bluuebunny/crossref_metadata_2025 huggingface dataset:
Unilateral Ectopie Multiple Pregnancy — A Case Report
Authors: Chadwick John M. , O'Sullivan Brendan T.
Published: February 2008

Summary: A case is described of twin pregnancy occurring in the left Fallopian tube 5 years after a ruptured ectopie pregnancy on the right side was treated by salpingo‐oöphorectomy.
The Genesis and Implementation of the Tasmanian Obstetric Survey
Authors: Correy J. F. , Gartlan G. J. , Schokman F. C. M. , Newman N. M. , Nightingale R.
Published: February 2008

Summary: The genesis and implementation of a continuing obstetric audit in Tasmania is described. The survey includes all public and private deliveries in Tasmania. Some of the early difficulties and their resolution are discussed. Because of its simplicity, the suggestion has been made that such a system would be suitable for a national audit.
Pituitary Control of Ovarian Function — Concepts Derived from Gonadotrophin Therapy
Authors: Brown J. B.
Published: February 2008

Summary: From experience gained in the monitoring of ovarian responses to gonadotrophin therapy, it has been possible to develop concepts concerning the mechanisms which operate during the normal menstrual cycle. It is shown that the ovarian requirement for FSH operates in a very narrow range, involving changes in concentration of only 10%; this range operates from a threshold level, through an intermediate level to a maximum level. After adequate stimulation, the follicle goes through a coasting phase during which it is independent of further FSH stimulation and it acquires sensitivity to LH. Methods for determining optimum requirements for FSH and HCG for the induction of singleton pregnancies are presented. The relevance of the findings in providing hypotheses explaining some aspects of ovulatory and anovulatory cycles are discussed.
Oestrogen Receptor Studies in Carcinoma of the Endometrium, Carcinoma of the Uterine Cervix and other Gynaecological Malignancies
Authors: Martin J. D. , Hähnel R.
Published: February 2008

Summary: The tissues from 30 cases of endometrial cancer and 44 cases of cervical cancer were examined for oestrogen receptor activity. Twenty of the endometrial and 9 of the cervical tumours contained oestrogen receptor levels above 4 fmol/mg protein, The proportion of oestrogen receptor‐positive tumours was significantly greater in adenocarcinomas of the cervix than in squamous carcinomas of the cervix. Tissues from 3 mixed mesodermal tumours of the uterus, 2 carcinomas of the vagina, a carcinoma in situ of the cervix and a carcinoma in situ of the endometrium were receptor‐negative. One ovarian carcinoma and a single case of uterine sarcoma were receptor‐positive. The implications of these findings in relation to hormonal therapies are discussed.
New Aspects of the Treatment of Tubal Infertility
Authors: Wood C.
Published: February 2008

Summary: Three aspects of the treatment of tubal infertility are discussed: current surgical procedures, including the use of microsurgery; an attempt at tubal transplantation; and the use of in vitro fertilization.
Idiopathic Pericarditis and Pregnancy
Authors: Krausz Y. , Naparstek E. , Eliakim M.
Published: February 2008

Summary: The association of idiopathic pericarditis and pregnancy is described in 3 patients. The disease preceded the onset of pregnancy in 2 patients and appeared during the sixth month in the third. All pregnancies reached term and the deliveries were uneventful. One patient had mild heart failure before the pregnancy. This deteriorated slightly during its course. The remaining 2 patients had no signs of heart failure and none of the 3 had arrhythmias or embolic phenomena. Two patients were treated with aspirin and prednisone and one was treated for heart failure only. All patients are still symptomatic and require treatment 9 months, 1 year and 21 years after the pregnancy. Two of the patients underwent partial pericardiectomy.
Idiopathic Fatty Liver of Pregnancy With Maternal and Fetal Survival
Authors: Gillespie Peter , Hunter Christopher
Published: February 2008

Summary: A case of idiopathic fatty liver of pregnancy with survival of mother and child is reported. The management of this condition is essentially supportive; coagulation disturbances may require special attention. Maternal survival should be the major consideration and is favourably influenced by early delivery. Fetal monitoring aids obstetric management and may indirectly improve fetal survival.

Evidence from the literature suggests that the condition does not usually recur in subsequent pregnancies.
The Use of Ritodrine in The Management of The Fetus During the Second Stage of Labour
Authors: Campbell J. , Anderson I. , Chang A. , Wood C.
Published: February 2008

Summary: A double blind controlled trial was conducted to assess whether maternal intravenous infusion of ritodrine during the second stage benefits the fetus. The pH of both umbilical arterial and umbilical venous blood was increased significantly as a result of the infusion. In addition, the time dependent fall of pH during delivery was abolished. The benefit of ritodrine infusion was therefore demonstrated, and its possible use in women with high risk fetuses should be further tested.
Sexual Feelings in Pregnancy and After Childbirth
Authors: Lumley Judith
Published: February 2008

Summary: First pregnancy was associated with a progressive decline in both sexual desire and frequency of intercourse in a study group of couples. After childbirth the changes were more variable. The median interval before finding intercourse enjoyable was 2 months. Twenty per cent of subjects reported that intercourse was still painful 14 weeks after delivery. An equal proportion had more enjoyment from sex postpartum than they had ever experienced before pregnancy. Factors associated with the new baby halved the frequency of intercourse for half the couples.
Comparison of Plasma Volume Levels in Normal Pregnancy Between Two Ethnic Groups in Fiji
Authors: Coleman R. J.
Published: February 2008

Summary: In the normal pregnancy Indian women have a lower plasma volume than Fijian women. Volume studies in the third trimester on the normal pregnancies of 191 Fijian women and 92 Indian women showed that the latter group also had lower red cell volumes and blood volumes. Consequently, both groups showed a similar distribution of haemoglobin concentration. The reduction in plasma volume is not related to parity and the plasma volumes of Indian women did not show the correlation with maternal height of the Fijian women. In view of the higher reported incidence of toxaemia in Indian women, these findings support the concept that a reduction in plasma volume occurs before the onset of clinical signs of toxaemia.

