bluuebunny/crossref_metadata_2025 huggingface dataset:
THE ROLE OF THE FETUS IN THE FORMATION OF AMNIOTIC FLUID
Authors: Lind T. , Kendall Anne , Hytten F. E.
Published: August 2005

One hundred and thirty‐one conceptuses obtained at hysterotomy between 12 and 22 weeks were examined to establish the relation between amniotic fluid volume and fetal weight, and between the sodium and urea content of amniotic fluid and that of maternal and fetal plasma. In 37 of the fetuses bladder urine was obtained for the estimation of sodium and urea. In 44, samples of abdominal skin were obtained and the movement of sodium and water through it was studied in an Ussing‐type cell; ion movement across the amnion and chorion was also measured. Up to mid‐pregnancy amniotic fluid volume was closely related to fetal weight, and the sodium and urea content of amniotic fluid volume was closely related to fetal weight, and the sodium and urea content of amniotic fluid was more closely related to that in fetal plasma than to that in maternal plasma.

Data showing that the fetal kidney is capable of reabsorbing sodium and concentrating urea even before mid‐pregnancy is presented. Intermittent addition of fetal urine may explain why the sodium content of amniotic fluid is slightly below that of plasma.

Fetal skin was shown to be freely permeable to sodium and water in early pregnancy but the rate of diffusion slowed as mid‐pregnancy was reached with evidence of a block at the external skin surface. No electrical potentials were detected and neither vasopressin nor angiotensin affected the rate of diffusion. Fetal membranes, at least in the experimental conditions used, were also freely permeable to sodium and water.

The evidence supports the hypothesis that, in the first half of pregnancy, amniotic fluid may be an extension of the fetal extracellular fluid space.
PROTEINURIA IN TOXAEMIA AND ABRUPTIO PLACENTAE
Authors: MacLean PamelaR. , Paterson W. G. , Smart G. E. , Petrie J. J. B. , Robson J. S. , Thomson D.
Published: August 2005

Differential protein clearances were carried out in 31 patients with toxaemia of pregnancy and in 21 non‐toxaemic patients with abruptio placentae. In 6 patients with toxaemia and in 7 with abruptio placentae, dextran clearance determinations were also performed. Results were expressed in terms of selectivity indices relating the clearances of these macromolecules to their molecular weights. In toxaemia, protein and dextran selectivity results were in the intermediate range, dextran values being slightly higher than the values obtained for protein. In abruptio placentae, however, the values obtained for protein selectivity were very low, while those obtained for dextran selectivity were very high.

The results suggest than in toxaemia the proteinuria is of glomerular origin, but that in abruptio placentae the urinary protein is post‐glomecular and is derived from plasma protein passing through damaged renal tubular epithelium.
SERUM SEROMUCOID AND THE MATERNO‐PATERNAL MIXED LEUCOCYTE REACTION FOLLOWING PREVIOUS SEVERE PRE‐ECLAMPSIA
Authors: Jenkins D. M. , Good W. , Good Sheila M.
Published: August 2005

A group of 12 parous women was investigated following severe pre‐eclampsia or eclampsia to see if there was any relationship between serum seromucoid levels, known to be elevated in some of these patients, and cell mediated immune reactions in mixed cultures of their leucocytes and those of their husbands. Statistically significant linear correlations were demonstrated. High levels of maternal serum seromucoid are apparently immunosuppressive in materno‐paternal mixed leucocyte reactions. The possible significance of these findings in relation to the aetiology of pre‐eclampsia or eclampsia is discussed.
INTRAVENOUS INFUSION OF SALBUTAMOL IN THE MANAGEMENT OF PREMATURE LABOUR
Authors: Liggins G. C. , Vaughan G. S.
Published: August 2005

Salbutamol, a ß‐adrenergic stimulant, was administered to 88 women in premature labour in an attempt to delay delivery by 24 hours while corticosteroid was administered to prevent respiratory distress syndrome in the newborn. Treatment by continuous intravenous infusion of salbutamol varied in duration from 6 to 72 hours and the dose ranged from 1.8–43 μg. per minute. Delivery was postponed for more than 24 hours in 85 per cent of patients. The presence of ruptured membranes did not influence the outcome of treatment but dilatation of the cervix beyond 4 cm. was associated with successful treatment in only 58 per cent. No serious side effects were noted but tachycardia up to 140 per minute occurred frequently. It is concluded that salbutamol is a safe, well tolerated and effective uterine relaxant.
THE EFFECT OF INTRA‐AMNIOTIC OESTRIOL SULPHATE ON ABORTION INDUCED BY HYPERTONIC SALINE
Authors: Dennis K. John , Farr Valerie , Klopper Arnold
Published: August 2005

A double‐blind trial of the effect of oestriol sulphate on myometrial activity was performed on 20 women undergoing termination of pregnancy by hypertonic saline at 15 to 18 weeks. Intrauterine instillation of oestriol sulphate did not cause a significant increase in myometrial activity; nor did prior treatment with oestriol sulphate cause a stronger myometrial response to the hypertonic saline. On the average there were non‐significant improvements in myometrial activity and the inductiondelivery interval was shorter in the treated group. None of the women given oestriol sulphate required an oxytocin drip while four of the placebo treated patients did so. It is concluded that such oestrogen treatment marginally improves the response of the uterus to intra‐amniotic saline.
INTRA‐AMNIOTIC PROSTAGLANDIN E2 AND F2α FOR INDUCTION OF ABORTION : A DOSE‐RESPONSE STUDY
Authors: Craft Ian
Published: August 2005

An attempt was made to establish whether a single intra‐amniotic injection of the naturally occurring prostaglandins could effectively induce mid‐trimester abortion. Initially doses previously reported to be effective (5 mg. of prostaglandin E2 or 25 mg of prostaglandin and F2α) were evaluated, but because of limited success a dose‐response study was undertaken. Abortion occurred within 24 hours in 31 of 35 patients given 20 mg. of prostaglandin E2 and in all 8 patients given 100 mg. of prostaglandin F2α by intra‐amniotic injection.
SCREENING FOR GONORRHOEA, TRICHOMONIASIS, MONILIASIS AND SYPHILIS IN PREGNANCY
Authors: Cassie Ralph , Stevenson Archibald
Published: August 2005

