bluuebunny/crossref_metadata_2025 huggingface dataset:
FACTOR VIII RELATED ANTIGEN/COAGULANT ACTIVITY RATIO AS A PREDICTOR OF FETAL GROWTH RETARDATION: A COMPARISON WITH HORMONE AND URIC ACID MEASUREMENTS
Authors: Whigham Kathryn A. E. , Howie P. W. , Shah M. M. , Prentice C. R. M.
Published: August 2005

Factor VIII related antigen (VIIIRAg), Factor VIII coagulant activity (VIIIC), plasma uric acid, total plasma oestriol, plasma human placental lactogen (hPL) and urine oestrogen/creatinine ratio were measured in a group of 21 patients clinically suspected of fetal growth retardation and compared with normal pregnancy. Of the hormone assays, hPL was better than either oestriol or oestrogen/creatinine ratio at distinguishing between normal and growth retarded pregnancies. Uric acid levels tended to be higher than normal in patients with fetal growth retardation, but the best means of distinguishing normal from growth retarded pregnancies proved to be the VIIIRAg/VIIIC ratio. This ratio was significantly elevated in fetal growth retardation compared with normal pregnancy, and the increase was evident as early as 30 weeks gestation. Using the VIIIRAg/VIIIC ratio test, the outcome of 17 of the 21 suspect pregnancies could be correctly predicted.
MANAGEMENT OF PATIENTS WITH A LIVE FETUS AND CESSATION OF FETAL MOVEMENTS
Authors: Homburg R. , Matzkel A. , Birger M. , Insler V.
Published: August 2005

Sixty‐seven patients with a history of no fetal movements for at least 12 hours and a live fetus were managed according to a fixed protocol. Twelve of these patients were found to have meconium‐stained amniotic fluid and/or abnormal unstressed or oxytocin‐stressed cardiotocograms; all of them were delivered within 24 hours of a live infant. The remaining 55 patients had no meconium and normal unstressed and stressed cardiotocograms, and their pregnancy was allowed to continue. All felt fetal movements again and were delivered of live babies one to ten weeks later.
AN ANALYSIS OF THE FACTORS ASSOCIATED WITH RESPIRATORY DISTRESS SYNDROME IN PREMATURE INFANTS WHOSE MOTHERS HAD BEEN GIVEN DEXAMETHASONE THERAPY
Authors: Caspi E. , Schreyer P. , Reif R. , Goldberg M.
Published: August 2005

The incidence of respiratory distress syndrome (RDS) in 259 premature infants whose 218 mothers had received antepartum dexamethasone therapy was 8·9 per cent. The main characteristics of those infants who developed RDS were a shorter gestational age and a lower Apgar score at delivery: all were delivered before 35 weeks gestation, and those with Apgar scores below 7 had a significantly higher incidence of RDS. The incidence of RDS in vaginal breech deliveries (15·4 per cent), Caesarean sections (14·6 per cent), and multiple births (16·0 per cent) was higher than in vaginal vertex deliveries (6·8 per cent), and in singletons (6·0 per cent). The use of isoxsuprine and the length of time membranes were ruptured before delivery were unrelated to the incidence of RDS. The results of this study suggest that while maternal glucocorticoid administration is an important ancillary to the prevention of RDS in premature infants it cannot substitute for optimal delivery conditions.
RAISED MATERNAL SERUM AND AMNIOTIC FLUID ALPHA‐FETOPROTEIN LEVELS ASSOCIATED WITH A PLACENTAL HAEMANGIOMA CASE REPORT
Authors: Schnittger A. , Liedgren S. , Rådberg C. , Johansson S. G. O. , Kjessler B.
Published: August 2005

We report a patient who had raised serum and amniotic fluid alpha‐fetoprotein levels at 16 weeks gestation. Ultrasonography revealed an apparently normal fetus and amniography displayed a soft tissue tumor in front of the fetus. The tumor turned out to be a placental haemangioma, when an apparently healthy girl weighing 2·88 kg was born at term.
BURKITT'S LYMPHOMA OF THE VULVA CASE REPORT
Authors: Egwuatu V. E. , Ejeckam G. C. , Okaro J. M.
Published: August 2005

A 13‐year‐old Nigerian girl with Burkitt‐type metastatic malignant lymphoma of the vulva is presented. Diagnosis and treatment are discussed and the literature is reviewed.
ORAL CONTRACEPTION AND CONGENITAL ABNORMALITIES
Authors: Kasan Pravin N. , Andrews Joan
Published: August 2005

Of 10 479 single births in South Glamorgan between January 1974 and June 1976, 27·3 per cent of infants were born to women who had used oral contraception in the three months prior to their last menstrual period (users) and 72·3 per cent were born to women who had not used oral contraception during the same period (non users). There were significantly more infants with neural tube defects among users compared with non users. Abnormalities of the digestive, genito‐urinary and cardiovascular systems, bones, muscle, skin and connective tissues, endocrine glands, blood, chromosomes and oral clefts, were of similar incidence in the two groups.
ANTEPARTUM FETAL HEART RATE MONITORING IN MULTIPLE PREGNANCY
Authors: Bailey Dorothy , Flynn Anna M. , Kelly J. , O'Conor Maria
Published: August 2005

The assessment of fetal wellbeing in patients with multiple pregnancy by non‐stressed antepartum cardiotocography is technically feasible and of clinical value. In 50 patients (101 babies) who were monitored during the antepartum period, there were five patients in whom one of a pair of twins showed a non‐reactive cardiotogram. Four of these babies died (two intrauterine deaths and two neonatal deaths). All of these five babies were growth retarded at birth. The cardiotocograms from the other 96 fetuses were ‘reactive’ and these babies were normal. Cardiotocography seems to be a better predictor of perinatal mortality and morbidity than serial urinary oestrogens or serial biparietal diameter measurements in multiple pregnancy.
BIRTH WEIGHT OF INFANTS WITH SPINA BIFIDA CYSTICA
Authors: Wald N. J. , Cuckle H. S. , Boreham Jillian , Althouse R.
Published: August 2005

