bluuebunny/crossref_metadata_2025 huggingface dataset:
The Cone Biopsy—Hysterectomy Time Interval Related to Wound Infection
Authors: Wisborg Tove
Published: December 2009

A group of 99 patients, who underwent total hysterectomy because of carcinoma in situ of the cervix uteri between 3 and 57 days after cervical cone biopsy, were compared with a control group of 130 patients who were subjected to hysterectomy because of uterine fibroids with no preceding biopsy. A significantly increased frequency of wound infections was found in the cone‐biopsy‐hysterectomy group, 23.2% as compared with 6.2% in the control group. Furthermore a significant increase in febrile morbidity was found in the cone‐biopsy‐hysterectomy group, 31.3% as compared with 10.8% in the control group. In the cone‐biopsy‐hysterectomy group wound infections only occurred when the time interval between the two operations was between 3 and 14 days. With an interval of 15 days or more no wound infections were found. No relationship could be established between the febrile morbidity rate and the cone‐biopsy‐hysterectomy interval. Other complications were similar in both groups. The most frequent complications were urinary tract infections and pneumonia. No deaths occurred. It is recommended that hysterectomy should not be performed until at least two weeks after a cone biopsy of the cervix, in order to avoid the risk of wound infection which was 4 times commoner than in our control series.
Laparoscopy in Suspected Ectopic Pregnancy
Authors: Samuelsson Stig , Sjövall Alf
Published: December 2009

In order to assess the value of laparoscopy as a routine procedure in suspected ectopic pregnancy (E.P.) a study was made on 489 laparoscopies performed on this indication. The laparoscopy was technically successful in 478 cases (97.8%). Only one of 166 E.P. was overlooked. A false diagnosis of E.P. was made in 6 of 312 women without ectopic gestation. Thus, the total diagnostic accuracy in successful laparoscopies was 98.5%. Combining swiftness and exactitude and covering the whole field of different conditions where a suspicion of E.P. arises, laparoscopy is superior to other diagnostic procedures. It is concluded that routine use of laparoscopy in suspected E.P. is justified. Apart from fulminant cases in which it is contraindicated, laparoscopy should be regarded as the method of choice to diagnose as well as to exclude E.P.
The Engagement of the Foetal Head in the Uterus when the Vertex Presents
Authors: Lindgren Lennart
Published: December 2009

In earlier investigations the author demonstrated that the head to cervix pressure both during and between contractions in labour is greatest at the equator of the foetal head and that the head to cervix pressure decreases towards the lower pole of the foetal head. These pressure conditions explain the biomechanics of cervical dilatation during labour under different conditions. The author has used small flat strain gauge receptors sited between the foetal head and the uterine wall. In the present investigation the head to cervix pressure was also measured above the equator of the foetal head. Between the contractions the head to cervix pressure decreases progressively above the equator of the head and finally the amniotic fluid pressure is measured. In some cases, especially primi‐gravidae, the head to cervix pressure curves rise very steeply at the beginning of a contraction but as the amniotic pressure approaches its maximum, the head to cervix pressure decreases and ultimately falls to the same level as the amniotic fluid pressure. In other women, especially multigravidae, the increase of the head to cervix pressure at the beginning of the contraction is less, but usually the pressure at the beginning of the contraction increases more rapidly than the head to cervix pressure below the equator. During the contractions the amniotic pressure was measured first at high level and at higher amniotic pressure successively towards the equator. The findings are supported by model experiments using a wooden sphere over which a rubber sheath has been drawn. The investigations explain the engagement of the foetal head in the lower part of the uterus. The importance of the engagement of the foetal head when the vertex presents is related to the influence upon the friction between the foetal head and the uterine wall and the mechanism of cervical dilatation. The engaged foetal head prevents the outflow of amniotic fluid after rupture of the membranes and minimises the risk of prolapse of the umbilical cord.
Gestational Choriocarcinoma in Denmark 1940–1969: A Reappraisal Based on Modern Histologic Criteria
Authors: Mogensen Bent , Olsen Steen
Published: December 2009

In Denmark, 94 cases of trophoblastic disease were classified as choriocarcinoma (CHC) or “probably CHC” during the period 1940–1969. All these cases were subjected to a reappraisal in the study presented here. Based on the criteria laid down by the Armed Forces Institute of Pathology, 50 of the cases were classified as CHC, 18 as invasive moles (IM), and 26 as other trophoblastic proliferations (OTP).

Among the CHC patients, 30 died of generalized disease and one from postoperative complications. Eighteen patients (36%)—10 of them with metastases—recovered. Four of these patients have been observed for 2–5 years and 14 for more than 5 years. Finally, one patient has still active disease.

Forty‐four patients suffering from IM (18) or OTP (26) were cured of their disease, including 5 with metastases. Determination of chorionic gonadotrophs was performed in 88 of the 94 patients at the time of the original diagnosis. Based on the findings at the re‐evaluation, the frequencies of IM and CHC were one case per 126 000 and 49 000 births, respectively. The ratio of IM to CHC was 1 to 2.6. As compared with Norway and Sweden, Denmark seems to have the lowest incidence of these diseases. During the years 1943–1963, CHC accounted for approx. 0.03% of all malignant neoplasms in Danish females.

