bluuebunny/crossref_metadata_2025 huggingface dataset:
Genetic Variants of the NOTCH3 Gene in Migraine—A Mutation Analysis and Association Study
Authors: Schwaag S , Evers S , Schirmacher A , Stögbauer F , Ringelstein EB , Kuhlenbäumer G
Published: August 2005

Mutations in the NOTCH3 gene cause cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). Exons 3 and 4 are mutation hotspots. Migraine is a clinical hallmark of CADASIL. The objective of this study was to investigate whether genetic variants in exons 3 and 4 of the NOTCH3 gene are associated with migraine. Exons 3 and 4 of the NOTCH3 were analysed for mutations and polymorphisms by direct DNA sequencing in 97 migraineurs and the same number of control individuals. No mutations in exons 3 and 4 of the NOTCH3 gene were found in 97 patients with migraine. However, association analysis revealed significant association of the single nucleotide polymorphism (SNP) rs1043994 with migraine.
NEONATAL AND MATERNAL SERUM IRON LEVELS AT BIRTH
Authors: Kessel I. , Sills D. J.
Published: August 2005

Summary

The serum iron levels in mothers and their newborn full‐term infants at the time of birth has been measured. There is no correlation between the maternal and neonatal levels, and the high cord blood serum levels bear no relation to sex or birthweight.
LATENT DIABETES IN PREGNANCY
Authors: Drury M. I. , Timoney F. J.
Published: August 2005

Glycosuria, a family history of diabetes mellitus, a history of previous unexplained fetal loss or of large babies may indicate possible latent diabetes in pregnancy. The value of the oral glucose tolerance test in detecting latent diabetes in an antenatal clinic over a five‐year period is reviewed and 220 women with latent diabetes were observed in 293 pregnancies. The fetal loss in 244 viable pregnancies in which latent diabetes was recognized prior to delivery was 2.9 per cent.

The cortisone modified glucose tolerance test employed after the puerperium in 108 of the women was of less diagnostic value as a test for latent diabetes than pregnancy itself.
GASTRIC EMPTYING TIME IN LATE PREGNANCY AND LABOUR
Authors: Davison Joseph S. , Davison Mary C. , Hay David M.
Published: August 2005

Gastric emptying was measured in non‐pregnant, pregnant and labouring women.

The results suggest an explanation for previously conflicting studies and support the suggestion that slowing of gastric emptying contributes to heartburn in pregnancy. However, there was no clear evidence that in pregnant women generally gastric emptying is impaired.

Gastric emptying times during labour were shown to be prolonged and the pattern of emptying altered.
AN INVESTIGATION OF THE CELLULAR SOURCE OF RENIN IN HUMAN CHORION
Authors: Symonds E. M. , Skinner S. L. , Stanley M. A. , Kirkland J. A. , Ellis R. C.
Published: August 2005

An investigation has been made into the cellular source of renin in human chorion. Using cytogenetic techniques the cells producing renin in tissue cultures of chorion have been identified as fetal and not maternal in origin.

Histochemical studies using the Bowie stain have shown the presence of cells containing Bowie‐positive granules in the cytoplasm in the spongy layer of amnion and the reticular layer of chorion. These cells do not occur in the trophoblastic layer and morphologically have been shown to resemble the Hofbauer cell.

Chorion cells producing renin during in vitro culture do not, however, display Bowie‐positive cytoplasmic granules.
A CONTINUOUS RECORD OF FETAL HEART RATE OBTAINED BY SERIAL COUNTS
Authors: Steer P. J. , Beard R. W.
Published: August 2005

A simple method for obtaining a continuous record of the fetal heart rate by serial counting in relation to uterine contractions, recorded by abdominal palpation, is described.

By comparing serial counts with the record obtained at the same time of a continuous heart rate monitor it has been shown that the optimal counting period is 10 seconds. Comparison of records obtained by several observers shows no significant influence of experience on the accuracy of counting or of palpating uterine contractions.
THE INTERPRETATION OF URINARY OESTROGEN AND PREGNANEDIOL EXCRETION IN PREGNANT WOMEN RECEIVING CORTICOSTEROIDS
Authors: Oakey R. E.
Published: August 2005

The urinary excretion of oestrogens and pregnanediol of 17 pregnant women who were receiving corticosteroids was measured. In all 10 patients who received less than 75 mg. cortisol (or its equivalent) daily and who gave birth to infants of satisfactory weight and without fetal abnormality, oestrogen excretion was within the normal range. The 4 patients who received less than 75 mg. cortisol daily but who showed subnormal oestrogen excretion gave birth to infants with retarded fetal growth or, in 1 instance, with hypoplastic adrenal glands. All 3 patients who received more than 75 mg. cortisol daily showed subnormal oestrogen excretion. Urinary pregnanediol excretion was within the normal range in 5 out of the 7 pregnancies in which oestrogen excretion was subnormal.

It is concluded that subnormal oestrogen excretion in pregnant women who are receiving less than 75 mg. cortisol (or equivalent) daily is indicative of a failure of the fetus to thrive.
THE VASCULAR PATTERNS IN MYOMATOUS UTERI
Authors: Farrer‐Brown Geoffrey , Beilby J. O. W. , Tarbit M. H.
Published: August 2005

The arterial and venous patterns in myomatous uteri have been studied by injection, microradiographic and histological techniques. The changes of the myometrial and endometrial veins produced by myomata are illustrated and their importance as a cause of uterine bleeding is discussed.
THE EFFECT OF ETHANOL ON THE MYOMETRIAL RESPONSE TO OXYTOCIN IN WOMEN AT TERM
Authors: Mantell C. D. , Liggins G. C.
Published: August 2005

Oxytocin dose‐response curves were constructed from amniotic pressure records in ten women who were infused with ethanol at term. Comparison of the slopes of the curves obtained before and during ethanol infusion showed that uterine activity was unaffected in two. In the remainder, the curves obtained during ethanol infusion were displaced to the right of the control curves, remaining parallel in three and diverging in five. It is concluded that inhibition by ethanol of oxytocin‐induced myometrial contractility may be due both to competitive antagonism and to inhibition of release of oxytocin.

