bluuebunny/crossref_metadata_2025_split huggingface dataset:
Measurement of fetal liver, brain and placental volumes with echo–planar magnetic resonance imaging
Authors: Baker Philip N. , Johnson Ian R. , Gowland Penny A. , Hykin Jonathan , Adams Valerie , Mansfield Peter , Worthington B. S. 
Published: August 2005

ABSTRACTObjective To quantify accurately in utero fetal liver, brain and placental volumes using echo planar imaging, and to assess whether the technique has the potential to enhance intrauterine fetal assessment.Design Thirty‐two singleton, complicated pregnancies were scanned using echo planar imaging, a form of magnetic resonance imaging. Pregnancies were subdivided on the basis of whether the fetus was found subsequently to have an individualised birthweight ratio above (n= 21) or below (n= 11) the 10th centile. Comparisons of the organ volumes of these two groups were made.Results The first quantitative in utero measurement of fetal liver volume showed a linear relation between liver volume and gestational age in fetuses where the individualised birthweight ratio was above the 10th centile (the normal growth group). Ten of the 11 liver volume measurements of fetuses subsequently found to have an individualised birthweight ratio below the 10th centile fell on or outside the 95% confidence limits established for the normal growth group. In contrast, no such differences were demonstrated when the brain and placental volumes were considered, with 10 of the 11 brain measurements and all of the 11 placental measurements falling within the 95% confidence limits of the normal growth group.Conclusions A single measurement of fetal liver volume using echo planar imaging enabled accurate identification of fetuses subsequently found to have individualised birthweight ratios below the 10th centile. If these findings are repeated in larger, more representative studies, this suggests that the technique has the potential to contribute to intrauterine fetal assessment.
Standing at work and preterm delivery
Authors: Henriksen Tine Brink , Hedegaard Morten , Secher Niels Jørgen , Wilcox Allen J. 
Published: August 2005

ABSTRACTObjective Guidelines in some European countries and the United States suggest that pregnant women should avoid prolonged standing and heavy lifting in the workplace during the second and third trimester of pregnancy. However, results from epidemiological studies on this topic are ambiguous. The aim of this study was to evaluate the influence of standing and walking at work in the second trimester on preterm delivery in a population with a low frequency of other workplace hazards.Subjects and design A prospective cohort of 8711 women with singleton pregnancies was established during 1989 through 1991. Information was collected during the 16th week of pregnancy about medical and obstetrical history, general lifestyle factors and exposures at work. The analyses were restricted to 4259 respondents who worked at the 16th week. Potential confounders and effect modifiers were evaluated by stratification and multivariate analyses.Results After adjustment for confounders, women standing more than five hours per work day had an odds ratio (OR) for preterm delivery of 1.2 (95% CI 0.6 to 2.4) compared with women standing two hours or less. For walking, the OR was 1.4 (95% CI 0.7 to 2.5). Many women were unable to separate periods of standing from periods of walking; a combined measure of these two exposures was created to reflect exposure intensity. Women who reported more than five hours of both standing and walking had an adjusted OR of 3.3 (95% CI 1.4 to 8.0) compared with women who reported two hours or less on either of the exposures. No adverse effects were seen for lifting or other types of physical exertion.Conclusions Our findings suggest that standing and walking at work during the second trimester may present a particular risk for preterm delivery, and workplace guidelines are justified. Further research is needed to address the specific mechanisms by which physical exertion, including standing and walking, might cause preterm delivery.
A Scottish audit of hysteroscopic surgery for menorrhagia: complications and follow up
Authors:   Scottish Hysteroscopy Audit Group
Published: August 2005

