bluuebunny/crossref_metadata_2025_split huggingface dataset:
Placental hormones and maternal glucose metabolism. A study of fetal growth in normal pregnancy
Authors: LANGHOFF‐ROOS JENS , LINDMARK GUNTLLA , WIBELL LARS , GEBRE‐MEDHIN MEHARI 
Published: August 2005

SummaryThe interrelations between three placental hormones (oestradiol, progesterone and hPL), maternal glucose metabolism, maternal anthropometry and fetal growth were studied in a sample of 52 carefully selected pregnant women. A relation was found between infant birthweight and both fasting blood glucose and t½ of glucose of an intravenous glucose tolerance test at week 37 of pregnancy. The serum concentrations of the placental hormones were not significantly related to the glucose variables. The correlation between birthweight and the maternal levels of hPL in late pregnancy (r= 0·60) persisted when fasting blood glucose and tt½ of glucose were taken into account. Maternal fat mass was found to explain more of the Variation in basal insulin levels around week 37 than did the placental hormones.
A study of the experience of Glasgow women in the climacteric years
Authors: BARLOW D. H. , GROSSET K. A. , HART H. , HART D. M. 
Published: August 2005

SummaryOverall, 424 women between 40 and 60 years of age were interviewed with reference to their experience of the menopause; 179 (42%) expressed a ‘need for treatment’ which was more marked in those who had had a hysterectomy (57%) or oophorectomy (76%). Of those who sought help (174) a large majority (92%) had seen their general practitioner and 72% received some form of drug therapy, predominantly hormone replacement therapy (HRT) or psychotropic drugs. Twenty‐eight women were currently having HRT (7%) and 39 (9%) had previously had HRT. Only 12 women (3%) had received >3 years of HRT and nine of these had had an oophorectomy. Only 1% of other women were ‘long‐term’ users of HRT. Of the 424 women 11% expressed dissatisfaction with their general practitioner's approach to this subject.
Ethnic influence on uterine activity in spontaneous normal labour
Authors: ARULKUMARAN S. , GIBB D. M. F. , CHUA S. , SINGH P. , RATNAM S. S. 
Published: August 2005

SummaryUterine activity in spontaneous normal labour was studied in Singaporean Malay women at term with a singleton vertex presentation. Nulliparae had significantly higher uterine activity compared with their multiparous counterparts. Uterine activity in the Malay population was compared with that of a similar Chinese population. When controlled for parity, maternal height and birthweight of babies, there was no difference in uterine activity between the two groups.
Some endocrinological events associated with early pregnancy failure
Authors: WHITTAKER P. G. , STEWART M. O. , TAYLOR A. , LIND T. 
Published: August 2005

SummarySerial measurements of serum progesterone, oestradiol, human chorionic gonadotrophin (hCG) and human placental lactogen (hPL) have been determined in 33 women experiencing early pregnancy failure and compared with the values of the same hormones in 72 healthy women having uncomplicated pregnancies. Steroid production by the corpus luteum seemed similar in both groups up to 6 weeks gestation but thereafter placental steroidogenesis was not evident in those women in whom spontaneous pregnancy losses occurred. Placental production of the two protein hormones, hCG and hPL, did take place, and whereas the circulating levels were not as high as in normal pregnancies, levels did usually increase before clinical evidence of miscarriage occurred. hCG was not a sensitive discriminator of subsequent failure. In these women there were no significant hormone differences between those with evidence of a fetus and those without.
Nausea and vomiting of early pregnancy and pregnancy outcome. A meta‐analytical review
Authors: WEIGEL RONALD M. , WEIGEL M. MARGARET 
Published: August 2005

SummaryThe generalizability of the apparent decreased risk of miscarriage and perinatal mortality associated with early pregnancy nausea and vomiting was investigated by examining data available from 11 previous studies. Statistical reanalyses of these studies indicated a strong significant association of nausea and vomiting of pregnancy with decreased risk of miscarriage, and no consistent associations with perinatal mortality. A statistical meta‐analysis confirmed the decreased risk of miscarriage associated with gestational nausea and vomiting (common odds ratio = 0·36, 95% CI 0·32 to 0·42) and indicated that the association with decreased fetal mortality was restricted to the first 20 weeks gestation. The meta‐analysis also revealed that over 150 additional possibly unreported studies with contradictory evidence would be required to refute this observed association.
Vulval intraepithelial neoplasia—management and outcome
Authors: SHAFI M. I. , BYRNE P. , LUESLEY D. M. , REDMAN C. W. , ROLLASON T. P. , SAMRA J. S. , JORDAN J. A. 
Published: August 2005

