bluuebunny/crossref_metadata_2025 huggingface dataset:
Prolonged Labour in Multigravidae
Authors: Giles P. F. H.
Published: February 2008

An analysis is presented of labours lasting 36 hours or longer in 155 multigravidae delivered at the Royal Women's Hospital, Melbourne, from 1958 to 1965. The method of delivery was Caesarean section in 24%, forceps delivery in 21%, and unaided vaginal delivery in 49%.

In booked patients the corrected perinatal mortality was 40/1000 and in non‐booked patients it was 100/1000; the overall perinatal mortality was 111/1000. The perinatal mortality was highest in those delivered by Caesarean section and in those who had a difficult vaginal delivery; it was not raised in those who had an unaided vaginal delivery. Cephalopelvic disproportion was common; 48% of the babies delivered weighed over 4000g.

Friedman's curves showing dilatation of the cervix against elapsed time were found to be invaluable in predicting the outcome of prolonged labours. Prolongation of the latent phase of labour carried a low perinatal mortality (33/1000, corrected to 0/1000) and a 70% normal vaginal delivery rate; a protracted active phase or secondary arrest in the active phase of labour carried perinatal mortality rates of 180/1000 (corrected 109/1000) and 200/1000, and a very high Caesarean section rate.

Analysis of the prolonged labours showed that favourable prognostic signs for the vaginal delivery of a healthy baby were (in order of importance) a favourable fetal lie and position, good placental function, membranes remaining intact until late in labour, and lack of maternal distress.

Signs of maternal distress (such as the need for intravenous fluids, frequent analgesics, or a rising maternal pulse) or the need for oxytocin infusion because of delay in the active phase pointed to the need for careful evaluation and possible early Caesarean section.
Point of View: Human Pregnancy Nutrition: An Examination of Traditional Assumptions
Authors: Brewer Thomas H.
Published: February 2008

The traditional assumptions with reference to nutrition in human pregnancy which dominate clinical thinking and practice are critically reviewed.
The Place for Anti‐D Gamma Globulin in Abortion
Authors: Edwards R. F.
Published: February 2008

A study was made of the incidence and volume of feto‐maternal haemorrhage in 129 patients with threatened or incomplete abortion, and in a control group of 110 healthy pregnant women. The incidence of feto‐maternal haemorrhage was 15.5% in the abortion group and 3.6% in the control group. The incidence of significant feto‐maternal haemorrhage was 14.3% in patients with incomplete abortion. The significant of these findings is discussed and it is concluuded that prophylactic anti‐D gamma globulin should be given to all non‐immunised rhesus negative women having any type of abortion.
The Management of Eclampsia with Intravenous Diazepam and Protoveratrine
Authors: Elliott Peter M.
Published: February 2008

Eclampsia is uncommon in Australia but remains an important cause of maternal mortality. The present paper reports the efficacy of diazepam (“Valium”) and protoveratrine (“Puroverine”) in the management of 3 patients with eclampsia. Convulsions were controlled initially by direct intravenous injection of diazepam and sedation was maintained by repeated intramuscular administration of this drug. After immediate control of convulsions, the blood pressure was lowered by intravenous and thereafter intramuscular protoveratrine. No further convulsions occurred after the commencement of treatment.
The Management of Missed Abortion
Authors: Ratten Graeme J.
Published: February 2008

A review has been made of 83 patients with missed abortion. Conservative management would appear to be the treatment of choice of this condition about which the risks of haemorrhage at the time of curettage and hypofibrinoganaemia are discussed.
Endocrinology of the Conceptus
Authors: France John T.
Published: February 2008

Steroid metabolism in pregnancy involves complex inter‐relationships between fetus, placenta and mother.

Evidence indicates that the placenta lacks certain enzymes that are necessary for the biosynthesis of steroid hormones. The fetus possesses these enzymes, but on the other hand lacks those enzymes which are present in the placenta. The placenta and fetus are then themselves not complete endocrine organs, but together complement each other, forming a functional unit for the production of steroids. Thus, progesterone is produced in the placenta mainly from maternal cholesterol. Oestrogen production takes place in the fetal‐placental unit. The placenta converts dehydroepiandrosterone sulphate and 16α‐hydroxydehydro‐epiandrosterone sulphate of fetal origin into oestrone/oestradiol and oestriol respectively.

Dehydroepiandrosterone sulphate secreted by the maternal adrenal can also be utilised by the placenta for oestrogen biosynthesis. About 50% of the oestrone and oestradiol produced arises from this source.
Labour and Delivery after Caesarean Section
Authors: Kuah K. B.
Published: February 2008

Three hundred and sixty‐six patients with a history of previous Caesarean section or hysterotomy have been studied with reference to subsequent labour and mode of delivery in 454 pregnancies.

Elective Caesarean section was performed in 132 (29%); vaginal delivery, which was attempted in 322 cases, was successful in 78%. The vaginal delivery rate for the whole series was 55%.

The type of uterine scar and state of scar at subsequent delivery are recorded. The incidence of scar dehiscence was found to be 1.1%. There was no maternal mortality in the series but an increase was noted in maternal morbidity.
Pelvic Lymph Node Metastases in Carcinoma of the Cervix
Authors: Kneale Barry
Published: February 2008

During 1951‐1959 inclusive 391 patients with invasive cervical cancer were subjected to pelvic lymphadenectomy, usually in association with radical hysterectomy. Twenty‐nine per cent, had nodal metastases, the incidence being 20% in Stage 1 and 26% in Stage 2. Of the patients with involved nodes only 32% survived 5 years or more, compared with 76% in those without involved nodes. Patients in the latter group with Stage 1 lesions had a much better prognosis than those with Stage 2 lesions.

