bluuebunny/crossref_metadata_2025 huggingface dataset:
Nausea and vomiting and dietary cravings and aversions during pregnancy in South African women
Authors: WALKER A. R. P. , WALKER B. F. , JONES J. , VERARDI M. , WALKER C.
Published: August 2005

Summary. Frequency and severity of nausea and of vomiting during pregnancy, and of pronounced dietary cravings and aversions, were determined in a series of South African rural and urban black, Indian, coloured (European‐African‐Malay) and white women. Frequency of severe nausea ranged from 3.8% in rural blacks to 19.8% in white women, and of severe vomiting from 3.1% in rural blacks to 17.8% in white and Indian women. Proportions in the other groups were intermediate. Pronounced cravings, claimed by 67–84% in the various groups, included sour, savoury and sweet foods, also fruit and milk. Aversions were claimed by 45–81% of the women in the different groups with meat, fish, coffee and fatty foods, the foods most often avoided. Pica, the consumption of such substances as earth, clay, varied ethnically and regionally; frequency was high in rural and urban black women (44.0% and 38.3%), but much lower (5%) in Indian, coloured and white women.
Microaerophilic/anaerobic bacteria as a cause of urinary tract infection in pregnancy
Authors: BARR J. G. , RITCHIE J. W. K. , HENRY O. , EL SHEIKH M. , EL DEEB K.
Published: August 2005

Summary. The involvement of microaerophilic/anaerobic bacteria as a cause of urinary tract infection was investigated by appropriate culture of urine samples obtained after periurethral toilet from 48 pregnant women admitted to hospital with urinary tract symptoms. Significant bacterial counts were demonstrated in 28 of these patients; 24 were due to microaerophilic/anaerobic organisms, and the remaining four were due to established urinary pathogens. In 25 pregnant women admitted without urinary tract symptoms, who were used as controls, four had significant bacterial counts, all of which were due to microaerophilic/anaerobic organisms. It is concluded that these organisms may be responsible for urinary tract symptoms in pregnant women when no significant growth is demonstrated on urinary culture by conventional methods.
Increased sensitivity to thromboplastin synthesis in blood monocytes from pre‐eclamptic patients
Authors: ØIAN PÄL , OMSJØ IVAR , MALTAU JAN MARTIN , ØSTERUD BJARNE
Published: August 2005

Summary. The thromboplastin activity in blood monocytes was investigated in third‐trimester pregnancies comprising 11 patients with severe pre‐eclampsia, 10 with essential hypertension and 18 normal pregnancies. Thromboplastin activity in unstimulated monocytes from the severe pre‐eclamptic group was on average three times that found in the normal pregnant group, but variation was wide and the differences were not statistically significant. Thromboplastin activity in endotoxin‐stimulated monocytes was significantly higher in the severe pre‐eclamptic group than in the other two groups (normal and chronic hypertensive). In the severe pre‐eclamptic group, there was a significant negative linear correlation between thromboplastin activity of the endotoxin‐stimulated monocytes and factor VII. Fibrinogen, factor VII and α2‐antiplasmin were significantly lower in the severe pre‐eclamptic group than in the normal pregnant group, whereas no differences were observed in factors V, VIII, AT‐III and prekallikrein.
The role of cytoreductive surgery in advanced carcinoma of the ovary: an analysis of primary and second surgery
Authors: WILTSHAW E. , RAJU KANKIPATT S. , DAWSON I.
Published: August 2005

Second operations were performed as part of planned management in 53 patients 5–7 months after starting apparently successful chemotherapy. The survival of these patients is compared with 56 other patients who did not have a second laparotomy but appeared t o be responding to chemotherapy equally well. Survival advantage was seen for those who had a partial remission followed by a further debulking procedure later. However, those patients who have a clinical complete remission do not seem to benefit from a second surgical intervention.
Catecholamine responses to changes in posture during human pregnancy
Authors: WHITTAKER P. G. , GERRARD JEAN , LIND T.
Published: August 2005

Summary. Human pregnancy may induce changes in the sensitivity of the cardiovascular system to endogenous catecholamines. This was investigated in multigravid women with little likelihood of unsuspected vascular disease. Txe responses of blood pressure, pulse rate, plasma noradrenaline and adrenaline to a change in posture from semi‐decumbency to standing were assessed in six normotensive women at 36 weeks gestation and in six non‐pregnant control subjects. Standing for 10 min caused a surge in blood pressure, pulse rate and plasma noradrenaline in non‐pregnant women. The pregnant women, whose basal levels of noradrenaline were higher than those in non‐pregnant women, showed a slower noradrenergic response to postural change, and this response had less effect upon the cardiovascular indices. Blood pressure dropped immediately on standing and pulse rate remained unaffected throughout. It is suggested that some women may maintain a non‐pregnant level of pressor sensitivity during pregnancy and thereby become hypertensive.
Quantitative measurement of fetal blood flow using Doppler ultrasound.
Authors: ERSKINE R. L. A. , RITCHIE J. W. K.
Published: August 2005

Summary. Blood flow in the descending human fetal aorta and in the intra‐abdominal portion of the umbilical vein was quantified using pulsed Doppler ultrasound in a longitudinal series of normal pregnancies. the accuracy of the method having been verified in vitro. The results obtained are in keeping with previous studies but indicate that, although the method is relatively simple, determination of absolute blood flow in these vessels has little clinical potential because of inherent measurement inaccuracies.
Umbilical artery blood flow characteristics in normal and growth‐retarded fetuses.
Authors: EKSKINE R. L. A. , RITCHIE J. W. K.
Published: August 2005

