bluuebunny/crossref_metadata_2025 huggingface dataset:
Prenatal Diagnosis of Chromosomal Abnormalities: Analysis of 1000 Consecutive Amniotic Fluids
Authors: Bell J. A. , Ansford A. J.
Published: February 2008

Cytogenetic studies have been performed on 1,000 amniotic fluid specimens referred for prenatal diagnosis. Two‐thirds of the patients had strong clinical indications for prenatal chromosome studies and the remaining one‐third were referred because of maternal anxiety or a family history of neural tube defect. A total of 18 affected fetuses were detected in this series (1.8%) and these included 3 male fetuses in patients with a history of sex‐linked disorder and 15 fetuses with chromosome abnormalities. The overall culture success rate was 97.4% and the average time taken to obtain sufficient material for initial chromosome analysis was 13 days. Fetal loss within 4 weeks of the amniocentesis was 1.2%.
Atypical Discharge from the Breast During Pregnancy and/or Lactation
Authors: O'Callaghan M. A.
Published: February 2008

The breast of a pregnant or lactating woman will occasionally secrete a blood‐like discharge which discolours the colostrum or milk. The condition, and medical responses to it, are described as seen in a survey of 37 cases. Suggestions are made regarding management of the phenomenon.
Circulating Gonadotropins and Urinary Oestrogens in Postmenopausal Diabetic Women
Authors: Quinn M. A. , Ruffe H. , Brown J. B. , Ennis G.
Published: February 2008

Serum FSH and LH and total urinary oestrogens were measured in 20 mature onset postmenopausal diabetic women and compared to 20 nondiabetic women matched for age, years since menopause, surface area and per cent ideal weight. Significantly higher levels of urinary oestrone, oestradiol and oestriol and significantly lower levels of FSH and LH were found in the diabetic women. Closer analysis of these findings showed that the differences were maintained for the diabetics who required insulin for adequate control, whereas diabetics controlled on diet alone or diet and oral hypoglycaemic drugs were not significantly different from control subjects except in urinary oestrone excretion.
Myotonic Dystrophy and Pregnancy
Authors: Cope Ian
Published: February 2008

“Always shake the hand of the pregnant patient with cataracts”. A patient with undiagnosed myotonic dystrophy presented in pregnancy with a history of postpartum haemorrhage in her previous pregnancies. She had been operated on for cataracts. Problems arose after delivery which lead to the diagnosis of myotonic dystrophy being made at that time. The features of this condition and its implications for pregnancy are discussed.
Primary Nongestational Choriocarcinoma of the Ovary
Authors: Sengupta S. K. , Hamilton D. R.
Published: February 2008

A rare case of primary, nongestational choriocarcinoma of the ovary in a 11‐year‐old girl is presented and the literature is reviewed.
Premature Rupture of the Membranes, Oligohydramnios and Pulmonary Hypoplasia
Authors: Fliegner John R. , Fortune Denys W. , Eggers T. R.
Published: February 2008

Summary: The clinical and pathological features of oligohydramnios associated with severe pulmonary hypoplasia are described in 10 infants without renal anomalies. In 8 patients the condition was associated with prolonged premature rupture of the membranes at 16 to 36 weeks of gestation in a study of 244 patients (3.3%). Seven of the infants died of respiratory failure within 24 hours of delivery; the other infant survived. In the remaining 2 patients with severe oligohydramnios at term, but unassociated with premature rupture of the membranes, both infants succumbed.

Problems with resuscitation should be anticipated in pregnancies complicated by prolonged leakage of amniotic fluid or oligohydramnios, and pulmonary hypoplasia should be recognized as a cause of respiratory distress. Apart from the ultrasonic predelivery confirmation of normal kidneys to exclude Potter's syndrome it is recommended that ultrasonic assessment of thoracic cage volume should be made before delivery.
Ethnic Considerations in Ultrasonic Scanning of Fetal Biparietal Diameters
Authors: Walton Stuart M.
Published: February 2008

Summary: Biparietal diameters (BPD) were determined by ultrasonography on 86 Caucasians and 107 Polynesians at different gestations. Analysis of variance showed a highly significant (p<0.01) difference between groups. At any gestational age, Polynesian fetuses had BPDs 1.89 mm greater than Caucasian fetuses and this fact must be taken into consideration when a single measured value of BPD is being used in the estimation of gestational age.

In areas where the obstetrical population comprises different ethnic groups, there is a need for establishing local reference tables by race.
Prediction of the Extremes of Birth Weight From a Single Ultrasound Examination at 34 Weeks of Gestation
Authors: Duff G. B. , Evans L. J.
Published: February 2008

Summary: One hundred and forty patients were subjected to ultrasound examination at about 34 weeks of gestation. Using the product of the biparietal diameter measurement and either the fetal abdominal circumference or abdominal area measurement, it was possible to predict three‐quarters of both large for dates infants (false positive rate, 21.3%) and small for dates infants (false positive rate, 15.7%). Using the presence of a head and/or abdomen measurement above the 90th percentile for gestation, it was possible to predict 62.5% of large for dates infants (false positive rate, 15.7%). Using the presence of any measurement below the 10th percentile, it was possible to predict 81.3% of small for dates infants (false positive rates, 21.3%).
An Improved Light Source for Vaginal Specula
Authors: O'Neil G. , Hammond I. , Vella P.
Published: February 2008

Summary: A modification to metal specula is described which provides an inexpensive and convenient light source.
Prospective Comparative Trial of Tinidazole and Metronidazole as Prophylaxis for Elective Hysterectomy
Authors: Cocks P. S. , Munro R. , Norton B. , Nutting J. , Shanker S. , Cheng S.
Published: February 2008

Summary: A prospective randomised controlled study has demonstrated that tinidazole and metronidazole are effective in reducing post‐operative morbidity in women undergoing the operation of elective hysterectomy.

