bluuebunny/crossref_metadata_2025_split huggingface dataset:
Induction of abortion in early first trimester human pregnancy using epostane
Authors: WEBSTER MICHAEL A. , GILLMER MICHAEL D. G. 
Published: August 2005

SummaryThe role of epostane (Sterling Winthrop, Guildford, UK), a competitive inhibitor of the 3β hydroxysteroid dehydrogenase enzyme system (3β‐HSD), as an abortifacient agent in early human pregnancy has been studied in 54 women. All were less than 49 days from their last menstrual period. Thirty were treated with 200 mg of epostane every 8 h for 7 days and 24 were given 200 mg every 6 h for 7 days. This caused a sustained reduction in circulating progesterone concentrations, a smaller fall in 17 β‐oestradiol and no effect on serum cortisol. Abortion occurred in 21 women (70%) in the lower dosage group and in 20 women (87%) in the higher dosage group. Abortion was incomplete in 6 of these 41 women. A worsening of pregnancy nausea and vomiting was noted by 66% of women in the first group and 84% in the second. There was no delay in the resumption of normal menstruation following abortion. This study confirms the potential of epostane as an effective inhibitor of ovarian and placental steroidogenesis and as a potent abortifacient agent in early human pregnancy.
Absorption of irrigating fluid during laser photocoagulation of the endometrium in the treatment of menorrhagia
Authors: MORRISON L. M. M. , DAVIS J. , SUMNER D. 
Published: August 2005

SummaryTwelve women undergoing laser ablation of the uterus for menorrhagia were studied by haemodynamic, biochemical and haematological indices including radioisotope dilution studies of plasma volume to assess the degree of fluid absorption into the circulation during laser surgery. There was a significant rise in central venous pressure and serum chloride and a significant decrease in plasma protein, albumin and haematocrit. Absorption of the irrigating fluid used was demonstrated and in one woman whose case history is illustrated this was excessive.
The excretion of 5‐oxoproline in urine, as an index of glycine status, during normal pregnancy
Authors: PERSAUD C. , McDERMOTT J. , DE BENOIST B. , JACKSON A. A. 
Published: August 2005

SummaryThe urinary excretion of 5‐oxoproline, which may be used as an index of glycine status, was investigated in 30 normal pregnant women during different stages of pregnancy and in 18 non‐pregnant female volunteers. During an 18‐h study there was little variation in the 5‐oxoproline/creatinine index, and a single sample gave a representative value. The excretion of 5‐oxoproline/creatinine (μmol/mmol) rose progressively as pregnancy advanced (non‐pregnant mean 10, SD5, first trimester mean 46, SD 12, second trimester mean 150, SD 180, and third trimester mean 280, SD 320) and by the third trimester was over 20 times greater than in non‐pregnant women. The data suggest that as pregnancy advances the endogenous production of glycine may be insufficient to satisfy the increasing demands.
Prostaglandin E production by the fetal membranes in unexplained preterm labour and preterm labour associated with chorioamnionitis
Authors: BERNAL A. LÓPEZ , HANSELL D. J. , KHONG T. Y. , KEELING J. W. , TURNBULL A. C. 
Published: August 2005

SummaryThe production of prostaglandin E (PGE) by amnion, choriodecidua and placenta was measured in 45 women delivered after spontaneous preterm labour, in 10 women delivered electively preterm, in 30 women at elective caesarean section at term, and in 28 women after spontaneous labour at term. In the preterm labour group 24 women had normal placental histology, and gestational age was 34 (31–36) weeks (median and range); 18 women had evidence of chorioamnionitis and gestational age was significantly shorter, 30 (24–36) weeks; three other patients had placental abruption. In the absence of inflammatory infiltration of these tissues the highest PGE output (fmol/mg dry weight/2 h) was found after labour at term and the lowest after uncomplicated preterm labour: 2640 (360–15 580) (median and range) compared with 1414 (164–11 045) in amnion, 677 (100–3245) compared with 308 (39–1086) in choriodecidua, and 1200 (520–3022) compared with 578 (150–1859) in placenta, respectively. Tissues showing chorioamnionitis produced much higher outputs of PGE from amnion (12278, 1799–82 617) and from choriodecidua (1018, 216–11 768), but not from placenta (616, 89–4131). Chorioamnionitis seems to cause very early preterm labour by increasing PG production in the amnion and choriodecidua.
Alternative positions in the second stage of labour: a randomized controlled trial
Authors: GARDOSI JASON , SYLVESTER SHARON , B‐LYNCH CHRISTOPHER 
Published: August 2005

