bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of the prostaglandin E1 analogue gemeprost on the blood flow velocity waveforms of uterine arteries during the first trimester of pregnancy
Authors: Jouppila Penhi , Suomalainen‐König Sanna 
Published: August 2005

ABSTRACTObjective
To investigate the effect of the vaginal application of the prostaglandin (PGE1) analogue gemeprost on the vascular resistance of the main uterine arteries in early pregnancy.Design
A prospective observational study.Subject
Twenty‐one patients seeking legal termination of pregnancy at 7–12 weeks gestation.Methods
Pulsatility indices for the main uterine arteries were measured by vaginal colour Doppler ultrasound before and 3 to 4 h after vaginal application of the PGE1 analogue gemeprost.Results
A significant increase of pulsatility indices was observed (P < 0001) which was not affected by parity or gestational age. The change was similar in both uterine arteries, and placental lateralisation did not affect the results. All fetuses were still alive at the second examination.Conclusions
Vaginal application of prostaglandin analogue gemeprost in early pregnancy increases the vascular resistance of uterine arteries. This may be caused by a direct vasoconstrictory effect or be secondary to uterine contractions.
Pudendal nerve damage during labour: prospective study before and after childbirth*
Authors: Sultan Abdul H. , Kamm Michael A. , Hudson Christopher N. 
Published: August 2005

ABSTRACTObjective
To establish the effect of childbirth on pudendal nerve function and identify obstetric factors associated with such damage.Design
A prospective investigational study.Setting
Antenatal clinic, St Bartholomew's (Homerton) Hospital.Subjects
One hundred and twenty‐eight unselected pregnant women beyond 34 weeks’ gestation.Intervention
Pudendal nerve terminal motor latencies (PNTML) and perineal plane were measured during pregnancy and six to eight weeks after delivery, and remeasured in a subgroup (n= 22) at six months.Main outcome measures
Effect of mode of delivery on PNTML and the plane of the perineum.Results
Vaginal delivery resulted in a significant (P < 0.0001) prolongation of the mean PNTML bilaterally in both primipara (n= 57) 1.91 ms (SD 0.19) vs 2.00 ms (SD 0.22), antenatal vs postnatal, right PNTML; 1.96 ms (SD 0.21) vs 2.06 ms (SD 0.24) left PNTML, and multipara (n= 32) (P < 0.01). Perineal descent during straining was also increased after vaginal delivery (P < 0.001). Greater damage to the pudendal nerve occurred on the left side (P= 0.03). PNTML were not altered after elective caesarean section (n= 7), but were increased on the left side when caesarean section was performed during labour (1.94 ms (SD 0.13) vs 2.08 ms (SD 0.29), P < 0.01). A heavier baby and a longer active second stage of labour were both associated with significant prolongation of PNTML. Eight out of 12 women with a prolonged PNTML at six weeks had normal measurements when restudied six months after delivery.Conclusion
Vaginal delivery, particularly the first, results in significant pelvic floor tissue stretching and pudendal nerve damage. Women who have a caesarean section during labour may also be at risk of pudendal nerve damage. The process of labour and vaginal delivery can both cause pudendal nerve damage which may be asymmetrical in extent.
Chorionic villous haemorrhage is associated with retroplacental haemorrhage
Authors: Mooney E. E. , Al Shunnar A. , O'Regan M. , Gillan J. E. 
Published: August 2005

ABSTRACTObjective
To examine the frequency of occurrence of chorionic villous haemorrhage in placentas with retroplacental haemorrhage, and to discuss the pathogenesis of these conditions.Design
A retrospective study using histological sections of formalin‐fixed, paraffin‐embedded placental tissue stained with haematoxylin and eosin.Setting
Department of Histopathology, Rotunda Hospital, Dublin.Subject
Sixty cases of retroplacental haemorrhage, 34 cases of chorioamnionitis, and 24 histologically normal placentas.Main outcome measurement
Presence or absence of chorionic villous haemorrhage.Results
Chorionic villous haemorrhage was present in 31 of 60 cases of retroplacental haemorrhage (51 %), one of 34 cases of chorioamnionitis (2.9 %) and in no normal placentas.Conclusions
It is postulated that chorionic villous haemorrhage reflects a disturbance of fetal vascular dynamics and precedes retroplacental haemorrhage. Such a disturbance could trigger the events leading to abruption.
Chronic pelvic pain caused by residual ovaries and ovarian remnants
Authors: Siddall‐Allum J. , Rae T. , Rogers V. , Witherow R. , Flanagan A. , Beard R. W. 
Published: August 2005

