bluuebunny/crossref_metadata_2025_split huggingface dataset:
Previous miscarriage and stillbirth as risk factors for other unfavourable outcomes in the next pregnancy
Authors: PAZ JOAQUIN E. , OTANO LUCAS , GADOW ENRIQUE C. , CASTILLA EDUARDO E. 
Published: August 2005

ABSTRACTObjective
To look for associations between previous fetal loss and fetal malformation or low birthweight in a subsequent pregnancy.Design
A cas‐ontrol study with place of birth, time and sex matched controls.Setting
72 South American maternity hospitals.Subjects
18 534 malformed, 1150 no‐alformed babies of low birthweight and 16 394 controls. All babies were from mothers with at least one previous pregnancy.Main outcome measures
Frequency of stillbirths and miscarriages in the previous pregnancy and outcome of the index pregnancy.Results
Multiple malformation, Down's syndrome, anencephaly, spina bifida, pes equinovarus, congenital dislocation of the hip and low birthweight are associated with previous fetal loss.Conclusion
A miscarriage or a stillbirth in a previous pregnancy should be taken into account when the risk of malformations or low birthweight in a subsequent pregnancy is assessed.
A prospective study comparing the outcome of oocytes retrieved in the aspirate with those retrieved in the flush during transvaginal ultrasound directed oocyte recovery for in‐vitro fertilization
Authors: EL HUSSEIN ELSIR , BALEN ADAM H. , TAN SEANG‐LIN 
Published: August 2005

ABSTRACTObjective
To study prospectively the fate of oocytes collected from the follicular aspirate and subsequent flushes during transvaginal ultrasound directed oocyte recovery for in‐vitro fertilization (IVF).Setting
A tertiary referral assisted conception centre.Subjects
100 consecutive patients undergoing 100 cycles of IVF. Four patients were withdrawn because their embryos were electively cryopreserved. Therefore 96 cycles were studied.Main outcome measures
The oocyte recovery rate, viability, fertilization and cleavage rates and outcome of embryos generated from oocytes that were obtained from either the initial aspirate (Al), dead space in the collecting system (A2) or the first two 2 ml flushes (Fl and F2) were compared.Results
The overall oocyte recovery rate was 87.8%. Of the 1046 oocytes collected, 40.3% were from Al, 41.3% from A2, 13.7% from Fl and 4.7% from F2. There were comparable numbers of viable and fertilized oocytes and cleaved, transferred and frozen embryos in tubes Al and A2 but all these parameters were significantly lower in tubes Fl and F2 (P<0.0001). All these parameters were also significantly higher in Fl compared with F2 (P<0.001), except for the number of embryos frozen, in which there was no difference. The overall pregnancy rate per cycle was 28.1% and the pregnancy rate per embryo transfer was 31.0%. There were no pregnancies in any of the cycles in which embryos originating from F2 were transferred, nor were there pregnancies in cycles in which only embryos from Fl were transferred.Conclusion
Follicular aspiration together with one 2 ml flush maximises the recovery of oocytes that will result in pregnancies.
The variability of urinary protein and creatinine excretion in patients with gestational proteinuric hypertension
Authors: LINDOW S. W. , DAVEY D. A. 
Published: August 2005

ABSTRACTObjective
To determine the variability of protein excretion in patients with proteinuric hypertension and the accuracy of either a urinary protein/creatinine ratio or a Multistix examination for the estimation of a 24 h protein excretion.Design
An indwelling urinary catheter was placed for 24 h and successive 8 h specimens examined.Setting
A tertiary referral hospital in Cape Town, South Africa.Subjects
22 women with significant proteinuria in pregnancy were studied.Main outcome measures
The urine volume, protein excretion and creatinine excretion in eight hourly periods were measured. Multistix examination of each specimen was recorded.Results
A large coefficient of variation in urine volume (41%), amount of protein excreted (44%) and the amount of creatinine excreted (22%) in the eight hourly specimens were noted. The protein creatinine ratio did not accurately predict the 24 h protein excretion. The Multistix examination was less accurate with increasing amounts of proteinuria. The amount of creatinine excreted correlated with the volume of urine passed (r = 0.43).Conclusion
The analysis of a 24 h specimen or urine for protein excretion remains the best method of monitoring proteinuria in pregnancy. The amount of creatinine excreted in 24 h cannot be used as an index of completeness of collection of the 24 h specimen.
Pregnancy in sickle cell disease in Bahrain
Authors: EL‐SHAFEI AFFAF M. , DHALIWAL JAGJEEVAN KAUR , SANDHU AMARJEET KAUR 
Published: August 2005