A further patient with diabetes insipidus was similarly investigated. Basal uterine activity was low and remained so until oxytocin was infused at a rate of 16 mU. per minute. Otherwise the response curves were comparable to those of normal women.
A CLINICAL EVALUATION OF THE SELENOMETHIONINE UPTAKE TEST
Authors: Lee P. , Garrow J. S.
Published: August 2005

The 75Se‐Selenomethionine uptake test for placental competence has been performed on 467 patients. No adverse reactions attributable to the test have been found.

Average values for the uptake ratio at each week of gestation from 32 to 43 weeks are given. The lower limit of the normal range has been arbitrarily taken as 75 per cent of the average.

In patients with clinical evidence of placental insufficiency, those who have a low uptake have a significantly increased number of dysmature babies compared to those with a normal uptake.

The value of the test in predicting intrauterine death, and in the management of hypertensive disease, abruptio placentae and postmaturity is discussed. It is concluded that this test provides information about the state of fetal nutrition which could not be obtained so quickly or easily by any other means.
THE HEAT‐STABLE ALKALINE PHOSPHATASE CONTENT OF HUMAN PLACENTAE
Authors: Hawes Susan F. , Halliday D.
Published: August 2005

Alkaline phosphatase increases per placenta and per gram of placental tissue from 32 weeks until term. It appears that the enzyme tends to leak out of postmature placentae, since the intracellular concentration falls while the serum concentration rises.

Smaller babies have less alkaline phosphatase per placenta but more per gram of placental tissue.

No significant correlation could be found between the iso‐enzyme patterns, developed after electrophoretic separation, and the quality of placental function.
HAEMODYNAMIC CHANGES IN WOMEN TAKING ORAL CONTRACEPTIVES
Authors: Walters William A. W. , Lim Yean Leng
Published: August 2005

Haemodynamic changes were monitored serially in a group of 30 healthy young women receiving combined oestrogen‐progestogen oral contraceptive therapy. Significant increases in cardiac output (expressed as cardiac index), systolic and mean blood pressures and plasma volume occurred during therapy. Changes in heart rate and diastolic blood pressure were not significant. An increase in stroke volume was mainly responsible for the increase in cardiac output.

Plasma renin substrate and renin activity increased, renin concentration decreased, while blood angiotensin levels increased markedly during oral contraceptive administration in all 13 of the 30 subjects in whom these investigations were carried out.

A significant increase in body weight occurred in most subjects while receiving oral contraceptive therapy.
WEGENER'S GRANULOMA COMPLICATING PREGNANCY
Authors: Cooper Kenneth , Stafford J. , Warwick M. Turner
Published: August 2005

Successful pregnancy is reported in a patient with Wegener's granuloma, during which time she received immunosuppressant therapy, without apparent harm resulting to mother or child.
PREGNANCY AND DELIVERY AFTER BILATERAL ADRENALECTOMY FOR PHAEOCHROMOCYTOMA
Authors: Schenker J. G. , Luttwak E.
Published: August 2005

The association of bilateral adrenalectomy and pregnancy is rare: 18 cases reported in the literature are reviewed and an additional case of pregnancy and delivery following bilateral adrenalectomy for phaeochromocytoma is reported. With good management the prognosis for both the mother and the newborn is good.
THE DURATION OF INDUCED LABOUR
Authors: Sheikh G. N. , Prysor‐Jones D.
Published: August 2005

The average duration of labour after induction by amniotomy or amniotomy and oxytocin infusion was shorter by approximately 2 hours in primigravidae and 1·8 hours in multigravidae than spontaneous labour in comparable groups of patients with hypertension and postmaturity (P = <0·001).

In this series the duration of labour was considerably shorter than previously stated by other authors.

The birthweight of the infant bore no significant relationship to the duration of labour.

The duration of labour was longer in patients with prolonged pregnancies in whom the labour had started spontaneously than in the controls and patients with hypertension. This difference, however, was negligible in those whose labour had been induced by amniotomy.
A SAFE ALTERNATIVE TO CAESAREAN SECTION?
Authors: Moolgaoker A.
Published: August 2005

A prospective study has been carried out over six years to determine whether or not assisted delivery before full dilatation of the cervix is a safe alternative to Caesarean section.

Malmstrom's vacuum extractor was employed to accelerate the first stage of labour in 86 patients. This was successful in 82 patients, 39 being delivered with the ventouse alone, and 43 with the additional aid of forceps. In 4 patients vaginal delivery was not possible owing to unsuspected disproportion and the attempt in each case resulted in serious fetal injury or death.

The results of successful vacuum extraction in 82 patients are compared with those of a similar group of 110 patients delivered with special forceps.

Once the decision was taken to accelerate delivery in the first stage of labour, the time taken to deliver the baby with forceps was about one‐fifth of that required with the ventouse. When rotation of the fetal head was required prior to delivery it was achieved in all the cases of forceps delivery but failed to occur in almost half the number of vacuum extractions.

There were no maternal deaths and maternal morbidity was less with each of these methods than might have been expected had Caesarean section been employed. Cervical tears occurred in 18 per cent of patients after vacuum extraction and in half this number after forceps delivery. In subsequent pregnancies these patients showed no evidence of cervical incompetence.

