bluuebunny/crossref_metadata_2025 huggingface dataset:
INTENSIVE CARE OF THE FETUS IN BREECH LABOUR
Authors: Hill J. G. , Eliot B. W. , Campbell J. , Pickett‐Heaps A. A.
Published: August 2005

A review of 186 cases of breech presentation with a corrected perinatal mortality rate of 0.54 per cent is presented. Details of paediatric follow‐up are given. Careful selection of patients for vaginal delivery and the liberal use of Caesarean section are advocated. The importance of asphyxia as the main danger of breech delivery is emphasized and the use of fetal blood sampling as a practicable method of detecting early asphyxia is discussed.
THE RELATION BETWEEN EASE OF FORCEPS DELIVERY AND SPEED OF CERVICAL DILATATION
Authors: Davidson A. C. , Weaver Judith B. , Davies P. , Pearson J. F.
Published: August 2005

An attempt has been made to predict a difficult forceps delivery. The duration of the 7 to 10 cm cervical dilatation interval was measured from the completed cervimetric chart in 952 consecutive patients who delivered spontaneously between December 1973 and September 1974. The 7 to 10 cm cervical dilatation intervals of this group were compared with those of 378 consecutive patients in whom forceps were applied with the fetal head in the occipito‐anterior position and 83 consecutive patients where Kielland's forceps rotation from the occipito‐transverse or occipito‐posterior position was performed. The forceps deliveries were graded as ‘easy’, ‘moderately difficult’, or ‘difficult’. In only 5 per cent of the spontaneous delivery group did the 7 to 10 cm cervical dilatation interval exceed two hours. In the occipito‐anterior and Kielland's forceps groups an ‘easy’ delivery could be expected if the 7 to 10 cm cervical dilatation interval was less than two hours. The greater this interval increased beyond two hours, the greater was the proportion of ‘moderately difficult’ and ‘difficult’ forceps deliveries.
STUDIES IN THE INVOLVEMENT OF PROSTAGLANDINS IN UTERINE SYMPTOMATOLOGY AND PATHOLOGY
Authors: Willman Eve A. , Collins W. P. , Clayton S. G.
Published: August 2005

The concentrations of prostaglandins E2 and Fα were measured by radioimmunoassay in samples of endometrial tissue from 155 women. The results showed that the concentration of prostaglandin E2 (ng/100 mg of wet tissue; mean ± SD) in tissue from apparently healthy women with regular menstrual cycles was 79·3 ± 9·9 during the menstrual period. The level in the proliferative and early secretory phases fell to 11·8 ± 4·0 and 13·3± 8·3 respectively. During the late secretory phase there was a significant increase to 20·1±10·8. The corresponding values from patients with fibromyomata and without menorrhagia were similar. However, the concentration in tissue from patients with fibromyomata and menorrhagia was significantly higher (63·9 ±17·9) during the secretory phase of the uterine cycle. In addition, the amount was significantly higher in the groups with dysmenorrhoea (19 ·0 ± 4·5 proliferative; 68 · 0 ± 18 ·15 secretory) and irregular uterinbleeding (78·3 ± 59·0 proliferative; 87·4 ± 64·9 secretory). The mean concentration was higher in cases of endometriosis, and significantly elevated in endometrial carcinoma. The results for prostaglandin Fα showed a similar pattern, but the changes were less marked in patients with irregular dysfunctional bleeding. The findings are discussed.
FACTORS ASSOCIATED WITH SPONTANEOUS PRE‐TERM BIRTH
Authors: Fedrick Jean , Anderson Anne B. M.
Published: August 2005

Factors associated with spontaneous pre‐term birth in 283 singleton pregnancies were compared with those present in a total population of 16 994 women at risk studied in the First British Perinatal Mortality Survey. It was shown that the risk of spontaneous pre‐term birth was related to low maternal age, low maternal weight, maternal smoking, low social class, illegitimacy, threatened abortion, and a previous history of antepartum haemorrhage, perinatal loss, or low birth weight livebirths.
TUMOUR ASSOCIATED IMMUNITY AND IMMUNOCOMPETENCE IN OVARIAN CANCER
Authors: Levin L. , Mchardy J. E. , Poulton T. A. , Curling O. M. , Hudson C. N.
Published: August 2005

Cell‐free extracts of autologous ovarian cancer cells evoked a delayed hypersensitivity response (DHR) in skin in four out of six patients in remission from disease and none of seven patients in relapse. These initial results appear to be consistent with in vitro blastogenic assay using the same autologous extracts. To assess whether diminished tumour‐associated immunity was due to impaired cellmediated immunocompetence, blastogenic responses to purified protein derivative of tuberculin (PPD), a secondary recall antigen, and phytohaemagglutinin (PHA) were assessed. Impaired responses to PHA were seen in the relapse group of patients, but responses to PPD did not appear to be impaired in this group.
LIPOGRANULOMA OF THE UTERINE PARAMETRIUM
Authors: Ghosh A.
Published: August 2005

A case of lipogranuloma of the uterine parametrium is described. The granuloma may have developed following injury to fat cells after a cone biopsy of the cervix or may have resulted from a reaction to paraffin.
INFLUENCE OF LABOUR ON THE LECITHIN, LECITHIN/ SPHINGOMYELIN (L/S) RATIO AND PALMITIC ACID VALUES IN THE AMNIOTIC FLUID
Authors: Cabero L. , Roses A. , Viscasillas P. , GlRALT M. QuilezE. , Duran‐Sanchez P.
Published: August 2005

The lecithin/sphingomyelin (L/S) ratio, lecithin concentrations and palmitic acid levels in amniotic fluid were studied during labour and compared with values found before labour. All were significantly higher in women in labour. The explanation and significance of this finding are briefly discussed.
MONOAMINE OXIDASE ACTIVITY IN THE FETAL LUNG AND LIVER
Authors: Jones J. B. , Papadaki Lucienne , Hubbard Joyce
Published: August 2005