Indian women also have a lower plasma volume for a given birth‐weight/ maternal size ratio. There is some evidence that they have smaller babies than Fijian women after allowing for the differences in maternal size but the results are statistically inconclusive.
Cryosurgery of Benign Cervical Lesions as an Out‐Patient Procedure
Authors: Chew W. C. , Chew W. Y.
Published: February 2008

Summary: Seventy‐three patients had cryocautery to the cervix for the treatment of cervical erosion. The cure rate was 99%, whereas 85% were cured after 8 weeks.

Postcoital and intermenstrual bleeding and vaginal discharge were the presenting symptoms most responsive to treatment. The most common side‐effect was a watery vaginal discharge which was present in 93% of the patients. The discharge subsided after 2–4 weeks. There were no systemic side‐effects.

Cryocautery of benign cervical lesions has been found to be safe, simple and convenient for the patient and could be performed on an outpatient basis.
Primary Adenocarcinoma of the Fallopian Tube
Authors: Sieck Ulla V.
Published: February 2008

Summary: Primary adenocarcinoma of the Fallopian tube is a rare lesion with a generally poor prognosis; it has an incidence of approximately 0.5% of all female genital tract malignancies. To date, approximately 900 cases have been described in the literature; the present paper adds another 10 cases and compares the pathology, clinical data, and outcome with the findings of other authors. Four patients survived more than 3 years.
Pregnancy in an Unattached Rudimentary Horn of the Uterus
Authors: Itskovitz Joseph , Brandes Joseph M. , Kerner Hedviga
Published: February 2008

Summary: A rare case of pregnancy in an unattached rudimentary horn of the uterus is presented. The pregnancy passed unrecognized and resulted in lithopaedion formation. The anatomical and physiological aspects associated with rudimentary horn pregnancy are discussed.
Urethral Coitus in a Patient with Congenital Absence of the Vagina
Authors: Khanam Wazira , Chogtu Leela , Mir Zubeeda , Shawal Farida
Published: February 2008

Summary: A case of urethral coitus is presented in which the patient had maximum urethral dilation and good urinary control and had no symptoms of cystitis. She had a left hypoplastic kidney, cervicodorsal kyphoscoliosis, and absent internal genitalia.
Tubal Microsurgery – A Review
Authors: Paterson Peter
Published: February 2008

Summary: Microsurgery is being applied with considerable advantage to tubal reconstruction, particularly in relation to improved pregnancy rates. These results justify the additional costs in equipment and time which are required.
The Effects on Sexual Response and Mood after Sterilization of Women Taking Long‐Term Oral Contraception: Results of a Double‐Blind Cross‐Over Study
Authors: Leeton J. , McMaster R. , Worsley A.
Published: February 2008

Summary: Twenty women using oral contraception for a minimum of 2 years with no side effects volunteered to take part in this experiment which commenced after they had undergone laparoscopic sterilization. In a double‐blind cross‐over design, the patients were administered either 1.0 mg ethynodiol diacetate + 0.1 mg mestranol (“Ovulen”) each day for 21 days or an identical‐looking placebo for the same number of days. The following month the alternative (cross‐over) tablet was given. On days 12 and 25 of each cycle the women completed a modified form of Pitt's Depression Index and a short Sexual Response Score. The results indicated that the active pill (“Ovulen”) was associated with a decreased sexual response, but with no increase in the depression index (relative to placebo). The significance of these findings is discussed in relation to previous work, the methodology of the study and hormone‐behaviour experiments.
The Effect of Oestradiol Valerate Therapy on Coagulation Factors and Lipid and Oestrogen Levels in Oöphorectomised Women
Authors: Saunders D. M. , Hunter J. C. , Shutt D. A. , O'Neill B. J.
Published: February 2008

Summary: The effect of oestradiol valerate on levels of blood cholesterol, triglycerides, free oestradiol and coagulation factors, as well as on urinary oestrogens and free cortisol was measured in 10 oöphorectomised women. Despite the very high urinary oestrogen levels obtained, there was no significant change found in the other parameters during and after treatment. These findings are discussed, as is the significance of the metabolism of both endogenously produced and orally administered oestrogens in the menopausal woman.
Relative Bradycardia: A Sign of Acute Intraperitoneal Bleeding
Authors: Jansen Robert P. S.
Published: February 2008

Summary: Acute intraperitoneal bleeding with hypotension may be accompanied by a relatively normal pulse rate instead of the tachycardia usually produced by blood loss. Four cases of intraperitoneal bleeding of diverse, though pelvic, origin, are described. In each patient, symptomatic hypotension occurred with a pulse rate less than 80 per minute, thereby initially confusing the diagnosis of internal bleeding. The hypotension and relative bradycardia responded to atropine followed by fluid replacement. Response to atropine implies that the reflex that produces bradycardia is mediated by the parasympathetic nervous system. It is concluded that relative bradycardia occurring with intraperitoneal haemorrhage may be the cause of both diagnostic difficulty and disproportionately severe hypotension.
Compound Presentation Following External Version
Authors: Ang L. T.
Published: February 2008

