bluuebunny/crossref_metadata_2025 huggingface dataset:
ANTENATAL SCREENING FOR DIABETES MELUTUS BY RANDOM BLOOD GLUCOSE SAMPLING
Authors: Lind T. , McDougall A. N.
Published: August 2005

A system is described for screening an antenatal population for diabetes mellitus based upon random blood glucose sampling. Samples obtained from 186 healthy pregnant women at 28 weeks gestation provided a range of blood glucose concentrations after normal meals from which it was possible to derive two glucose values to define an upper limit of normality. The first, 6‐4 mmol/1 if within two hours of eating and the second, 5.8 mmol/1 when taken more than two hours postprandial were prospectively applied to the screening of 763 consecutive antenatal patients. Ten women exceeding these limits were referred for an oral glucose tolerance test and three were found to have a diabetic response, an incidence of about four undiagnosed diabetic women per 1000 antenatal population.
A COMPARISON OF PLASMA PROSTAGLANDIN LEVELS IN TERM AND PRETERM LABOUR
Authors: Sellers Susan M. , Mitchell M. D. , Bibby J. G. , Anderson Anne B. M. , Turnbull A. C.
Published: August 2005

Peripheral plasma levels of 13,14‐dihydro‐15‐keto‐prostaglandin F (PGFM) were determined in women during pregnancy and in term and preterm labour. The PGFM concentrations at term were not significantly different from the levels between 26 and 34 weeks gestation. In both term and preterm labour there was a rise in PGFM levels with increasing cervical dilatation although the mean values tended to be lower during preterm labour. These findings may provide an explanation for the effectiveness of prostaglandin synthetase inhibitors in suppressing myometrial activity in preterm labour.
MEASUREMENT OF PLACENTAL PROTEIN 5, PLACENTAL LACTOGEN AND PREGNANCY‐SPECIFIC β1 GLYCOPROTEIN IN MID‐TRIMESTER AS A PREDICTOR OF OUTCOME OF PREGNANCY
Authors: Salem H. T. , Lee J. N. , Seppälä M. , Vaara L. , Aula P. , Al‐Ani A. T. M. , Chard T.
Published: August 2005

The circulating levels of placental protein 5 (PP5), placental lactogen (hPL) and pregnancy‐specific β1‐glycoprotein (SP1 were measured in 254 women at the 16th week of pregnancy and the levels were correlated to fetal outcome in late pregnancy. A significant association was shown between high PP5 levels and premature delivery, and low SP1 levels and intrauterine growth retardation. Measurement of placental proteins in the first half of pregnancy may be a valuable clinical index of fetal outcome in late pregnancy.
THE MEASUREMENT OF HYPOXANTHINE, XANTHINE, INOSINE AND URIDINE IN UMBILICAL CORD BLOOD AND FETAL SCALP BLOOD SAMPLES AS A MEASURE OF FETAL HYPOXIA
Authors: O'Connor M. C. , Harkness R. A. , Simmonds R. J. , Hytten F. E.
Published: August 2005

Hypoxanthine, xanthine, inosine, urate and uridine, were measured in 149 samples of umbilical cord plasma using high pressure liquid chromatography. In spite of a good correlation with the simpler oxygen consumption method for measuring hypoxanthine, there was no clear discrimination between hypoxic and well oxygenated infants, although mean concentrations were higher in infants with well defined criteria of intrapartum hypoxia or birth asphyxia, there was overlap with the normal range. Fetal scalp blood samples were also found to be clinically unhelpful in the diagnosis of intrapartum hypoxia, at least in part due to variable degrees of haemolysis in the specimens. There were poor correlations between hypoxanthine concentrations and those of hydrogen ion, base deficit and lactate. Uridine concentrations were significantly higher in arterial cord blood than in venous cord blood but hypoxanthine or xanthine concentrations did not show this difference.
ASPIRATION CYTOLOGY VERSUS HISTOLOGY IN THE ASSESSMENT OF THE ENDOMETRIUM OF WOMEN ATTENDING A MENOPAUSE CLINIC
Authors: Ellice R. M. , Morse Anne R. , Anderson M. C.
Published: August 2005

The endometrium of 100 women attending a menopause clinic was assessed cytologically, using the Isaacs cell sampler, and then histologically, using the Vabra suction curette. Satisfactory specimens for diagnosis were obtained in 96 per cent of cases with the Isaacs cell sampler and in 62 per cent of cases with the Vabra suction curette. There were eight discrepancies between the diagnoses obtained by the cytological and histological methods and these are analysed. Thirty patients were asked to grade the discomfort experienced during the procedures, and of these 26 found the Vabra method more painful than the Isaacs method.
PROSTAGLANDIN SYNTHESIS IN THE ENDOMETRIUM OF WOMEN WITH OVULAR DYSFUNCTIONAL UTERINE BLEEDING
Authors: Smith S. K. , Abel M. H. , Kelly R. W. , Baird D. T.
Published: August 2005

The endogenous concentrations of prostaglandins F2α (PGF2α) and E (PGE) were measured during the luteal phase of the menstrual cycle in the endometrium from 14 women with unexplained menorrhagia (measured menstrual blood loss in excess of 50 ml) and 15 women with normal menses (blood loss 50 ml or less). Although there was no significant difference in the PGF 2α/PGE ratio between the two groups, this ratio was significantly lower in the endometrium from eight of the women whose blood loss exceeded 90 ml (p <0.05). There was a significant inverse correlation between the PGF2α/PGE ratio and blood loss (r = 0.36, p <0.025). The synthetic capacity of the endometrium was assessed by incubation of the tissue with 14C arachidonic acid. Endometria from nine women with unexplained menorrhagia synthesized more PGE2 than PGF2α, whereas the converse was true with 11 control endometria. Consequently the PGF2α/PGE2 ratio was significantly reduced in the former group (p <0.025). Oestradiol‐17β (200 μM) and to a greater extent 2 hydroxy oestradiol (200 μM) increased the total prostaglandin synthesis by the endometria, but did not significantly alter the PGF2α/PGE2 ratio. These results suggest that excessive blood loss may be associated with a shift in the endometrial conversion of prostaglandin endoperoxide from PGF2α to PGE2.
COMBINED SYNCHRONOUS ABDOMINO‐VAGINAL OPERATION IN MANAGEMENT OF RECURRENT URINARY STRESS INCONTINENCE
Authors: Swingler G. R. , Smith P. J. B. , Pollard W.
Published: August 2005