Postoperative febrile morbidity, pelvic infection and antibiotic usage were reduced in those patients receiving either tinidazole or metronidazole as compared with a placebo group, but no advantage could be demonstrated with metronidazole administration preoperatively and for 7 days postoperatively as opposed to a single preoperative dose of tinidazole.
Experimental Tubal Transplantation
Authors: Paterson Peter
Published: February 2008

Summary: The development of a microsurgical technique for Fallopian tube transplantation is described. One patient underwent the procedure, receiving a graft from a histocompatible sister. The hazards and future of such surgery are discussed.
Improved Diagnosis of Neural Tube Defects: Measurement of Concanavalin A‐Reactive Variants of AFP in Amniotic Fluid
Authors: Hay D. L. , Teisner B. , Davey M. W. , Horacek I. , Hart A. , Grudzinskas J. G.
Published: February 2008

Summary: The proportion of alphafetoprotein (AFP) not reacting with Concanavalin A(Con A) was determined by crossed line affinity immunoelectrophoresis (CLAIE) in amniotic fluid obtained from 16 pregnancies with open neural tube defects and other fetal abnormalities, and 25 pregnancies with normal outcome. The percentage of Con A non‐reactive AFP was significantly lower in the presence of open neural tube defects (< 3.9%, n = 13) compared with that in normal pregnancy (range 6.4–25.2%, n = 25). In this retrospective analysis, 2 pregnancies affected by open neural tube defect escaped diagnosis on the basis of an ambiguous total AFP estimation (+2SD < × < +5SD) in the amniotic fluid. These observations suggest that the elimination of false diagnoses based on total AFP levels may be possible, if supplementary analysis by CLAIE is performed.
Human Chorionic Gonadotrophin and Pregnancy‐Specific β‐1 Glycoprotein (SP‐1) in Ectopic Pregnancy
Authors: Forbes K. , Brennecke A. M. , Ho P. C. , Jones W. R.
Published: February 2008

Summary: Human chorionic gonadotrophin (hCG) was estimated by radioreceptor assay (RRA), and βhCC and pregnancy‐specific β1, glycoprotein(SP‐1) by radioimmunoassay (RIA) in 48 consecutive patients undergoing laparoscopy for suspected ectopic pregnancy. Twenty patients subsequently proven to have ectopic pregnancy had positive results for RIA‐βhCG, but RRA‐hCG and SP‐1 were negative in 3. Twenty‐one nonpregnant patients had negative results for RRA‐hCG and RIA‐βhCG, but one had a positive result with SP‐1. Seven patients with intrauterine pregnancy had positive results in all 3 assays.
Assay of Urinary Oestriol in Infertility Patients by Radioimmunoassay
Authors: Masters A. M. , Giles P. F. H. , Hähnel R.
Published: February 2008

Summary: A radioimmunoassay for urinary oestriol in patients receiving human pituitary FSH ‐ HCG treatment is described. This procedure compares favourably with the previously used fluorescence method for total urinary oestrogens.
Endometrial Carcinoma in Young Women
Authors: Ostor A. G. , Adam R. , Gutteridge B. H. , Fortune D. W.
Published: February 2008

Summary: Endometrial carcinoma in young women is uncommon. The majority of cases occur in women who have been taking oestrogen‐containing oral contraceptives, in those with the Stein‐Leventhal syndrome, or in those with gonadal dysgenesis treated by long‐term oestrogen replacement therapy. We have observed 4 women under 40 years of age with adenocarcinoma of the uterus in whom chromosomal abnormalities associated with Turner's syndrome were confirmed only after the diagnosis of carcinoma had been made. None of these had received replacement oestrogen therapy. It is postulated that chromosomal abnormalities in young women with endometrial carcinoma are more common than previously thought. As the disease in this group appears to behave in a benign fashion, a conservative approach to therapy is advocated.
A Comparison of the Vabra Aspirator and the Mimark Endometrial Sampler in the Screening of Postmenopausal Women
Authors: Wren Barry G.
Published: February 2008

Summary: A comparison of Vabra aspirator and Mimark endometrial sampler in postmenopausal women has shown the Mimark instrument to be significantly less painful and distressing than the Vabra and superior in terms of evaluable endometrial material obtained. Neither instrument is entirely satisfactory as a clinical screening procedure for postmenopausal women receiving hormonal replacement therapy.
Chronic Consumptive Coagulopathy With A Uterine Leiomyoma
Authors: Harris M. G. , Bannatyne P. , Russell P. , Atkinson K. , Rickard K. A. , Kronenberg H.
Published: February 2008

Summary: A case of benign uterine leiomyoma presenting as chronic consumptive coagulopathy and microangiopathic haemolytic anaemia (MAHA) is reported. Resection of the tumour was followed by recovery of normal haemostatic function. The histological finding of extensive thrombosis of sinusoidal blood vessels within the large tumour suggested interesting pathogenetic relationships.
Platelet Count During Normal Pregnancy
Authors: Harrison K. L. , Bramich L. , Collins K. A.
Published: February 2008