ABSTRACTObjective
To review the maternal and fetal complications in pregnant women with sickle cell disease and to compare their pregnancy outcome with those of controls.Design
A case‐control study.Setting
Ministry of Health hospitals in Bahrain.Subjects
147 pregnancies in 140 women with sickle cell disease and 294 controls matched for age and parityMain outcome measures
The characteristics of women who had crises, the frequency of the crises, hypertensive disorders of pregnancy, infection, diabetes, perinatal mortality and the delivery statisties in the index and control women.Results
Maternal mortality was 1.4% and perinatal mortality was 73.3/1000 total births in women with sickle cell disease, there were no maternal deaths and the perinatal mortality was 6.8/1000 births in the control group. Anaemia was treated by blood transfusion in 47% of women with sickle cell disease and, of these, 39% had a crisis that appeared to have been precipitated by the transfusion in the absence of any other predisposing factors. The presence of raised HbF did not decrease the number of crises but reduced their severity.Conclusion
Pregnancy in women with sickle cell disease should be monitored very closely as it constitutes a high risk to both the mother and the baby.
Jejunal atresia related to the use of methylene blue in genetic amniocentesis in twins
Authors: VAN DER POL JOHAN G. , WOLF HANS , BOER KEES , TREFFERS PIETER E. , LESCHOT NICO J. , HEY HUGO A. , VOS ANTON 
Published: August 2005

ABSTRACTObjective
To calculate the incidence of jenunal atresia in newborns in The Netherlands. To study the relation between the occurrence of jejunal atresia and genetic amniocentesis to determine a possible iatrogenic cause for the unexpected high incidence of this anomaly in twins.Design
Retrospective study.Subjects
Eighty‐nine consecutive twin pregnancies in which amniocentesis had been performed for prenatal diagnosis. In 86 methylene blue solution had been used to mark the amniotic cavity that was punctured first.Main outcome measure
The occurrence of jejunal atresia in one of the two twin infants.Results
The incidence of jejunal atresia at birth in The Netherlands is estimated to be 1 in 14 000. This anomaly occurred in 17 out of 89 twin pregnancies (19%). In 15 of the 17 it was possible to determine which of the two children had been exposed to intra‐amniotic methylene blue. In all 15 pregnancies, the infant exposed to the dye was suffering from jejunal atresia.Conclusion
A causal relation between the use of methylene blue in second trimester amniocentesis and the occurrence of jejunal atresia is strongly suggested. We recommend that no dyes should be injected into the amniotic sac.
Clinical overview of cardiotocography
Authors: Spencer John A. D. 
Published: August 2005

ABSTRACTTwenty years after its widespread introduction, the role of continuous fetal heart rate and contraction monitoring in labour (cardiotocography, CTG) remains uncertain. Although a normal pattern is very reassuring about fetal condition, the predictive value of an abnormal pattern is low. In most studies the use of CTG has been associated with an increase in intervention in labour, particularly caesarean section, without clear evidence of benefit. Fetal blood sampling is the most useful associated technique for minimizing unnecessary intervention. The relationship between fetal heart rate, fetal blood pH changes and long‐term outcome remains obscure and further work to clarify this relationship is urgently needed.
The fetal ECG: accuracy of measurements
Authors: Dawes G. S. 
Published: August 2005

ABSTRACTAnalysis of fetal heart rate is very dependent upon the accuracy with which fetal events can be timed. This depends upon signal quality and the type of processing used in signal analysis. Signal quality is affected by mode of recording and positioning of sensors. Signal loss can be kept to below 5% in routine clinical practice with appropriate attention to technique. Accuracy of beat‐to‐beat measurement needs to be 1 ms if shortterm variability (epoch length 1/16 min) is to be assessed reliably.
The effects of exercise induced tachycardia on the maternal electrocardiogram
Authors: Asher U. A. , Ben‐Shlomo I. , Said M. , Nabil H. 
Published: August 2005

