bluuebunny/crossref_metadata_2025 huggingface dataset:
Amniotic Fluid β2 Microglobulin: Correlation with L/S Ratios and Creatinine Levels
Authors: Cauchi M. N. , Goriup Dorothy , Horacek I.
Published: February 2008

Summary: : β2 microglobulin (β2m) levels were measured in amniotic fluids taken after the 32nd week of gestation. β2m levels fell continuously from 5.2 μg/ml at the 32nd week to 3.08 μg/ml after the 39th week of gestation. Abnormally high levels of β2m were found in 12.6% of samples. There was a significant correlation between β2m levels and lecithin/sphingomyelin ratios at 32 weeks of gestation and with creatinine levels at 37–38 weeks (P < .05). Although elevated β2m levels may be associated with maternal and/or fetal abnormalities, the precise relationship is not clearly established: in particular, our data do not suggest that estimation of β2m levels could be of value in determining fetal maturity.
The Immunobiology of Placentation
Authors: Kaye Michael D.
Published: February 2008

Summary: : A review of the current theories on the nature of the placental allograft and the evolution of placentation in the presence of a cellular immune response highlights the inability of current hypotheses to explain the success of both invertebrate and vertebrate placentation. Only one theory –“the anatomical separation of the fetus from the mother”– appears relevant. How this separation might develop during implantation is discussed.
Seven Years Experience in the Evaluation and Management of Patients With Urge Incontinence of Urine
Authors: Fliegner John R. , Glenning Peter P.
Published: February 2008

Summary: : In 1970 the authors established a specific clinic at the Royal Women's Hospital in an attempt to evaluate the causes of urinary incontinence, to improve the follow‐up of patients treated for this complaint, and to determine areas where treatment was deficient. Of 258 patients seen in the clinic so far 80 (31%) were considered to have had stress incontinence, 84 (33%) urgency, and 82 (32%) both symptoms. Incontinence of urine with exertion was common in patients with urgency and furthermore, the Bonney test of urethral elevation was of no value in distinguishing stress from urge incontinence. Therapy with Probanthine 15 mg t.d.s. and Tofranil 25 mg t.d.s. was effective in 127 patients (90%) in whom urgency was the sole or dominant complaint.
Therapeutic Evaluation of Elase as Adjunctive Therapy in the Treatment of Monilial Vaginitis
Authors: Elliott Peter
Published: February 2008

Summary: : The effectiveness of a lytic enzyme preparation (Elase*–Parke‐Davis) plus natamycin (Pimafucin–Gist‐Brocades) was compared to natamycin therapy alone in a controlled clinical trial involving 120 patients suffering from monilial vulvo‐vaginitis. The results indicate that addition of Elase to a natamycin treatment regimen increases the effectiveness of therapy both with respect to alleviation of symptoms and to eradication of the organism as determined by vaginal culture in patients with acute infection and in those in whom infection is complicated by pregnancy or diabetes.
Water Intoxication and Syntocinon Infusion
Authors: Eggers T. R. , Fliegner J. R.
Published: February 2008

Summary: : A case of severe water intoxication with convulsion and prolonged coma, following the use of a high dose Syntocinon infusion is described. The pathogenesis and treatment of the condition are discussed.
Value of Total Serum Oestriol and Human Placental Lactogen in the Assessment of Fetal‐Placental Function
Authors: Lsouard Godfrey
Published: February 2008

Summary: Serum levels of total oestriol and human placental lactogen (HPL) were measured in 360 pregnancies; in 182 there were abnormalities likely to be associated with increased fetal risk. A total of 217 estimations of oestriol and HPL were performed in 163 normal pregnancies to define the normal ranges. The value of both tests in the management of complicated pregnancies was assessed. Serum oestriol was found to be very efficient in the diagnosis of intrauterine growth retardation. In such cases, 76% of patients had unfavourable oestriol levels. Patients with mild pre‐eclampsia had HPL levels similar to normal, but values decreased significantly in the presence of fetal distress. The mean serum oestriol level in patients with pre‐eclampsia were lower than normal, and were further reduced in the presence of fetal distress. The importance of measuring serum oestriol levels at each antenatal visit is stressed in the detection of developing fetal complications; in such cases, 73% of patients had subnormal values. Both tests provided accurate assessments in the 8 patients with intrauterine death. Significant fetal‐placental dysfunction was present in 55 patients, and 41 (75%) were predicted by serum oestriol, 23 (42%) by HPL, and 45 (82%) by the use of both tests. In the 142 complicated pregnancies that resulted in a favourable outcome, confirmation was obtained in 102 (72%) by serum oestriol and in 121 (86%) by HPL.
A Comparison of Early Fetal Growth Curves
Authors: Duff G. B.
Published: February 2008

Summary: The curves of the growth of the maximum fetal diameter and the biparietal diameter before 20 weeks of gestation, measured by ultrasound and derived from a New Zealand population, are presented. They are compared with other published growth curves and reveal that in the New Zealand population there is a greater variation from the mean. In the case of the maximum fetal diameter there is a significantly lower mean after 10 weeks of gestation.
Significance of Amniotic Fluid Glucose in Late Pregnancy
Authors: Marin R. D. , Hood W.
Published: February 2008

Summary: Glucose levels were estimated in over 150 amniotic fluid samples and were found to fall with advancing gestational age. Significantly lower levels were found in post‐term pregnancies and in association with fetal growth retardation. Amniotic fluid glucose estimation was found to be superior to human placental lactogen in distinguishing between normal pregnancies and those complicated by fetal growth retardation. The role of the membranes in influencing the level of amniotic fluid glucose was investigated using in vitro perfusion experiments. The permeability of the membranes to glucose decreased with advancing gestational age.
Giant Condyloma Acuminatum of the Vulva and Anal Canal
Authors: Baird Phillip J. , Elliott Peter , Stening Malcolm , Korda Andrew
Published: February 2008