Summary. Time‐velocity waveforms or sonograms obtained by pulsed Doppler ultrasound from the umbilical artery were analysed in a longitudinal study o f 15 normal pregnancies. The sonograms from nine fetuses with intrauterine growth retardation were compared qualitatively and had quite different characteristics implying a high distal impedance to blood flow. Methods of analysis capable of differentiating between the normal and abnormal sonograms are described and discussed.
Fetal plasma renin and renin substrate in mid‐trimester pregnancy
Authors: SYMONDS E. M. , CRAVEN D. J. , RODECK C. H.
Published: August 2005

Summary. Blood samples were obtained by fetoscopy from 30 fetuses in the middle trimester of pregnancy. The results indicate that high concentrations of renin and relatively low levels of renin substrate are present in the fetus early in pregnancy. These values are similar to those previously demonstrated in the full‐term fetus.
A practical assessment of ultrasound‐guided transcervical aspiration of chorionic villi and subsequent chromosomal analysis
Authors: MAXWELL D. , CZEPULKOWSKI B. H. , HEATON D. E. , COLEMAN D. V. , LILFORD R.
Published: August 2005

Summary. Aspiration biopsy of trophoblastic villi was performed on 56 patients immediately preceding suction termination of pregnancy, using a malleable metal cannula and ultrasound guidance. Villi were obtained from 47 patients (84%), with sampling success rising to 93% after experience. Immediate complications were noted in 14% of patients and correlated with placental positions situated furthest from the cervical canal. Karyotyping from cultured and/or direct preparations was attempted on the villus samples and was successful in 42. Clarity of the karyotypes obtained from direct preparations in this series was not found to be adequate for diagnostic purposes. A number of practical suggestions which facilitate chorion villus sampling are described.
Ultrasound demonstration of increased frequency of functional ovarian cysts in women using progestogen‐only oral contraception
Authors: TAYOB YUNUS , ADAMS JUDITH , JACOBS H. S. , GUILLEBAUD JOHN
Published: August 2005

Summary. Asymptomatic volunteer women with a regular pattern of uterine bleeding and using the progestogen‐only oral contraceptive pill were compared with control women who were not exposed to hormones. Pelvic ultrasound scanning at the end of the next bleeding episode after recruitment demonstrated functional cysts with maximum diameters ranging between 30 and 58 mm in eight of the 21 pill users, four of whom also had palpable ovaries, three cysts regressed during the next cycle. Of the 13 women with normal ovaries initially, four developed a new functional cyst of which two were associated with pain. Of the 12 women with cysts seven complained of pain at some time during the monitored cycle. Among 21 control women only one symptom‐free (42 mm) cyst was shown on the initial postmenstrual ultrasound scan and this resolved painlessly during the scanned cycle with ovulation from the opposite ovary. Ovulation was also demonstrated in 16 of the remainder; but in none of the three control women who developed asymptomatic functional cysts (35–47 mm in size) while under observation. Since 11 of the 14 pill‐users who failed to ovulate also had a functional cyst, the contraceptive efficacy may depend in part on this association. Pain symptoms may make the method less acceptable and give rise to diagnostic problems and inappropriate therapies.
Infant outcome following mid‐trimester amniocentesis: development and physical status at age six months
Authors: FINEGAN JO‐ANNE K. , QUARRINGTON BRUCE J. , HUGHES HELEN E. , RUDD NOREEN L. , STEVENS LINDA J. , WEKSBERG ROSANNA , DORAN TERENCE A.
Published: August 2005

Summary. Ninety‐one infants whose mothers had had amniocentesis, because age increased their risk for a fetal chromosome abnormality, were compared with 53 infants whose mothers chose not to have the test. Mental and motor development and temperament were studied to assess potential influence of amniocentesis on the brain. Physical growth was assessed and the infants were examined for orthopaedic abnormalities and needle injury. The results indicated that amniocentesis does not appear to influence infant mental and motor development, temperament, physical growth or the risk of orthopaedic abnormalities. However, amniocentesis is not entirely free of risk because several of the infants had needle marks. Reassessment of the cohort at age 4 and 7 years and will provide information on the potential longer term consequences of mid‐trimester amniocentesis.
Echocardiography in the investigation of anterior abdominal wall defects in the fetus
Authors: CRAWFORD DIANE C. , CHAPMAN MICHAEL G. , ALLAN LINDSEY D.
Published: August 2005

Summary. Of 20 pregnancies referred for fetal echocardiography with a diagnosis of anterior abdominal wall defect, congenital heart disease was present in eight of the 17 with exomphalos and in none of the three with gastroschisis. Four of these eight affected pregnancies were terminated because trisomy 18 was diagnosed, of the remaining four, only one baby survived infancy. We conclude that ultrasound investigation of the fetal heart is an important part of the diagnostic assessment of anterior abdominal wall defect if an accurate prognosis and appropriate obstetric management are to be provided.
Cortisol concentrations in the umbilical artery and vein of breech‐presenting infants at term in relation to the method of delivery
Authors: FARQUHARSON R. G. , DYAS J. , PIERREPOINT C. G.
Published: August 2005

Summary. Umbilical cord artery and vein cortisol levels and cord artery pH were measured in 32 breech deliveries. There was no detectable increase in fetal cortisol output in relation to fetal acidosis. It is considered t h a t elevation of fetal cortisol levels is caused by maternal transfer of this hormone transplacentally during stressful delivery rather than by enhanced fetal adrenal activity.
The effect of oxytocin infusion on uterine activity levels in slow labour
Authors: STEER P. J. , CARTER M. C. , BEARD R. W.
Published: August 2005