With forceps fetal injuries were trivial, no perinatal death occurred and paediatric follow‐up has shown no permanent central nervous system damage. With the ventouse the injuries were more serious, there was a corrected perinatal mortality rate of 24 per thousand and follow‐up has revealed permanent central nervous system damage in 4·5 per cent of surviving infants.
KYPHOSIS COMPLICATING PREGNANCY
Authors: Chau W. , Lee K. H.
Published: August 2005

A study was made of 27 Chinese patients with kyphosis complicating 38 pregnancies encountered at Tsan Yuk Maternity Hospital, Hong Kong, over a 25‐year period. There was no cardio‐respiratory embarrassment in any of the cases. Obstetric hazards such as abortion, pelvic abnormality, marked pendulous abdomen, malpresentation and necessity for classical Caesarean section were found almost exclusively in those with kyphosis in the thoraco‐lumbar region of the vertebral column. Deformities situated above or below the thoraco‐lumbar region were much less likely to have adverse effects on childbirth. The incidences of anaemia, toxaemia of pregnancy, uterine inertia and prematurity were raised in kyphotic patients.
DYSTOCIA DUE TO CONGENITAL POLYCYSTIC KIDNEYS
Authors: Lee K. H. , Chang Effie
Published: August 2005

A case of dystocia due to polycystic disease of the kidneys in the fetus is reported. Delivery was completed after hysterotomy and removal of one of the kidneys through the uterine wound.
CEREBRAL VASCULAR DISEASE IN PREGNANCY I. HAEMORRHAGE
Authors: Amias A. G.
Published: August 2005

Fifty‐two patients with intracranial haemorrhage have been studied, of whom 40 were pregnant and 12 recently delivered. Angioma was encountered more often than aneurysm in the pregnant group. The relative rarity of these lesions makes management difficult to plan for the individual clinician.

The possibility of cerebral disease should be considered in any patient with recurrent headache or neurological symptoms. The fact of pregnancy should not deter full investigation including lumbar puncture and cerebral angiography, if clinically indicated.

There was a considerably higher incidence of hypertension among patients with cerebral aneurysms compared with those with other lesions. Intracranial bleeding in a hypertensive patient should not be assumed to be a secondary phenomenon without further investigation, and a diagnosis of “atypical eclampsia” should be regarded with suspicion. Patients with severe hypertension require long‐term follow‐up.

Unless labour begins during investigation a cerebral lesion should be treated before delivery irrespective of the stage of pregnancy and the method of treatment should be decided primarily on neurosurgical grounds.

Conversely, the mode of delivery need not be unduly influenced by the cerebral lesion. The rarity of intracranial bleeding during labour is confirmed in this series, and is supported by haemodynamic considerations. Caesarean section carries no demonstrable advantage for mother or child over controlled vaginal delivery, even when the lesion has not been surgically obliterated. Forceps delivery under sedation and regional anaesthesia is the method of choice.

Pregnancy per se does not influence the mortality from intracranial bleeding in young women, but haemodynamic and hormonal changes may explain an increased tendency for vascular anomalies to bleed in the second half of pregnancy, especially in the presence of hypertension.

Recurrent bleeding did not occur in nine patients who became pregnant again. The question of further childbearing should be decided individually and based on obstetric rather than neurological grounds.
INSULIN AND GLUCOSE LEVELS IN UMBILICAL CORD BLOOD AFTER INFUSIONS OF GLUCOSE AND GLUCOSE WITH INSULIN TO WOMEN IN LABOUR
Authors: ŠAbata V. , Frerichs H. , Wolf H. , Stubbe P.
Published: August 2005

Insulin and glucose levels were measured in eleven women in labour and in the umbilical arterial and venous blood of their babies. Twelve women received an infusion of 10 per cent glucose at a rate of 1 g. per minute for an average of 42·2 minutes. Thirteen women were given a similar infusion, and crystalline zinc insulin was added in a concentration of 1 unit to 3 g. of glucose. The average infusion time was 48·5 minutes.

Exogenous insulin did not improve the transplacental passage of glucose.

The infusion of glucose with insulin caused an eighteenfold increase in insulin level of the women in labour. This change was not reflected by the levels of insulin in umbilical blood. Similar umbilical insulin levels after both types of infusion show that exogenous insulin does not pass from the mother to the fetus during labour.

An increase in the insulin level of umbilical blood began 22 minutes after the start of the infusion. This most probably reflects the poor capacity of the fetal pancreas to react to changes in blood glucose levels.
3:4 BENZPYRENE‐INDUCED IN VITRO FLUORESCENCE OF FETAL CELL LIPIDS IN THE DIAGNOSIS OF RUPTURED MEMBRANES
Authors: Montanari G. D. , Grismondi G. L. , Zanoio L.
Published: August 2005

3 : 4‐benzpyrene‐induced in vitro fluorescence of fetal cell lipids was used in the diagnosis of ruptured membranes. The technique and the characteristic appearance of fetal squames displaying a silvery, bluish‐white fluorescence were described. The diagnostic accuracy of the method is fairly good: there was one false positive result in 134 patients with intact membranes and one false negative result in 62 samples of amniotic fluid.
BACTERIOLOGY OF FALLOPIAN TUBE IN RELATION TO PUERPERAL STERILIZATION
Authors: Mustafa Mutasim Abubakr , Pinkerton J. H. M.
Published: August 2005

About 50 per cent of postpartum women harbour micro‐organisms in their Fallopian tubes in the puerperium. In most patients the organisms are present in both tubes, but occasionally they are recoverable from one tube only. The presence of micro‐organisms in the Fallopian tube in the early puerperium does not seem to be related to pregnancy disease, surgical induction of labour, operative delivery, indication for sterilization or the delivery‐sterilization interval; neither does it significantly increase the incidence of post‐sterilization pyrexia, nor require any treatment in itself.
THE INDUCTION OF LABOUR WITH PROSTAGLANDIN E2
Authors: Beazley John M. , Dewhurst C. J. , Gillespie Arnold
Published: August 2005

Prostaglandin E2 was used to induce labour in 40 patients, between 29 and 42 weeks gestation. Vaginal delivery occurred in 37 patients; 3 other patients required Caesarean section. No fetal complications attributable to PGE2 were observed, nor any maternal cardiovascular or alimentary effects. One patient demonstrated transient uterine hypertonus when infused with 40 ng./kg./min.