SummaryA controlled clinical trial involving 151 primigravidae and 18 midwives assessed the acceptability and outcome of second‐stage labour in upright positions. Women who had no specific antenatal preparation and preferences regarding labour positions were managed either conventionally (semi‐recumbent and lateral), or encouraged to adopt upright positions (squatting, kneeling, sitting or standing) according to individual preference. Of the women allocated to the upright position 74% completed the second stage upright, with kneeling being the most favoured position, but squatting was, despite all assistance, too difficult to maintain. Adoption of upright positions resulted in a higher rate of intact perineums. There was a clinically apparent reduction of forceps deliveries in the upright group which influenced midwives' attitudes. Moving the parturient from recumbent to upright positions was often perceived to be beneficial when there was slow progress. Estimated blood loss was similar in the two groups, as was the condition of the newborn (Apgar score and umbilical artery pH). Alternative positions in the second stage of labour, in particular kneeling, are achievable even without specific birth aids and antenatal preparation. They appear safe, acceptable to most parturients and their midwives, and arc easily integrated into modern labour ward practice; they may have clinical advantages which need further investigation.
The effect of anorexia nervosa on skin thickness, skin collagen and bone density
Authors: SAVVAS M. , STUDD J. , MONIZ C. , BRINCAT M. , TREASURE J. , FOGELMAN I. 
Published: August 2005

SummaryThe effects of anorexia nervosa on skin thickness, skin collagen content and bone density were investigated in a cross‐sectional study of 36 women with anorexia nervosa with a 4‐year median duration of amenorrhoea and compared with a group of 33 women of comparable age without anorexia and with normal periods. The median skin thickness, assessed radiologically, was significantly reduced (P<0·01) from 0·88 mm in the comparison group to 0·70 mm in the anorectic group and the median collagen content was significantly reduced from 209 μg/mm2 in the comparison group to 164 μg/mm2 in the anorectic group (P<0·05). The median bone density in the comparison group was 0·93 gHA/cm2 at the lumbar spine and 0·84 gHA/cm2 at the proximal femur. These values were greatly reduced in the women with anorexia nervosa to 0·77 gHA/cm2 and 0·65 gHA/cm2 respectively (P<0·01). Our findings confirm the loss of bone mass with anorexia and demonstrate the coexistent loss of skin thickness and skin collagen content. This association supports the hypothesis that a generalized loss of collagen is a major factor in the causation of osteoporosis following oestrogen deficiency.
Melanoma and pregnancy: a long‐term follow‐up
Authors: McMANAMNY D. S. , MOSS A. L. H. , BRIGGS J. C. , POCOCK P. V. 
Published: August 2005

SummaryTreatment of the pregnant woman with melanoma is contentious. With the aid of a computerized melanoma register, in which pregnancy data can be recorded, 290 women with melanoma were reviewed (249 alive and 41 dead). Overall, 23 patients were pregnant at ithe time of diagnosis of melanoma, and another 23 became pregnant at some time after primary treatment of a melanoma. Pregnancy appears to have no significant influence on the survival of patients with melanoma J but it is recommended that pregnancy should be avoided for the first three years following excision of a melanoma.
Comparison of the Foley catheter and dinoprostone pessary for cervical preparation before second trimester abortion
Authors: HACKETT G. A. , REGINALD P. , PAINTIN D. 
Published: August 2005

SummaryThe Foley catheter and a 3 mg dinoprostone pessary (Prostin E2) were compared as methods for cervical preparation before second trimester dilatation and evacuation. The catheter was well tolerated and provided significantly greater change in cervical dilatation and improved cervical compliance. The Foley catheter would seem to provide a readily available and efficacious means of cervical preparation.
Second trimester pregnancy termination using extraamniotic ethacridine lactate
Authors: BHATHENA R. K. , SHERIAR N. K. , WALVEKAR V. R. , GUILLEBAUD J. 
Published: August 2005

