bluuebunny/crossref_metadata_2025 huggingface dataset:
Thromboxane A2 and prostacyclin levels in molar pregnancy
Authors: ROY A. C. , KARIM S. M. M. , KOTTEGODA S. R. , RATNAM S. S.
Published: August 2005

Summary. Plasma levels of thromboxane (TX) A2 and prostacyclin (PGI2), as measured by radioimmunoassay of their respective stable metabolites TXB2 and 6–keto PGF1α, were studied in six molar pregnancies immediately before, immediately following and 24 h after evacuation of the uterus. The mean (SD) levels for TXB2 were 150 (41), 137 (32) and 125 (25) pg/ml respectively, and for 6–keto PGF1α the respective values were 225 (52), 226 (127) and 213 (49) pg/ml. There was no significant difference in the levels of prostanoids between the samples taken at the various time intervals. The concentration of these prostanoids in molar intravesicular fluid was also determined. Their respective mean (SD) pg/ml values were 3682 (760) for TXB2 and 2969 (744) for 6–keto PGF1α. In 15 normal pregnancies of equivalent gestation, the mean amniotic fluid levels of TXB2 and 6–keto PGFlα were 34 (17) and 146 (86) pg/ml respectively. The ability of molar trophoblast to generate the prostanoids from [14C]arachidonic acid in vitro was also demonstrated. Mean (SD) values for TXB2 and 6‐keto PGF1α were 12.2 (2.6) and 13.2 (1.8) pg/mg protein/min, respectively. It is likely that the high concentrations of prostanoids in vesicular fluid reflect the synthesizing ability of the villus vesicles. The mole contributes little to the circulatory prostanoids possibly because its villi are deficient in blood circulation.
Use of a super active luteinizing hormone releasing hormone (LHRH) agonist in the treatment of menorrhagia
Authors: SHAW ROBERT W. , ERASER HAMISH M.
Published: August 2005

Summary. A luteinizing hormone releasing hormone agonist, d‐Ser(But)6des Gly10‐LHRH ethylamide, was administered intranasally to four women with unexplained ovulatory menorrhagia. Dramatic reductions in excessive menstrual blood losses were induced without significant side‐effects, although the pattern of loss returned to pretreatment levels within 2 months of ceasing therapy.
Genital infections with Chlamydia trachomatis in women attending an antenatal clinic
Authors: WOOD P. L. , HOBSON D , REES E.
Published: August 2005

Summary. Cervical swabs for isolation of C.trachomatis and serum for anti‐chlamydial antibodies were taken from 252 pregnant women on their first visit to an urban antenatal clinic. Chlamydial infection was found in 18 (7%) women, and antibody at titres >l/32 in 48 (19%); of the 18 infected women only 10 (56%) showed antibody. The likelihood of infection could not have been predicted by urogenital symptoms, the social or medical history or serology. Hypertrophic cervical ectopy and mucopus were significantly more common in infected than in uninfected women but underestimate the true rate of infection. The consorts of 10 infected women had signs of non‐gonococcal urethritis but were asymptomatic; C.trachomatis was isolated from the urethra of one man. The indications for routine screening of antenatal patients for chlamydial infections is discussed.
Does smoking influence serum α‐fetoprotein levels in mid‐trimester pregnancies?
Authors: HADDOW JAMES E. , PALOMAKI GLENN , KLOZA EDWARD M. , KNIGHT GEORGE J. , WYLIE PHILIP
Published: August 2005

Summary. The effect of cigarette smoking during pregnancy on serum α‐fetoprotein (AFP) levels was studied in 1925 consecutive women at 16–18 weeks gestation who subsequently had liveborn singleton infants. Cotinine and AFP were measured in sera in all the women and answers to a smoking questionnaire were analysed in 894. Cotinine, a metabolic derivative of nicotine, serves as an objective measure of the average daily absorption of smoking products because of its relatively long half‐life. Infants born to women who smoked were, on average, 198 g lighter than those born to non‐smokers, even though maternal weights were comparable. Whether analysed by self‐reporting or by serum cotinine, cigarette smoking had no measurable effect on serum AFP levels.
Can the fetus regulate its calcium uptake?
Authors: KUOPPALA TAPIO , TUIMALA RISTO , PARVIAINEN MARKKU , KOSKINEN TIMO
Published: August 2005

Summary. To investigate the role of the fetus in vitamin D metabolism concentrations of vitamin D metabolites, 25(OH)D, 24,25(OH)2D and 1,25(OH)2D, were measured in human umbilical artery and vein. There were no differences between artery and vein in 25(OH)D and 24,25(OH)2D levels. 1,25(OH)2D concentrations were statistically significantly higher in the artery than in the vein. It has been shown in animal experiments that 1,25(OH)2D is an important factor in the maintenance of the placental calcium gradient. We suggest that the fetus actively produces 1,25(OH)2D and hence has the capacity to control its calcium influx.
Salivary oestriol in normal and abnormal pregnancies
Authors: TRURAN PETER L. , READ GRAHAM F. , PEARSON JAMES F.
Published: August 2005

Summary. Profiles of daily salivary oestriol concentrations throughout the third trimester of pregnancy have been constructed for 14 normal and 11 abnormal pregnancies. Day‐to‐day variations were significantly higher than those reported for unconjugated oestriol in plasma or serum. A sustained decline in salivary oestriol concentrations was observed in one pregnancy in which intrauterine death occurred. Sustained falls were also observed in two pregnancies in which a healthy infant was born at term. In all other patients a normal salivary oestriol profile correlated with a favourable outcome. Salivary oestriol measurements provide similar information to plasma unconjugated oestriol measurements while offering the advantages of a simple, non‐invasive sample collection procedure.
Placental protein measurements in complicated pregnancies. I. Intrauterine growth retardation
Authors: WESTERGAARD J. G. , TEISNER B. , HAU J. , GRUDZINSKAS J. G.
Published: August 2005