Monoamine oxidase (MAO) in lung and liver is important in the degradation of circulating 5‐hydroxytryptamine. These sites of MAO activity have been investigated histochemically in the human fetus of 12 to 18 weeks gestation. Enzyme activity could be demonstrated in the liver by both tryptamine and adrenaline oxidation. In the lung, MAO activity was present only when adrenaline was used as substrate. It may be, therefore, that in the premature baby the capacity of MAO to metabolize 5‐hydroxytryptamine is not fully developed, which could lead to deleterious effects on pulmonary function.
SCANNING ELECTRON MICROSCOPE APPEARANCES OF NORMAL HUMAN AMNION AND UMBILICAL CORD AT TERM
Authors: Pollard Stella M. , Aye N. N. , Symonds E. M.
Published: August 2005

The surface morphology of normal term amnion was studied by scanning electron microscopy. Four patterns were observed. Two of the patterns showed distinctive minority populations of cells. In one, there were cells surrounded by intracellular channels; in the other, there were large flat cells. The microvilli in all four patterns showed variable morphology in different samples. Possible functional implications of the findings are discussed.
PLACENTAL METABOLISM OF DEHYDROEPIANDROSTERONE SULPHATE IN NORMAL PREGNANCY
Authors: Klopper A. , Varela‐Torres R. , Jandial V.
Published: August 2005

An intravenous injection of 50 mg dehydroepiandrosterone was given to 19 women at the 38th week of pregnancy. The concentration of androstenedione, testosterone, oestradiol and oestrone in plasma was measured at intervals following the injection. The concentration of androstenedione and testosterone rose rapidly, reaching a peak after 10 minutes and returning to near baseline level by 30 minutes. Oestradiol rose more slowly, reaching a peak after 45 minutes and being sustained at high levels for 3½ hours before returning slowly to baseline. Oestrone rose yet more slowly and did not reach a peak until 2½ hours after the injection. It is concluded that the steroid responses are too variable from one individual to another for this test to be useful in the clinical assessment of fetal wellbeing but that it was likely to be a powerful tool in the investigation of placental steroid biogenesis.
THE EFFECT OF INTERNAL URETHROTOMY AND URETHRAL DILATATION ON THE POSTOPERATIVE COURSE OF PATIENTS UNDERGOING SURGERY FOR STRESS INCONTINENCE
Authors: Moolgaoker A. S. , Rizvi J. H. , Payne P. R. , Parker J. C.
Published: August 2005

Three years' experience of a total of 128 patients undergoing surgery for stress incontinence is described. Forty‐three patients had an internal urethrotomy performed routinely at the end of the operation, 26 had routine urethral dilatation and 59 had neither procedure. Internal urethrotomy, and to a lesser extent urethral dilatation, resulted in prompt return of spontaneous and efficient micturition following removal of the Foley catheter on the third postoperative day. The postoperative stay averaged 6·4 days in the urethrotomy group of patients, 7·6 days in those who had urethral dilatation and 10·6 days in the others. The two‐year cure rate in the patients who had neither procedure performed was 85 per cent and as yet no failures have occurred in the patients who had internal urethrotomy or urethral dilatation performed.
HORMONAL PATTERNS IN CONCEPTUAL CYCLES AND EARLY PREGNANCY
Authors: Corker C. S. , Michie E. , Hobson B. , Parboosingh J.
Published: August 2005

Androstenedione, testosterone, progesterone and human chorionic gonadotrophin (HCG) in plasma and total oestrogens, luteinizing hormone (LH) and HCG in urine were measured in five women during conceptual cycles and in early pregnancy. There were increased levels in plasma and urine of all the hormones measured between 12 to 48 days after ovulation except progesterone. The concentration of this hormone in plasma decreased during this time. The possible sources of these hormones in early pregnancy are discussed.
INTRAMUSCULAR ADMINISTRATION OF 15‐METHYL PROSTAGLANDIN F2α FOR INDUCTION OF LABOUR IN PATIENTS WITH INTRAUTERINE FETAL DEATH OR AN ANENCEPHALIC FETUS
Authors: Ylikorkala O. , Kirkinen P. , Järvinen P. A.
Published: August 2005

The 15‐methyl analogue of PGF2α was administered intramuscularly between 23 and 36 weeks of gestation, to induce labour in 11 mothers with intrauterine fetal death and two with anencephaly. All were delivered within 20 hours (mean 7 hours). The mean dose of 15‐me‐PGF2α was 400 μg (range 100 to 700) given by a mean of 3·1 (range 1 to 7) injections. Diarrhoea was the most frequent sideeffect.
AVULSION INJURY OF UTEROVAGINAL PROLAPSE AND BLADDER
Authors: Khanna Shail , Tripathi V. N. P.
Published: August 2005

A 40‐year‐old postmenopausal female with complete uterine prolapse received an avulsion injury when her sari was caught in the fast‐moving belt of a flour mill machine. Part of the prolapsed anterior vaginal wall with underlying bladder wall was torn off. Primary repair together with vaginal hysterectomy led to an uneventful recovery.
PLANNED PREGNANCY IN A RENAL TRANSPLANT RECIPIENT
Authors: Davison J. M. , Lind T. , Uldall P. R.
Published: August 2005

A scheme is described for the investigation and management of a renal transplant recipient before conception, over conception and during the subsequent pregnancy, delivery and puerperium. The patient showed the physiological changes in homeostasis of normal pregnancy. Methods of monitoring maternal, fetal and renal well‐being are discussed. The patient was delivered of a live male child and the neonatal problems are described. The puerperium was uneventful.
CONCENTRATIONS OF FREE FATTY ACIDS IN MATERNAL AND UMBILICAL CORD BLOOD DURING ELECTIVE CAESAREAN SECTION
Authors: Elphick M. C. , Hull D. , Sanders R. R.
Published: August 2005