Summary: Platelet counts were performed on 1,020 normal patients at different stages of pregnancy. Patients with complications of pregnancy known to influence the platelet count were excluded from the study. There was no evidence of any significant change in platelet count during pregnancy.
Gynaecological Tuberculosis in Victoria: A 20‐Year Survey
Authors: Csordas Stefan E. , Monheit Benny M.
Published: February 2008

Summary: A review of the 181 cases of gynaecological tuberculosis notified in Victoria between the years 1961 and 1980 is made. The incidence of the disease is gradually falling and is currently 0.16 per 100,000. The majority of affected women were found to be immigrants to Australia with Southern European patients predominating. Nearly 46% of the women presented with infertility, while 43% were investigated for various symptoms. Twenty‐one patients had children before the diagnosis was made, but only 4 conceived after treatment. A comparison with overseas studies is made.
Amniotic Fluid Squalene: A Useful Test in Prolonged Pregnancy
Authors: Jenkins Donald T. , Wysocki Stan J. , Davies Diane M.
Published: February 2008

Summary: This study further investigates the predictive value of measurement of squalene in amniotic fluid in assessing the gestational age of the fetus in term and in prolonged pregnancies (>42 weeks). A preliminary finding that high squalene values were characteristic of prolonged pregnancies was confirmed. A retrospective search of medical records from patients whose pregnancies were thought to be prolonged demonstrated that a high percentage of these pregnancies indeed were not so. The availability of a test which is a good indicator of prolonged pregnancy may in fact lower the rate of unnecessary obstetric intervention in prolonged pregnancies
The Humidicrib … A Model of Isolation?
Authors: Adler Robert
Published: February 2008

Summary: The premature infant, whose physical well‐being often depends on his remaining in an incubator for a variable period, is in a particularly vulnerable psychological situation, being separated from his parents and cut off from the world outside the “humidicrib” or “isolette”. The name itself highlights the isolation experienced by parent and child; the mother feeling cut off from her baby, inadequate in not being able to produce a healthy, term infant and incompetent to care for him or her. The infant, on the other hand, is robbed of many of the normal opportunities for contact and stimulation, while being exposed to multiple noxious stimuli essential for survival.
Recent Progress in the Management of Gestational Trophoblastic Disease
Authors: Khoo S. K.
Published: February 2008

Summary: This review was undertaken to record recent progress in understanding and management of this unusual, relatively rare, but potentially fatal disease of trophoblast in the fetal allograft. The generic term “gestational trophoblastic neoplasia” has been introduced to represent the broad spectrum of clinical behaviour. The cytogenetic origin is interestingly diverse and the chromosomal karyotype of the tumour is varied, depending upon the type of antecedent pregnancy. The major contribution to progress in the last decade has come from the accumulation of experience by tumour registries and referral centres. Data from studies of biochemical markers, especially of hCG‐β and more recently, SP1, and their accurate measurement have led to the development of a sensitive method of monitoring the disease during follow‐up and treatment. Diagnosis is enhanced by ultrasound examination and treatment by suction aspiration is generally regarded as the safest mode of molar evacuation. Although prophylactic chemotherapy has resulted in reduction in incidence of persistent disease (especially in the “high risk” patient), an alternative and, perhaps more rational method, is close follow‐up by hCG‐β levels. A better understanding of the use of chemotherapy and the success in achieving the objectives of early treatment when tumour load is small, and selection of the most effective regimen, on the basis of matching type of treatment to the likelihood of drug response (or resistance), are now extended to consideration of treatment for the resistant tumour or tumour in less accessible sites, such as in the brain. With these advances, reproductive function can safely be preserved in the younger patient, unnecessary drug toxicity avoided, mortality reduced considerably and long‐term sequelae of chemotherapy kept at an insignificant level.
Does Subcuticular Green Polyglycolic Acid Suture Tattoo?
Authors: Reti L. L. , Kendall C. H.
Published: February 2008

Summary: An histological study of the behaviour of subcuticular green polyglycolic acid (GPGA) suture was undertaken to investigate if the green dye is retained by macrophages or histiocytes. Fifteen rats had subcuticular closure of a dorsal incision with GPGA suture. The closure site was excised at intervals and examined by light and electron microscopy. There was no evidence of dye retention, but a brisk inflammatory reaction was noted.
Type 1 Hyperlipoproteinaemia and Pregnancy
Authors: Potter Julia M. , Michael Con A.
Published: February 2008

Whilst hyperlipoproteinaemia is a physiological accompaniment of normal pregnancy (Potter and Nestel, 1979), in patients with inherited disorders marked by hypertriglyceridaemia, the increase in plasma triglycerides in pregnancy may precipitate medical sequelae, placing the pregnancy and the patient at risk. The number of case reports concerning such patients are few (Glueck et al., 1980) and there is little information to guide the obstetrician and physician as to likely complications. The majority of cases which are reported concern the identification of women who present with complications such as pancreatitis during pregnancy and are subsequently found to have hypertriglyceridaemia (Millen et al., 1956; Adlersberg et al., 1959).
Unusual Cord Intertwining in Monoamniotic Twins
Authors: Golan A. , Amit A. , Baram A. , David M. P.
Published: February 2008

