AMERICAN JOURNAL OF OBSTETRICS & GYNCOLOGY
VOL. 180, NO. 6, JUNE 1999
Introduction S341
Isaac Schiff, MD, Guest Editor
Boston, Massachusetts .
Benefits and risks of oral contraceptives S343
Katherine Sherif, MD
Philadelphia, Pennsylvania
This article reviews the mechanisms, benefits, risks, drug interactions, and contraindications of modern low-dose oral contraceptives.
Cardiovascular disease: Pathogenesis, epidemiology, and risk among users of S349
oral contraceptives who smoke
William P. Castelli, MD
Framingham, Massachusetts
The article describes the pathogenesis of cardiovascular disease and findings related to the effects of concurrent smoking
and oral contraceptive use on cardiovascular disease risk.
Smoking and use of oral contraceptives: Impact on thrombotic diseases S357
0jvind Lidegaard, MD
Copenhagen, Denmark
An analysis of the Danish National Patient Registry, evaluating the risks of thromboembolic disease in users and
nonusers of oral contraceptives who smoke, is given.
Effects of smoking on prostacyclin formation and platelet aggregation in users S364
of oral contraceptives
Subir Roy, MD
Los Angeles, California
This article reviews the effects of smoking and oral contraceptive use on factors affecting the coagulation pathway and discusses
implications for increased cardiovascular risk.
Hemostatic effects of smoking and oral contraceptive use S369
Franca Fruzzetti, MD
Pisa, Italy
The article reviews effects of oral contraceptives on heinostatic profile in smokers and nonsmokers, with particular
reference to ethinyl estradiol dose.
Effects of oral contraceptives on hemostasis and thrombosis S375
Jan Rosing, PhD, and Guido Tans, PhD
Maastricht, The Netherlands
This article reports the effects of oral contraceptives on the coagulation-related protein C pathway and discusses the association of
acquired APC resistance with increased venous thrornboernbolism.
Oral contraceptives and smoking, current considerations: Recommendations of a S383
consensus panel
Isaac Schiff, MD, William R. Bell, MD, Victoria Davis, MD, Craig M. Kessler, MD, Carole Meyers, MD,
Steven Nakajima, MD, and Brenda J. Sexton, MD
Boston, Massachusetts, Baltimore, Maryland, Toronto, Ontario, Canada, Washington, DC, Louisville, Kentucky,
and Yarmouth, Maine
Recommendations regarding the identification, education, and management of patients who smoke, with specific
reference to smokers who use or want to use oral contraceptives, are given.
_________________________________
Table of Contents
Organization...................................................... III Letter from the Program Chair ........................................ IV Program Committee................................................ V List of Revie wers .................................................. VI Acknowledgments.................................................. VII Map of Meeting Areas - San Francisco Hilton & Towers. ................... VIII Program.................................. ........................ IX Scientific Forums .................................................. XIII Luncheon Roundtables.............................................. XIV Scientific Sessions Program .......................................... XV Or al Session I (Plenary) ............................................ SI Concurrent Oral Sessions
Session A.................................................... S5 Session B ........ ...... ........ ........ ...................... S9 Oral Session II (Plenary) ........................................... S13 Con current Oral Sessions
Session C.................................................... S17 Session D........ ............. ...... ....... ....... ........... S21 Concurrent Oral Sessions
Session E. ...... ......... ....... ...... ......... .............. S25 Session F ....... ...... ................... .................... S29 Poster Session 1................................................... S33 Post er Session II.................................................. S63 Poster Session III.................................................. S93 Poster Session IV.................................................. S 123 Poster Session V........................ ........................... S153 Subject Index ..................................................... SI 83 Author Index...................................................... S187 Academic Institution Index. ................................... S203
__________________________________
AMERICAN JOURNAL OF OBSTETRICS & GYNECOLOGY
VOL. 180, NO. 1, JANUARY 1999 PART 3
Introduction S207
A role for estriol In human labor, term and preterm S208
T. Murphy Goodwin, MD
Los Angeles, California
Estriol in the maternal compartment is a direct indicator of fetal adrenal activity, which increases before the onset of
spontaneous labor in mammalian species
Accuracy of salivary estriol testing compared to traditional risk factor assessment S214
in predicting preterm birth
R. Phillip Heine, MD, James A. McGregor, MD, CM, and Vivian K. Dullien, PhD
Pittsburgh, Pennsylvania, Denver, Colorado, and Dublin, California
Serial salivary estriol testing predicted preterm birth more accurately than did use of the modified Creasy score.
Serial betamethasone administration: Effect on maternal salivary estriol levels S219
Colleen M. Hendershott, MD, Vivian Dullien, PhD, and T. Murphy Goodwin, MD
Los Angeles and Dublin, California
Maternal administration of betamethasone significantly suppressed salivary estriol levels, but levels returned to
pretreatment values within one week.
Diurnal variation in saliva estriol level during pregnancy: A pilot study S223
James A. McGregor, MD, CM, Cherie Hastings, MS, Tracy Roberts, MT (ASCP), and
Joan Barrett, MSN
Denver, Colorado, and Dublin, California
There is diurnal variation (increased at night) in salivary estriol in the latter half of pregnancy. This nighttime increase
corresponds with increased nocturnal uterine activity.
Saliva as a fluid for measurement of estriol levels S226
H. Fred Voss, PhD
Dublin, California
Saliva is an excellent fluid to monitor physiological hormone levels, especially levels of estriol in pregnancy, to detect
risk of preterm labor and delivery.
A central theory of preterm and term labor: Putative role for corticotropin-releasing S232
hormone
Joseph A. Majzoub, MD, James A. McGregor, MD, Charles J. Lockwood, MD, Roger
Smith, MD, Martha Snyder Taggart, MA, and Jay Schulkin, PhD
Boston, Massachusetts, Denver, Colorado, New York, New York, Newcastle, Australia, and Washington, DC
Placental corticotropin-releasing hormone: Function and regulation S242
Joseph A. Majzoub, MD, and Katia P. Karalis, MD
Boston, Massachusetts
New approaches to the diagnosis of preterm labor S247
Alan D. Booking, MD, John R.G. Challis, DSC, FRS(C), and Claudia Korebrits, MD
London and Toronto, Ontario, Canada
Reproductive placental corticotropin-releasing hormone and its clinical implications S249
G. R Chrousos, MD
Bethesda, Maryland
Immunoendocrinology of preterm labor: The link between corticotropin-releasing S251
hormone and inflammation
Donald J. Dudley, MD
Salt Lake City, Utah
Corticotropin-releasing hormone may play an important in the pathophysiology of preterm labor by acting as a
link between the hormonal and immunologic systems.
Maternal plasma corticotropin-releasing hormone associated with stress at S257
20 weeks' gestation in pregnancies ending in preterm delivery
Calvin J. Hobel, MD, Christine Dunkel-Schetter, PhD, Scott C. Roesch, PhD, Lony
C. Castro, MD, and Chander P. Arora, PhD
Los Angeles, California
There is an elevation in maternal plasma corticotropin-releasing hormone in pregnancies associated with stress as
early as 18 to 20 weeks of gestation.
Stress-associated preterm delivery: The role of corticotropin-releasing hormone S264
Charles J. Lockwood,
New York, New York
Corticotropin-releasing hormone expression acts as a mediator of stress-associated preterm delivery.
How far upstream or downstream is corticotropin-releasing hormone in the S267
overall process of parturition in rhesus monkeys?
Peter W. Nathanielsz, MD, PhD, ScD
lthaca. New York
Corticotropin-releasing hormone and the fetoplacental clock: An Australian S269
perspective
Roger Smith, MD
Newcastle, Australia
Stress and reproductive failure: An evolutionary approach with applications to S272
premature labor
Samuel K. Wasser, PhD
Seattle, Washington
____________________________________________________
American Journal of Obstetrics and Gynecology
VOL. 180, NO . 3, MARCH 1999 PART 1
CONTENTS
EDITORIAL
Summary of analysis of published articles 511
CLINICAL OPINION
Supracervical hysterectomy: Back to the future? 513
D.E. Damell Jones, MD, D. Paul Shackelford, MD, and Robert G. Brame, MD
Greenville and Charlotte, North Carolina
The risk of subsequent cervical cancer may not outweigh potential benefits of supracervical hysterectomy, which
should be included as an option available to selected patients.
Restructuring residency training in obstetrics and gynecology 516
John M. Bissonnette, MD, Steven G. Gabbe, MD, Charles B. Hammond, MD, Paul C. MacDonald, MD,
Mary Lake Polan, MD, PhD, and James M, Roberts, MD
Portland, Oregon, Seattle, Washington, Durham, North Carolina, Dallas, Texas, Stanford, California, and
Pittsburgh, Pennsylvania
Restructuring the residency training experience has advantages for both general obstetrician-gynecologists and the
subspecialists in our discipline.
GENERAL OBSTETRICS AND GYNECOLOGY
Gynecology
Recurrence of ovarian endometrioma after laparoscopic excision 519
Mauro Busacca, MD, R. Marana, MD, R Caruana, MD, M. Candiani, MD, L. Muzii, MD, C. Calia, MD,
and S. Bianchi, MD
Milan and Rome, Italy
After laparoscopic excision of ovarian endometrioma the cumulative rates of ultrasonographic recurrence and reoperation over 48 months
were 11.7% and 8.2%, respectively.
Vaginal heat shock protein expression in symptom-free women with a history 524
of recurrent vuivovaginitis
Paulo Giraldo, MD, Andreas Neuer, MD, Irina L. Komeeva, MD, PhD, Ayrton Ribeiro-Filho, MD,
Jose A. SimBes, MD, and Steven S.Witkin, PhD
New York, New York, and Sao Paulo, Brazil
Symptom-free women with a history of recurrent vaginitis express heat shock proteins in the vagina, indicating the
presence of a stress response.
Modification of plasma insulin-like growth factors and binding proteins during 530
oral contraceptive use and the normal menstrual cycle
Melissa Westwood, PhD, J. Martin Gibson, MD, PhD, Louise A. Pennells, BSc, and Anne White, PhD
Manchester, United Kingdom
Oral contraceptive use modulates the insulin-like growth factor axis by increasing levels of insulin-like growth factor
binding protein I and decreasing levels of insulin-like growth factor I.
Prevalence of bone mineral changes during postpartum amenorrhea and after 537
resumption of menstruation
Doris HoImberg-Marttila, MD, and Harri Sievanen, PhD
Tampere, Finland
Reproduction can predispose the proximal femur to permanent bone loss in a considerable proportion of
postpartum women.
