bluuebunny/crossref_metadata_2025 huggingface dataset:
Cytoplasmic steroid receptors in ovarian tumours
Authors: QUINN M. A. , PEARCE P. , ROME R. , FUNDER J. W. , FORTUNE D. , PEPPERELL R. J.
Published: August 2005

Summary. Cytoplasmic oestrogen receptors were measured in 40 primary and four secondary ovarian tumours; of these, 43 tumours were also analysed for cytoplasmic progesterone receptors and 34 tumours for cytoplasmic androgen receptors. Serous tumours were significantly more likely to be oestrogen‐receptor positive than mucinous tumours, but the incidence of positive progesterone and androgen receptors was similar in serous, mucinous and endometrioid tumours. The mean oestrogen receptor content of serous tumours was significantly higher than that of endometrioid tumours. Well‐differentiated epithelial tumours were significantly more likely to be oestrogen‐receptor and progesterone‐receptor positive than less differentiated epithelial tumours. Two granulosa cell tumours were oestrogen‐receptor positive and one of these was also progesteronereceptor and androgen‐receptor positive. Four normal óvaries were also analysed for receptor content and two were found to be androgen‐receptor positive. The presence of cytoplasmic receptors in ovarian tumours may explain their reported response to endocrine therapy.
Amniotic fluid phospholipid profile in multiple pregnancy and the effect of zygosity
Authors: DOBBIE H. G. , WHITTLE M. J. , WILSON A. I. , WHITFIELD C. R.
Published: August 2005

Summary. Because respiratory distress syndrome (RDS) may occur in one twin but not the other it may be misleading to assess fetal lung maturity using amniotic fluid from only one sac. We compared the amniotic fluid lecithin/sphingomyelin (L/S), phosphatidyl glycerol/sphingomyelin (PG/S) and phosphatidyl inositol/sphingomyelin (PI/S) ratios between co‐twins and co‐triplets in 32 sets of twins and three set of triplets. In the twin pregnancies we found a weak correlation for L/S ratio but a much improved one for PG/S and PI/S. The concordance between sacs for all three ratios was better in monozygotic than in dizygotic twins. The efficacy of amniotic fluid PG in the determination of fetal lung maturity was demonstrated and the discrepancies between the sacs was much less for PG than for the L/S ratios. Employing the L/S ratio combined with the presence or absence of PG should reduce false results to a minimum.
A randomized double‐blind controlled trial of the value of stilboestrol therapy in pregnancy: long‐term follow‐up of mothers and their offspring
Authors: VESSEY M. P. , FAIRWEATHER D. V. I. , NORMAN‐SMITH BEATRICE , BUCKLEY J.
Published: August 2005

Summary. In the early 1950s, a randomized, double‐blind, controlled trial of the value of prophylactic stilboestrol therapy given antenatally to reduce the incidence of late pregnancy toxaemia and to improve perinatal mortality was conducted at University College Hospital, London. Women expecting their first baby were allocated to one or other of two groups. Those in the stilboestrol group started treatment at the 12th week of pregnancy on average and received a mean dose of about 11.5 g of the drug while those in the control group received placebo tablets. In spite of the fact that the original trial documentation was lost, it was possible to be fairly certain which was the treated group and follow‐up data from 650 mothers and 660 offspring were obtained from death certificates, cancer registrations and questionnaires sent to general practitioners. We found no indication of any harmful long‐term effect of stilboestrol exposure during pregnancy on the mothers—in particular 10 out of 331 women in the untreated group and 9 out of 319 women in the treated group were found to have developed breast cancer. Amongst the daughters, those in the treated group suffered an excess of minor benign lesions of the cervix uteri and an excess (not statistically significant) of unfavourable pregnancy outcomes. None of the daughters had developed clear cell adenocarcinoma of the vagina or cervix uteri. Amongst the sons, we discovered no evidence of any significant excess of genital tract disorders or of impaired reproductive performance in the treated group but one son developed a (fatal) teratoma of the testis. Unexpectedly, psychiatric disease (especially depression and anxiety) was reported by general practitioners about twice as often in the treated group offspring (sons and daughters) as in the untreated group. This result cannot be due to bias, and is unlikely to be due to confounding or chance, and may thus represent an adverse effect of exposure to stilboestrol in utero.
A randomized trial of weekly cardiotocography in highrisk obstetric patients
Authors: LUMLEY JUDITH , LESTER ARLENE , ANDERSON IAN , RENOU PETER , WOOD CARL
Published: August 2005

Summary. A randomized clinical trial of once‐weekly antenatal fetal heart rate monitoring in 539 high‐risk patients could find no benefit of monitoring in terms of perinatal mortality, morbidity or Apgar score. The previously well‐documented association between abnormal antenatal fetal heart rate traces and low Apgar score was confirmed. A detailed case review showed that in this population monitoring was irrelevant to almost all of the 13 perinatal deaths.
Pregnancy‐associated hypertension, a comparison of its prediction by ‘roll‐over test’ and plasma noradrenaline measurement in 100 primigravidae
Authors: TUNBRIDGE R. D. G. , DONNAI P.
Published: August 2005

Summary.One hundred primigravidae had a ‘roll‐over test’ between 28 and 32 weeks of gestation. Of the 10 women with positive results (a rise of ≥20 mmHg in diastolic blood pressure after roll‐over) only two later developed diastolic blood pressures >90 mmHg. Of the 90 patients with a negative result, 17 subsequently sustained diastolic pressures of >90 mmHg. The change in plasma noradrenaline levels measured before and after roll‐over, in all patients, did not distinguish between those patients who remained normotensive and those who subsequently developed hypertension. At 28–32 weeks gestation, those patients who subsequently developed hypertension had a higher mean plasma noradrenaline level and a higher systolic blood pressure than the patients who remained normotensive.
Portsmouth operative delivery trial: a comparison vacuum extraction and forceps delivery
Authors: VACCA ALDO , GRANT ADRIAN , WYATT GEOFFREY , CHALMERS IAIN
Published: August 2005

