bluuebunny/crossref_metadata_2025 huggingface dataset:
The Variability of Fetal Lie, Presentation and Position During “Normal” Pregnancy
Authors: Morrison John , Orr Christopher J. B. , Teoh Gloria G. C.
Published: February 2008

Summary: The fetal lie, presentation, and position was recorded serially from the 16th week of gestation until delivery in 100 pregnant women.

The incidence of these characteristics varied with gestation and parity, with stabilization of fetal lie occurring at the 22nd week in nulliparous patients, and at the 30th week in parous patients; the frequency of longitudinal lie rose from 63% at 16 weeks of gestation to 99% at 32 weeks of gestation.

Only 1 persistent breech presentation and 1 persistent transverse lie occurred in the 100 patients. The predominant position in the cephalic presentations was left occipital with a significantly higher incidence in the nullipara.

Considerable variability of lie, presentation, and position occurred in serial examinations, and late spontaneous version from breech to vertex occurred in 4 multiparous patients.
An Appraisal of Clomiphene in the Induction of Ovulation
Authors: Correy J. F. , Schokman F. C. M.
Published: February 2008

Summary: From a total of 252 patients with presumed anovulation referred by specialist gynaecologists to the gynaecological endocrine clinic of the Royal Hobart Hospital, 93 were regarded as suitable for treatment with clomiphene citrate. Thirty‐four patients (37%) have become pregnant either with clomiphene (28) or spontaneously in the month following the clomiphene being discontinued (6). The low pregnancy rate is attributed to the method of selection of patients for treatment with clomiphene.

An analysis has been made of the 321 courses of clomiphene given to the 93 patients to determine the incidence of ovulation and pregnancy, the time of ovulation in relation to the completion of each course of clomiphene, and the length of the secretory phase.
Massive Rectal Bleeding as a Sign of Secondary Abdominal Pregnancy
Authors: Cheah S. F. , Sen D. K. , Sivaloganathan V.
Published: February 2008

Summary: A case report of a secondary abdominal pregnancy in which the presenting symptom was one of profuse rectal haemorrhage is presented and the hazards of management are discussed.
The Influence of Smoking on Intrauterine Fetal Growth and on Maternal Oestriol Excretion
Authors: Targett Christopher S. , Ratten Graeme J. , Abell David A. , Beischer Norman A.
Published: February 2008

Summary: Of 3,000 patients with singleton pregnancies, 237 (7.9%) smoked more than 20 cigarettes per day. Heavy smoking had a highly significant correlation with intrauterine growth retardation (P<0.001) and subnormal oestriol excretion (P<0.001), but these parameters of fetal welfare were not significantly influenced by light smoking when compared to non‐smokers. Birth weight was lower and the incidence of intrauterine growth retardation was increased in proportion to increasing total consumption of tar and nicotine during pregnancy. It was concluded that heavy smokers should be encouraged to reduce the number of cigarettes smoked to less than 5 per day.
Measurement of the Beta ‐ Subunit of Chorionic Gonadotrophin in Uncomplicated, Complicated, and Molar Pregnancies
Authors: Khoo S. K.
Published: February 2008

Summary: The beta‐subunit of chorionic gonadotrophin (HCG‐β) was measured in serum by radioimmunoassay in patients with uncomplicated, complicated, and molar pregnancies. In normal pregnancy, HCG‐β was just detectable at levels of less than 10 ng per ml at 4 weeks of amenorrhoea; the levels increased rapidly to a peak mean value of 135.1 ng per ml at 9–10 weeks. Serum levels in patients with abortion or tubal ectopic pregnancy were much lower for the period of amenorrhoea, and results were negative for all patients who were not found to be pregnant. Serum levels were greatly elevated, often exceeding 1,500 ng per ml, in patients with hydatidiform mole. The majority of patients with molar pregnancies showed levels exceeding 750 ng per ml, whereas the highest level in patients with normal pregnancy was 325 ng per ml. The use of serial HCG‐β levels provides a sensitive means of follow‐up of hydatidiform mole, being able to distinguish the disease undergoing spontaneous regression from residual or metastatic disease.
An Aid in Mini ‐ Laparotomy Tubal Ligation
Authors: Benny H. R. C. , Benny P. S.
Published: February 2008

Summary: The use of an instrument is described which simplifies tubal ligation by allowing a smaller incision.
Adhesion of the Labia Minora ‐ a Study of 75 Cases
Authors: Khanam Wazira , Chogtu Leela , Mir Zubida , Shawl Farida
Published: February 2008

Summary: A comparison of 2 treatment regimens was made in 75 children aged between 3 months and 4 years with adhesion of the labia minora. The success rate in 25 treated surgically was 60%, whereas that for 50 treated with local oestrogen cream was 90%. Brief reference is made to associated clinical features of this disorder.
Ultrasound in the Management of Threatened Abortion
Authors: Hunter Christopher , Picker Richard H.
Published: February 2008

Summary: The use of grey scale B‐mode ultrasonography at the Royal North Shore Hospital of Sydney in the management of suspected threatened abortion is described. The results obtained with this technique indicate that it is a rapid, reliable means of evaluation of bleeding per vaginam in the first 20 weeks of pregnancy, and should be considered as part of the routine investigation of threatened abortion.
Spontaneous Improvement in Severity of Erythroblastosis With Advancing Parity
Authors: Drew J. H. , Mountain K. R. , Beischer N. A.
Published: February 2008