ABSTRACTObjective
To determine whether pregnancy has an effect on the maternal electrocardiographic response to stress.Design
Eight maternal ECG parameters were screened before, during and after exercise induced tachycardia at 29 and 37 weeks gestation and at 6 weeks post partum for each participant.Setting
General Hospital in Safed, Israel.Subjects
Fifteen healthy, pregnant women aged 22 to 34 years with singleton pregnancies volunteered from the peripheral antenatal clinics.Intervention
Exercise stress tests were performed on a Quinton 3000 treadmill stress test system according to a Modified Bruce Protocol, producing a heart rate of 85% of age predicted maximum.Main outcome measures
The ST‐segment, T‐wave, QRS complex, axis, rhythm, disorders of impulse conduction, the P–Q and Q–T intervals were screened before, during and after the exercise test.Results
The study results suggest an increase in the ST‐segment changes induced by stress at 37 weeks of pregnancy compared to 29 weeks (ST‐depression in 6 women out of 15 versus 2, P= 0.125, McNemar's Test for Correlated Proportions – Exact Test, two tailed; 95% CI, 0.042–0.492,0.01 < P<0.05) and to the post partum test (ST‐depression in 6 women out of 15 versus 1, P= 0.125; 0.029–0.637, 0.01 P < 0.05). No significant alteration of the other ECG parameters. No significant correlation between blood haemoglobin level, serum levels of sodium, potassium, calcium, glucose and 17β‐oestradiol with the appearance of the ECG change.Conclusions
The increase in the exercise induced ST‐segment abnormalities at 37 weeks of pregnancy may be another physiological effect of late pregnancy which has not been demonstrated previously.
Angiotensin sensitivity predicts aspirin benefit in placental insufficiency
Authors: Cook Colleen‐M , Trudinger Brian J. 
Published: August 2005

ABSTRACTObjective
To determine whether the beneficial effects of aspirin in the treatment of Doppler umbilical placental insufficiency correlate with the maternal pressor response to angiotensin infusion.Design
An open trial.Setting
A tertiary referral obstetric service.Patients
Women identified at between 25 and 36 weeks of pregnancy with an elevated umbilical artery Doppler systolic/diastolic (S/D) ratio and a positive pressor response to angiotensin infusion.Intervention
Low dose aspirin (100mg/day) treatment of mothers.Main outcome measure
Fetal and placental size at delivery in relation to subsequent maternal angiotensin responsiveness.Results
Women who converted from a positive angiotensin pressor response to angiotensin refractoriness after aspirin administration had larger infants and placentas compared with those whose response remained positive.Conclusion
Angiotensin sensitivity predicts women with umbilical Doppler detected placental insufficiency responding to aspirin therapy. Loss of the normal refractory response in pregnancy may be a consequence of vascular pathology in the placenta.
A nonpenetrating fetal scalp electrode
Authors: Justus Hofmeyr G. , Cheryl Nikodem V. , Metin Gülmezoǧlu A. , Bunn Anthony E. 
Published: August 2005

ABSTRACTObjective
To develop a nonpenetrating scalp electrode for intrapartum fetal monitoring.Design
Preliminary observational evaluation of the device.Setting
An urban academic hospital in Johannesburg, South Africa.Subjects
Fifteen women in labour.Intervention
Application of the electrode for intrapartum monitoring.Outcome measures
Quality of tracings, duration of application, disconnection of the electrode, marking of the scalp.Results
Application was successful in 13of 15 women, and high quality tracings obtained in 12.Conclusions
The design of scalp electrode tested is effective and produces high quality tracings in most cases.
Antithyroid antibodies underlying thyroid abnormalities and miscarriage or pregnancy induced hypertension
Authors: Lejeune B. , Grun J. P. , de Nayer Ph. , Servais G. , Glinoer D. 
Published: August 2005

ABSTRACTObjective
To assess whether asymptomatic abnormalities, including thyroid auto‐antibodies, were associated with an abnormal miscarriage rate or a poor obstetric outcome.Design
Prospective study of thyroid auto‐antibodies and thyroid function in an unselected obstetric population.Setting
Saint‐Pierrie Hospital, Brussels, Belgium.Subjects
Seven hundred and thirty consecutive pregnant women attending the antenatal clinic.Main outcome measures
Miscarriage and pregnancy induced hypertension.Results
Elevated antithyroperoxidase (TPO‐Ab) and antithyroglobuline (TG‐Ab) antibody titres are associated with an increased miscarriage rate. Also, asymptomatic thyroid abnormalities, mainly abnormal echostructure but not antithyroid antibodies, are associated with pregnancy induced hypertension.Conclusion
The presence of thyroid auto‐antibodies during pregnancy constitutes a marker of increased risk of miscarriage and poor obstetric prognosis.
An audit of the obstetric outcome of 148 consecutive pregnancies from assisted conception: implications for neonatal services
Authors: McFaul P. B. , Patel N. , Mills J. 
Published: August 2005

