bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative profiles of reliability, cycle control and side effects of two oral contraceptive formulations containing 150 μg desogestrel and either 30 μg or 20 μg ethinyl oestradiol
Authors: ÅKerlund Mats , Rødez Arne , Westergaard Jes 
Published: August 2005

ABSTRACTObjective
To compare two oral contraceptive pills, both containing 150 μg desogestrel, but with either 20 μg (Mercilon®) or 30 μg (Marvelon®/Desolett®) ethinyl oestradiol (EE), regarding reliability, cycle control and side effect profile.Design
A double blind, randomised, multicentre study over one year with follow up after three, six and 12 months. The women noted tablet intake and all bleedings on specifically designed diary cards.Setting
University clinics, central hospitals and private gynaecological practices in Norway, Sweden and Denmark.Subjects
One thousand women aged 18 to 40 years requesting oral contraceptive pills.Main outcome measures
Reliability, cycle control, side effects, blood pressure, body weight and haemoglobin.Results
In a total of 4543 cycles with the 20 μg EE dose pill and 4688 cycles with the 30 μg EE dose pill, the number of pregnancies ascribed to method failure were 0 and 2, respectively. Irregular bleeding (breakthrough bleeding or spotting) was signficantly more frequent with the 150/20 combination in about two‐thirds of the cycles randomly distributed over the one year of the study. Mean blood pressure decreased slightly, particularly in the group on the 150/20 combination (about 1 mmHg), whereas mean body weight increased approximately 0.5 kg in the group with the 150/30 combination after 12 months. Haemoglobin did not change. Side effects other than bleeding problems were rare, but dizziness and mood changes were more frequent in the group on the 150/20 combination. Due to side effects, more women on the 150/20 combination discontinued the study during the one to three and four to six month periods, and women on this pill were also less positive about continuing the study drug at the end of the trial.Conclusions
Both pills have high contraceptive reliability and are well tolerated, but with the 150/20 combination the cycle control is less effective. However, in view of the potentially increased safety profile of the 150/20 combination, many women can be expected to accept some additional discomfort due to irregular bleeding.
Pregnancy after renal transplantation: 25 years experience in Spain
Authors: Cararach V. , Carmona F. , Monleón F. J. , Andreu J. 
Published: August 2005

ABSTRACTObjective
To study the outcome of pregnancy in renal transplant patients in Spain.Design
A retrospective review based on two consecutive national inquiries.Setting
Departments of Obstetrics and Gynaecology and Renal Transplant Units in Spain.Subjects
Pregnant women who had renal transplants between 1965 and 1989.Main outcome measures
From the preliminary inquiry the frequencies of miscarriage, therapeutic abortion, preterm birth, fetal malformation, twins, stillbirths, neonatal deaths and loss of maternal renal function were recorded. The subsequent, more detailed inquiry provided additional information including donor type, previous rejection episodes and interval between rejection and pregnancy, previous creatinine level, previous hypertension and development of hypertension in pregnancy, developments during labour and delivery and the occurrence of intra uterine growth retardation and low birth weight.Results
The preliminary inquiry yielded information about 133 pregnancies. The miscarriage rate was 10% and the therapeutic abortion rate was 16%. Of the 99 pregnancies that continued, 46% ended before term and 53% progressed to term. The perinatal mortality rate was 107.8 per 1000 and 4% of the infants had minor congenital malformations. The second inquiry yielded more detailed data about 66 pregnancies. There were no therapeutic abortions and 12% of the pregnancies ended in miscarriage. Among the 58 pregnancies that reached 28 weeks gestation, preterm birth occurred in 28 (48%) and intra uterine growth retardation occurred in 17 (29%). Among 48 women with normal renal function before pregnancy, the perinatal mortality rate was 68 per 1000, the miscarriage rate was 8% and in 10 of these women (21%) renal function was impaired after pregnancy. In constrast, among 18 women with impaired renal function before pregnancy, the perinatal mortality rate was 142 per 1000, the miscarriage rate was 22% and in six of these women (33%) renal function deteriorated after the pregnancy. Impairment of renal function was most common in women with hypertension during pregnancy or with rejection episodes during the year before conception.Conclusions
Women with a renal transplant can have a successfull pregnancy, but there are definite risks for both mother and fetus. Pregnancy should be discussed with the woman and encouraged only if there is good renal graft function.
Findings on lipid peroxidation and antioxidant function in hypertensive complications of pregnancy
Authors: Uotila J. T. , Tuimala R. J. , Aarnio T. M. , Pyykkö K. A. , Ahotupa M. O. 
Published: August 2005