Summary. Maternal serum levels of human placental lactogen (hPL), schwangerschaftsprotein l (SP1) and pregnancy‐associated plasma protein A (PAPP‐A) were measured serially throughout pregnancy in 753 women who had a normal pregnancy when recruited during the second trimester. Thirty‐three women were delivered of an infant with low birth‐weight and with phenotypic features of intrauterine growth retardation (IUGR). The predictive value of an abnormal (< 10th centile) hPL result (PVpos) in the identification of IUGR was between 28 and 32%, the sensitivity (36–54%) being greatest at 35 weeks gestation. The predictive value of a normal result (PVneg) was 87–96% at various stages of pregnancy, also greatest at 35 weeks gestation. For SP1, the sensitivity and predictive values were also greatest at 35 weeks gestation (PVpos, 20%; sensitivity, 32%; PVneg, 95%), but for PAPP‐A these values were considerably less at all gestations. The trends in levels of hPL, SP1 and PAPP‐A observed in individual patients with IUGR were not apparently related to any clinically recognizable feature of the pregnancy or the degree of fetal compromise, irrespective of whether the levels were within or outside the 80% confidence limits of the normal range or whether the levels fell from within the normal range. These data suggest that maternal hPL measurements are superior in the identification of IUGR in samples obtained at 30–35 weeks gestation.
Placental protein measurements in complicated pregnancies. III. Premature labour
Authors: WESTERGAARD J. G. , TEISNER B. , HAU J. , GRUDZINSKAS J. G.
Published: August 2005

Summary. Maternal serum levels of pregnancy‐associated plasma protein‐A (PAPP‐A), human placental lactogen (hPL) and schwangerschafts‐protein 1 (SP1) were measured serially during second and third trimester in 753 women with a normal pregnancy when they were recruited to the study. In 24 women spontaneous premature labour occurred before 37 completed weeks and these women had significantly lower mean levels of serum SP1 at 29–31 weeks and at 33–34 weeks gestation but similar mean levels of serum PAPP‐A and hPL at all gestations compared with corresponding values in normal pregnancy. The predictive value of an abnormal SP1 result was 5.2% at 29–31 weeks and 10.3% at 33–34 weeks. Furthermore, trends of levels of the three placental proteins in individual patients were similar to those seen in normal pregnancy, and the trends were unrelated to the occurrence of other complications and the time of onset of labour. This study suggests that measurements of the three placental proteins are unlikely to be of any value in the prediction of spontaneous premature labour.
The effect of exogenous hormones on the resistance of the early pregnant human cervix
Authors: ANTHONY G. S. , FISHER J. , COUTTS J. R. T. , CALDER A. A.
Published: August 2005

Summary. The force required to dilate the cervix to a diameter of 8 mm (cervical resistance index) has been measured in 355 patients undergoing suction termination in the first trimester of pregnancy. The cervical resistance index (CRI) was significantly lower in multigravid patients compared with primigravid patients. Prior treatment with prostaglandin E2 pessaries produced a consistent reduction in CRI in multigravidae but not in primigravidae. The effect of the prostaglandin was more pronounced on the compliance of the cervical tissue than on the diameter of the cervical canal. Treatment with pessaries of oestradiol, progesterone and medroxy‐progesterone acetate produced no changes in the CRI.
Normal levels of active contraction area in spontaneous labour
Authors: STEER P. J. , CARTER M. C. , BEARD R. W.
Published: August 2005

Summary. A detailed study has been made of uterine activity in a group of 21 unselected women in spontaneous labour. Measurements were made of contraction frequency, active pressure, Montevideo units and active contraction area. The level of Montevideo units were comparable with ‐values previously reported in spontaneous labour. Active contraction area correlated better than any of the other measures with the rate of cervical dilatation in the active phase of labour (r= 0.69). The mean contractionarea was 1099 (SD 333) kPas/15 min.
Intrauterina infections with group B β‐haemolytic streptococci
Authors: DESA D. J. , TREVENEN CYNTHIA L.
Published: August 2005

Summary. The case records of 15 infants with intrauterine infections due to group B β‐haemolytic streptococci were traced from the records of two geographically separate centres over a 4‐year period (1979–1982). Six infants were stillborn and the other nine died within the first 6 h. All the infants weighed 1000g and were 28 weeks gestation. Placental examination in 14 of the 15 infants showed the presence of chorioamnionitis and funisitis. The infants also showed evidence of pneumonitis. Four infants had evidence of otitis media, two had evidence of an early meningitis. A history of antepartum bleeding was present in six infants and abundant retroplacental clot was noted in four of them. The membranes had been ruptured for >24 h in only three infants. In six of the infants the membranes were intact at the time of delivery. A history of intact membranes at the time of delivery does not exclude a diagnosis of an intrauterine infection with this organism, and this series of infants highlights the importance of routine bactriologie studies of all perinatal deaths.
Serum prolactin and ovarian function after discontinuation of drug treatment for hyperprolactinaemia: a study with bromocriptine and metergoline
Authors: MATTEI ANNA MARIA , FERRARI CARLO , RAGNI GUIDO , BENCO ROSANNA , PICCIOTTI MARIA CHIARA , RAMPINI PIETRO , CALDARA ROBERTO , CROSIGNANI PIER GIORGIO
Published: August 2005

