bluuebunny/crossref_metadata_2025_split huggingface dataset:
Biochemical modifications of human whole saliva induced by pregnancy
Authors: Salvolini E. , Di Giorgio R. , Curatola A. , Mazzanti L. , Fratto G. 
Published: August 2005

Objective
To assess human unstimulated whole saliva components during pregnancy, to determine the relation, if any, between pregnancy and oral health, particularly total protein concentration, α‐amylase activity, sialic acid content and calcium and phosphate concentrations were evaluated.Design
Cross‐sectional study.Participants
Forty‐five healthy primigravid women; 15 nonpregnant women acted as controls.Results
1. A higher total protein content at 10 and 21 weeks of gestation with respect to the controls and to pregnant women at 40 weeks; 2. a higher α‐amylase activity at 10 and 21 weeks of gestation compared with the controls and to pregnant women at 40 weeks; 3. an increased sialic acid content at 21 and 40 weeks; 4. decreased calcium and phosphorus concentrations at 21 and 40 weeks of gestation.Conclusions
Pregnancy modifies saliva composition. This could play a pivotal role in the incidence of pregnancy‐induced dental caries.
Does antenatal care influence postpartum health behaviour? Evidence from a community based crosssectional study in rural Tamil Nadu, South India
Authors: Bruun Nielsen Birgitte , Hedegaard Morten , Haraksingh Thilsted Shakuntala , Joseph Abraham , Liljestrand Jerker 
Published: August 2005

Objective
To study the association between attendance to antenatal care and postpartum health behaviour among women in rural Tamil Nadu, South India.Design
Community based, cross‐sectional questionnaire study of 30 randomly selected areas served by health subcentres.Setting
Rural parts of Salem District, Tamil Nadu, South India.Population
1321 women who were delivered in the six months before the questionnaire‐based interview.Main outcome measures
Feeding of colostrum, time of initiation of breastfeeding and maternal dietary habits during the first month postpartum.Results
The median number of antenatal visits was four (range 0‐51; lower quartile 3, upper quartile 7)., The fifth month of pregnancy was the median time for the initiation of antenatal care. Pregnant women 1. who had a large number of antenatal care visits, 2. who initiated antenatal care in the first trimester or 3. who reported having received information about breastfeeding were more likely to feed colostrum (odds ratio 1.48; 95% CI 1.06 to 2.07), (odds ratio 1.40; 95% CI 1.06 to 1.85), (odds ratio 1.66; 95% CI 1.29 to 2.14, respectively). Only women who reported having received information about breastfeeding were more likely to initiate early breastfeeding (odds ratio 1.81; 95% CI 1.34 to 2.43). Use of antenatal care facilities was not associated with maternal postpartum dietary habits.Conclusions
A large number of women attended antenatal care in the study area, but antenatal care had a limited effect on postpartum health behaviour. As antenatal care is considered an essential part of primary health care and takes up considerable resources, we recommend further research to explain the gap between the intentions of antenatal care and the actual outcome of such care.
Therapeutic and other interventions to reduce the risk of mother‐to‐child transmission of HIV‐1 in Europe
Authors:   The European Collaborative Study
Published: August 2005

Objectives
To document policies regarding the use of interventions to reduce risk of vertical transmission of human immunodeficiency virus (HIV) and assess the extent of changes since 1994.Design
A postal questionnaire survey and data from the European Collaborative Study (ECS), a prospective multi‐centre cohort study.Setting
Fifty‐four obstetric centres in 16 European countries.Sample
A questionnaire response from 54 obstetricians; 669 deliveries to HIV‐infected women enrolled in the ECS from 1994 to 1997.Main outcome measures
Use of zidovudine during pregnancy, at delivery and to the neonate; caesarean section delivery rates; vaginal lavage; avoidance of breastfeeding; vertical transmission rate.Results
Zidovudine therapy to reduce vertical transmission is now widespread in Europe and routine in all but one centre surveyed, although regimens vary. In 11 (26%) centres elective caesarean section is offered to all HIV‐infected women and a further nine (21%) have a policy of routine vaginal lavage. In all centres HIV‐infected women are advised to avoid breastfeeding. In the ECS there has been a significant temporal decline in the vertical transmission rate with an increase in zidovudine use. More than 90% of women in the ECS who were delivered in 1997 received one or more components of zidovudine therapy; the rate of vertical transmission is 9% where zidovudine has been used, compared with 15% without use of zidovudine.Conclusions
Although the use of zidovudine to reduce vertical transmission is increasing in Europe and, with the avoidance of breastfeeding, is associated with a decline in vertical transmission, the success of these interventions will be limited by the uptake of antenatal screening.
Planned vaginal delivery versus elective caesarean section: a study of 705 singleton term breech presentations
Authors: Irion Olivier , Hirsbrunner Almagbaly Pascale , Morabia Alfredo 
Published: August 2005