External irradiation of lymph nodes prior to surgery markedly reduced the incidence of metastases. The serious effects of megavoltage therapy prior to radical surgery were noted. The significance of the site and number of nodal metastases was examined. The importance of survival for 3 years in the patient with positive nodes is emphasised.
The Management of Severe Postpartum Eclampsia with D‐Tubocurarine and Controlled Ventilation in the Intensive Care Unit
Authors: Chan Dr. W. F. , Delilkan Dr. A. E.
Published: February 2008

A case of severe postpartum eclampsia treated with d‐tubocurarine and controlled ventilation in the intensive‐care unit is described.
Genital Tract Sources of Renin
Authors: Symonds E. M. , Skinner S. L. , Stanley M. A. , Kirkland J. A. , Ellis R. C.
Published: February 2008

Myometrium from a non‐pregnant subject has been shown to produce renin in tissue culture. The pattern of renin productionin vitroby myometrium from a non‐pregnant subject was similar to that demonstrated in tissue culture of myometrium from pregnant subjects.

Bowie‐positive cells have been demonstrated in a scattered distribution throughout the myometrium and chorion. It is suggested that these cells are the site of synthesis of renin in these tissues. These cells occur much more frequently in chorion than in myometrium, a finding which relates well to the renin content of these tissues.
The William Hawksworth Memorial Lecture 1970
Authors: Lewis T. L. T.
Published: February 2008

I deeply appreciate the honour of being entrusted with the responsibility of delivering the first William Hawksworth Memorial Oration in New Zealand. My immediate reaction to the invitation was to wonder why you had not asked a New Zealander to undertake such an important task; but as I thought it over I realized that by coming half way round the world to pay tribute to this great and dedicated obstetrician and gynaecologist, who was at the same time one of the most genuine, frank and unassuming of men, my pilgrimage might serve to emphasise his international reputation as clinician, teacher and surgeon. He was a man who, for all his fame on both sides of the Atlantic, never forgot he was first and foremost a New Zealander. A man who, although he took life seriously, thoroughly enjoyed it and saw always the good points in others. I am greatly honoured, therefore, to undertake the happy duty of trying to capture for you some memories of a personal friend whose integrity and patent sincerity remain a shining example to us all.
A Review of 50 Cases of Primary Amenorrhoea
Authors: Evans James H.
Published: February 2008

Summary: Fifty cases of primary amenorrhoea are reviewed with reference to the aetiology. In all patients the buccal smear chromatin complement was measured and chromosomal study proceeded to if this revealed less than 25% of cells to be chromatin positive. Total urinary gonadotrophin and oestrogen assays were performed in all patients and the spectrum of values seen is presented.

The most common cause was chromosomal abnormality (24%). Although investigation to the extent performed is often not necessary to establish a precise diagnosis, such study is indicated to assess gonadal potential and subsequent fertility potential. In the present series, 31 (62%) patients were potentially fertile. With rational and physiological therapy all patients should be capable of leading normal, sexually active lives. To the present time, pregnancy has resulted from gonadotrophin therapy in the 5 patients in whom it has been indicated.
Urinary Gonadotropins — General, F.S.H. and L.H. and Urinary Oestrogens in Dysfunctional Amenorrhoea
Authors: Taft H. P. , Ekkel I. , Brown J. B. , Evans J. H.
Published: February 2008

Summary: Urinary gonadotrophins—general, F.S.H. and L.H.—and urinary oestrogens were measured in 10 patients, two with primary and eight with secondary dysfunctional amenorrhoea.

Gonadotrophin levels were within the normal range whether or not urine oestrogen excretion was at postmenopausal levels. No pattern of relationship between the F.S.H.: L.H. ratio and urine oestrogen emerged, these ratios being similar to those found in other “non‐cycling” situations.

The absence of an inverse relationship between gonadotrophin and oestrogen with gonadotrophin levels being inappropriately low relative to oestrogen levels, considered together with the clinical history and outcome of treatment, support the thesis of hypothalmic‐pituitary failure as the cause of the defect in these patients.
Education in Obstetrics and Gynaecology The Needs of South Pacific Territories
Authors: Lancaster D. J.
Published: February 2008

The Pacific Ocean covers an area of 68 million square miles in which are scattered many island groups. In the Eastern area Samoa, Tonga, Cook and Tokelau are the main groups. In the south‐west Pacific area are Papua New Guinea, the Solomons, New Hebrides and New Caledonia.
Haemoperitoneum Complicating a Case of Combined Intra‐ and Extra‐uterine Pregnancy at 25 Weeks of Gestation
Authors: Voigt J. C. , Chalk P. A. F.
Published: February 2008

Summary: A case is described of massive haemoperitoneum complicating a normal 25‐week intra‐uterine pregnancy. The source of the bleeding was a coexisting tubal ectopic gestation.
A Trial of Chlormezanone, a Non‐hormonal Tranquillizer, for Inhibition of Postpartum Lactation
Authors: Lee K. H.
Published: February 2008

Summary: In view of the risk of thrombo‐embolism from the postpartum use of oestrogens, an attempt was made to find a non‐hormonal substance for the inhibition of lactation. A trial of chlormezanone (Fenarol) showed that it was not better than a placebo and that stilboestrol was distinctly superior in the initial suppression of lactation.
An Unusual Presentation of Varicose Veins of the Vulva
Authors: Royle J. P. , Macafee C. A. J. , Beischer N. A.
Published: February 2008

Summary: In the case presented, a large varix resulted in a painful lump, deep in the vulva, when the patient was standing or straining. Initially the mass was thought to be a hernia. The radiographic investigation of the patient is described and the subsequent surgical management is outlined.
Contraception with a Six‐Monthly Injection of Progestogen: Part 1. Effects on Blood Pressure, Body Weight and Uterine Bleeding Pattern, Side‐Effects, Efficacy, and Acceptability
Authors: V. Mackay E. , K. Khoo S. , R. Adam R.
Published: February 2008

: A clinical study of the use of medroxyprogesterone acetate as a method of contraception, administered as 6‐monthly intramuscular injections of 300 mg., was carried out in 61 women. A total of 989 months of study were completed and 14 women received 4 injections or more.