summary

Serum prolactin (PRL) was estimated for up to 2 months after discontinuation of therapy with either bromocriptine (n=33; 15 with idiopathic disease, 12 with pituitary microadenoma, and six with macro‐adenoma) or metergoline (n=23; 11 with idiopathic disease, and 12 with microadenoma) that had been administered for 8–30 months. Only five patients treated with bromocriptine and two treated with metergoline had PRL levels that remained normal or below 50% of pretreatment values. Among the patients followed‐up for up to 12 months, four showed a fall in PRL at 3–4 months, but this was followed by a rise in one patient. Five patients showing persistently lower or normal PRL after drug withdrawal were retested with thyrotrophin‐releasing hormone; the two responsive women also had a normal response before treatment. Of 10 patients followed for 9 months, three had persistently normal PRL levels. Amenorrhoea and anovulation recurred, with some delay, in all the patients showing PRL rebound except one. Medical treatment of hyperprolactinaemia only rarely results in permanent benefit.
Haemostatic and fibrinolytic properties of peritoneal fluid in the menstrual cycle
Authors: BOUCKAERT P. X. J. M. , VAN WERSCH J. W. J. , SCHELLEKENS L. A. , EVERS J. L. H. , ROLLAND R.
Published: August 2005

summary

The haemostatic and fibrinolytic properties of peritoneal fluid aspirated during laparoscopy were studied in a group of 49 women, 12 patients during the follicular phase of the menstrual cycle, and 37 during the luteal phase. Haemoglobin concentration and platelet count were low and similar in the pre‐ and post‐ovulatory groups. Factor VIII was present in low concentrations both in the pre‐ and post‐ovulatory period. The fibrinolytic and antifibrinolytic activity as judged by measurements of plas‐minogen, α2‐antiplasmin, fibrinogen degradation products, fibrinogen and antithrombin HI, rose significantly in the postovulatory period. It is concluded that the fibrinolytic activity of the peritoneal fluid depends on the stage of the menstrual cycle and is higher during the luteal phase.
Treatment of motor urge incontinence with clenbuterol and flavoxate hydrochloride
Authors: GRÜNEBERGER A.
Published: August 2005

summary

A controlled double‐blind trial is reported of the para‐sympatholytic drug, flavoxate hydrochloride, and the new sympatho‐mimetic drug, clenbuterol, in the treatment of 39 women with motor urge incontinence. The clinical results and the urodynamic findings of urethrocystomanometry after therapy showed clenbuterol to be very effective with few side effects.
Amnion graft for treatment of congenital absence of the vagina
Authors: DHALL KAMALA
Published: August 2005

summary

The successful alication of an amniotic membrane graft in the treatment of congenital absence of the vagina is described. Follow up with vaginal smears and vaginal biopsies revealed that amnion when used alone with mesenchyme alied to the host gives protection to the underlying granulation tissue and facilitates epithelialization.
Lipoprotein levels during hormone replacement therapy by vaginal ring pessaries
Authors: FLETCHER COLIN D. , FARISH ELIZABETH , HART DAVID M. , LINDSAY ROBERT , SHARPE GRAHAM L. M.
Published: August 2005

summary

Nineteen women who had had a surgical menopause had a vaginal ring pessary containing levonorgestrel and oestradiol in situ for a period of 3 months. Fasting lipoprotein levels were measured before, and after 1 and 3 months on therapy. After 3 months total triglycride levels were significantly lower than baseline values (P<0.01) as were very‐low‐density‐lipoprotein cholesterol (P<0.01), low‐density‐lipoprotein cholesterol (P<0.05) and high‐density‐lipoprotein cholesterol (P>0.001) levels. These changes suggest that in this preparation the effects of the progestogen component are dominant.
Congenital toxoplasmosis: a prospective survey in Brussels
Authors: FOULON W. , NAESSENS A. , VOLCKAERT M. , LAUWERS S. , AMY J. J.
Published: August 2005

summary

A prospective survey of antenatal patients was made at a hospital in Brussels over the period 1979–1982 to assess the incidence of congenital toxoplasmosis. Of 2986 patients assessed, 1403 (47%) had no toxoplasma antibodies and were at risk. The susceptible population was assessed every 6 weeks and 20 of these women (1.4%) seroconverted during pregnancy. Ten of the seroconverters had a therapeutic abortion; of the remaining 10 two gave birth to congenitally infected infants. Of the 1583 (53%) patients with a positive serology for toxoplasmosis initially, 17 (1.1%) had high antibody litres indicating that the infection could have taken place early in pregnancy. Nine infants born to these women were followed at our hospital and two of them were affected.
A survey of tocolytic drug treatment in preterm labour
Authors: KEIRSE M. J. N. C.
Published: August 2005

summary

In a questionnaire survey among 1004 qualified and trainee obstetricians in The Netherlands and northern Belgium (Flanders) to which 521 (52%) replied, only one claimed never to use tocolytic drugs in preterm labour. At 32 weeks gestation drug treatment would be used by 88% if the cervix was 4 cm and by 97% if it was 2 cm dilated. At 4 cm dilatation Dutch obstetricians refrained from treatment significantly more often than Belgian obstetricians, but there was no such difference at 2 cm dilatation, nor was there a difference between university and other hospitals or between trainee and specialist obstetricians. Belgian respondents relied more heavily on prostaglandin synthesis inhibitors than Dutch respondents, but most used betamimetic drugs, virtually always (98%) by intravenous infusion. No one used ethanol or sedatives. Ritodrine (62%) and fenoterol (31%) were the main choices. Orciprenaline was used only in The Netherlands (4%), isoxsuprine only by non‐academic obstetricians in both countries (3%) and no one claimed to use salbutamol, isoprenaline or terbutaline.
Betamimetic drugs in the prophylaxis of preterm labour: extent and rationale of their use
Authors: KEIRSE M. J. N. C.
Published: August 2005