Summary: A unique case of severe cord entanglement and knotting in a monoamniotic twin pregnancy is described resulting in 2 live babies. An interesting phenomenon of a possible fetal placental transfusion during labour was noted.
Occurrence of Bone in Serous Cystadenocardnoma of the Ovary
Authors: Barua R. , Cox L. W.
Published: February 2008

Summary: Psammoma bodies are relatively common in papillary serous tumours of the ovary, but bone formation in these tumours is rare. The occurrence of such a change in 3 papillary serous cystadenocarcinomas of the ovary in 2 patients is reported. According to the authors' knowledge, these are the first documented cases with such a change.
Braxton‐Hicks Contractions and Fetal Breathing Movements
Authors: Wilkinson C. , Robinson J.
Published: February 2008

Summary: Fetal breathing movements were observed for periods of approximately 100 minutes in 10 women at 36–42 weeks' gestation. Simultaneous recordings of uterine activity were made using an external tocograph. Fetal breathing movements were present at the onset of 82 Braxton‐Hicks' contractions. There was a significant change in the rate of fetal breathing with a trough before the acme of the contraction, followed by a peak as uterine activity decreased. It is suggested that these changes are related to pressure on the fetus during the contraction and probably are unrelated to changes in fetal oxygenation.
Vulvovaginal Candidiasis: Treatment and Recurrence
Authors: Dennerstein Graeme J. , Langley Russell
Published: February 2008

Summary: This study compares the effectiveness of 6 treatment regimens for vulvovaginal candidiasis with 6 months' follow‐up. 292 patients randomly allocated to the treatments completed the trial. Significant differences were found in the rates of recurrence within the different treatment groups. The most successful treatment was miconazole vaginal cream with oral nystatin, with a cure rate of 81%. The high rate of recurrence of this condition is noted and the need for at least 6 months' follow‐up in future trials of candidacides is emphasized.
Malignant Mixed Mesodermal Tumour of the Uterus Initially Confined to a Polyp
Authors: Klomp Andre , Smith L. A. , Pounder D. J.
Published: February 2008

Summary: A malignant mixed mesodermal tumour (MMMT) of the uterus, in a 68‐year‐old woman, was initially confined to an endometrial polyp. Despite the absence of myometrial invasion, the tumour metastasized to the omentum. This experience conflicts with previously reported cases. An aggressive approach to the management of these tumours is suggested
Adolescent Primigravidae and Their Obstetric Performance
Authors: Lee Peter Y. A. , Walters William A. W.
Published: February 2008

The obstetric performance of adolescent primigravidae in a major metropolitan teaching hospital was analysed retrospectively and found to be similar, if not superior, to that of a control group of primigravidae. This was surprising in view of the late antenatal presentation of the adolescents and their smaller physique. More low birth weight infants, however, were born to adolescent than to older primigravidae, although the perinatal mortality was not increased because of this.

Modern obstetric practice is increasingly concerned with adolescent pregnancies, many of the latter occurring in younger age groups (Oliver, 1975; Baldwin, 1976; Hunt, 1976). Traditionally, such pregnancies have been associated with an increased prevalence of social, psychological and obstetric problems. Therefore, we thought that a review of the obstetric performance of adolescent primigravidae in our Hospital would be useful in order to define any particular problems and to assess the increased risk of complications if such existed.

An adolescent primigravid pregnancy was defined as a first pregnancy when the maternal age at delivery was 16 years or less (taken to the last completed year). The controls were delivered subsequent to one of the adolescent primigravidae.

All adolescent pregnancies that resulted in spontaneous or therapeutic abortion were excluded from the study. The racial composition of both groups was similar and included mainly Australians, Greeks, and Italians as well as some other migrants.
Impacted Shoulders – A Personal Experience
Authors: Schramm Mary
Published: February 2008

Failure of the shoulders to follow readily after delivery of the head is a life‐threatening emergency for the mother and baby which is occasionally encountered by most obstetricians, and receives scant attention in current obstetric textbooks.

This is a record of my personal experience of the condition, including 7 patients in whom a destructive procedure was required.
A Comparison of Intraamniotic Prostaglandin and Extraamniotic Prostaglandin Gel For Midtrimester Termination of Pregnancy
Authors: Smith D. H. , Dalrymple J. C.
Published: February 2008

A comparison between midtrimester abortion induced by the intraamniotic injection of prostaglandin F2α and abortion induced by prostaglandin F2α in Tylose gel administered extraamniotically was made in a group of 40 patients. The induction‐abortion interval in the extraamniotic group was 12.1 hours which was significantly shorter (P < 0.001) than the intraamniotic group (27.6 hours). The placenta was expelled completely more often and there were no cervical lacerations using the extraamniotic method whereas 2 patients required repair of cervical lacerations after intraamniotic prostaglandin. Extraamniotic administration of prostaglandin F2α in Tylose gel is recommended as a safe and more effective method for inducing midtrimester abortion than intraamniotic prostaglandin.
A Double‐Blind Trial of Ethinyl Oestradiol and Norethisterone Separately and Together, in Menopausal Women
Authors: Smith M. , Evans D. V. , Vella P. V. , Nordin B. E. C.
Published: February 2008

In previous publications (Jones et al., 1977; Nordin et al., 1980) we have shown that menopausal symptoms respond well to 15 pig of ethinyl oestradiol and rather less well to 5 mg daily of norethisterone. We have not previously established whether even smaller doses of ethinyl oestradiol might be effective or whether combining this preparation with norethisterone might produce an additive effect. The present paper describes a trial designed to answer these questions.
Bowel Complications in the Management of Ovarian Cancer
Authors: Solomon H. J. , Atkinson K. H. , Coppleson J. V. M. , Elliott P. M. , Houghton C. R. S. , Tattersall M. H. N. , Green D.
Published: February 2008