The mean birth weight of 189 singleton infants with spina bifida cystica (including 21 with encephalocele) was statistically significantly less than the mean birth weight of 3816 singleton infants without neural tube defects, 0·20 kg less among male infants and 0·24 kg less among female infants. Most, if not all, of this difference in birth weight was due to the spina bifida infants being light for their gestational age. The difference could not be explained by differences in parity or social class.
PLASMA VOLUME CHANGES IN PREGNANCY IN INDIAN AND EUROPEAN PRIMIGRAVIDAS
Authors: Hutchins C. J.
Published: August 2005

Serial measurements of plasma volume were made in 60 normal healthy primigravidae, 30 of European and 30 of Indian origin, matched for age. Recordings were made at 16, 22, 28, 34 and 38 weeks gestation using the Evan's blue dye dilution technique with the women lying on their sides. A progressive increase in volume was demonstrated to a plateau between 34 and 38 weeks. The plasma volume of the European group was significantly higher at all stages. There was a significant difference in body size between the groups, and European infants had a higher mean birth weight. When plasma volume was expressed in terms of body weight, both groups gave identical results throughout pregnancy. It is unlikely that there is a constant physiological difference between the two groups that might account for differing obstetric performance.
URINARY EXCRETION OF OESTRIOL AND PLASMA LEVELS OF UNCONJUGATED AND TOTAL OESTRIOL DURING LATE UNCOMPLICATED PREGNANCY
Authors: Carlström K. , Llndberg B. S.
Published: August 2005

Plasma levels of unconjugated and total oestriol and urinary excretion of oestriol were measured in ten healthy women with uncomplicated pregnancy and with normal renal function. A significant correlation between plasma total oestriol and urinary oestriol was found in five out of ten patients and between plasma total and unconjugated oestriol in only four out of ten patients. When the data from the ten patients were combined there were significant correlations between urinary oestriol and the two plasma oestriol species as well as between plasma unconjugated and total oestriol. The mean urinary oestriol excretion correlated significantly with the mean urine volume. No significant correlation was found in the individual subjects between oestriol clearance and creatinine clearance, but the combined data from the ten patients yielded a highly significant correlation. The differences within or between days was highest for plasma unconjugated oestriol and lowest for urinary oestriol/mmol of creatinine. Over a three to four day period, a drop of 20 per cent in urinary oestriol/mmol of creatinine, 25 per cent in urinary oestriol/24 hours, 35 per cent in plasma total oestriol and 40 per cent in plasma unconjugated oestriol do not necessarily indicate fetal danger.
CURE OF POSTPARTUM HYPERPROLACTINAEMIA GALACTORRHOEA‐AMENORRHOEA BY REMOVAL OF BENIGN OVARIAN TERATOMA
Authors: Wahba M. H.
Published: August 2005

Two multiparous patients were cured of hyperprolactinaemia with galactorrhoea and amenorrhoea by surgical removal of a benign ovarian teratoma. No unusual endocrine tissue was found in the wall of the ovarian tumours.
SERIAL CHANGES IN RENAL HAEMODYNAMICS DURING NORMAL HUMAN PREGNANCY
Authors: Dunlop W.
Published: August 2005

Effective renal plasma flow (ERPF) and glomerular filtration rate (GFR) were determined at constant intervals during and after the normal pregnancies in 25 healthy women. Compared with non‐pregnant values, ERPF increased by 80 per cent during early pregnancy but fell significantly from this new level during the third trimester. GFR, however, remained at a level 50 per cent above the non‐pregnant throughout pregnancy. Filtration fraction (GFR/ERPF) was significantly reduced during early pregnancy but rose to a value equivalent to the non‐pregnant during the third trimester. Comparable data of previous workers are re‐interpreted.
SERIAL CHANGES IN 24 HOUR CREATININE CLEARANCE DURING NORMAL MENSTRUAL CYCLES AND THE FIRST TRIMESTER OF PREGNANCY
Authors: Davison J. M. , Noble M. C. B.
Published: August 2005

Serial changes in 24‐hour creatinine clearance were determined in 11 women during several menstrual cycles before conception, the conceptional cycle and the first trimester of pregnancy. During the menstrual cycle, a 20 per cent mean increase occurred between the week of menstruation and the late luteal phase. Following conception, this increase continued such that a 45 per cent mean increase was evident by the ninth week of gestation. In two women who aborted spontaneously, the change in 24‐hour creatinine clearance in early pregnancy was not as great nor as sustained, this feature being apparent at least three weeks before any clinical abnormality. Possible reasons for the changes in glomerular filtration rate in early pregnancy and its clinical implications are discussed.
OBSERVATIONS ON THE VITAMIN D STATE OF PREGNANT ASIAN WOMEN IN LONDON
Authors: Brooke O.G. , Brown I. R. F. , Cleeve H. J. W. , Sood Anita
Published: August 2005

Vitamin D nutrition in pregnancy was investigated in 115 Asian women living in London, and in 50 of their newborn infants. Mean serum 25‐hydroxy cholecalciferal (25‐OHD) concentration at the beginning of the last trimester was 20.2 nmol/1, and fell to 16.0 nmol/1 post partum. Thirty‐six per cent of the women post partum and 32 per cent of the infants had undetectable 25‐OHD concentrations (<3 nmol/1). Such low values are commonly associated with osteomalacia and rickets. The bone isoenzyme of alkaline phosphatase was elevated in 20 per cent of the women post partum, and in 50 per cent of the infants, indicating the presence of sub‐clinical bone disease. Five infants had symptomatic hypocalcaemia. Vitamin D deficiency was most likely to occur in Pakistanis, Hindu Indians and East African Asians, and in vegetarians. All British Asians should receive supplementary Vitamin D during pregnancy.
THE EFFECT OF CARCINOMA OF THE CERVIX ON THE L‐LACTATE‐NICOTINAMIDE‐ADENINEDINUCLEOTIDE OXIDOREDUCTASE ACTIVITY IN VAGINAL ASPIRATES
Authors: Emes A. V. , Latner A. L. , Guthrie D. , Philips P. R. , Way S. A.
Published: August 2005

