bluuebunny/crossref_metadata_2025 huggingface dataset:
THE BLOOD SUPPLY OF THE UTERUS
Authors: Farrer‐Brown Geoffrey , Beilby J. O. W. , Tarbit M. H.
Published: August 2005

The patterns of capillary and venous networks in the endometrium and myometrium of the normal uterus studied by injection, microradiographical and histological techniques, are described and illustrated.
HORMONE LEVELS IN THREATENED ABORTION
Authors: Brown J. B. , Evans J. H. , Beischer N. A. , Campbell D. G. , Fortune D. W.
Published: August 2005

Fifty‐five patients admitted to hospital with the diagnosis of threatened abortion were assessed by means of urinary oestrogen, pregnanediol and chorionic gonadotrophin assays and by vaginal cytology. Oestrogen excretion was abnormally low (below the first percentile for the period of gestation) in 22 patients all of whom aborted, usually within a week of the measurement. Twenty‐two of the 33 patients with oestrogen values in the normal pregnancy range had pregnancies which continued and resulted in surviving infants. Eleven patients with normal oestrogen values subsequently aborted. These abortions occurred more than one week after the original assessment and usually in the second trimester. Pregnanediol measure ments provided comparable information. In patients who aborted, vaginal cytology and initial chorionic gonadotrophin levels were less useful investigations.
COMPLETE HEART BLOCK IN PREGNANCY TREATED WITH AN INTERNAL CARDIAC PACEMAKER
Authors: Ginns H. M. , Hollinrake K.
Published: August 2005

A case of congenital heart block complicated by Adams‐Stokes attacks treated by the insertion of a permanent fixed‐rate transvenous cardiac pacemaker is reported. No special difficulties were encountered during pregnancy, labour or puerperium except that the site of implantation of the pacemaker battery required revision.

With the development of cardiac pacing there is little centra‐indication to pregnancy in such cases. The prognosis is worse in cases of acquired rather than congenital complete heart block.
ELECTRONIC TECHNIQUES IN THE TREATMENT OF FEMALE URINARY INCONTINENCE
Authors: Paterson Peter J. , Harrison Neville W.
Published: August 2005

The results of electronic treatment in 29 incontinent women are described. The implanted stimulator was employed in 3 patients but was associated with a number of technical failures and complications. The electrode‐bearing vaginal pessary produced worthwhile results in more than half of the patients. It is considered to have a place in selected cases in which surgery is contraindicated.
CORRELATIONS BETWEEN HUMAN CHORIONIC SOMATO‐MAMMOTROPHIN (LACTOGEN), IMMUNOREACTIVE INSULIN, GLUCOSE AND LIPID FRACTIONS IN PLASMA OF PREGNANT WOMEN
Authors: Fioretti P. , Genazzani A. R. , Aubert M. L. , Gragnoli G. , Pupillo A.
Published: August 2005

The authors have assayed in 81 pregnancies, at various stages of gestation, the fasting values of plasma lipids, non‐esterified fatty acids, triglycerides, cholesterol, phospholipids, glucose and immunoreactive insulin, and have compared the findings with the values of immuno‐reactive human chorionic somato‐mammotropin assayed in the same women and in a further 31 pregnancies.

On the bases of the results obtained and the biological activity of HCS, the importance of this hormonal peptide in the determination of the modifications of the metabolism of glucose and lipids is confirmed. The biological activities of HCS have also been compared with those of other hormonal factors which undergo particular increases in pregnancy (thyrotrophic, adrenocorticotrophic hormones and chorionic gonadotrophin). The pathogenesis of alterations in the glucoselipids metabolism of the pregnant women have been interpreted in the light of the glucose‐fatty‐acid cycle of Randle.
EFFECT OF ADRENOCORTICOTROPHIC HORMONE ON URINARY OESTROGENS AND VAGINAL EPITHELIUM IN OVARIECTOMIZED PATIENTS
Authors: Zárate Arturo , Hernández‐Ayup Samuel , Canales Elias S. , Munguía Héctor , Franco Esther
Published: August 2005

Increased urinary oestrogen excretion was observed in 8 out of 10 oöphorectomized women who were given intravenous adrenocorticotrophic hormone for two consecutive days. The maturation index of the vaginal epithelium showed an oestrogenic response.
AMNIOTIC FLUID CREATININE IN NORMAL AND ABNORMAL PREGNANCIES
Authors: Roopnarinesingh Syam
Published: August 2005

Amniotic fluid creatinine values were studied in normal, toxaemic and diabetic pregnancies. In normal patients, there was a consistent linear rise as pregnancy progressed, although there were variations in the levels at each stage of pregnancy in different patients. There was also a linear rise in toxaemia, but levels were much higher than in normal pregnancy at the same period of gestation, although the rate of increase was similar. In both groups, there was a significant correlation between birthweight and creatinine values.
HYPERFLEXION OF THE SMALL‐FOR‐DATES FETUS
Authors: Croall J. , Grech P.
Published: August 2005

Of 93 small‐for‐dates fetuses X‐rayed in utero, 12 were considered to be hyperflexed. Of 47 grossly small‐for‐dates fetuses (corrected birthweights 200 g. or more below the 5th percentile of birthweights), 10 showed hyperflexion; 8 of these were delivered vaginally; 3 died during labour and one was born severely asphyxiated.
EXTRAMEMBRANOUS PREGNANCY AND AMNIORRHOEA
Authors: Kohler H. G. , Peel K. R. , Hoar Rosemary A.
Published: August 2005

A case of extramembranous pregnancy is reported; it was associated with brown vaginal discharge at 15 weeks and loss of liquor amriii from 16 weeks. The infant was born alive in the 28th week but died after three hours. At autopsy the volume of the body was found to be more than three times the capacity of the sac of membranes. The external appearance of the infant resembled that of bilateral renal agenesis, but no anomaly of the urinary organs was detected.

