bluuebunny/crossref_metadata_2025 huggingface dataset:
EMERGENCY MATERNAL EXCHANGE TRANSFUSION FOR SICKLE‐CELL ANAEMIA COMPLICATING TWIN PREGNANCY
Authors: Edwards R. F. , Saáry M.
Published: August 2005

A patient with sickle‐cell anaemia whose twin pregnancy was complicated by pre‐eclampsia and repeated sickling crises is described. Partial exchange transfusion of the mother at 34 weeks gestation achieved a marked reduction of haemoglobin‐S. After premature onset of labour, live twins were delivered by Caesarean section within 24 hours of exchange transfusion. Some aspects of management are discussed, and the literature is briefly reviewed.
HEMIPLEGIC MIGRAINE ASSOCIATED WITH MENSTRUATION
Authors: Sood Satya V.
Published: August 2005

The following report describes a case of pre‐menstrual migraine which steadily worsened until it caused repeated attacks of hemiparesis and later hemiplegia. There was no recurrence after total hysterectomy and bilateral salpingo‐oöphorectomy.
CHANGES IN PLASMA OESTRIOL CONCENTRATION ASSOCIATED WITH THE ONSET OF LABOUR
Authors: Masson G. M. , Klopper A.
Published: August 2005

The concentration of unconjugated oestriol, of oestriol glucosiduronate and of oestriol sulphate was measured by a radioimmunoassay technique in the plasma of five normal primigravidae before and during labour. The only consistent changes in the concentration of any of oestriol fractions was a tendency for the concentration of unconjugated oestriol to rise to a peak immediately before the onset of labour.
MATERNAL PLASMA OESTROGEN AND PROGESTERONE LEVELS DURING THERAPEUTIC ABORTION INDUCED BY INTRA‐AMNIOTIC INJECTION OF PROSTAGLANDIN F2α
Authors: Symonds E. M. , Fahmy D. , Morgan C. , Roberts G. , Gomersall C. R. , Turnbull A. C.
Published: August 2005

Plasma 17β‐oestradiol, total unconjugated oestrogens and progesterone levels were measured in ten patients in the second trimester of pregnancy who were undergoing abortion by intra‐amniotic injection of prostaglandin F2α (PGF2α). The correlation between total unconjugated plasma oestrogens and 17β‐oestradiol was highly significant (r =+0.92; p<0.001). A similar positive correlation between total unconjugated plasma oestrogen and progesterone was observed (r =+0.66; p<0.001). The concentration of these steroids in samples, taken at intervals during normal pregnancy, showed considerable variation. Following administration of PGF2α no consistent change was seen in plasma steroid concentrations until after delivery of the fetus and placenta. PGF2α therefore appears to have no direct effect on oestrogen and progesterone biosynthesis and may act principally by direct stimulation of myometrial contractility.
LYMPHOCYTE RESPONSE TO PHYTOHAEMAGGLUTIN IN PREGNANCY
Authors: Watkins Sylvia M.
Published: August 2005

Phytohaemagglutin‐induced responsiveness of the lymphocytes from non‐pregnant healthy women and from women at all stages of normal pregnancy was studied. There was no significant difference between the two groups. The implications of this finding in relation to the ability of the mother to tolerate her antigenically foreign fetus are discussed.
THE VARIATION OF NEUTROPHIL ALKALINE PHOSPHATASE DURING THE MENSTRUAL CYCLE
Authors: Cochrane P. , Weatherall D. J.
Published: August 2005

The variation of neutrophil alkaline phosphatase (N.A.P.) activity during the menstrual cycle was investigated in 9 normal females, 7 females taking various oral contraceptives, and an infertile female receiving gonadotrophin therapy. The day to day variation of N.A.P. values in 2 males and the range of values in 272 normal adults and 72 pregnant women were also determined. Adult females have a significantly higher N.A.P. value than males. Normal females show two physiological peaks of N.A.P. activity during the menstrual cycle, the first at ovulation, and a second in the luteal phase. The variation of N.A.P. in the menstrual cycle is probably related to fluctuating oestrogen levels. In most cases these peaks are not affected by oral contraceptive administration which is often associated with high enzyme levels as in pregnancy. The N.A.P. response varies with different oral contraceptives. The present study provides further evidence that combined oral contraceptive preparations do not always inhibit ovulation. Daily N.A.P. estimations should prove useful in the assessment of menstrual function, and the investigation of infertility.
VACUUM EXTRACTION OF HYDROCEPHALIC FETUS
Authors: Price T. G.
Published: August 2005

Vacuum extraction of a hydrocephalic fetus after preliminary decompression by craniotomy is described.
THE VALUE OF URINARY OESTRIOL ESTIMATION IN PREDICTING DYSMATURITY
Authors: Barnard W. P. , Logan R. W.
Published: August 2005

The use of an automated method of urinary oestriol determination in pregnancy has enabled an assessment of the value of such estimations in predicting the presence of dysmaturity. Single oestriol measurements early in the third trimester are shown to be of little value in the detection of dysmaturity. The presence or absence of a rising trend in oestriol results is a more reliable index of the occurrence of dysmaturity. For any given urinary oestriol excretion within the period considered the probability of dysmaturity is shown.
SERUM LIPIDS AND FIBRINOLYTIC ACTIVITY IN PREGNANT AFRICAN, ASIAN AND EUROPEAN WOMEN IN UGANDA
Authors: Damani P. , Macintosh D. , Patel Ila , Patel Hansa , Stafford W. L. , Shaper A. G.
Published: August 2005