ABSTRACTObjective
To assess lipid peroxidation and antioxidant function in hypertensive complications of pregnancy.Design
Cross sectional study comparing pre‐eclamptic and control patients.Setting
Tampere University Hospital, Finland.Subjects
Twenty healthy women with normal, uncomplicated pregnancy; 23 women with severe pre‐eclampsia; 20 women with mild pre‐eclampsia; and 13 women with pregnancy‐induced hypertension.Main outcome measures
Conjugated dienes; tiobarbituric acid—reactive material or malondialdehyde (MDA); fluorescent chromolipids (FCL); glutathione peroxidase (GSHPx); selenium; uric acid; and vitamin E.Results
Lipid peroxidation assessed by the appearance of conjugated dienes and malondialdehyde was significantly increased in the hypertensive patients as compared with control patients. Lipid peroxidation products also showed high correlation to the level of blood pressure, but failed to show significant relation to the outcome of the fetus. The activities of erythrocyte and plasma glutathione preoxidase were increased in severe pre‐eclampsia, and high levels of plasma or platelet glutathione peroxidase were found to have some association with fetal growth retardation or asphyxia.Conclusions
Our findings give support to those few studies considering lipid peroxidation as an important factor in the pathogenesis of pre‐eclampsia. The rise in antioxidants is probably of compensatory nature responding to the increased peroxide load in pre‐eclampsia and may reflect the severity of the disease.
Breech delivery in very preterm and very low birthweight infants in the Netherlands
Authors: Gravenhorst J. Bennebroek , Schreuder A. M. , Veen S. , Brand R. , Verloove‐Vanhorick S. P. , Verweij R. A. , van Zeben‐van der Aa D. M. , Ens‐Dokkum M. H. 
Published: August 2005

ABSTRACTObjective
To study the relation between various perinatal factors and the sequelae of very preterm birth, applying logistic regression analysis.Design
In a nationwide collaborative study in the Netherlands, perinatal and follow up data were collected on 899 liveborn singleton nonmalformed infants with gestational age less than 32 weeks or birthweight less than 1500 g born in 1983.Main outcome measures
Neonatal mortality rate and total handicap rates (minor and major) in surviving children at two years and five years of age.Results
Comparing breech with vertex presentation, the odds ratio for neonatal mortality (adjusted for duration of pregnancy, birthweight, maternal hypertension and prolonged rupture of membranes) is 1.6 (P<0.05). Comparing abdominal versus vaginal delivery, the odds ratio indicates equal risks. When breech and vertex presentation are analysed separately it appears that breech presenting infants have a significantly lower mortality risk when born by caesarean section compared with vaginal delivery. However, comparing abdominal versus vaginal delivery in breech presentation, the odds ratio for handicap at five years (0.9) is not significantly different from 1.Conclusion
The data presented suggest a reduced neonatal mortality rate in breech presenting infants born by caesarean section but because of the observational design of the study the statistical analysis described only identifies a possible trend and cannot prove the issue.
Evaluation of six markers of haemostatic system in normal pregnancy and pregnancy complicated by hypertension or pre‐eclampsia
Authors: Cadroy Yves , Grandjean Hélène , Pichon Josiane , Desprats Roland , Berrebi Alain , Fournié Alain , Boneu Bernard 
Published: August 2005