Summary: This publication describes the second known reported case of benign giant condyloma acuminatum of the vulva and anal canal (Buschke‐Loewenstein tumour). The diagnosis of squamous cell carcinoma was made initially on clinical examination and could not be excluded by punch biopsy. A full pathological study of the tumour established the diagnosis. A defunctioning colostomy and a perineo‐ano‐vulvectomy with groin gland dissection was performed and the patient is free of disease 36 months later. The biology of this type of tumour is discussed.
A Simple Operation for Postcoital Urethrotrigonitis in Women
Authors: Blackledge David
Published: February 2008

Summary: Definitive treatment of postcoital urethrotrigonitis, or “honeymoon cystitis”, as it is commonly called, has only been paid serious attention since 1967. It has been suggested (O'Donnell, 1959) that the introduction of bacteria into the urethra is more likely when the urethra assumes a relatively hypospadiac position during coitus. This is commonly associated with incomplete rupture of the hymen. Division of the anterior bridge of the hymen on either side of the external urethral meatus appears to be as effective as more complicated procedures in preventing ascending infection associated with coitus.
Parity and Pre‐Eclampsia
Authors: Long P. A. , Abell D. A. , Beischer N. A.
Published: February 2008

Summary: In a series of 26,209 patients, the incidence of pre‐eclampsia was 9.3%, being significantly higher in primiparae (14.1%) than multiparae (5.7%) (P<0.001). In patients with early‐onset pre‐eclampsia there were highly significant (P<0.001) increases in the incidences of proteinuria, severe hypertension, placental abruption, fetal growth retardation, neonatal asphyxia and perinatal mortality. There were no significant differences between the incidences of these complications in primiparae and multiparae. The incidence of subnormal oestriol excretion was increased before the emergence of early‐onset pre‐eclampsia with equal significance (P<0.001) in primiparae and multiparae. Eclampsia was more common in patients with late‐onset pre‐eclampsia, but not significantly so.
Perinatal Death: Audit and Classification
Authors: Chang A. , Keeping J. D. , Morrison J. , Esler E. J.
Published: February 2008

Summary: Two hundred and thirteen perinatal deaths occurred in a population of 10,539 deliveries over a 4‐year period. The associated obstetric complications and circumstances were analysed.

The majority of perinatal deaths occurred in fetuses in whom there was a serious malformation, or whose birth weight was less than 800 g.

Of the 110 deaths which occurred in normal babies weighing 800 g or more, 54 were antepartum, 5 were intrapartum, and 51 were neonatal. The clinical features surrounding these deaths were classified, and their implications discussed.
Mechanical Dilatation of the Cervix During Labour
Authors: Rooke Peter W.
Published: February 2008

Summary: An instrument designed to produce vibrations to the cervix was assessed as a method of shortening the active phase of labour in 138 patients with abnormal labour. Results showed that it shortened labour in multiparous but not in nulliparous women. The cervilator's obvious benefit in certain patients and lack of apparent complications suggest that it can be a valuable addition to labour ward equipment. Further work is required to establish in which patients the instrument is likely to have the greatest value.
Infertility – A Flow Chart Approach
Authors: Kovacs G. T.
Published: February 2008

Summary: A logical approach to the diagnosis and treatment of infertility using a “flow‐chart” is outlined. Its application in the treatment of 100 patients in a peripheral gynaecology unit is presented. The distribution of the aetiological factors is also discussed.
Endometriosis of Umbilicus
Authors: Charles S. X. , Samyuktha K.
Published: February 2008

Summary: Two cases of umbilical endometriosis are reported because of the rarity of the condition and the possible effectiveness of conservative treatment with hormones.
Uterus Didelphys Associated with Unilateral Cervical Atresia and Renal Agenesis
Authors: Monks Peter
Published: February 2008

Summary: A case is reported of uterus didelphys associated with unilateral cervical atresia and renal agenesis on the same side. Two successful pregnancies occurred in the affected side after surgical correction.
Volvulus of the Small Bowel Complicating Mid‐Trimester Pregnancy
Authors: Sivasuriya M. , Wickramasinghe S. Y. D. C.
Published: February 2008

Summary: A case of volvulus of the small bowel with gangrene extending from the duodenojejunal flexure to 15 cm from the ileocaecal junction is reported. The complication arose during the second trimester and was successfully treated by resection and end‐to‐end anastomosis.
Multicentric, Pigmented Carcinoma In Situ of the Vulva in Association with Vulval Condyloma Acuminata
Authors: Laohadtanaphorn S. , Hunter J. C. , Ansell I. D.
Published: February 2008

Summary: A case report is presented of a 22‐year‐old woman with carcinoma in situ of the vulva in a multicentric pigmented form in association with vulval condyloma acuminata. The aetiology of the disease, varied appearances, malignant potential, and mode of treatment are discussed.
Placental Sulphatase Deficiency with Spontaneous Labour
Authors: Grose D. J.
Published: February 2008

Summary: A case of placental sulphatase deficiency with spontaneous labour is reported. Ultrasound and antenatal cardiotocography were used to monitor fetal well‐being.
Integrated Concentrations of Prolactin in Breast‐Feeding Mothers
Authors: Gross B. A. , Eastman C. J. , Bowen K. M. , McEIduff A.
Published: February 2008

