bluuebunny/crossref_metadata_2025_split huggingface dataset:
Limb reduction defects in South America
Authors: Castilla Eduardo E. , Cavalcanti Denise P. , Dutra Maria G. , Lopez‐Camelo Jorge S. , Paz Joaquin E. , Gadow Enrique C. 
Published: August 2005

ABSTRACTObjective
Limb reduction defects were considered as possible indicators of environmental teratogenesis; it was suggested that also invasive prenatal procedures could increase the risk for limb reduction defects. The purpose of this work is to give a baseline frequency for limb reduction defects, using data from a population not exposed to prenatal diagnosis procedures.Design
Using data collected in the period 1967 to 1992 within the frame of the Latin American Collaborative Study of Congenital Malformations which clinically examined 2,917,074 newborn infants, a total of 1715 with limb reduction defects were found. All cases were classified and analysed in 25 categories. Geographic differences in recorded rates were tested by χ2 for homogeneity. Secular trends were analysed using χ2 test for linear trends.Results
The overall birth prevalence rate of limb reduction defects among liveborn infants was 4.91 (per 10,000 births) (3.05 for isolated and 1.85 for associated cases). For stillbirths, the total prevalence was 2673/10,000 (553 for isolated and 21.20 for associated cases). The inclusion of the brachydactylies increased those figures to 5.55110,000 (3.39 for isolated and 2.16 for associated cases), and 27.42, respectively, (5.53 for isolated and 21.89 for associated cases). When isolated and associated cases were considered together, a geographic heterogeneity was found in pre‐axial limb reduction defects; there was also some heterogeneity for amputations. A maternal age effect was found for the isolated hypoplasias. Standardising by maternal age, the overall prevalence of limb reduction in liveborn infants was 5.66 per 10,000 (95% CI = 5.38–5.93). An increasing trend was suggested by the isolated form of distal amputations which involved hands, feet, or digits.Conclusions
Our data suggest that clustering limb reduction defects in wide groups as transverse and longitudinal may lead to heterogeneous entities. When a possible association is suspected, it would be preferable to present and analyse data in the most discriminant form available. Due to the maternal age effect, it would be advisable to standardise the rates of transversal limb reduction defects by this variable.
Single pre‐delivery symphysis‐fundal height measurement as a predictor of birthweight and multiple pregnancy
Authors: Walraven G. E. L. , Mkanje R. J. B. , van Roosmalen J. , van Dongen P. W. J. , van Asten H. A. G. H. , Dolmans W. M. V. 
Published: August 2005

ABSTRACTObjective
To compare the value of different pre‐delivery maternal indices for predicting birth‐weight, and to examine the usefulness of a single pre‐delivery symphysis‐fundal height measurement for the detection of low birthweight and twin pregnancy or macrosomia.Design
Symphysis‐fundal height measurements were gathered from 1509 women who had both a singleton delivery and available data of pre‐delivery weight, height and mid‐upper arm circumference, and from 73 women who had a twin delivery.Setting
A district hospital in rural Tanzania.Results
Symphysis‐fundal height, pre‐delivery weight and mid‐upper arm circumference, respectively, explain 41%, 13% and 4% of the observed variation in birthweight. At a cut‐off level of 30 cm for symphysis‐fundal height, the detection rate for birthweight below 2500 g and 2000 g was 66% and 68%, respectively, and the false positive rate was 9% and 14%, respectively. At a cut‐off level of 38 cm for symphysis‐fundal height the detection rate for twin pregnancy or birthweight > 4000 g was 76%, and the false positive rate was 4%.Conclusion
Symphysis‐fundal height was a better predictor of birthweight than maternal height, pre‐delivery weight or mid‐upper arm circumference. It seems justified to investigate the value of a simple tricoloured symphysis‐fundal height measuring tape for use in antenatal care in developing countries at village level.
Fatty acid pattern of esterified and free fatty acids in sera of women with normal and pre‐eclamptic pregnancy
Authors: Lorentzen Bjørg , Drevon Christian A. , Endresen Marit J. , Henriksen Tore 
Published: August 2005