Fibrinolytic activity is known to be markedly diminished during pregnancy. Blood lipids are also significantly altered during pregnancy but to a different extent in different ethnic groups in Uganda. A study of fibrinolytic activity and blood lipids in African, Asian and European women (non‐pregnant and pregnant) showed no relationship between the changes in these two parameters and did not suggest that altered blood lipid levels are responsible for abnormal fibrinolytic activity in pregnancy.
HAEMOGLOBIN AND HAEMATOCRIT VALUES IN PREGNANT WOMEN ON A HIGH IRON INTAKE AND LIVING AT A HIGH ALTITUDE
Authors: Ross S. M.
Published: August 2005

Low haemoglobin levels were found to be very uncommon in 497 pregnant women living at 2500 metres above sea level, despite the fact that 37 per cent of them were desperately poor. The explanation for this may be their unusually high iron intake but a less than normal increase in plasma volume or a greater than normal increase in red cell mass among the underprivileged women could be contributory factors.
FACTORS ASSOCIATED WITH THE OCCURRENCE OF STRIAE GRAVIDARUM
Authors: Davey C. M. H.
Published: August 2005

A scoring system was used to study the occurrence of abdominal striae gravidarum in a group of 74 primiparae during the puerperium. The striae score was correlated with maternal age, height, weight, weight gain, abdominal skinfold thickness and with the birthweight of the infant. Striae were less common when birthweight was low and more common in the heavier, fatter women. The prophylactic use of olive oil to massage the abdomen was associated with a low incidence of striae.
OVARIAN TERATOMA WITH INTRA‐ABDOMINAL DISSEMINATION
Authors: Garden Anne S. , Best Philip V.
Published: August 2005

A report is given of a patient, aged 42 years, with peritoneal dissemination from an ovarian teratoma composed of tissues which were predominantly well‐differentiated although many were immature. More than 10 kg. of tumour was formed over a period of about nine months. Tissue maturity in the teratoma was more advanced and the amount of embryonic elements relatively less at the time of autopsy than in the surgical specimen removed seven months earlier. Repeated surgical excision of recurrences may be the best form of treatment for this type of tumour.
VARIATION IN LH AND FSH RESPONSE TO LH‐RELEASING HORMONE DURING THE MENSTRUAL CYCLE
Authors: Nillius Sven Johan , Wide Leif
Published: August 2005

Synthetic luteinizing hormone‐releasing hormone (LRH) was injected intravenously in a dose of 100 μg. to test the capacity of the pituitary to respond to LRH with a release of luteinizing hormone (LH) and follicle‐stimulating hormone (FSH) in 16 healthy regularly menstruating women. A total of 28 LRH tests were performed during different stages of the menstrual cycle. Venous blood was obtained before and at frequent intervals during the first two hours after the LRH injection and assayed for LH, FSH and in five tests also for thyrotrophic (TSH) and growth hormone (GH). No consistent change of TSH or GH was observed after LRH. In all the 28 LRH tests there was a significant increase of LH and in tests also of FSH. The mean LH and FSH increase was 292 and 40 per cent, respectively. The maximum response was usually observed after 30 to 45 minutes. There was a pronounced variation in the response to LRH in the course of the menstrual cycle. During the late follicular phase the average LH response was 4‐ to 6‐fold that obtained in the early and mid‐follicular phase. An increased pituitary responsiveness was also found in the luteal phase. It was suggested that this variation in the response to LRH is due to the changes of the ovarian secretion of oestrogens during the menstrual cycle. In one amenorrhoeic woman exogenous oestrogen was found to enhance the LH response to LRH.
ENZYMES IN AMNIOTIC FLUID: A STUDY OF SPECIFIC ACTIVITY PATTERNS DURING PREGNANCY
Authors: Sutcliffe R. G. , Brock D. J. H. , Robertson J. G. , Scrimgeour J. B. , Monaghan J. M.
Published: August 2005

The specific activity patterns of a group of enzymes were studied in the supernatants of amniotic fluid obtained between 10 weeks of gestation and term. A number of different patterns were found. α‐l,4‐Glucosidase showed a peak in specific activity between 13 and 18 weeks of gestation. Heat‐labile alkaline phosphatase had an early peak of specific activity which was similar to that of α‐l,4‐glucosidase and, in addition, a specific activity peak after 37 weeks. Acid phosphatase showed a peak of specific activity after 32 weeks. Hexosaminidase remained unchanged during most of pregnancy, although the lowest levels were found before 14 weeks. Finally, placental alkaline phosphatase showed a gradual increase in specific activity between 10 and 30 weeks, after which time a more rapid increase occurred. Expression of the results on a protein basis led to an exaggeration of the specific activity peaks in early and late gestation. The significance of the results is discussed in the context of their possible use for the estimation of fetal maturity.
AMNIOTIC FLUID CREATININE: AN UNRELIABLE INDEX OF FETAL MATURITY
Authors: Foulds J. W. , Pennock C. A.
Published: August 2005

Amniotic fluid creatinine was measured in 306 samples. There was a wide scatter of values at each week of gestation, and although there was a tendency for the levels to rise with increasing gestational age the scatter was so wide and so much overlap occurred that the method must be regarded as unreliable for estimating maturity in clinical practice.
A BIOCHEMICAL STUDY ON NUCLEIC ACIDS AND PROTEIN SYNTHESIS IN THE HUMAN FETUS AND ITS CORRELATION WITH RELEVANT EMBRYOLOGICAL DATA
Authors: Kapeller‐Adler R. , Hammad W. A.
Published: August 2005

Although concentrations of nucleic acids have been determined by various workers in some animal embryonic organs, reports on similar studies in human material are scarce. This communication describes some biochemical investigations in regard to nucleic acid and protein concentrations in various organs and membranes of human fetuses obtained by therapeutic abortion. The pattern of nucleic acid and protein concentrations at various stages of the first half of gestation appears to be characteristic of each organ. The recorded results are related to known embryological data such as the differential rates of development in individual organs, and the relevant biochemical aspects of human embryonic and fetal growth are discussed.
A CASE CONTROL STUDY INTO THE POSSIBLE EFFECTS OF BIRTH CONTROL PILLS ON PRE‐CLINICAL CARCINOMA OF THE CERVIX
Authors: Worth A. J. , Boyes D. A.
Published: August 2005