Summary: Two cases of severe rhesus isoimmunization with spontaneous improvement in severity of erythroblastosis with advancing parity are presented. The infant of one of these patients had a cord haemoglobin value of 4.6 g per 100 ml and required abdominal paracentesis, 9 exchange transfusions, and survived 3 cardiorespiratory arrests to develop into a normal child. In a subsequent pregnancy this patient was delivered of an infant whose cord blood was Coombs positive and had a cord haemoglobin value of 15.0 g per 100 ml; the infant survived without an exchange transfusion.
Detection of Carcinoembryonie Antigen and Alphafetoprotein in Serum and Ascitic Fluid from Patients with Ovarian Cancer
Authors: Khoo S. K. , Hill R. , Mackay E. V.
Published: February 2008

Summary: Samples of serum from 108 patients and ascitic fluid from 15 patients with different types of ovarian cancer were tested for carcinoembryonie antigen (CEA) and alphafetoprotein (AFP) by radioimmunoassay. CEA was detected in serum in 63% of patients; the incidence was highest in those with serous (76%) and endometrioid carcinoma (67%). AFP was detected in serum in only 17% of patients: 20% of those with serous carcinoma, 25% with endometrioid carcinoma, and none with mucinous carcinoma. High AFP levels were present in 3 of 7 patients with germ cell tumour. There was no correlation between serum levels of CEA and AFP, but 14 patients showed detectable levels of both antigens. CEA was detected in the ascitic fluid of 12 of the 15 patients studied: in 2 of them, it was present in ascitic fluid but not in serum. This finding supports the value of using other biological fluids for the detection of CEA.
Phaeochromocytoma in Pregnancy
Authors: Ping Wong Wai , Ngan Arlene , Somasundrum K. , Liew Robert
Published: February 2008

Summary: An unusual case of phaeochromocytoma in pregnancy is reported. The patient had a history of recurrent hypertension and abruptio placentae with fetal death before the diagnosis was made. Another pregnancy complicated by ‘toxaemia’ followed excision of the tumour. General principles concerning diagnosis and management of phaeochromocytoma during pregnancy are discussed.
Antenatal Cardiotocography in Patients with Persistently Subnormal Urinary Oestriol Excretion
Authors: Chew Franklin T. K. , Abell David A. , Beischer Norman A.
Published: February 2008

Summary: Antenatal cardiotoccgraphy was performed in 137 consecutive patients with persistently subnormal urinary oestriol excretion in spite of rest in hospital. Abnormal fetal heart rate (FHR) patterns were detected in 25 patients (18.2%). Late deceleration FHR patterns associated with Braxton Hicks contractions were recorded in 8 patients, and were associated with intrauterine death in 2 patients when delivery was delayed. The late deceleration FHR pattern occurring with Braxton Hicks contractions is a manifestation of acute on chronic fetal distress. The appropriate management is delivery within 24 hours, preferably by Caesarean section, especially if there is loss of beat‐to‐beat variation, and absence of sporadic FHR accelerations.
Experience With an Antenatal Diagnostic Genetic Clinic
Authors: Harkins J. L. , Doran T. A. , Benzie R. J. , Pirani B. B. K.
Published: February 2008

Summary: A regionalized, multi‐disciplined approach to antenatal diagnosis of genetic disease is a significant and positive contribution to modern obstetrical care. The indications, pick‐up rate, pregnancy outcome, and complications in such a programme are described.

Rather than providing but another reason for abortion, our Unit has carried out only 37 abortions in 1,016 patients. The vast majority of our patients have been reassured and have carried their pregnancies, with less stress, successfully to term.

Detailed cost‐benefit studies of the programme have not yet been carried out; however, a 4% incidence of significant abnormalities in any screening programme is considered to be acceptable. With respect to Down's syndrome, we feel that the screening of all women 35 years of age or older, or those with translocation problems yields personal and financial relief to the parents and to the State where affected pregnancies are identified and terminated.

Ideally, this service should be made available to all patients at risk of genetic disease.

Experience with the Canadian Registry indicates that by the end of 1976, only 2% of Canadian women at risk had availed themselves of the service. This situation is, however, rapidly changing.

As increased utilization of antenatal genetic services occurs, new problems of personnel, equipment, techniques and space (to say nothing of money) will continue to occur. Careful attention to technological developments will be an essential feature of future progress.
Single Dose Preoperative Prophylactic Antibiotic in Vaginal Hysterectomy
Authors: Lander J. L. , Steigrad S. J.
Published: February 2008

Summary: A retrospective study of patients following vaginal hysterectomy showed a postoperative morbidity of 75%. A trial of a single preoperative intravenous injection of cephalothin sodium to patients about to undergo vaginal hysterectomy showed a significant (P < 0.01) reduction in postoperative morbidity.
Acute Traumatic Tetraplegia During Pregnancy
Authors: Morrison J. , Chang A. , Thearle M. J. , Tabrett D. G. , Teoh G.
Published: February 2008

Summary: A case of acute traumatic tetraplegia during pregnancy resulting in maternal death is presented, and problems of management are discussed. Difficulties experienced by the mother were intractable urinary tract infection and respiratory insufficiency; those in the neonate were prematurity and the effects of drugs administered to the mother.
Serial Changes in Plasma Levels of Progesterone, Unconjugated Oestradiol and Unconjugated Oestriol in Normal Pregnancy
Authors: Tungsubutra Vanee , France J. T.
Published: February 2008