One thousand unselected antenatal patients were investigated for evidence of gonorrhoea, trichomoniasis, moniliasis and serological evidence of syphilis. Two cases of gonorrhoea were found–one in the group screened at the initial booking visit while a second case was detected on repeat screening after the emergence of suspicious symptoms. The incidence of trichomoniasis was 8.9 per cent and moniliasis 22.3 per cent. Trichomonal infection was best detected by routine cytology smears whereas culture on Sabouraud's medium proved the more efficient method of diagnosing monilial infection.
HETEROKARYOTYPIC MONOZYGOTIC TWINS AND THE ACARDIAC MONSTER
Authors: Scott Jean M. , Ferguson‐Smith M. A.
Published: August 2005

Two acardiac monsters occurring in monozygous diamniotic monochorionic twin pregnancies are described. In one case chromosome analysis of the acardius failed. In the other case fibroblast cultures showed that the acardius had G‐trisomy whereas its twin had normal chromosomes. The demonstration of heterokaryotypic monozygosity supports the concept that the acardiac monster is a monozygous twin with a lethal primary defect whose survival in utero is permitted solely by placental anastomoses which allow its normal twin to provide a circulation.
JUVENILE MELANOMA OF CLITORIS
Authors: Hulagu Cebbar , Erez Selçuk
Published: August 2005

A case of primary melanoma of clitoris in a 9‐year‐old child is presented which did not recur during seven years after simple excision.
THE ORIGIN AND EFFECTS OF PROTEINURIA IN PREGNANCY*
Authors: Studd John
Published: August 2005

The proteinuria of nephrotic syndrome in pregnancy and pre‐eclampsia was investigated by immunochemical techniques that enabled identification of individual proteins and estimated the renal clearance of proteins, and hence the selectivity of the proteinuria. It has been shown that the proteinuria of pre‐eclampsia is a result of a leak through a damaged glomerular basement membrane with no apparent tubular cause for protein loss.

The differential protein clearance in pre‐eclampsia does not suggest that this will be a promising method for distinguishing pre‐eclamptic nephropathy from most cases of chronic glomerulonephritis, but the proteinuria of pre‐eclampsia does show some similarities to that in renal vein thrombosis. This suggests that the deposition of fibrinoid material in the glomerular basement membrane is the probable cause of proteinuria in pre‐eclampsia.

The heavy urinary protein loss in pre‐eclampsia produces hypogammaglobulin‐aemia in the fetus. A fall in serum albumin, transferrin and IgG, with an elevation of alpha2‐macroglobulin and β‐lipoprotein is found in the mother. These maternal protein changes are identical to those occurring in nephrotic syndrome and are a result of “molecular sieving” of proteins of intermediate molecular weight through the damaged basement membrane.

It is postulated that these serum protein changes are in part responsible for some of the clinical complications of both conditions, and that a rise in the level of the two macroglobulins may, by their antiplasmin activity, exacerbate disseminated intervascular coagulation and deposition of fibrin within the kidneys of a patient with pre‐eclampsia.
PLASMA VOLUME IN NORMAL FIRST PREGNANCY
Authors: Pirani B. B. K. , Campbell D. M. , MacGillivray I.
Published: August 2005

Serial measurements of plasma volume were made in 56 normal, healthy primigravidae at 12, 16, 20, 25, 30, 34 and 38 weeks' gestation using the Evans Blue (T‐1824) dye dilution technique with the women lying on their sides. Measurements were also made on 19 of these patients six weeks post partum. There was a progressive plasma volume expansion to a maximum between 30 to 34 weeks, with a terminal plateau. The expansion between the mean non‐pregnant volume and the mean maximum measured volume during pregnancy was 1246 ml. There was a significant relationship between plasma volume at 38 weeks' gestation and the birthweight of the baby.
UTERINE ACTIVITY AND PLASMA BUPIVACAINE LEVELS AFTER CAUDAL EPIDURAL ANALGESIA
Authors: Tyack A. J. , Parsons R. J. , Millar D. R. , Nicholas A. D. G.
Published: August 2005

Uterine activity was measured in ten normal women in the active phase of labour before and after caudal epidural analgesia had been effected with bupivacaine. There was a small, statistically non‐significant, fall in uterine activity immediately following the induction of anaesthesia, but activity rose to or above pre‐anaesthetic levels within about 20 minutes; no correlation with plasma bupivacaine concentrations was observed.
THE AMNIOTIC FLUID LECITHIN : SPHINGOMYELIN AREA RATIO (LSAR) IN PREGNANCIES COMPLICATED BY DIABETES
Authors: Whitfield C. R. , Sproule W. B. , Brudenell M.
Published: August 2005

The lecithin : sphingomyelin area ratio (LSAR) was measured in 108 samples of amniotic fluid obtained after 32 weeks' gestation from 66 pregnant diabetics and in 34 samples from 27 women with latent diabetes during pregnancy. A previously reported finding that the normal terminal rise in the ratio did not occur in approximately one‐third of such patients was confirmed. The clinical value of this test, in timing delivery to minimize the risk of neonatal respiratory distress, is discussed; its routine use in pregnancies complicated by established or latent diabetes is advocated.
THE SURVIVAL OF ERYTHROCYTES IN AUTOTRANSFUSED BLOOD
Authors: Mati J. K. G. , Dunlop W. , Wanguru S.
Published: August 2005