This paper reports a study of the possible relationship between oral contraceptives and preclinical squamous carcinoma of the cervix in women in their third decade in the Province of British Columbia. A total of 310 cases of preclinical carcinoma of the cervix and 682 matched controls were evaluated. The mean interval between first use of contraceptives and entry into the study was 5·3 years for the 25‐29‐year‐old patients with preclinical carcinoma of the cervix, while the interval for the 20‐24‐year‐old patients was 2·9 years. No significant difference in the pattern or duration of contraceptive usage was found between the case and control groups. The use of the different contraceptive methods in the screened population of the entire province of British Columbia paralleled that of the selected case control study group with the exception of a less frequently reported use of sequential preparations. In terms of the social data, however, there did appear to be a significantly greater number of pregnancies and of atypical marital situations among the women with preclinical carcinoma of the cervix. This suggested a different pattern of social behaviour in the two groups.
HUMAN PLACENTAL LACTOGEN LEVELS IN PRE‐ECLAMPSIA
Authors: Letchworth A. T. , Chard T.
Published: August 2005

A prospective study has been carried out on human placental lactogen (HPL) levels in pre‐eclampsia. The general conclusions were as follows: (1) the levels were lower than those in normal subjects; (2) the levels in mild pre‐eclampsia were lower than those in the moderate and severe cases; (3) the levels were lower in multipara than in primipara. The influence of severity and parity may partly explain the discrepancies encountered in earlier studies. Low levels of HPL were found in patients with fetal complications. However, since similar levels may be found in pre‐eclampsia without such complications, it was not possible to reach definite conclusions on the value of HPL determinations as a predictor of fetal well‐being. The results indicate the need for further investigation of the prognostic significance of HPL levels within sub‐groups of patients with pre‐eclampsia.
COMPARISON OF MATERNAL RESPONSE IN FIRST AND SECOND PREGNANCIES IN RELATION TO BABY WEIGHT
Authors: Campbell Doris M. , MacGillivray Ian
Published: August 2005

Twenty‐one normal women were studied in their first and second pregnancies. The plasma volume continued to expand to term in second pregnancies compared to the slight drop near term in first pregnancies. This may have been due to the postural difference when making the measurements in the two pregnancies. There was a significant correlation between the plasma volume at 30 weeks gestation and birthweight of the baby in both pregnancies. The total protein concentration was the same in both pregnancies, but the serum albumin concentration was significantly lower at 38 weeks gestation in second pregnancies. The total intravascular protein mass was greater at 38 weeks gestation in second pregnancies whereas the intravascular albumin mass remained constant in both pregnancies. The total body water was less but the women's body weight was greater at the corresponding maturity of gestation in second pregnancies, suggesting that there is a change in fat deposition. There was no correlation between total body water and birthweight in second pregnancies. There was no difference between the two pregnancies in the red cell volume, urinary oestriol excretion, serum electrolytes and osmolality.
THE EFFECT OF FETAL HEART MONITORING BY ULTRASOUND ON MATERNAL AND FETAL CHROMOSOMES
Authors: Watts P. Looby , Stewart C. R.
Published: August 2005

Since the initial report that ultrasound radiation at diagnostic frequencies and power levels causes chromosome damage in vitro several investigators have tried unsuccessfully to confirm this. The purpose of the present study was to determine if chromosome damage could be demonstrated following fetal heart monitoring in vivo. White blood cells from ten mothers and from the cords of their newborn infants after 2 to 10 hours of fetal heart monitoring during labour were cultured and scored for chromosome damage. When the irradiated samples were compared to controls no increase in chromosome damage was found.
THE VALUE OF HISTOLOGICAL GRADING IN THE MANAGEMENT OF HYDATIDIFORM MOLE
Authors: Elston C. W. , Bagshawe K. D.
Published: August 2005

Study of material from a selected group of 70 patients with hydatidiform mole in 21 per cent of whom choriocarcinoma developed showed no relationship between the histological grade of a hydatidiform mole and subsequent malignancy. Every patient who aborts a hydatidiform mole should be given an adequate follow‐up.
ACCIDENTAL ADMINISTRATION OF SYNTOMETRINE TO A NEWBORN INFANT
Authors: Kenna A. P.
Published: August 2005

A case is described in which one ml. of Syntometrine was inadvertently administered to a newborn infant instead of Vitamin K. Profound respiratory depression and convulsions occurred as a result, necessitating prolonged ventilatory assistance. Recovery was complete. It is recommended that the routine administration of Vitamin K be deferred until the infant is admitted to a postnatal ward or a nursery.
PLASMA BIOCHEMISTRY IN RELATION TO OEDEMA OF PREGNANCY
Authors: Robertson E. G. , Cheyne G. A.
Published: August 2005

Biochemical changes were measured serially throughout pregnancy in 83 women. The fall in total osmolality observed was unrelated to the development of oedema and there was little change in the levels of major electrolytes and urea with pregnancy. Decreased colloid osmotic pressure values were found, and they closely followed the changes in both total protein and serum albumin values. The degree of fall of these values appeared to be more important in the genesis of oedema than the absolute level reached. Changes in haematological indices were unrelated to the presence of oedema but a change in red cell fragility was found which appeared to be related to variations in colloid osmotic pressure. This change seemed to be of physiological rather than pathological significance.
NITROGEN RETENTION IN PREGNANCY
Authors: Johnstone F. D. , MacGillivray I. , Dennis K. J.
Published: August 2005