Summary. A total of 304 women, for whom operative delivery was considered necessary in the second stage of labour, were randomly assigned to delivery by vacuum extraction or forceps. Of those allocated to forceps a higher proportion of babies were actually delivered with the allocated instrument; however, the caesarean section rate was also higher in this group. Maternal trauma, use of analgesia and blood loss at delivery were significantly less in the group allocated to vacuum extraction. Vacuum extraction did, however, appear to predispose to an increase in mild neonatal jaundice. More serious neonatal morbidity was rare in both groups and the trial was of insufficient size to rule out a clinically important differential effect of the two instruments on these measures of outcome. Another trial is now needed to address this still open question more rigorously.
Maternal and cord plasma concentrations of β‐lipotrophin, β‐endorphin and γ‐lipotrophin at delivery; effect of analgesia
Authors: BROWNING A. J. F. , BUTT W. R. , LYNCH S. S. , SHAKESPEAR R. A. , CRAWFORD J. SELWYN
Published: August 2005

Summary. Maternal venous plasma concentrations of β‐LPH, β‐EP and γ‐LPH were compared in (i) patients undergoing vaginal delivery, 11 with an epidural block and 13 with pethidine and nitrous oxide or no analgesics; (ii) patients delivered by caesarean section, 7 under epidural block and 8 under general anaesthesia. Patients delivered by either method under epidural block had significantly lower levels of all three peptides than those receiving no epidural. There were significant negative correlations between umbilical vein β‐LPH, β‐EP and γ‐LPH concentrations and umbilical artery pH and positive correlations between β‐LPH and β‐EP but not γ‐LPH and cord PCO2 in 29 patients. There was no relation between cord levels of any of the three peptides and the method of analgesia or the route of delivery. Although concentrations of all three peptides were closely correlated to one another in either maternal or cord plasma, there was no relationship between maternal and fetal levels.
Women's recollection of pain during and after carbon dioxide laser treatment to the uterine cervix
Authors: LOWLES I. E. , AL‐KURDI M. , HARE M. J.
Published: August 2005

Summary. By use of postal questionnaires women who had undergone laser treatment to the uterine cervix without analgesia or anaesthesia were asked to comment retrospectively on their recollections of the pain that this caused. One hundred (42%) of 239 who replied had found the pain ‘moderate’ or ‘severe’, 102 (43%) thought it ‘very slight’ or ‘mild’, and 37 (15%) said they felt no pain at all. No greater sensation of pain was reported with higher intensity treatment. A total of 58 (24%) suggested that they would wish for some form of anaesthesia if they needed to have the same treatment again.
Some effects of maternal pethidine administration on the newborn
Authors: ROOTH GÖSTA , LYSIKIEWICZ ANDRZEJ , HUCH RENATE , HUGH ALBERT
Published: August 2005

Summary. The effects of maternal pethidine administration (100 mg itramuscularly) were investigated in 150 infants at 1–2 h after birth, 95 infants whose mothers had not received pethidine served as a control group. Pethidine administration showed no effect on pH or Pco2 of cord blood and neonatal arterial blood at 1–2 h after birth if the time interval between pethidine administration and delivery was ≤1 h. However, when the interval was >1 h: umbilical vein blood PCO2 was higher; neonatal arterial blood PCO2 was higher; neonatal baseline heart rate was higher, although long‐term variability was similar; the percentage time spent crying was considerably reduced compared with the corresponding values in the control group. The long‐term effects of pethidine are unknown but the adverse neonatal factors particularly if the time interval between administration of the drug and delivery is >1 h should be kept in mind.
Immunoreactive endorphin peptides in amniotic fluid during labour
Authors: RISS PAUL A. , BIEGLMAYER CHRISTIAN
Published: August 2005

Summary. Immunoreactive endorphin peptides (irEP) were measured in term amniotic fluids at induction by amniotomy (n=8), during early and late first stage of labour (n=52), at vaginal delivery (n=30) and at caesarean section (n= 10). Individual values ranged from 50 to 222 pg/ml, but mean values did not differ significantly, and serial determinations revealed that irEP in the amniotic fluid remained almost constant in each woman from the first stage of labour through to delivery. There was no correlation between pathological changes in the cardiotocogram or low umbilical artery pH and irEP levels in the amniotic fluid at vaginal delivery. We conclude that immunoreactive endorphin peptides in the amniotic fluid probably are of fetal or placental origin and do not reflect fetal wellbeing or distress.
Measurement of the motor nerve conduction velocity: precise method of estimating maturity in newborn
Authors: GOESCHEN K. , PLUTA M. , ROTHE J. , SALING E.
Published: August 2005

Summary.During the period from 1 October 1979 to 31 January 1981, 548 estimations of maturity were made on 523 infants at the Department of Medical Obstetrics of the Neukolln Hospital in Berlin, using the motor nerve conduction velocity (NCV) of the ulnar nerve combined with the Farr system. The mean value of the NCV increases from 13.0 m/s in the 33rd week of gestation to 30.4 m/s in the 44th week. Over the whole range the NCV showed a highly significant correlation (r=0.946,P<0.00001) with the gestational age of the infant, whereas the Farr system deviated strongly in a false positive direction up to the 38th week of gestation. The measurement of the NCV of the ulnar nerve is a simple and very precise postpartum estimation of the gestational age.
Changes in plasma vitamin A in lactating and non‐lactating oral contraceptive users
Authors: CUMMING FIONA J. , BRIGGS MICHAEL H.
Published: August 2005