There were no significant changes in the systolic and diastolic pressure or in the body weight during 18 months of observation as compared with the pre‐treatment levels.

Disorganisation of the uterine bleeding pattern was encountered, particularly during the first 6 months. However, there was a progressive decrease in the duration of bleeding per month and increase in the proportion of women who had amenorrhoea with time.

Side‐effects were varied but mild; depression and diminution in libido were comparatively common.

No pregnancy occurred during the period of study. Twenty of the 61 women discontinued treatment for reasons related to the drug, the important factor in 75% of the drop‐outs was unacceptable bleeding.
Contraception with a Six‐Monthly Injection of Progestogen: Part 2. Effects on Cervical Mucus Secretion and Endocrine Function
Authors: V. Mackay E. , K. Khoo S. , R. Adam R.
Published: February 2008

The cervical mucus and the endocrine function were studied in 61 women who received 6‐monthly intramuscular injections of 300 mg. medroxyprogesterone acetate as a method of contraception.

Changes in cervical mucus were immediate and marked; its ferning and spinnbarkeit properties were absent, and its volume was greatly reduced. The karyopycnotic index of the vaginal smear remained relatively low during treatment

Urinary oestrogen excretion was only temporarily affected; depression in mean levels occurred only in the first 1 to 2 months after each injection. Urinary total gonadotrophins were depressed and an increasing proportion of women showed subnormal activity after each subsequent injection. The majority of urinary pregnanediol levels obtained were not consistent with corpus luteum activity.

There were no significant changes in urinary excretion of ketosteroids and 17 hydroxycorticosteroids.

No obvious differences in the hormonal indices of women with different patterns of uterine bleeding were noted.

The mechanism of action of medroxyprogesterone is discussed with reference to the literature. Contraceptive efficacy is probably provided by changes in cervical mucus as well as inhibition of ovulation, without severe disturbance of endogenous oestrogen production.
Post‐haemorrhagic Shock in the Newborn
Authors: L. Tan K.
Published: February 2008

: Post‐haemorrhagic shock in the newborn is a relatively rare condition. If evidence of fetal bleeding during labour was not available, a baby in this condition would often be misdiagnosed as having shock due to asphyxia. Three cases of post‐haemorrhagic shock are presented. The routine examination of vaginal blood shed during the first stage of labour for the presence of fetal haemoglobin is recommended. This would enable prompt obstetric action and perhaps avert fetal disaster. Careful examination of the placenta is also important and may permit the diagnosis of fetal haemorrhage soon after birth of the infant.
An Unusual Cause of Postmenopausal Bleeding
Authors: B. Duff G.
Published: February 2008

: A case of mucinous cystadenocarcinoma of the ovary metastasizing to the endometrium with resultant postmenopausal bleeding is presented.
Laparoscopic Removal of an Intra‐uterine Divice
Authors: W. Page S. , L. Monks P.
Published: February 2008

: A case is reported wherein a plastic contraceptive device was removed by means of the laparoscope and biopsy forceps from an extra‐uterine site in the pelvis. The removal under direct laparoscopic vision was both rapid and simple.
The Evolution of Placentation*
Authors: Kaye M. D.
Published: February 2008

The evolution of the primate chorio‐allantoic placenta is traced from its earliest beginning in Invertebrates ascending through the Vertebrate classes to man. Placental evolution appears to be progressing towards greater invasion of maternal tissues and endocrine autonomy independent of the maternal host.
Growth and Malignancy of Ovarian Tumours in Pregnancy
Authors: Beischer N. A. , Buttery B. W. , Fortune D. W. , Macafee C. A. J.
Published: February 2008

A series of 164 ovarian tumours diagnosed during pregnancy or the puerperium is presented. The commonest were the benign cystic teratoma (45 cases) and the mucinous cystadenoma (40 cases). Rapid growth of the tumour during pregnancy was observed in 5 of the 41 patients (12%) in whom assessment was possible; in none of these was the lesion malignant. The incidence of malignancy was 2.4% (4 of 164 cases) or 10 times less than that of ovarian tumours in non‐pregnant patients. This difference was accounted for by the variation in age distribution in pregnant and non‐pregnant patients with ovarian tumours.

There were 21 patients with tumours 15 cm. or more in diameter. In this group the incidence of malignancy was 5% and the commonest complications were torsion (5 patients) and infection during the puerperium (4 patients).
A Comparison of the Long‐Acting Contraceptive Agents Norethisterone Oenanthate and Medroxyprogesterone Acetate
Authors: Chinnatamby Siva
Published: February 2008

Two intramuscular contraceptive agents, norethisterone oenanthate, 200 mg. given each 84 days, and medroxyprogesterone acetate, 150 mg. given each 90 days, have been studied in 1035 women for 10,161 cycles. Continuation of medication is about 85% at the end of 15 months; this rate is much higher than that of any other method in use in Ceylon. Of the side‐effects the most important is the disruption of the menstrual cycle leading to either long periods of amenorrhoea or continued bleeding. In spite of this, only 26 patients abandoned therapy for this reason. Oestrogen was given only to selected patients to arrest bleeding or to cause withdrawal bleeding in cases with long periods of amenorrhoea. The pregnancy rates were 2.3 per 100 women years for the norethisterone oenanthate, and 0.4 for the medroxyprogesterone; these could have been minimised if the drug was administered early in the cycle and on the 84th day as planned.