Lactate dehydrogenase (L‐lactate‐NAD+ oxidoreductase; EC 1. 1. 1. 27) has been assayed in saline extracts of vaginal aspirates obtained from patients with carcinoma in situ and from patients with clinically detectable invasive carcinoma of the cervix. Taking premenopausal and postmenopausal patients separately, significant differences were found between the aspirate lactate dehydrogenase activities obtained from patients with carcinoma in situ and the activities obtained from patients with invasive carcinoma; generally higher activities were obtained from the latter. With the exception of postmenopausal patients with carcinoma in situ, aspirate enzyme activities obtained from both groups of patients were significantly different from those obtained from normal women. Significantly higher lactate dehydrogenase activity was found in aspirates from patients for whom histology showed the presence of an adenocarcinoma or certain highly malignant cell types. Treatment by radium insertion usually resulted in a fall in total lactate dehydrogenase activity. Significant differences between patient groups were found for the proportions of single lactate dehydrogenase isoenzymes in a few instances but no significant difference in overall isoenzyme distribution was found.
DETECTION OF URINARY INCONTINENCE
Authors: Robinson Heather , Stanton S. L.
Published: August 2005

Thirty patients complaining of stress incontinence were investigated by clinical examination, videocystourethrography and Urilos device. The latter was the most effective method of confirming the history. Standing and lying made no difference to detection of incontinence on clinical examination. A scheme for use of these investigations was proposed.
THE USE OF A BETA‐SYMPATHOMIMETIC DRUG IN LOCKED TWINS
Authors: Sevitz H. , Merrell D. A.
Published: August 2005

Locked twins were born vaginally after hexoprenaline sulphate, a β‐sympathomimetic drug, had been used to relax the uterus so that the fetal heads could be disimpacted.
PREDICTION OF SMALL‐FOR‐DATES INFANTS BY MEASUREMENT OF SYMPHYSIAL‐FUNDAL‐HEIGHT
Authors: Quaranta P. , Currell R. , Redman C. W. G. , Robinson J. S.
Published: August 2005

A standard chart of symphysial‐fundal height from 20 to 40 weeks of pregnancy was derived from measurements in 103 women who were delivered of infants weighing between the 25th and 90th centile for gestation. The chart was used to predict birth weight in a group of 138 high‐risk patients. Thirty (73.1 per cent) of 41 infants with birth weight for gestation less than 10th centile could be detected by this one clinical measurement. A single measurement was most accurate for detecting low birth weight for gestation at 32 to 33 weeks. It is suggested that symphysial‐fundal height measurements should be made routinely on all antenatal patients and that each obstetric unit should derive its own standard curves.
PLACENTAL TRANSFER OF CEFUROXIME
Authors: Craft I. , Mullinger Brenda M. , Kennedy Margaret R. K.
Published: August 2005

The transfer of cefuroxime across the placenta was studied in 10 women in labour and 12 women being delivered by Caesarean section. Following a single intramuscular injection of 750 mg cefuroxime, high antibiotic concentrations were found in the amniotic fluid in women in labour; the peak concentration of 18 mg/1 was achieved after five hours. Therapeutic concentrations of cefuroxime were present in umbilical vein serum for up to eight hours after injection. A similar pharmacokinetic picture was observed in the women undergoing Caesarean section although in the limited time interval (up to four hours) between injection and delivery the amniotic fluid levels of cefuroxime achieved were lower. Cefuroxime appears to cross the placenta well to produce effective concentrations in fetal blood and amniotic fluid.
CEFUROXIME: POTENTIAL USE IN PREGNANT WOMEN AT TERM
Authors: Bousfield P. , Browning A. K. , Mullinger Brenda M. , Elstein M.
Published: August 2005

The placental transfer of cefuroxime was studied in 20 women after one or more 1.5 g intravenous injections. Ten women had labour induced at term and ten were delivered by elective Caesarean section. High concentrations of cefuroxime were found in the cord blood and amniotic fluid and therapeutically active antibiotic levels were found in the infants for up to six hours after delivery.
A COMPARISON OF SERUM OESTROGEN LEVELS AFTER PERCUTANEOUS AND ORAL ADMINISTRATION OF OESTRADIOL‐17β
Authors: Lyrenäs S. , Carlström K. , Bäckström T. , von Schoultz Bo
Published: August 2005

Equivalent doses of oestradiol‐17β were given orally and percutaneously to eight post‐menopausal women and three men. The resultant serum levels of unconjugated immunoreactive oestrogens and total oestrone were followed during 48 hours after hormone administration. A single percutaneous dose of 4 mg oestradiol‐17β resulted in increased serum levels of oestradiol‐17β in all individuals. Compared to oral administration the increase in serum oestrogen levels was quite slow and they were maintained for 48 hours. In contrast to the rapid and very marked increase in serum total oestrone following oral administration of oestradiol‐17β, only a moderate increase was obtained after percutaneous administration and there was a tendency to a biphasic pattern. Topical administration of oestradiol‐17β might have physiological advantages as the steroid will reach the peripheral circulation without passing the entero‐hepatic circulation.
THE OBSTETRIC OUTCOME OF TEENAGE PREGNANCY
Authors: Osbourne G. K. , Howat R. C. L. , Jordan M. M.
Published: August 2005