Summary: Two cases of compound presentation following external version are presented. The frequent combination of the feet with the vertex following this procedure and its association with a higher fetal mortality, interference rate, and obstructed labour than the hand and vertex combination are highlighted. The aetiology, problems in diagnosis, and management are discussed. Measures to prevent and deal with this complication are suggested.
Serum Ferritin in Pregnancy: The Effect of Iron Supplementation
Authors: Taft L. I. , Halliday June W. , Russo Anna M. , Francis Barbara H.
Published: February 2008

Summary: Serum ferritin concentration was measured in 196 pregnant women at different stages of gestation. The effect of supplemental iron during pregnancy on ferritin concentration was also studied. The mean serum ferritin concentration in the first 20 weeks of pregnancy was within the normal range for females, but in 13% of patients presenting before the 13th week of gestation the concentrations were in the range of iron deficiency. The values fell in all patients by the 28th week of gestation, but the fall was significantly greater in those subjects not taking supplemental iron and in these the levels were in the range of iron deficiency by the 35th week. By the 6th postpartum week, values had risen in all patients whether iron supplemented or not, but the rise was significantly less in the non‐supplemented group. Serum ferritin appears to provide a useful assessment of body iron stores during pregnancy, particularly in an iron deficiency state not severe enough to produce frank microcytosis, hypochromia, or anaemia.
An Hypothesis for High Multiple Pregnancies after Clomiphene
Authors: Healy D. L. , Burger H. G.
Published: February 2008

Summary: A triplet and a quadruplet pregnancy following induction of ovulation with clomiphene are described; in each patient secondary amenorrhoea followed oral contraceptive use and several anovulatory or inadequate menstrual cycles had occurred on initial clomiphene therapy. Conception occurred in the fist cycle after increasing drug dosage or the addition of human chorionic gonadotrophin (HCG) to the treatment regimen. We suggest, in explanation of these pregnancies, that repeated suboptimal stimulation of the ovaries as a result of clomiphene therapy develops several follicles to a critical stage; a subsequent greater ovulatory stimulus allows for synchronous development of several large follicles and multiple ovulation.
The Incarcerated Intrauterine Device
Authors: Gunaratne Mahasara
Published: February 2008

Summary: Complete embedding or incarceration of the IUD is likely to cause difficulty at removal. Attempts at vaginal removal with ‘heavy’ instrumentation are hazardous and should be abandoned in favour of an abdominal approach. A trial demonstrating the superiority of the latter approach is described. The characteristics of patients with an incarcerated loop make concomitant tubal ligation possible in most instances.
A Spinal Epidural Abscess Complicating an Intrauterine Contraceptive Device
Authors: Atkinson Leigh , Deambrosis Warren , Sheehy John , Teoh Gloria
Published: February 2008

Summary: A case of spinal epidural abscess as a complication of the use of an intrauterine device is presented and the management of same discussed.
Ovarian Teratoma with Peritoneal Gliomatosis
Authors: Khoo S. K. , Jones I. S. C. , McKenna H.
Published: February 2008

Summary: The case report describes the clinical and pathological features of a young girl with ovarian teratoma which showed a predominance of neural tissue. The peritoneal involvement by an admixture of mature and immature glial tissue resulted in the death of the patient despite surgery and cytotoxic chemotherapy. There was an association between this tumour and the presence of carcinoembryonic antigen and alphafetoprotein in the serum and ascitic fluid.
Factors Influencing the Time of Introduction of Steroidal Contraception in the Breast‐Feeding Mother
Authors: Cox John W.
Published: February 2008

Summary: : To ensure infertility whilst breast feeding many mothers ingest steroidal contraceptives. Animal experiments have shown how sexual differentiation of the brain occurs during perinatal life and can be affected by exogenous steroids. The amount of sex steroid secreted in the milk of lactating mothers is very small and dependent on the type of steroid chosen. “On demand” breast feeding is associated with a longer period of lactational amenorrhoea, obviating the necessity for early usage of contraceptives.

In view of the possibility that sexual differentiation may be disturbed, it is suggested that, where steroidal contraception is required, the progesterone with the minimal amount of oestrogenic metabolite be used.
An Endocervical Speculum
Authors: Chanen William
Published: February 2008

Summary: : An endocervical speculum has been devised for use with the colposcope in the evaluation of abnormal cytologic smears. Lt allows inspection of the endocervical canal and helps delineate the uppermost limits of the dysplastic and/or CIS lesion in those patients in whom it extends into the endocervical canal.
A Case of Dysgerminoma‐Gonadoblastoma in Pure Gonadal Dysgenesis
Authors: Foulkes J. , Nicholls P. E.
Published: February 2008

Summary: : A case is described in which the diagnosis of dysgerminoma‐gonadoblastoma in an 18‐year‐old phenotypical female with primary amenorrhoea was initiated by biopsy of an ovary which appeared normal at laparoscopy.
A Large Cyst of Skene's Duct – a Rare Cause of Superficial Dyspareunia
Authors: James S. T.
Published: February 2008

Summary: : A case is reported which illustrates a rare cause of external dyspareunia, probably of Neisserial origin, and satisfactorily resolved by surgical extirpation. The morphological and embryological significance of the Skene's duct and related cysts are discussed.
Routine Fetal Maturity Estimation by Ultrasound
Authors: Duff G. B.
Published: February 2008