summary

A questionnaire survey among 1004 specialist and trainee obstetricians in The Netherlands and northern Belgium (Flanders), revealed that 45% of the 521 (52%) respondents would use prophylactic betamimetics to prevent preterm labour. A further 33% would only use them as maintenance therapy after an acute episode of preterm labour. Only 22% would use neither form of prophylaxis, 23% would not prescribe oral betamimetics for out‐patients, and a mere 12% would use neither prophylaxis nor out‐patient treatment. Nevertheless, only 4% of those using betamimetics either prophylactically or as maintenance therapy said that they were very effective. The data indicate that a large body of obstetricians will resort to dubious treatments with poor effectiveness and unknown risks in an attempt to avoid the known risks of a condition for which aetiological insight and effective therapy are lacking.
The value of ultrasound measurement of amniotic fluid ume in the management of prolonged pregnancies
Authors: CROWLEY PATRICIA , O'HERLIHY COLM , BOYLAN PETER
Published: August 2005

summary

Ultrasound assessment of amniotic fluid ume was used to monitor 335 patients with prolonged pregnancy. Reduced amniotic fluid was diagnosed when no single vertical pool of amniotic fluid measured >30 mm. Sixty‐five patients with reduced amniotic fluid had labour induced while 270 patients with normal amniotic fluid were managed expectantly unless the cervix was favourable. Patients with reduced amniotic fluid had a statistically significant increase in meconium‐stained amniotic fluid and growth‐retarded babies and were more likely to require delivery by caesarean section for fetal distress. There were no perinatal deaths in the series and the perinatal outcome was satisfactory in both groups. Ultrasound measurement of amniotic fluid represents an effective discriminatory test in post‐term pregnancy.
Steroid receptors and response of ovarian cancer to hormones in vitro
Authors: GRÖNROOS M. , KANGAS L. , MÄENPÄÄ J. , VANHARANTA R. , NIEMINEN A.‐L. , JOHANSSON R.
Published: August 2005

Summary. Oestrogen receptor (ER) and progesterone receptor (PR) content and the response in vitro to tamoxifen (T), medroxyprogesterone acetate (MPA) and to a combination of the two hormones were determined in 21 epithelial ovarian carcinomas. The response was assessed by the level of adenosinetriphosphate in the cells. ER and PR were detected in 62% and 57%, respectively, with significant variations between the different histopathological cancer types. ER and PR predicted the response in vitro in 62% of the tumours exposed to the combined hormones, and in 38% and 33% of those exposed to T and MPA, respectively. The value of steroid‐receptor determinations in selecting the proper hormonal treatment in ovarian cancer is significantly reduced because of the high proportion of incorrect predictions.
Monoclonal antibodies for the histopathological diagnosis of cervical neoplasia
Authors: JHA R. S. , WICKENDEN C. , ANDERSON M. C. , COLEMAN D. V.
Published: August 2005

summary

Five monoclonal antibodies (Cal, HMFG 1 and 2, 8.30.3 and 77.1) were used to study the distribution of antibody binding sites in cervical tissue with a view to identifying a marker which would distinguish between benign and malignant cervical epithelium. Both benign tissue (mature and immature metaplastic squamous epithelium, congenital transformation zone and glandular epithelium) and neoplastic tissue (cervical intraepithelial neoplasia, 1, 2 and 3 and invasive squamous cell carcinoma) were stained by these antibodies. Although immature metaplastic epithelium stained strongly with all the antibodies, the intensity and distribution of staining in general did not distinguish between benign and neoplastic conditions. All five antibodies, raised against three different antigens, stained cervical tissue in a similar way and thus were unsuitable for use as specific tumour markers in equivocal cases. Further studies on other tumour markers are indicated in view of the potential value of this aroach.
Does oestriol add to the beneficial effect of combined hormonal prophylaxis against early postmenopausal osteoporosis?
Authors: CHRISTIANSEN C. , RØDBRO P.
Published: August 2005

summary

Sixty‐nine healthy women in the early menopause were assessed in terms of calcium metabolism, coronary risk factors, Kuerman index, and various serum hormones before and during replacement therapy with l7β‐oestradiol plus oestriol and norethisterone acetate. The patients were followed for 1 year, and the daily doses used were: 17β‐oestradiol: 2 mg from day 1 to day 22, 1 mg from day 23 to day 28; oestriol: 1 mg from day 1 to day 22, 0.5 mg from day 23 to day 28; and norethisterone acetate: 1 mg from day 13 to day 22. Group A (n=22) received 17β‐oestradiol and norethisterone acetate; group B (n=20) received 17β‐oestradiol plus oestriol and norethisterone acetate and group C (n=23) received a placebo. The responses in groups A and B were similar with no significant difference between the two therapy regimens. The results suggest that in the dose given, oestriol does not add significantly to the beneficial effect of combined hormonal prophylaxis against early postmenopausal osteoporosis.
Neural‐tube defects and vitamins: the need for a randomized clinical trial
Authors: WALD NICHOLAS J. , POLANI PAUL E.
Published: August 2005

It has been suggested that taking extra vitamins around the time of conception may reduce the risk of fetal neural‐tube defects. We have examined the evidence for this and conclude that there is considerable doubt about the efficacy of such a regimen. Also, it cannot be assumed that the taking of extra vitamins has no adverse medical effects. We give reasons for our view that a large randomized clinical trial is ethical and the only satisfactory way of resolving the matter. The Medical Research Council is currently conducting such a study in centres in Britain and abroad, involving women who have already had a pregnancy with a fetal neural‐tube defect. The design of the Medical Research Council study is described briefly.
Variability of fetal scalp blood flow during labour: continuous transcutaneous measurement by the laser Doppler technique
Authors: SMITS T. M. , AARNOUDSE J. G.
Published: August 2005

