bluuebunny/crossref_metadata_2025_split huggingface dataset:
The frequency of salpingitis and ectopic pregnancy as epidemiologic markers of Chlamydia trachomatis
Authors: BJARTLING CARINA , OSSER STELLAN , PERSSON KENNETH 
Published: March 2003

Background. To study the incidence of non‐gonococcal salpingitis, gonococcal salpingitis and ectopic pregnancy in a defined population over a 28‐year period on the assumption that the frequency of salpingitis and ectopic pregnancy may indirectly illustrate the epidemiological pattern of Chlamydia trachomatis.Design. A retrospective epidemiological study.Setting. University hospital with an urban catchment area.Patients. Five thousand two hundred and thirty‐three patients admitted to the hospital between 1969 and 1996 with a diagnosis of ectopic pregnancy, non‐gonococcal salpingitis, or gonococcal salpingitis.Results. The frequencies of both non‐gonococcal and gonococcal salpingitis increased steeply early in the period under study, rising to a peak in the early 1970s, then decreasing throughout the period except for the last 3 years when a slight increase was seen again. The frequency of ectopic pregnancy showed a steady increase, peaking in the late 1980s and early 1990s and then declining at the end of the study period. While the introduction of more sensitive pregnancy tests and programs for assisted fertility would increase the rate of ectopic frequency the decline during the ŉineties cannot be accounted for in this way. The peak of salpingitis cases in the early 'seventies seems to be mirrored exactly by the peak of ectopic pregnancies fifteen years later in the late 'eighties.Conclusion. The frequencies of salpingitis and of ectopic pregnancy can probably be used to estimate the incidence of preceding Chlamydia trachomatis. Thus the incidence of C. trachomatis has probably declined since the early 'seventies like that of N. gonorrheae.
Oxytocin‐induced oscillations of cytoplasmic Ca2+ in human myometrial cells
Authors: FU XIN , LIU YI‐JIA , CIRAY NADIR , OLOVSSON MATTS , ULMSTEN ULF , GYLFE ERIK 
Published: March 2003

Background. To investigate the mechanisms of oxytocin (OT) induced oscillations of the cytoplasmic Ca2+ concentration ([Ca2+]i) in cultured human myometrial cells.Methods. [Ca2+]i was measured in individual myometrial cells by dual wavelength spectrophotofluorometry using the fluorescent indicator fura‐2. Myometrium was obtained at abdominal hysterectomy (n=8) and during cesarean section (n=7).Results. OT (10–300 nM) typically induced [Ca2+]i oscillations with frequencies in the 0.6–0.8/min range. There were no obvious differences in the responses of cells taken from non‐pregnant and term pregnant women. The frequency and amplitude of the oscillations were not significantly affected by OT concentrations up to 300 nM. The amplitude of the oscillations decreased in the presence of the voltage‐dependent Ca2+ channel antagonist verapamil and gradually disappeared in Ca2+‐free medium. The oscillations were further blocked by the inorganic Ca2+ antagonist La3+ and by the intracellular Ca2+‐ATPase inhibitor 2.5‐di‐tert‐butylhydroquinone (DTBHQ). Caffeine inhibited the OT‐induced oscillations in a concentration‐dependent manner. DTBHQ and high concentrations of OT made [Ca2+]i remarkably sensitive to changes in the external Ca2+ concentration.Conclusions. The results indicate that OT‐induced [Ca2+]i oscillations in human myometrial cells are due to inositol 1,4,5‐trisphosphate‐mediated release of intracellular Ca2+ combined with capacitative as well as voltage‐dependent influx of the ion.
Stratified rates of cesarean sections and spontaneous vaginal deliveries
Authors: BREDAHL RASMUSSEN OLE , PEDERSEN BETH LILJA , WILKEN‐JENSEN CHARLOTTE , VEJERSLEV LARS O. 
Published: March 2003