A unique feature of this case was superficial linear skin grooves on the fetus caused by the free margin of the membranes.
THE DIAGNOSIS OF DEEP VEIN THROMBOSIS IN THE PUERPERIUM
Authors: Friend John R. , Kakkar V. V.
Published: August 2005

A sensitive technique for the diagnosis of deep vein thrombosis in the puerperium is described and the results of its application to 100 patients discussed.
A COMPARISON BETWEEN PETHIDINE AND PHENAZOCINE (NARPHEN) FOR RELIEF OF PAIN IN LABOUR
Authors: Grant A. M. , Holt E. M. , Noble A. D.
Published: August 2005

A double‐blind study was made comparing pethidine 150 mg. with phenazocine (Narphen) 3 mg. for relief of pain in labour. In these doses neither pethidine nor phenazocine gave consistently effective analgesia.

Phenazocine was less effective as an analgesia but had a lower incidence of side effects and fetal depression. It was concluded that the doses chosen were not equivalent.
A COMPARISON OF THE EFFECTS OF PENTAZOCINE AND PETHIDINE ADMINISTERED DURING LABOUR
Authors: Moore J. , Carson R. M. , Hunter R. J.
Published: August 2005

A double‐blind between‐patient study was carried out to compare the efficacy of pentazocine 40 mg. and pethidine 100 mg. and 50 mg. for the relief of pain during labour. After the first injection pentazocine 40 mg. and pethidine 100 mg. produced a comparable degree of analgesia. The second injection of pentazocine 40 mg. was not as effective as the second injection of pethidine 100 mg. but this may be because the duration of action of pentazocine is shorter. Side effects were not very serious with either drug, but vomiting was more common after pethidine injections; hallucinations occurred in some instances after the higher doses of pethidine.
EFFECTS OF DAILY ADMINISTRATION OF A RETROSTEROID ON THE PLASMA LEVELS OF PROGESTERONE AND ON THE URINARY EXCRETION OF LUTEINIZING HORMONE AND TOTAL OESTROGENS
Authors: Larsson‐Cohn U. , Johansson E. D. B. , Wide L. , Gemzell C.
Published: August 2005

Following one control cycle, four women were treated with 4 mg. daily of the retrosteroid Ro 6‐3129 during two menstrual cycles. Judged by the plasma levels of progesterone and the urinary excretion of LH and total oestrogens, the control and treatment cycles were ovulatory.

One apparently normal pregnancy and one very early spontaneous abortion occurred. There was a tendency to a reduction of the length of the follicular phase of the treatment cycles, possibly related to the medication.
BILHARZIASIS OF THE CERVIX UTERI
Authors: Youssef Abdel Fattah , Fayad Mohamed M. , Shafeek M. Alaa‐El‐Din
Published: August 2005

The cervix is the commonest site in the female genital tract to be affected by bilharziasis. The pathology, clinical features, diagnosis and treatment of bilharziasis of the cervix are discussed on the basis of experience in 121 cases. Attention is drawn to the aetiological significance of bilharziasis of the cervix in the development of carcinoma, and the clinico‐pathological peculiarities of bilharzial carcinoma of the cervix are described.
BILATERAL TORSION OF FALLOPIAN TUBES A CASE REPORT
Authors: Lewis A. C. W.
Published: August 2005

A case of bilateral torsion of the Fallopian tubes due to associated paraovarian cysts is described. Torsion of one tube occurred seven weeks after the torsion of the other tube at 39 weeks gestation.
STRESSED CARDIOTOCOGRAPHY IN LATE PREGNANCY
Authors: Spurrett Brian
Published: August 2005

A method of examination of the fetus in late pregnancy by serial and stressed cardiotocograms is described. The clinical application of this form of investigation is appraised. Advantages and disadvantages of the test are discussed.
CHANGES IN PLASMA TOTAL PROTEIN, ALBUMIN, UREA AND α‐AMINO NITROGEN CONCENTRATIONS IN PREGNANCY AND THE PUERPERIUM
Authors: Macdonald H.N. , Good W.
Published: August 2005

The plasma levels of total protein, albumin, urea and α‐amino nitrogen have been measured serially during pregnancy and the early puerperium. Significant decreases occurred in the concentrations of total protein and albumin from the 10th to the 28th week of pregnancy; a further decrease was evident at the 37th week but was significant for albumin only. The plasma urea also fell significantly from 10 to 28 weeks of gestation but there was no further change between 28 and 37 weeks. There was a significant increase in the level of α‐amino nitrogen from 10 to 28 weeks of pregnancy but a decrease occurred at 37 weeks, although it was not significant. In the early puerperium the levels of urea and α‐amino nitrogen were significantly higher than in late pregnancy: the levels of total protein and albumin at this time were lower than at 37 weeks but the difference was only significant for total protein. The possible physiological significance of these observations is discussed.
INSULIN TREATMENT OF LATENT AND POTENTIAL DIABETICS DURING PREGNANCY
Authors: Van Der Linden S. J. L. , Mastboom J. L.
Published: August 2005

The outcome of 84 treated pregnancies of 73 latent diabetics and of 35 treated pregnancies of 31 potential diabetics has been compared with the outcome of their previous pregnancies. Treatment consisted of insulin and carbohydrate enriched salt‐free diet. This treatment increased the fetal salvage from 60 per cent to 89.5 per cent in latent diabetics and from 39 per cent to 89 per cent in potential diabetics.
PREPARATION OF CERVICAL SCRAPE MATERIAL FOR AUTOMATIC SCREENING
Authors: Tucker J. H. , Gresham G. A.
Published: August 2005