Progestational effects of combinations of gestodene on the postmenopausal 539
endometrium during hormone replacement therapy
Inger Byrjalsen, MSc, Nina H. Bjamason, and Claus Christiansen, MD
Ballemp, Denmark
This study assessed the dose-response effects of combinations of estradiol and gestodene on the postmenopausal
endometrium.
Comparison of fine-needle aspiration cytologic findings of ovarian cysts with 550
ovarian histologic findings
Robert V. Higgins, MD, Jerry F. Matkins, MD, and Marie-Claire Marrourn, MD
Charlotte, North Carolina
Cytologic findings from ovarian cyst fluid are a poor predictor of ovarian histologic characteristics.
Gasless laparoscopic ovarian cystectomy during pregnancy: Comparison with 554
laparotomy
Shigeo Akira, MD, Atsuko Yamanaka, MD, Tamaki Ishihara, MD, Toshiyuki Takeshita, MD, and
Tsutomu Araki, MD
Tokyo, Japan
Gasless laparoscopic ovarian cystectomy can be performed safely during pregnancy with little risk to the fetus or the mother.
Halofuginone, an inhibitor of collagen type I synthesis, prevents 558
postoperative adhesion formation in the rat uterine horn model
Amon Nagler, MD, Olga Genina, MSc, Irina Lavelin, MSc, Meir Ghana, MSc, and Mark Pines, PhD
Jerusalem and Bet Dagan, Israel
Inhibition of collagen a(l) gene expression by halofuginone prevents adhesion formation in the rat uterine horn model.
Human immunodeficiency virus screening among pregnant women in France: 564
Results from the 1995 national perinatal survey
Christophe Vayssiere, MD, Christiane Du Mazaubrun, MS, and Gerard Breart, MD
Paris, France
In France, where systematic human immunodeficiency virus screening is offered to pregnant women, the 1995
National Perinatal Survey showed that only 5.1% of pregnant women were unaware of their screening status.
Risk factors for rapid-onset cervical cancer 571
Allan Hildesheim, PhD, Olympia Hadjimichael, MPH, Peter E. Schwartz, MD, Cosette M. Wheeler, PhD,
Willard Barnes, MD, David M. Lowell, MD, Jerry Willett, MD, and Mark Schiffman, MD
Bethesda, Maryland, New Haven, Connecticut, Albuquerque, New Mexico, and Washington, D.C.
Rapid-onset cervical cancer differs from normal-onset cervical cancer with respect to histologic features and age but
not human papillomavirus and other cervical cancer risk factors.
The microbiologic effect of digital cervical examination 578
Hytham M. lmseis, MD, Wayne C. Trout, MD, and Steven G. Gabbe, MD
Columbus, Ohio
Digital cervical examination introduces vaginal organisms into the cervix.
M Obstetrics
Impact of the fetal fibronectin assay on admissions for preterm labor 581
Increased contents of phospholipids, cholesterol, and lipid peroxides in decidua 587
basalis in women with preeclampsia
Anne Cathrine Staff, MD, Trine Ranheim, MSc, PhD, Janette Khoury, MD, and Tore Henriksen, MD, PhD
Oslo, Norway
Decidua basalis is proposed as a source of oxidized lipid products with the potential to cause maternal endothelial
dysfunction in preeclampsia.
Randomized controlled trial of prevention of perineal trauma by perineal massage 593
during pregnancy
Michel Labrecque, MD, Erica Eason, MDCM, Sylvie Marcoux, MD, PhD, Francois Lemieux, MD,
Jean-Jacques Pinault, MD, Perle Feidman, MDCM, and Louise Laperriere, RN
Quebec City and Montreal, Quebec, and Ottawa, Ontario, Canada
Perineal massage increases the chance of delivery with an intact perineum among women with a first vaginal delivery
but not in those with a previous vaginal birth.
Effects of blood pressure on orbital and middle cerebral artery resistances in 601
healthy pregnant women and women with preeclampsia
Michael A. Belfort, MD, George R. Saade, MD, Charlotta Grunewald, MD, PhD, Gary A. Dildy, MD,
Michael A. Varner, MD, and Henry Nisell, MD, PhD
Salt Lake City, Utah, Galvston, Texas, and Stockholm, Sweden
Preedampsia causes an abnormal response in the vascular resistance of orbital and cerebral arteries.
Induction of intrauterine growth restriction with a low-sodium diet fed to pregnant rats 608
Eve Roy-Clavel, MSc, Serge Picard, BSc, Jean St-Louis, PhD, and Michele Brochu, PhD
Montreal, Quebec, Canada
A low-sodium diet given to pregnant rats in the last week of 3 weeks' gestation leads to higher plasma renin activity
and aldosterone levels, reduced plasma volume expansion, and fetal growth restric.
The action of prostaglandin Eg on the human cervix: Stimulation of interleukin 614
8 and inhibition of secretory leukocyte protease inhibitor
Fiona C. Denison, MD, Andrew A. Calder, MD, and Rodney W. Kelly, PhD
Edinburgh, United Kingdom
Prostaglandin E^ stimulates release of the proinflammatory chemokine interleukin 8 and inhibits secretion of the
anti-inflammatory secretory leukocyte protease inhibitor from cervical explants.
Role of oxytocin in the initiation of term and preterm labor in rats: Changes in 621
oxytocin receptor density and plasma oxytocin concentration and the effect of
an oxytocin antagonist, L-366,509
Mamoru Kobayashi, PhD, Masuo Akahane, PhD, Keiko Minami, BS, Makoto Moro, MS,
Yukiyoshi Ajisawa, PhD, Yoshihito Inoue, MD, and Tatsuhiko Kawarabayashi, MD
Nagano and Fukuoka, Japan
The functional roles of oxytocin were similar in the initiation of term and preterm labor in rats.
Induction of labor and the relationship to cesarean delivery: A review of 7001 628
consecutive inductions
John D. Yeast, MD, Angela Jones, MS, and Mary Poskin, MSN
Kansas City, Missouri
A 7/:-year review of 7001 consecutive inductions of labor demonstrates a significant increase in the use of induction with
minimal impact on the overall cesarean delivery rate.
Ultrasonographic measurement of liver length in the small-for-gestational-age fetus 634
Alistair B. Roberts, MD, Jennifer M. Mitchell, MSc, Lesley M. McCowan, MD, and Sarah Barker, RM
Auckland, New Zealand
Fetal liver length was measured in 98 small-for-gestational-age fetuses, with ultrasonographic abdomen circumference
measurements <10th percentile, and was within normal limits in 82% of cases.
Cervical length in uncomplicated pregnancy: A study of sociodemographic 639
predictors of cervical changes across gestation
Karolien Dijkstra, MD, Hennie C.J.P. Janssen, MSc, Edward Kuczynski, PhD, and Charles J. Lockwood, MD
New York, New York
Cervical length in uncomplicated pregnancy resulting in term delivery is significantly shorter among women who are
black or are experiencing stress.
Perinatal management of women with immune thrombocytopenic purpura: Survey 645
of United States perinatologists
David Peleg, MD, and Stephen K. Hunter, MD, PhD
Iowa City, Iowa
One third of women with immune thrombocytopenic purpura in the United States undergo testing to determine fetal
platelet counts before delivery.
Reactivities to serotonin and histamine in umbilical and placental vessels during 650
the third trimester after normotensive pregnancies and pregnancies complicated
by preeclampsia
Charles Bertrand, MD, MSc, and Jean St-Louis, PhD
Montreal, Quebec, Canada
Reactivity of umbilical and placental arteries and veins to serotonin and histamine was altered during the third trimester
after both normotensive and preeclamptic pregnancies.
Changes in homocysteine levels during normal pregnancy 660
Mark C. Walker, MD, Graeme N. Smith, MD, PhD, Sherry L. Perkins, PhD, Erin J. Keely, MD, and
Peter R. Garner, MD, MSc
Ottawa and Toronto, Ontario, Canada
Plasma homocysteine levels decrease significantly during pregnancy and are directly correlated with folic acid
supplementation and a decrease in serum albumin levels.
Obstetric determinants of neonatal survival: Antenatal predictors of neonatal 665
survival and morbidity in extremely low birth weight infants
S.F. Bottoms, MD, R.H. Paul, MD, B.M. Mercer, MD, C.A. MacPherson, MD, S.N. Caritis, MD,
A.H. Moawad, MD, J.P. Van Dorsten, MD, J.C. Hauth, MD, G.R. Thumau, MD, M. Miodovnik, MD,
P.M. Meis, MD, J.M. Roberts, MD, D. McNellis, MD, and J.D. lams, MD
Bethesda, Maryland
Ultrasonographic assessment of either fetal femur length or gestational age is superior to other tests for antenatal
prediction of survival of extremely low birth weight infants.
Double-blind comparison of carbetocin versus oxytocin in prevention of uterine 670
atony after cesarean section
Jerome Dansereau, MD, MHSc, Arvind K. Joshi, MD, Michael E. Helewa, MD, Terence A. Doran, MD,
lan R. Lange, MD, Edwin R. Luther, MD, Dan Farine, MD, Mikios L. Schuiz, PhD, Gwendolyn L.A.
Horbay, PhD, Patricia Griffin, MSc, and Willem Wassenaar, MD
Vancouver, British Columbia, Montreal, Quebec, Winnipeg, Manitoba, Toronto, Etobicoke, and North York,
Ontario, Calgary, Alberta, and Halifax, Nova Scotia, Canada
Carbetocin, a new long-acting oxytocin agonist, appears more effective than oxytocin for the prevention of uterine atony
after cesarean section.
Fetus-Placenta-Newborn
Benefits of maternal corticosteroid therapy in infants weighing <1000 grams at 677
birth after preterm rupture of the amnion
Shelley J. Chapman, MD, John C. Hauth, MD, Sidney R Bottoms, MD, Jay D. lams, MD, Baha Sibai, MD,
Elizabeth Thorn, PhD, Atef H. Moawad, MD, and Gary R. Thumau, MD
Birmingham, Alabama
Corticosteroid treatment in women with preterm amnion rupture was of no apparent benefit in newboms weighing 1000 g.
Indicated versus spontaneous preterm delivery: An evaluation of neonatal morbidity 683
among infants weighing 1000 grams at birth
Debora F. Kimberlin, MD, John C. Hauth, MD, John Owen, MD, Sidney F. Bottoms, MD, Jay D. lams, MD,
Brian M. Mercer, MD, Elizabeth A. Thorn, PhD, Atef H. Moawad, MD, J. Peter VanDorsten, MD, and
Gary R. Thumau, MD
Birmingham, Alabama
In a population of infants who weighed <1000 g at birth and survived >2 days, selected neonatal outcomes did not
differ among infants delivered after spontaneous labor, after premature amnion rupture, or for maternal-fetal indications.