SummaryForty‐six patients with a primary diagnosis of vulval intraepithelial neoplasia (VIN) have been managed over a 10‐year period. The prevalence of VIN has increased and the age at presentation has decreased over the last decade; 59% of our patients had histological evidence of human papillomavirus infection. Pruritis was the commonest symptom at presentation (59%). Of the 46 patients 44 were treated by laser skinning vulvectomy, local excision or simple vulvectomy. Symptomatic relief was best achieved by local excision. Clinical and definitive relapse occurred more often in the laser‐treated group. The median time to relapse was 38 months in the laser‐treated group and 74 months in the surgically treated group (excision and simple vulvectomy). Two patients have not been treated and their disease has not progressed. The carbon dioxide laser almost certainly has a role in conservative management and although our data possibly do not reflect its full potential they demonstrate a need for a controlled prospective study.
Maternal haematocrit in labour is related to fetal cord pH at delivery
Authors: SAUNDERS NIGEL J. St. G. , SPIBY HELEN , PATEL DAKSHA 
Published: August 2005

Abstract Objective–To determine whether a correlation exists between maternal haematocrit in labour and umbilical cord pH values at delivery. Design–An observational study. Setting–The delivery suite. Subjects–200 pregnant women in labour. Main outcome measures–Umbilical artery and vein blood pH values. Results–A statistically significant inverse correlation was observed between maternal haematocrit levels during labour and umbilical vein pH (r=−0.22; P= 0.001) and umbilical artery pH (r=–0.18; P = 0.008) at delivery. Conclusions–Although an inverse correlation does appear to exist between maternal haematocrit and cord pH values, it is unlikely that this weak association will prove to be of clinical value in the management of labour.
Menstrual symptoms in women with pelvic endometriosis
Authors: MAHMOOD T. A. , TEMPLETON A. A. , THOMSON L. , FRASER C. 
Published: August 2005

AbstractObjective— To investigate menstrual symptoms in relation to pelvic pathology.Design— A prospective questionnaire‐based study.Setting— Aberdeen Royal Infirmary, Scotland.Subjects— 1250 questionnaires were sent out prior to planned admission and 1200 women (96%) brought the completed questionnaires. They comprised 598 women undergoing laparoscopic sterilization, 312 having laparoscopy because of infertility, 156 having laparoscopy because of chronic pelvic pain and 134 women undergoing abdominal hysterectomy for dysfunctional uterine bleeding.Main outcome measures— The occurrence of dysmenorrhoea, menorrhagia, menstrual regularity, premenstrual spotting, deep dyspareunia and pelvic pain in women with either endometriosis and post infective pelvic adhesions or a normal pelvis.Results— Menorrhagia, menstrual irregularity and premenstrual spotting occurred with equal frequency in all groups. Deep dyspareunia, pain after intercourse and recurrent pain unrelated to menstruation or coitus was more common in women with endometriosis and those with post infective pelvic adhesions than in those with a normal pelvis. Dysmenorrhoea appears to be more prevalent among women having endometriosis.Conclusions— Menstrual symptoms, while raising a high index of suspicion for endometriosis, are not entirely reliable as indicators of disease. Dysmenorrhoea is the most common reported symptom in endometriosis sufferers. Diagnostic laparoscopy should be considered before institution of treatment in women complaining of pelvic pain and menstrual symptoms.
Microsurgical salpingostomy is not an obsolete procedure
Authors: WINSTON R. M. L. , MARGARA R. A. 
Published: August 2005

