bluuebunny/crossref_metadata_2025_split huggingface dataset:
Randomised evaluation of a prototype suction fetal scalp electrode
Authors: Metin A. , Cheryl V. , Hofmeyr G. Justus , Bunn Anthony E. 
Published: August 2005

Objective
To compare the performance and acceptability of a prototype suction fetal scalp electrode with that of a double helix spiral electrode.Setting
An urban academic hospital in Johannesburg, South Africa.Design
Randomised, by means of sealed opaque envelopes opened consecutively.Participants
One hundred women in active labour with an indication for direct fetal heart rate monitoring.Intervention
Application of a fetal scalp electrode to the presenting part.Outcome measures
Performance of the electrodes with respect to application success, detachment, quality of the tracings, scalp trauma and women's preferences.Results
Application of the suction electrode was unsuccessful in 15/50 (30%) compared to 1/50 (2%) with the spiral electrode. Detachment rates were similar. There were more tracings of average quality with the suction electrode (nine versus four). There were three instances of scalp bleeding at delivery with the spiral electrode. The suction electrode was preferred by more women and its application caused somewhat less discomfort.Conclusions
The lower rate of successful application with the suction electrode needs to be weighed against the advantage of avoiding fetal scalp penetration. In particular, women's concerns about pain or harm to the baby from needle electrodes, the theoretical risk of viral transmission, and the risk of serious scalp infection must be considered. These factors favour the use of a suction electrode when direct fetal heart rate monitoring is required. Needle electrodes should be considered when suction electrode application is unsuccessful. Correction of practical problems experienced with the prototype suction electrodes used in this study may result in improved success rates.
Effects of fish oil supplementation in late pregnancy on blood pressure: a randomised controlled trial
Authors: Salvig Jannie Dalby , Olsen Sjúrdur F. , Secher Niels Jsrgen 
Published: August 2005

Objective
To study the effect of fish oil supplementation on blood pressure during the third trimester of pregnancy.Design
In the 30th week of pregnancy 533 healthy women were randomly assigned in a ratio 2:1:1 to receive fish oil (2–7 g/day n‐3 fatty acids (Pikasol)), or a control regimen of either olive oil or no oil supplementation.Main Outcome measures
Blood pressure measured with an automatic device (Dinamap 1846 SX, Criticon) at baseline and in weeks 33, 37, 39 and subsequently weekly until delivery.Results
Mean blood pressure increased during the third trimester, and this was not influenced by group assignment. No significant effects on either systolic or diastolic blood pressure were seen in the fish oil group compared to the control groups. The proportions of women with a systolic blood pressure above 140 mmHg or a diastolic blood pressure above 90 mmHg were not significantly different in the fish oil group compared with the control groups, although the proportion of women with diastolic above 90 mmHg tended to be lower in the fish oil group compared with the olive oil group. The corresponding relative risk was RR = 048 (95 % CI 0.22–1.06; P= 007).Conclusion
2.7 g/day of marine n‐3 fatty acids provided in the third trimester of normal pregnancy showed no effect on blood pressure.
Central and peripheral haemodynamic changes in post‐term fetuses: correlation with oligohydramnios and abnormal fetal heart rate pattern
Authors: Weiner Zeev , Farmakides George , Schulman Harold , Casale Angela , Itskovitz‐Eldor Joseph 
Published: August 2005