Summary: Mean 24‐hour integrated concentrations of serum prolactin (PRL) in 8 breast‐feeding mothers (62 ± 10.4 μg/1) was significantly higher than in 4 control subjects (14.8 ± 3.3 μg/1). No correlation was found between the mean integrated concentrations and time after delivery or breast‐feeding status. There was no relationship between the mean integrated concentration of PRL or the basal PRL and the frequency of feedings, the total suckling time, the mean interval between feedings or the longest interval between feedings in the 24‐hour period. The study provides conclusive evidence for increased prolactin secretion in long‐term puerperal lactation.
A Comparison of Obstetric Morbidity and Management Between Clinic and Private Patients
Authors: Chang A. , Keeping J. D. , Morrison J. , Esler E. J.
Published: February 2008

Summary: The patterns of morbidity and management among clinic and private patients in a teaching hospital were compared by an audit of computerized case records. The clinic patients were more likely to have a poor obstetric history and antenatal complications, and the private patients were managed more actively. Perinatal mortality in the clinic patients was higher and was related to the higher frequency of low birth weight babies.
A Transvesical Approach to Stress Incontinence
Authors: Taylor John D.
Published: February 2008

Summary: Seventy‐three patients with urinary incontinence were carefully investigated; only 12 were selected as suitable for operation. In each case the surgical approach was transvesical, as this most rapidly and accurately identified the urethrovesical junction. The outcome was completely successful in 9 of the 12 patients in this highly selective series at the time of review 12 months later.
Are There Recognizable Symptoms of Abnormal Glucose Tolerance (Hypoglycaemia and Hyperglycaemia) in Pregnancy
Authors: Abell David A. , Beischer Norman A.
Published: February 2008

Summary: The symptoms noted by 1,291 consecutive patients undergoing a glucose tolerance test during the third trimester of pregnancy were studied to determine whether their presence was attributable to obstetrically important hypoglycaemia or hyperglycaemia. Relevant symptoms were common and, apart from the more frequent occurrence of palpitations in patients with hyperglycaemia, did not have a significant relationship to maternal glucose tolerance patterns. Patients with hypoglycaemia weighed less, but did not evidence a reduced dietary intake, whereas those with hyperglycaemia smoked less. Symptoms classically associated with biochemical hypoglycaemia and hyperglycaemia were not reliable indicators for selection of patients with obstetrically significant hypoglycaemia or hyperglycaemia.
Choriocarcinoma Coexistent with Intrauterine Pregnancy
Authors: Kuhn R. J. P. , Long A. R. , Fortune D. W.
Published: February 2008

Summary: Two cases of choriocarcinoma coexisting with intrauterine pregnancy are presented. The literature on 28 previously reported cases is reviewed with reference to mode of presentation, maternal survival and pathogenesis.
Incidence of the Respiratory Distress Syndrome in Infants of Diabetic Mothers – Perinatal Influences
Authors: Bye Ann , Henderson‐Smart D. J. , Storey B. , Shearman R. P.
Published: February 2008

Summary:This survey of 73 infants of insulin dependent (ID) diabetic mothers and 70 infants of gestational diabetics (GD) born at King George V Memorial Hospital between January, 1968 and December, 1975, showed that all 12 babies with RDS were from the ID group. RDS was the cause of all 6 neonatal deaths and together with the 5 stillbirths gave this high risk group a 15% mortality rate. Since no deaths occurred in the GD group, the overall mortality was 8%.

In the 6 years, 1970–1975, RDS occurred 21 times more often in babies of ID mothers than in control babies born to non‐diabetics. Babies born to ID mothers were of significantly lower mean gestational age than those born to the GD mothers. Within the ID group, those babies with RDS were of significantly lower gestation than those without and the mean gestation was similar to control babies with RDS.

Provided the diabetes is controlled and fetal welfare ensured, later delivery, following documentation of lung maturity, may lower the incidence of RDS and therefore perinatal mortality and morbidity.
Classical Caesarean Section in Preterm Deliveries
Authors: Keeping J. D. , Morrison J. , Chang A. M. Z.
Published: February 2008

Summary: A series of 14 classical Caesarean sections is reported, and the place of operation in certain preterm deliveries is discussed.
Adipocytic Metaplasia Associated with Idiopathic Vaginal Adenosis
Authors: Honore L. H.
Published: February 2008

Summary: The first case of stromal adipocytic metaplasia associated with benign vaginal adenosis is presented in a young woman without intrauterine exposure to diethylstilboestrol.
Cytosol Oestradiol and Progesterone Receptors in Endometrial Hyperplasia and Adenocarcinoma: Determination by Single Saturating Dose Exchange Assays
Authors: Elliott Peter M. , Krozowski Zygmunt , Jansen Robert P. S.
Published: February 2008

Summary: Available oestradiol and progesterone binding site concentrations in endometrial cytosols were determined by a simplified single saturating dose assay in 16 normal women with proliferative endometrium, in 10 patients with endometrial hyperplasia, and in 20 patients with endometrial adenocarcinoma. The mean oestrogen receptor level tended to be higher in endometrial hyperplasia than in either proliferative or carcinomatous endometria. Mean progesterone receptor levels were comparable in proliferative and hyperplastic endometria, but were sequentially lower in highly differentiated carcinoma, moderately differentiated carcinoma, and undifferentiated carcinoma.