Variability of fetal scalp blood flow was measured in 15 patients in labour. Using the continuous transcutaneous laser Doppler technique adapted for fetal intrapartum measurements, it was possible to obtain recordings from a cervical dilatation of 3 cm until delivery. The general trend of fetal scalp blood flow showed a decrease in the majority of the patients during the first and the second stages of labour, with a fall of more than 50% of the initial value at the end of the first stage in seven. During the second stage the decrease in flow was generally less pronounced, although in one fetus scalp blood flow fell to 18% of the initial level by the end of the second stage. Of all the uterine contractions recorded, 57% were accompanied by a transient decrease in blood flow, often by 40–50%, but a temporary increase in scalp blood flow was found in 25% of contractions. Caput succedaneum formation was associated with a more pronounced transient decrease in local scalp blood flow during contractions. It is concluded that during labour a considerable reduction in fetal scalp blood flow occurs. It follows that the reliability of fetal transcutaneous blood gas monitoring techniques, which need a substantial increase in local capillary blood flow, seems highly questionable.
An automatic electronic device (Rite Time) to detect the onset of the infertile period by basal body temperature measurements
Authors: ROYSTON J. P. , HUMPHREY S. J. E. , FLYNN A. M. , MARSHALL J. , ZARZOSA‐PEREZ A.
Published: August 2005

Two trials of an electronic thermometer (Rite Time), designed to record and interpret basal body temperature (BBT) patterns in normal ovulating women, are described. A total of 140 menstrual cycles from 34 women, who used the thermal or symptothermal methods of natural family planning, were studied. Rite Time gave a signal for the start of the infertile period in 117 cycles, of which 114 (97%) appeared to have occurred at appropriate times. Further studies using hormonal and ultrasound reference points for ovulation were carried out in 21 cycles. Rite Time generally produced BBT patterns of quality acceptable for interpretation of the periovulatory BBT shift. About one‐half of the volunteers said that they would be willing to replace their conventional charting methods with Rite Time.
The congenital cervicovaginal transformation zone in young women exposed to diethylstilboestrol in utero
Authors: McDONNELL J. M. , EMENS J. M. , JORDAN J. A.
Published: August 2005

Twenty‐seven young women exposed in utero to diethylstilboestrol have been studied for > 24 months. Serial study of the cervicovaginal transformation zone has been by the non‐invasive techniques of cytology, colposcopy and scanning electron microscopy. Minimal change has been noted in aceto‐white areas within the transformation zone and, although some progressive glycogenation has been observed, this has never been to the stage of fully glycogenated epithelium. Scanning electron microscopy has shown maturation of the epithelium although there has been some slowing or arrest of the process at the stage of immature squamous epithelium. The neoplastic potential of this epithelium is discussed.
Assessment of fetal biparietal diameter during normal pregnancy by ultrasound in Nigerian women
Authors: OKUPE R. F. , COKER O. O. , GBAJUMO S. A.
Published: August 2005

The fetal biparietal diameter (BPD) was measured on 1104 occasions in 552 Nigerian women during normal pregnancy, and the range of BPD values for each week of pregnancy between 12 and 40 weeks was determined. Growth of the BPD in our population showed an asymptotic curve like that of Europeans but our values were slightly higher. The mean weekly increase in the BPD between 13 and 30 weeks gestation was 4.9 mm/week, between 30 and 36 weeks, 3.3 mm/week and between 37 and 40 weeks, 17 mm/week. But there was no significant difference between the BPD measurements of Europeans and Nigerian fetuses except towards term.
Survival and 2‐year outcome of extremely preterm infants
Authors: YU V. Y. H. , ORGILL A. A. , BAJUK B. , ASTBURY J.
Published: August 2005

The survival of 163 infants born within the hospital at 24–28 weeks gestation during a 41/2‐year period and the morbidity in survivors at 2 years of age were reported. Hospital survival rates from 24–28 weeks at each week of gestation, excluding six infants with birth defects, were 36%, 32%, 57%, 70% and 74% respectively. The late outcome of children born at 24–26 weeks was compared with those born at 27–28 weeks. Of the 81 infants in the former group 46 (57%) died, nine (11%) survived with significant functional handicap and 26 (32%) were developing within the normal range. Of the 82 infants in the latter group, 28 (34%) died, eight (10%) survived with significant functional handicap and 46 (56%) were developing within the normal range. Although the mortality rate was significantly higher in the 24–26‐weeks group, the physical disability and functional handicap rates in survivors were not statistically different between the two groups. Neither was developmental progress, as determined by psychological assessment, different.
Haemodynamic assessment of fetal heart arrhythmias
Authors: LINGMAN GÖRAN , DAHLSTRÖM JAN‐ANDERS , EIK‐NES STURLA H. , MARŠÁL KAREL , OHLIN PER , OHRLANDER STEN
Published: August 2005

The effects of fetal heart arrhythmias were examined serially in two pregnancies by three non‐invasive methods: fetal ECG, fetal phonocardiography and ultrasonic measurement of fetal blood flow. In a case of supraventricular arrhythmia, there was evidence suggesting that the stroke volume varied with ventricular filling according to the Frank ‐ Starling law. In a case of total atrioventricular block the mean blood flow in the fetal descending aorta and in the umbilical vein was within the normal range. Blood flow velocity in the inferior vena cava of the fetus reflected atrial contractions. In the phonocardiogram, a phenomenon similar to‘bruit de canon’ was found. Both pregnancies had good outcomes and subsequent development of the infants was normal except for the persisting dysrhythmias. The two cases exemplify how fetal heart function can be assessed in utero.
Effects of maternal cigarette smoking on fetal trunk movements, fetal breathing movements and the fetal heart rate
Authors: GOODMAN J. D. S. , VISSER F. G. A. , DAWES G. S.
Published: August 2005

