bluuebunny/crossref_metadata_2025 huggingface dataset:
The Place of Colposcopy in the Detection and Diagnosis of Carcinoma in Situ of the Cervix*
Authors: Cope Ian
Published: February 2008

Colposcopy is a very useful tool in the hands of the gynaecological cancer detection team.

Colposcopy will detect about 85% of cases of carcinoma in situ, it will act as an independent check for cytology and it will differentiate dysplasia.

It should be used routinely in all hospital cancer detection clinics.

Its use in the diagnosis of the type of lesion requiring treatment and its extent makes the colposcope an essential tool in the operating theatre for all patients being investigated because of positive or suspicious cytology.
Histomorphology of Minimally‐Invasive Cervical Squamous Cancer*
Authors: Barter R. A.
Published: February 2008

A description is given of the more important in situ atypias of the cervix.

 The characteristic changes of minimally‐invasive squamous cell carcinoma are presented on the basis of a study of 14 patients with this condition.

 The importance of separating the different abnormalities of cervical squamous epithelium is stressed.
The Role of Radioactive Phosphorus in the Investigation of Cervical Lesions*
Authors: Thoms George
Published: February 2008

Radioactive phosphorus uptake has been utilized in the diagnosis of cervical pathology in a series of 55 patients.

 A scan 24 hours after intravenous administration of the isotope enables patients to be classified into 3 broad groups, according to the degree of cellular activity.

 The technique is of diagnostic value and serves as a rational basis for therapy.
Conjoined Twins
Authors: Fahmy Kamal , Al‐Ghonaimi Bashir
Published: February 2008

Two cases of conjoined twins are reported, one being a thoracopagus and the other a syncephalus monster.

 The frequency, types, diagnosis, mechanism of labour and management of conjoined twins are outlined.
Acute Pancreatitis in Pregnancy
Authors: Texler K. C.
Published: February 2008

A case of acute pancreatitis in pregnancy is reported.

The diagnosis of this disease is best confirmed by early serum amylase estimation.

The treatment is conservative.

The occurrence of pancreatitis in pregnancy is coincidental and has no specific effect on the outcome of the pregnancy, apart from early termination in some instances.
Illegitimate Pregnancy in the Adolescent
Authors: O'Connor D. T.
Published: February 2008

A retrospective review of illegitimate pregnancy in 414 Australian teenagers during a two‐year period is presented.

 The special problems in pregnancy were pre‐eclamptic toxaemia and eclampsia, anaemia, venereal disease and urinary tract infection.

 Premature labour, prolonged labour, postpartum haemorrhage and sepsis were the main problems related to parturition.

 Factors responsible for perinatal mortality in these cases have been discussed. The rate of 37 per 1000 was slightly in excess of the hospital figure.
Coagulation Defect in Pregnancy
Authors: Beischer N. A.
Published: February 2008

A series of 66 patients with coagulation defect is presented.

 The common predisposing conditions were accidental haemorrhage (38 patients) and prolonged foetal death in utero (14 patients). In 8 patients clotting failure occurred after normal delivery and was probably due to amniotic fluid embolism in at least 2 of them. Three patients had septicaemia.

 Reaction to fibrinogen administration occurred in 15 patients. Six patients subsequently developed homologous serum hepatitis.

 There were 5 maternal deaths in the series and 3 were associated with massive amniotic fluid embolism. Intravascular fibrin emboli were present in 4 of these patients.
The Use of the Malmström Vacuum Extractor in Operative Obstetrics
Authors: Bird G. C.
Published: February 2008

One hundred and thirty‐five of a personal series of 233 vacuum extractions are described in detail and the whole series of 233 is summarised.

 The vacuum extractor is considered safe for mother and baby. Poor foetal results are thought to be due to over‐persistence with the method and bad selection of cases.

 The efficiency and versatility of the vacuum extractor is demonstrated and its use in operative obstetrics is discussed.

 The writer does not think the time has yet come for the vacuum extractor to replace the forceps completely.
Acute Glomerulitis in Pregnancy
Authors: McQueen E. G. , Gwynne J. F.
Published: February 2008

Six patients are reported in whom progressive renal insufficiency occurred during pregnancy.

Renal biopsy shortly after delivery showed inflammatory lesions of the glomeruli in all patients.

Hypertension and impairment of renal function tended to persist after delivery.

Attention is drawn to the high foetal mortality and serious maternal morbidity resulting from acute glomerular lesions occurring during pregnancy.
Krukenberg Tumours in Pregnancy
Authors: Ward R. H. T.
Published: February 2008

Two patients with Krukenberg tumours associated with pregnancy are described and the literature on the subject is briefly reviewed. The prognosis is very poor and any treatment can only be palliative, since the primary disease process is so advanced by the time of diagnosis. The chief site of the primary is usually the stomach and often the symptoms of vomiting and indigestion are related to the pregnancy itself. Since the prognosis is so hopeless, and because there is no evidence that pregnancy materially accelerates the disease, pregnancy should be allowed to continue to term after removal of the tumours.
The Treatment of Ovulatory Defects with Clomiphene
Authors: Grant Alan
Published: February 2008

Sixty‐three patients have been treated with clomiphene for ovulatory disorders; 41 patients suffered from anovulation or oligo‐ovulation with menses at intervals of 4 months or more, and 22 patients were treated for a short or abnormal luteal phase, a disorder which has a confusing and varied nomenclature as indicated in the text.