Summary: Plasma levels of progesterone, unconjugated oestradiol and unconjugated oestriol have been measured by radio‐immunoassay methods in 33 normal pregnant women serially from 28 weeks of gestation until term. The mean concentrations of all 3 hormones were found to increase steadily with advancing pregnancy. Expressing results relative to the actual day of delivery revealed no evidence of significant changes in trends in progesterone and/or oestradiol levels which could be indicative of an endocrine mechanism leading to onset of labour. The progesterone:oestradiol ratio remained relatively constant during the last few weeks of pregnancy while the progesterone: oestriol ratio showed a slight decrease.
Clinical Features and Plasma Hormone Levels After Surgical Menopause
Authors: Dennerstein Lorraine , Wood Carl , Hudson Bryan , Burrows Graham
Published: February 2008

Summary: This study reports the plasma levels of follicle stimulating hormone, luteinising hormone, oestradiol and testosterone in 43 women who had undergone bilateral oöphorectomy. Age was the only variable of those investigated which appeared to influence a hormone level; testosterone levels were found to decrease with increasing age. Two significant associations were found between clinical features of the menopause and the plasma hormone levels measured. Low levels of oestradiol were associated with pruritus vulvae and high levels of testosterone were associated with headaches.
The Hypercoagulable State and Pulmonary Embolism in Patients With Ovarian Carcinoma
Authors: Planner R. S. , O'Sullivan E. F. , Campbell J. J. , Ball D. L.
Published: February 2008

Summary: Fifty‐nine patients with ovarian carcinoma were studied with particular reference to abnormalities of the coagulation mechanism. The notable findings were the high incidence of episodic thrombocytosis (73%) and the relation of these peaks of thrombocytosis to periods of expected maximum tumour breakdown. The incidence of pulmonary embolism for the series was 44%, with the majority occurring in the group demonstrating significant thrombocytosis; in this latter group, pulmonary embolism constituted the major cause of death. The abnormalities in coagulation are discussed, together with pragmatic significance and methods of control.
Antepartum Stress Cardiotocography Using Buccal Oxytocin
Authors: Jofre Manuel E. , Green Roslyn , Gillespie Arnold
Published: February 2008

Summary: The use of buccal pitocin in the performance of stressed antenatal cardiotocography was studied. Sixty‐three tests were performed on 40 patients. All the patients were followed through labour and delivery. The results were evaluated and compared with those where an intravenous oxytocin infusion was used. Buccal pitocin produced comparable uterine contractions to those obtained by intravenous oxytocin, with similar test results. The avoidance of venepuncture and infusion was a positive advantage of this method of applying the stress.
A Review of the Use of Barton's Forceps for the Rotation of the Fetal Head from the Transverse Position
Authors: Marin R. D.
Published: February 2008

Summary: The technique of use of Barton's forceps is described. A series of 248 patients in a 4‐year period has been assessed to determine the safety of the instrument. It is concluded that the forceps can be used with safety for both mother and baby under pudendal block anaesthesia, in mid‐cavity and low‐cavity deliveries.
Urinary Stress Incontinence and Common Sense
Authors: Salter Roger
Published: February 2008

Summary: Retropubic bladder neck suspension has been used to treat 352 women presenting with the primary complaint of urinary stress incontinence. The author's concept of the proper assessment and management of such patients, in whom previous surgical treatment has failed, is stated. A plea is made for the abandonment of traumatic surgical methods and the confusing multiplicity of names that accompanies them.
A Survey of Tubal Ectopic Pregnancy, with Particular Reference to Cases Following Sterilization
Authors: Walton Stuart M.
Published: February 2008

Summary: In a series of 47 ectopic pregnancies occurring over a 2‐year period, 5 followed tubal sterilization. Foreknowledge of the previous sterilization resulted in delay of surgical management. Sterilization techniques should be revised to prevent the incidence of ectopic pregnancy.
A Survey of Women With Unplanned Exnuptial Pregnancies in Brisbane
Authors: Chang Allan , Rosevear Wendell , Mylonas Kris , Keeping Douglas , Morrison John
Published: February 2008

Summary: : The social circumstances of women with exnuptiai unplanned pregnancies were surveyed, and the differences between those continuing with their pregnancy and those who decided to terminate their pregnancy were compared.

Women who continued their pregnancies were younger, poorer, less educated, and more likely to be employed in unskilled jobs when compared with those who decided to have their pregnancy terminated.
Shoulder Dystocia: A Study of 47 Cases
Authors: Johnstone Neil R.
Published: February 2008

Summary: : Shoulder dystocia at vaginal delivery occurred in 0.2% of cases. Antenatal prediction of this complication was very difficult. In primigravidae in labour, delay late in the first stage was a warning sign; induction of labour, the use of regional analgesia, and forceps delivery for delay in the second stage of labour were associated with subsequent shoulder dystocia, although a cause‐effect relationship was not established.

The immediate maternal and fetal morbidity were high, nearly 30% of the babies suffering from a severe neural or bony injury. Forty‐four per cent of the babies were beyond 41 weeks of gestation, and 70% weighed over 4,000 g. The avoidance of postmaturity by elective induction of labour at 41 weeks of gestation would significantly reduce the incidence of shoulder impaction at delivery.
A Technique for Management of Obstructed Labour with Antenatal Fetal Death
Authors: Kampf D. , Jaschevatzky O. E. , Georghiou P. , Anderman S. , Grünstein S.
Published: February 2008