It is suggested that as the uterine threshold for PGE2 is variable a slow rate of PGE2 infusion should be used initially, but increased steadily until an effective infusion rate is obtained.
INDUCTION OF LABOUR WITH PROSTAGLANDIN E2
Authors: Karim S. M. M. , Hillier K. , Trussell R. R. , Patel R. C. , Tamusange S.
Published: August 2005

The effect of prostaglandin E2 on the activity of the pregnant human uterus in vivo has been studied in 50 women at or near term and in need of induction. Labour was successfully induced in all cases with a continuous infusion of 0·5 μg./min. The uterine activity produced by prostaglandin infusion resembled that of normal spontaneous labour. No unphysiological increase in uterine tonus was observed. The average infusion time was 5·5 hours and the average infusion‐delivery interval was 10 hours.
THE VOLUME AND COMPOSITION OF AMNIOTIC FLUID IN EARLY PREGNANCY
Authors: Sinha R. , Carlton M.
Published: August 2005

The volume and biochemical composition of amniotic fluid from early normal pregnancies terminated between 8 and 24 weeks were studied. The volume was measured directly in 27 of 33 cases. There was a small, but steady increase between 8 and 11 weeks. From 11 weeks there was a rapid and almost linear increase to a peak volume at 20 weeks. The bilirubin concentration and the optical density difference at 450 mμ. were related to gestational age rather than to the volume of fluid and reached a peak at about 18 weeks. The sodium, potassium and creatinine concentrations were comparable with plasma levels. The urea, glucose, protein and carbon dioxide concentrations were lower, whereas the chloride content was higher than the plasma level. The concentrations of these constituents were not related to either volume or gestational age during the period investigated.
LIQUOR BILIRUBIN VALUES IN EARLY PREGNANCY
Authors: Carlton M. A. , Sinha R.
Published: August 2005

Liquor bilirubin concentrations have been measured chemically and spectrophotometrically throughout normal pregnancy in 80 patients and in 30 patients with fetuses affected by rhesus incompatibility.

A normal curve and confidence intervals for a single observation of Δ 450 mμ. have been calculated. Prognostic criteria may be applied to gestations earlier than 28 weeks by use of the normal Δ 450 mμ. curve and the curve designating the 0·5 per cent confidence limit.

Accurate criteria for intrauterine transfusion cannot be derived from Δ 450 mμ. values before 23–24 weeks and at this stage of pregnancy emphasis should be placed on the obstetric history.
NON‐IMMUNOLOGICAL HYDROPS FETALIS
Authors: Macafee C. A. J. , Fortune D. W. , Beischer N. A.
Published: August 2005

In a consecutive series of 182 cases of hydrops fetalis 33 (17·6 per cent) were due to causes other than blood group incompatibility, the incidence of non‐immunological hydrops fetalis being 1 in 3538 deliveries. Of the 33 cases, 13 were idiopathic, 6 were associated with twin pregnancies, 7 had major malformations and the remaining 7 had a variety of associated diseases.

The high incidence of polyhydramnios, pre‐eclampsia and prematurity in cases of idiopathic hydrops was confirmed, and the series included one case of eclampsia. The subsequent obstetric performance of these patients was very different to what occurs with rhesus immunization and 21 of 22 further pregnancies were uncomplicated, the other resulting in a surviving hydropic infant.

There is an association (3 of 13 cases) between severe maternal anaemia and idiopathic hydrops. This association is more significant than that between hydrops fetalis and any fetal malformation other than adenomatoid hamartoma of the lung. No relationship between diabetes and of fetal hydrops was found.

Urinary oestriol excretion was low in two cases of idiopathic hydrops in which this test was performed indicating that hydrops probably represents chronic feto‐placental dysfunction rather than an acute episode of circulatory failure. In non‐immunological hydrops the placental weights are of the same order as those seen in erythroblastosis.

Fetal anaemia was not found in any case nor were fetal plasma protein levels consistently low. In the twin transfusion syndrome the exsanguinated twin can become hydropic and both twins may be affected. It is concluded that hydrops is unlikely to have a single aetiology and that the pathogenesis cannot be explained by such simple considerations as fetal anaemia.
FETAL HAEMOGLOBIN IN CORD BLOOD AS ESTIMATED BY TWO DIFFERENT TECHNIQUES
Authors: Bhoyroo S. K. , D'Souza S. W. , Gordon H. , Scopes J. W.
Published: August 2005

Although there is a significant correlation between the percentage of fetal cells as estimated by the Kleihauer technique and the amount of fetal haemoglobin in the same specimen, the variation is large. The information cannot be used for accurate prediction of the concentration of fetal haemoglobin or of gestational age.
BLOOD SUGAR AND PLASMA INSULIN LEVELS IN PREGNANCY
Authors: Mowat J. , Lindsay A. C. , Mckiddie M. T.
Published: August 2005

Glucose tolerance and plasma insulin levels were studied during the third trimester of pregnancy in 32 normal women. 35 patients with glycosuria and 25 “at risk” patients. Blood sugar levels were lower and plasma insulin levels were higher than in non‐pregnant controls. No difference was found between the normal pregnant patients and either the glycosurics or the “at risk” group. It is suggested that the criteria for normal glucose tolerance might be modified during pregnancy.
TEENAGE PREGNANCY—AN INTER‐RACIAL STUDY
Authors: Scher J. , Utian Wulf H.
Published: August 2005

The obstetrical outcome of pregnancy in primigravid patients aged 16 years or less of three racial groups, white, Cape coloured and Bantu, is compared. Each group consisted of 100 consecutive patients.

