bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of polymorphism of methylene‐tetrahydro‐folate‐reductase with urinary albumin excretion rate in type 1 diabetes mellitus but not with preeclampsia, retinopathy, and preterm delivery
Authors: Lauszus Finn Friis , Grøn Poul Lange , Klebe Joachim G. 
Published: March 2003

Aim. The genetic setting is a potential risk factor for dysfunction of vascular endothelial cells. The prevalence of polymorphism in the methylene‐tetrahydro‐folate‐reductase (MTHFR) gene (677C→T) was evaluated in diabetic pregnancy complicated by preeclampsia, nephropathy, retinopathy, and preterm delivery. The role of hyperhomocysteinemia in microangiopathy in diabetes mellitus has been debated and is mainly seen with reduced activity of the MTHFR gene. A polymorphism in the gene for MTHFR is identified causing this phenomenon.Design. Two hundred and sixty‐eight pregnant women with type 1 diabetes mellitus were recruited. Two hundred and thirty‐three women were successfully analyzed for MTHFR gene polymorphism 677C→T and compared to the incidence of the polymorphism in the background population (n=1084). The pregnancy data charts were reviewed retrospectively.Results. The frequency of the MTHFR polymorphism in the background population was 29% and the heterozygozity 42%. The women with type 1 diabetes mellitus had a higher frequency of the MTHFR polymorphism with 52% heterozygotes and 9% homozygotes than had the background population (heterozygotes, background vs. type 1 diabetes mellitus: χ2=14, df=1, p<0.0002). The odds ratio for heterozygozity of the MTHFR polymorphism was 1.8 (95% Cl: 1.3–2.4) in women with type 1 diabetes mellitus. Women with either micro‐ or macroalbuminuria had a higher frequency of MTHFR polymorphism with 61% heterozygotes and 3% homozygotes than had the background population (heterozygotes: χ2=8.9, df=1, p<0.01). The odds ratio for heterozygozity of the MTHFR polymorphism was 2.3 (95% CI: 1.4–4) in women with type 1 diabetes mellitus.Conclusion. An association was demonstrated between the MTHFR polymorphism and type 1 diabetes mellitus as well as increasing albumin excretion rate in pregnant women.
Factors influencing the decision to use or discard cryopreserved embryos
Authors: Svanberg Agneta Skoog , Boivin Jacky , Bergh Torbjörn 
Published: March 2003

Background. Couples’ reasons for discarding supernumerary fertilized cryopreserved embryos and gender differences in attitudes toward the frozen embryos were investigated among Swedish couples undergoing in vitro fertilization (IVF) at a private clinic. At the time of the study Swedish law stipulated that couples could keep their frozen embryos for a maximum of one year, with the possibility of an extension based on individual requests.Methods. A questionnaire with structured and unstructured questions was sent to 124 women and 124 men who had entered the IVF treatment and obtained supernumerary embryos from 1 January 1994 to 1 March 1995. Eighty‐two women and 74 men completed the questionnaire.Results. After a mean storage time of 25.3 (±11.0) months 22 (26.8%) of the responding couples had their embryos discarded. The reasons were mainly practical, such as a positive outcome of IVF and a legally too short storage time. Comparisons between women and men showed that fewer women (13;17.6%) than men (20;27%) had been uncertain during the IVF treatment about using the frozen embryos at a later date and that men more often than women expressed anxieties about possible effects of the freezing procedure on the potential child (p=0.009).Conclusion. A positive outcome of the original IVF treatment and a short maximum legal time of cryopreservation were the most common reasons why couples discarded their embryos. The men more often than women expressed anxieties about possible effects on a potential child. The results emphasize the need for giving detailed information to the couples about cryopreserved embryos and children born by this method.
Torsion of the previously normal uterine adnexa
Authors: Chen Ming , Chen Chin‐Der , Yang Yu‐Shih 
Published: March 2003