There is no doubt that the long‐acting injectable is a very acceptable form of control of conception to the woman of low socio‐economic group provided the side effects (especially the disruption of the menstrual cycle) can be minimised.
Ketone Bodies in Fetal and Maternal Blood During Parturition
Authors: Bencini F. X. , Symonds E. M.
Published: February 2008

Summary: Ketone bodies in fetal and maternal blood were studied in 23 normal women during parturition. There was a highly significant positive linear relationship between levels of ketone bodies in fetal and maternal blood, but no relationship could be shown between the level of ketone bodies and acid‐base status in either maternal or fetal blood. The level of total ketone bodies in maternal blood was significantly related to the length of labour. Quantitatively, the major ketone body in maternal and fetal blood was β‐hydroxybutyric acid.
The Place of Laparoscopy in “Normal” Gynaecological Practice
Authors: Blunt Alan
Published: February 2008

Summary: One hundred and eight diagnostic laparoscopies performed at the Princess Alexandra Hospital, Brisbane, between July, 1969, and January, 1971, are reviewed. The 4 principal indications were infertility, endocrine disorders, chronic pelvic pain, and suspected ectopic pregnancy. There were no serious complications.
An Artificial Conduit for the Collection of Ova in the Rabbit
Authors: Taylor R. McK. , McKinnon L. J. , Wood C.
Published: February 2008

Summary: A technique is described for the repeated collection of oocytes from rabbits. It involves the use of a Silastic conduit, one end enclosing the ovary and the other lying in the vagina or subcutaneously. After stimulation of ovulation it was possible to collect oocytes from 20 of the 38 rabbits. The implications of the technique, particularly in the field of human infertility surgery, are discussed.
A Study of Uncomplicated Prolongation of Pregnancy*
Authors: Sinnathuray T. A.
Published: February 2008

Summary: A study of the obstetrical hazards in 1,000 patients with uncomplicated prolongation of pregnancy revealed a highly significant increase in the incidence of fetal distress (× 2) and perinatal mortality (× 10) without any appreciable difference in the Caesarean section and oxytocin drip rates in those patients who were induced after the 43rd week of gestation compared with those who were induced at the 43rd week of gestation.
An Investigation of Trophoblast Iso‐Immunization in Normal Pregnancy
Authors: Jones W. R. , Kaye M. D. , Ing R. M. Y.
Published: February 2008

Summary: There has been widespread interest in the survival of the mammalian placenta as an allograft and in the possibility that humoral isoimmunization against placental antigens might occur in normal pregnancy.

In this study, an indirect immunofluorescent test for circulating antitrophoblast antibodies failed to confirm previous reports of their presence in the serum of pregnant and postpartum women. An incidental, but common and non‐specific immunofluorescent staining characteristic of extra‐cellular fibrinoid material was demonstrated in sections of early placenta and to a lesser degree in late placenta.
Thrombotic Thrombocytopenic Purpura Presenting as Eclampsia
Authors: Perel I. D. , Forgan‐Smith W. R.
Published: February 2008

Summary: A 29‐year‐old woman presented with mild thrombocytopenia in early pregnancy. In the third trimester she developed symptoms of eclampsia with severe focal neurological signs, renal failure and intravascular coagulation. Some benefit was obtained from anticoagulant therapy, which consisted of heparin in the acute phases of her illness and oral anticoagulants during several months' management as an outpatient. The disease process is discussed in relation to the clinical course, haematological abnormalities, and autopsy findings.
Locked Twins — An Unusual Case
Authors: Chang Allan
Published: February 2008

Summary: A case of locked twins associated with fetal abnormality is presented.

Fetal abnormality and polyhydramnios as the cause of fetal interlocking in this case is suggested.
Squamous Cell Carcinoma Arising in a Dermoid Cyst of the Ovary
Authors: Sivanesaratnam V. , Lee T. T.
Published: February 2008

Summary: A case of unexpected squamous cell carcinoma arising from a benign cystic teratoma is presented. The tumour occurred in a 57‐year‐old Chinese patient. No recurrence was evident after 1 year. The literature is briefly reviewed.
Menstrual Disorders in Patients With Thyrotoxicosis
Authors: Saunders D. M. , Stiel J. N. , Hales I. B.
Published: February 2008

Summary: A retrospective study of the menstrual pattern of 137 thyrotoxic patients attending the thyroid clinic of the Royal North Shore Hospital of Sydney was undertaken and comparison with a euthyroid control group was made.

