bluuebunny/crossref_metadata_2025 huggingface dataset:
THE INCIDENCE OF SEVERE PRE‐ECLAMPSIA AMONGST MOTHERS AND MOTHERS‐IN‐LAW OF PRE‐ECLAMPTICS AND CONTROLS
Authors: Sutherland A. , Cooper D. W. , Howie P. W. , Liston W. A. , MacGillivray I.
Published: August 2005

In order to distinguish between a maternal, fetal or maternal and fetal genetic predisposition towards severe pre‐eclampsia, the first pregnancies of 158 mothers and 160 mothers‐in‐law of pre‐eclamptic women and of matched controls were analysed. Fourteen per cent of mothers of pre‐eclamptics were found to have had severe pre‐eclampsia, confirming previous suggestions that the condition‘runs in families', in contrast to only a 3% incidence amongst mothers of controls. The incidence in mothers‐in‐law of both pre‐eclamptics and controls was 4%, in full agreement with a maternal genotype hypothesis and suggesting that the fetal genotype plays, at most, only a minor role in the aetiology of severe pre‐eclampsia. The data are in agreement with the hypothesis that a single recessive gene acting in the mother could be responsible for severe pre‐eclampsia, but multifactorial inheritance is not ruled out. Mild pre‐eclampsia showed no such familial tendency, indicating that the mild and severe forms of pre‐eclampsia may represent separate pathological entities.
BRIEF PSYCHOSOMATIC THERAPY FOR CONSUMMATION OF MARRIAGE
Authors: Bramley H. Morag , Brown Joe , Draper Katherine C. , Kilvington Jane M.
Published: August 2005

We describe the treatment of sexual problems by Members of the Institute of Psychosexual Medicine who are trained to recognise and use therapeutically the doctor‐patient interaction. A prospective study of long‐standing cases of non‐consummation was chosen for evaluation of therapy as there was a definite outcome. Of 50 couples, most of whom had previously had many unsuccessful consultations, 64 per cent consummated within six months and 72 per cent in 14 months. Among those who had failed actually to consummate at six months, one third had increased their ability to enjoy sexual activity. The average number of attendances was six, involving altogether about four hours’ work. These findings compare well with those reported in other studies and suggest that referral of such cases to a doctor specially trained in brief psychosomatic therapy tends to bring the best results.
THE ABSORPTION AND METABOLISM OF ORAL OESTRADIOL, OESTRONE AND OESTRIOL
Authors: Townsend P. T. , Dyer G. I. , Young O. , Whitehead M. I. , Collins W. P.
Published: August 2005

The absorption, metabolism and clearance of oestradiol, oestrone and oestriol from the peripheral circulation were investigated in five postmenopausal women after the oral administration of Hormonin (oestradiol 600 μg, oestrone 1400 μg, oestriol 270 μg) daily for five consecutive days. In addition the concentrations of plasma oestrone‐3‐sulphate, oestrone‐3‐glucuronide, LH and FSH were determined in the same plasma samples. The maximum concentrations of each steroid in peripheral plasma and the time intervals during which the peak occurred after ingestion of the last tablet were:—oestrone (750 to 2116 pmol/1, 0·5 to 6·0 hours), oestradiol (246 to 813 pmol/1, 1 to 8 hours), oestriol (173 to 241 pmol/1, 5 to 12 hours), oestrone‐3‐glucuronide (32·2 to 78·8 nmol/1, 0·5 to 3·0 hours) and oestrone‐3‐sulphate (21·9 to 39·0 nmol/1, 1 to 7 hours). The mean factorial increases in the concentration of each compound during the first 12 hours post‐treatment over the baseline values were:—oestrone (4·1); oestradiol (4·4); oestriol (1·7); oestrone‐3‐sulphate (2·6) and oestrone‐3‐glucuronide (8·1). After treatment, the concentration of plasma oestradiol remained significantly higher than the baseline values (p <0·025) for 24 hours and the values for each subject were within the normal range for premenopausal women. Moreover, there was a significant reduction (p < 0·025) in the level of circulating LH. It is concluded that the simultaneous administration of oestrone, oestradiol and oestriol, by mouth, to postmenopausal women is a good approach to maintaining an appropriate concentration of oestradiol in peripheral plasma.
HAEMOGLOBIN AIc PREDICTS THE PERINATAL OUTCOME IN INSULIN‐DEPENDENT DIABETIC PREGNANCIES
Authors: Ylinen K. , Raivio K. , Teramo K.
Published: August 2005

Haemoglobin AIc (Hb AIc) was measured in 112 insulin‐dependent diabetic pregnancies on an average 4.7 times. Hb AIc was high in early pregnancy in all three patients with severe fetal malformations. There were six pregnancies with a perinatal death. The maximum Hb AIc values were significantly higher in the second trimester (p <0.001) in these pregnancies than in the other diabetic pregnancies. When neonatal hypoglycaemia was present, the mean maternal Hb AIc was significantly higher in the second (p <0.005) and third (p <0.02) trimesters of pregnancy than in the group without neonatal hypoglycaemia. In the group with neonatal hyperbilirubinaemia the mean maternal Hb AIc was significantly higher in the third trimester (p <0.02) than in the group with no neonatal hyperbilirubinaemia. The results suggest that poor metabolic control of maternal diabetes during the second trimester is associated with a clearly increased risk of perinatal death and during the second and third trimesters with metabolic derangements in the neonatal period. The results also indicate that Hb AIc could be used to detect the pregnant diabetics at special risk.
ANTHROPOMETRIC AND BIOCHEMICAL CHANGES DURING PREGNANCY IN ASIAN AND EUROPEAN MOTHERS HAVING WELL GROWN BABIES
Authors: Bissenden J. G. , Scott P. H. , Hallum Jean , Mansfield H. N. , Scott P. , Wharton B. A.
Published: August 2005