ABSTRACTObjective
To determine the composition of esterified and free fatty acids in sera of women with normal and pre‐eclamptic pregnancy.Setting
Department of Obstetrics and Gynaecology, Aker Hospital, Oslo, Norway.Subjects
Blood samples were taken from 510 healthy nulliparae at a gestational age of 17–19 weeks. Nineteen of these subsequently developed pre‐eclampsia. Seventeen of these, for whom blood samples were still available, and a control group of 17 women taken from the same population and matched for age, body mass index, gestational age and parity, were later studied in detail. A further group of 29 women admitted to the hospital with pre‐eclampsia were also studied, as was a matched control group of 29 women with normal pregnancies recruited from the antenatal clinic.Methods
Blood samples were drawn after 8 to 10 h fasting. The patterns of serum free fatty acids and esterified fatty acids were determined by thin‐layer chromatography combined with gas‐liquid chromatography. Free fatty acids were also determined enzymatically.Results
Among the circulating free fatty acids, the levels of palmitic (16:0), oleic (18:1 12–9) and linoleic acids (18:2 n‐6) were significantly higher early in pregnancy in women who later developed pre‐eclampsia. The same free fatty acids were also significantly increased in women with pre‐eclampsia. The level and composition of the esterified fatty acids in phospholipids, triglycerides and cholesteryl esters did not, however, differ between the two groups early in pregnancy. In contrast, in women with pre‐eclampsia, the relative content of oleic acid was increased in the phospholipid fraction, whereas linoleic acid was decreased in the phospholipid and triglyceride fractions.Conclusions
We observed that the level and composition of circulating free fatty acids were already altered 10–20 weeks before the clinical onset of pre‐eclampsia. When the disease became overt there were changes in both esterified and free fatty acids.
Incidence of cervical smears indicating dysplasia among Austrian women during the 1980s
Authors: Kainz Christian , Gitsch Gerald , Heinzl Harald , Breitenecker Gerhard 
Published: August 2005

ABSTRACTObjective
To determine the incidence of cervical smears indicating cervical intraepithelial neoplasia during the 1980s and to compare two quinquennia.Design
A retrospective epidemiologic analysis was performed, based on a large collection of 238261 cervical smears obtained from Austrian women screened between 1980 and 1989. After application of strict epidemiologic criteria to avoid bias of changes in socio‐economic status and methodological changes in cytology, 12604 women were eligible for further analysis. We calculated incidences and relative risks of cytologically indicated cervical intraepithelial neoplasia, comparing the time periods of 1980 to 1984 and 1985 to 1989 for different age cohorts.Results
We found a statistically significant increase in the incidence of cervical cytology indicating cervical intraepithelial neoplasia in the second time period for patients between 21 and 40 years of age. Women older than 40 years showed a significant decrease of this incidence.Conclusions
In Austrian women between the ages of 21 and 40 years an unidentified risk factor or a pattern of risk factors during the period prior to 1985 resulted in an increase of cervical intraepithelial neoplasia during the last years studied. This increasing incidence of cervical intraepithelial neoplasia indicates the importance of regular cytological screening. The significant decrease of the cervical intraepithelial neoplasia incidence in women older than 40 years provides an argument for increasing screening intervals in these women.
Obstetric outcome of Bangladeshi women in East London
Authors: Versi Eboo , Liu Ka Lai , Chia Patrick , Seddon Gaynor 
Published: August 2005

ABSTRACTObjective
To study the obstetric outcome of women of Bangladeshi origin in comparison with the white Caucasian population in East London.Design
A retrospective study of 16718 pregnancies over a five year period (1987–1991). Setting An East London teaching hospital district.Subjects
Six thousand four hundred and sixty Bangladeshi women compared with 7592 white Caucasian women.Main outcome measures
Maternal: antenatal complications; induction and augmentation rates; analgesia and anaesthesia; instrumental delivery and caesarean section rates; third stage complications. Fetal: gestation and weight at birth; perinatal mortality rates.Results
The following statistically significant findings were noted: Bangladeshi women had a longer reproductive age span and were of greater parity including grand multiparity. They suffered fewer antenatal complications except for gestational diabetes. They had lower induction rates and, among the parous group, lower augmentation rates. During labour they required less analgesia but more commonly had general anaesthesia for caesarean section deliveries. They required instrumental delivery less often but there was no difference in overall caesarean section rate for the two groups. However, overall Bangladeshi women had a lower elective caesarean section rate, although parous Bangladeshi women had a higher emergency section rate. In the third stage there were no differences in the complication rates for the nulliparous women, however the parous Bangladeshi women had a higher postpartum haemorrhage rate and a lower perineal repair rate consistent with their higher parity. Whilst preterm births were more common in Bangladeshi women, significant prematurity (less than 28 weeks gestation) was less common. Similarly, although Bangladeshi babies weighed less at birth, they had fewer babies weighing less than 1500 grammes. There was no statistically significant difference in the perinatal mortality rate between the two groups, being 8.1 per thousand births overall. Whilst there was a statistically insignificant decline in death rates over the five‐year period, between the groups there was no consistent difference.Conclusion Pregnant Bangladeshi women in East London constitute a relatively high parity, low risk population who have less obstetric intervention and yet manage an equivalent (or better) perinatal outcome compared to their white Caucasian neighbours.
Perineoplasty compared with vestibuloplasty for severe vulvar vestibulitis
Authors: Bornstein Jacob , Zarfati Doron , Goldik Zeev , Abramovici Haim 
Published: August 2005