Summary: : A technique for management of obstructed labour associated with fetal death is presented. The new method makes it possible to decrease fetal head size by evacuation of brain tissue by suction using thoracic‐type trocar. Three patients with obstructed labour and fetal death were managed successfully using this technique. The method permits a decrease of fetal head size easily and rapidly, avoiding the risks of other techniques. Moreover, its use makes it possible to eliminate craniotomy from obstetric practice. The method should be equally suitable for cases of major hydrocephaly.
Investigation and Management of Symptomatic Hyperprolactinaemia
Authors: Holdaway I. M. , Frenglcy P. A. , Mountjoy K. G. , Ibbertson H. K. , Graham F. M. , France J. T.
Published: February 2008

Summary: Fifteen patients with infertility and hyperprolactinaemia have been investigated using tests of prolactin and LH secretion, and treated by prolactin suppression. In addition, 4 patients with hyperprolactinaemia not desiring fertility were also investigated. Of the total group, 16 had galactorrhoea and 15 had amenorrhoea. Pituitary tumours were present in 6 patients and 4 had pituitary microadenomas. Prolactin levels measured by both radioimmunoassay and radioreceptor assay were elevated before treatment and fell during therapy with bromoergocryptine (7.5 mg daily). Tests of prolactin release with TRH and chlorpromazine before treatment did not distinguish patients with functional hyperprolactinaemia from those with pituitary tumours. Basal plasma gonadotrophin concentrations were not elevated despite subnormal urinary oestrogen levels. The serum LH response to LRH was normal during hyperprolactinaemia, but LH release in response to oestrogen provocation was impaired in 14 of 17 patients. During prolactin suppression, mean oestrogen excretion rose significantly and the oestrogen provocation test became normal in all except 2 patients. Pregnancy occurred in all of the 15 patients desiring fertility. Abortion has occurred in 4 patients, all of whom are currently pregnant again. Nine pregnancies have reached term, with no complications from pituitary expansion. It appears that during hyperprolactinaemia there are defects in both positive and negative feedback of oestrogen on LH secretion, and that prolactin suppression in such patients is highly effective in restoring fertility.
Sterilization: A Comparative Review
Authors: Keeping J. D. , Chang A. , Morrison J.
Published: February 2008

Summary: Publications relating to surgical procedures for sterilization have been reviewed, and the incidences of complications and subsequent pregnancies compared.

Laparoscopic sterilization has the lowest incidence of complication, the morbidity rate being lower than that of laparotomy sterilization or hysterectomy, and the mortality rate lower than that of a single pregnancy or taking oral contraceptives for 1 year.
Prenatal Diagnosis of Placental Sulphatase Deficiency
Authors: Phillipou G. , Seamark R. F. , Sweet R.
Published: February 2008

Summary: A gas chromatographic procedure for the quantitation of neutral steroid sulphates in maternal urine and its application to a suspected case of placental sulphatase deficiency is described. Low levels of oestriol coincident with elevated 16‐hydroxylated metabolites of dehydroepiandrosterone in the maternal urine are shown to occur in this particular condition, and thus provide a convenient differentiation from fetal adrenal hypoplasia before birth.
Kielland‐Barton‐Laufe (K.B.L.) Forceps with Luikart Modification in the Management of Transverse and Posterior Positions of the Fetal Head
Authors: Mounsey Douglas , Darwin
Published: February 2008

Summary: Disadvantages of Kielland and Barton forceps are described. A trial of K.B.L. forceps was undertaken in transverse and posterior positions of the fetal head. It was concluded that these forceps are easier to apply than Kielland forceps. Rotation of the head is easier, and they are the equal of Kiellands as tractors, with the advantage of causing less marking of the fetal head than either Kielland or Barton forceps.
Control Chart for Urinary Oestriol Excretion During Pregnancy
Authors: Chang A. M. Z. , Morrison J. , Biggs J. S. G.
Published: February 2008

Summary: Calculations to define the distribution of normal urinary oestriol excretion values during pregnancy are presented. The values had a normal distribution, uniform variance and increased linearly with time after logarithmic conversion. The variance could, therefore, be partitioned and a control chart constructed.
An Evaluation of the Counselling Given to Patients Having a Therapeutic Abortion
Authors: Hunton R. B. , Spicer J.
Published: February 2008

Summary: The results of a questionnaire evaluating patient's reactions to counselling for their therapeutic abortion are reported. Most considered that counselling was necessary and that it provided support throughout the abortion process. The counselling appeared to relieve anxiety for many patients, but seemed to be less effective for patients who were not of European origin.
Perinatal Mortality in Vaginal Breech Delivery in Tasmania
Authors: Correy J. F.
Published: February 2008

Summary: A Tasmanian survey from 1975 to 1978 inclusive is presented of 742 vaginal breech deliveries and 26,424 cephalic deliveries of infants weighing 1,000 g or more. There was a significantly higher intrapartum and neonatal death rate associated with the preterm breech delivery, Caesarean section is advocated for this group.
Primary Peritoneal Pregnancy Implanted on the Uterine Fundus
Authors: Goh Tai H. , Rahman Sabariah Abdul
Published: February 2008

Summary: A case of primary peritoneal pregnancy implanted on the uterine fundus is presented. The differential diagnosis and aetiology of this condition is briefly discussed together with a review of recent literature.
The Effect of Maternal Cardiac Disease and Digoxin Administration on Labour, Fetal Weight and Maturity at Birth
Authors: Ho P. C. , Chen T. Y. , Wong Vivian
Published: February 2008

Summary: One hundred and twenty‐two patients with cardiac disease were compared with 250 controls with respect to the duration of pregnancy and labour, birth weight percentile and Apgar score. The babies of the patients with cardiac disease were light‐for‐dates (18% below the 10th percentile); the mothers, if multiparous, delivered at an earlier gestational age. The patients with cardiac disease did not have shorter labours than the control group. Digoxin administration and the severity of heart disease had no significant effect on these variables.
Chemoprophylaxis with Tinidazole in Major Gynaecological Surgery
Authors: Kuhn R. J. P.
Published: February 2008