The study showed that there was no significant difference in menstrual function between the 2 groups.
Palliation of Metastatic Endometrial Adenocarcinoma With Dimethisterone
Authors: Morrison J. , Blunt V. A. W.
Published: February 2008

Summary: Sixteen patients with proven metastatic endometrial carcinoma were treated with Dimethisterone. There was an objective response rate of 30% and a subjective response rate of 25%. It is concluded that Dimethisterone is a useful drag in the treatment of metastatic endometrial carcinoma.
The Timing and Dosage of Oxytocin in the Induction of Labour
Authors: Webb M. J. , Fogarty A. J.
Published: February 2008

Summary: A comparison is made between a series of 104 consecutive patients induced by amniotomy and an oxytocin infusion 3 hours later if the patient was not in established labour, and a series of 104 patients where a 24‐hour delay was allowed before the infusion was started. The benefits of the former regimen were a significantly shorter induction‐delivery interval and duration of labour without an increase in fetal or maternal morbidity; there were consequent advantages to both the mother and the medical staff.
The Control of Hypertension in Labour
Authors: Michael C. A.
Published: February 2008

Summary: Twenty‐five patients with severe pre‐eclamptic toxaemia in labour were treated with one of the hypotensive drugs bethanidine or diazoxide combined with diazepam. In all patients a satisfactory reduction and subsequent control of the blood pressure occurred. There was no maternal mortality or morbidity and there was one neonatal death from prematurity. Diazoxide has a more rapid and predictable action than bethanidine, but it may cause hyperglycaemia in the fetus and therefore should probably be avoided in diabetic patients.

It is contended that the combination of a hypotensive agent with an anticonvulsant drug such as diazepam is more effective in controlling an elevated blood pressure in labour than the conventional administration of heavy sedatives with their associated maternal and fetal hazards.
Primary Melanoma of the Vagina
Authors: Ng K. H. , Chan D. P. C. , Prathap K.
Published: February 2008

Summary: A case of primary melanoma of the vagina treated initially by radiotherapy and later by Wertheim hysterectomy is described and the literature on this rare tumour is reviewed.
Ultrasonic Film Echoscopy for Placental Localization
Authors: Kossoff George , Garrett William J.
Published: February 2008

Summary: A different ultrasonic appearance of the placenta is seen when film echography is used instead of the standard storage tube echoscopy. Film echography gives more detailed information about the placenta and makes localization uniformly successful.
Physiological Weight Changes in Pregnancy in Malaysian Women*
Authors: Sinnathuray T. A. , Wong W. P.
Published: February 2008

Summary: A study was made of the changes in weight during pregnancy and puerperium of 600 Malaysian women of 3 ethnic groups.

The average total weight gain throughout pregnancy was about 11 kg. (24 lb.), the figure being higher for primigravidae (about 11.7 kg.) and lower for multigravidae (10.7 kg.).

The average total weight gain throughout pregnancy was about 1–2 kg. (2–4 lb.) less than that for European and American women, but about 5–6 kg. (11–13 lb.) more than that reported for Indian and Nigerian women.

The net weight gain of 4.5 kg. (10 lb.) at the end of the puerperium in Malaysian women is higher than that reported in Western studies. This is probably a reflection of the cultural, dietary, and physical habits of Malaysian women in the puerperium.
Infertility, Practice and Practicability
Authors: Cox L. W.
Published: February 2008

Summary: The results of treatment of anovulatory infertility over a 6‐year period, which included the introduction of gonadotrophins and clomiphene citrate, are presented. Two hundred and sixty patients have been treated, and 139 of these became pregnant. Eighty‐nine of the first 100 completely treated patients had no other infertility factors and 69 of these (78%) achieved at least 1 pregnancy. The reasons for withdrawal from treatment before successful pregnancy had occurred included problems of remote management, and the acceptance of adoption. Four patients required psychiatric advice for disorders occurring during the treatment regimen.
Radiation Treatment of Invasive Cancer of the Cervix in Queensland
Authors: Bourne R. G. , Roberts S. J.
Published: February 2008

Summary: Results of treatment of 476 consecutive patients with invasive carcinoma of the cervix treated at the Queensland Radium Institute are reported, the crude 5‐year survival rate being 57.4%. Distribution according to histology, stage and age are recorded. Details of the treatment policy in existence at the time of the survey are given as are modifications which have occurred since.
Abortifacient Action of Prostaglandins with Particular Reference to the Use of PGF2α Administered into the Amniotic Sac in the Second Trimester of Pregnancy
Authors: Shearman Rodney , Korda Andrew , Smith Ian
Published: February 2008

The results of the intra‐amniotic administration of prostaglandin F2a to 117 patients for the termination of second trimester pregnancy are recorded.

The mean induction‐abortion interval was 23.7 hours, with a range of 5 to 61 hours in 111 successful cases. The induction‐abortion interval was influenced by parity and time of administration of the PGF2a, but not by the gestational age of the pregnancy.

There were 6 failures (5.1 % of cases treated) and of these, only one patient required hysterotomy. Abortion was complete in 74 patients and obviously incomplete in 37 patients.

There was a high incidence of systemic sideeffects, however they were transient. The most common side‐effects were nausea, vomiting and diarrhoea, dyspnoea, sweating and skin flushing.

There were two cases of cervical damage; one involved bilateral lacerations and the other a bucket handle rupture of the cervix.
Carcinoembryonic Antigen in Cancer of the Female Reproductive System Sequential Levels and Effects of Treatment*
Authors: Khoo S. K. , Mackay E. V.
Published: February 2008

Summary: Carcinoembryonic antigen (CEA) in serum was studied serially in 27 patients with cancer of the female reproductive system and 7 patients with other cancers, particularly of the colon or rectum, after surgical excision, irradiation, or no treatment. CEA became undetectable 2 weeks after complete surgical excision of cancer, whereas persistence of elevated levels of CEA indicated residual cancer. However, there was no decline in levels of CEA after radical radiotherapy of cervical carcinoma over a 10‐week period of study, suggesting continuous release of CEA from tumour tissues undergoing radiation‐induced necrosis. Sequential levels of CEA in serum represent a good index of effectiveness of surgical excision of cancer and should thus be of great value in post‐operative follow‐up.
Serum Heat Stable Alkaline Phosphatase Compared with Urinary Oestriol in Abnormal Pregnancy
Authors: Ward Humphry , Whyley G. A. , Fricker E. S. A. , Stolen A. E.
Published: February 2008

Summary: Three hundred and one estimations of serum heat stable alkaline phosphatase were made in 46 normal pregnancies to obtain mean values and a range between 22 weeks and term.