In vitro modulation of the expression of 15-hydroxy-prostaglandin dehydrogenase 690
by trophoblast differentiation
Carol Lennon, MD, Matthew G. Carlson, D. Michael Nelson, MD, PhD, andYoel Sadovsky, MD
St Louis, Missouri
The expression and activity of 15-hydroxy-prostaglandin dehydrogenase, a key enzyme in prostaglandin inactivation,
are enhanced in differentiated trophoblasts but diminished by cyclic adenosine monophosphate.
Simultaneous quantitation from infrared spectra of glucose concentrations, 696
lactate concentrations, and lecithin/sphingomyelin ratios in amniotic fluid
Kan-Zhi Liu, MD, PhD, and Henry H. Mantsch, PhD
Winnipeg, Manitoba, Canada
Simultaneous determinations from infrared spectra of glucose, lactate. and lecithin/sphingomyelin ratios provide a
simple, rapid means of assessing preterm infection, fetal distress, and lung maturity.
Amniotic fluid composition in the fetal lamb with intrauterine growth restriction 703
Salha S. Daniel, PhD, Raymond 1. Stark, MD, Pamela J. Tropper, MD, and L. Stanley James, MD
New York, New York
In contrast to the results in normal and mildly hypoxemic fetal lambs, no decrease in amniotic fluid osmolality with gestation was
found in severely hypoxemic fetuses.
Maternal Lyme disease and congenital heart disease: A case-control study in 711
an endemic area
Barbara Strobino, PhD, Syed Abid, PhD, and Michael Gewitz, MD
Valhalla, New York
This retrospective case-control study did not find a significant risk of congenital heart disease associated with maternal
Lyme disease.
Endoscopic laser surgery versus serial amniocenteses in the treatment of severe 717
twin-twin transfusion syndrome
Kurt Hecher, MD, Hanno Plath, MD, Thomas Bregenzer, MSc, Manfred Hansmann, MD, and
Bernhard J. Hackeloer, MD
Hamburg and Bonn, Germany
Laser coagulation ofplacental vascular anastomoses as a single invasive procedure offers a more effective alternative
to serial amniocenteses as treatment of second-trimester twin-twin transfusion syndrome.
Pretreatment with magnesium sulfate protects against hypoxic-ischemic brain 725
injury but postasphyxial treatment worsens brain damage in seven-day-old rats
Hiroshi Sameshima, MD, Arturo Ota, MD, and Tsuyomu Ikenoue, MD
Miyamki, Japan
Pretreatment with magnesium sulfate protects against hypoxic-ischemic brain damage in 7-day-old rats, but treatment after
hypoxia worsens brain damage.
Maternal plasma leptin is increased in preeclampsia and positively correlates 731
with cord concentration
John F. McCarthy, MD, PhD, Dhirendra N. Misra, PhD, and James M. Roberts, MD
Pittsburgh, Pennsylvania
Compared with normal pregnancy, preeclampsia is associated with an increase in maternal plasma leptin concentration
that strongly correlates with fetal cord concentration at delivery.
Maternal and neonatal phytoestrogens in Japanese women during birth 737
Herman Adiercreutz, MD, Teiichi Yarnada, MD, Kristiina Wahala, PhD, and Shaw Watanabe, MD
Helsinki, Finland, and Tokyo, Japan
Dietary phytoestrogens are found in high concentrations in the plasma of pregnant Japanese women and in cord blood
and amniotic fluid in their neonates.
Changes in prostacyclin synthase in pregnant sheep myometrium, endometrium, 744
and placenta at spontaneous term labor and regulation by estradiol and progesterone
Wen Xuan Wu, MD, PhD, Xiao Hong Ma, MD, and Peter W. Nathanielsz, MD, PhD, ScD
lthaca, New York
We describe expression of prostacyclin synthase in pregnant sheep myometrium, endometrium, and placenta at
spontaneous term labor and regulation by estradiol and progesterone.
The Doppler cerebroplacental ratio and perinatal outcome in intrauterine growth 750
restriction
Ray 0. Bahado-Singh, MD, Ertug Kovanci, MD, Andrea Jeffres, MD, Utku Oz, MD, Ozgur Deren, MD,
Joshua Copel, MD, and Giancarlo Man, MD
New Haven, Connecticut
The cerebroplacental ratio predicts pregnancy complications in intrauterine growth restriction at <34 weeks' gestation at
the time of Doppler imaging.
Risk factors for neonatal death in twin gestations in the state of South Carolina 757
Roger B. Newman, MD, Jill G. Mauldin, MD, and Myla Ebeling
Charleston, South Carolina
Very low birth weight (<1500 g) twins born in South Carolina have improved neonatal survival when delivered
at tertiary care centers with high obstetric volumes.
AJOG REVIEWS
Selective estrogen receptor modulators: Women's panacea for the next 763
millennium?
Chris P. Spencer, MD, Edward P. Morris, MD, and Janice M. Rymer, MD
London, United Kingdom
Selective estrogen receptor modulators are a group of antiestrogens that in the future may be important in
preventive medical strategies for women's health.
LETTERS TO THE EDITORS
Triplet pregnancy: A difficult challenge in perinatal medicine Rafael Ceres, MD, Ana Atares, MD, and Orencio F.
Tarrio, MD Pamplona, Spain 771
Reply Richard K. Silver, MD Evanston, Illinois 771
SpeCUlOSCOpy Stewart A. Lonky, MD Torrance, California 772
Reply Mark Spitzer, MD Jamaica, New York 772
Laparoscopy-associated intestinal infarction: A new syndrome? MarcoA. Pelosi ill, MD, and MarcoA. Pelosi, MD
Bayonne, New Jersey 773
Reply Hamid H. Sheikh, MD Lexington, Kentucky 774
Vertical transmission of human papillomaviruses John Cason, PhD, Jennifer M. Best, PhD, and K. Shanti Raju, MD
London, United Kingdom 774
Reply D. Heather Watts, MD, Jane Kuypers, PhD, and Nancy B. Kiviat, MD Seattle, Washington 775
The difference in group B Streptococcus prophylaxis protocols Elliot M. Levine, MD Chicago, Illinois 775
Reply Erich Hafner, MD Vienna, Austria 776
Few Observations are really new Robert C. Goodlin, MD Placerville, California 776
Reply Helayne M. Silver, MD Providence, Rhode Island 777
READER SERVICE
Information for Authors 21A
Information for Readers 28A
Items 778
Professional Opportunities Available 42A
Index to Advertisers 44A
American Journal of Obstetrics and Gynecology
VOL:180, NO:1, JANUARY 1999
PRIMARY CARE
Comparison of binge drinking among pregnant and nonpregnant women, United 1
States, 1991-1995
Shahul H. Ebrahim, MD, MSc, DrMed, Shane T. Diekman, MPH, R. Louise Floyd, RN, DSN, and Pierre
Decoufle, ScD
Atlanta, Georgia
Preconception and prenatal care providers need to be aware of the recent increase in binge drinking as a pattern of
reported alcohol use among US pregnant women.
GENERAL OBSTETRICSANDGYNECOLOGY
Gynecology
Uterine ultrasonographic changes with gonadotropin-releasing hormone 8
agonists
Andrew D. Weeks, MD, Sean R.G. Duffy, MD, and James J. Walker, MD
Leeds, United Kingdom
Gonadotropin-releasing hormone agonists cause significant uterine shrinkage over 8 weeks even in the absence of
uterine fibroids; the uterine artery pulsatility index also shows significant increases.
Effect of antibiotic use on the prevalence of symptomatic vulvovaginal candidiasis 14
Arsenic) Spinillo, MD, Ezio Capuzzo, MD, Salvatore Acciano, MD, Antonella De Santolo, MD, and
Francesca Zara, MD
Pavia, Italy
Antibiotic use is a short-term risk factor for symptomatic vulvovaginal candidiasis.
Randomized controlled trial of the management of premenstrual syndrome and 18
premenstrual mastalgia using luteal phase-only danazol
P.M. Shaughn O'Brien, MD, and I.E.H. Abukhalil, MD
Stoke-on-Trent and Lyndon, WestBromich West Midlands, United Kingdom
Luteal phase-only danazol is ineffective in treating the general symptoms of premenstrual syndrome but appears
highly effective for the relief of premenstrual mastalgia.
Paget's disease of the vulva: Prevalence of associated vulvar adenocarcinoma, 24
invasive Paget's disease, and recurrence after surgical excision
James Fanning, DO, H.C. Lois Lambert, MD, Theodore M. Hale, MD, Peter C. Morris, MD, and
Conrad Schuerch, MD
Toledo, Ohio
Paget's disease of the vulva is rarely associated with vulvar adenocarcinoma, and invasive Paget's disease is
uncommon but the recurrence rate is high.
Serum levels of macrophage colony-stimulating factor-1 in cervical human 28
papiflomavirus infection and intraepithelial neoplasia
Rony A. Adam, MD, Ira R. Horowitz, MD, and Rajeshwar R. Tekmal, PhD
Atlanta, Georgia
Both high-grade cervical intraepithelial neoplasia and high-risk human papillomavirus infection are associated with
higher mean serum colony-stimulating factor-1 levels than are found in normal control subjects, suggesting a possible
role for colony-stimulating factor-1 in cervical neoplasia.
An illuminated vaginal speculum 33
Martin J. Quinn, MB, ChB, MD
Cardiff, United Kingdom
A laryngoscope and Sims' speculum have been adapted to provide an effective instrument for examination of the
lower genital tract that is particularly useful for the evaluation of patients with genital prolapse.
Success rates and estimation of gestational age for medical abortion vary with 35
transvaginal ultrasonographic criteria
Mitchell D. Creinin, MD, and Heather Jerald, BS
Pittsburgh, Pennsylvania
Success rates with any medical abortion regimen are dependent on the criteria used for establishing gestational age
by both mean sac diameter and embryonic pole.
A new clinical option for hormone replacement therapy in women with secondary 42
amenorrhea: Effects of cyclic administration of progesterone from the sustained-
release vaginal gel Crinone (4% and 8%) on endometrial morphologic features
and withdrawal bleeding
Michelle P. Warren, MD, Beverly M.K. Biller, MD, and Mona M. Shangold, MD
New York, New York, Boston, Massachusetts, and Philadelphia, Pennsylvania
Transvaginal administration of a new polycarbophil-based natural progesterone gel is both safe and effective for
hormone replacement therapy in women with secondary amenorrhea.
Obstetrics
A new splenic artery Doppler velocimetric index for prediction of severe fetal 49
anemia associated with Rh alloimmunization
R. Bahado-Singh, MD, Utku Oz, MD, 0. Deren, MD, J. Pirhonen, MD, E. Kovanci, MD, J. Copel, MD,
and L. Onderoglu, MD
New Haven, Connecticut
The Doppler velocimetric angle of deceleration in the splenic artery is a strong predictor of anemia in fetuses with
Rh aJJoimmunization.