 Eighty‐four per cent, of the patients with anovulation were cured as judged by two or more criteria of ovulation.

 Thirty‐six per cent, of married patients achieved a pregnancy.

 Twenty‐eight per cent, of ovulations resulted in the production of a corpus luteum with a life span of 10 days or less.

 Approximately one‐third of patients treated for a naturally occurring short or abnormal luteal phase became pregnant.

 Investigations on the effect of clomiphene on a poorly functioning corpus luteum (defective ovulation) suggest that this compound may have a wider therapeutic field than has previously been anticipated. For this purpose the compound was given after the end of menstruation; its effect at this time was superior to that obtained when administration was delayed until after ovulation had taken place.
The Process of Cervical Regeneration After ElectrocauterizationL:Part 2. Histochemical, Autoradiographic, and pH Study
Authors: Reid Bevan L. , Singer Albert , Coppleson Malcolm
Published: February 2008

summary

Detailed studies were made of certain aspects of regenerating cells produced in response to destruction of cervical erosions by electrocautery. These aspects were local pH variarions by a polarographic technique, autoradiographic studies, studies of the formationof the epithelial basement membrane and phagocyte properties of the regenerating cells.

The range of pH environment over the regenerating area was 7‐7.4. There was evidence indicating that lower values induced a keratinproducing epithelium and higher values induced a mucinproducing epithelium. Labelled thymidine incorporation showed desoxyribose nucleic acid sythesis to be active in cells migrating into the wounded area. It was especially active in presumptive squamous epithelium formed by these cells. Ribosenucleic acid synthesis and amino acid uptake was distributed throughout the regenerating tissue but was especially marked in new squamous epithelium.

Evidence is presented that the basement membrane of the epithelium is produced by a restriction of the pericellular glycoprotein capsule of the migrating cells to their basal aspect. The capsule beneath each cell then joins its neighbours laterally.

Regenerating cells are actively phagocytic toward spermatozoa.
Maternal Mortality in Fiji
Authors: Lancaster D. J.
Published: February 2008

summary

An outline of the medical services in the Fiji Islands is given with particular reference to the nature of the plural society of Fiji, medical and nursing training, and family planning services.

The maternity services and the training of specialist obstetricians is discussed. The maternal death statistics of the 3 main hospitals are presented, 56 deaths occurring in 25,335 deliveries (incidence 2.21 per 1000 births).

The causes of maternal death are outlined: haemorrhage, pre‐eclampsia and eclampsia were the main causes. lmportant factors which are associated with these deaths are discussed and corrective factors, both present and future, are outlined.

The importance of preventive obstetrics, including efficient antenatal care with improvement in the general health of the mother, together with accurate recording and investigation of each maternal death is emphasised.
Eclampsia with Subsequent Massive Intravascular Haemolysis and Anuria
Authors: Singer Albert , Morgan Trefor
Published: February 2008

Acute renal failure is a serious complication of pregnancy with a mortality rate of 40–60% (Sheehan and Moore, 1952; Ober et al, 1956; Blagg and Parsons, 1960).

A case of eclampsia with subsequent in‐travascular haemolysis and anuria is reported.

Information is presented concerning the administration of the hypotensive agent, Protoveratrine, and its possible implication in the haemolytic process.
A Concept of the Mechanism of Labour
Authors: Hawker R. W. , Klemm G. H.
Published: February 2008

The uterotonic activity of samples of blood has been investigated in this laboratory in a series of healthy women in late pregnancy, normal labour, and prolonged labour (Hawker et al., 1961a, b; Hawker et al., 1963). The results may be summarised as follows:
Over‐Span
Authors: Lawson D. F.
Published: February 2008

We know from the Bible that the allotted span is 3 score years and 10, so it becomes interesting to consider gynaecology in people past their span, people living on borrowed time, and gynaecologically speaking, what happens in borrowed time, like stolen fruit, is sweetest.
A Technique for Intra‐Arterial Infusion of the Pelvis
Authors: R. Stewart George , Singer Albert
Published: February 2008

The increasing use of single intra‐arterial injections of a cytotoxic agent for advanced malignancy (Harrison, 1963, 1964; Falcson et al., 1964) has led to the development by us of a simple technique for direct infusion of the internal iliac artery and its branches. Previous methods of pelvic infusion (Scott, 1958; Thomson et al., 1963; Hodgkinson and Boyce, 1965) have relied upon long‐term infusion techniques, which are well established but have several complications (Sullivan, 1962).
Herpetic Cervico‐Vaginitis
Authors: S. Wilkcy I.
Published: February 2008

Acute herpetic lesions of the cervix, vagina and vulva have been described by various authors but the lesion is not commonly recognized. In a recent paper by Josey et al. (1966), 80 cases are reported. In the following case, the diagnosis is based on cytomorphological changes and clinical features.
The Effect of Dimenhydrinate on Uterine Contractions
Authors: Hay Tan Bock , Wood Carl
Published: February 2008

Controversy exists regarding the action of dimenhydrinate (Dramamine) on the course of labour.
Depression of Urinary Oestrogen Values During Methenamine Mandelate Administration
Authors: V. Mackay E. , A. J. Macafee C. , Anderson Caroline
Published: February 2008

In view of the reliance that is now placed on the level of urinary oestrogen in complicated pregnancies, it is important to record extraneous factors which may significantly alter laboratory findings. One substance which appears to act in this way is the urinary antiseptic drug, methenamine mandelate (Mandelamine). The effect of this drug is illustrated in the following 2 case reports which were collected within a short time of one another.
A Clinical Trial of a New Low Dose Oral Contraceptive Compound
Authors: McBride W. G.
Published: February 2008

A new oral contraceptive compound (Norgestrel and ethinyl oestradiol) has been assessed in a clinical trial over a period of 12 months. The preparation has proved to be completely reliable, with minimal unpleasant side‐effects.