The major differences found were an increased incidence of cephalo‐pelvie disproportion and associated high Caesarean section rate in the Cape coloured and Bantu groups, a lower rate of engagement of the fetal head before labour in the non‐white patients and a high prematurity rate in the Cape coloured group.

An equally high incidence of toxaemia of pregnancy was found in all racial groups and the increased incidence of this syndrome in the young primigravid patient was confirmed.
EFFECTS OF OESTROGENS ON THE HUMAN CIRCULATION
Authors: Lim Yean Leng , Lumbers Eugenie R. , Walters William A. W. , Whelan Robert F.
Published: August 2005

The naturally occurring oestrogens, oestrone and oestriol, were given by intraarterial infusion into the brachial artery and by intravenous injection. No changes in blood flow through the hand or forearm were observed with either route of administration. Intravenous injection resulted in a significant rise in blood pressure but no significant changes in heart rate or limb vascular resistance. It is suggested that this rise in blood pressure may be due to a direct action of the hormones on the heart.
PHYSIOCHEMICAL RESPONSES TO HEPARIN IN NON‐PREGNANT, NORMAL PREGNANT, AND ECLAMPTIC PATIENTS
Authors: Nelson George H. , Strickland John A.
Published: August 2005

Heparin 50 mg. was injected intravenously into four groups of patients: non‐pregnant women who were not taking oral contraceptives, non‐pregnant women taking oral contraceptives, normal pregnant women, and eclamptic patients. Blood was collected before and ten minutes after the injection, and the following determinations were carried out: Lee‐White clotting time, serum free fatty acid concentration, in vitro lipoprotein lipase assay, in vitro post‐heparin phospholipase assay, and in vitro post‐heparin esterase assay.

After the heparin injection, non‐pregnant patients showed a significantly greater prolongation of clotting time than pregnant patients. No significant differences were noted in increments of serum free fatty acid concentrations. The lipoprotein lipase and post‐heparin esterase assays in the post‐heparin serum showed greatest activity in the non‐pregnant women who were not taking oral contraceptives, least activity in the pregnant women, with the non‐pregnant women who were taking oral contraceptives intermediate between the others. The post‐heparin phospholipase activity in the post‐heparin serum from the women who were not pregnant or taking oral contraceptives was significantly greater than the activity from the non‐pregnant women who were taking oral contraceptives and from the pregnant women. No significant difference was found by any determination between the normal pregnant and the eclamptic groups. On the fifth postpartum day the responses of the normal pregnant and eclamptic groups resembled more closely those of the non‐pregnant women who were not taking oral contraceptives, but in general were not quite as large.
ACTIVE MANAGEMENT OF LABOUR AND CEPHALOPELVIC DISPROPORTION
Authors: O'Driscoll Kieran , Jackson Reginald J. A. , Gallagher John T.
Published: August 2005

A preoccupation with cephalopelvic disproportion is the main reason for a reluctance to abandon the conservative attitude towards labour which prevails in the United Kingdom and Ireland. In a series of 1000 consecutive primigravidae, in which an active approach to labour was adopted, the incidence of disproportion was less than 1 per cent and there was notable absence of trauma, especially to the child.

Oxytocin stimulation is recommended as an essential instrument to define disproportion when the natural forces are not adequate. Excessive caution is criticized because a diagnosis of disproportion cannot be made unless uterine action is adequate. It is concluded that the possibility of cephalopelvic disproportion does not justify a passive attitude towards labour in a modern maternity unit.
THE PROTEINS OF CERVICAL MUCUS AND THE INFLUENCE OF PROGESTAGENS
Authors: Elstein Max
Published: August 2005

A study is presented of the proteins of cervical mucus in relation to its changing physical properties. The effects of various low dose progestagens on these characteristics were investigated.

A technique was developed to solubilize cervical mucus so that protein quantitation, reproducible disc electrophoresis and immunodiffusion could be carried out. Protein concentration reached a nadir at midcycle. Whe n progestagens of the 17‐α‐acetoxy series were given the lowest level was significantly higher than at midcycle in normal cycles and when norgestrel 75 μg. was administered at which time only albumin was present. In progestational states the concentration of protein was higher and in addition immunoglobulins and transferrin were present.

These findings support the hypothesis that the 17‐α‐acetoxy progestagens exert their major contraceptive action through an effect on the cervical mucus. In contrast, norgestrel at doses of 75 μg. probably has its major action by disturbing ovarian steroidogenesis.