The study reported here forms the basis of subsequent immunologic investigations into the transplantation aspects of CHC and IM.
Inactivation of Oxytocin by Human Myometrial Preparations: I. Preliminary Evidences for the Presence of a Thiol‐Oxido‐Reductase Activity and an Amino‐Peptidase Activity in Crude Extracts
Authors: Melander Stig
Published: December 2009

In a planned series of studies of the ways in which human myometrial preparations inactivate oxytocin a pilot study was made with the three synthetic model substrates L‐Cystyl‐di‐β‐Naphthylamide, S‐Benzyl‐L‐Cy‐steinyl‐β‐Naphthylamide, S‐Benzyl‐β‐Mercaptopropionyl‐β‐Naphthylamide and with Oxytocin and Deamino‐oxytocin. The syntheses of S‐benzyl‐β‐cysteinyl‐β‐naphthyl‐amide and S‐benzyl‐β‐mercaptopropionyl‐β‐naphthylamide are described. Incubations with crude extracts from myometria of non‐pregnant women and pregnant women in the three trimesters liberated β‐naphthylamine from L‐cystyl‐di‐β‐naphthylamide and S‐benzyl‐L‐cysteinyl‐β‐naphthylamide but not from S‐benzyl‐β‐mercaptopropio‐nyl‐β‐naphthylamide. The liberation of β‐naphthylamine from L‐cystyl‐di‐β‐naphthylamide was competitively inhibited by oxytocin and non‐competitively inhibited by deamino‐oxytocin. The results are interpreted as giving preliminary evidence for the presence of a thiol‐oxido‐reductase activity and an amino‐peptidase activity in the extracts.
Aortic Coarctation and Pregnancy
Authors: Hillestad Leif
Published: December 2009

An 18‐year‐old primigravida was admitted in the seventh month of pregnancy with a diagnosis of pre‐eclampsia, based on a recent rise of the blood pressure up to 175/110 mmHg. Oedema and proteinuria were absent. Examination revealed absent femoral pulses and no measurable blood pressure in the lower limbs. A harsh holosystolic murmur, grade 4, was audible over the pre‐cordium. A collateral pulse was felt at the medial border of the left scapula. The chest film showed rib erosions and a possible widening of the ascending aorta. A diagnosis was made of aortic coarctation with probable aortic aneurysm. To avoid the strain of labour a Caesarean section was successfully undertaken. Subsequent aorto‐angiography showed the presence of a marked aortic coarctation, an aneurysm of the ascending aorta and markedly dilated innominate, left subclavian and mammary arteries. Surgical repair was undertaken eight weeks after delivery. The aortic stenosis had a diameter of only 3 mm. Histologic examination of the removed specimen revealed marked atheromatosis, intimal fibrosis and mucoid degeneration. The findings thus justified the therapeutic procedure selected. The diagnosis of aortic coarctation is reviewed and the management when found during pregnancy is discussed.
A Flowmeter for the Determination of Small Flow Rates
Authors: Joelsson Ingemar , Odeblad Erik
Published: December 2009

A method, capable of determining very small flow rates, 0.01–0.10 μ1·sec−1, is described. The technique, which is devised with the aim of measuring the rate and fluctuation in the flow of uterine secretions, is based upon the detection of the asymmetry in the dispersion of heat, added as a label. The accuracy in measurement of basal secretion rates over long periods of time is ± 15%, the accuracy in the detecting of flow fluctuations is ± 5%.
Post‐Term Pregnancy
Authors: Nakano Ryosuke
Published: December 2009

The effects of post‐term pregnancy on fetal and neonatal survival have been analyzed in 5 596 single pregnancies, including 275 post‐term pregnancies, during the five‐year period from January 1, 1962 to December 31, 1966 at the Department of Obstetrics and Gynaecology, Osaka National Hospital. The perinatal mortality rate at term was 0.7% and post‐term was 2.2%. The increased perinatal mortality characteristic of post‐term pregnancy could not be explained. No significant improvement in fetal outcome is achieved by induction of labour in post‐term pregnancy. It would not appear to be justifiable, on the strength of the data presented here, to perform induction of labour solely because pregnancy is prolonged or in the absence of other generally accepted obstetrical indications.
The Value of Renography in the Assessment of Obstruction in the Upper Urinary Tract
Authors: Lundgren Nils , Ulmsten Ulf , Dahl Olof , Ranudd Nils
Published: December 2009

Simultaneous renography and intravenous urography have been done to assess the value of renography in detecting the presence of upper urinary tract obstruction. 45 women were treated by Wertheim's operation (radical hysterectomy and pelvic lymph node dissection) and were investigated preoperatively and at 14 days, 2–6 months and 1, 2 and 3 years postoperatively. A total of 193 investigations have been done. Good agreement was found in 33 cases, i.e. 73% (21 had normal flow and 12 had varying degrees of obstruction). A false diagnosis of obstruction was made in 8 cases (i.e. 17%) after renography and in 3 cases after i.v. urography. Renography would appear to be a reliable screening method for detecting ureteric obstruction after Wertheim's operation. A normal renogram excludes obstruction. Abnormal renograms should be followed by urography, not only because the high sensitivity of renography can lead to a false diagnosis of obstruction, but also to delect the site of the lesion.
Experience with Depo‐Medroxyprogesterone Acetate (Depo‐Provera) as a Contraceptive Agent
Authors: Jeppsson Sten
Published: December 2009

Pure, long‐acting gestagen, medroxyprogesterone acetate (Depo‐Provera), was tested as a contraceptive agent in a dose of 150 mg i. m. every 12th week. 139 women were observed for altogether 1 251 calendar months without any undesired pregnancy occurring in the group. The normal regular menstrual cycle was replaced initially by unpredictable vaginal bleeding and/or spotting, most often gradually followed by amenorrhoea. About 15% of the women discontinued the trial because of such menstrual irregularities. About 6% of the women stopped because of weight gain. Only few other side‐effects occurred. Withdrawal of the preparation is followed by regular ovulation and menstruation, but often not until long after the last injection. The method therefore appears to be suitable mainly for women who have decided to have no more children.