A method of preparing cervical scrape specimens for automatic analysis is described. A cell suspension is obtained by washing the spatula used to scrape the cervix in a balanced salt solution. Cell clumps are disaggregated by pumping the specimen to and fro through a hypodermic syringe needle, and the resulting suspension is centrifuged, fixed and pipetted onto a glass slide. Specimens are stained with haematoxylin and eosin.
ORAL GLUCOSE TOLERANCE IN THE EARLY PUERPERIUM
Authors: Macdonald H. N. , Good W. , Schwarz K. , Stone Joan
Published: August 2005

From the results of 685 modified oral glucose tolerance tests performed during the first week post partum, it is shown that the mean blood glucose levels, both fasting and 2½ hours after glucose, fall below the corresponding antenatal values This decrease is transient and most marked from 36 to 59 hours after delivery. In consequence, the normal upper limit of fasting blood glucose (mean plus two standard deviations) on the third puerperal day is 5 mg. per 100 ml. less than in late pregnancy. The corresponding decrease in the normal upper limit of 2½ hours blood glucose is probably greater than 7 mg. per 100 ml. and this is more likely than the fasting blood glucose level, to reveal the latent diabetic in the puerperium. Interpretation of glucose tolerance tests performed early in the puerperium must take account of these changes which result, most probably, from variation in hormonal influences following childbirth.
ACQUIRED GENITO‐URINARY FISTULAE IN THE SUDAN
Authors: Mustafa AsimZaki , Rushwan Hamid M. E.
Published: August 2005

A review of 122 cases of vesico‐vaginal and other fistulae treated in Khartoum Teaching Hospital (1966–8) is presented. The vast majority were due to ischaemic necrosis as a result of obstructed labour.

The underlying factors, methods of treatment and results are described. Closure of the fistula was successful in 90 patients while urinary diversion was necessary in 2; the other 30 patients are awaiting further attempts at repair. Suggestions for the improvement of results are offered.

In the Sudan genito‐urinary fistulae constitute a major problem. Most of them result from prolonged neglected labour and would be prevented by better antenatal and intranatal care. The results of treatment are not entirely satisfactory, but the causes of failure are largely avoidable.
RECURRENT ABDOMINAL PREGNANCY
Authors: Tan K. L. , Vengadasalam D. , Lean T. H.
Published: August 2005

A case of abdominal pregnancy occurring on two consecutive occasions is reported; such an occurrence is unique. Apparently the abdominal pregnancy was a result of a rent in the uterine fundus, a most unusual route of escape from the uterine cavity.
THE REGULARITY OF EARLY MENSTRUAL CYCLES
Authors: Dewhurst C. J. , Cowell Carol A. , Barrie Lorna C.
Published: August 2005

An investigation into the irregularity of menstrual cycles within two years of the menarche does not indicate any increasing regularity when compared with reports of 30 years ago. Intervals of 4, 5 and 6 months between periods are not uncommon, especially during the first five cycles. Cycle length gradually declined during the 15 cycles studied but a wide cycle range persisted in cycles 11 to 15.
CARCINOID TUMOURS OF THE OVARY
Authors: Haines Magnus
Published: August 2005

Eight examples of carcinoid tumour of the ovary are described. Four arose in ovarian teratomatous cysts, two were metastatic from carcinoid of the bowel, and in two cases neither a teratomatous or extrinsic source was evident.
CARCINOMA OF THE CERVIX IN CHILDHOOD
Authors: Dalley Vera M. , Dewhurst C. J. , Flood Charles M.
Published: August 2005

Two cases of adenocarcinoma of the cervix in girls aged 10 and 15 are reported. Both were treated by radiotherapy. The younger patient is alive and well nine years later.
PLASMA THYROTROPHIN LEVELS DURING PREGNANCY
Authors: Genazzani A. R. , Fioretti P. , Lemarchand‐Beraud Th.
Published: August 2005

Plasma levels of thyrotrophin (TSH) were studied by radio‐immunoassay using homologous human TSH in 142 normal pregnant women and in 19 women with pre‐eclampsia, in 2 normal pregnant women who were followed up for almost a month, in 1 patient with a hydatidiform mole before and after hysterotomy, in 10 women 30 minutes after delivery and in the arterial and venous cord blood of 11 newborn infants. Thirty‐one normal euthyroid adults and 23 normal children were studied as controls.

An increase in TSH plasma levels was found from the 7th week of pregnancy until delivery. Thirty minutes after delivery, and in the molar pregnancy 15 minutes after hysterotomy, the TSH levels returned to the upper normal range. In pre‐eclampsia the TSH plasma levels were found to be higher than in normal pregnancy. In the newborn at delivery the hypophyseal thyrotrophic function appeared to be slightly higher than in normal children. The increased plasma TSH level during pregnancy is probably due to the placental thyrotrophic‐like peptide secretion.

During the different stages of purification from the placenta of human chorionic somatomammotrophin, immunoreacting thyrotrophic factor was found only in the starting material.

The existence of a cross‐reaction between human TSH and human chorionic thyrotrophin was confirmed.
SERUM HEAT STABLE ALKALINE PHOSPHATASE LEVELS AND THEIR RELATIONSHIP TO URINARY OESTROGEN OUTPUT AND FETAL AND PLACENTAL WEIGHTS
Authors: Elder M. G.
Published: August 2005

One hundred and fifty‐two paired estimations of serum heat stable alkaline phosphatase (HSAP) and urinary oestrogen excretion were performed on 37 patients; there was no correlation between these values. There was no correlation between the serum HSAP levels and fetal or placental weight, although there were correlations between urinary oestrogen output and fetal and placental weights. Serum HSAP levels are probably of no value in the prediction of a small‐for‐dates baby.
THE ARIAS‐STELLA PHENOMENON AND THE DIAGNOSIS OF PREGNANCY
Authors: Beswick Isobel P. , Gregory Monica M.
Published: August 2005