Summary. Uterine activity was studied in 31 women who were progressing slowly in spontaneous labour. In 75%, levels of uterine activity were below the tenth centile for normal spontaneous labour (mean uterine activity integral, UAI, 593 kPas/15 min; SD 296). Following oxytocin infusion, there was a significant increase in uterine activity to a mean of 1124 kPas/15 min (SD 276), which was t h e same as in normal spontaneous labour. The response t o oxytocin was dependent upon the pre‐existing level of uterine activity, and sensitivity to oxytocin, rather than the dose rate; 84% responded t o infusion rates of < 8 mU/min. The response t o oxytocin was best expressed in terms of active contraction area (uterine activity integral, UAI) or Montevideo units, rather than the frequency or active pressure of contractions. The rate of cervical dilatation following oxytocin augmentation could not be predicted either by t h e increase in uterine activity or by the actual level of activity achieved.
Non‐stress antenatal cardiotocography—a prospective blind study
Authors: KIDD L. C. , PATEL N. B. , SMITH R.
Published: August 2005

Summary. A prospective blind study of non‐stress antenatal cardiotocography was undertaken in a group of 216 ‘high risk’ pregnancies. The ‘Cardiff’ scores and the outcome of t h c pregnancies were compared subsequently. Low scores were associated with infants that were small‐for‐gestational age and fetal distress in labour, while high scores were associated with normal intrauterine growth. Although antepartum cardiotocography is predictive of fetal and neonatal outcome the extent to which its availability will prevent adverse outcome appears limited.
Non‐stress antenatal cardiotocography‐a prospective randomized clinical trial
Authors: KIDD L. C. , PATEL N. B. , SMITH R.
Published: August 2005

Summary. A randomized controlled trial examined the effects of non‐stress antepartum cardiotocography on obstetric management and assessed its usefulness as a diagnostic test of fetal compromise. Daily cardiotocograph recordings were made in 396 antenatal patients at increased risk of fetal compromise but were withheld from the clinicians responsible for care in half the cases. The frequency of intrapartum fetal distress and low Apgar score was similar in the two groups. The three normally‐formed perinatal deaths all occurred in the revealed group but in only one case could earlier obstetric intervention have altered the outcome. Availability of non‐stress cardiotocography was not associated with an increased rate of induction of labour or caesarean section.
Pain relief after episiotomy‐a comparative study of suprofen and dihydrocodeine
Authors: WALTERS B. N. J. , SMITH V. A. , DE SWIET M. , MUSTILL T. A.
Published: August 2005

Summary. In a single‐dose, randomized. double‐blind study of 100 women, suprofen and dihydrocodeine were compared in the relief of pain after episiotomy. The drugs were equal in terms of analgesic efficacy, duration of analgesia and onset of action. Neither drug demonstrated any serious adverse effects.
Is bladder catheterization really necessary before laparoscopy?
Authors: AKHTAR M. S. , BEERE D. M. , WRIGHT J. T. , MacRAE K. D.
Published: August 2005

Summary. A randomized prospective controlled trial compared a policy of bladder catheterization with no catheterization in patients undergoing laparoscopy. Of the 41 patients randomized to receive no catheterization, seven were actually catheterized on the judgment of the surgeon, but only one of them had <50 ml of urine. Midstream urine obtained 6 days after laparoscopy was infected in 9 (21%) of the 42 patients allocated to receive catheterization and in only five (12%) of those allocated to the no‐catheter group. Four of these five were actually not catheterized, giving an infection rate of 12% in the 34 patients not catheterized. The differences are statistically significant. A routine policy of catheterization for patients undergoing laparoscopy is questionable. All patients who are catheterized should be investigated for urinary tract infections after operation.
Debendox revisited
Authors: ELBOURNE DIANA , MUTCH LESLEY , DAUNCEY MARJORIE , CAMPBELL HUBERT , SAMPHIER MICHAEL
Published: August 2005

Summary. Two further studies re‐examine the findings by Golding et al. (1983) in Oxford that mothers of children born with oral clefts had been more frequently prescribed Debendox (Bendectin) than had the mothers of matched controls. In Cardiff, 86 283 total births between 1965 and 1979 included 139 infants with oral clefts. Detailed information was obtained about 93 of these infants and matched controls. The relative risk of the birth of an infant with an oral cleft to women prescribed Debendox within 69 days of the first day of their last men‐strual period was 0.64 (95% confidence limits 0.12–3.34). No increased effect was found amongst women who smoked. In Aberdeen, 17 640 livebirths between 1976 and 1979 included 31 children with oral clefts. Compared with the non‐exposed group the risk of a birth of an infant with an oral cleft to a woman prescribed Debendox in early pregnancy was 0.37 (95% confidence limits 0.09–1.47). These results do not confirm the previous findings in Oxford of a possible association between exposure to Debendox in early pregnancy and the occurrence of oral clefts in the child.
Chorioamnionitis and funiculitis in the placentas of 200 births weighing less than 2.5 kg.
Authors: CHELLAM V. G. , KUSHTON D. I.
Published: August 2005