ABSTRACTObjective To evaluate the efficacy and safety of hysteroscopic surgery undertaken by a cross section of gynaecologists.Design A prospective registration of cases of hysteroscopic surgery by gynaecologists. Patient satisfaction was assessed at six and twelve months post‐operatively by postal questionnaire.Setting Thirteen hospitals in seven Scottish Health Boards. Secretariat in Aberdeen Royal Infirmary.Subjects Women having hysteroscopic surgery for menstrual problems.Interventions A few questions were added to the proforma during the audit.Results Between December 1991 and December 1993, 978 cases were registered. Consultants performed the majority of procedures. Complications occurred in 12% of cases and included one death from toxic shock syndrome. Uterine perforation and significant fluid overload occurred in 1 % of cases. To date, 732 women have been followed up at six months, 554 at twelve months and 80 at 24 months. Eighty‐four percent of those returning their questionnaires were satisfied or very satisfied at twelve months. By twelve months, repeat procedures had been performed in 13% and hysterectomy in 11%. Sixty‐six percent of women with a paid job had returned to work within two weeks and 88% within four weeks.Conclusions Overall, hysteroscopic surgery had a low rate of morbidity and satisfactory efficacy with rapid post‐operative recovery. Gynaecologists who have shown caution with the advent of this surgery can now be encouraged to take up endometrial ablation for dysfunctional uterine bleeding. Clinical guidelines are currently being prepared.
Scalp blood lactate: a new test strip method for monitoring fetal wellbeing in labour
Authors: Nordström Lennart , Ingemarsson Ingemar , Kublickas Marius , Persson Bengt , Shimojo Nobuo , Westgren Magnus 
Published: August 2005

ABSTRACTObjective
To determine fetal scalp blood lactate with a new test strip method in parturients with normal and abnormal cardiotocograms during labour and to describe the relation to maternal lactate, fetal scalp blood pH, cord artery lactate and acid‐base balance.Setting
Labour wards at the University Hospitals of Huddinge and Lund and at the County Hospital of Östersund, Sweden.Materials and method
Fetal scalp blood was sampled for lactate (n= 269) and pH (n= 285) determination in 177 parturients with abnormal intrapartum CTG. Lactate and pH were also analysed in a group of 64 women with normal pregnancies and with a reactive fetal heart rate tracing prior to sampling of fetal scalp blood. At fetal blood sampling lactate was also determined in maternal capillary blood, while at birth lactate and acid‐base balance in cord artery blood was performed in almost all cases.Main outcome measurements
Medians and percentiles (lactate and acid‐base balance). Correlation between fetal scalp blood lactate (dependent) and scalp blood pH, cord artery blood lactate and acid‐base parameters and labour time prior to fetal blood sampling.Results
In the group with abnormal cardiotocograms, fetal scalp and umbilical artery blood lactate and acid‐base parameters differed significantly from the same parameters in the normal group. The fetal‐maternal lactate gradient changed from negative in the normal group to positive in the fetal distress group. Multiple regression analysis, with scalp lactate as the dependent parameter, revealed a significant correlation with fetal scalp blood pH (P < 0.001) and umbilical artery lactate (P < 0.01).Conclusions
Intrapartum scalp blood lactate was significantly correlated with pH and cord artery lactate. The results indicate that increased lactate levels in fetal blood sampling describes fetal lactacidosis. The new disposable test strip requiring only 5 μl of blood for lactate determination may be better than traditional methods for monitoring fetal wellbeing in labour.
A randomised double blind comparison of Syntometrine® and Syntocinon® in the management of the third stage of labour
Authors: Yuen Pong Mo , Chan Norman S. T. , Yim So Fan , Chang Allan M. Z. 
Published: August 2005

ABSTRACTObjective
To compare the effect of intramuscular Syntometrine and Syntocinon in the management of the third stage of labour.Design
A randomised double blind prospective study.Setting
Department of Obstetrics and Gynaecology, Prince of Wales Hospital, Hong Kong.Subjects
One thousand consecutive patients with singleton pregnancy and vaginal delivery in February and March 1993.Results
The use of Syntometrine in the management of the third stage not only reduced the blood loss after delivery but was associated with a 40% reduction in the risk of postpartum haemorrhage (odds ratio 0.60; 95% CI 0.21–0.88), and the need for repeat oxytocic injections (odds ratio of 0.63; 95% CI 0.44–089). The two drugs did not differ in their effect on the duration of the third stage. However, the incidence of manual removal of the placenta was higher when Syntometrine was used (odds ratio 3.7; 95% CI 1.03–123), although the overall incidence remained low. Side effects from both drugs, such as nausea, vomiting, headache and hypertension, were uncommon.Conclusion
Intramuscular Syntometrine is a better choice than Syntocinon in the management of the third stage of labour.
Clinical, laparoscopic and microbiological findings in acute salpingitis: report on a United Kingdom cohort
Authors: Bevan C. D. , Johal B. J. , Mumtaz G. , Ridgway G. L. , Siddle N. C. 
Published: August 2005