At this hospital, about a third of all mothers are Asian. Although generally they have smaller and lighter babies, many Asian mothers achieve similar standards of intrauterine growth to the European mother. This paper describes the nutritional status of Asian and European mothers having well grown babies. Twenty eight European and 11 Asian mothers, who had a normal past obstetric history and a normal present pregnancy resulting in a well grown baby, were studied throughout pregnancy. At each visit, weight, skinfold thickness, and mid‐upper arm circumference were measured and biochemical measurements of nutritional status were performed (serum albumin, transferrin and alkaline ribonuclease, plasma amino acids and nitrogen partition of urine). Asian mothers were fatter than European mothers at booking and put on more fat during the second trimester. At the same time, the biochemical tests suggested that the Asian mothers had a higher plane of nutrition. It seems that if the Asian mothers are well nourished in the second trimester, they can achieve a standard of intrauterine growth comparable to the Europeans.
ANTHROPOMETRIC AND BIOCHEMICAL CHANGES DURING PREGNANCY IN ASIAN AND EUROPEAN MOTHERS HAVING LIGHT FOR GESTATIONAL AGE BABIES
Authors: Bissenden J. G. , Scott P. H. , King Jean , Hallum Jean , Mansfield H. N. , Wharton B. A.
Published: August 2005

An assessment of nutritional status using anthropometric and biochemical measurements was made during pregnancy in 8 European and 15 Asian women who produced babies which were light for gestational age. These results were compared with similar measurements in women of both races with normal or pathological pregnancies (hypertension or bleeding) who produced babies of normal size. European mothers of light for gestational age babies with one exception had pregnancies complicated by pathology. They were heavy and fat but apart from urinary peptide hydroxyproline (which was reduced), no other biochemical measurement was specifically associated with poor intrauterine growth. Asian mothers of light for gestational age babies mostly had pregnancies not complicated by obstetric pathology. They gained less weight and fat during the second trimester and during the third trimester, they had biochemical evidence of a poorer nutritional status. Some of the biochemical changes were also noted in pathological pregnancies even though the mothers gained weight and fat normally and had well grown babies.
A RAPID LUTEINIZING HORMONE RADIOIMMUNOASSAY FOR THE PREDICTION OF OVULATION
Authors: Djahanbakhch O. , McNeilly A. S. , Hobson B. M. , Templeton A. A.
Published: August 2005

A rapid luteinizing hormone (LH) radioimmunoassay (total time 4 h) has been developed and used to measure the preovulatory LH surge in 22 patients. Ovulation, assessed by laparoscopy or mini laparotomy, did not occur until at least 32 h after the start of the LH surge. This rapid LH radioimmunoassay provides a simple method of predicting ovulation for the correct timing of oocyte collection or artificial insemination.
HUMAN LUTEAL PHASE FUNCTION FOLLOWING OOCYTE ASPIRATION FROM THE IMMEDIATELY PREOVULAR GRAAFIAN FOLLICLE OF SPONTANEOUS OVULAR CYCLES
Authors: Kerin J. F. , Broom T. J. , Ralph M. M. , Edmonds D. K. , Warnes G. M. , Jeffrey R. , Crocker J. M. , Godfrey B. , Cox L. W. , Seamark R. F. , Matthews C. D.
Published: August 2005

Human luteal phase function as evaluated by peripheral venous blood steroid levels does not appear to be impaired following the aspiration of follicular fluid together with a cumulus enclosed oocyte and a number of granulosal cells from the immediate preovular follicle in women having otherwise spontaneous ovular cycles. The day to day levels of luteinising hormone, oestradiol‐17β, 17α‐hydroxyprogesterone, progesterone and basal temperatures in 14 women who had their preovular follicle aspirated were compared with a control group of 28 spontaneously ovulating women. It was concluded that a carefully performed single aspiration of the contents of a preovular follicle, for the purpose of extra‐corporeal fertilisation of the mature oocyte, did not lead to impaired steroid function of the subsequent corpus luteum, although the prolactin levels were increased due to the effects of the relaxant anaesthetic and/or the laparoscopic procedure. A safe and simple laparoscopic procedure is also described, which is particularly suitable for women with a likelihood of extensive pelvic adhesions.
ENGAGEMENT OF THE FETAL HEAD IN THE NEGRO PRIMIGRAVIDA
Authors: Briggs N. D.
Published: August 2005

A prospective study into causes of non‐engagement of the fetal head at term in the negroid primigravida showed no correlation with fetal birth weight nor with the pelvic brim inclination. However, there was a significant difference (p <0.05) between the mean head circumference of babies with heads which had not engaged (34.1 cm) and with those which had (33.1 cm). Labour was generally prolonged with a high head at term, but there was no increase in the incidence of fetal or maternal mortality and morbidity nor was it associated with an increase in the rate of operative interference. In addition, retrospective studies on pelvic brim inclination between 31 Nigerian primiparae and matched Caucasians at the Queen Charlotte's Maternity Hospital showed no statistically significant differences. It is suggested that an unengaged fetal head in early labour should not by itself be an indication for early delivery by caesarean section.
COMPLICATIONS OF FEMALE CIRCUMCISION IN NIGERIAN IGBOS
Authors: Egwuatu V. E. , Agugua N. E. N.
Published: August 2005

An analysis is made of 43 children and 15 adult female patients who presented with post‐circumcision complications at the University of Nigeria Teaching Hospital, Enugu, between January 1973 and December 1980; 57 patients had been circumcised within 21 days of birth and one patient in the seventh month of her first pregnancy. Age of presentation varied with the severity of the symptoms: 21 children and 11 adults presented with varying degrees of labial occlusion, while 9 children and 4 adults had implantation dermoids. Urinary retention was the problem in 12 children and one adult
THE EFFECT OF MATERNAL WEIGHT ON MATERNAL SERUM ALPHA‐FETOPROTEIN LEVELS
Authors: Wald Nicholas , Cuckle Howard , Boreham Jillian , Terzian Emanuela , Redman Christopher
Published: August 2005