The concentration of free fatty acids was measured in blood taken from the umbilical artery and vein of 29 infants during elective Caesarean section and compared with levels in maternal venous blood. The mean venous‐arterial (v–a) difference was 0·07 mEq/1. There was a direct and significant correlation between the umbilical v–a difference and maternal venous concentrations.
ARTERIAL PRESSURES IN NIGERIAN WOMEN UP TO MID‐PREGNANCY
Authors: Akinkugbe A.
Published: August 2005

A group of 497 women whose pregnancies did not exceed 22 weeks and who were booked at the antenatal clinic between 1st August, 1971 and 31st January, 1972 have been included in a survey of arterial pressures in early pregnancy. The arterial pressures showed a low range and confirmed similar previous observations. The blood pressures among the primigravidae in the group were found to be lower than those of their Aberdeen counterparts. It was also found that the arterial pressures were lower than those of comparable non‐pregnant women within the same community. The low arterial pressures in early pregnancy did not offer any special advantage in relation to the incidence of pre‐eclampsia and eclampsia, diseases known to be prevalent within the community.
TREATMENT AND SURVIVAL IN 631 PATIENTS WITH INVASIVE CARCINOMA OF THE CERVIX
Authors: Gad C.
Published: August 2005

From 1951 to 1972, a total of 631 cases of invasive carcinoma of the cervix were diagnosed in Frederiksberg, Copenhagen, Denmark. Treatment was either by surgery or radiotherapy, a combination of both being rarely used. The crude five‐year survival rates were 99 per cent in stage Ia, 79 per cent in stage Ib, 67 per cent in stage IIa, 45 per cent in stage IIb, 23 per cent in stage III, 5 per cent in stage IV and 63 per cent for all stages. The relative survival rates were respectively 100 per cent, 81 per cent, 73 per cent, 48 per cent, 26 per cent, 5 per cent and 66 per cent. Radical hysterectomy was found more effective than radiotherapy in stage Ib carcinoma of the cervix. This difference was not explained by age but other factors possibly playing a role are considered. The combination of surgery and radiotherapy is discussed and only seems indicated for patients with stage Ib carcinoma and lymph node metastases.
EFFECT OF ORAL 17‐β‐OESTRADIOL ON THE LIVER IN WOMEN WITH INTRAHEPATIC CHOLESTASIS (HEPATOSIS) DURING PREVIOUS PREGNANCY
Authors: Jeppsson S. , Rannevik G.
Published: August 2005

The effects of 17‐β‐oestradiol in 14 women who had had intrahepatic cholestasis of pregnancy (hepatosis) were studied. This natural oestrogen was given orally in a daily dose of 5 mg for two 20‐day periods with a 7‐day interval between courses. The bromsulphthalein (BSP) retention rose during the treatment, but only occasionally to levels above the upper limit of normal. Other conventional liver function tests did not usually become abnormal. In a previous investigation in the same type of patients, we studied the effects of mestranol (a synthetic 17‐alky‐ lated oestrogen) in a daily dose of 0·1 mg with the same dose‐schedule as the present investigation and 17‐β‐oestradiol appeared to impair liver function less than mestranol. It might thus be safer to use 17‐β‐oestradiol as a therapeutic agent.
EFFECT OF STERILIZATION ON MENSTRUAL BLOOD LOSS
Authors: Kasonde J. M. , Bonnar J.
Published: August 2005

Menstrual blood loss was measured objectively in 25 women for up to three months before and for six to twelve months after tubal ligation. The operation made no significant difference to menstrual blood loss.
THE DISTRIBUTION OF NEOPLASM IN PATIENTS DYING AFTER TREATMENT OF ENDOMETRIAL CARCINOMA
Authors: De Mǔelenaere G. F. G. O.
Published: August 2005

An analysis of 155 patients with endometrial carcinoma, first seen more than five years ago, shows that 31 per cent died with tumour. Trans‐coelomic spread of tumour was the most frequent cause of death and occurred in 13·6 per cent of all patients and in 17·1 per cent of those who were operable. A second important cause of death was haematogenous spread of tumour (6·5 per cent). Local pelvic recurrence was the cause of death in 25 per cent of those who did not survive, and local spread was found in 2·2 per cent of operable patients. A rational approach to therapy for endometrial carcinoma is suggested.
A SUCCESSFUL PREGNANCY FOLLOWING MALIGNANT PHASE HYPERTENSION
Authors: Weir R. J. , Willocks J.
Published: August 2005

We describe a patient who had a successful pregnancy three years after starting treatment for malignant phase renal hypertension and two years after a nephrectomy for right renal artery thrombosis and an aorto‐femoral graft for right common iliac artery thrombosis.
PROBLEMS IN ASSESSING EFFECTS OF INDUCTION OF LABOUR ON PERINATAL MORTALITY
Authors: Yudkin Patricia
Published: August 2005

Data on births in the Oxford area for 1965 and 1972 are examined, and a model presented for analysing some effects of induction of labour during this period. It is suggested that this model is generally useful in understanding the various possible explanations for an apparent improvement in perinatal mortality figures.
DOWN'S SYNDROME AND ORAL CONTRACEPTIVE USAGE
Authors: Janerich D. T. , Flink E. M. , Keogh M. D.
Published: August 2005

We examined the history of oral contraceptive usage in a group of 103 mothers of infants with Down's syndrome and an equal number of matched normal controls. We found no evidence of increased pill use among mothers of the abnormal infants either during the pregnancy or in the year before pregnancy.
MATERNAL FACTORS ASSOCIATED WITH FETAL CHROMOSOMAL ANOMALIES IN SPONTANEOUS ABORTIONS
Authors: Alberman Eva , Creasy M. , Elliott Maureen , Spicer C.
Published: August 2005

