bluuebunny/crossref_metadata_2025_split huggingface dataset:
Volume sonography of the pelvic floor in nulliparous women and after elective cesarean section
Authors: Ochsenbein Nadin , Kurmanavicius Juozas , Huch Renate , Huch Albert , Wisser Josef 
Published: March 2003

Objective. To describe the sonographic appearance of the pelvic floor which has not been stressed by forces of labor or vaginal delivery in pregnant women and after childbirth.Subjects and methods. In a prospective observational study 14 nulliparous women during first trimester pregnancy and 26 primiparous women after elective cesarean were examined within the first week postpartum. The integrity of the internal anal sphincter expressed as the ratio between the anterior and the posterior internal anal sphincter muscle thickness (a/p‐ratio), asymmetry of the levator ani muscle and the paraurethral fixation of the lateral vaginal edges at the arcus tendineus were assessed using volume sonography.Results. The a/p‐ratio in nulliparous women was significantly higher (p<0.01) than after elective cesarean section. Asymmetry of the levator ani muscle did not differ between both groups but was more frequently in the nulliparous patients with an odds‐ratio of 1.16 (CI 0.74–1.82). In both groups of women the paraurethral fixation of the lateral vaginal edges were above the suburethral level of the vagina.Conclusions. This study gives sonographic features of the pelvic floor in nulliparous women and in primigravidae after elective cesarean section. Data from the post‐cesarean group can serve as reference values for further studies evaluating pelvic floor damage after various modi of vaginal delivery.
Gestational diabetes diagnosed in third trimester pregnancy and pregnancy outcome
Authors: Lao Terence T. , Tam Kar‐Fai 
Published: March 2003

Background. The clinical significance of gestational diabetes diagnosed in the third trimester is unclear. A prospective observational study was performed on a cohort of women without pre‐existing gestational diabetes or other medical disorders to examine the effect of gestational diabetes on pregnancy complications and infant outcome.Methods. Four hundred and eighty‐nine consecutive women were assessed at 28–30 weeks by random glucose screening and/or a 75 g oral glucose tolerance test. The subsequent management was according to established departmental protocols. The outcome of pregnancy was compared among the groups with negative screening, positive screening but normal glucose tolerance, and gestational diabetes which was controlled with diet therapy.Results. Women with gestational diabetes (n=67 or 13.7%) had significantly increased maternal age, pre‐pregnancy weight and body mass index, hemoglobin levels at booking and at 36–38 weeks, and incidences of parity >1, pre‐eclampsia, and female infants, while the gestational age was shorter and there was no significant difference in the birthweight outcome or neonatal morbidity.Conclusions. Despite diet treatment, gestational diabetes diagnosed in the last trimester is associated with increased risk of pre‐eclampsia and shorter length of gestation, and this is likely to reflect a pathological process rather than the physiological effect of pregnancy on maternal glucose tolerance.
Is preeclampsia an infectious disease?
Authors: Trogstad Lill I. S. , Eskild Anne , Bruu Anne‐Lise , Jeansson Stig , Jenum Pål A. 
Published: March 2003

Background. Studies have suggested a strong paternal factor in the etiology of preeclampsia. If preeclampsia is caused by an infectious agent transmitted by the woman’s partner, seronegative women who may experience primary infection in pregnancy should be at increased risk of preeclampsia as compared to previously infected women. The aim of this study was to assess the impact of being seronegative for some viruses transmitted by close contact on the risk of developing preeclampsia.Methods. Nine hundred and seventy‐eight women were randomly drawn from a basic study population of 35,940 pregnant women in Norway. A serum sample drawn at the first antenatal visit was analyzed for specific IgG antibodies against herpes simplex virus type‐2, cytomegalovirus and Epstein‐Barr virus. For comparison, antibody status against Toxoplasma gondii was also assessed. Information on preeclampsia in pregnancy was obtained through linkage to the Medical Birth Registry of Norway.Results. Thirty‐three (3%) women developed preeclampsia. The risk of developing preeclampsia seemed to be increased for women who were seronegative for the viruses studied. Seronegativity for Toxoplasma gondii did not show such a pattern.Interpretation. Women who are seronegative for antibodies against viral agents transmitted through close contact seem more likely to develop preeclampsia. This finding indicates that women who are seronegative to such agents may acquire primary infection in pregnancy, and subsequently be at increased risk of preeclampsia. This hypothesis could represent a new approach to the causes of preeclampsia, and encourage search for yet unidentified microbes as a possible causal factor.
Histopathological prognostic factors of adult granulosa cell tumors of the ovary
Authors: Fujimoto Toshio , Sakuragi Noriaki , Okuyama Kazuhiko , Fujino Takafumi , Yamashita Kohki , Yamashiro Shigekatsu , Shimizu Michio , Fujimoto Seiichiro 
Published: March 2003