Summary. A retrospective histopathological study of the placental and non‐placental membranes and umbilical cords of 200 live and stillborn babies weighing <2·5 kg is reported. The pathological studies were specifically concerned with the presence of infection as evidenced by a polymorphonuclear leucocytie infiltrate at these sites. Inflammatory lesions were demonstrated in 48·5% of specimens. The incidence of inflammatory lesions was highest in those with prolonged rupture of the membranes, and in the placentas of the smallest and least mature infants of a size appropriate t o their gestational age. Puerperal pyrexia, neonatal sepsis and perinatal mortality were also more common in the infected group but none of the perinatal deaths was directly attributable to infection. The role of infection as a cause of premature rupture of the membranes, premature labour and subsequent perinantal outcome is still unclear though our data would suggest it is not unimportant.
Uroflowmetry for predicting postoperative voiding difficulties in women with stress urinary incontinence
Authors: BERGMAN ARIEH , BHATIA NARENDER N.
Published: August 2005

Summary. Pre‐operative knowledge of uroflowmetry and postvoiding residual urine volumes in a group of 45 women undergoing urinary incontinence surgery failed to predict risks of postoperative voiding difficulties. Only one out of nine patients needing prolonged post‐operative bladder drainage (7 days) gave a pre‐operative history of voiding difficulties. More than half the patients (5/9) who needed prolonged catheterization had normal flow rates pre‐operatively and five of the nine patients with reduced flow rates were able to resume spontaneous voiding within 7 days following incontinence surgery.
Age as a prognostic factor in epithelial ovarian carcinoma
Authors: SMEDLEY HOWARD , SIKORA L KAKOL
Published: August 2005

Summary. One prognostic factor in epithelial ovarian cancer appears to be the patient's age at presentation. We have retrospectively analysed data from 2305 patients with this tumour in East Anglia during the period 1960–1980. The influence of age as a factor in survival was studied by comparing outcome in young patients between the ages of 15 and 35 (3.1% of all cases) with the outcome in the women over 35. The prognosis was significantly better in young patients, even when age correction is applied. This has implications for the management of patients with this common tumour.
Recurrent pregnancy losses and parental chromosome abnormalities: a review
Authors: THARAPEL AVIRACHAN T. , THARAPEL SUGANDHI A. , BANNERMAN ROBIN M.
Published: August 2005

Summary.A compilation of the cytogenetic results taken from 79 published surveys of couples with two or more pregnancy losses (comprising 8208 women and 7834 men) showed an overall prevalence of major chromosome abnormalities of 2.9%. This is five to six times higher than that of the general adult population. In every group of chromosome abnormalities in the parents a predominance of female to male affected was noted (2:1). Approximately 50% of all chromosome abnormalities detected were balanced reciprocal translocations, 24% were Robertsonian translocations, 12% were sex chromosomal mosaicisms in females, and the rest consisted of inversions and other sporadic abnormalities. Parents with two or more idiopathic pregnancy losses should be karyotyped to aid in management and counselling. When a translocation or other abnormality (e.g. X chromosomal mosaicism) predisposing to an abnormal zygote is found, prenatal diagnosis is indicated in future pregnancies. Even when parental karyotypes are normal, prenatal diagnosis should be considered in subsequent pregnancies of parents with two or more pregnancy losses because of the high incidence of chromosome abnormalities in spontaneous abortions. For the same reason, if a single previous pregnancy loss is known to have been chromosomally aneuploid, parental karyotypes may have to be examined (depending upon the finding in the pregnancy loss), and prenatal diagnosis should also be considered in subsequent pregnancies.
Myometrial activity in first trimester human pregnancy after Epostane therapy. Effect of intravenous oxytocin
Authors: WEBSTER M. A. , PATTISON N. S. , PHIPPS S. E. , GILLMER M. D. G.
Published: August 2005

Summary. The effect on myometrial activity of Epostane, a competitive inhibitor of the 3β‐hydroxy steroid dehydrogenase enzyme system (3β‐HSD) has been studied in 20 women awaiting termination of pregnancy. The women were randomly allocated by a double‐blind procedure into two groups. In the Epostane‐treated group there were significant falls in serum progesterone and oestradiol concentrations after 3 days of treatment. The placcbo‐treated group showed a small but significant decline in serum progesterone concentration. Insertion of an intrauterine balloon catheter for pressure measurements produced significantly greater uterine activity in the Epostane‐treated group. The oxytocin response was variable and there was no significant difference between the two groups. A small rise in the peripheral plasma concentration of a prostaglandin F20r metabolite (PGFM) was observed in the placebo group following oxytocin injection. There was a significant inverse correlation between post treatment progesterone values and uterine activity. Epostane appears to sensitize the myometrium to endogenous oxytocics and this probably results from progresterone ‘withdrawal’. This effect may prove useful in potentiating the action of exogenous myometrial stimulant5, such as prostaglandins, and may have a role in the termination of early pregnancy.
Langerhans' cells and lymphocyte subsets in the female genita1 tract.
Authors: EDWARDS J. N. T. , MORRIS H. B.
Published: August 2005