Abstract Objective–To investigate the efficacy of ethacridine lactate by the extraamniotic route for second trimester pregnancy termination and its associated complications. Design–Retrospective study of women undergoing second trimester termination, over 3½ years, with extra‐amniotic ethacridine alone, or extra‐amniotic ethacridine supplemented later by extra‐amniotic 15‐methyl prostaglandin F,α. Setting–Teaching hospital in Bombay. Patients–315 consecutive women undergoing late abortions with extraamniotic ethacridine. Demographic features were similar in the two groups. Interventions–In group 1, 207 women had 150ml of 0.1% ethacridine lactate injected slowly into the extra‐amniotic space. In group 2, 108 women had the initial injection supplemented 6 h later by an extra‐amniotic injection of 250 μ.g (1 ml) of 15‐methyl prostaglandin F2α. Main outcome measures–The occurrence of abortion following the induction procedure. The development of complications such as haemorrhage, infection, or injury to the uterus or cervix. Results–The method was successful in 191 women (92%) in group 1 and in 106 (98%) in group 2. The median induction‐abortion intervals were 35 and 19 h, respectively (Mann‐Whitney U test, P<0.001). The corrected complication rate was <10% (30 women), with unplanned uterine evacuation in 6% (20), haemorrhage in 1% (4), and pelvic infection in 4% (14). Conclusion–The use of extra‐amniotic ethacridine lactate provides an effective and safe treatment method for second trimester legal abortion. The inductionabortion interval can be appreciably reduced by supplementary prostaglandin.
External cephalic version at term. A randomized controlled trial using tocolysis
Authors: MAHOMED K. , SEERAS R. , COULSON R. 
Published: August 2005

AbstractObjective— To assess the role of external cephalic version (ECV) at term, using tocolysis.Design— A randomized controlled trial over a 12 month period.Setting— Harare Maternity Hospital, Harare, Zimbabwe.Subjects— 208 women with breech presentation at term were recruited after satisfying eligibility criteria. There were 103 women in the study group and 105 in the control group. At the end of the study a further 104 women were recruited for ECV.Intervention— ECV attempted after intravenous injection of 10 μg of hexaprenaline, using either forward or backward somersault over a maximum period of 5 min.Main outcome measures— Success rate in terms of presentation during labour, need for caesarean section, and various variables related to fetal outcome.Results— ECV reduced the frequency of breech presentation during labour from 83% to 17% and that of caesarean section from 33% to 13%. There were no troublesome complications from the procedure.Conclusion— In carefully selected women with breech presentation, ECV at term using tocolysis, safely reduced the rate of breech presentation in labour and also the caesarean section rate. Further research is needed to determine the role of ECV in early labour.
The use of the GnRH analogue buserelin for IVF—does it improve fertility?
Authors: SHELTON KAREN , FISHEL SIMON , JACKSON PETER , WEBSTER JOHN , FARATIAN BAHMAN , JOHNSON JOANNE 
Published: August 2005

AbstractObjective— To determine the effect of a short course of the GnRH analogue buserelin and human menopausal gonadotrophin (hMG), for ovarian stimulation in our IVF programme, on reproductive endocrinology and pregnancy rates compared with conventional clomiphene citrate and hMG treatment.Design— Prospective randomized allocation to one of two ovulation stimulation regimens.Setting— Fertility clinic.Subjects— 373 infertile couples with various factors associated with their subfertility. All the women were <46 years of age and had normal menstrual cycles.Intervention— The first group (n = 151) was given clomiphene citrate (CC) from days 2–6 of the menstrual cycle and hMG from day 5 onwards (CC/hMG). The second group (n = 222) was given buserelin from days 1–3 and hMG from day 2 (buserelin/hMG).Main outcome measures— Concentration of plasma luteinizing hormone (LH), oestradiol (E2) and progesterone, number of ovulatory follicles induced and the occurrence of pregnancy.Results— Plasma LH, E2 and progesterone concentrations were reduced in the late follicular phase after buserelin/hMG compared with CC/hMG. Buserelin/hMG promoted the development of more follicles than CC/hMG. The overall pregnancy rate after buserelin/hMG was not significantly different from that following CC/hMG treatment.Conclusion— The chance of pregnancy is not improved by the short‐term use of buserelin with hMG, provided adequate follicular phase management is maintained.
Pretreatment of the primigravid uterine cervix with mifepristone 30 h prior to termination of pregnancy: a double blind study
Authors: COHN MIKE , STEWART PETER 
Published: August 2005