In 902 singleton pregnancies, maternal serum alpha‐fetoprotein (AFP) levels between 15 and 20 weeks of pregnancy were significantly related to maternal weight (r =−0.24, p <0.0001). Lighter women had on average higher AFP levels than heavier women, perhaps on account of the greater concentration of AFP in their relatively smaller volume of blood. The mean AFP level for women weighing less than 45 kg was 68 % higher than the mean level for women weighing 85 kg or more. Maternal weight was found to be an important factor which could account for false positive AFP results in antenatal screening for open neural tube defects. A policy of adjusting maternal serum AFP values according to maternal weight among women with borderline positive results could reduce the number having a diagnostic amniocentesis with only a negligible loss of detection for open spina bifida. With such a policy, using a cut‐off level of 2.5 × normal median, the false positive rate in the 902 women screened would have been reduced from 2.8 % to 2.0%.
MATERNAL PLASMA 6‐OXO‐PROSTAGLANDIN F1α LEVELS THROUGHOUT PREGNANCY: A LONGITUDINAL STUDY
Authors: Bolton P. J. , Jogee M. , Myatt L. , Elder M. G.
Published: August 2005

Serial measurements of maternal plasma concentrations of 6‐oxo‐prostaglandin F1α were made throughout 12 normal pregnancies. The highest levels were found during the second trimester with a progressive decline during the second half of pregnancy.
BLOOD LOSS AND SIDE EFFECTS IN DAY CASE ABORTION
Authors: Cochrane G. W. , Moore C. A. , Swinhoe June R. , Subramanian N. , Chakrabarti P.
Published: August 2005

Suction termination of pregnancy was performed in 276 patients as an out‐patient procedure under general anaesthesia. Ergometrine, oxytocin, or sterile water were given with the induction of anaesthesia. There was no significant difference in blood loss in the three treatment groups, although blood loss in termination of pregnancy performed after eight weeks was increased in all three groups. Nausea, vomiting and abdominal pain occurred significantly more often after ergometrine compared to oxytocin or water.
CHLAMYDIA TRACHOMATIS AND HERPES SIMPLEX VIRUS IgA ANTIBODIES IN CERVICAL SECRETIONS OF PATIENTS WITH CERVICAL ATYPIA
Authors: Kalimo Kirsti , Terho P. , Honkonen E. , Grönroos M. , Halonen P.
Published: August 2005

The association of Chlamydia trachomatis (CT) and herpes simplex virus (HSV) with malignant or premalignant changes in the cervix uteri was studied by determining immunoglobulin A (IgA) antibodies in the cervical secretions of 28 women with inflammatory, 28 with dysplastic, 7 with malignant changes of the uterine cervix, and 26 healthy controls. In cervical secretions IgA antibodies to CT were found in 24 of 35 (69%) patients with malignant or premalignant changes, in 11 of 28 (39%) with cervicitis and in 3 of 26 (12%) controls. IgA antibodies to HSV were found in 10 of 35 (28%) patients with malignant atypia or dysplasia but in none of the women with cervicitis or the controls. The highest frequency of antibodies was found in the patients with cervical carcinoma. Serum IgA antibodies to CT and HSV were found equally in the patients and the controls. Our results suggest that in patients with cervical atypia, local IgA CT antibody production occurs. Whether this association is aetiological or coincidental can not be concluded from this study.
THIRTY‐TWO YEARS EXPERIENCE IN MANAGEMENT OF PRIMARY TUMOURS OF THE VAGINA
Authors: Al‐Kurdi M. , Monaghan J. M.
Published: August 2005

A retrospective study is presented of 99 patients with a diagnosis of primary tumour of the vagina who were managed at the Gynaecological Oncology Department, Queen Elizabeth Hospital, Gateshead, between the years 1947 and 1979. The lesions have been staged according to the FIGO system. The corrected five year survival rates for patients given definitive treatment were: stage I, 71 % (10 of 14), stage II, 29 % (10 of 34), stage III, 25 % (2 of 8), stage IV, 22 % (2 of 9). The overall corrected five year survival rate when definitive treatment was given was 37 % (24 of 65).
VAGINAL STENOSIS DUE TO BULLOUS ERYTHEMA MULTIFORME (STEVENS‐JOHNSON SYNDROME)
Authors: Graham‐Brown R. A. C. , Cochrane G. W. , Swinhoe J. R. , Sarkany I. , Epsztejn L. J.
Published: August 2005

Bullous erythema multiforme is a disorder in which oral and genital erosions, ocular inflammation and cutaneous bullae may follow a viral or bacterial infection or the ingestion of certain drugs, such as sulphonamides. Unpleasant sequelae have been reported including residual scarring, and death may occasionally result from infection or renal failure; severe scarring can cause blindness and infrequently the genital tract is involved. We report a patient who developed complete vaginal stenosis following bullous erythema multiforme in pregnancy.
SPONTANEOUS BACTERIAL PERITONITIS DURING PREGNANCY
Authors: Browne M. K. , Cassie R.
Published: August 2005

A patient is described with spontaneous bacterial peritonitis occurring at 27 weeks gestation. The causative organism was a Group B haemolytic Streptococcus which was also found in blood culture and in the vagina. The possible mechanisms of this rare infection are described.
MORPHOLOGICAL CHANGES OF THE SPIRAL ARTERIES IN THE PLACENTAE BED IN RELATION TO PRE‐ECLAMPSIA AND FETAL GROWTH RETARDATION
Authors: Gerretsen G. , Huisjes H. J. , Elema J. D.
Published: August 2005