One hundred and twelve patients with complications of pregnancies had 674 serial serum HSAP assays and 586 urinary oestriol estimations performed.

Serum HSAP levels alone or those expressed as a percentage of the total alkaline phosphatase were found to be of little or no value in monitoring the fetal welfare in high risk pregnancies or in predicting stillbirth or neonatal death.

Serial urinary oestriol estimations were abnormal in 83% of pregnancies complicated by intra‐uterine fetal growth retardation and in 88% of these pregnancies if fetal distress had occurred.
Rubella Antibody Titres, Rubella Vaccination, and the Obstetrician
Authors: Giles P. F. H. , Mackay‐Scollay E. M. , Christiansen K.
Published: February 2008

Summary: The performance of a rubella haemagglutination‐inhibition antibody test at the first antenatal visit of 1,765 women was found to have several advantages; the 81% of patients found to be immune were reassured, the 19% at risk were identified, told what to do if they should be exposed to rubella or developed a rash, and were subsequently offered rubella vaccination in the puerperium.

Rubella antibody titres of maternal and cord blood are compared and any significant differences are discussed.

One case of rubella in pregnancy, and another of rubella vaccination just before conception, are presented. Of 20 mothers vaccinated in the puerperium, 5 reported side effects, and 2 did not develop antibodies.

The place of tests on cord bloods for rubella haemagglutination‐inhibiting antibodies is discussed.
Subnormal Maternal Urinary Oestriol Excretion When the Fetus has Diabetes Insipidus, Optic Atrophy, and Absence of the Septum Pellucidum
Authors: Macafee C. A. J. , Beischer N. A. , McBride Frances
Published: February 2008

Summary: Subnormal urinary oestriol excretion was present in an apparently normal pregnancy and it is suggested that a rare combination of fetal anomalies including diabetes insipidus, absence of the septum pellucidum and optic nerve hypoplasia was the explanation.
An Aid to Cervical Cerclage
Authors: Orr Christopher
Published: February 2008

Closure of the incompetent internal cervical os by whatever method presents few technical difficulties when attempted before effacement and dilatation have occurred. In the latter situation, unless the protruding fetal membranes can be reduced safely, their rupture during placement of the sutures is sometimes difficult to avoid. The following procedure has been evolved to facilitate the operation.
Serum Heat Stable Alkaline Phosphatase as a Test of Fetal Welfare: Correlation with Urinary Oestrogen Determinations
Authors: Wilson E. W.
Published: February 2008

Summary: Two hundred and eighteen paired estimates of serum heat stable alkaline phosphatase (HSAP) and 24‐hour urinary oestrogen excretion were obtained from 94 inpatients during the last 10 weeks of pregnancy. There was no correlation between serum HSAP and urinary oestrogens, or between serum HSAP within 1 week of delivery and birthweight or placental weight. There was significant correlation between serum HSAP within 1 week of delivery and the placental coefficient. There was good correlation between the oestrogen excretion within 1 week of delivery and birthweight. It is concluded that serum HSAP estimations are of no value in routine obstetric care. There may be a place for serum HSAP estimations in pre‐eclamptic toxaemia.
A Comparative Study of Laparoscopy with Hystero‐Salpingography in 100 Infertility Patients
Authors: Leeton John , Talbot J. McKenzie
Published: February 2008

Summary: A comparative study of the findings between hystero‐salpingo‐graphy and laparoscopy on 100 infertile patients over an 18‐month period showed that in 38 the findings differed significantly. In 24 patients with normal hystero‐saipingographic findings the laparoscope demonstrated bilateral tubal disease. Conversely, in 8 patients with abnormal hystero‐saipingographic findings the laparoscope showed normal tubes and patency.
Haemodynamic Effects of Low Doses of Female Sex Steroids
Authors: Walters William A. W. , Cain Deirdre
Published: February 2008

Summary: Haemodynamic changes were monitored serially in 3 groups of healthy young women taking (i) a combined oestrogen‐gestagen oral contraceptive containing a low dose of oestrogen, (ii) an oestrogen alone and (iii) a gestagen alone. Similar significant increases in plasma volume occurred in those women taking the combined preparation and in those taking the oestrogen. A small but significant decrease in forearm blood flow occurred in subjects taking the combined oral contraceptive. Cardiac output, blood pressure, heart rate and hand blood flow did not alter significantly in any of the 3 groups of subjects, while body weight increased in the subjects taking gestagen alone.

