bluuebunny/crossref_metadata_2025 huggingface dataset:
THE TREATMENT OF ADVANCED CYSTADENOCARCINOMA OF THE OVARY WITH GESTRONOL AND CONTINUOUS ORAL CYCLOPHOSPHAMIDE
Authors: Guthrie D.
Published: August 2005

Fifty‐four patients with advanced cystadenocarcinoma of the ovary were treated with gestronol (Depostat), 200 mg/week, by intramuscular injection and continuous oral cyclophosphamide, the dose of the latter being varied to maintain the patient's white cell count at about 1.5 X 109/1. A combined partial and complete remission rate of 76 per cent was obtained. The length of survival depended upon the type of remission and the type of remission was markedly affected by the amount of tumour removed at initial laparotomy.
THE ACCURACY OF RADIOLOGICAL ESTIMATES OF GESTATIONAL AGE USING EARLY FETAL CROWN‐RUMP LENGTH MEASUREMENTS BY ULTRASOUND AS A BASIS FOR COMPARISON
Authors: Robinson H. P. , Sweet Elizabeth M. , Adam A. H.
Published: August 2005

Radiological estimates of gestational age in late pregnancy were compared with the gestational ages based on first trimester ultrasound crown‐rump length measurements in a series of 125 patients. It was found that the 95 per cent confidence limits of a radiological estimate were ± 3½ weeks, that both distal femoral and upper tibial epiphyses were frequently present much earlier than 36 and 38 weeks respectively, and that in almost half of the growth‐retarded babies in the series there was a bone‐age discrepancy of three or more weeks. It is recommended that more liberal use is made of early ultrasound measurements for the assessment of gestational age.
EFFECT OF VARYING AMOUNTS OF ETHINYL OESTRADIOL IN THE COMBINED ORAL CONTRACEPTIVE ON PLASMA SEX HORMONE BINDING GLOBULIN CAPACITY IN NORMAL WOMEN
Authors: Pogmore J. R. , Jequier Anne M.
Published: August 2005

The plasma sex hormone binding globulin (SHBG) capacity has been measured in 52 normal women, 11 women on various oral contraceptives containing 50 μg of ethinyl oestradiol and 11 women on oral contraceptives containing less than 35 μg of ethinyl oestradiol. The results show that women on oral contraceptives containing 50 μg of ethinyl oestradiol have a significantly raised SHBG capacity (p < 0·005) whereas those patients on oral contraceptives containing 35 μg or less of ethinyl oestradiol have SHBG capacities which do not differ significantly from normal ovulating women (p >005). Thus the 35 μg pill interferes less with bound/unbound sex steroid ratios than does the 50 μg pill.
FACTORS INFLUENCING THE TREATMENT OF PATIENTS WITH STAGE IA CARCINOMA OF THE CERVIX
Authors: Iversen T. , Abeler V. , Kjbrstad K. E.
Published: August 2005

A total of 122 patients with Stage Ia carcinoma of the cervix was followed for 5 to 25 years. Eight recurrences were found, four of which were located in the vagina, cervix or the bladder and four on the pelvic wall. Five of the recurrences were detected after 5 years of follow‐up. Tumour cells were found in blood vessels or lymphatic channels in eight patients and five of them developed metastases. It is proposed that only tumours with a depth of stromal invasion of less than 5 mm should be treated conservatively. If blood vessels or lymphatic channels contain tumour, we would recommend a Wertheim's hysterectomy or treatment by intracavitary and external irradiation.
THE EFFECTS OF MATERNALLY ADMINISTERED PETHIDINE OR EPIDURAL BUPIVACAINE ON THE FETUS AND NEWBORN
Authors: Lieberman B. A. , Rosenblatt Deborah B. , Belsey Elizabeth , Packer M. , Redshaw Margaret , Mills Margaret , Caldwell J. , Notarianni Lidia , Smith R. L. , Williams M. , Beard R. W.
Published: August 2005

The continuous fetal heart rate pattern, condition of the baby at birth and its subsequent behaviour were compared in three groups of infants whose mothers received during labour either no drugs, intramuscular pethidine or epidural bupivacaine. The blood levels of pethidine and bupivacaine were measured at delivery in a maternal vein, and umbilical artery and vein, and in the newborn during the first 48 hours of life. The only significant changes in the fetal heart rate pattern occurred in association with maternal hypotension or uterine hyper‐stimulation. The Apgar scores at one minutes were 7 or less in more infants in the intramuscular pethidine and epidural bupivacaine groups as compared with the controls. There were no differences in the Apgar scores at five minutes. Neonatal behaviour during the first six weeks of life was not significantly affected by pethidine or epidural bupivacaine when compared with the control group. Pethidine and bupivacaine were shown to cross the placenta freely. The half‐life of these drugs in the newborn was longer than in the adult.
FETAL BREATHING AND GENERALIZED FETAL MOVEMENTS IN NORMAL ANTENATAL PATIENTS
Authors: Nox Ritchie J. W.
Published: August 2005

Fetal breathing movements (FBM) and generalized fetal movements (GFM) were recorded for 30 minutes using a real time B‐scan instrument in 46 women with uncomplicated pregnancies. FBM occurred for 27.6±3.5 (SE) per cent and GFM for 10.9±0.9 (SE) per cent of the recording time. The time occupied by FBM was not significantly related to smoking, meal times or plasma glucose concentrations. FBM were absent during the observation period in 15 per cent of patients and present for less than 10 per cent of the time in 33 per cent of patients.
INDOMETHACIN IN THE TREATMENT OF PRIMARY DYSMENORRHOEA
Authors: Elder M. G. , Kapadia L.
Published: August 2005