ABSTRACTObjective
To determine the clinical features and microbial aetiology of acute salpingitis in women attending an inner city teaching hospital.Design
Prospective, longitudinal cohort study.Subjects
One hundred and forty‐seven women presenting consecutively with acute abdominal pain and clinical signs of acute salpingitis were evaluated microbiologically and laparoscopically.Results
One hundred and four women (70.7%) had acute salpingitis diagnosed at laparoscopy. Other pathological conditions were identified in 20 women (13.6%). No visually identifiable pathology was found in 23 (15.6%). Thirty‐five women with acute salpingitis had evidence of pelvic adhesions (33.7%). Bilateral tubal occlusion was present in 6 (5.8%) cases. Chlamydia trachomatis was identified in the genital tract in 40 (38.5%) of the women with acute salpingitis and Neisseria gonorrhoeae in 15 (14.4%). A dual infection was present in eight cases (7.7%). Serological evidence suggested that a further seven women (6.7%) had acute chlamydial infections at the time of diagnosis. C. trachomatis was identified in the genital tract of 5/23 (21.7%) of the women who had no laparoscopic evidence of intra‐abdominal pathology.Conclusions
The responsible care of women with suspected acute salpingitis depends on establishing an accurate diagnosis, so that appropriate therapy can be instigated. This study provides evidence to challenge the outpatient management of acute salpingitis on clinical grounds alone as potentially inadequate. Early laparoscopy in hospitalised women improves diagnostic precision and accurately determines disease severity, providing prognostic information for future fertility. In this urban population, sexually transmitted micro‐organisms were the commonest pathogens found in the genital tract of women with acute salpingitis. The high prevalence of C. trachomatis in these women suggests that appropriate chemotherapy for acute salpingitis should always include a specific antichlamydial agent.
Fertility in β thalassaemia major: a report of 16 pregnancies, preconceptual evaluation and a review of the literature
Authors: Jensen C. E. , Tuck S. M. , Wonke B. 
Published: August 2005

ABSTRACTObjectives
To examine the pregnancies, mode of delivery and outcomes, review the literature on fertility and discuss preconceptual guidance for women with β thalassaemia major.Design
An observational study.Subjects
Sixteen women with p thalassaemia major.Setting
Two collaborating London teaching hospitals.Main outcome measures
Pre‐pregnancy assessment, pregnancy course, mode of delivery, gesta‐tional age at delivery and birthweight.Results
There were 16 pregnancies in 11 women. Three of these pregnancies were terminated. Of the 13 deliveries, there were two normal deliveries, one forceps delivery and 10 caesarean sections. The main findings in a further five women seeking fertility treatment were of hypogonadotrophic hypogonadism, diabetes and cardiomyopathy.Conclusions
Pregnancy in women with p thalassaemia major does not appear to have a deleterious effect on the course of the disease. No increased obstetric complications were encountered except for the high caesarean section rate, essentially due to cephalopelvic disproportion. A high incidence of cardiomyopathy and diabetes dictates a careful assessment before embarking on ovulation induction to treat the hypogonadotrophic hypogonadism which is common in these women.
A comparison of colour Doppler sonography and the pelvic arteriogram in assessment of patients with gestational trophoblastic disease
Authors: Chan F. Y. , Chau M. T. , Pun T. C. , Lam C. , Ngan H. Y. S. , Wong R. L. C. 
Published: August 2005