Background. The prognostic factors of adult granulosa cell tumor (AGCT) have not been well defined.Methods. In 27 AGCT patients, we examined clinical stage, microscopic patterns, mitotic index (MI), and lymph‐vascular space invasion (LVSI) to determine whether these factors were related to disease‐free survival (DFS) of patients with AGCT. We also performed immunohistochemical examination for p53.Results. Seventeen cases represented stage I tumors, four stage II, five stage III, and one stage IV. Patients with stage I disease had more favorable prognosis than those with stage II to IV disease (p=0.034). There was no relation between the microscopic patterns and the DFS. The MI, which was categorized into 3/10high power field (HPF) and 4/10 HPF, was significantly related to patients DFS (p<0.0005). The DFS time for patients with moderate or prominent LVSI was significantly shorter than that for patients with no or minimal LVSI (p<0.0001). By multivariate analysis, MI and LVSI were shown to be independent prognostic factors. Five of seven patients with recurrent tumor had extrapelvic spread; two in the abdominal cavity and three in the liver.Conclusion. The results of this study suggest that prognosis for patients with AGCT depends on the MI and LVSI. During the follow‐up period of patients, they need to be examined for distant metastasis including liver.
Risk factors and outcome of failure to progress during the first stage of labor: a population‐based study*
Authors: Sheiner Eyal , Levy Amalia , Feinstein Uri , Hallak Mordechai , Mazor Moshe 
Published: March 2003

Background.  One of the major indications for Cesarean section (CS) is failure of labor to progress. This study was aimed at defining obstetric risk factors for failure of labor to progress during the first stage, and to determine pregnancy outcome.Methods.  A population‐based study comparing all singleton, vertex, term deliveries between the years 1988 and 1999 with an unscarred uterus, complicated with failure of labor to progress during the first stage with deliveries without non‐progressive labor (NPL). Multiple logistic regression analysis was performed to investigate independent obstetric risk factors associated with failure of labor to progress during the first stage.Results.  Failure to progress during the first stage of labor complicated 1.3% (n = 1197) of all deliveries included in the study (n = 92 918), and resulted in CS. Independent risk factors for failure of labor to progress during the first stage, using a multivariable analysis, were premature rupture of membranes (PROM; OR = 3.8, 95% CI 3.2–4.5), nulliparity (OR = 3.8, 95% CI 3.3–4.3), labor induction (OR = 3.3, 95% CI 2.9–3.7), maternal age > 35 years (OR = 3.0, 95% CI 2.6–3.6), birth weight > 4 kg (OR = 2.2, 95% CI 1.8–2.7), hypertensive disorders (OR = 2.1, 95% CI 1.8–2.6), hydramnios (OR = 1.9, 95% CI 1.5–2.3), fertility treatment (OR = 1.8, 95% CI 1.4–2.4), epidural analgesia (OR = 1.6, 95% CI 1.4–1.8) and gestational diabetes (OR = 1.4, 95% CI 1.1–1.7). Although newborns delivered after failure of labor to progress during the first stage had significantly higher rates of Apgar scores lower than 7 at 1 and 5 min as compared with the controls (18.2% vs. 2.1%; P < 0.001 and 1.3% vs. 0.2%; P < 0.001, respectively), no significant differences were noted between the groups regarding perinatal mortality (0.3% vs. 0.4%; P = O.329). Maternal anemia and accordingly packed cells transfusion (47.4% vs. 22.8%; P < 0.001 and 5.6% vs. 1.0%; P < 0.001, respectively) were higher among pregnancies complicated with failure of labor to progress during the first stage as compared with the controls.Conclusions.  Major risk factors for failure of labor to progress during the first stage were PROM, nulliparity, induction of labor and older maternal age. Indications for labor induction should be carefully evaluated in order to decrease the rate of operative deliveries.
Risk of intrauterine growth retardation, malformations and other birth outcomes in children after topical use of corticosteroid in pregnancy
Authors: Mygind Helle , Thulstrup Ane Marie , Pedersen Lars , Larsen Helle 
Published: March 2003

