bluuebunny/crossref_metadata_2025 huggingface dataset:
FLURBIPROFEN IN THE MANAGEMENT OF DYSMENORRHOEA
Authors: Pogmore J. R. , Filshie G. M
Published: August 2005

The analgesic effect of flurbiprofen, aspirin and placebo in the treatment of primary dysmenorrhoea was compared in 41 patients using a double blind triple crossover study. No statistically significant differences were found between any pair of treatments and the control for pain relief. Thirty patients had assessments for all three treatment months, 11 preferred flurbiprofen, 9 preferred placebo, 6 preferred aspirin and 4 had no preference between any of the treatments. Side effects were reported by 14 of the 41 patients: 3 during the control month, 6 during the flurbiprofen month, 4 during the aspirin month and 7 during the placebo month.
EFFECT OF DANAZOL ON SERUM GONADOTROPHINS AND STEROID HORMONE CONCENTRATIONS IN WOMEN WITH MENORRHAGIA
Authors: Chimbira T. H. , Anderson Anne B. M. , Cope E. , Turnbull A. C
Published: August 2005

In 13 ovulatory women with objective evidence of menorrhagia (menstrual blood loss greater than 80 ml), danazol 400 mg given daily for 12 weeks suppressed ovulation as shown by absence of gonadotrophin peaks, low serum progesterone levels and flat basal body temperature recordings. Serum concentrations of luteinising hormone and follicle stimulating hormone were within the range found during the normal menstrual cycle but oestradiol concentrations tended to fall, reaching levels less than 100 pmol/1 in some patients. Danazol treatment had no effect on levels of androstenedione or dehydroepiandrosterone and its sulphate. The presence or absence of cyclical bleeding on treatment, and the measured blood loss was unrelated to circulating oestradiol levels.
INTRAUTERINE DIGOXIN TREATMENT OF FETAL PAROXYSMAL TACHYCARDIA CASE REPORT
Authors: Llngman G. , Ohrlander S. , Ohlin P.
Published: August 2005

A patient with fetal paroxysmal supraventricular tachycardia (PST) with a heart rate above 300 beats/minute in the 29th week of pregnancy is described. The fetus showed signs of severe cardiac failure and was, therefore, digitalized by giving the mother 0.5 mg digoxin intravenously on the first day and then 0.25 mg oral digoxin daily throughout the pregnancy. After one day a normal rhythm was observed. The patient was delivered of a healthy girl after 38 weeks of pregnancy. Digoxin concentrations in samples of umbilical cord vein and artery, intrapartum scalp capillary, and amniotic fluid were almost equal, but somewhat lower than in simultaneously obtained maternal serum. Intrauterine digoxin treatment of fetuses with PST is discussed.
A CASE OF BENIGN INTRACRANIAL HYPERTENSION IN PREGNANCY
Authors: Shekleton P. , Fidler J. , Grimwade J.
Published: August 2005

We describe a 30‐year‐old patient who developed benign intracranial hypertension at 34 weeks in her second pregnancy and was treated both medically and by decompression of the perioptic meninges; her visual symptoms and signs remained static and she was delivered at 35 weeks by Caesarean section for poor progress in an induced labour.
A SUCCESSFUL PREGNANCY FOLLOWING TOTAL HYSTERECTOMY
Authors: Jackson P. , Barrowclough I. W. , France J. T. , Phillips L. I.
Published: August 2005

Abdominal pregnancy followed total hysterectomy performed three days after coitus. A healthy infant was born by laparotomy after 36 weeks of gestation.
WOMEN'S ATTITUDES TO SCREENING FOR NEURAL TUBE DEFECTS
Authors: Bennett M. J. , Gau Gillian S. , Gau D. W.
Published: August 2005

The attitudes of 2254 pregnant and 262 other women to serum alphafetoprotein (AFP) screening for neural tube defects (NTDs) were investigated, the former by interview and the latter by questionnaires to which 228 replies were received. Over 97 per cent of the pregnant women wanted to be included in such a screening programme. Ninety‐six per cent of other women who completed the questionnaire were in favour of national screening for NTDs but 14 per cent of them were uncertain about the action they would take if the test were positive.
SCREENING FOR DIABETES DURING PREGNANCY
Authors: Gillmer M. D. G. , Oakley N. W. , Beard R. W. , Nithyananthan R. , Cawston M.
Published: August 2005

Blood was taken for plasma glucose estimation one hour after oral ingestion of 50 g of glucose in 948 of 970 women booking at an antenatal clinic during one year. An abnormal result (≧7.7 mmol/1) was obtained in 74 subjects of whom 68 subsequently had an oral glucose tolerance test. Fourteen of these women (1·5 per cent of the study population) were found to have chemical diabetes.
EVALUATION OF PLASMA GLUCOSE CONTROL IN PREGNANCY COMPLICATED BY CHEMICAL DIABETES
Authors: Rizvi J. , Gillmer M. D. G. , Oakley N. W. , Beard R. W.
Published: August 2005

Two‐hourly plasma glucose measurements were made over a 24‐hour period in 24 pregnant women with chemical diabetes treated by dietary carbohydrate restriction alone. The values obtained between midnight and 0600 hours displayed the best correlation with the mean of the diurnal values, the strongest individual correlation being at 0200 hours. During the daytime, the mean of the plasma glucose values before breakfast (0600 hours) and lunch (1200 hours) and two hours after supper (2000 hours) provided the strongest correlation with the mean diurnal value and these are recommended as the routine sampling times for assessment of diabetic control in pregnant women with dietary treatment for chemical diabetes.
SENSITIVITY OF A DOUBLE‐BLIND TRIAL OF RITODRINE AND PLACEBO IN TWIN PREGNANCY
Authors: Prescott P.
Published: August 2005