The only serious side‐effect which may perhaps be attributed to the compound was the development of a superficial venous thrombosis in 1 of the 210 patients.

The most important feature of the tablet is the low dose of steroid hormone ingested over the 21 days of medication ‐ 10.5 mg. of Norgestrel and 1.05 mg. of ethinyl oestradiol.
Stress Incontinence and the Combined Synchronous Vaginal‐Abdominal Operation in its Management
Authors: Truskett Ian D.
Published: February 2008

The physiology of micturition and the mechanisms involved in maintaining continence are briefly outlined.

The place of a combined synchronous vaginal and suprapubic operation in the management of stress incontinence is discussed and one variant of such an operation is described.

The importance of complete vaginal and suprapubic dissection of the urethra and bladder neck is stressed, particularly in patients with recurrence, before proceeding to surgical correction. It is in such patients that the synchronous operation is particularly recommended.
Haematocolpos
Authors: Sivasamboo R.
Published: February 2008

Twenty‐two cases of haematocolpos are reported. Disturbances of micturition were prominent in the symptomatology. “Radiological examination disclosed patent tubes in 19 of the 20 patients who were investigated. The aetiology of the transverse septum at the vaginal outlet is discussed. The evidence obtained in this series supported the theory of invasion of primitive streak mesoderm.
Choriocarcinoma with Intact Pregnancy Report of a Case with Review of the Literature
Authors: Steigrad S. J. , James R. W. , Osborn R. A.
Published: February 2008

The literature concerning choriocarcinoma in association with an intact intrauterine pregnancy is reviewed and a further case reported.

A detailed study of the placenta demonstrated a site of abnormal trophoblastic proliferation.
Uterine Artery Ligation in a Case of Placenta Accreta
Authors: Ton Keith B. Lay
Published: February 2008

A case of partial placenta accreta with post partum haemorrhage is described. The condition probably resulted from septic abortion and post abortal curettage causing decidual deficiency.

Bilateral ligation of uterine vessels was successful in controlling the haemorrhage and allowed preservation of the uterus.
Lymph Node Metastases in Cancer of the Cervix Stage 1b*
Authors: Kolstad Per
Published: February 2008

A survey is given of the shift in the stage distribution of cancer of the cervix as seen in the Norwegian Radium Hospital during the past 35 years. Today, approximately 45% of lesions are early Stage 1. Since treatment of cervical cancer in Norway to a large extent is centralized to this hospital, the absolute number of patients admitted with Stage 1 lesions now has reached approximately 150 a year.

During the same time period there also has been a shift in the treatment methods, the routine procedure now being radium insertions followed 8 weeks later by radical hysterectomy with pelvic lymphadenectomy. In a series of 694 Stage lb lesions 20% lymph node metastases were found. Approximately 50% of the patients with metastases were cured. The crude survival rate of the total material was 83.5%. The follow‐up showed that 5.9% died of distant metastases, 1.4% of intercurrent disease, and 3.5% were found to have such an extensive spread during operation that a radical dissection was impossible. There were 2 post‐operative deaths (0.3%).

Finally, it was observed that the adenomatous lesions seem to metastasize later but are slightly less radiosensitive than the squamous cell lesions.
Recent Investigations Concerning the Aetiology of Ectopic Pregnancies
Authors: Iffy L.
Published: February 2008

Embryos of early ectopic pregnancies have been compared with those obtained at the time of artificially induced abortion. The stage of development of the ectopic embryos indicated that conception had taken place several days after the biological mid‐cycle. The evidence has indicated that such delayed conceptions are followed by bleeding at the time of the next expected period.

The results of this investigation offer support for the menstrual reflux theory; a concept that attributes ectopic displacement of the fertilized ovum to the mechanical effect of the menstrual flow.
Combined Extrauterine and Intrauterine Pregnancy
Authors: Kamal F. H. , El‐Tannir A. D.
Published: February 2008

A case of combined intrauterine and extrauterine pregnancy is reported.

The initial diagnosis was that of threatened abortion at the eighth week of pregnancy. Signs of an acute surgical disturbance in the pelvis necessitated laparotomy 3 weeks later.

A right tubal ectopic pregnancy was excised and the intrauterine pregnancy was terminated at the 37th week by Caesarean section for placenta praevia.
Thoughts on Transplantation of the Fertilized Egg in Women
Authors: Radovic Petar
Published: February 2008

Summary

In this paper, the idea and some of the principles involved in transplantation of the fertilized egg in the human have been given. It is my hope that this will stimulate others to seek refinements in the technique that will enable a successful approach to be made to the problem.
The Vasomotor Response of the Human Umbilical Cord Vessels to Changes in its External Thermal Environment*
Authors: Sinnathuray T. A.
Published: February 2008

Perfusion studies conducted on fresh isolated segments of the human umbilical cord show that the umbilical vessels display a remarkable intrinsic property of vasomotor response to changes in external thermal environment.