Objective
To assess the hypothesis that the occurrence of oligohydramnios and abnormal fetal heart rate (FHR) pattern in post‐term fetuses is associated with impaired fetal cardiac function.Design
A cross sectional study was performed on post‐term and term fetuses. Fetal tests included a computerised analysis of the FHR, a biophysical profile and Doppler studies of the abdominal aorta, umbilical artery, middle cerebral artery and the fetal heart. Pulsatility index (PI) was calculated from the abdominal aorta, umbilical and middle cerebral artery flow velocity waveforms. Peak velocity, velocity time integral (VTI), E:A ratio, and heart rate (HR) were calculated from the flow velocity waveforms obtained from the aortic and pulmonic outflow, and from the mitral and tricuspid valves.Setting
Maternal fetal laboratory, Department of Obstetrics.Sample
One hundred and twenty post‐term and 42 term fetuses.Results
Only the tricuspid E: A ratio was significantly higher (P < 0.05) in post‐term fetuses with a normal amniotic fluid index compared with term fetuses. Post‐term fetuses with an abnormal amniotic fluid index had a significantly lower aortic peak velocity (P < 0.01), aortic VTIxHR (P < 0.01), and mitral VTIxHR(PP < 0.05) compared with post‐term fetuses with a normal amniotic fluid index or compared with term fetuses. Post‐term fetuses with reduced FHR variation had a significantly lower aortic peak velocity (P < 0.01), pulmonic peak velocity (P < 0.05), aortic VTI xHR(P < 0.01), pulmonic VTI xHR(P < 0.05) and a significantly lower mitral VTI xHR (P < 0.05) when compared with post‐term fetuses with normal FHR variation. Similar results were obtained in comparing fetuses with normal and adverse perinatal outcome.Conclusion
The occurrence of oligohydramnios and abnormal FHR pattern in post‐term fetuses appears to be associated with impaired fetal cardiac function. This finding should allow further investigations of post‐term fetuses.
Nonclosure of the visceral and parietal peritoneum at caesarean section: a randomised controlled trial
Authors: Irion Olivier , Lwuy Frank , Béguin François 
Published: August 2005

Objective
To assess the short term morbidity of nonclosure of the peritoneum at caesarean section.Design
Women undergoing a lower segment caesarean section were randomly allocated to either closure or nonclosure of the visceral and parietal peritoneum.Setting
Tertiary Care University Hospital of Geneva.Main outcome measures
Length of post‐operative hospital stay. Other outcomes include maternal pain as assessed by both a visual analogue scale and the amount of post‐operative analgesics administered, post‐operative ileus, and febrile morbidity. Operative time was recorded.Results
We allocated 137 women to the nonclosure group and 143 to the closure group. Population characteristics were similar between groups. The mean length of hospital stay was 6.5 (SD 1.9) days for the nonclosure group and 6.8 (SD 2.2) days for the closure group (P= 0.21). No differences were found in the level of post‐operative pain, the number of analgesic doses given, nor in the proportion with febrile morbidity. Post‐operative ileus resolved later in the closure group (P= 0.006). The mean operative time was shorter by 6 min (P= 0.006) in the nonclosure group.Conclusions
Short term post‐operative morbidity and maternal pain are not increased by a shorter and more simple surgical procedure in which the peritoneum is left unsutured.
The intrapartum CTG prior to neonatal encephalopathy at term: a case‐control study
Authors: Spencer John A. D. , Badawi Nadia , Burton Paul , Keogh John , Pemberton Patrick , Stanley Fiona 
Published: August 2005

Objective
To compare cardiotocograph (CTG) records during labour in cases of neonatal encephalopathy and matched controls.Design
Case—control study.Setting
Metropolitan area of Perth, Western Australia.Subjects
Term deliveries complicated by neonatal encephalopathy and controls matched for sex, hospital, time of birth, day of week of birth and maternal health insurance.Main outcome measures
Low fetal heart rate (FHR) variability, FHR accelerations, late decelerations, total Kreb's score and FIGO classification of CTG records.Results
The neonatal encephalopathy group had significantly more abnormal CTG records (89%) classified according to FIGO, although 52% of control CTG records were also abnormal. CTG records from cases developed significant differences in terms of absence of FHR accelerations and low FHR variability, but not late decelerations, prior to delivery.Conclusion
Given the low incidence of neonatal encephalopathy in this study (7 per 1000) the predictive value of an abnormal CTG record is clinically unhelpful. However, the changes in the FHR in such cases suggest a greater disturbance of fetal (rest—activity) behaviour during labour.
Antecedent circumstances surrounding neural tube defect births in 1990–1991
Authors: Williamson P. , Alberman E. , Rodeck C. , Fiddler M. , Church S. , Harris R. ,   On behalf of the Steering Committee of the National Confidential Enquiry into Counselling for Genetic Disorders
Published: August 2005