The spiral arteries at the level of the decidual‐myometrial junction in the placental bed were examined histologically in 93 biopsies. Of these, 23 originated from normal uncomplicated pregnancies, 30 from pre‐eclamptic and 40 from otherwise complicated pregnancies. The association of the‘physiological changes’ of the spiral artery with uncomplicated pregnancy and their absence in pre‐eclampsia, as noted by Brosens and others, has been confirmed. In addition, in pregnancies without pre‐eclampsia, these changes were significantly more often absent with fetal growth retardation. The hypothesis is put forward that hypertension of pregnancy is a compensatory mechanism to ensure an adequate blood supply to the placenta when the‘physiological changes’ fail to occur.
THE RELATION OF CIRCULATING PROGESTERONE AND OESTRADIOL CONCENTRATIONS TO THE ONSET OF MENSTRUATION
Authors: Godfrey K. A. , Aspillaga M. O. , Taylor A. , Lind T.
Published: August 2005

Forty patients have been studied over 96 menstrual cycles during which a blood sample was obtained within five days of the next menstrual period. Two features emerged: circulating concentrations of progesterone and oestradiol could be elevated on the day bleeding began and conversely the levels of these hormones could be low for some days without menstruation occurring. These data suggest there may not be any direct relation between circulating ovarian hormone levels and the onset of menstrual bleeding.
OESTRADIOL: THE PREDOMINANT INTRANUCLEAR OESTROGEN IN THE ENDOMETRIUM OF OESTROGEN‐TREATED POSTMENOPAUSAL WOMEN
Authors: Whitehead M. I. , Lane G. , Dyer G. , Townsend P. T. , Collins W. P. , King R. J. B.
Published: August 2005

Intracellular oestrogen metabolism has been investigated in endometrial tissue from postmenopausal women receiving oestrogen therapy either alone or in combination with a progestogen. During oestrogen therapy alone, there was a 3·2 fold predominance of oestradiol over oestrone within the endometrial cell nucleus and the mean nuclear oestrogen receptor content was 1·40 pmol/mg DNA. The addition of norethisterone decreased the nuclear oestradiol/oestrone ratio to 1–4:1 by lowering the oestradiol mass. A concurrent reduction in the mean level of the nuclear oestrogen receptor to 0·58 pmol/mg DNA indicated a decrease in oestro‐genic stimulation. The activity of oestradiol‐17β dehydrogenase was significantly increased. There was a plasma excess of oestrone over oestradiol during oestrogen therapy alone and the oestrone/oestradiol ratio was not significantly altered following norethisterone administration. The ability of the endometrium to incorporate oestradiol selectively into the nucleus is discussed in relation to the risk of endometrial hyperplasia with unopposed oestrogen therapy. The profound biochemical changes induced by norethisterone help elucidate mechanisms whereby progestogens lower oestrogenic potency and thereby protect the endometrium against excessive stimulation.
SPONTANEOUS PNEUMOMEDIASTINUM IN PREGNANCY
Authors: Crean P. A. , Stronge J. M. , Fitzgerald M. X.
Published: August 2005

A primagravida developed pneumomediastinum in the second stage of labour. This was the first case recorded in approximately 100 000 deliveries at the National Maternity Hospital Dublin. The literature is reviewed.
Cervical ripening with dehydroepiandrosterone sulphate
Authors: SASAKI K. , NAKANO R. , KADOYA Y. , IWAO M. , SHIMA K. , SOWA M.
Published: August 2005

Summary. Dehydroepiandrosterone sulphate (DHEA‐S) was given intravenously twice a week after 38 weeks gestation to ripen the uterine cervix in 20 nulliparae and 24 parous women who subsequently went into labour at term. The condition of the uterine cervix was assessed by Bishop scoring. The increase in the score in nulliparous women given DHEA‐S was significantly greater than that in the control group, who were given placebo injections, on the 7th, 14th and 21st days. The increase in the parous women was significant only on the 7th day. In nulliparous women the dilatation, effacement and consistency improved significantly, while in the parous women the effect of DHEA‐S was apparent only in the consistency. The duration of labour was significantly shortened by treatment with DHEA‐S in nulliparae but this effect was not found in parous women. The interval between the first administration of DHEA‐S and the onset of labour in nulliparae was significantly shorter than that in the control group. There were no serious side effects or complications. Our results suggest that DHEA‐S may be used safely and effectively to ripen the uterine cervix and to trigger the onset of labour in late pregnancy.
Blood levels of proteinase inhibitors in pregnancy
Authors: WALKER J. E. , CAMPBELL D. M. , OGSTON D.
Published: August 2005

Summary.Plasma volume, serum α2‐macroglobulin, α1‐antitrypsin, Cï inactivator and α2‐antiplasmin, and plasma antithrombin III were measured in 10 pregnant women at gestation periods of 12–14 and 37–38 weeks. The proteinase inhibitors were also measured in 10 non‐pregnant healthy women. There was a significant increase in the α1‐antitrypsin concentration and significant decreases in α2‐macroglobulin and Cï inactivator, but the total circulating quantity of all the proteinase inhibitors was significantly increased.
A randomized double‐blind cross‐over trial into the effect of norethisterone on climacteric symptoms and biochemical profiles
Authors: PATERSON M. E. L.
Published: August 2005