A synchronous combined abdpmino‐vaginal repair Operation is described which enables adequate mobilisation and subsequent fixation of the urethro‐vesical junction with accurate insertion of supporting stitches. This procedure is of great value in the management of patients with previous failed anterior colporrhaphy for stress incontinence.
A STUDY OF GONADOTROPHIN RELEASE IN A WOMAN WITH HYPOGONADOTROPHIC HYPOGONADISM AND ANOSMIA
Authors: Glass M. R. , Martin R. H. , Hancock K. W. , Scott J. S.
Published: August 2005

A patient with hypogonadotrophic hypogonadism with anosmia is presented. The patient's response to repeated gonadotrophin releasing hormone administration indicated a significant priming effect of such therapy on the anterior pituitary.
FETAL ASCITES ASSOCIATED WITH CONGENITAL HEART DISEASE
Authors: Allan Lindsey , Little D. , Campbell S. , Whitehead M. I.
Published: August 2005

Fetal ascites occurs for many reasons and has been diagnosed more frequently following the introduction of routine ultrasound scanning during pregnancy. We report the diagnosis of fetal ascites associated with an isolated congenital heart malformation.
PERFORATION OF THE APPENDIX DURING PREGNANCY; A RARE COMPLICATION OF ENDOMETRIOSIS
Authors: Gini P. C. , Chukudebelu W. O. , Onuigbo W. I. B.
Published: August 2005

Perforation of the appendix in a 23‐year‐old Nigerian Igbo woman during the 35th week of pregnancy is reported. In the perforated area, the wall of the appendix was replaced largely by decidualized endometriotic tissue.
PLACENTAL PROTEIN 5 (PP5): DEVELOPMENT OF A RADIOIMMUNOASSAY AND MEASUREMENT OF CIRCULATING LEVELS IN NORMAL PREGNANCY
Authors: Nisbet A. D. , Bremner R. D. , Herriot R. , Jandial V. , Horne C. H. W. , Bohn H.
Published: August 2005

A specific and sensitive, double antibody, solid phase radioimmunoassay was developed for measurement of placental protein 5 (PP5) in serum. A sensitivity limit of 0.8 μg/1 was achieved by pre‐incubation with antiserum and use of a small assay volume. Single serum samples from 244 retrospectively proven normal pregnancies were used to construct a normal range of PP5 concentrations. PP5 was detectable at week 7 and rose to reach a maximum mean value of 54 μg/1 at weeks 36–37. Diurnal variation of PP5 concentration was similar to that encountered from day to day, and slightly greater than variation due to the radioimmunoassay. The decline of serum PP5 concentration post partum was initially rapid (half‐life 5–14 minutes), but slowed after 0.5–1 hours; immunoreactive PP5 was still detectable seven days after delivery.
PLACENTAL PROTEIN 5 (PP5) IN COMPLICATED PREGNANCIES
Authors: Nisbet A. D. , Bremner R. D. , Jandial V. , Sutherland H. W. , Horne C. H. W. , Bohn H.
Published: August 2005

Maternal serum PP5 concentrations were assayed in pregnancies complicated by intrauterine growth retardation, pre‐eclampsia, diabetes mellitus, placental abruption and twins. Elevated PP5 levels were noted in twin pregnancies and to a lesser extent in diabetes and pre‐eclampsia. Measurement of PP5 was of no value in the detection of fetal growth retardation. The great majority of PP5 levels above the normal range were associated with a placental abnormality.
PROSTACYCLIN PRODUCTION INCREASES DURING HUMAN PARTURITION
Authors: Ylikorkala O. , Mäkäräinen L. , Viinikka L.
Published: August 2005

The role of prostacyclin (PGI2) in human parturition was studied by measuring the concentrations of its main metabolite, 6‐keto‐prostaglandin Flα, before, during and after term labour in the plasma of 9 women and after delivery in umbilical artery and vein plasma. The mean level of 6‐keto‐PGF1α rose significantly over the course of labour. The mean level was 266 pg/ml before labour, 341 pg/ml in the presence of regular contraction, 387 pg/ml at a cervical dilatation of 5 cm, 386 pg/ml at delivery, and 397 pg/ml at the expulsion of the placenta. The 6‐keto‐PGF1α concentration dropped to below pre‐labour levels of 233 pg/ml within 2 hours of delivery, and this level was maintained for the first four postpartum days. The mean levels of 6‐keto‐PGF1α in the umbilical artery and vein plasma, 1667 and 1193 pg/ml respectively, were significantly higher than the maternal plasma levels, but there was no significant difference between the artery and vein levels. PGI2 is characterized by its antiaggregatory and vasodilating abilities, so that the rise in PGI2 during labour may play a role in the prevention of intrapartum thromboembolic complications in the maternal and the uteroplacental circulation.
INCREASED POSTOVULATORY PLASMA FOLLICLE STIMULATING HORMONE LEVELS IN THE LUTEINIZED UNRUPTURED FOLLICLE SYNDROME: A ROLE FOR INHIBIN?
Authors: Koninckx P. R. , Brosens I. A. , Verhoeven G. , De Moor P.
Published: August 2005

In women who ovulated, the midcycle plasma follicle stimulating hormone (FSH) concentrations returned to basal concentrations within two days following the peak, whereas in women with a luteinized unruptured follicle, plasma FSH concentrations declined more slowly over a 4–5 day period. Since the peri‐ and postovulatory concentrations of plasma luteinizing hormone, prolactin, oestradiol‐17β and progesterone were not significantly different between the two groups, we suggest that following the rupture of the Graafian follicle some substance in follicular fluid is resorbed from the peritoneal cavity which suppresses FSH secretion. Inhibin has biological properties which suggest it could be the substance involved.
CEFUROXIME AND METRONIDAZOLE IN GYNAECOLOGICAL SURGERY
Authors: Leabeater B. , Kingston Janet
Published: August 2005