The survival of autotransfused red cells was studied using radioactive chromium. In five patients with ruptured ectopic pregnancy who had peritoneal blood labelled, the percentage survival of the cells on the fifth day was 67.0 ± 9.8 (standard deviation) as compared to 96.0 ± 4.6 in the case of labelled venous blood in four control patients. The difference between the means was statistically significant (P<0.05). By extrapolation the half‐life of peritoneal blood cells was approximately 8 days while the half‐life for venous blood red cells was approximately 60 days. The implication of these findings is discussed.
SPONTANEOUS HAEMOPERITONEUM IN PREGNANCY DUE TO A RUPTURE OF A UTERINE VEIN
Authors: Cordiner J. W. , Low Robert A. L. , Hart D. McKay , Smith I. S.
Published: August 2005

A patient with spontaneous rupture of a uterine vein at 29 weeks of pregnancy is described.
SERUM GLUCOSE‐6‐PHOSPHATASE LEVELS IN NORMAL PREGNANCY
Authors: Elder M. G.
Published: August 2005

A total of 176 serum glucose‐6‐phosphatase estimations was made during 35 normal pregnancies; these showed a wide range of levels which did not increase during pregnancy and which were not significantly different from those recorded in the nonpregnant.
CONGENITAL CYSTIC MALFORMATION OF THE LUNG AND ITS RELATION TO HYDRAMNIOS
Authors: Kohler H. G. , Rymer Barbara A.
Published: August 2005

The clinical histories and postmortem findings of two infants with congenital cystic adenomatoid malformation of the lung (CCAML) are reported. One, liveborn though hydropic, died within one hour; the other was stillborn, but not hydropic. In both cases there had been maternal hydramnios. The association of hydramnios with this condition is probably due to impaired absorption of amniotic fluid by both the cystic tumour and the remaining lung tissue which is displaced and compressed.
THE TERMINATION OF PREGNANCY BY INTRAVENOUS INFUSION OF A SYNTHETIC PROSTAGLANDIN F2α ANALOGUE
Authors: Sharp D. S. , Burslem R. W.
Published: August 2005

A synthetic analogue of prostaglandin F2α was successfully used to induce abortion in six patients, five of whom were in the second trimester of pregnancy. Five of the patients had a complete abortion and in one the abortion was incomplete. The mean induction‐abortion interval was 25 hours 15 minutes, ranging from 7 hours 45 minutes to 49 hours 30 minutes. The side‐effects were similar to those reported with natural prostaglandin F2α.
THE VALUE OF A CERVICAL SCORE IN THE ASSESSMENT OF OVARIAN FUNCTION
Authors: Flynn A. M. , Bertrand P. V.
Published: August 2005

Three normal, healthy volunteer women were each studied during one menstrual cycle. A cervical score based on amount, ferning and Spinnbarkeit of mucus and on the condition of the cervix was determined daily throughout each menstrual cycle. This, used in conjunction with the basal body temperature was found to be in agreement with ovarian function assessed by the daily excretion of total oestrogen and follicle stimulating hormone (FSH) and plasma oestradiol, plasma FSH and plasma progesterone measured at selected times. The karyopyknotic index, which was also measured, was not found to reflect accurately follicular development or ovulation. It is suggested that the simple technique of serial determination of the cervical score and measurement of the basal body temperature can be used to detect normal ovulatory cycles of patients treated in clinics not having facilities for measurement of hormone excretion.
GYNAECOLOGICAL SYMPTOMS FOLLOWING RECTAL EXCISION
Authors: Nye E. B.
Published: August 2005

The incidence of gynaecological symptoms was studied in 157 women after rectal excision. The relatively frequent occurrence of gynaecological problems suggests that the operation has wider gynaecological implications than may have been recognized.
POSTMORTEM CAESAREAN SECTION
Authors: Smith Graham E.
Published: August 2005

A postmortem Caesarean section with survival of the infant as an apparent spastic quadriplegic is described. Implications of the operation are briefly discussed.
VAGITUS UTERINUS
Authors: Thiery M. , Yo Le Sian A. , Vrijens M. , Janssens D.
Published: August 2005

Three recently observed cases of vagitus uterinus are reported. They are probably the first to have been investigated by continuous fetal heart rate monitoring and by fetal blood analyses.
ANTENATAL GONOCOCCAL ARTHRITIS
Authors: Baddeley P. , Shardlow J. P.
Published: August 2005

Two cases of gonococcal arthritis in antenatal patients are described, and the diagnosis is discussed.
CRITERIA FOR DIAGNOSIS OF CANDIDA VULVOVAGINITIS IN PREGNANT WOMEN
Authors: Carroll Carthage J. , Hurley Rosalinde , Stanley Valerie C.
Published: August 2005

In this prospective study of 303 pregnant women C. albkans was found in 50 patients (16‐5 per cent) but only once was it isolated from the healthy vagina. The majority of isolates (84 per cent) were associated with signs of vaginitis or vulvovaginitis. In the remainder, isolation of the fungus was associated with discharge or other sign of morbidity. Discharge and irritation were not specifically associated with isolation of the thrush fungus, but 85 per cent of women with vaginitis during pregnancy had precipitins in their serum, or C. albicans in the vagina. Candida albicans was isolated from 23 of 28 women with vulvitis, and from 11 out of 16 women with vaginal plaques or a cheesy appearance of the vaginal epithelium.
INTRA‐AMNIOTIC ADMINISTRATION OF PROSTAGLANDIN 15 (S) 15‐METHYL‐E2 METHYL ESTER FOR TERMINATION OF PREGNANCY
Authors: Amy J. J. , Karim S. M. M. , Sivasamboo R.
Published: August 2005

Intra–amniotic administration of a single dose of 100 μMg. of prostaglandin 15 (S) 15–methyl–E2 methyl ester was successful in terminating 18 or 20 randomly selected mid‐trimester pregnancies. The remaining two patients aborted after intra–amniotic instillation of a second 100 μg. dose of the analogue 24 hours after the first one. The mean induction‐abortion interval was 16.5 hours. Side effects were limited to a rise in temperature (1.0°C. to 1.5 °C.) in three patients and vomiting in three patients. An additional group of 10 patients were given, by intra–amniotic injection, 200 μg. of prostaglandin 15 (S) 15–methyl–E2 methyl ester, 24–hourly. No shortening of the mean induction‐abortion interval (17.25 hours) was noted. Although side effects after intra–amniotic administration of a 200 μg. dose were minimal (a temperature elevation of 1.6 °C. in one patient and vomiting in two patients), accidental injection or rapid absorption of this amount of compound into the general circulation could cause serious side effects.
ALPHA‐FETOPROTEIN LEVELS IN AMNIOTIC FLUID IN NORMAL PREGNANCY AND IN PREGNANCY COMPLICATED BY ANENCEPHALY
Authors: Randle G. H. , Cumberbatch K. N.
Published: August 2005