Objective
To compare neonatal mortality and neonatal and maternal morbidity in planned vaginal delivery versus elective caesarean section for breech presentation at term. To identify factors associated with the risk of caesarean section during labour.Design
Cohort study.Setting
University Hospital of Geneva.Population
Seven hundred and five consecutive singleton term breech presentations: 385 planned vaginal deliveries and 320 elective caesarean sections.Methods
Relative risk and risk difference with their 95% confidence intervals (95% CI) were calculated for neonatal and maternal morbidity. Prognostic factors for the risk of intrapartum caesarean section were analysed by multiple logistic regression.Main outcome measures
1. Neonatal mortality 2. Neonatal morbidity (eg. fracture, haematoma with hyperbilirubinemia, paresis, paralysis, visceral trauma, respiratory distress, umbilical cord arterial pH < 7.0 with 5 minute Apgar score < 7), corrected neonatal morbidity was defined as morbidity after exclusion of major malformations. 3. Maternal morbidity (eg. endometritis, urinary infection, pulmonary infection, surgical complications, hysterectomy, anaemia, pulmonary embolism, cardio‐respiratory arrest).Results
There were significantly fewer maternal complications in the planned vaginal delivery group than in the elective caesarean section group (risk difference 10.5%, 95% CI 3.9 to 17.0). Five neonates with major malformations died. There was no difference in corrected neonatal morbidity between the planned vaginal delivery and the elective caesarean section groups (risk difference 1.9%, 95% CI ‐1.0 to 4.9). Nulliparity, maternal age > 30 years and a higher body mass index were independently associated with the risk (30%) of intrapartum caesarean section, but it was not possible to construct a predictive model useful for clinical practice.Conclusions
There is no firm evidence to recommend systematic elective caesarean section for breech presentation at term. Large unbiased studies are needed to determine whether a potential benefit for the newborns outweighs the increased risk for the mothers associated with elective caesarean section.
Nifedipine versus expectant management in mild to moderate hypertension in pregnancy
Authors:   Gruppo di Studio Ipertensione in Gravidanza
Published: August 2005

Objective
To compare the effect of routine treatment with the calcium channel blocker nifedipine in mild to moderate hypertension in pregnancy.Design
Randomised clinical trial.Setting
General and University hospitals.Participants
Pregnant women, between 12 and 34 weeks of gestation, with chronic, pregnancy‐induced or unclassifiable hypertension and diastolic pressure between 90 and 110 mmHg.Methods
Eligible women were randomly assigned treatment with slow‐release nifedipine, 10 mg twice daily until delivery, or no treatment. In the no treatment group nifedipine was given if the diastolic pressure exceeded 110 mmHg. A total of 145 women were assigned nifedipine and 138 no treatment.Results
In the nifedipine group 45.0% of women were delivered before term, compared with 37.0% in the no treatment group; the difference was not significant. In all, 56.3% of women allocated nifedipine and 62.1% allocated no treatment underwent caesarean section; the difference was not statistically different (OR 0.7,95% CI 041.1). There was no significant difference between the two groups in the percentage of babies weighing less than the 10th centile (OR 0.8; 95% CI 0.4–1.4) or in the mean birthweight. The frequency of admission of infants to the neonatal intensive care unit was not affected by treatment.Conclusions
This trial found no benefit on pregnancy outcome of routine treatment with nifedipine. In clinical practice, the treatment of hypertension in pregnancy may be delayed until the hypertension becomes severe.
Effect of routine screening for Down's syndrome on the significance of isolated fetal hydronephrosis
Authors: Oluleye Thompson M. , Thilaganathan Baskaran 
Published: August 2005