ABSTRACTObjective
To evaluate the efficacy of vestibuloplasty (vestibular undercutting without excision) to treat severe vulvar vestibulitis.Design
Prospective randomisation of patients scheduled for surgery to undergo either perineoplasty or vestibuloplasty. Differences in outcome between groups were analysed using Fisher's exact test.Setting
The Vulvar Clinic and referral centre for vestibulitis, Kupath Holim Health System, Department of Obstetrics and Gynaecology, Carmel Medical Centre, Rapapport Faculty of Medicine, Hatechnion, Haifa, Israel.Subjects
Twenty‐one women with vulvar vestibulitis.Results
Vestibuloplasty failed to relieve symptoms in 10 women, while perineoplasty resulted in complete resolution of symptoms in 9/11 women (P < 0–002).Conclusions
The poor outcome of vestibuloplasty, if also reported by other centres, may render it an unacceptable treatment for vulvar vestibulitis. Vestibuloplasty aims to denervate sensitive vestibular tissue, and its failure may suggest that innervation disturbances are not the main cause of the syndrome.
A longitudinal study of the cervix in pregnancy using transvaginal ultrasound
Authors: Cook C‐M. , Ellwood D. A. 
Published: August 2005

Objective
To study longitudinal changes in the cervix during pregnancy using transvaginal ultrasound and secondly, to determine whether the measures used change with gestational age, and whether there are differences between nulliparous and primiparous women.Design
A longitudinal study involving five transvaginal ultrasound examinations of each woman at specified gestational ages from 18 to 30 weeks.Participants
Twenty‐one nulliparous and 20 primiparous women completed the study and were delivered at term. Cervical length, diameter and dilatation were assessed at each examination.Results
In both nulliparous and primiparous women there is no significant change in either cervical length or diameter over the time period studied. In primiparous women the cervix is significantly longer than in nulliparous women (44.4 (5.1) mm versus 40.6 (4.7) mm [mean (SD)]; P 0.001). The cervical diameter in primiparous women is also significantly greater (31.8 (4.0) mm versus 29.0 (3.7) mm; P < 0.001).Conclusions
Cervical length and diameter are constant in both nulliparous and primiparous women throughout this gestational period. The cervix in primiparous women is both longer and thicker than in nulliparous women.
Platelet sensitivity to prostaglandin E1 inhibition is reduced in pre‐eclampsia but not in nonproteinuric gestational hypertension
Authors: Torres Pere Joan , Escolar Ginés , Palacio Montse , Gratacós Eduard , Alonso Pedro L. , Ordinas Antonio 
Published: August 2005

Objective
Platelet aggregometry was used to discriminate platelet sensitivity to prostaglandin E, (PGE.) inhibition, to evaluate whether platelet behaviour in pre‐eclamptic women was different in this respect than from that in nonproteinuric hypertensive women.Methods
The amount of PGE1 required to inhibit in vitro platelet aggregation induced by arachidonic acid was determined in samples from 60 women: 20 nonpregnant controls, 20 women with normal pregnancies, 10 women with gestational hypertension and 10 with pre‐eclampsia.Results
The response to arachidonic acid was similar among the four groups. Amounts of PGE1 necessary to inhibit platelet aggregation were significantly higher in normal pregnant women compared with nonpregnant controls (P < 0.001). Platelets from pre‐eclamptic women required significantly higher concentrations of PGE, to inhibit aggregation than the other groups studied (P < 0.001). However, there was no significant difference between normal and nonproteinuric hypertensive pregnant women.Conclusions
Our findings support the notion that increased platelet reactivity during late pregnancy is exacerbated in pre‐eclamptic women but not in nonproteinuric hypertensive women. This is in agreement with the hypothesis that pre‐eclampsia and gestational hypertension are different conditions. Prospective studies are required to confirm if this simple test may be useful in the early identification of pregnant women at risk for pre‐eclampsia.
Laser doppler‐recorded reactive hyperaemia in the forearm skin during the menstrual cycle
Authors: Bungum Leif , Kvernebo Knut , Øian Pål , Maltau Jan Martin 
Published: August 2005