It is concluded that the “serum‐like” proteins might play a significant role as a cross‐linking agent between the thread‐like glycoproteins. It is suggested that studies of the protein changes in the cervical mucus during administration of various progestational agents in relation to their effects on hormone output, might be applied in the search for a contraceptive with an optimal cervical mucus effect.
OBSTETRIC PRACTICE AND EPIDURAL ANALGESIA
Authors: Nicholas A. D. G. , Tipton R. H. , Wheatley C. J. , Bircumshaw J.
Published: August 2005

The problems of introducing epidural analgesia into the labour wards are discussed and the results of a double blind trial of 1 per cent lignocaine and 0·25 per cent bupivicaine are presented. The trial included 84 patients having continuous caudal analgesia. Bupivicaine was the more satisfactory analgesic agent. Epidural analgesia has a definite part in obstetric management as well as being a safe and efficient method of pain relief in labour.
THE MUCOPROTEIN LAYERS IN THE PLACENTAE OF PRE‐ECLAMPTIC PATIENTS
Authors: Curzen Peter , Rigby Pamela , Barber Christopher
Published: August 2005

No difference was found in the distribution of acellular mucoprotein layers in placentae from pre‐eclamptic patients, as compared with placentae from normal patients.
A METHOD FOR THE ESTIMATION OF PREGNANEDIOL IN AMNIOTIC FLUID
Authors: Klopper A. , Wilson G. R. , Shearman R. P.
Published: August 2005

A method for the estimation of pregnanediol in liquor amnii has been devised. It consists of extraction of the liquor with Delsal's reagent, evaporation of the solvent and partition of the residue between water, hexane and toluene. An internal standard of radioactive pregnanediol is added to the aqueous phase which is submitted to hot acid hydrolysis under toluene overlay. After hydrolysis the pregnanediol is further purified as in the method described by Klopper, Michie and Brown (1955). This includes chromatography on columns of aluminium oxide first as the free steroid and then as the diacetate. A chromatography standard of androstenedione is added to the eluate containing pregnanediol diacetate. After removing an aliquot for radioactivity measurement the steroids are determined by gas‐liquid chromatography. The data on the reliability of the method are given.
THE USE OF COLICINE TYPING IN A STUDY OF THE RELATIONSHIP OF INFECTING URINARY ORGANISM TO THE FAECAL FLORA IN PREGNANT PATIENTS WITH SIGNIFICANT BACTERIURIA
Authors: Mustafa Mutasim Abubakr , Dunbar J. M.
Published: August 2005

In a study of pregnant patients with significant bacteriuria the colicine type of Escherichia coli recovered from two or more specimens of urine was constant for each patient. Faecal strains tested in the same way were of variable colicine type but detailed results on two patients were consistent with the existence of a constant and variable colicine type. The constant colicine type was the same as that found in the urine.
EFFECT OF ORAL CONTRACEPTIVES ON SERUM FOLIC ACID CONTENT
Authors: Castrén O. M. , Rossi R. R.
Published: August 2005

Thirty healthy women were examined before and after three months treatment with oral contraceptives to see whether the treatment affected the serum folic acid content. Three combined regimens were used. Prior to treatment serum folic acid was 6·0±2·4 ng./ml. and after treatment 5·5±2·2 ng./ml. No difference was noted between drugs containing different oestrogen‐progestagen components. Treatment of longer duration, 5–32 cycles, did not affect serum folic acid levels significantly. The haemoglobin concentration and packed cell volume remained unchanged during the period of treatment.
ORAL CONTRACEPTIVES AND SERUM LIPIDS
Authors: Barton Gwen M. G. , Freeman Peter R. , Lawson June P.
Published: August 2005

Serum cholesterol and triglyceride were estimated in subjects taking oral contra‐ ceptives in three different dose regimes. Tests were made at three‐monthly intervals for two years. A rise in serum cholesterol and triglyceride was seen in those taking contraceptives containing both oestrogen and progestagen, but not in those receiving progestagen only. The rise was greater in those on the higher dose combined pill, and serum triglyceride rose more than cholesterol. The rise began early and was maintained throughout. In a separate group of subjects who had previously been taking oral contraceptives for over 30 months a fall in serum cholesterol and triglyceride was found following withdrawal of oral contraceptives for six months. The results show that the adverse effect of oral contraceptives on lipid metabolism is due to oestrogen and not progestagen.
LOSS OF SKELETAL CALCIUM IN LACTATING WOMEN
Authors: Atkinson P. J. , West R. R.
Published: August 2005

The calcium changes which occur during lactation have been measured in the lower femoral shaft of ten subjects. Measurements were made by scanning the leg with a photon beam from 241Am. The results obtained from the scan trace were expressed as a “bone index” which was proportional to the bone in g. per unit length of the femur shaft. Mineral losses varied from subject to subject but the mean for all ten was a loss of 2·2 per cent over 100 days. The changes were of the same order as those which were observed in metabolic balance studies during lactation. The present method provides a valuable means of measuring such small bone mineral changes directly.
NEONATAL JAUNDICE IN CHINESE NEWBORNS
Authors: Lee K. H. , Yeung K. K. , Yeung C. Y.
Published: August 2005

Neonatal jaundice (15 mg. or more of total bilirubin per 100 ml.) occurred in 2687 out of 22 122 babies in Hong Kong (12·1 per cent). Jaundice was significantly more common in summer, in first born babies and in male infants.

The aetiology of neonatal jaundice in Chinese newborn infants is different from that in western communities.