Focal endometrial atypia (the Arias‐Stella reaction) as an indication of pregnancy is examined, with special reference to the diagnosis of ectopic pregnancy. The diagnostic importance of clear‐cell transformation of endometrial glands is discussed. Infiltration with glycogen as the cause of the clear appearance of epithelial cells is suggested. It is also suggested that disturbance of trophoblast is of importance in the hormonal mechanisms which probably causes this atypia.
THE SIGNIFICANCE OF RISES IN RHESUS ANTIBODY TITRE FOLLOWING AMNIOCENTESIS
Authors: Aickin D. R.
Published: August 2005

The relationship between increases in rhesus antibody titre following amniocentesis and perinatal mortality, in current and subsequent pregnancies, is assessed. In a current pregnancy, fetal prognosis was related more closely to antibody level before amniocentesis than to rises occurring after it. In patients with no history of severe immunization prior to the initial pregnancy in which amniocentesis was performed, a significant rise in antibody titre following amniocentesis indicated a very bad fetal prognosis in subsequent pregnancies. Where severe immunization was already established prior to the initial pregnancy in which amniocentesis was performed, rises in antibody titre following amniocentesis were not associated with any alteration in fetal prognosis in a subsequent pregnancy.
THE INFLUENCE OF PRE‐ECLAMPSIA AND DIABETES MELLITUS ON PLASMA FREE AMINO ACIDS IN MATERNAL, UMBILICAL VEIN AND INFANT BLOOD
Authors: Cockburn F. , Blagden A. , Michie E. A. , Forfar J. O.
Published: August 2005

Plasma amino acid and total protein concentrations in the mother at delivery, in the newborn infant and in the infant at the seventh day were compared for 12 small‐for‐dates infants born to mothers with severe pre‐eclampsia and low urinary oestriol excretion, 9 large‐for‐dates infants born to mothers with diabetes mellitus and normal oestriol excretion, and 26 appropriate‐weight‐for‐dates control infants born after normal pregnancy. The latter included vaginal deliveries at and before term and deliveries by Caesarean section at term.

Severe pre‐eclampsia was associated with a reduced mean maternal plasma total protein concentration and a generalized increase in plasma amino acid concentrations. Plasma total protein values in the small‐for‐dates infants at birth and at the seventh day were not significantly different from values in control infants of similar gestation period, but amino acid values at birth were usually higher than those in control infants.

In diabetic mothers and their infants there were increased concentrations of aspartic acid and α‐amino‐n‐butyric acid. The concentrations of the remaining amino acids and the total plasma protein concentrations did not differ from the normal control values either in mother or infant (birth and seventh day). Ten of the twenty amino acids examined in diabetic mothers and their infants showed significant positive correlations between maternal and umbilical venous values. This degree of correlation was not found in normal or pre‐eclamptic pregnancy. Due to failure of the infant to reflect fully the higher maternal levels in toxaemia, the umbilical venous/maternal venous plasma amino acid ratios for total mean plasma amino acid concentrations and particularly for the branched‐chain amino acids valine, leucine and isoleucine were reduced.

The umbilical venous plasma/maternal venous plasma ratios for normal, toxaemic and diabetic pregnancy were 1.6: 1, 1.4: 1 and 1.6: 1 respectively.

In small‐for‐dates infants there was a negative correlation between amino acid concentration at birth and both birthweight and umbilical venous plasma protein concentration, suggesting a possible endogenous mobilization of amino acids in such infants.
SPECTROPHOTOMETRIC EXAMINATION OF THE AMNIOTIC FLUID IN RH‐ISO‐IMMUNIZATION: A SIMPLE METHOD FOR THE EVALUATION OF RESULTS
Authors: Poláček K. , Zwinger A. , Vedra B.
Published: August 2005

A simple diagram for evaluating the reliability of spectrophotometric examination of the amniotic fluid is proposed. In a series of 40 iso‐immunized women the condition at birth of all infants requiring active treatment during pregnancy was correctly predicted, but there were three false positive results.
ABDOMINAL STERILIZATION USING THE PROCTOSCOPE
Authors: Stevenson T. C.
Published: August 2005

In a series of 50 cases a proctoscope was inserted suprapubically into the peritoneal cavity and the Fallopian tubes ligated under direct vision. The short incision and the use of an absorbable subcuticular suture allowed the patients to leave hospital 48 hours after operation. The method is quick and easy, and peritoneal insufflation is avoided.
EFFECTS OF ORAL ADMINISTRATION OF PROSTAGLANDINS E2 AND F2α ON THE HUMAN UTERUS
Authors: Karim S. M. M.
Published: August 2005

The effects of oral administration of prostaglandins E2 and F2α have been studied in 42 male and non‐pregnant female volunteers and in pregnant women.

Oral doses of 0.5 mg. prostaglandin E2 or 5 mg. prostaglandin F2α stimulated the pregnant uterus in vivo at term to contract.

Single oral doses of up to 3 mg. of prostaglandin E2 or 30 mg. prostaglandin F2αdid not produce any noticeable effect on the gastrointestinal tract or the cardiovascular system. Doses of 4.5 mg. prostaglandin E2 and 40.50 mg. prostaglandin F2α produced contractions of the uterus in early pregnancy and in addition produced diarrhoea and vomiting.