A retrospective case record analysis of the obstetric outcome in 715 consecutive teenage primigravidae was performed. They were late in booking for hospital confinement and were frequently unsure of their expected date of delivery; 82 per cent were unmarried before conception. When compared with primigravidae aged 20 to 24 years, anaemia was the only antenatal complication that was significantly increased. There was no evidence of an increased obstetric risk in the teenage women as a group but those who remained single showed significantly higher rates of premature labour and perinatal mortality when compared with the married women and appear to constitute an at risk group.
CHANGES IN SERUM BILE ACID CONCENTRATIONS DURING NORMAL PREGNANCY, IN PATIENTS WITH INTRAHEPATIC CHOLESTASIS OF PREGNANCY AND IN PREGNANT WOMEN WITH ITCHING
Authors: Heikkinen J. , Mäentausta O. , Ylöstalo P. , Jänne O.
Published: August 2005

Two primary bile acids, cholic acid (CA) and chenodeoxycholic acid (CDCA), and one secondary bile acid, deoxycholic acid (DCA), were measured by radioimmuno‐assay in pregnancy serum from 30 healthy women, 49 women with itching and 45 with intrahepatic cholestasis of pregnancy. All subjects were studied serially from between 16 and 20 weeks gestation until 35–60 days post partum. In healthy pregnant women, serum CA and DCA levels did not change significantly at any time. The mean CDCA level rose significantly towards term. In women with intrahepatic cholestasis, serum levels of CA and CDCA were increased ten‐ and five‐fold, respectively, at the time of appearance of clinical Symptoms and the CA/CDCA ratio rose from l/l to 2/1; there was also a moderate increase in the serum concentration of DCA. In 4 of 8 women studied prospectively an increase in serum bile acid levels preceded the appearance of Symptoms or other laboratory evidence of intrahepatic cholestasis. Nine of the women with itching with normal routine liver function test results had increases in serum CA and CDCA concen‐trations suggesting mild cholestasis.
FETAL POSITION AND SKULL SHAPE
Authors: Sunderland R.
Published: August 2005

The skull shapes of 615 consecutively born babies weighing over 2500 g were examined visually and by palpation. A characteristic deformity of the occiput was found which was strongly associated with breech presentation; it is suggested that this be termed hyptiocephaly. Severe forms of hyptiocephaly might partially explain the high incidence of occipital osteodiastasis in breech babies. A lesser occipital deformity was associated with occipito‐posterior presentation. It was found that facial asymmetry declined with increasing parity. Statistical trends suggest that all of these abnormalities of skull shape are the effect, rather than the cause, of the abnormal fetal position.
ORIGIN OF AMNIOTIC FLUID CELLS IN MID‐TRIMESTER PREGNANCIES
Authors: Tydén O. , Bergström S. , Nilsson B. A.
Published: August 2005

Amniotic fluid cells provide important information about the fetus. Studies of the surface ultrastructure of such cells identified four cell populations in midgestational fluids. A parallel study of tissue surfaces in contact with or communicating with the amniotic fluid showed that some tissues made no contribution to the cell populations, while others contributed extensively. Two principal cell shedding mechanisms were found in mid‐trimester—exfoliation of whole cells and detachment of cellular fragments. The latter mechanism was observed from skin and umbilical cords during a limited period in mid‐pregnancy. The majority of cells were derived from exfoliation of squamous epithelia.
IMMUNOFLUORESCENT STUDIES OF THE UTEROPLACENTAL ARTERIES IN NORMAL PREGNANCY
Authors: Weir P. E.
Published: August 2005

Immunofluorescent studies were performed on placental bed biopsies from 27 normal pregnancies. Uteroplacental arteries were present in 26 of the 27 biopsies and all showed deposition of fibrin in relation to the fibrinoid layer within the vessel wall; 12 also showed deposition of C3. Interstitial fibrinoid deposits also stained positively with fibrin. There was no deposition of immunoglobulins within the arterial changes nor in association with intramural or interstitial trophoblast. This study indicates that fibrin is a significant contributor to the fibrinoid layer within the Uteroplacental arteries, and suggests that the presence of bound C3 is due to the activation of the complement system by fibrinogenesis. There was no evidence that the humoral immune response was involved in the aetiology of the physiological changes in the Uteroplacental arteries.
THE EFFECTS OF PROTAMINE ON SERUM LEVELS OF PLACENTAL PROTEIN 5 (PP5) IN NORMAL AND ABNORMAL PREGNANCY: A POSSIBLE RELATION TO COAGULATION ABNORMALITIES
Authors: Salem H. T. , Seppälä M. , Ranta T. , Bohn H. , Chard T.
Published: August 2005

The levels of placental protein 5 (PP5) in pregnancy serum show an apparent increase after the addition of protamine sulphate. The difference of the apparent concentrations of serum PP5 in the presence and absence of protamine (ΔPP5) was determined in 345 normal and abnormal pregnancies. A positive ΔPP5 was less frequent in diabetic pregnancy (45 per cent) and pre‐eclampsia (57 per cent) than in normal pregnancy (80 per cent). These findings provide further evidence that PP5 may be involved in the coagulation system, and in particular may relate to abnormal coagulation processes at the placental site.
RAISED HYPOXANTHINE, XANTHINE AND URIDINE CONCENTRATIONS IN MECONIUM STAINED AMNIOTIC FLUID AND DURING LABOUR
Authors: O'Connor M. C. , Harkness R. A. , Simmonds R. J. , Hytten F. E.
Published: August 2005

Amniotic fluid samples were obtained at induction of labour in 64 women; in 15 of these there was meconium staining of the amniotic fluid; the remainder showed no signs of fetal distress. Using high pressure liquid chromatography, compared to the samples from normal patients there were highly significantly raised levels of hypo‐xanthine, xanthine and uridine in the meconium stained samples; oxypurines in the meconium itself could not explain the difference. Where serial samples were obtained during labour by intrauterine catheter, a terminal rise in oxypurine levels was apparent. Where the proportion of oxypurine present as hypoxanthine exceeded one per cent in amniotic fluid at the time of induction, there was a significantly greater occurrence of late fetal heart rate decelerations in the ensuing labour. These findings are consistent with other evidence that when tissues become hypoxic the metabolic products of nucleotide breakdown escape from the cells and appear in extracellular fluid. Oxygen lack in the fetus probably causes loss of these compounds from the hypoxic kidneys to the urine so that they appear in amniotic fluid.
SIMPLIFIED ANTEPARTUM FETAL HEART ASSESSMENT
Authors: Baskett T. F. , Boyce C. D. , Lohre M. A. , Manning F. A.
Published: August 2005