Objective
To investigate births with neural tube defects at a time when most districts were screening for the condition. The objective was to document the circumstances surrounding each affected birth and assess the care provided against given standards.Design
Retrospective review of antenatal casenotes by the obstetric team.Population
Three hundred and eight births in England and Wales in 1990 to 1991 were reported to the Office of Population Census Survey (OPCS) to involve neural tube defects. Sufficient information was available to identify both the woman and the obstetrician in 213 pregnancies. Details were obtained from a questionnaire completed by the obstetric team for 168 (79%). In 20/168 cases either the reported outcome was not a live birth/stillbirth or the pregnancy did not involve a neural tube defect: eight resulted in a ‘normal’ infant, eight were terminated and in four the abnormality was not a neural tube defect. Thus 148 eligible cases were available for analysis.Results
Of the 148 births, the anomaly was not detected prenatally or detected later than 25 weeks of gestation in 98 cases (66%), diagnosed in a multiple pregnancy in 24 (16%) and diagnosed prenatally but the woman chose to continue the pregnancy in 26 (18%). Of the 98 births not detected prenatally or detected late during pregnancy, the surrounding circumstances were that screening was declined in six cases (4%), screening was not offered due to late booking in 30 (20%), serum alpha‐fetopro‐tein screening gave a false negative result in eight (5%), ultrasound screening gave a false negative result in 29 (20%), both screening methods gave false negative results in 17 (11%) and other reasons in eight (5%). The estimated sensitivity of ultrasound screening for anencephaly was 100%. For spina bifida the estimated sensitivity for singleton pregnancies is higher for serum alpha‐fetoprotein screening, 84% to 92%, than ultrasound screening, 70% to 84%, for a range of assumptions regarding the degree of under‐reporting to OPCS of live births and terminations.Conclusions
Late booking precluded the offer of screening tests in a substantial proportion (22%) of cases. The presence of multiple fetuses including one or more with a neural tube defect was a serious additional complication in prenatal screening, diagnosis and counselling. Screening for neural tube defects was widespread in 1990 to 1991, although variations in the services provided were documented. Ultrasound scanning was a major component but was associated with a lower sensitivity than maternal serum alpha‐fetoprotein screening for neural tube defects other than anencephaly.
Serum levels of the tumour‐associated trypsin inhibitor in patients with endometriosis
Authors: Medl Michael , Ogris Emil , Peters‐Engl Christian , Mierau Michael , Buxbaum Pia , Leodolter Sepp 
Published: August 2005

Objective
To show that in patients with endometriosis a 6 kD polypeptide, the tumour‐associated trypsin inhibitor (TATI), can occur at elevated concentrations in serum.Design
In a prospective study TATI serum levels were assessed prior to surgery in 368 consecutive patients suffering from benign gynaecological diseases (e.g. pelvic pain, infertility, elective sterilisation, uterine fibroids and pelvic masses) with (n= 71) and without (n= 297) endometriosis, who underwent laparoscopy or laparotomy for diagnosis and/or treatment.Results
The TATI serum levels of patients suffering from endometriosis were significantly different from those in the control group and showed a positive correlation with the stage of endometriosis. The sensitivity of TATI was 0.34 with a specificity of 0.85 for all cases of endometriosis, with an increase of sensitivity (0.67) and slight decrease of specificity (0.82), considering only a group of Stage III/IV patients. Excluding patients with benign ovarian cysts, the specificity of TATI was 0.91 and 0.85, respectively. The combination of TATI and CA125 showed an increase of sensitivity to 0.59 for all cases of endometriosis and 0.89 for patients with Stage III/IV endometriosis.Conclusions
The sensitivity of TATI as a screening method for endometriosis is too low, but considering its high specificity, TATI in combination with CA125 could provide an additional diagnostic tool in diagnosis and follow up of patients with endometriosis.
Gestational trophoblastic disease with liver metastases: the Charing Cross experience
Authors: Crawford Robin A. F. , Newlands E. , Rustin G. J. S. , Holden L. , A'Hern Roger , Bagshawe K. D. 
Published: August 2005