The implications of these findings with respect to the clinical use of prostaglandins as oral abortifacients and oxytocics are discussed.
THE USE OF AN “UNNATURAL” PROSTAGLANDIN IN THE TERMINATION OF PREGNANCY
Authors: Gillespie Arnold , Beazley John M. , van Dorp David A.
Published: August 2005

Three mid‐trimester abortions were successfully carried out using an “unnatural” prostaglandin (ω‐homo‐PGE1). The effects of this prostaglandin are described and its possible advantages discussed.
INTERACTION OF E PROSTAGLANDINS AND SYNTOCINON ON THE PREGNANT HUMAN MYOMETRIUM
Authors: Brummer Hilary C.
Published: August 2005

The possibility that ketonic prostaglandins (PGEs) and oxytocin (Syntocinon, Sandoz) may be used to supplement each other on the pregnant human uterus has been investigated in vitro. The enhancement effect of E prostaglandins on the myometrial response to oxytocin is described both for mid‐trimester and term myometrial strips. An hypothesis regarding the role of prostaglandins in labour is put forward and discussed. The application of this sensitizing effect to the induction of mid‐trimester abortion is also considered.
URINARY OESTRIOL EXCRETION BEFORE ACCIDENTAL HAEMORRHAGE
Authors: Beischer N. A. , Brown J. B. , Macafee C. A. J. , Reid S.
Published: August 2005

The findings in 30 patients who had urinary oestriol assays performed before the onset of accidental haemorrhage are presented. The correlation between retro‐placental haemorrhage and fetal growth retardation is examined.

In 4 of the 5 patients who had severe placental abruption causing immediate fetal death the oestriol values were within the normal range. Normal oestriol values therefore provide no assurance against imminent severe placental abruption.

Five out of 6 patients with clinically mild accidental haemorrhage had low oestriol excretion values recorded before vaginal haemorrhage occurred. Nine patients who experienced neither abdominal pain nor vaginal haemorrhage during pregnancy had subclinical episodes of retroplacental bleeding with severe impairment of fetoplacental function. Subclinical retroplacental haemorrhage may thus be an important cause of fetal growth retardation and may precede clinically obvious accidental haemorrhage. This would explain the association between accidental haemorrhage and placental insufficiency.
THE BLOOD COAGULATION AND FIBRINOLYTIC SYSTEMS IN THE NEWBORN AND THE MOTHER AT BIRTH
Authors: Bonnar John , McNicol G. P. , Douglas A. S.
Published: August 2005

The coagulation and fibrinolytic systems were investigated in the mother and in the cord blood of the infant at term immediately after delivery and striking differences in both these systems were found. Low levels of factors II (prothrombin), VII, IX and X contrasted with the increased level of factors II, VII and X and a normal level of factor IX in the mother. Increased levels of factors V and VIII were found in the newborn and highly significant correlation was present between the maternal and neonatal levels. The levels of fibrinogen and plasminogen in the baby were half those found in the maternal blood. A high level of fibrinolytic activity was found in all the newborn infants in contrast to the diminished activity present in the maternal blood. The cord blood had a very high level of inhibitor to urokinase‐ induced lysis. The increased fibrinolytic activity in the infant may have a protective role for the rapid clearance of intravascular fibrin. High levels of circulating inhibitor in the baby would serve to protect the susceptible plasma proteins and confine the results of plasminogen activation to the digestion of fibrin. The findings suggest that normal delivery activates the clotting and fibrinolytic systems of the baby and the mother, probably due to thromboplastin entering the fetal and maternal circulations during placental separation.
OPERATIVE TREATMENT OF CARCINOMA OF THE CERVIX*
Authors: Currie David W.
Published: August 2005

The results of 552 radical operations for carcinoma of the cervix are presented.

475 cases were treated surgically before July 1965 with the following 5‐year survival rates:

Stage 1 189 cases 86·3 per cent

Stage 2a 103 cases 75·0 per cent

Stage 2b 78 cases 58·9 per cent

Other stages 41 cases 34·1 per cent

The operative technique, complications and results are set out in detail.
PHAEOCHROMOCYTOMA OF THE OVARY
Authors: Fawcett F. J. , Kimbell N. K. B.
Published: August 2005

A case of phaeochromocytoma of the ovary simulating pre‐eclamptic toxaemia of pregnancy in a 15‐year‐old girl is reported.
ENDOCRINE STUDIES IN POST‐MENOPAUSAL WOMEN WITH OVARIAN TUMOURS
Authors: Edwards R. Logan , Nicholson H. Oliphant , Zoidis T. , Butt W. R. , Taylor C. W.
Published: August 2005

An endocrine assessment was made in 78 post‐menopausal women.

The urinary excretion of oestriol was greater than 10 μg. per 24 hours in 14 out of 31 cases with malignant ovarian tumours, in 2 out of 24 cases with benign ovarian tumours, and in 6 out of 23 cases without ovarian tumours. Although the urinary oestriol excretion was increased in all 8 cases with mucinous carcinoma it was raised in only 4 out of 18 cases with serous carcinoma. Some of the greatest amounts of urinary oestriol were found in cases without ovarian tumours.

The urinary excretion of pregnanediol was increased in 6 out of 18 cases. These six patients also had increased oestriol excretion.

The excretion of steroids was normal after oöphorectomy.

Tests of adrenal cortical activity and ovarian vein blood analysis also point to the diseased ovary as the site of increased steroid synthesis.

The correlation of increased urinary oestriol with vaginal cornification index was fair, but with vaginal bleeding and endometrial activity was poor.
FETAL ADRENAL WEIGHT AND THE CAUSE OF PREMATURE DELIVERY IN HUMAN PREGNANCY
Authors: Anderson AnneB. M. , Laurence K. M. , Davies Kathleen , Campbell H. , Turnbull A. C.
Published: August 2005

In a group of 79 infants delivered before the end of the 36th week of pregnancy, and who either were stillborn or died within 12 hours, the weights of the adrenal glands in relation to fetal weight and gestational age were determined. Three groups were identified according to the clinical cause of the premature labour, namely those due to no known cause, those due to antepartum haemorrhage and those due to pre‐eclampsia.

The weight of the fetal adrenals in cases without apparent cause for premature labour was increased compared to the weight in cases of similar fetal weight or gestational age in the other two groups. The adrenal weight in cases of pre‐eclampsia was less than that in the cases of antepartum haemorrhage. The weight of the kidneys was similar in the three groups and there was no relationship between adrenal weight and thymic weight. In 15 spontaneous and 40 therapeutic abortions the difference between the weight of the fetal adrenals in the two groups was not significant.