A critical examination is made of the results of a recently reported double blind trial comparing ritodrine and placebo. It is shown that interval estimates are more informative than p‐values obtained from significance tests and that the trial involving 49 patients was insensitive to differences which could be clinically important. Contrary to the conclusions presented, the data suggest that further evaluation of the effects of ritodrine in twin pregnancies is necessary to clarify the situation.
FETAL HEART RATE MONITORING USING THE ABDOMINAL FETAL ELECTROCARDIOGRAM
Authors: Carter M. C. , Gunn Philippa , Beard R. W.
Published: August 2005

An evaluation of a prototype abdominal fetal electrocardiogram (ECG) module for use in a Sonicaid FM3R monitor is described; 103 antenatal recordings of fetal heart rate (FHR) were attempted in 56 patients between 21 and 43 weeks gestation. The overall success rate was 54 per cent but the proportion of successful recordings was reduced between 24 and 36 weeks gestation. Most successful recordings were obtained with the first electrode placings and the quality of the recordings was generally higher than those obtained by simultaneously recorded FHR from ultrasound. Monitoring using the abdominal ECG during parturition was found to be unreliable. The advantages of the method are that it is non‐invasive, the patient is not restricted by belts and the technique is easy to apply. However the uncertainty of obtaining a FHR trace between 24 and 36 weeks gestation is a major disadvantage.
A COMPARISON BETWEEN MIDLINE AND MEDIOLATERAL EPISIOTOMIES
Authors: Coats P. M. , Chan K. K. , Wilkins M. , Beard R. J.
Published: August 2005

A randomised prospective study of 407 primiparous patients compared the consequences of midline and mediolateral episiotomies. The patients' estimates of the pain from their episiotomies were similar. Anal sphincter injury was significantly more common after a midline procedure but no rectovaginal fistulae occurred. Scarring was less noticeable after the midline incision and intercourse began earlier.
POLYAMINE OXIDASE ACTIVITY IN AMNIOTIC FLUID AND FETAL MEMBRANES
Authors: Illei G. , Morgan D. M. L.
Published: August 2005

Polyamine oxidase activity, already shown to be present in maternal serum, was measured in amniotic fluid between 15 and 40 weeks of gestation in 38 samples. The enzyme activity increased as pregnancy progressed, the levels being lower than those found in the maternal serum. Homogenates of chorion, amnion, separately and together, also showed the presence of enzyme activity, the levels being lower than those previously found in the decidua, but substantially higher than those found in the placenta. It is suggested that the enzyme found in amniotic fluid might be the consequence of a diffusion from the decidua through the membranes.
A NEURILEMMOMA OF THE CERVIX
Authors: Gwavava N. J. , Traub A. I.
Published: August 2005

We present a case of neurilemmoma of the cervix which is the first to be reported in the English literature. The characteristic histological features are described and its differentiation from a leiomyoma is confirmed by electron microscopic studies.
FETOSCOPY GUIDED BY REAL‐TIME ULTRASOUND FOR PURE FETAL BLOOD SAMPLES, FETAL SKIN SAMPLES, AND EXAMINATION OF THE FETUS IN UTERO
Authors: Rodeck C. H.
Published: August 2005

Techniques for sampling pure fetal blood, fetal skin and for fetal examination by fetoscopy are described in detail after experience gained in 151 diagnostic fetoscopies on 145 patients. Of particular importance were a real‐time scanner and a particle size analyser. The region of insertion of the umbilical cord into the placenta was the optimum site for obtaining pure fetal blood, and this was achieved in 136 out of 143 patients (95 per cent) sampled at 18 to 23 weeks gestation. This made maternal blood transfusion before prenatal diagnosis of haemoglobinopathies unnecessary. An anterior placenta rarely prevented successful fetoscopy, and often made fetal blood sampling easier. Four fetal losses (3·7 per cent) were judged to be due to fetoscopy.
REPRODUCIBILITY OF BIPARIETAL DIAMETER MEASUREMENTS OBTAINED WITH A REAL‐TIME SCANNER
Authors: Osinusi B. O. , Hall A. J. , Adam A. H. , Fleming J. E. E.
Published: August 2005

In 80 patients, multiple measurements of the fetal biparietal diameter were made during one examination using a real‐time scanner equipped with a coded cephalometer. From the sets of data, the means and standard deviations for the group of 80 patients were calculated. In 80 per cent of cases, the individual standard deviations of the results were less than or equal to the estimated standard deviation of the group as a whole. The variability of measurement related to biparietal diameter was least in the range 59 to 83 mm. Comparison of the results obtained with the coded device and others obtained ‘blind’ does not reveal any significant advantage for the coded device.
FETAL ACTIVITY IN 100 NORMAL THIRD TRIMESTER PREGNANCIE
Authors: Roberts A. B. , Griffin D. , Mooney R. , Cooper D. J. , Campbell S.
Published: August 2005

The incidence of fetal breathing movements (FBM)*, fetal trunk movements (FTM), and total fetal activity (TFA) was assessed in 100 normal pregnancies between 28 weeks and term. One 30‐minute recording was made from each patient between 0900 and 1700 hours. The mean incidences of FBM, FTM and TFA were respectively 37±26 (SD) per cent, 18±10 per cent, and 53±24 per cent. The mean breathing rate was 48±12 per minute, and the mean number of movements per 30‐minute study period was 29±15. There was a slightly higher incidence of FBM postprandially, but this failed to reach statistical significance. The mean incidence of FBM was lower before 31 weeks and after 40 weeks, compared to that between 31 and 40 weeks, when the values of FBM and FTM were constant. The breathing rate was directly related to gestational age. The mean number of movements per 30‐minute study period was inversely related to gestational age, but the duration of movements increased progressively towards term, so that the incidence of FTM was constant throughout the third trimester. There was only one recording of TFA below 10 per cent.
FETAL ACTIVITY IN PREGNANCIES COMPLICATED BY MATERNAL DIABETES MELLITUS
Authors: Roberts A. B. , Stubbs S. M. , Mooney R. , Cooper D. , Brudenell J. M. , Campbell S.
Published: August 2005