In a consecutive series of 163 patients referred with malignant ovarian tumours there were 24 (14.7%) who developed major bowel complications; 21 patients were operated upon for bowel obstruction and had a mean survival time of 8.1 months; 8 of the 24 patients are alive with cancer and 4 are alive without evidence of residual tumour. It is concluded that laparotomy is indicated when bowel complications occur in patients with ovarian carcinoma.
Prognostic Significance of Oncofetal Antigens in Patients with Ovarian Cancer
Authors: Koh S.H. , Cauchi M.N.
Published: February 2008

The prognostic significance of elevated oncofetal antigens, namely carcinoembryonic antigen (CEA), alphafetoprotein (AFP), and β subunit of human chorionic gonadotrophin (β HCG) were studied in 39 patients with cancer of the ovary. At low cut‐off levels, (CEA > 2.5 μ g/1, AFP > 5 μg/1, and β HCG > 3 IU/1) the median survival was 21 months in patients with one or more positive markers compared to >43 months in patients without markers. At high cut‐off points (namely CEA >10 μg/1, AFP > 10 μg/1 and β HCG > 10 IU/1), the median survival of patients having one or more positive markers was 10 months compared to > 46 months in patients with no markers. Using linear regression and Logrank analysis, the difference between the observed and expected death rate was significant (P < 0.05 at low cut‐off levels, and < 0.01 at high cut‐off levels).

These results indicate that patients who have one or more positive oncofetal markers on presentation are likely to have a significantly worse prognosis than patients without markers. Moreover, higher levels of oncofetal markers are associated with correspondingly worse prognosis.
Amniotic Fluid Pre‐AIbumin and Retinoi Binding Protein in Complicated Pregnancies
Authors: Legge Michael
Published: February 2008

Amniotic fluid pre‐albumin and retinol binding protein levels were assayed in normal pregnancies and in those complicated by Rhesus isoimmunization, maternal diabetes mellitus, and intra‐uterine fetal growth retardation ranging from 35 to 40 weeks' gestation. Only pregnancies complicated by severe erythroblastosis demonstrated any significant change in amniotic fluid pre‐albumin levels (P < 0.001). No retinoi binding protein was detected in any of the amniotic fluid samples tested.
Partial Hydatidiform Mole: Ultrasonographic Features
Authors: Woo J. S. K. , Hsu C. , Fung L. L. Y. , Ma H. K.
Published: February 2008

Four patients with partial hyatidiform mole managed at the Queen Mary Hospital, Hong Kong, are described. The diagnosis of blighted ovum or missed abortion was made on the sonographic findings prior to suction evacuation. The dominant features in these cases consisted of a relatively large central transonic area bearing the appearance of an empty gestational sac and surrounded by a thick rim of low‐level placenta‐like echoes; in contrast with the case of the blighted ovum, a well‐defined echogenic sac wall is absent. In another 9 patients with molar pregnancy managed during the same period, the more typical ‘snow‐storm’ vesicular appearence was present. It was concluded that the anembryonic appearance described should alert the sonologist and clinician to the possible diagnosis of partial hydatitiform mole. The evacuated material from the uterine cavity should be examined morphologically and if possible cytogenetically.
Characteristic Fetal Heart Rate Changes in Severe Rhesus Isoimmunization
Authors: Haines Christopher J. , Read Michael D.
Published: February 2008

A case of pregnancy complicated by severe rhesus isoimmunization is described. The finding of a sequence of fetal heart pattern changes on daily cardiotocography offers a simple method of detecting the severely compromised fetus, which appears to be related to the underlying pathological process, and is more sensitive than other tests of fetal well‐being currently used.
Prolapse and Presentation of the Umbilical Cord
Authors: Woo J. S. K. , Ngan Y. S. , Ma Ho‐Kei
Published: February 2008

Summary: The outcome of pregnancies with prolapse and presentation of the umbilical cord at Tsan Yuk Hospital, Hong Kong, 1976 to 1982, was reviewed. The incidence was 0.17%, 70 of 41,939 deliveries; 98% of cases were diagnosed in hospital. Breech presentation, low birth‐weight and artificial rupture of membranes were found to be significant associations; 78% of cases were discovered by vaginal examination and the diagnosis‐delivery interval was less than 30 minutes in 75%. There were 8 perinatal deaths and 3 of these occurred in babies whose birth‐weights were less than 1,000 g; 2 stillbirths were associated with presentation of the cord. The corrected perinatal mortality was 8.6% with a corresponding Caesarean section rate of 73.3%. 80% of the babies born by Caesarean section had 5 minutes Apgar scores of 7 or more. It was concluded that early diagnosis of umbilical cord prolapse followed by prompt treatment are effective in reducing the perinatal mortality rate. Energetic intrapartum monitoring is also essential in order that patients with occult prolapse or presentation of the umbilical cord be diagnosed early and treated promptly.
Prospective Follow‐Up of Growth Retarded Infants and of Those From Pregnancies Complicated by Low Oestriol Excretion – 7 Years
Authors: Drew J. H. , Bayly J. , Beischer N. A.
Published: February 2008