The simplicity of the method, the absence of estrogen (probably involving a reduced risk of thromboembolic disease and effect on the liver), the high level of safety and reliability combined with good acceptability, despite unpredictable bleeding, and the fact that the method is well tolerated by women who had previously been unable to tolerate hormonal contraception containing estrogen, suggest that the method should have a place in our contraceptive armamentarium. However, it should not be recommended as the primary choice, at any rate not for younger women. The method is probably very suitable for women who have tried other methods without success, followed by unplanned pregnancies and subsequent legal abortions.
Fibrinolytic Activity of Veins During Treatment with Medroxyprogesterone Acetate
Authors: Åstedt Birger
Published: December 2009

Coagulation and fibrinolytic studies were performed on 18 postmenopausal women receiving medroxyprogesterone acetate S mg a day by mouth for one month. The fibrinolytic activity in the vessel wall was determined histochemically in vein biopsy specimens and in the blood after stimulation by venous stasis.

In contrast with what is seen after oestrogen treatment the fibrinolytic activity in the vein vessel wall was unchanged. Neither were any changes found in the response of the fibrinolytic activity to venous stasis, or of the coagulation factors or components of the fibrinolytic system. The investigation thus produced no evidence of a thrombogenic effect of medroxyprogesterone acetate.
Concentration of Antithrombin III During Combined and Progestogen‐Only Oral Contraceptive Treatment
Authors: Larsson‐cohn Ulf , Fagerhol Magne K. , Abildgaard Ulrich
Published: December 2009

Oral contraceptive treatment with a low daily dose of Norethindrone did not lower the Antithrombin‐III level in serum. This was in contrast to what was found in subjects taking estrogen‐progestogen agents.
Cystine Aminopeptidase Activity in Pregnancy
Authors: Rydén Gunnar
Published: December 2009

Using a new method for estimation of cystine aminopeptidase (CAP) activity in maternal serum, serial CAP determinations have been performed in 7 women during normal pregnancy, in 7 patients after delivery, in 10 patients with pre‐eclampsia, in 5 patients with suspected placental insufficiency and in 4 multiple pregnancies. The results were as follows.

The enzyme activity decreased slowly after delivery. The half‐life of the enzyme in maternal blood was calculated as 3–6 days except in one patient where only 20% of the enzyme activity was lost within 4 days. The decrease of CAP activity in serum after intra‐uterine foetal death was also very slow. In patients with uncomplicated mild toxaemia of pregnancy the CAP values were in the normal range. In patients with severe pre‐eclampsia the results varied. In one patient with acute severe pre‐eclampsia and a threatening eclamptic attack the CAP values were high, and this might be explained by the presence of non‐specific aminopeptidase activity in serum. In preeclampsia with associated retardation of foetal growth the CAP values were rather low, with decreasing values prior to foetal death. In patients with pronounced placental insufficiency the CAP values were consistently low, whereas high figures were often found in multiple pregnancy.

The observations indicate that determination of CAP in maternal serum might be a valuable parameter in judging the condition of the placenta. However, the significance of CAP assays in assessing placental function cannot be established until the method is compared with other placental function tests on the same clinical material.
Amenorrhoea Following Oral Contraception
Authors: Starup Jørgen
Published: December 2009

Investigation of 31 patients who developed amenorrhoea following the use of combined oral contraceptives for a period of 3 to 84 months revealed that 55% had a variable degree of oligomcnorrhoea prior to the treatment. It is therefore concluded that an antecedent menstrual dysfunction is a relative contra‐indication to treatment with combined oestrogen‐gestagen preparations, and that another form of contraception should be recommended in these cases.

In 5 of the 31 patients the amenorrhoea was associated with galactorrhea. None of these patients had any signs of a hypothalamic or hypophyseal tumour, and no explanation can be given for this phenomenon.

Eighteen patients were observed without any subsequent hormonal treatment, 9 patients were treated with clomiphene alone, 1 patient with clomiphene‐HCG, 4 patients with HMG‐HCG, and in 1 patient a bilateral ovarian resection was performed. These forms of treatment resulted in ovulation in 16 patients and pregnancy in 5 patients. On the basis of both the present and previous investigations the following lines of treatment are recommended. In patients with no sterility problem the management should be expectant, whereas hormonal treatment should be initialed in patients with infertility. Clomiphene either alone or combined with HCG is the treatment of choice in patients with a normal oestrogen level, but in patients with a low oestrogen level treatment with human gonadotropins is preferred.
Unilateral Pregnancy in the Rabbit
Authors: Petersohn Lennart
Published: December 2009

In 24 conscious unilaterally pregnant rabbits the spontaneous and oxytocin‐induced uterine activity was recorded by either one or two sponge‐tipped catheters placed in each horn. In the pregnant horn the catheters were placed between the fetal membranes and the uterine wall. The recordings were repeated daily during the last days of pregnancy, for 4 to 8 days post partum, and thereafter at longer intervals for up to several weeks. The pregnant horn was consistently more active and more sensitive to oxytocin than the sterile horn up to about 1 week after delivery, when the difference disappeared. Intravenous vasopressin injections up to 0.05 IU did not increase the activity in either horn.
Modified Uterine Phlebography and Hysterography in the Diagnosis of Uterine Myomas
Authors: Pietilä K. , Kauppila A.
Published: December 2009