AbstractObjective— A review of the results of microsurgery for bilateral distal tubal blockage.Design— A retrospective review.Setting— Hammersmith Hospital London and local private hospitals.Subjects— 388 patients with bilateral ampullary occlusion treated between 1971 and 1988 by microsurgery.Interventions— Full investigation for other causes of infertility followed by abdominal microsurgical salpingostomy. Repeated meticulous follow‐up was essential with check laparoscopy one year after surgery.Main outcome measure— Successful pregnancy in relation to tubal damage.Results— In 65 women microsurgery followed tubal reocclusion after failed conventionally performed salpingostomy. 74 women (23%) had one term pregnancy after primary salpingostomy and 12 women (18%) after repeat salpingostomy. Over half the women having a term pregnancy subsequently had a second infant. The tubal damage was classified in four stages according to the degree of mucosal damage and tubal fibrosis, the presence of isthmic disease and the quality of tubal and ovarian adhesions. Approximately one quarter of patients had stage I disease and amongst these 39% had babies after primary salpingostomy and 25% after repeat salpingostomy.Conclusion— Microsurgical salpingostomy is a specialized procedure. Proper selection of patients, competent microsurgical technique and adequate follow‐up appear crucial to success. In selected patients treatment by salpingostomy gives better results than multiple cycles of in vitro fertilization.
Outcomes of referrals to gynaecology outpatient clinics for menstrual problems: an audit of general practice records
Authors: COULTER ANGELA , BRADLOW JEAN , AGASS MARTYN , MARTIN‐BATES CHARLES , TULLOCH ALISTAIR 
Published: August 2005

AbstractObjective— To determine referral rates and intermediate and long‐term outcomes for patients consulting for menstrual disorders and referred by their general practitioner to gynaecology outpatient clinics.Design— General practitioners' records of referrals to outpatient clinics and retrospective audit of general practice notes to determine outcomes.Setting— General practices in the Oxford Regional Health Authority area referring to 19 gynaecology outpatient clinics.Subjects— 205 patients aged 15–59, referred in 1983/4 and follow up in 1988/9.Main outcome measures— Immediate outcomes: the initiation by hospital specialists of investigation, treatment or advice. Five year outcomes: general practice consultation rates and symptom prevalence.Results— Of 18 754 index referrals recorded by 33 practices over a period of 6 months, 2513 (13%) went to gynaecology clinics. Menstrual disorders constituted 21% (n = 539) of the gynaecology referrals; there was more than three‐fold variation between the practices in referral rates. In the 5 years following the index referral, of the 205 audited patients 167 (81%) had been admitted to hospital, 91 (44%) had had a hysterectomy (including 87 (60%) of the 145 patients referred for menorrhagia), 98 (48%) had dilatation and curettage; 25 (12%) received only drug therapy; and 10 (5%) had no active treatment for these symptoms from either the specialist or the general practitioner. Only 29 (14%) had consulted their general practitioners about menstrual problems in the 12 months preceding the audit.Conclusions— Guidelines are needed to assist referral decision‐making. If audit is to be used to promote good practice these guidelines should consider the patients' anxieties and preferences, as well as the most appropriate use of investigations and treatments.
Early amniocentesis: alphafetoprotein levels in amniotic fluid, extraembryonic coelomic fluid and maternal serum between 8 and 13 weeks
Authors: WATHEN NEVILLE C. , CASS PETER L. , CAMPBELL D. JAMES , KITAU MURIEL J. , CHARD TIM 
Published: August 2005

AbstractObjective— The aim was to establish a normal range of alphafetoprotein (AFP) concentrations in amniotic fluid from 8 to 12 weeks gestation, and to determine any difference between AFP levels in amniotic fluid and extraembryonic coelomic fluid.Design and subjects— 150 women had a transvaginal ultrasound guided amniocentesis before termination of an apparently normal first trimester pregnancy. Separately identified samples of amniotic fluid and extraembryonic coelomic fluid were obtained and assayed by radioimmunoassay for AFP.Results— In amniotic fluid, very high levels of AFP were present at 8 weeks, levels falling rapidly up to 10 weeks after which there was a slight rise. Thus over the period 8 to 10 weeks, there was a significant inverse correlation between amniotic fluid AFP and gestational age (r= 0.67; P <0.001). In extraembryonic coelomic fluid, by contrast there was no trend in AFP relative to gestational age.Conclusions— The rapidly changing levels of AFP from 8 to 10 weeks as well as the small volume of the amniotic cavity makes the use of amniocentesis impracticable before 11 weeks gestation. The lack of any relation between AFP levels in amniotic fluid and extraembryonic coelomic fluid emphasises the importance of identifying the site of amniocentesis in the first trimester.
Doppler investigation of uteroplacental blood flow resistance in the second trimester: a screening study for pre‐eclampsia and intrauterine growth retardation
Authors: BEWLEY SUSAN , COOPER DEREK , CAMPBELL STUART 
Published: August 2005