The implications of these findings are discussed in relation to the role of the fetal adrenal in the initiation of premature labour.
SERIAL OBSERVATIONS OF GLUCOSE TOLERANCE IN PREGNANCY AND THE EARLY PUERPERIUM
Authors: Macdonald H. N. , Good W. , Schwarz K. , Stone Joan
Published: August 2005

It is shown from a longitudinal study of 540 women that the mean random blood glucose concentration in late pregnancy is significantly lower than in early pregnancy. A modified glucose tolerance test on 412 of these women late in the third trimester of pregnancy showed no significant difference between the mean fasting blood glucose and the value 2½ hours after oral ingestion of 50 g. glucose. When this test was repeated in the early puerperium on 357 of these women the mean blood glucose at 2½ hours postglucose was very significantly lower than the mean fasting blood glucose. Both the mean fasting and the mean 2½‐hour blood glucose were significantly lower in the early puerperium than in late pregnancy. One implication is that glucose tolerance tests of women in the early puerperium may be wrongly interpreted as normal.
ORAL GLUCOSE TOLERANCE TESTS IN PREGNANT WOMEN WITH POTENTIAL DIABETES, LATENT DIABETES AND GLYCOSURIA
Authors: Campbell Norah , Pyke D. A. , Taylor K. W.
Published: August 2005

Oral glucose tolerance tests were performed at two stages of pregnancy and after delivery in women who were thought liable to have an abnormality of glucose tolerance, i.e. those who had a first‐degree diabetic relative, those who had given birth to an infant weighing more than 4·84 kg. (10 pounds) or a stillborn infant, those who had glucose in more than one routine urine specimen, and those who were known to have had an abnormal glucose tolerance in a previous pregnancy. Some normal pregnant women were also tested to provide a control group.

In normal subjects there was a small increase in peak glucose levels at 32 weeks but not at 22 weeks. Insulin levels were higher during pregnancy than after delivery: the difference being significant at 32 weeks.

In women who had a first degree diabetic relative, those who had given birth to an infant weighing more than 4·84 kg. (10 pounds) and those who had glucose in routine urine specimens in pregnancy, the mean glucose level two hours after oral glucose was significantly elevated at the 32nd week. Insulin levels differed little from the normal group, although the two‐hour level at 32 weeks tended to be higher than in the normal group.

In women who had had an abnormal glucose tolerance in a previous pregnancy (latent diabetics) glucose tolerance was again markedly abnormal and this was associated with impaired insulin secretion.

It is concluded that pregnancy may reveal defects in insulin secretion in women who are at risk for the development of diabetes. In the case of latent diabetes the defect is severe enough to produce a temporary diabetic state. In the other groups tested (potential diabetics) there is some evidence of a lesser defect in insulin secretion which is not severe enough to cause frank diabetes. The significance of these findings for mother and fetus is discussed.
COMPOSITION OF AMNIOTIC FLUID AND MATERNAL BLOOD THROUGH PREGNANCY
Authors: Lind T. , Billewicz W. Z. , Cheyne G. A.
Published: August 2005

Samples of amniotic fluid and of maternal blood were obtained at abdominal hysterotomy, by amniocentesis from patients with rhesus iso‐immunization and at surgical induction of labour. In 135 women whose pregnancies were beyond mid‐term, the menstrual dates were accurately known.

The characteristics of the cells in amniotic fluid, after staining with haematoxylin and eosin, enabled three stages of gestation—under 32 weeks, 33–36, and 37 weeks and over—to be distinguished with reasonable certainty.

The samples of amniotic fluid and blood were examined biochemically. In amniotic fluid after mid‐term, osmolality and sodium concentrations fell with gestational age, while levels of urea and creatinine rose. Though the levels of these factors in maternal blood remain fairly constant throughout gestation, it was possible to relate differences between levels in blood and in amniotic fluid to gestational age. Equations showing these relationships are presented.

The results were not influenced by the severity of haemolytic disease in the fetuses.
THE NATURAL HISTORY OF OEDEMA DURING PREGNANCY
Authors: Robertson E. G.
Published: August 2005

Clinical evidence of oedema was found in 69 out of 83 women selected during early pregnancy as being healthy; 11 of the 83 developed some hypertension during late pregnancy. Measurements of body weight, leg volume, ankle circumference and finger size suggested that increased hydration of the tissues is likely to be universal in normal pregnancy.

The patterns of clinical oedema, when present, were exceedingly variable. Cluster analysis was used to differentiate four broad categories: I, no clinical oedema; II, sporadic signs; III, late oedema; IV, early and persistent oedema. There was a statistically significant, but unexplained, difference of mean birthweights between cases with no or sporadic oedema (3416 g.), those with “late” oedema (3653 g.) and those with “early” oedema (3157 g.). These differences were not related to the occurrence of pre‐eclampsia.
A RAPID RADIOIMMUNOASSAY FOR HUMAN CHORIONIC SOMATOMAMMOTROPHIN
Authors: Letchworth A. T. , Boardman R. , Bristow Christine , Landon J. , Chard T.
Published: August 2005

A rapid radioimmunoassay for human chorionic somatomammotrophin has been developed which permits an individual plasma determination to be completed in one hour. It is based on the use of high concentrations of antibody and labelled hormone, which ensures equilibration within 15–20 minutes and eliminates the need for a preliminary plasma dilution step. Antibody‐bound and free peptide are separated in less than 10 minutes by the addition of two volumes of ethanol.
CONTINUOUS LUMBAR EPIDURAL ANALGESIA USING BUPIVICAINE: A STUDY OF THE FETUS AND NEWBORN CHILD
Authors: Noble A. D. , Craft I. L. , Bootes J. A. H. , Edwards P. A. , Thomas D. J. , Mills K. L. M.
Published: August 2005