Antepartum fetal heart rate monitoring based on the association of fetal heart rate accelerations with fetal movements (non‐stress test) is a standard method for fetal surveillance. Application of this ‐method requires a continuous fetal heart rate recording monitor. Audible detection of heart rate accelerations was compared with recorded accelerations in 100 tests. A listening observer detected 77–7 per cent of all accelerations with an amplitude of at least 15 beats/minute. This allowed the detection of 94.2 per cent (82 out of 87) reactive non‐stress tests. In no case was a non‐reactive test called falsely reactive by the listening observer. This method may be useful for assessing fetal condition when continuous fetal heart rate monitors are not available.
THE INFLUENCE OF MATERNAL ANALGESIA ON NEONATAL BEHAVIOUR: I. PETHIDINE
Authors: Belsey Elizabeth M. , Rosenblatt Deborah B. , Lieberman B. A. , Redshaw Margaret , Caldwell J. , Notarianni Lidia , Smith R. L. , Beard R. W.
Published: August 2005

Neonatal behaviour in a group of infants whose mothers received pethidine during labour was assessed at delivery and during the first six weeks of life by means of the Brazelton Neonatal Behavioural Assessment Scale. The influence of the total maternal dose of pethidine and umbilical cord blood concentration of the drug on such behaviour has been examined with the confounding effects of all other variables controlled. Higher cord blood levels of pethidine were associated with babies who were more prone to respiratory difficulties, drowsy and unresponsive immediately after delivery. Throughout the six weeks in which the assessments were made, depressed attention and social responsiveness were found in infants with high drug levels. At three and six weeks, the infant whose exposure to pethidine had been high tended to change state more frequently, to cry during the test and to be less capable of quieting himself. These findings suggest that the newborn infant responds to pethidine in the same way as the adult, but the changes observed were relatively subtle, and comparison of these infants with a control group whose mothers had received no drugs revealed no between‐group differences in behaviour.
THE INFLUENCE OF MATERNAL ANALGESIA ON NEONATAL BEHAVIOUR: II. EPIDURAL BUPIVACAINE
Authors: Rosenblatt Deborah B. , Belsey Elizabeth M. , Lieberman B. A. , Redshaw Margaret , Caldwell J. , Notarianni Lidia , Smith R. L. , Beard R. W.
Published: August 2005

Four areas of neonatal behaviour have been assessed at delivery and during the following six weeks in a group of infants whose mothers were given epidural bupivacaine during labour. The influence on such behaviour of the total maternal dose of bupivacaine and umbilical cord blood concentration of the drug has been examined with the confounding effects of other maternal and obstetric variables controlled. Significant and consistent effects of bupivacaine throughout the assessment period can be demonstrated. Immediately after delivery, infants with greater exposure to bupivacaine in utero were more likely to be cyanotic and unresponsive to their surroundings. Visual skills and alertness decreased significantly with increases in the cord blood concentration of bupivacaine, particularly on the first day of life but also throughout the next six weeks. Adverse effects of bupivacaine levels on the infant's motor organisation, his ability to control his own state of consciousness and his physiological response to stress were also observed. Muscle tone alone appeared to improve with increases in the values of the drug variables. These results show that the neonate differs from the adult in respect of both the nature of effects of the drug and sensitivity to it.
ISOLATED DEFECT IN HUMAN PLACENTAL LACTOGEN SYNTHESIS IN A NORMAL PREGNANCY
Authors: Borody I. B. , Carlton M. A.
Published: August 2005

A deficiency in the synthesis of human placental lactogen (hPL) was found in a woman in her second pregnancy. Other placental hormone levels were normal. The woman gave birth to a healthy female infant. hPL deficiency is rare and a survey of the literature has revealed only one previous case report which described the birth of a male infant. The present report of a hPL deficiency is the first associated with the birth of a normal female infant.
PLASMA OSMOLALITY AND URINARY CONCENTRATION AND DILUTION DURING AND AFTER PREGNANCY: EVIDENCE THAT LATERAL RECUMBENCY INHIBITS MAXIMAL URINARY CONCENTRATING ABILITY
Authors: Davison J. M. , Vallotton M. B. , Lindheimer M. D.
Published: August 2005

In nine women studied serially before conception and through the first trimester, plasma osmolality (Posm) started to decline with the first missed menstrual period, was significantly decreased by the fifth week of pregnancy and was 10 mosmol/kg lower than preconception values by the tenth week, changing little thereafter. Changes in plasma sodium (and its attendant anion) accounted for the majority of the decrement. In separate studies, urinary concentration and dilution, assessed by water deprivation and loading, were studied in nine women during their last trimester and again 10–12 weeks post partum. Basal Posm was 9 mosmol/kg lower in the last trimester than post partum (p < 0.001) but the results of concentration and dilution tests were similar during and after pregnancy. Basal urinary arginine vasopressin (AVP) excretion was similar during and after pregnancy and water loading suppressed AVP excretion in both pregnant and postpartum women. An unanticipated observation was that lateral recumbency interfered with urinary concentration tests in both pregnant and postpartum women. The results demonstrate that the decrement in Posm during pregnancy is an early event. The data (urinary AVP excretion, its suppression by water loading and normal concentration and dilution despite a lower plasma tonicity) also suggest that human pregnancy is accompanied by a resetting of the threshold for vasopressin secretion to a lower Posm
SUBCUTANEOUS OXYGEN TENSION IN THE FETAL SCALP DURING LABOUR CONTINUOUS MONITORING WITH A NEEDLE ELECTRODE
Authors: Aarnoudse J. G. , Huisjes H. J. , Oeseburg B. , Zijlstra W. G.
Published: August 2005