The predominant potential pathogens in the vaginal flora, sampled before operation in 41 patients undergoing gynaecological surgery, included E. coli, α‐haemolytic streptococci, Streptococcus faecalis, anaerobic Gram‐positive cocci and Bacteroides fragilis. All the aerobic Gram‐negative bacilli and 89.7 per cent of the streptococci isolated were sensitive to 4 μg/ml of cefuroxime. Most of the anaerobes were also very sensitive to cefuroxime, although the minimum inhibitory concentration (MIC) for 52 per cent of B. fragilis isolates was at least 8 μg/ml. The MIC of metronidazole was less than 1 μg/ml for almost all anaerobes. All patients were given 1 g of metronidazole by suppository on the night before operation and a second suppository was given, together with 750 mg of cefuroxime injected intramuscularly with the premedication. The mean extravascular tissue concentrations of cefuroxime and metronidazole, assayed in 29 patients, were respectively 8.9 and 8.0 μg/g (uterus), 14.2 and 22.2 μg/g (cervix), 13.1 and 6.3 μg/g (Fallopian tube), 12.3 and 2.1 μg/g (ovary), 10.3 and 12.4 μg/g (vagina), 13.3 and 13.7 μg/ml (serum), 3570.3 and 122.3 μg/ml (urine). None of the patients developed postoperative wound infections or adverse reactions.
PSEUDO‐SARCOMATOUS POLYPS OF THE AGINA IN PREGNANCY CASE REPORT
Authors: Davies Sylvia W. , Makanje H. H. , Woodcock A. S.
Published: August 2005

A case of pseudo‐sarcomatous polyps of the vagina in a pregnant woman caused anxiety because of the possible differential diagnoses of sarcoma botyroides of the vagina or mixed mesenchymal tumours of the genital tract. These polyps are rarely described in the literature and their recognition is important for clinical management.
MASSIVE OVARIAN OEDEMA CASE REPORT
Authors: Alberda A. Th. , Wladimiroff J. W. , Wielenga G. , Verschoor L.
Published: August 2005

A case is described of massive ovarian oedema with secondary amenorrhoea and evidence of masculinization in a young girl. Pre‐operative testosterone levels in peripheral plasma were markedly raised, but returned to normal immediately following wedge resection of both ovaries. Microscopic examination revealed lutein cells in the right ovary which were predominantly located within and around atretric follicles and Stein‐Leventhal‐like features in the left ovary. Irregular ovulatory cycles started four weeks after surgery.
A PROSPECTIVE STUDY OF PLASMA ANGIOTENSIN‐CONVERTING ENZYME IN NORMOTENSIVE PRIMIGRAVIDAE AND THEIR INFANTS
Authors: Oats J. N. , Pipkin Fiona Broughton , Symonds E. M. , Craven D. J.
Published: August 2005

Plasma angiotensin‐converting enzyme (ACE) has been measured prospectively throughout pregnancy, at delivery and in the puerperium in 18 normotensive primi‐gravidae and their infants. Plasma ACE was consistently lower during pregnancy than in comparable, non‐pregnant controls, but rose progressively from about 30 weeks to term. At vaginal delivery maternal and fetal ACE levels did not differ significantly. There was a steady increase in maternal ACE activity up to 6 weeks post partum, when the levels were not significantly different from non‐pregnant controls. No correlation could be found between plasma ACE and plasma renin activity or concentration, or plasma AIL Plasma aldosterone increased in parallel with ACE during the last ten weeks of pregnancy.
SERTOLI CELL TUMOUR IN A TRUE HERMAPHRODITE: SUGGESTIVE EVIDENCE FOR ECTOPIC GONADOTROPHIN PRODUCTION BY THE TUMOUR
Authors: Gunasegaram R. , Mathew T. , Ratnam S. S.
Published: August 2005

A Sertoli cell tumour that occurred in a true hermaphrodite with a 46, XX chromosome constitution is described. Removal of the tumour was followed by an immediate fall in plasma FSH and LH concentrations. It is suggested that the tumour possessed the capacity for ectopic production of the gonadotrophins.
TRAUMATIC INTRACRANIAL HAEMORRHAGE IN FIRSTBORN INFANTS AND DELIVERY WITH OBSTETRIC FORCEPS
Authors: O'Driscoll K. , Meagher D. , Macdonald D. , Geoghegan F.
Published: August 2005

Exclusive of breech presentation, traumatic intracranial haemorrhage was demonstrated at necropsy on 27 occasions in 36 420 consecutive firstborn infants. All 27 were forceps deliveries. The main conclusion is that serious injury to the forecoming head at birth is almost invariably a direct effect of forceps. The relevance of this conclusion to some aspects of contemporary obstetric practice is discussed briefly.
THE PRESUMPTIVE DIAGNOSIS OF PRIMARY CYTOMEGALOVIRUS INFECTION IN EARLY PREGNANCY BY MEANS OF A RADIOIMMUNOASSAY FOR SPECIFIC‐IgM ANTIBODIES
Authors: Griffiths P. D.
Published: August 2005

During a 30 month investigation 3633 women were studied when they booked for antenatal care. Complement fixing antibodies against cytomegalovirus (CMV) were detected in 2078 (57 per cent) of the women and these sera were further tested for the presence of specific IgM antibodies by means of a solid‐phase radioimmunoassay. Since specific IgM antibodies have previously been shown to persist for up to four months after primary CMV infection, their presence in a booking serum sample (mean gestation 15 weeks) was taken as presumptive evidence of a first trimester primary CMV infection. From theoretical considerations, 11·6 positive CMV‐IgM reactions were predicted in these women and 11 were observed. A highly significant (p < 0·001) excess of fetal death was seen in the infected women since three pregnancies ended in missed abortion (15 weeks), intrauterine death (29 weeks) and spontaneous abortion (24 weeks) whilst the remaining 8 women gave birth to apparently normal babies. Cord sera were available from 5 of the surviving babies and only one contained specific IgM antibodies, showing that transplacental spread of the maternal infections had not occurred in 4 of the 5 survivors.
PREVALENCE OF BACTERIA IN THE VAGINA OF NORMAL YOUNG WOMEN
Authors: Watt B. , Gold Acre M. J. , Loudon N. , Annat D. J. , Harris R. I. , Vessey M. P.
Published: August 2005