Summary: The accuracy of ultrasonic estimation of fetal maturity and, therefore, the delivery date is greatest when the biparietal diameter is Jess than 5.0 cm and least when it is greater than 9.0 cm. A comparison of the accuracy of ultrasonic and last menstrual period based estimations of the delivery date revealed that there is no significant increase in accuracy for ultrasonic estimations when the biparietal diameter is less than 9.0 cm, but when the diameter is greater than 9.0 cm the accuracy of delivery date estimation is significantly less than that based on the last menstrual period. In pregnancies complicated by uncertain dates, recent hormonal contraception, bleeding in early pregnancy, or an irregular or prolonged menstrual cycle, ultrasound is significantly more accurate in predicting the delivery date. Ultrasonic examination for fetal maturity is indicated only when there are clinical indications such as uncertain dates for some reason or when there is fundal height discrepancy.
A Review of 2,003 Consecutive Amniocenteses Performed Under Ultrasonic Control in Late Pregnancy
Authors: Picker R. H. , Smith D. H. , Saunders D. M. , Pennington J. C.
Published: February 2008

Summary: A review of 2003 consecutive amniocenteses performed in late pregnancy under ultrasonic control is presented. No perinatal mortality was encountered. On this evidence the method described is suggested to be the safest available for obtaining liquor in late pregnancy.
The Relative Value of the Non‐Stress and Stress Cardiotocograph: A Protocol and Pilot Study
Authors: Marsden D. E. , Correy J. F.
Published: February 2008

Summary: A simple and safe protocol is described for the conduct of a controlled comparison of the relative predictive values of the antenatal cardiotocograph in the absence and in the presence of artificial stress (oxytocin challenge) to the fetus. Each patient serves as her own control, the tests are performed on the same day, and labour also commences on the same day, so that fetal performance in labour and status at birth are closely related in time to both tests and provide a reasonable assessment of the relative value of the tests. A pilot study of 83 patients has been carried out and the results are presented.
Prolactin Secretion During Prolonged Lactational Amenorrhoea
Authors: Gross B. A. , Eastman C. J.
Published: February 2008

Summary: Basal serum prolactin levels were elevated up to 66 weeks postpartum in lactating amenorrhoeic women. The serum prolactin level in fully breast‐feeding women was significantly higher than in women who were partially breast‐feeding. The mean basal serum prolactin level in menstruating, lactating women was significantly higher than the mean level in women who had weaned and had normal menstrual cycles. The rise in prolactin due to suckling was seen up to 66 weeks postpartum. The marked variability and lack of reproducibility of individual suckling responses may obscure the importance of prolactin secretion in the postpartum period. Nevertheless, this study confirms that prolactin secretion is increased in women with prolonged lactational amenorrhoea.
Social and Psychological Factors in Relation to Premenstrual Tension and Menstrual Pain
Authors: Wood C. , Larsen L. , Williams R.
Published: February 2008

Summary: Age, country of birth, marital status, attitude to work, smoking and drinking habits, childbearing, sex life and psychological factors are all linked to the frequency of menstrual pain and premenstrual tension. The relationship between the psychosocial and menstrual characteristics may be causal or related to some other constitutional factor (or factors) which determines both. The profile of women suffering from premenstrual tension and menstrual pain is described. In management, associated psychosocial factors and the relationship between these and the described menstrual problems needs to be taken into account.
Duration of Menstruation
Authors: Wood C. , Larsen L. , Williams R.
Published: February 2008

Summary: Menstrual length was analysed in 2,342 women attending the Shepherd Foundation. Prolonged menses were more common in Australian and New Zealand born, in women with irregular, short or long menstrual cycles, menstrual pain, high parity, and an intrauterine device. In contrast to women with premenstrual tension and menstrual pain, psychological factors, smoking and drinking were not more common in women with increased menstrual length. It is concluded that somatci factors alone control menstrual length, and results in the present study support the hypotheses that both the hypothalmic‐pituitary system and prostaglandins may be involved in this control. Evidence was found that the use of the contraceptive pill reduces the incidence of premenstrual tension when menstrual length is also reduced.
Simplified Antibiotic Prophylaxis for Vaginal Hysterectomy
Authors: Jackson P. , Ridley W. J.
Published: February 2008

Summary: Single dose administration of antibiotics prior to vaginal hysterectomy was found to be an efficient and safe way of providing prophylaxis against infection. Metronidazole was as efficient as ampicillin in achieving a significant reduction in major morbidity, pelvic sepsis, and the “quantity” of postoperative fever. Antibiotic prophylaxis reduced hospital stay by an average of 3 days.
The Use of Iodine in the Marsupialization of Bartholin's Duct Cysts
Authors: Hollyock Vernon E.
Published: February 2008

Summary: Anatomical localization of the incision for marsupialization of Bartholin's cyst and abscess can be determined by the application of iodine to the surface of the duct swelling.
Prophylactic Anticoagulation in the Management of Recurrent Pre‐Eclampsia and Fetal Death
Authors: Schramm Mary
Published: February 2008

Summary: The case is described of a patient whose third pregnancy ended successfully, after 2 perinatal deaths caused by severe pre‐eclampsia in the second trimester of her previous pregnancies. Anticoagulant therapy with warfarin was given in the third pregnancy.
A Case of Cornual Pregnancy
Authors: McPherson S. , Houlihan B.
Published: February 2008