ABSTRACTObjective
To determine the diagnostic effectiveness and treatment of women with chronic lower abdominal pain due to residual ovaries or ovarian remnants.Design
A prospective observational study.Setting
Tertiary referral pelvic pain clinic.Subjects
Seventeen women complaining of chronic pelvic pain of up to 25 years’ duration, of whom seven had residual ovaries and 10 ovarian remnant(s).Main outcome measures
Persistent lower abdominal pain, pelvic tenderness and quality of life one year post‐operatively.Results
Six of the seven women with residual ovaries, and nine of the 10 women with presumed ovarian remnants experienced relief of the original pain, loss of pelvic tenderness and an improved quality of life.Conclusions
Residual ovaries after hysterectomy and ovarian remnants are established causes of chronic pelvic pain. Diagnosis and surgical removal is frequently difficult. Management strategies are proposed for both conditions.
A population‐based, controlled study of the relation between HIV infection and cervical neoplasia
Authors: Johnstone Frank D. , McGoogan Euphemia , Smart George E. , Brettle Ray P. , Prescott Robin J. 
Published: August 2005

ABSTRACTObjective
To study a geographically defined population of women exposed to a drug‐related risk for human immunodeficiency virus (HIV), together with carefully matched neighbourhood controls, in order to examine (1) the proportion of different groups having cervical cytopathology screening; (2) the association between HIV infection and cervical intraepithelial neoplasia; (3) the independent effect of CD4+ lymphocyte count and duration of HIV infection; and (4) the correspondence between cervical cytopathology and colposcopically directed biopsy.Design
A population‐based study.Subjects
All women domiciled in Lothians with the following characteristics: between 1983 and 1987 they had a history of injection drug use or a seropositive partner with a history of injection drug use; they had a pregnancy after that exposure where their serostatus was known. In addition, neighbourhood controls were identified by computer matching for the following criteria—post‐code sector, housing deprivation score, age, parity, pregnancy outcome, ethnic group, year of pregnancy, smoking.Main outcome measures
Search was carried out for the cervical smear nearest in time to the index pregnancy end date, providing serostatus was known at that time. All identified smears were assessed by a cytopathologist without knowledge of clinical information, study group or serostatus.Results
Of 376 women, appropriate cervical smears were identified for 336. The proportions screened in the different groups were similar. There were more abnormal smears in the seropositive group than in the drug‐related seronegative (P < 0.01) or the neighbourhood control groups (P < 0.001). HIV‐infected women with abnormal smears had lower CD4+lymphocyte counts (P < 0.0005). There was a reasonable correspondence between cytopathological classification and histological grading, and this was of similar strength in cases and controls (weighted kappa 0.72, 0.74).Conclusions
There is a definite relation between HIV infection and cervical intraepithelial neoplasia. This is related to immune depletion but whether this is the sole mechanism for the association is unclear.
Relative influence of serum follicle stimulating hormone, age and other factors on ovarian response to gonadotrophin stimulation
Authors: Cahill D. J. , Prosser C. J. , Wardle P. G. , Ford W. C. L. , Hull M. G. R. 
Published: August 2005

ABSTRACTObjective
To determine the relative value of the woman's age, basal follicle stimulating hormone (FSH), basal luteinising hormone (LH) and menstrual cycle pattern (all denned prior to treatment) in predicting the ovarian response to gonadotrophin stimulation for in vitro fertilisation.Design
Open, descriptive cohort study.Patients
One hundred and seventy‐one consecutive ovulatory women undergoing their first cycle of in vitro fertilisation with ovarian stimulation after pituitary desensitisation.Interventions
Measurement of basal (early follicular phase) and down‐regulated concentrations of serum FSH and LH, and calculation of age at treatment and of median length of menstrual cycles and range of variation prior to treatment.Main outcome measures
Duration and amount of gonadotrophin stimulation to achieve follicular maturity, number of mature follicles, peak serum oestradiol concentration and number of mature oocytes, were compared between banded values of variables studied.Results
Increasing basal FSH concentrations were significantly associated with reducing oestradiol levels, numbers of mature follicles and oocyte yield even when the FSH levels were still within the normal range though above average (6 to 8.9 i.u./l). There were similar but weaker associations with FSH levels after down‐regulation. There were also significant differences between women over and under 40 years old in their oestradiol levels, numbers of follicles and of oocytes. Analysis of variance showed significant independent association of basal FSH with both oestradiol and numbers of oocytes, but not of age, menstrual pattern, or serum LH concentrations.Conclusion
Serum FSH is more sensitive than the woman's age in determining her ovarian responsiveness to stimulation. LH concentrations and menstrual cycle patterns are unhelpful.
Perinatal findings in children born to HIV‐infected mothers
Authors:   The European Collaborative Study
Published: August 2005