We report on factors related to the prevalence of bacteria in the vagina of 1498 women who were attending a family planning clinic. Anaerobes were significantly commoner in women with an abnormal vaginal discharge on clinical examination, in women with a history of a troublesome vaginal discharge and in women who used an intrauterine contraceptive device (IUCD) than in others. The association between anaerobes and abnormalities of vaginal discharge was found both in women who used the IUCD and in women who did not. We found no significant associations between symptoms and other bacterial species or combinations of species. Coliforms were significantly commoner in women who did not use tampons, in women who used the diaphragm and in women who had received recent antibacterial or antifungal treatment than in others. Lactobacilli were significantly commoner in women who used the contraceptive pill, and were significantly less common in women who harboured Candida albicans, anaerobes, coliforms or enterococci and in women who had been treated with antibacterial drugs, than in others. We found no important associations between the presence of bacteria and the patients' age, parity or social class.
PREVALENCE OF YEASTS AND FUNGI OTHER THAN Candida albicans IN THE VAGINA OF NORMAL YOUNG WOMEN
Authors: Goldacre M. J. , Milne L. J. R. , Watt B. , Loudon N. , Vessey M. P.
Published: August 2005

Yeasts and fungi other than Candida albicans were isolated from the vagina of 86 out of 1498 women (5·7 per cent) who attended a family planning clinic and they comprised 27·7 per cent of all fungal species obtained. These fungi were significantly more common in women aged 35 years and over and in those who used the diaphragm than in others. They were no more common in women with an abnormal vaginal discharge on examination than in others; and they were no more common in women with genitourinary symptoms than in women without.
ULTRASONOGRAPHY IN THE DIAGNOSIS OF CERVICAL INCOMPETENCE IN PREGNANCY—A NEW DIAGNOSTIC APPROACH
Authors: Brook I. , Feingold M. , Schwartz A. , Zakut H.
Published: August 2005

Ultrasonography was used to measure the width of the internal os in 24 patients, for whom a McDonald Operation was planned because they were considered to have cervical incompetence and in 19 women with normal obstetric histories. The mean widths of the internal os were 2·57 cm ±0·36 and 1·67 cm ± 0·23, respectively (p <0·001). This new and objective procedure, which is used during pregnancy, provides an additional method for the diagnosis of cervical incompetence.
FETAL DEATH FOLLOWING EXTRA‐AMNIOTIC PROSTAGLANDIN GEL REPORT OF TWO CASES
Authors: Quinn M. A. , Murphy A. J.
Published: August 2005

Intrauterine fetal death occurred in two pregnancies following the extra‐amniotic insertion of prostaglandin gel to ripen the cervix. An antenatal cardiotocogram before gel insertion was normal in each case. Continuous external cardiotocography should be used in patients with a high risk pregnancy who undergo ripening of the cervix before induction of labour.
THE CONSERVATIVE MANAGEMENT OF CERVICAL INTRAEPITHELIAL NEOPLASIA: THE USE OF CRYOSURGERY AND THE CARBON DIOXIDE LASER
Authors: Wright V. C. , Davies Eleanor M.
Published: August 2005

This study comprises 336 consecutive patients of whom 283 were candidates for conservative therapy involving either cryosurgery or the carbon dioxide laser for the management of cervical intraepithelial neoplasia (CIN). A total of 152 patients were treated first in the series with cryosurgery followed by 131 patients in the laser group. Distribution of disease classification within CIN groups was similar. The overall persistent disease after one treatment was higher in the cryo group (14·5 per cent) as compared to the laser group (3·1 per cent). Of particular significance is the high percentage of failures in the cryo treated group (25·0 per cent) with CIN III disease as compared to the CIN III laser treated group (7·7 per cent). The high persistent disease rate observed in the CIN III lesions treated by cryosurgery suggests that this modality be employed with caution in this disease classification.
COMPARISON OF EPIDURAL AND INTRAMUSCULAR PETHIDINE FOR ANALGESIA IN LABOUR
Authors: Husemeyer R. P. , Davenport H. T. , Cummings A. J. , Rosankiewicz J. R.
Published: August 2005

Analgesia mediated by a direct spinal action of narcotic drugs administered via the epidural route may have considerable advantages over conventional (conduction block) epidural analgesia in labour. The efficacy, mode of action and placental transfer of epidurally administered narcotics in labour has not yet been established. We have compared the systemic absorption, analgesia and other effects on the mothers and transfer of drug to the fetus in primigravidae who received epidural or intramuscular pethidine 100 mg in labour. The superior analgesia following epidural pethidine did not appear to be attributable to a selective spinal action but rather to higher plasma concentrations of pethidine together with a possible weak regional conduction block due to local anaesthetic action of 1 % pethidine solution. Epidural pethidine is not an advantageous method for providing analgesia in labour.
EFFECTS OF INTRAMUSCULAR PETHIDINE ON FETAL HEART RATE VARIABILITY DURING LABOUR
Authors: Kariniemi Veikko , ÄMmälä Pirkko
Published: August 2005