AbstractObjective— To assess the screening properties of a mid‐trimester uteroplacental Doppler scan in a normal unselected population.Design— A cross‐sectional study measuring an averaged resistance index (AVRI) from four sites (left and right uterine and arcuate arteries) with continuous wave Doppler ultrasound.Setting— Routine booking ultrasound, King's College Hospital, London.Subjects— 977 women at 16–24 weeks gestation.Main outcome measures— Intrauterine death, birthweight, pregnancy‐induced hypertension (PIH), antepartum haemorrhage.Results— There was a 96.5% follow‐up. Pregnancies with high AVRI values had a higher prevalence of proteinuric hypertension, placental abruption, small‐forgestational‐age babies, and fetal loss. When AVRI was >95th centile, the overall risk of pregnancy complications was 67%, and the risk of a severe complication was 25%. However, the sensitivity of the test for these complications was only 13% and 21% respectively. The risk for an individual woman with a high AVRI of developing a complication was increased by up to 9.8 times.Conclusion— Although Doppler screening does detect a unifying defect leading to perinatal death, pre‐eclampsia, growth retardation and placental abruption, the predictive values do not yet justify its introduction as a routine test.
Doppler flow velocity waveform analysis in high risk pregnancies: a randomized controlled trial
Authors: NEWNHAM JOHN P. , O'DEA MICHELLE R‐A. , REID KAREN P. , DIEPEVEEN DEAN A. 
Published: August 2005

AbstractObjective— To test whether the introduction of Doppler waveform analysis into the ultrasound department of a tertiary level hospital reduces neonatal morbidity and improves obstetric management.Design— A randomized controlled trial.Setting— Department of Ultrasound, King Edward Memorial Hospital, Perth, Western Australia.Subjects— 505 women with pregnancy abnormalities referred to an ultrasound department for fetal investigation during the third trimester.Intervention— Continuous wave Doppler studies of umbilical and utero‐placental arterial circulations. Results were revealed to patients and clinicians.Main outcome measures— Principal end point was the duration of neonatal stay in hospital; other end points included the number and type of fetal heart rate monitoring studies, obstetric interventions, frequency of fetal distress, birthweight, Apgar scores and need for neonatal intensive care.Results— There was no effect on the duration of neonatal stay in hospital. Small trends in obstetric management were observed with study group patients having fewer contraction stress tests, less likelihood of antepartum fetal distress, and more likelihood of fetal distress after induction of labour leading to emergency cacsarean section. Depressed Apgar scores were more frequent in the study group.Conclusion— Introduction of Doppler waveform studies did not result in reduced neonatal morbidity but did have a small effect on obstetric management. For each institution the role of Doppler studies in late pregnancy will be influenced by the usage of other tests of fetal welfare already entrenched in clinical practice.
(Patho)physiological implications of chronic dietary sodium restriction during pregnancy; a longitudinal prospective randomized study
Authors: STEEGERS E. A. P. , VAN LAKWIJK H. P. J. M. , JONGSMA H. W. , FAST J. H. , DE BOO T. , ESKES T. K. A. B. , HEIN P. R. 
Published: August 2005

AbstractObjective— To study the possible pathophysiological implications of long continued dietary sodium restriction in pregnancy.Design— Longitudinal prospective randomized study of the effects of a low sodium diet compared with unrestricted sodium intake in pregnancy.Setting— Academic Department of Obstetrics and Gynaecology at Sint Radboud Hospital, Nijmegen, The Netherlands.Subjects— 42 healthy nulliparous women.Intervention— A low sodium diet (20 mmol sodium daily) started in the 14th week of pregnancy and stopped after delivery.Main outcome measures— Maternal weight gain, food intake, blood pressure, cardiac output, systemic vascular resistance, haematocrit and birthweight.Results— Total maternal weight gain and dietary energy intake during pregnancy and weight at 1 and 6 weeks postpartum were significantly lower in the low sodium group. Blood pressure during pregnancy did not show major differences. Stroke volume and cardiac output during pregnancy were significantly lower in the low sodium group whereas systemic vascular resistance was significantly higher. Haematocrit values in the low sodium group tended to be lower during pregnancy, but were significantly lower at 1 and 6 weeks postpartum than in the unrestricted group. Placental and birthweights were not significantly different between the two groups.Conclusions— Chronic dietary sodium restriction during pregnancy is characterized by a diminished body fat accumulation and a reduction in circulating volume, due to a decrease in both plasma and red cell volume, in combination with a high systemic vascular resistance without major effects on blood pressure and birthweight.
A new treatment for endometrial cancer with gonadotrophin releasing‐hormone analogue
Authors: GALLAGHER C. J. , OLIVER R. T. D. , ORAM D. H. , FOWLER C. G. , BLAKE P. R. , MANTELL B. S. , SLEVIN M. L. , HOPE‐STONE H. F. 
Published: August 2005