The incidence of fetal breathing movements (FBM), fetal trunk movements (FTM), and total fetal activity (TFA) was assessed in 25 pregnancies complicated by maternal diabetes mellitus; 20 mothers had been juvenile insulin dependent diabetics, 4 were diagnosed during pregnancy (one of whom required insulin) and there was one other who was changed from chlorpropamide to insulin during the first trimester of pregnancy. Thirty‐minute records were made postprandial between 32 and 38 weeks making a total of 161 recordings. There were 15 well‐controlled insulin‐dependent diabetic women with uncomplicated pregnancies; and in this group the mean percentage incidence of FBM was 60±25 (SD) per cent, FTM 16±10 (SD) per cent and TFA 73±22 (SD) per cent. The mean breathing rate per minute was 53±12 and the mean number of movements per 30‐minute period 29±18. The incidences of FBM and TFA were significantly higher than those found in postprandial recordings in normal pregnancies. There was only one recording out of 115 where the incidence of TFA fell below 10 per cent. The mean percentage incidences of FBM, FTM and TFA were similar in the four uncomplicated pregnancies in which diabetes was diagnosed during pregnancy. The mean percentage incidence of TFA was significantly lower in the six pregnancies with obstetric complications, and levels of TFA below 10 per cent correlated well with abnormal cardiotocograph traces or fetal distress in labour.
CONSERVATIVE MANAGEMENT OF PITUITARY PROLACTINOMAS; EVIDENCE FOR BROMOCRIPTINE‐INDUCED REGRESSION
Authors: Hancock K. W. , Scott J. S. , Lamb J. T. , Gibson R. Myles , Chapman C.
Published: August 2005

Thirty‐six women with sustained hyperprolactinaemia, 29 showing radiological abnormality of the pituitary fossa, were managed conservatively; 28 accepted bromocriptine treatment which controlled hyperprolactinaemia in all and was associated with improvement in the radiological appearance of the pituitary in 4 cases. Two of the 8 patients who did not accept bromocriptine showed radiological extension of the pituitary lesion; one showed radiological improvement. Bromocriptine should be regarded as a drug to control the pituitary tumour, not merely one which inhibits the endocrine effects.
ENDODERMAL SINUS TUMOUR OF THE OVARY: SERUM ALPHA‐FETOPROTEIN LEVELS BEFORE AND AFTER TREATMENT AND DURING PREGNANCY CASE REPORT
Authors: Duncan I. D. , Young J. L.
Published: August 2005

We report the apparently successful treatment of an endodermal sinus tumour. The patient became pregnant after unilateral oophorectomy and adjuvant chemotherapy, and was delivered of a normal female infant. The levels of serum alphafetoprotein, having been raised before treatment of the tumour, were within the normal range during pregnancy and undetectable before and afterwards.
PULMONARY OEDEMA AFTER THE ADMINISTRATION OF INTRAVENOUS SALBUTAMOL AND ERGOMETRINE CASE REPORT
Authors: Davies Angharad E. , Robertson Margaret J. S.
Published: August 2005

A patient in premature labour was treated with an intravenous salbutamol infusion for 56 hours before delivery by Caesarean section. Ergometrine was given 45 minutes after the salbutamol infusion was stopped and the patient developed pulmonary oedema postoperatively. We discuss the pharmacological implications of the interaction between these drugs and their effect on the sympathetic system.
SUPPRESSION OF UTERINE CONTRACTIONS WITH ENOTEROL AND ITS EFFECT ON FETAL TcPo2 IN HUMAN TERM LABOUR
Authors: Schneider H. , Strang Fiona , Hugh R. , Huch A.
Published: August 2005

The significance of spontaneous regular uterine contractions during the first stage of labour for fetal oxygenation was studied in 13 patients at term in uncomplicated pregnancies. The drop in transcutaneous (Po2 (tcPo2) recorded from the fetal scalp which usually followed each contraction correlated significantly with the strength of the contraction but generally was less than 2 mm Hg. The mean fetal tcPo2 in the first stage of spontaneous uncomplicated labour was 16·9±5·2 (SD) mm Hg. Suppression of contractions with intravenous fenoterol for 20 minutes did not give a statistically significant change in mean fetal tcPo2. With the administration of supplementary oxygen to the mother during continued suppression of labour, fetal tcPo2 rose significantly to 21·3±4·7 mm Hg. Maternal mean tcPo2 at the same time climbed from 83·2±10·5 to 235·1±97·8 mm Hg. While the mother responded to the infusion of fenoterol with a rise in heart rate from 92·3±15·2 to 122·8±19·7 beats per minute the fetal heart recording showed no significant change in rate or pattern. It is concluded that in the first stage of normal labour no significant impairment of fetal oxygenation is caused by uterine contractions. An important improvement in oxygen supply to the fetus, however, may be achieved in certain forms of fetal distress in labour by the combined administration of β‐sympathomimetics and supplementary oxygen to the mother.
THE CONTINUOUS MEASUREMENT OF TISSUE pH IN THE HUMAN FETUS DURING LABOUR USING A NEW APPLICATION TECHNIQUE
Authors: Flynn Anna M. , Kelly J.
Published: August 2005

The subcutaneous tissue pH (tpH) of 61 fetuses has been measured continuously during labour using the tissue pH electrode designed by Stamm (Stamm et al, 1976) and adapted for use by Roche Medical and Laboratory Systems. These 61 fetuses fell chronologically into two groups: Group 1 comprised 31 fetuses in whom the original method of fixation to the fetal scalp was used, and Group 2 comprised 30 fetuses in whom the fixation apparatus incorporated the latest technical developments of the double spiral electrocardiograph (ECG) electrode and the fetal tpH Applicator Tool Set Model 678449. Better results were obtained with Model 678449.
PERSISTENT ABNORMALITIES OF FIBRINOLYTIC ACTIVITY AND PLATELET FUNCTION IN PATIENTS WITH REVERSIBLE OESTROGEN‐ASSOCIATED HYPERTENSION
Authors: Al‐Khader A. A. , Aber G. M.
Published: August 2005