Correlation between results obtained by single saturating dose assays and by conventional Scatchard analysis in those endometria subjected to both procedures was high for both oestrogen (r = 0.998) and progesterone (r = 0.949) and indicates that with the simplified assays, large scale clinical studies on hormone sensitivity of endometrial adenocarcinomas are feasible.
A.I.D. — A Pretreatment Social Assessment
Authors: Clayton Christine E. , Kovacs Gabor T.
Published: February 2008

Summary: The findings of a structured pretreatment interview of 200 prospective artificial insemination by donor (A.I.D.) couples is reported, and areas of concern are discussed.
A Review of Ectopic Pregnancies in Southern Tasmania
Authors: Marsden D. E. , Correy J. F.
Published: February 2008

Summary: Over the 10‐year period 1968–1977, 131 patients with ectopic pregnancy were treated at the Royal Hobart Hospital. The clinical features of these patients are discussed. Using data on the number of ectopic pregnancies confirmed in Southern Tasmania in the period 1973–1977, it was shown that in terms of the ratio of ectopic pregnancies to total births, the incidence of ectopic gestation in the essentially stable population has risen from 1:130 to 1:72; possible reasons for this increase are discussed. The difficulty in diagnosis of the condition is emphasised.
Changing Patterns of Intercourse During the Menses With Age: Relevance to Cervical Carcinoma
Authors: Cattanach John F.
Published: February 2008

Summary: There was a statistically higher incidence of intercourse at the time of the menses in women who commenced regular sexual activity before the age of 18 years. This finding may have relevance to the incidence of cervical carcinoma.
Cancer of the Cervix (Stages 1B, 2A and 2B): Treatment and Results
Authors: Townsend S. L. , Kurrle G. R.
Published: February 2008

Summary: Combined methods of treatment of carcinoma of the cervix Stage 1B and 2 (A and B) are described using irradiation and surgery. In a personally conducted series of 101 patients, a.5‐year survival rate of 86% for Stage 1 and 65.4% for Stage 2 was achieved. The urinary tract morbidity associated with combined methods of treatment and the modifications adopted to prevent it are described. It is concluded that the preferred method of treatment of carcinoma of the cervix Stages IB, 2A and 2B is irradiation (intracavitary + external megavoltage irradiation) followed by modified radical hysterectomy.
Advanced Abdominal Pregnancies: 2 Case Reports
Authors: Astill A. N.
Published: February 2008

Summary: Two cases of advanced abdominal pregnancy are presented. They were managed at the Edendale General Hospital in South Africa. They posed difficult diagnostic problems and added to the controversy over management.
Retained Grafenberg Ring for 39 years Discovered During Abdominal Hysterectomy
Authors: Farghaly Samir A. , Mathie J. G.
Published: February 2008

Summary: A 71‐year‐old female with a Grafenberg ring retained for 39 years is described. At operation, the device was presenting beneath the serosal surface of the posterior uterine wall. The literature is briefly reviewed.
A Large Submucous Fibroid Polyp Causing Inversion of the Uterus
Authors: Henderson Peter R.
Published: February 2008

Summary: A case of chronic inversion of the uterus, with involvement of bladder and ureters, due to the prolapse through the cervix and vagina of a submucous fibroid, is presented. A safe scheme of operative treatment is outlined.
Review of Current Progress: Antenatal Diagnosis
Authors: Pearn J. H. , Biggs J. S. G. , Smith H. , Clague A. , Cooper D.
Published: February 2008

Summary: Approximately 1 child in every 30 is born with a significant physical or mental handicap and 41% of deaths in children aged 1 month to 15 years are the result of a congenital malformation. New and improved forms of treatment are available for some congenital abnormalities; in others there appears to be advantage in antenatal diagnosis so that termination of the pregnancy may be considered before the stage of extrauterine viability of the fetus is reached.

Practical methods of early antenatal diagnosis are reviewed, with their indications, risks, and shortcomings. The use of alphafetoprotein estimations in amniotic fluid and maternal blood to identify neural tube defects and the karyotyping and biochemical assay of cultured amniotic cells are currently the most important of these. The history of antenatal diagnosis is reviewed and cost‐benefit analysis is discussed. With the concept of antenatal diagnosis and its widespread implementation and acceptance, there have arisen important questions of medical ethics and community policy, and these are discussed. A team consisting of an obstetrician, a geneticist and a paediatrician should be working together to provide genetic counselling prior to testing to explain the natural history of the disease in question and the mathematical risks concerned. Prospects for future endeavours in this field are discussed.
Grafting as a Principle in the Surgical Management of Vesicovaginal and Rectovaginal Fistulae
Authors: Zacharin Robert F.
Published: February 2008

Summary: The treatment of 49 genital fistulae in the past 18 years is reported from the Department of Gynaecology, Alfred Hospital, Melbourne. The series included 32 vesicovaginal fistulae, 15 rectovaginal fistulae and 2 double fistulae.

Whilst utilising the accepted principles of fistula closure, the high success rate is believed due, in large measure, to the additional step of grafting which has been used extensively. It is advocated as a most important principle in all genital fistula surgery.
Use of the Cardiff Infusor for Induction of Labour in a Metropolitan Maternity Unit
Authors: Gaal Robert
Published: February 2008

Summary: Use of the Cardiff infusor was studied over a 3‐year period at Manly District Hospital to assess its advantages in relation to labour parameters and gross effects on the newborn infant.
Placenta Praevia Without Antepartum Haemorrhage
Authors: Hill David J. , Beischer Norman A.
Published: February 2008