Objective
To determine the risk of Down's syndrome in fetuses with isolated hydronephrosis at 18–23 weeks in an unselected general population after routine screening for Down's syndrome, using first trimester nuchal translucency measurement and second trimester maternal serum biochemistry.Population
All pregnant women undergoing a routine 18–23 week ultrasound scan, from a population who had been offered screening for Down's syndrome.Setting
A district general hospital serving a low risk obstetric population.Methods
Prospective study of all routine 18–23 weeks ultrasound scans. The prevalence of isolated hydronephrosis and Down's syndrome was determined and the relative risk for Down's syndrome was calculated for different ultrasound findings.Results
10,971 women were scanned at 18–23 weeks during the study period. Down's syndrome was diagnosed in 14 of 20 cases before this stage using first trimester nuchal translucency measurement and second trimester maternal serum biochemistry. Isolated fetal hydronephrosis was diagnosed in 423 pregnancies (3.9%); none of these pregnancies were affected by Down's syndrome. The relative risk for Down's syndrome was 0.18 (95% CI 0.06–0.53) for women with a normal scan (n= 9983). When multiple ultrasound markers were found (n= 565), the relative risk for Down's syndrome was 2.00 (95% CI 0.18–22‐10) and 9.00 (95% CI 1.14–71.30) for all other aneuploidies.Conclusion
The finding of isolated fetal hydronephrosis does not significantly increase the age‐related risk for Down's syndrome. The presence of multiple ultrasound markers is associated with an increased risk of aneuploidies other than Down's syndlome. These findings are explained by the reduced prevalence of Down's syndrome as a result of prior screening and diagnosis of this condition.
The impact of rubella immunisation on the incidence of rubella, congenital rubella syndrome and rubella‐related terminations of pregnancy in South Australia
Authors: Cheffins Tracy , Chan Annabelle , Keane Rosemary J , Haan Eric A. , Hall Robert 
Published: August 2005

Objectives
To describe the impact of rubella immunisation on the incidence of rubella, congenital rubella syndrome and rubella‐related terminations of pregnancy in South Australia, and to identify factors associated with a re‐emerging problem.Design and Methods
A population‐based descriptive study using data from South Australian notifications of disease, births and terminations of pregnancy, the rubella immunisation programme, antenatal rubella antibody screening and paediatric hospital case records.Setting
South Australia (population 1.48 million people; 20,000 births per year).Main outcome measures
Incidence of rubella (age‐sex specific), congenital rubella syndrome and rubella‐related terminations of pregnancy; antenatal rubella sero‐positive rates; rubella immunisation uptake rates.Results
Rubella notification rates in 1990–1996 were significantly higher for males than females for ages 15–34 years. There were five cases of congenital rubella syndrome notified in 1980–1996 compared with at least 20 confirmed or compatible cases in 1965–1979. Rubella‐related terminations of pregnancy are now rare, with the last termination for maternal rubella being in 1993. The antenatal rubella sero‐positive rate in 1995 was 96.7%, but was significantly lower among Asian women born overseas (78.6% among those 30 years or older). Vaccination uptake rates in schoolgirls decreased between 1990 and 1994 (91.2% to 86.9%).Conclusions
Since the introduction of rubella immunisation, the incidence of rubella infection among women of reproductive age, and of rubella‐related terminations, has fallen. Congenital rubella syndrome has not been notified since 1990 but its risk persists with a recent increase in rubella notifications, a fall in school immunisation rates, a relatively low antenatal sero‐positive rate among older Asian women born overseas and the trend towards giving birth at older ages. Effective immunisation programmes must be maintained, particularly in schools and for young children and migrant women.
An immunoscintigraphic evaluation of the engineered human monoclonal antibody (hCTMO1) for use in the treatment of ovarian carcinoma
Authors: Davies Q , Perkins A. C. , Roos J. C. , Molthoff C. F. M. , Verheijen R. H. M. , Frier M. , Kenemans P. , Broadhead T. , Sopwith M. , Symonds E. M. 
Published: August 2005