The umbilical artery is much more responsive than the umbilical vein; both vessels consistently exhibit vasoconstriction on cooling and vasodilatation on re‐warming.
Invasive Carcinoma of the Vulva Current Views on Diagnosis and Treatment
Authors: Cavanagh Denis , Desai Sharayu
Published: February 2008

An analysis of 50 patients with invasive carcinoma of the vulva seen in the Department of Obstetrics and Gynecology at the University of Miami School of Medicine, Jackson Memorial Hospital, from January 1, 1955, to August 1, 1965, is presented.

Predisposing conditions such as leukoplakia (6 patients), granulomatous disease (2 patients) and syphilis (2 patients) were noted in 10 patients (20%). Two patients were pregnant.

Use of the Collins test in patients with leukoplakia and other lesions of the vulva is suggested for the purpose of selecting optimum biopsy sites.

Radical vulvectomy, bilateral groin and/or pelvic lymphadenectomy was performed in 30 patients; in addition to ilio‐femoral lymphadenectomy, pelvic exenteration was performed in 3 patients. There was one death attributed to the operation (3%).

Significant post‐operative complications were wound breakdown in 30 (91%), rupture of the femoral artery 3 (9%), rupture of the femoral vein 1 (3%), and persistent leg oedema in 3 (9%).

No meaningful 5‐year survival rate statistics are available, but 1‐year survival rates were as follows: 4 of 11 patients with positive lymph nodes, and 16 of 22 patients with negative lymph nodes. For 40 patients with McKelvey 1‐3 lesions the 1‐year survival was 65%. Of 10 patients treated palliatively only, 1 survived the first year.

Lymphography was useful in predicting nodal metastases in 17 of 20 patients (85%).

No patient with negative groin nodes had positive pelvic nodes and so the wisdom of “routine” pelvic lymphade‐nectomy is in doubt.
Biphasic Effects of Oxytocin on Human Uterine and Tube Motility
Authors: Nakanishi H. , Wood Carl
Published: February 2008

The effects of syntocin, pituitrin and pitressin on the human nonpregnant and pregnant myometrium and fallopian tube were studied in vitro.

1. Syntocin had a biphasic effect on nonpregnant myometrium. Relatively low doses (0.1 to 20 mU/ml.) of syntocin usually produced a slight excitation, while more than 100 mU/ml. of syntocin always produced an inhibition. In contrast, 0.1 to 200 mU/ml. of syntocin always produced excitation of the pregnant uterus.

2. Pituitrin also had a biphasic effect on nonpregnant myometrium; 0.1 to 20 mU/ml. of pituitrin usually produced a slight excitation, while high doses (more than 100 mU/ml.) of pituitrin frequently produced inhibition.

3. On the other hand, a wide‐range of doses (0.4 mU/ml. to 200 mU/ml.) of pitressin always produced excitation of nonpregnant and pregnant myometrium.

4. “Syntocin (0.1 to 100 mU/ml.) had an inhibitory effect on both the nonpregnant and pregnant fallopian tube. However, the inhibitory effect of syntocin was converted into an excitatory effect after prolonged exposure (more than 7 hours) in Krebs‐Ringer's solution at 37oC.
Meconium Contamination of the Amniotic Fluid in Labour
Authors: Johnson Douglas G.
Published: February 2008

1. A prospective series of 254 patients who developed meconium staining of the liquor in labour is presented. The incidence of this sign was 18%.

2. One‐third of the patients delivered spontaneously less than 30 minutes after meconium contamination was detected. Antepartum detection of the foetus at risk may improve the perinatal mortality in this group.

3. In two‐thirds of the patients there was time for re‐assessment of the labour and for operative delivery when indicated. Thus in 11 % of all pregnancies meconium contamination will occur sufficiently early in labour for foetal acid‐base studies to be performed and acted upon. The implications of this are discussed.

4. Prolonged pregnancy was a common but not a serious complication in this series.

5. The wisdom of disregarding meconium contamination in breech presentations is questioned.
A Simpler Technique of Uterine Lavage for the Study of Endometrial Cytology
Authors: Barbaro Charles
Published: February 2008

A simpler technique of aspiration lavage of the uterine cavity is described in which, by rapid aspiration, air from the endomet‐rial cavity is replaced by irrigating fluid.

The principle of the technique and the apparatus employed is described with emphasis on its simplicity of action. Endo‐metrial cells are obtained in more than 90% of cases and accuracy of the cytology report in relation to the histology approaches 85%.

The clinical applications are enumerated.
A Survey of 5,000 Consecutive Deliveries in Private Practice
Authors: Correy J. F.
Published: February 2008

A study has been made of 5,000 consecutive pregnancies in booked patients in the care of the writer in private hospitals in Hobart over the period 1954–1966.

A statistical survey of the complications of pregnancy and labour in this material is given.

The management routines during the antenatal period and in labour have been presented briefly and reference is made to difficulties of adequate data recording in certain conditions.
Shute's Parallel Forceps — An Australian Experience
Authors: Wilson L. Hardy
Published: February 2008

Summary and Conclusions

Shute's parallel forceps are described together with the technique required for their use.

Experience with 76 “difficult” vaginal deliveries is recorded.