Normotensive women with a previous history of oestrogen‐associated hypertension were found to have raised platelet factor 3 (PF3) availability, raised triglycerides and pre‐β‐lipoprotein and impaired fibrinolytic activity and capacity, but were shown to have normal platelet lifespan and renal platelet localization. The significance of these abnormalities in relation to the development of hypertension and to the intrarenal vascular disease found in these patients is discussed.
FETAL GROWTH RETARDATION AND THE MATERNAL ARTERIAL SUPPLY OF THE HUMAN PLACENTA IN THE ABSENCE OF SUSTAINED HYPERTENSION
Authors: De Wolf F. , Brosens I. , Renaer M.
Published: August 2005

In five patients with fetal growth retardation in pregnancies with no or only a moderate and transient rise in blood pressure, vascular lesions in the placental bed spiral arteries were found. These lesions are characterized by less well developed physiological morphological changes, by extensive intimal thickening, by fibrinoid degeneration of the media and by acute atherosis. The recurrent fetal growth retardation in these pregnancies may be the first clinical manifestation of underlying reno‐vascular disease.
MATERNAL PLASMA ANDROGENS IN EARLY HUMAN PREGNANCY
Authors: Harrison R. F. , Mansfield M. D.
Published: August 2005

Mean maternal plasma levels of testosterone, androstenedione, and 5 α‐dihydro‐testosterone were established from 4 to 16 weeks gestation from twice‐weekly blood samples taken from 15 pregnant women. All three hormone levels were raised when compared with the non‐pregnant state. There were significant differences in mean maternal plasma testosterone levels at 4 to 5 and 7 to 8 weeks gestation, when comparing women carrying male and female fetuses. Androstenedione levels in a twin pregnancy were increased throughout and testosterone levels were more than 1 SD above the mean from week 15. Steroid levels fell late in the two women who aborted. Hormone levels in three women being given progestogens were within normal limits.
TREATMENT OF ENDOMETRIOSIS: A STUDY OF MEDICAL MANAGEMENT
Authors: Noble A. D. , Letchworth A. T.
Published: August 2005

Fifty patients with endometriosis were treated with hormones: 27 with danazol and 23 with Enavid (mestranol 75 μg and norethynodrel 5 mg). Side effects were more common and potentially more serious in the group treated with Enavid. Fewer women completed treatment with Enavid and their physical signs showed little improvement. Danazol was better tolerated and the results of treatment, as judged by improvement of symptoms or signs and in future fertility rates, were superior to those recorded in the Enavid treated group. Patients with large endometriotic cysts or severe fibrosis did not benefit from medical treatment. Danazol treatment appeared helpful for women who had mild or moderate endometriotic disease. It may be used alone or as a complimentary treatment after conservative surgical operations.
SYSTEMIC LUPUS ERYTHEMATOSUS AND HABITUAL ABORTION
Authors: Hartikainen‐Sorri Anna‐Liisa , Kaila J.
Published: August 2005

A case report is presented of a woman with nine previous spontaneous abortions. At the beginning of her tenth pregnancy a high amount of anti‐nuclear antibodies was found. The patient was given prednisolone and pregnancy and the puerperium were uncomplicated. The newborn infant had complete heart block.
COITAL FUNCTION AFTER RADIOTHERAPY FOR CARCINOMA OF THE CERVIX UTERI
Authors: Adelusi B.
Published: August 2005

The interference of treatment with the sexual life of the patient is an important but relatively neglected aspect of the study of carcinoma of the cervix uteri. In a study of the coital function of patients who had radiotherapy for Stages I to III (FIGO Classification) carcinoma of the cervix in the University College Hospital (UCH), Ibadan, Nigeria, dyspareunia and the fear of recurrence of the malignancy accounted for a marked reduction in the frequency of intercourse after treatment of their disease. A significant finding was the disruption in marital relationships directly attributable to the illness. Steps to minimise these problems are discussed.
THE EFFECT OF VARIOUS REGIMENS OF HORMONE THERAPY ON SERUM CHOLESTEROL AND TRIGLYCERIDE CONCENTRATIONS IN POSTMENOPAUSAL WOMEN
Authors: Paterson M. E. L. , Sturdee D. W. , Moore B. , Whitehead T. P.
Published: August 2005

The serum cholesterol and triglyceride concentrations of 84 postmenopausal women both before and after 2, 6 and 12 months therapy with various regimens of hormone therapy were measured. There was little alteration in mean serum cholesterol concentration with cyclical oestrogens but both sequential mestranol and norethisterone and sequential oestradiol valerate and norgestrel significantly reduced the mean serum cholesterol concentration to a level similar to that found in age‐matched premenopausal women. There was a small and sometimes significant rise in serum triglyceride concentration with cyclical oestrogens. Sequential mestranol and norethisterone significantly elevated serum triglyceride levels, but sequential oestradiol valerate and norgestrel significantly depressed them. The results suggest that the progestogenic agent norgestrel has an important role to play in reducing both serum cholesterol and triglyceride levels, and that the sequential preparations, by virtue of their greater cholesterol lowering effect, should perhaps be preferred to cyclical oestrogens.
PROPHYLAXIS FOR MENDELSON'S SYNDROME BEFORE ELECTIVE CAESAREAN SECTION. A COMPARISON OF CIMETIDINE AND MAGNESIUM TRISILICATE MIXTURE REGIMENS
Authors: Husemeyer R. P. , Davenport H. T.
Published: August 2005