Background. Treatment of adnexal torsion remains a clinical dilemma when future fertility is wanted. The purpose of this study was to evaluate the correlation between the pathological changes and the clinical characteristics on patients having torsion of the previously normal uterine adnexa which may help us decide whether detorsion is worthwhile.Methods. A retrospective study of 69 patients undergoing surgical intervention for adnexal torsion was performed. Among them, 13 patients diagnosed with torsion of the previously normal adnexa were identified. Their clinical and pathological features were compared.Results. Extensive hemorrhagic necrosis of the twisted ovary was observed in five patients, and each of them had their duration of torsion last 48 hours or longer. Three of 13 cases (23.1%) with torsion of the previously normal adnexa had local thrombus formation within the twisted adnexa. Their duration of torsion varied from 18 hours to 288 hours.Conclusions. The likelihood of preserving viable ovarian tissue is significantly decreased if the duration of torsion lasts 48 hours or longer. Local thrombus formation in the twisted adnexa cannot be predicted simply from the duration of torsion.
Induction of labor in women with previous cesarean section using the double balloon device
Authors: Khotaba Samia , Volfson Margaret , Tarazova Lidya , Odeh Marwan , Barenboym Rafael , Fait Vladimir , Ophir Ela , Oettinger Moshe 
Published: March 2003

Background and methods. To evaluate the efficacy and safety of labor induction by the double balloon device in women with previous cesarean section. Induction of labor was carried out in 37 women with previous cesarean section for various indications. All the inductions of labor were performed using the Atad double balloon device (ARD).Results. Cervical ripening (Bishop scores above 5) was achieved in 82.3% of the induced women with subsequent vaginal delivery in 78.6% and repeat cesarean section in 22.3%. An important observation of the results was the chances to achieve a vaginal delivery according to the second Bishop score that was recorded 12 hours following the insertion of the device. When the second was above 5 the chances for vaginal delivery were 79.4%. The mean time from removal of the device to delivery was 10.8 hours. No complications were noted using the device.Conclusions. The double balloon device appears to be a safe and effective method of inducing labor in women with a previous lower segment cesarean section. Wide scale studies and further use of the device for induction of labor in women who have had previous cesarean sections are warranted.
Induced abortion and placenta complications in the subsequent pregnancy
Authors: Zhou Weijin , Nielsen Gunnar Lauge , Larsen Helle , Olsen JØrn 
Published: March 2003

Background. To study the risk of placenta complications following an induced abortion as a function of the interpregnancy interval.Methods. This study is based on three Danish national registries; the Medical Birth Registry, the Hospital Discharge Registry, and the Induced Abortion Registry. All primigravida women from 1980 to 1982 were identified in these three registries. A total of 15,727 women who terminated the pregnancy with a first trimester induced abortion were selected to the abortion cohort, and 46,026 women who did not terminate the pregnancy with an induced abortion constituted the control cohort. By register linkage all subsequent pregnancies were identified from 1980 to 1994. Only women who had a non‐terminated pregnancy following the index pregnancy were selected to the study. Placenta complications were identified using either the Hospital Discharge Registry ICD‐8 codes or the Medical Birth Registry records.Results. A slightly higher risk of placenta complications following an abortion was found. Retained placenta occurred more frequently in women with one, two or more previous abortions, compared with women without any previous abortion of similar gravidity. Adjusting for maternal age and residence at time of pregnancy, the interpregnancy interval, and the number of previous miscarriages (control cohort only), the odds ratios of retained placenta in deliveries of singleton live births in women with one previous abortion was 1.17 (95%CI=1.02–1.35), and for women with two or more previous abortions it was 1.68 (95%CI=1.23–2.30), respectively, compared with the control cohort of similar gravidity. Only for women who had one abortion did the results follow the predicted pattern of a higher risk of retained placenta after a short pregnancy interval. No association with placenta previa was seen.Conclusions. The findings suggest a positive association between abortions and retained placenta in subsequent singleton live births, but the association was weak and confounding cannot be ruled out.
Ultrasonographic monitoring of pregnancies complicated by red blood cell alloimmunization in a cohort with mild to moderate risk according to previous obstetric outcome
Authors: Haugen Guttorm , Husby Henrik , Helbig Ann E. , Schmidt‐Melbye Anne‐Christine 
Published: March 2003

