bluuebunny/crossref_metadata_2025 huggingface dataset:
A Prospective Study of Smoking and Pregnancy
Authors: Kullander Stig , Källén Bengt
Published: December 2009

A prospective study was performed on the effect of smoking on pregnancy, using information from 6 363 pregnancies with known smoking habits. Of these, 2806 (44%) smoked during pregnancy, and 2731 (97%) of the 2 806 reported that they smoked during the whole pregnancy. The well‐known effect on prematurity rate and mean birth weight was verified in this study. A 50% increase of prematurity rate was registered among smoking women compared with non‐smoking women. The mean birth weight reduction was 170 g among live‐born, non‐malformed children. These effects were found to occur irrespective of other variables studied: maternal age, parity, and whether the pregnancy was wanted. The body length, head circumference, and shoulder circumference were found to be reduced in children born to smoking women. Placental weight was also reduced, but the ratio placental weight over body weight increased with smoking. No effect on the malformation rate was observed, but the series is too small to exclude a teratogenic effect of smoking. Children were followed to 1 year of age. The death risk for a child of a smoking woman was found to be increased to 1.6 times that for a child of a non‐smoking woman. No significant difference in stillbirth rate was found, but an effect was found on neo‐natal death both before and after the age of 1 week, although only among non‐premature children. Among children dying before the age of 1 week, a significant increase in frequency of abruptio placentae was noted. No other specific cause of death was noted. An overall increased risk of spontaneous abortion among smoking women was verified; this was shown to be almost completely due to the association between the fact that the pregnancy was unwanted and smoking. An even higher incidence of smoking was seen among women with induced abortions. Spontaneous abortion is also associated with unwanted pregnancies, perhaps due to the presence of induced abortions among the group recorded as spontaneous abortions. Smoking was shown to be associated only with late spontaneous abortions. If there is an abortifacient effect of smoking, it must be very slight. The decreased rate of preeclamptic complications among smoking women, described by earlier authors, was verified. A similar decrease in frequency of morning sickness was also found. No effect of smoking on the mean Apgar score of surviving, non‐malformed children was seen. The sex ratio among children born to smoking women differed slightly from that born to non‐smoking women, but this difference was not statistically significant.
Rupture of the Normal Spleen Occurring as a Birth Injury
Authors: Halvorsen Jan F.
Published: December 2009

A case of rupture of the normal spleen as a birth injury is reported. The child was born 2 weeks past term. There was a vertex presentation, and no history of trauma could be elicited except that associated with a normal spontaneous birth. Eight hours after birth the infant developed signs of shock, and it died 7 hours later. Autopsy showed haemoperitoneum from a subcapsular tear of the spleen at the insertion of the lieno‐renal ligament. An explanation of the probable mechanism of this injury is given.
Ultrastructure of the Anchoring Villi and Trophoblastic Shell in the Second Week of Placentation
Authors: Larsen Jørgen Falck , Knoth Mogens
Published: December 2009

The fine structure of the anchoring villi and the trophoblastic shell of a human embryo with four somites is described. The ultrastructure of the cytotro‐phoblast of the proximal part of the anchoring villi was similar to that of the Langhans' cells of the free villi. The distal cytotrophoblasts had irregular nuclei and contained more rough endoplasmic reticulum. The cytotrophoblasts of the base of the villi were large and contained large amounts of glycogen.

The basal plate comprised a variety of trophoblastic cells. Most commonly seen was the mononuclear giant cell, which was rich in rough endoplasmic reticulum, glycogen and fibrils. In the periphery of the placental site, the trophoblasts were scattered among the maternal cells. Foetal and maternal cells were often found side by side without any reaction. However, the cell membranes of trophoblastic giant cells and those of the uterine gland cells were closely apposed and desmosomes were observed between the foetal and maternal cells. In other places cell membranes between trophoblastic cells and uterine epithelium seemed to disintegrate.
The Urinary Excretion of Chorionic Gonadotrophins After Induced Abortion
Authors: Sloth Merete , Stakemann Georg
Published: December 2009

The urinary excretion of chorionic gonadotophins after legal abortion has been followed using an immunological pregnancy test (Pregnosticon®). The test only became negative after several days, and 25% of the cases still had positive tests 11 days after the evacuation of the ovum.
Weight Loss in Secondary Amenorrhea: A Gynaecologic, Endocrinologic and Psychiatric Investigation of 54 Consecutive Clinic Cases
Authors: Holmberg Nils‐Gunnar , Nylander Ingvar
Published: December 2009

Fifty‐four consecutive cases of secondary amenorrhea seen in the Department of Obstetrics and Gynaecology of Umeå University Hospital were systematically studied from the somatic, endocrinologic and psychiatric points of view. The study showed that 51 patients had lost weight at or about the time of onset of amenorrhea and that 41 of these had symptoms characteristic of anorexia nervosa; some were cachectic. In none of these cases was there any reason to suspect a primary endocrine disturbance. On the other hand, two of the patients who had not lost weight, had significantIy elevated urinary 17‐ketosteroids in both total and fractional analysis.