Summary. A randomized double‐blind cross‐over study into the effect of northisterone on climacteric symptoms was performed on 23 postmenopausal women. Active therapy resulted in a significant reduction in the number and severity of hot flushes and night sweats. There was also a slight improvement in memory, insomnia and lack of energy but the other climacteric symptoms were not consistently altered. Side effects were minimal. There was a significant reduction in serum calcium, alkaline phosphatase, cholesterol, triglycerides, follicle‐stimulating hormone and luteinizing hormone levels. There was a variable effect on serum creatinine and urea but there was no significant alteration in the other biochemical profiles, liver‐function tests, weight or blood pressure.
Use of dextrans for the prevention of postoperative peritubal adhesions in rabbits
Authors: VEMER H. M. , BOECKX W. , BROSENS I.
Published: August 2005

Summary. Saline, 6% or 32% dextran was instilled into the peritoneal cavity of rabbits after salpingostomy of experimentally induced hydrosalpinx. Moderate or severe adhesions recurred in 40% of rabbits. Adhesions occurred with similar frequency in the three treatment groups.
Evidence for an association between Chlamydia trachomatis and cervical intraepithelial neoplasia
Authors: HARE M. J. , TAYLOR‐ROBINSON D. , COOPER PAULINE
Published: August 2005

Summary. Attempts were made to isolate Chlamydia trachomatis, Mycoplasma hominis and Ureaplasma urealyticum from women with cervical intraepithelial neoplasia (CIN), from those with microinvasive or invasive cervical cancer, and from a control group of similar women with other gynaecological problems. C. trachomatis was found in a significantly greater proportion of women with CIN (8%) or cervical cancer (18%) than in the control group (1%), whereas M. hominis and U. urealyticum were approximately as common in each group. Histological examination of the cervix in cone biopsies or hysterectomy specimens from 26 women with CIN and from 39 women of similar age with no evidence of CIN showed lymphoid follicles, previously reported to be associated with chlamydial infection, in nine of the specimens with CIN, but in none of the specimens without CIN.
Rotational delivery of the fetus: Kielland's forceps and two other methods compared
Authors: HEALY D. L. , QUINN M. A. , PEPPERELL R. J.
Published: August 2005

Summary. A retrospective comparison was undertaken of 552 cases in which Kielland's forceps were used for rotation and delivery, 95 cases in which other forceps were used for rotation and delivery, and 160 cases in which manual rotation and forceps were used. There was no significant difference in maternal or fetal morbidity between the three groups, regardless of whether the indication for delivery was delay in the second stage of labour or fetal distress. When Kielland's forceps were used by junior staff, significantly more vaginal and cervical lacerations and primary postpartum haemorrhage occurred, but there was no increase in fetal morbidity.
Body weight, exercise and menstrual status among ballet dancers in training
Authors: ABRAHAM SUZANNE F. , BEUMONT P. J. V. , FRASER I. S. , LLEWELLYN‐JONES DEREK
Published: August 2005

Summary. A prospective study of the menstrual pattern and weight changes was made in the first year of training of 29 new female entrants to a professional ballet school. Seventy‐nine per cent of the student girls had menstrual disturbances at entry: primary amenorrhoea, four; secondary amenorrhoea, 11; irregular menses, eight. The incidence of secondary amenorrhoea increase substantially by the end of the year (20), but was not associated with any significant change in body weight. Only three students menstruated regularly during the year. Menstrual regularity improved during periods of injury and long vacation and it appears that deterioration of the menstrual pattern during dancing periods was related to strenuous physical exercise rather than to any change in body weight.
Pituitary function in young women in a reformatory institution
Authors: ADAMOPOULO D. A. , IERAPETRITAKIS G. , KAPOLLA N.
Published: August 2005

Summary. Pituitary function was assessed by measuring serum prolactin thyroid stimulating hormone (TSH), follicle stimulating hormone (FSH) and luteinizing hormone (LH) before and after LH releasing hormone (LH‐RH) (lOO mg intravenously) and sulpiride (lOO mg intramuscularly) administration in 13 young women in a reformatory institution, and in six employees of the same establishment with regular cycles, serving as control group. Ovarian endocrine activity was assessed with basal oestradiol estimations. Seven out of the 13 restricted women had secondary amenorrhoea that began shortly after their imprisonment and six had regular cycles. Basal oestradiol concentration was similar in the three groups of women studied. Basal prolactin concentration was also similar in the three groups, but prolactin response to sulpiride was significantly higher in the control group than that in either group of inmates. Basal FSH, LH and TSH concentrations as well as FSH and TSH responses were not different in the three groups, but the LH response to LH‐RH was significantly higher in the group of inmates with amenorrhoea than that in the two remaining groups.
Fetal growth delay in threatened abortion: an ultrasound study
Authors: MANTONI MARGIT , PEDERSEN JAN FOG
Published: August 2005

Summary. Out of 255 patients with threatened abortion 67 gave a regular menstrual history and at ultrasound examination had a live fetus with a crown‐rump length (CRL) of 10‐65 mm, equivalent to a gestational age of 7‐13 weeks. The CRL of these fetuses was smaller than expected from their menstrual age (P < 0.01). For this phenomenon we suggest the term early fetal growth delay. Seven patients aborted and one experienced intra‐uterine fetal death. These eight fetuses had on average smaller CRL than the remainder 59 fetuses (P < 0.05). Fetal growth delay may therefore be considered a risk factor in threatened abortion.
Human chorionic gonadothropin levels in maternal blood in late pregnancy: relation to birth weight, sex and condition of the infant at birth
Authors: OBIEKWE B. C. , CHARD T.
Published: August 2005

Summary. A total of 527 blood samples was obtained from an unselected population of women between 36 and 40 weeks gestation. Serum human chorionic gonadotrophin (hCG) levels were measured using a specific radioimmunoassay for the (β1‐subunit of hCG. Serum hCG levels were higher in primigravidae and in women carrying female fetuses. They were also related to the birthweight of the child and to the occurrence of fetal distress.
Antenatal detection of growth retardation: actual practice in a large maternity hospital
Authors: ROSENBERG KATHRYN , GRANT J. M. , HEPBURN MARY
Published: August 2005