The advantages of the instrument are described. They are comparable to Kiel‐land's forceps, but are easier to apply and rotation and delivery can be carried out with great ease, usually with local anaesthesia. There is a minimum of trauma to the fetus and a pleasing lack of disfigurement to its face and scalp.
Peripheral Plasma 11 ‐ Deoxy ‐ 17 ‐ Oxosteroids: Alterations during Pregnancy
Authors: Hankin Margaret E. , Cox R. I.
Published: February 2008

The peripheral plasma levels of 17‐0times0‐steroids were measured serially by gas chromatography during pregnancy for 11 healthy primigravidae and compared with non‐pregnancy values. Dehydroepiandrosterone sulphate and androsterone sulphate decreased markedly and progressively during pregnancy, the most rapid change being in the first trimester. Aetiocholanolone sulphate was undetectable. There was no variation in levels during the menstrual cycle. The changes in DHEA‐S are consistent with the increased utilization for fetoplacental synthesis and haemodilution.
Surgical Conditions Complicating Pregnancy Part 2. Diseases of the Gall‐Bladder and Pancreas
Authors: O'Neill James P.
Published: February 2008

Summary

After acute appendicitis, gall‐bladder disease is the common surgical condition seen by the obstetrician. Despite this, the literature on the subject is remarkably sparse.

Twenty‐one patients were seen over a 14 year period; their clinical features and treatment have been reviewed, and debatable aspects discussed.

Acute pancreatitis is a less common but often more dramatic complication, which may be difficult to diagnose with certainty. Six cases were seen, and their features have been compared with others reported in the literature.
Racial Factors in Invasive Carcinoma of the Uterine Cervix
Authors: Jameson M. H.
Published: February 2008

Summary

During a 20 year period, 1116 patients with invasive carcinoma of the cervix were treated. Of these, 147 were Polynesians and 967 were non‐Polynesian. None was lost to follow‐up.

The 5 year survival of Polynesians is poorer than for non‐Polynesians. The reason for this is found in the delay in presenting for treatment and thus the later stage at diagnosis.

The incidence is greater in Polynesians and the age at onset is one decade earlier, but these may be socio‐economic influences rather than purely racial ones.

A general improvement in presentation at an earlier stage of the disease has been demonstrated for both races.
Torsion of a Colonic Fibroma Complicating Pregnancy
Authors: Atlay Robert D. , Cuschieri Alfred
Published: February 2008

Summary

A woman 22 weeks pregnant presented clinically with a classical picture of acute appendicitis; at laparotomy, torsion of a colonic fibroma was found. This is an extremely rare cause of an acute abdomen, whether or not there is a coexisting pregnancy.
Placenta Percreta Presenting as Intra‐Abdominal Antepartum Haemorrhage
Authors: Welch Ian D.
Published: February 2008

A case is reported of placenta percreta presenting as an antepartum intra‐peritoneal haemorrhage at 32‐34 weeks in a New Guinea woman. The patient had a history of previous partial placenta accreta and postpartum haemorrhage treated conservatively. The warning signs of abdominal pain, usually with progressive anaemia, occurring during pregnancy in a woman with a suspicious history of previous third stage trouble, may alert the obstetrician to this rare condition.
Placenta Praevia Accreta
Authors: Fahmy Kamal
Published: February 2008

Five cases of placenta praevia accreta are reported. One patient was managed by total hysterectomy, and the other 4 by conservative measures. These cases bring the number reported to 100. The accretic process in placenta praevia was mainly the result of deficient decidual reaction in the lower segment; another common predisposing factor is the presence of a previous Caesarean section scar. Placenta praevia accreta may be associated with primary or secondary haemorrhage, uterine perforation or rupture, acute hypofibrinogenaemia, and intra‐uterine infection. The best treatment is total hysterectomy as this results in the lowest maternal mortality. However, the uterus might be conserved in some cases by the use of packing, and uterine and/or internal iliac artery ligation.
Choriocarcinoma in Uganda –A Case for Active Prophylaxis
Authors: Smith P.
Published: February 2008

A review of 48 patients with choriocarcinoma was carried out. In this series, age and parity increased the risk of choriocarcinoma following on a hydatidiform mole. In view of the inadequate follow‐up of patients with molar pregnancies in this country, a policy of active prophylaxis – hysterectomy with chemotherapy – has been adopted in our hospital.
Fused Bilateral Adeno‐Fibromata of the Ovaries – A Report of a Case
Authors: Traill M. A.
Published: February 2008

A case of bilateral ovarian adeno‐fibromata with fusion across the mid‐line is presented.

Whilst bilateral adeno‐fibromata are not particularly rare, for them to become fused across the mid‐line would appear to be uncommon.
The Value of Urinary Oestriol Estimation in Patients with Antepartum Haemorrhage
Authors: Beischer N. A. , Reid S. , Brown J. B. , Macafee C. A. J.
Published: February 2008

The clinical results and patterns of urinary oestriol excretion in 139 consecutive patients with antepartum haemorrhage are presented. The perinatal mortality rate was 14.8% in the 54 patients with low oestriol excretion and was 4.7% in those with normal oestriol excretion.

Persistently low oestriol values indicated the advisability of delivery before 37 weeks of gestation in 2 of the 36 patients with placentae praevia. In abruptio placentae the incidence of low oestriol excretion was quadruple that of a normal population, and 12 of 43 patients had consistently low oestriol values. Induction of labour was carried out because of low oestriol values alone in only 2 of 60 patients in whom the cause of bleeding was undetermined.

Urinary oestriol estimation is of value in selecting the optimum time for delivery in patients with mild to moderate antepartum haemorrhage.
Vacuum Extraction after Fetal Blood Sampling
Authors: Lee K. H.
Published: February 2008

Sixty‐three cases of vacuum extraction subsequent to fetal blood sampling in labour are presented. No bleeding was observed from the site of scalp puncture and there was no statistically significant increase in the incidence of cephalhaematoma following the procedure.
Reactions of Women to Perinatal Death
Authors: Giles P. F. H.
Published: February 2008

Forty women who had just lost babies in the perinatal period showed emotional and physical reactions similar to those seen following the death of a loved person.