A prospective, randomized comparison of Foley catheter insertion versus 55
intracervical prostaglandin Eg gel for preinduction cervical ripening
Anthony C. Sciscione, DO, Helen McCullough, DO, James S. ManJey, MD, Philip A. Shiossman, MD,
Marjorie Pollock, MSN, CRNP, and Garrett H.C. Colmorgen, MD
Newark, Delaware
The Foley catheter is more cost-effective, results in higher postinduction Bishop scores, and requires less time for
preinductcervical ripening than prostaglandin E2gel.
Androgens in preeclampsia 60
Michael T. Acromite, MD, Christos S. Mantzoros, MD, Richard E. Leach, MD, Janet Hurwitz, MA, and
Leonard G. Dorey, MD
Pontiac and Detroit, Michigan, and Boston, Massachusetts
Testosterone levels are significantly higher in primigravid women with preeclampsia than in control subjects.
Favorable response of Eisenmenger syndrome to inhaled nitric oxide during 64
pregnancy
T. Murphy Goodwin, MD, Robert B. Gherman, MD, Afshan Hameed, MD, and Uri Elkayam, MD
Los Angeles, California
Inhaled nitric oxide can be used to correct the hypoxemia of Eisenmenger syndrome.
The role of soluble adhesion molecules in evaluating endothelial cell activation 68
in preeclampsia
Wolfgang Heyl, MD, Stefan Handt, MD, Frank Reister, MD, Johanna Gehien, PhD, Christian Mittermayer, MD,
and Werner Rath, MD
Aachen, Germany
Increased distribution of membrane-bound adhesion molecules on cultured endothelial cells after stimulation with
preeclamptic sera does not correlate with release of soluble adhesion molecules into supernatant.
The prediction of fetal acidosis by means of intrapartum fetal pulse oximetry 73
Birgit Seelbach-Gobel, MD, PhD, Michaela Heupel, MD, Maritta Kuhnert, MD, and
Michael Butterwegge, MD, PhD
Wurzburg, Frankfurt, and Osnabriick, Germany
Intrapartum fetal pulse oximetry may predict the development of fetal acidosis and perhaps diminish fetal blood
samplings and surgical deliveries performed because of nonreassuring fetal heart rate.
Maternal l-deamino-8-D-arginine-vasopressin-induced sequential decreases in 82
plasma sodium concentration: Ovine fetal renal responses
Todd J. Roberts, PhD, Mark J.M. Nijiand, PhD, Mark Curran, MD, and Michael G. Ross, MD, MPH
Torrance, California
Maternal administration of l-deamino-8-D-arginine-vasopressin induced sequential decreases in maternal and fetal
plasma sodium; fetal urine production rate correlated highly with the degree of plasma hypotonicity.
Neonatal behavioral profile of the offspring of women who continued to exercise 91
regularly throughout pregnancy
^ ' ' James F. Clapp III, MD, Beth Lopez, RN, and Rose Harcar-Sevdk, RN
Cleveland, Ohio
' Neonates born to women who continue to exercise regularly throughout pregnancy express more interest in their
environment and quiet themselves more readily than control infants.
AngiotensinogenThr235 variant is associated with abnormal physiologic change 95
of the uterine spiral arteries in first-trimester decidua
Terry Morgan, PhD, Catherine Craven, MD, Jean-Marc Lalouel, MD, PhD, and Kenneth Ward, MD
Salt Lake City', Utah
Quantitative histologic experiments suggest that the angiotensinogen Thr235 allelic variant predisposes women to abnormal
physiologic changes, potentially beginning the cascade of events leading to preeclampsia.
Expression of prostaglandin H synthase isoforms in human myometrium at 103
parturition
Sue D. Moore, MD, Julia Brodt-Eppley, PhD, Leah M. ComeUson, Scott E. Burk, MD, PhD,
Donna M. Slater, PhD, and Leslie Myatt, PhD
Cincinnati, Ohio, and London, United Kingdom
The prostaglandin H synthase isoforms PGHS-I and PGHS-2 are present in lower-segment human myometrium; PGHS-I is the
predominant isofonn and its expression is highest at term in anticipation of labor, whereas expression of PGHS-2
apparently does not change significantly with gestational age or the onset of labor.
Pregnancy in von Hippel-Lindau disease 110
Philippe Grimbert, Dorninique Chauveau, Stephane Richard, Philippe Remy, and Jean Pierre GrUnfeld
Paris, France
In patients with von Hippel-Lindau disease most pregnancies have favorable outcomes; survival rate for infants is
96.4% and the von Hippel-Lindau-specific morbidity rate in the mothers was 5.4%.
Pregnancy enhances the sensitivity of glomerular ecto-adenosine triphosphate- 112
diphosphohydrolase to products of activated polymorphonuclear leukocytes
Maria M. Faas, PhD, Winston W. Bakker, PhD, Julius F.W. Bailer, AS, and Gerar'. A. Schuiling, PhD
Groningen, The Netherlands
Incubation of kidney sections from pregnant and cycling rats with activated polymorphonuclear leukocytes shows
greater sensitivity of glomerular ecto-adenosine triphosphatase activity in pregnant rats.
Repeated antenatal corticosteroids: Size at birth and subsequent development 114
Noel P. French, MB, ChB, Ronald Hagan, MB, BCh, Sharon F. Evans, PhD, Maryelkn Godfrey, RN,
and John P. Newnham, MD
Perth, Western Australia, Australia
Repeated antenatal cortlcosteroids are associated with reduced birth weight and head circumference in this observational
regional cohort study of very preterm infants.
Maternal cardiac troponin I levels during normal labor and delivery 122
Stephan A. Shivvers, MD, Frank H. Wians, Jr, PhD, Joseph H. Keffer, MD, and Susan M. Ramin, MD
Dallas, Texas
Troponin I levels are potentially the most useful biochemical marker for monitoring pregnant women for myocardial injury.
Reproductive hormones and aminoterminal propeptide of type III procollagen in 128
serum as early markers of pelvic pain during late pregnancy
Per Kristiansson, MD, PhD, Kurt Svardsudd, MD, PhD, and Bo von Schoultz, MD, PhD
Uppsala and Stockholm, Sweden
Serum relaxin and propeptide of type III procollagen measured in early pregnancy may reflect the cause and
indicate an increased risk of pelvic pain during late pregnancy.
Effect of aspirin in pregnant women is dependent on increase in bleeding time 135
Alexandre Dumont, MD, Antoine Flahault, MD, Michel Beaufils, MD, Elisabeth Verdy, MD, and
Serge Uzan, MD
Paris, France
Effects of aspirin in pregnant women depend on increase in bleeding time, suggesting that dose be
adjusted according lo a biologic marker of the antiplatelet effect.
Urinary trypsin inhibitor levels in amniotic fluid of normal human pregnancy: 141
Decreased levels observed at parturition
Hiroshi Kobayashi, MD, PhD, Kazunao Suzuki, MD, Dan Sugino, PhD, and Toshihiko Terao, MD, PhD
Shi^lloka and Shiga, Japan
Parturition may occur through the down-regulation of amniotic fluid-derived urinary trypsin inhibitor, which may
decrease uterine contractility during pregnancy.
Fetus-Placenta-Newborn
Prenatal ultrasonographic prediction of homozygous type 1 a-thalassemia at 148
12 to 13 weeks of gestation
Yung-Hang Lam, MB, BS, Mary Hoi-Ym Tang, MB, BS, Chin-Peng Lee, MB, BS, and Hei-Yee Tse, MB, BS
Hong Kong, China
Homozygous tt-thalassaemia type I can be accurately predicted by an ultrasonographic measurement of the fetal
cardiothoracic ratio at 12 to 13 weeks of gestation.
The clinical significance of intermittent sinusoidal fetal heart rate 151
Audrey H. Kang, MD, and Frank H. Boehm, MD
Nashville, Tennessee
The intermittent sinusoidal fetal heart rate pattern may appear in early fetal compromise, but clinical context must be
considered in urgency of assessment and management.
Endoscopic coverage of fetal myelomeningocele in utero 153
Joseph P. Bruner, MD, William 0. Richards, MD, Noel B. Tulipan, MD, and Timothy L. Amey, MD .
Nashville, Tennessee
In 4 fetuses myelomeningocele was covered in utero with a maternal skin graft during an endoscopic approach in a
carbon dioxide environment.
Measurement of obstetric conjugate by ultrasonic tomography and its significance 159
Man Katanozaka, MD, MitsuhiroYoshinaga, MD, PhD, Kazuo Fuchiwaki, MD, PhD, and
Yukihiro Nagata, MD, PhD
Kagoshima, Japan
Ultrasonic obstetric conjugate closely correlated with obstetric conjugate measured by pelvic radiography.
Placental glucose transport and GLUT 1 expression in insulin-dependent diabetes 163
Thomas Jansson, MD, PhD. Margareta Wennergren, MD, PhD, and Theresa L. Powell, PhD
Goteborg, Sweden
Placental GLUT I expression and glucose transport activity are up-regulated in insulin-dependent diabetes, which might
contribute to fetal overgrowth despite rigorous glycemic control.
A high-sensitivity alternative to "routine" genetic amniocentesis: Multiple urinary 169
analytes, nuchal thickness, and age
R. Bahado-Singh, MD, U. Oz, MD, E. Kovanci, MD, D. Cermik, MD, J. Copel, MD, M.J.
Mahoney, MD, ID, and L. Cole, MD
New Haven, Connecticut
A combination of the urinary core fragment/total estriol ratio, nuchal thickness, and maternal age has a high
sensitivity for fetal Down syndrome in high-risk pregnancies.
Placental transfer of sulindac, sulindac sulfide, and indomethacin in a human 174
placental perfusion model
Eija S. Lampela, MB, Laura H. Nuutinen, MSc, Tero 1. Ala-Kokko, MD, PhD, Riitta M. Parikka, MB,
Risto S. Laitinen, PhD, Pentti 1. Jouppila, MD, PhD, and Kirsi H. Vahakangas, MD, PhD ;
Oulu, Finland
Sulindac sulfide crossed the placenta from maternal to fetal side in higher concentration than sulindac or indomethacin;
no placental metabolism of the drugs was detected.
Fetal heart rate patterns in term labor vary with sex, gestational age, epidural 181
analgesia, and fetal weight
Nicholas W. Dawes, DPhil, Geoffrey S. Dawes, DM, Mary Moulden, and Christopher W.G. Redman, MD
Ottawa. Ontario, Canada, and Oxford, United Kingdom
The heart rate of the felus in labor is modulated by several factors, including fetal sex, use of epidural anesthesia,
duration of labor, and maternal parity.