It is concluded that the combined oestrogen‐gestagen oral contraceptives containing 50 μg. of oestrogen result in minimal haemodynamic side effects, and hence are safer than the older combined preparations containing a higher dose of oestrogen. The increase in plasma volume observed was due to oestrogen rather than gestagen. No additional information was obtained concerning the site of sex steroid action in the cardio‐vascular system.
Use of the Vibrodilator in Outpatient Termination of Pregnancy
Authors: Ng Allan Y. H.
Published: February 2008

Summary: One hundred first trimester pregnancies were terminated by vacuum aspiration. The Vibrodilator and Hegar's dilators were used in alternate patients. The Vibrodilator was less painful and took less time to dilate the cervix than the Hegar dilators. However, there were 3 failures and 3 instances of cervical laceration when the Vibrodilator was used.
Migrants in Hospital
Authors: Laakso Leo
Published: February 2008

Non‐English migrants in Australia rarely attain full command of the English language, certainly not for many years. They understand everyday English, but difficulties appear in special situations, such as in hospital. To explain some things freely and adequately is impossible. This inadequacy engenders frustration and/or anxiety, and chronic mental stress often results.
Changes in the Cervico‐vaginal Epithelium in Gestational Megaloblastic Anaemia
Authors: Blackledge David , Goodall H. B.
Published: February 2008

Summary: In gestational megaloblastic anaemia cervical and vaginal epithelial cells may undergo characteristic changes; the nucleus is enlarged and hypo‐chromatic, but features associated with infection or malignancy are not found. These changes have been assessed quantitatively by the measurement of nuclear diameters on Papanicolaou preparations. Comparison between cases and controls shows a highly significant difference. Studies on a folate‐deficient subgroup in the control series indicate that this dysplasia may occur insidiously.

Three patients presented with vulvo‐vaginitis, glossitis and angular stomatitis. This was reversed by folate therapy alone.

The possibility that folate deficiency may cause some cells to be vulnerable to potential carcinogens is disussed.
The Use of Prostaglandin F2α for the Induction of Mid‐Trimester Abortion
Authors: Gillespie Arnold , Matthews C. D. , Petrucco O.
Published: February 2008

Summary: Ninety‐eight patients were given prostaglandin F2α for the induction of mid‐trimester abortion. In 42 the PGF2α was administered by the extra‐amniotic route and 37 aborted. A further 56 received the PGF2α intra‐amniotically and 55 aborted. Dose regimens are compared.
White Gland Openings of the Uterine Cervix — A Colposcopic, Cytological and Pathological Study
Authors: Puig‐Tintoré Luis M. , Gonzalez‐Merlo Jesus
Published: February 2008

Summary: The significance of the gland openings with a white ring, in the colposcopic transformation zone, is reviewed and its importance discussed.

This picture was present in 9.8% of colposcopic examinations on 914 patients selected on cytological and/or clinical basis. In these 90 patients cytology suggested mild dysplasia in 22.4% and severe dysplasia, carcinoma in situ or invasive carcinoma in 14.4%. Histological study in 73 of the 90 patients showed mild dysplasia in 20.5%, severe dysplasia in 13.7%, carcinoma in situ in 9.6% and invasive carcinoma in 1.3%.

We were impressed by the fact that these carcinomas showed very striking, easily identifiable glandular openings. We believe that the colposcopic study of the white gland openings is important, since they can be the only site where lesions are detected.
Mucinous Cystatlenoma of the Ovary in a Patient With Laurence‐Moon‐Biedl Syndrome — A New Association?
Authors: Warne G. L. , McDonald I. A. , Martin F. I. R.
Published: February 2008

Summary: A female aged 26, with the Laurence‐Moon‐Biedl syndrome, presented with massive abdominal enlargement of 5 years' duration. At laparotomy a huge mucinous cystadenoma weighing 19 kg. was found in the left ovary and broad ligament. The post‐operative course was uneventful.

This is the first report of an ovarian tumor in a patient with the Laurence‐Moon‐Biedl syndrome, and may be of a relevance in that an increased incidence of ovarian tumors has been found in patients with ovarian dysgenesis (Turner's syndrome).
The Prognosis of Carcinoma of the Cervix with Particular Reference to Infection
Authors: Davy Margaret
Published: February 2008

Summary: 150 case records of patients with Stage 1 and Stage 2 cervical carcinoma were reviewed to discover whether genital tract infection influenced the prognosis.

74 patients with no pyrexia had a 70% survival rate. 47 patients with pyrexia from any source had a survival rate of 45%. 14 patients with frank genital tract infection had a 15% survival rate.

It is suggested that prophylactic antibiotic treatment may be desirable before and during the first intra‐cavitary treatment.
Cryosurgery in the Treatment of Cervical Erosions
Authors: Pang J. C. K.
Published: February 2008

Summary: Forty‐seven patients with cervical erosions were treated by cryosurgery with no analgesia or anaesthesia. Healing occurred in 34 after one treatment and in a further 7 after a second treatment, making a cure rate of 87.2%. Success of treatment appears to be related to the size of the erosion. The most serious complication after cryosurgery was secondary haemorrhage which occurred in one patient.
Pregnancy following Conservative Management of Dysplasia and Carcinoma‐in‐situ of the Uterine Cervix
Authors: Johnstone N. R.
Published: February 2008

Summary: A series of 68 pregnancies in 56 patients following conservative management of dysplasia and carcinoma‐in‐situ of the uterine cervix is presented. Of 54 patients seeking to become pregnant after radical electrocoagulation diathermy to the cervix, 48 succeeded (89%). Eight of these patients had long labours, but no other complication of pregnancy was apparent. Only 10 patients were trying to conceive following previous cone biopsy and 8 succeeded. Cervical stenosis was not present in those patients failing to conceive.
An Evaluation of Placental Localization using the Doppler Ultrasound in Singapore
Authors: Tsakok F. H. M. , Cheng Mark C. E.
Published: February 2008

Summary: The Doppler ultrasound was used to localise the placental site in 107 patients, including 21 with placenta praevia. Although the accuracy obtained was 82%, the high percentage of false negatives (10 of 21) made it unacceptable as a guide for clinical management. Inability to diagnose posterior placenta praevia may be an inherent disadvantage of this method of placental localization.
Histophotometric Determination of Near‐Triploidy in Products of Conception Including Hydatidiform Moles
Authors: Atkin N. B.
Published: February 2008

Summary: Histological sections cut at 50μ, of material from three products of conception showed evidence of triploidy when the DNA contents of the nuclei were measured by a photometric technique in which the cells were flattened by the use of a crushing condenser. A partial mole and a spontaneous abortion showed clear modes in the triploid region. A hydatidiform mole which persisted following evacuation, necessitating cytotoxic therapy, had a wider distribution with evidence for the presence of cells in the diploid, triploid and tetraploid regions.