The needs of these bereaved women, the effect of bereavement on mental and physical health, and the importance of mourning are discussed.

Although doctors treated the women's physical symptoms and prescribed sedatives liberally, in about half the cases they avoided discussing the death of the baby. These women need a sympathetic listener and his reassuring explanations to remove misconceptions and guilt, and to provide confidence for the future.
Premature Labour with Renal Infections: The Action of Coliform Endotoxin on the Pregnant Rat Uterus
Authors: Wren Barry G.
Published: February 2008

The possibility that endotoxin from coliform organisms may initiate premature labour in women with renal infection is discussed. The action of endotoxin as a direct oxytocic was investigated, but no evidence of sustained activity was found. Rather, endotoxin appeared to have a depressant effect, even if a temporary stimulation took place initially. Neither could evidence for “sensitising” of uterine muscle by endotoxin be elicited when oxytocin was used to stimulate contractions.
Serum C‐Reactive Protein in Pregnancy, Labour and the Puerperium
Authors: Jones W. R.
Published: February 2008

A study is reported of serum C‐reactive protein in 202 normal pregnant, parturient, and puerperal women. The incidence of positive tests increased progressively throughout these stages culminating in a 97% positive rate after the first postpartum day. An abrupt increase in incidence was noted when labour was prolonged beyond 12 hours, suggesting an association of the appearance of C‐RP with dynamic tissue changes at a utero‐placental level. This probably represents an acute phase of a more subtle process present in the 29% of patients showing a positive C‐RP test in the third trimester of pregnancy. It is suggested that the appearance of this protein in the serum of pregnant women may indicate intra‐uterine tissue changes based on minor biological (?immunological) variations from the normal feto‐maternal relationship. C‐RP was found to be present in 2 out of 70 cord sera tested, thus confirming its inability to cross the placenta.
Duration of Symptoms and Survival Rates for Invasive Cervical Cancer
Authors: Green G. H.
Published: February 2008

The results of treatment (actuarial survival rates) of 640 patients with invasive cervical cancer (79% being in Stages 1 and 2) are presented. These are comparable to those from many centres and are better for surgical than radiation treatment (Stages 1 and 2); the surgically‐treated patients, however, form a highly selected group.

Survival rates for the various stages according to the duration of localised symptoms (0‐3, 4‐12, >12 months) are presented. Except for an indication that Stage 1 patients with symptoms for more than 12 months (16 patients only) may have a better prognosis than others in Stage 1, the duration of symptoms made no difference to survival rates.

It is concluded that the attributability of systemic symptoms will have to be studied more carefully, preferably prospectively, if they are to be included with local symptoms in estimating prognosis. It is suggested that if anatomic staging and duration and type of symptomatology are important in prognosis, then the mode of treatment may be less important than is thought.
Identical Ovarian Malignant Disease in Two Sisters
Authors: Molloy William B.
Published: February 2008

The occurrence of anaplastic ovarian carcinoma involving the right ovary of 2 sisters during reproductive life is reported.
Cytological and Histological Correlation in 300 Cases of Cervical Cone Biopsy
Authors: Hollyock V. E. , Fortune D. W.
Published: February 2008

Summary: This is a study of 300 cases of cervical cone biopsy, 292 being performed as a result of findings at cytology and punch biopsy and 8 on clinical appearances of the cervix alone. Findings at cytology, punch biopsy, conization and subsequent hysterectomy have been correlated.

Cytological prediction of a specific lesion agreed with the histological findings in the cone biopsy in 60% of 231 smears. Punch biopsy findings agreed with those of the cone biopsy in 42% of 52 patients, but in 24% a more severe lesion was found. Cone biopsy revealed the histological severity of all lesions in 97 of 100 patients having subsequent hysterectomy for non‐invasive lesions. There were 38 residual lesions in the 100 patients. Post‐conization smears were accurate in 94% of cases in predicting the presence or absence of a residual lesion. Invasive carcinoma was diagnosed by conization in 32 patients (11%).
Trends in the Treatment of Pelvic Malignant Diseases
Authors: Lewis T. L. T.
Published: February 2008

There are 2 ways of attacking the problem of malignant disease — diagnosis at an earlier stage, and better treatment. Gynaecologists all over the world have made a great effort in the past few years to diagnose pelvic cancer at an earlier stage, especially in the case of carcinoma of the cervix. I wish to deal only with the second line of attack and to review recent changes in attitude to the treatment of the commoner types of pelvic malignancy in women.
Golden Ovaries
Authors: Page S. W.
Published: February 2008

Summary: This report concerns 6 women who presented with an excessive intake of carotene‐containing foodstuffs and menstrual disturbance. Four of these were well nourished with respect to protein intake, while the other 2 were undernourished (anorexia nervosa type syndrome).

Four of the patients were in an older age group (range 35‐58) with excessive or irregular vaginal bleeding; 2 of the patients were younger (22, 23) and presented with oligo‐amenorrhoea. The ovaries in all patients were golden yellow in colour and possessed a characteristic histological appearance. Fat stains revealed abundant, highly‐dispersed, lipid granules occurring throughout the ovarian cortex, not restricted to areas around the corpora lutea; special stains for carotenoid pigments were strongly positive, the latter giving the ovary its uniformly yellow colour, which is usually only seen in relation to the corpus luteum.