The effects of intramuscularly administered pethidine on indices of fetal heart rate (FHR) variability were studied during labour in 20 women. The differential index, describing the short term variability, and the interval index, describing the long term variability, were measured from direct fetal electrocardiograms by a microprocessor‐based ‘on‐line’ system. The indices were measured from 10‐minute samples, once before the pethidine injection and nine times after the injection. The interval index decreased significantly (p <0·01) with the maximum effect 40 minutes after the injection. The differential index also showed a decreasing trend, with a maximum at 40 minutes, but the change was not significant. Both indices returned to the pre‐injection level after 60 minutes. The effect of pethidine on FHR variability during labour might cause difficulties in assessing the fetal state.
IS OXYTOCIN INVOLVED IN PARTURITION?
Authors: Sellers Susan M. , Hodgson Helena T. , Mountford Lesley A. , Mitchell M. D. , Anderson Anne B. M. , Turnbull A. C.
Published: August 2005

Peripheral plasma levels of oxytocin were determined in women during pregnancy and labour. There was a significant increase in maternal plasma oxytocin with advancing gestation but no significant change in levels at any stage of labour. Oxytocin concentrations in umbilical cord plasma were measured after spontaneous vaginal delivery and at elective caesarean section. A significant arteriovenous difference, with higher arterial levels, was found in both groups and the values after labour were significantly higher than at elective caesarean section. These findings suggest that the fetus is able to produce oxytocin which may play a role in human parturition.
CLINICAL SIGNIFICANCE OF SUSPICIOUS ANTEPARTUM CARDIOTOCOGRAMS: A STUDY OF NORMAL AND HIGH‐RISK PREGNANCIES
Authors: Keirse M. J. N. C. , Trimbos J. B.
Published: August 2005

Analysis of 594 antepartum cardiotocograms (CTGs) from 91 strictly normal pregnancies and of 2770 CTGs from 405 high‐risk pregnancies showed a sus‐picious pattern in 7·2 and 17·4 percent respectively. Careful analysis of these CTGs shows that they cannot be considered as either normal or abnormal, whereas their value for predicting the outcome of pregnancy is too limited to be of a direct clinical significance. Although their characteristics vary little between normal and high‐risk pregnancy, their recurrence rate is much higher in high‐risk pregnancy. During high‐risk pregnancy this pattern was obtained on at least two consecutive recordings in 13·3 per cent and on at least three consecutive recordings in 6·2 per cent of patients, as compared to respectively 3·3 and 1·1 per cent during normal pregnancy. Although a single or even repeat occurrence of a suspicious CTG does not justify intervention during pregnancy, our study shows that an adequate follow‐up of repeat CTGs will usually be able to distinguish pregnancies that are in need of intervention from those that are not.
HYDROPS FETALIS DUE TO CONGENITAL CARDIAC RHABDOMYOMA
Authors: Soltan M. H. , Keohane Catherine
Published: August 2005

A case is presented of hydrops fetalis, polyhydramnios and intrauterine death diagnosed antenatally by ultrasound in which congenital cardiac rhabdomyoma was found at postmortem. Conditions associated with rhabdomyoma are briefly discussed.
MONOAMNIOTIC TWINS WITH AN UNUSUAL CORD COMPLICATION
Authors: McLeod FraserN. , McCov DavidR.
Published: August 2005

During the birth of monoamniotic twins the second twin's cord was divided after the birth of the first twin's head. Both infants survived. Division of a cord around the neck of a first twin should be avoided wherever possible.
EXTENSIVE THROMBO‐EMBOLIC DISEASE IN PREGNANCY TREATED WITH A KIMRAY GREENFIELD VENA CAVA FILTER
Authors: Scurr J. , Stannard P. , Wright J.
Published: August 2005

A case of extensive ileofemoral venous thrombosis complicating a twin pregnancy was treated with a Kimray Greenfield inferior vena caval filter to prevent embolism. This is the first report of an inferior vena caval filter being used during pregnancy. Successful management of thrombo‐embolic disease in pregnancy requires accurate diagnosis and aggressive surgical management together with a standardised anticoagulant regimen.
MICTURITION AND THE HEART PERIOD CYCLE IN THE HUMAN FETUS
Authors: Visser G. H. A. , Goodman J. D. S. , Levine D. H. , Da Wes G. S.
Published: August 2005

Campbell et al (1973) suggested that from 32 weeks gestation there was a cyclic filling and emptying of the fetal bladder, with a mean cycle length of 110 minutes. In the present study it was found that emptying of the bladder was associated with cyclic changes in fetal heart rate variation. In 95 per cent of the observations voiding occurred within 30 minutes after a change from a low to a high fetal heart rate variation episode. The possible relation of this association to fetal behavioural states is discussed.
AN ENDODERMAL SINUS TUMOUR OF THE VAGINA IN AN INFANT WITH SEVEN YEAR SURVIVAL CASE REPORT
Authors: Dewhurst John , Ferreira H. P.
Published: August 2005

Malignant tumours of the vagina in infants and children are fortunately rare events. The Botyroid sarcoma (mesodermal mixed tumour or rhabdomyosarcoma) has until recently been the least uncommon but the clear cell adenocarcinoma associated with diethyl‐stilboestrol (DES) therapy taken by the mother during pregnancy is now more often seen. One of the rarest vaginal tumours in this age group is the endodermal sinus tumour and it is also one of the most malignant. A case is described in an infant who is still alive and well seven years after treatment.
LATE THIRD TRIMESTER UNCONJUGATED SERUM OESTRIOL LEVELS IN NORMAL AND HYPERTENSIVE PREGNANCY: RELATION TO BIRTH WEIGHT
Authors: Hardy Michael J. , Humeida Ahmed K. , Bahuri Suhad M. , Basalamah Abdullah H.
Published: August 2005

In 100 normal singleton pregnancies and in 44 patients with pregnancy hypertension (pre‐eclampsia) linear regression analyses demonstrated highly significant positive correlations between birth weights and late third trimester maternal serum unconjugated oestriol (O3) levels. Correlation coefficients increased, though not significantly, after standardising birth weights according to maternal size, parity and sex of infant. Pregnancy hypertension was classified according to the duration of clinical signs. In 23 patients with short duration pregnancy hypertension (onset 14 days or less before delivery) neither maternal age nor birth weight differed from normal controls. Mid‐pregnancy weights were greater and unconjugated O3 levels lower and only one infant was growth retarded. Twenty one patients with long duration pregnancy hypertension (onset more than 14 days before delivery) were found on average to be heavier at mid‐pregnancy and older than those in whom the condition was short‐lived. Unconjugated O3 levels in patients with long duration hypertension were significantly below those in the short duration group. One third of infants born following long duration hypertension were growth retarded.
CARCINOMA OF THE FALLOPIAN TUBE TREATED WITH A COMBINATION OF SURGERY AND CYTOTOXIC CHEMOTHERAPY
Authors: Guthrie D. , Cohen S.
Published: August 2005