Background. Topical corticosteroids are frequently used drugs, but little is known of the exposure during pregnancy and birth outcome.Methods. In a population‐based follow‐up study restricted to primigravida women, we examined the risk of low birth weight, malformations and other birth outcomes following pregnancy upon exposure to topical corticosteroids. We compared the offspring of 363 women exposed to topical corticosteroids during pregnancy with 9263 controls, who received no prescriptions at all.Results. The prevalence of malformations was 2.9% among 170 infants exposed during the first trimester and 3.6% among the controls. Adjusted odds ratios for low birth weight, malformations and preterm delivery among women receiving weak/medium strong corticosteroids were 0.7 (95% CI 0.17–2.85), 0.93 (95% CI 0.23–3.80) and 1.04 (95% CI 0.56–1.92), respectively, and adjusted odds ratios for strong/very strong corticosteroids were 1.23 (95% CI 0.45–3.37), 0.56 (95% CI 0.14–2.28) and 0.99 (95% CI 0.54–1.84), respectively.Conclusions. The study showed no increased risk of low birth weight, malformations or preterm delivery in the offspring of women exposed to topical corticosteroid during pregnancy.
Smoking during pregnancy: comparison of self‐reports and cotinine levels in 496 women
Authors: Lindqvist Rune , Lendahls Lena , Tollbom ÖRjan , ÅBerg Hans , Håkansson Anders 
Published: March 2003

Objective. To validate self‐reported smoking habits in smoking pregnant women and estimate the prevalence of substantial exposure to passive smoking in non‐smoking pregnant women.Design. Retrospective, quantitative study, consecutively collected samples.Setting. One antenatal clinic in Blekinge County, Sweden.Subjects. 509 pregnant women.Method. Information about smoking habits were taken from the antenatal records of 496 women (97%). Serum samples from these women were tested for cotinine, a nicotine metabolite.Main outcome measures. Self‐reported smoking habits and cotinine levels in ng/mL.Results. Of 407 women, reporting to be non‐smokers, 6% were most likely smokers, and 3% had cotinine levels suggesting exposure to substantial passive smoking. Of 60 women, reporting smoking 1–10 cigarettes per day, 32% were likely to smoke more.Conclusion. If the true facts about exposure to tobacco smoke are not revealed, a number of women who might benefit from information and support at the antenatal clinic will miss the opportunity of such assistance, resulting in increased risks for both the woman and her fetus.
Maternal mortality in northern rural Tanzania: assessing the completeness of various information sources
Authors: Olsen Bjørg E. , Hinderaker Sven G. , Lie Rolv T. , Bergsjø Per , Gasheka Petro , Kvåle Gunnar 
Published: March 2003

Background. To assess the completeness of various information sources and the subsequent estimates on maternal mortality.Methods. Maternal deaths in the study area, rural northern Tanzania, in 1995 were identified from hospital records, health centers and dispensaries, registration by village leaders, follow up of an antenatal cohort, and a household survey. Data from some of these sources were also obtained in 1996.Results. In 1995, 22 of a total of 26 maternal deaths were identified at the Haydom hospital. Three of the 15 deaths (20%) reported by the village leaders were not identified at any health facility. Four deaths were found in the antenatal cohort and one death in the household survey. Only two deaths were reported by the official statistics. Of the identified maternal deaths, 85% were found from health facility data. Including data from 1996, a total of 45 maternal deaths were identified; 13 of which were direct and 32 indirect obstetric deaths.The 1995 estimated maternal mortality ratio, based on reports from the multiple source registrations, was 382 (95% confidence interval 250–560) per 100 000 live births. The antenatal cohort yielded an estimate of 322 (95% confidence interval 160–580). The ratio based on official figures for 1995 and 1996 combined was 123 (95% confidence interval 70–200).Conclusions. Even a high quality routine registration of maternal deaths will miss a small proportion of cases. Investing in better registration of direct and indirect obstetric deaths will give better insight into this important health problem. Estimates based on official reports showed substantial underreporting.
Does urinary incontinence occurrence depend on the menstrual cycle phase?
Authors: Hvidman Lone , Foldspang Anders , Mommsen Soeren , Bugge Nielsen John 
Published: March 2003