A clinical trial was conducted in which patients undergoing elective Caesarean section received either oral cimetidine 400 mg or magnesium trisilicate mixture BPC 20 ml before anaesthesia. The pH values of gastric fluid were significantly higher and the incidence of pH less than 2·5 was significantly lower in patients who received magnesium trisilicate mixture BPC. No adverse effects were observed in newborn infants whose mothers had received cimetidine and there was no significant difference in pH values of gastric fluid from the newborn in the two groups. The findings suggest that as a means of prophylaxis for Mendelson's syndrome in patients undergoing elective Caesarean section, magnesium trisilicate mixture BPC 20 ml is more effective than a single oral dose of cimetidine 400 mg, administered in the manner described.
PLASMA PROLACTIN AND PUERPERAL BLOOD PRESSURE
Authors: Jenkins D. M. , Soltan M. H.
Published: August 2005

Plasma prolactin concentration was measured on days 1, 3, 6 and 21 of the puerperium in women who had been normotensive or hypertensive during pregnancy. Elevated plasma prolactin concentration due to breast feeding or reduced plasma prolactin concentration due to treatment with bromocriptine was found not to be related to blood pressure changes in the puerperium in women with essential hypertension, pregnancy induced hypertension or in normotensive patients.
DOPPLER ULTRASOUND AND THE PREGNANT UTERUS
Authors: Goodman J. D. S.
Published: August 2005

Precise location of the sources of sound heard from the pregnant uterus when using continuous wave Doppler ultrasound was achieved with depth‐gated pulse Doppler and real‐time ultrasound. The characteristics of these sounds are described. No sounds were identified from the main mass of the placenta.
RELATION BETWEEN MEASURED MENSTRUAL BLOOD LOSS AND PATIENT'S SUBJECTIVE ASSESSMENT OF LOSS, DURATION OF BLEEDING, NUMBER OF SANITARY TOWELS USED, UTERINE WEIGHT AND ENDOMETRIAL SURFACE AREA
Authors: Chimbira T. H. , Anderson Anne B. M. , Turnbull A. C.
Published: August 2005

In 92 women complaining of heavy but regular periods for which no cause was found, the relation was studied between measured menstrual blood loss during two consecutive periods and the patient's subjective assessment of blood loss, the number of days of bleeding, and the number of sanitary pads and tampons used. There was no correlation between menstrual blood loss and these parameters. In many women these parameters are not a reliable indicator of the volume of menstrual blood loss. In 40 of the 92 women, who subsequently had a hysterectomy because of their complaint of menorrhagia, the uterus was weighed and the endometrial surface area measured. The view that menorrhagia is associated with a large uterus or a large endometrial surface area could not be confirmed.
MONITORING OVARIAN FOLLICULAR DEVELOPMENT WITH REAL‐TIME ULTRASOUND
Authors: O'Herlihy C. , De Crespigny L. J. Ch , Robinson H. P.
Published: August 2005

Ovarian follicular growth during the periovulatory period was measured using real‐time ultrasound in 33 patients during 53 spontaneous ovulatory cycles. The mean follicular diameter increased from 14·1 mm four days before ovulation to a maximum of 20·1 mm on the day of presumptive ovulation. The results correspond with previous static ultrasound studies of follicular development and in nine cycles in which both methods were employed the correlation between measurements on the same day was highly significant (r = 0·944; p <0.001). The day of ovulation could not be anticipated from a single measurement because of the relatively wide range of follicular size. Except in some obese subjects, real‐time ultrasound examination of the developing follicle appears to be a useful technique for assessing the progress of the ovarian cycle.
THE TREATMENT OF PREMENSTRUAL SYMPTOMS WITH MEFENAMIC ACID
Authors: Wood C. , Jakubowicz D.
Published: August 2005

Thirty‐seven patients suffering from premenstrual symptoms were each studied through three menstrual cycles. After a control cycle, mefenamic acid and placebo were given during the luteal phase of the cycle in a random double‐blind cross over manner, each patient serving as her own control. The dosage of mefenamic acid was 500 mg thrice daily. Medication significantly improved premenstrual symptoms, particularly tension, irritability, depression, pain and headache. It was not effective for breast symptoms. Most patients complaining of premenstrual symptoms also had menstrual symptoms, which were also improved by the mefenamic acid.
DETECTION OF THE SMALL‐FOR‐DATES TWIN FETUS BY ULTRASOUND
Authors: Neilson J. P.
Published: August 2005

As methods for identifying the small‐for‐dates fetus in twin pregnancies, serial ultrasonic cephalometry and a new two‐stage ultrasound examination schedule have been evaluated and compared. Serial cephalometry is associated with technical and interpretative problems, and only 24 (56 per cent) of 43 small‐for‐dates fetuses in 66 retrospectively studied twin pregnancies showed detectably abnormal biparietal diameter growth. The two‐stage schedule comprises an accurate assessment of gestational age in early pregnancy, and determination of the product of the crown‐rump length and trunk area at 34 to 36 weeks; this identified all 15 small‐for‐dates fetuses in 21 prospectively studied twin pregnancies, and the method offers several other advantages over serial cephalometry.
SITES OF STEROID PRODUCTION IN THE POLYCYSTIC OVARY
Authors: Biggs J. S. G. , Thomas Frances J.
Published: August 2005

Tissue culture of slices of polycystic ovaries shows that androstenedione and oestradiol are mostly produced by the cortical, cyst‐containing portions, with little steroid production in vitro by medullary stromal tissues.
INTRAUTERINE HAEMATOMA AN ULTRASONIC STUDY OF THREATENED ABORTION
Authors: Mantoni Margit , Pedersen J. Fog
Published: August 2005

Ultrasonic scanning in patients with symptoms of threatened abortion occasionally revealed an echo‐free area between the membranes and the uterine wall. The echo‐free area was found in patients at 11 to 20 weeks gestation who had a live fetus and is believed to represent blood. Seven smaller haematomas of less than 35 ml gradually disappeared and the pregnancies continued until term. Three patients who had haematomas of more than 50 ml subsequently aborted or had a premature delivery.
GROWTH OF A PROLACTINOMA DURING PREGNANCY
Authors: Dommerholt H. B. R. , Assies J. , van der Werf A. J. M.
Published: August 2005