Summary. Plasma vitamin A and retinol‐binding protein (RBP) concentrations have been studied in women using oral contraceptives (OC) for up to 4 years. In eight women taking an oestrogenic OC(1 mg of nor‐ethisterone acetate +50 μg of ethinyloestradiol) values almost doubled within 6 months, but diminished somewhat after 4 years. Saturation of RBP with retinol remained fairly constant. Five lactating women who took pro‐gestogen‐only OC (30 μg of levonorgestrel or 350 μg of norethisterone) showed no significant alteration in plasma vitamin A or RBP concentrations as compared with nine lactating non‐OC users. All lactating women showed significant differences between the highest and lowest plasma vitamin A (P<0.005) and RBP (P<0.05) concentrations during the first 6 months of lactation. Highest values occurred 11–12 weeks post‐partum and the lowest at 15–17 weeks. Percentage saturation of RBP with retinol was significantly higher (P<0.005) when vitamin A concentration was highest.
Tuberculous endometritis: a clinicopathological study of 1000 cases
Authors: BAZAZ‐MALIK GAURI , MAHESHWARI BABU , LAL NEERA
Published: August 2005

Summary. A histopathological diagnosis of tuberculous endometritis was made in 2.3% of 42 770 specimens of non‐pregnant endometrial curet‐tings and biopsies examined in Delhi. A retrospective analysis of the women with tuberculous endometriosis showed that 62% were in their third decade and the commonest presenting symptoms were infertility (47%) and amenorrhoea (26%). Discrete granulomas were seen in 60%. In the absence of a typical granuloma dilatation of glands, active destruction of epithelium and inflammatory exudate in the lumen suggested tubercular aetiology.
Antenatal oestradiol and progesterone concentrations in patients subsequently having preterm labour
Authors: BELL ROBIN
Published: August 2005

Summary. Plasma levels of oestradiol and progesterone were measured in patients with a history of preterm labour but otherwise uncomplicated pregnancies who subsequently had a preterm labour. The plasma hormone levels were found to lie within the normal range, suggesting that the peripheral levels of these hormones do not play a role in the onset of labour before term.
Obstetric characteristics in different racial groups
Authors: TUCK SUSAN M. , CARDOZO LINDA D. , STUDD J. W. W. , GIBB D. M. F. , COOPER D. J.
Published: August 2005

Summary. A detailed analysis of 2632 consecutive pregnancies in white, black and Asian women, who were delivered during the period 1978 to 1980, found significant differences between the three ethnic groups. Asian primiparae had the longest first and second stages of labour, with the highest incidence of prolonged latent phase (14%) and primary dysfunctional labour (30%). Black primiparae and multiparae had the highest incidence of secondary arrest in the first stage of labour (10% and 4% respectively) and of primary dysfunctional labour, with the greatest recourse to emergency caesarean section (13% and 4% respectively). The mean birthweight for singletons born between 37 and 42 weeks was 3.37 kg for white babies, 3.25 kg for black babies and 3.14 kg for Asian babies. There was no racial difference in perinatal mortality or morbidity in this survey.
Cardiotocographic changes after external cephalic version
Authors: HOFMEYR G. JUSTUS , SONNENDECKER ERNST W. W.
Published: August 2005

Summary. Cardiotocographic tracings before and after 53 attempts at external cephalic version (ECV) in 52 patients were analysed. Hexoprenaline (Ipradol) was used to facilitate ECV in 25 of the 53 attempts. There was a significant decrease in fetal movements and fetal heart rate (FHR) variability and reactivity after external cephalic version; temporary baseline bradycardia occurred in five patients. The most likely explanation for the changes observed is that they represent the fetal response to a period of stress caused by decreased uteroplacental blood flow during the procedure.
The use of intravaginal oestrogen cream in genuine stress incontinence
Authors: HILTON P. , STANTON S. L.
Published: August 2005

Summary. Ten women presenting with symptoms of post‐menopausal urogenital oestrogen deficiency, including atrophic vaginal changes and a variety of urinary symptoms, were studied urodynamically and shown to have genuine stress incontinence. Their urethral function was assessed by resting and stress pressure profiles before and after treatment with an intravaginal oestrogen cream. A reduction in the severity of symptoms of stress incontinence, urgency and voiding difficulties was found. No significant changes were induced in the resting urethral pressure profile although the maximum urethral closure pressure on stress was significantly increased as a consequence of improved pressure transmission in mid‐urethra. The distribution of pressure transmission suggests that the effect of oestrogen therapy may be due to improved efficiency of urethral closure by the pelvic floor in response to stress.
The influence of oral contraceptives on activated factor X inhibitor (XaI)‐activity: a prospective study
Authors: BERGQVIST A. , BERGQVIST D. , TANGEN O.
Published: August 2005

Summary. A prospective study of activated factor X inhibitor (XaI) activity has been performed in women randomly allocated to contraceptive pills containing 30μg+150μg (63 women) or 50μg+250μg (44 women) ethinyl oestradiol and levonorgestrel, and a reference group of 35 women using other contraceptive methods. The XaI‐activity was measured six times during 1 year of observation. There was a significant reduction of XaI‐activity after 1 month of oestrogen consumption but there was no significant difference between 30 and 50 μg users. The maximal reduction during the observation period was 12% in both groups. There was positive correlation between the pretreatment value and the maximal reduction in the same patient, but the activity did not fall below the normal range (75–125% of normal human plasma).
Laparoscopic diagnosis of acute pelvic inflammatory disease
Authors: ALLEN LESLIE A. , SCHOON MARTHINUS G.
Published: August 2005

