Preoperative assessment of endometrial carcinoma by three-dimensional power Doppler angiography.

Objective: Preoperative evaluation of the depth of myometrial invasion in endometrial carcinoma is challenging. The objective of this study was to evaluate the usefulness of three-dimensional power Doppler angiography (3D-PDA) in this setting.

Methods: Sonographic and histological data on 100 consecutive cases of endometrial carcinoma were analyzed.

Prediction of successful labor induction by evaluation of maternal symptoms at an early stage of the misoprostol induction protocol.

Objective: This prospective observational study evaluated maternal symptoms and characteristics that predict successful labor induction with oral misoprostol.

Methods: A total of 244 consecutive women undergoing labor induction voluntarily completed a questionnaire about subjective sensations and pain scores during the induction protocol. Maternal and neonatal characteristics were collected retrospectively from patient files.

Fetal sex determination: obstetricians' attitudes in antenatal screening units in Finland.

Aim: To study obstetricians' attitudes in Finnish antenatal screening units concerning fetal sex determination without medical indication.

Methods: A structured questionnaire to all delivery units (n = 37) and the main outpatient screening units (n = 18) in the country.

Results: The majority of units made fetal sex determination without medical indication at patient's request during the second-trimester ultrasonographic screening.

Good pregnancy outcome despite intrahepatic cholestasis.

Objective: Pregnant women complaining of itching are screened for intrahepatic cholestasis (ICP) by laboratory tests in primary healthcare. Cases of ICP are referred to specialist care. In Finland, ICP occurs in 1% of pregnancies.

Sonographic diagnosis of postpartum pseudoaneurysms of the uterine artery: a report of 2 cases.

Two cases of post-partum uterine artery pseudoaneurysm are described, 1 after normal vaginal delivery and the other after Caesarean section. Both cases were complicated by heavy bleeding and treated with catheter embolization. A turbulent arterial-type velocity waveform with high peak velocity and forward end-diastolic flow was registered in the feeding vessel.

Diamniotic omphalopagus conjoined twins in a diamniotic pregnancy.

Objective: To present antepartal diagnostic findings including 2D/3D ultrasonography in a rare case of conjoined twins with diamniotic placentation.

Methods: In ultrasonographic examination, a communicating structure containing solid and cystic components together with cord vessels was found between the fetuses. The long axes of the fetuses were not parallel and they moved independently.

Spontaneous bleeding from the uterine arteries during pregnancy--problems in diagnosis and therapy--bleeding from uterine arteries during pregnancy.

Arterial bleeding, initially negative on MRI, ultrasonography and radiographic angiography, complicated the course of pregnancy with severe and recurrent vaginal and pelvic haemorrhage in the second trimester. Bleeding from the left uterine artery was successfully terminated by angiographic embolisation. No harmful effects on the fetal well-being were recorded after the embolisation.

Traumatic experience with vacuum extraction--influence of personal preparation, physiology, and treatment during labor.

Objective: To assess pre-labor attitudes and post-labor experiences of the use of vacuum extraction during delivery. To seek associations between traumatic labor experience and personal preparation, physiology of labor and treatment during labor.

Methods: A total of 205 women filled in a questionnaire within five days of vacuum extraction delivery.

What determines the analgesic effect of paracervical block?

Background: The objective of the study was to evaluate the analgesic effect of paracervical block (PCB) in labor pain relief and to discover the determinants associated with good analgesia.

Methods: In a prospective trial, 341 women received PCB for pain relief in the first stage of labor, with 10 ml of 0.25% levobupivacaine or racemic bupivacaine.

A comparative study of the safety of 0.25% levobupivacaine and 0.25% racemic bupivacaine for paracervical block in the first stage of labor.

Background: The objective of the study was to evaluate and compare the safety of levobupivacaine and racemic bupivacaine for paracervical block (PCB) in the first stage of labor after uncomplicated pregnancy.

Methods: Forty women in an open pilot study and 397 women in a double-blind randomized study received PCB for pain relief in the first stage of labor, either with 25 mg of levobupivacaine or with 25 mg of racemic bupivacaine. The incidence of cardiotocographic pathology was compared between the groups using Fisher's exact test.

Good perinatal outcome in selective vaginal breech delivery at term.

Background And Aim: To compare perinatal outcome in groups of planned vaginal breech delivery, elective cesarean section with the fetus in breech presentation, and planned vaginal delivery with the fetus in cephalic presentation in a university hospital with a tradition of managing breech deliveries by the vaginal route.

Methods: A cohort study from a 7-year period 1995-2002, including 590 planned vaginal deliveries with a term (> 37 weeks) singleton fetus in breech presentation, 396 elective cesarean sections with a term singleton fetus in breech presentation, and 590 control women intending vaginal delivery with a singleton term fetus in cephalic presentation.

Results: The Apgar scores were lower in the group of planned vaginal breech delivery, but in other outcome measures there were no significant intergroup differences.