Objective
To define management options for women presenting with gestational trophoblastic disease (GTD) which had already metastasised to the liver.Design
Retrospective analysis of case records between 1958 and 1994.Setting
A national referral centre for trophoblastic disease.Results
The database containing 1676 treated patients was reviewed and 46 patients with hepatic metastases were identified (2.7%). The median age was 32 years (range 19–52 years). The antecedent pregnancy to the GTD was normal in 65% (30/46), and the time interval between the antecedent pregnancy and presentation was longer than one year in 50% (22/44). Lung metastases were present in 43 patients (93%) and brain deposits in 15 patients (33%). Forty‐five patients (98%) were high risk by WHO criteria. The five‐year overall survival was 27%. The five‐year survival of the subgroup of patients having both hepatic and cerebral metastases was 10%. There was no significant survival difference between the different chemotherapy regimens used in the study period (pre‐1979 CHAMOCA: methotrexate, actinomycin D, cyclophosphamide, doxorubicin, melphalan, hydroxyurea and vincristine; 1979 onwards EMA/CO‐EP: etoposide, methotrexate, adriamycin‐D/cyclophosphamide, vincristine‐etoposide and cis‐platinum). Multivariate analysis revealed that a prognostic score > 12 was significant (Hazard ratio 5.4,95% CI 0.7–41.9; P= 0.04).Conclusions
The outcome for women presenting with hepatic metastases from GTD is poor with an even worse prognosis if cerebral metastases are also present. Alternative therapeutic measures, such as high dose therapy or new drugs, should be explored in these women.
Antenatal corticosteroid therapy and fetal behaviour: a randomised study of the effects of betamethasone and dexamethasone
Authors: Mulder Eduard J. H. , Derks Jan B. , Visser Gerard H. A. 
Published: August 2005

Objectives
To compare the effects of maternal betamethasone and dexamethasone administration on fetal behaviour and fetal heart rate variation.Design
Aprospective randomised study of 60 women at increased risk of preterm delivery.Outcome measures
Fetal heart rate and its variation, the incidence of fetal body and breathing movements.Setting
Obstetric unit, University Hospital, Utrecht, The Netherlands.Results
Following maternal betamethasone administration (day 2), fetal heart rate variation was reduced by 19% and fetal body and breathing movements by 49% and 85%, respectively. After dexamethasone treatment there was a significant increase in short term fetal heart rate variation (24%) on day 1. All values returned to baseline on day 4, indicating that no fetal deterioration had occurred during the course of the study period.Conclusion
Betamethasone, with probably the greater beneficial effect, has more effects on fetal behaviour and fetal heart rate variation than dexamethasone. When assessing fetal condition, due account needs to be taken of these effects.
Selection biases invalidate current low birthweight weight‐for‐gestation standards
Authors: Tin W. , Wariyar U. K. , Hey E. N. ,   on behalf of the Northern Neonatal Network
Published: August 2005

Objective
To obtain unbiased estimates of the variation of birthweight with gestation in infants born before 32 weeks of gestation.Setting
The former Northern Regional Health Authority.Design
Information on birthweight was collected during a collaborative study of every registered and unregistered birth at 22 to 31 weeks of gestation in the region in 1983 and 1990 to 1991. These birthweights were then related to computer‐generated Tyneside norms for all registered births at 28 to 42 weeks of gestation between 1984 and 1991. Some local information was also collected on fetal weight after termination of pregnancy on social grounds at 16 to 21 weeks of gestation.Results
Weight centiles constructed after excluding infants with a gross, externally visible, malformation and those dying before the onset of labour suggest that previously published European standards have overestimated birthweight in infants < 28 weeks of gestation, some low centiles being 30% in error. Female and first‐bom infants weighed 4% less than their male and later‐born counterparts at all gestations studied. A single correction factor can therefore be used to correct for sex and parity, eliminating the need for separate centile graphs. Twin pregnancy was associated with a 10% reduction in mean birthweight in pregnancies lasting < 37 weeks, and this difference increased progressively in pregnancies lasting longer than this.Conclusion
The small number of low birthweight infants in previous datasets and the selective exclusion of all nonregistered births have made previous second trimester weight‐for‐gestation norms unreliable.
Suppression of serum vascular endothelial growth factor immunoreactivity in normal pregnancy and in pre‐eclampsia
Authors: Lyall Fiona , Greer Ian A. , Boswell Fiona , Fleming Richard 
Published: August 2005