Summary: A case of cornual pregnancy is reported. The diagnosis was uncertain at laparoscopy, made by ultrasound, and confirmed at laparotomy.
A Patient with Pure Gonadal Dysgenesis, Gonadal Tumour and Virilisation
Authors: Schokman F. C. M. , Correy J. F.
Published: February 2008

Summary: A phenotypic female, karyotype XY, presented with virilisation and amenorrhoea. The gonads showed evidence of oestrogen and testosterone production and, in view of the risk of malignancy, a laparotomy was performed. A streak gonad was present on one side with a streak gonad containing discrete tumours on the other. The uterus and Fallopian tubes were present. Removal of the gonads and uterus and subsequent oestrogen replacement therapy have produced a satisfactory clinical result.
THE AUSTRALIAN & NEW ZEALAND JOURNAL OF OBSTETRICS & GYNAECOLOGY
Authors: Brinsmead M. W. , Liggins G. C.
Published: February 2008

Summary: In order to assess the possible influence of fetal polypeptide hormones on birth size, somatomedin‐like receptor activity (SmLRA) (n = 281), prolactin (n=158), growth hormone(n=133) and insulin (n=108) concentrations were measured in the cord blood of 281 singleton infants born after different complications of pregnancy. Infant sex did not significantly affect the concentration of any hormone. SmLRA concentrations appeared to rise from 25 to 38 weeks of gestation, but thereafter fell. Concentrations of prolactin, growth hormone and insulin correlated negatively with gestational age. Insulin emerged as the hormone most clearly related to fetal growth, since concentrations were high (mean ± SD = 20.6 ± 11.5 uU/ml) in serum from infants of diabetic mothers (IDM) and other large‐for‐dates infants (10.1 ± 4.8 uU/ml), but low (5.3 ± 0.5 uU/ml) in infants who were small‐for‐dates (SFD). In contrast, SmLRA concentrations were high in serum from SFD infants (0.63 ± 0.29 U/ml) and low in IDM (0.43 ± 0.16 U/ml). Prolactin concentrations were higher in serum from SFD infants (212 ± 101 ng/ml) and from IDM (237 ± 182 ng/ml) than from normal infants born at term (139 ± 68 ng/ml). Administration of intramuscular betamethasone to pregnant women in premature labour resulted in significant elevations in the concentrations of prolactin and insulin in cord blood.
Fetal Heart Rate Monitoring During Ambulant Labour Using a Modified Adult Radiotelemetry System
Authors: MacLennan Alastair H. , Green Roslyn C.
Published: February 2008

Summary: commercially available adult radiotelemetry system has been adapted successfully to allow continuous fetal heart rate monitoring during labour in ambulant patients. The modifications necessary to the adult equipment and its routine use in a large maternity unit are described. High quality recordings were obtained from 90% of the patients studied, with minimal inconvenience to the patient. The telemetry system combined the benefits of intrapartum fetal heart rate monitoring with those of ambulation during labour, decreasing the patient anxiety often associated with visible fetal monitoring.
Inhibition of Puerperal Lactation Evaluation of Bromocriptine and Placebo
Authors: Bhardwaj Neelam
Published: February 2008

Summary: Bromocriptine and placebo were randomly allocated to 50 patients who wished to suppress lactation. Patients on bromocriptine suffered no subjective symptoms such as breast pain and engorgement, and lactation was significantly reduced compared with patients on the placebo with or without breast binding. No side‐effects were noted, and rebound lactation was seen in only 3 patients. In most patients contraceptives were commenced once the drug therapy ceased on the fourteenth day.
A Double Blind Dose Trial of Intravaginal Prostaglandin F2α for Cervical Ripening and the Induction of Labour
Authors: MaeLennan Alastair H. , Green Roslyn C.
Published: February 2008

Summary: A randomised double‐blind trial involving 90 patients was set up to compare the efficacy of 25 mg PG F2α, 50 mg PG F2α and a placebo on cervical ripening when given in a vaginal tylose gel on the evening before surgical induction of labour. Preliminary stretching of the cervix and sweeping of the fetal membranes was not undertaken. In the 30 control patients, labour was not initiated and the mean improvement in the cervical score before surgical induction the next morning was 0.86. In the group of 30 patients receiving 25 mg PG F2α, labour commenced during the night in 9 patients and the mean improvement in the cervical score was 3.76 (P < 0.0005); the corresponding figures for the 30 patients receiving 50 mg of PG F2α were 10 patients coming into labour and cervical score improvement of 4.63 (P < 0.0005). he difference in the mean improvement of the cervical score between the 2 prostaglandin groups was not significant. Significantly fewer prostaglandin‐treated patients needed augmentation during labour with intravenous oxytocin (P < 0.025) and there was a significant increase in the spontaneous delivery rate in the combined prostaglandin‐treated group (P < 0.025). There was no statistical difference in the outcome of labour between the 2 prostaglandin groups. It was not possible to predict the patients whose cervices would not respond to PG F2α pretreatment (15%) or those in whom labour would be initiated (30%). No side effects were experienced.
Epidural Analgesia in Labour Performed by Obstetricians
Authors: Grünstein S. , Shalit A. , Jaschevatzky O. E. , Kampf D. , Anderman S.
Published: February 2008

