bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retracted: Randomised controlled trial of the use of human chorionic gonadotrophin in recurrent miscarriage associated with polycystic ovaries
Authors: Malcolm Pearce J. , Hamid Rosol I. 
Published: August 2005

ABSTRACTObjective
To determine whether the use of human chorionic gonadotrophin (hCG) would reduce the recurrent miscarriage rate in women with polycystic ovarian disease.Design
Double‐blind, prospective, randomised controlled trial.Setting
A pregnancy loss clinic in a London teaching hospital.Subjects
One hundred and ninety‐one women with a history of three consecutive spontaneous first trimester miscarriages and polycystic ovary syndrome.Intervention
10000 i.u. of hCG or a placebo were given when the leading follicle was ≥ 21 ram, then 5000 i.u. of hCG or a placebo were given twice weekly until miscarriage or the tenth week of pregnancy.Main outcome measure
Miscarriage rate.Results
Women with polycystic ovaries who received hCG treatment had a lower miscarriage rate (14%) compared with women who received placebo (43%). In women with follicular phase luteinising hormone ≥ 10 iu/1, those who received hCG therapy had a miscarriage rate of 10% compared with a rate of 44% in women who received the placebo. When clomiphene was used for ovulation induction, women treated with hCG had a miscarriage rate of 14% compared with a rate 47 % in women who received the placebo. There was no significant benefit from hCG therapy in natural cycles.Conclusion
The use of hCG in women with recurrent miscarriage and polycystic ovary syndrome improves the pregnancy outcome.
A multicentre randomised trial of amniotomy in spontaneous first labour at term
Authors:   The UK Amniotomy Group
Published: August 2005

ABSTRACTObjective
To measure the effect of a policy of routine amniotomy on nulliparous labour.Design
A multicentre randomised controlled trial.Subjects
One thousand four hundred and sixty‐three nulliparous women in spontaneous labour at term with intact membranes and a single cephalic fetus.Interventions
To have the membranes ruptured routinely early in labour or left intact for as long as possible.Main outcome measures
Duration of labour, operative and instrumental delivery rates, use of analgesia, perinatal death, neonatal convulsions and admission to special care.Results
Median duration of labour was 8.4 h in the early rupture group and 9.4 h in the late group. There was no difference in caesarean section, typical odds ratio (OR) 1.1, 95% CI 0.65–1.8; operative vaginal delivery, OR 1.1, 95% CI 0.83–1.5; use of epidural/spinal, OR 0.92 95% CI 0.72–1.2; use of pethidine, OR 1.0, 95% CI 0.79–1.4; neither method of analgesia, OR 0.96, 95% CI 0.68–1.3; blood transfusion, OR 0.71, 95% CI 0.28–1.8. There was no effect on fetal intubation, OR 1.40 (95% CI 0.78–2.5); admission special care, OR 1.28 (95% CI 0.65–2.5). One fetus in the early amniotomy group had neonatal convulsions, but there were no perinatal deaths.Conclusions
Beyond a modest shortening of labour, a policy of routine amniotomy has little effect on important outcomes and should not be recommended.
Is total abdominal hysterectomy with bilateral salpingo‐oophorectomy adequate for new FIGO Stage I endometrial carcinoma?
Authors: Lin Ho‐Hsiung , Chen Chin‐Der , Chen Chun‐Kai , Chen Chi‐Long , Chow Song‐Nan , Huang Su‐Cheng 
Published: August 2005

ABSTRACTObjective The new FIGO staging for endometrial cancer cases complies with other forms of surgical staging and correlates better with clinical outcomes because it includes prognostic factors. This study was done to investigate whether total abdominal hysterectomy with bilateral salpingo‐oophorectomy (TAH + BSO) is adequate for new FIGO Stage I endometrial carcinoma.Subjects Sixty‐five cases of endometrial carcinoma defined according to the new FIGO Stage Ia (n= 26), Ib (n= 24) and Ic (n= 15) were analysed. They all received TAH + BSO only and were followed up for at least two years.Methods The histologic type, grade, depth of myometrial invasion, lympho‐vascular tumour emboli and tumour size were analysed by t‐test to correlate the risk factors for treatment failure.Results There were no recurrences after TAH + BSO in Ia and Ib cases. However, recurrences occurred in five cases (33 %) of Stage Ic with deep myometrial invasion, high histologic grade, large tumour size and tumour emboli.Conclusions TAH + BSO is inadequate in some Ic cases with a high histologic grade, deep myometrial invasion and tumour emboli. Thus, thorough pre‐operative and intra‐operative staging, adequate operation method and prompt post‐operative adjuvant therapy are indispensable for successful treatment.
First trimester amnifiltration: technical, cytogenetic and pregnancy outcome of 104 consecutive procedures
Authors: Byrne Dominic L. , Penna Leonie , Marks Karen , Offley‐Shore Drbrigid 
Published: August 2005