The effect is described of maternal factors on the proportion of fetal chromosomal anomalies in a series of 2620 spontaneous abortions, of which 992 specimens were karyotyped. Maternal age was the most important factor associated with a rise in the proportion abnormal, followed by Social Class I or II and the use of oral contraception before conception. The problem of extrapolating from the proportion abnormal to absolute incidence of anomalies is discussed. In the case of increasing maternal age, the evidence suggests that the rise in incidence of spontaneous abortions with age is accounted for by an increased incidence of chromosomally abnormal fetuses. In the case of high social class and a history of oral contraception, the evidence on incidence is scanty and the rise in the proportion abnormal may either reflect a decrease in the abortion rate of chromosomally normal fetuses, or a small increase in the incidence of lethal chromosomal anomalies.
A SERIAL STUDY OF COAGULATION FACTORS XII, XI AND X IN PLASMA IN NORMAL PREGNANCY AND IN PREGNANCY COMPLICATED BY PRE‐ECLAMPSIA
Authors: Condie R. G.
Published: August 2005

A serial study of coagulation factors XII, XI and X in plasma has been carried out on 60 primigravidae, prospectively comparing those who remained normal with those who developed pre‐eclampsia. In the normal group of 48 patients, the levels of all factors rose as pregnancy advanced, a secondary increase in factors XI and X occurring in the puerperium. Cord levels of all three factors were depressed. In the pre‐eclampsia group of 12 patients, factor XII was significantly higher than in the normal group throughout the study, while factors XI and X were slightly lower. Observed changes failed to support the idea of a strong primary role for the coagulation mechanism in the pathogenesis of pre‐eclampsia.
CHORIONIC HAEMANGIOMATA AND ABRUPTIO PLACENTAE
Authors: Kohler H. G. , Iqbal Naheed , Jenkins D. M.
Published: August 2005

A case of fetal death from abruptio placentae is reported in which the placenta was the seat of multiple chorangiomata. This association is believed not to have been fortuitous and a possible mechanism is suggested by which chorangioma may contribute to the pathogenesis of placental abruption. The incidence, morphological variation and clinical manifestations of placental chorangiomata are briefly discussed.
SIX YEARS'EXPERIENCE OF THE PREDICTION OF SEVERITY IN RHESUS HAEMOLYTIC DISEASE
Authors: Fairweather D. V. I. , Whyley G. A. , Millar M. D.
Published: August 2005

Prediction charts used in the management of patients suffering from rhesus haemolytic disease are presented and the accuracy investigated for two methods of amniotic fluid analysis. In 468 samples from 141 patients there were 7·9 per cent errors of prediction when both methods were used together but in only four cases (2·8 per cent) was the error thought to have possibly contributed to wrong management.
FURTHER CLINICAL EVALUATION OF THE SELENOMETHIONINE UPTAKE TEST
Authors: Nye E. B.
Published: August 2005

A review of the selenomethionine uptake ratio as a measure of placental function is presented. Attempts at the early identification of the poorly growing fetus were unsuccessful, and the previously published close correlation of results with clinical findings in later pregnancy has not been confirmed. The theoretical basis of the test has been re‐examined. Although modification much reduced the incidence of technically unsatisfactory readings, other difficulties prevented the test from being clinically useful. To some extent the aim of the test has been superseded by concurrent developments and advances in care of the premature baby.
MEASUREMENT OF INTERVILLOUS AND MYOMETRIAL BLOOD FLOW BY AN INTRAVENOUS 133Xe METHOD
Authors: Rekonen A. , Luotola H. , Pltkänen M. , Kuikka J. , Pyörälä T.
Published: August 2005

A new ‘non‐invasive’ method for measuring intervillous and myometrial blood flow is presented. After 2 mCi of 133Xe in physiological saline was injected intravenously the patient held her breath for 20 seconds. The tracer entered the placenta as a short bolus and its removal was followed with a scintillation detector. Intervillous and myometrial blood flow per unit volume was calculated from the two‐exponential curve. The mean ±SD intervillous flow in normal pregnancy was 135±49 ml/minute/100 ml, the corresponding half time being 0·56±0·16 minutes. The myometrial flow was 7 ·7±2·5 ml/minute/100 g. The method gave reproducible results and took only 20 minutes to perform. The dose of radiation to the mother was less than 1 mrad.
EARLY POSTPARTUM TUBAL LIGATION UNDER EPIDURAL ANALGESIA
Authors: Ghosh A. K. , Tipton R. H.
Published: August 2005

Tubal ligation under epidural analgesia in the early puerperium (within 10 hours of delivery) was attempted in 51 patients who had an epidural block established during labour. The results are described. No major difficulties were encountered.
THE SCANNING ELECTRONMICROSCOPY OF HUMAN CERVICAL MUCUS IN THE NON‐PREGNANT AND PREGNANT STATES
Authors: Daunter B. , Chantler E. N. , Elstein M.
Published: August 2005

The ultrastructure of the high viscosity phase of human cervical mucus was studied by scanning electronmicroscopy. In the normal woman, sequential mucus samples taken throughout the menstrual cycle showed a honeycomb‐like structure with interconnecting channels separated by thin membraneous walls. The diameter of the channels in the mucus was 2 to 6 μm in the early follicular phase, 30 to 35 μm in the late follicular phase and 4 to 6 μm in the luteal phase. During the first trimester of pregnancy and also at the beginning and end of the menstrual cycle a compact, dense form of mucus structure was observed. In women using either copper‐releasing or pharmacologically inert intrauterine contraceptive devices (IUCDs), the basic structure was similar to that seen in normal women. The channel diameters were normal in women using the inert IUCD but the mucus from women using a copper‐releasing IUCD showed a slight decrease in the late follicular phase channel diameter which was dependent on the time the device had been in place. Globular appendages to the membraneous walls of the mucus were observed in the presence of a copper‐releasing IUCD.
THE EFFECT OF NORMAL PREGNANCY UPON THE RENAL HANDLING OF URIC ACID
Authors: Dunlop W. , Davison J. M.
Published: August 2005