Aim. To evaluate the detection rate of fetal anemia and pregnancy outcome as related to our policy of monitoring pregnancies with red blood cell alloimmunization.Methods. From August 1997 to July 2000 35 pregnant women with maternal red blood cell alloantibodies were monitored by ultrasonographic measurements of the fetal spleen perimeter and peak systolic Doppler flow velocities of the middle cerebral artery, by semiquantification of maternal antibody titers and by general ultrasonographic and clinical evaluation. According to previous obstetric outcome they all had mild to moderate risk of developing fetal anemia.Results. Eleven fetuses were anemic defined as a hemoglobin value ≤ 2SD according to gestational age. A spleen perimeter > + 2SD and a middle cerebral artery peak systolic velocity > 95% prediction interval showed sensitivity and specificity of 64 and 92% and 45 and 100%, respectively. The area under receiver operating characteristic curves was 0.926 (95% CI 0.842–1.000; P < 0.001) for the spleen perimeter and 0.837 (95% CI 0.688–0.987; P < 0.01) for the middle cerebral artery peak systolic velocity. Cordocentesis was performed in one pregnancy only. None of the fetuses developed hydrops and all infants survived. Twelve women delivered before 37 weeks gestation. In 10 patients cesarean section was performed due to possible fetal anemia. Six of the 10 neonates had normal hemoglobin values.Conclusions. The ultrasonographic parameters did not predict all cases of fetal anemia defined as a hemoglobin concentration ≤ 2SD according to gestational age. The present policy of monitoring seemed to reduce the number of invasive tests but possibly increased the number of preterm and cesarean deliveries.
Perinatal complications among ethnic Somalis in Norway
Authors: Vangen Siri , Stoltenberg Camilla , Johansen R. Elise B. , Sundby Johanne , Stray‐Pedersen Babill 
Published: March 2003

Background. The majority of ethnic Somali women in Norway have undergone an elaborate form of circumcision (infibulation). The aim of this study was to examine the risk of perinatal complications among ethnic Somalis and to discuss its relation to circumcision.Methods. We conducted a cross‐sectional population‐based registry study. Data on all births to women born in Somalia (1733) and Norway (702 192) from 1986 to 1998 was provided from the Medical Birth Registry of Norway. We analyzed the risk of perinatal complications among women of Somali origin vs. ethnic Norwegians using univariate and multivariate methods.Results. Perinatal complications were more frequent among women of Somali origin than among ethnic Norwegians. These included induction of labor, fetal distress, secondary arrest, prolonged second stage of labor, operative delivery and perinatal death. Particularly elevated odds ratios were found for fetal distress (odds ratio=2.6, 95% confidence interval (CI); 2.2–3.0), emergency cesarean sections (odds ratio=3.0, 95% confidence interval 2.6–3.4), Apgar scores below seven (odds ratio = 3.1, 95% confidence interval 2.4–4.0) and prelabor fetal deaths (odds ratio=2.5, 95% confidence interval 1.7–3.7).Conclusion. Similar findings in infibulated vs. noncircumcised women have been demonstrated previously in other studies indicating that circumcision could play a role. The current study is the first to be conducted among Somali women in Europe. However, the results are not informative on whether the adverse birth outcomes are caused by infibulation as such or in combination with suboptimal perinatal care, intercurrent diseases and sociocultural factors. Somali women represent a high‐risk group in obstetrics, calling for special attention and care.
Gestational trophoblastic disease: one more risk in adolescent pregnancy
Authors: Uberti Elza M. H. , Diestel Maria Do Carmo F. , Guimarães Fernando E. , Goloubkova Tatiana , Rosa Marcos W. , De Nápoli Gilberto 
Published: March 2003

Background.  An evaluation of the performance of a Referral Center in the diagnosis, treatment and follow up of adolescents with gestational trophoblastic disease.Methods.  In a 13‐year prospective cohort study, between March 1987 and March 2000, 124 adolescents with gestational trophoblastic disease were followed up and/or treated by a multidisciplinary team. Adolescents underwent strict clinical and laboratory control after mole evacuation to guarantee adhesion to follow up, early diagnosis, and prompt treatment of persistent disease. The Student‐Fischer t‐test and the chi‐square test were used for the statistic analysis of the results.Results.  Adolescents represented 21.3% of the 583 patients with gestational trophoblastic disease: 102 (82.3%) had uncomplicated hydatidiform moles, and 22 (17.7%) underwent chemotherapy for persistent gestational trophoblastic disease or a gestational trophoblastic tumor. Complications were diagnosed earlier (p < 0.001) in patients managed and treated at the referral center. Of the adolescents with complications, 81.8% were low risk, 54.5% were at the International Federation of Gynecology and Obstetrics stage I, and 90.9% were treated with chemotherapy only. Time to remission and follow up were shorter for uncomplicated hydatidiform moles (9.8 ± 3.4 weeks and 8.8 ± 1.8 months, respectively) than for persistent disease (16.2 ± 5.8 weeks and 45 ± 24.5 months, respectively). Adhesion to follow up was similar in the two groups (84.2% and 91.8%). To this date, 50% of the adolescents have had one or more gestations, and 82% of these pregnancies were normal.Conclusions.  Adolescents comprise approximately 20% of all gestational trophoblastic disease patients and have high adhesion to follow up. The disease did not affect their reproductive capacity, and chances of a normal subsequent gestation were high.
Disappearance of human chorionic gonadotropin after cesarean section with regard to fetal sex
Authors: Steier Johan A. , Bergsjø Per B. , Myking Ole L. 
Published: March 2003