Summary. At Ngwelezana Hospital, 103 patients admitted from the outpatient clinic with a diagnosis of pelvic infection were laparoscoped and in only 63 was the diagnosis confirmed. A disturbingly high incidence of ectopic pregnancy (8 patients) was found.
Studies on the effect of mode of delivery on the renin‐angiotensin system in mother and fetus at term
Authors: TETLOW HAZEL J. , PIPKIN FIONA BROUGHTON
Published: August 2005

Summary. Plasma renin substrate (PRS) and renin (PRC) concentrations were measured in the paired umbilical artery and vein blood of 54 babies and in the venous blood of 23 of their mothers at vaginal delivery. Similar samples were collected from 31 babies and their mothers at elective caesarean section. Fetal renin concentrations in both umbilical artery and vein blood were markedly increased at vaginal delivery compared with values at operative delivery. Renin substrate concentration was correlated with the length of second stage of labour. Umbilical vein PRC and PRS were greater than corresponding umbilical artery values at vaginal, but not at operative delivery, suggesting that some factor associated with delivery might stimulate the placenta to produce renin and renin substrate during vaginal delivery. Maternal and umbilical concentrations of both renin and renin substrate were unrelated, supporting the view that the maternal and fetal compartments are independent. It is suggested that hyperactivity of the renin‐angiotensin system may be an integral part of the marked changes in cardiovascular homeostasis which occur at birth.
Amniotic fluid gel cholinesterase density ratios in fetal open defects of the neural tube and ventral wall
Authors: GOLDFINE CHRISTINA , MILLER WAYNE A. , HADDOW JAMES E.
Published: August 2005

Summary. Densitometry was used to measure gel acetyl‐ and pseudo‐cholinesterase bands in a selection of amniotic fluid samples yielding positive α‐fetoprotein and positive gel acetylcholinesterase results. The samples were associated with the following conditions: 28 anencephaly (10 stained with fetal blood), 20 open spina bifida (3 stained with fetal blood), 10 open ventral‐wall defects (2 stained with fetal blood) and 5 unaffected pregnancies (all stained with fetal blood). In samples not visibly stained with fetal blood, the ratio of the acetylcholinesterase density to the pseudo‐cholinesterase density distinguished between open ventral‐wall defects and open neural‐tube defects: the former group all had values less than 0.13, while the latter all had values greater than that. In amniotic fluid samples which were stained with fetal blood the acetylcholinesterase/pseudo‐cholinesterase ratio did not offer useful diagnostic information; results from unaffected pregnancies overlapped with those from pregnancies with both ventral‐wall defects and open neural‐tube defects.
Epidemiology of group B streptococci: one year's experience in an obstetric and special care baby unit
Authors: EASMON C. S. F. , HASTINGS M. J. G. , BLOWERS ANGELA , BLOXHAM BARBARA , DEELEY JANE , MARWOOD R. , RIVERS R. P. A. , STRINGER JACKIE
Published: August 2005

Summary. The epidemiology of group B streptococci (GBS) was studied in an obstetric unit and the related special care baby unit (SCBU). In 1 year 53 (77%) of 69 babies who acquired GBS from their mothers were colonized within 24 h of birth, compared with only 9 (35%) of 38 who acquired GBS from non‐maternal sources. While 38 (36%) of 107 GBS colonized babies in the obstetric unit derived the organism from a non‐maternal source, the value for the SCBU was only 2 (9%) of 23. In babies rectal and umbilical swabs gave the highest GBS isolation rates. Phage‐typing and serotyping suggested that colonized mother baby pairs, rather than staff, were the primary source of hospital acquired GBS. This mode of GBS acquisition did not result in long‐term carriage once babies had left hospital. Nosocomial transmission can play an important part in GBS epidemiology, but can be minimized by attention to infection control procedures.
Decreased prostacyclin production by placental cells in culture from pregnancies complicated by fetal growth retardation
Authors: JOGEE M. , MYATT L. , ELDER M. G.
Published: August 2005

Summary. Production of prostacyclin (PGI2) in vitro by human placental cells from pregnancies complicated by fetal growth retardation was significantly reduced compared with that in placental cells from normal pregnancies of either matched gestation or at term. This appeared to be due to a reduction of synthesis of PGI2 rather than to any alteration in the rate of its enzymic metabolism. Addition of oestradiol and progesterone increased PGI2 production by cells from pregnancies with fetal growth retardation in a similar manner to that by cells from first trimester pregnancies, implying that the placental cells are not irreversibly damaged by ischaemia. The decreased PGI2 production by cells of trophoblastic origin may be an aetiological factor in the thrombotic occlusion of the uteroplacental circulation which impairs fetal growth.
Iron requirement in normal pregnancy as assessed by serum ferritin, serum transferrin saturation and erythrocyte protoporphyrin determinations
Authors: ROMSLO INGE , HARAM KJELL , SAGEN NORVALD , AUGENSEN KÅRE
Published: August 2005