Summary: A double‐blind trial involving 200 patients failed to show a statistically significant reduction in postoperative pelvic infection with tinidazole chemoprophylaxis. Preoperative and postoperative cervical or vaginal bacteriological swabs and full blood counts did not contribute to management. Drains to the vaginal vault were not associated with a reduction in this complication. The incidence of postoperative pelvic sepsis was also unrelated to the experience of the surgeon.
Poor Antenatal Attendance and Obstetric Performan
Authors: Keeping J. D. , Chang A. M. Z. , Morrison J. , Esler E. J.
Published: February 2008

Summary: A survey of attendance for antenatal care at a public hospital in Brisbane was carried out.“Poor attenders” were more likely to be young, unmarried, grande multiparous, or aboriginal, and to live in a poorer area of the City. This group comprised 6.5% of the total population, but accounted for 14.6% of all low Apgar scores, 23 % of all low birth weight babies, 23.1 % of all stillbirths, and 18.2% of all neonatal deaths.
Demographic and Social Background Characteristics of Members of The Royal College of Obstetricians and Gynaecologists in Australia
Authors: Barnes Keith , Dent Owen
Published: February 2008

Summary: Demographic and social background characteristics of a random sample of 200 Australian members of the Royal College of Obstetricians and Gynaecologists were obtained in a questionnaire survey. Data are presented on age‐sex distribution, marital status, period since graduation, length of College membership, type of practice, birthplace, education, religion, political orientation and social rank of family of origin.
Bilateral Adrenal Phaeochromocytoma with Pregnancy
Authors: Shroff Chandralekha P. , Deodhar Kamlakar P.
Published: February 2008

Summary: A case is reported of fatal terminal shock following normal labour; bilateral adrenal phaeochromocytoma and pituitary necrosis was revealed at autopsy.
Small‐Dose Diazoxide Administration in Pregnancy
Authors: MacLean A. B. , Doig J. R. , Chatfield W. R. , Aickin D. R.
Published: February 2008

Summary: The administration of diazoxide in a smaller dosage (150 mg) than usual in the management of hypertension in pregnancy is described. Such doses are effective and do not have the undesirable profound hypotension occasionally produced by larger doses.
The Antenatal and Perinatal Characteristics of Socio‐Economically Depressed Caucasians
Authors: Cox John W.
Published: February 2008

Summary: Many studies have shown that Aborigines have an above average obstetric risk, but the results are not clear as to whether this is a racial characteristic or attributable to social circumstances. The co‐existence of sufficient numbers of unemployed and unskilled Caucasians and Aborigines living in similar social circumstances in a Western Queensland town enabled a valid evaluation of this problem. It was found that the incidence of obstetrical problems and resulting morbidity amongst Caucasians of low socio‐economic standing and Aborigines were almost identical. As low socio‐economic status seems to be more closely linked with antenatal, obstetrical and neonatal risk than race, it seems prudent to expand the present health projects catering for Aborigines to encompass all underprivileged people.
Antenatal Diagnosis of Homozygous β Thalassaemia in Mediterraneans in Australia
Authors: Smith M. B. , Betheras F. R. , Davison G. , Batchelder E. , Barton J. , Cauchi M. N.
Published: February 2008

Facilities for the antenatal diagnosis of homozygous β thalassaemia have recently become available in Australia and in this paper, data from a series of 18 pregnancies examined at The Royal Women's Hospital, Melbourne, are analysed.

Fetal blood was collected by fetoscopy and adequate samples were obtained in 16 cases (89%). In 5 pregnancies, fetal blood was shown to have a marked reduction in β globin production (β/α synthesis < 0.030) and these pregnancies were terminated. Two pregnancies (11%) were lost in the immediate post‐fetoscopy period and in a third pregnancy, neonatal death followed premature labour at 26 weeks' gestation. Seven babies were delivered normally at 36–40 weeks' gestation and cord blood studies excluded homozygous thalassaemia in all cases. The remaining pregnancy has yet to be delivered.
Tamoxifen and Aminoglutethimide in the Management of Patients With Advanced Endometrial Carcinoma Not Responsive to Medroxyprogesterone
Authors: Quinn M. A. , Campbell J. J. , Murray R. , Pepperell R. J.
Published: February 2008

Eleven patients with advanced endometrial carcinoma not responsive to medroxyprogesterone were entered into a trial of therapy with tamoxifen, aminoglutethimide or both in combination. Two patients had a complete response, 1 to aminoglutethimide and 1 to tamoxifen. One patient who initially had a partial response to tamoxifen but then relapsed, had a partial response to aminoglutethimide. Two patients had stable disease for 8 and 6 months on aminoglutethimide, and 1 patient who initially showed no response to tamoxifen has had stable disease for 14 months since addition of aminoglutethimide to therapy. The relative lack of toxicity of these drugs make their use attractive in the management of such patients.
Trends in Adolescent Pregnancies
Authors: Ward Pamela M. , Biggs J. S. G.
Published: February 2008

Summary: Pregnancies in adolescents aged under 17 years constitute about 1.3% of all births in Queensland. A study of 189 adolescent pregnancies at the Royal Women's Hospital, Brisbane in 1977–1979 showed adequate antenatal care, and antenatal complications similar to those of a control group. There were greater incidences of unplanned Caesarean section, postpartum haemorrhage and puerperal infection. The major difference in the adolescent group was a perinatal mortality more than double that for the overall hospital population. The role of inadequate education in reproduction in the genesis of many adolescent pregnancies is stressed.
Medium Term Complications After Termination of Pregnancy
Authors: Hunton R. B. , Bates Deidre
Published: February 2008