Background. A fundamental point when auditing labor management is to ensure present and stratified process data.Method. Stratification of deliveries into ten mutually exclusive groups enabled comparisons of rates of cesarean sections and rates of spontaneous vaginal deliveries between labor wards.Results. Data from five labor wards in Denmark in 1996 were included in the study comprising a total of 11,287 women. The overall cesarean section rates were between 13.2 and 15.2% which was not a significant difference, whereas cesarean section rates in several of the ten groups and the rates of spontaneous vaginal delivery in group 1 and 3 were significantly different between the labor wards.Discussion. The method presented here is simple and can be used as an integrated part of the daily work and quality assurance. We advocate that stratification of the delivering women into ten groups should take place in every labor ward with focus on both the cesarean section rate and the rate of spontaneous vaginal delivery. Stratification provides data for periodical evaluation of the outcome within a department and for comparison between departments with different populations and policy.
Cervical intraepithelial neoplasia in pregnancy
Authors: PALLE CONNIE , BANGSBØLL SUSANNE , ANDREASSON BENNY 
Published: March 2003

Objective. To determine the progression/regression rate of cervical intraepithelial neoplasia in pregnancy and to describe the number of patients requiring treatment for cervical neoplasia during or following the pregnancy.Methods. A retrospective analysis of 305 pregnant women with abnormal cervical cytology was performed. The colposcopic, cytologic and histologic findings of repeated examinations during pregnancy and of the subsequent examination eight weeks postpartum were registered and compared. All smears were obtained by cotton bud and Cytobrush. Colposcopy was performed using standard techniques and cervical biopsies were taken in case of colposcopic abnormalities. Endocervical curettage was omitted during pregnancy. At postpartum evaluation colposcopy, directed biopsies and endocervical curettage were performed in all cases.Results. One hundred and two patients (33%) were followed only by cytology and colposcopy. The remaining 203 patients (67%) had one to four colposcopically directed biopsies during the pregnancy. Comparing the initial histology in pregnancy to the postpartum histologic evaluation 25% showed spontaneous regression while 75% of the women exhibited progression (28%) or persistence (47%) in the severity of cervical neoplasia. Two patients were treated by cervical conization in early pregnancy and 143 women (53%) were treated within the first year after the pregnancy. In the postpartum period microinvasive carcinoma was diagnosed in two patients, but no women advanced to more serious stages of cervical cancer.Conclusions. The high persistence rate of cervical intraepithelial neoplasia in pregnancy leads us to recommend a liberal use of colposcopically directed biopsies during pregnancy and to ensure a high follow‐up rate in the postpartum period.
Danish National IVF Registry 1994 and 1995. Treatment, pregnancy outcome and complications during pregnancy
Authors: WESTERGAARD HANNE BRIX , JOHANSEN ANNE METTE TRANBERG , ERB KARIN , ANDERSEN ANDERS NYBOE 
Published: March 2003

Subject. Data from the compulsory Danish National IVF Registry from 1994 and 1995 regarding treatments, abortions and complications following assisted reproductive technologies.Methods. Data were generated through registries and compared to pregnancies in Denmark in 1995. Those pregnancies that resulted in a delivery were compared to a matched control group.Results. In 1994 and 1995 5219 women were treated in 9471 initiated cycles. The numbers increased over the period. The overall delivery rate per initiated cycle was 19%, egg donation 24%, IVF 20%, ICSI 16% and frozen egg replacement 10%. The rates increased over the period. The rate of spontaneous abortions was highest for ICSI (25%) and egg donation (27%). For IVF and ICSI the birth rates per transfer of 1 embryo was 13, 1%, 2 embryos 25, 4%, 3 embryos 25, 8% and 4 or more 3, 8%. Transfer of 2 embryos resulted in 75% singleton, 25% twin and 0.2% triplet deliveries. After transfer of 3 embryos the corresponding rates were 68%, 29% and 4%. No quadruplet deliveries occurred. Totally, 1.4% reported complications to the treatment, the most frequent being ovarian hyperstimulation syndrome. In the study group 5.8% of the women who gave birth were diagnosed with imminent abortion vs. 3.0% in the control group (OR 1.98, CI 1.41–2.78).Conclusions. Transfer of three embryos did not result in higher pregnancy rates as compared to transfer of two embryos. The first data from the Danish IVF Registry support data from other registries regarding treatment, pregnancy outcome and complications during pregnancy.
Doppler ultrasound of the maternal uterine arteries: disappearance of abnormal waveforms and relation to birthweight and pregnancy outcome
Authors: CAMPBELL STUART , BLACK REBECCA S. , LEES CHRISTOPH C. , ARMSTRONG VALERIE , PEACOCK JANET L. 
Published: March 2003