Summary: The incidence of placenta praevia in a series of 26,155 patients was 0.9%; in 81 of the 238 patients (34%) there was no antepartum haemorrhage. Placenta praevia was known to be present before delivery in only 12 of the latter group, the condition being diagnosed after vaginal delivery in 17 and at Caesarean section in 52. Approximately 40% of patients with placenta praevia who deliver vaginally have had no antepartum haemorrhage.
The Beta‐Subunit of Chorionic Gonadotropin as a Tumour Marker in Gestational Trophoblastic Disease
Authors: Khoo S. K. , Daunter B.
Published: February 2008

Summary: The clinical usefulness of the serum level of the β subunit by radioimmunoassay was evaluated in 96 patients with gestational trophoblastic disease. The measurement of the hormone‐specific β subunit has allowed a better understanding of the activity of the various types of disease, with a correlation between the initial serum levels and the different subtypes of hydatidiform mole, and the ability to predict the development of malignant sequelae. The phenomenon of trophoblastic persistence after uterine evacuation was confirmed: although the half‐life of the β subunit was 4 days during the early phase, there was an average period of 8 weeks before levels fell to negative and 12 weeks was the limit for spontaneous regression. The serial β subunit levels were found to provide an accurate indication of the clinical course of the disease in untreated and treated patients, and treatment could be withheld after 3 consecutive weekly negative values.
Excessive Bleeding from Fetal Scalp Blood Sampling
Authors: Reti Leslie L. , Adey F. Douglas , Brown Mary F.
Published: February 2008

Summary: A case of excessive fetal bleeding following scalp blood sampling is reported. The literature is reviewed and recommendations are made to reduce the incidence of this potentially fatal complication.
Case Report — Pregnancy and Intestinal Lymphangiectasis (Familial Neonatal Hypoproteinaemia)
Authors: Liu D. T. Y. , Sherman Anne M.
Published: February 2008

Summary: A patient with a history of familial intestinal lymphangiectasis and exudative enteropathy was observed during 2 consecutive pregnancies. Normal pregnancy is compatible with the condition and pregnancy need not aggravate the disease.
Haemangioma of the Uterine Cervix — Case Report
Authors: Weerasinghe D. S. L. , Walton S. M. , Bilous A. M.
Published: February 2008

Summary: A cervical haemangioma of a size not previously reported was found in a 45‐year‐old parous patient. Treatment was by lateral retrograde hysterectomy.
Pelvic Actinomycosis Following Insertion of an Intrauterine Contraceptive Device
Authors: Gudgeon C. W. , McCormack D. D.
Published: February 2008

Summary: A case of actinomycosis following insertion of an intrauterine contraceptive device is reported. The patient was treated successfully by antibiotic therapy and conservative surgery.
The Roll‐Over Test as a Screening Procedure for Gestational Hypertension
Authors: Andersen Graham J.
Published: February 2008

Summary: One hundred and ninety‐one primigravidae each had 2 roll‐over tests between 28 and 34 weeks of gestation. The first identified 21 (44%) and the second 20 (42%) of the 48 women who later became hypertensive. Of the women who remained normotensive, the first test identified 82 (57%) and the second, 78 (54%). Only 10 (21%) of the women who became hypertensive had 2 positive results and only 50 (35%) of those who remained normotensive had 2 negative results. The mean increase in diastolic pressure on moving from the left lateral to the supine position was the same in women who remained normotensive as in those who became hypertensive. The results of the investigation suggest that the roll‐over test is not sufficiently reliable, sensitive, or specific for use as a screening test for gestational hypertension in clinical practice.
Hysterectomy in Obstetric Practice
Authors: Hill David J. , Beischer Norman A.
Published: February 2008

Summary: A 9‐year review (1971–1979) is presented of patients undergoing hysterectomy in the course of pregnancy. The incidence was 1 in 1,044 pregnancies (34 in 35,506). The principal indications were ruptured uterus (9), postpartum haemorrhage (8), placenta accreta (5) and neoplastic trophoblastic disease (4). In spite of the high incidence of hysterectomy in our community, the procedure was undertaken during pregnancy with great reluctance and usually only as a life‐saving procedure.
Lack of Effect of Bromocriptine on Semen Quality in Men with Normal or Slightly Elevated Prolactin Levels
Authors: Baker H. W. G. , Pepperell R. J.
Published: February 2008

Summary: Bromocriptine, 2.5 mg twice daily, was given for 3–4 months to 27 men with poor semen quality. Serum prolactin levels were suppressed. Minor side effects occurred in over half the subjects. Sperm concentration, motility and morphology and FSH, LH, testosterone and dehydroepiandrosterone sulphate levels were not changed significantly. Results for 7 men with 1 or more pretreatment prolactin levels above the upper limit of the normal range, but without other evidence of pituitary disease, were no different from those for the normoprolactinaemic men. It is concluded that bromocriptine is not useful for treatment of infertile men with normal or slightly elevated prolactin levels.
Secondary Amenorrhoea Due to Autoimmune Ovarian Failure
Authors: Leer J. , Patel B. , Innes M. , Cameron D. P.
Published: February 2008

Summary: A case of spontaneous premature menopause due to autoimmune ovarian failure is described. This report emphasises that this uncommon condition is important to diagnose because of its association with other autoimmune endocrine disorders including Addison's disease. In addition, in the present case, the marked increase in lutenising hormone with relatively normal follicle stimulating hormone raises the possibility of a non‐steroidal inhibitory feedback of follicle stimulating hormone.
Postcoital Posthysterectomy Vaginal Vault Disruption With Haemorrhagic Shock
Authors: Hacker Neville F. , Charles Elsworth H. , Savage Edward W.
Published: February 2008