Summary: In the 3–9 months after first trimester therapeutic abortion at a freestanding, counsellor‐orientated hospital, the great majority of 309 randomly selected patients reported no physical, emotional or social repercussions. The negative effects reported by the remainder were predominantly of minor severity.
The Outcome of Pregnancy Resulting from Clomiphene‐Induced Ovulation
Authors: Correy J. F. , Marsden D. E. , Schokman F. C. M.
Published: February 2008

Summary: The outcome of pregnancy was studied in all women conceiving after ovulation induction with clomiphene at the gynaecological endocrine clinics operating in 2 Tasmanian cities. In 156 pregnancies where details were available, the main findings were: abortion rate 10.3%; multiple pregnancy rate 4.1%; congenital abnormality rate 3.6%; and perinatal mortality rate 3.5%. The results are compared with other reported series.
Design Errors in Kielland's Forceps
Authors: Healy D. L.
Published: February 2008

Summary: All Kielland's forceps used at the Royal Women's Hospital, Melbourne, were measured with engineering calipers. All forceps varied by 3 mm or more in at least one obstetrically important measurement from Kielland's design. Cephalic and pelvic curve abnormalities were found. Obstetricians should measure their Kielland's forceps for design accuracy.
Small Bowel Prolapse Through the Vaginal Vault
Authors: Astill A. N.
Published: February 2008

Summary: A case of small bowel prolapse through a vaginal vault defect in a patient presenting with an abdominal aortic aneurysm is presented. An abdominal hysterectomy had been performed 15 years previously.
Frequency of Insemination for Artificial Insemination by Donor
Authors: Selwood T. S. , Leeton J. F.
Published: February 2008

Summary: Two programmes of artificial insemination by donor (A.I.D.) using fresh semen are compared. In both studies the selection of donors and recipients, and the techniques of timing and insemination were identical, except that the first group had 1 insemination per cycle and the second group had 2 inseminations per cycle. The ratio of pregnancies per insemination cycle was 11.3: 20.1, respectively and cumulative pregnancies per 100 women after 6 months were 50.3 from the first group and 66.3 for the second.
Meta AMSA (m‐AMSA) in Patients with Advanced Ovarian Carcinoma
Authors: Kearsley John H. , Page Jonathon P. , Levi John A. , Woods Robert L. , Tattersall Martin H. N. , Fox Richard M. , Coates Alan S.
Published: February 2008

Summary: A phase 2 study of 41‐(9‐acridinylamino) methane‐sulfon‐m‐anisidide (meta‐AMSA) was conducted in previously treated patients with advanced ovarian cancer. Two of 14 patients (14%) evaluable for tumour response achieved partial remissions for 9 and 18 weeks and 8 of the 14 (57%) maintained stable disease for periods ranging from 3 to 24 weeks. Myelosuppression, particularly leucopenia, proved the major toxicity, occurring in 45% of treatment courses. Meta‐AMSA has only modest antitumour efficacy as a single agent in the treatment of advanced ovarian cancer.
Ovarian Carcinoma in Identical Twins
Authors: Tucker M. H. M. , Fryer J. A. , Saunders D. M.
Published: February 2008

Summary: Advanced ovarian adenocarcinoma presenting within 3 years in identical twins is reported. The carcinomas presented at a similar stage and the microscopic appearances showed strong histological similarities.
Glucose Tolerance in Twin Pregnancy
Authors: Dwyer P. L. , Oats J. N. , Walstab J. E. , Beischer N. A.
Published: February 2008

Summary: Over a 10‐year period, 50 g oral glucose tolerance tests were performed in 288 patients with twin pregnancies and 20,030 with singleton pregnancies. In multiple pregnancies the fasting blood glucose value was significantly reduced (P<0.001), but the values at 1, 2 and 3 hours were not significantly different from those in singleton pregnancies. The incidences of both gestational diabetes (5.6%) and gestational hypoglycaemia (3.9%) in twin pregnancies were more than double those in singleton pregnancies (2.5% and 1.7%, respectively) (P<0.01). As the risk of perinatal death is increased in these patients, glucose tolerance tests should be performed in all patients with twin pregnancies.
Spontaneous Uterine Inversion in Association with Marfan's Syndrome
Authors: Quinn R. J. , Mukerjee B.
Published: February 2008

Summary: We report a case where spontaneous acute inversion of the uterus in a primigravida was associated with Marfan's syndrome. As far as we can ascertain no other case with such an association has been documented before.
Dysgerminoma … Gonadoblastoma and Familial 46XY Pure Gonadal Dysgenesis: Case Report and Review of the Genetics and Pathophysiology of Gonadal Dysgenesis and H‐Y Antigen
Authors: Khalid B. A. K. , Bond A. G. , Ennis G. , Medley G.
Published: February 2008