Twenty‐four women were investigated serially during and after normal pregnancy. Plasma uric acid concentration appeared to be inversely related to uric acid clearance under infusion conditions, and comparison with simultaneous inulin clearance suggested an alteration in renal function resulting in increased ‘net tubular reabsorption’ of uric acid as pregnancy progressed. No difference was detected between primigravidae and multigravidae. The implications of these changes are discussed with reference to the renal handling of uric acid in pre‐eclampsia.
EVIDENCE FOR A LOCAL CONTROL OF PROSTAGLANDINS WITHIN THE PREGNANT HUMAN UTERUS
Authors: Mitchell M. D. , Keirse M. J. N. C. , Anderson Anne B. M. , Turnbull A. C.
Published: August 2005

Prostaglandin F (PGF) and 13,14‐dihydro‐15‐keto‐PGF (PGFM) have been measured in amniotic fluid in late human pregnancy. The method used to obtain amniotic fluid greatly influenced the levels of prostaglandins: fluid obtained by vaginal amniotomy contained significantly higher levels of both PGF and PGFM than samples taken at amniocentesis, reflecting an increase in synthesis and/or release of prostaglandin rather than a decrease in the rate of metabolism. After 36 weeks gestation there was no increase in levels of either PGF or PGFM if samples obtained by amniotomy and amniocentesis were considered separately, although if such samples were considered together a significant increase could be obtained. The apparently rapid change in prostaglandin concentrations in amniotic fluid in response to amniotomy strongly supports a local control of these compounds within the pregnant uterus.
EFFECTS OF SPONTANEOUS AND ARTIFICIAL MEMBRANE RUPTURE IN LABOUR UPON FETAL HEART RATE
Authors: Aladjem S. , Miller T.
Published: August 2005

This study reports the effects of spontaneous rupture of membranes and artificial rupture of membranes on fetal heart rate patterns during labour in 87 normal and 25 complicated pregnancies. The incidence of early deceleration patterns following membrane rupture was 6.25 per cent during the first 15 minutes and 1.78 per cent after 45 minutes, regardless of whether the pregnancy was normal or complicated. It is concluded that rupture of membranes does not significantly increase the incidence of early deceleration patterns. However, the occurrence of other heart rate alterations such as late decelerations, loss of beat‐to‐beat variability, changes in base line and tachycardia, need to be investigated further in larger collaborative studies.
SERUM PROLACTIN LEVELS AND THE VALUE OF BROMOCRIPTINE IN THE TREATMENT OF ANOVULATORY INFERTILITY
Authors: Pepperell R. J. , Evans J. H. , Brown J. B. , Smith Margery A. , Healy D. , Burger H. G.
Published: August 2005

Basal serum levels of prolactin were measured in 37 infertile anovulatory patients who had failed to conceive on therapy with clomiphene citrate. Twenty of these patients, 16 of whom had galactorrhoea, had elevated basal serum prolactin values which were suppressed to normal or subnormal values during therapy with bromocriptine, the most commonly effective dose being 2·5 mg twice daily. Ovulation, as assessed by urinary oestrogen and pregnanediol measurements, was induced in 17 of these patients with pregnancy in 14. Ovarian responses short of defined criteria for ovulation were induced initially in eight patients, but these progressed to full ovulatory responses in five patients, either on the same or increased doses of bromocriptine. In all the patients who ovulated, the prolactin levels had been reduced below the mean value for normal women (10·6 ng‐ml). The three patients who failed to ovulate all had values higher than this at a dose of bromocriptine reaching 5·0 mg thrice daily. There seemed to be no value in increasing the dose of bromocriptine once ovulation had been achieved. Of the 17 patients with normal basal prolactin values, only one had an unequivocal response to bromocriptine with ovulation and conception, even though the prolactin values in the majority were suppressed to below normal.
SEVERE INTRAVASCULAR COAGULATION PRECEDING SEVERE PRE‐ECLAMPSIA
Authors: Imrie A. H. , Raper C. G. L.
Published: August 2005

A patient is described in whom clinical and laboratory evidence of intravascular coagulation preceded the development of fulminating pre‐eclampsia necessitating the delivery of a fresh stillbirth by Caesarean section at 31 weeks.
GREY‐SCALE ULTRASONOGRAPHY IN THE DIAGNOSIS OF HYDATIDIFORM MOLE WITH A COEXISTENT FETUS
Authors: Cunningham Mary E. , Walls W. J. , Burke M. F.
Published: August 2005

A patient is presented who had a hydatidiform mole with a coexistent fetus and bilateral theca lutein cysts. The complete diagnosis was made by grey‐scale ultrasonography.
OBSTETRIC PRACTICE AND INFANT MORBIDITY
Authors: Adelstein Philippa , Fedrick Jean , Howat Pamela , Robinson R. , Turnbull A. C.
Published: August 2005

A method is described of using matched pairs of index infants and controls to examine the hypothesis that induction or some other obstetric practice is associated with increased morbidity in the mature infant. All infants over 2250 g and 37 weeks gestation, without severe congenital defect or history of severe maternal disorder, born in the John Radcliffe and admitted to the Special Care Baby Unit in 1975 were identified. For each of these index infants a matched control was chosen using strict criteria. Contrast between the 109 matched pairs showed no significant differences between maternal characteristics, induction of labour, use of forceps or duration of labour. There was an excess of index infants born to mothers who had had epidural anaesthesia (P<0·05).
NONSPECIFIC DECELERATIONS IN FETAL HEART RATE DURING HIGH‐RISK PREGNANCY
Authors: Trimbos J. B. , Keirse M. J. N. C.
Published: August 2005

Solitary nonspecific decelerations in fetal heart rate occurring in three patients during antepartum cardiotocography are described. The decelerations were nonspecific in that they were neither variable nor late nor associated with maternal hypotension. All occurred in pregnancies complicated by hypertension and placental insufficiency. In the three patients described, the fetus lived for at least three days after the first nonspecific deceleration was observed. Although solitary nonspecific decelerations may indicate danger to the fetus from placental insufficiency, these decelerations should not be considered as an indication for immediate delivery.
EPIDEMIOLOGICAL FEATURES OF PERINATAL DEATH DUE TO OBSTRUCTED LABOUR IN ADDIS ABABA
Authors: Naeye R. L. , Dozor A. , Tafari N. , Ross S. M.
Published: August 2005