A patient with hyperprolactinaemia and anovulation is described. Ovulation was induced with bromocriptine and the ensuing pregnancy caused rapid deterioration of vision and neurosurgical intervention. The management of hyperprolactinaemic infertility and the complications occurring during pregnancy in these patients are discussed.
DIAGNOSIS BY REAL TIME ULTRASOUND OF HOURGLASS HERNIATION OF THE FETAL MEMBRANES
Authors: Redford D. H. A. , Nicol B. D. , Wittmann B. K.
Published: August 2005

We present two patients in whom hourglass herniation of the fetal membranes through the cervix occurred at 26 weeks gestation. The diagnosis was made by real time ultrasound and led to conservative management. One of the infants survived and might well not have done so without conservative management.
MORPHOLOGICAL AND FUNCTIONAL RELATIONS OF GRAAFIAN FOLLICLE GROWTH TO OVULATION IN WOMEN USING ULTRASONIC, LAPAROSCOPIC AND BIOCHEMICAL MEASUREMENTS
Authors: Kerin J. F. , Edmonds D. K. , Warnes G. M. , Cox L. W. , Seamark R. F. , Matthews C. D. , Young G. B. , Baird D. T.
Published: August 2005

The daily growth rates of ovarian follicles were recorded ultrasonically for five days until ovulation in 56 spontaneously ovulating women and related to endocrine and clinical parameters. Over the 5‐day period, the average diameter of the follicle destined to ovulate increased from 12 to 23 mm, the second largest follicle from 6 to 12 mm, the third largest follicle from 5 to 9 mm and the fourth largest follicle from 4 to 8 mm. Similar but lesser growth rates occurred in the follicles in the contralateral ovary. Ovulation occurred within 24 hours of the luteinizing hormone (LH) peak, and the mean peak diameter of the ovulating follicle was 23.2±0.3 (SEM) mm, (range 18–29 mm) before ovulation, and subsequent luteal function was judged to be normal. Follicular growth was most closely correlated with increasing peripheral blood oestrogen levels. In 16 women who had a laparoscopy within 12 hours of the last ultrasound and following the LH peak, the mean diameter of the largest follicle as measured by ultrasound (23.6±0.4 mm) was similar to that measured at laparoscopy (22.8±0.4 mm) and estimated from the volume of follicular fluid aspirated (average 5.8±0.2 ml), 22.5 mm. The follicular fluid levels of progesterone were high on the day of the LH peak and blood progesterone levels had risen significantly indicating that luteinization of the dominant Graafian follicles had already occurred prior to ovulation. This study confirms that ultrasonic monitoring provides a reliable measure of follicular growth and allows studies correlating morphological changes with both normal and abnormal endocrine function of the human ovary.
HYPEREXTENSION OF THE FETAL HEAD IN BREECH PRESENTATION A STUDY WITH LONG‐TERM FOLLOW‐UP
Authors: Westgren M. , Grundsell H. , Ingemarsson I. , Mühlow A. , Svenningsen N. W.
Published: August 2005

The attitude of the fetal head was determined in 445 women with breech presentations. Thirty‐three women (7.4 per cent) were found to have a fetus with the head in various degrees of hyperextension. Of these 26 were born vaginally and seven by Caesarean section. At follow‐up (2 to 4 years) five of the vaginally born infants (22 per cent) had neurological sequelae referable to spinal, supraspinal and cerebellar injuries but all infants born by Caesarean section were normal. The results emphasise the value of an abdominal X‐ray examination of all women with breech presentations. Caesarean section is recommended if the fetal head is hyperextended.
PLASMA NORADRENALINE IN NORMAL PREGNANCY AND IN HYPERTENSION OF LATE PREGNANCY
Authors: Tunbridge R. D. G. , Donnai P.
Published: August 2005

Plasma noradrenaline was measured by radioenzymatic assay on 90 occasions in 72 women throughout normal pregnancy. Plasma noradrenaline levels declined as pregnancy advanced. A total of 21 patients who developed hypertension in late pregnancy were found to have plasma noradrenaline levels significantly lower than controls at the same stage of pregnancy. It is concluded that plasma noradrenaline is reduced in hypertension of late pregnancy. This indicates a compensatory reduction in sympathetic nervous system activity.
RACIAL VARIATIONS IN TESTS OF FETOPLACENTAL FUNCTION
Authors: Bissenden J. G. , Scott P. H. , Hallum Jean , Mansfield H. N. , Scott P. , Wharton B. A.
Published: August 2005

Fetoplacental function tests discriminated well between poorly grown and well grown fetuses in European mothers. In contrast, apart from human placental lactogen, the individual values of poorly grown Asian fetuses fell within the well grown range. Haemoglobin values rose in the second trimester in European pregnancies associated with poor growth, whereas the values fell in the Asian pregnancies both with well grown and poorly grown fetuses. These observations imply fundamental differences in the aetiology of intrauterine growth retardation in the two races.
DIAGNOSIS OF NEURAL TUBE DEFECTS BY ESTIMATION OF AMNIOTIC FLUID ACETYLCHOLINESTERASE
Authors: Dale G. , Archibald Angela , Bonham J. R. , Lowdon P.
Published: August 2005

Acetylcholinesterase (AChE) activity in amniotic fluid was assayed directly by a reaction rate method at 30°C using acetylthiocholine iodide as substrate and ethopropazine as a safe ‘pseudo’ cholinesterase inhibitor. Fresh samples from 101 normal pregnancies of 14–24 weeks gestation had a mean AChE activity of 2.56 u/1 (SD 1.10). Elevated levels of AChE were found in association with open spina bifida (5.5–20.4 u/1), anencephaly (10‐2‐19‐5 u/1), exomphalos (2.7–15.6 u/1), intrauterine death (30.2–59.3 u/1) and Turner's syndrome (36.4 u/1) but not with closed spina bifida or rhesus isoimmunisation. When AChE activity was expressed as a percentage of the total cholinesterase activity (‘percentage AChE’), there was a good correlation between AChE activity and‘percentage AChE’in normal pregnancies and the values associated with the 37 pregnancies affected by open neural tube defects (NTD) fell outside the 99.9 per cent confidence limits of the normal group. Qualitative differences in cholinesterase activity could be demonstrated between the groups with exomphalos and open NTD. It is suggested that the assay might be used satisfactorily to demonstrate the presence of open NTD in affected pregnancies.
A STUDY OF THE PROCOAGULANT PROPERTIES OF AMNIOTIC FLUID AND THEIR CORRELATION WITH THE LECITHIN/SPHINGOMYELIN RATIO
Authors: English Christine J. , Poller L. , Burslem R. W.
Published: August 2005