The value of modified uterine phlebography (simultaneous phlebography and hysterography) was studied in 34 patients with a clinical diagnosis of uterine myomas. All the findings were verified at operation, and 31 of the patients were found to have myomas. The group best suited for comparative purposes comprised 25 patients with intramural or submucous myomas. Uterine phlebography gave a quantitative diagnosis in 22/25 of these patients and hysterography in 10/25. Uterine phlebography failed to reveal the diagnosis in one case of cervical myoma. The diagnosis was qualitative in both examinations in the other cases. Hysterography was better for detecting submucous myomas, and uterine phlebography for intramural myomas. The results show that the information given by modified uterine phlebography and hysterography is complementary. The uterine phlebography instrument employed in the investigation requires further development.
Treatment of Ovarian Cancer with Treosulfan
Authors: Larsen Mogens Salling
Published: December 2009

During a three‐year period from 1967–70, 27 of 28 patients operated for ovarian cancer in all stages, including six with metastatic tumours in the ovaries, have been treated post‐operatively with Treosulfan. Clinically, the non‐radically operated patients improved considerably for varying periods. In the radically operated patients treated immediately with Treosulfan, we have not yet seen any recurrence. Apart from marrow depression, the drug has shown very few side effects. Subjectively, all patients have been more comfortable during treatment.
Ovarian Carcinoma Treatment with Treosulfan
Authors: Sørensen Hilda Mygind
Published: December 2009

78 patients with malignant epithelial ovarian tumours were treated with a new cytostatic, didydroxybusulfan (Treosulfan), which belongs to the group of alkylating agents. The treatment was given intermittently, mostly in the outpatient department. The period of observation was from three years to six months. II patients did not complete one course of treatment for several reasons. Two stage I a patients received prophylactic treatment following a radical operation. No follow‐up for one patient. The main group consists of 64 patients, 29 with recurrences and 35 with tumour residues following a non‐radical operation. Of the latter we have 6 in stage II b, 22 in stage III and 7 in stage IV. 45% of the main group showed excellent and good response, 55% poor or no response. The mean survival time for cass with excellent and good response was twice as long as that recorded for cases with poor or no response (12 and 6 months). In the group responding most favourably, the tumours were mainly comparatively poorly differentiated. Ascites disappeared entirely for more than 3 months in 19 out of 29 patients. Two patients previously inoperable could be radically operated after treatment. The only toxic effect was bone marrow depression.
Interrelation of Different Parameters at Cervical Mucus Penetration of Spermatozoa
Authors: Ulstein Magnar , Fjällbrant Bo
Published: December 2009

Abstract. Linear penetration, number of penetrating spermatozoa and their motility were studied in 400 semen samples using a capillary tube method and with cervical mucus as a test medium. A close correlation was found between these parameters. All three showed a high correlation with a proposed “penetration score”. Of the semen properties routinely tested sperm motility showed the highest correlation with the penetration parameters.
Hepatic and Adrenocortical Function During Cyclophosphamide Stoss Therapy
Authors: Ylöstalo Pekka , Kauppila Antti , Jouppila Pentti , Kiviniitty Kalevi , Vehaskari Allan
Published: December 2009

Abstract. Forty‐one patients with ovarian cancer were investigated for the effect of cyclophosphamide stoss therapy on liver function. The patients were tested for serum bilirubin, alkaline phosphatase, aminotransferases (GOT, GPT) serum total proteins, and ten of them also underwent an intravenous galactose tolerance test. Serum total protein was found to decrease significantly during the cyclophosphamide stoss therapy. It was further noted that the number of pathological results for serum total bilirubin, alkaline phosphatase, GOT, and GPT increased during the treatment, whereas the number of pathological half‐lives of galactose tolerance decreased. Fifteen patients underwent 19 intramuscular Homactid tests before the beginning of cyclophosphamide stoss therapy and one and two weeks after the therapy. The responsiveness of the adrenal cortex two weeks after the therapy was found to be lower and shorter in duration, compared with the results obtained before the therapy. Cyclophosphamide stoss therapy was not found to cause any serious disorders of hepatic or adrenocortical function.
The Induction and Stimulation of Labour With Buccal Desaminooxytocin and Oxytocin Tablets
Authors: Poulsen Erik Fangel
Published: December 2009

Abstract. 241 pregnant women were treated with buccal oxytocin tablets (129) and buccal desaminooxytocin tablets (112) respectively with a view to the induction of labour (135) and the stimulation of labour (106). Delivery was achieved within 48 hours after 190 of the treatments (79%). It was found that the dilatation time was significantly shorter, and the dosage of biologically active compound required was less, for women treated with desaminooxytocin. Otherwise there was no significant difference between the results of treatment, and the frequency of side‐effects and complications was deemed to be of the same magnitude in the two treatment groups.
Amniotic Fluid Creatinine, Uric Acid and Urea as Indices of Gestational Age
Authors: Teoh Eng Soon , Lau Y. K. , Ambrose Anselm , Ratnam S. S.
Published: December 2009

Abstract. Amniotic fluid creatinine, uric acid and urea were measured by an automated method in 127 pregnancies. The concentration of each solute increased with gestational age. A creatinine concentration of 2.0 mg/100 ml could be used to pick up 52.9% of “mature” fetuses (i.e. fetuses which had passed the 37th week of gestation) but there was a false positive pick‐up of 5%. A uric acid concentration of 5.0 mg/100 ml correctly indicated a mature fetus in 41.5% of patients, the false positive pick‐up being 3.3%. Amniotic fluid urea was not a useful index of fetal maturity.
Amenorrhea Following Use of Combined Oral Contraceptives
Authors: Furuhjelm Mirjam , Carlström Kjell
Published: December 2009