It is proposed that those women with a normal protein and a high carotene intake suffered from a hypervitaminosis A syndrome leading to a bleeding tendency. Those women with a sub‐normal protein intake may have had a suboptimal conversion of carotene to vitamin A and no bleeding tendency.
Rupture of a Dermoid Cyst during Pregnancy
Authors: Lee K. H. , Yeung K. K.
Published: February 2008

Summary: A case of spontaneous rupture of an infected dermoid cyst during the third trimester of pregnancy is reported.

Removal of the cyst, which was adherent to the uterine fundus and sigmoid colon, was effected after the uterus had been emptied by Caesarean section. Transverse colostomy was necessary because of damage to the bowel at the time of operation. The post‐operative course was complicated by subphrenic abscess.
Pilonidal Sinus of the Suprapubic Region
Authors: Logan G. , Edwards S. O.
Published: February 2008

Summary: A case of suprapubic pilonidal sinus in a young female is presented and previously reported cases of this condition are reviewed.
The Distribution of Water and Electrolytes in the Fetus, Placenta and Mother at the End of Pregnancy and After Labour at Term
Authors: Lander Cecilie , Khoo S. K. , Mackay E. V. , Gaffney T.
Published: February 2008

Summary: A study of the composition of water and electrolytes in the fetal‐placental‐maternal system is presented. Fifteen patients of gestational age 38–40 weeks were investigated either before labour (elective Caesarean section (4 patients)) or after labour (11 patients). The parameters studied comprised the osmolality and electrolytes of maternal venous blood and urine, placental and cord arterial and venous blood, fetal urine, and amniotic fluid, together with the water and electrolyte content of uterine muscle, placenta and cord. The main effect of labour was a fall in the tissue electrolyte levels without a corresponding change in body fluids.
A New Limited Traction Obstetrical Forceps
Authors: Asab I. , Kelly J. V. , Adams M. L.
Published: February 2008

Summary: A new type of limited‐traction forceps in which negator‐springs are used to regulate traction is described. The principle of action of the regulator is described in detail.
Human Pregnancy – An Experimental Model for the Study of Immunological Disease
Authors: R. Jones W.
Published: February 2008

: The paradoxical survival of the mammalian fetus as an allograft provides a useful experimental model in immunology. In human pregnancy, studies of the placental transmission of serological and clinical manifestations of maternal auto‐immune diseases have resulted in important discoveries concerning the aetiology and pathogenesis of these conditions. These studies are reviewed with particular reference to thyrotoxicosis, myasthenia gravis, idiopathic thrombocytopenic purpura, systemic lupus erythematosus, scleroderma and pernicious anaemia.
Placental Scanning with 113m In with Particular Reference to Sources of Error
Authors: Connolly Roger , M. Schokman Christopher
Published: February 2008

There are blood pools in and around the gravid uterus other than those of the placenta. Radionuclide scanning to localize the placenta can be confused by these pools. The left uterine vessels are brought closer to the abdominal wall by dextro‐rotation of the uterus and provide a particular source of confusion. This paper attempts to correlate the density of the photoscan with direct measurement of the distance of these vessels from the abdominal wall. Scans were made before operation, using113m indium (113m In). The merits of photoscanning using this radionuclide are discussed.
Experience Gained from a Personal Series of One Hundred and Thirty Scalp Blood Samplings from One Hundred Fetuses
Authors: Nattrass Peter
Published: February 2008

: The results of 130 scalp samplings personally carried out by the author on 100 fetuses in labour are presented and discussed with reference to the literature,

A study is made of the association between clinical signs of fetal distress and the pH of the scalp blood and the value of pH, as opposed to clinical signs, as a means of predicting a depressed infant, is discussed.

Reference is also made to the complications involved and a conclusion as to the justification and place for fetal scalp sampling is arrived at.
Transient Fetal Acidosis and Artificial Rupture of the Membranes
Authors: Lumley Judith , Wood Carl
Published: February 2008

A retrospective analysis of 121 cases of fetal acidosis disclosed that in 20 per cent of them the disturbance was temporary and recovery spontaneous. The important clinical associations of transient acidosis were collection of the scalp blood sample immediately after amniotomy, maternal metabolic acidosis after fasting for amniotomy or after prolonged labour, and episodes of fetal bradycardia. The mechanisms by which amniotomy may lead to acidosis are discussed. The most probable is a short‐lived fall in uterine blood flow.
Suprapubic Bladder Puncture as an Alternative to Midstream Specimen of Urine in Obstetric Patients
Authors: Tischler E.
Published: February 2008

Suprapubic aspiration of urine in pregnant women is a safe and easy method of obtaining uncontaminated specimens of urine. The results of 186 suprapubic bladder punctures on both antenatal and postnatal patients are presented. The excellent patient acceptance and virtual absence of complications confirm previous claims that suprapubic puncture is a suitable alternative to midstream specimen of urine in obstetric patients.
Termination of Pregnancy by Intra‐uterine Prostaglandin F2α
Authors: Korda Andrew , Shearman Rodney P. , Smith Ian D.
Published: February 2008