Summary. Cryostat sections of healthy cervical, vaginal and vulva1 epithelium were examined using immunohistological labelling techniques and a panel of monoclonal antibodies recognizing Langerhans' cells, T‐ and B‐lymphocytes and HLA‐DR antigen. The distribution of Langerhans' cells in squamous epithelium of the cervix, vagina and vulva showed a marked variation with the highest median values in the vulva (18·7 per 100 basal squamous cells) and the lowest in the vagina (5·5 per 100 basal squamous cells). There was also a substantial variation in number and distribution of lymphocytes of each of these three areas with a distinct preponderance in the transformation zone of the cervix. In addition, intraepithelial lymphocytes, predominantly of the T‐cytotoxic suppressor sub‐type were present at all sites with the greatest number in the transformation zone. We conclude from this study that lymphoid tissue of the cervical transformation zone has several unique characteristics which are not observed at other sites in the lower genital tract. We suggest that this tissue be designated ‘cervical lymphoid tissue’ and that it forms a part of the ‘mucosal associated lymphoid tissue’ (MALT) as noted at other mucosal sites exposed to the external environment.
Spironolactone in combination with an oral contraceptive: an alternative treatment for hirsutism
Authors: CHAPMAN M. G. , DOWSETT M. , DEWHURST C. J. , JEFFCOATE S. L.
Published: August 2005

Summary. The clinical efficacy of a combination of spironolactone and an oral contraceptive pill (Conova 30) was assessed in 23 patients presenting with hirsutism of whom 20 completed 6 months of treatment. Of the 20 patients, 16 showed improvement on objective (Ferriman & Gallwey hair score) and subjective assessment. Serum levels of androgens (testosterone, androstenedione and 17‐hydroxy progesterone) were suppressed and sex hormone binding globulins were elevated. Nausea was the only significant side effect.
First magnetoencephalographic recordings of the brain activity of a human fetus
Authors: BLUM T. , SALING E. , BAUER R.
Published: August 2005

Summary. Using a one‐channel neuromagnetometer adjusted to a special site on the mother's abdomen, we succeeded in recording prenatally, for the first time, human fetal brain activity in late pregnancy. It was possible to record both the fetal auditory‐evoked neuromagnetic field and to detect fetal brain activity by analysis of the frequency spectrum. Such measurements may soon prove valuable for the non‐invasive investigation of human brain function.
Serum salbutamol concentrations during oral and intravenous treatment in pregnant women
Authors: HAUKKAMAA MAIJA , GUMMERUS MARTTI , KLEIMOLA TERTTU
Published: August 2005

Summary. The serum concentration of salbutamol was determined in 29 pregnant women during oral treatment (4 mg five times per day) and in seven during intravenous infusion (6–30 μg/min) because of premature labour. The concentration of salbutamol was determined by combined gas‐liquid chromatography mass spectrometry. The mean concentration of serum salbutamol was twice as high during intravenous treatment (24; SD 9 ng/ml), than during oral treatment (12; SD 3 mg/ml). During oral treatment: the salbutamol levels were not correlated to maternal height, weight or the incidence or severity of side‐effects. The serum concentrations of salbutamol in patients with twin pregnancies did not differ from those with singleton pregnancies. After stopping intravenous treatment, serum salbutamol levels remained high for several hours and oral treatment can be started 4–6h after stopping intravenous infusion.
Amerlex free triiodothyronine and free thyroxine levels in normal pregnancy
Authors: PARKER JOHN H.
Published: August 2005

Summary. Free triiodothyronine (FT3) and free thyroxine (FT4) were measured in 159 women during normal pregnancy and compared with non‐pregnancy reference ranges for these hormones. FT3 values fell from the reference level of 6·34 (SD 1·06) pmol/l to 3·87 (SD 0·54) pmol/l in the 3rd trimester; corresponding figures for FT4 were: reference 16·92 (SD 2·97) pmol/l, 3rd trimester 11·29 (SD 2·01) pmol/l. There were no significant changes in the 1st trimester; 4% and 69% of FT3 results in the 2nd and 3rd trimesters respectively fell below the reference range of mean ±2 SD. The corresponding findings for FT4 were 4% and 42%. FT3 correlated reasonably well with total T3 (r=0·90) and was acceptably precise (within‐batch CV 2·1% at 5·6 pmol/l, between‐batch CV between 3·1% and 4·7% at six levels).
Maternal height and shoe size as predictors of pelvic disproportion: an assessment
Authors: FRAME SUE , MOORE JUDY , PETERS ALLISON , HALL DAVID
Published: August 2005

Summary. A total of 351 women who gave birth in the Paddington and North Kensington Health District were studied in order to establish a factual basis for recording height and shoe size as indicators of pelvic adequacy. Because only 19 women had radiological pelvimetry assessment, type of delivery and length of labour were used as proxy measures of disproportion. Of the 57 women with a shoe size <4½, 21% were delivered by caesarean section compared with 10% of the group with shoe size between 4½ and 6 and only 1% of the group with shoe size 6½. Similar relations with height were not generally found. The data were further examined using logistic regression models of the expected percentages of mothers having an adverse delivery. The models confirmed and extended the more simple analysis.
Uterine activity in the second stage of labour and the effect of epidural analgesia
Authors: BATES R. G. , HELM C. W. , DUNCAN A. , EDMONDS D. K.
Published: August 2005

Summary. Uterine activity was measured during the second stage of normal labour in 20 patients with and 31 patients without epidural analgesia. There was a significantly lower uterine activity integral (UAI) in patients having epidural analgesia, and it is suggested t h a t this may contribute to the increased rate of instrumental delivery associated with epidural analgesia.
Hypothalamic disease presenting as amenorrhoea: value of computed tomography
Authors: FERRARI CARLO , CROSIGNANI PIER GIORGIO
Published: August 2005