Summary: Two cases of haemorrhagic shock secondary to partial disruption of the vaginal vault by sexual intercourse occurring 2 and 8 weeks after abdominal hysterectomy are presented. One patient required bilateral hypogastric, bilateral ovarian, and unilateral uterine artery ligation to control the bleeding, and is believed to be the first such case reported.
Effect of Diazoxide on the Antepartum Cardiotocograph in Severe Pregnancy‐Associated Hypertension
Authors: Barr Peter A. , Gallery Eileen D. M.
Published: February 2008

Summary: Intravenous diazoxide was given to 8 patients with severe pregnancy‐associated hypertension (diastolic pressure ≥ 110) in the antepartum period. Maternal hypertension was rapidly controlled in all patients; the diastolic blood pressure fell to ≤ 100 in all patients and to ≤ 85 in 7. Diazoxide had no significant effect on the basal fetal heart rate (FHR) or on the latency period or amplitude of late decelerations in the 3 patients with abnormal (positive) stress cardiotocographs (SCTG) and abnormal (unreactive) non‐stress cardiotocographs (NSCTG). In the 5 patients with reactive NSCTGs, diazoxide had no significant effect on the basal FHR or on the frequency of fetal movement‐induced FHR accelerations. Thus, diazoxide did not adversely affect fetal well‐being in these patients with severe pregnancy‐associated hypertension as assessed by cardiotocography.
Colposcopic Differential Diagnosis of Dysplasia, Carcinoma in Situ and Microinvasive Carcinoma of the Cervix
Authors: Noda Sadamu
Published: February 2008

Summary: Two hundred and twenty‐eight patients with cervical neoplasia, detected in routine uterine cancer screening at the Center for Adult Diseases, Osaka, from 1973 through 1977 were selected. The histological diagnosis was as follows: dysplasia, 69; carcinoma in situ, 102; and microinvasive carcinoma, 57. A retrospective study of this material was made with the aid of adequate colposcopic colour photographs, and features likely to be useful in differential diagnosis were determined.

Atypical vessels were seen in 24 of 36 patients (67%) with Stage la1 lesions, but only in a few of those with Stage 02 lesions. Punctation, mosaic and white epithelium were less evident in stage la2 than in Stage 01 and Stage 02. Punctation, mosaic and white epithelium in patients with dysplasia were less formed, and their borders were less distinct than in patients with Stage 0 lesions. These characteristic changes are of value in accurate colposcopic diagnosis.
Case Report — A True Hermaphrodite Presenting With Hypospadias and an Undescended Testicle
Authors: O'Neil G.
Published: February 2008

Summary: A case of true hermaphroditism in a 20‐month‐old child is presented, together with a review of the literature.
Malignant Evolution with Fatal Outcome in a Patient with Partial Hydatidiform Mole
Authors: Looi L. M. , Sivanesaratnam V.
Published: February 2008

Summary: Recent studies suggest that partial hydatidiform moles are not potentially malignant and that prophylactic chemotherapy need not be administered. Our experience does not support that opinion. We report a 28‐year‐old Malay primigravida who succumbed to choriocarcinoma complicating a partial mole. The partial mole is likely to be part of a spectrum of gestational trophoblastic disease and should be viewed as a potentially malignant lesion.
Relaxin – A Review
Authors: MacLennan Alastair H.
Published: February 2008

: Relaxin is a polypeptide hormone, similar in structure to insulin and has been found in the female of all species studied. The corpus Iuteum of pregnancy is the main source of relaxin in many species but in others the decidua is apparently of greater importance. It has also been found in other tissues; e.g. prostatic fluid, testis and ovary. First discovered and extracted from the corpora lutea of pregnant sows in an impure form in 1926, it was found to relax the pubic ligament of the oestrogen primed guinea‐pig. It was named after this action, but has since been found to have many other possible roles, including preparation of the endometrium for implantation, inhibition of uterine activity in early pregnancy, remodelling of the uterine stroma during pregnancy, cervical ripening and the initiation of parturition. Relaxin's main cellular action in pregnancy may be to drive collagen biosynthesis in its target organs, thus facilitating the remodelling of the connective tissue. Due to the impurity of relaxin preparations used in clinical trials until the mid‐1970's, the role of relaxin in the human has been in doubt. Porcine and rat relaxins have now been highly purified and their detailed structure is known. Human relaxin awaits adequate isolation, purification and characterization, and is not yet available for laboratory and clinical trials. However, the recent preparation of purified porcine relaxin for clinical trials and the availability of specific radioimmunoassays for this relaxin together with the identification of relaxin receptor sites, are rapidly helping to establish the concept that relaxin is indeed an important hormone both in human reproduction and in other physiological processes.
The Cost of Routine Antenatal Screening for Syphilis
Authors: Bryce Robert L. , Pritchard Robert C.
Published: February 2008

The incidence of new cases of syphilis diagnosed after routine antenatal screening at a Sydney teaching hospital between 1975 and 1979 was 2 in 12,222. Both patients were treated and no infants were born with congenital syphilis. The cost of the screening programme for this period was estimated at $9,778.
Endodermal Sinus Tumour of the Ovary: The Place of Alphafetoprotein Detection, Surgery and Chemotherapy
Authors: Khoo S. K. , Buntine D. W. , Massey P. F. , Jones I. S. C.
Published: February 2008

