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1999 by The American College of Obstetricians and Gynecologists
Obstetrics & Gynecology: Vol. 94, No. 1, July 1999
Obstetrics & Gynecology Table of Contents Volume 94 / Number 1 / July 1999 1 Amniotic Fluid Matrix Metalloproteinase-9 Levels in Women With Preterm Labor and Suspected Intra-amniotic Infection The concentration of matrix metalloproteinase-9 in amniotic fluid increases markedly and constantly in women with preterm labor and intra-amniotic infection. Gregory J. Locksmith, Penny Clark, Patrick Duff, & Gregory S. Schultz 7 Elevated Amniotic Fluid Nucleosome Levels in Women With Intra-amniotic Infection Pregnant women with intra-amniotic infection had significantly higher amniotic fluid soluble nucleosome concentrations than those without intra-amniotic infection. Li-Cheng Lu & Chaur-Dong Hsu 11 Prostaglandin E2 Cervical Ripening Without Subsequent Induction of Labor Intracervical prostaglandin E2 gel decreases the interval to delivery and shortens labor in women with unfavorable cervices at term. David S. McKenna, Stephanie W. Costa, & Philip Samuels 15 Pregnancy in Women With Systemic Sclerosis Pregnant women with systemic sclerosis have increased risks of preterm births but not miscarriages or fetal deaths. Virginia D. Steen 21 Anal Sphincter Tears at Vaginal Delivery: Risk Factors and Clinical Outcome of Primary Repair Risk factors for anal sphincter injuries are identifiable and should be considered to decrease anal continence disturbances postpartum. Jan Zetterström, Annika López, Bo Anzén, Margareta Norman, Bo Holmström, & Anders Mellgren 29 Cost-Effectiveness of Estimating Gestational Age by Ultrasonography in Down Syndrome Screening First-trimester ultrasonography to confirm gestational age can be justified economically on the basis of improved efficiency of Down syndrome screening. Peter A. Benn, John F. Rodis, & Tryfon Beazoglou
Obstetrics & Gynecology: Vol. 94, No. 1, July 1999
Rapid Testing and Zidovudine Treatment to Prevent Vertical Transmission of Human Immunodeficiency Virus in Unregistered Parturients: A Cost-Effectiveness Analysis Rapid antibody testing and zidovudine treatment are potentially effective and cost-saving approaches to preventing vertical transmission of human immunodeficiency virus in unregistered parturients. Jeffrey S. A. Stringer & Dwight J. Rouse 41 Selection of Delivery Method in Pregnancies Complicated by Autoimmune Thrombocytopenia: A Decision Analysis Funipuncture is preferable to scalp sampling for fetal platelet testing to determine delivery mode in term pregnancies complicated by autoimmune thrombocytopenia. David M. Stamilio & George A. Macones 48 Thoracic-Fluid Conductivity in Peripartum Women With Pulmonary Edema Thoracic-fluid conductivity of at least 65 kohm–1 measured by noninvasive thoracic electrical bioimpedance is associated with peripartum pulmonary edema. Roger B. Newman, Harold Pierre, & James Scardo 52 Bone Mineral Changes During and After Lactation Lactation duration of 6 months allows bone mass recovery in the subsequent year, regardless of calcium supplementation or duration of postpartum amenorrhea. Franco Polatti, Ezio Capuzzo, Franco Viazzo, Rossella Colleoni, & Catherine Klersy 57 The Effect of Aging on Ovarian Volume Measurements in Infertile Women Ovarian volume does not correlate with age or FSH levels, although women with small ovarian volumes may be at risk for impending ovarian failure. Fady I. Sharara & Howard D. McClamrock 61 Continuous, Combined Hormone Replacement: Randomized Comparison of Transdermal and Oral Preparations Continuous, combined hormone replacement in a low-dose, transdermal application is equally effective and safe and induces amenorrhea to a similar extent as an oral formulation. Lars A. Mattsson, Heinz G. Bohnet, Thomas Gredmark, Joachim Torhorst, Friedhelm Hornig, & Gabriele Hüls 66 Prevalence of Urinary Incontinence and Associated Risk Factors in Postmenopausal Women Predictors of urge incontinence are increasing age, diabetes, and urinary tract infections; predictors of stress incontinence are white race, higher body-mass index, and higher waist-to-hip ratios. Jeanette S. Brown, Deborah Grady, Joseph G. Ouslander, A. Regula Herzog, R. Edward Varner, & Samuel F. Posner for the Heart & Estrogen/Progestin Replacement Study (HERS) Research Group 71 Apoptosis and Ki-67 Expression in Adenomyotic Lesions and in the Corresponding Eutopic