The procoagulant properties of amniotic fluid have been studied in samples taken throughout pregnancy and the results correlated with the lecithin/sphingomyelin ratio: acceleration effects on the prothrombin time, Russell's viper venom test, activated partial thromboplastin time and specific factor VII and X assays and contact acceleration. Although amniotic fluid is shown to function as a complete thromboplastin and to activate factor X directly, none of these tests of procoagulant activity of amniotic fluid is a reliable index of fetal lung maturity.
IMPROVED DIAGNOSIS OF PREGNANCY‐RELATED GYNAECOLOGICAL EMERGENCIES BY RAPID HUMAN CHORIONIC GONADOTROPHIN BETA‐SUBUNIT ASSAY
Authors: Seppälä M. , Ranta T. , Rutanen E.‐M. , Stenman U.‐H. , Tontti K. , Chard T.
Published: August 2005

A pregnancy‐related disorder was identified by a rapid radioimmunoassay of serum chorionic gonadotrophin (hCG‐RIA) in 122 out of 470 women (26 per cent) with lower abdominal pain or bleeding, while a routine pregnancy test in urine was positive in only 7 per cent of these cases. In 49 patients with ectopic pregnancy the rapid hCG‐RIA was positive in 90 per cent as compared with 13 per cent for the routine pregnancy test. In patients with evidence of intrauterine pregnancy (66 cases) the rapid hCG‐RIA was positive in 98 per cent and the routine pregnancy test in 38 per cent. The clinical sensitivity of the hCG‐RIA was 95 per cent, specificity 96 per cent and predictive value 89 per cent. The test can improve the efficiency of the routine diagnosis of early intra‐ and extrauterine pregnancy‐related disorders.
PZ‐PEPTIDASE ACTIVITY IN THE PREGNANT AND NON‐PREGNANT HUMAN CERVIX
Authors: Hutchins C. J. , Parkin E. N.
Published: August 2005

PZ‐peptidase activity was determined in homogenates of cervical tissue from non‐pregnant women, women in late pregnancy and women immediately after delivery. There was a significant increase in activity in late pregnancy and a further increase in post‐delivery specimens when compared with non‐pregnant tissue. A possible link between rising prostaglandin levels and cervical softening is suggested.
THE OBSTETRIC AND GYNAECOLOGICAL COMPLICATIONS OF BLADDER EXSTROPHY AND EPISPADIAS
Authors: Blakeley C. R. , Mills W. G.
Published: August 2005

A study has been made of 16 girls (14 with bladder exstrophy and 2 with epispadias) treated in the United Birmingham Hospitals since 1946 and surviving to puberty. Eight of these are married, of whom 5 have been delivered of 8 children. Ten have required some form of gynaecological surgery, with uterine prolapse as the most troublesome lesion.
FOLLICULAR CERVICITIS—COLPOSCOPIC APPEARANCES AND ASSOCIATION WITH CHLAMYDIA TRACHOMATIS
Authors: Hare M. J. , Toone Elaine , Taylor‐Robinson D. , Evans R. T. , Furr P. M. , Cooper Pauline , Oates J. K.
Published: August 2005

Follicular cervicitis was recognised in 15 (44 per cent) of 34 women who were examined colposcopically and who were sexual partners of men with non‐gonococcal urethritis. Valid results of culture for Chlamydia trachomatis were obtained in 26 cases: the organism was isolated from the cervix of five of 11 women in whom follicular cervicitis had been diagnosed, but from only one of 15 whose cervices did not have this change. A similar correlation was not found for infection with Mycoplasma hominis or Ureaplasma urealyticum.
EFFECT OF ETHYL ALCOHOL ON MATERNAL AND FETAL ACID‐BASE BALANCE AND CARDIOVASCULAR STATUS IN CHRONIC SHEEP PREPARATIONS
Authors: Cook P. S. , Abrams R. M. , Notelovitz M. , Frisinger J. E.
Published: August 2005

Thirteen chronically catheterized pregnant sheep were given intravenous infusions of 10 per cent ethyl alcohol in 5 per cent dextrose solution (15 ml/kg over two hours). Samples of blood from maternal femoral artery, uterine vein, and fetal brachiocephalic artery were drawn at hourly intervals before, during and after the infusions. Plasma was analyzed for alcohol concentration, protein concentration, haematocrit, PCO2 and pH. Maternal and fetal arterial blood pressures were monitored continuously. There were no significant differences between maternal and fetal arterial blood alcohol levels at any sampling interval nor was there any difference in elimination constants. Alcohol infusion did not produce any significant change in plasma protein concentration, haematocrit, PCO2 and pH, and mean arterial blood pressure in either mother or fetus. However, both maternal and fetal heart rate increased significantly following alcohol infusion.
PRIMARY HYPOTHYROIDISM AND OVARIAN ACTIVITY EVIDENCE FOR AN OVERLAP IN THE SYNTHESIS OF PITUITARY GLYCOPROTEINS
Authors: Evers J. L. H. , Rolland R.
Published: August 2005