Thirty‐two patients were treated with placebo tablets or indomethacin (25 mg three times daily) in a six‐month, double‐blind, cross‐over trial. During indomethacin therapy, 75 per cent of patients experienced significant pain relief while associated vomiting and diarrhoea were relieved in 44 per cent and 64 per cent of patients respectively. The efficacy of indomethacin was comparable to that of other prostaglandin synthetase inhibitors.
THE EFFECT OF LAPAROSCOPIC STERILISATION BY DIATHERMY OR SILASTIC BANDS ON POST‐OPERATIVE PAIN, MENSTRUAL SYMPTOMS AND SEXUALITY
Authors: Lawson S. , Cole R. A. , Templeton A. A.
Published: August 2005

A total of 530 patients was reviewed six months after laparoscopic sterilisation by diathermy (235 patients) or silastic bands (295 patients). In the immediate post‐operative period severe lower abdominal pain was more common in the patients who had silastic bands. There was one failure with diathermy and two with silastic bands. There were no differences in the nature or incidence of menstrual problems when the two methods were compared. In all, 40 per cent of patients reported an increase in menstrual blood loss and 26 per cent of patients an increase in menstrual pain, and this could not be attributed entirely to stopping oral contraception; 42 per cent of patients reported improvement in their sex lives after sterilisation, while 6.6 per cent reported deterioration mainly due to lack of libido. There was some regret about the operation in 5.1 per cent of patients.
THE TECHNIQUE OF FETAL ELECTROENCEPHALOGRAPHY DURING LABOUR
Authors: Wilson Patricia C. , Levy L. F. , Spies Sally , Chadwicke J.
Published: August 2005

A method for recording the fetal electroencephalogram (EEG) during labour is described. Technical specifications for the construction of a suitable electrode are detailed. One hundred and twenty‐three patients in labour were monitored using this technique and the success rate of obtaining records for analysis was 91 per cent.
THE EFFECT OF FETAL HEAD COMPRESSION AND FETAL ACIDAEMIA DURING LABOUR ON HUMAN FETAL CEREBRAL FUNCTION AS MEASURED BY THE FETAL ELECTROENCEPHALOGRAM
Authors: Wilson Patricia C. , Philpott R. H. , Spies Sally , Ahmed Yasmin , Kadichza Mary
Published: August 2005

We investigated the effect of head compression and acidaemia during labour in 25 African primigravidae. Evidence that head compression had occurred during labour was confirmed by both clinical and radiological means at the end of a trial of labour. No significant difference could be demonstrated in the quantity of fetal electroencephalogram (EEG) abnormality that occurred in the groups with marked head compression as compared to the groups without marked head compression. Deterioration in the fetal EEG to a flat record known as electro‐cerebral silence (ECS) was associated with the development of acidaemia. As fetal heart rate (FHR) decelerations appeared the percentage of ECS in the fetal EEG record increased significantly (P <0.05), and likewise, as fetal acidaemia developed a highly significant increase in ECS in the fetal EEG was demonstrated (P <0 001). We concluded that in the management of trial of labour there was no significant deleterious change in the fetal EEG as a result of head compression, unless fetal acidaemia supervened. However, in the majority of these cases a significant increase in ECS to more than 20 per cent occurred in association with only moderate acidaemia (pH 7.25 to 7.30).
PROSTAGLANDINS IN UMBILICAL PLASMA AT ELECTIVE CAESAREAN SECTION
Authors: Bibby J. G. , Brunt Jane D. , Hodgson Helena , Mitchell M. D. , Anderson Anne B. M. , Turnbull A. C.
Published: August 2005

Prostaglandin E (PGE), prostaglandin F (PGF) and 13,14‐dihydro‐l5‐keto‐prostaglandin F (PGFM) have been measured in umbilical cord plasma obtained immediately after delivery by elective Caesarean section. Umbilical venous plasma levels of PGE were significantly greater than the corresponding arterial levels (p <0.02); there were no significant arterio‐venous differences for PGF or PGFM. In general, concentrations of PGFM exceeded those of PGE which in turn were greater than concentrations of PGF. Umbilical venous levels of PGE and both arterial and venous levels of PGF and PGFM were significantly greater after spontaneous labour with vaginal delivery than after elective Caesarean section.
SEQUENTIAL CHANGES IN THE HUMAN RENIN‐ANGIOTENSIN SYSTEM FOLLOWING THERAPEUTIC TERMINATION OF PREGNANCY
Authors: Broughton Pipkin F. , Oats J. J. N. , Hunter J. C. , Craven D. J. , Symonds E. M.
Published: August 2005

Plasma renin and angiotensin II levels were measured in nine patients immediately before and at half‐hourly intervals in the four hours following therapeutic termination of pregnancy. There was a small fall in renin and angiotensin II levels over the first 1 to 2 hours, followed by a slight increase. The magnitude of these effects was much smaller than those previously seen following normal delivery. It is concluded that in early pregnancy maternal, rather than feto‐placental, factors are controlling the renin‐angiotensin system.
PRENATAL AND POSTNATAL MATERNAL LEUCOCYTE ASCORBIC ACID CONCENTRATIONS
Authors: Moore M. R. , Rohatgi Sharadini , Low R. A. L.
Published: August 2005

Leucocyte ascorbic acid was measured in 79 pregnant women in the 34th to 38th week of gestation and on the first, and third or fifth days post partum. No differences were found for time of year or age of the subjects. There was a significantly lower vitamin C status in social classes IV and V. The leucocyte ascorbic acid concentration fell significantly on the first day post partum and rose again to initial values by the fifth day. In late pregnancy 40 per cent of all subjects had leucocyte ascorbic acid concentrations less than the lower limit of normal (100 nmol/l08 leucocytes). This rose to 75 per cent on the first day post partum.
EFFECT OF INTRAUTERINE CONTRACEPTIVE DEVICE ON UTERINE HAEMOSTASIS: A MORPHOLOGICAL STUDY
Authors: Aparicio S. R. , Bradbury K. , Bird C. C. , Foley M. E. , Jenkins D. M. , Clayton J. K. , Scott J. S. , Rajah S. M. , Mcnicol G. P.
Published: August 2005