Carcinoma of the Fallopian tube is a relatively rare condition which is invariably fatal if primary surgical removal is not possible. In the patient described below potentially curative surgery was possible as a result of cytotoxic chemotherapy.
MYOMETRIAL HAEMANGIOMA A RARE CAUSE OF SEVERE MENORRHAGIA CASE REPORT
Authors: Milton P. J. D. , Thonet R. G. N.
Published: August 2005

A patient with a myometrial haemangioma is described. Arteriographic techniques were used to make the diagnosis. Conservative therapy was ineffective and, after one successful pregnancy, hysterectomy was performed.
NON‐ENDOCRINE CARCINOID TUMOUR OF THE UTERINE CERVIX; ASPECTS OF DIAGNOSIS AND TREATMENT
Authors: Hsu C. , Ma L. , Wong L. C. , Chan C. W.
Published: August 2005

A case of primary well‐differentiated carcinoid tumour of the uterine cervix in a Chinese woman of 62 years without endocrine Symptoms is reported and its clinico‐pathological features, ultrastructure and response to radiotherapy discussed. To our knowledge, it is the first of such cases seen in Hong Kong. Clinically, it presented as a polypoid lesion. The initial diagnosis was squamous carcinoma of cervix stage Ib and the patient was treated with radiotherapy. The tumour dis‐appeared after application of first intracavitary irradiation of 4500 mg h. After completion of 9000 mg h, Wertheim hysterectomy followed and no residual tumour was found. Retrospective staining of the pre‐irradiation cervical tumour by Grimelius method was positive for argyrophil granules and electron microscopic study demonstrated neurosecretory granules in the cytoplasm and established the diagnosis.
OBSTETRIC OUTCOME AND PROBLEMS OF MID‐TRIMESTER FETAL BLOOD SAMPLING FOR ANTENATAL DIAGNOSIS
Authors: Ward R. H. T. , Modell B. , Fairweather D. V. I. , Shirley I. M. , Richards B. A. , Hetherington C. P.
Published: August 2005

Detailed follow‐up is presented of 335 pregnancies in which mid‐trimester fetal blood sampling was performed for the diagnosis of a haemoglobinopathy, mostly β‐thalassaemia. There were three twin pregnancies. Thirty‐eight fetuses were lost including four in whom a diagnosis of thalassaemia major was made. Placenta‐centesis was particularly associated with fetal vessel trauma, exsanguination and early intrauterine fetal death, while late complications associated with fetoscopy or failed fetoscopy necessitating subsequent placentacentesis included spontaneous abortion, leakage of amniotic fluid and premature onset of labour.
TROPHOBLAST SAMPLING IN EARLY PREGNANCY. CULTURE OF RAPIDLY DIVIDING CELLS FROM IMMATURE PLACENTAL VILLI
Authors: Niazi Meena , Coleman Dulcie V. , Loeffler F. E.
Published: August 2005

Trophoblast was obtained by ordinary suction curettage and by transcervical aspiration with a medicut cannula from women having a therapeutic abortion in the first trimester of pregnancy. The decidual tissue which is invariably attached to early placental villi was separated and pure cultures obtained from the trophoblast layers and from the mesenchymal core of placental villi. Cytotrophoblast had a very limited life span in tissue culture, whereas mesenchymal cells grew rapidly and could be used for antenatal diagnosis.
MATERNAL, FETAL AND AMNIOTIC FLUID ACTH, CORTISOL AND PROLACTIN IN ASSOCIATION WITH MEDICAL BETA‐ADRENERGIC STIMULATION
Authors: Kauppila A. , Jouppila R. , Moilanen K. , Pakarinen A. , Tuimala R.
Published: August 2005

In view of observations indicating accelerated fetal pulmonary maturation after tocolytic therapy with beta‐adrenergic agonists, this study was undertaken to determine whether the phenomenon is related to enhanced maternal or fetal ACTH, cortisol or prolactin secretion. The concentrations of ACTH, cortisol and prolactin in maternal venous blood, umbilical arterial and venous blood, and amniotic fluid were similar after short‐term maternal intravenous infusion of isoxsuprine, fenoterol or isotonic saline, and they did not increase in the maternal venous blood during these treatments or during long‐term treatment with intravenous ritodrine. These results suggest that the accelerated fetal pulmonary maturation induced by beta‐adrenergic stimulation is not mediated by ACTH, cortisol or prolactin.
THE EFFECT OF PROGESTERONE, OESTROGENS AND HYDROCORTISONE ON THE MITOGENIC RESPONSE OF LYMPHOCYTES TO PHYTOHAEMAGGLUTININ IN PREGNANT AND NON‐PREGNANT WOMEN
Authors: Skinnider L. F. , Laxdal V.
Published: August 2005

The mitogenic response to phytohaemagglutinin of lymphocytes from women in the third trimester of pregnancy is not inhibited by progesterone, oestriol or oestradiol even at much greater than normal physiological levels. There was no difference in the response of lymphocytes from pregnant or non‐pregnant women. Inhibition in the mitogenic response to phytohaemagglutinin was achieved with hydrocortisone but not at the physiological levels found in pregnancy. The results from this in vitro study would not support the view that the level of steroid hormones in pregnancy significantly affects the immunological status of the mothers.
THROMBOCYTOPENIA AND MACROTHROMBOCYTOSIS IN GESTATIONAL HYPERTENSION
Authors: Giles C. , Inglis T. C. M.
Published: August 2005