Continuous intrapartum PO2 recordings were made in 25 fetuses, using a needle electrode that measures PO2 in the subcutaneous (sc) tissue of the scalp or the breech. This small electrode is combined with a spiral ECG electrode and can be easily applied in early labour. One hour after application of the electrode in the early first stage, a mean fetal scPO2 of 29.4±7.5 mm Hg was found. In the course of labour, scPO2 gradually fell to a mean value of 22.2±5.6 mm Hg, recorded just before the onset of bearing down contractions, and stabilised in the second stage of labour. ScPO2 values of less than 10 mm Hg were not recorded for a longer period except in one case of severe fetal distress. The relation between scPO2 just before delivery and cord arterial PO2 revealed a coefficient of correlation of 0.85. In general, scPO2 appeared higher than tcPO2 as described in the literature. This is ascribed to the different technique of measurement: the needle electrode measures in the deeper layers of the scalp, whereas the tc electrode is supplied with oxygen from the more superficial capillaries, where blood flow is more liable to be affected by mechanical factors.
INTESTINAL ATRESIA CAUSED BY SECOND TRIMESTER AMNIOCENTESIS
Authors: Therkelsen A. J. , Rehder H.
Published: August 2005

In an amniotic fluid sample obtained by mid‐trimester amniocentesis a string of fetal mucosa and submucosa from the small intestine was found. The fetus was aborted 21 days after the amniocentesis. There was no lesion of the abdominal wall, but an ileal atresia, fibrous adhesions, bilateral hydronephrosis and kinked ureters were found at autopsy.
PREMATURE OVARIAN FAILURE ASSOCIATED WITH THE CANDIDA ENDOCRINOPATHY SYNDROME CASE REPORT
Authors: Dempsey A. T. , de Swiet M. , Dewhurst John
Published: August 2005

A 27‐year‐old woman with premature ovarian failure associated with the Candida endocrinopathy syndrome is reported. A review of the literature is presented.
OVARIAN CANCER: THE TEN YEAR EXPERIENCE OF A DISTRICT GENERAL HOSPITAL
Authors: Kennedy C. R. , Gordon H.
Published: August 2005

Ninety‐seven cases of ovarian cancer were diagnosed and treated at Northwick Park Hospital between 1970 and 1980. In this retrospective study data are presented about symptomatology and certain aetiological factors. The survival with different treatment regimens is compared, with particular reference to the improved figures resulting from a policy of aggressive surgery followed by multiple chemotherapy.
USE OF HIGH DOSE CIS‐DICHLORODIAMMINE PLATINUM (II) (NSC—119875)† FOLLOWING FAILURE ON PREVIOUS CHEMOTHERAPY FOR ADVANCED CARCINOMA OF THE OVARY
Authors: Barker G. H. , Wiltshaw E.
Published: August 2005

Cis‐dichlorodiammine platinum II (cisplatin) in high dose was given to 40 patients with advanced carcinoma of the ovary, 31 had been previously treated with alkyl‐ating agents or various chemotherapy regimens excluding cisplatin and 9 patients had tumours resistant to low dose cisplatin regimens. The high dose regimen consisted of cisplatin given at 100 mg/m2 with 24 hours pre‐ and post‐treatment hydration, at monthly intervals up to a maximum of 5 doses. Seventeen of the 31 patients (55%) showed a therapeutic response including 25% who had complete regression of tumour. The median duration of complete remissions was 10 months. Unfortunately, patients who had already been exposed to cisplatin at low doses (20 mg/m2) responded less well, only 2 out of 9 (22%). Even at this late stage of disease, seven patients showed a good enough response to undergo further surgery and of these three were macroscopically clear of tumour and in two patients multiple biopsy material failed to show residual tumour microscopically.
THE WEEKEND—A DANGEROUS TIME TO BE BORN?
Authors: Hendry Robert A.
Published: August 2005

Analysis of all births occurring in Tayside during the years 1974–1978 inclusive showed that there was a significantly smaller number of births on Sundays than any other day of the week. The babies born on Sundays were more at risk of dying during or after birth. The reasons for this are multiple and difficult to ascertain.
A RIGOROUS COMPARISON OF REAL TIME AND B SCAN CEPHALOMETRY
Authors: Davies Peter , Richardson R. E.
Published: August 2005

Real time cephalometry has been compared with B scan cephalometry by a rigorous method with complete partition of variables. Analysis was by standard analysis of variance techniques. Systematic and random errors between and within observers, machines and days have been evaluated. The largest systematic error has been shown to be between machines. This is due to failure to align the beam precisely at right angles to the mid‐line of the fetal head using B scanners. Real time scanners with bar calipers are, therefore, superior to B scanners for cephalometry. There is a lesser difference between observers. An additional element of variability arises when measurements are made on different days but this is smaller than other sources of variation and smaller than the random variation. Random errors are described by a standard deviation of 1 mm and systematic errors are all numerically smaller than this.
MATERNAL SERUM LEVELS OF SEX STEROID‐BINDING PROTEIN DURING PREGNANCY
Authors: Uriel José , Dupiers Michelle , Rimbaut Christiane , Buffe Demise
Published: August 2005