Summary. A retrospective analysis of the antenatal management of 226 cases of growth retardation was carried out. One‐hundred‐and‐fourteen cases (50%) were not suspected antenatally. Of the 112 suspected cases, 107 were subjected to further tests of fetal well‐being. Eighty‐one (72%) of the 112 received no further action or surveillance because of erroneously reassuring results or no further tests. Thirty‐one women were either admitted antenatally (15) or delivered early (16). The low rate of initial suspicion combined with the disappointing results of the further tests emphasizes the need for more accurate screening procedures for growth‐retarded babies.
Pregnancies in women with hyperprolactinaemia: obstetric and endocrinological management of 50 pregnancies in 37 women
Authors: RANDALL S. , LAING I. , CHAPMAN A. J. , SHALET S. M. , BEARDWELL C. G. , KELLY W. F. , DAVIES D.
Published: August 2005

Summary. Fifty pregnancies occurred in 37 women with hyperprolactinaemia. Thirty women (81%) initially attended with infertility and 24 (65%) had secondary amenorrhoea. Twelve women (31%) had pituitary macroadenomas, of whom seven (19%) were treated with neurosurgery and/or external radiotherapy before conception. Fortyone conceptions (82%) followed treatment with bromocriptine. There were no unusual obstetric or endocrinological complications. Scrum prolactin measured at least 6 months post partum when under basal conditions, without bromocriptine and not breast feeding, showed no significant trends compared with initial values. Tumour growth was not stimulated by the high oestrogen levels of pregnancy.
Neurological normality after extreme birth asphyxia
Authors: FYSH W. J. , TURNER G. M. , DUNN P. M.
Published: August 2005

Summary. A case of extremely severe birth asphyxia is reported. In spite of successful resuscitation the arterial pH was still only 6.6 at the age of 1 h. Assessment at 3 years 10 months revealed that the child was not only completely normal, but was of superior intelligence. This case demonstrates the advisability of maintaining an optimistic approach even when very severe fetal acidosis is detected around the time of birth.
Predictive value of cervimetric labour patterns in primigravidae
Authors: CARDOZO L. D. , GIBB D. M. F. , STUDD J. W. W. , VASANT R. V. , COOPER D. J.
Published: August 2005

Summary. From a study of 2000 consecutive labours the outcome of the 684 primigravid patients admitted in spontaneous labour has been examined according to their cervimetric progress during the first stage of labour. A partogram and labour stencil were used to identify dysfunctional labour which was treated with a standard protocol of augmentation by oxytocin. This policy achieved labours with a mean‘observed first stage’ of 6.3 h and a caesarean section rate of 8.7%. There was one stillbirth due to multiple congenital abnormalities and no increase in perinatal morbidity. Our data show that the type of first stage cervimetric pattern is helpful in predicting the outcome of labour. A normal cervimetric pattern resulted in a vaginal delivery rate of 98.4%; primary dysfunctional labour, which could be improved by oxytocin, had a 93.8% incidence of vaginal delivery, but if there was no improvement in the rate of cervical dilatation when this was administered the vaginal delivery rate was only 22.7%. A prolonged latent phase was associated with a caesarean section rate of 16.7% and the incidence of neonatal intubation was nearly as high as that found in uncorrected primary dysfunctional labour. The neonatal asphyxia in secondary arrest was minimal with an overall caesarean section rate of 28.4%; there was no increased incidence of neonatal morbidity with this cervimetric type.
Spontaneous labour: when should the membranes be ruptured?
Authors: STEWART P. , KENNEDY J. H. , CALDER A. A.
Published: August 2005

Summary. Sixty‐eight patients (32 multigravidae, 36 primigravidae) with intact membranes admitted in early spontaneous labour were studied. Patients were randomly allocated to two groups: group I had an immediate amniotomy and group II were allowed to retain their membranes intact until full dilatation. Early amniotomy significantly shortened the length of labour and reduced the need for augmentation and instrumental delivery. There were no differences between the two groups in fetal outcome as measured by Apgar scores, umbilical arterial and venous blood pH, neonatal jaundice or admission to the special‐care baby unit. Fetal heart‐rate recordings obtained in group I by applying a fetal electrode after amniotomy were of superior quality to those obtained in group II by ultrasound and were more suitable for interpretation.‘Normal’ and ‘suspicious’ tracings occurred equally in the two groups. Our results suggest some benefits from early amniotomy and no adverse effects on the fetus.
Circumstances influencing umbilical‐cord plasma catecholamines at delivery
Authors: FALCONER A. D. , LAKE D. M.
Published: August 2005

Summary. Blood gases and plasma catecholamines were measured in umbilical arterial and venous blood samples after delivery. In all cases umbilical arterial noradrenaline concentrations were higher than venous levels. The lowest concentrations of noradrenaline were found after elective cacsarean section. Vaginal delivery, particularly when accompanied by instrumental manipulation, was associated with significantly higher concentrations of arterial noradrenaline. High concentrations of catecholamines were commonly recorded in those deliveries showing evidence of acid‐base disturbance. Noradrenaline was the predominant catecholamine in all cases. A linear relation was demonstrated between arterial noradrenaline and arteriovenous noradrenaline difference.
Circulating antithrombins in pregnancy
Authors: TEISNER B. , DAVEY MARY W. , GRUDZINSKAS J. G.
Published: August 2005