The acute effect of maternal cigarette smoking was studied in 10 patients between 37 and 40 weeks gestation. There was a significant reduction in the percentage of time the fetus spent moving during the first 16 min of smoking (P<0.02). No significant changes were seen in the proportion of time the fetus spent breathing or the number of times the fetus changed from high or intermediate to low heart period variability. There were significant reductions in the number of accelerations (P<0.01), beat‐to‐beat variation (P<0.01) and root‐mean‐square of the deviation around the mean (P<0.02).
Normal variation in the length of the luteal phase of the menstrual cycle: identification of the short luteal phase
Authors: LENTON ELIZABETH A. , LANDGREN BRUT‐MARIE , SEXTON LYNNE
Published: August 2005

Normal probability plots were used to assess the homogeneity of a population of 327 luteal phases from apparently ovulatory menstrual cycles. The length of the luteal phase was defined as the interval (in days) following but not including, the luteinizing hormone peak, up to and including the day before onset of menstruation. A small sub‐set of the population consisted of cycles with abnormally short luteal phases but the majority of the data followed a normal frequency distribution which gave a mean (± SD) for normal luteal phase length of 14.13 (± 1.41) days. It was estimated that all cycles with a luteal phase 9 days were abnormal, and that 74%, 22% and 2% respectively of cycles with luteal phases of 10, 11 and 12 days were also abnormal. The total incidence of short luteal phases defined as above was 5.2%.
Healing of cervical epithelium after laser treatment of cervical intraepithelial neoplasia
Authors: MAcLEAN ALLAN B.
Published: August 2005

The recognition that only a minority of cervical premalignant lesions progress to invasion, and the increasing incidence of these lesions in young women, has led to a more conservative approach in the treatment of cervical intraepithelial neoplasia. One such method uses the carbon dioxide laser but inadequate length of follow‐up has prevented a prediction of risk of recurrence. Observations made in this study on the speed of healing, source of new epithelium, maturation of the epithelium and the absence of herpes nucleic acid suggest that this risk is low.
Multicentred controlled trial of cervical cerclage in women at moderate risk of preterm delivery
Authors: LAZAR P. , GUEGUEN S. , DREYFUS J. , RENAUD R. , PONTONNIER G. , PAPIERNIK E.
Published: August 2005

Summary. A total of 506 women at moderate risk of preterm delivery were randomly allocated to either cervical cerclage or a control group. Significantly more women in the group allocated to cerclage were admitted to hospital for reasons other than the operation and more received oral toco‐lytic drugs. There were also more caesarean sections and more preterm deliveries in the women allocated to cerclage although the differences between the two groups were small and not statistically significant.
Midtrimester amniocentesis: is it safe? A single centre controlled prospective study of 517 consecutive amniocenteses
Authors: SANT‐CASSIA L. J. , MAcPHERSON MARION B. A. , TYACK A. J.
Published: August 2005

Summary. The outcome of pregnancy following amniocentesis was studied prospectively in 517 consecutive patients undergoing amniocentesis in a single centre. The outcome in 289 of these pregnancies was compared with that in 289 control patients strictly matched for social class, age and parity. There were no significant differences in fetal loss, perinatal mortality or vaginal bleeding between the amniocentesis and control groups. There were significantly more congenital abnormalities in the amniocentesis group (P<0.01). These appear to be associated with the amniocentesis procedure and not with the occurrence of raised maternal serum a‐fetoprotein levels. Although there was an increased risk of preterm delivery (P<0.02) there was no significant difference in the distribution of birth weights by centiles for gestational age between amniocentesis and control groups. There was a significant association between intrauterine growth retardation and raised serum α‐fetoprotein (P<0.005). It is concluded that where the indications are strong, amniocentesis continues to be justified.
Umbilical artery concentrations of androstenedione increase in early labour in the leading twin fetus
Authors: NORMAN R. J. , DEPPE W. M. , JOUBERT S. M. , MARIVATE M.
Published: August 2005

Summary. Umbilical artery concentrations of androstenedione, progesterone, pregnenolone, pregnenolone sulphate and dehydroepiandrosterone sulphate were measured at birth in twin pairs, born by caesarean section. In the group born before the onset of labour, there were no significant differences in concentration of any of the steroids between the leading twin (twin I) and the second twin (twin II). In the group born during the latent phase of labour, levels of umbilical artery progesterone were significantly less in twin I (mean 501, SE 112 nmol/1) than in twin II (mean 887, SE 131) (P < 0.05), while concentrations of androstenedione were increased in twin I [9.9 (SE 1.7) vs 4.7 (SE 0.7) nmol/1, P < 0.01]. In patients delivered during active labour, androstenedione levels were consistently increased in twin I compared with twin II [11.7 (SE3.4) vs 4.3 (SE 0.7) nmol/1, P < 0.01]. It is suggested that the rise in umbilical artery levels of androstenedione is derived from the fetal adrenal gland and may have an important role in the onset of labour.
Abnormal concentrations of prostaglandins in amniotic fluid during delayed labour in multigravid patients
Authors: REDDI K. , KAMBARAN S. R. , NORMAN R. J. , JOUBERT S. M. , PHILPOTT R. H.
Published: August 2005

