OBJECTIVE:To determine uterine and ovarian size in Turner syndrome (TS) and to compare uterine and ovarian size evaluated by transabdominal ultrasound (US) and magnetic resonance imaging (MRI) in girls with TS and two groups of controls. DESIGN:A cross-sectional study. PATIENTS:Forty-one girls with TS (17·0 ± 3·3 years, range 11·2-24·9 years), 50 healthy age-matched controls (16·9 ± 3·2 years, range 12·5-25·0 years) and 107 Tanner-stage-matched controls (15·0 ± 3·2 years, range 10·1-24·2). MEASUREMENTS:Uterine and ovarian volume by US and MRI. RESULTS:Ovaries were detected in 37% in TS by US and in 55% in TS by MRI (P = 0·1). Total ovarian volume was lower in TS compared to both groups of controls (TS vs C-US: median 1·1 ml (range 0·1-29·3) vs 11·52 ml (1·9-77·9), P = 0·001, TS vs C-MRI: 1·0 ml (0·1-34·2) vs 13·2 ml (2·4-30·1), P < 0·0005). Mean difference in total ovarian volume measured by MRI and US in patients with TS was 2·3 ± 3·8 ml (P = 0·01). Mean uterine volume by MRI was lower in TS compared to controls (29·5 ± 25·1 vs 54·3 ± 23·3 ml, P < 0·0005). Uterine volume by US was lower in TS at Tanner stage B5 compared to controls (TS vs C: 33·6 ± 18·2 vs 50·2 ± 18·0 ml, P = 0·007). CONCLUSIONS:A larger ovarian volume was detected by MRI in TS compared to US. This finding is important with the advancements of performing ovarian biopsies for cryopreservation and later reimplantation. Mean uterine volumes by MRI and US in fully matured TS were lower compared to controls despite appropriate hormonal replacement therapy in TS.

BACKGROUND:In 1991 the rate of intrapartum death of non-malformed fetuses was higher in Denmark than in Sweden (4.2 vs. 1.9 per 10,000, OR 2.24). However, it is not clear whether this difference reflects potentially avoidable cases and/or suboptimal care. MATERIAL AND METHODS:Short descriptions were made from medical records of all 50 intrapartum deaths in Denmark and Sweden in 1991. Ten obstetricians, two from each of the Nordic countries, reviewed the cases to determine whether (1) intra-uterine death might have occurred before admission, (2) surveillance and intervention were insufficient, (3) fetal death was potentially avoidable by improved obstetric care; and, if so, to suggest ways of improved health care. RESULTS:There was a statistically higher rate of insufficient care (surveillance and intervention) (high or less degree) in the Danish cases (66% vs. 55%). The proportion of potentially avoidable fetal deaths was also higher in Denmark (59% vs. 52%) although the difference was not statistically significant. CONCLUSION:The significantly higher rate of intrapartum death of non-malformed infants in 1991 in Denmark compared to Sweden might be reduced by improved intrapartum surveillance and interventions.

Objective To determine whether treatment with ampicillin and metronidazole in women with threatened idiopathic preterm labour will prolong the gestation and reduce maternal and neonatal infectious morbidity.Design Randomised controlled double-blind trial.Setting Six obstetric departments in the Copenhagen area.Population One hundred and twelve women with singleton pregnancies, with threatened idiopathic preterm labour and intact amniotic membranes at 26 to 34 weeks of gestation.Methods Random allocation to eight days intravenous and oral treatment with ampicillin and metronidazole, or placebo.Main outcome measures Number of days from admission to delivery, gestational age at delivery, rates of preterm delivery, low birthweight, maternal infections and neonatal infections.Results Treatment with ampicillin and metronidazole was associated with a significant prolongation of pregnancy (admission to delivery 47.5 days versus 27 days, P < 0.05), higher gestational age at delivery (37 weeks versus 34 weeks, P < 0.05), decreased incidence of preterm birth (42% versus 65%, P < 0.05), and lower rate of admission to neonatal intensive care unit (40% versus 63%, P < 0.05), when compared with placebo treatment. Antibiotic treatment had no significant effects on infectious morbidity.Conclusions Treatment with ampicillin and metronidazole in women with threatened idiopathic preterm labour significantly prolonged the gestation, but had no effects on maternal and neonatal infectious morbidity.

Background. Since 1950 the perinatal mortality has been significantly higher in Denmark than in Sweden. In 1991 the rate in Denmark was 8.0/1000 deliveries compared to 6.5/1000 in Sweden. An international audit was designed to investigate whether the perinatal death rates in the two countries to some extent could reflect differences in the quality of care, indicated by the numbers of perinatal deaths in categories of potentially avoidable deaths.Material and methods. Medical records of 97% of all perinatal deaths in 1991 in the two countries were analyzed. A new classification focusing on potential avoidability from a health services perspective was elaborated at a Nordic-Baltic workshop. using the variables: time of death in relation to admission and delivery, fetal malformation, gestational age, growth-retardation and Apgar score at 5 min.Results. Rates of perinatal deaths of malformed infants (0.00195 and 0.00145) and intrapartum deaths of non-malformed infants (0.00042 and 0.00019) was significantly higher in Denmark than in Sweden.Conclusion. Application of the Nordic-Baltic Perinatal Death Classification on perinatal deaths in Denmark and Sweden in 1991 raises the questions as to why the rate of perinatal death of malformed infants is higher in Denmark than in Sweden and whether intrapartum care in Denmark could be improved.