Nitrogen balance studies were performed in 21 primigravida who were eating their usual diets in the third trimester. The mean apparent nitrogen retention was 1.17 g. per day. This figure tends to contradict the belief that large amounts of protein are laid down as stores by the mother in pregnancy.
DISTRIBUTION OF 9‐H3‐PROSTAGLANDIN F2α, IN PREGNANT AND NON‐PREGNANT SUBJECTS
Authors: Beazley John M. , Brummer Hilary C. , Kurjak Asim
Published: August 2005

Study of three pregnant and two non‐pregnant women showed no differences in distribution or elimination of injected 9‐H3‐prostaglandin F2α. There was no selective uptake by the uterus. Measurement of radioactivity in fetal tissue samples indicated that the transfer of PGF2α or its radioactive metabolites occurred freely.
PLACENTAL FUNCTION IN PROSTAGLANDIN INDUCED LABOUR
Authors: Keller P. J. , Ruppen M. , Gerber C. , Schmid J.
Published: August 2005

The effects of prostaglandin F2α on the function of the human placenta has been studied during induction of labour in prolonged pregnancies. The serum levels of human chorionic somatomammotrophin, human chorionic gonadotrophin, progesterone and heat‐stable alkaline phosphatase were estimated at short intervals. There were no significant changes during the administration of various doses of PGF2α when compared with spontaneous labour. No adverse effects of this compound on placental function have been observed.
THE COMBINED USE OF CARDIOTOCOGRAPHY AND FETAL BLOOD SAMPLING IN MONITORING THE FETUS IN LABOUR
Authors: Simmons S. C. , Lieberman B.
Published: August 2005

The use of cardiotocography for screening high risk and clinically distressed fetuses during routine work in a busy department is described. When abnormal patterns appeared the decision whether to interfere was determined by fetal blood sampling. Two years' results have been analyzed. Although there was a high degree of accuracy in the diagnosis of fetal distress there are still limitations of monitoring methods for routine application.
THE EFFECT OF PULSED AND CONTINUOUS WAVE ULTRASOUND ON THE ENZYME HISTOCHEMISTRY OF PLACENTAL TISSUE IN VITRO
Authors: Robinson Hugh P. , Sharp Frank , Donald Ian , Young Hamish , Hall Angus J.
Published: August 2005

Enzyme histochemical studies were made on placental fragments maintained in vitro and insonated for 8 hours with pulsed and continuous wave ultrasound at 2 MHz, and at intensities substantially above those used in clinical apparatus. No difference was observed in the activity of eleven enzymes examined in the insonated fragments compared with a control series.
OVARIAN CHANGES DURING PROGESTOGEN AMENORRHOEA
Authors: El‐Mahgoub S. , Ammar R.
Published: August 2005

Ovarian tissue was studied from 19 women who developed prolonged amenorrhoea (6–21 months) after Depomedroxyprogesterone acetate or norethisterone enanthate injections for contraception for 18 to 33 months. The ovarian specimens were obtained in 11 of the patients during progestogen medication and in the other eight 2 to 6 months after stopping treatment. In four cases withdrawal bleeding was induced by oestrogen before examination of the ovaries.

The ovarian tissue showed either follicular suppression, when only primordial follicles were detected, or a multicystic pattern with many non‐luteinized cystic follicles or follicular cysts in different stages of development and degeneration. This multicystic pattern was seen mainly in women with amenorrhoea persisting after stopping therapy. Oestrogen administration to induce withdrawal bleeding produced no change in the ovary other than increased congestion.
POLYGLYCOLIC ACID SURGICAL SUTURES IN GYNAECOLOGICAL SURGERY
Authors: Rahman M. S. , Way Stanley
Published: August 2005

The results of the use of Dexon Sutures in 593 gynaecological operations are presented.
BILATERAL THECA LUTEIN CYSTS ASSOCIATED WITH APPARENTLY NORMAL PREGNANCY
Authors: Dick J. S.
Published: August 2005

A case of bilateral theca lutein cysts associated with normal pregnancy is reported.
THE AMINOACIDURIA OF PREGNANCY
Authors: Hytten F. E. , Cheyne G. A.
Published: August 2005

The concentration of free amino acids in plasma and their excretion in urine was measured serially in ten healthy women during pregnancy and again postpartum. Almost all amino acids were excreted in greater amounts during pregnancy than in the non‐pregnant state and there appeared to be three definable patterns. The excretion of the five amino acids lost in greatest amount, glycine, histidine, threonine, serine and alanine, increased rapidly in early pregnancy to three or four times the non‐pregnant rate and continued to increase as pregnancy proceeded. For seven others: lysine, cystine, taurine, tyrosine, phenylalanine, valine and leucine, there was also a greatly increased excretion in early pregnancy, but there after excretion tended to fall. The remaining six amino acids measured showed little or no increase in excretion.

Renal clearance increased commensurately, approximately 30 ml. per minute for histidine and glycine, and it could be calculated that an average of some 20 per cent of filtered glycine and histidine was lost in the urine.