Abstract. 249 cases of long‐standing amenorrhea after the use of oral contraceptives have been examined clinically, and their hormonal excretion in the urine has been determined. In April 1972 a follow‐up of the patients was undertaken and 178 had answered before May 1, 1972. 59.3% of the patients had recovered spontaneously, 38 of them had amenorrhea from 6 to 12 months and 69 more than 12 months. 72 patients still had amenorrhea at the time of the follow‐up. Of the patients 122 probably had amenorrhea as a direct result of the treatment. In the other patients other factors could be taken into consideration, as being the cause of amenorrhea. Three patients had a premature menopause. In our series 35.4% of the patients had had menstrual irregularities antedating the use of oral contraceptives. The frequency of previous oligo‐amenorrhea among post‐“pill” amenorrhea cases is obvious and such women would be better to choose another kind of contraception. The longest period of amenorrhea before remission was 39 months. A low excretion of low polar oestrogens is associated with a long duration of the amenorrhea. No treatment should be used in patients with a moderate excretion of oestrogens in the urine except for those who desire to become pregnant. Treatment with clomiphene or clomiphene and HCG is then the method of choice. Patients with a low excretion of oestrogens in the urine can be treated with low doses of ethinyoestradiol (10–20 μg daily) in order to avoid atrophy of the genital organs and to stimulate the FSH and LH releasing factor. If they want children, HMG followed by HCG should be used or FSH‐LH releasing hormones.
A Quiet Type I Hyperlipidemia in Pregnancy: Review and Report of a Case
Authors: Martinez L. R. , Degennaro V. A. , Veloso E. J.
Published: December 2009

Abstract. Hyperlipoproteinemia is a condition characterized by increase lipid content of the blood. It may occur as a primary familial disease or as secondary to various clinical conditions such as seen in systemic lupus, alcoholism and liver disease. Of the primary forms of hyperlipoproteinemia, Type I is the least common and to our knowledge this condition has not been previously reported in pregnancy. The present report deals with Type I Hyperlipoproteinemia in a 32 weeks pregnant patient, confirmed by electrophoresis study.
Percutaneous Nephropyelostomy in Postrenal Obstruction
Authors: Ulmsten Ulf , Molin John
Published: December 2009

Percutaneous nephropyelostomy as a therapeutic method in postrenal obstruction is evaluated in a series of 44 cases. 12 of the patients had been treated for carcinoma of the cervix uteri by Wertheim's operation. 10 patients had ureteric stones with or without enclosed pyelitis. 11 patients had progressive uremia due to inoperable cancer of the pelvis with stenosed ureters. To relieve the obstruction the renal pelvis was drained for a long period of time and this maintained or improved renal function until the optimal time for definitive treatment was reached. The operation allowed repeated antegrade pyelography, and in some cases split function, to be performed. Thus the effect of the therapy could be checked repeatedly. Though we consider that the method should, as a rule, be used only temporarily, it may be used for up to 7 months as shown in Table III. The investigations cover the period 1966 to 1971.
Detection of the “Pregnancy Zone” Protein by Means of an Immunodiffusion Method
Authors: Beckman Lars , von Schoultz Bo , Stigbrand Torgny
Published: December 2009

A precipitating monospecific rabbit antiserum was produced by immunization with purified “pregnancy zone” protein. By means of double diffusion in agar gel 27 out of 30 pregnant women at term and 23 out of 30 women treated with oral contraceptives were found to have the “pregnancy zone” protein in their serum. The “pregnancy zone” protein was not detectable in 30 sera from non‐pregnant women, 30 cord sera and 30 samples of amniotic fluid. A comparison between the electrophoretic and immunodiffusion methods for the detection of the “pregnancy zone” protein showed that the immunodiffusion method was about twice as sensitive as the electrophoretic method.
The Effect of Oxygen Ventilation and a Vasodilator on Uterine Perfusion, Foetal Oxygen and Acid‐Base Balance
Authors: Tervilä Leo , Vartiainen Eero , Kivalo Inkeri , Finnilä Matts‐Johan , Väyrynen Martti
Published: December 2009

Uterine perfusion, the po2 in maternal ear capillary blood, the po2 and pH in portio blood, and the po2 PH, BE and pco2 in blood from the foetal scalp were investigated in 50 normal women in the 36th or subsequent weeks of pregnancy, women were given either oxygen ventilation, xanthinol nicotinate (Complaminr`), or oxygen ventilation in conjunction with this drug. Uterine perfusion decreased in all groups, the greatest fall being in the group ventilated with 100% oxygen. The po2 rose in all groups given oxygen. The smallest rise was noted in foetal blood. The remaining changes in blood chemistry were very small.
Contraceptive Treatment with Low Doses of Gestagen in Cases with Medical History of Hepatosis of Pregnancy
Authors: Ylöstalo Pekka , Vuopala Salme
Published: December 2009