ABSTRACTObjective To investigate the technical, cytogenetic and pregnancy complications of first trimester amnifiltration for the diagnosis of fetal karyotype.Design Observational study.Setting The fetal medicine unit, UMDS St Thomas' Campus, London.Subjects One hundred and four women seeking prenatal diagnosis of fetal karyotype.Main outcome measures Sampling success, culture rate, harvest time and karyotype, pregnancy outcome and complications.Results Sampling was successful in all 104 cases, but equipment failure forced the procedure to be changed to early amniocentesis in eight (7%) cases. The karyotype was normal in 101 (97%) cases, abnormal in three. The mean harvest time was 14 days (range 9‐26 days; SD = 3.4), and three cultures failed (2.8 %). Pregnancies resulted in 99 (95%) live births, with a mean gestation of 277 days (range 182‐300 days; SD = 16). There was one termination for trisomy 21 and four spontaneous miscarriages (3.8%). Amniotic fluid leakage occurred in six cases (5%), all resulted in live births, five at term and one at 35 weeks.Conclusions This study demonstrates that amnifiltration is technically possible in the first trimester of pregnancy, and that samples can be successfully karyotyped. The harvest time for culture is similar to early amniocentesis and chorion villus sampling. The rate of fetal loss, adjusted by the estimated natural loss, is 1.7%, whch compares favourably with both chorionic villus sampling and early amniocentesis.
The role of a single progesterone measurement in the diagnosis of early pregnancy failure and the prognosis of fetal viability
Authors: Al‐Sebai Mohamed Azmy Hassanein , Kingsland Charles Richard , Diver Michael , Hipkin Leslie , McFadyen Iain Ross 
Published: August 2005

ABSTRACTObjective
To assess the role of a single maternal serum progesterone measurement in the immediate diagnosis of early pregnancy failure and in the long term prognosis of fetal viability.Design
A prospective comparative study of women presenting with vaginal bleeding and abdominal pain in early pregnancy. The comparison group was defined retrospectively as women who presented with abdominal pain without history of, or the subsequent occurrence of, vaginal bleeding and whose pregnancies continued to viability. The study groups were defined retrospectively as threatened‐continuing, non‐continuing (including blighted ovum, missed abortion, incomplete and complete abortion) and tubal pregnancy groups, according to the outcome of the pregnancies.Setting
The emergency room at the gynaecology department of a teaching hospital.Subjects
Four hundred and eighty‐nine women presenting with singleton pregnancy, vaginal bleeding and/or abdominal pain in the first 18 weeks of pregnancy. The comparison group comprised 131 women without vaginal bleeding whose pregnancies continued to viability. The study group comprised 358 women with 148 threatened‐continuing pregnancies, 175 non‐continuing and 35 tubal pregnancies.Interventions
A 10 ml blood sample was taken and pelvic ultrasonography was performed at presentation. Otherwise, conventional management was used.Main outcome measures
Progesterone levels were interpreted in accordance with the outcome of the pregnancy: comparison, threatened‐continuing, non‐continuing or tubal. Viability was defined as 28 weeks or more weeks of gestation.Results
Progesterone levels were significantly lower in the non‐continuing and tubal pregnancy groups than in the comparison and threatened‐continuing groups (P < 0.001 in all cases). A cut‐off level at 45 nmol/l was found to differentiate between the viable (comparison and threatened‐continuing) pregnancies and the abnormal (non‐continuing and tubal) pregnancies with 87.6% sensitivity and 87.5% specificity.Conclusions
A single serum progesterone measurement taken in early pregnancy is valuable in the immediate diagnosis of early pregnancy failure and the long term prognosis of viability.
Does colposcopically directed punch biopsy reduce the incidence of negative LLETZ?
Authors: Denny L. A. , Soeters R. , Dehaeck K. , Bloch B. 
Published: August 2005