AbstractObjective— To determine the effect of the antiprogestogen mifepristone (RU 486) on cervical resistance before first trimester termination of pregnancy.Design— Prospective double blind randomized placebo controlled study.Setting— Department of gynaecology in a university teaching hospital, Sheffield.Subjects— 80 Primigravid women >18 years of age, undergoing termination of pregnancy at between 7 and 13 weeks gestation.Interventions— A single dose of 600 mg of mifepristone or placebo given orally 30 h before termination of pregnancy under general anaesthesia.Main outcome measures— Cervical resistance to dilatation.Results— Pretreatment with mifepristone significantly reduced the amount of force required to dilate the cervix to 10 mm. In comparison with placebo, the mean sum of the peak forces obtained with dilators 4 to 10 mm was reduced from 84.3 N (SD 29.7) to 46.0 N (SD 26.7). Two women in the treated group had a cervical resistance of >100 N compared with nine women in the placebo group (RR 0.18, 95% Cl 0.04–0.89). The 8 mm dilator could be passed with less than 5 N force in 16 women (43%) in the treated group compared with none in the placebo group. Women in the active treatment group had more preoperative pelvic pain and vaginal bleeding but less postoperative pain.Conclusion— Mifepristone significantly reduces cervical resistance in the first trimester of pregnancy and produces minimal side effects.
Follicular development in spontaneous and stimulated cycles in women with minimal‐mild endometriosis
Authors: MAHMOOD TAHIR A. , MESSINIS IOANNIS E. , TEMPLETON ALLAN 
Published: August 2005

AbstractObjective— To study follicle development in women with minimal‐mild endometriosis.Design— In women with endometriosis a spontaneous ovulatory cycle was compared with two subsequent cycles in which either clomiphene or clomiphene and FSH were given to stimulate folliculogenisis. Spontaneous cycles in women with tubal infertility provided a comparison group.Setting— Infertility clinic, Aberdeen Maternity Hospital.Subjects— 17 women with minimal‐mild endometriosis and 10 women with tubal infertility.Interventions— The women with endometriosis were treated with 150 mg clomiphene citrate from days 2 to 6 in one cycle and in a subsequent cycle with 150 mg clomiphene citrate on days 2 to 6 plus 75 iu FSH daily thereafter.Main outcome measures— Follicular size measured daily using ultrasound. Serum FSH estimated on days 5 and 7 and then daily.Results— Spontaneous follicular growth in the women with endometriosis was similar to that in the women with tubal infertility. Follicular development began earlier in cycles with clomiphene/FSH and the leading follicle reached 16 mm 2 days sooner but the rate of growth was similar whether or not either regimen of stimulation was used.Conclusion— Follicular growth is not impaired by minimal‐mild endometriosis. Infertility with this condition cannot be explained by altered follicular growth or responsiveness.
Cotinine‐assisted intervention in pregnancy to reduce smoking and low birthweight delivery
Authors: HADDOW JAMES E. , KNIGHT GEORGE J. , KLOZA EDWARD M. , PALOMAKI GLENN E. , WALD NICHOLAS J. 
Published: August 2005

AbstractObjective— To investigate the feasibility and impact of integrating a cotinine‐assisted smoking intervention programme with an existing antenatal maternal serum alpha‐fetoprotcin (AFP) screening service for open neural tube defects.Design— A multisite randomized controlled trial.Setting— 139 physician offices and clinic sites in Maine providing antenatal care.Subjects— 2848 pregnant women who smoked 10 or more cigarettes daily, enrolled at between 15 and 20 weeks gestation, from a population base of approximately 18 000 pregnancies.Interventions— The women were individually allocated at random to intervention or control groups within each centre at the time the serum sample was received for AFP measurement. The intervention group received an interpreted measurement of the serum cotinine, reported through the physician to the woman, along with a self‐help smoking cessation booklet and a repeat serum cotinine measurement one month later, again interpreted and reported through the physician to the woman. Women in the control group received the usual anti‐smoking advice provided by the antenatal care site and were not told of the study.Main outcome measures— Birthweight, physician cooperation with study protocol (as measured by effectiveness in obtaining repeat serum samples for cotinine measurements).Results— Pregnancy outcome data were available for 97% of the study population, including birthweight for 2700 singleton viable pregnancies. The smoking intervention programme led to a significant 66 g increase in mean birthweight (P = 0.03; 95% CI+9 to +123 g) and to a 30% reduction in the rate of low birthweight in pregnancies managed by the 70 physicians who secured the highest rate of obtaining repeat serum samples for cotinine measurements in their intervention group. Among the remaining 69 physicians, intervention had no detectable effect on birthweight.Conclusion— A cotinine‐assisted smoking intervention programme managed from a central location as an adjunct to a maternal serum AFP screening service can, with the cooperation of physicians responsible for antenatal care, lead to a significant and cost‐effective reduction in the number of low birthweight babies. This programme is inexpensive, requires little extra effort, and does not need specially trained personnel.
Fetal blood sampling and pregnancy loss in relation to indication
Authors: MAXWELL DARRYL J. , JOHNSON PAM , HURLEY PAULINE , NEALES KATE , ALLAN LINDSEY , KNOTT PETER 
Published: August 2005