The effect of the intrauterine contraceptive device (IUCD) on uterine haemostasis was studied at various stages of the menstrual cycle in a series of 46 patients by light‐ and electron‐microscopy and by following the distribution of an infusion of 51Cr‐labelled autologous platelets. The endometrium in contact with the IUCD in the majority of cases showed grooving with atrophy and mild chronic inflammation in the surrounding tissues. The adjacent stroma also showed increased vascularity and occasional foci of haemorrhage but the increased blood loss associated with the presence of the IUCD could not be attributed to mechanical erosion or disruption of stromal blood vessels by the device. During menstruation the presence of an IUCD does not appear to inhibit the formation of fibrin/platelet thrombi although both in control and IUCD patients there was a striking paucity of platelet/fibrin thrombi in circumstances where their formation should be enhanced. In contrast to other workers we have not observed that gaps or breaks in the endothelial lining of endometrial blood vessels occur with any greater frequency in patients fitted with an IUCD. The principal mechanism by which uterine haemostasis is achieved remains to be established.
METASTATIC BASAL CELL CARCINOMA OF THE VULVA CASE REPORT
Authors: Sworn M. J. , Hammond G. T. , Buchanan Rose
Published: August 2005

A patient with basal cell carcinoma of the vulva with tumour in local lymph nodes is described.
RESULTS OF THE COLPOSUSPENSION OPERATION FOR INCONTINENCE AND PROLAPSE
Authors: Stanton S. L. , Cardozo Linda D.
Published: August 2005

One hundred and eighty female patients complaining of Stress incontinence were treated by a modified Burch colposuspension. Follow‐up results were available at six months in 146 patients, at one year in 88 patients and at two years in 43 patients. The overall objective cure for stress incontinence was 87 per cent at six months, 87.5 per cent at one year and 86 per cent at two years. No relationship was found between the cure of incontinence and either the time taken to resume spontaneous voiding after surgery or concomitant hysterectomy. Cystourethrocele was effectively corrected by this procedure.
PREGNANCIES IN WOMEN WITH HYPERPROLACTINAEMIA: CLINICAL COURSE AND OBSTETRIC COMPLICATIONS OF 41 PREGNANCIES IN 27 WOMEN
Authors: Kelly W. F. , Doyle F. H. , Mashiter K. , Banks L. M. , Gordon H. , Joplin G. F.
Published: August 2005

Observations are reported on 41 pregnancies in 27 patients who initially had infertility and raised serum prolactin concentrations. Associated symptoms were secondary amenorrhoea (81 per cent) and galactorrhoea (81 per cent). All patients were at risk of pituitary expansion during pregnancy, especially these 19 (70 per cent) with radiological evidence of pituitary tumours. Fifteen patients had 21 pregnancies after pituitary implantation with 90yttrium; 14 patients had 20 pregnancies without prior pituitary implantation or any other attempt to prevent tumour expansion. During pregnancies, tumour enlargement as shown by diminished visual acuity, visual field defects, severe headaches, diabetes insipidus and radiological changes occurred only in 3 of the 14 patients who had not had implants. Two patients who became pregnant both before and after pituitary implantation suffered tumour expansion in their pregnancies before implantation, but not when pregnant after the operation. The induction and Caesarean section rates were about 30 per cent in 32 term pregnancies in 25 patients. Details of how pregnancy was achieved and the associated obstetric problems are given.
DOUBLE BLIND TRIAL OF RITODRINE AND PLACEBO IN TWIN PREGNANCY
Authors: O'Connor M. C. , Murphy H. , Dalrymple I. J.
Published: August 2005

In a double blind trial, 25 patients with twin pregnancy were given 40 mg of ritodrine hydrochloride by mouth daily and 24 similar patients received a placebo. The ritodrine group had no significant prolongation of pregnancy nor increase in birth weight, and a high incidence of side effects occurred.
ABORTION ASSOCIATED WITH INTRAUTERINE INFECTION BY CANDIDA ALBICANS CASE REPORT
Authors: Buchanan R. , Sworn M. J. , Noble A. D.
Published: August 2005

A 27‐year‐old patient who became pregnant whilst fitted with an intrauterine contraceptive device developed an intrauterine Candida albicans infection and aborted. The diagnostic (and other inconspicuous) features of C. Albicans infection in the fetus are described. The presence of the intrauterine contraceptive device may have predisposed to the establishment of the infection.
RETROPERITONEAL SARCOMAS OBSTRUCTING DELIVERY TWO CASE REPORTS
Authors: Foruhan B.
Published: August 2005

Two patients with abnormal fetal lies underwent elective Caesarean section. Both abnormal lies were found to be due to retroperitoneal sarcomas overlying the bifurcation of the iliac vessels. One proved to be an inoperable and radioresistant fibrosarcoma. At seven and a half years after Caesarean section and following chemotherapy this patient is alive and well and has had two more children. The other tumour was a large myxoid liposarcoma which was completely removed at the time of Caesarean section. This patient is alive and well 18 months after operation.
HYPERTENSION DURING PREGNANCY WITH AND WITHOUT SPECIFIC TREATMENT; THE DEVELOPMENT OF THE CHILDREN AT THE AGE OF FOUR YEARS
Authors: Ounsted Margaret K. , Moar Valerie A. , Good Frances J. , Redman C. W. G.
Published: August 2005

In a controlled trial pregnant women who were hypertensive before the 28th week of gestation were randomly allocated to treatment with methyldopa or no anti‐hypertensive treatment. The children from these pregnancies have been re‐examined at four years of age and their development compared with a random sample from the same maternity hospital population. Their health, height, weight, and the incidence of sight, hearing and speech problems did not differ. None had gross neurological abnormalities. Boys in the treated hypertensive group had significantly smaller heads than in the other two groups, but there was no correlation between head circumference and developmental score in this group (r = 0.020). On average the children in the random sample were the most advanced when assessed a global score of development. In each developmental sector the mean score for the treated hypertensive group was consistently higher than the untreated hypertensive group. We conclude that maternal hypertension is associated with slight developmental delay in early childhood. There are some indications that treatment with methyldopa may reduce this effect.
MATERNAL AND CORD PLASMA LEVELS OF HIGH‐DENSITY LIPOPROTEIN CHOLESTEROL AND TRIGLYCERIDES IN NIGERIA
Authors: Taylor G. Oladunni , Olufunwa S. A. , Agbedana E. O. , Akande E. O.
Published: August 2005