ABSTRACTObjective
To assess whether colour Doppler sonography can replace pelvic arteriography in the assessment of patients with gestational trophoblastic disease.Design
An observational study in which patients with gestational trophoblastic disease were assessed with both pelvic arteriography and colour Doppler sonography.Setting
The oncology unit of the Department of Obstetrics and Gynaecology, University of Hong Kong. The unit is the main tertiary referral centre for treatment of trophoblastic diseases in Hong Kong.Subjects
Thirty‐two consecutive women referred over an 18 month period.Main outcome measures
The site of localisation of the tumour and the size of the tumour as assessed by both methods.Results
Eleven patients had a spontaneous fall of β‐hCGtitres and did not have pelvic arteriograms performed. The remaining 21 patients had both investigations performed. Four patients had no evidence of abnormal pelvic vessels either on colour Doppler sonography or on pelvic arteriography. Their raised P hCG titres were due to metastatic disease elsewhere. In the remaining patients the location of the tumour vessels was found to be concordant between the two methods of imaging. Measurements of the mean diameter of tumour bulk by the two methods also agreed well (r = 0.93, P < 0–0001). Pelvic arteriogram over‐estimated the size of the tumour in two patients by 2 and 3 cm, respectively, but this did not alter the risk categories of the patients.Conclusion Colour Doppler sonography is a noninvasive technique that can replace pelvic arteriography in the assessment of patients with trophoblastic diseases.
Standards for ultrasound fetal growth velocity
Authors: Owen Philip , Donnet M. Louise , Ogston Simon A. , Christie Alexander D. , Howie Peter W. , Patel Naren B. 
Published: August 2005

Objective
An ultrasound study to establish the nature and limits of fetal growth in a low risk population from 22 weeks of gestation until term.Design
Prospective, longitudinal ultrasound study of 274 low risk pregnancies involving organised scanning schedules with all measurements performed by one observer using the same equipment.Results
Growth velocity charts have been created for a number of ultrasound parameters including estimated fetal weight, by applying appropriate statistical methods to the serial data. The rates of growth of the biparietal diameter, femur length, abdominal area and estimated weight each have characteristic patterns demonstrating maximal growth rates at different gestations.Conclusions
Appropriately derived and calculated ultrasound fetal growth velocity standards have been established. These data are suitable for the evaluation of ultrasonically estimated fetal growth rates in the prediction of adverse perinatal outcome and the further investigation of the role of the intrauterine environment in the origin of adult disease.
Evaluation of post‐operative analgesia following laparoscopic application of Filshie clips
Authors: Fiddes T. M. , Williams H. W. , Herbison G. P. 
Published: August 2005

Objective
To evaluate the efficacy of injecting 1% lignocaine into the subserosal aspect of the cornual end of the fallopian tubes to control post‐operative pain after laparoscopic Filshie clip application.Design
A double blind, randomised controlled trial. Setting The day surgery unit of the Dunedin Public Hospital, Otago, New Zealand.Participants
Fifty–nine women attending the public hospital requesting sterilisation.Interventions
The experimental group received an infiltration of 1% lignocaine into the subserosal aspect of the cornual end of the fallopian tubes. The control group received an infiltration of normal saline in the same site.Main outcome measures
The use of post–operative pethidine and the scores obtained on a modification of the McGill present pain intensity score, a visual analogue scale of present pain, a pain relief score and comparisons of time to first analgesia use.Results
The use of pethidine in the experimental group was significantly reduced [P= 0. 001] Pain relief scores indicated significant benefit from the intervention. The time to first analgesic use was significantly greater in the experimental group.Conclusion
Lignocaine infiltration at the cornual end of the fallopian tubes during laparoscopic Filshie clip application is highly effective in producing post–operative pain relief.
Recurrent Stage IB cervical carcinoma: evaluation of the effectiveness of routine follow up surveillance
Authors: Ansink Anca , de Barros Lopes Alberto , Naik Raj , Monaghan John M. 
Published: August 2005