Lipoic acid prevention of neural tube defects in offspring of rats with streptozocin- 188
induced diabetes
Arnon Wiznitzer, MD, NirAyalon, BSc, Reli Hershkovitz, MD, Mogher Khamaisi, MSc, E. Albert Reece, MD,
Hans Trischler, PhD, and Nava Bashan, PhD
Beer-Sheva, Israel, Frankfurt, Germany, and Philadelphia, Pennsylvania
These data may further support the hypothesis that reactive oxygen species are causally related to diabetic embryonic
maldevelopment.
Increased midtrimester amniotic fluid activin A: A risk factor for subsequent 194
fetal death
F. Petraglia, MD, R. Gornez, MD. S. Luisi, MD, P. Florio. MD, J.E. Tolosa, MD, M. Stomati, MD, and
R. Romei-o, MD
Udine and Pisa, Italy, andBethesda, Maryland
Midtrimester amniotic fluid concentrations of activin A are significantly higher in women who subsequently had a
fetal death than in those who were delivered of healthy infants at term.
In vitro models to predict the in vivo mechanism, rate, and extent of placental 198
transfer of dideoxynucieoside drugs against human immunodeficiency virus
Tove Tuntland, PhD, Aleksandrs Odinecs, PhD, Conrad M. Pereira, PhD, Connie Nosbisch, BS, and
Jashvant D. Unadkat, PhD
Seattle, Washington
The perfused human placenta model and the octanol-water partition coefficient can predict the rate and extent of in
vivo placental transfer of anti-human immunodeficiency virus dideoxynucieoside drugs that passively cross the placenta.
Impact of pregnancy-induced hypertension on fetal growth 207
Xu Xiong, DrPH, Damon Mayes, MSc, Nestor Demianczuk, MD, David M. Olson, PhD, Sandra T. Davidge, PhD,
Christine Newbum-Cook, PhD, and L. Duncan Saunders, PhD
Edmonton, Alberta, Canada
Preeclampsia increases the risk of intrauterine growth restriction and low birth weight.
Correction of hemorrhage-induced anemia with intra-amniotic iron in the ovine 214
fetus
Robert A. Brace, PhD, Andree Gruslin, MD, Andrew D. Hull, MD, John A. Widness, MD, and
Cecilia Y. Cheung, PhD
San Diego, California, and Iowa City, Iowa
Ovine fetuses remain anemic after a major blood loss; intra-amniotic iron injection at the time of hemorrhage
completely restores red blood cell mass in 7 days.
Neonatal outcome in severe preeclampsia at 24 to 36 weeks' gestation: Does 221
the HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome
matter?
Dorel Abramovici, MD, Steven A. Friedman, MD, Brian M. Mercer, MD, Francois Audibert, MD,
Lu Kao, RN, and Baha M. Sibai, MD
Memphis, Tennessee
Neonatal outcome in women with severe preeclampsia is related to gestational age at delivery rather than to the presence
or absence of the HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome.
Genetic amniocentesis after multifetal pregnancy reduction 226
Belgin Selam, MD, Olga Torok, MD, Arda Lembet, MD, Joanne Stone, MD, Robert Lapinski, PhD,
and Richard L. Berkowjtz, MD
New York, New York
Genetic amniocentesis after multifetal pregnancy reduction does not introduce an additional risk of pregnancy
Joss over that observed in association with the reduction itself.
The role of forceps rotation in maternal and neonatal injury 231
Gaiy D.V. Hankins, MD, Terry Leicht, RN, MSN, James Van Hook, MD, and Eda M. U^kan, RNC, MSN
Galveston, Texas
A role remains for selective use of forceps rotations of 90 degrees or more to achieve vaginal birth.
Maternal body fat and water during pregnancy: Do they raise infant birth 235
weight?
Sally Ann Lederman, PhD, Anne Paxton, DrPH, Steven B. Heyrnsfield, MD, Jack Wang, MS,
John Thornton, PhD, and Richard N. Pierson, Jr, MD
New York, New York
Total and net maternal weight and body water at week 37 of pregnancy are significantly and positively associated
with infant birth weight at term.
AJOG REVIEWS
Estimates of the risk of cardiovascuiar death attributable to low-dose oral 241
contraceptives in the United States
Pamela J. Schwingi, PhD, Howard W. Ory, MD, and Cynthia M. Visness, MPH
Research Triangle Park, North Carolina
The annual mortality rate associated with low-dose oral contraceptives in young nonsmokers is 0.06 per 100,000 users;
smokers >35 years old are advised to use a non-estrogen-containing contraceptive.
LETTERS TO THE EDITORS
Prevention of group B streptococci and Centers for Disease Control and Prevention compliance
John Seguin, MD Columbus, Ohio 250
Reply Marvin S. Amstey, MD Rochester, New York 250
Ethical accountability and novel perinatal treatments Lisa Hams, MD Ann Arbor, Michigan 250 -
Reply Richard P. Porreco, MD Denver, Colorado 250
Tight nuchal cord morbidity and mortality Jason H. Collins, MD, Slidell, Louisiana 251
Reply Karin B. Nelson, MD, and Judith K. Grether, PhD Bethesda, Maryland, and Emeryville, California 251
Ultrasonographic evaluation of endometrial disease in postmenopausal patients with breast cancer and
tamoxifen treatment llan Cohen, MD, Ron Tepper, MD, and Yoram Beyth, MD Kfar-Saba, Israel 252
Reply Kathryn F. McGonigle, MD, Jean F. Simpson, MD, and Subir Roy, MD Los Angeles, California, and Nashville, Tennessee 252
Induction of labor with misoprostol for premature rupture of membranes beyond thirty-six weeks' gesta-
tion Luis Sanchez-Ramos, MD, and Isaac Deike, MD Jacksonville, Florida 253
Reply Deborah A. Wing, MD, and Richard H. Paul, MD Los Angeles, California 253
In defense Of Apgar Scores Antonio Farina, MD, Luisa Di Luzio, MD, and Nicola Rizzo, MD Boston, Massachusetts, and
Bologna, Italy 254
Reply Gilbert 1. Martin, MD West Covina, California 254
Reply Harish M. Sehdev, MD, George A. Macones, MD, MSCE, and Mark A. Morgan, MD Camden, New Jersey, and
Philadelphia, Pennsylvania 255
ROSTER
Roster of American obstetric and gynecologic societies 256
CORRECTIONS
Prevalence of sexual assault history among women with common gynecologic 255
symptoms
(Golding JM, Wilsnack SC, Learman LA. Am J Obstet Gynecol 1998;179:1013-9)
The Noble-Mengert-Fish operation—Revisited: A composite approach for 257
persistent rectovaginal fistulas and complex perinea) defects
(Veronikis DK, Nichols DH, Spino C. Am J Obstet Gynecol 1998,179:1411-7)
READER SERVICE
Information for Authors 23A
Information for Readers 30A
items 58A
Professional Opportunities Available 46A
Index to Advertisers 50A
___________________________________
American Journal of obstetrics and Gynecology
VOL. 180, NO. 2, FEBRUARY 1999
CLINICAL OPINION
Legal considerations in screening pregnant women for human immunodeficiency 259
virus
Richard M. Grimes, PhD, Edward P. Richards, JD, MPH, Andrew W. HeHgott, MD, and Nancy L. Eriksen, MD
Houston, Texas, and Kansas City, Missouri
Pelvic actinomycosis: A review and preliminary look at prevalence 265
Jack Lippes, MD
Buffalo, New York
GENERAL OBSTETRICS AND GYNECOLOGY
Gynecology
Laparoscopically assisted vaginal hysterectomy versus total abdominal 270
hysterectomy: A prospective, randomized, multicenter study
Riccardo Marana, MD, Mauro Busacca, MD, Errico Zupi, MD, Nicola Garcea, MD, Pierluigi Paparella, MD,
and Giovan Fiore Catalano, MD
Rome and Milan, Italy
Cold-knife conization versus conization by the loop eleexcision 276
procedure: A randomized, prospective study
Bridgette D. Duggan, MD, Juan C. Felix, MD, Laila 1. Muderspach, MD, Judith A. Gebhardt, MS,
Susan Groshen, PhD, C. Paul Morrow, MD, and Lynda D. Roman, MD
Los Angeles, California
Effects of hormone replacement therapy on hemostatic cardiovascular risk factors 283
Lars F. Andersen, MD, J0rgen Gram, DSc, Sven O. Skouby, DSc, and J0rgen Jespersen, DSc
Copenhagen and Esbjerg, Denmark
Cervicography screening for cervical cancer among 846O women in a high-risk 290
population
Diana L. Schneider, MA, Rolando Herrero, MD, PhD, Concepcion Bratti, MD, Mitchell D. Greenberg, MD,
Allan Hildesheim, PhD, Mark E. Sherman, MD, Jörge Morales, MD, Martha L. Hutchinson, MD, PhD,
Thomas V. Sedlacek, MD, Attila Lorincz, PhD, Laurie Mango, MD, Sholom Wacholder, PhD,
Mario Alfaro, MD, and Mark Schiffman, MD, MPH
Bethesda, Baltimore, and Silver Spring, Maryland, Philadelphia, Pennsylvania, Providence, Rhode Island,
Suffern, New York, Lyon, France, and San Jose, Costa Rica
Signs of genital prolapse in a Swedish population of women 20 to 59 years of 299
age and possible related factors
Eva C. Samuelsson, MD, F.T. Arne Victor, MD, PhD, Gosta Tibblin, MD, PhD, and Kurt F. Svardsudd, MD, PhD
Uppsala and Ostersund, Sweden
Laterally extended endopelvic resection: Surgical treatment of infrailiac pelvic 306
wall recurrences of gynecologic malignancies
Michael Hockel, MD, PhD
Leipzig, Germany
Adhesion-related small-bowel obstruction after gynecologic operations 313
Sundus Al-Took, MD, Robert Platt, PhD, and Togas Tulandi, MD
Montrecd, Quebec, Canada
Immunohistochemical localization of inhibin and activin subunits in human 316
epithelial ovarian tumors
KazuyaYamashita, MD, MareoYamoto, MD, Toshihiko Shikone, MD, Sawako Minami, MD, and
Ryosuke Nakano, MD
Wakayama, Japan
Review of the granulosa-theca cell tumors from the Emil Novak Ovarian Tumor 323
Registry
Hendrik S. Cronje, MD, Illse Niemand, BSc, Roosmarie H. Barn, MD, and J. Donald Woodruff, MD