Summary: The use of epidural analgesia by obstetricians in 2,645 women in labour is reported. The use of this technique as one of the routine methods is proposed even in those centres where no anaesthetist for pain relief is available for the 24‐hour period. This is possible by the previous training of obstetricians. Advantages, side‐effects and complications of epidural analgesia are discussed.
A Comparison of Assay Methods for Pregnancy Specific β1 Glycoprotein (SP‐1)
Authors: Ho P. C. , Jones W. R.
Published: February 2008

Summary: Three methods were compared for the assay of pregnancy specific β1 glycoprotein (SP‐1): radial immunodiffusion (RID), electroimmunodiffusion (EID) and radioimmunoassay (RIA). There was a significant correlation between EID and RIA. A lower, but still significant correlation was found between EID and RID, but wide discrepancies were seen in some cases. This finding suggests heterogeneity of SP‐1 molecule(s). The data indicate that EID is the method of choice for assay of SP‐1 after the tenth week of pregnancy, while the more sensitive RIA should be reserved for use before that stage.
Malignant Stromal Tumour of the Ovary with Virilizing Effects in an XXX Female with Streak Ovaries
Authors: Khoo S. K. , Buntine D.
Published: February 2008

Summary: In gonadal dysgenesis, the presence of the Y sex chromosome appears to have a strong influence on the development of germ cell tumours. The risk of malignancy associated with other sex chromosomal abnormalities is much lower. In the present report, the clinical manifestations – including primary amenorrhoea, tall stature, infertility and poor development of the genitalia and breasts – associated with a predominantly 47, XXX karyotype are described. Malignant change of the streak ovary to an unusual gonadal stromal tumour with lipid‐containing cells occurred at a late stage in her life, and this was associated with progressive virilization and production of androgenic and oestrogenic steroids. In view of the risk of malignancy as well as the abnormal endocrine effects, especially in the presence of a Y chromosome, there is a place for the prophylactic removal of these dysgenetic gonads.
Problems in the Diagnosis of Ectopic Pregnancy
Authors: O'Neil A. G.B.
Published: February 2008

Summary: Problems in the diagnosis of ectopic pregnancy have been assessed over a 4‐month period at King Edward Memorial Hospital. Twenty‐three of thirty women (77%) were sent home after their initial presentation with symptoms of their ectopic pregnancy. Thirteen were sent home from major teaching hospitals and the remaining 10 by their general practitioners.

In 76 patients, laparoscopy was performed to exclude ectopic pregnancy; the diagnosis was confirmed in only 30. Plasma β HCG values were elevated in all patients with an ectopic pregnancy within the Fallopian tube. The finding of a β HCG value of less than 2.5 i.u./1 could have allowed 36 of these patients to avoid diagnostic laparoscopy. Nine patients with intrauterine pregnancies (5 continuing and 4 aborting) might have avoided laparoscopy if ultrasonography had been used.

Careful application of these tests, together with good history taking, will minimise the number of patients in whom an incorrect diagnosis is made.
Fetal Abdominal Paracentesis in the Management of Gross Fetal Ascites
Authors: de Crespigny Lachlan Ch. , Robinson Hugh P. , McBain John C.
Published: February 2008

Summary: A case of non‐immunological hydrops fetalis with gross ascites is reported. Following definitive ultrasonic diagnosis, a fetal abdominal paracentesis was performed under ultrasonic control with a view to minimising fetal trauma during delivery.
Treatment of Severe Pre‐Eclampsia by Plasma Exchange
Authors: D'Apice Anthony J. F. , Reti Leslie L. , Pepperell Roger J. , Fairley Kenneth F. , Kincaid‐Smith Priscilla
Published: February 2008

Summary: Three women with pre‐existing renal disease developed severe preeclampsia with renal failure during the midtrimester of pregnancy. Plasma exchange was commenced at 23, 26 and 29 weeks of gestation and continued, initially daily then second daily, until delivery at 32, 29 and 32 weeks, respectively. During this period, signs of pre‐eclampsia regressed and renal function stabilised or improved. One baby with severe hyaline membrane disease died at 6 days; the other 2, now aged 7 months and 4 months, are in good health. Plasma exchange may offer an alternative to termination of pregnancy in the management of patients with severe pre‐eclampsia when fetal maturity is insufficient for viability.
Ectopic Vaginal Trophoblast in Association With a Partial Mole
Authors: Jones I. S. C. , Buntine D. , Vesey E. J.
Published: February 2008

Summary: A case of ectopic vaginal trophoblast in association with a blighted ovum showing hydropic degeneration is presented. This combination satisfied the histological criteria of Szulman and Surti for inclusion as a partial mole. Subsequent follow‐up revealed non‐progression of the condition. The problems of obtaining a satisfactory classification for proliferative trophoblastic lesions are outlined.
Carcinoid Tumour of the Appendix Discovered at the Time of Abdominal Hysterectomy and Incidental Appendicectomy
Authors: Giesteira M. V. K. , Venter P. F. , Westhuizen F. W. Vd
Published: February 2008

Summary: Two cases of carcinoid tumour of the appendix discovered at the time of abdominal hysterectomy are reported. Aspects of the carcinoid syndrome relevant to the gynaecologist are discussed with reference to the value of routine elective appendicectomy during abdominal surgery.
Obstetric Care of the Very Premature Fetus
Authors: Wood C. , Yu V.
Published: February 2008