Objective
By means of laser Doppler flowmetry to describe the changes in resting microvascular perfusion and post‐occlusive reactive hyperaemia in skin of the forearm and finger pulp throughout the menstrual cycle.Design
Prospective descriptive study.Setting
University Hospital of Tromss, Norway.Sample
Fifteen nonsmoking healthy women were studied in the follicular (days 2 to 7) and the luteal (days 19 to 24) phase of the menstrual cycle.Results
Resting perfusion in forearm and finger pulp as well as post‐occlusive reactive hyperaemia in finger pulp were unchanged from the follicular to the luteal phase. The peak perfusion value of the reactive hyperaemic response after 1 min of arterial occlusion was significantly reduced from the follicular to the luteal phase (P < 0.01) in forearm skin. The repayment for the blood flow debt, which is the hyperaemic response in percentage of the ischaemic build‐up, was also reduced (P < 0.01). After 3 min of arterial occlusion, significant reductions in peak post‐occlusive flow (P < 0.01), recovery time, which is the total duration of the hyperaemic response (P < 0.01), and the repayment (P < 001) were observed. A significant correlation was found between the ratio serum oestradiol/progesterone and repayment after 3 min of arterial occlusion in forearm skin (r= 0.71, P < 0.001).Conclusions
Vascular reactivity is altered during the menstrual cycle. In the luteal phase, significant reductions in peak perfusion, repayment and recovery time were seen. The mechanisms behind these findings are unclear, but probably involve changes in both serum oestradiol and progesterone levels.
Women's involvement with the decision preceding their caesarean section and their degree of satisfaction
Authors: Mould T. A. J. , Chong S. , Spencer J. A. D. , Gallivan S. 
Published: August 2005

Objective
To assess the extent to which women contribute to1 the decision for caesarean section and their satisfaction with the decision and procedure.Design
Observational study of women undergoing caesarean section who were interviewed using a standard proforma.Setting
University College Hospital, London.Participants
One hundred and two consecutive women Undergoing caesarean section.Results
The women's perceived reason for the caesarean section agreed with the doctors' reason in 91 cases (89.2%). Only 2/29 women having elective sections stated they had no contribution, compared with 22/73 women having emergency sections (P= 0.018, two‐tailed Fisher's exact test). Twenty out of 29 women (69%) having elective procedures and 37/73 women (51%) having emergency sections recorded medium or more contribution. All women except one were 50% or more satisfied with the decision. Women's satisfaction with the operation was high in the immediate post‐operative period and remained so over the following six weeks. Forty‐three women (49%) said they would prefer an elective section in the next pregnancy given the choice.Conclusions
Women undergoing caesarean section were well informed and took a considerable part in the decision‐making process. This suggests that women's wishes may be playing a role in increasing caesarean section rates. High levels of satisfaction with both the decision and the procedure itself indicate that caesarean section is an acceptable method of delivery, particularly when an elective procedure.
Acid accumulation during end‐stage bradycardia in term fetuses: how long is too long?
Authors: Gull Ilan , Jaffa Ariel J. , Oren Mary , Grisaru Dan , Peyser M. Reuben , Lessing Joseph B. 
Published: August 2005