AbstractObjective— To assess the relation between the indication for fetal blood sampling and pregnancy loss following the procedure.Design— Retrospective study.Setting— The tertiary referral Fetal Medicine Units at Guy's and University College Hospitals, London.Subjects— Women undergoing diagnostic fetal blood sampling in four groups: (1) 94 having prenatal diagnosis with normal ultrasound findings; (2) 94 with a structural fetal abnormality; (3) 30 having fetal assessment and (4) 35 with non‐immune hydrops.Interventions— Freehand ultrasound guided fetal blood sampling from umbilical cord, intrahepatic vein or fetal heart.Main outcome measures— Pregnancy losses were divided into those within 2 weeks and those 2 weeks after the procedure, obstetric accidents and neonatal deaths.Results— The 253 patients had fetal blood sampled on 268 occasions. Fifty‐one pregnancies were terminated. Overall, 51 of the remaining 202 desired continuing pregnancies were lost, of which 19 (9%) were lost within 2 weeks of the procedure. After exclusion of the pregnancies that were terminated, the procedure‐related losses within 2 weeks of sampling were 1 in 76 (1%), 5 in 76 (7%), 4 in 29 (14%) and 9 in 36 (25%) in groups 1, 2, 3 and 4 respectively.Conclusions— The risk of fetal blood sampling is increased in abnormal pregnancies, reflecting the underlying pathology and this must be taken into account when counselling patients before the procedure.
Magnesium intake and status and pregnancy outcome in a Danish population
Authors: SKAJAA KRISTJAR , DØRUP INGE , SANDSTROM BRITT‐MARIE 
Published: August 2005

AbstractObjective— To investigate the relation between pregnancy outcome and magnesium intake and status.Design— A prospective observational study in which the estimate of nutrient intake and serum samples were obtained before the final outcome of pregnancy was known. A second part of the investigation was a cross‐sectional comparison of magncsium status of normal pregnant women and women with certain pathological pregnancies.Setting— Antenatal clinic associated to the University Clinic of Obstetrics and Gynaecology, University of Aarhus, Denmark.Subjects— 1203 consecutive women in the 30th week gestation were invited to participate in the study, 991 (82.4%) accepted and records for 965 (80.2%) were available for analysis.Data— Food intake data were collected by a combination of a self administered questionnaire and a structured interview of a dietary history type. Serum samples were obtained from blood withdrawn in the 30th and 37th week gestation. Obstetric data were collected from the midwifery and hospital records. For a second part of the investigation, biopsies from the uterus and the abdominal rectus musclc were obtained from women delivered by caesarean section.Results— In the women with normal pregnancies and in the three groups of pathological pregnancies (pre‐eclampsia, SGA‐infants and preterm labour) the average magnesium intake was with in the range of 200 to 208 mg per 1000 kcal perday (SD 32)and there were no differences between the groups. Neither were differences in serum magnesium observed. Birthweight for gestational age was not influenced by determinationm intake. No differences in magnesium status as assessed by determination of magnesium content in muscle biopsies were found between the normal pregnancies and women with pre‐eclampsia, SGA‐infants or preterm labour.Conclusion— The intake of magnesium seemed adequate, and pre‐eclampsia, SGA‐infants, or preterm labour did not seem associated with a low dietary intake of magnesium or magnesium deficiency. Routine magnesium supplementation during pregnancy is not recommended for populations of relative good socio‐economic status.