Summary. Concentrations of prostaglandins E (PGE), F2α (PGF), 13,14‐dihydro‐15‐keto prostaglandin F2α (PGFM), 6‐keto F1α and thromboxane B2 were measured by specific radioimmunoassay in samples of amniotic fluid from 22 multigravid patients during labour. Normal labour in 10 patients was associated with a significant increase of PGE, PGF and PGFM with close correlation to cervical dilatation (P< 0.05). In the 12 patients with clinically delayed labour, in the absence of cephalopelvic disproportion, there were significantly lower PGF (P<0.002) and PGFM (P < 0.05) concentrations obtained while no differences were observed in the other prostanoids measured. Administration of oxytocin to the latter group to enhance labour did not have any effect on the concentrations of prostaglandins obtained in spite of an improvement in intrauterine pressures and accelerated progress of labour.
Age of menopause in black women in South Africa
Authors: WALKER A. R. P. , WALKER B. F. , NCONGWANE J. , TSHABALALA E. N.
Published: August 2005

Summary. Among South African black women in rural areas, breast cancer is rare and remains very uncommon among urban dwellers in Soweto, Johannesburg. Since time of menopause is an influencing factor in breast cancer in white women, mean times were determined in series of 1850 and 1255 black women in rural and urban areas, respectively. Using probit analysis, respective means were 49.5 (SD 4.7) years, and 48.9 (SD 4.2) years. Values thus differ little from those reported for white women. Obviously case control studies are needed to learn of the bearing of menopausal age on breast cancer proneness in this very‐low‐risk population.
Ovarian function after renal transplantation: comparison of cyclosporin A with azathioprine and prednisone combination regimens
Authors: HANDELSMAN D. J. , McDOWELL I. F. W. , CATERSON I. D. , TILLER D. J. , HALL B. M. , TURTLE J. R.
Published: August 2005

Summary. Ovarian function was assessed in 24 women after renal transplantation who were treated either with cyclosporin A (10 patients) or with a combination of azathioprine and prednisone (14 patients) as immunosuppressive therapy. The different regimens were not associated with any differences in clinical or endocrine indices of ovarian function (LH, FSH, prolactin, testosterone, oestradiol, dehydroepiandrosterone sulphate). Excessive hair growth was common in both treatment groups. Levels of testosterone and dehydroepiandrosterone were higher in cyclosporintreated women but this was due to prednisone‐induced suppression of adrenal androgen output in the azathioprine‐ and prednisonetreated women. Excessive hair growth was present in postmenopausal women on both treatments suggesting that hypertrichosis is a consequence of renal transplantation and is not a specific side‐effect of cyclosporin A therapy.
Operative management of vaginal vault prolapse following hysterectomy
Authors: GRUNDSELL H. , LARSSON G.
Published: August 2005

Summary. Nine women suffering from vaginal vault prolapse had an abdominal sacropexy between 1972 and 1983. Marlex mesh was used to anchor the vaginal vault to the promontory of the sacrum and was completely buried retroperitoneally. The women had all had previous attempts at surgical correction. There were no intra‐ or post‐operative complications. No recurrences of vault prolapse occurred during a mean follow‐up period of 3.9 years. One woman developed a moderate cystocoele 4 years after sacropexy.
Modifications of the urethral rest and stress profiles after different types of surgery for urinary stress incontinence
Authors: WEIL ANTOINE , REYES HERNAN , BISCHOFF PAUL , ROTTENBERG RENE D. , KRAUER FELIX
Published: August 2005

Summary. Full urodynamic assessment, including urethral profiles at rest and under stress, using microtransducers, was made before and at least 6 months after surgery for urinary stress incontinence in 86 patients. Cure was assessed objectively. Procedures compared were Burch colposus‐pension, Pereyra urethrovesical suspension and anterior colporrhaphy. The Burch colposuspension increased the pressure transmission ratio more efficiently than the vaginal operations and the cure rate was 91%. Only 50% of Pereyra operations were successful and success was related to an increase in the functional urethral length and in the pressure transmission ratio. The success rate for anterior colporrhaphy was 57% and was associated with a significant decrease in the maximal urethral closure pressure and the continence area. The prognostic value of the urethral profiles at rest and under stress and the therapeutic implications are discussed.
Carcinoma‐in‐situ of the cervix: is post‐hysterectomy cytology worthwhile?
Authors: FAWDRY R. D. S.
Published: August 2005

Summary. The cytological records for the years 1950–1980 from South East Scotland revealed 1062 patients who had had histologically confirmed carcinoma‐in‐situ (or severe dysplasia) of the cervix at the time of hysterectomy. Ten cases of early ‘recurrence’ were detected in the first year of follow‐up. During 4304 women‐years of subsequent regular follow‐up by vaginal vault smears, only one further confirmed recurrence was detected, this being a poorly differentiated squamous carcinoma in a 26‐year‐old patient, 4 years after hysterectomy. Two further patients not in regular follow‐up presented clinically with invasive carcinoma. The implications for follow‐up policies are discussed.
Effects of vasoactive autacoids on the human umbilical‐fetal placental vasculature
Authors: MAK K. K.‐W. , GUDE N. M. , WALTERS W. A. W. , BOURA A. L. A.
Published: August 2005