The pattern of excretion is not related to plasma levels, which for most amino acids are somewhat below non‐pregnant levels; nor does it appear to be related to the chemical structure or biological function of the amino acids. The picture is of a variable failure of normal reabsorptive mechanisms, cause unknown.
FACTORS INFLUENCING THE SPECTROPHOTOMETRIC EVALUATION OF LIQUOR AMNII
Authors: Fairweather D. V. I. , Millar M. D. , Whyley G. A.
Published: August 2005

Factors influencing the spectrophotometric examination of liquor amnii have been investigated. Various methods of clarification and handling of liquor samples are compared, and their effects upon results obtained by seven currently used methods of assessment of bilirubin content are described. It is essential to follow the exact method originally described for each method of expression of liquor bilirubin content when using prediction graphs or tables to indicate severity of rhesus haemolytic disease.
MASSIVE GASTRIC HAEMORRHAGE IN LATE PREGNANCY FOLLOWED BY HYPOPITUITARISM
Authors: Taylor D. S.
Published: August 2005

Massive gastric haemorrhage from an acute gastric ulcer during pregnancy, necessitating surgical intervention, was followed by hypopituitarism.
HYPOTHALAMO‐PITUITARY‐ADRENAL FUNCTION DURING ORAL CONTRACEPTIVE THERAPY WITH COMBINED PREPARATIONS OESTROGEN‐PROGESTOGEN AND PROGESTOGEN‐ONLY PREPARATIONS
Authors: Daly J. R. , Elstein Max
Published: August 2005

Plasma corticosteroid levels and the urinary excretion of 17‐0x0 and 17‐oxogenic steroids have been determined in a group of healthy women taking combined oestrogen‐progestogen oral contraceptives. The results have been compared with those obtained in untreated patients and in a group taking preparations containing only progestogens (the mini pill). The marked changes produced by the combined preparations are not seen with the mini pill which does not appear to affect cortisol metabolism. Dynamic tests of hypothalamo‐pituitary‐adrenal function (the assessment of the nyctohemeral rhythm of plasma corticosteroids and urinary free cortisol, ACTH stimulation, insulin‐hypoglycaemia and dexamethasone suppression tests) showed no abnormality in patients taking either the combined pill or the mini pill.
SURGICAL TREATMENT OF ACUTE PELVIC SEPSIS
Authors: Fraser A. C.
Published: August 2005

Surgical management of acute pelvic sepsis is not without risk. The correct selection of cases and the extent of surgery performed require careful individual assessment. Practical points are discussed.
BABIES BORN ALIVE AFTER INTRAUTERINE TRANSFUSIONS FOR SEVERE RHESUS HAEMOLYTIC DISEASE
Authors: Girling D. J. , Scopes J. W. , Wicglesworth J. S.
Published: August 2005

Fifty‐two babies born alive after intrauterine transfusions for severe rhesus haemolytic disease during a seven‐year period are described. There was a diagnostic error in one case in which the fetus proved to be rhesus negative. Thirty fetuses (58 per cent) survived. Most of the 22 deaths occurred during the early neonatal period.

The main problems encountered at birth were severe birth asphyxia, hydrops fetalis, anaemia and hypothermia. Thirty‐four of the babies were asphyxiated at birth, 24 of these required abdominal paracentesis before adequate ventilation could beachieved. Of 21 babies born in a frankly hydropic condition 6 survived. Cord haemoglobin levels of less than 10 g. per 100 ml. were found in 29 infants; the lowest value was 3·4 g. per 100 ml. Twenty‐one babies became hypothermic. Undue trauma resulted from intrauterine transfusion in 9 babies, and one suffered liver injury during paracentesis after birth.

The main problems encountered during the neonatal period were those of prematurity. The most important was respiratory distress which carried a very poor prognosis, due in part to pulmonary hypoplasia in hydropic babies. Other important problems were hypoglycaemia, enterocolitis, neurological abnormalities, protracted jaundice, congestive heart failure, infections and bleeding diathesis. Of the survivors old enough to be adequately assessed, all except three have developed normally.

The implications of these findings are discussed.
ANAEMIA AND FOLATE STATUS IN LATE PREGNANCY IN A MIXED ASIATIC POPULATION
Authors: Hibbard Bryan M. , Hibbard Elizabeth D.
Published: August 2005

A haematological survey was carried out on 545 women in late pregnancy in Singapore, with particular reference to differing patterns in the three principal ethnic groups (Chinese, Malay and Indian).

Anaemia during pregnancy does not constitute such a major problem as in many other Asian communities and haemoglobin levels below 9 0 g. per 100 ml. were found in only 1·7 per cent of patients.

Folate depletion and megaloblastic anaemia occurred most frequently among Indian patients, whilst iron deficiency was found most often in Malay women.

The haematological status of the Chinese was superior to that of both Malays and Indians.

Multigravidae in all ethnic groups showed higher incidences of anaemia and of folate depletion, but the changes with increasing gravidity were most marked amongst Indian patients.

The bias towards high gravidity in the Malays and Indians only partly accounts for the poorer haematological status in these ethnic groups. Even when allowance is made for gravidity, ethnic differences persist which can probably be accounted for by differences in diet and methods of food preparation.
SERUM LEVELS OF OESTRADIOL‐17β DEHYDROGENASE IN NORMAL AND ABNORMAL PREGNANCIES
Authors: Plotti G. , Menini E. , Bompiani A.
Published: August 2005

Serum levels of oestradiol‐l7β dehydrogenase have been determined in 113 normal pregnant women. The mean level increases ten‐fold from the 8th to the 40th week. Serum levels of this enzyme have been determined in women with threatened abortion in the first trimester and in women with intrauterine death of the fetus. Low or declining levels of the enzyme activity were associated with abortion, but the serum levels in cases of intrauterine fetal death corresponded to those of normal pregnancy.
DIURNAL VARIATIONS IN OESTROGEN EXCRETION IN PREGNANCY
Authors: Salvadori B. , Vadora E. , Coppola F.
Published: August 2005

In 20 normal pregnant women the excretion of oestrogen and creatinine during four fractions of a 24‐hour period was determined. For each urine specimen the total oestrogen content, the oestrogen concentration, the total creatinine content and the oestrogen‐creatinine ratio were studied.