Background.  To evaluate the influence of gender on the disappearance of human chorionic gonadotropin by cesarean section after fullterm pregnancies.Materials and methods.  Forty‐nine uncomplicated pregnancies: 26 had male (male group) and 23 had female (female group) fetuses.Results.  Before the cesarean section the serum human chorionic gonadotropin levels were higher in the female than in the male bearing pregnancies. After cesarean section the human chorionic gonadotropin levels fell rapidly. The decrease in the human chorionic gonadotropin values was significantly faster in the male than in the female group during the first hours after delivery (2P < 0.02), while no significant difference was seen after 24 and 72 h.Conclusion.  This study shows a significantly faster human chorionic gonadotropin disappearance rate in pregnancies with male compared with female fetuses during the first hours after a cesarean section. This indicates a gender difference, which could be related to different human chorionic gonadotropin molecular structures or to more specific metabolic events.
Individual risk assessment of thrombosis in pregnancy
Authors: Lindqvist Pelle G. , Kublikas Marius , Dahlbäck Björn 
Published: March 2003

Background. Thromboembolic complications during pregnancy are major contributors to maternal death, but there is no reliable way to estimate the absolute risk of thrombosis before the occurrence of a thromboembolic complication.Objective. To create a model for individual estimation of thrombosis risk during pregnancy and to determine the distribution of risk estimates in a series of gravidae.Method and patients. Estimates of absolute risk of pregnancy‐related thromboembolism were calculated by multiplying reported figures of thrombosis incidence by prevalence‐adjusted odds ratios of the following variables: smoking, parity, preeclampsia, mode of delivery, age, overweight, activated protein C resistance (FV Leiden or FV:Q506), thrombosis heredity, and previous thrombosis. We present the risk distribution among a unselected prospectively gathered cohort of 2384 unselected gravidae who were interviewed and tested for activated protein C resistance in early pregnancy.Results and conclusions. A model for individual estimation of the absolute risk of thrombosis is presented, which is provided to the readers as a free automatic Internet‐based service (http://www.riskpreg.com). As compared with antepartum, more women at high risk can be identified in the postpartum period and we suggest that this might be of use in planning the prevention of thrombosis.
Para‐aortic lymph node metastasis in relation to serum CA 125 levels and nuclear grade in endometrial carcinoma
Authors: Ebina Yasuhiko , Sakuragi Noriaki , Hareyama Hitoshi , Todo Yukiharu , Nomura Eij , Takeda Mahito , Okamoto Kazuhira , Yamada Hideto , Yamamoto Ritsu , Fujimoto Seiichiro 
Published: March 2003

Background. To investigate the relationship between preoperative serum CA 125 levels and para‐aortic lymph node (PAN) metastasis as determined by systematic pelvic and para‐aortic lymph node dissection in endometrial carcinoma.Methods. This study included 180 patients (n= 55, premenopausal; n= 125, postmenopausal) with endometrial carcinoma treated by complete surgical staging. Cut‐off values of preoperative serum CA 125 levels for PAN metastasis were determined by receiver characteristic curve (ROC) analysis. Logistic regression analysis was used to determine independent predictors for PAN metastasis.Results. The median serum CA 125 levels of patients with PAN metastasis were significantly higher than the levels of those with no metastasis in both premenopausal and postmenopausal groups. Based on ROC analysis, we could determine four cut‐off values (70 and 210 U/mL for premenopausal patients, 20 and 60 U/mL for postmenopausal patients) and categorize the serum CA 125 levels into low, moderate and high groups. By logistic regression analysis, the CA 125 level and nuclear grade were found to be significant predictors of PAN metastasis, respectively. Using this model, the patients were stratified into three risk groups. The probabilities of PAN metastasis for patients in the low‐risk, intermediate‐risk and high‐risk groups were less than 2%, 2–25% and more than 50%, respectively.Conclusions. Serum CA 125 levels and nuclear grade are important risk factors for PAN metastasis in endometrial carcinoma.
Menstrual diary data and menopausal transition: methodologic issues
Authors: Taffe John , Dennerstein Lorraine 
Published: March 2003