Obstetrics & Gynecology: Vol. 94, No. 1, July 1999
Endometrium Ectopic endometrium in adenomyotic lesions is influenced rarely by hormonal change and has different biologic and proliferative properties than these events in the eutopic endometrium. Yumi Matsumoto, Tsuyoshi Iwasaka, Fumio Yamasaki, & Hajime Sugimori 78 Secretion of Vascular Endothelial Growth Factor in Adenocarcinoma and Squamous Cell Carcinoma of the Uterine Cervix Cervical adenocarcinomas secrete significantly higher amounts of the angiogenic and immunosuppressive cytokine vascular endothelial growth factor compared with squamous cell cervical cancers. Alessandro D. Santin, Paul L. Hermonat, Antonella Ravaggi, Sergio Pecorelli, Martin J. Cannon, & Groesbeck P. Parham 83 Entry Force and Intra-abdominal Pressure Associated With Six Laparoscopic Trocar-Cannula Systems: A Randomized Comparison A system designed to evaluate insertional force of laparoscopic trocar-cannula systems found that pyramidal-tipped trocars required the lowest insertional force. Christopher M. Tarnay, Karen B. Glass, & Malcolm G. Munro 89 Incision Characteristics Associated With Six Laparoscopic Trocar-Cannula Systems: A Randomized, Observer-Blinded Comparison A system designed to evaluate the wounds of laparoscopic trocar-cannula systems found that those with blunt conical tips result in smaller fascial defects. Christopher M. Tarnay, Karen B. Glass, & Malcolm G. Munro 94 Major Complications of Laparoscopy: A Follow-Up Finnish Study Without proper experience and training programs, laparoscopic hysterectomies are associated with the risk of major complications, unlike other laparoscopies. Päivi Härkki-Siren, Jari Sjöberg, & Tapio Kurki 99 Test-Retest Reliability of the Cough Stress Test in the Evaluation of Urinary Incontinence The cough stress test is a reliable test in the evaluation of incontinent women, particularly in patients with pure genuine stress incontinence. Steven E. Swift & Eleanor A. Yoon 103 Once-Daily Valacyclovir Hydrochloride for Suppression of Recurrent Genital Herpes Valacyclovir hydrochloride (500 mg once daily) is an effective, well-tolerated, continuous, suppressive therapy for men and women with recurrent genital herpes. David A. Baker, James G. Blythe, & J. Mitchell Miller 107 Urine Free Beta-hCG and Total Estriol for Down Syndrome Screening During the Second
Obstetrics & Gynecology: Vol. 94, No. 1, July 1999
Trimester in an Asian Population Second-trimester free -hCG and total estriol in the maternal urine are useful markers for Downsyndrome screening in an Asian population. Jenn J. Hsu, Te Y. Hsu, T'Sang T. Hsieh, Yung K. Soong, Fon J. Hsieh, & Kevin Spencer
112 Modern Obstetric Management and Outcome of Infants With Gastroschisis Outcomes of infants with gastroschisis are not affected by maternal-fetal medicine surveillance, mode of delivery, or site of delivery. Brian K. Rinehart, Dom A. Terrone, Christy M. Isler, J. Elaine Larmon, Kenneth G. Perry, Jr, & William E. Roberts 117 Change in Cervical Length After Prophylactic Cerclage Prophylactic cerclage results in measurable increases in cervical length. Edmund F. Funai, Michael J. Paidas, Andrei Rebarber, Loraine O'Neill, Todd J. Rosen, & Bruce K. Young 120 Neonatal Morbidity at 34–37 Weeks: The Role of Ruptured Membranes Membrane status prior to the onset of labor does not significantly influence neonatal outcome in deliveries occurring between 34 and 37 weeks' gestation. Joy D. Steinfeld, Catherine Lenkoski, Trudy Lerer, Joseph R. Wax, & Charles J. Ingardia 124 Natural Protective Mechanisms Against Endoscopic White-Light Injury in the Fetal Lamb Eye The fetal lamb eye is well protected against endoscopic white-light injury. Jan A. Deprest, François I. Luks, Koen H. E. Peers, Jan D'Olieslager, & Rita Van Ginderdeuren 128 Matrilineal Transmission of Birth Weight in the Rhesus Monkey (Macaca mulatta) Across Several Generations Birth weight in the rhesus monkey follows a matrilineal transmission pattern in which improvements in maternal condition result in larger, more reproductively successful daughters. Kimberly C. Price, Janet Shibley Hyde, & Christopher L. Coe 135 Cystic Fibrosis and Chromosome Abnormalities Associated With Echogenic Fetal Bowel Fetal testing for cystic fibrosis and chromosome abnormalities is warranted when echogenic fetal bowel is detected in the second trimester. Beth M. Berlin, Mary E. Norton, Elaine A. Sugarman, Judith E. Tsipis, & Bernice A. Allitto 139 Effect of Causing Fetal Cardiac Asystole on Second-Trimester Abortion Induced fetal death significantly reduces the interval to expulsion and the doses of prostaglandin E2 required for second-trimester abortion. Andrew Elimian, Uma Verma, & Nergesh Tejani