Obstructed labour was the second most common cause of perinatal death in Addis Ababa, Ethiopia, being responsible for 9·1 perinatal deaths/1000 births. Most obstructed labours were due to cephalopelvic disproportion. There was a ninefold increase in the perinatal death rate when the patients were anaemic but most perinatal deaths were due to delays in seeking available obstetrical care. Formal education of the patients had little influence on the death rates but the informal education that comes with prolonged urban residence had a markedly favourable effect. Use of prenatal medical services and adequate income also had a favourable influence.
RECURRENT POSTPARTUM UTERINE INVERSION
Authors: O'Connor M. C.
Published: August 2005

A patient with recurrent postpartum uterine inversion is presented and discussed.
HODGKIN'S DISEASE DIAGNOSED IN PREGNANCY
Authors: Johnson I. R. , Filshie G. M.
Published: August 2005

A patient is described in whom Hodgkin's disease was diagnosed and treated during the antenatal period, and who was delivered of a premature, but otherwise normal, infant.
β‐THALASSAEMIA TRAIT IN A PREGNANT GIRL OF BRITISH STOCK
Authors: Valentine B. H.
Published: August 2005

A pregnant patient with anaemia due to β‐thalassaemia trait is described. The patient was apparently of British stock.
A SURVEY OF AMNIOCENTESIS IN 925 PATIENTS AT HIGH RISK OF FETAL GENETIC DISORDER
Authors: Goldman B. , Mashiah S. , Serr D.M. , Blankstein J. , Chaki R. , Navon R. , Padeh B.
Published: August 2005

Over a nine‐year period, 925 pregnancies at an Israeli medical centre were selected for investigation by amniocentesis for genetic reasons. In only 30 pregnancies did failure of laboratory methods or difficulty with amniocentesis lead to a lack of results with which to assess the normality of the fetus. The information obtained by examination of the amniotic fluid in the other 895 pregnancies is presented and discussed.
AMNIOTIC FLUID INSULIN AND GLUCAGON IN NORMAL PREGNANCY AND PREGNANCY COMPLICATED BY RHESUS ISOIMMUNIZATION
Authors: Derlini G. , Fallucca F. , Pachi' A. , Bresadola M. , Ossicini C. , Russo A. , Sbraccia C.
Published: August 2005

Immunoreactive insulin (IRI) and immunoreactive glucagon (IRG) were determined in the amniotic fluid from 28 rhesus isoimmunized pregnancies with moderately affected fetuses and from 15 normal pregnancies; in umbilical arterial plasma from nine newborn infants with rhesus haemolytic disease of moderate degree and from 19 normal infants; in plasma from their respective mothers at delivery; and in the urine of 13 normal infants at birth. Levels of IRI and IRG in amniotic fluid from rhesus cases were not different from those of normal pregnancies. IRG was detected in the first voided neonatal urine.
BIOCHEMICAL CHANGES IN PROLONGED LABOUR IN THE TROPICS
Authors: Akinkugbe A. , Adewoye H. O. , Eneli A. C.
Published: August 2005

Serum electrolytes, creatinine, urea and urine osmolality were estimated in 25 healthy pregnant women at term, 25 women in early normal labour, and 25 healthy parturients in prolonged labour. A statistically significant fall in serum potassium was found in early labour with a further significant fall in prolonged labour. Bicarbonate changes followed the same pattern of a progressive fall. Sodium fell slowly, reaching significant levels only in prolonged labour and chloride fell even more slowly. There was a conspicuous or significant rise in serum urea with a smaller, not significant rise in creatinine. The rapid insensible loss of water in tropical areas was reflected in the rise in serum urea while homeostatic mechanisms maintained a slower fall in sodium and chloride by renal conservation.
EPIDEMIOLOGICAL ASPECTS OF HYDATIDIFORM MOLE IN THE REPUBLIC OF PARAGUAY (SOUTH AMERICA)
Authors: Roloan P. A. , de Lopez Berta Hochsztajn
Published: August 2005

A total of 227 hydatidiform moles was recorded in Paraguay over a 10‐year period (1960 to 1969). Using demographic studies, the annual incidence of hydatidiform moles was calculated as 0·229 per 1000 pregnancies or 1 per 4369 pregnancies, with the highest incidence occurring at the extremes of reproductive life.
THE EFFECT OF TREATMENT WITH OESTRADIOL AND OESTRIOL ON FASTING SERUM CHOLESTEROL AND TRIGLYCERIDE LEVELS IN POSTMENOPAUSAL WOMEN
Authors: Walter S. , Jensen H. K.
Published: August 2005

The effect of natural oestrogens on serum cholesterol and serum triglyceride levels was studied in a controlled double‐blind clinical trial. No statistically significant changes were found in the blood lipids when comparing the patients treated with oestradiol, 2 mg, and oestriol, 1 mg, and those given placebo.
MALE INTERSEXUALITY PRESENTING AT PUBERTY
Authors: Dowd Pauline , Dewhurst John , Ginsburg Jean
Published: August 2005

A 15‐year‐old girl was referred to the Endocrine Unit because of a deep voice and the absence of menstruation. Secondary sex hair showed a male pattern of distribution and there was a phallic clitoris 4 cm long, with the urethral orifice posterior. Plasma testosterone was within the normal male range. The karyotype was 46XY. Gonadectomy and clitoridectomy were performed. Histology suggested a diagnosis of anatomical testicular failure, which, in view of the imperfect attempt at masculinization, was thought to be only partial. Possible causes are discussed.
A DOUBLE‐BLIND TRIAL OF SINGLE‐DOSE CHEMOPROPHYLAXIS WITH CO‐TRIMOXAZOLE DURING TOTAL ABDOMINAL HYSTERECTOMY
Authors: Mathews D. D. , Ross Helen , Cooper J.
Published: August 2005