The platelet count in 550 patients with gestational hypertension was significantly lower and the mean platelet volume significantly higher than in normal pregnant women. Both the platelet count and volume became increasingly abnormal when hypertension was accompanied by oedema, proteinuria or both, and women with severe pre‐eclampsia or eclampsia had the lowest platelet counts and the highest mean platelet volume. The proportion of patients with thrombocytopenia and/or macrothrombocytosis also varied with the severity of the clinical presentation. Fibrinogen degradation products were found mainly in fully developed preeclampsia. These findings confirm the concept of a rapid platelet turnover caused by low‐grade disseminated intravascular coagulation in gestational hypertension. The platelet pattern in essential hypertension is similar to that seen in normal pregnancy.
PRIMARY CARCINOMA OF THE FALLOPIAN TUBE
Authors: Raju Kankipati S. , Barker G. H. , Wiltshaw Eve
Published: August 2005

Twenty‐two patients with primary carcinoma of the Fallopian tube treated at the Royal Marsden Hospital are reported. The age distribution, parity and variety of presentation of the disease were in accordance with previous reports in the literature. Overall survival at 5 years was 48% and the place of radiotherapy and chemotherapy in its management remains to be established.
RADICAL SURGERY IN STAGE I CARCINOMA OF THE CORPUS UTERI
Authors: Iversen T. , Holter J.
Published: August 2005

Thirty‐four patients with stage I adenocarcinoma of the corpus uteri were selected for radical hysterectomy combined with bilateral transperitoneal pelvic lymphadenectomy and followed 8 to 15 years. Metastases to the pelvic lymph nodes were diagnosed in 18%. Invasion of tumour in lymph or blood vessels was found in 17 patients, and five of these patients had lymph node metastases whereas this was true in only one out of 17 patients without demonstrable vessel invasion. The 5‐year crude survival was 80% with 15% urinary tract complications.
FETAL BLOOD VELOCITY WAVEFORMS IN UNCOMPLICATED LABOUR
Authors: Stuart B. , Drumm J. , Fitzgerald D. E. , Duignan N. M.
Published: August 2005

A combination of pulsed echo and continuous wave Doppler ultrasound was used to obtain blood flow velocity signals from the umbilical arteries of 10 patients during uncomplicated spontaneous labour. Audio frequency analysis of these signals yielded fetal blood velocity waveforms. Analysis of these waveforms demonstrated that placental vascular resistance to feto‐placental blood flow is not altered by uterine contractions, artificial rupture of the membranes, the infusion of oxytocin nor the administration of analgesia during uncomplicated labour.
MATERNAL SEXUALITY DURING FIRST PREGNANCY AND AFTER CHILDBIRTH
Authors: Robson Kay Mordecai , Brant H. A. , Kumar R.
Published: August 2005

Information about sexual activity, enjoyment and libido was obtained at intervals from 119 primiparous women during a longitudinal survey of maternal emotional health in pregnancy and for a year after delivery. Most subjects described some reduction in the frequency of sexual intercourse and a diminution of libido and sexual enjoyment during pregnancy; this was most marked in the third trimester. After delivery, about a third of subjects had resumed intercourse by six weeks and nearly everyone had done so by three months. Nevertheless, 77 % and 57 % of the women were having intercourse less often at three and 12 months after delivery respectively, in comparison with the month before they became pregnant. Selected variables were examined for relationships with a low, or reduced frequency of intercourse and with a lack of enjoyment. Significant associations were found with aspects of maternal personality and childhood relationships, marital conflict, maternal depression, previous miscarriages, difficulties in conceiving and fears of harming the fetus. Nausea and vomiting during pregnancy, the mode of delivery and related obstetric and medical variables, breast‐feeding and characteristics of the baby, did not appear to significantly influence maternal sexuality.
THE EFFECT OF AGE AND GRAVIDITY ON MENSTRUATION
Authors: Chamberlain Geoffrey , Roman Eve , Pharoah Peter , Alberman Eva , Osborn John
Published: August 2005

An analysis of reported menstrual cycles of 1615 women doctors has shown that the duration of menstrual bleeding was not associated with increasing age but the total length of cycle decreased. Hence that part of cycle free from menstruation decreased with increasing age. There was no apparent association between gravidity and total cycle length.
SCANNING ELECTRON MICROSCOPY OF THE ENDOMETRIAL CELL SURFACE IN POSTMENOPAUSAL WOMEN RECEIVING OESTROGEN THERAPY
Authors: Thom Margaret H. , Davies K. J. , Senkus R. J. , Allen J. M. , Studd J. W. W.
Published: August 2005

The surface ultrastructure of normal and abnormal endometrial cells from patients receiving oestrogen therapy for the climacteric syndrome was studied by scanning electron microscopy. Patients with endometrial pathology were treated with oral progestogens. Excessive oestrogen stimulation caused proliferation of cilia and microvilli. Cystic hyperplasia was characterised by a proliferation of cilia until they covered more than one‐third of the surface area of the endometrium; further proliferation occurred in cases of adenomatous hyperplasia when the surface was almost completely covered with cilia. Cell morphology remained apparently normal until atypical hyperplasia, when occasional cells appeared large and irregular, or adenocarcinoma occurred, when the surface cells appeared large, pleomorphic and sometimes wrinkled, being mostly devoid of cilia. Although cystic hyperplasia was converted to a normal histological picture of atrophic or pseudo‐decidual endometrium by courses of progestogen, the deciliated endometrial cells showed persisting abnormal ultrastructural characteristics.
CARDIOVASCULAR RESPONSES DURING THE MENOPAUSAL HOT FLUSH
Authors: Ginsburg Jean , Swinhoe June , O'Reilly Barbara
Published: August 2005