Background. To assess whether the gestation at which abnormal uterine artery waveforms disappear is related to birthweight and complications of pregnancy.Methods. A prospective study of outcome of pregnancy after a uterine artery Doppler screening program set in an inner city teaching hospital. One thousand five hundred and twenty‐four consecutive women attending the Obstetric Department for a routine anomaly scan at between 19 and 21 weeks gestation had maternal uterine arteries assessed using color wave Doppler. Those women in whom the flow was deemed abnormal were recalled for a further scan at 24–26 weeks gestation. The main outcome measures were birthweight, gestation at delivery and incidence of pre eclampsia.Results. The women in whom the uterine artery blood flow was normal at 20 weeks had babies with significantly higher mean birthweight than those who normalized between 20 and 24–26 weeks gestation (‘late normalizers’) after adjustment for confounding factors; gestational age, maternal height, parity, ethnic group and smoking (mean difference=173 g, 95% confidence intervals 42 to 303 g).Conclusions. The timing of trophoblast invasion, as reflected by abnormal uterine artery waveforms, may have an effect on birthweight.
Child rate, pregnancy outcome and ovarian function in females with classical 21‐hydroxylase deficiency
Authors: JÄÄSKELÄINEN JARMO , HIPPELÄINEN MARITTA , KIEKARA OLAVI , VOUTILAINEN RAIMO 
Published: March 2003

Background. Ovulatory disorders and decreased fertility rates have been found in females with classical 21‐hydroxylase deficiency (21‐OHD). We analyzed the pregnancies of 29 females with classical 21‐hydroxylase deficiency and examined 16 of these women in a cross‐sectional study.Methods. The child rate of the 29 patients was compared with that in the general Finnish female population with equal age distribution.The cross‐sectional study of the 16 patients included a standardized questionnaire, clinical examination, ultrasonography of the internal genitalia, basal measurements of serum steroids, sex hormone binding globulin, PRL, gonadotropins and plasma ACTH.Results. The child rate was significantly lower than that in the general population (0.34 vs 0.91; p<0.001). A total of 13 pregnancies could be registered. From these pregnancies, ten healthy children were born, all for females with a simple virilizing disease. None of the nine females with salt wasting 21‐OHD had any children or had sought treatment for infertility. In the cross‐sectional study, females with regular menses (5/16; 31%) had well controlled adrenal androgen secretion and they had normal serum progesterone concentrations whereas the females with irregular menses (11/16; 69%) were often undersubstituted and presented with high serum progesterone concentration in the follicular phase. Polycystic ovaries could not be detected in any of these patients.Conclusions. Females with simple virilizing 21‐OHD often have irregular menses but their final prognosis for fertility seems to be better than previously reported. On the contrary, our study confirms the extremely low child rate in the salt wasting group.
The diagnosis of urinary tract infections among pregnant women in rural Tanzania; prevalences and correspondence between different diagnostic methods
Authors: OLSEN BJØRG EVJEN , HINDERAKER SVEN GUDMUND , LIE ROLV TERJE , GASHEKA PETRO , BAERHEIM ANDERS , BERGSJØ PER , KVÅLE GUNNAR 
Published: March 2003

Background. To assess the prevalence of dysuria, dipsticks positive on nitrite and leukocyte esterase and positive Uricult® dip slides among pregnant women in rural Tanzania.Methods. 3715 pregnant women were examined for dysuria and had their urine tested with nitrite and leukocyte esterase dipsticks and Uricult® dipslides, at their first antenatal visit in 1995–96.Results. The prevalences of positive symptoms and tests were as follows: dysuria 32%, nitrite 40.3%, leukocyte esterase 65.6%, and Uricult® dip slides 16.4%. A general log‐linear model where all four variables were analyzed simultaneously showed poor correspondence between the diagnostic methods. Odds ratio with 95% confidence intervals were as follows: dysuria vs. nitrite [1.6 (1.4–1.8)], dysuria vs. leukocyte esterase [1.2 (1.0–1.4)], nitrite vs. leukocyte esterase [4.2 (3.6–4.9)], and leukocyte esterase vs. Uricult®[1.4 (1.1–1.7)]. Dysuria and nitrite were not associated with Uricult® dipslide.Conclusion. A high prevalence of positive tests, but a poor correspondence between the methods was found, emphasizing the need for more attention to the problem of urinary tract infections among pregnant women in developing countries, and the need for better screening tests for urinary tract infections in these countries.
Relation of estrogen receptor expression in endometrial cancer specimens to bone mineral density
Authors: DOUCHI TSUTOMU , TSUJI TAKAHIRO , TOKUHISA TAKUYA , FUJIE YUKA , KATANOZAKA MARI , YOSHINAGA MITSUHIRO , NAGATA YUKIHIRO 
Published: March 2003