Summary. Five women presenting with amenorrhoea (three with secondary amenorrhoea and galactorrhoea, and two with primary amenorrhoea) were shown to have suprasellar abnormalities by computed tomography. Organic hypothalamic disease was confirmed at surgery (craniopharyngioma in three, intra‐ and suprasellar Rathke's cleft cyst in one, aqueductal stenosis and suprasellar arachnoid cyst in one). Moderate hyperprolactinaemia was present in the first four, while the last had isolated gonadotrophin deficiency of hypothalamic origin. One o f the hyperprolactinaemic women had entirely normal residual pituitary function, visual fields and tomography of the sella. Two of the patient, with secondary amenorrhoea and galactorrhoea had resumption of menses during bromocriptine therapy before operation. Spontaneous menarche and subsequent pregnancy occurred after ventriculoatrial shunt in the girl with aqueduetal stenosis. Organic hypothalamic diseases may present with amenorrhoea (sometimes as the only symptom) more commonly than previously appreciated. Computed tomography should replace conventional tomography of the sella and should be an essential part of the clinical investigation in all patients with amenorrhoea of hypothalamo‐pituitary origin.
Routine outpatient diagnostic uterine curettage using a flexible plastic aspiration curette
Authors: MACKENZIE I. Z.
Published: August 2005

Summary.Diagnostic curettage using a flexible aspiration curette was possible in 97% of 246 women with abnormal uterine bleeding or discharge. Altogether 15 women with pelvic malignancy were detected or suspected by histological examination of the tissue obtained; no uterine malignancy was missed. The technique appears simple, safe, reliable and cheap and acccptablc to patients. Delays i n diagnosis and treatment arc reduced and formal curettage under general anaesthetsia is avoided in the majority o f women requiring investigation.
Can fetal electrocardiography improve the prediction of intraparturn fetal acidosis?
Authors: JENKINS H. M. L. , SYMONDS E. M. , KIRK D. L. , SMITH P. R.
Published: August 2005

Summary. An outline is given of a computer‐based system which continuously enhances and measures the waveform of the intrapartum fetal electrocardiogram. This system has been used to examine the behaviour of the ST segment and T wave in a group of 14 fetuses where the outcome was biochemically and clinically normal, and in a group of 10 fetuses which were acidotic at birth. When the mean values in each group were compared, highly significant differences were found for both of these components of the waveform. These differences have also been demonstrated by the analysis of long‐term trends in the behaviour of these variables. The highly significant correlation between both a long‐term increase in ST segment and T wave height and fetal acidosis, found in this study, reflects earlier work by others in the experimental animal fetus. The findings suggest that continuous monitoring of the waveform of the fetal electrocardiogram in labour may give a much better prediction of fetal acidosis than is currently achieved with the monitoring of heart rate alone.
Quantitative structural studies on placentas from pregnancies complicated by diabetes mellitus
Authors: BOYD PATRICIA A. , SCOTT ANDREW , KEELING JEAN W.
Published: August 2005

Summary. Fourteen placentas from pregnancies complicated by insulin‐dependent diabetes mellitus have been examined by quantitative morphometry. The results have been compared with those from 22 placentas of comparable gestation from uncomplicated pregnancies. The volume of parenchymatous tissue in the placentas from diabetic mothers was significantly increased while the volume of non‐parenchyma was decreased. The villous surface area was increased in placentas from the diabetic group, the mean value being 17·3 m2 compared with the 11·4 m2of the normal group. This increase was larger than would be expected when the increase in fetal weight of some babies born to diabetic mothers is taken into account.
Results of CO2 laser cylinder vaporization of cervical intraepithelial disease in 1234 patients. An analysis of failures
Authors: ALI S. W. , EVANS A. S. , MONAGHAN J. M.
Published: August 2005

Summary. This report analyses 1234 patients with CIN and noncondylomatous wart virus infection (NCWVI) managed by CO2 laser ablation in the Regional Department of Gynaecological Oncology, Queen Elizabeth Hospital, Gateshead from 1979 to 1983. Thirty‐five patients (3%) were lost to follow‐up. Of the 1157 patients currently under review and with at least 1 year of follow‐up, 44 (3·8%) were laser treatment failures. This group is analysed and the results compared with other series.
Blood group antibody screening tests during pregnancy
Authors: BOWELL P. J. , ALLEN D. L. , ENTWISTLE C. C.
Published: August 2005

Summary. In a 2‐year period 667 sera from approximately 70 000 (0·95%) antenatal patients were found to contain 726 atypical red blood cell antibodies. Overall, 66% of the immunized mothers were rhesus (D) positive. Apart from four antibody specificities to rhesus system antigens, knowledge of the rhesus (D) group gave no guide to the ability of the patients to form any of the remaining 21 specificities encountered. Of the 726 antibodies 221 (30%) were not detected in the initial sample tested and 50 of the 92 patients who produced antibodies during pregnancy had not developed detectable antibody when they were sampled at 28 weeks. The significance of these late onset antibodies is discussed both in relation to the risk of haemolytic disease in the newborn and transfusion reactions in the mother. An optimum protocol for testing is defined which takes account of antibody production during the pregnancy and use of this protocol constitutes an attempt to combine maximum clinical safety with minimal consumption of resources.
The significance of anti‐c alloimmunization in pregnancy
Authors: BOWELL P. J. , BROWN S. E. , DIKE A. E. , INSKIP M. J.
Published: August 2005

Summary. In an 8‐year period, 177 of 280 000 pregnancies were complicated by maternal anti‐c alloimmunization. Although there was one neonatal death associated with anti‐c haemolytic disease of the newborn, only two infants were severely anaemic at birth. A total of 11 babies required exchange transfusion, but nine of these developed hyperbilirubinaemia alone. The remaining c positive infants were either unaffected or only mildly affected by erythroblastosisfetalis. A strategy for management of these pregnancies is outlined, and proposed methods of prevention and serological control are discussed.
Classifying perinatal death: fetal and neonatal factors
Authors: HEY E. N. , LLOYD D. J. , WIGGLESWORTH J. S.
Published: August 2005