Summary. In a cross‐sectional study circulating levels of antithrombins, antithrombin III1α‐antitrypsin and α2‐macroglobulin were measured in groups of 20 women before pregnancy, during each trimester and post partum. Blood levels of antithrombin III were signicantly lower, α1 antitrypsin higher and %aL2‐macroglobulin no different when compared with those of the non‐pregnant and puerperal states. These findings suggest that there may be not only an increase in total antithrombin production, but also a qualitative change in antithrombin‘activity’, the principal protein during pregnancy being α1‐antitrypsin.
Circulating placental proteins (hCG, SP1 and PP5) in trophoblastic disease
Authors: LEE J. N. , SALEM H. T. , CHARD T. , HUANG S. C. , OUYANG P. C.
Published: August 2005

Summary. Scrum human chorionic gonadotrophin (hCG), pregnancyspecific β1‐glycoprotein (SP1) and placental protein 5 (PP5) levels have been measured by radioimmunoassay in 20 patients (116 samples) with hydatidiform mole, one patient (nine samples) with invasive mole and 10 patients (103 samples) with choriocarcinoma. Measurement of both serum SP1 and hCG are useful in the monitoring of these diseases. The presence of PP5 in hydatidiform mole and its absence in choriocarcinoma support the hypothesis that PP5 is closely associated with the invasive activity of malignant trophoblast.
Down‐regulation of gonadotrophin secretion in postmenopausal women by a superactive LHRH analogue: lack of effect on menopausal flushing
Authors: LIGHTMAN STAFFORD L. , JACOBS HOWARD S. , MAGUIRE ANITA K.
Published: August 2005

Summary. The effect of the LHRH analogue D‐Ser (TBU)6‐EA10‐LRH (Hoe 766) on the response of plasma gonadotrophins and the frequency of climacteric flushing was studied in five postmenopausal women. Following an initial stimulatory effect on gonadotrophin secretion plasma gondotrophins returned to near baseline concentrations with loss of their pattern of pulsatile release and of their sensitivity to exogenous LHRH. The frequency of flushing was unaltered during the treatment period.
Plasma progesterone in the umbilical vessels at vaginal delivery of term infants
Authors: MAYNARD P. V. , HEYES VIVIEN M. , SHAXTED E. J.
Published: August 2005

Summary. The influence of stress and related factors on umbilical‐cord vessel progesterone concentrations have been investigated in 150 vaginal deliveries. Cord vein progesterone levels were greater in breech deliveries than in forceps deliveries and in vaginal deliveries by maternal effort alone. Within the forceps group there was no difference in cord vessel progesterone concentrations between lift‐out, mid‐cavity or rotational forceps deliveries. Levels of progesterone were significantly greater in forceps deliveries where the infant was clinically distressed (P<0.01). Similarly, within the normal group progesterone levels were greater in a stressed group of infants, where cord vein pH, artery pH, Apgar score at 1 min or birthweight fell below the 10th centile for the study group. No differences in plasma progesterone concentration were found with labour commencing spontaneously or by induction, nor did the sex of the infant appear to influence this hormone. Progesterone levels were higher in samples from primiparae than in those from multiparae due to a small number of primiparae who had excessively long labours and high progesterone concentrations. There was, however, no strong statistical correlation between length of labour and progesterone concentrations.
Does oral iron supplementation have an erythropoietic effect?
Authors: TAYLOR DAVID J. , MALLEN CAROL , LIND TOM
Published: August 2005

Summary. Haematological indices and serum ferritin were measured for 6 months in 20 healthy non‐pregnant women, nine of whom took oral iron supplements. Whereas the mean serum ferritin concentration increased from 16.2 μg/1 to 41.7 μg/1 during oral iron supplementation, the mean haemoglobin concentration remained unchanged at 13.5g/dl. No stimulatory action of iron on erythropoiesis could be demonstrated.
Effect of iron supplementation on serum ferritin levels during and after pregnancy
Authors: TAYLOR DAVID J. , MALLEN CAROL , McDOUGALL NEIL , LIND TOM
Published: August 2005

Summary. Serum ferritin, total plasma ferritin and haematological indices were determined during and for 6 months after normal pregnancy in 45 healthy women, 21 of whom took oral iron supplements. The physiological effect of pregnancy was to markedly depress serum ferritin concentration. During unsupplemented pregnancy median serum ferritin concentration decreased to approx. 6.0 μg/l by 28 weeks gestation, this concentration was maintained until term and was associated with the appearance of erythrocyte microcytosis during the third trimester. At 6 months postpartum, individual and average serum and total plasma ferritin values showed a deficit compared with the values recorded at the beginning of pregnancy. Oral iron supplementation during pregnancy modified the fall in serum ferritin, median serum ferritin concentrations remained about 14.0μg/I after 28 weeks gestation; normocytic erythropoiesis was maintained throughout the third trimester and no deficit in serum and total plasma ferritin occurred as a result of pregnancy. It is concluded that routine oral iron administration should be recommended during pregnancy, certainly after 28 weeks gestation.
Feto‐maternal surveillance in labour: a new approach with an on‐line microcomputer
Authors: TROMANS PHILIP M. , SHEEN MARTIN A. , BEAZLEY JOHN M.
Published: August 2005

Summary. A new method of real‐time computer surveillance during labour is described with a commercially available‘low‐cost’ microcomputer and integral video display unit (VDU). The fetal monitoring program gives accurate and reliable information on eight parameters of fetal and maternal wellbeing, four of which may be displayed simultaneously, with the facility of instant data recall. Emphasis is on simplicity of operation, and clarity of data display in the form of horizontal bar graphs updated at 5‐min intervals, with most recent information in numerical form. Flexibility of the system enables program modification with relative ease, and adaptation to two unmodified commercial electronic fetal monitors.
A randomized study comparing timolol and methyldopa in hospital treatment of puerperal hypertension
Authors: FTDLER JACK , SMITH VALERIE , DE SWIET MICHAEL
Published: August 2005