Abstract. The effect of low‐dose gestagen pills on hepatic function was investigated in 5 subjects who had previously suffered from hepatosis of pregnancy and 9 healthy controls. The gestagen used was 0.3 mg of norethisterone daily. The following laboratory tests were performed during the 6 months of low‐dose gestagen medication: Serum alanine aminotransferase (S‐ALAT‐GPT), serum cholesterol, triglycerides, total bilirubin, total proteins, electro‐phoretic distribution of proteins, α‐1‐antitrypsin, cerulo‐plasmin, acid α‐1‐glycoprotein, α‐2‐HS‐glycoprotein, total haptoglobin, β‐lipoproteins, α‐2‐macroglobulin, transferrin, and IgG immunoglobulin. The tests either revealed no differences between the two groups or showed only minor changes. None of the subjects discontinued the treatment because of hepatic dysfunction or symptoms suggestive of such. The authors consider oral contraceptives containing low doses of gestagen to be suitable even for patients who have suffered from hepatosis of pregnancy.
Ultrasonic Fetal Cephalometry in Pre‐Eclampsia
Authors: Bergsjö Per , Brodtkorb Christian
Published: December 2009

Abstract. Fetal cephalometry with pulsed ultrasound (A and B scan) has been performed in 35 patients with pre‐eclampsia. A classification of fetal growth retardation was based on standard tables for newborn infants. The biparietal diameters were generally small in growth‐retarded fetuses, both in relation to fetuses of normal weight in pre‐eclamptic mothers, and in relation to the average measurements in a previously compiled group of normal pregnancies.
Postoyulatory Endometrial Development in Women with I.U.D
Authors: Nicolaisen Hans Henrik , Pedersen Henning , Guttorm Eigil , Rebbe Heinrich
Published: December 2009

Abstract. Histological “dating” of endometrial biopsy specimens within the postovulatory period was performed in a group of normal women having an I.U.D. and another group of normal women without an I.U.D. In both groups the time of ovulation was determined by basal temperature measurement. By comparing the “histological” date with the actual point of time in the cycle, given in days after the ovulation, the group of women with an I.U.D. showed an average retardation of 2 days. In the control group the average retardation was zero days. The difference between the two groups was statistically significant. The group with an I.U.D. presented focal stromal changes, which should be investigated further with a view to a possible endocrine secretion. The results of the present investigation of a fairly small series show that the contraceptive effect of an I.U.D. may be due to delayed endometrial development.
New Instruments: A New Mechanical Instrument for the Measurement of Fibro‐Elasticity, with Special Reference to its Use in the Assessment of the Consistency of the Uterine Cervix
Authors: Bakke Trygve
Published: December 2009

Abstract. A mechanical instrument for the measurement of fibro‐elasticity is described. It consists of a mechanism for control of the force used, which enables the examiner to exert the same pressure on the material each time, and another mechanism for recording the fibro‐elasticity. The applied force K can be varied and is calibrated by the use of a balance. The fibro‐elasticity is characterized by the angle a between the walls of the impressed area recorded on the indicator mechanism. The instrument has been tested on foam rubber materials, on water‐filled rubber balloons, and on the uterine cervix both in vivo and in vitro. The results show that within a large range of a and K to a first approximation the following relationship is valid: F=α/K where F is a constant which on a relative basis can be used to characterize the elastic properties of a material. A brief discussion of the properties and the applicability of the instrument is given.
Acridine Orange in Gynecologic Cancer
Authors: Höglund Astrid , Joelsson Ingemar , Ingelman‐Sundberg Axel , Odeblad Erik
Published: December 2009

Abstract. The methyl line of the proton magnetic resonance spectrum of acridine orange zinc trichloride, dissolved in heavy water, has been studied. This line consists of two overlapping components with different widths. A mathematical technique has been developed to resolve the two components quantitatively. Their relative proportion depends on the acid‐base state of the molecular environment. If the stain is adsorbed on albumin the narrow component quickly disappears, while adsorption on RNA gives rise to a broadening of the narrow line. With large amounts of albumin or RNA, both components disappear. DNA strongly adsorbs acridine orange with complete disappearance of all NMR spectral lines. Mitochondria, submitochondrial particles and microsomes cause some broadening of the narrow component of the methyl line. Due to the obvious alterations of the NMR spectrum, in the circumstances mentioned, this type of spectroscopy may be used for the biophysical characterization of interaction mechanisms between acridine orange and various proteins, nucleic acids and cell fractions.
Induction of Midtrimester Abortion by Increasing Intra‐Uterine Volume
Authors: Pulkkinen M. O. , Liukko P. , Piiroinen O. , Rauramo L.
Published: December 2009

Abstract. The intra‐uterine volume of 10 obstetrically normal nulliparous midtrimester patients was increased by the intra‐amniotic instillation of 350 ml Macrodex. There were 2 treatment failures due to the rupturing of the fetal membranes within 2 hours of the instillation. In all the remaining 8 patients the intra‐uterine pressure increased gradually, following volume increase. However, it only reached the magnitude demanded for clinical abortion in 4.
Experience with Shirodkar's Operation and Postoperative Alcohol Treatment1
Authors: Lauersen Niels H. , Fuchs Fritz
Published: December 2009

Abstract. During the period 1960–1970, the post‐conceptional cerclage of the cervix as first described by Shirodkar was used in 143 patients with cervical incompetence. The majority of the patients received heavy sedation with sodium amytal and demerol postoperatively, a smaller group was treated prophylactically with alcohol intravenously, and another small group was treated with alcohol after failure of the sedation regime to prevent uterine activity. The success rate was the same in groups 1 and 2 (83%); in the cases where alcohol was given after the occurrence of uterine contractions, the success rate was 71%.
Low Dose Intermittent Epidural Anaesthesia with Lidocaine for Vaginal Delivery II
Authors: Zador Göran , Nilsson Bo A.
Published: December 2009