Summary. It has been common practice in the United Kingdom for more than 30 years to classify perinatal deaths according to the maternal condition that initiated the events that led to death. However, such an approach tends to ignore the baby as an individual in his or her own right. The need for an additional classification that identifies the pathological processes occurring in the baby in every perinatal death has long been recognized, and the classification adopted in the 1958 British Perinatal Mortality Survey has now been revised with this need in mind.
Conceptual dating using ultrasonically measured fetal femur length and abdominal diameters in early pregnancy
Authors: SELBING ANDERS
Published: August 2005

Summary. The association between fetal anthropometric measurements and conceptual age was determined for the femur length and the mean of two abdominal diameters for conceptual ages between 10 and 20 completed weeks. The conceptual age used for reference was determined by the fetal crown‐rump length measured at an earlier examination. Two equations are presented for the calculation of conceptual age from isolated estimations of the femur length or the mean of two abdominal diameters. Mean abdominal diameter and femur length measurement values were found to have similar precisions of dating.
Birthweight‐for‐gestational age charts based on early ultrasound estimation of gestational age
Authors: SECHER N. J. , HANSEN P. KERN , LENSTRUP C. , PEDERSEN‐BJERGAARD L. , ERIKSEN P. SINDBERG , THOMSEN BIRTHE LYKKE , KEIDING N.
Published: August 2005

Summary. Birthweight‐for‐gestational age charts were based on the analysis of 3888 consecutive births in which the gestational age was estimated by measuring the fetal biparietal diameter before the 20th week of gestation. The data showed, in contrast to previous studies, a linear relation between gestational age and birthweight without inflection after term. The regression parameters showed a strongly significant difference between girls and boys. Thus, boys were 1·5% heavier than girls at 190 days gestation and 3·6% heavier at 300 days gestation. The linearity in the birthweight‐for‐gestational age charts could be due to the more reliable gestational age based on early ultrasound.
Caesarean section dissected, 1978–1983
Authors: YUDKIN P. L. , REDMAN C. W. G.
Published: August 2005

Summary.Of 32 735 singleton births in Oxford in the 6 years 1978–1983, 10% were by caesarean section. In contrast to the national data, no trend in this rate was observed. Repeat caesarean sections accounted for 30% of all sections and the proportion of women who had had a previous caesarean section rose gradually in the hospital population. The other main indications for section were dystocia, fetal distress in labour and breech presentation, which together accounted for a further 45% of all sections. Comparison with caesarean section rates reported from North America shows that repeat sections and sections for dystocia were less frequent in Oxford but the rates for other indications were similar. Dystocia is likely to be a key factor in determining future section rates. Dystocia occurred mainly in primiparae, and was more common with short stature and with increasing gestation and maternal age. For all height, age and gestation groups dystocia was more than twice as frequent in induced as in non‐induced labour. This association does not imply a causal relationship, but neither is one excluded.
A syndrome of liver damage and intravascular coagulation in the last trimester of normotensive pregnancy. A clinical and histopathological study
Authors: AARNOUDSE J. G. , HOUTHOFF H. J. , WEITS J. , VELLENGA E. , HUISJES H. J.
Published: August 2005

Summary. Six women without hypertension or proteinuria, admitted for severe upper abdominal pain in the third trimester of pregnancy had elevated serum liver enzymes (SGOT, SGPT), markedly increased serum LDH levels, thrombocytopenia and abnormal blood coagulation tests, in particular low antithrombin III levels, indicating disseminated intravascular coagulation (DIC). Liver biopsies showed periportal and/or focal parenchymal lesions with large fibrin deposits, comparable to the liver lesions in eclampsia. Immunofluorescence (IF) showed microthrombi and large fibrin deposits. Three of the six women recovered spontaneously before delivery; in the remaining three all signs and symptoms rapidly disappeared after delivery. Perinatal outcome was poor. Seven women with pregnancy‐induced hypertension and elevated serum liver enzymes constituted a reference series. Histopathological examination of liver biopsies in the reference group revealed periportal and/or focal parenchymal lesions in three whereas IF showed fibrin deposition in all seven, but less extensive than in the study group. The present findings indicate that upper abdominal pain in the last trimester of pregnancy can be caused by a syndrome of (pre) eclamptic liver damage and DIC, even when hypertension and proteinuria are lacking.
The use of a birthroom: a randomized controlled trial comparing delivery with that in the labour ward
Authors: CHAPMAN M. G. , JONES M. , SPRING J. E. , DE SWIET M. , CHAMBERLAIN G. V. P.
Published: August 2005

Summary. A randomized controlled trial of two environments for delivery was conducted at Queen Charlotte's Maternity Hospital. A total of 253 parous women expecting to have a labour ward delivery were invited to participate in the trial but only 148 agreed. These women were randomly allocated to be delivered either with standard labour ward management (n= 72) or in the birthroom—a small bedroom decorated in a homely manner, without facilities for epidural analgesia or electronic fetal monitoring (n= 76). Eleven women in the birthroom group and 10 in the labour ward group withdrew from the trial before labour and four were transferred from the birthroom to the labour ward when in labour. A questionnaire sent in the postnatal period to the women who completed the trial was returned by 80%. In the birthroom group there was significantly (i) decreased admission‐to‐delivery interval (ii) less analgesia (iii) more freedom of movement (iv) less suturing (v) increased rooming‐in. No difference was found in the assessment of difficulty of labour nor in the method of subsequent infant feeding.
The intraventricular conduction time of fetal heart in pregnancies with suspected fetal growth retardation
Authors: PARDI GIORGIO , MARCONI ANNAMARIA , FERRAZZI ENRICO
Published: August 2005