A 14‐year‐old girl presented with precocious sexual development, galactorrhoea and symptoms and signs suggestive of hypothyroidism. On physical examination a tumour was found in the lower abdomen. Serum gonadotrophins, especially luteinizing hormone, serum thyroid stimulating hormone and prolactin were elevated. Measurement of thyroid hormones and additional thyroid function tests confirmed the diagnosis of primary hypothyroidism. Ultrasound investigation revealed the mass in the lower abdomen to be of a cystic nature and to originate from the right ovary. Following the institution of thyroid substitution therapy, all symptoms disappeared, biochemical and hormonal abnormalities returned to normal and the ovarian size decreased to normal. A hypothesis is presented for non‐specific pituitary glycoprotein hormone synthesis secondary to the hypothyroidism, as the cause of the syndrome.
DERMATOFIBROSARCOMA PROTUBERANS OF THE VULVA
Authors: Soltan M. H.
Published: August 2005

A woman aged 83 had a vulval swelling measuring 8 cm × 3.5 cm excised. Histologi‐cal examination showed the features of dermatofibrosarcoma protuberans. This tumour, which is usually only locally invasive, has not previously been described in the vulva.
EPIDEMIOLOGICAL EVIDENCE FOR TWO COMPONENTS OF CERVICAL CANCER
Authors: Hakama M. , Penttinen J.
Published: August 2005

Incidence rates for cervical cancer were analyzed for Finland in 1953 to 1974. The age‐specific incidence rates fit an age‐incidence curve based on the assumption of two epidemiological components. The time trends give support to the hypothesis that one of the components occurs at a lower age and is preceded by a carcinoma in situ stage. The risk of cervical cancer originating from the component occurring in younger women showed a decreasing trend which correlated with the organized mass screening programme. The other component occurred later in life and was not influenced by the screening programme. It was estimated that the proportion of the cases in the earlier category decreased from 53 per cent in the 1950s to 17 per cent in 1973 to 1974 of all cases of cervical cancer diagnosed in the Finnish population.
THE MERITS OF SPECIAL ANTENATAL CARE FOR TWIN PREGNANCIES
Authors: O'Connor M. C. , Arias E. , Royston J. P. , Dalrymple I. J.
Published: August 2005

A combined series of 101 twin pregnancies for whom routine hospital rest during the last trimester was replaced by intensified antenatal care in a special twins clinic was studied. Perinatal mortality and morbidity was similar to that found in a comparison group of 137 twin pregnancies under the care of consultants and not referred to the twins clinic. Routine cervical assessments and uterine activity measurements were unhelpful in predicting premature delivery. Urinary oestrogens and ultrasonic measurements of fetal biparietal diameter were of little or no value in predicting weight for gestational age but the ultrasonic measurement of abdominal circumference provided limited information on fetal growth. The contribution of a placebo effect to the results of patients receiving more personalised care cannot be discounted.
A COMPARISON OF OESTRADIOL AND PROSTAGLANDIN E2 FOR RIPENING THE CERVIX
Authors: Stewart P. , Kennedy J. H. , Barlow D. H. , Calder A. A.
Published: August 2005

A study was conducted to compare the cervical ripening effect of extra‐amniotic prostaglandin E2 with that of extra‐amniotic oestradiol valerate in preparation for induction of labour. Sixty primigravidae with an unripe cervix received one or other agent suspended in a viscous gel. The degree of cervical ripening was similar in both groups but more patients treated with prostaglandins became established in labour before planned amniotomy, and poor progress in labour was less common in this group.
ASSESSMENT OF GESTATION BY ULTRASOUND IN VARIOUS STAGES OF PREGNANCY IN INFANTS DIFFERING IN SIZE AND ETHNIC ORIGIN
Authors: Dubowitz Lilly M. S. , Goldberg Cissie
Published: August 2005

A clinical assessment of gestational age after birth has been compared with the ultrasound measurement in utero at various stages of pregnancy in a population of mixed socio‐economic status and racial origin. In infants who were small‐for‐dates or large‐for‐dates at birth, accurate prediction from ultrasound measurement could only be achieved if the crown rump length or the biparietal diameter was measured before 20 weeks gestation. At this time, the infants destined to be small‐for‐dates or large‐for‐dates at birth show no growth retardation or acceleration. There is also no influence of racial origin on the measurements.
MORPHOLOGIC CHARACTERISTICS OF THE NORMAL TERM HUMAN TROPHOBLAST MAINTAINED IN PROLONGED IN VITRO CULTURES
Authors: Aladjem S. , Lueck Judith
Published: August 2005

The development of a new technique for prolonged in vitro culture of normal human term trophoblast without stromal growth has facilitated the study of the morphologic characteristics of trophoblast in culture. Cytotrophoblast (epithelioid) cells were observed along with subsequent formation of syncytiotrophoblast in vitro. Hormonal assessment of hPL production has confirmed the viability and biologic specificity of the tissue. The morphologic characteristics of normal human term trophoblast maintained in vitro include projections, circular growths and syncytial sprouts. Growth patterns of trophoblast in vitro were similar to those described in vivo.
THE MAINTENANCE OF HUMAN AMNIOTIC MEMBRANES IN CULTURE
Authors: Burgos H. , Faulk W. Page
Published: August 2005

A culture system is described for the long‐term maintenance of human amnion in vitro. This has been developed because of the need for an amnion organ culture to study immunological aspects of this extra‐embryonic membrane as well as the increasing surgical use of amnion in wound healing. The intact amnion can be maintained for 2–3 weeks with 50–90 per cent viability as determined by morphological and trypan‐blue extraction techniques. This puts forward the feasability of developing an amnion bank for clinical investigations of wound healing as well as the possibility of in vitro studies of this membrane in the materno‐fetal relationship in human pregnancy.
PREGNANCY IN WOMEN AFTER REPAIR OF BLADDER EXSTROPHY
Authors: Ikeme A. C. C.
Published: August 2005

Improved techniques in urinary diversion operations have enabled a large number of patients with bladder exstrophy to achieve urinary control. They can live fairly normal lives and some have achieved pregnancy. Case reports of such exist in the literature. Two more cases are reported in this paper, the pregnancies and their outcome are discussed.