ABSTRACTObjective
To evaluate the role of punch biopsy in reducing the occurrence of negative histology provided by large loop excision of the transformation zone in the management of cervical intraepithelial neoplasia.Design
Retrospective review of computerised data base and clinic files.Setting
Colposcopy Clinic, Groote Schuur Hospital, Cape Town, South Africa.Subjects
Two hundred and ninety‐eight women considered suitable for the local outpatient management of cervical intraepithelial neoplasia.Methods
Two groups of patients were identified: group A consisted of women who had cervical intraepithelial neoplasia confirmed colposcopically and who underwent directed punch biopsy; group B consisted of women who had cervical intraepithelial neoplasia confirmed colposcopically and were referred for large loop excision of the transformation zone without confirmatory punch biopsy.Results
In Group A (n= 184) 123 women had cervical intraepithelial neoplasia diagnosed on punch biopsy. Large loop excision of the transformation zone was performed on 116 women and 7 were lost to follow up. The procedure confirmed cervical intraepithelial neoplasia in 95 cases (82%), but there was no cervical intraepithelial neoplasia in 21 cases (18%). Sixty‐one women had negative punch biopsies. Of these, 13 underwent large loop excision of the transformation zone, 31 had persistently negative follow up cytology, and 9 had positive cervical smears of which 7 were treated with large loop excision of the transformation zone, and 8 were lost to follow up. Overall, 25YO of all negative punch biopsies were falsely negative. In group B 114 were treated with large loop excision of the transformation zone and cervical intraepithelial neoplasia was confirmed in 97 cases (85%); one woman had unsuspected microinvasion (1%) and 16 women (14%) had no cervical intraepithelial neoplasia. Negative histology after large loop excision of the transformation zone was not statistically different in groups A and B.Conclusion
Punch biopsy does not reduce the occurrence of negative histology after large loop excision of the transformation zone.
HLA‐G deletion polymorphism and pre‐eclampsia/eclampsia
Authors: Humphrey K. E. , Harrison G. A. , Cooper D. W. , Wilton A. N. , Brennecke S. P. , Trudinger B. J. 
Published: August 2005

ABSTRACTObjective
To investigate a HLA‐G deletion polymorphism in pre‐eclamptic pedigrees and the general population.Design
A population association study of HLA‐G genotypes from pre‐eclamptic/eclamptic patients and control groups.Setting
Analyses undertaken in the School of Biological Sciences, Macquarie University. Patients were from Royal Women's Hospital, Melbourne, and controls were from Westmead Hospital and Macquarie University, Sydney.Subjects
One hundred and ninety‐six individuals, consisting of 29 pre‐eclamptic/eclamptic (PE/E) patients, 13 individuals born of a PE/E pregnancy, 46 blood relatives of PE/E patients, 21 husbands of PE/E patients, 25 women normotensive in first pregnancy, 15 husbands of women normotensive in first pregnancy and 47 staff and students of Macquarie University.Results
Genotypic and gene frequencies were not significantly different in the seven groups examined.Conclusion There is no detectable relationship between susceptibility to pre‐eclampsia or being born of a pre‐eclamptic pregnancy and HLA‐G genotype.
Serum parameters and nuchal translucency in first trimester screening for fetal chromosomal abnormalities
Authors: Zimmermann R. , Hucha A. , Savoldelli G. , Binkert F. , Achermann J. , Grudzinskas G. 
Published: August 2005

Objective
To assess the relation between serum parameters and nuchal translucency in pregnancies affected by fetal aneuploidy in the first trimester.Design
Retrospective study of different serum parameters collected prior to chorionic villus sampling and measurement of nuchal translucency in relation to fetal aneuploidy.Setting
Switzerland (German and Italian sector) and Bregenz, Austria.Population
One thousand one hundred and fifty‐one women aged 25 to 44 years at 10 to 13 weeks of gestation undergoing chorionic villus sampling, mostly for advanced maternal age. Fetal aneuploidy was found in 23 pregnancies including four cases of trisomy 21, five of trisomy 18 and one case of trisomy 13.Main outcome measure
Fetal karyotype, serum levels of free β‐hCG, pregnancy‐associated plasma protein A (PAPP‐A) and alpha‐fetoprotein and the measurement of nuchal translucency.Results
Serum PAPP‐A was decreased in all common chromosomal abnormalities. Free β‐hCG levels were increased in trisomy 21 but decreased in trisomy 18, whereas alpha‐fetoprotein was low in trisomy 21, 18 and other chromosomal abnormalities. Nine of twenty‐three abnormal embryos had evidence of an increased nuchal translucency. Nuchal translucency, however, did not seem to be associated with any alteration in the levels of the biochemical parameters in either chromosomally normal or abnormal embryos. A low serum PAPP‐A or an increased nuchal translucency was seen in two‐thirds of all pregnancies with chromosomal abnormalities.Conclusion
A nuchal translucency 3 mm and depressed serum PAPP‐A levels have a good predictive value in the detection of fetal aneuploidy at 10 to 13 weeks of pregnancy. Serum free 0‐hCG and alpha‐fetoprotein levels may give additional information. An increased nuchal translucency was not‐associated with altered serum parameters. This would allow these different markers to be used in combination.
The suitability of DNA cytometry for the prediction of the histological diagnosis in women with abnormal cervical smears
Authors: van Leeuwen A. M. , Ploem‐Zaaijer J. J. , Pieters W. J. L. M. , Consultant H. Hollema , Burger M. P. M. 
Published: August 2005