Objective
To assess the safety and targeting ability of the engineered human antibody (hCTMO1) in women with ovarian carcinoma.Design
The monoclonal antibody labelled with Indium‐1 11 was administered to women with suspected primary or recurrent ovarian carcinoma six days pre‐operatively. The first group of women was given a dose of 0.1 mg per kg body weight of radiolabelled antibody. A second group of women received 1 mg per kg body weight and finally a third group was given 1 mg per kg body weight of unlabelled antibody followed one hour later by 0.1 mg per kg body weight of radiolabelled antibody. All the women were then imaged using a gamma camera one hour and up to 96 hours after injection.Participants
Fourty‐four women in whom there was a high suspicion of primary ovarian carcinoma on the basis of ultrasound or CT imaging and serum CA125 and those in whom there was a suspicion of recurrent ovarian carcinoma after being treated for histologically confirmed carcinoma.Setting
The Queen's Medical Centre, Nottingham and University Hospital Vrije Universiteit, Amsterdam, The Netherlands.Results
At the low dose of antibody the sensitivity for detection of ovarian carcinoma was 70%. After increasing the dose of antibody and also after pre‐dosing with unlabelled antibody the sensitivity increased to 100%, but there was a large number of false positive results at the higher dose, and therefore the specificity was low. The liver and bone marrow were the organs with the highest activities.Conclusion
The genetically engineered antibody hCTMO1 is safe for use in women. This antibody effectively targets ovarian carcinoma and has greater potential as a vector for therapeutic use than as a diagnostic agent.
Neural networks in the diagnosis of malignant ovarian tumours
Authors: Clayton R. D. , Snowden S. , Weston M. J. , Mogensen O. , Eastaugh J. , Lane G. 
Published: August 2005

Objective
To assess the role of neural networks in predicting the likelihood of malignancy in women presenting with ovarian tumours.Design
Retrospective case study.Setting
University Department of Obstetrics and Gynaecology, St James's Hospital, Leeds.Methods
Information from 217 cases with histologically proven benign, borderline or malignant tumours was extracted for study. Four variables (age, ultrasound findings with and without colour Doppler imaging and CA125) were entered in the neural network classifier. The neural network results were compared with logistic regression analysis.Results
When used in the neural network the variables of age, CA125 and ultrasound score produced the best result with a sensitivity of 95% and a corresponding specificity of 78% in predicting malignancy. Logistic regression gave a sensitivity or 82% for a specificity of 51%.Conclusion
The neural network is a good method of combining diagnostic variables and may be a useful predictor of malignancy in women presenting with ovarian tumours. A comparison of the performance of the neural network with conventional diagnostic methods would be warranted prior to use in clinical practice.
Laparoscopic‐assisted Doderlein hysterectomy: retrospective analysis of 300 consecutive cases
Authors: Hawe Jeremy A. , Clayton Richard , Phillips Graham , Whittaker Mark , Kucukmetin Ali , Garry Ray 
Published: August 2005

Objective
To assess the clinical outcomes of the Doderlein laparoscopic‐assisted hysterectomy.Design
A retrospective study.Setting
Women's Endoscopic Laser Foundation at South Cleveland Hospital, Middlesbrough and St James's University Hospital, Leeds.Population
Three hundred consecutive women who had a laparoscopic‐assisted Doderlein hysterectomy.Methods
Patients were identified from the laparoscopic hysterectomy theatre log at both sites. Case notes were requested and examined.Main outcome measures
Operative time, uterine weight, associated pelvic pathology, blood loss, hospital stay, intra‐operative and post‐operative complications.Results
The operations were performed by eight different surgeons, seven of whom were laparoscopic trainees. The mean operating time was 102 minutes (SD 30). Additional surgery including unilateral or bilateral salpingo‐oophorectomy, was carried out in 247 patients (82%). The mean uterine weight was 140 g (SD 74). One hundred and thirty‐two women (44%) had a normal pelvis at hysterectomy. The mean drop in haemoglobin and haematocrit was 1.46 g (SD 0.95) and 4.4% (SD 24), respectively. The overall complication rate was 18%, of which 6.2% were classed as major. The major complications included four cystotomies, five unscheduled laparotomies, seven post‐operative blood transfusions, one pulmonary embolus and two re‐operations (within six weeks). The mean hospital stay was three days.Conclusions
Laparoscopic‐assisted Doderlein hysterectomy is an alternative to standard laparoscopic hysterectomy techniques. It has the advantage of being easy to learn and is associated with low complication rates, compared with other laparoscopic and traditional techniques for hysterectomy.
Association of reduced selenium status in the aetiology of recurrent miscarriage
Authors: Nicoll A. E. , Norman J. , Macpherson A. , Acharya U. 
Published: August 2005