ABSTRACTObjective
To explore in children born to HIV‐infected women, the association between a child's HIV infection status and birthweight, gestational age, congenital abnormalities and other perinatal findings.Design
A prospective study of children born to women known to be HIV‐infected at or before the time of delivery enrolled in the European Collaborative Study.Setting
Nineteen European centres.Subjects
A cohort of 853 children with known HIV infection status.Results
There was no evidence for an HIV dysmorphic syndrome, and the frequency of congenital abnormalities was similar in infected and uninfected children with no consistent pattern of defects. Injecting drug use during pregnancy had the most marked effect on birthweight and gestational age. Multivariate analysis demonstrated a weak association between birthweight and the child's HIV infection status, but this could partly be explained by the confounding effect of maternal immunological HIV status. HIV infection in the infant was not associated with gestational age, and the mean and distribution of gestational age were similar for infected and noninfected children.Conclusions
The finding that HIV‐infected and noninfected children are of similar birthweight, the absence of a dysmorphic syndrome and no evidence of associated congenital abnormalities suggest that a substantial proportion of infection occurs late in pregnancy or at the time of delivery.
Doppler colour flow imaging of fetal intracerebral arteries and umbilical artery in the small for gestation; age fetus
Authors: Noordam M. J. , Heydanus R. , Hop W. C. J. , Hoekstra F. M. E. , Wladimiroff J. W. 
Published: August 2005

ABSTRACTObjective
To assess with Doppler colour flow imaging whether a brain‐sparing effect is present in all cerebral arteries of the circle of Willis in the small for gestational age fetus, to determine which cerebral flow velocity parameter is most discriminating in this pathological condition, and to relate this parameter to the umbilical artery pulsatility index.Design
Prospective, cross‐sectional, matched case‐control study.Setting
Academic department of obstetrics and gynaecology.Subjects
Twenty‐eight small for gestational age fetuses and 28 normal controls at 24 to 38 weeks of gestation.Interventions
Blood flow velocity waveforms from the umbilical and fetal intracerebral arteries were studied with Doppler colour flow imaging for measurement of peak systolic, end‐diastolic and time averaged velocities, and calculation of the pulsatility index.Main outcome measures
Comparison of intracerebral and umbilical artery waveform parameters between small for gestational age fetuses and controls.Results
Acceptable flow velocity waveforms were obtained in the intracerebral circulation in more than 85%. In small for gestational age fetuses, all intracerebral arteries displayed reduced downstream impedance. The end‐diastolic velocities of the middle and anterior cerebral artery are the most discriminative factors between small for gestational age fetuses and controls. The highest sensitivity was reached for the umbilical artery pulsatility index.Conclusions
Doppler colour flow imaging allows easy identification of fetal intracerebral arterial vasculature. Whereas for the intracranial vasculature, the end‐diastolic blood flow velocities in the anterior and middle cerebral artery are the most sensitive parameters discriminating between small for gestational age and controls, umbilical artery pulsatility index remains the best indicator for the small for gestational age fetus.
Sacrocolpopexy: a retrospective study of a clinician' experience
Authors: Valaitis Sandra R. , Stanton Stuart L. 
Published: August 2005