The possible value of this technique in evaluating ploidy levels in products of conception, particularly where chromosome studies are not possible, is discussed.
An Unusual Case of Pseudomyxoma Peritonei
Authors: Sutherst J. R.
Published: February 2008

Summary: A case is reported of a woman with pseudomyxoma peritonei, who 20 years previously had had an ovarian cyst and mucocoele of the appendix removed.
The Treatment of Recurrent Cervical Cancer
Authors: Kitchen D. H.
Published: February 2008

Summary: A retrospective study was made of 110 patients treated for recurrent cervical cancer at National Women's Hospital, Auckland, New Zealand, between 1946 and 1970. The methods of re‐treatment tended to be conservative and gave comparable results to those obtained from other centres where a more aggressive policy was followed.

The patient who receives treatment for recurrent cancer of the cervix may have a small chance of cure, even if only palliation is intended, and has a definite advantage over the patient who receives no treatment.
A Source of Error in Fetal Scalp Blood Sampling — The Heparin Impregnated Thread
Authors: Chang Allan , Wood Carl
Published: February 2008

Summary: The use of heparin impregnated thread in collection tubes, used for fetal scalp blood sampling, is associated with a decrease in measured pH. The pH is altered by the threads used rather than by heparin or dilution. This change may be eliminated by soaking the thread in alcohol for 48 hours prior to impregnation with heparin.
Hypogonadotrophic Hypogonadism Associated with Anosmia in the Female
Authors: Giles P. F. H. , Hahnel R. , Martin J. D. , Roberman B.
Published: February 2008

Summary: Three women with hypogonadotrophic hypogonadism associated with anosmia were subjected to ovarian stimulation with human gonadotrophins. The first responded normally to conventional dosage of human pituitary gonadotrophins (HPG). The second, known to have primordial follicles in the ovary, failed to respond to massive doses of HPG. The third, who was unmarried, failed to respond to an intramuscular injection of 75 I.U. of human menopausal gonadotrophs daily for 3 days. The importance of testing olfactory acuity in patients with menstrual irregularities is re‐emphasised.
Pethilorphan‐Promethazine, Diazepam Intravenous Analgesia for Minor Gynaecological and Obstetrical Operations
Authors: Fahmy Kamal , Elbanna Maeel
Published: February 2008

Summary: A study of 380 minor gynaecological and obstetrical operations (342 were terminations of pregnancy), in which pethilorphan‐promethazine, diazepam intravenous analgesia was used is presented. Only two patients recalled slight pain and showed appreciable movement during the operation. There was no airway trouble or significant changes in the pulse, blood pressure or respiration. The fasting state was unnecessary in urgent cases, and no special nursing was needed. The mean time until the patients became aware of their surrounding was 2.5 hours, and until out of the bed 7.5 hours. There was no mortality. The significant side effect was a high incidence of postanalgesic postural giddiness and/or headache which appeared to be due to diazepam, and increased with the dosage. Intravenous analgesia is safe, effective, lessens the work load of trained anaesthetists and reduces the admission‐operation interval.
Utilization of the Mass Screening Programme for Cervical Cancer in N.S.W.
Authors: Pacey N. F.
Published: February 2008

Summary: Figures sampled from the N.S.W. cervical cancer programme suggest that it shares the prime difficulty of mass screening programmes elsewhere, namely in reaching the previously unscreened population of women, especially the older age groups at most risk from death from the disease.

Some implications of this problem are briefly discussed.
Carcinoma of the Cervix with an Unusual Pattern of Metastases
Authors: Murugasu R. , Fook Chan Wing , Sinnathuray T. A. , Singh Joginder
Published: February 2008

Summary: A case report is presented of a 40‐year‐old Sikh female with carcinoma of the cervix and extensive secondary deposits involving the skull, vertebrae, ribs, clavicles, pelvis and long bones of both upper and lower extremities. The liver and lung parenchyma, common sites for distant metastases in carcinoma of the cervix, were free of disease, whereas the heart, a rare site, was involved. The history and clinical course was short. Death was due to hypercalcaemia, resulting from the extensive skeletal metastases.
Clinical Value of the IgM FTA‐ABS Test for Congenital Syphilis in the Newborn
Authors: Garner M. F.
Published: February 2008

A serological study was undertaken of 63 newborn babies in whom the diagnosis of congenital syphilis had to be considered.

The mothers of 58 of the babies had been adequately treated for syphilis: the IgM FTA‐ABS test was non‐reactive in the sera of 57 of these babies, and reactive in 1 (a false positive result). The sera of 5 babies gave reactive IgM FTA‐ABS test results: the mothers of these babies were found to have untreated secondary syphilis.

It is advisable for the IgM FTA‐ABS test to be carried out at monthly intervals for 3 months on all babies whose serological tests for syphilis are reactive at birth. This is to ensure that the delayed onset of congenital syphilis is not missed when a non‐reactive IgM FTA‐ABS test at birth becomes reactive at a later date.