Abstract. Intermittent lumbar epidural block, using lidocaine without (series I), or with epinephrine (series II), for pain relief in labour was carried out in a total of 190 women with uncomplicated pregnancies. In a number of randomly selected cases in these two series the uterine contractility, the foetal heart rate pattern, and the acid‐base balance of the mothers and their foetuses were studied. Transitory decrease in uterine activity, primarily due to depressed intensity of the contractions, was observed after each injection in both series. This phenomenon was, however, much more pronounced in cases where epinephrine was added to the local anaesthetic solution. In both series the effect on the contractions declined with the number of injections. Ominous foetal heart rate patterns were rare and occurred almost exclusively in association with transient maternal hypotension. Good correlation was found between maternal arterial, and arterialized capillary blood with respect to the acid‐base components. The acid‐base values in foetal scalp blood, maternal capillary blood, and in umbilical cord blood showed a less pronounced tendency to metabolic acidosis in cases where epidural blocks were given than in cases in a non‐anaesthetized control group. Prolongation of the second stage was accompanied by the development of metabolic acidosis in anaesthetized, as well as in non‐anaesthetized cases. In the epidural series, however, this acidosis tended to appear later and to develop more slowly, indicating an overall good and stable intrauterine foetal condition.
THE INDUCTION OF LABOUR WITH PROSTAGLANDIN F2α BY INTRAVENOUS INFUSION
Authors: Lindmark Gunilla , Zador Göran , Nilsson Bo A.
Published: December 2009

Abstract. Attempt to induce labour with PGF2α was made for various indications in 22 primiparous and 27 multiparous patients being between the 35th and 44th weeks of pregnancy. Intravenous infusion of PGF2α was started with 3 μg/min. and increased in steps of 3 μg/min. at intervals of about one hour until labour‐like contractions were recorded. This dose level was then maintained until delivery. Uterine activity and fetal heart rate was monitored prior to and throughout the infusion. The clinical condition of the newborns was also assessed by Apgar score and by physical examination one and four days after delivery. Labour was successfully induced with total doses ranging between 0.4 and 8.4 mg. In 88 per cent of the cases this resulted in vaginal deliveries within 2 to 12 hours. The latter part of the first stage as well as the second stage were remarkably short. Uterine hypertonus was observed in five cases (10 %). Other types of abnormal uterine contractility patterns were fairly common. These were, however, not associated with pathological FHR changes except in one case where severe late decelerations were observed following marked uterine hyperactivity. The condition of the newborns was generally good and maternal side effects were very rare. PGF2α seems particularly valuable in cases of pre‐term inductions where low Bishop scores are present but the risk of overstimulation demands careful supervision, if possible with cardiotochographic monitoring.
A STUDY OF COMPARATIVE EFFICACY OF ORAL PROSTAGLANDIN E2 AS LIQUID FORMULATION AND TABLETS FOR INDUCTION OF LABOUR
Authors: Obel Erik B. , Larsen Jørgen Falck
Published: December 2009

Abstract. 16 patients were treated with prostaglandin E2 tablets and 15 patients with the liquid formulation. Seven of the patients who received tablets delivered vaginally within 24 houres (44 %). In the group treated with the liquid formulation eight patients delivered within 24 hours (53 %). Only three patients had severe side effects from the alimentary tract, but in all cases the treatment could be continued. No serious side effects were observed. As no significant difference between the tablets and liquid formulations was found, with regard to tolerance and efficacy, the tablets are recommended because they need no special preparation before use.
INTRAUTERINEINJECTION OF PROSTAGLANDIN F2α FOR TERMINATION OF EARLY PREGNANCY IN OUT‐PATIENT
Authors: Ylikorkala O. , Jouppila P. , Ylöstalo P. , Jαrvinen P. A.
Published: December 2009

Abstract. Prostaglandin F2α administered as single intrauterine injection was used for termination of very early pregnancy in 34 outpatients. Twelve patients were induced with 1.0 mg, 18 patients with 2.0 mg and 4 patients with 4.0 mg of PGF2α. After 2 weeks, abortion was complete in 58 % induced with 1.0 mg, in 78 % induced with 2.0 mg, and in all 4 patients induced with 4.0 mg. After 3 weeks, abortion was complete in 83 % induced with 1.0 mg and in 100% induced with 2.0 mg. There was one failure, which occurred in the group treated by using 1.0 mg PGF2α. Immediate sideeffects were kept at an acceptable level with a very mild premedication. No serious complications occurred but curettage was performed on 2 patients because of bleeding. Spontaneous menstruation started in the 1.0 mg group within an average of 33 days (range 23‐60), in the 2.0 mg group within an average of 36 days (range 25‐61). The use of 2.0 mg PGF2α for the routine termination of very early pregnancy is recommended.
COMPARISON OF EXTRA‐AMNIOTIC ADMINISTRATION OF PGF2α, 0.9 PER CENT SALINE, AND 20 PER CENT SALINE FOLLOWED BY OXYTOCIN FOR THERAPEUTIC ABORTION
Authors: Lange Aksel P. , Secher Niels Jørgen , Pedersen Gunnar Thomsen
Published: December 2009

Abstract. 168 patients between 1Oth and 18th week of pregnancy admitted to hospital for legal abortion were treated accordingly to three different protocols.

In group I comprising 80 women, repeated instillations of PGF2α were administered, extra‐amniotically, through a Foley catheter. Within 30 hours abortion occurred or evacuation was performed without dilatation of the cervix in 85 per cent of the women. Slight side‐effects (vomiting, diarrhoea and flushing) were noted in 47 (i.e. 59 per cent) of the women.