Summary. Treatment of puerperal hypertension (diastolic blood pressure 95–105 mm Hg) with methyldopa 750–3000 mg/day was compared with treatment with timolol 15–60 mg/day in a random trial of 80 patients. Within these dose ranges and over the period studied (9 days) both drugs appeared equally effective. Therefore, in the treatment of puerperal hypertension, timolol could be considered as a suitable alternative to methyldopa.
Plasma noradrenaline and adrenaline levels in normal pregnancy and in pregnancy‐induced hypertension
Authors: NATRAJAN P. G. , McGARRTGLE H. H. G. , LAWRENCE DAPHNE M. , LACHELIN GILLIAN C. L.
Published: August 2005

Summary. Plasma concentrations of noradrenaline and adrenaline were measured serially during normal pregnancy in 52 women who remained normotensive and in nine who developed pregnancy‐induced hypertension but were otherwise normal. There was a significant fall in both noradrenaline (P<0.005) and adrenaline (P<0.05) levels during normal pregnancy. Throughout pregnancy the mean levels of both catecholamines were lower in the patients who developed pregnancy‐induced hypertension than in the normotensive patients. There was no evidence of increased sympathetic nervous system activity in the women who developed pregnancy‐induced hypertension.
Effect of estimating gestational age by ultrasound cephalometry on the specificity of α‐fetoprotein screening for open neural‐tube defects
Authors: WALD NICHOLAS , CUCKLE HOWARD , BOREHAM JILLIAN , TURNBULL A. C.
Published: August 2005

Summary. A total of 1268 women had a maternal serum α‐fetoprotein (AFP) screening test for open neural‐tube defects between 15 and 22 weeks gestation and a routine ultrasound examination at their first antenatal visit. All had a singleton infant without a neural‐tube defect. AFP values were expressed as multiples of the normal median at the relevant gestational age (MoM). The percentage of women with raised maternal serum AFP levels was less when gestation was estimated by the fetal biparietal diameter (BPD) than when the time since the first day of the last menstrual period (LMP) was used; 1.8% compared with 2.3% at a serum AFP cut‐off level of 2.5 MoM. Different ultrasound policies were compared for their effect on AFP screening and the best was found to be routine BPD measurement used together with a higher cut‐off level than usual. For example, using a cut‐off level of 3.0 MoM the detection rate for open spina bifida at 16–18 weeks gestation would be about 88% and the proportion of unaffected singleton pregnancies with raised levels only 0.9%. These results are materially better than those achieved by a policy of scanning only those women with a raised AFP level (79% and 1.4% respectively with a more conventional cut‐off level of 2.5 MoM) or, in addition, scanning those with doubtful gestational ages (82% and 1.7% respectively with a cut‐off level of 2.5 MoM).
The breech head and its ultrasound significance
Authors: KASBY C. B. , POLL V.
Published: August 2005

Summary. Breech babies were shown to have a smaller mean biparietal diameter (BPD) neonatally compared with that of a matched group of vertex babies. This was due to a mild skull deformation which occurred in at least one‐third of 100 consecutive term breech babies examined. Features of this skull deformation (dolichocephaly, a prominent occiput with a suboccipital shelf, an elongated face and a parallel‐sided head) constitute the‘breech head’. The caliper‐determined occipitofrontal/biparietal diameter ratio (OFD/BPD) in these newborn infants was consistently above 1.30. This ratio, when calculated from sonar examination in the third trimester, was also found to correlate well with the‘breech head’ shape. The identification by ultrasound of these babies should prevent the misdiagnosis of fetal growth retardation based on serial BPD measurements alone.
A randomized controlled trial of complete bed rest versus ambulation in the management of proteinuric hypertension during pregnancy
Authors: MATHEWS D. D. , AGARWAL VASANTIKA , SHUTTLEWORTH T. P.
Published: August 2005

Summary. Forty patients participated in a randomized controlled trial of complete bed rest versus ambulation as desired in the management of proteinuric hypertension during pregnancy. Daily increases in serum human placental lactogen and oestriol concentrations were greater in the rested group. An especially‘at risk’ group of 10 patients with both hyperuricaemia and severe fetal growth retardation was identified. Strict confinement to bed in these cases seemed to encourage the development of the premonitory symptoms of eclampsia, but was associated with a better prognosis for the fetus.
Sex ratio of births resulting from artificial insemination
Authors: MORTIMER D. , RICHARDSON D. W.
Published: August 2005

Summary. A survey of available data has shown that the sex ratio of births is significantly affected both by the practice of artificial insemination (AI) and by the cryostorage of semen. Comparison of the sex ratio of all infants born in England, Scotland and Wales between 1969 and 1978 (51.5% males) with that of British births after AI showed that the prevalence rate of male births after AI with either fresh or cryostored semen was lower than that for the general population: fresh semen (47.8%); cryostored semen (42.9%). When data from European countries and the US were combined, AI with fresh semen significantly increased the prevalence rate of male infants to 57.7%, whereas AI with cryostored semen significantly decreased the rate to 49.7%. The mechanism/s whereby the cryostorage of spermatozoa affects the secondary sex ratio remains to be determined.
Sex ratio of live‐born Hausa infants
Authors: REHAN N. ‐E.
Published: August 2005

Summary. With data from the birth registry of the Katsina Local Government Authority, the sex ratio was calculated for 1113313 Hausa children born alive between 1961 and 1980. The sex ratio was 1.07, which is significantly higher than the usually accepted value (<1.04) for populations of African origin. There was no seasonal variation or apparent relation to coital frequency or gonadotrophin levels. The sex ratio in another set of data comprising 5780 hospital births was 1.17 for normal and 1.31 for complicated deliveries. The sex ratio did not appear to be influenced by maternal age or parity. This set of data point to some selective bias in hospital statistics.