Amniotic fluid levels of alpha–fetoprotein were measured in 93 patients with normal uncomplicated pregnancies and in 10 patients with anencephalic fetuses. The amniotic fluid levels in normal pregnancies between 12 and 41 weeks' gestation are presented. In all the pregnancies with anencephaly the alpha‐fetoprotein levels were significantly raised above the normal range. Two patients who had previously had an anencephalic fetus are also reported.
THE INFLUENCE OF MATERNAL POSTURE AT BIRTH ON THE FETUS
Authors: Humphrey Michael , Hounslow Dianne , Morgan Susan , Wood Carl
Published: August 2005

A random controlled trial examined the hypothesis that the supine position may be harmful to the fetus during labour and delivery. Similar groups of women were delivered in the dorsal and 15° left tilt positions. Significant fetal asphyxia occurred in two of the twenty patients delivered in the dorsal position.
A RANDOMISED DOUBLE BLIND CLINICAL TRIAL OF ABDOMINAL DECOMPRESSION FOR THE PREVENTION OF PRE‐ECLAMPSIA
Authors: Coxon A. , Fairweather D. V. I. , Smyth C. N. , Frankenberg J. , Vessey M.
Published: August 2005

A randomized double blind study of twice–weekly abdominal decompression from the 28th week of pregnancy, involving 411 primigravidae in three hospitals, is reported. No significant difference was noted in the admission rate for pre–eclampsia between 200 patients who were subjected to a suction pressure of 70 mm. Hg and 211 patients who were subjected to a suction pressure of only 20 mm. Hg. Although the length of hospital stay was significantly less in the former group, we conclude that routine antenatal decompression therapy plays no role in the prophylaxis of pre–eclampsia.
THE EFFECTS OF ABDOMINAL DECOMPRESSION ON PREGNANCY COMPLICATED BY THE SMALL–FOR–DATES FETUS
Authors: Varma Thankam R. , Curzen Peter
Published: August 2005

The effects of daily abdominal decompression were investigated in 70 pregnant patients with “small–for–dates” fetuses, and were compared with the outcome in 70 pregnant patients with “small–for–dates” fetuses who served as controls. The mean growth rate of the fetal biparietal diameter was 2.08 mm. per week in the decompression group and 1.49 mm. per week in the control group. The mean 24–hour urinary oestrogen excretion increased more rapidly in the decompression group than in the control group. The incidence of fetal distress was 14.3 per cent in the decompression group and 38.6 per cent in the control group. The incidence of infants with a low Apgar score at one minute was 10 per cent in the decompression group and 38.6 per cent in the control group. The incidence of “light–for–dates” babies was 25.7 per cent in the decompression group and 83 per cent in the control group. There were two perinatal deaths in the decompression group and eight perinatal deaths in the control group.
ULTRASONIC SCANNING OF THE PUERPERAL UTERUS FOLLOWING SECONDARY POSTPARTUM HAEMORRHAGE
Authors: Malvern John , Campbell Stuart , May Pamela
Published: August 2005

A group of 117 patients with secondary postpartum haemorrhage was examined by ultrasonic compound B scanning for retained products of conception. False positive diagnoses were made in 17 per cent of this group of patients and retained products of conception were overlooked in 1 ‐7 per cent. Using this technique, 74 per cent of patients could be spared unnecessary curettage. It is therefore concluded that ultrasonic scanning is valuable in determining the management of secondary postpartum haemorrhage.
PREOPERATIVE INTRAMUSCULAR PROGESTOGEN IN THE TREATMENT OF ENDOMETRIAL CARCINOMA
Authors: Boyd I. E. , Pollard W. , Blaikley J. B.
Published: August 2005

When an injection of intramuscular 17a‐hydroxy‐progesterone caproate (Primolut Depot) was given before each radium insertion and before hysterectomy in 38 patients with endometrial carcinoma, there was a recurrence rate of 10–5 per cent as against 20 · 5 per cent in 44 controls.
PLASMA OESTRADIOL AND PROGESTERONE CONCENTRATION IN THE NORMAL MENSTRUAL CYCLE
Authors: Shaaban Mamdouh M. , Klopper Arnold
Published: August 2005

The plasma concentration of oestradiol‐l7β and of progesterone was assayed using radioimmunoassay and protein binding methods throughout the menstrual cycle in ten young women. Eight women had normal ovulatory cycles but two were found to be non‐ovulatory. The values from the eight normal cycles are put forward as criteria for the evaluation of assay results in the investigation and treatment of menstrual disorders.
MATERNAL ANAEMIA AND FETAL BIRTHWEIGHT
Authors: Harrison K. A. , Ibeziako P. A.
Published: August 2005

The pattern of fetal birthweight distribution was examined in singleton babies bora to several groups of pregnant Nigerian women: 43 of them were anaemic throughout pregnancy and also at delivery; 142 had been successfully treated for anaemia during pregnancy; 35 had sickle‐cell anaemia; and 65 served as healthy controls. The causes of anaemia were haemolysis from malaria, folate deficiency and haemoglobinopathies. When other factors known to reduce fetal birthweight were excluded, it was found that maternal anaemia (haematocrit less than 30 per cent) was itself associated with retardation of fetal growth and that this was most marked in the presence of sickle‐cell anaemia. If, at the end of pregnancy, maternal anaemia still remained uncorrected, then a 2 per cent drop in maternal haematocrit reduced fetal birthweight by about 100 g.
FETAL HEART RATES AS DETERMINED BY SONAR IN EARLY PREGNANCY
Authors: Robinson Hugh P. , Shaw‐Dunn John
Published: August 2005