Summary: Growth and neurological outcome to 7 years of age were determined in 273 growth retarded infants, 341 infants from pregnancies complicated by subnormal urinary oestriol excretion and 72 control infants. By 1 year of age 80.6% of growth retarded infants were above the 10th percentile for weight. Growth continued so that after 2 years of age only 10.6% were beneath the 10th percentile. A neurological abnormality was detected in 9.5% of growth retarded infants and 8.3% of control infants (P=NS). Only 6 (2.2%) of the growth retarded infants were severely handicapped. A neurological abnormality was detected in 16.4% of infants from pregnancies with low oestriol excretion and although this incidence was higher than that of the control infants (8.3%), the difference failed to achieve statistical significance. The neurological abnormality was severe in only 7 infants (2.1%). The intelligence quotient (IQ) was the same in infants from pregnancies complicated by chronically low oestriol excretion whether hypertonic dextrose (mean IQ 103) had been administered to the mother or not (mean IQ 105). It is concluded that the pregnancy complicated by low oestriol excretion and/or fetal growth retardation should be treated with optimism.
A Prospective Study of βHCG Radioimmunoassay in the Diagnosis of Ectopic and Other Complicated Early Pregnancies
Authors: Khoo S.K. , Molloy D.
Published: February 2008

Summary: The β‐subunit of chorionic gonadotrophin (/JHCG) was measured by radioimmunoassay in the serum of 190 consecutive patients admitted to hospital with the suspicion of ectopic pregnancy. The detection limit was set at 1 ng/ml. A urine sample was also taken for pregnancy testing on admission. A positive serum βHCG result was obtained in 36 patients (19%); pregnancy was confirmed in 32 (ectopic pregnancy 14, abortion 8, continuing normal pregnancy 7, retained products 3), giving a predictive value of 89%. There was poor correlation between serum and urine results. The serum levels were low in patients who subsequently aborted, intermediate in those with ectopic pregnancy and within the normal range in patients in whom the pregnancy continued normally. The high predictive value of the test should identify the patients for further investigation, thus avoiding unnecessary operative procedures and prolonged hospital stay.
Pregnancy Complicated by an Insulinoma
Authors: Wilson J. Dennis , Hugh Thomas B.
Published: February 2008

Summary: The case of a 33‐year‐old patient suffering from severe hypoglycaemia due to an insulinoma during the first trimester of pregnancy is reported. The diagnosis was established on clinical grounds and by the demonstration of hypoglycaemia, inappropriate hyperinsulinism and an increase in the percentage of circulating proinsulin. Dietary therapy maintained blood glucose at a satisfactory level from the 9th to the 17th gestational week. Localization of the tumour was achieved at that time by limited CT scanning with a narrow field. A 2 cm tumour was removed from the head of the pancreas and the blood sugar levels and insulin secretion returned to normal. Pregnancy proceeded normally and a healthy male infant weighing 3,880g was delivered at term. Ten months after delivery both mother and child were well.
Intrauterine Growth Retardation*
Authors: Beischer N. A. , Abell D. A. , Drew J.H.
Published: February 2008

Fetal growth retardation ranks third after prematurity and malformations as a cause of perinatal deaths. Antenatal fetal monitoring (biochemical testing of fetoplacental function plus cardiotocography) has emerged as the most important means of reduction in the number of stillbirths and improvement in the quality of survival of infants who are born alive. Clinical acumen combined with biochemical and/or ultrasonographic testing will identify no more than 70% of growth retarded fetuses. However, not all small for dates fetuses are at risk, and many doomed to die in utero are not by definition, growth retarded.

It should be the obstetrician's aim to identify the fetus at risk of death from hypoxia whether growth retarded or not. Biochemical and ultrasonographic methods of testing are not truly comparable, since some aim to identify the growth retarded fetus, irrespective of his state of health, whereas others aim to detect fetoplacental dysfunction, irrespective of whether or not the fetus is growth retarded.

With present methods of antenatal diagnosis and treatment and timing of delivery determined by nonstressed cardiotocography, the physical and intellectual prognosis of growth retarded infants is most satisfactory; follow‐up studies have shown that only about 2% of these infants are severely handicapped.
Bivariate Analyses Of Attitudes Towards Breast‐Feeding
Authors: Counsilman J. J. , Mackay E. V. , Copeland R. M.
Published: February 2008

1,790 postpartum women were asked about their breast‐feeding attitude, physical and other attitudinal variables. Bivariate analyses were conducted between attitude and each of 38 other variables. Of the causally independent variables, education and occupation were the most strongly related to attitude, and along with doctor's preference were perhaps the most important influences on a mother's baby‐feeding attitude. No physical or health measure was strongly related to attitude towards breast‐feeding, although there were consistent associations between favourable attitudes and optimal categories of the physical and health variables. A hypothesized model of the influences on breast‐feeding attitude and behaviour is presented.
Ritodrine In The Management Of A Case Of Acute Fetal Distress
Authors: Zentner Rodney
Published: February 2008

Acute fetal distress occurred during the first stage of labour in a multipara. Since Caesarean section was unavoidably delayed an intravenous bolus dose of ritodrine was given resulting in abolition of uterine contractions and return of the fetal heart tracing to normal. Subsequently a healthy infant was born by Caesarean section.
Acute Severe Hypertension in Pregnancy
Authors: Korda Andrew R. , Horvath John S.
Published: February 2008