A prospective trial compared 100 normal labouring women who had epidural analgesia with 102 similar women given conventional analgesia. Fetal welfare was assessed by five parameters. Statistical analysis of these parameters in the two groups shows that babies born to mothers who had epidural analgesia were in better condition.
CARDIOMYOPATHY AND RENAL FAILURE OCCURRING IN THE PUERPERIUM
Authors: Parsons Victor , Porter Andrew , Dische Frederick
Published: August 2005

A fatal case of puerperal cardiomyopathy in a 28‐year‐old woman is described. Congestive cardiac failure with episodes of collapse and hypotension developed about a month after confinement. Acute renal tubular necrosis supervened, necessitating dialysis, and the patient died after a brief illness. Necropsy revealed granulomatous and eosinophilic myocarditis. The aetiology of the lesion was not established but there are grounds for suspecting that it was due to hypersensitivity to sulphamethoxypyridazine.
PERINATAL LISTERIOSIS
Authors: Voigt J. C. , Claireaux A. E. , Hopper P. K. , Beck A.
Published: August 2005

A case is described of infection of a mother and her baby with Listeria monocytogenes.
A SERIAL STUDY IN PREGNANCY OF THE PLASMA CONCENTRATIONS OF RENIN, CORTICOSTEROIDS, ELECTROLYTES AND PROTEINS AND OF HAEMATOCRIT AND PLASMA VOLUME
Authors: Weir R. J. , Paintin D. B. , Brown J. J. , Fraser R. , Lever A. F. , Robertson J. I. S. , Young J.
Published: August 2005

Fifteen pregnant women (including one with a twin conception) were studied at the 16th, 28th, 34th and 38th weeks of gestation.

Blood pressure increased slightly in late pregnancy in 3 women, including the one with twins; the remainder had normal pregnancies throughout.

Plasma concentrations of renin, electrolytes, haemoglobin and proteins, together with plasma volume, osmolality, colloid osmotic pressure and packed cell volume, were measured in all the women; plasma concentrations of aldosterone in 7; and plasma corticosterone and cortisol in 6.

Between the 16th and the 38th weeks of gestation there was no significant change in the mean plasma electrolyte concentrations, osmolality, colloid osmotic pressure or haematocrit. Plasma volume increased markedly between the 16th and 34th weeks. The mean plasma protein concentration showed a significant rise between the 28th and 38th weeks.

Plasma renin concentration was increased above the non‐pregnant range in most, but not all, of the women.

Plasma aldosterone concentration was markedly increased in all measurements in each of the 7 women studied, the highest mean value being found at 16 weeks.

With the exception of 3 of a total of 24 estimations, plasma corticosterone remained within the normal non‐pregnant range.

Plasma cortisol was increased above the non‐pregnant range at 38 weeks in all the women studied; less consistent increases were found in earlier weeks.

Multiple regression analysis revealed no significant correlation between any of the factors measured in the 12 women whose blood pressures remained normal throughout.
TOLERANCE LIMITS FOR FETAL AND PLACENTAL GROWTH RELATIONSHIPS
Authors: Girmes D. H. , Hamilton W. J.
Published: August 2005

The tolerance limits for fetal and placental growth relationships have been investigat.
THE SEROMUCOID GLYCOPROTEIN SUB‐FRACTION IN PREGNANCY AND THE EARLY PUERPERIUM
Authors: Good W. , Hancock K. W. , Macdonald H. N.
Published: August 2005

An investigation has been made of the seromucoid glycoprotein subfraction in pregnancy and the early puerperium. The results show that the seromucoid concentration remains virtually constant for the first 28–30 weeks of pregnancy and increases slightly in the last 10–12 weeks. Allowing for the expansion of plasma volume, there is, therefore, a steady increase in the total amount of seromucoid with increasing maturity. After delivery the seromucoid level rises to about twice the average value in pregnancy.

These findings are discussed in relation to immunological aspects of gestation and they are in keeping with the view that the mother lays down an immunological barrier between herself and the fetus.
PREGNANCY AFTER RUPTURE OF THE PREGNANT UTERUS
Authors: Ritchie Edgar H.
Published: August 2005

Since 1932 a total of 194 women who had 253 pregnancies after rupture of the pregnant uterus have been listed, including the 28 patients with 36 such pregnancies who are the subject of this report. Twenty‐five of the women (12·8 per cent) had a repeat rupture. Two patients died. The risk of repeated rupture is least if the scar is confined to the lower uterine segment; greater if the scar extends into the upper segment; and greatest in patients who have had previous rupture of a classical Caesarean section scar. The management of these patients is discussed in the light of these findings.
FOLEY CATHETER URETHROGRAPHY IN STRESS INCONTINENCE
Authors: Frewen W. K.
Published: August 2005

The technique of urethrography and its role in the diagnosis and management of stress incontinence is described. The significance of dilatation of the urethrovesical junction and the urethra in the aetiology of incontinence of urine in the female is discussed. It is suggested that Foley catheter urethrography should be part of urethrocystography in order to enhance the merit of the latter investigation. The purpose of the Foley catheter test and its clinical application, both in the preoperative and postoperative stages is illustrated.
URETHRAL LENGTH IN URINARY STRESS INCONTINENCE
Authors: Mitrani A. , Sharp M. , Zilberman A. , Singer J.
Published: August 2005

In 78 women with stress incontinence the urethral length was measured before and after urethro‐colporrhaphy. The urethral length was increased by 0·5–2·5 cm. and this procedure cured 88·5 per cent of patients. The urethral length before operation had no reaction to the prognosis.
THE VALUE OF FOLIC ACID SUPPLEMENTS IN PREGNANCY
Authors: Fletcher J. , Gurr A. , Fellingham F. R. , Prankerd T. A. J. , Brant H. A. , Menzies D. N.
Published: August 2005