Using a pulsed ultrasound technique, the human fetal heart rate was studied between 45 days and 15 weeks after the first day of the last menstrual period. The heart rate rose from a level of 123 beats per minute at 45 days to a peak of 177 beats per minute at 9 weeks, and then gradually fell to a value of 147 beats per minute at 15 weeks. In cases of threatened abortion the fetal heart rates were not statistically different from those in normal pregnancies. The changes in heart rate were correlated with the morphological and physiological changes which occur in the fetal heart during this period.
THE INDUCTION OF SECOND TRIMESTER ABORTIONS USING AN INTRA‐AMNIOTIC INJECTION OF UREA AND PROSTAGLANDIN E2
Authors: Bowen‐Simpkins Peter
Published: August 2005

Of 31 patients in the second trimester of pregnancy who were given an intraamniotic injection of 80 g. of urea and 5 mg. of prostaglandin E2, 30 aborted within 26 hours. The mean injection‐to‐abortion interval was 10 hours and 30 minutes. Vomiting occurred in 32 per cent of patients.
THE CLINICAL AND ENDOCRINOLOGICAL EFFECT OF OESTRADIOL IMPLANTS AT THE TIME OF HYSTERECTOMY AND BILATERAL SALPINGO‐OOPHORECTOMY
Authors: Hunter D. J. S. , Akande E. O. , Carr P. , Stallworthy J.
Published: August 2005

The plasma oestrogen level was maintained within the premenopausal physiological range for 16 months following the insertion of an implant of 100 mg. of oestradiol B.P.C. during the operation of hysterectomy and bilateral salpingo‐oophorectomy. The karyopyknotic index (KI) was elevated for the same duration, and levels of luteinizing hormone (LH) and follicle stimulating hormone (FSH) were depressed. None of the 42 patients who had an oestrogen implant developed hot flushes whereas 11 out of 14 without an implant did so and were severely distressed thereby.
THE INDUCTION OF OVULATION BY TAMOXIFEN
Authors: Williamson J. G. , Ellis J. D.
Published: August 2005

A new anti‐oestrogen, tamoxifen, has been synthesized and is available for clinical trials. Its value in the treatment of anovulatory infertility has been assessed in 32 patients. A total of 26 patients apparently ovulated, 16 patients conceived during a treatment cycle, and 2 patients became pregnant during the first spontaneous cycle thereafter. There was no increase in the abortion rate and there were no multiple pregnancies. Side‐effects were uncommon and none were serious.
BIOCHEMICAL CHANGES IN PREGNANCIES FOLLOWING OVULATION‐INDUCTION THERAPY
Authors: Macdonald H. N. , Good W. , Hancock K. W.
Published: August 2005

Changes in the major biochemical constituents of maternal plasma have been followed serially in five women who became pregnant after ovulation‐induction therapy. The observed changes do not differ significantly from those which occur in normal pregnancies.
BIRTHWEIGHTS IN CONSECUTIVE PREGNANCIES
Authors: Billewicz W. Z. , Thomson A. M.
Published: August 2005

An analysis was made of birthweights in consecutive pregnancies among 6702 married women who were mostly followed up for ten years or more after the first viable birth. To facilitate comparisons between pregnancies, birthweights were standardized for sex and to 40 weeks gestation.

The second baby was heavier than the first in 60 per cent of women; in third or later pregnancies, the chances of a baby being heavier or lighter than its predecessor were about equal. When the reproductive history began with one or more spontaneous abortions, birthweights in subsequent pregnancies appeared to be unaffected: but when the first pregnancy ended in stillbirth, birthweights in subsequent pregnancies tended to be considerably reduced.

Individual women had a low but highly significant tendency to have pregnancies of similar gestational length, and the full‐sib coefficient of correlation between adjusted birthweights was 0.53. The similarity of birthweights within sibships could not be explained on grounds of maternal size.

Birthweights in consecutive pregnancies tended to rise with increase of maternal weight between pregnancies and with greater gains of weight during pregnancy.
SEROLOGICAL TESTS FOR TREPONEMAL DISEASE IN PREGNANCY
Authors: Hare M. J.
Published: August 2005

The results of antenatal screening for treponemal disease during a 10‐year period at Queen Charlotte's Hospital, London, are reported. Positive results were obtained on sera from 6.8 per thousand patients booked for confinement and in 3.9 per thousand these were due to previously undiagnosed treponemal infections. In 25 per cent of cases where the serum gave a positive reaction this was due to a Biological False Positive phenomenon.
THE EFFECT OF POSTURE ON SERUM HUMAN PLACENTAL LACTOGEN (HPL) LEVELS IN NORMAL AND COMPLICATED LATE PREGNANCY
Authors: Ylikorkala O. , Haapalahti J. , Järvinen P. A.
Published: August 2005

Serum HPL levels were determined in the supine and upright positions at two‐hour intervals in normal and complicated late pregnancies. No significant difference could be demonstrated.
SUPPRESSIVE ACTIVITY OF PREGNANCY PLASMA ON THE MIXED LYMPHOCYTE REACTION
Authors: Jones Elizabeth , Curzen Peter , Gaugas J. M.
Published: August 2005

Complement inactivated plasma obtained from patients in late pregnancy, or at delivery, had a suppressive effect on in vitro mixed lymphocyte reactivity (MLR) between unrelated individuals. In contrast, complement inactivated plasma obtained in the early stages of pregnancy did not suppress mixed lymphocyte reactivity.
THE IMMUNOLOGICAL REACTIVITY OF MATERNAL LYMPHOCYTES IN PREGNANCY
Authors: Jones Elizabeth , Curzen Peter
Published: August 2005

Mixed lymphocyte reactions were performed using lymphocytes from women at various stages of pregnancy, and these were compared to mixed lymphocyte reactions between cells from non‐pregnant adult volunteers. Immunological reactivity of lymphocytes at all stages of pregnancy was significantly reduced compared to the reactivity of lymphocytes from non‐pregnant donors. There was, however, no significant difference between lymphocyte reactivity at 12 to 16, 28, and 36 to 40 weeks of pregnancy.
VARIATIONS IN MATERNAL PLASMA LEVELS OF HUMAN PLACENTAL LACTOGEN (HPL) IN NORMAL PREGNANCY AND LABOUR
Authors: Lindberg Bo S. , Nilsson Bo A.
Published: August 2005

Plasma levels of human placental lactogen (HPL) in normal pregnancy from the 22nd week until delivery were measured with a rapid radioimmunoassay. The HPL concentration in plasma rose steadily up to the 37th week and thereafter gradually decreased until delivery. Individual women followed during the latter part of pregnancy showed a characteristic pattern with very small deviations from their original relative level within the normal range.