Plasma total cholesterol, triglycerides and high‐density lipoprotein cholesterol levels were determined in 70 pregnant women immediately after delivery and in the cord blood of their babies; 62 non‐pregnant women served as controls. The mean lipid levels were significantly higher in the pregnant women than in the non‐pregnant women. The lipid levels in the cord blood were much lower than those in the maternal blood but were not different from values which have been reported from the developed countries; they were independent of socio‐economic class. The total and high density lipoprotein cholesterol levels were related to socio‐economic status both in the pregnant and non‐pregnant women, but the ratio of high density lipoprotein cholesterol to total cholesterol and triglyceride levels were not. The cord blood lipid levels were also independent of socio‐economic class.
THE EFFECT OF IMMUNOGLOBULINS ON SPERM‐MIGRATION INHIBITION IN THE CERVICOVAGINAL SECRETIONS OF INFERTILE WOMEN
Authors: Cantuaria A. A. , Jones A. L.
Published: August 2005

We studied 40 infertile couples in whom cervical hostility was the only known cause of infertility, and 18 fertile women. IgA, IgG and IgM together with α‐2‐macroglobulin and albumin were measured in the cervicovaginal secretions and serum using the Mancini radial diffusion technique. IgA and IgG were present in the cervicovaginal secretions of all the women and the concentrations found did not differ significantly in the two groups. Levels of IgM were significantly higher in the infertile group. The ratio of protein levels in cervicovaginal fluid to serum levels were calculated using the formulae of Donovan et al (1970). Locally‐produced IgA, IgG and IgM were found in more of the infertile women and in greater amounts than in the fertile women. Class specific anti‐immunoglobulin antibodies conjugated to inert particles were used to selectively remove specific classes of immunoglobulin from the cervicovaginal secretions. Removal of a particular immunoglobulin class or all three resulted in less inhibition of sperm migration. IgA appeared to be responsible for more inhibition than either IgG or IgM. In infertile women with locally produced IgA and IgG, there was greater inhibition of sperm migration than in those women who lacked locally produced immunoglobulins.
SINGLE DOSE OF TINIDAZOLE IN PROPHYLAXIS OF INFECTIONS FOLLOWING HYSTERECTOMY
Authors: Karhunen M. , Koskela O. , Hannelin M.
Published: August 2005

A single dose of 2 g tinidazole was given preoperatively to 70 patients undergoing elective hysterectomy; 76 patients served as controls. One patient in the drug therapy group and 10 in the control group had a temperature of 38°C at some time after the first postoperative day. One patient in the tinidazole group and seven among the controls had abscess formation. The differences between the tinidazole and the control groups were highly significant. This simple prophylactic procedure reduced treatment costs and minimised infection following hysterectomy.
SUCCESSFUL PREGNANCIES IN WOMEN TREATED BY DIALYSIS AND KIDNEY TRANSPLANTATION
Authors:   The Registration Committee Of The European Dialysis And Transplant Association
Published: August 2005

The Registry of the European Dialysis and Transplant Association collected information on 120 successful pregnancies in women treated by dialysis and transplantation in 19 countries. Ninety‐seven women with transplants gave birth to 110 babies including five multiple pregnancies. The incidence of severe congenital malformation in these children was not substantially increased. There was evidence of damage to the transplant occurring either during or after pregnancy in 22 of the mothers. Sixteen successful pregnancies occurred in women on dialysis, all of whom had some residual renal function.
ORIGIN OF AMNIOCENTESIS‐INDUCED RISES OF ALPHA‐FETOPROTEIN CONCENTRATIONS IN MATERNAL SERUM
Authors: Dallaire L. , Bélanger L. , Smith Carol J. P. , Kelleher P. C.
Published: August 2005

An elevation of alpha‐fetoprotein concentration in maternal serum occurred in 7 of 65 patients (11 per cent) following amniocentesis. Analysis of the molecular heterogeneity of the alpha‐fetoprotein by chromatography on concanavalin A‐agarose indicated that the source of the alpha‐fetoprotein was fetal serum in three patients and amniotic fluid in four patients.
RENIN SUBSTRATE, ACTIVE AND ACID‐ACTIVATABLE RENIN CONCENTRATIONS IN HUMAN PLASMA AND ENDOMETRIUM DURING MENSTRUAL CYCLES CONTROLLED BY ORAL CONTRACEPTIVE PREPARATIONS
Authors: Johnson I. R.
Published: August 2005

Measurements of active and acid‐activatable renin concentrations and renin substrate concentrations in plasma and endometrial samples taken from 31 patients are described. All of these patients were taking oestrogen‐containing oral contraceptive preparations. Plasma active renin concentration was lower in these cycles than in normal cycles and the substrate concentrations higher. In the endometrium the concentrations of all of the components of the system were raised by oral contraceptives. As with normal cycles, the maximum potential for production of the angiotensins was in the premenstrual stage of the cycle. It is suggested that this increase in potential is associated with the onset of menstruation.
A COMPARATIVE STUDY OF SYMPTOMS AND OBJECTIVE URODYNAMIC FINDINGS IN 214 INCONTINENT WOMEN
Authors: Cantor T. J. , Bates C. P.
Published: August 2005

Videocystourethrography was used to investigate 214 incontinent women. Their urinary symptoms were assessed in relation to urodynamic findings. Nocturia, nocturnal enuresis and urge incontinence were the most reliable symptoms distinguishing those patients with detrusor instability. Frequency of micturition and urgency were less reliable in this respect, and it was felt that these symptoms were not indications for Videocystourethrography.
AN ASSESSMENT OF URODYNAMIC EXAMINATION IN INCONTINENT WOMEN
Authors: Jarvis G. J. , Hall S. , Stamp S. , Millar D. R. , Johnson A.
Published: August 2005