Background. The aim was to study an eventual co‐variation of menstrual cycle progression and urinary incontinence (UI) occurrence in 20–54‐year‐old‐women, who have regular menstrual cycles, which are not influenced by exogenous sex hormones.Methods. An age‐stratified random sample of of 3900 women, aged 20–59 years, answered a questionnaire on UI. The present analysis included 821 women, who reported regular menstrual cycles un‐intervened by sex hormone intake.Results. Five percent of the women reported episodes of UI the day before they answered the questionnaire. Urinary incontinence was unassociated with menstrual cycle characteristics, such as time position from day one in the menstrual cycle, presence and amount of bleeding and the number of sanitory towels or tampons used. There was however, a borderline significant association (P = 0.08) with day 11–15 before the expected next menstrual bleeding.Conclusions. The present data allow for limited co‐variation, if any, to exist in UI ocurrence with the natural menstrual cycle phases, including the menstruation itself. A hypothesis of a moderate UI increase associated with ovulation however, merits attention.
Physical activity: measurement in mid‐life women
Authors: Guthrie Janet R. 
Published: March 2003

Objectives. To review methods of assessing physical activity, and to compare two different questionnaires that were administered in the Melbourne Women's Midlife Health Project (MWMHP).Methods. Cross‐sectional and subsequent longitudinal population‐based study of Australian‐born women who were aged 45–55 at baseline. Self‐administered modified form of the Minnesota Leisure‐Time Physical Activity questionnaire and interviewer‐administered short physical activity question.Results. Two hundred and ninety‐two women completed the Minnesota Leisure‐Time Physical Activity questionnaire at both cross‐sectional and 3rd year of follow‐up (L3) and there was no difference in the total mean time spent exercising at both phases [5.9 (SD, 5.7) and 5.8 (SD, 5.0) hours per week, respectively]. The responses to the two questionnaires were significantly associated (β = −0.89, SE 0.17, p < 0.0005). Using the Minnesota Leisure‐Time Physical Activity questionnaire between the cross‐sectional and L3 phases, 10% of the women increased the time they spent exercising by 5 h per week and 10% decreased it by the same amount. Using the short exercise question, 12% of women decreased their participation by two or more sessions per week and 14% increased their participation by this amount between the cross‐sectional and L3 phases.Conclusion. In this cohort of mid‐life women the short exercise question was comparable in terms of measuring participation and change in physical activity with the more complex Minnesota Leisure‐Time Physical Activity questionnaire.
Expression of αvβ3 and α4β1 integrins throughout the putative window of implantation in a cohort of healthy fertile women
Authors: Nardo Luciano G. , Bartoloni Giovanni , Di Mercurio Silvana , Nardo Filadelfo 
Published: March 2003

Background.  Blastocyst implantation is a dynamic process requiring a specific cascade of cellular interactions and endometrial changes. The aim of this prospective observational study was to investigate the endometrial expression of αVβ3 and α4β1 integrins throughout the window of implantation in healthy fertile women.Materials and methods.  Forty fertile women (mean age 29.7 ± 6.2 years) were recruited for this study. All underwent two endometrial biopsies in a single menstrual cycle. The first biopsy was performed on postovulatory day 6, while the second was taken on postovulatory day 8. Histological dating and immunohistochemical assessments of αVβ3 and α4β1 integrins were analyzed. Oestradiol and progesterone serum concentrations were also measured at the time of biopsy.Results.  Second endometrial biopsy could not be performed in two of the 40 women (5%) because their menses had started in advance. No inflammatory or reactive phenomena were observed after biopsy. All the samples showed an in‐phase endometrium. αVβ3 integrin expression was found in 21 out of the 38 first biopsies and in all 38 second biopsies (55.2% vs. 100%, p < 0.001). α4β1 integrin expression was not significantly different between first and second biopsies (68.4% and 76.3%, NS). Oestradiol and progesterone serum concentrations were similar throughout the implantation window. Twelve of the 38 women (31.6%) conceived within 12 months of completing the study. All these had significantly higher αVβ3 integrin expressions in mid‐luteal phase biopsies compared with those who did not conceive.Conclusions.  These immunohistochemical findings demonstrate that both αVβ3 and α4β1 integrins have a spatial and temporal expression throughout the implantation window in the endometrium of fertile women. Moreover, the shortage of αVβ3 integrin expression during the mid‐luteal phase results in a detrimental effect for blastocyst implantation.
Association of interleukin‐6 and estradiol with hepatocyte growth factor in peritoneal fluid of women with endometriosis
Authors: Khan Khaleque Newaz , Masuzaki Hideaki , Fujishita Akira , Hamasaki Tetsushi , Kitajima Michio , Hasuo Atsuko , Miyamura Yasutake , Ishimaru Tadayuki 
Published: March 2003