Summary. Serum iron, serum iron‐binding capacity, serum ferritin and erythrocyte protoporphyrin were determined during uncomplicated pregnancy in 45 healthy women; 22 were given oral iron while the others were given a placebo. When iron was not given, 15 out of 23 women had exhausted iron stores and iron deficiency at term, as judged from low serum ferritin, low serum transferrin saturation and high erythrocyte protoporphyrin values. Only seven of them had a haemoglobin concentration between 10 and 11 g/dl at term but none had values < 10 g/dl. In the iron‐treated group (n=22) none of the women developed iron deficiency. Serum ferritin was the most sensitive and specific test of iron deficiency. A practical procedure to detect iron deficiency and to control iron supplementation in pregnancy is suggested.
Serum protein pattern in normal pregnancy with special reference to acute‐phase reactants
Authors: HARAM KJELL , AUGENSEN KÅRE , ELSAYED SAID
Published: August 2005

Summary. The concentrations of acute‐phase protein reactants, total protein, albumin and globulin fractions were measured throughout normal pregnancy in 27 women. α1‐Antitrypsin and caeruloplasmin concentrations increased gradually to reach their highest levels in the third trimester. Orosomucoid and haptoglobin showed similar patterns: higher levels in the first and third trimester with a decline around 24 weeks gestation. C‐Reactive protein showed levels similar to those of non‐pregnant healthy individuals (< 5 mg/1) throughout pregnancy. α1,‐, α2 and β‐Globulin concentrations increased from the first trimester towards term. γ‐Globulin concentration changed little during gestation. The data obtained provide reference ranges for serum proteins in healthy pregnancy.
Value of Schwangerschaftsprotein 1 (SP1) and pregnancy‐associated plasma protein‐A (PAPP‐A) in the clinical management of threatened abortion
Authors: MASSON GORDON M. , ANTHONY FREDERICK , WILSON MARY S.
Published: August 2005

Summary. Pregnancy‐associated plasma protein‐A (PAPP‐A) and Schwangerschaftsprotein 1 (SP1) levels were measured in single serum samples from 60 patients admitted with vaginal bleeding in the first 14 weeks of pregnancy. When based on ultrasound diagnoses the prediction of non‐viability (the predictive value) was 97% for SP1 and 84% for PAPP‐A. Whereas the prediction of viability (above –2SD of the normal range) with SP1 was 88% the value with PAPP‐A was only 57%; the poorer result obtained with PAPP‐A probably reflects its longer half‐life. Pregnancy outcome is not related to the duration of bleeding.
Use of progestogens as an adjuvant to surgery in the treatment of stage I adenocarcinoma of the uterine corpus
Authors: MOAZZAMI B. , VAN DER WALT J. D. , BOYD N. R. H.
Published: August 2005

Summary. Fifty‐nine patients with proven stage I adenocarcinoma of the uterine corpus were treated by total abdominal hysterectomy and bilateral salpingo‐oophorectomy, followed by gestronal hexanoate intramuscularly for 3 months and then medroxyprogesterone acetate orally for a prolonged period. In the 7‐year period of study, there were no vaginal recurrences, but one patient suffered a recurrence in the inguinal lymph nodes and pelvis. Undesirable side effects did not occur. These results compare favourably with other reported studies in which surgery and radiotherapy were used.
Changes in serum immunoreactive erythropoietin during the menstrual cycle and normal pregnancy
Authors: COTES P. MARY , CANNING CELIA E. , LIND T.
Published: August 2005

Summary. Immunoreactive erythropoietin was estimated in samples of serum collected during the follicular and luteal phases of the menstrual cycle in seven women and in sera collected sequentially throughout normal pregnancy in these and three other women. Estimates of serum erythropoietin during the follicular and luteal phases of the menstrual cycle were almost identical. During pregnancy in all 10 subjects serum erythropoietin increased at some time after 8 weeks gestation. These changes were not related to other endocrine values, to indicators of haematological and renal function or to infant birthweight except that changes in serum erythropoietin and placental lactogen were related (P < 0.00001). In one other woman treated over 17 weeks of pregnancy with continuous intravenous infusion of salbutamol, erythropoietin levels were within the range found in normal pregnancies.
Complex formation of pregnancy‐specific α2–glycoprotein (SP1α) and heparin
Authors: AHMED A. G. , KLOPPER A.
Published: August 2005

Summary. The Schwangerschaftsprotein 1 (SP1,)α values in blood measured by rocket immunoelectrophoresis are affected by the addition of anticoagulants. When compared with values in serum, those in heparin plasma were much higher, while those in sequestrene ethylenediaminetetra acetic acid), sodium citrate and fluoride oxalate were lower. On the other hand, SP1 and SP1β concentrations were not significantly affected in heparin or sequestrene and were only slightly depressed in sodium citrate and flouride oxalate. The effect of heparin on SP1α in serum was dosedependent. We surmise that SP1α forms a complex with heparin and that it may be involved in the coagulation system in pregnancy.
Circulating levels of pregnancy‐associated plasma protein‐A (PAPP‐A) and human chorionic gonadotrophin (hCG) in intrauterine and extrauterine pregnancies
Authors: BISCHOF P. , REYES H. , HERRMANN W. L. , SIZONENKO P. C.
Published: August 2005