ABSTRACTObjective
To assess the factors that may predispose patients to the development of vaginal vault prolapse and enterocele, and to determine the success of sacrocolpopexy in correcting prolapse.Design
A retrospective study of women with vault prolapse undergoing sacrocolpopexy over a 10 year period between 1983 and 1993, with analysis of postoperative complications and success.Setting
St. George's Hospital in London, a university teaching hospital, and private practice.Subjects
Forty‐one women, presenting with symptomatic vault prolapse, who desired preservation of sexual function.Interventions
Forty‐one patients underwent 43 sacrocolpopexies. Of these, 39 were performed by the senior author. All but four were reviewed in the clinic within the last year.Main outcome measures
Pre‐ and post‐operative data and any interim prolapse or incontinence surgery were recorded. Success was assessed subjectively and by clinical examination for recurrence of prolapse, associated post‐operative complications, subsequent voiding difficulties, and incidence of incontinence.Results
Failure was denned as a symptomatic enterocele or evidence of a third degree enterocele on examination. The 41 patients were followed for a mean time of 21.2 months. The cure rate of vault prolapse was 88 %. The most common complications were stress incontinence, urinary tract infection, and persistent vaginal discharge. Using the unpaired t‐est and χ2 analysis, there was no significant difference between failures or successes in terms of weight, parity, age, previous surgery, pulmonary history, or difficulties with defaecation, although the number of patients studied was small.Conclusions
Sacrocolpopexy is a successful operation for the correction of prolapse. Complications include the development of genuine stress incontinence, detrusor instability, voiding difficulty, and mesh infection.
Intermittent versus continuous electronic monitoring in labour: a randomised study
Authors: Herbst Andreas , Ingemarsson Ingemar 
Published: August 2005

ABSTRACTObjective
To compare the efficacy in detecting signs of fetal hypoxia in labour of intermittent (I‐group) versus continuous (C‐group) electronic fetal monitoring in women with low or moderate risk factors for fetal distress.Design
A prospective, randomised study.Setting
A tertiary referral centre.Subjects
Four thousand and forty‐four parturients at low risk for obstetric complications with a reactive fetal heart rate admission test at arrival in labour. During the study period (October 5 1989 to May 31 1991), 5647 women were delivered in the labour ward. Of these, 1178 women (20.9%) were excluded because of high risk factors in pregnancy or at admission for labour, including women undergoing elective caesarean section. Of the remaining 4469 women 4044 (905 %) were randomised to either intermittent (n= 2015) or continuous monitoring (n= 2029) during the first stage of labour.Methods
In the C‐group the fetal heart rate was recorded continuously with electronic fetal monitoring during the first stage of labour. In the I‐group the fetal heart rate was recorded with electronic fetal monitoring for 10 to 30 min every 2 to 2.5 h during the first stage of labour, and the fetal heart rate was auscultated every 15 to 30 min in between recording periods. If complications occurred, recording was changed to continuous. In the second stage of labour all the women were monitored continuously. Umbilical cord artery acid‐base status was assessed at birth.Main outcome measures
Duration of electronic fetal monitoring, rates of abnormal fetal heart rate patterns, caesarean section for fetal distress, acidosis in umbilical cord arterial blood at birth, Apgar scores of less than 7 at 1 or 5 min, and referrals to the neonatal intensive care unit.Results
There were no significant differences between the study groups in the incidence of ominous fetal heart rate recordings: 6.3 % (I‐group) versus 6.6% (C‐group), or the interval from arrival to first detected abnormal fetal heart rate, although the number of suspicious fetal heart rate patterns was higher in the C‐group (28.6%) than in the I‐group (24.6%). In the I‐group electronic fetal monitoring was performed for (median monitoring time) 38.8 % of the first stage of labour as compared with 78.6 % in the C‐group. The incidence of caesarean section for fetal distress was similarly low in both groups: 1.2%versus 1.0%. There were no significant differences in the immediate neonatal outcome in terms of umbilical artery pH, Apgar scores, or admissions to the neonatal care unit.Conclusions
Intermittent use of electronic fetal monitoring at regular intervals (with stethoscopic auscultation in between) appears to be as safe as continuous electronic fetal monitoring in low risk labours.
Employment during pregnancy in relation to risk factors and pregnancy outcome
Authors: Henriksen Tine Brink , Savitz David A. , Hedegaard Morten , Secher Niels Jørgen 
Published: August 2005