Summary: Acute severe hypertension is a significant cause of fetal and maternal morbidity and mortality. The rationale for treatment and the various modes of management are reviewed. The importance of timely delivery is stressed.
Chronic Hypertension in Pregnancy
Authors: Gallery Eileen D. M.
Published: February 2008

Summary: Chronic hypertension in pregnancy is associated with significant potential risks to both mother and baby. The risks can be reduced to, or even below those of the general population by appropriate and adequate therapy. This requires close supervision and maintenance of excellent blood pressure control and should involve in therapeutic decisions, not only the obstetrician, but also the physician and neonatologist. In our own experience this is best achieved by a specialised unit approach to the problem.
Prenatal Diagnosis by Fetoscopy and Chorion Biopsy
Authors: Rodeck C. H.
Published: February 2008

Amniotic fluid and its cells, obtained by amni‐ocentesis, is the fetal tissue most commonly used for prenatal diagnosis. The conditions that can be investigated include chromosome abnormalities, neural tube defects and inborn errors of metabolism. This review deals with the tissues that can be obtained by fetoscopy and chorion biopsy and the indications and techniques for performing these procedures.
The Dilemma of Mild Hyperprolactinaemia
Authors: Pepperell Roger J. , Martinez Cecilia , Dickinson Ann
Published: February 2008

Summary: Ninety‐eight women with mild hyperprolactinaemia (<4N) were followed for a mean duration of 5.5 years. Where pregnancy was desired treatment with bromocriptine (pM clomiphene) was effective in 87%. Following cessation of bromocriptine therapy almost one‐third had a ‘spontaneous' resolution of hyperprolactinaemia and resumed cyclical menstrual activity and fertility.

Pituitary tumours were identified on coned‐view assessment in 9% of patients at the time of presentation and a further 10% during follow‐up. Although some of these latter tumours may have been diagnosed earlier had CAT scans been performed routinely in all hyperprolactinaemic patients, such a policy would be hard to justify for those with mild hyperprolactinaemia as the tumours were small, produced no harmful effects, and would almost certainly have responded to bromocriptine should this have been administered.

All patients found to have pituitary tumours and given bromocriptine, showed no evidence of tumour progression subsequently, even where pregnancy occurred and the bromocriptine therapy was ceased. In addition, patients without pituitary tumours who were given bromocriptine to achieve pregnancy, were less likely to develop tumours during follow‐up even when pregnancy had occurred.

Bromocriptine therapy can thus be justified in mildly hyperprolactinaemic patients to reduce troublesome galactorrhoea, achieve pregnancy, improve the chance of ‘spontaneous' resolution of the menstrual problem and infertility, control or reduce tumour growth where a pituitary tumour has been identified, and reduce the risk of tumour development in patients with normal radiographs at the time of presentation.
Is Endocrine Status Relevant to Treatment Planning in Patients with Gynaecological Cancer?
Authors: Quinn M. A.
Published: February 2008

Summary: The presence or absence of steroid receptors in breast carcinomas has an important influence on prognosis and response to hormonal therapy. Data on the receptor content of endometrial carcinomas and sarcomas and of ovarian tumours are fast accruing but the clinical relevance of the receptor content of these gynaecological tumours remains to be fully assessed. Overall, 76% of endometrial carcinomas are oestrogen receptor (ER) positive and 74% progesterone receptor (PR) positive. Poorly‐differentiated tumours are less likely to be receptor positive as are deeply invasive tumours. The presence of ER and PR have been shown to be a good guide to eventual hormonal therapy, but this is not absolute; actual receptor levels seem to be important. Information on receptors in uterine sarcomas is too scanty at present to be evaluated. Approximately 64% of epithelial ovarian tumours contain ER, 42% PR and 46% androgen receptor (AR); the presence of such receptors may point to a better prognosis, but correlations between receptor status and response to hormonal agents such as progestogens and tamoxifen have not been studied.
Risk in the Vaginal Delivery of the Large Fetus
Authors: Jaschevatzky O. E. , Mor G. , Miller M. , Avinery R. , Grunstein S.
Published: February 2008

Summary: The problem of the excessively weighted fetus was studied. For this purpose, over a period of 2 years, each delivery with fetal weight of 4,500 g or more was included in the study. The history and examination findings of the present pregnancy were reviewed following delivery. The postpartum outcome and later complications in both mothers and infants were investigated prospectively. A total of 82 deliveries of large babies were included in the study and the outcome was compared with that of parallel deliveries of babies with in the normal weight range (2,500–4,000 g). Factors frequently associated with excessive fetal weight were identified. A relatively high perinatal mortality and morbidity relating to vaginal delivery were observed among the large infants. In all those cases who developed delay in the second stage of labour, Caesarean section is proposed when macrosomia is clinically suspected and confirmed by ultrasonic assessment. Moreover elective Caesarean section should be considered before labour, when macrosomia is associated with hyperglycaemia or other pathology.
Symphysial‐Fundal Height from 12 Weeks' Gestation
Authors: Taylor P. , Coulthard A. C. , Robinson J. S.
Published: February 2008

Summary: There is a strong association between birth‐weight and perinatal mortality and morbidity. Intrauterine growth retardation (IUGR) is an important cause of perinatal morbidity and mortality and 50% of cases occur in low risk patients. Despite an obvious need, the diagnosis of IUGR by clinical means has remained difficult and inaccurate. To aid this diagnosis a graph of symphysial‐fundal height, based on a local population in Australia, is presented. When used in conjunction with standard charts showing centiles of birth‐weight for gestational age, an estimate of fetal weight may be simply and quickly made. When tested in 49 pregnancies the mean error of predicted birth‐weight was 86 ±pM 67 gm/Kg.
Factors Influencing Referrals for Prenatal Cytogenetic Diagnosis
Authors: Bell J. A. , Pearn J. H. , Bowling F. G. , Martin N. J.
Published: February 2008