Summary. Pregnancy‐associated plasma protein‐A (PAPP‐A) and human chorionic gonadotrophin (hCG) have been measured in the plasma of pregnant and non‐pregnant women attending the outpatient clinic for suspicion of pregnancy. The plasma concentrations obtained were grouped into intrauterine or extrauterine pregnancies and compared with values obtained in non‐pregnant patients with similar periods of amenorrhoea. Patients with ectopic pregnancies had slightly lower PAPP‐A levels and significantly lower hCG concentrations than those in women with normal intrauterine pregnancies. Non‐pregnant women had very low hCG and PAPP‐A levels compared with those in pregnant patients. These data suggest that in patients with extrauterine pregnancies the poorly sustained ectopic trophoblast is unable to produce normal concentrations of hCG and probably PAPP‐A and that the slightly diminished levels of PAPP‐A in ectopic pregnancies might be derived from a decidual production.
A comparison of liver protein induction in postmenopausal women during oral and percutaneous oestrogen replacement therapy
Authors: HOLST J. , CAJANDER S. , CARLSTRÖM K. , DAMBER M.‐G. , von SCHOULTZ B.
Published: August 2005

Summary. Two groups of postmenopausal women with climacteric symptoms were investigated during unopposed cyclic replacement therapy with tablets of micronized 17β‐oestradiol (2 mg daily) and percutaneous 17β‐oestradiol (3 mg daily). The resultant serum levels of 17β‐oestradiol, total oestrone and three liver proteins: sex‐hormone‐binding globulin (SHBG), pregnancy‐zone protein (PZP) and caeruloplasmin were followed. In both groups similar levels of serum 17β‐oestradiol (ca 500 pm) were recorded, while the increase of total oestrone was much more pronounced after oral treatment. During oral therapy the serum levels of all three proteins showed a marked increase after the first cycle and the levels then remained stable. In contrast, protein levels were unchanged during percutaneous treatment, in spite of the highly increased concentrations of circulating oestrogens. This observation is important as several side‐effects of oestrogen therapy may be related to liver function.
Langerhans’cells in human cervical epithelium: an immunohistological study
Authors: MORRIS H. H. B. , GATTER K. C. , STEIN H. , MASON D. Y.
Published: August 2005

Summary. Langerhans’cells are intraepithelial dendritic cells believed to be important in the recognition and processing of exogenous antigens. They were demonstrated by immunohistological methods in cervical tissue obtained from 10 subjects ranging in age from 30 weeks gestational age to 62 years. Langerhans’cells were clearly delineated in all tissue sections and appear to form a relatively constant component of both the transformation zone and ectocervical epithelium. In addition to Langerhans’cells, a population of T lymphocytes characterized as predominantly T‐cytotoxic/suppressor cells have also been demonstrated. The interaction between Langerhans’cells, T lymphocytes and stromal macrophages and their relation to antigen recognition is discussed.
Prognostic significance of herpes simplex virus antibody status in women with cervical intraepithelial neoplasia (CIN)
Authors: COLEMAN D. V. , MORSE A. R. , BECKWITH P. , ANDERSON M. C. , GARDNER S. D. , KNOWLES W. A. , SKINNER G. R. B.
Published: August 2005

Summary. A total of 107 women with abnormal cervical smears showing cytological changes consistent with cervical intraepithelial neoplasia (CIN) 1 or CIN 2 were kept under regular cytological, colposcopic, virological and serological surveillance for an average of 18 months (range 9 months‐3 years). Regression of the cervical lesion was noted in 31 (29%) and progression to CIN 3 in nine women (8.4%). We found a positive correlation between the presence of type 2 antibody and progression of CIN 1 and 2 to CIN 3 and a negative association with the presence of type 1 antibody and suggest the antibody status of a woman with CIN 1 or CIN 2 may provide a useful basis for follow‐up. We found no association between the outcome of the cervical lesion and active infection with herpes simplex or cytomegalovirus or any other infectious agent or sex‐related factors.
Fetal growth achievement and elevated maternal serum α‐fetoprotein
Authors: PURDIE DAVID W. , YOUNG JOHN L. , GUTHRIE KATHERINE A. , PICTON CATHARINE E.
Published: August 2005

Summary. Maternal serum α‐fetoprotein (AFP) was measured by radio‐immunoassay in 7223 unselected patients between 16 and 20 weeks gestation. In 141 patients an elevated AFP level (.2.5 multiples of the median for gestation) was found in the absence of a primary cause. When the birthweights of the 137 liveborn infants were corrected for maternal height and weight, sex and birth rank, 37 (27%) fell below the 10th centile of normal birthweight standards. No excess of premature deliveries was found, but there was a significant association with primiparity. Patients delivered of their second infant showed a significant decrement in mean birthweight when compared with their first‐born infants and with a matched control group (normal maternal serum AFP levels). There was a highly significant association between elevated serum AFP and subsequent placental abruption.
Feto‐maternal haemorrhage as a cause of fetal morbidity and mortality
Authors: FAY ROGER A.
Published: August 2005

Summary. Massive feto‐maternal haemorrhage is a cause of significant fetal morbidity and mortality, but is often overlooked because screening for fetal erythrocytes in the maternal circulation has not been a routine procedure in stillbirths, fetal distress or neonatal anaemia; there are few recognized clinical symptoms or signs, or histopathological features. This report covers three cases. A screening blood test in the last month of pregnancy could be of value in detecting feto‐maternal haemorrhage before irreversible damage to the fetus occurs.
Absence of a factor blocking a cellular cytotoxicity reaction in the serum of women with recurrent abortions
Authors: FIZET D. , BOUSQUET J.
Published: August 2005

Summary. The serum of pregnant women contains a non‐specific immuno‐suppressive factor able to block an in vitro cellular cytotoxicity reaction. This activity increases during the first trimester and persists for 3 months after delivery. The factor is active in dilution. Ten women who had recurrent abortions were typed for HLA antigens and were found to share several antigens with their husband. In all these women, the‘blocking factor’was absent from their serum. The absence of the‘blocking factor’could be used as a clinical test to predict spontaneous abortion.
Tubal mucosa and ectopic pregnancy
Authors: VASQUEZ G. , WINSTON R. M. L. , BROSENS I. A.
Published: August 2005