Background.  Different cytokines and ovarian steroid hormones have been reported to regulate the growth and maintenance of endometriosis. We determined the relationship between peritoneal fluid concentrations of interleukin‐6, ovarian steroids and hepatocyte growth factor in different revised American Fertility Society (AFS) staging and morphologic appearances of endometriosis.Methods.  Peritoneal fluid was collected from 30 women with endometriosis and 20 women without endometriosis during laparoscopy, and hepatocyte growth factor, interleukin(IL)‐6 and ovarian steroids were measured in peritoneal fluid. The concentrations of hepatocyte growth factor and IL‐6 in peritoneal fluid were measured by ELISA, and that of estradiol and progesterone by using the immulyze‐enzyme amplified luminescence system. Changes in peritoneal fluid concentrations of hepatocyte growth factor, IL‐6, estradiol and progesterone in different stages and morphologic appearances of endometriosis were examined to demonstrate their differences in early and advanced endometriosis.Results.  Peritoneal fluid levels of hepatocyte growth factor in women with stage I–II endometriosis were significantly higher than in both women with stage III–IV endometriosis and without endometriosis. A similar significant increase in stage I–II endometriosis was also observed for IL‐6 and estradiol. When we divided the women according to different morphologic appearances of endometriosis, we found significantly higher concentrations of hepatocyte growth factor (HGF), IL‐6, estradiol and progesterone in women containing red lesions compared with other pigments or without endometriosis. A positive correlation was observed between peritoneal fluid levels of IL‐6 and hepatocyte growth factor only but not between other markers. Although estradiol levels in peritoneal fluid showed an increased tendency to elevate in the proliferative phase of endometriosis women, hepatocyte growth factor and progesterone displayed higher concentrations in the secretory phase of the menstrual cycle. After adjusting different variables in peritoneal fluid, multiple analysis of covariance indicated that hepatocyte growth factor levels in peritoneal fluid were independently involved in the red morphologic activity of endometriosis.Conclusions.  Early staging and red color appearance of endometriosis are associated with the elevation in peritoneal fluid concentrations of hepatocyte growth factor, IL‐6 and estradiol, demonstrating the combined effect of these cytokines and ovarian steroids in the production of hepatocyte growth factor from endometrial tissues in active endometriosis.
Immunohistochemical staining of IGF‐I, IGF‐binding proteins‐1 and ‐3, and transforming growth factor beta‐3 in the umbilical cords of preeclamptic patients
Authors: Inan S. , Vatansever S. , Kuscu N. K. , Laçin S. , Ozbilgin K. , Koyuncu F. 
Published: March 2003

Background. To detect the immunoreactivity of insulin‐like growth factor‐I, insulin‐like growth factor‐binding proteins‐1 and ‐3 and transforming growth factor beta‐3 in the umbilical cords of normal and preeclamptic patients.Methods. Umbilical cords were obtained from 15 normal and 15 preeclamptic patients. Immunoreactivities were determined using either indirect immunofluorescence or immunoperoxidase techniques on formalin‐fixed, paraffin‐embedded sections. Staining intensity was graded by a semiquantitative scoring method. The results were compared by Mann–WhitneyU‐test.Results. The umbilical cords were thinner and the vessels were hypoplastic in the preeclamptic group. Moderate staining intensity for insulin‐like growth factor‐I, insulin‐like growth factor binding protein‐1 and ‐3 and transforming growth factor‐beta 3 was observed in normal patients. The preeclamptic group had mild and strong intensities for insulin‐like growth factor‐I and insulin‐like growth factor binding protein‐1, respectively, and intensity for insulin‐like growth factor binding protein‐3 did not change, but diffuse and increased intensity was observed for transforming growth factor‐beta 3.Conclusion. Changes in the intensity of insulin‐like growth factor‐I and its major binding protein and the transformation of growth factor‐beta 3 may play a role in the pathogenesis of preeclampsia by altering the structure and responsiveness of the umbilical cord