Serum concentrations of sex steroid‐binding protein (SBP) were measured by an immunodiffusion technique in a total of 133 samples from 70 healthy pregnant women, 18 puerperal women and 21 non‐pregnant women. In 6 individuals, trends of serum SBP were established from multiple samples taken throughout pregnancy. Maternal serum SBP levels had increased significantly above base line values as early as by 10 weeks gestation, and attained a plateau between 25 and 30 weeks, at which time mean values were about 10‐fold higher than the normal non‐pregnant range, the levels then declined slightly twoards term. Parallel measurements of dihydrotestosterone‐binding capacity of SBP showed a good correlation between SBP content and biological activity. Six abnormal pregnancies were encountered in the present study, and in five of them the molar ratios of bound hormone to SBP concentration were much lower than the normal value, suggesting a reduced binding capacity of the protein for the hormone.
M‐MODE ULTRASONIC ASSESSMENT OF FETAL CARDIOVASCULAR DYNAMICS
Authors: Wladimiroff J. W. , McGhie J. S.
Published: August 2005

A combined two‐dimensional real‐time and M‐mode technique for measuring fetal right and left ventricular cardiac geometry and function is presented. From 64 normal women studied between 27 and 41 weeks gestation, 53 technically acceptable recordings showed a significant increase in left and right ventricular size. Both ventricles are geometrically and functionally uniform. Mean velocity of blood flow in the fetal descending aorta as measured by pulsed Doppler ultrasound showed no relation to mean velocity of fractional shortening of both cardiac ventricles.
OESOPHAGEAL STRICTURE DUE TO REFLUX OESOPHAGITIS IN PREGNANCY
Authors: Swinhoe June R. , Cochrane G. W. , Wishart R.
Published: August 2005

A patient with persistent vomiting in pregnancy due to oesophageal stricture secondary to reflux oesophagitis is reported. Reflux oesophagitis is common during pregnancy but usually responds to small frequent meals, the avoidance of certain positions and simple antacid therapy. Where symptoms are persistent and become worse in late pregnancy we suggest that more energetic therapy in the form of cimetidine or alginate antacid mixture (Gaviscon) should be considered to prevent oesophageal stricture formation.
PLASMA ADRENALINE, NORADRENALINE AND DOPAMINE IN PREGNANCY HYPERTENSION
Authors: Davey D. A. , Macnab M. F.
Published: August 2005

The resting plasma adrenaline, noradrenaline and dopamine were measured in nine hypertensive women and seven normotensive women in the third trimester of pregnancy on two successive days. The mean plasma adrenaline concentrations on the two days in the hypertensive women (442 and 298 pg/ml) were significantly higher than in the normotensive women (43·9 and 61·6 pg/ml). The mean plasma noradrenaline concentrations in the hypertensive women (232 and 274 pg/ml) were higher than in the normotensive women (48 and 110 pg/ml) and the difference was significant on Day 1 but not Day 2. The mean plasma dopamine concentrations in the hypertensive women (98·6 and 62·1 pg/ml) were higher than in the normotensive women (23·2 and 26·0 pg/ml) and the difference was significant on Day 1 but not Day 2. The plasma adrenaline/noradrenaline ratios were significantly increased in the hypertensive compared with the normotensive women on both days. It is suggested that sympathetic nervous system activity may be increased in some women with hypertension in pregnancy.
INSULIN‐INDUCED HYPOGLYCAEMIA IN DIABETIC WOMEN DURING LATE PREGNANCY AND ONE YEAR POST PARTUM
Authors: Stangenberg M. , Persson B. , Fredholm B. B. , Lindblad B. S. , Stånce L.
Published: August 2005

Insulin (0·1 IU/kg) later followed by glucose was injected intravenously in nine diabetic women in the supine position both during pregnancy and one year post partum. C‐peptide was present in five subjects, indicating some residual (β‐cell function. Their mean basal C‐peptide level, before insulin, was twice as high in the pregnant as in the non‐pregnant state. C‐peptidedecreasedprogressivelyafterinsulin. The mean basal plasma glucose level was lower during pregnancy (4·8 mmol/l) than after it (9·6 mmol/l), but decreased to the same level (2·2 mmol/l) after insulin. The rate of fall in glucose was thus lower during pregnancy (kt= 2·54) than after (kt= 4·08), but was unrelated to the basal glucose levels. Basal levels of free fatty acids (FFA), 3‐hydroxybutyrate (3‐HB), cyclic AMP, and lactate were similar, while glycerol was lower during pregnancy. Insulin‐induced changes in FFA, glycerol, 3‐HB, cyclic AMP, and lactate were similar during and after pregnancy. Plasma amino acid concentrations were generally lower in pregnancy, significantly so only for arginine and glycine. Amino acid levels were unaffected by insulin in pregnancy, whereas leucine, isoleucine and tyrosine decreased significantly in the non‐pregnant state. We conclude that there are differences in metabolic responses to insulin in diabetic women during and after pregnancy, indicating a decreased sensitivity to insulin during pregnancy in some tissues.
DARK BROWN AMNIOTIC FLUID—IDENTIFICATION OF CONTRIBUTING PIGMENTS
Authors: Legge M.
Published: August 2005

A total of 208 second trimester amniotic fluid samples were examined visually and spectrophotometrically for pigmentation. Of these, 15 samples had dark brown colouration. Fourteen of the 15 samples had chemically detectable haemoglobin derived pigments and one had meconium only. All 15 of the pigmented amniotic fluid samples had haemoglobin A and eight also had haemoglobin F. None of the remaining 193 amniotic fluid samples contained abnormal pigmentation. Four of the pregnancies from which the dark brown amniotic fluid was obtained failed to continue to term; in three of these myoglobin was detected.
VERY LOW MATERNAL PLASMA ALPHA‐FETOPROTEIN CONCENTRATION AN INDICATION FOR FOLLOW‐UP
Authors: Stein Shirley M. , Watt Muriel S. , Scrimgeour John B.
Published: August 2005