Summary. Fallopian tubes containing a gestation are frequently normal on macroscopical and gross histological examination. Scanning electron microscopy and light microscopy studies of tubal biopsies taken from five groups of women showed marked differences in the ciliated surface which was measured planimetrically on photographs. The proportion of ciliated cells was significantly lower in biopsies taken from 25 women with tubal pregnancies compared with that in biopsies from seven women with intrauterine pregnancies at the same gestation. Marked deciliation was also seen in eight women biopsied during tubal surgery sometime subsequent to an ectopic pregnancy and in four women biopsied during tubal surgery who subsequently had a tubal pregnancy when compared with a group of women biopsied during tubal sterilization.
Prognostic significance of the new placental proteins in trophoblastic disease
Authors: TSAKOK F. H. M. , KOH S. , CHUA S. E. , RATNAM S. S. , TEISNER B. , JONES G. R. D. , SINOSICH M. , GRUDZINSKAS J. G.
Published: August 2005

Summary. Circulating levels of four specific placental proteins, human chorionic gonadotrophin (hCG), Schwangerschafts protein 1 (SP1), placental protein 5 (PP5) and pregnancy‐associated plasma protein A (PAPP‐A), were measured in 31 patients with hydatidiform mole before treatment. Seven patients subsequently developed clinical chorio‐carcinoma and three of them had pulmonary metastases. The estimations of hCG, PP5 and PAPP‐A levels were found to be of no value in the prediction of malignant sequelae. Levels of SP1≥ 16.5 i.u./l were associated with a higher incidence of subsequent malignant disease (P < 0.05), the risk being at least nine times greater in these patients. The predictive value of high levels of SP1 was 35%, the specificity 45.8% and sensitivity 100%.
Fetal anatomical abnormalities and other associated factors in middle‐trimester abortion and their relevance to patient counselling
Authors: HAXTON M. J. , BELL J.
Published: August 2005

Summary. Fetuses present in 91 consecutive spontaneous or missed middle‐trimester abortions were studied anatomically and tissue karyotyping was attempted. Anatomical abnormalities were found in 32 fetuses, two of these also had chromosomal abnormalities, six of these abortions were associated with other possible aetiological factors. In a further 23 pregnancies there were probably significant aetiological factors associated with the abortion and in 10, where the fetus had arrested growth, there were two with other possible factors. From a prospective analysis of subsequent pregnancies it would appear that if all the factors relating to middle‐trimester abortion, including fetal autopsy, are analysed, better patient counselling and realistic prognoses can be given for subsequent pregnancy.
Problems and pitfalls of risk assessment in antenatal care
Authors: LILFORD R. J. , CHARD T.
Published: August 2005

Summary. Current obstetric risk‐scoring systems do not make a precise prediction of the chances of an abnormal outcome and so cannot be used in formal decision analysis. We examine here the feasibility of using Bayes' theorem to provide an accurate assessment of fetal risk and conclude that two severe limitations effectively exclude this approach as a useful contribution to antenatal care: (1) inaccuracy of .the data base: geographical variations and the ‘treatment paradox’ conspire to reduce the reliability on which any assessment may be made; (2) ‘dependency’ of the risk factors: most obstetric variables are interdependent and are not therefore amenable to analysis by means of Bayes' theorem. Although fetal risk will be assessed subjectively for the foreseeable future, obstetricians should be aware of the essentially mathematical nature of decision‐making.
Maternal blood levels of human placental lactogen in the prediction of fetal growth retardation: choosing a cut‐off point between normal and abnormal
Authors: LILFORD R. J. , OBIEKWE B. C. , CHARD T.
Published: August 2005

Summary. Single estimations of serum human placental lactogen (hPL) were made in 527 unselected women between 36 and 40 weeks gestation. The association between decreased serum levels of hPL and intrauterine growth retardation was confirmed. The effect of changing the cut‐off point between normality and abnormality on the sensitivity, specificity and predictive value was determined. When the 10th centile of hPL values was used, 29% of all growth‐retarded fetuses were identified ard 91% of all ‘normal’ fetuses were excluded. The 15th and 25th centiles yielded improved sensitivities of 37 and 50% respectively, but specificity was reduced. It is suggested that the 10th centile provides a good compromise between sensitivity on the one hand and specificity and predictive value on the other.
Metabolic inactivation of noradrenaline in human placenta, umbilical cord and fetal membranes
Authors: SAARIKOSKI SEPPO
Published: August 2005

Summary. Metabolic inactivation of noradrenaline (NA) was studied in human placenta, umbilical vessels, Wharton's jelly and fetal membranes. Highest degradation capacity was observed in the placenta and fetal membranes, where the NA was inactivated by both monoamine oxidase (MAO) and catechol‐O‐methyltransferase (COMT). No MAO and COMT activity was found in the cord jelly and the activities in umbilical vessels were very low.
Endogenous opioid peptides in pregnancy
Authors: NEWNHAM J. P. , TOMLIN SUSAN , RATTER SALLY J. , BOURNE G. L. , REES LESLEY H.
Published: August 2005