ABSTRACTObjective
To assess the outcome of pregnancy following assisted conception.Design
Cohort descriptive study.Setting
Unit of Reproductive Medicine, Ninewells Hospital and Medical School.Subjects
One hundred and forty‐eight consecutive assisted conceptions.Main outcome measures
Patient characteristics and outcome of pregnancy.Results
Seventy‐nine percent of mothers were aged between 26 and 35 years (mean 31.4). The main causes of infertility were tubal (48%), unexplained (35%), anovulatory (8%) and male factor (8%). Primary infertility accounted for 61% of cases and 82% of pregnancies occurred within 3 treatment cycles. Thirty‐five (24%) pregnancies miscarried before 14 weeks and 7 (5%) between 15 and 24 weeks gestation. One hundred and three pregnancies resulted in 136 liveborn infants. There was one neonatal death. Thirty‐five babies were admitted to SCBU. Antenatally, 13% of patients were admitted to hospital with hypertension and 8% with APH; 50% of multiple and 13% of singleton pregnancies were delivered prematurely, 68% following preterm labour. There were 28 sets of twins (four miscarried at less than 24 weeks) and four sets of triplets. Multiple pregnancy was not associated with cause of infertility, treatment, age or ovarian hyperstimulation syndrome. Seventy‐eight per cent of singletons and 50% of multipara were delivered vaginally.Conclusions
Our data confirm the high incidence of pregnancy loss and preterm delivery associated with assisted conception once allowing for the high rate of multiple pregnancies. The effect of assisted conception programme on health services is discussed.
What is vestibular papillomatosis? A study of its prevalence, aetiology and natural history
Authors: Welch Jan M. , Nayagam Maria , Parry Graham , Das Robert , Campbell Meg , Whatley Julie , Bradbeer Caroline 
Published: August 2005

ABSTRACTObjectives
To clarify the prevalence, aetiology, symptoms and natural history of vestibular papillomatosis.Design
Study in two parts: 1. prevalence assessed by colposcopic examination of the vulva of unselected patients by one doctor (J.M.W.); 2. patients selected by clinical appearance as having vestibular papillomatosis (by J.M.W. and other doctors) assessed in a research clinic.Setting
Outpatient genitourinary medicine clinic in South London.Subjects
Part 1 study: 295 female clinic attenders; part 2 study: 18 women with clinical vestibular papillomatosis.Main outcome measures
Part 1 study: number of unselected patients found to have vestibular papillomatosis. Part 2 study: associated symptoms, histology, DNA hybridisation and polymerase chain reaction on vulval biopsies. Clinical regression of lesions. Cervical cytology and colposcopy.Results
Part 1 study: Vestibular papillomatosis was identified by colposcopic examination of the vulva in 3/295 (1%) of women. Part 2 study: 9/18 (50%) women with vestibular papillomatosis were asymptomatic; the other nine had intermittent mild symptoms. Thirteen (72%) had a history of genital warts. Vulval biopsies had features suggestive of wart virus infection on histology in 17/18 (94%) and HPV16 was found by DNA hybridisation studies or polymerase chain reaction in 7/18 (39%). On follow up (mean duration 9 months) the vulval lesions had regressed in 9/12 patients. Ten patients had cervical wart virus infection or intraepithelial neoplasia (CIN), or both, and five needed laser treatment for this.Conclusions
In this study vestibular papillomatosis was associated with human papillomavirus (HPV) infection. This study suggests that vestibular papillomatosis need not be treated, but patients with it may be at increased risk for CIN.
Nifedipine versus ritodrine for suppression of preterm labour
Authors: Kupferminc M. , Lessing J. B. , Yaron Y. , Peyser M. R. 
Published: August 2005