A peak of oestrogen excretion was found in the first fraction. The oestrogen‐creatinine ratio of the second fraction was most closely correlated to the 24‐hour oestrogen‐creatinine ratio.
THE EFFECTS OF DIAZEPAM ON THE FETUS
Authors: Scher J. , Hailey D. M. , Beard R. W.
Published: August 2005

Diazepam causes loss of beat‐to‐beat variation of the fetal heart rate pattern within two minutes of the intravenous administration of 20 mg. This effect lasts an average of 65 minutes. This is not associated with a significant alteration of fetal pH or Apgar score at birth, High fetal plasma levels do not appear to affect the fetus adversely in labour or at birth. Rapid placental transfer occurs and the maternal and fetal blood ratios are variable.
THE RELATIONSHIP OF THE POSTPARTUM RISE IN SEROMUCOID TO PRIMIGRAVID PLACENTAL WEIGHT
Authors: Good W. , Hancock K. W. , Macdonald H. N.
Published: August 2005

The postpartum rise in seromucoid, which is an heterogenous acid‐soluble glycoprotein sub‐fraction, is related to placentalweight in primigravidae but not in multigravidae. This observation supports the view that primigravidae, who have had no previous exposure to paternal histocompatibility antigens, depend on glycoprotein to mask the trophoblast from the cellular immune response. With previous exposure to paternal histocompatibility antigens, as in multigravidae, the maternal antibodies so formed may coat the trophoblast and thus reduce the need for a covering of nonspecific glycoprotein.
THE EFFECTS OF HYPOXIA ON HYDROXYSTEROID DEHYDROGENASE ACTIVITY IN PLACENTAL VILLI MAINTAINED IN ORGAN CULTURE
Authors: Sharp Frank , Carty MatthewJ. , Young Hamish
Published: August 2005

Hydroxysteroid dehydrogenase (HSD) enzyme activity has been studied histochemically in placental villi maintained in organ culture, some under fully oxygenated conditions and some under conditions of hypoxia. HSD activity was diminished in hypoxia. The process is apparently selective, with trophoblastic activity more sensitive than that in villous core, and 3β‐HSD more so than 17β‐HSD. Also, with 17β‐HSDs, activity using oestradiol‐17β as substrate was more sensitive than that using testosterone as substrate. The possible correlation with the clinical picture in placental insufficiency is discussed.
UTERUS DIDELPHYS WITH UNLLATERAL HAEMATOCOLPOS
Authors: Johansen Karl
Published: August 2005

Seven examples of uterus didelphys with unilateral haemotocolpos are described and some of the practical surgical and obstetric difficulties are discussed.
SONAR IN THE MANAGEMENT OF ABORTION
Authors: Robinson H. P.
Published: August 2005

The clinical, sonar and pathological findings in 264 patients with a abortion were reviewed. It was found that sonar was a valuable diagnostic aid, especially in those patients in whom a complete abortion was diagnosed clinically. Using this technique the number of “unnecessary” evacuations could be reduced, and the duration of stay in hospital shortened.
THE ULTRASTRUCTURE OF HUMAN TROPHOBLAST IN SPONTANEOUS AND INDUCED HYPOXIA USING A SYSTEM OF ORGAN CULTURE
Authors: MacLennan Alastair H. , Sharp Frank , Shaw‐Dunn John
Published: August 2005

The ultrastructural changes in normal trophoblast maintained in organ culture are described. In well oxygenated conditions the fine structural integrity of the trophoblast is maintained up to 96 hours, and the tissue appears to function normally. Hypoxia quickly damages the syncytium and marked changes occur throughout the trophoblast, including apparent attempts at regeneration. These experimentally produced changes in hypoxia are very similar to the ultrastructural placental bnormalities already described in pre‐eclampsia, and more so to the placental abnormalities in placental insufficiency, which are described here for the first time. These similarities suggested that hypoxia is a primary aetiological factor in these conditions rather than an effect of the primary disease process.
CONCENTRATION OF CHORIONIC GONADOTROPHIN AND CHORIONIC SOMATOMAMMOTROPHIN IN MATERNAL SERUM, AMNIOTIC FLUID AND CORD BLOOD SERUM AT TERM
Authors: Crosignani P. G. , Nencioni T. , Brambati B.
Published: August 2005

The mean concentration of chorionic gonadorophin in maternal serum at term was 9.45±0.93 LU. per ml. and that of chorionic somatomammotrophin was 6.34±0.39μg. per ml. In the amniotic fluid the levels were respectively 0.380±0.048 I.U. per ml. and 0.547±0.067 μg. per ml. In the cord blood serum mean values of 0.027±0.003 I.U. per ml. of HCG and 0.027±0.003 μg. per ml. of HCS were found.

The barrier‐effect of the amnion and placenta to the passage of these hormones is shown by the ligh ratio between concentrations in maternal serum (MS), amniotic fluid (AF) and cord blood serum (CS). The ratios between mean values (±SE) MS/AF and MS/CS for HCG is 41.62±3.49 and 440±46.33 respectively, while for HCS are 12.21±2.37 and 281±33.95 respectively. The transfer through the amniotic barriers of albumin, transferrin, IgG anf HCS is inversely related to the molecular weight, while HCG crosses the membranes as in amounts proportional to IgG.

The amniotic fluid concentrations of both these hormones are positively correlated with corresponding maternal serum and amniotic fluid HCG concentration were found when the fetus was female than when it was male.

Significantly high maternal serum and amniotic fluid HCG concentration were found when the fetus was female than when it was male.
SERUM HEAT STABLE ALKALINE PHOSPHATASE IN NORMAL PREGNANCY AND ITS RELATIONSHIP TO URINARY OESTRIOL AND PREGNANEDIOL EXCRETION, PLACENTAL WEIGHT AND BABY WEIGHT
Authors: Pirani B. B. K. , MacGillivray I. , Duncan R. O.
Published: August 2005

Serial estimations of serum heat stable alkaline phosphatase (HSAP) were performed in 28 normal healthy primigravidae at 16, 20, 25, 30, 34 and 38 weeks gestation, during labour and in the puerperium. Serum HSAP was measured on a further 15 normal primigravidae at 30, 34 and 38 weeks. Urinary pregnanediol output was measured at 20, 25, and 30 weeks and urinary oestriol estimations made at 30, 34 and 38 weeks.