Significant fluctuations in HPL levels were noted during a 24‐hour period of sampling and during shorter periods. No systematic circadian variation was observed. The variations showed no clear relation to sleep, meals or light exercise. During spontaneous and induced labour significant fluctuations in HPL concentrations occurred but these were of the same magnitude as those during the latter part of normal pregnancy; no correlation between HPL levels and uterine contraction and relaxation was found.

Strenuous physical exercise during the last month of pregnancy sufficient to affect the fetal heart rate did not influence the HPL levels.
EXPERIMENTAL OBSERVATIONS ON THE ENERGY METABOLISM OF HUMAN PLACENTA
Authors: Paparella P. , Galeotti T. , Bompiani A. , Terranova T.
Published: August 2005

Oxygen consumption of histologically abnormal placentae was reduced but the effect on the fetus probably depends on the timing of the abnormality. A reduced placental respiratory rate, whether accompanied by no obvious histological change, or with the “senescent” changes of postmaturity, or by damage due to rehsus isoimmunization was associated with an adverse effect on fetal growth or wellbeing.

Rotenone, antimycin A and cyanide, all inhibitors of mitochondrial electron transfer, markedly decreased the endogenous respiration of both normal and pathological placentae. Respiration was also reduced by from 35 per cent to 60 per cent by oligomycin, whereas it was increased by as much as 70 per cent by 2,4‐dinitrophenol. Oligomycin inhibition of endogenous respiration was largely offset by 2,4‐dinitrophenol. The results obtained showed that: (i) placental respiration was decreased in all the pathological conditions studied, (ii) the organization of the mitochondrial respiratory chain of placental cells might be similar to that of other normal tissues and (iii) placental respiration was coupled to energy conservation reactions both in normal and pathological conditions.
SERUM LEVELS OF GONADOTROPHINS IN RELATION TO MULTIPLE PREGNANCY IN NIGERIA
Authors: Nylander P. P. S.
Published: August 2005

Serum levels of follicle stimulating hormone (FSH) and luteinizing hormone (LH) were measured daily for 10 days from the 7th day of the menstrual cycle in 15 healthy Yoruba women, six of whom had singleton infants, seven of whom had had one set of twins, and two of whom had had two sets of twins.

Mean FSH levels were higher at the peak and for four days before and after the peak in women who had had twins, compared to those who had had singletons, and higher still in the women who had had two sets of twins. Mean LH levels and the height of the LH peak were less clearly related to the twinning history.
THE COAGULATION AND FIBRINOLYTIC PROPERTIES OF PERITONEAL AND VENOUS BLOOD IN PATIENTS WITH RUPTURED ECTOPIC PREGNANCY
Authors: Carty M. J. , Barr R. D. , Ouna Noel
Published: August 2005

The coagulation and fibrinolytic properties of peritoneal and venous blood were studied in ten African patients with ruptured ectopic pregnancy. The peritoneal blood showed marked depletion of coagulation factors and the level of fibrinfibrinogen degradation products (FDP) was grossly elevated. A slight but significant elevation of FDP was the only abnormality detectable in the venous blood. In the light of these findings the value and hazards of autotransfusion are discussed.
A LATE FOLLOW‐UP STUDY OF GLUCOSE TOLERANCE AFTER PRE‐ECLAMPSIA
Authors: Singh M. M. , MacGillivray I. , Sutherland H. W.
Published: August 2005

No significant difference was found in intravenous glucose tolerance between 95 women who had had proteinuric pre‐eclampsia more than 10 years previously and a control group of 58 women with no history of pre‐eclampsia. Obesity, defined as above standard weight for height, was more common in the pre‐eclamptic group than in the control group but the difference was not significant.
PLASMA OESTRIOL IN PREGNANCY COMPLICATED BY ESSENTIAL HYPERTENSION
Authors: Masson Gordon M.
Published: August 2005

Serial plasma oestriol estimations were made in five hypertensive patients. A significant negative correlation was demonstrated between the percentage change in diastolic blood pressure and the change in plasma oestriol concentration. It is suggested that antihypertensive therapy leads to improved feto‐placental function.
AN ANTILACTOGENIC EFFECT OF PYRIDOXINE
Authors: Foukas Matthias D.
Published: August 2005

The efficacy of pyridoxine in the suppression of lactation has been tested in a placebo‐controlled, double‐blind trial of 253 puerperal patients. Ninety‐five per cent of the women treated with pyridoxine had their lactation successfully suppressed within one week, compared to 83 per cent for stilboestrol and 17 per cent for the placebo.
THE EXCRETION OF TOTAL OESTROGENS AND 11‐DEOXY‐17‐OXOGENIC STEROIDS IN WOMEN TREATED WITH GONADOTROPHINS
Authors: Crooke A. C. , Ljpede A. B. , Hodgson Christine
Published: August 2005