Urodynamic investigation was performed in 100 consecutive incontinent women. The clinical diagnosis was confirmed in only 65 women and management was significantly altered in 31 women. Pressure‐flow studies should precede, whenever possible, the treatment of incontinent patients.
THE IMMEDIATE EFFECT OF ABDOMINAL HYSTERECTOMY ON INTRAVESICAL PRESSURE AND DETRUSOR ACTIVITY
Authors: Wake C. R.
Published: August 2005

This study was undertaken to determine the effect of simple abdominal hysterectomy on bladder function in the first postoperative week. It was found that initially there was a significant reduction in voluntary capacity, a rise in residual volume and an increase in intravesical pressure but that this was returning to normal after one week. The degree to which these changes occurred did not seem to be related to postoperative disturbances of micturition.
PLASMA TOCOPHEROL AND LIPID LEVELS IN PREGNANCY AND ORAL CONTRACEPTIVE USERS
Authors: Jagadeesan V. , Prema K.
Published: August 2005

Plasma tocopherol (vitamin E), cholesterol and triglycerides were estimated in normal non pregnant women and in women throughout pregnancy. All three constituents were increased in the later stages of pregnancy. There was a significant statistical correlation between tocopherol and cholesterol levels, but not between the vitamin and triglycerides. The data suggest that the increase in tocopherol may be associated with a corresponding increase in cholesterol since both are known to share a common transport system, but the association was evident only during pregnancy. Compared to controls, plasma vitamin E levels were not altered in pre‐eclampsia nor in oral contraceptive users.
MULTIPLE BIRTHS IN HAUSA WOMEN
Authors: Rehan N. , Tafida D. S.
Published: August 2005

The incidence of multiple births was studied using the maternity records of 5750 Hausa women living in the savannah zone of Nigeria. There were 40 twins and 2 triplets/1000 births. Twenty six per cent of twins were monozygous. The incidence of multiple births, which was about five times higher than that observed in any western population, was significantly lower than that of other ethnic groups, who live in the hot and humid climate of the southern part of country. The incidence of multiple births was related to maternal age but did not bear any association to the climate or prevalence of malaria.
ACUTE LIVER DISEASE WITH ENCEPHALOPATHY AND RENAL FAILURE IN LATE PREGNANCY AND THE EARLY PUERPERIUM A STUDY OF FOURTEEN PATIENTS
Authors: Davies M. H. , Wilkinson S. P. , Hanid M. A. , Portmann B. , Brudenell J. M. , Newton J. R. , Williams R.
Published: August 2005

Fourteen patients, aged 18 to 38 years, presented in the last trimester of pregnancy, or immediately post partum, with severe acute hepatic dysfunction. Liver biopsy confirmed the presence of acute fatty liver in six patients; the cause of hepatic dysfunction was presumed viral hepatitis in five patients, pre‐eclampsia in two, and gram‐negative septicaemia in one. There was one set of twins and the perinatal mortality was 33 per cent; there were three maternal deaths (21 per cent). Two survivors with acute fatty liver subsequently had successful pregnancies without evidence of hepatic dysfunction.
ARTIFICIAL INSEMINATION WITH FROZEN SPERM: PROTOCOL, METHOD OF ANALYSIS AND RESULTS FOR 1188 WOMEN
Authors: David G. , Czyglik F. , Mayaux M. J. , Martin‐Boyce A. , Schwartz D.
Published: August 2005

The experience of a sperm bank during a five year period is reported. Artificial insemination by donor (AID) was carried out on 1188 women using frozen sperm prepared in doses of 0.25 ml. A single insemination was called for during each of the first two cycles. The patients were classified in 4 categories: lost to follow‐up, successes, dropouts and open cases. The success rate per cycle was about 10 per cent and was very stable for each of the first 12 cycles. The cumulative success rate was calculated by the life table technique adapted for AID analysis. A theoretical success rate (without dropouts) and an effective success rate (with dropouts) were calculated. These two rates were 68 and 55 per cent respectively after 12 cycles. The median delay to conception was 7 and 9 cycles, respectively, under theoretical and effective conditions. The spontaneous abortion rate (17 per cent) and sex‐ratio (106 males for 100 females) resemble those for natural reproduction but the success rate per cycle was markedly lower even after adjusting for age.
MOTHERS' VIEWS OF OBSTETRIC CARE
Authors: Kirke P. N.
Published: August 2005

To obtain mothers' views of their obstetric care, 210 mothers were interviewed postnatally in two hospitals. The findings relating to staff‐patient communication are presented in this paper. Half of the mothers mentioned some failure of communication. There was a significant association between satisfaction with communication and overall satisfaction with care. Many mothers said that the purposes and nature of the procedures which they had during labour and delivery were not explained by the staff despite evidence of positive attitudes of the doctors towards giving such explanations. Although mothers who did not know why procedures were carried out generally wanted to know, they did not ask. Sixty‐five per cent of the mothers said that the staff did not tell them anything about breast‐feeding at any stage and 75 per cent said this about bottle‐feeding. The need for health professionals to see communication with patients as an integral part of medical care is stressed.
AN AUDIT OF PRESCRIBING IN AN OBSTETRIC SERVICE
Authors: Lewis P. J. , Boylan P. , Bulpitt C. J.
Published: August 2005

An audit of drug prescribing was carried out in an obstetric service. Sixty‐five different drugs were prescribed in 976 separate prescriptions. Nitrazepam and paracetamol accounted for 75 per cent of all prescriptions. Many of the prescriptions were incomplete. In 83 per cent of cases the drugs prescribed were not referred to in the patients' case notes, suggesting that their prescription did not form part of a therapeutic plan for the patient.
POLYACRYLAMIDE GEL ELECTROPHORESIS OF AMNIOTIC FLUID CHOLINESTERASES: A GOOD PRENATAL TEST FOR NEURAL TUBE DEFECTS
Authors: Seller Mary J. , Cole Kathleen J.
Published: August 2005