The connection between starvation, psychogenic amenorrhea and anorexia nervosa is discussed.
A Radiotelemetrtc Study of Uterine Activity in Labour
Authors: Persianinov L. S. , Davydov S. N.
Published: December 2009

The radiotelemetric investigation of intra‐uterine pressure was carried out in 904 women and proved to be a method of studying uterine activity which is harmless for both mother and fetus and can be carried out at all stages of labour. The investigation of intra‐uterine pressure allows uterine contractions to be judged both qualitatively and quantitatively, and all the necessary amplitude‐time measurements which interest the obstetrician can be obtained. It has been shown that the intensity and duration of uterine contraction and uterine tone increases, while the intervals decrease as labour progresses. The activity of the woman in labour who frequently changes her position accelerates labour by increasing uterine tone and the frequency of contractions.
Plasma Oestrogens and the Fetal Outcome
Authors: Fischer‐Rasmussen Wiggo
Published: December 2009

Oestriol, oestrone, and oestradiol‐17β concentrations in plasma were studied in a series of “high risk” pregnancies. A gas chromatographic method of measurement was used. Plasma determinations have an advantage over urine determinations, because the collection of 24 h urine specimens is ledious and particularly liable to error. Low and subnormal plasma oestriol values were found to be correlated with the subsequent occurrence of fetal asphyxia or intrauterine death. Plasma oestriol values well within normal limits, or increasing, indicated that fetuses were not at risk of the more severe grades of asphyxia, or of intrauterine death. An exception was observed when the mothers had impaired renal function. Oestrogen clearance is reduced and, therefore, apparently normal values are not significant. Low oestrogen concentrations may not be significant when patients are on (halogenated) steroid therapy. Plasma oestrone and oestradiol‐17β values in the asphyxia group showed a similar pattern to those of oestriol, but gave no additional information. In the groups without asphyxia, especially oestradiol‐17β values lay low in the normal range with many subnormal values. In many of these cases, there was also the discrepancy that plasma oestriol values were normal, while urine oestriol values were subnormal. The plasma analysis will probably become a valuable guide to care in the obstetrical clinic.
Radiographic Study of Extra‐Amniotically Injected Hypertonic Saline in Therapeutic Abortion
Authors: Gustavii Björn , Göthlin Jan
Published: December 2009

Examination of radiographs from thirty‐six women after extra‐amniotic injection of 20% NaCl containing contrast medium revealed as follows: (a) In most cases, the solution spread around the entire amniotic sac. (b) In no case was filling of the fallopian tubes observed. (c) In most cases, the solution disappeared from the uterus within four hours. (d) In some cases, the solution disappeared immediately from the uterus and appeared in the uterine veins and urinary bladder, indicating intravascular injection. Effective myometrial contractions was obtained when the solution was retained in the uterus for one to two hours. Further retention did not shorten the interval between injection and delivery.
The Incidence of Complications Following Hysterectomy in Relation to the Time Interval Between Cone Biopsy of the Cervix and Hysterectomy
Authors: Skaarup P. , Berget A. , Szczepanski K.
Published: December 2009

A series of 230 patients was studied with a view to the effect of the time interval between cone biopsy of the cervix and hysterectomy on the postoperative febrile course and on the incidence of severe complications, such as abscess and/or haematoma in the true pelvis or in the abdominal wound. Fever as well as severe complications were found to be most common in patients treated by hysterectomy 4‐14 days after cone biopsy. The causes are discussed. It is concluded that cone biopsy and hysterectomy should be carried out at the same time, with frozen section microscopy of the biopsy. Otherwise, the hysterectomy should be deferred until 5 or 6 weeks after the cone biopsy.
Progesterone Levels in Amniotic Fluid and Plasma from Women I. Levels during Normal Pregnancy
Authors: Johansson E. D. B. , Jonasson L.‐E.
Published: December 2009

Amniotic fluid samples from 45 early and 46 late pregnancies have been assayed for progesterone using a protein binding technique. Only 100 μl of amniotic fluid was needed for the determination. Simultaneous samples of plasma or serum have also been assayed. The highest progesterone levels in amniotic fluid were found between the 13th and 16th week of pregnancy when the levels were higher than in plasma. After this time there was a steady decline in amniotic fluid levels throughout pregnancy. The mean level during the 13th‐16th week period was 55.3 ng/ml amniotic fluid and 26.4 ng/ml between the 37th and 40th week. In contrast plasma levels of progesterone increased with advancing pregnancy and exceeded amniotic fluid levels from the 21st‐24th week onwards. The decrease in amniotic fluid progesterone concentration may be due to a relative decrease in placental progesterone synthesis and an increasing resistance to the passage of progesterone into the amniotic cavity.
Feto Maternal Haemorrhage in Ectopic Pregnancy
Authors: Liedholm Percy
Published: December 2009

Feto‐maternal transfusion was found to be significantly more common in ectopic pregnancy than in normal pregnancy of corresponding duration. Ectopic pregnancy, but never normal pregnancy in the first trimester, was sometimes associated with feto‐maternal transfusion sufficiently large to cause Rh‐imnuinisation.