New developments in the management of the rare endodermal sinus tumour of the ovary, together with the reporting of 2 additional patients, are presented. There is a need for accurate clinical and pathological evaluation of the disease. As shown in the present study, histochemical staining for alphafetoprotein (AFP) provides an additional factor in diagnosis, and monitoring of AFP levels in serum is a useful guide to treatment. The prognosis, previously uniformly poor, appears to be improved with the use of multidrug chemotherapy. In a collated series of 98 patients, the 24‐month survival rate was 65% in Stage I disease and 67% in Stage II disease. However, the choice of effective drugs remains uncertain. The improved survival of young patients with aggressive chemotherapy has now raised the question of preservation of fertility at the time of surgery. In a small collated series of 26 patients with Stage I disease, survival to 36 months was not jeopardized by the conservative removal of one tube and ovary.
The Pattern of Hydatidiform Moles in Singapore
Authors: Lee Y. S. , Cheah E. , Szulman A. E.
Published: February 2008

Hydatidiform mole is common in Singapore, and the incidence of malignant trophoblastic neoplasia is significantly higher than in Western countries. Within a 10‐year period (1968–1977), 538 cases of hydatidiform mole were diagnosed. On retrospective study, 498 (92.6%) were considered to be complete and 40 (7.4%) partial. The ratios of complete to partial moles were similar for the major population groups.

In the present study, only complete moles were found to give rise to persistent trophoblastic disease. The lack of such association in partial hydatidiform moles is in keeping with their known low malignant potential. Occasional abnormal post‐evacuation hCG curves, however, are being described from other centres, and while the underlying pathology remains largely undocumented, partial moles have to be dealt with on an empirical basis in the light of the hCG follow‐up levels.
Ultrasound in Gonadotrophin Therapy: A Better Predictor of Ovarian Hyperstimulation?
Authors: Bryce Robert L. , Picker Richard H. , Saunders Douglas M.
Published: February 2008

A case of ovarian hyperstimulation as a result of gonadotrophin therapy is reported. This occurred despite close ultrasonic monitoring in the absence of hormonal profiles.
Two Cases of Placental Sulphatase Deficiency with Unusual Endocrine Features
Authors: Knox David J. , Fraser Ian S. , Shutt Donald A.
Published: February 2008

Two cases of placental sulphatase deficiency are described both of which showed typical clinical features, associated with very low urinary and serum oestrogens. In the one case that reached term there was a spontaneous rise in serum oestradiol levels (from 16 to 44 nmol/1) after 38 weeks, although no oestradiol rise occurred after DHEAS loading. She later achieved a vaginal delivery. Although no steroid sulphatase activity could be detected in the placenta of case 2, there was a small transient rise in serum oestradiol (from 15.4 to 32.7 nmol/I) after maternal DHEAS loading. However, the absolute levels reached were very low compared to the response seen in normal pregnancies. The spontaneous rise in basal oestradiol levels between 38 and 41 weeks and the transient rise following DHEAS loading have not been previously reported for patients with placental sulphatase deficiency. Umbilical cord blood levels of several steroids in case 2 showed some similarities to previous case reports. Levels of DHEA, 16αOH DHEA, 170H pregnenolone and Cortisol were significantly lower than control values. DHEAS, 16αOH DHEAS, 170H progesterone and andros‐tenedione were within the normal range.
Bilateral Retinal Detachment in Association with Preeclampsia
Authors: McEvoy M. , Runciman J. , Edmonds D. K. , Kerin J. F. P.
Published: February 2008

Bilateral, serous, non‐rhegmatogenous retinal detachment is a rare complication of preeclampsia. Duke‐Elder and Dobree (1967) stated than Van Graefe reported the first case in 1855. Since then 24 further cases have been reported – Wagener (1933), Wahrsinger (1943), Singh (1953), Bosco (1961), Gitter (1968), Klein (1968), Kenny (1972), Mabie (1980) and Oliver (1980). The incidence over the past 40 years appears to be decreasing and probably reflects the lower incidence of severe preeclampsia as a result of better antenatal care. These detachments are bilateral, serous and non‐rhegmatogenous i.e. atraumatic. They often only involve the posterior pole. Bosco (1961) arrived at an incidence of 1 in 18,524 pregnancies. Previous case reports have suggested a higher incidence in primigravidas and all previous cases have occurred antenatally. In all but 1 previous case (Mabie, 1980), the detachment occurred concomitantly with hypertensive retinopathy. We report a multigravida with preeclampsia who, in the absence of any hypertensive retinopathy, developed bilateral, bullous retinal detachments in the puerperium.
Staphylococcal Toxic Shock Syndrome
Authors: Sorrell T. C. , Packham D. R. , Helprin G. , Munro R. , Gibson J. S.
Published: February 2008

A case of postpartum fever due to staphylococcal toxic shock syndrome, and a case of menstruation‐associated disease are described. Features pertinent to early diagnosis and management, particularly in patients with postpartum fever, are emphasized. Epidemiological data are discussed with reference to current theories of pathogenesis.
Intrapartum Fetal Intensive Care: 2‐Year Experience
Authors: Kuhn R. J. P.
Published: February 2008

Summary: Reappraisal of 2,279 electronically‐monitored labours in the fetal intensive care unit enabled the formation of a policy for the management of high risk pregnancies in labour. In the presence of meconium, major cardiotocographic heart rate abnormalities were as predictive of perinatal outcome as fetal acidosis (pH < 7.25). However, fetal scalp pH estimation did significantly reduce the incidence of Caesarean section for fetal distress. The perinatal mortality in the study was 1.32 per 1,000 births.
Vaginal Prostaglandin F2α Gel Before First Trimester Termination of Pregnancy
Authors: Quinn M. A. , Jalland M. , Wein R. , Kloss M.
Published: February 2008

