronan in cervical mucus in the 1st stage of labor (0.97×106, 0.86–1.41) was significantly (p<0.05) lower than in the preterm and term groups (preterm: 1.60, 1.21–2.20, term: 1.41, 1.21–2.20). There was a significant correlation between hyaluronidase activity and molecular weight of hyaluronan (p<0.05, r=−0.41, n=23).Conclusion. These findings suggest that either hyaluronidase or low‐molecular weight hyaluronan could be one of the most important regulators in the process of cervical ripening.
Ultrasonographic guided ovarian stroma hydrocoagulation for ovarian stimulation in polycystic ovary syndrome
Authors: Ramzy Abdel Maguid , Al‐Inany Hesham , Aboulfoutouh Ismail , Sataar Mehany , Idrees Omaima A. , Shehata Mohammed Hany 
Published: March 2003

Objective. To evaluate the safety and effectiveness of transvaginal ultrasound guided injection of hot saline into the ovarian stroma in polycystic ovary syndrome (PCOS) cases in an office based gynecology practice under local anesthesia.Setting. Outpatient gynecologic clinic.Study design. Pilot study.Participants. Fifty‐two anovulatory infertile females diagnosed as PCOS by clinical, chemical and ultrasound criteria were recruited for the study. All cases were resistant to clomiphene citrate for more than 6 months.Intervention. Injection of warm sterile saline (75C) into the ovarian stroma under transvaginal monitoring using ovum pickup needle.Outcome measures. Cycle regularity, ovulation rate and safety were primary outcomes. Pregnancy rate and patient convenience were our secondary outcomes.Results. Ovulation has been achieved in 73.1% of clomiphene citrate resistant PCOS cases and resulted in pregnancy in 26.9% of these cases. No adverse effects were recorded and the procedure was tolerable in most cases.Conclusion. Transvaginal ultrasound guided ovarian stroma hydrocoagulation (TOSH) in an office setting seems to be a safe, economic and practical procedure that is acceptable by the patients. If larger studies confirm its effectiveness it may be an attractive alternative to conventional ovarian drilling.