Summary: 46XY gonadal dysgenesis is a rare condition of intersexuality first described in detail by Swyer in 1955. It is characterized by a phenotypic female who is tall, eunuchoid with normal female external genitalia, hypoplastic uterus and Fallopian tubes, streak ovaries and primary amenorrhoea. The patients exhibit none of the associated congenital defects such as webbing of the neck and genu valgum seen in Turner's syndrome. Although rare, this clinical entity is important to recognize because of the high incidence of gonadoblastomas and subsequent development of dysgerminoma. The condition may be familial and therefore siblings need to be screened. To the geneticists and scientists researching in the area of intersexuality, hermaphroditism and sexual determination, it has helped to unveil the mechanisms of gonadal and genital sexual development.
Serum Uric Acid as a Marker of Pregnancy‐Induced Hypertension
Authors: Hickman Peter E. , Michael Con. A. , Potter Julia M.
Published: February 2008

Summary: A prospective longitudinal study was conducted, looking at the changes in serum uric acid during pregnancy in women who were normotensive at initial presentation. In our sample of 78 women having a total of 88 singleton pregnancies, 13 developed pregnancy‐induced hypertension during labour only, whilst a further 6 developed hypertension during pregnancy. Women who developed hypertension had significantly higher uric acid levels than women who remained normotensive throughout. However, there was an appreciable overlap between the groups. Women with essential hypertension showed similar changes. We conclude that the serum uric acid level is an unreliable indicator of developing hypertension in the individual woman. However, a rapidly rising uric acid level should be viewed with caution.
Antenatal Pregnancy Complications and Fetal Growth Retardation
Authors: Dobson P. C. , Abell D. A. , Beischer N. A.
Published: February 2008

Summary: This study reports the associations between antenatal complications, subnormal urinary oestriol excretion and perinatal death in 500 pregnancies when the baby weighed less than the 10th centile for gestational age at birth, compared with those in a series of 500 pregnancies when the baby was of a normal weight for gestation. The overall incidence of antenatal complications was not higher in those pregnancies in which the fetus was growth retarded, although early onset pre‐eclampsia, threatened abortion, diabetes mellitus and accidental haemorrhage were commoner (P < 0.05). The incidence of subnormal urinary oestriol excretion was significantly higher in pregnancies in which the, fetus was growth retarded, both when other antenatal complications were present (54.7% in the study group, 18.4% in the control group P < 0.001) and in uncomplicated pregnancies (37.7% and 13.3%, respectively, P < 0.001). Subnormal oestriol excretion identified 20 of the 26 perinatal deaths in the growth retardation group and 4 of the 6 perinatal deaths in the control group. Perinatal mortality was 10 times higher in growth retarded infants than in infants of appropriate size for gestation when pregnancy was not complicated antenatally. This study confirms the need to identify the presence of fetal growth retardation antenatally to enable appropriate treatment and improvement in perinatal mortality. The presence of antenatal complications is not appropriate for identification, whilst subnormal urinary oestriol excretion was seen to have highly significant predictive value.
Ultrasonic Detection of Maternal Ascites in Patients with Severe Pre‐Eclampsia
Authors: Woo Joseph S. K. , Liang Shuk‐Tak , Wong Vivian Taam
Published: February 2008

Summary: Ultrasonography is a reliable method in the detection of free fluid in the abdomen. In 2 patients with severe pre‐eclampsia, maternal ascites was diagnosed by ultrasound. Both babies were delivered prematurely by Caesarean section, indicated by deteriorating maternal condition. One of the babies died in the early neonatal period. The sonologist should be aware of the possible presence of peritoneal free fluid in patients with severe pre‐eclampsia, and be able to demonstrate this accordingly in the ultrasonogram.
Sipple's Syndrome (Multiple Endocrine Neoplasia) in Pregnancy … Case Report
Authors: Chodankar Cussuma M. , Abhyankar Shashikala C. , Deodhar Kamlakar P. , Shanbhag Anant M.
Published: February 2008

Summary: A case of Sipple's syndrome (multiple endocrine neoplasia) in a 24‐year‐old pregnant Hindu patient is described. Classical features included multiple carcinoma of the thyroid and adrenal glands. The patient died shortly after admission with hypertensive encephalopathy/preeclampsia.
Maternal Alcohol, Tobacco and Cannabis Consumption and the Outcome of Pregnancy
Authors: Gibson G. T. , Baghurst P. A. , Colley D. P.
Published: February 2008

In a prospective study of 7,301 births, associations were sought between maternal alcohol, tobacco and cannabis use and several adverse outcomes of pregnancy. Apparent effects of alcohol use on prematurity, intrauterine growth retardation, congenital abnormalities and low Apgar score were consistent with previously reported work, but were not statistically significant. Infants born to smokers had lower birthweights and were more prone to intrauterine growth retardation, but they did not appear to have an increased risk of prematurity or perinatal death. Only 36 women reported using cannabis 2 or more times a week, not merely as smokers of marijuana but also as users of the more potent resin forms of cannabis. Subsequently 25% of these women gave birth to premature infants.
Term Breech Delivery – Is a High Caesarean Section Rate Justified?
Authors: Woo J. S. K. , Chan P. H. , Ghosh A. , Wong V. , Ma H. K.
Published: February 2008

The Caesarean section rate for breech presentation has fallen from 60% in 1978 to 38% in 1980 at the University teaching hospital in Hong Kong. The number of Caesarean sections carried out for the indication of ‘unfavourable pelvis’ in 1980 was approximately half that in 1978. No significant difference in perinatal outcome was noted in the group delivered vaginally in these 2 years. It was concluded that a high Caesarean section rate in term breech presentation may not be justified in modern obstetric practice because of the associated increase in maternal morbidity. Many patients labelled as having an 'unfavourable pelvis' can in fact have a safe vaginal breech delivery.
Touching and Birthing*
Authors: Older Jules
Published: February 2008