Summary: Tylose gel containing either 10 mg prostaglandin F2α or sterile water was inserted into the posterior vaginal fornix of 130 patients either 12 hours or 4 hours before suction curettage. No benefit in terms of cervical softening or blood loss was noted in patients who received the prostaglandin gel.
Multiple Dose Extraamniotic Prostaglandin Gel for Second Trimester Termination of Pregnancy
Authors: Quinn M. A. , Duke J. , Wein R. , Kloss M.
Published: February 2008

Summary: Multiple doses of PGF2α gel were administered into the extraamniotic space in 30 patients to induce mid‐trimester termination of pregnancy. In 18 of these patients, repeat doses of gel were given only in the absence of uterine contractions and in 12 patients the gel was administered every 4 hours, irrespective of uterine activity. The mean time to abortion in all patients was 13.9 hours; no benefit seemed to accrue from using routine 4‐hourly doses and it is recommended that repeat doses are given only when contractions are absent. The latter technique compares favourably with the use of other natural prostaglandins and prostaglandin analogues.
Is Placental Function Testing Worthwhile? An Update on Placental Lactogen
Authors: Grudzinskas J. G. , Gordon Y. B. , Wadsworth J. , Menabawey M. , Chard T.
Published: February 2008

Summary: A prospective survey of 2,069 women delivered during 1976 and 1977 at St. Bartholomew's Hospital was undertaken to evaluate a variety of clinical, ultrasonic and biochemical variables in the prediction of unsatisfactory fetal outcome. Severe pre‐eclampsia and depressed maternal serum levels of human placental lactogen were each associated with a high fetal risk.
First‐Dose Effects of Bromocriptine in Hyperprolactinaemic Infertility
Authors: Biggs John S. G. , Edwards Vivian E.
Published: February 2008

Summary: The start of bromocriptine treatment is occasionally associated with collapse, unconsciousness or as in the present case, the uncovering of an epileptic tendency. Suggestions for the safe initiation of therapy are outlined.
Cervical Cytology Screening of Non‐Gynaecological Female Hospital Inpatients
Authors: Duncan G. R. , Parker R. E.
Published: February 2008

Summary: A programme of cervical cytology screening showed that women admitted to hospital with non‐gynaecological disease have a higher prevalence of carcinoma of the cervix and its precursors than the general population. Approximately one‐third of all patients with invasive or in situ carcinoma of the cervix had been inpatients in the preceding 5 years; thus, admission to hospital must be regarded as a strong indication for screening. The greatest benefit from this type of screening would be achieved if all patients had a smear taken as part of the admission examination.
Human Embryo Transfer in the Treatment of Infertility
Authors: Lopata A. , KelIow G. N. , Johnston W. I. H. , Speirs A. L. , Hoult I. J. , Pepperell R. J. , du Plessis Y. P.
Published: February 2008

Summary: In vitro fertilization and embryo transfer (IVF and ET) may be used to overcome reproductive failure caused by conditions which prevent the passage of gametes or interfere with fertilization in the female genital tract. The aim of the procedure is to bypass a block to conception whether it is due to mechanical, immunological or biological factors.
Microsurgical Reversal of the Artificially Induced Hydrosalpinx in the Rabbit—Morphological Studies
Authors: Petrucco O. M. , Tulsi R. S.
Published: February 2008

Summary: Mechanical occlusion of the rabbit oviduct at 2 sites produces a hydrosalpinx which was found to be associated with a predictable degree of loss of cilia from the mucosal cells (deciliation). The morphological changes observed closely resemble the light and surface electron microscopic appearances of a human hydrosalpinx. Microsurgical reconstitution of the obstructed oviduct in oestrus rabbits produced almost complete reversal to normal mucosal morphology. This suggests that the morphological changes observed in the rabbit hydrosalpinx may be due to an increase in intraluminal pressure and that reduction of this pressure may effect a reversal to normal.
“Spurious” Labour — Does it Matter?
Authors: Quinn Michael A. , Murphy Anthony J. , Gallagher Jane
Published: February 2008

Summary: The obstetrical outcome of 357 pregnancies complicated by “spurious” labour was documented and compared with that in a control group. Patients with spurious labour were more likely to have had a spontaneous or induced abortion in the preceding pregnancy. In almost 85% of patients, the painful uterine contractions had ceased within 1 hour of hospital admission and there was no increased fetal morbidity in this group. There was a significantly increased incidence of meconium‐stained liquor in patients who continued to have painful uterine contractions, but in whom labour did not ensue. Placental abnormalities were significantly more common in patients with spurious labour.
Unusual Oestrogen Concentrations During Pregnancy
Authors: Evans J. J. , Stewart C. R. , Peddie D. J. , Aickin D. R.
Published: February 2008

Summary: A pregnancy is reported in which low urine and plasma total oestriol levels were observed concurrently with normal plasma unconjugated oestriol concentrations. It is suggested that the apparently conflicting data were a result of atypical maternal metabolism of oestriol, perhaps due to an abnormal enterohepatic circulation.
Homologous Artificial Insemination Following Retrograde Ejaculation
Authors: Bryce Robert L. , Medcalf Stephen C. , Saunders Douglas M.
Published: February 2008

Summary: A case is reported of successful homologous artificial insemination using semen recovered from the bladder following retrograde ejaculation. The technique for spermatozoa protection and preservation is described.
Asymptomatic Genital Sarcoidosis
Authors: Honoré Louis H.
Published: February 2008

Summary: a 53‐year‐old woman with steroid‐treated clinical sarcoidosis was subjected to hysterectomy and bilateral adnexectomy for irregular vaginal bleeding related to postmenopausal genital atrophy. Histological examination revealed many sarcoid granulomas located subserosally in the uterus, parametrium, perisalpinx and ovaries. The differential diagnosis is discussed.