Objective
To study the effectiveness of follow up surveillance in detecting recurrent disease following radical hysterectomy for Stage IB cervical carcinoma.Design
Retrospective analysis of clinical records using a computerised database.Participants
Six hundred and seventy‐four patients with Stage IB carcinoma of the cervix underwent radical hysterectomy and lymph node dissection.Interventions
Standard follow up surveillance consisted of clinical history and physical examination six weeks post surgery, and subsequently three monthly for the first year, six monthly for the second year, and yearly thereafter until 10 years post‐treatment.Results
Of the 674 patients, 112(17%) developed recurrent disease. In only 29/112 (26%) was recurrent disease detected at the time of routine follow up visits. Nearly half of the patients (44%) were referred by their general practitioner between visits to the clinic because of suspicion of recurrent disease.Conclusion
Routine follow up surveillance is ineffective in detecting recurrent cervical carcinoma. Only one in four recurrences were detected at the time of a clinical visit.
Serum lipids in early pregnancy and risk of pre‐eclampsia
Authors: van den Elzen Helga J. , Wladimiroff Juriy W. , Cohen‐Overbeek Titia E. , de Bruijn Anton J. , Grobbee Diederick E. 
Published: August 2005

Objective
To determine whether first and late second trimester serum total and high density lipoprotein cholesterol are associated with blood pressure, uterine artery pulsatility index and pregnancy outcome.Design
A prospective cohort study. Data were analysed using multiple linear and logistic regression analysis.Participants
Three hundred and ninety‐three pregnant women requesting chorionic villus sampling because of advanced maternal age (36 years and older).Main outcome measures
Serum total cholesterol and high density lipoprotein cholesterol were measured by an automated enzymatic method. Uterine artery flow velocity waveforms were recorded using continuous Doppler ultrasound. Pregnancy outcome was assessed by questionnaire.Results
First trimester serum total cholesterol was significantly associated with the risk of pre‐eclampsia, with the adjusted relative risk exceeding 5 for women with serum total cholesterol levels above 6.0 mmol/l when compared with women with a cholesterol level below 5.0 mmol/l. First trimester serum total cholesterol also showed a significant relationship with diastolic blood pressure (coefficient of linear regression = 0.02 (mmol/l)/mmHg, 95% CI = 0.01 to 0.03), and the change in both diastolic and systolic blood pressure from the first to the late second trimester was associated with linear changes in serum total cholesterol and high density lipoprotein cholesterol.Conclusions
These data suggest a relation between serum lipids in early pregnancy and the development of pre‐eclampsia.
Selenium deficiency and miscarriage: a possible link?
Authors: Barrington J. W. , Lindsay P. , James D. , Smith S. , Roberts A. 
Published: August 2005

Objective
To investigate a possible relationship between a deficiency in serum selenium concentration and first trimester miscarriage.Design
An observational study.Setting
A teaching hospital in South Wales.Participants and methods
Serum selenium, albumin and total protein concentration were measured in 40 women admitted with first trimester nonrecurrent miscarriage. The results were compared with an equal number of age‐matched nonpregnant healthy volunteers, and also from 40 pregnant women attending the antenatal clinic for booking in the first trimester.Results
A reduction in serum selenium normally occurs in the first trimester of pregnancies that progress to term. However, a further statistically highly significant decrease in serum selenium was observed in those women who miscarried.Conclusion
Further studies are required to assess the potential benefits of selenium supplements.
Chlamydia1 antibodies in women who suffer miscarriage
Authors: Osser Stellan , Person Kenneth 
Published: August 2005

Objective
To ascertain the relation between previous chlamydial infection and miscarriage.Design
A prospective study of 349 women who had a miscarriage.Participants
Women surgically treated for spontaneous pregnancy loss on an outpatient basis at a hospital.Subjects
Three hundred and forty‐nine women who miscarried, of whom 91 had at least one previous miscarriage and 33 had had two or more miscarriages previously. Age‐matched women who had a normal pregnancy served as controls.Interventions
Blood samples were drawn from patients and controls for antibody determination.Main outcome measures
Patients and controls were compared regarding the frequency of Chlamydia trachomatis IgG antibodies (titre 2 1/32). Antibodies to C. pneumoniae were also analysed to study cross reactivity.Results
The frequency of IgG antibodies among the patients was 137/349 (39.3%) which was not statistically different from that among controls (116/349; 33.2%). Even among those who had miscarried previously the antibody frequencies did not differ significantly between patients and controls. The rate of C. trachomatis antibodies was about the same whether or not antibodies to C. pneumoniae were present in both patients and controls.Conclusion
No association was found serologically between previous chlamydial infection and miscarriage and no significant cross reactivity between C. pneumoniae and C. trachomatis could be detected.