Obstetrics & Gynecology: Vol. 94, No. 1, July 1999
Editorial 142 Informed Consent, Patient Choice, and Physician Responsibility The trend toward completely nondirective counseling is lamentable. Dwight P. Cruikshank Graduate Education 144 Effect of Residency Program Merger on Undergraduate Medical Student Education in Obstetrics and Gynecology Merger of residency programs does not adversely affect the quality of third-year medical student core clerkships. Jeffrey F. Hines, Andrew J. Satin, Matrice Browne, Alicia Y. Armstrong, & William H. J. Haffner 148 Angiogenesis of the Endometrium Angiogenesis actively participates in the development of normal cyclic regenerating endometrium and in a wide spectrum of benign and malignant pathologic conditions of the endometrium. Ovadia Abulafia & David M. Sherer 153 Serious Group A Streptococcal Infection Around Delivery The clinical course and pathogenesis of serious, perinatal, group A streptococcal infection are different from puerperal or other streptococcal toxic shock syndromes. Hideo Udagawa, Yoshihiro Oshio, & Yoshikata Shimizu 158 Letters
1999 by The American College of Obstetricians and Gynecologists
Obstetrics & Gynecology: Vol. 94, No. 1, July 1999
The American College of Obstetricians and Gynecologists: National Meeting Dates
The American College of Obstetricians and Gynecologists National Meeting Dates July 22–25 October 14–17
Gynecologic Oncology Group, Scottsdale, AZ
American Urogynecologic Society, SanDiego, CA
September 16–18 The American Gynecological and Obstetrical November 8–12
The American Board of Obstetrics andGynecology (oral examinations), Chicago, IL
September 25–30 American Society for Reproductive Medicine, Toronto, ON January 13–15 May 20–24
The American College of Obstetricians andGynecologists, San Francisco, CA
January 22–25 The South Atlantic Association of June 16–21
Obstetricians and Gynecologists, St. January 31–February 5 July 28–30
Society for Maternal-Fetal Medicine, Miami
Gynecologic Oncology Group, St. Louis, MO
September 3–8 February 4–7
International Federation of Gynecology and
Obstetrical and Gynecological Assembly of
September 7–9 February 5–9 September 8–10 February 28–March 1
The American Gynecological and Obstetrical
September 20–23 March 1–4
Society of Pelvic Reconstructive Surgeons, St.
The American College of Obstetricians and Gynecologists: National Meeting Dates
Association of Professors of Gynecology and
Obstetrics and the Council on ResidentEducation in Obstetrics and Gynecology, New
October 19–21
Central Association of Obstetricians andGynecologists, Chicago, IL
March 13–17 American Society for Coloscopy and Cervical October 21–25
American Society for Reproductive Medicine,San Diego, CA
March 22–25 Society for Gynecologic Investigation, October 26–29
American Urogynecologic Society, HiltonHead, SC
April 14–16 North American Society for Pediatric and November 16–20
Pacific Coast Obstetrical and GynecologicalSociety, Big Island, HI
April 25–May 1 Pacific Coast Fertility Society, Rancho Mirage, CA
1999 by The American College of Obstetricians and Gynecologists
1830 14th Avenue South * Birmingham, Alabama 35205 POST-SURGICAL INSTRUCTIONS Care of the Mouth Begin gentle brushing the day after the surgery unless otherwise instructed. Brushing should be limited to above the gum line in the treated areas in the first week. You may begin flossing and brushing along the gum line after about 7 days. Remember that a little bleeding upon brushing is normal
ENGLISH SUMMARY The report contains two chapters; the first one gives an economic outlook for the Danish economy and the second one an analysis of Danish labour market policy Chapter I: Economic outlook The economic situation in Europe is still dominated by lack of confidence in public finances in a number of countries and weak developments in demand and production. Initia- tives f