It is concluded that an ectopic pregnancy in a Rh‐negative non‐immunised woman is an indication for prophylaxis with anti‐D‐gammaglobulin, administered as early as possible after the operation.
Cnjoined Twins
Authors: Tan K. L. , Goon S. M. , Salmon Y. , Wee J. H.
Published: December 2009

During the years 1960 to 1970 inclusive, six conjoined twins were delivered out of a total of 403 441 deliveries including 3 276 twins and 37 triplet deliveries, an incidence of 1 in 67 241 deliveries and 1 in 655 twin deliveries. A seventh conjoined twin was delivered in late January 1971; inclusion of this case as well as the deliveries in January 1971 would lead to an incidence of 1 in 57 975 deliveries and 1 in 546 twin deliveries. Four of the twins were thoracopagus, one craniopagus, one dicephalus tripus tetrabrachius and one syncephalus. One of the thoracopagus twins occurred in a triplet pregnancy. All except two were delivered alive; four died within a few hours to a few days. One thoracopagus survived till 3 months of age; surgical separation was then attempted resulting on one survival who has developed normally and is now 7 years old. Antenatal diagnosis is necessary if the survival rate is to be improved.
The Radiofrequency Field Distribution Surrounding Coils for Intrauterine Diagnostic Procedures: I. Geometrical Factors
Authors: Rudolfsson Carin , Joelsson Ingemar , Ingelman‐Sundberg Axel , Odeblad Erik
Published: December 2009

The absorption of radio frequency energy emitted by a small intrauterine coil has been used for intrauterine scanning in order to localize intrauterine pathology, especially cancer. In order to improve the method the distribution of RF field intensities around coils of different geometries has been measured. Ringshaped coils have longer axial effective fields than other coil geometries, probably allowing diagnosis of more deeply lying processes. Still deeper processes may be reached by two‐coil systems of special design. The RF absorption has been shown to follow the squared value of RF field intensity.
Serum Ceruloplasmin, α1‐Antitrypsin, α2‐Macroglobulin and Iron and T3 Binding Proteins During Hypertonic Saline‐Induced Abortion
Authors: Willman K. , Salmi T. T. , Vanharanta H. , Pulkkinen M. O.
Published: December 2009

Serum ceruloplasmin, α1‐antitrypsin, α2‐macro‐globulin and the iron and T3 binding proteins were studied in six women during abortion induced by hypertonic saline. After correction of the results for total serum protein changes (15%), no significant variations in the concentrations of the proteins studied could be observed within 48 hours following saline treatment. The insensibility of specific serum proteins as indicators of the welfare of the fetoplacental unit is discussed.
Environmental Temperature and the Occurrence of Toxaemia of Pregnancy in a Subarctic Area
Authors: YlóstaloYlóstalo Pekka , Kauppila Antti , Sotaniemi Eero
Published: December 2009

A study was conducted on the effect of variations of environmental temperature in a subarctic area on the incidence of admission to hospital of patients with toxaemia of pregnancy. Toxaemia of pregnancy was the reason for 1 152 admissions in 1965‐1968, and essential hypertension was the reason for 209 admissions. The environmental temperature was correlated with the admission rate: the higher the temperature, the greater was the number of admissions. A minor drop was seen in the rate of admissions in the temperature range 10° to + 10°C, and the same trend was observed in the frequency of the individual symptoms of toxaemia of pregnancy: oedema, proteinuria and hypertension. The incidence of eclampsia followed the same pattern, but to a greater degree. The rate was higher in the temperature ranges 10° to 19°C and + 10° to + 19°C than in the 10° to + 10°C range.

Temperature changes during the two days before the day of hospital admission did not influence the frequency of hospital admissions.
Dislocation of the Nasal Septal Cartilage in the Newborn: Aetiology, Spontaneous Course and Treatment
Authors: Jeppesen Finn , Windfeld Ib
Published: December 2009

Following a dislocation of the lower edge of the nasal septal cartilage from the furrow in the pre‐maxilla and vomer (Figs. 1, 2) the cartilaginous outer nose is often twisted and the support is poor (Figs. 4 a, b). In 7% of the cases no deviation is evident unless a compression‐test is carried out (Fig. 4 b). This procedure is recommended in the routine examination of newborn infants. If twisting is found the infant should be examined by a specialist in ear, nose and throat diseases. 141 cases of dislocation of the nasal septal cartilage were found in a series of 9 707 living newborn infants (1.45%) (Fig. 5). However, in a series of 907 newborn infants all examined rhinologically 29 cases were found (3.19%) (Fig. 6). Two thirds of the cases are apparently caused by trauma during pregnancy and the early stages of labour. They are equally distributed between right and left. One third of the cases are caused by trauma solely during internal rotation, which in the L.O.A.‐presentation causes a dislocation of the inferior edge to the right, in the R.O.A.‐presentation to the left (Figs. 10, 11, 12). The condition occurred significantly more commonly in firstborn infants but the reason for this was not evident from the analyses of the data. It was also more common in multiparae if second‐stage of labour was prolonged beyond 15 min (Table VIII). Therefore it is suggested that the second stage should not exceed 15 min in multiparae. The dislocation does not reduce spontaneously. The results obtained after reduction according to the method of Metzenbaum (Fig. 4 c) are good (Fig. 13), and the procedure can be carried out under local anaesthesia.
In Vivo Determination and Cyclic Variability of Intrauterine Volume
Authors: Joelsson Ingemar
Published: December 2009

A description is given of hysterometry, a method for in vivo determinations of the pressure response to linear increments in volume of the non‐pregnant human uterus. The analyses of pressure‐volume diagrams obtained during consecutive phases of the menstrual cycle reveal that the volume of the uterine cavity during the secretory phase is larger than during the proliferative phase by a factor of 2 or more. If ovulation does not occur, however, the relation between pressure and volume remains unchanged throughout the interval between two menstrual flows. It is suggested that hysterometry might prove of value for assessing the effect of hormones and pharmacologically active agents upon the myometrium.
Bead Chain Urethrocystography in the Investigation of Postoperative Urinary Stress Incontinence
Authors: Kauppila A. , Pietilä K. , Sjöstedt J. E. , Korhonen M. , Vahala J.
Published: December 2009