In group II comprising only 8 women, a Foley catheter was introduced into the extra‐amniotic space and repeated instillations of 0.9 per cent sterile saline were given. After 30 hours no abortions had occurred in this group. In five nulli‐paras the cervical os was closed after treatment, while the cervix was dilated in 2 of 3 women, who had earlier delivered a baby. In these two women evacuation of the uterus was performed without surgical dilatation. A Foley catheter itself placed above the internal orifice was not found to be a contributory factor to abortion in nulli‐paras within 30 hours.

In group III comprising 80 women a single dose of 20 per cent saline in a volume of 10 ml per week of gestation was introduced to the extra‐amniotic space. Subsequently repeated injections of oxytocin were given subcutaneuosly. After a single instillation of hypertonic saline, which in most cases was followed by oxytocin for one day, abortion occurred in 64 per cent of the women.

The number of complications was highest (4 of 8 women) in the group with repeated instillations of sterile 0.9 per cent saline through a Foley catheter, while complications were registered in 26 per cent of the cases in the group treated with hypertonic saline followed by oxytocin and in 14 per cent of the cases in the group treated with PGF2α.

The average stay in hospital calculated from the commencement of treatment was shorter (3.4 days) in the PGF2α‐group, than in the hypertonic saline group (4.5 days) and in the group with Foley catheter and repeated instillation of sterile saline (5.5 days). The PGF2α method in this study turned out to be the most preferable way of inducing abortion, but the frequency of side‐effects and the need for repeated instillations every second hour prevent the method being ideal.
Action of Clomiphene Citrate on Rat Testicular Steroid Biosynthesis in Vitro
Authors: Carlström Kjell , Macagno N. , Furuhjelm Mirjam
Published: December 2009

Abstract. The side chain cleavage of cholesterol and of pregesterone in rat testis preparations is stimulated in vitro by 0.5–2.0 × 10−3 M clomiphene citrate. The mechanism is thought to be analogous with that demonstrated by Hagerman and co‐workers (1966) for the stimulation of placental ring A aromatization. The results seem to give additional support to the possibility of direct action of the drug on the steroidogenic organs in vivo.
Lumbar Epidural Analgesia in Labour
Authors: Thalme B. , Belfrage P. , Raabe N.
Published: December 2009

Abstract. Twenty‐four full‐term nulliparae and their babies were studied. Twelve received lumbar epidural analgesia with bupivacaine (Marcain‐adrenalin®) and twelve conventional obstetrical analgesia with meperidine (Petidin®), chlorpromazine (Hibernal®), nitrous oxide and a pudendal nerve block with prilocaine (Citanest®). The acid‐base balance was determined in fetal and maternal blood during labour and in neonatal blood after birth. The newborn infants were placed in incubators after birth and several clinical parameters were recorded during the first two hours. Epidural analgesia to the mothers resulted in a lower degree of metabolic acidosis than conventional obstetrical analgesia. The clinical and blood‐chemical parameters recorded in this study indicated no harmful effects on the newborn infants after epidural analgesia to the mothers.
Normal Blood Sugar Variation During Pregnancy
Authors: Victor Arne
Published: December 2009

Abstract. Blood sugar determinations were made four times daily on non‐diabetic pregnant and non‐pregnant women admitted to hospital for reasons not supposed to influence carbohydrate metabolism. All blood sugar values were found to decrease during pregnancy. The fasting blood sugar decreased from 78 to 65 mg%, and the daily mean value from 99 to 80 mg%. The increase in blood sugar after the main meal of the day was found to be smallest in late pregnancy. The results indicate a progressive change in carbohydrate tolerance during pregnancy. Some implications of the results on the management and outcome of diabetic pregnancy are discussed.
Content of β2‐Microglobulin and Albumin in Human Amniotic Fluid: A Study of Normal Pregnancies and Pregnancies Complicated by Haemolytic Disease
Authors: Jonasson Lars‐Erik , Evrin Per‐Eric , Wibell Lars
Published: December 2009

Abstract. The content of the low‐molecular weight protein β2‐microglobulin and albumin was measured by immunochemical methods in amniotic fluid from 136 patients in the 13th to the 43rd week of pregnancy. Parallel estimations of β2‐microglobulin in maternal plasma were made in the majority of patients. Some samples of cord serum and urine from the newborn were also analysed. In normal patients the levels of β2‐microglobulin followed the albumin pattern with a peak value around the 24th week and a gradual decrease during the last trimester. In contrast to other proteins β2‐microglobulin showed higher levels in amniotic fluid than in maternal plasma. During the last trimester levels in maternal plasma exhibited a significant increase. Levels in cord serum were higher than in amniotic fluid. Urine from the newborns contained at least 5 times the amount previously found in adults. The results indicate that β2‐microglobulin in amniotic fluid is largely derived from the fetus itself. Patients with pregnancies complicated by haemolytic disease showed significantly higher levels in amniotic fluid than normal patients for comparable periods but the levels showed no close correlation with the degree of fetal involvement. The ratio of β2‐microglobulin to albumin in amniotic fluid was elevated in patients with fetal haemolytic disease. The albumin content showed no significant differences between the clinical groups but tended to decrease more rapidly during the last weeks of pregnancy in patients with fetal haemolytic disease. Further studies of β2‐microglobulin might supply important information about the transfer mechanisms of amniotic fluid proteins and also permit studies of some physiological and pathological processes in the fetus.