The excretions of total oestrogens and 11‐deoxy‐17‐oxogenic steroids (as a measure of pregnanetriol) were measured during 61 courses of treatment with gonadotrophins in 26 patients. During the follicular phase of the induced cycles the increase in oestrogens was more rapid than that of pregnanetriol; the latter was not significantly raised until the day before giving the ovulating dose of human chorionic gonadotrophin (HCG). The use of these estimations to monitor treatment is discussed; at present the most reliable index is the total oestrogen excretion and a method of treatment is described whereby some multiple pregnancies and hyperstimulation may be avoided. Steroid excretion is very variable in the early luteal phase. There is a tendency for elevated values to occur in hyperstimulated patients whether they conceive or not.
“THE ANATOMY OF THE HUMAN GRAVID UTERUS” 1774–1974
Authors: Thornton John L. , Want Patricia C.
Published: August 2005

The bicentenary of the publication of William Hunter's The anatomy of the human gravid uterus provides the opportunity of investigating the events leading up to its publication, and of presenting information on the artists, engravers and the printer responsible for the production of this outstanding contribution to the literature of obstetrics.
FETAL PLASMA STEROIDS IN RELATION TO PARTURITION
Authors: Smith Ian D. , Shearman Rodney P.
Published: August 2005

Total plasma corticosteroid levels were measured by competitive protein binding assay in matched umbilical arterial and venous samples obtained immediately following delivery of 78 infants by Caesarean section. At 38 to 40 weeks gestation, the mean umbilical arterial levels (±S.E.) were 94.9 ± 10.0 ng./ml. following elective Caesarean section and 142.2 ± 23.7 ng./ml. following emergency Caesarean section in labour. The corresponding mean venous levels were 132.3 ± 10.0 ng./ml. and 172.9± 19.1 ng./ml. Within the emergency Caesarean section group, corticosteroid levels were related to the stage of labour. In fetuses obtained by hysterotomy, the mean heart blood level of plasma corticosteroids was 16.3±3.6 ng./ml. at 12 to 16 weeks gestational age. Within the elective Caesarean group, corticosteroid levels increased with gestational age, reaching a peak at 35 to 37 weeks gestation.
THE MEASUREMENT OF INDOCYANINE GREEN RETENTION IN THE DIFFERENTIAL DIAGNOSIS OF HYPERTENSION DURING PREGNANCY
Authors: Mati J. K. G. , Kahuho S. K. P.
Published: August 2005

Pre‐eclampsia consists of hypertension, proteinuria and oedema in varying degrees. Unless patients are seen early in pregnancy it is not always possible to exclude underlying essential hypertension or renal disease. Using the indocyanine green (ICG) retention test we have found that patients with definite pre‐eclampsia retain more dye than normal pregnant women or those known to have essential hypertension. It is suggested that the IGC retention test may be of value in the differential diagnosis of hypertension during pregnancy.
HUMAN AMNIOTIC AND FETAL NEONATAL PHARYNGEAL FLUIDS
Authors: Biggs J. S. G. , Hemming J. , McGeary Hsceather , Gaffney T. J.
Published: August 2005

The phospholipid and chloride content of pharyngeal fluid from 14 newborn infants have been studied, and compared in eight cases with amniotic fluid obtained at the time of amniotomy. The concentrations of total phospholipids and lecithin were found to be, on average, eleven times greater in pharyngeal fluid than in amniotic fluid. Chloride concentrations were higher in pharyngeal fluid in every case. The findings give support to the contention that amniotic fluid phospholipids have their origin in the fetal lung.
INTRAUTERINE ADMINISTRATION OF L‐NORADRENALINE AND PROPANOLOL DURING THE SECOND TRIMESTER OF PREGNANCY
Authors: Amy J. J. , Karim S. M. M.
Published: August 2005

The effect of intrauterine administration of noradrenaline and propanolol on myometrial activity during the second trimester of pregnancy was investigated. Extra‐amniotic doses of 1–2 mg. of noradrenaline given two‐hourly to 13 women increased myometrial contractility and resulted in abortion in six. Administered by the intra‐amniotic route, noradrenaline (4 mg. two‐hourly) also increased uterine activity but failed to terminate pregnancy. Propanolol, a β‐adrenergic blocking agent, was also oxytocic when instilled into the extra‐amniotic space and a termination of pregnancy with this compound is reported. It is suggested that under physiological conditions, adrenaline may exert an inhibitory action on the gravid uterus.
YOLK SAC TUMOUR OF THE OVARY
Authors: Beilby J. O. W. , Todd P. J.
Published: August 2005

Within the last two years we have seen four examples of a highly malignant neoplasm in young patients for which the name yolk sac tumour is recommended. We now describe the pathology and discuss the histogenesis of these tumours. The collection of information about them is impeded by the variety of names applied to them.
CORTISOL, CORTISONE, AND 11‐DEOXYCORTISOL LEVELS IN HUMAN UMBILICAL AND MATERNAL PLASMA IN RELATION TO THE ONSET OF LABOUR
Authors: Cawson M. J. , Anderson Anne B. M. , Turnbull A. C. , Lampe L.
Published: August 2005

Levels of unconjugated cortisol, cortisone and 11‐deoxycortisol were measured in umbilical arterial and venous plasma, and in maternal antecubital and uterine venous plasma by a method specific for each steroid, utilizing competitive proteinbinding radioassay following steroid fractionation by column chromatography. Samples were obtained (1) at elective Caesarean section, (2) at vaginal delivery or emergency Caesarean section after induced labour, and (3) at vaginal delivery or emergency Caesarean section after labour of spontaneous onset. In the umbilical circulation there was no significant arteriovenous difference for any of the steroids measured. There were significantly higher (p<0.001) umbilical cord cortisol levels at vaginal delivery after labour of spontaneous onset (149±13ng./ml.; mean ±S.E.M.) than after induction of labour (65 ± 9 ng./ml.) and in both these groups, the concentration of cortisol in the umbilical cord was higher than at elective Caesarean section (26 ± 4 ng./ml.) If Caesarean section was performed during labour, cord cortisol levels were again higher (p<0 05) after labour of spontaneous onset (93 ± 9 ng./ml.) than after induced labour (67 ± 8 ng./ml.). Umbilical cord cortisone and maternal cortisol levels were more related to the process of labour itself rather than to its initiation since levels in induced labour or labour of spontaneous onset were equally high. Cortisol was quantitatively the most important 17‐hydroxycorticosteroid in the maternal circulation, whereas cortisone was quantitatively at least as important as cortisol in umbilical cord plasma.
EXAMINATION OF THE RELATIONSHIP BETWEEN BIRTHWEIGHT, CIGARETTE SMOKING DURING PREGNANCY AND MATERNAL WEIGHT GAIN
Authors: Rush David
Published: August 2005