In the course of a screening programme for the detection of fetal neural tube abnormalities by measurement of maternal plasma alpha‐fetoprotein (AFP), 57 patients were identified who had plasma AFP levels of less than 7 units/ml at 15–20 weeks gestation. Follow‐up at the time of screening included requests to confirm that the patient was pregnant and also to repeat the AFP test. Two patients were lost to follow‐up and of the remaining 55, 17 patients (31 per cent) were subsequently shown not to have a live fetus and 31 patients (56 per cent) had in‐correct estimates of gestation. No particular reason for the very low plasma AFP could be identified in the other seven patients.
A DOUBLE BLIND TRIAL OF EXTRA‐AMNIOTIC OESTRIOL AND PROSTAGLANDIN F2α GELS IN CERVICAL RIPENING
Authors: Quinn M. A. , Jmurphy A. , Kuhn R. J. P. , Robinson H. P. , Brown J. B.
Published: August 2005

Forty nulliparous patients with a Bishop score of 3 or less were given 15 mg oestriol gel, 10 mg PGF2α gel or gel alone via the extra‐amniotic route. Both the oestriol and prostaglandin treated patients had a significant increase in Bishop score and a significant reduction in induction‐delivery interval compared to con‐trols. Oestriol gel had significantly less stimulatory effect on uterine activity than prostaglandin gel, indicating a possible local action.
FETAL HEART MONITORING DURING OPEN HEART SURGERY TWO CASE REPORTS
Authors: Lamb M. P. , Ross Keith , Johnstone A. M. , Manners J. M.
Published: August 2005

Two patients with critical mitral stenosis underwent open mitral valvotomy during the third trimester of pregnancy. Fetal monitoring throughout heart‐lung bypass produced evidence of acute fetal hypoxia. Healthy live full‐term infants were subsequently delivered.
MANAGEMENT OF TERM BREECH PRESENTATION IN PRIMIGRAVIDAE
Authors: Jaffa A. J. , Peyser M. R. , Ballas S. , Toaff R.
Published: August 2005

In a prospective study of 321 breech presentations in primigravidae at term, 260 (81 per cent) were delivered vaginally with no perinatal mortality. A single case of fetal injury (Erb's palsy) was recorded and only one infant had an Apgar score of under 7 at 5 minutes. In 17 patients selected for vaginal delivery, caesarean section was necessary for abnormal uterine activity, prolapse of the umbilical cord of fetal distress. Elective caesarean section was performed if routine x‐ray pelvimetry showed values below defined limits at the brim, midcavity, or outlet or if the fetal head was extended.
THE REPRODUCIBILITY OF FETAL CROWN RUMP LENGTH MEASUREMENTS OBTAINED WITH REAL TIME ULTRASOUND SYSTEMS COMPARED WITH THOSE OF A CONVENTIONAL B‐SCANNER
Authors: Parker A. J. , Docker M. F. , Davies P. , Newton J. R.
Published: August 2005

Comparison of the reproducibility of fetal crown rump length measurements (CRL) obtained in a resting state by sonar with a phase focused linear array real time scanner, a real time mechanical sector Scanner, and a static B‐scanner did not show any significant differences between machines. Maternal movement was found to produce a change in fetal intrauterine position and to induce fetal movement. Examination following maternal movement was feit to be more representative of clinical conditions and produced greater variability of CRL measurement, shown by all machines to a differing extent, although the differences between machines were not substantial. There is some evidence that the discernment of fetal movement and the quality of fetal echoes obtained with different machines affects the reproducibility of CRL measurement. Thus variability of CRL measurement with every machine is small in terms of gestational age and justifies the use of real time machines to establish gestational age.
THE EFFECT OF GENITAL MYCOPLASMAS ON HUMAN FETAL GROWTH
Authors: Ross Jean M. , Furr Patricia M. , Taylor‐Robinson D. , Altman D. G. , Coid C. R.
Published: August 2005

The relation between maternal genital colonization by mycoplasmas and fetal growth was examined in a study of 195 women. Swabs were taken from the endo‐cervix on three occasions during pregnancy and once post partum. Ureaplasma urealyticum organisms (ureaplasmas) were recovered from 42·7 per cent of Caucasian women and from 34·6 per cent of Asian women at their first antenatal visit. These Isolation rates remained similar throughout pregnancy, although there was a decrease in isolation after delivery. Mycoplasma hominis was recovered from 6·5 per cent of Caucasians and from 11·5 per cent of Asians at their first antenatal visit and these rates remained fairly constant during pregnancy and after delivery. Caucasian women colonized by ureaplasmas had a longer mean length of gestation (p < 0·025) than non‐colonized women. Furthermore, the colonized women gave birth to infants who had a statistically significant greater mean birth weight and a greater mean birth weight‐for‐dates than those of the non‐colonized Caucasians. There was no correlation between gestational length, birth weight, or birth weight‐for‐dates and genital colonization of Asian mothers by ureaplasmas or M. hominis. It is clear that ureaplasmas are not associated with low birth weight in our popu‐lation.
TECHNIQUE FOR COLLECTING MATURE HUMAN OOCYTES FOR IN VITRO FERTILIZATION
Authors: Wood C. , Leeton J. , Talbot J. Mc. , Trounson A. O.
Published: August 2005

Mature oocytes may be obtained from 85 per cent of preovulatory follicles at laparoscopy. The technique of oocyte collection is described. The most important factors contributing to the success rate are surgical expertise and a satisfactory aspiration System.
TUBAL PATENCY TESTING IN A PROGRAMME OF ARTIFICIAL INSEMINATION WITH DONOR SEMEN
Authors: Edmonds D. K. , Matthews C. D. , Cox L. W.
Published: August 2005

The value of investigating tubal patency by hysterosalpingography, before artificial insemination with donor semen (AID), was studied retrospectively in 167 patients. The results suggest that unless there is a history of pelvic inflammatory disease preliminary hysterosalpinography is unnecessary. Conception rates were similar in women who had a normal hysterosalpingogram (44%), in those who had an abnormal hysterosalpingogram (46 %), and in those who had no preliminary tubal investigation (39 %) before AID. Life table analysis of expectancy of conception suggests that tubal patency testing should be delayed until after AID has been unsuccessful for four cycles. Laparoscopy is then the most worthwhile investigation.