Vacuum extraction was found to predispose to neonatal jaundice even when no obvious cephalhaematoma developed.
TRANSFER OF CEPHALOTHIN SODIUM TO THE FETUS
Authors: Paterson Lindsay , Henderson A. , Lunan C. Burnett , McGurk Sheila
Published: August 2005

The transfer to the fetus of cephalothin sodium (Keflin) given to the mother at varying times before the induction of labour has been investigated.
THE UTERUS AS CONTRIBUTOR OF PLASMINOGEN ACTIVATOR TO THE BLOOD
Authors: Menon I. Sudhakaran , Barron S. L. , Weightman Doris , Dewar H. A.
Published: August 2005

It is suggested that the uterus makes a contribution of plasminogen activator to the circulation of the body which may play an important part in the prevention of pelvic thrombosis.
MYOCARDIAL INFARCTION IN PREGNANCY
Authors: Ginz Beryl
Published: August 2005

Thirty‐six cases of myocardial infarction during pregnancy, reported in the literature since 1922, together with three new cases from National Women's Hospital, Auckland, New Zealand, are reviewed. The incidence of the condition appears to be about 1 in 10000 deliveries and the mortality is just under 30 per cent; the mortality appears to be highest in the puerperal patients, and surprisingly in those patients under 35 years of age. Present knowledge of the value of anticoagulants in the female patient with myocardial infarction, pregnant or otherwise, probably does not justify the use of such drugs, and the management of labour depends only on obstetrical circumstances.
THE 30‐MINUTE SYNACTHEN TEST IN PREGNANCY AND LABOUR
Authors: Campbell Stuart , Bain Christopher , Dewhurst C. J. , Fotherby K.
Published: August 2005

Changes in plasma cortisol levels following the 30‐minute Synacthen test were studied in 13 women throughout normal pregnancy and in the non‐pregnant state. The plasma 11 OHCS response to Synacthen was also studied during labour in 9 of the 13 patients. A rise in resting plasma glucocorticoids as pregnancy progressed was found, similar to that described by previous workers. The post synacthen response was normal in early and mid pregnancy, enhanced in the third trimester and diminished during labour. The significance of these results is discussed.
OVULATION—ITS DETECTION AND EVALUATION USING MULTIPLE CRITERIA IN THE INFERTILE WOMAN
Authors: Pennington G. W. , Beazley J. M. , Wilson E. W.
Published: August 2005

Six subfertile women were each studied by basal body temperature, bi‐weekly hormone excretion assays, uterine curettage and laparoscopy, and histological and histochemical evaluation of the endometrium, during one normal menstrual cycle. The results showed little correlation between the various accepted criteria of ovulation, and in particular the histological findings and the values of oestriol and pregnanediol excretion were in direct conflict in all except one patient. The relevance of the finding of secretory activity in the endometrium is discussed and suggestions are made for the investigation of subfertile women. It is not known if these variable results are found in normally menstruating fertile women, or if the variations are directly responsible for the infertile state.
THE OXYGEN AFFINITY OF THE BLOOD OF INFANTS TREATED BY INTRAUTERINE TRANSFUSION
Authors: Mathers N. P. , James G. B. , Walker J.
Published: August 2005

Oxygen dissociation curves have been constructed on cord blood from fetuses which had had intrauterine transfusions, and compared with those of their mothers’ bloods, and those from normal fetal‐maternal pairs. The results show that a difference in oxygen affinity between fetal and maternal bloods is not required for survival of the fetus.
CONGENITAL ADRENAL HYPOPLASIA
Authors: Roberts G. , Cawdery J. E.
Published: August 2005

A case of congenital adrenal hypoplasia is described in which the mother's urinary excretion of oestriol during pregnancy was very low, and sometimes absent. The pregnancy was prolonged, and after delivery the infant showed evidence of adrenal insufficiency, which required treatment with cortisone.
TOXIC HAEMOLYTIC ANAEMIA IN PREGNANCY DUE TO A PICA FOR PARADICHLOROBENZENE
Authors: Campbell D. M. , Davidson R. J. L.
Published: August 2005

A pregnant woman developed toxic haemolytic anaemia as a result of a pica for toilet air‐freshener blocks whose chief constituent is paradichlorobenzene.
THE BLOOD SUPPLY OF THE UTERUS
Authors: Farrer‐Brown Geoffrey , Beilby J. O. W. , TARBIT M. H.
Published: August 2005

A detailed study of the arterial system of the human uterus is described using an injection technique coupled with microradiography and histology. The micro‐vascular patterns and their variations during the menstrual cycle are illustrated.
THE ACTION OF PROSTAGLANDINS ON THE HUMAN ISOLATED NON‐PREGNANT CERVIX
Authors: Najak Zeeba , Hillier Keith , Karim S. M. M.
Published: August 2005

The isolated non‐pregnant cervix has been shown to exhibit spontaneous isotonic and isometric contractility and to respond to drugs. PGE2 causes a marked relaxation whilst the effect of PGF2α is more variable. Oxytocin and adrenaline cause contraction of the muscle.

The implications of the finding that the cervix can show isotonic and isometric contractility and the effects of prostaglandins are discussed.
TILT CAESAREAN SECTION
Authors: Ansari I. , Wallace G. , Clemetson C. A. B. , Mallikarjuneswara V. R. , Clemetson C. D. M.
Published: August 2005

Use of a ten degree left‐side‐down “tilt” position for Caesarean section has resulted in a very significant improvement in the oxygen saturation of umbilical artery and vein blood of infants at birth. This is especially notable in infants delivered from mothers under spinal block. It is believed that this improvement in the oxygenation of the fetus is due to release of pressure on the mother's vena cava which causes an increase in her cardiac output and improved perfusion of the uterus.
THE RESULTS OF TREATMENT OF 4389 CASES OF PRECLINICAL CERVICAL SQUAMOUS CARCINOMA
Authors: Boyes D. A. , Worth A. J. , Fidler H. K.
Published: August 2005