Objective
To analyse the suitability of DNA cytometry for predicting the histological diagnosis in women with cervical dyskaryosis.Design
Survey with the use of diagnostic information to revise disease probability.Setting
Colposcopy clinic of a university hospital.Participants
One hundred and ten women with two mildly or moderately dyskaryotic cervical smears and 98 women with one severely dyskaryotic smear.Interventions
DNA cytometric analysis using cytocentrifuge preparations of single cell suspensions from a cervical scrape. The main DNA cytometric parameter was N5C (i.e. the absolute number of cells with a DNA content of more than 5C on a given surface with a predefined cell density).Main outcome measure
The probability of finding CIN II or worse. On arbitrary grounds, a positive test should point to a probability of 85% or higher.Results
In the patients with cervical neoplasia, the value of N5C increased significantly with an increasing CIN grade (P < 0.001). In the patients with one severely dyskaryotic smear and in those with two mildly or moderately dyskaryotic smears, the prior probability of finding CIN II or worse was 94% and 53%, respectively. Therefore, DNA cytometric analysis might be particularly useful in women with mild or moderate dyskaryosis; further analysis was restricted to this group. All of the women in whom the N5C value was higher than 52 were diagnosed as having CIN II or worse. Only 16 (14.5%) of the 110 women had an N5C value of 52 or higher. When the N5C value was 27, the probability of finding CIN II or worse was estimated to be 85%. Only 28 (25%) patients had an N5C value of 27 or higher.Conclusions
DNA cytometry produced significant diagnostic information, as was shown by the relation between N5C and the histological diagnosis. However, the N5C value could not discriminate sufficiently between women with CIN II or worse and CIN I or better. Therefore, the management of individual patients with cytological abnormalities cannot be based on the results of DNA cytometric analysis.
A comparative study of caesarean deliveries by assistant medical officers and obstetricians in Mozambique
Authors: Pereira Caetano , Bugalho Antonio , Bergström Staffan , Vaz Fernando , Cotiro Manuel 
Published: August 2005

Objective
To evaluate the outcome of caesarean delivery performed by assistant medical officers and specialists in obstetrics and gynaecology with particular attention to post‐operative complications.Design
We performed a nonrandomised analysis of 2071 consecutive caesarean deliveries at Maputo Central Hospital. Of these, 958 (46.3%) were performed by assistant medical officers (medical assistants trained for surgery) and the rest (53.7%) by specialists in obstetrics and gynaecology. The age and parity distributions of women in the two groups were almost identical.Setting
University Hospital in Maputo, covering all emergency obstetrics with about 48,000 deliveries per year.Population
Two thousand and seventy‐one consecutive caesarean deliveries.Main outcome measures
Post‐operative complications and the duration of post‐operative hospital stay.Results
There were no differences in the indications for caesarean delivery. The surgical interventions associated with caesarean delivery did not differ in the two groups. The only significant difference was in the group of superficial wound separation due to haematoma, which was slightly more common (0.35%vs 0.05%) in the group operated on by assistant medical officers (Odds Ratio 2.2; 95% Confidence Interval 1.3–3.9)Conclusion
Training selected medical assistants to perform caesarean delivery, even on women in poor general condition, is justified in settings in which doctors are scarce.
Trends and variations in use of antenatal corticosteroids to prevent neonatal respiratory distress syndrome: recommendations for national and international comparative audit
Authors:   Scottish Neonatal Consultants, Collaborative Study Group, International Neonatal Network
Published: August 2005