Summary: This paper reports the results of an investigation into factors influencing the referral of women for prenatal cytogenetic diagnosis, following mid‐second‐trimester amniocentesis. The overall diagnostic amniocentesis rate for women over the age of 35 years was 16.8%. One hundred and forty consecutive Brisbane women referred to the 2 Queensland laboratories offering chromosome analysis of amniotic fluid cells were included in this study. 72% were referred for advanced maternal age. The socioeconomic status (SES) of the 140 women was skewed very significantly towards the professional and semiprofessional classes (Classes A and B on the Congalton Australian Four‐point Scale). Twenty seven percent of all women are in SES Class D in the Brisbane population, but only 7.4% of such women (SES Class D) were within the group studied. Forty nine percent of women indicated that they themselves raised the question of prenatal diagnosis with their doctor. Diagnostic amniocentesis is not acceptable to a certain proportion of couples, but it is estimated that 60% would accept it if there were medical indications, and if it were offered. Our studies have indicated that of those women who are at increased risk of having a child with a significant chromosomal abnormality (including those over the age of 35 years) and to whom prenatal diagnosis is acceptable, 28% are actually receiving it in current practice. Those who do are a well informed, self‐motivated upper and middle class group.
Lymphocyte Subclasses in Pregnancy Induced Hypertension
Authors: Barnett Mark A. , Holland Jennifer M. , Learmonth Robert P. , Walters William A. W. , Pihl Eric
Published: February 2008

Summary: Peripheral blood lymphocyte subclasses were studied by flow cytofluorimetry and monoclonal antibodies in 21 women with Pregnancy Induced Hypertension (PIH), 20 healthy women in their third trimester of pregnancy and in 20 nulliparous, nonpregnant women. The cells were stained with the monoclonal antibodies OKT3, OKT4 and OKT8 to define total T cells, T helper cells (Th) and T suppressor‐cytotoxic cells (Ts/c) respectively. B lymphocyes were defined by their surface immunoglobulin. Absolute numbers of total T cells and Ts/c cells were significantly decreased (p<0.05) in patients with PIH compared to either control group. The proportion of B lymphocytes was significantly (p<0.01) increased and absolute numbers were marginally increased. These findings reflect an immune disturbance which may be of prime importance in the pathogenesis of this disease.
Monitoring Early Production of Chorionic Gonadotrophin (HCG) Following In Vitro Fertilization and Embryo Transfer
Authors: Hay D. L. , Gronow M. , Lopata A. , Brown J. B.
Published: February 2008

Summary: A rapid, sensitive assay was developed for monitoring HCG production and applied to serum and urine collection between days 4 and 20 after OPU in 55 patients treated by ovarian hyperstimulation and IVF. Eleven ongoing pregnancies, 2 ectopic pregnancies and I clinical abortion resulted. The earliest detection of a rise in HCG was on day 7 after OPU. The HCG values showed that trophoblastic tissue functioned transiently in another 11 patients and probably in another 5. Thus evidence for functioning trophoblastic tissue was obtained in a total of 30 patients (55%). These findings are important for the further improvement of IVF. No antibodies to administered HCG were detected.
Who Attends Family Planning Clinics?
Authors: MB Pamela Chick , Nixon James
Published: February 2008

Summary: Data were obtained from 1,810 consecutive women who attended a central metropolitan (Brisbane) Family Planning Clinic during a 5 week period in 1982. Young women in particular formed the major client group with 32% being under 20 years of age. The client population was skewed towards women of upper socioeconomic status (SES). There was no SES disproportion in the use of oral contraceptives or IUD's. However, diaphragm use occurred disproportionately in women of upper SES groups; postcoital contraception was sought by and limited to, women of SES classes A and B only. The clinic satisfied a need for women with a history of failed or absent contraception and 15% had already had a termination of pregnancy by the time they first presented at the clinic.
Acute and Severe Menorrhagia Due to Cervical Artery Damage
Authors: Fraser Ian S. , Rencoret Rudolfo H.
Published: February 2008

Acute and severe menorrhagia necessitating emergency hysterectomy is a rare occurrence. It is occasionally encountered in women with systemic coagulation disorders (I), but hardly ever in other situations. This report describes an unusual case of menorrhagia associated with unexpected damage to a cervical artery.
Prognostic Variables in Epithelial Ovarian Cancer: A Review
Authors: Friedlander Michael L.
Published: February 2008

Epithelial ovarian cancer is the third most frequent fatal cancer of women in Australia and is one of the leading causes of female cancer deaths in the United States, Northern Europe, Canada and Israel (1,2). There are no identified preventable causes and no reliable means for early diagnosis so that improved survival must lie with the optimal management of patients. While there have undoubtedly been major advances in radiotherapy and chemotherapy over the last 3 decades, the available data suggest that these developments have not improved survival rates for the group of patients with epithelial ovarian cancer. This may be attributed, in part, to a lack of understanding of the multiplicity of prognostic variables that contribute to the outcome of patients with ovarian cancer and perhaps inappropriate selection between treatment options (3).