ABSTRACTObjective
To establish the plasma evolution of prothrombin fragments 1+2 (F1+2), thrombin–antithrombin III complexes (TAT), fibrin fragment D‐Dimers (DD), von Willebrand factor antigen (vWf), Type 1 plasminogen activator inhibitor antigen (PAI) and blood platelet count during normal pregnancy and to compare these values with those obtained in hypertensive or pre‐eclamptic pregnancies.Design
Cross‐sectional study.Subjects
Forty‐seven healthy pregnant women with gestational age ranging between 5 and 40 weeks, and fourteen women with gestational age ranging between 25 and 38 weeks presenting with either gestational hypertension (n= 4) or pre‐eclampsia (n= 10). Numbers of nulliparous women in the control, hypertension and pre‐eclampsia groups were 13/47 (28%), 1/4 (25%) and 9/10 (90%), respectively.Results
All six markers increased with gestational age in normal pregnant women (P<0.01). Using the upper limit of 95% prediction interval obtained from regression curves as normality threshold, TAT showed the best sensitivity (71%vs <30% for F 1+2, DD, vWf, PAI and platelet count).Conclusion
TAT appears to be an interesting marker for detecting haemostatic system alterations in pregnancies complicated by hypertension or pre‐eclampsia. A large prospective study to determine its clinical usefulness for such complicated pregnancies is currently in progress.
Biparietal diameter and crown‐rump length in fetuses with Down's syndrome: implications for antenatal serum screening for Down's syndrome
Authors: Wald N. J. , Smith D. , Kennard A. , Palomaki G. E. , Salonen R. , Holzgreve W. , Pejtsik B. , Coombes E. J. , Mancini G. , MacRae A. R. , Wyatt P. , Roberson J. 
Published: August 2005

ABSTRACTObjectives
1. To compare the ultrasound biparietal diameter and crown‐rump length of fetuses with and without Down's syndrome in the first half of pregnancy; 2. To investigate the effect of estimation of gestational age using either measure on the detection rate of serum screening for Down's syndrome.Design
Matched case‐control study. Cases were singleton Down's syndrome pregnancies with a biparietal diameter or a crown‐rump length recorded. Five controls were matched to each case on: medical centre; the date of the ultrasound scan examination (within two years); gestational age measured as the number of days since the first day of the last menstrual period; and the ultrasound measure used (ie the biparietal diameter (the measure of choice), or the crown‐rump length otherwise). If a woman had a serum screening test for Down's syndrome, the biparietal diameter or crown‐rump length measurement had to be taken prior to the screening test so that the result of the test could not influence whether a scan was performed.Setting
Ten antenatal screening centres in seven countries in Europe and North America.Subjects
Two hundred and one women with singleton Down's syndrome pregnancies and 1005 women with unaffected singleton pregnancies.Results
The median biparietal diameter of fetuses with Down's syndrome was identical to that among the controls (median difference 0.0mm, 95% confidence intervals (CI)–0.5 to 0.5mm). The estimates of gestational age based on biparietal diameter yielded a median gestational age less than that based on the women's last menstrual period: three days less for cases and two days less for controls; small but statistically significant differences probably reflected a minor systematic difference in the conversion of a biparietal diameter to a gestational age estimate. The median crown‐rump length of fetuses with Down's syndrome was also identical to that among controls (median difference 0.0mm, 95% CI–1.5 to 2.0 mm). There was no significant difference between the median gestational age estimate based on crown‐rump length and that based on the women's last menstrual period.Conclusion
In antenatal screening for Down's syndrome the routine use of an ultrasound biparietal diameter or crown‐rump length measurement to estimate gestational age will not adversely affect the detection rate. To avoid differences in gestational age estimates using the last menstrual period and the biparietal diameter influencing screening performance, separate medians should be derived for each serum marker using the two methods of estimating gestational age. The appropriate set of medians can then be used to calculate the multiple of the median value for each woman screened depending on the method used to estimate her gestational age.
Transient diabetes insipidus and acute fatty liver of pregnancy
Authors: Kennedy Suzanne , Hall Pauline de la M. , Seymour Anthony E. , Hague William M. 
Published: August 2005