Objective
To determine whether vascular endothelial growth factor (VEGF) concentrations are altered in pre‐eclampsia.Design
Serum was prepared from peripheral venous blood and stored at −70°C. Serum VEGF concentrations were measured by ELISA.Setting
University of Glasgow Department of Obstetrics and Gynaecology, Royal Infirmary, Glasgow.Participants
Twenty‐two healthy nonpregnant volunteer women, 34 normal pregnant women and 34 women with pre‐eclampsia were studied.Results
Serum concentrations of VEGF were significantly lower in normal pregnant women (median value 12.89 pg/mL) than in nonpregnant women (median value 166 pg/mL; P < 0.0001). In pre‐eclampsia VEGF concentrations were significantly lower (median value 2.34 pg/mL) than normal pregnancies (P < 0.0001). Postpartum concentrations of VEGF in the group complicated by pre‐eclampsia (median value 76.42 pg/mL) were not significantly different from nonpregnant values (P= 0.2).Conclusions
Our results show that serum concentrations of VEGF are suppressed in pregnancy and further reduced in pre‐eclampsia. Further studies to elucidate the mechanisms which lead to a reduction in VEGF concentrations may provide new clues to the aetiology of this disorder.
The role of endogenous nitric oxide synthesis in contractility of term or preterm human myometrium
Authors: Jones G. D. , Poston L. 
Published: August 2005

Objective
To assess in vitro the role of endogenous myometrial nitric oxide synthesis on human myometrial contraction.Design
Strips of myometrium were mounted in a standard organ bath for assessment of isometric contraction and the response to modulators of nitric oxide synthesis determined.Setting
A teaching hospital research laboratory.Sample
Women undergoing elective nonlabour caesarean section under regional anaesthesia: 54 at term and seven preterm.Results
Neither addition of L‐arginine, the substrate for nitric oxide synthase, nor of an inhibitor of nitric oxide synthase led to any specific change in spontaneous myometrial contraction.Conclusion
Endogenous nitric oxide production does not play an important role in the control of human term or preterm nonlabouring uterine smooth muscle contractility.
Lipid peroxidation in cord blood: the effects of umbilical nuchal cord
Authors: Wang Chi Chiu , Rogers Michael Scott 
Published: August 2005

Objective
To examine the relation between cord entanglement around the fetal neck and umbilical arterial measures of free oxygen radical activity at birth.Design
Prospective observational stuy of the lipid peroxide levels in umbilical cord arterial blood.Setting
Delivery suite of Prince of Wales Hospital, Hong Kong.Population
Women with a singleton pregnancy, at term (37 to 42 weeks of gestation), cephalic presentation, spontaneous or induced labour and an initially normal fetal heart rate tracing.Methods
A series of 230 singleton deliveries had determination of two lipoperoxides in umbilical arterial cord blood: malondialdehyde and organic hydroperoxide. Umbilical pH, PO2, PCO2 and base excess were also measured in both umbilical cord arterial and venous blood.Main outcome measures
Umbilical cord blood gases and arterial malondialdehyde and organic hydroperoxide levels.Results
Forty‐nine cases of nuchal cord were observed: 14 tight and 35 loose. Tight nuchal cord was associated with a low 1‐min Apgar score and increased lipid peroxide levels. Loose nuchal cord was associated with larger amniotic fluid volume and significantly decreased lipid peroxide levels.Conclusions
This study suggests that tight nuchal cord is associated with increased free oxygen radical activity in the fetus, but that loose nuchal cord carries no adverse effects.
Randomised controlled trial of cardiotocography versus umbilical artery Doppler in the management of small for gestational age fetuses
Authors: Haley J. , Tuffnell D. J. , Johnson N. 
Published: August 2005

Objective
To compare the impact on use of resources in the management of small for gestational age babies using Doppler ultrasound versus cardiotocography.Design
A randomised controlled trial.Setting
A large district general hospital delivering 5500 to 6000 infants each year, 30% to 35% of which are to women of Pakistani origin.Population
One hundred and fifty women delivered of small for gestational age infants.Main outcome measures
Primary outcome measures were length of hospital inpatient stay and induction of labour rates. Secondary outcome measures included caesarean section rates and length of stay on neonatal unit.Results
The use of Doppler reduced average hospital inpatient stay from 2.5 days to 1.1 days, compared with cardiotocography (P= 0.036). There was no effect on induction of labour rates or caesarean section rates. There was no significant difference in length of stay on the neonatal unit (P= 0.33). There was a reduction in monitoring frequency and fewer hospital antenatal clinic visits.Conclusion
The use of Doppler ultrasound to manage small for gestational age infants reduces the use of resources, compared with cardiotocography.