In a double‐blind trial of folic acid supplements (5 mg. per day) during pregnancy‐no effects were seen in the incidence of anaemia or complications of pregnancy, although the serum folate levels were less abnormal in the treated group. Nor was evidence found that anaemia or serum folate levels determined the incidence of complications and the outcome of pregnancy. No justification for giving routine folate supplements to this population of patients was apparent.
IMMUNOGLOBULINS IN NORMAL PREGNANCY, PRE‐ECLAMPSIA AND PREGNANCY COMPLICATED BY THE NEPHROTIC SYNDROME
Authors: Studd J. W. W.
Published: August 2005

The immunoglobulins IgG, IgA, IgM and IgD have been measured serially in ten normal pregnancies by the Mancini method of immunodiffusion. A depression of IgG and IgA concentrations and elevation of IgD concentration was found. Eighteen patients with severe pre‐eclampsia and heavy proteinuria, and four patients with a proven diagnosis of nephrotic syndrome due to chronic glomerulo‐nephritis were also studied. In both protein‐losing conditions a depression of IgG and IgD was found. This is believed to be a result of “molecular sieving” of these globulins of intermediate size by the glomerular basement membrane into the urine.

The biochemical and pathological similarity of pre‐eclampsia and nephrotic syndrome is discussed and a comparison is made to nephrotic syndrome produced by renal vein thrombosis.
CHANGES IN PLASMA SODIUM, POTASSIUM AND CHLORIDE CONCENTRATIONS IN PREGNANCY AND THE PUERPERIUM, WITH PLASMA AND SERUM OSMOLALITY
Authors: Macdonald H. N. , Good W.
Published: August 2005

Serial estimations of plasma sodium, potassium and chloride concentrations, with plasma and serum osmolality, have been made during pregnancy and the early puerperium. Both sodium and potassium concentration decrease until 28 weeks, after which both rise, potassium significantly so. Plasma chloride concentration and serum osmolality rise significantly from 10 to 37 weeks, but plasma osmolality falls below the serum value as pregnancy progresses, and this difference is significant at 37 weeks gestation. There are significant increases in plasma potassium and sodium concentrations and of both plasma and serum osmolality in the early puerperium, when plasma chloride concentration falls. The possible physiological significance of these findings is discussed. Plasma is preferred to serum for the estimation of osmolality during pregnancy.
INDUCTION OF THE UNSTABLE LIE BY AMNIOCENTESIS
Authors: Ward G. D.
Published: August 2005

The treatment of persistent unstable lie by amniocentesis is described. By avoiding rupture of the membranes until the head is engaged the incidence of cord prolapse, transverse lie in labour and Caesarean section is reduced.
SPINAL ANAESTHESIA BY THE OBSTETRICIAN
Authors: McNie T. McG. , Dudley AinsworthG. , Markham Sanford M.
Published: August 2005

In 12 years 2995 spinal anaesthetics were administered in one obstetric unit, 2854 of them for vaginal deliveries. In the latter the spontaneous delivery rate was 9 per cent and the operative delivery rate 89 per cent, the remainder being breech and twin deliveries. There was no maternal mortality, no permanent nerve injury, and the perinatal mortality was 11 per thousand total births.

We regard low spinal anaesthesia as a safe and acceptable method of regional anaesthesia for vaginal delivery, which can be administered by any obstetrician who learns the details of the method. However, it is not a method to be used casually or as an emergency procedure only; to attain precision in its technique it must be practised regularly.
THE SIGNIFICANCE OF CALCIUM DEPOSITS OCCURRING ON INTRAUTERINE DEVICES
Authors: Howard Geraldine
Published: August 2005

Intrauterine contraceptive devices were examined after removal from the uterus. The surfaces of the devices were roughened by a deposit consisting of mucopolysaccharide and calcium salts. The degree of roughness had no relationship to the menorrhagia of which some patients complained.
AN INDEX OF FETAL WELFARE IN LABOUR
Authors: Tipton Richard H. , Shelley Trevor
Published: August 2005

An index of fetal welfare in labour has been devised based upon the fetal basal heart rate, the dip area (Shelley and Tipton, 1971) and the presence or absence of meconium. This index appears to surpass other methods of predicting fetal outcome in labour.
STERILIZATION AND THROMBO‐EMBOLISM
Authors: Turner Gillian , Hooper N.
Published: August 2005

The incidence of thrombo‐embolism was 0.8 per cent after 743 postpartum tubal ligations but nil after 499 non‐puerperal sterilizations. The incidence of thrombo‐embolic complications after vaginal delivery without sterilization in 17 836 patients was 0.2 per cent. Although the differences are significant it is suggested that puerperal sterilization is justified in patients of high parity and low socio‐economic status because they are at greater risk from complications in a further pregnancy and are less likely to return for sterilization at another time.
ANDROGEN PATTERNS IN A CASE OF HILAR CELL HYPERPLASIA OF THE OVARY
Authors: MacRae D. J. , Willmott M. P. , Ismail A. A. A. , Love D. N.
Published: August 2005

Hilar cell hyperplasia of the ovaries, associated with high plasma and ovarian cyst‐fluid testosterone, was found in a postmenopausal woman presenting with hirsutism. Decrease in plasma testosterone levels are recorded after surgery.
ACUTE INTERMITTENT PORPHYRIA AND PREGNANCY
Authors: Hunter D. J. S.
Published: August 2005

The case of a woman with acute intermittent porphyria successfully completing her second pregnancy is described.

Seventy‐two reported cases of acute intermittent porphyria complicated by pregnancy are reviewed. All but 5 of these patients suffered an attack during pregnancy. The mortality rate amongst primigravidae was 52 per cent, and in all cases 27 per cent.

The severity of the disease during pregnancy is probably due to combination of the effect of pregnancy and injudicious administration of barbiturates. The mortality rate in pregnancy seems to be falling, probably due to an increasing awareness of the disease and its precipitating factors.