Summary: A group of 27 premature fetuses, between 27 and 35 weeks of gestation, were studied in the fetal intensive care unit. Both late deceleration of fetal heart rate and loss of beat to beat variation were associated with significantly lower Apgar scores. Four of 5 of the very premature fetuses who died of asphyxia soon after birth, showed evidence of asphyxia in the fetal heart rate trace before birth. Because of the improved short‐ and long‐term outlook for the liveborn very premature fetus, active obstetric intervention when intrauterine asphyxia is diagnosed may further improve survival rate.
Changes in the Vaginal and Rectal Carriage of Group B Streptococci During Pregnancy
Authors: Davis G. H. G. , MacIvor J. , Freeman M.
Published: February 2008

Summary: The group B streptococcus carrier status of pregnant women appears to be relatively unstable. By using multiple low vaginal and rectal samples cultured on 2 or more media, an overall carrier rate of 38% was found in 187 women. Sequential samples commonly showed changes in the nature of the carrier status with time. More carriers were detected late in pregnancy; women giving negative results early in pregnancy often produced positive cultures later and there was a significant tendency towards rectal positivity.
Is Diagnostic Gonadotrophs Stimulation Useful?
Authors: Wu Roxanne L. , Shearman Rodney P. , Fraser Ian S.
Published: February 2008

Summary: Urinary excretion of oestrogens in response to stimulation with a standardized dose of gonadotrophin has been used previously in the differential diagnosis of oligomenorrhoea/amenorrhoea. Patients with polycystic ovarian disease were said to have a characteristic excessive response. In the present study, some patients with laparoscopically proven polycystic ovaries did not show such an excessive response, while others with laparoscopically normal ovaries did. A high LH/FSH ratio correlated well with the laparoscopic finding of polycystic ovaries. It is concluded that where there are adequate facilities for diagnostic laparoscopy and determination of plasma gonadotrophins, there is no further place for the routine use of the standardized gonadotrophin stimulation test in the evaluation of suspected polycystic ovarian disease.
An Evaluation of Two Methods of Antenatal Ultrasonic Fetal Weight Estimation
Authors: Finikiotis G. , MacLennan A. H. , Verco P. W. , Ogden S. E.
Published: February 2008

Summary: The accuracy of 2 methods of antenatal ultrasonic fetal weight estimation has been compared. The method of Warsof et al. (1977) computes the estimated fetal weight from measurements of the abdominal circumference and the biparietal diameter, whilst the method of Higginbottom et al. (1975) utilises the circumference of the abdomen alone. The estimated weights obtained by the 2 methods were compared with the actual weights at birth occurring within 48 hours of the estimation.

Using the tables of Warsof et al., 77% of the actual birth weights were within 10% of the estimated weight, with a coefficient of correlation of 0.95. Eighty‐two per cent, of babies less than 2,500 g fell within 10% of the estimated weight (Warsof et al.), with a coefficient of correlation of 0.96. Using the formula of Higginbottom et al., 56% of the total birth weights fell within 10% of the estimated weight and the coefficient of correlation was 0.89. Forty‐five per cent, of the babies weighing less than 2,500 g were within the 10% range, the coefficient of correlation of this subgroup being 0.91. It is concluded that antenatal fetal weight estimation using the computed tables of Warsof et al. is superior in our population to the method described by Higginbottom et al., and such antenatal fetal weight estimation is of potential value in many high risk pregnancies.
Glycosylated Haemoglobin in Pregnancy
Authors: Davies D. M. , Welborn T. A.
Published: February 2008

Summary: A study of the use of glycosylated haemoglobin (glyco Hb) levels to identify the pregnant woman with abnormal glucose tolerance and as an adjunct in the control of the diabetic pregnant patient was undertaken.

There was no difference in glyco Hb levels in pregnant women with normal or abnormal glucose tolerance. Mean glyco Hb levels were found to increase with the progress of pregnancy.

Serial estimations of glyco Hb level in diabetic pregnant women reflected the degree of overall control, but were inadequate, when compared with serial glucose estimations, to assess the often rapidly‐changing requirements of pregnancy.
Cervical Ectopic Pregnancy—Case Report
Authors: Giorgio B. , Ball K.G , Ogden Sue , Verco P. W. , Finikiotis G.
Published: February 2008

Summary: A case is described of an early cervical pregnancy in a 30‐year‐old patient following curettage 6 months perviously for an inevitale abortion. The condition was managed initially by suction aspiration, but further curettage with circumsutre of the cervix was required for delayed haemorrhage. The condition was suspected at laparoscopy and confirmed by ultrasonic scan. Laparocopy indicated that the gestation sac was below the level of the uterine vessels, and was thus of prognostic as well as diagnostic value.
An Incremental‐Dose Combined Oestrogen‐Progestogen Oral Contraceptive: Cycle Control and Endometrial Changes
Authors: Khoo S. K. , McKenna H.
Published: February 2008

Summary: A study of bleeding patterns and endometrial histology was made in women using an incremental‐dose combined oestrogen‐progestogen formulation. The proliferative activity during the first 11 days of treatment was less well‐developed, and there was an early appearance of secretory changes (transitional pattern). The increased dose of d‐norgestrel resulted in an endometrium showing either early or deficient secretory changes. Menstrual patterns were very satisfactory in terms of cycle length and duration of bleeding.
An Incremental‐Dose Combined Oestrogen‐Progestogen Oral Contraceptive: Effects on Body Weight, Blood Pressure, and Biochemical Parameters
Authors: Khoo S. K. , Hacker N. , Chang A.
Published: February 2008