The results of bead chain urethrocystography on 74 patients with postoperative urinary stress incontinence (USI) are reported. USI occurred after vaginal plastic operation, vaginal hysterectomy or suprapubic surgery performed for repair of uterovaginal prolapse and/or USI. The findings in the bead chain urethrocystographic examination varied depending on the type of operation. Distribution by type (Green) based on loss of the posterior urethrovesical (PUV) angle and the angle of the urethral inclination is not suitable for every case of postoperative USI, for 20% of the cases displayed a normal PUV angle during straining. The so‐called base plate (Hutch) on the floor of the bladder did not remain flat during straining in any of the patients examined. In the planning of treatment for a patient with postoperative USI attention should be paid not only to the urethral inclination and PUV angle but also to the anterior urethrovesical (AUV) angle and the position of the UV junction at rest and during straining.
Ovarian Tumours and Peutz‐Jeghers Syndrome
Authors: Steenstrup Else Kirketerp
Published: December 2009

Ovarian tumours (or tumour‐like conditions) and Peutz‐Jeghers syndrome are associated more frequently than by mere chance. This seems to be particularly true for the “Sex cord tumour with annular tubules”, a new entity described by Scully in 1970. A case of this ovarian tumour found bilaterally together with a unilateral mucinous cystadenoma in a patient with Peutz‐Jeghers syndrome is presented with a discussion of the implications of this association.
Evaluation of a Capillary Tube Sperm Penetration Method for Fertility Investigations
Authors: Ulstein Magnar
Published: December 2009

The sperm penetration test introduced by Kremer was studied, using cervical mucus as the test medium and human semen samples with varying properties. The spermatozoa from semen samples of good quality penetrated rapidly, to more than 30 mm within one hour. Spermatozoa from semen samples of poor quality penetrated slowly and a maximum penetration of less than 20 mm was noted. Capillary tube size, incubation temperature, and the amount of mucus protruding from the capillary tube, had no appreciable influence on the results. Reproducibility was good. Storage of the cervical mucus at + 4°C or ‐ 20°C for 3 weeks did not influence its suitability as a test medium. The test is easy to perform and well suited for routine semen analysis.
The Effect of Tranexamic Acid (Amca) On Postoperative Bleeding After Conization
Authors: Rybo Göran , Westerberg Hans
Published: December 2009

A double blind randomized trial was made to ascertain the effect of tranexamic acid (AMCA) (Cyklo‐kapron®) on the postoperative blood loss after conization. The case material consisted of 50 women referred to the clinic because of dysplasia or non‐invasive cancer of the cervix. Five patients were excluded for various reasons. The treatment started in the evening of the day of operation and was continued for another 12 days, the dose being three tablets every 8 hours, corresponding to 4.5 g of tranexamic acid daily when the active drug was given. During the first 7 postoperative days, when the patients were in hospital, the blood losses were determined quantitatively. Prophylactic treatment with tranexamic acid reduced the postoperative blood loss as compared with the placebo group, the blood losses being 23 ± 3.2 ml and 79 ± 20.4 ml respectively. Sudden profuse bleeding postoperatively, requiring remedial measures, occurred in 7 patients, all in the placebo group. With the exception of 1 patient in the placebo group, who complained of nausea, no side effects were recorded.
Utero‐Vaginal Differential Pressure at Rest and During Physical Efforts in Early Pregnancy
Authors: Söderberg Göran
Published: December 2009

Simultaneous recordings of the intra‐uterine and intra‐vaginal pressures were carried out in 24 women in early pregnancy. At rest the uterine pressure was slightly higher than the vaginal pressure. Body position and physical efforts resulting in increased intra‐abdominal pressure had no essential effect on the utero‐vaginal pressure difference. This would seem to be an important mechanism for protection of the ovum during pregnancy.
Ultrastructure of a Human Implantation Site
Authors: Knoth Mogens , Larsen Jørgen Falck
Published: December 2009

The fins structure of the trophoblast from a previllous human ovum is described. The extra‐embryonal mesoderm was lined by cylotrophoblasts, which were beginning to form the primary villi. The ultrastructure of these cells was similar to that of the Langhans' cells of the definitive villus. The syncytiotrophoblast was located peripherally and consisted of a mixture of giant cells and syncytial masses. This cell type was well differentiated, with its cytoplasm occupied by large amounts of granular endoplasmic reticulum. Golgi elements, and vesicles. The syncytiotrophoblast had many microvilli and pinocytotic vesicles at the surface, lining the lacunae which contained maternal blood cells. Close contact was observed between the trophoblast and the cells of the maternal glands. The trophoblastic invasion of a maternal vessel is described, and the trophoblastic invasion is discussed.
Congenital Arrhythmias with Supraventricular Tachycardia in the Perinatal Period
Authors: Herin Peter , Thorén Claes
Published: December 2009