The follow‐up data of 4389 treated cases of preclinical squamous carcinoma of the cervix is presented. After 5 years of follow‐up 1.86 per cent of patients with carcinoma in situ had developed further disease and after ten years 8.2 percent had developed further disease. These rates indicate the need for prolonged and careful follow‐up. Hysterectomy does not mean the end of follow‐up as there appears to be a significant risk of developing recurrent disease or new foci of disease in the vaginal vault after hysterectomy. Carcinoma in situ with microinvasive foci appears to behave in much the same fashion as carcinoma in situ, so that similar treatment would appear justified. Occult invasive carcinoma, however, is frequently associated with lymphatic infiltration and has a five‐year mortality rate of 6.5 per cent. These patients have a greatly increased risk of development of further disease and require more extensive original treatment as well as careful and continued follow‐up.
FETO‐MATERNAL TRANSFUSION IN ANTEPARTUM HAEMORRHAGE, AN INDEX OF PLACENTAL DAMAGE AND FETAL RISK
Authors: Minchin A. J. , Bhoyroo S. K.
Published: August 2005

Twenty‐two patients with antepartum haemorrhage and seven with late threatened abortion were investigated to see whether there was a correlation between the magnitude of feto‐maternal bleeding and the outcome of the pregnancy. It was found that the greater the feto‐maternal transfusion the greater the incidence of placental infarction and of fetal distress in labour. No correlation was found between the amount of revealed antepartum haemorrhage and placental damage.
SERUM PROTEIN CHANGES IN THE PRE‐ECLAMPSIA‐ECLAMPSIA SYNDROME
Authors: Studd J. W. W. , Blainey J. D. , Bailey D. E.
Published: August 2005

The technique of crossed antigen‐antibody immuno‐electrophoresis has been used to compare the serum protein changes of severe pre‐eclampsia with the changes of normal pregnancy.

Decrease in the concentrations of serum albumin, transferrin and haemopexin and an increased concentration of α1 glycoprotein, α2 macroglobulin and β lipoprotein were found, giving a protein pattern essentially like that of the nephrotic syndrome.

It is believed that these changes are a result of urinary loss of the proteins of intermediate molecular weight, with a compensatory unselective increased synthesis of protein in the liver, and retention in the serum of macroglobulins which are too large to pass through the defective glomerular basement membrane.
A COMPARISON OF THE EFFECT OF ADMINISTRATION OF DILUTE OXYTOCIN WITH OXYTOCIN TITRATION FOLLOWING AMNIOTOMY
Authors: Howie P. W. , MacVicar J.
Published: August 2005

Induction of labour with intravenous oxytocin by the “titration method” and by infusion of dilute oxytocin at a slowly increasing rate were compared in two groups of patients closely matched for age, parity, gestational age and indication for induction.

Oxytocin titration reduced the induction‐delivery interval and the incidence of pyrexia in labour. The incidences of Caesarean section, postpartum haemorrhage, and fetal asphyxia were similar in both groups.
THE EFFECT OF OXYTOCIN TITRATION ON THE OUTCOME OF LABOUR FOLLOWING AMNIOTOMY
Authors: Mac Vicar J. , Howie P. W.
Published: August 2005

After surgical induction of labour, the effect of the administration of oxytocin by “titration” on the outcome of labour has been studied by comparing the results for two years before and two years after instituting this method.

There was no statistically significant difference in the mode of delivery or state of the fetus, but the induction‐delivery interval was considerably reduced.
FETAL SCALP TISSUE OXYGEN TENSION MEASUREMENTS IN RELATION TO MATERNAL DERMAL OXYGEN TENSION AND FETAL HEART RATE
Authors: Walker Adrian , Maddern Lynne , Day Evan , Renou Peter , Talbot James , Wood Carl
Published: August 2005

A membrane covered tissue Po2 electrode is described which can be applied to the fetal scalp early in labour to provide a continuous measurement of fetal tissue Po2. The use of a membrane cover has reduced the oxygen consumption of the electrode and its sensitivity to diffusion conditions in the region of measurement so that it may be calibrated in absolute terms. When the oxygen concentration breathed by the mother was reduced from 100 to 21 per cent or from 21 to 15 per cent fetal tissue Po2 declined more slowly than the maternal tissue Po2. Changes in fetal tissue Po2 associated with various patterns of transitory fetal heart rate change are also presented.
LACK OF AGREEMENT ON NORMAL VALUES FOR FETAL SCALP BLOOD
Authors: Lumley Judith , McKinnon Loris , Wood Carl
Published: August 2005

There are significant differences between authors in the values given for the normal range of p H and blood gases in fetal scalp blood during the first stage of labour. Oxygen tensions show the least agreement. The differences cannot be explained by the ways the normal study group were selected (clinically normal; normal monitored fetal heart rate; healthy newborn infants) nor by choice of measuring system. Both inaccuracy of measurement and variation in the arterial and venous contributions to scalp capillary blood are probably involved.

An alternative way of deriving the normal range is described. This gives 7–25 as the lower limit of normal for p H and 60 mm. Hg as the upper limit of normal for Pco2. Definition of hypoxaemia and therefore discussion of its extent and significance remains impracticable at present. However, the normal human fetus does not appear to be in a state of metabolic acidosis in early labour.
THE EFFECTS OF ABDOMINAL DECOMPRESSION ON VASCULAR HAEMODYNAMICS IN PREGNANCY AND LABOUR
Authors: Coxon Alan , Haggith J. W.
Published: August 2005

The use of radioisotopes in localization of the placental site facilitates study of alterations in vascular haemodynamics under varying conditions. Measurements demonstrated that during pregnancy the application of abdominal decompression results in a 30 per cent increase in count rate over the placental site. There was a simultaneous fall in count rate over the head and lower limbs during the application of decompression. Severe exercise did not produce any change in count rate over the placental site. Measurements carried out during labour showed no change in count rate over the placental site during a uterine contraction, but a 10 per cent fall in count rate over the uterine wall away from the placental site. The application of abdominal decompression during a uterine contraction in the first stage of labour resulted in a 15 per cent increase in count rate over the placental site and over the uterine wall away from the placental site.