There was a progressive increase in the level of serum HSAP with advancfing pregnancy, the peak being reached during the second stage of labour followed by a gradual fall ink the puerperium. There was no correlation between serum HSAP level and urinary pregnanediol output, crude baby weight or placental weight. Significnat degrees of correlation were demonstrated between serum HSAP level and urinary oestriol output at 30, 34 and 38 weeks.
THE MEASUREMENT AND SIGNIFICANCE OF TRANSIENT FETAL BRADYCARDIA DURING LABOUR
Authors: Tipton Richard H. , Finch Ann K.
Published: August 2005

The quantitative measure of transient bradycardia during labour is significantly related to the neonatal condition. The temporal relationship of fetal bradycardia to uterine contractions is not important. The aetiology of trnasient fetal bradycardia during labour in uncertain.
THE POSTPARTUM HAEMOLYTIC URAEMIC SYNDROME
Authors: Eisinger A. J.
Published: August 2005

Three fatal cases of acute postpartum renal failure caused by the haemolytic uraemic syndrome are presented. There were no obvious aetiological features during pregnancy or confinement no evidence of any pre‐existing disease which could explain the illness of any of these patients. This developed up to six weeks after delivery, and by the time the patients were readmitted to hospital they were severely uraemic. The uraemia was treated by peritoneal dyanlysis; intracenous heparin was given and, in one case streptokinase too, but without any improvement in the renal failure. Renal histology showed intimal thickening in the small arteries, with fibrin deposition in places, causing narrowing or occulusion of the vessels.
AMNIOTIC FLUID COMPOSITION IN MALFORMATIONS OF THE CENTRAL NERVOUS SYSTEM
Authors: Emery A. E. H. , Eccleston D. , Scrimgeour J.B. , Johnstone M.
Published: August 2005

In pregnancies in which the fetus had a malformation of the central nervous system (anencephaly, spina bifida, or anencephaly with spina bifida) amniotic fluid levels of 5‐hydroxyindole acetic acid (5HIAA), expressed on a protein basis, were less than in normal pregnancies of comparable gestation. This was not observed with a number of other substances present in amniotic fluid nor in 5HIAA levels in cases of polyhydramnios where the fetus was normal. The urinary excretion of 5HIAA in children with spina bifida was normal. A number of possible interpretations are discussed, including the idea that the reduced levels of 5HIAA may reflect the reduction in functioning neural tissue in more severe CNS malformations.
VACUUM CURETTAGE OF THE UTERUS WlTHOUT ANAESTHESIA
Authors: Saunders Peter , Rowland Robert
Published: August 2005

A comparison has been made of the histologinal appearances of the endometrium of 73 patients undergoing vacuum curettage of the uterus without anaesthesia followed by conventional curettage under general anaesthesia a day later. Vacuum curettage specimens may show epithelial cell cytoplasmic vacuolation which may falsely suggest that ovulation has taken place, and a loose stromal pattern which can mask cystic hyperplasia.

Conventional curettage specimen on the following day may show a pattern of endometritis.

One endometrial polyp and one case of cystic hyperplasia were diagnosed only by conventional curettage.

One endometrial polyp and one case of cystic hyperplasia were diagnosed only by conventional curettage.

The discomfort produced by vacuum curettage was comparable with dysmenorrhoea or the insertation of an intrauterine contraceptive device. In all but two patients it last for less than one hour.
EFFECT OF NORGESTREL ON CORPUS LUTEUM FUNCTION
Authors: Mukherjee T. K. , Wright S. W. , Davidson N. J. H. , Fotherby K.
Published: August 2005

Corpora lutea were obtained at laparotomy between days 17 and 25 of the menstrual cycle from nine patients who received 75 μg. Norgestrel daily from the first day of the cycle and from six patients not receiving Norgestrel. All of the control patients had normal corpora lutea which contained significant amounts of progesterone and all except one of the corpora lutea were able to synthesize progesterone in vitro. Oestrogen excretion was within the normal range in all except one patient. Pregnanediol excretion was more variable but plasma progesterone levels showed adequate in vivo luteal function. In all except one of the treated patients a normal corpus luteum was found and oestrogen excretion was within the normal range but pregnanediol excretion and plasma progesterone levels were below the normal range. Only two of the corpora lutea contained progestrone and only one was able to synthesize progesterone from pregnenolone on incubation in vitro. Thus administration of small doses of Norgestrel appeared to reduce the ability of the corpus luteum to produce progesterone and this may be one of the ways in which Norgesterel exerts an antifertility effect.

This in vivo finding was supported by showing that low concentrations of Norgestrel inhibited the in vitro synthesis of progestrone by normal corpora lutea.
FRACTURE OF THE LIPPES LOOP IN UTERO
Authors: Last PatriciaA.
Published: August 2005

Fifteen cases of fracture of the Lippes loop in utero are presented and the management of these cases is discussed.
NON‐GLUCOSE REDUCING SUBSTANCES IN PREGNANCY
Authors: Macdonald H. N. , Good W. , Schwarz K. , Stone Joan
Published: August 2005

The mean random blood concentration of non‐glucose reducing substances is lower in 540 pregnant women than in 56 non‐pregnant controls. The mean blood levels of non‐glucose reducing substances were also measured during a 50 g. oral glucose tolerance test on 412 women in pregnancy and the puerperium and were little different from random levels; the levels at 2½ hours were lower than those fasting. A significant negative correlation of blood glucose levels and those of non‐glucose reducing substances may be a technical artefact, although a functional relationship cannot be excluded. The levels of non‐glucose reducing substances do not appear to increase during pregnancy, but the range of values is so wide, and at present, unpredictable that blood glucose should be measured by a method for “true” glucose in pregnant women as in others.
FOLIC ACID DEFICIENCY AND ABRUPT10 PLACENTAE
Authors: Hall Marion H.
Published: August 2005