ABSTRACTObjective
To review the association of transient diabetes insipidus and acute fatty liver of pregnancy.Design
A retrospective study.Setting
Six women presenting with polyuria and polydipsia in the third trimester or in the immediate postpartum period, referred over a two and a half year period; five out of six were primigravida. All had raised liver transaminases and biopsy‐proven acute fatty liver of pregnancy. Four out of six also had pre‐eclampsia.Subjects
Tertiary referral centre.Main outcome measures
There were no maternal deaths and only one fetal death. Desamino‐cys‐1‐D‐arg‐8‐vasopressin administration produced a reduction in urine output in all five women to whom it was administered. In all cases symptoms had resolved by the end of the fourth postpartum week. Three of the women have had subsequent pregnancies uncomplicated by either transient diabetes insipidus or acute fatty liver of pregnancy.Conclusions
The association of transient diabetes insipidus and acute fatty liver of pregnancy appears more common than previously recognised. Both may be part of the spectrum of pre‐eclampsia.
Specificity of antenatal ultrasound in the Yorkshire Region: a prospective study of 2261 ultrasound detected anomalies
Authors: Brand Ian R. , Kaminopetros Petros , Cave Mairead , Irving Henry C. , Lilford Richard J. 
Published: August 2005

ABSTRACTObjective
To evaluate the specificity of the ultrasound diagnosis of fetal anomalies. Pregnancies which proceeded to termination and ultrasound‐diagnosed fetal anomalies which were not offered termination were considered.Design
Prospective, region‐wide study over three and a half years.Setting
Cases were identified through 25 ultrasound departments representing the 15 districts in the Yorkshire Region.Subjects
Pregnant women with an ultrasound‐diagnosed fetal anomaly.Main outcome measures
Information obtained from the ultrasound report was compared with the outcomes determined by cytogenetics, postmortem or paediatric examination.Results
Of 2261 pregnancies with an ultrasound‐diagnosed fetal anomaly 369, (16%) were terminated and 357 (97%) were followed by postmortem examination. Ultrasound findings exactly matched those of the postmortem or were accompanied by additional anomalies in 325 cases (91%). In 32 cases ultrasound findings were not confirmed by postmortem, but in 30 of these the decision to offer termination remained justified because the correct diagnosis was judged equally or more serious. Two (0.5%) were terminated for an anomaly which subsequently proved less severe than predicted on ultrasound. Ultrasound significantly over‐or under‐diagnosed a major fetal anomaly in 27 of the 1139 (2.4%) cases in which an anomaly was detected, but the pregnancy was not terminated.Conclusion
Termination of pregnancy was based on the correct prognosis in over 99.5 % of cases. This does not obviate the need for pathological examination of the fetus which changed or refined the diagnosis in 35 % of cases.
Fetal immunological and haematological changes in intrauterine infection
Authors: Thilaganathan Baskaran , Carroll Steve G. , Plachouras Nicholas , Makrydimas George , Nicolaides Kypros H. 
Published: August 2005

ABSTRACTObjective
To study fetal immunological and haematological changes to intrauterine infection.Design
In 37 pregnancies at risk of intrauterine infection, fetal blood obtained by cordocentesis at 20 to 36 weeks gestation was used for differential leucocyte counts, platelet count, enumeration of lymphocyte subpopulations, and neutrophil adhesion receptor expression.Setting
Harris Birthright Research Centre for Fetal Medicine, London.Results
All four fetuses with viral infections had platelet counts below the 5th centile and three had natural killer (NK) cell counts greater than the 95th centile of the normal range. Similarly, all five fetuses with bacterial or candidal infection had neutrophil counts greater than the 95th centile of the normal range; lymphocyte subpopulations were normal.Conclusions
In pregnancies complicated by intrauterine infection, fetuses exhibit NK cell lymphocytosis and thrombocytopenia in response to viraemia, and neutrophilia in response to bacteraemia from at least 21 weeks gestation.
The dose–response of percutaneous oestradiol implants on the skeletons of postmenopausal women
Authors: Studd John W. W. , Nigel Holland E. F. , Leather Andrew T. , Smith Roger N. J. 
Published: August 2005