Objective
To estimate the existence and degree of fetal accumulation of acid during end‐stage bradycardia as reflected by the base deficit. This may set a criterion for proper intervention during labour.Setting
Maternity unit of the Tel Aviv Medical Centre.Subjects
Forty‐three consecutively born term infants whose mothers were delivered by vacuum extraction were analysed 27 because of end‐stage bradycardia and 16 controls whose mothers were delivered electively because of maternal indications.Main outcome measures
Analysis of umbilical arterial cord blood for pH, Pco2, and base deficit. The base deficit was compared between the groups using the two‐tailed Student's t test, and was correlated with variables of fetal heart rate monitoring using the Pearson correlation coefficient.Results
The base deficit was greater in newborns who had end‐stage bradycardia than in controls (11.02 vs 5.01, P < 0.0001). The duration of loss of short term variability in fetal heart rate during end‐stage bradycardia correlated positively with the base deficit (r= 0.8, P < 0.0005). Conversely, the time until the loss of short term variability during end‐stage bradycardia correlated negatively with the base deficit. The length and the depth of the bradycardia and their product, had a weaker correlation with the base deficit.Conclusions
End‐stage bradycardia, which presumably reflects fetal hypoxia, is associated with acidaemia in the umbilical artery at birth in some fetuses. The fetuses who are predisposed to acidaemia, as reflected by an increased base deficit, are those who lost their fetal heart rate variability during end‐stage bradycardia for more than 4 min or started to lose this in less than 3 min from the beginning of the end‐stage bradycardia. Operative vaginal delivery should be reserved for these indications.
A longitudinal study of risk factors for the occurrence, duration and severity of menstrual cramps in a cohort of college women
Authors: Harlow Siobán D. , Park Meekyong 
Published: August 2005

Objective
To describe how menstrual cramps vary from cycle to cycle within a woman over time. To examine the influence of weight and lifestyle factors on occurrence, duration, and severity of menstrual pain.Design
A one‐year prospective menstrual diary study.Participants
One hundred and sixty‐five women aged 17 to 19 years entering a local university in 1985.Main outcome measures
The occurrence, length, and maximum severity of pain during a menstrual period.Results
Menstrual pain occurred during 71.6% of observed menstrual bleeds, most commonly beginning the first day of menses. The median duration was two days. Sixty percent of women reported at least one episode of severe pain, while 13% reported severe pain more than half the time. Earlier age at menarche and long menstrual periods increased the occurrence, duration and severity of pain. In smokers, cramps tended to last longer. Being overweight was an important risk factor for menstrual cramps and doubled the odds of having a long pain episode. Frequent alcohol consumption decreased the probability of having menstrual cramps, but in women who had pain it increased duration and severity. Physical activity was not associated with any pain parameter.Conclusions
Women who have pain lasting three days are an important target group for prophylactic therapy. The occurrence and severity of menstrual cramps is influenced by potentially modifiable characteristics including weight, smoking, and alcohol consumption. Doctors may wish to counsel women presenting with dysmenorrhoea about the importance of healthy lifestyles and about the inefficacy of alcohol consumption as a treatment for dysmenorrhoea.
Nuchal translucency measurements: frequency distribution and changes with gestation in a general population
Authors: Braithwaite Jeffrey M. , Morris Richard W. , Economides Demetrios L. 
Published: August 2005

Objective
To investigate nuchal translucency variation with crown‐rump length (CRL) in the first trimester in normal fetuses.Design
A prospective observational studySetting
Department of obstetrics in a London teaching hospital.Participants
One thousand seven hundred and seven pregnant women (1685 singleton and 22 twin pregnancies) with chromosomally normal fetuses between 9+0 and 14+6 weeks of gestation were recruited sequentially from a dating scan clinic. Nuchal translucency was measured in 94.9% by transabdominal sonography (TAS) and by transvaginal sonography (TVS) if difficulty was encountered with TAS (5.1%). Nuchal translucency measurement was repeated in 136 fetuses: the first scan between between 9+0‐11+6 weeks and the second over 12 weeks of gestation.Results
Of this general population, 4.2% had a nuchal translucency (NT) measurement 2 2–5 mm, but this proportion varied significantly between gestational age groups (P= 0.011). The repeatability coefficients for NT measurements were 0.44 mm and 0.23 mm for TAS and TVS, respectively. The cross‐sectional data demonstrate an increase in nuchal translucency measurement between 9 and 12 weeks of gestation and then a decrease at 13–14 weeks. This relation is best modelled using the quadratic equation: log, (NT) =−1.03 + (0.0314 × CRL) − (2.20 × 10−4× CRL). Longitudinal data confirmed an increase of nuchal translucency measurements with increasing gestation.Conclusion
Nuchal translucency measurements increase significantly with increasing gestation. The use of a single threshold nuchal translucency measurement throughout the first trimester is inappropriate. We propose reference ranges of nuchal translucency measurements with gestation, aiming to improve the performance of nuchal translucency screening for chromosomal abnormalities.