Thirty patients received 10 ml co‐trimoxazole and 29 a placebo by intravenous infusion during one hour from induction of anaesthesia for total abdominal hysterectomy. The incidence of postoperative urinary tract infections was significantly lower in patients who had received co‐trimoxazole. Co‐trimoxazole was also found to inhibit postoperative colonization of the upper vagina with Escherichia coli. The incidences of postoperative pyrexia (38°C or over) and both early and late abdominal wound abscess formation were almost identical in the two groups of patients.
CORPUS LUTEUM FUNCTION IN EARLY PREGNANCY FOLLOWING OVULATION INDUCTION WITH BROMOCRIPTINE
Authors: Pepperell R. J. , McBain J. C. , Winstone S. M. , Smith Margery A. , Brown J. B.
Published: August 2005

Serum prolactin levels and urinary oestrogen and pregnanediol excretion were measured during early pregnancy in 12 hyperprolactinaemic subjects who became pregnant during treatment with bromocriptine. Prolactin levels were suppressed below normal whilst taking the bromocriptine, but rose significantly when this drug was stopped and by eight weeks of gestation reached values significantly higher than those observed in normal pregnancy. Further increases in prolactin levels were, however, not observed. Urinary oestrogen and pregnanediol excretion was initially normal but, following cessation of bromocriptine, urinary pregnanediol excretion decreased and was significantly less than normal at 11 to 14 weeks gestation. These results suggest that elevated prolactin levels affect corpus luteum function of early pregnancy. Because the effect is maintained until at least 14 weeks gestation, prolactin may also affect progesterone production by the placenta.
THE CLINICAL SIGNIFICANCE OF MARGINAL AND VELAMENTOUS INSERTION OF THE CORD
Authors: Uyanwah‐Akpom P. , Fox H.
Published: August 2005

The claims that marginal and velamentous insertion of the cord are associated with a high incidence of abortion, low birth weight, premature delivery, fetal malformation, fetal hypoxia and intrauterine fetal death have been investigated. A study of 1000 cases has failed to demonstrate any such association.
THROMBOCYTOPATHIA AS A CAUSE OF MENORRHAGIA
Authors: Bloch B. , Kort H.
Published: August 2005

Thrombocytopathia is a condition in which the platelets have a qualitative rather than a quantitative defect. Two patients with thrombocytopathia who presented with menorrhagia are described.
HAEMOSTATIC MECHANISMS IN MATERNAL, UMBILICAL VEIN AND UMBILICAL ARTERY BLOOD AT THE TIME OF DELIVERY
Authors: Foley M. E. , Clayton J. K. , McNicol G. P.
Published: August 2005

Studies of the haemostatic mechanism were made on paired samples from the umbilical vein and artery and from a maternal peripheral vein immediately following delivery in 80 healthy patients with uncomplicated pregnancies. Neonatal blood showed a significant decrease in clotting ‘activity’ and platelet function, and a significant increase in fibrinolytic activity. The umbilical vein, in comparison to the umbilical artery, showed increased clotting ‘activity’, increased platelet function and decreased fibrinolytic activity. The possible adverse influence of the placenta on haemostasis in the fetus and newborn is discussed.
A CRITICAL EVALUATION OF TESTS USED TO ASSESS GESTATIONAL AGE
Authors: Harrison R. F. , Roberts A. P. , Campbell S.
Published: August 2005

The reliability of eight methods for estimating gestational age in the third trimester of pregnancy has been assessed in patients with fetuses of known maturity. Late ultrasound cephalometry, amniotic fluid creatinine estimations and lecithin/ sphingomyelin ratio were found to be significantly more reliable than the other five methods. The mean of estimated gestational ages provided by the three techniques used in combination gave a significantly more accurate prediction of fetal age than any single test and allowed formation of a ‘maturity profile’.
A RANDOMIZED CONTROLLED TRIAL OF BED REST AND SEDATION OR NORMAL ACTIVITY AND NON‐SEDATION IN THE MANAGEMENT OF NON‐ALBUMINURIC HYPERTENSION IN LATE PREGNANCY
Authors: Mathews D. D.
Published: August 2005

One hundred and thirty‐five patients took part in a randomized controlled trial designed to determine whether bed rest and sedat ion are of any general benefit to either the mother or the baby in pregnancies complicated by mild non‐albuminuric and non‐symptomatic hypertension after the 28th week. The results suggest that they are not.
THE TREATMENT OF HIRSUTISM WITH CYPROTERONE ACETATE (AN ANTI‐ANDROGEN)
Authors: Dewhurst C. J. , Underhill R. , Goldman S. , Mansfield M.
Published: August 2005

The rationale of anti‐androgen treatment for hirsutism is explained. The results are presented of treatment with cyproterone acetate of idiopathic hirsutism or hirsutism associated with polycystic ovarian disease. Ten out of 14 patients showed a good response after six months treatment. The response was dramatic in two patients.
TERMINATION OF PREGNANCY WITH VAGINAL ADMINISTRATION OF 16, 16 DIMETHYL PROSTAGLANDIN E2 p‐BENZALDEHYDE SEMICARBAZONE ESTER
Authors: Karim S. M. M. , Ratnam S. S.
Published: August 2005

A 16, 16 dimethyl prostaglandin E2 p‐benzaldehyde semicarbazone ester was used for termination of pregnancy in 54 late first trimester and second trimester patients. The drug (750 μ.g in gelatine glycerine pessaries) was administered every four hours. Fifty patients (92·5 per cent) aborted during the 36 hours treatment. Side effects were mild and consisted of vomiting in five patients, diarrhoea in three patients and transient pyrexia in two.
USE OF THE NITRAZINE YELLOW SWAB TEST IN THE DIAGNOSIS OF RUPTURED MEMBRANES
Authors: Mills Angela M. , Garrioch D. B.
Published: August 2005