Objectives. To identify problems arising in the analysis of menstrual diary data in a longitudinal study of the menopausal transition, and to propose solutions.Subjects and methods. Menstrual diary information provided by 372 women over a period 7 years is the basis of the study. This paper considers the processes and decisions associated with transforming this information into a form suitable for answering research questions.Results. We decided to use ‘cycle’ as the unit of analysis and to regard spotting‐only episodes as nonmenstrual bleeding. Difficulties in distinguishing between long cycles and gaps because of recording lapses are shown to be related to both the design of the menstrual diary cards and the procedures used by fieldworkers. A new design that should minimize such difficulties is presented. Procedural changes are also proposed.Conclusions. It is important to minimize uncertainty about the meaning of gaps in menstrual diary data, especially in studies of the menopausal transition. Methodologic improvements that can help to achieve this aim include design of diary cards and fieldwork procedures to reduce uncertainty. The design of data entry interfaces to facilitate the checking of raw data and the use of graphs as a diagnostic tool are other important steps.
Hormone replacement therapy with tibolone: effects on sexual functioning in postmenopausal women
Authors: Egarter Christian , Topcuoglu Ata M. , Vogl Sonja , Sator Michael 
Published: March 2003

Objective.  Because hormonal changes in postmenopausal women may be accompanied by sexual problems and a worsening of various aspects of libido, the aim of this study was to assess the effect of tibolone (Liviel®) on sexual life.Methods.  Postmenopausal first‐time users of hormone replacement therapy (HRT) were included in this open, multicenter study. Patients were treated with tibolone 2.5 mg daily for at least 4 months. Both at baseline and after 4 months of treatment, patients were asked to complete two different questionnaires rating the women's subjective assessment of their sexual problems or desires.Results.  One hundred and eighty‐four women were enrolled to receive HRT with tibolone. Overall, a significant increase in women's satisfaction with their sexual lives and a significant improvement in different aspects of libido was found.Conclusion.  Tibolone has beneficial effects on several aspects of sexual life in postmenopausal women. These effects may be due to both an increase in genital blood flow and the central estrogenic/androgenic activity.
Audit of neonatal deaths of nonmalformed infants of 34 or more weeks' gestation: unavoidable catastrophic events or suboptimal care?
Authors: Holt Jan , Fagerli Ingebjørg , Holdø Bjørn , Vold Ingar Nikolai 
Published: March 2003

Background.  The neonatal death rate (death ≤ 28 days/1000 live births) has decreased and the level is now so low that it has been questioned whether further improvement is possible. The aim of this study was to categorize nonmalformed infants of 34 weeks' or more gestational age dying in the neonatal period to analyze if these deaths might have been prevented.Material and methods.  We used the audit method to study neonatal deaths during 1986–98 in a county population of approximately 240 000 inhabitants.Results.  Twenty‐six neonatal deaths from a population of 41 901 live births were analyzed. The neonatal deaths were found to be associated with antepartum hypoxia (six cases); intrapartum catastrophes (seven cases); intrapartum monitoring deficiencies (five cases); resuscitation and stabilization after birth (two cases); infection (one case); sudden infant death syndrome (four cases); and peritonitis (died at home, one case). Suboptimal care was recorded in 16 cases. Neonatal death was unlikely to be associated with suboptimal care in six cases, but in 10 cases suboptimal care might or was likely to have brought about the fatal outcome.Conclusion.  Avoiding suboptimal care might or is likely to prevent neonatal death in 10/26 (38.5%) of nonmalformed infants of 34 weeks' or more gestational age. Such improvements may, however, only slightly influence the neonatal death rate, with a reduction from 4.4 to 4.2/1000 live births.