The qualitative assay of the cholinesterases (ChE) in amniotic fluid on polyacrylamide gel gave a single major band (cholinesterase) in all samples from normal pregnancies, and two major bands (cholinesterase and acetylcholinesterase) in all cases from fetuses with open neural tube defects. Five fluids which were true false positive on alpha‐fetoprotein (AFP) assay (elevated AFP in a clear fluid but normal fetus) had a single band, and two fluids which were false negative on AFP testing (normal AFP but spina bifida fetus) had two bands. The second ‘diagnostic’ ChE band sometimes occurred, together with other extra bands, in some fluids which were very severely contaminated by maternal or fetal blood, but in four of six fluids from normal fetuses where fetal blood staining was sufficient to cause the AFP to be elevated, there was only one ChE band. It is suggested that the qualitative assay of ChE should be performed in addition to AFP in the prenatal diagnosis of neural tube defects.
COMPARATIVE STUDY OF PROTEINASE INHIBITORS IN HUMAN AMNIOTIC FLUID AND MATERNAL SERUM
Authors: Bhat A. Ramesh , Pattabiraman T. N.
Published: August 2005

Serum and amniotic fluid samples from five pregnant women were analyzed for different proteinase inhibitors by ion‐exchange chromatography on DEAEcellulose. Alpha‐2 macroglobulin was found to be absent in amniotic fluid. Even though α‐1 antichymotrypsin was identified in amniotic fluid, its concentration gradient between serum and amniotic fluid (20–60) was much higher than that of α‐1 antitrypsin (8–20). Two forms of α‐1 antitrypsin were identified in both the fluids. In pregnancy, the ratio of the two forms was altered in favour of the less anionic form compared to normal sera. The contribution of the heat stable proteinase inhibitor for total antitryptic activity in amniotic fluid was more than in serum. The observation that urine samples from immature infants had higher heat stable inhibitory activity than urine samples from normal infants suggests that the heat stable inhibitor in amniotic fluid may arise from fetal kidney.
THE ADJUSTMENT OF BASAL BODY TEMPERATURE MEASUREMENTS TO ALLOW FOR TIME OF WAKING
Authors: Royston J. P. , Abrams R. M. , Higgins Mary P. , Flynn Anna M.
Published: August 2005

During one menstrual cycle, each of eleven volunteer student nurses at Northwick Park Hospital recorded their vaginal temperature on waking and noted the clock time. Waking times varied between 0530 hours and 1100 hours. Regression analysis revealed a highly significant linear relation between temperature and time of waking, with a slope of 0–086°C/hour (SE, 0–009°C/hr) in the postmenstrual (hypothermal) phase. A rounded adjustment factor of 0–1°C/hour is shown to improve the interpretability of basal body temperature (BBT) charts in a group of seven women regularly using natural family planning methods. The adjustment factor is simple to apply and only involves counting one square on a BBT chart for each hour that the waking time differs from normal.
HYDROPS FETALIS, AN UNUSUAL CAUSE, PRESENTATION AND METHOD OF DIAGNOSIS
Authors: Rees L. , Vlies P. R , Adams J.
Published: August 2005

A case of hydrops fetalis due to fetal supraventricular tachycardia is described. The patient presented with polyhydramnios, maternal oedema and proteinuria and the diagnosis was made by ultrasound.
MISDIAGNOSIS OF FETAL HEART RATE DURING A TWIN LABOUR
Authors: Fehrmann H.
Published: August 2005

Death of a first twin was unsuspected despite continuous fetal scalp electrode and ultrasound fetal heart rate monitoring. The electrocardiogram of the live second twin was detected via the scalp electrode attached to the dead first twin, and the coincidence of the two recordings was not appreciated.
PROLAPSED URETEROCELE PRESENTING AS A VULVAL MASS IN A CHILD
Authors: Kasby C. B , Parsons K. F
Published: August 2005

A child with a vulval mass due to a prolapsed ureterocele is described.
OBSTETRIC ASPECTS OF MIDTRIMESTER FETAL BLOOD SAMPLING BY NEEDLING OR FETOSCOPY
Authors: Fairweather D. V. I. , Ward R. H. T. , Modell B.
Published: August 2005

We describe our experience at University College Hospital, London, with the first 135 patients submitted to midtrimester fetal blood sampling for antenatal diagnosis of β‐thalassaemia major, other thalassaemias and homozygous sickle cell disease. Blind needling and fetoscopy with sampling are evaluated and their application dişcussed. With experienced operators 9 per cent of patients experienced a fetal loss.
OUTCOME OF PREGNANCIES COMPLICATED BY EARLY VAGINAL BLEEDING
Authors: Funderburk S. J. , Guthrie D. , Meldrum D.
Published: August 2005

Obstetrical and neonatal data were analysed for pregnancy outcome in 259 deliveries complicated by first or second trimester vaginal bleeding. There was a high incidence of low birth weight, low gestational age, perinatal death, asphyxia, breech delivery, placental infarcts and small‐for‐dates term infants. Fetal anomalies were slightly though not significantly increased. Combined suboptimal pregnancy outcome occurred in 29.7 per cent of these deliveries compared to 15.2 per cent of 25 118 concurrent deliveries without reported early pregnancy bleeding (p<0.0001). The combined risk remained approximately doubled even for primigravidae and for women without prior illness or pregnancy complications. The highest combined risk, 61.5 per cent, was for women with at least two prior abortions, premature births or perinatal deaths and no prior term births. These findings suggest that early gestational vaginal bleeding is one predictor of suboptimal pregnancy outcome.
A STUDY OF THE BENEFITS AND ACCEPTABILITY OF AMBULATION IN SPONTANEOUS LABOUR
Authors: Williams R. M. , Thom Margaret H. , Studd J. W. W.
Published: August 2005