Macrocephaly-cutis marmorata telangiectatica congenita syndrome--prenatal signs in ultrasonography.

A new case of macrocephaly-cutis marmorata telangiectatica congenita (M-CMTC) syndrome is described. The patient presented typical congenital findings in utero, although the syndrome was diagnosed postnatally. The M-CMTC syndrome should be considered when there is a marked fetal overgrowth and progressive macrocephaly with no indications of maternal hyperglycemia or fetal hyperinsulinism.

Transmembrane carbonic anhydrase isozymes IX and XII in the female mouse reproductive organs.

Background: Carbonic anhydrase (CA) classically catalyses the reversible hydration of dissolved CO2 to form bicarbonate ions and protons. The twelve active CA isozymes are thought to regulate a variety of cellular functions including several processes in the reproductive systems.

Methods: The present study was designed to investigate the expression of transmembrane CAs, CA IX and XII, in the mouse uterus, ovary and placenta.

Massive multicystic dilatation of the uterine wall with myometrial venous thrombosis during pregnancy.

We present a pregnancy complicated by multicystic dilatation of the uterine wall during the second trimester, leading to massive uterine distension, anemia and preterm Cesarean section. The cystic changes detected by ultrasound and magnetic resonance imaging involved the whole uterine wall surrounding the entire amniotic cavity. Histopathological examination revealed the benign nature of the cystic changes, which represented dilated and thrombosed venous lacunae.

Severe cardiotocographic pathology at labor: effect of acute intravenous tocolysis.

The purpose of this study was to evaluate the effect of acute tocolysis on severely pathological cardiotocographic (CTG) readings during the first stage of labor. Seventy-three consecutive parturients with full-term pregnancy were treated by acute tocolysis with a beta-mimetic agent after recognition of severe CTG abnormality in the first stage of labor. The main outcome measures were normalization or persistence of the CTG pattern after tocolysis.

Outcome after a high number (4-10) of repeated caesarean sections.

Objective: To evaluate outcomes in caesarean sections repeated several times.

Population: Sixty-four women had had four or more (up to 10) caesarean sections.

Methods: The outcomes of these operations N= 149, study group) were compared with other caesarean sections.

Do objective urodynamic or clinical findings determine impact of urinary incontinence or its treatment on quality of life?

Objectives: To correlate the clinical and urodynamic parameters with two measures of incontinence-specific quality of life (QOL), to describe the changes in those measures after treatment, and to explore the factors determining these changes.

Methods: A total of 82 incontinent women (mean age 52 years, range 28 to 80) underwent urodynamics testing and a 48-hour pad test. They also completed the frequency/volume chart, estimated the degree of bother from urinary incontinence using the visual analog scale (VAS), and completed a validated QOL instrument--the Urinary Incontinence Severity Score (UISS).

An evaluation of pelvic floor anatomy and function by MRI.

Objective: In this experimental study, we wanted to evaluate the informative value of dynamic magnetic resonance imaging in pelvic floor anatomy during pelvic floor muscle contractions in asymptomatic women and women with urinary continence dysfunction.

Study Design: Eight outpatients with stress urinary symptoms and eight asymptomatic women were scanned with a 1.5 T GE Signa CV/i high-speed scanner with real time fluorescopic imaging possibilities.

Myometrial inflammation in human delivery and its association with labor and infection.

The presence of inflammation in decidual and myometrial samples as defined by histopathologic examination and the association between the myometrial inflammation and different maternal infectious morbidity and labor-related clinical variables were evaluated in 648 consecutive women who underwent cesarean section at various gestational periods. Altogether, 1,205 histologic (559 decidual and 646 myometrial) samples were studied. In normal pregnancies, myometrial inflammatory lesions were detected rarely before parturition, indicating their abnormality in these cases.

Obstetric prognosis in sisters of preeclamptic women - implications for genetic linkage studies.

BACKGROUND: To investigate obstetric prognosis in sisters of preeclamptic women. METHODS: We identified consecutive 635 sib pairs from the Birth Registry data of Kuopio University Hospital who had their first delivery between January 1989 and December 1999 in our institution. Of these, in 530 pairs both sisters had non-preeclamptic pregnancies (the reference group), in 63 pairs one of the sisters had preeclampsia and the unaffected sisters were studied (study group I).

Kinetics of a US contrast agent in benign and malignant adnexal tumors.

Purpose: To evaluate the effects of a microbubble contrast agent on the power Doppler ultrasonographic (US) examination of adnexal tumors, with a special focus on the timing of the transit of the microbubble bolus.

Materials And Methods: Seventy patients who were suspected of having ovarian tumors were examined preoperatively with contrast material-enhanced US. Images obtained during a 5-minute examination were stored digitally, and the behavior of the contrast agent was evaluated objectively with measurement of the time-dependent image intensity at the region of interest with a computer program.