Summary. Plasma levels of two endogenous opioid peptides, β‐endorphin and met‐enkephalin, as well as immunoreactive N‐terminal β‐lipotrophin (N‐LPH) were studied in normal pregnant women from 8 to 41 weeks gestation. A total of 116 samples were assayed for β‐endorphin‐like immunoreactivity (C‐LPH), 103 for N‐LPH and 75 for met‐enkephalin. Plasma β‐endorphin‐like immunoreactivity and N‐LPH levels rose progressively throughout gestation and reached a maximum at term. Plasma met‐enkephalin immunoreactivity did not significantly change throughout pregnancy. These results reflect an increasing and consistent adreno‐corticotrophin (ACTH)/β‐LPH and β‐endorphin secretion throughout pregnancy, while the unchanged met‐enkephalin levels are compatible with its known derivation from a separate precursor system.
Luteinizing hormone releasing hormone analogue in treatment of hypergonadotrophic amenorrhoea
Authors: MENON V. , EDWARDS R. LOGAN , LYNCH S. S. , BUTT W. R.
Published: August 2005

Summary. The effect of a luteinizing hormone releasing hormone analogue (HOE 766) was studied in four patients with hypergonadotrophic amenorrhoea (resistant ovary syndrome). After an initial phase of stimulation, there was a uniform and sustained suppression of gonadotrophin concentrations in all the patients during the 20–24 days of treatment, presumably due to down‐regulation of the pituitary receptors. One patient ovulated after stopping treatment.
Plasma progesterone levels as an index of ovulation
Authors: ABDULLA U. , DIVER M. J. , HIPKIN L. J. , DAVIS J. C.
Published: August 2005

Summary. Plasma progesterone levels were measured in three groups of untreated women. (1) Nine women with follicle rupture, proved by laparotomy or laparoscopy, had values of ≥40 nmol/l on days 18–24 (days −10—5 from the next period); thus a value of <40 nmol/1 should not be taken as evidence of ovulation. (2) Nineteen healthy women with normal menstrual histories had hormone assays on alternate days during one cycle. In five of them all values were <38 nmol/1. (3) Forty women had a single progesterone assay on days 20–29 of a conceptual cycle. Eight of them had a level <40 nmol/l. Ovulation had certainly occurred in all of them, but it is difficult to assess whether the sample timing was optimal since there was no following menstrual period. Progesterone levels in drug‐induced conceptual cycles were in general higher than those in spontaneous pregnancy cycles. Women with luteinization of the unruptured follicle frequently had values of >40 nmol/l. Conversely, a secretory endometrium was not uncommon in cycles with values of <38 nmol/l.
Mullerian mixed tumour of the uterine corpus: a clinical histopathological review of 28 patients
Authors: SHAW R. W. , LYNCH P. F. , WADE‐EVANS T.
Published: August 2005

Summary. Clinical and histopathological features of 28 patients with Mullerian mixed tumours of the uterine corpus presenting to the Birmingham and Midland Hospital for Women between 1972 and 1977 are reviewed. The 5‐year survival value for this group of patients was 25% with 53.5% of patients dying within 12 months of diagnosis. The most important rinding of prognostic value was the extent of the tumour at the time of diagnosis and where this was localized to the uterus, there was a 50% 5‐year survival. The presence of specific types of heterotopic elements or numbers of mitotic elements were not correlated with outcome. Five patients had previously received radium for induction of a radiation menopause and the relevance of this treatment and other factors in the aetiology of the tumour are discussed.
Menstrual blood loss in dysmenorrhoea: effects of proquazone and indomethacin
Authors: MÄKÄRÄINEN LEO , YLIKORKALA OLAVI
Published: August 2005

Summary. Abnormal production of uterine prostaglandins (PG) causes primary dysmenorrhoea and excessive menstrual blood loss (MBL). We measured here MBL in primary dysmenorrhoea and found it to be normal during treatment with opiate analgesics (33.5±1.6 ml; mean±D, n=13), placebo (33.4±18.6 ml; n=8), proquazone (31.8±18.0ml; n=8) and indomethacin (26.4±18.7 ml; n=8). Proquazone and indomethacin relieved pain and other dysmenorrhoeic symptoms similarly in 33 women.
Some new aspects of the endocrinological response to pregnancy
Authors: ASPILLAGA M. O. , WHITTAKER P. G. , TAYLOR A. , LIND T.
Published: August 2005

Summary. Serial measurements of serum progesterone, oestradiol, prolactin, human chorionic gonadotrophin (hCG) and human placental lactogen (hPL) have been determined in 32 healthy women at regular intervals throughout pregnancy. The data confirm previous reports that levels of these hormones vary widely between individuals at each stage of gestation, but further analyses have shown two other features: first there is a clear tendency for individuals to retain their rank in the spectrum of hormone values throughout pregnancy; second when the concentrations of the individual hormones (except hCG) are transformed to logarithmic values, the trends within individuals approximate well to straight lines during the second and third trimester of pregnancy. These findings provide a relatively simple method for describing the rates of change in the concentrations of these hormones and for examining possible relations between them. They also suggest that the quality of the maternal endocrine milieu may be determined at an early stage of gestation.
Diagnosis of early pregnancy by assay of placental proteins
Authors: AHMED A. G. , KLOPPER A.
Published: August 2005

Summary. The plasma concentrations of Schwangerschaftsprotein 1 (SP1) and human chorionic gonadotrophin (hCG) were measured in 22 women before and after conception. In these pregnancies ovulation occurred spontaneously in seven subjects, or followed treatment with either clomiphene citrate (6 subjects), or human menopausal gonadotrophin (hMG) and hCG (6 subjects). The remaining three patients became pregnant after artificial insemination with donor semen. Seventeen of these pregnancies were normal and five were abnormal (3 abortions, 1 ectopic and 1 twin). SP1 could be detected 6–14 days after ovulation in all these patients. In contrast 40 non‐pregnant women gave a negative test for SP1.