Circulatory responses during spontaneous and stress induced menopausal flushes were measured by a plethysmographic technique. With the onset of symptoms there was an immediate and marked increase in hand blood flow which was sustained over three to four minutes and then fell to control levels over a further three minutes. Forearm and calf flow increased simultaneously though to a lesser extent and regained control levels within four‐and‐a‐half minutes from the onset of symptoms. Mean pulse rate also increased during the flush but fell to control values at a time when limb flow was still elevated. There was no significant change in blood pressure during or after the flush. The peripheral circulatory changes are attributed to altered autonomic activity and may in part reflect a disturbance of thermoregulatory control in the menopause of which the flush is but one manifestation.
TERMINATION OF MIDTRIMESTER MISSED ABORTION BY EXTRAOVULAR INSTILLATION OF NORMAL SALINE
Authors: Abramovici H. , Rofé A. , Atad J. , Lewin A.
Published: August 2005

Abortion was successfully induced in 36 patients with midtrimester missed abortion by instillation of normal saline solution into the extraovular space. This technique avoids the risks of amniocentesis and the unwanted side effects of methods using prostaglandins, oxytocin or hypertonic saline. The possible mechanism of abortion by using the extraovular instillation of normal saline is discussed.
ACTINOMYCES‐LIKE STRUCTURES AND THEIR ASSOCIATION WITH INTRAUTERINE CONTRACEPTIVE DEVICES, PELVIC INFECTION AND ABNORMAL CERVICAL CYTOLOGY
Authors: Sykes Gary S. , Shelley Glenys
Published: August 2005

A total of 1919 cervical cytology smears from South Glamorgan family planning clinic patients were studied and actinomyces‐like structures were identified in 38. All 38 were from women reported as having an intrauterine contraceptive device (IUCD) and they represent 25 per cent of the 147 women in the whole study who were reported as having an IUCD. There was no evidence of pelvic infection or significant increase in gynaecological problems amongst these 38 women, but there was a significant increase in atypical and dyskaryotic cells in the cervical smears.
THE MANAGEMENT OF CHORIOCARCINOMA CAUSING SEVERE THYROTOXICOSIS
Authors: Soutter W. P. , Norman R. , Green‐Thompson R. W.
Published: August 2005

Two patients with metastatic choriocarcinoma complicated by severe thyrotoxicosis, leading to cardiac failure in one instance and thyroid crisis in the other, are described. The successful treatment of these complications is detailed, and routine prophylaxis for high risk patients, using propylthiouracil, oral iodide, propranolol and urgent, aggressive chemotherapy, is recommended.
GONADAL DYSGENESIS AND X CHROMOSOME DELETION
Authors: Dewhurst John
Published: August 2005

Three cases of gonadal dysgenesis associated with deletion of the long arm of the X chromosome and one associated with an isochromosome for the long arm are here described. Their features support the proposition that genes concerned with ovarian differentiation are located in the region of the centromere. The long arm of the X chromosome may, nonetheless, contain some statural determinants whilst loss of all the short arm material may occasionally be associated with normal stature.
Is end‐stage deceleration of the fetal heart ominous?
Authors: KATZ MIRIAM , SHANI NAFTALI , MEIZNER ISRAEL , INSLER VACLAV
Published: August 2005

Summary. End‐stage deceleration (ESD) defined as deep and sustained fetal bradycardia during the second stage of labour was observed in 55 patients. Fetal well‐being and neonatal outcome were assessed with fetal‐scalp pH, umbilical‐vein pH and l‐min Apgar score values. Only six infants with pathological fetal heart‐rate patterns before ESD had a l‐min Apgar score of <7 and an acidotic umbilical‐vein pH. The remaining 49 babies were born in excellent condition, although when ESD persisted for more than 15 min umbilical‐vein pH decreased.
Factors associated with preterm labour and changes in the cervix before labour in twin pregnancy
Authors: HOULTON M. C. C. , MARIVATE M. , PHILPOTT R. H.
Published: August 2005

Summary. A total of 132 twin pregnancies in black African women were studied prospectively after 30 weeks gestation. Delivery occurred before 37 weeks in 32%. There was a trend (0.1 > P > 0.05) towards a higher preterm delivery rate in nullipara (57%), in women under the age of 20 years (60%) and in those with a height/weight ratio of >2.5 (50%). The cervix was assessed with a score based on the length of the canal minus the dilatation of the internal os. In both term and preterm labour there was a significant relation between a cervical score of 0 or a decrease in cervical score and the onset of labour within the subsequent 14 days (P < 0.001). By these criteria to predict impending labour, 60% of all labours that ensued within 14 days of the assessment would have been predicted with a 20% false positive rate. When nulliparae were excluded the predictive value of cervical assessment for preterm labour was 80% with a false positive rate of < 5%. Plasma oestriol levels were significanty higher in the preterm labour group but had no clinical prognostic value.
Immune status of anaemic pregnant women
Authors: PREMA K. , RAMALAKSHMI B. A. , MADHAVAPEDDI R. , BABU S.
Published: August 2005

Summary. Immune status during the third trimester of pregnancy was investigated in relation to maternal haemoglobin levels. The proportion of T and B lymphocytes showed a tendency to fall in anaemic women which was significant when haemoglobin levels were <8 g/dl. Immunoglobin G showed the opposite trend. There were no alterations in phytohaemag‐glutinin‐induced lymphocyte transformation in relation to haemoglobin concentration.
Levels of circulating immune complexes in patients with ovarian cancer
Authors: CLARKE ANN G. , VASEY D. P. , SYMONDS E. M. , FARATIAN B. , McLAUGHLIN P. J. , PRICE M. R. , BALDWIN R. W.
Published: August 2005

Summary. Sera from patients with ovarian tumours were assayed for circulating immune complexes (CIC) by four well established assays based on the interaction of immune complexes with components of the complement system. There was no difference in control, pre‐ or post‐operative or BCG‐treated patients' sera. Levels were also unchanged in sera in antigen excess. In patients with ovarian tumours therefore the measurement of CIC would appear to be of little value as a screening test, as a guide to the extent of disease, prognosis or therapy. In a small pilot therapy‐trial there was no difference in the survival rate between patients with stage III and IV ovarian cancer treated with cyclophosphamide plus BCG and those who received only cyclophosphamide. Treatment with BCG was associated with postoperative pyrexia and a prolonged hospital stay.