AbstractObjective— To test the antitumour effect of gonadotrophin releasing‐hormone (GnRH) analogues in women with recurrent endometrial cancer.Design— An open phase II observational trial of GnRH analogues. Serial measurements of gonadotrophins, sex hormones and tumour dimensions were made together with repeat biopsy when possible to assess the response to treatment.Setting— The outpatient clinics of the Department of Medical Oncology at The Royal London, Royal Marsden and St Bartholomew's hospitals.Subjects— 17 patients with endometrial cancer which had recurred after surgery, radiotherapy and progesterone treatment and was symptomatic, progressive and assessable for response.Intervention— Monthly subcutaneous injection of GnRH analogue.Main outcome measures— Reduction in serum gonadotrophins and reduction in tumour dimensions.Results— Six out of 17 patients (35%, 95% CI 12.6–58%) achieved a complete or partial remission which continues for a median of 20 months with no adverse effects.Conclusion— GnRH analogues have a significant antitumour effect in recurrent endometrial cancer which warrants further examination in comparison with progestogens.
Patient acceptability of laser and cold coagulation therapy for pre‐malignant disease of the uterine cervix
Authors: GOODMAN J. D. S. , SUMNER D. 
Published: August 2005

AbstractObjective— To determine patient acceptability of cold coagulation and laser treatment for cervical intraepithelial neoplasia (CIN).Design— A prospective study with alternate allocation.Setting— Teaching hospital in London.Subjects— 155 women requiring treatment for CIN.Main outcome measures— Time taken to complete the treatment; visual analogue scores for pain experienced, anxiety felt and acceptability of the procedure; post treatment bleeding and discharge, and follow‐up smear.Results— Cold coagulation treatment was found to be quicker and less painful than laser treatment, there were no other significant differences between the two methods of treatment.Conclusion— Cold coagulation is a more acceptable form of treatment for CIN than laser.
Presence of an oestradiol receptor‐related protein in the skin: changes during the normal menstrual cycle
Authors: FRASER DAVID , PADWICK MALCOLM L. , WHITEHEAD MALCOLM , COFFER ARNOLD , KING ROGER J. B. 
Published: August 2005

AbstractObjective— To investigate the presence of an oestradiol receptor‐related protein (P29) in skin and skin oraganelles, and to assess changes in its content during the normal menstrual cycle.Design— An observational study.Setting— King's College School of Medicine and Dentistry, London.Subjects— Twenty‐one premenopausal women with regular menstrual cycles undergoing gynaecological surgery. They were allocated to proliferative or secretory phases of the menstrual cycle on the basis of menstrual dating and histological examination of an endometrial sample.Interventions— Small full thickness sections of skin (about 5 mm in depth) taken from the anterior abdominal wall at hysterectomy or laparoscopic sterilization.Main outcome measures— The concentration of the oestradiol receptor‐related protein in skin and its organelles was assessed semi‐quantitatively, using a monoclonal antibody technique. The intensity of staining was compared between the proliferative and secretory phases of the cycle.Results— The receptor‐related protein was consistently observed in epidermis, sebaceous glands, hair follicles and sweat ducts; there was no significant difference in its concentration between the proliferative and secretory phases of the menstrual cycle. The protein was not present in dermis and sweat ducts.Conclusions— Epidermis and some skin organelles contain an oestradiol receptor‐related protein and must be considered as oestrogen target tissues. However, the content of this protein does not appear to change significantly during the normal menstrual cycle.