A prospective study of 300 consecutive deliveries has been made to assess the benefits and acceptability of ambulation during spontaneous labour. Ambulation during the first stage occurred in 48 patients with 55 non‐ambulant patients acting as controls. No difference in the length of first or second stage, incidence of fetal distress or mode of delivery was observed. In spite of the lack of apparent advantage to the fetal condition, ambulation was acceptable to both patients and nursing staff and should not be discouraged.
THE INFLUENCE OF BETAMETHASONE AND ORCIPRENALINE ON THE INCIDENCE OF RESPIRATORY DISTRESS SYNDROME IN THE NEWBORN AFTER PRETERM LABOUR
Authors: Schutte M. F. , Treffers P. E. , Koppe J. G. , Breur W.
Published: August 2005

In a randomized double‐blind trial on antenatal corticosteroid treatment for the prevention of respiratory distress syndrome (RDS) a corticosteroid related beneficial effect was found. Possibly of more significance was the finding that the children born within 12 hours of their mother's admission to hospital showed a higher incidence of RDS than those born between 12 hours and one week after admission even in the placebo and untreated groups. Beta‐adrenergic drugs seemed to exert no other influence on the occurrence of RDS than can be explained by the delay of delivery. Prolonged ruptured membranes appeared to decrease the incidence of RDS to the same extent as other symptoms of threatened preterm labour.
INTERACTION OF VASOPRESSIN AND PROSTAGLANDIN ON MYOMETRIAL ACTIVITY IN VIVO IN THE FIRST TRIMESTER OF HUMAN PREGNANCY
Authors: Laudański T. , ÅKerlund M.
Published: August 2005

The interaction of vasopressin (VP) and prostaglandin (PG) F2α on myometrial activity was studied by intrauterine pressure recording in 40 women due to undergo therapeutic abortion in the first trimester. In a control group the uterine activity did not change during eight hours of recording without drug administration. In a second group, who had intravenous injections of 8‐lysine vasopressin (LVP, 0.1–0.5 IU), it was found that 0.3 1U was the smallest dose that consistently gave an effect on myometrial activity, and that repeated injections gave responses of practically the same magnitude. In the remaining women in the study, LVP injections, 0.3 IU, were given before, during and two hours after an intravenous infusion of PGF2α at 4 or 20 [μg/minute. Although there were great individual variations, potentiation and enhancement of the LVP effect were the most common reactions, especially with the lower dose of PG. An interaction of PG and other endogenous myometrial stimulants such as VP might be important in the aetiology of spontaneous abortion and the combination of PG with VP‐like substances might be of value in therapeutic abortion during the first trimester.
THE RESPONSE OF ENDOMETRIAL BLOOD VESSELS TO INTRAUTERINE CONTRACEPTIVE DEVICES: AN ELECTRON MICROSCOPIC STUDY
Authors: Sheppard B. L. , Bonnar J.
Published: August 2005

The ultrastructure of the vascular supply of the endometrium in uteri containing inert and copper bearing intrauterine contraceptive devices (IUCDs) has been compared with that in uteri removed at comparable stages of the menstrual cycle for dysfunctional uterine bleeding. In the endometrium from all uteri containing inert and copper IUCDs, stromal capillaries below the devices showed extensive microthrombosis with platelet and fibrin aggregations filling gaps in the endothelial linings of the vessels. Considerable stromal haemorrhage and erosion of surface epithelium was associated with this vascular pathology. In the uteri removed for dysfunctional bleeding, microthrombosis was a rare occurrence. In the stromal vessels of the endometrium not in contact with the devices, the surface epithelium was usually intact and the underlying stromal capillaries often showed breaks in the endothelial lining but without a haemostatic plug. Leucocyte migration into the stroma was more evident in association with the copper IUCDs than the other devices. The ultrastructural changes in the microvasculature of the endometrium associated with IUCDs did not appear to be related to a stage of the menstrual cycle. The extent and type of microvascular changes appeared to be related to the proximity and surface area of the IUCD and to the presence or absence of copper in the device.
GENUINE STRESS INCONTINENCE AND DETRUSOR INSTABILITY—A REVIEW OF 200 PATIENTS
Authors: Cardozo Linda D. , Stanton S. L.
Published: August 2005

A clinical and urodynamic analysis of 100 women with geniune stress incontinence and 100 women with detrusor instability is presented to compare and contrast the conditions and the results of their treatment. Emphasis is placed on the need to distinguish accurately between these two conditions.
INDUCTION OF LABOUR WITH VAGINAL PROSTAGLANDIN E2 PESSARIES
Authors: Hefni M. A , Lewis G. A.
Published: August 2005

Wax‐based pessaries, each containing 3 mg of prostaglandin E2 (PGE2), were administered intravaginally for the induction of labour. The induction to delivery intervals were shorter than those in a control group induced by amniotomy and intravenous oxytocin. There was a remarkable reduction in the Caesarean section rate from 12 per cent in the control group to 2.4 per cent in the study group in primiparae, and from 8 per cent to 1.6 per cent in multiparae. Side effects associated with the PGE2 were rare, as were complications.
INTRAMUSCULAR ADMINISTRATION OF 15(S)‐15‐METHYL PROSTAGLANDIN F2α FOR INDUCTION OF LABOUR IN PATIENTS WITH FETAL DEATH
Authors: Wallenburg H. C. S. , Keirse M. J. N. C. , Freie H. M. P. , Blacquière J. F.
Published: August 2005