ABSTRACTObjective
To compare the efficacy of tocolysis with specific regimens of nifedipine and ritodrine. Maternal side effects and neonatal outcome also were evaluated.Design
A prospective, randomised trial.Subjects
Seventy‐one women, including 11 with twin pregnancies, who had uterine contractions and observed cervical changes.Main outcome measures
Prolongation of pregnancy for 48 h, seven days and until 36 weeks of pregnancy were evaluated for each treatment. Maternal side effects and haemodynamic changes were compared, as well as neonatal outcomes.Results
Delivery was delayed for 48 h, seven days, and until the 36th week of gestation in 83%, 67%, and 50%, respectively, of women in the nifedipine group, compared with 77%, 63% and 43%, respectively, of women in the ritodrine group (no significant difference). Maternal side effects were significantly less common in the nifedipine group (27%) than in the ritodrine group (77%) (P <0.001). The neonatal outcome was similar in the two groups. The fall in mean arterial and diastolic blood pressure, and the rise in maternal heart rate were significantly greater in the women who received ritodrine compared with those treated with nifedipine.Conclusions
Nifedipine is as effective as ritodrine in suppressing preterm labour. Its use is associated with less frequent side effects.
Differential diagnosis of ovarian cancer with tumour markers CA 125, CA 15‐3 and TAG 72.3
Authors: Jacobs Ian J. , Rivera Hector , Oram David H. , Bast Robert C. 
Published: August 2005

ABSTRACTObjective
To determine the accuracy of tumour associated antigens CA 125, CA 15–3 and TAG 72.3 in the differential diagnosis of benign and malignant pelvic masses and to compare the results with a previously defined risk of malignancy index (RMI).Design
Retrospective analysis of samples collected during a prospective observational study.Setting
Department of Obstetrics and Gynaecology, the Royal London Hospital and Duke University Medical Center.Subjects
One hundred and forty‐three consecutive patients undergoing surgery for an adnexal mass.Method
Tumour marker levels were determined by radio‐immunoassay in stored serum samples obtained from 143 study subjects.Results
The highest diagnostic accuracy of the tumour marker panel was achieved by defining a positive result as elevation of any two of CA 125 (>30 u/ml), CA 15–3 (>30 u/ml) and TAG 72.3 (> 10 u/ml), (sensitivity 66.7%, specificity 93.1%). Similar diagnostic accuracy could be achieved by CA 125 alone using an upper limit of 50 u/ml (sensitivity 66.7%, specificity 94.1%). Inclusion of CA 15–3 or TAG 72.3 in stepwise logistic regression analysis did not improve the discriminative performance of the RMI.Conclusion
The risk of malignancy index incorporating CA 125, menopausal status and ultrasound is superior to the panel of three tumour markers for pre‐operative differential diagnosis of the pelvic mass.
Pressor, heart rate and plasma catecholamine responses to noradrenaline in pregnant and nonpregnant women
Authors: Ramsay M. M. , Pipkin F. Broughton , Rubin P. C. 
Published: August 2005

ABSTRACTObjective
To study cardiovascular responses to noradrenaline during early pregnancy.Design
Administration of incremental intravenous infusions of noradrenaline under basal conditions.Setting
University Hospital, Nottingham.Subjects
Nineteen women admitted for termination of pregnancy in first or second trimester and 18 nonpregnant women as control subjects.Interventions
Recordings of blood pressure and heart rate responses during the infusion of noradrenaline. Blood samples taken before, during and after the infusion.Main outcome measures
Evoked responses of systolic and diastolic blood pressure and heart rate at steady state during the noradrenaline infusion. Plasma catecholamine concentrations measured by high performance liquid chromatography.Results
There were no significant differences between the evoked pressor responses to noradrenaline in pregnancy compared to the nonpregnant state, but there was a lesser bradycardia in response to a standardised change in blood pressure. Neither basal plasma catecholamine concentrations nor those achieved during infusion of noradrenaline differed between pregnant and nonpregnant women. Thirty minutes after discontinuance of the infusion there was a persistent elevation of heart rate in all women, although plasma catecholamine concentrations had returned to basal levels. In pregnant women, systolic and diastolic blood pressures were also elevated at this time, compared to preinfusion levels.Conclusion
Cardiovascular regulatory mechanisms are altered in pregnancy with a diminution in the bradycardic response to a pressor challenge evoked by noradrenaline and a delayed recovery from that challenge.