Abstract. Fourteen cases with perinatal tachyarrhythmia are described. Intra‐uterine cardiac arrhythmia was observed in 8 cases: 6 with paroxysmal supraventricular tachycardia (PST) and 2 with atrial flutter, all but one with variable AV‐block, and heart rate ranging between 120–230 beats/min. Caesarean section was performed because of suspected asphyxia in 4 cases and delivery by vacuum extraction in 2 of the 8 cases. All 6 cases first appearing in the first 4 days of life had PST with a heart rate varying from 210–310. Congestive heart failure, occurring in 10 cases in the total series, developed significantly earlier in the patients with intra‐uterine diagnosed tachycardia. No cause was found in 10 cases, and only 2 cases displayed the Wolff‐Parkinson‐White (WPW) syndrome. The importance of early ECG recording in all neonates with arrhythmia is stressed. An increased use of the fetal ECG is recommended in cases with rapid or irregular fetal heart sounds. The delivery should be accelerated when the fetal heart rate is constantly more than 200 beats/min.
Ovarian Carcinoma—a 10‐Year Series from a Provincial Hospital
Authors: Timm J.
Published: December 2009

74 cases of ovarian carcinoma diagnosed and treated at the department of obstetrics and gynaecology, Helsingborg's hospital during the years 1956‐1965 were examined with special reference to the effect of various biological, social and clinical factors on the later course. The following features were associated with a more favourable prognosis: younger age groups; married women; high haemoglobin values; short duration of symptoms; uterine bleeding as first symptom; low stage of tumour; mucinous cystocarcinoma; and following tumour characteristics: unilateral tumour; unruptured tumour; non‐adherent tumour; absence of metastases; absence of ascites. The differences regarding the 5‐year survival rate were found to be statistically significant within the groups relating to age, haemoglobin value, stage and the variables given under “tumour characteristics” (with the exception of “unruptured tumour”). The patient's parity and the size of the tumour was of little or no prognostic value in the present series. The prognosis was significantly better for patients who had bilateral oophorectomy combined with hysterectomy, than for those who had bilateral oophorectomy alone. The total 5‐year survival rate was 35.1%. 6‐16 years after the diagnosis 29.7% of the patients were still alive, 5.4% had died from intercurrent diseases and 64.9% from the tumour.
Radioisotope Renography in the Surgical Management of Carcinoma of the Cervix
Authors: Mogensen P. , Rødbro P. , Lefèvre H.
Published: December 2009

The results of intravenous pyelography (IVP) and radioisotope renography (RNG) were compared pre‐ and postoperatively in 77 patients with carcinoma of the cervix. A comparison was made of the occurrence of obstructive uropathy. A total of 161 comparisons between the two tests were done. The results revealed that the IVP never was abnormal without the RNG also being so. The data suggest that radioisotope renography to a large extent can replace intravenous pyelography in the evaluation of gynecological patients after operation.
The Clinical Value of Amniotic Fluid Analysis in Pregnancies Complicated by RH‐Isoimmunization or Hepatosis
Authors: Jonasson Lars Erik
Published: December 2009

605 samples of amniotic fluid were obtained by abdominal amniocentesis in 363 late pregnancies. The liquor was analysed with respect to ΔE450 (the optical density at 450 nm), progesterone and total protein content. On 172 samples measurements of the acid and alkaline phosphatase activity were also performed. Most of the samples came from pregnancies complicated by isoimmunization, but the material also contained samples from women with hepatosis gravidarum or other complications as well as from normal pregnancies. The measurements have been studied in relation to duration of pregnancy, cord blood haemoglobin levels, cord serum bilirubin levels, infant birth weight, maternal serum bilirubin levels, maternal alkaline phosphatase levels, maternal age, order of pregnancy, maternal and infant blood groups. For part of the series the relationships between the parameters were studied by multiple regression analysis. The results indicate a rather weak correlation between infant cord blood haemoglobin levels and the other parameters. The ABO blood groups of mother and infant influence the levels of cord blood haemoglobin, cord serum bilirubin and amniotic fluid total protein. Amniotic fluid progesterone and ΔE450 values are correlated to amniotic fluid total protein levels. Low ΔE450 values indicate that the fetus is mature. Determinations of ΔLE460 before the 37th week show a better correlation with the condition of the infant than later ones. Order of pregnancy influences the total protein content of amniotic fluid in normal pregnancies. Determinations of acid and alkaline phosphatases in amniotic fluid do not give any clinically important information in cases of isoimmunization. Meconium contamination strongly increases alkaline phosphatase activity. Attempts to use the rapid method of Brown for oestrogen determinations in amniotic fluid proved to be difficult for technical reasons.
Metabolism of Glucose in the Human Endometrium with Special Reference to Fertility and Contraception
Authors: Hackl Heinrich
Published: December 2009

On the basis of numerous biopsy specimens of the endometrium, in which substrates and enzymes concerned in the metabolism of glucose were examined in vitro, the following observations were made. Respiration and redox capacity as well as endogenous and exogenous glycolysis of the endometrium are increased maximally during the secretory phase. In this phase also the absolute Pasteur effect is increased to a maximum, while the control of glycolysis by the substrate is decreased. In addition, a Crabtree‐effect appears at the same time. This suggests that the endometrium in the implantation phase endeavours to deliver constant amounts of ATP and to maintain a stable physico‐chemical environment. While, from a gynaecological point of view various endometrium‐associated disorders cause no notable differences in metabolism, the uptake of glucose, or respiration, cytochrome oxidase and succinate dehydrogenase activity in the secretory endometrium decrease with advancing age and thereby presumably diminish the fertility of the elderly woman. The use of oral contraceptives reduces the glucose metabolism from endogenous and from exogenous substrates in the endometrium, despite increasing synthesis of glycogen during the cycle. The reduction of metabolism occurs to such an extent that it must be expected that a contraceptive effect in the endometrium takes place.
Uterus Didelphys with an Abortion into a Unilateral Imperforate Vagina
Authors: Nygren Karl‐Gösta , Persson Bengt H.
Published: December 2009