Summary: Although humans are mammals, experts have often acted as though we were not, especially in the realm of our need for touch. Psychologists, surgeons and maternity hospitals are among those who have sought to discourage this basic mammalian form of contact and comfort. Yet there is ample evidence that touch is needed in a number of ways at the time of birth, for the months that precede it and for the years that follow. Even those who criticize touch‐advocates for overstating the scientific evidence for their case, share their conclusion about the importance of touch at the time of birth.
Maternal Exposure to Environmental Chemicals and the Aetiology of Teratogenesis
Authors: Gibson G. T. , Colley D. P. , Baghurst P. A.
Published: February 2008

Summary: Data on exposure of 10,879 pregnant women to various household and agricultural chemicals were obtained by interview; 6,267 of these women were seen both antenatally and postnatally, enabling a genuine prospective study of the association between chemical exposure and congenital abnormalities in the infant. The remaining 4,612 women were privately booked and were first seen postnatally.

Statistical analysis of the 2 groups revealed a strong association of malformations with chemical exposure in both groups, even after other known risk factors were taken into account.
Primary Syphilis and Papular Dermatitis of Pregnancy
Authors: Gaffoor P. M. Abdul , Gaffoor S. Fathima
Published: February 2008

Summary: A case of papular dermatitis of pregnancy with primary syphilis is discussed.
The Effect Of Prenatal Diagnosis On The Incidence Of Down Syndrome In Western Australia
Authors: Mulcahy Marie T.
Published: February 2008

This paper compares the incidence rates of Down syndrome livebirths in Western Australia during two 5‐year periods before and after the advent of prenatal cytogenetic diagnosis. A statistically significant fall in the incidence of liveborn Down syndrome is demonstrated and the relevance of amniocentesis screening is discussed in the light of possible future demographic change.
Understanding Preterm Labour: The Use Of Path Analysis
Authors: Chenoweth J. N. , Esler E. J. , Chang A. , Keeping J. D. , Morrison J.
Published: February 2008

A retrospective study was performed on 465 spontaneous preterm and 13,949 term births, in order to analyze the sequence of events that culminate in preterm labour. Twenty‐one variables were investigated by the mathematical technique of Path Analysis. Nine direct and independent precursors of preterm labour were identified. These were antepartum haemorrhage, poor antenatal attendance, previous delivery of a small baby, multiple pregnancy, proteinuria, grand multiparity, cervical suture, low maternal weight, and a history of bleeding before 20 weeks.
The Effect Of Ampicillin and Colistin On Post‐Caesarean Section Endometritis With Identification Of Possible Risk Factors
Authors: Birkenfeld Arie , Anteby Shaoul O.
Published: February 2008

Two hundred and seventy eight women undergoing Caesarean section were evaluated retrospectively to determine the value of prophylactic antibiotic treatment. The patients were divided into 2 groups: 180 women who received no prophylactic treatment and 98 who were treated prophylactically with ampicillin and colistin (Colymycin). Significantly lower rates of infection with prophylactic treatment were found in all groups studied (P < 0.001) (P < 0.05 in the group with premature rupture of membranes). Premature rupture of membranes was found to be the only risk factor significantly altering the rate of infection in the untreated group. Patients with premature rupture of membranes or with prolonged stay in the labour room prior to surgery had a significantly higher rate of infection even after the introduction of prophylactic treatment with ampicillin and colistin (P < 0.001).
Persistent Chest Opacity in Trophoblastic Disease: Is Thoracotomy Justified?
Authors: Wong L. C. , Ma H. K.
Published: February 2008

From 1972 to June 1980, 138 patients were admitted into the University Gynaecological Unit, Queen Mary Hospital for persistent gestational trophoblastic tumours. Forty had pulmonary metastases, all were treated by chemotherapy and 5 died shortly after commencement of treatment. The remaining 35 patients went into biochemical remission. Five of these patients had persistent chest shadows and 2 had evidence of active disease. Thoracotomy is of doubtful value both in therapy and in predicting prognosis. These patients have an increased risk of relapse. Close and long‐term follow‐up HCG assay is advocated.
A Comparison of the Fetal Femur Length and Biparietal Diameter in Predicting Gestational Age in the Third Trimester
Authors: Tse C. H. , Lee K. W.
Published: February 2008

Summary: Using 2 published normograms relating ultrasonic fetal femur length and gestational age, the accuracy of predicting gestational age using fetal femur length was compared to that using the biparietal diameter after 28 weeks' gestation in 50 patients. The results showed that ultrasonic feta! femur length was more accurate than the biparietal diameter in predicting gestational age in the third trimester. Ultrasonic fetal femur length provides an additional parameter in assessing gestational age in late pregnancy.
Relationship Between Contraceptive Method and Vaginal Flora
Authors: Peddie Barbara A. , Bishop Vicki , Bailey Ross R. , McGill Helen
Published: February 2008

Summary: This study was undertaken to assess whether the vaginal flora was affected by the method of contraception, and in particular as to whether the incidence of vaginal candidiasis increased when oral contraceptives were used. One thousand and two consecutive vaginal or cervical swabs from women attending a family planning centre were cultured. Candida albicans was isolated from 13% of women using no contraception, 16% using oral contraceptives, and from 9%, 19% and 18% of those using diaphragms, intrauterine contraceptive devices (IUCD) and condoms respectively. These differences were not statistically significant. Women using an IUCD had significantly more Gram‐positive cocci cultured than women in any other group, while those using diaphragms had significantly more Gram‐negative bacilli. Our clinical impression that the use of oral contraceptives led to an increase in vaginal candidiasis, was not confirmed by this study.