Summary: An evaluation is presented of the effects of an incremental‐dose combined oestrogen‐progestogen contraceptive (0.05 mg ethinyl oestradiol throughout the cycle plus d‐norgestrel 0.05 mg for the first 11 days and 0.125 mg for the subsequent 10 days). The majority of women showed weight changes less than 1.0 kg; a weight gain in excess of 2 kg was observed in 11.4% and a similar loss in 14.3%. The net change in blood pressure after 12 months was a slight reduction; no excessive elevation of pressure was recorded. Although no significant change in glucose tolerance was noted, triglyceride levels became progressively elevated; the increase in cholesterol levels were observed mainly in the second half of the cycle. Changes occurred in some but not all haematologic parameters: a significant increase in plasminogen level and decrease in activated prothrombin time; factors 7, 9 and 10 were progressively increased, whereas factors 5, 8, fibrinogen and anti‐thrombin activity remained unaltered. This new preparation provides effective contraception with satisfactory cycle control and body weight changes. It is particularly useful in women who require additional oestrogen.
Coital Laceration of the Vagina
Authors: Ahnaimugan S. , Asuen M. I.
Published: February 2008

Summary: Fifteen cases of coital laceration of the vagina are presented. The importance of early diagnosis and simplicity in treatment is stressed. In every case of vaginal bleeding, possible coital laceration should be kept in mind and considered in the differential diagnosis.
Salbutamol Infusion for Premature Labour — The Australian Trials Experience
Authors: Pincus Richard
Published: February 2008

Summary: Fourteen clinical trials were conducted in Australia to evaluate the safety and efficacy of salbutamol infusions in the prevention of premature labour. A total of 527 single pregnancies and 36 multiple pregnancies during which this treatment was used were reported sufficiently fully for inclusion in this report. The results suggest that significant prolongation of pregnancy can be achieved in most cases, provided that cervical dilatation is less than 3 cm and that the membranes are intact. If either of these conditions is absent, prolongation of pregnancy is still possible in some cases.

The treatment is not without risks, and adequate supervision is essential.
Meconium‐Stained Liquor at Second Trimester Amniocentesis — Is it Significant?
Authors: Svigos J. M. , Stewart‐Rattray S. F. , Pridmore B. R.
Published: February 2008

Summary: Meconium‐stained liquor was found on 10 occasions in 520 consecutive midtrimester amniocenteses performed for prenatal diagnosis.“ Nine cases terminated in the birth of healthy children, whilst one infant was born with multiple skeletal abnormalities compatible with survival. Meconium in the liquor discovered at midtrimester amniocentesis may represent a previous transient episode of fetal compromise and usually does not indicate a poor fetal outcome.
Labour‐Onset Pre‐Eclampsia
Authors: Long P. A. , Oats J. N. , Beiscber N. A.
Published: February 2008

Summary: In a consecutive series of 1,201 singleton pregnancies with preeclampsia, the onset occurred during labour in 290 (24.1 %). There was no difference between the primparous and parous patient in this respect (25.9% v 20.7% P < 0.10). The tendency for pre‐eclampsia to develop during labour increased with advancing maturity of the pregnancy and seldom occurred before 38 weeks of gestation; this was again equally true of the primiparous and parous patient, as was the incidence of severe hypertension (diastolic pressure > 110mm Hg) (36.1% v 34.1%). The high incidences of severe hypertension (35.5%), proteinuria (41.7%), and eclampsia (2.1%), and the I maternal death testified to the severity of the disease process and the need for aggressive management. After delivery, the clinical signs tended to subside rapidly, but the early third stage of labour was a time of maternal risk, irrespective of whether ergometrine or Syntocinon was the oxytocic agent administered. Analysis of perinatal results showed that the risk to the fetus was minimal.
Polycystic Ovarian Disease — Current Concepts
Authors: Biggs J. S. G.
Published: February 2008

Summary: The Stein Leventhal syndrome, now commonly referred to as polycystic ovarian disease (PCOD) has provided a focus for application of new methods of investigation of the ovary. The first description of the condition referred to 7 women; subsequent large‐scale studies have confirmed menstrual irregularity, hirsutism and infertility as the principal symptoms.

PCOD has been shown to be associated with certain histopathological changes in the ovaries, notably capsular thickening, subcapsular follicular cysts and hyperplasia of the theca interna, with or without follicular atresia.

The development of urine hormone assays allowed the endocrine basis of PCOD to be described. Urine determinations have now been largely replaced by assays in blood and profiles of hormone changes in PCOD have been proposed. The significant changes are high, fluctuating levels of luteinizing hormone, raised oestrone and androgen concentrations. Oestradiol and follicle stimulating hormone levels are often reduced. Other abnormalities underlying PCOD include defects in steroidogenic enzymes, especially aromatase, this leading to blocked conversion of oestrogen precursors and a resulting accumulation of androgenic steroids.

The origin of the disease is unknown. The abnormal gonadotrophin release which is found, however, leads to deficient follicular development and androgen excess at the expense of oestradiol production. The disordered gonadal steroid secretion results in altered pituitary sensitivity to gonadotrophin releasing hormone and abnormal gonadotrophin production. Once established, the disease is self‐perpetuating.

Current management problems include the uncertain value of ovarian resection, the best method of treatment where infertility is no longer a problem, and the risks of endometrial cancer in the presence of chronically‐raised endogenous oestrogen levels. The inadequacy of treatment of hirsutism in these women is a particular problem.

More work is needed to establish the factors which initiate PCOD and to resolve the problems in its management.