Objective
To determine whether recurrent miscarriage is associated with reduced selenium status.Design
Case–control study.Setting
Department of Obstetrics and Gynaecology, Glasgow Royal Infirmary and Glasgow Royal Maternity Hospital.Population
Twenty nonpregnant women with a history of unexplained recurrent miscarriage, and 47 nonpregnant parous women with a history of at least one successful pregnancy and no more than one miscarriage.Methods
A 7 mL blood sample from each woman was collected into lithium heparin ‘vacutainer’ tubes. Samples were centrifuged at 3000 g for 15 minutes, and plasma was extracted and stored at −20°C. Selenium concentrations were measured using a fluorescence spectrophotometer. The selenium concentrations in the two groups were compared and the differences examined using the Student's t test.Main outcome measures
Plasma selenium concentration (μg/L).Results
The mean selenium concentration for women with a history of unexplained recurrent miscarriage was 67.7 μg/L (SD 16.4). The selenium level for the women with no history of recurrent miscarriage was 70.3 μg/L (SD 12.7). There was no difference in selenium concentrations between the two groups (P= 0.53).Conclusions
In this study there is no association between unexplained recurrent miscarriage and reduced selenium status, implying that reduced selenium status is not a factor in the pathogenesis of recurrent miscarriage. We can find no rationale for a trial of selenium therapy in women with a history of recurrent miscarriage.
A randomised controlled trial comparing transvaginal ultrasound, outpatient hysteroscopy and endometrial biopsy with inpatient hysteroscopy and curettage
Authors: Tahir M. M. , Bigrigg M. A. , Browning J. J. , Brookes T. , Smith Phillip A. 
Published: August 2005

Objective
To compare the use of outpatient and inpatient procedures in the investigation of abnormal uterine bleeding.Design
A randomised controlled trial.Setting
Two university teaching hospitals.Participants
Four hundred women with abnormal uterine bleeding (postmenopausal bleeding, menorrhagia, intermenstrual bleeding, postcoital bleeding, or irregular periods) above the age of 35 years, between June 1993 and January 1995.Main outcome measures
1. Incidence of detection of abnormal pathology by vaginal ultrasound, outpatient hysteroscopy and endometrial biopsy compared with inpatient hysteroscopy and curettage; 2. Number of ‘lesions’ (e.g. fibroids, polyps, endometrial hyperplasia or malignancy) found by hysteroscopy that would have been missed by the combination of endometrial sampling and ultrasound; 3. Comparison of the quality of tissue obtained for histology by outpatient endometrial sampling and inpatient curettage; and 4. An evaluation of patient acceptability of outpatient and inpatient procedures.Results
1. A combination of transvaginal sonography, Pipelle endometrial biopsy and outpatient hysteroscopy has similar efficacy to inpatient hysteroscopy and curettage for the investigation of abnormal uterine bleeding; 2. Hysteroscopy will detect some fibroids and polyps missed by a combination of transvaginal ultrasound and Pipelle endometrial sampling; 3. The quality of histological samples obtained by outpatient Pipelle were comparable to those obtained by formal inpatient curettage; and 4. Outpatient procedures were well tolerated, with good patient acceptability.Conclusion
Transvaginal sonography and endometrial biopsy can safely be used as the initial investigations in the management of abnormal uterine bleeding. Hysteroscopy can be used as a second line investigation. Outpatient hysteroscopy with local anaesthesia is well tolerated although general anesthesia may occasionally be necessary.