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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
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
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
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
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
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
Cost-Effectiveness of Estimating Gestational Age by Ultrasonography in Down Syndrome
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
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
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
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
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
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
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
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
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
Alessandro D. Santin, Paul L. Hermonat, Antonella Ravaggi, Sergio Pecorelli, Martin J. Cannon, &
Groesbeck P. Parham
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
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
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
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
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
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
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.
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
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
Matrilineal Transmission of Birth Weight in the Rhesus Monkey (Macaca mulatta
) Across Several
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
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
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
Informed Consent, Patient Choice, and Physician Responsibility
The trend toward completely nondirective counseling is lamentable.
Dwight P. Cruikshank
Graduate Education
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
Jeffrey F. Hines, Andrew J. Satin, Matrice Browne, Alicia Y. Armstrong, & William H. J. Haffner
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
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
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
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

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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

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