In a prospective study of 2949 singleton pregnancies of whom one‐third were treated with folic acid, the maternal serum folate concentration was assayed at booking and at 30 weeks gestation. No association was found between a low serum folate level and abruptio placentae either in the index pregnancy or in previous pregnancies, and folic acid therapy did not reduce the incidence of abruptio placentae.
INDUCTION OF LABOUR FOLLOWING FETAL DEATH
Authors: Ursell W.
Published: August 2005

Induction of labour by amniotomy has been used in the treatment of the retained dead fetus in 50 cases. The results have been compared with those in 41 cases in which the onset of labour was spontaneous, and 63 cases in which labour was induced with oxytocin over the same five‐year period. There was a slightly increased incidence of puerperal pyrexia in the amniotomy group compared to the oxytocin group but this was considered to be compensated for by the saving of patient and hospital time, and the prevention of any risk of coagulation disorder.
LEIOMYOMATA OF THE UTERUS ASSOCIATED WITH ASCITES AND HYDROTHORAX
Authors: Williamson J. G. , Patel Devbala , Menzies D. N.
Published: August 2005

A case of ascites, right‐sided hydrothorax and subserous parasitic fibromyoma is described. The history suggested repeated attacks of degeneration and ascites occurring over twelve months. Since hysteretomy the patient has remained well for two and a half years. Eleven such cases are reviewed.
THE RENAL LESIONS OF TOXAEMIA AND ABRUPTIO PLACENTAE STUDIED BY LIGHT AND ELECTRON MICROSCOPY
Authors: Thomson D. , Paterson W. G. , Smart G. E. , MacDonald M. K. , Robson J. S.
Published: August 2005

Renal biopsy in the early puerperium was carried out on 20 patients with toxaemia and 13 abruptio placentae without preceding toxaemia. The tissue obtained was studied by light and electron microscopy. All patients had a very similar glomerular lesion with (1) swelling and slight proliferation of the endotheliat cells, (2) increase in the number of mesangial cells and the amount of the mesangial matrix, and (3) granular deposits derived from fibrinogen within the endothelial cells and the mesangial matrix.

It is suggested that in both toxaemia and abruptio placentae there is release of thromboplastin from the placental site into the circulation which causes disseminated intravascular coagulation; this process is complicated by the fact than in pregnancy the fibrinolytic mechanism is in any case impaired. The glomerular lesion in both groups is the result of the response of the endothelial cells and mesangium to deposited fibrin or its derivatives.
THE XYLOSE TEST IN RELATION TO FOLIC ACID STATUS IN PREGNANCY
Authors: Hayward Margaret , Montgomery R. Darragh , Wilson C. I. D.
Published: August 2005

Seven out of twenty anaemic pregnant women showed a reduced five‐hour excretion of xylose. The defect was most marked in patients with megaloblastic anaemia. In two such patients the test had returned to normal 3 to 4 months after delivery, and further follow‐up showed no clinical evidence of malabsorption. Thirteen of the twenty patients had reduced two‐hour xylose excretion, but intravenous tests showed that the two‐hour figure is an unreliable index of malabsorption in pregnancy anaemia, probably due to the dilution effect of an increased “xylose pool”. Low serum folate levels were found in all types of pregnancy anaemia, but values below 2.0 ng. per ml. were clinically relevant. Treatment of folate deficiency did not influence the abnormal xylose test. It is concluded that a substantial proportion of cases of folate‐deficiency amaemia of pregnancy in Britain may have xylose malabsorption, and that in certain cases this defect is temporary.
THE INFLUENCE OF FETAL SEX UPON LIQUOR CYTOLOGY AS A MEANS OF ESTlMATING GESTATIONAL AGE
Authors: Bennett M. J. , Morris H. H. B. , Davey D. A.
Published: August 2005

Prenatal sex determination after 30 weeks of pregnancy can be achieved simply and with a high degree of accuracy using the cyanophilic cell count on amniotic fluid. Differential cell counts as a means of estimating gestational age may be incorrect because of the sexual difference.
SCREENING FOR GONORRHOEA IN PREGNANCY
Authors: Rees D. A. , Hamlett J. D.
Published: August 2005

Antenatal patients with symptoms suggestive of lower genital tract infection and selected asymptomatic pregnant women investigated for evidence of gonorrhoea. Two cases of gonococcal infection were found among 319 women studied, and in both instances there symptoms to alert the medical attendant. It is concluded that routine antenatal screening for silent gonorrhoea is unnecessary, but that investigations for gonococcal infection should be undertaken whenever pregnant women have symptoms or signs suggestive of lower genital tract infection.
DISTIGMlNE BROMIDE (UBRETID) FOR THE PREVENTION OF URINARY RETENTION AFTER VAGINAL HYSTERECTOMY
Authors: Walsh John , Bonnar John
Published: August 2005

After vaginal hysterectomy patients were given intramuscular injectinons of Ubretid or of a placebo. No significant difference was found in the number of patients requiring catheterization or in the incidence of postoperative urinary tract infection in the treated and control groups.
A PITUITARY FUNCTION TEST WITH SYNTHETIC LH‐RELEASING HORMONE
Authors: Keller P. J.
Published: August 2005

Synthetic LH‐releasing hormone (LH‐RH) was used as a pituitary function test in amenorrhoeic women. A dose of 12.5 μm U g. was administered intravenously and serum LH was measured by radioimmunoassay before and at 15, 30, 60 and 120 minutes after injection. Four principle types of reaction were defined and correlated with the therapeutic response to ovulation‐inducing compounds.