There has been no reported systematic exploration of the hypothesis that the low birthweight of infants whose mothers smoke in pregnancy is mediated by depressed caloric intake. Using gestational weight gain as an index of energy balance, we have studied this question among 162 mothers and their liveborn singleton infants, in a poor, black, urban American community. Smoking mothers had lower mean weekly weight gain (0.73 versus 0.90 pounds per week; t=2.63; p<0.01), and a strong and highly significant gradient of decreasing weight gain with increased amount smoked (0.017 fewer pounds per week gained per additional cigarette per day; F=12.45; p<0.005). Women who stopped smoking before delivery had higher weight gain than those who continued; the difference was not significant, but numbers were small. Regression analyses were performed in order to quantitate the unique and joint contributions of smoking and change in maternal weight to birthweight. At least half, and usually closer to three‐quarters, of the effect of smoking on birthweight was jointly shared with maternal weight change. Smoking is in all likelihood depressing fetal growth, in large part, by depression of caloric intake, reflected by lower maternal weight gain. No other examined differences between smokers and non‐smokers accounted for these differences.
FETO‐MATERNAL AMINO ACID METABOLISM
Authors: Dallaire L. , Potier M. , Mflancon S. B. , Patrick J.
Published: August 2005

Concentrations of amino acids and related compounds in 111 samples of amniotic fluid obtained by transabdominal amniocentesis, and 89 corresponding maternal plasmas were measured using a Beckman 121 Automatic amino acid analyzer. Thirty‐six amino acids and related compounds were identified in amniotic fluid and/or maternal plasma samples. The concentration of eight amino acids (Phe, Tyr, Val, Leu, He, Lys, Ala and His) decreased towards the end of pregnancy in amniotic fluid but the Phe/Tyr ratio remained constant. Thirteen amino acids (Gly, Ser, Thr, Asp, Asn, Glu, Arg, Met, Pro, Orn, Ans, Tau, Cit) showed no significant change from the 10th to the 40th week of gestation, while ten were present in trace amounts during the same period (lMeh, 3Meh, PSer, PEam, Asp, αAAD, αABA, 1/2CyS, Cyth, Hyp). Our results show that the great variation in lysine concentration between the 10th to the 20th week does not permit fetal age correlation studies. We found that alanine was measurable both in early and late pregnancy with a mean of 0.4 mM. at 10 weeks and 0.1 mM. at 40 weeks. The mean serine, glycine and arginine concentrations showed no statistically significant variation from the 10th to the 40th week of pregnancy. Hydroxyproline was found at a concentration of less than 0.01 mM. in amniotic fluid from the 22nd to the 37th week of pregnancy in our study, but homocarnosine was too low for accurate measurement. Ethanolamine was present at levels of less than 0. 03 mM. in 27 amniotic fluid and 8 maternal plasma samples throughout gestation. There was a marked elevation of amino acid concentrations in amniotic fluid obtained from sacs containing two fetuses. The glycine concentration in one amniotic fluid sample obtained around the 45th day of gestation was 6.1 mM.
PLASMA PROGESTERONE CONCENTRATION DURING THE THIRD TRIMESTER OF DIABETIC PREGNANCY
Authors: Booth Mollie , El Garf T. A. R.
Published: August 2005

Progesterone concentrations in extracts of plasma from normal and diabetic women in the third trimester of pregnancy were measured by gas liquid chromatography. Plasma progesterone concentrations increased curvilinearly in 61 normal women and linearly in 39 diabetic patients between days 194 and 283 of gestation. Between days 215 and 225 of pregnancy, progesterone concentrations in diabetic women rose significantly above normal, and subsequent similar rates of increase in the two groups maintained this difference until parturition. It is still not possible to define unequivocally normal and abnormal ranges. The findings are discussed with relation to the maternal and neonatal complications of diabetic pregnancy.
THE EFFECT OF OESTROGEN ON PLASMA LEVELS OF LUTEINIZING HORMONE IN EUTHYROID AND THYROTOXIC POSTMENOPAUSAL WOMEN
Authors: Akande E. O.
Published: August 2005

The effect of oestrogen administration on plasma levels of luteinizing hormone (LH) in twelve euthyroid and twelve thyrotoxic postmenopausal women was studied to further elucidate the changes in gonadal steroids and gonadotrophic hormone levels which have been previously reported in thyrotoxic women. Preliminary experiments showed that 125 μg. of oestradiol benzoate (approximately 2 μg./kg. of bodyweight) was the smallest effective dose which significantly reduced LH levels in euthyroid postmenopausal women. This dose was, however, ineffective in reducing LH levels in thyrotoxic postmenopausal women. Similar results were obtained with 250 μg. (approximately 4 μg./kg. of bodyweight) diethylstilboestrol which does not bind to sex hormone binding globulin (SHBG), thus showing that the results could not be attributable to the high levels of SHBG which have been shown in thyrotoxicosis. The diminished sensitivity of the hypothalamo‐pituitary system of thyrotoxic postmenopausal women to oestrogen which this study shows lend further support to the hypothesis that changes in gonadal steroid and gonadotrophic hormone levels in thyrotoxicosis may be due to blunting of the feedback mechanism.
COMPLETE TRANSURETHRAL INVERSION OF THE BLADDER IN LABOUR A CASE REPORT
Authors: Armon P. J.
Published: August 2005

Spontaneous complete transurethral inversion of the bladder, occurring in labour is rare. Three cases appear to have been described previously and a fourth is reported here.