Background. To investigate the relation of estrogen and progesterone receptor (ER and PR) expression in endometrial cancer specimens to bone mineral density (BMD).Materials and methods. Subjects were 48 postmenopausal women with endometrial cancer treated with hysterectomy. Baseline characteristics included age, years since menopause (YSM), height, weight, and body mass index (BMI). Lumbar spine BMD (L2–4), the ratio of trunk fat to leg fat mass (trunk‐leg fat ratio), body fat mass, and the percentage of body fat were measured by dual‐energy x‐ray absorptiometry (DEXA). ER and PR expression in endometrial cancer specimens were determined immunohistochemically.Results. Of 48 women, 32 (66.7%) were ER/PR‐positive, nine (18.8%) were ER/PR‐negative, three (6.3%) were ER‐positive/PR‐negative, and four (8.3%) were ER‐negative/PR‐positive. Lumbar spine BMD and trunk‐leg fat ratio were significantly higher in women with ER‐positive than in those with ER‐negative (p<0.05), but other variables did not differ between the two groups. BMD and baseline‐ and anthropometric characteristics did not differ between the two groups divided by the presence or absence of PR expression.Conclusions. ER expression in endometrial cancer specimens is associated with higher lumbar spine BMD.
Effects of leptin on basal and FSH stimulated steroidogenesis in human granulosa luteal cells
Authors: GREISEN SUSANNE , LEDET THOMAS , MØLLER NIELS , JØRGENSEN JENS OTTO LUNDE , CHRISTIANSEN JENS SANDAHL , PETERSEN KARSTEN , OVESEN PER 
Published: March 2003

Background. Body weight influences fertility and studies in mice have indicated that leptin is one of the mediators of this effect. Leptin is believed to centrally stimulate the hypothalamic‐pituitary axis resulting in increased gonadotropin release. Moreover, leptin is present in follicular fluid and the receptor is expressed in the human ovary. The aim of this study was to evaluate the direct effect of leptin on cultured human granulosa cell steroidogenesis.Methods. Granulosa cells were obtained in connection with IVF procedures, and then cultured in a serum‐free medium containing androstenedione (1 μM) for a total of 4 days. After 2 days of culture the medium was changed and the hormones under study were added. We tested the effect of leptin (1, 20, 100 ng/ml) on basal, FSH (10–100 ng/ml), and FSH (10–100 ng/ml)+IGF‐I (30 ng/ml) stimulated steroidogenesis.Results. Leptin (20 ng/ml and 100 ng/ml) significantly reduced basal and FSH‐stimulated estradiol secretion (p<0.05). Basal and FSH (10 and 30 ng/ml) stimulated progesterone production was significantly inhibited by leptin 20 ng/ml, whereas leptin 100 ng/ml significantly reduced basal but not FSH stimulated progesterone production. Finally, steroidogenesis stimulated by IGF‐I alone and in combination with FSH was not influenced by leptin.Conclusion. These results suggest that leptin acts directly to inhibit basal and FSH stimulated estradiol and progesterone production in cultured human granulosa cells. This raises the possibility that high circulating leptin levels as seen in obese women may compromise fertility through peripheral mechanisms.
Effectiveness of the conveen continence guard (a disposable vaginal device) in the treatment of complicated female stress incontinence
Authors: NILSSON CARL GUSTAF 
Published: March 2003

Background. Treatment alternatives for women with stress urinary incontinence, complicated by prior unsuccessful surgery or concomitant diseases that prevent surgical intervention are limited. The aim of this study was to investigate the usefulness and effectiveness of a disposable vaginal device, the Conveen Continence Guard, in cases where surgery was not recommended for treatment of stress urinary incontinence.Methods. Twenty‐eight women, with a urodynamically proven stress urinary incontinence, were offered the use of a vaginal device during a prospective three‐week treatment period. Objective and subjective prevention of urinary leakage was assessed by a 24‐h pad‐weighing test, by a visual analog scale and a quality of life questionnaire. At the end of the treatment period the women answered a questionnaire on the ease and comfort of use of the device.Results. Of the nineteen women who completed the study, 89.5% were cured or improved according to subjective assessments, the respective figure being 84.2% according to objective assessment.Conclusion. The Conveen Continence Guard seems to be a promising treatment alternative for women for whom other treatment methods have failed. The device was well tolerated by the women and was regarded easy to use.
Carcinoma of the cervical stump. The Radiumhemmet series 1959–1987. Treatment and prognosis
Authors: Hellström Ann‐Cathrin , Sigurjonson Thore , Pettersson Folke 
Published: March 2003