Objective
In 1990 a meta‐analysis of randomised trials showed 70% lower mortality after antenatal corticosteroid therapy for 24 h or more for infants born before 31 weeks gestation. We investigated whether antenatal corticosteroid therapy has increased in these infants since 1990 and studied variations in use by hospital of birth.Design
Retrospective cohort study in 1601 infants in nine neonatal units.Subjects
Neonatal admissions before 31 weeks of gestation from January 1988 to October 1993.Measure of outcome
Corticosteroids administered for 24 h or more before delivery.Results
Data were obtained in 1579 (99 %) infants. The proportion (range) in each hospital whose mothers had antenatal corticosteroids for 24 h or more was 16 % (0–43) in 1988–89 and 29 % (0–36) in 1990–93 (P < 0.001). In post hoc analyses, 65/347 (20%) births in district hospitals had treatment for 24 h or more compared with 354/1254 (28%) in teaching hospitals (P= 0.001).Conclusions
Antenatal corticosteroid therapy increased but varied by hospital of birth. This may reflect varying performance, or bias from reporting, selection or referral. Ideally, corticosteroid therapy should be compared in women at risk of preterm delivery, but standardising risk or indications for delivery between hospitals and accurate ascertainment presents major difficulties. To minimise selection or referral bias, hospitals should publish, for all mothers delivering between 24 and 33 weeks and 6 days gestation 48 h or more after admission, the proportions treated 1. for 24 h or more (target: > 70%), or 2. at all (target: > 90%).
A comparison of 600 and 200 mg mifepristone prior to second trimester abortion with the prostaglandin misoprostol
Authors: Webster Diana , Penney Gillian C. , Templeton Allan 
Published: August 2005

Objective
To compare the use of 600 and 200 mg mifepristone prior to second trimester termination of pregnancy with the prostaglandin misoprostol.Design
A randomised study. Setting A Scottish teaching hospital.Participants
Seventy women undergoing legal induced abortion between 13 and 20 weeks of gestation.Intervention
Administration of either 600 or 200 mg mifepristone 36 to 48 hours prior to prostaglandin.Main outcome measure
Induction‐abortion interval.Results
The geometric mean induction abortion interval was 6.9 (95 % CI 5.8–8.4) h and 6.9 (95 % CI 5.8–8.2) h in the 600 and 200 mg groups, respectively (no significant difference). The median dose of misoprostol was 1600 pg (three doses) in each group. Analgesic requirements and prostaglandin‐related side effects were similar between groups. Overall, 11‐4% of women required surgical evacuation of the uterus as a result of retained placenta.Conclusions
The dose of mifepristone used in second trimester abortion can be reduced from 600 to 200 mg.
Coagulation and fibrinolysis in smoking and nonsmoking pregnant women
Authors: Mercelina‐Rournans Patricia E. A. M. , Ubachs Johannes M. H. , van Wersch Jan W. J. 
Published: August 2005

Objective
To assess the effects of smoking during pregnancy on coagulation and fibrinolysis.Design
A cross‐sectional study.Setting
A teaching hospital in Heerlen, The Netherlands.Results
Parameters of coagulation activation increased significantly with gestational age. The values presented are median values. Prothrombin fragment 1+2 increased from 0.8 to 25 nmol/l in the nonsmoking group of pregnant women and from 1.0 to 1.8 nmol/l in the smoking group. Thrombin‐antithrombin III (TAT) levels increased from 2.2 to 9.9 μg/l in the nonsmoking group and from 3.1 to 8.5 μg/1 in the smoking group. Parameters of fibrinolysis showed a different picture. Plasminogen levels in both groups rose significantly in the first half of gestation reaching a plateau in the second half. The α2‐antiplasmin levels remained constant in both groups, although the smokers started with significantly higher levels: 119 versus 105 % in the nonsmokers. The D‐dimer levels rose significantly in both groups: from 278 to 847 μg/ml in the nonsmokers and from 215 to 520 μg/ml in the smokers. They were significantly lower in the smoking group from the 11th up to the 40th weeks. The D‐dimer/TAT ratio was significantly higher in the nonsmokers.Conclusions
In smoking pregnant women the activated coagulation process was not counterbalanced by an adequate increase of fibrinolysis which was the case in the nonsmokers.