A case of abortion into a unilateral imperforate vagina of a uterus didelphys is reported. This abnormality is very rare and a pregnancy in the uterine horn on the imperforate side seems not to have been reported before. No communication into the “hidden” horn of the uterus except the transperitoneal route was found. Therefore, conception must have occurred by transperitoneal migration either of spermatozoa or of a fertilized egg.
Premature Ovarian Failure
Authors: Starup J. , Sele V.
Published: December 2009

Abstract. Twenty‐six patients with premature ovarian failure (last menstrual period before the age of 30 years) were evaluated clinically and endocrinologically and, in addition, ovarian biopsies were obtained in 15 out of the 26 patients. Only 1 of the patients revealed a family history of early menopause. The typical menstrual pattern indicated a normal age at menarche with regular periods for various length of time followed either by amenorrhoea abruptly or by a period of oligomenorrhoea before the onset of amenorrhoea. All patients showed normal or slightly underdeveloped secondary sexual characteristics, and it should be noted that 2 patients had been pregnant previously.

It was characteristic of all patients that the excretion of total gonadotropins was constantly increased and that the excretion of total oestrogens was low, whereas both the adrenal and thyroid function were normal. All patients were X‐chromatin positive.

In 13 out of the 15 patients, in whom ovarian biopsies were obtained, the histological examination revealed a normal stroma without or with very few primordial and atretic follicles, a picture very similar to that characteristic of the postmenopausal ovary. In the last 2 patients, however, the histological examination showed a quite different picture, viz. a normal stroma with numerous primordial and primary follicles and even a few growing follicles. In spite of these morphologically normal follicles, it was not possible to stimulate the follicular development and to induce ovulation even with very high doses of human gonadotrophins. It is, therefore, concluded that the presence of a few growing follicles in the ovaries does not seem to exclude the diagnosis of premature ovarian failure.

Only 14 out of the 26 patients had the typical symptoms of the climacteric, and even in these cases the nuisance was only of a mild to moderate degree. It is generally agreed that all patients with symptoms should receive substitution therapy, but the essential risk of ischaemic heart disease and osteoporosis, together with the unquestionable psychological effect of having regular menstrual bleeding, have led us to the conclusion that this therapy is indicated in all cases of premature ovarian failure. Cyclical treatment either with a sequential preparation or with oestrogens alone is the treatment of choice.
“Triggering” of Ovulation after Infusion of Synthetic Luteinizing Hormone Releasing Factor (LRF)
Authors: Nakano Ryosuke , Mizuno Tadayoshi , Kotsuji Fumikazu , Katayama Kazuaki , Washio Motoo , Tojo Shimpei
Published: December 2009

Abstract. Synthetic luteinizing hormone releasing factor (LRF) was infused intravenously for 6 hours into two women who had donor insemination. Supplemental LRF was injected subcutaneously after a 6 hours continuous infusion. Ovulation was triggered by LRF infusion and two successful pregnancies were achieved. It is suggested that ovulation might be triggered by a continuous intravenous infusion of synthetic LRF, if follicular development of the ovary is sufficient. It is concluded that “triggering” of ovulation by a continuous infusion of LRF might be a convenient means for controlling the timing of ovulation in case of donor insemination.
Plasma Levels of Progesterone and Oestradiol After Injections of 17α‐Hydroxyprogesterone Caproate During the Luteal Phase of the Normal Menstrual Cycle
Authors: Johansson Elof D. B.
Published: December 2009

Abstract. 17α‐hydroxyprogesterone caproate (Proluton Depot®, Schering AG, Berlin) was given after ovulation in a dose of 500 mg intramuscularly to four women with normal menstrual cycles. The plasma levels of progesterone and oestradiol were measured and compared to the levels found during previous control cycles of the same women. In the four normal women a small reduction of the plasma levels of progesterone and oestradiol was found after the injection of 500 mg of 17α‐hydroxyprogesterone caproate. However, the number of days with progesterone concentrations above the mean level of the follicular phase was not changed. The menstrual bleeding was delayed and appeared to be a withdrawal bleeding from 17α‐hydroxyprogesterone caproate rather than from progester one.
The Ureterocalyceal System in Normal Pregnancy
Authors: Fayad M. M. , Youssef A. F. , Zahran M. , Kamel M. , Badr M.
Published: December 2009

Abstract. Sixty normal pregnant women were investigated by isotope renography and by intravenous pyelography. In 92.3% of patients in the third trimester of pregnancy both methods revealed the presence of urcterocalyceal obstruction. Renography was found to be the more sensitive method. Strong evidence is presented to suggest that mechanical pressure from the pregnant uterus is the essential factor in the causation of the changes observed.
ENDOGENOUS PROSTAGLANDINS AND THE INITIATION OF LABOR
Authors: Wiqvist N. , Bygdeman M. , Gréen K. , Lundström V.
Published: December 2009