ABSTRACTObjective
To describe the relation of employment status during pregnancy to potential demographic, behavioural and obstetrical risk factors for adverse late pregnancy outcome, as well as the risks of having a preterm delivery and a small for gestational age infant.Design
Cohort study.Setting
A university hospital.Subject
Of 8711 women with singleton pregnancies (1989–91), 5875 returned questionnaires about risk factors and employment status at 16 and 30 weeks gestation. Of the respondents 5552 were analysed in five groups: (1) women working throughout pregnancy, (2) women working in the first, but unemployed during the second trimester, (3) women on sick leave in the first and second trimester, (4) women unemployed throughout pregnancy, and (5) students. The association between employment status and having a small for gestational age infant and preterm delivery was evaluated, accounting for other risk factors.Results
Working women and students had the most and unemployed women the least favourable demographic risk factors. Women on sick leave had the least favourable obstetrical and medical history, followed by unemployed women. No clear pattern of the behavioural risk factors was found. Differences in risk of having a small for gestational age infant were a function of parity, smoking and maternal height. Adjustment for these factors plus education yielded a lower risk of preterm delivery in partially unemployed women and higher risk among women on sick leave compared to working women, accounted for by different risks of bleeding in the second and third trimester.Conclusions
Comparison of pregnancy outcome among women with different work status should consider the differences in risk factor profile. Adjusting for such risk factors, we found no evidence that work per se had any detrimental or beneficial effects on the risk of having a small for gestational age infant or preterm delivery.
Serum albumin and CA125 are powerful predictors of survival in epithelial ovarian cancer
Authors: Parker D. , Bradley C. , Bogle S. M. , Lay J. , Masood M. , Hancock A. K. , Naylor B. , Price J. J. 
Published: August 2005

ABSTRACTObjective
To assess the prognostic significance of presentation serum albumin, clinical stage and CA125 levels in ovarian cancer.Design
Retrospective analysis of data using a Cox proportional hazards model.Setting
A district general hospital oncology unit.Subject
One hundred and fourteen consecutive patients with epithelial ovarian cancer.Interventions
Cytotoxic chemotherapy and surgery.Main outcome measure
Survival.Results
A linear increase in risk was observed with high log CA125 (P < 0.0001) and with low albumin (P < 0.0001). In late stage patients (III and IV) albumin is the best predictor of survival (P= 0.0006). The presence of ascites, blood transfusion, type of surgery or chemotherapy did not improve the predictive model.Conclusions
CA125 and albumin can be used to identify prognostic subgroups independently of stage. Albumin alone can also be used as a predictor of survival. A simple classification of patients into three groups based on serum albumin of 41 g/l or more, 35 to 40 g/l and 34 g/l or less provides a clear separation of survival curves in the present group of patients.
A longitudinal study of bacterial vaginosis during pregnancy
Authors: Hay P. E. , Morgan D. J. , Ison C. A. , Bhide S. A. , Romney M. , McKenzie P. , Pearson J. , Lamont R. F. , Taylor‐Robinson D. 
Published: August 2005

ABSTRACTObjective
To determine the longitudinal changes in the incidence of bacterial vaginosis in pregnancy.Design
A prospective study of women during pregnancy.Setting
A District General Hospital in North‐West London.Subject
Seven hundred and eighteen pregnant women attending antenatal clinics. At their first attendance and subsequently, Gram‐stained vaginal smears were examined and Mycoplasma hominis and Gardnerella vaginalis were sought by culture.Results
Initially, 87 (12%) women had bacterial vaginosis diagnosed on Gram‐stained reading of the vaginal smears. Examination of further smears, obtained from 176 women at 36 weeks of gestation, showed that those whose vaginal flora was normal initially, and who went to term, rarely developed vaginosis (three of 127, 2.4%). Samples were obtained at 36 weeks gestation from 32 women who had bacterial vaginosis initially, and went to term. In almost 50% (15 of 32) of these a normal lactobacillus‐dominated flora had regenerated. Thirty‐five women (5%) had initial vaginal smears graded as intermediate. From this group, six of the 17 (35%) women from whom samples were obtained at 36 weeks gestation still had flora of an intermediate pattern; 10 (59%) now had normal flora and only one (6%) had developed bacterial vaginosis. Women with bacterial vaginosis were more likely to be culture‐positive for M. hominis than those with normal flora (34/78 versus 10/563, odds ratio 42.73 (18.9 to 102.3) P < 0.001), or to be culture‐positive for G. vaginalis than those with normal flora (35/78 versus 21/563, odds ratio 21.0 (10.75 to 41.2) P < 0.001).Conclusion
Pregnant women do not commonly develop bacterial vaginosis after 16 weeks gestation, and if present, it remits spontaneously in approximately half of those who reach term. As bacterial vaginosis is associated with increased rates of second trimester miscarriage and preterm delivery, any treatment aimed at its eradication in pregnancy should be given no later than the beginning of the second trimester of pregnancy.