Background. The purpose of this retrospective study is to evaluate the longterm prognosis for cervical stump cancer compared to matched controls with cancer in an intact uterus.Methods. From 1959 to 1987, 145 patients were treated for an infiltrating carcinoma of the cervical stump at Radiumhemmet representing 2.2% of all cervical cancers. Three control cases to each case were selected from the cohort of cervical carcinoma cases – matched to year of treatment, stage, histology and age (plus, minus 2 years). Actuarial survival was calculated for cases and controls. Survival differences were analyzed with the Kaplan‐Meier technique. The age distribution for cases ranged between 36 and 84 years with a mean age of 60.6 years. The mean age for the control series is 9 years of age (range 35–86 years). Among the cases 87.6% were squamous cell carcinoma and 12.4% were adenocarcinomas. Treatment of carcinoma of the uterine stump at Radiumhemmet followed the same modality as was practised for ordinary cervical cancer cases i.e. two brachyradium applications with 3 weeks interval followed by external irradiation. The dose of irradiation from the intracavitary application given to the stump cancers was lower than that given to comparable cases of the common cervical cases.Results. No evidence was found of poorer longterm prognosis for radiologically treated squamous cell carcinoma of the uterine stump compared to that of the ordinary cervical carcinomas. Stump cancers of the adenocarcinoma type had a worse prognosis than adenocarcinomas in an intact uterus (p<0.07) and also compared with stump cancers of the squamous epithelial type (p=0.05). The complication rate was higher for the stump cancer cases compared with that for cervical cancers in intact uterus. The mean time interval from subtotal hysterectomy to the stump cancer diagnosis was 17.6 years with a range from 1 to 46 years.Conclusions. Recent discussions argue for a better sexual function after subtotal hysterectomy. Our study gave no convincing argument in terms of poorer prognosis for radiologically treated carcinoma of the uterine stump compared to that of the total cervical cancer series. It is thus necessary to weigh the possible gains with subtotal hysterectomy against the relatively low risk to fall victim of a stump cancer. Complications following surgery, as well as possible physiologic and sexual functions of the cervix, should be taken into account.
Child births in a modified midwife managed unit: Selection and transfer according to intended place of delivery
Authors: Holt Jan , Vold Ingar Nikolai , Backe Bjørn , Johansen May Vollnes , Øian Pål 
Published: March 2003

Background. As small obstetrical departments may not be able to give second‐level perinatal care, the delivery unit at Lofoten hospital was for the years 1997–98 reorganized to a modified midwife managed unit. Women at low obstetrical risk were delivered at this unit and women at high risk were referred to the central hospital. We assessed the effectiveness of the risk selection.Material and methods. The study was a prospective, pragmatic, population‐based trial. Desired outcome was defined as a non‐operative delivery at 35–42 weeks gestational age giving an infant not needing resuscitation. Intermediate outcomes: Operative deliveries, infants transferred to neonatal intensive care unit and infants diverging from normal. The intended place of delivery was ultimately decided at admittance to the midwife managed unit.Results. Of the 628 women in study 435 (69.3%) gave birth at the midwife managed unit, 152 (24.2%) were selected to be delivered at the central hospital and 41 (6.5%) were transferred to the central hospital after admittance to the midwife managed unit. Desired outcome was recorded in 94% of the deliveries at the midwife managed unit as compared to 50.3% at the central hospital. Women who intended to be delivered at the midwife managed unit, needed fewer operative deliveries and relatively few infants were transferred to the neonatal intensive care unit or diverged from normal.Conclusions. As nearly 70% of the births occurred at the midwife managed unit and 94% of these deliveries had a desired outcome, this indicates an effective selection process. This model might be an alternative to centralization of births in sparsely population areas.