Abstract. An attempt to define the role of the prostaglandins in human parturition must necessarily be fragmentary at the present time. However, there is no doubt that considerable progress has been made during the last few years and that the prostaglandins have been established as important key intermediates in the complex hormonal and mechanical events integrated in the process. Improved chemical methods for the determination of prostaglandins in body fluids and tissues as well as some evidence of indirect nature have contributed to a better understanding of this complex problem.
Comparison Between Quinestrol and Diethylstilbestrol for the Inhibition of Lactation
Authors: Bergsjø Per , Brodtkorb Christian
Published: December 2009

Abstract. The effects on the inhibition of lactation of quinestrol (one single tablet of 4 mg) and diethylstilbestrol (5 mg 3 times daily for 5 days) were compared in a controlled clinical trial. During a hospital stay of 5 days breast tenderness was more frequent among the patients who took quinestrol. During the first month at home quinestrol treatment gave less milk secretion and considerably less breast tenderness than diethylstilbestrol. A series of antithrombin III determinations in plasma was too small for definite conclusions to be drawn.
Uterine Arterio‐Venous Fistula
Authors: Moberg P. J. , Dahlgren S. , Raabe N.
Published: December 2009

Abstract. A case of arterio‐venous fistula of the uterus is presented. The literature is reviewed and the etiology is discussed. Special attention should be paid to the occurrence of a previous pregnancy.
Plethysmographic Studies of Venous Volume in the Lower Legs During Normal Primipregnancy
Authors: Sandström Bo
Published: December 2009

Abstract. The venous volume of the lower legs was examined plethysmographically in 60 primigravidae, grouped according to duration of pregnancy. The three periods were 9–13 weeks (Group A), 15–22 weeks (Group B) and 36–41 weeks (Group C). In addition to the examination during pregnancy, in Group A examinations were performed 1 day and 2 weeks after abortion, while in Groups B and C the examinations were made 2 weeks after abortion and delivery respectively. The recordings were made at venous occlusion pressures of 40, 60 and 80 mmHg. Contrary to the information given in the literature on gravidae, it has not been possible to detect any difference in the venous volume of the lower legs during primipregnancy.
Ovarian Morphology and Pituitary Gonadotrophins in Serum During and After Long‐Term Treatment with Oral Contraceptives
Authors: Starup Jørgen , Visfeldt Jakob
Published: December 2009

Abstract. The aim of the present investigation was to directly correlate the development of ovarian follicles with the levels of FSH and LH in serum during long‐term treatment with oral contraceptives in order to discover to what extent follicular maturation beyond the stage of early primary follicles depends upon stimulation with pituitary gonadotropins.

Seventeen women aged 20 to 44 were treated cyclically for 6 to 100 months with different oral contraceptives of the combination type. Group I (10 women) were examined during treatment, while group II (7 women) were examined within the first 7 weeks after cessation of treatment. Laparotomy was performed in all cases, and FSH and LH in serum were determined radioimmunologically shortly before the operation. The ovaries were inspected macroscopically, and large wedge excisions were submitted to histological examination.

During treatment the values of serum FSH were low, but within the normal range in all women. The values of serum LH were very low in the normal range or even below the lower limit. The number of primordial follicles seemed to be mainly dependent on the age of the individual woman, whereas no correlation with the duration of treatment was found. All women except one revealed primary follicles in different stages of development. More surprising was the fact that 5 out of the 10 women showed antral and/or Graafian follicles in spite of the low levels of FSH and LH. No fresh corpora lutea were found. Two women showed a slight thickening of tunica albuginea, but in no case was perifollicular fibrosis found.

Within the first 7 weeks after treatment 6 out of the 7 women revealed antral and/or Graafian follicles, and 2 of them a fresh corpus luteum. In addition, all values of FSH and LH in serum were within the normal range, and significantly higher than during treatment.
Amniotic Fluid Oestriol Concentration During the Last Trimester of Pregnancy: I Normal Pregnancy
Authors: Jørgensen P. I. , Frandsen V. Aasted , Svenstrup B.
Published: December 2009

Abstract. The concentration of oestriol in the amniotic fluid during the last trimester of normal pregnancy was studied. by transabdominal amniocentesis in 98 pregnant women 144 samples of amniotic fluid were collected. Only women with uncomplicated pregnancies, giving birth to normal infants at term, were included. the results and conclusions were as follows: 1) a calculation of mean levels and upper and lower 95 % probabiliy limits was done for each gestational week in the last trimester. 2) Based on this a smooth curve, indicating the normal concentration area of amniotic fluid oestriol, was drawn. 3) the amniotic fluid oestriol concentration showed little variation before the 33rd gestational week (mean 86‐145 μg/l). During the subsequent period the concentration increased to a mean between 559‐881 μg/l and a lower limit between 294 and 464 μg/l at term (38—< 42 weeks). 4) Between the amniotic fluid oestriol concentration and the urinary oestriol excretion there was a highly significant correlation. Likewise, serial analyses of amniotic fluid and urinary oestriol showed the same increasing tendency during gestation. 5) Between the amniotic fluid oestriol concentration on the one hand and the infant's birth weight or sex or the weight of the placenta on the other hand there was no significant correlation. 6) Our method is suitable for clinical use, and on the basis of the normal concentration area described we intend to judge the clinical significance of the amniotic fluid oestriol assay as a measure of foetal well‐being.
Foetal Heart Rate and Intra‐Uterine Pressure Measured by a Single Miniature Transducer
Authors: Bang Jens , Northeved Allan , Bang Jens
Published: December 2009