Baltimore, Maryland
Telomerase activity in complete hydatidiform mole 328
Seog Nyeon Bae, MD, PhD, and Seung Jo Kirn, MD, PhD
Seoul, Korea
Effects of estrogen replacement therapy on plasma levels of nitric oxide in 334
postmenopausal women
Ettore Cicinelli, MD, Louis J. Ignarro, MD, Maria Giuseppina Matteo, MD, Pietro Galantine, MD,
Luca Maria Schonauer, MD, and Nunziata Faico, MD
Bari, Italy, and Los Angeles, California
Endometrial cancer in polyps associated with tamoxifen use 340
Lois M. Ramondetta, MD, Jennifer B. Sherwood, MD, Charles J. Dunton, MD, and Juan P. Palazzo, MD
Philadelphia, Pennsylvania
Histologie analysis of needle biopsy of urethral sphincter from women with 342
normal and stress incontinence with comparison of electromyographic findings
Douglass S. Hale, MD, J. Thomas Benson, MD, Linda Brubaker, MD, Maria C. Heidkanip, BS, and
Brenda Russell, PhD
Indianapolis, Indiana, and Chicago, Illinois
Timing of labor induction after premature rupture of membranes between 32 349
and 36 weeks' gestation
Mark G. Neerhof, DO, Carina Cravello, MD, Elaine I. Haney, MT, and Richard K. Silver, MD
Evanston, Illinois
Observations on labor epidural analgesia and operative delivery rates 353
Michael K. Yancey, MD, Brian Pierce, MD, Dina Schweitzer, MD, and Don Daniels, MD
Honolulu, Hawaii
Pregnancy in patients with well-treated p-thalassemia: Outcome for mothers 360
and newborn infants
Athanasios Aessopos, MD, Fotis Karabatsos, MD, Dimitrios Farmakis, MD, Aspassia Katsantoni, MD,
Antonia Hatziliami, MD, Jacqueline Yolissef, MD, and Markisia Karagiorga, MD
Athens, Greece
The effect of therapeutic McDonald cerclage on cervical length as assessed by 366
transvaginal ultrasonography
Sietske M. Althuisius, MD, GustaafA. Dekker, PhD, Herman P. van Geijn, PhD, and Pieter Hummel, PhD
Amsterdam, The Netherlands
Ketanserin versus dihydralazine in the management of severe early-onset 371
preeclampsia: Maternal outcome
Antoinette C. Bolte, MD, Jim van Eyck, PhD, Humphrey H. Kanhai, PhD, Hein W. Bruinse, PhD,
Herman P. van Geijn, PhD, and GustaafA. Dekker, PhD
Amsterdam, Zwolle, Leiden, and Utrecht, The Netherlands
Elastase activity of anaerobes isolated from amniotic fluid with preterm premature 378
rupture of membranes
Hiroshige Mikarno, MD, PhD, Kyoko Kawazoe, MD, Yasumasa Sato, MD, and Teruhiko Tamaya, MD, PhD
Gifu, Japan
Relationship between myometrial resistance artery behavior and circulating 381
lipid composition
Richard G. Hayman, MB, BS, Naveed Sattar, MB, ChB, Averil Y. Warren, MPhil, fan Greer, MD,
lan R. Johnson, DM, and Philip N. Baker, DM
Nottingham, United Kingdom
Myometrial nitric oxide synthase messenger ribonucleic acid expression does 387
not change throughout gestation or with the onset of labor
William J.B. Dennes, MB, BS, Donna M. Slater, PhD, Lucilla Poston, PhD, and Phillip R. Bennett, MD, PhD
London, United Kingdom
Lack of local reflection of national changes in cesarean delivery rates: 393
The Canadian experience
Vincent V. Richman, MBA, PhD
New York, New York
A randomized double-blind study comparing the fetal effects of sulindac to 396
terbutaline during the management of preterm labor
Wayne B. Krämer, MD, George R. Saade, MD, Michael Beifort, MD, Karen Dorman, RN, MS,
Mary Mayes, RN, and Kenneth J. Moise, Jr, MD
Houston, Texas
Effects of red blood cells on the coagulation of blood in normal and preeclamptic 402
pregnancies
Manabu Kaibara, MD, Yoichi Mitsuhashi, MD, Takaya Watanabe, MD, Flirniko Tamiaki, MD,
Masayuki Nishihira, MD, Miyuki Sadatsuki, MD, and Kohzo Aisaka, MD
Ichihara City, Japan
Maternal oxygen transport variables during the third trimester of normal pregnancy 406
Gary D.V. Hankins, MD, Steven L. dark, MD, Eda Uckan, RNC, MSN, and James W. Van Hook, MD
Galveston, Texas, and Salt Lake City, Utah
Treatment of toxoplasmosis during pregnancy: A multicenter study of impact 410
on fetal transmission and children's sequelae at age 1 year
Walter Foulon, MD, PhD, Isabelle Villena, MD, Babill Sti-ay-Pedersen, MD, PhD, Anne Decoster, MD,
Maija Lappalainen, MD, PhD, Jean-Michel Pinon, MD, PhD, Pal A. Jenum, MD, Klaus Hedman, MD, PhD,
and Anne Naessens, MD, PhD
Brussels, Belgium, Reims and Lille, France, Oslo, Nonvay, and Helsinki, Finland
Maternal and neonatal infection rates with three different protocols for prevention 416
of group B streptococcal disease
Gregory J. Locksmith, MD, Penny Clark, PhD, and Patrick Duff, MD
Gainesville, Florida
Ultrasonographic differential diagnosis of fetal intracranial interhemispheric cysts 423
Patrizia Vergani, MD, Anna Locatelli, MD, Maria Giovanna Piccoli, MD, Patrizia Ceruti, MD, Luisa Patane, MD,
Giuseppe Paterlini, MD, and Alessandro Ghidini, MD
Monza, Italy, and Washington, D.C.
Differential fetal and maternal contributions to the cytokine milieu in a murine 429
model of infection-induced preterm birth
Emmet Hirsch, MD, Ryan Blanchard, BS, and Sheetal R Mehta, BS
New York, New York
Reliability and clinical application of fetal RhD genotyping with two different 435
fluorescent duplex polymerase chain reaction assays: Three years' experience
Gerd Crombach, MD, PhD, Dieter Niederacher, PhD, Dorothee Larbig, Frauke Picard, PhD,
Boris Tutschek, MD, Matthias W. Beckmann, MD, PhD, and Hans-Georg Bender, MD, PhD
Dusseldorf, Germany
Diagnosis of fetal pulmonary hypoplasia by measurement of blood flow velocity 441
waveforms of pulmonary arteries with Doppier ultrasonography
ShuichiroYoshimura, MD, Hideaki Maslizaki, MD, Kiyonori Miura, MD, Kunio Muta, MD,
Hideo Gotoh, MD, and Tadayuki Ishimaru, MD, PhD
Nagasaki, Japan
Fetal supply of amino acids and amino nitrogen after maternal infusion of amino 447
acids in pregnant sheep
Maciej Jozwik, MD, PhD, CeciliaTeng, MS, Frederick C. Baltaglia, MD, and Giacoino Meschia, MD
Denver, Colorado, and Biatystok, Poland
The effect of amniotic fluid on the human omental artery in vitro 454
Yuri P. Vedernikov, MD, PhD, George R. Saade, MD, Marya Zlatnik, MD, Elizabeth Martin, RN,
Robert E. Garfield, PhD, and Gary D.V. Hankins, MD
Galveston, Texas
Heat shock protein 70 and heat shock cognate protein 70 messenger ribonucleic 457
induction in the brains, hearts, and livers of neonatal rats after hypoxic stress
Tomoaki Ikeda, MD, Koji Abe, MD, Arturo Ota, MD, and Tsliyomu Ikenoue, MD
Miyazaki, Japan
Two sinusoidal heart rate patterns in fetal lambs undergoing extracorporeal 462
membrane oxygenation
Tomoaki Ikeda, MD.Yuji Murata, MD, Edward J. Quilligan, MD, Paula Ciftientes, MD, Shigeharu Doi, MD,
and Sonng-Day Park, MD
Orange, California
Regulation of human placental chloride channel by arachidonic acid and other 469
cis unsaturated fatty acids
Gloria Riqueime, MSc, and Mauro Parra, MD
Santiago, Chile
Stem villous arteries from the placentas of heavy smokers: Functional and 476
mechanical properties
Helle V. Clausen, MD, Jorgen C. Jorgensen, MD, PhD, and Bent Ottesen, MD, PhD
Copenhagen and Holbak, Denmark
Adding zinc to prenatal iron and folate tablets improves fetal neurobehavioral 483
development
Mario Merialdi, MD, MPH, Laura E. Caulfield, PhD, Nelly Zavaleta, MD, MS, Alberto Figueroa, MD,
and Janet A. DiPietro, PhD
Baltimore, Maryland, and Lima, Peru
Nuchal thickness, urine p-core fragment level, and maternal age for Down 491
syndrome screening
R.o. Bahado-Singh, MD, A.U. Oz, MD, D. Flores, MD, D. Cermik, MD, E. Acuna, MD,
MJ. Mahoney, MD, and L. Cole, MD
New Haven, Connecticut
Education
Response of obstetrics and gynecology program directors to a domestic 496
violence lecture module
Ronald A. Chez, MD, and Deborah L. Horan
Tampa, Florida, and Washington, D.C.
AJOG REVIEWS
Preeclampsia: An excessive maternal inflammatory response to pregnancy 499
Christopher W.G. Redman, MD, Gavin P. Sacks, MD, and lan L. Sargent, PhD
Oxford, United Kingdom
LETTERS TO THE EDITORS
Death of the Papanicolaou smear? Future litigation Terry L. wade Minneapolis, Minnesota 507
What are the clinical implications? Steven R. Wells, MD, Robert A. Strauss, MD, and Jeffrey A. Kuller, MD Chapel Hill,
North Carolina 507
Reply Umberto Nicolini Milan, Italy 508
READER SERVICE
information for Authors 22A
Information for Readers 33A
Items 509
Professional Opportunities Available 42A
Index to Advertisers 43A
__________________________________
American Journal Of Obstetrics and Gynecology
vol:180, no:5, may 1999
CLINICAL OPINION
Is human papillomavirus testing of value in clinical practice? 1049
Raymond H. Kaufman, MD, and Ervin Adam, MD
Houston, Texas
In our opinion current human papillomavirus testing is of little clinical use to the practitioner; its use should be limited
to appropriately designed and implemented research studies.
A comparison of intermittent and continuous support during labor: A meta-analysis 1054
Kathryn D. Scott, DrPH, Gale Berkowitz, DrPH, and Marshall Klaus, MD
San Francisco, California
Physical and emotional support during childbirth is most beneficial when provided by a female birth attendant on a
continuous rather than an intermittent basis.