summary

Studies have been made of the effects of autacoids on vascular tone of the human perfused fetal umbilical vein and placental lobule. The thromboxane A2 (TxA2)‐mimetic substance U46619, 5‐hydroxytryptamine and bradykinin were powerful constrictors of the vein. Prostaglandins E2 (PGE2), F2α(PGF2α), adrenaline, noradrenaline, histamine and angiotensin II were much less potent. Venoconstriction caused by U46619, bradykinin and 5‐hydroxytryptamine was reduced during inhibition of phospholipase A2 with mepacrine. Responses to U46619 were also reduced after inhibition of cyclo‐oxygenase with indomethacin whereas those to bradykinin and 5‐hydroxytryptamine were potentiated. In the placenta U46619 was the most potent vasoconstrictor, bradykinin, 5‐hydroxytryptamine, angiotensin II, PGE2 and PGF2α being 10–100 times less active. Responses to U46619 were reduced by either mepacrine or indomethacin. Arachidonic acid caused umbilical venoconstriction but vasodilatation in the placenta. Both effects were reduced by indomethacin. Prostacyclin (PGI2) caused vasodilatation in both preparations. It is suggested that TxA2 in the placenta and TxA2, 5‐hydroxytryptamine and bradykinin in the umbilical vein could contribute to control of vascular smooth muscle tone. Their vasoconstrictor effects are partly indirect and affected by the concomitant local release of eicosanoids. The results add suort to previous conclusions that these autacoids may normally have important influences on blood flow in the fetal extra‐corporeal circulation. Agents inhibiting their synthesis, eg non‐steroidal anti‐inflammatory agents, should only be prescribed during pregnancy with these facts in mind.
Umbilical vein blood flow as an indicator of fetal hypoxia
Authors: JOUILA PENTTI , KIRKINEN PERTTI
Published: August 2005

summary

Umbilical vein blood flow was measured using a combination of real‐time and pulsed Dolerultrasonic equipment in 11 pregnancies associated with chronic fetal hypoxia. All the results obtained during the last 12 h before delivery demonstrated pathologically low flow values, mainly due to constriction of the umbilical vein.
Fetal blood sampling during the third trimester of pregnancy
Authors: DAFFOS F. , FORESTIER F. , PAVLOVSKY M. CAPELLA
Published: August 2005

summary

Fetal blood sampling was possible during the third trimester of pregnancy by direct puncture of the umbilical vein near its placental insertion, using a needle guided by ultrasound. Between 2 and 6 ml of pure fetal blood were obtained from three pregnancies without adverse effect on the fetuses. If this new procedure proves to have an acceptable complication rate it should widen the field of prenatal diagnosis for the detection of treatable diseases of the fetus.
Male twins at birth and 18 years later
Authors: NILSEN STEIN TORE , BERGSJØ PER , NOME SIRI
Published: August 2005

summary

An 18‐year follow‐up examination on 56 male twins born in 1962–1963 was done by comparing birth records with the results of medical examinations at drafting for military service in 1981 Of the studied twins, 14.3% were unfit for military service compared with 6.2% of the total population of Norwegian conscripts in the same year. Preterm delivery rather than twinning per se is suggested as an explanation for this result. Vision was impaired in the preterm twins more often than in the total group of conscripts. The general intelligence, measured by standardized tests at the military medical board, did not differ significantly between the group of twins and the control conscripts.
Changes in serum uric acid concentrations during normal pregnancy
Authors: LIND T. , GODFREY K. A. , OTUN H. , PHILIPS P. R.
Published: August 2005

summary

Serial changes in serum uric acid concentrations have been studied in a group of healthy women before conception, at regular intervals throughout pregnancy and finally 12 weeks afterdelivery. Compared with pre‐pregnancy values uric acid concentrations decreased significantly by 8 weeks gestation and this reduced level was maintained until about 24 weeks. Thereafter the concentrations increased such that by term they were greater than the pre‐pregnancy values in the majority of patients and remained elevated until at least 12 weeks after delivery. If clinical management during the second half of pregnancy is to be based on increases in serum uric acid concentrations then such increases will have to be carefully interpreted against the background of rising concentrations which occur as part of the physiological response to normal pregnancy.
Progesterone concentrations in maternal and fetal blood
Authors: FARQUHARSON R. G. , KLOER A. I.
Published: August 2005

summary

Progesterone concentrations in cord artery and vein and in retroplacental and maternal blood were measured in 43 women delivered by caesarean section. The cord vein concentration was consistently higher than the cord artery concentration. The two were correlated but neither was related to the concentration in retroplacental blood. It was concluded that progesterone is secreted by the placenta independently to the mother and the fetus. No role for fetal progesterone was evident from the data.
Fetal cephalometry by ultrasound as a screening procedure for the prenatal detection of Down's syndrome
Authors: PERRY TRACY B. , BENZIE RONALD J. , CASSAR NAGIB , HAMILTON EMILY F. , STOCKER JUAN , TOFTAGER‐LARSEN KIM , LIMAN ABBY
Published: August 2005

summary

Infants and children with Down's syndrome have a cephalic index (ratio of biparietal to occipitofrontal diameter) higher than that in normal children. To determine whether this difference is present and detectable by ultrasound measurement of the second‐trimester fetal head, we calculated the cephalic indices for 308 normal fetuses and eight fetuses with a 47,+21 karyotype. The mean cephalic index in the fetuses with Down's syndrome (0.829, SD 0.033) was indistinguishable from that in the normal fetuses (0.825, SD 0.042). These data suggest that the documented difference in mean cephalic index between liveborn children with Down's syndrome and normal control children is not detectable in the mid‐gestation fetus and that ultrasound cephalometry alone is unlikely to discriminate reliably between normal and affected fetuses.
The advantage of antenatal diagnosis of intestinal and urinary tract malformations
Authors: KULLENDORFF C. M. , LARSSON L. T. , JÖRGENSEN C.
Published: August 2005

summary

In a 24‐month prospective screening programme 6020 pregnant women were examined with diagnostic ultrasound at 17 and 32 weeks gestation. In a total of 23 (0.38%) abnormalities, four cases of urinary tract and two of intestinal tract abnormalities were discovered. The antenatal diagnosis influenced the management of these disorders both before and after birth.