Abstract. A method is described by which it is possible to record the pressure and frequency of labour pains, and the action of the foetal heart, using a single miniature pressure transducer introduced between the amniotic membrane and the uterine wall.
The Dhea‐S Loading Test in the Evaluation of Fetoplacental Function
Authors: Gummerus Martti
Published: December 2009

Abstract. The DHEA‐S loading test was used to evaluate fetoplacental function in 105 pregnant women. The test gave 84% correct results in the 43 cases of fetoplacental deficiency. However, in the control group of 62 subjects it gave only 42% correct results. Measurement of estriol excretion in maternal urine is one of the biochemical tests routinely carried out on pregnancies at risk. The prognostic value of the test is, however, restricted by the big daily fluctuations in estriol excretion. Fluctuations of between 60% and 140% have been reported (12). In addition to the routine determination of estriol levels, the following tests are of importance for the biochemical evaluation of fetoplacental function: 15α‐hydroxyestriol (7), pregnanediol (8), placen‐tal lactogen (8), heat‐stable alkaline phosphatase (8, 14), and finally, the test discussed in this publication, the dehydroepiandrosterone sulphate (DHEA‐S) loading test (4). The present investigation evaluated the usefulness of this test in the early detection of danger to the fetus.
Cystine Aminopeptidase Activity in Pregnancy
Authors: Rydén Gunnar
Published: December 2009

Abstract. Maternal cystine aminopeptidase activity (CAP) and total urinary oestriol excretion have been compared in 11 normal patients between 30 and 41 weeks gestation, in 9 patients with toxaemia of pregnancy and in 3 patients with a history of complication during the actual or previous pregnancy. The statistical correlation between maternal CAP and oestriol excretion in normal patients was poor (r=0.32). In patients with pre‐eclampsia the results were as follows: low CAP levels generally were associated with low oestriol excretion, whereas with high or normal CAP values there were varying levels of oestriol. CAP levels in blood are only related to the function of the placenta, whereas the oestriol excretion is related to the condition of the whole fetoplacental unit. Therefore serial CAP assays cannot replace oestriol assays in assessing the condition of the foetus and placenta. However, in some patients where intrauterine fetal death occurred, decreasing CAP values were observed before there was a significant change in oestriol excretion. This indicates that decreased placental function might be observed at an earlier stage using CAP than using oestriol determinations. CAP assay is therefore justified as a valuable test alongside estimation of oestriol excretion in judging the condition of the placenta during the last trimester. As the methods of CAP assays are simple and reproducible, CAP can be used on a large scale for detecting and monitoring pregnancies at risk, in order to get a more diversified picture with respect to the condition of the fetus and placenta during the last trimester.
Medical and Social Aspects of Adolescent Pregnancies
Authors: Widholm O. , Kantero Riitta‐Liisa , Rautanen Elina
Published: December 2009

Abstract. The socio‐medical aspects of 131 abortion patients under the age of 18 were analysed. The following results were obtained. The social background and school education of this group of abortion patients is somewhat above average compared with the general population in Finland. The family of the subjects is incomplete more often than is the case in the average Finnish population (34.3% compared with the average of 14.4%). The girls were more often illegitimate and more parents were divorced than expected. The relationship between the subject's parents is often seriously disturbed (32.6%). III health is frequent among the mothers of the subjects (23.7%). The home environment seems to have lacked security. The subjects are sexually relatively well informed. 87.8% stated they understood the consequences before their first intercourse. An attempt to prevent pregnancy was made in only 35.9%. The subjects began sexual intercourse earlier than is common in Finland: 32.1 % before the age of 15 compared with 0.6 % in general and had several partners: 66.5% compared with 11% in general. In many cases there was a positive emotional involvement of the subjects with their partners. Abortion is used as a means of prevention; 80.9% decided to have abortion immediately. Pregnancy is discovered early and medical services are effectively used. 11.4% arrived at the hospital after the 13th week of gestation. 25.2% of the parents did not know about the abortion. 33.6% of the subjects were under the influence of alcohol at the time of intercourse, none of the girls was under the influence of drugs. This group of patients are in need of continuous medical and social counselling.
Fibrinolytic Inhibitors in Human Retroplacental Blood
Authors: Åstedt Birger
Published: December 2009

Abstract. Fibrinolytic inhibitors of plasminogen activation (urokinase inhibitors) and of plasmin (alpha2‐macroglobulin, antiplasmin and total antitrypsin activity) were measured in retroplacental blood and compared with that in placental extract and maternal venous blood obtained at 40 deliveries. In placental extract the concentration of inhibitors of plasminogen activation was extremely high. In contrast, it was found to be normal in retroplacental blood and close to the value found for maternal venous blood. It therefore seems unlikely that inhibitors from the placenta enter the bloodstream and contribute to the reduction of the fibrinolytic activity in the maternal circulation during pregnancy.
Complications Following the Intra‐Amniotic Administration of Prostaglandin F2αfor Therapeutic Abortion
Authors: Ylöstalo Pekka , Kauppila Erkki , Vapaatalo Heikki
Published: December 2009

Abstract.A case of intra‐amniotic prostaglandin F2αinduction of mid‐trimester abortion is reported, where bradycardia, hypothermia and hypotension developed as complications. When induction was completed by an intravenous oxytocin infusion, a rupture of the cervix occurred in connection with the abortion.