Summary: Fourteen pregnancies between the 12th and 19th weeks of gestation were terminated by intra‐uterine administration of prostaglandin F2α. In 7 patients the method of administration was transcervically into the extra‐ovular space; in the other 7, administration was directly into the amniotic sac. The methods of administration, the doses used, the side effects and results are discussed. The findings indicate that intra‐amniotic administration is the procedure of choice: firstly, because of the incidence of genital tract infection after transcervical administration; secondly, because 3 patients in the transcervical group had incomplete abortions and required anaesthesia for curettage; and finally, the induction‐abortion interval was significantly less when the drug was administered into the uterine cavity.
Fetal Cardiac Arrhythmias and Fetal Acid‐Base Status
Authors: Symonds E. M.
Published: February 2008

Summary: Three cases of fetal cardiac arrhythmia (one of nodal extrasystoles, one of nodal tachycardia and one of auricular flutter), are described in which there was evidence of acidosis during labour and/or at the time of delivery. The subsequent progress of these infants is described and the findings discussed in relation to previous observations on fetal cardiac arrhythmias.
The Accuracy of Diagnosing Placenta Praevia with Compound Ultrasonic Scanning
Authors: Morrison John , Lachelin Gillian C. , Blackwell Roland J.
Published: February 2008

Summary: Compound ultrasonic scanning as a method of diagnosing placenta praevia is considered in a group of 51 patients clinically assessed as having this condition at delivery. The gestation at which the ultrasonic diagnosis was made ranged from 22 to 39 weeks. Correct prediction was made in 48 patients (apart from several minor variations as to the grade of placenta praevia present). There were 3 false negative diagnoses by ultrasound, and 7 false positive errors. The problems of predicting placenta praevia, particularly minor grades, are considered.
Racial Incidence of Carcinoma of the Cervix in Fiji
Authors: Lancaster D. J.
Published: February 2008

Summary: Statistics are presented which indicate there is no significant racial difference in the incidence of cervical carcinoma in the 2 main ethnic groups living in Fiji — indigenous Fijian and Indian.
A Survey of Carcinoma of the Cervix in Western Australia over the 10‐Year Period 1956–1965
Authors: Nattrass Peter
Published: February 2008

Summary: A total of 390 cases of carcinoma of the cervix occurring in Western Australia over the period 1956–1965 has been studied and followed up. The cases have been reviewed from a number of aspects, including the 5‐year survival rate, and the figures have been compared with large published series from other centres.
Experimental Immunization Against Human Placental Antigens
Authors: Jones W. R. , Ing R. M. Y. , Kaye M. D.
Published: February 2008

Summary: The immunogenicity of human placental homogenates was studied in an experimental xenogeneic immunization system using the rabbit. The results provided evidence of the immunogenicity of certain non‐cellular and stromal elements of chorionic villi and of some cytotrophoblastic components. By contrast, a lack of immunogenicity of syncytiotrophoblast in this system demonstrates the relative antigenic “inertness” of this layer and suggests for it a possible role in providing a degree of immunological protection for the more immunogenic components, including cytotrophoblast, which it encompasses within the chorionic villus.
Major Intraperitoneal Bleeding Complicating Amniocentesis — Case Report
Authors: Francesco A. Di
Published: February 2008

Summary: A further case of major intraperitoneal bleeding following amniocentesis is reported.

The potential hazards of this complication to both mother and fetus are emphasized.
Post Mortem Caesarean Section Following Death by Electrocution
Authors: Toongsuwan Sommai
Published: February 2008

Summary: A case of a surviving infant delivered by post mortem Caesarean section is added to the 153 previously reported. The patient, a primigravid at 38 weeks of gestation, was delivered probably some 15 minutes after death of the mother by electrocution. At the age of 8 years the child shows normal physical and mental development. The literature on the subject is briefly reviewed.
Genital Bilharzia: A Report of 3 Cases
Authors: Bellingham F. R.
Published: February 2008

Summary: Genital Bilharzia is not uncommon in much of Africa, and may be seen elsewhere as travel becomes more popular with residents of this country. An important feature is the frequent association with urinary infestation. Three cases are reported to show the type of genital lesion which may be found.
Testicular Feminization: The Clinical Features, Endocrine Function and Gonadal Pathology in Six Patients
Authors: Khoo S. K. , Mackay E. V.
Published: February 2008

Summary: The clinical and endocrinological aspects of 6 patients with testicular feminization are presented. In 5 patients, operative findings and histological appearances of the gonads are detailed. One of the patients showed evidence of virilization.

Primary amenorrhoea, a history of similarly affected female relatives, relatively tall stature, inguinal hernia, absent or sparse body hair, good breast development and a cul‐de‐sac vagina were characteristic features. The chromosomal karyotype was typically 46 XY. Urinary oestrogen excretion was reduced from 10–30 μg./24 hours before gonadectomy to 1–3 μg./24 hours after the operation.

The gonads were located in the inguinal canal or at the pelvic brim; on histological examination, they resembled the testes in cryptorchidism, with immature seminiferous tubular development. Rudimentary structures resembling epididymis were present in 2 patients, and in one of these there were also remnants suggestive of a uterus and the Fallopian tube.

The disorder of androgen insensitivity is discussed with reference to pathogenesis, endocrine function, risk of malignancy in the gonads, inheritance and management.
A Review of 31 Cases of Malignant Trophoblastic Tumours
Authors: Vohra S. , Madan P.
Published: February 2008

Summary: In a series of 31 consecutive patients with malignant trophoblastic disease there were 28 patients with choriocarcinomas and 3 with invasive moles. More than three‐quarters of the patients were less than 30 years of age. Of the patients with choriocarcinoma, 13 died in hospital, 6 died at home within 3 months, 1 survived, and 8 were lost to follow‐up.