ABSTRACTObjective
To determine whether there is a dose‐iresponse effect of percutaneous oestradiol implants on the skeletons of postmenopausal women using a range of doses available in clinical practice.Design
One year randomised study.Subjects
Forty‐five postmenopausal women who requested oestrogen replacement therapy were randomised to receive 25 mg, 50 mg, or 75 mg oestradiol implants. The bone mineral density changes were compared with a control group of 15 untreated women.Main outcome measures
Dual energy X‐ray absorptiometry using Hologic 1000 QDR before treatment and after one year of treatment. Plasma oestradiol and follicle stimulating hormone levels before treatment and after one year.Results
There were significant correlations between the plasma oestradiol levels and the percentage increase in bone density at the lumbar spine, the total hip, the femoral neck, and the trochanter. The median (range) plasma oestradiol level was 327 pmol/1 (114–853) in the 25 mg group, 358 pmol/1 (220–957) in the 50 mg group and 518 pmol/1 (167–828) in the 75 mg group. Three women who lost a significant amount of bone from the clinically relevant sites in the 25 mg oestradiol group all had plasma oestradiol levels below 300 pmol/1. None of the women in either the 50 mg or 75 mg oestradiol groups lost bone from these sites.Conclusions
Oestradiol implants resulted in a wide range of circulating oestradiol levels with each of the doses used. There was a significant relation between plasma oestradiol levels and the increases in bone density at both the lumbar spine and the proximal femur. None of the women lost bone density at the clinically important sites of the spine and femoral neck if their plasma oestradiol levels were above 300 pmol/1.
Factors potentiating the smoking‐related risk of fetal growth retardation
Authors: Spinillo Arsenic , Capuzzo Ezio , Nicola Sabrina E. , Colonna Laura , Egbe Thomas O. , Zara Carlo 
Published: August 2005

ABSTRACTObjective
To estimate the risk of fetal growth retardation resulting from the interaction between maternal smoking during pregnancy and other recognized risk factors.Design
Case‐control study of prospectively recorded data.Setting
Department of Obstetrics and Gynaecology, University of Pavia, Italy.Subject
Three hundred and forty‐seven singleton pregnancies with diagnosis of fetal growth retardation and 694 control pregnancies with appropriately grown fetuses.Results
The overall odds ratio for fetal growth retardation associated with maternal smoking was 2.87 (95% confidence interval, 2.17–3.80). In logistic models the factors which independently increased the smoking‐related risk of fetal growth retardation were a male fetus, nulliparity, maternal age 20 years or less, a history of first trimester haemorrhage and low (less than 50 kg) pre‐pregnancy weight. The combined effect of smoking and caffeine consumption on the risk of fetal growth retardation was found to be additive rather than multiplicative.Conclusions
Several factors can affect the risk of fetal growth retardation associated with maternal smoking. The prenatal identification of these factors could help detect subgroups of women at high risk of fetal growth retardation.
Evaluation of an antenatal HIV testing programme in an inner London health district
Authors: Hawken Jennifer , Chard T. , Jeffries D. J. , Costeloe Kate , Grant K. , Ward F. , Hudson C. N. 
Published: August 2005

ABSTRACTObjective
To study an antenatal human immunodeficiency virus (HIV) testing programme in an inner London health district.Design
A standardised research interview was given to women in the first half of pregnancy and the findings were compared with those of the routine clinical interview. The observations were analysed in relation to the results of HIV antibody testing, either attributable by consent or anonymously, in these women.Setting
The Homerton Hospital, London.Subject
Three thousand seven hundred and twenty‐nine women, of whom 1696 (45.5%) consented to testing.Results
Four women who had consented to testing had a positive result. Amongst the 2033 women (54.5 %) who declined the test, four (or five) had a positive result. The number of risk factors ascertained by the research study interview was substantially greater than that elicited by the preceding routine interview. In addition, more information was obtained by a routine computer interview than by its unstructured equivalent. There was no obvious association between the presence of a risk factor and whether or not the women had consented to the test.Conclusions
Our formal voluntary testing programme detected nearly 44 % of HIV seropositive individuals. Thus, there were four known positives during the study period against a total of nine detected by anonymous testing. Since all the known positive results in the study were associated with recognised risk factors, there is some doubt as to the value of a universal testing programme. However, if testing is to be based upon the existence of a risk factor elicited at the booking history, then the deficiencies in this history revealed by the present study need to be corrected.