GENERAL OBSTETRICS AND GYNECOLOGY
• Gynecology
Epidemiologic determinants of vaginal pH 1060
Montserrat Garcfa-Closas, MD, DPH, Rolando Herrero, MD, PhD, Concepciôn Bratti, MD,
Allan Hildesheim, PhD, Mark E. Sherman, MD, Udia Ana Morera, RN, and Mark Schiffman, MD, MPH
Bethesda and Baltimore, Maryland, Lyon, France, and San José, Costa Rica
Vaginal pH increases gradually with increasing age, starting at around age 45 years and continuing into old age; this
increase is independent of the effect of the onset of menopause.
Rhythmic variation in the rate of ectopic pregnancy throughout the year 1067
Angelo Cagnacci, MD, Stefano Landi, MD, and Annibale Volpe, MD
Modena, Italy
The rate of ectopic pregnancy shows a seasonal rhythm, with peaks in frequency every 6 months.
A randomized, open, parallel-group study on the preventive effect of an 1072
estradiol-releasing vaginal ring (Estring) on recurrent urinary tract infections
in postmenopausal women
Bjarne C. Eriksen, MD, PhD
Haugesund, Norway
Treatment with an estradiol-releasing vaginal ring significantly prolonged lhe time to first recurrence of urinary tract
infection and alleviated other postmenopausal urogenital symptoms.
Effects of multiple applications of benzalkonium chloride and nonoxynol 9 on 1080
the vaginal epithelium in the pigtaifed macaque (Macaca nemestrina)
Dorothy L. Patton, PhD, Gretchen Ganzie Kidder, Yvonne Cosgrove Sweeney, Lorna K. Rabe, and
Sharon L. Hillier, PhD
Seattle, Washington, and Pittsburgh, Pennsylvania
In a monkey model of topical microbicide efficacy, multiple applications of either nonoxynol-9 or benzalkonium
chloride, or both, induced cervicovaginal tissue irritation; most of the severe responses occurred in animals treated
with benzalkonium chloride.
Menstrual cycle-specific inhibition of the proliferation of endometrial stromal 1088
cells by interleukin 6 and its soluble receptor
Hiroki Yoshioka, MD, Tasuku Harada, MD, Tornio lwabe, MD, Yorie Nagano, MD, Fuminori Taniguchi,
MD, Masahiro Tanikawa, MD, and Naoki Terakawa, MD
yonago, Japan
Interleukin 6 and its soluble receptor suppress proliferation of endometrial cells during the secretory phase.
Targeted cytotoxic analog of luteinizing hormone-releasing hormone AN-207 1095
inhibits growth of OV-1063 human epithelial ovarian cancers in nude mice
Masahiro MiyazakJ, MD, Andrew V. Schally, PhD, MD, Attila Nagy, PhD, Najib Lamharzi, PhD,
Gabor Halmos, PhD, Karoly Szepeshazi, MD, and Patricia Armatis, MS
New Orleans, Louisiana
Cytotoxic luteinizing hormone-releasing hormone analog AN-207 inhibited OV-1063 human ovarian cancers in
nude mice and reduced tumor levels and messenger ribonucleic acid expression of epidermal growth factor receptor.
The effect of hysterectomy on the risk of an abnormal screening Papanicolaou 1104
test result
John Fox, MD, Patrick Remington, MD, MPH, Peter Layde, MD, MSc, and Gail Klein, MS
Madison, Wisconsin
For women aged >50 years, the risk of an abnormal Papanicolaou smear is 10 times lower for women without a
uterine cervix than for women with a uterine cervix.
Cervical human papillomavirus deoxyribonucleic acid persists throughout 1110
pregnancy and decreases in the postpartum period
Kenneth H. Fife, MD, PhD, Barry P. Katz, PhD, Edward J. Bi-izendiiie, MS, and Dan-on R. Brown, MD
Indianapolis, Indiana
A follow-up of patients enrolled in a study of cervical human papillomavirus infections during pregnancy showed
a decrease in detectable infection after delivery.
Association of vitamin D and estrogen receptor gene polymorphism with the effect 1115
of hormone replacement therapy on bone mineral density in Japanese women
Takumi Kurabayashi, MD, Masatoshi Tomita, MD, Hiroshi Matsushita, MD, TetsuroYahata, MD,
Akira Honda, MD, Koichi Takakuwa, MD, and Kenichi Tanaka, MD
Niigata, Japan
TaqI polymorphism of the vitamin D receptor gene is associated wilh lhe effect of hormone replacement therapy on
lumbar-spinal bone mineral density and résorption markers in Japanese women.
Expression of adenosine triphosphate-sensitive potassium channel subunits 1121
in female rat reproductive tissues: Overlapping distribution of messenger
ribonucleic acid for weak inwardly rectifying potassium channel subunit 6.1
and sulfonylurea-binding regulatory subunit 2
Edward K. Chien, MD, YanHong Zhang, MD, Hiroto Furuta, MD, and Manami Hara, PhD
Chicago, Illinois
Messenger ribonucleic acid for SUR2B and Kir6.1 is expressed in myomelrium and corpus luteum during pregnancy;
SURI is expressed mainly within placenta and fetal membranes.
Obstetrics
Cardiovascular effects of a mu-selective opioid agonist (tyrosine-o-arginine- 1127
phenylalanine-lysine-NH2) in fetal sheep: Sites and mechanisms of action
Yasmin S. Holsey, BA, Dunii Wu, MD, Yi Soong, MD, Abimbola T. Omoniyi, MPhil, and
Hazel H. Szeto, MD, PhD
New York, New York
The fetal effects of DALDA (tyrosine-u-arginine-phenylalaniiie-lysine-NH2), a highly polar mu-selective opioid peptide,
differ from the adult pattern, suggesting different sites and mechanisms of action.
Comparison of maternal serum total activin A and inhibin A in normal, preeclamptic, 1131
and nonproteinuric gestationally hypertensive pregnancies
Helayne M. Silver, MD, Geralyn M. LMesserlian, PhD, Jami A. Star, MD, Joseph Hogan, ScD,
and Jacob A. Canick, PhD
Providence, Rhode Island
Maternal serum total activin A and inhibin A are increased in preeclampsia and activin A levels are increased in
gestational hypertension relative to normotensive pregnancy.
Effect of nitric oxide synthase inhibition on the uterine vasculature of the 1138
late-pregnant ewe
Suzanne L. Miller, PhD, Graham Jenkin, PhD, and David W. Walker, PhD
Clay ton, Victoria, Australia
Nitric oxide plays an important role in the maintenance of vasodilation of the literoplacental circulalion during
pregnancy in sheep.
High prevalence of hemostatic abnormalities in women with a history of severe 1146
preeclampsia
Maria G. van Pampus, MD, GustafA. Dekker, MD, Hans Wolf, MD, Peter C. Huijgens, MD, PhD,
Maria M.W. Koopman, MD, B. Mary E. von Blomberg, PhD, and Harry R. Buller, MD
Amsterdam, The Netherlands
Severe early-onset preeclampsia could be a first manifestation of thrombotic disease.
The Preterm Prediction Study: Failure of midtrimester cervical sialidase level 1151
elevation to predict subsequent spontaneous preterm birth
William W. Andrews, PhD, MD, Jun Tsao, PhD, Robert L. Goldenberg, MD, John C. Hauth, MD,
Brian Mercer, MD, Jay lams, MD, Paul Meis, MD, Atef Moawad, MD, Anita Das, MS,
Peter J. Van Dorsten, MD, Steve N. Caritis, MD, Gary Thumau, MD, Menachem Miodovnik, MD,
James Roberts, MD, and Donald McNellis, MD
Bethesda, Maryland, andBirnungham, Alabama
Elevated midtrimester cervical sialidase activity does not identify women at increased risk for spontaneous preterm birth.
A comparison of orally administered misoprostol with vaginally administered 1155
misoprostot for cervical ripening and labor induction
Deborah A. Wing, MD, Debby Ham, MD, and Richard H. Paul, MD
Los Angeles, California
Oral administration of 50-p.g doses of misoprostol is less effective than vaginal administration of 25-microg doses for
cervical ripening and labor induction.
Altered blood pressure course during normal pregnancy and increased preeclampsia 1161
at high altitude (3100 meters) in Colorado
Susan K. Palmer, MD, Lorna G. Moore, PhD, David A. Young, PhD, Betsey Cregger, MD,
Jonathan C. Berman, MD, and Stacy Zamudio, PhD
Denver, Colorado
Altitude alters the blood pressure course of pregnancy and operates independently of other factors to increase the
incidence of preeclampsia in patients living at 3100m.
Cervicovaginal fetal fibronectin as a marker for preterm delivery: A meta-analysis 1169
H. Leitich, MD, MSc, C. Egarter, MD, A. Kaider, MSc, M. Hohlagschwandtner, MD, P. Berghammer, MD,
and P. Hussiein, MD
Vienna, Austria
Cervicovaginal fetal fibronectin is a useful marker for preterm delivery in patients with symptoms of preterm labor.
Cesarean deliveries for Medicaid patients: A comparison in public and private 1177
hospitals in Los Angeles County
Kimberly D. Gregory, MD, MPH, Emily Ramicone, MS, Linda Chan, PhD, and Katherine L. Kahn, MD
Los Angeles and Santa Monica, California
After adjustment for case mix, Medicaid patients were 2.5 times more likely to have a cesarean delivery in private
nonteaching hospitals than in public hospitals.
Effects of pregnancy-induced hypertension on the essential fatty acid statuses 1185
of Ecuadorian and Dutch women
Suzie J. Otto, MSc, Adriana C. van Houwelingeii, MD, PhD, Patricio Lopez-Jaramillo, MD, PhD, and
Gérard Homstra, PhD
Maastricht, The Netherlandi, and Quito, Ecuador
Bnlianced conversion of essential fatty acids into their long-chain polyenes most likely occurs in Dutch women
with pregnancy-induced hypertension but is not present in Ecuadorian women.
The effect of indomethacin and prostacyclin agonists on blood pressure in a rat 1191
model of preeclampsia
Marya G. Zlatnik, MD, Irina Bulninschi, MD, Krislof Chwalisz, MD, PhD, Q. Ping Liao, MD,
George R. Saade, MD, and Robert E. Gal-Field, PhD
Cuilveston, Texas, and Berlin, Germiwy
In pregnant rats hypertension induced by nitric oxide deticiency can be partially reversed by prostacyclin but not by
nonselective inhibition of the cyclooxygenase en7.yme.