Summary. Electrocardiographs from 68 fetuses with ultrasound evidence of growth retardation were recorded from the maternal abdomen; QRS duration was measured and compared to normal standards previously obtained in our Institute. Of these fetuses, 54 were small‐for‐gestational‐age at birth and 44 exhibited QRS duration values below ‐2SD for their gestational age. All but one of the 14 normal fetuses showed normal QRS values (positive predictive value = 98%; negative predictive value = 57%). Of 11 fetuses with QRS duration values below ‐4SD, nine were particularly small, below the 2nd centile of weight for gestation. QRS duration measurements may represent a sensitive method for identifying fetal growth‐retardation. The QRS duration also seems to provide a reliable prognosis of perinatal outcome. Normal values are a reassuring factor: abnormal cardiotocographic records were observed in only 2 out of 23 cases and no low Apgar scores or perinatal deaths occurred. QRS values below ‐4 SD proved to be associated with abnormal cardiotocographic records (7/13), low Apgar scores (5/15) and perinatal deaths (3/15).
Results of donor insemination related to specific male infertility and unsuspected female infertility
Authors: FOSS G. L. , HULL M.G.R.
Published: August 2005

Summary. Apparently normal but infertile women were treated by artificial insemination using fresh donor semen. In 228 couples in which the male partner was azoospermic the average monthly conception rate was 13·3% and the 12‐month cumulative rate was 82·2% (SE 2·7%). In 116 couples in which the partner was oligospermic the monthly rate was 8·7% and the 12‐month rate 66·6% (SE 5·0%, P <0·0l). Previous smaller studies have given rise to conflicting or inconclusive results, but the reduced conception rates in the partners of oligospermic men in this large study suggests that unexplained female factors, discussed in the paper, contribute to their infertility in up to a third of patients.
Ibuprofen prevents IUCD‐induced increases in menstrual blood loss
Authors: MÄKÄRÄINEN LEO , YLIKORKALA OLAVI
Published: August 2005

Summary. To study the effects of a copper‐releasing intrauterine contraceptive device (IUCD) and a prostaglandin (PG) synthesis inhibitor, ibuprofen, on menstrual blood loss, 28 healthy women received either a Fincoid 350 or a ML Cu375 device and were then treated in a doubleblind randomized manner with ibuprofen (1200 mg daily) or a placebo during their next three menstruations. The preinsertion menstrual blood loss (2 cycles) was normal for healthy women (median 38 ml) with no difference between women who subsequently received either Fincoid 350 or ML Cu375 and ibuprofen or placebo treatment. The median increase in menstrual blood loss after the insertion of an IUCD was 74% (P <0·01) in women receiving placebo treatment, and this rise was not dependent on the type of IUCD. Ibuprofen treatment prevented the increase in blood loss following IUCD insertion, but it failed to shorten the duration of menstruation. Four women reported side‐effects (tiredness, irritability, sweating, dyspepsia) during ibuprofen treatment, and two women did so during placebo treatment. It is concluded that IUCDs with a large copper surface also increase menstrual blood loss, but that this increase can be prevented with ibuprofen treatment.
A randomized comparison of glycerol‐impregnated chromic catgut with untreated chromic catgut for the repair of perineal trauma
Authors: SPENCER JOHN A. D. , GRANT ADRIAN , ELBOURNE DIANA , GARCIA JO , SLEEP JENNIFER
Published: August 2005

Summary. Glycerol‐impregnated chromic catgut and untreated chromic catgut were compared in a randomized controlled trial involving 737 consecutive women who required repair of perineal trauma following spontaneous vaginal delivery. Medical staff preference was equally divided between the two materials. More untreated chromic catgut sutures required removal both by 10 days and by 3 months postpartum. Women whose perineal trauma was repaired with glycerol‐impregnated chromic catgut were 10% more likely to have perineal pain at 10 days and 33% more likely to suffer from dyspareunia in the 3 months following delivery. The high rates of maternal morbidity associated with glycerol‐impregnated chromic catgut appear to preclude its use for perineal repair.
Umbilical cord whole blood viscosity and the umbilical artery flow velocity time waveforms: a correlation
Authors: GILES WARWICK B. , TRUDINGER BRIAN J. , PALMER ALLAN A.
Published: August 2005

Summary. The possibility was examined of an association between umbilical cord whole blood viscosity and umbilical artery flow velocity time waveforms obtained with continuous wave Doppler ultrasound. The cord blood viscosity was measured at both high (100 s−l) and low (0·1 s−I) shear rates with a concentric cylinder viscometer. Plasma viscosity and fibrinogen were also measured. An abnormal pattern in the umbilical artery flow velocity waveform (high A/B ratio) indicative of high resistance was associated with an increase in whole blood viscosity at high shear (which may reflect a change in red cell rigidity). Viscosity at low shear (reflecting red cell aggregation and rouleaux formation) did not differ. There was a significant association between the small‐for‐gestational age fetus and abnormal umbilical artery waveform study (P <0·002) but not abnormal whole blood viscosity at high (P=0·09) or low (P=0·08) shear.