Labour was induced with repeated intramuscular injections of 125 or 250 μg of a 15‐methyl analogue of prostaglandin F2α (15‐me‐PGF2α) in 97 women harbouring a dead fetus for 1 to 42 days in the second or third trimester of pregnancy. The 24‐hour cumulative expulsion rate was 93 per cent in 35 nulliparae and 95 per cent in 61 multiparae in whom labour was successfully induced. There was one failure in a parous patient. The median time interval between the first injection and delivery was significantly longer in nulliparae (10.4 hours) than in parous women (7.3 hours). There were no important differences in efficacy or side effects between the 125 and the 250 μg dosage scheme. No serious complications occurred, but gastrointestinal side effects were prominent. It is concluded that these side effects are compensated for by the simplicity, efficacy and safety of the procedure.
THE IN VITRO PRODUCTION OF PROSTANOIDS BY THE HUMAN CERVIX DURING PREGNANCY: PRELIMINARY OBSERVATIONS
Authors: Ellwood D. A. , Mitchell M. D. , Anderson Anne B. M. , Turnbull A. C.
Published: August 2005

The ability of the pregnant human cervix to produce prostanoids has been studied using an in vitro superfusion technique. Tissues obtained from four patients during the first trimester of pregnancy produced prostaglandin E (PGE), prostaglandin F (PGF), 13,14‐dihydro‐15‐oxo‐prostaglandin F (PGFM) and 6‐oxo‐prostaglandin F2α (6‐oxo‐PGF1α). Production of thromboxane B2 (TXB2) was minimal. Preliminary studies using tissue taken at Caesarean hysterectomy during the last trimester of pregnancy indicate that the cervix may show increased prostanoid production during active dilatation. The implications of these observations for an involvement of prostanoids in cervical softening during human parturition are discussed.
SMALL BIPARIETAL DIAMETER OF FETUSES WITH SPINA BIFIDA: IMPLICATIONS FOR ANTENATAL SCREENING
Authors: Wald N. , Cuckle H. , Boreham Jillian , Stirrat G.
Published: August 2005

The biparietal diameter of 20 fetuses with spina bifida was measured during pregnancy by ultrasound scanning, mainly in the second trimester. The mean result was 0.83 cm smaller than the value based on 186 unaffected pregnancies at the same gestational ages (P<0.001), suggesting that spina bifida fetuses are growth retarded. The practical consequence of this finding is that the routine use of ultrasound in pregnancy will increase the sensitivity of AFP screening for open spina bifida at 16 to 18 weeks gestation from 79 per cent as estimated by the UK Collaborative AFP Study to about 90 per cent or more.
THE EFFECTS OF MECHANICAL PRESSURE AND LOCAL STASIS ON TRANSCUTANEOUS MONITORING OF FETAL OXYGEN TENSION
Authors: Fall O. , Ek B. , Nilsson B. A. , Rooth G.
Published: August 2005

A methodological study of the influence of local stasis and mechanical pressure on the continuous transcutaneous oxygen tension electrode (tcPO2 electrode) during intrapartum monitoring is presented. No effect of mechanical pressure up to 7.3 kPa (55 mm Hg) on the electrode membrane was found. Reduced blood flow in the capillaries of the tissue beneath the electrode caused by stasis or pressure effect resulted, below a certain threshold value, in tcPO2 decrease. The results emphasize that an attempt to differentiate between a methodologically caused decrease and a decrease due to impaired oxygenation must be made when evaluating the absolute fetal arterial oxygen tension from fetal tcPO2. The consistently observed decrease in relative local perfusion (‘flow’) may be a help in this respect.
THE EFFECT OF SEGMENTAL EPIDURAL ANALGESIA ON MATERNAL PROLACTIN DURING LABOUR
Authors: Jouppila R. , Jouppila P. , Moilanen K. , Pakarinen A.
Published: August 2005

Maternal plasma prolactin (PRL) concentrations were determined during the course of induced labours in 18 normal parturients. Every second mother was given segmental epidural analgesia for pain relief during the first stage of labour and the remaining parturients served as controls. The maternal PRL level declined during labour in both groups, which contrasts with the increased output seen in non‐pregnant patients subjected to stress. The lowest levels were reached during the first stage of labour. The reduction in PRL levels was statistically significant in the control group but not in the epidural group of patients.
ABNORMAL FETAL HEART RATE ASSOCIATED WITH CONGENITAL ABNORMALITIES
Authors: Powell Phillips W. D , Towell M. E.
Published: August 2005

The fetal heart rate (FHR) records obtained from 3140 patients were reviewed. Thirty‐seven patients gave birth to an infant with a major congenital abnormality. Fifty‐one per cent of this group demonstrated an abnormal FHR in the antepartum or intrapartum period. The Caesarean Section rate was 48 per cent and perinatal mortality was 50 per cent. In patients with an abnormal antepartum FHR record, an underlying congenital abnormality of the fetus should be considered.
BIRTH WEIGHT BEFORE AND AFTER A SPONTANEOUS ABORTION
Authors: Alberman Eva , Roman Eve , Pharoah P. O. D. , Chamberlain G.
Published: August 2005

A survey of pregnancies occurring in 3502 women doctors provided an opportunity to examine the relationship between early fetal loss and birth weight. This was found to be complex. The most important observations were that the mean birth weight of babies preceding a spontaneous fetal loss was lower than that of livebirths preceding another livebirth, and that in the subgroup of women with repeated early losses, mean birth weight fell with increasing pregnancy order. In contrast, mean birth weight of the first livebirth following a single spontaneous abortion was higher, though not significantly, than that of livebirths in the first pregnancy.
ADRENAL‐SEMINAL‐PITUITARY PROTEIN LEVELS IN MATERNAL SERUM AND AMNIOTIC FLUID
Authors: Etheridge R. J. , Al‐Awqati M. A. , Grudzinskas J. G. , Obiekwe B. , Chard T.
Published: August 2005

Adrenal‐seminal‐pituitary protein (ASP) was measured by radioimmunoassay in maternal serum and amniotic fluid samples obtained throughout pregnancy. Levels of ASP in maternal circulation showed a steady rise from a mean of 350 μg/1 at ten weeks gestation to 526 μg/1 at term. There was a further rise in ASP levels during labour. In contrast, a slight decline in amniotic fluid ASP was observed throughout pregnancy but the levels rose sharply during labour. These findings are in agreement with the hypothesis that ASP is closely associated with prosta‐glandin physiology.