Throat swabs impregnated with nitrazine yellow have been used to detect pH change in the vagina before and after amniotomy. The effect of infection on the test has been examined. A negative result is of use in excluding the diagnosis of ruptured membranes. A positive result is highly suggestive of the presence of amniotic fluid.
SIMULTANEOUS IN SITU CARCINOMA OF THE CERVIX, VULVA AND PERINEUM AFTER IMMUNOSUPPRESSIVE THERAPY FOR RENAL TRANSPLANTATION
Authors: Leckie G. B. , Cotton R. E.
Published: August 2005

A 31‐year‐old woman developed multiple synchronous in situ carcinomas of the cervix uteri, vulva and perineal skin, six years after successful renal transplantation for chronic renal failure due to chronic pyelonephritis. During this time she had been continuously treated with immunosuppressive drugs (azathioprine and prednisolone). The lesions were treated by local excision and there was no evidence of recurrence nearly two years after the primary treatment. The case history is compared to others recently described and highlights the risk of epithelial as well as lymphomatous malignancies in renal transplant recipients.
PLASMA RENIN AND ALDOSTERONE IN PREGNANCY COMPLICATED BY ADRENAL INSUFFICIENCY
Authors: Symonds E. M. , Craven D. J.
Published: August 2005

Serial measurements of plasma renin and plasma aldosterone were made throughout pregnancy in two women with adrenal insufficiency. The values were compared with levels obtained in eight normal primigravidae. Aldosterone levels were low or undetectable in adrenal insufficiency and plasma renin levels were grossly elevated in one patient with adrenal insufficiency but within the normal range in the other.
RELATIONSHIP BETWEEN FETAL URINE PRODUCTION AND AMNIOTIC FLUID VOLUME IN NORMAL PREGNANCY AND PREGNANCY COMPLICATED BY DIABETES
Authors: van Otterlo L. C. , Wladimiroff J. W. , Wallenburg H. C. S.
Published: August 2005

The hourly fetal urine production rate (HFUPR) was calculated from ultrasonic measurements of fetal bladder volume. A normal HFUPR reference curve, constructed from measurements in 189 normal pregnancies between 24 and 42 weeks gestation, showed a rapid increase of HFUPR from 3·3 to 24·4 ml up to 40 weeks followed by a slight decline. The amniotic fluid volume was estimated by the p‐aminohippuric acid method within 12 hours of HFUPR measurements. In 67 normal pregnancies, there was no relationship between HFUPR and amniotic fluid volume measured between 36 and 41 weeks gestation. In 12 patients with fetal growth retardation, a relationship was found between reduced fetal urinary output and low amniotic fluid volume between 36 and 38 weeks gestation. In the 16 diabetic patients studied between 28 and 40 weeks gestation, there was no relationship between HFUPR (within or below normal range) and the high amniotic fluid volume (above 1500 ml in 13 patients). The implications of these findings are discussed.
COMPARISON OF HISTOLOGICAL CHANGES SEEN IN PLACENTAL TISSUE CULTURES AND IN PLACENTAE OBTAINED AFTER FETAL DEATH
Authors: Hustin J. , Gaspard U.
Published: August 2005

The histological changes in placental tissue cultures were observed and compared with those seen in placentae obtained after intrauterine fetal death. Early damage of the syncytiotrophoblast and improvement in the appearance of cytotrophoblast were seen in both cases. It is suggested that it is the cessation of the fetal circulation which causes these changes.
CILIARY ACTIVITY IN THE HUMAN OVIDUCT
Authors: Critoph Frances N. , Dennis K. J.
Published: August 2005

Ciliary activity of the human oviduct was investigated using a cinematographic technique. Oviducts from preovulatory, postovulatory and puerperal subjects were analyzed and the fimbrial, ampullary and isthmic regions were compared. It was found that cilia beat more rapidly after ovulation, this difference being significant in both ampullary and isthmic regions, but not in the fimbriae. The implications of these findings are discussed.
ADVERSE REACTION TO EXTRA‐AMNIOTIC PROSTAGLANDIN E2
Authors: McNicol Evelyn , Gray Helen
Published: August 2005

An immediate and severe reaction to prostaglandin E2 (PGE2), given by the extra‐amniotic route to induce the abortion of a hydatidiform mole, is reported.
ABSENCE OF UPPER LIMBS (AMELIA) IN SURVIVING INTRAUTERINE TWIN AFTER SALPINGECTOMY FOR ECTOPIC PREGNANCY
Authors: Mathews D. D.
Published: August 2005

A patient is described who had simultaneous tubal and intrauterine pregnancies. The tubal pregnancy was treated by salpingectomy at 51 days after the onset of the last menstrual period. The surviving twin was born after 42 weeks gestation and had no upper limbs (amelia).
RIPENING OF THE CERVIX WITH EXTRA‐AMNIOTIC PROSTAGLANDIN E2 IN VISCOUS GEL BEFORE INDUCTION OF LABOUR
Authors: Calder A. A. , Embrey M. P. , Tait T.
Published: August 2005

A method of extra‐amniotic prostaglandin administration to achieve ripening of the cervix as a preliminary to induction of labour is described. Compared with a control group the method achieved a 25 per cent reduction in the length of the induced labour, a fall in the incidence of maternal pyrexia and fetal distress, an improvement in neonatal condition of the infants and a reduction in the need to resort to Caesarean section.
TREOSULFAN (DIHYDROXYBUSULPHAN) IN THE MANAGEMENT OF OVARIAN CARCINOMA
Authors: Fennelly J.
Published: August 2005

Of 36 patients with ovarian carcinoma treated with treosulfan (dihydroxybusulphan) 30·5 per cent had a complete response for a mean of 19·0 months and 33·3 per cent had a partial response. Treosulfan may have a role in the management of ascites associated with ovarian neoplasm.
ILEO‐UTERINE FISTULA AS A COMPLICATION OF MYOMECTOMY CASE REPORT
Authors: Fadel H. E.
Published: August 2005

A patient is described who developed an ileo‐uterine fistula after myomectomy. The fistula caused no symptoms and was discovered at hysterosalpingography for infertility.