Level of postoperative analgesia is a critical factor in regulation of myometrial 1196
contractility after laparotomy in the pregnant baboon: Implications for human
fetal surgery
Jennifer D. Tame, BS, Laura M. Abrams, BS, Xiu-Ying Ding, MD, Andrew Yen, BA, Dino A. Giussani, PhD,
and Peter W. Nathanielsz, MD, PhD, ScD
lthaca. New York
The level of postoperative analgesia modifies maternal adrenal function, estrogen production, and myometrial contractility
after laparotomy in the baboon during late gestation.
Alteration of fetal oxygénation and responses to acute hypoxemia by increased 1202
myometrial contracture frequency produced by pulse administration of oxytocin
to the pregnant ewe from 96 to 131 days' gestation
Norio Shinozuka, MD, PhD, Andrew Yen, BA, and Peter W. Nathanielsz, MD, PhD, ScD
lthaca, New York, and Tokyo, Japan
Increased myometrial contracture frequency produced by pulse administration of oxytocin to the pregnant ewe shifts
the fetal oxygen dissociation curve to the left.
Lymphocyte intracellular free calcium concentration is increased in preeclampsia 1209
Minoru Hojo, MD, Manikkam Suthanthiran, MD, Géraldine Helseth, RN, and Phyllis August, MD
New York, New York
Lymphocyte intracellular free calcium concentrations were significantly higher in women with preeclampsia than in
normotensive and chronically hypertensive pregnant women.
I Fetus-Placenta-Newborn
Differential effects of natural and synthetic glucocorticoids on cytochrome 1215
17a-hydroxylase (P45017alpha) and cytochrome P-450 side-chain cleavage (P450scc)
messenger ribonucleic acid in the sheep placenta
Xiao Hong Ma, MD, Wen Xuan Wu, MD, PhD, and Peter W. Nathanielsz, MD, PhD, ScD
lthaca, New York
Natural and synthetic glucocorticoids have différent regulatory effects on expression of placental cytochrome P45017alpha
and cytochrome P-450scc.
Hyperimmunoglobulin therapy for a twin fetus with cytomegalovirus infection 1222
and growth restriction
Giovanni Nigro, MD, Renato La Torre, MD, Mauri/.io M. Anceschi, MD, Manuela Mazzocco, MD, and
Ermelando V. Cosmi, MD
Rome, Italy
In aprimiparous woman with primary cytomegalovirus infection and placentitis, with growth restriction of I twin Ictus,
treatment with specific immunoglobulin was successful.
Cost-benefit analysis of targeted ultrasonography for prenatal detection of spina 1227
bifida in patients with an elevated concentration of second-trimester maternal
serum alpha-fetoprotein
Anthony M. Vintzileos, MD, Cande V. Ananth, PhD, MPH, Allan J. Fisher, MD, John C. Smulian, MD, MFH,
Debra Day-Salvatore, MD, PhD, Tryfon Beazoglou, PhD, and Robert A. Kluippel, MD, MPH
New Brunswick, New Jersey, and FarmingUm, Connecticut
Targeted ultrasonography instead of routine genetic amniocentesis in patients with elevated levels of second-trimester
maternal serum ot-fetoprotein is economically beneficial.
Fetal cell identifiers: Results of microscope slide-based immunocytdchemical 1234
studies as a function of gestational age and abnormality
Yun-Ling Zheng, PhD, Dong Kai Zhen, MS, Antonio Farina, MD, Stanley M. Berry, MD,
Ronald J. Wapner, MD, John M. Williams, PhD, and Diana W. Bianchi, MD
Boston and Cambridge, Massachusetts, Detroit, Michigan, and Philadelphia, Pennsyinmia
With the use ofimmunocytochemical labeling techniques on fetal blood, a developmental hematologic proFile was
demonstrated that varies with gestational age and abnormality.
Placing the newborn on the maternal abdomen after delivery increases the volume 1240
and CD34+ cell content in the umbilical cord blood collected: An old maneuver
with new applications
Dan Grisaru, MD, Varda Deutsch, PhD, Marjorie Pick, MSc, Gideon Fait, MD, Joseph B. Lessing, MD,
Shaul Dollberg, MD, and Amirain Eldor, MD
Tel Aviv, Israel
Placing the newborn on the maternal abdomen after delivery may increase the absolute amount of blood progenitors
required forengraftment success of umbilical cord blood transplant.
Efficacy of the selective prostaglandin synthase type 2 inhibitor nimesulide in 1244
blocking basal prostaglandin production and delaying ginduced
premature labor in sheep
Kirsten R. Poore, PhD, 1. Ross Young, PhD, and Jonathan J. Hirst, PliD
Melbourne, Victoria, Australia
Nimesulide, proposed as a selective prostaglandin synthase type 2 inhibitor, suppressed proslaglandin concentrations in
fetal and maternal plasma and delayed glucocorticoid-induced labor in sheep.
Heat shock protein 72 expression and microtubule-associated protein 2 1254
disappearance after hypoxia-ischemia in the developing rat brain
Xiao Y. Xia, MD, Tonioaki Ikeda, MD, Artliro Ota, MD, Yi X. Xia, MD, Hiroshi Sameshima, MD,
Tsuyomu Ikenoue, MD, and Kiyotaka Tosilimori, MD
Miyawki, Japan
In 5-day-old rats hypoxia-ischemia causes earlier changes in heat shock protein 72 and microtubule-associated protein
2 with less severe brain damage than in 14-day-old rats.
The midgestational rabbit as a model for the creation of membrane defects after 1263
needle fetoscopy
Eduard Gratacos, MD, PhD, Hirotoshi Yamamoto, MD, PhD, Nikolaos A. Papadopulos, MD,
Tom Adriaenssens, Thomas Phlips, Toni A. Lerut, MD, PhD, and Jan A. Deprest, MD
Leaven, Belgium
The midgestational rabbit is used as an in vivo model for the creation of membrane defects after needle insertion and
fetoscopy.
Multifetal pregnancy reductions of triplets to twins: Comparison with nonreduced 1268
triplets and twins
Yuval Yaron, MD, Peter K. Bryant-Greenwood, MD, Neha Dave, MD, Julie S. Moldenhauer, MD,
Ralph L. Kramer, MD, Mark P. Johnson, MD, and Mark 1. Evans, MD
Detroit, Michigan, and Tel Aviv, Israel
Multifetal pregnancy reduction of triplets to twins improves outcomes.
Adenosine modulates corticotropin and cortisol release during hypoxia in fetal sheep 1272
Andrew Chaii, MD, James C. Rose, PhD, and Brian J. Koos, MD, DPhil
Los Angeles, California, and Winston-Salem, North Carolina
Adenosine blunts fetal pituitary-adrenal responses to hypoxia.
Relationship of fetal growth to duration of heat stress in an ovine model of placental 1278
insufficiency
Henry L. Galan, MD, Michael J. Hussey, MD, Antonio Barbera, MD, Enrico Ferrazzi, MD, Misoo Chung, MS,
John C. Hobbins, MD, and Frederick C. Battaglia, MD
Denver, Colorado, and Milan, Italy
Intrauterine growth restriction in an ovine model of placental insuffiency is reduced but not prevented by shortening
the duration of heat stress.
Corticosteroid therapy for prevention of respiratory distress syndrome in severe 1283
preeclampsia
Melania M.R. Amorim, MSc, Luiz Carlos Santos, and Anibal Faundes, MD
Recife and Campinas, Brazil
In a double-blind randomized trial antenatal administration ofcorticosteroids significantly reduced the risk of respiratory
distress syndrome among infants born to mothers with severe preeclampsia.
The disposition of cocaethylene in rat maternal, placental, and fetal compartments 1289
Hisayo 0. Morishima, MD, PhD, Robert A. Whittington, MD, Yi Zhang, MD, and Thomas B. Cooper, MA
New York, New York
Transfer and disposition of cocaethylene in the maternal, placental, and fetal compartments were investigated in pregnant
rats given cocaethylene intravenously.
Association of polymorphism within the promoter of the tumor necrosis 1297
factor alpha gene with increased risk of preterm premature rupture of the fetal
membranes
Alice K. Roberts, Federico Monzon-Bordonaba, MD, PhD, Peter G. Van Deerlin, MD,
Joanne Holder, MD, George A. Macones, MD, Mark A. Morgan, MD, Jerome P. Strauss III, MD, PhD,
and Samuel Parry, MD
Philadelphia, Pennsylvania
The rare allele of a polymorphism at position -308 of the tumor necrosis factor a gene is associated with an
increased risk of preterm premature rupture of the fetal membranes and subsequent preterm birth.
AJOG REVIEWS
Brachial plexus palsy: An in utero injury? 1303
LCDR Robert B. Gherman, MC, USNR, Joseph G. Ouzounian, MD, and T. Murphy Goodwin, MD
Portsmouth, Virginia, and Baldwin Park and Los Angeles, California
In utero forces may underlie a significant portion of brachial plexus palsies. ,
LETTERS TO THE EDITORS
Bloodless cesarean delivery and perinatal transmission of the human immunodeficiency virus Aiessaniiro
Ghidini, MD, Helain J. Landy, MD, and Mary Young, MD Washington, D.C. 1308
Reply Craig V. Towers, MD, and Tamerou Asrat, MD Huntington Beach, California 1308
A question Of Statistical analysis William J. Ledger, MD New York, New York 1309
Reply Craig V. Towers, MD, and Tamerou Asrat, MD Huntington Beach, California 1309
Cotinine levels in women who smoke during pregnancy Graham R Cope, phD Edghaston, Birmingham, United
Kingdom 1310
Reply Marisa Rebagliato, PhD, Francisco Bolumar, MD, and lldefonso Herndndez-Aguado, MD San Juan De Alicante, Spain 1310
Peripheral blood leukocyte antigen expression in pregnancy and preeclampsia lan p. Crocker, Philip N. Baker,
MD, and John Fletcher, MD Nottingham, United Kingdom 1310
Reply Gavin R Sacks, MD, PhD, lan L. Sargent, PhD, and Christopher W.G. Redman, MD Oxford, United Kingdom 131 1
Shoulder dyStOCia maneuvers Jorge 0. Escamilla, MD Brooksville, Florida 1312
Reply Robert B. Gherman, MD Portsmouth, Virginia 1312
CORRECTIONS
Expression of cyclooxygenases in ductus arteriosus of fetal and newborn pigs 1313
(Guerguerian A-M, Hardy P, Bhattacharya M, Ollcy P, Clyman Rl, Fouron J-C, et al. Am J Obstet
Gynecol 1998;) 79:1618-26)
Low-molecular-weight heparin for obstetric thromboprophylaxis: Experience 1314
of sixty-nine pregnancies in sixty-one women at high risk
(Nelson-Piercy C, Letsky EA, cle Swiet M. Am J Obstet Gynecol 1997; 176:1062-8)
READER SERVICE
Information for Authors 29A
Information for Readers 36A
Items 1313
Professional Opportunities Available 44A