bluuebunny/crossref_metadata_2025 huggingface dataset:
SOTALOL AS A HYPOTENSIVE AGENT IN PREGNANCY
Authors: O'Hare M. F. , Murnaghan G. A. , Russell C. J. , Leahey W. J. , Varma M. P. S. , McDevitt D. G.
Published: August 2005

Sotalol, a beta‐adrenoceptor blocking drug, was administered to 12 hypertensive pregnant women. The concentration of the drug was assayed in samples of maternal plasma, amniotic fluid and mixed umbilical cord plasma at delivery and, in five mothers who elected to breast feed, in paired samples of maternal plasma and breast milk. Sotalol reduced blood pressure effectively at a mean daily dose of 433·1±54·1 mg but crossed the placental barrier. The mean maternal: fetal plasma concentration ratio was 1:1·05 and the mean amniotic fluid concentration was 7·0±2·7 μg/ml. Delivery occurred at mean gestational age of 37·7±0.7 weeks; 12 infants were liveborn with a mean weight of 2·8±0·1 kg and eight of them had no significant neonatal problems. Of the other four, two died from severe congenital anomalies, one had perinatal asphyxia and one mild transient hypoglycaemia. High sotalol concentrations were found in breast milk (mean plasma: milk ratio was 1:5·4) raising the possibility of pharmacological effect in the newborn infant. The results suggest that sotalol adequately controls blood pressure in hypertension complicating pregnancy but because, unlike results from the pregnant ewe, it crosses the human placental barrier it offers no apparent advantages over other beta‐adrenoceptor antagonists.
FETOMATERNAL BLEEDING DURING ATTEMPTS AT EXTERNAL VERSION
Authors: Gjøde P. , Rasmussen Th. Bremholm , Jørgensen J.
Published: August 2005

The frequency and size of fetomaternal bleeds during the first attempt at external version of the fetus in breech presentation in 50 pregnant women were investigated. Fetomaternal bleeds of 0–1 to 1–5 ml were detected in 14 women (28 per cent). It is concluded that rhesus negative women should be given anti‐D before attempts at external version are made.
HOW OBSTETRICIANS IN THE UNITED KINGDOM MANAGE PRETERM LABOUR
Authors: Lewis P. J. , de Swiet M. , Boylan P. , Bulpitt C. J.
Published: August 2005

A questionnaire survey was conducted in order to establish how obstetricians in this country manage preterm labour. The results indicate that the majority of obstetricians would use beta sympathomimetic agents to inhibit premature labour; most would use corticosteroids in some circumstances to accelerate pulmonary surfactant production, while the use of prophylactic antibiotics seemed variable. The findings and implications of the survey are discussed.
THE POTENTIAL OF MID‐TRIMESTER MATERNAL PLASMA ALPHA‐FETOPROTEIN MEASUREMENT IN PREDICTING INFANTS OF LOW BIRTH WEIGHT
Authors: Brock D. J. H. , Barron Lilias , Raab Gillian M.
Published: August 2005

Maternal plasma alpha‐fetoprotein (AFP) was measured at mid‐trimester in 113 women who subsequently were delivered of a singleton liveborn infant weighing less than 2·5 kg and in 113 matched controls whose infants weighed more than 2·5 kg. Plasma AFP levels were significantly higher in the subjects than in the controls, while 10 of the subjects and only 3 of the controls had values above 2·0 times the median. The higher AFP concentrations were seen both in pregnancies in which the outcome was a small premature infant and in those in which it was a small‐for‐dates baby.
SURGICAL TREATMENT OF TUBERCULOSIS OF THE FEMALE GENITAL TRACT
Authors: Sutherland A.M.
Published: August 2005

A study has been made of 91 women with proved tuberculosis of the genital tract treated by surgery between 1st January, 1951 and 15th October, 1979. In 77 the operation was performed during anti‐tuberculosis drug therapy. In the remainder the diagnosis was made after operation and drug therapy was started as soon as possible thereafter. The indications for operation were pain (40 patients), pelvic masses (36 patients), recurrence of endometrial tuberculosis (10 patients), uterine bleeding (3 patients) and suspicion of endometrial neoplasia (2 patients). Total hysterectomy with removal of both tubes and ovaries was done in all patients except two, in whom pelvic clearance was not technically feasible. No patient developed a fistula and there were no deaths. All patients were well at follow‐up.
SERUM PROGESTERONE AND OESTRADIOL CONCENTRATIONS IN WOMEN WITH UNEXPLAINED INFERTILITY
Authors: Driessen F. , Kremer J. , Alsbach G. P. J. , de Kroon R. A.
Published: August 2005

Twenty‐eight patients with longstanding, unexplained infertility were studied during one menstrual cycle by serial serum progesterone and oestradiol assays. For comparison the serum concentrations of these hormones were also measured during one cycle in ten fertile control subjects. Of the patients with infertility, one had an anovulatory cycle and one had a cycle with a short luteal phase. In the other 26 patients the length of the cycle, the preovulatory peak oestradiol concentration and the maximum oestradiol concentration during the luteal phase were less than in the controls but these differences were not statistically significant (p>0·10). However, the duration of progesterone secretion and the maximum progesterone concentration during the luteal phase were significantly less (p <0·01) in the patients with infertility than in the controls. It is, however, uncertain whether the subnormal progesterone secretion is responsible for the infertility.
OESTRADIOL IN SALIVA DURING THE MENSTRUAL CYCLE
Authors: Evans J. J. , Stewart C. R. , Merrick A. Y.
Published: August 2005

Sixteen women provided saliva samples throughout a menstrual cycle and the concentration of oestradiol was measured. Blood samples were taken around mid‐cycle and the luteinizing hormone peak was used to diagnose the timing of ovulation. The levels of oestradiol in saliva followed the same pattern as in blood. The peak of oestradiol in saliva could be used to predict accurately the time of onset of the next menstrual period. The analysis of saliva could be useful in the investigation of women in whom serial venepunctures are not possible.
THE PROGNOSIS OF BREECH DELIVERED SINGLETON LOW BIRTH WEIGHT INFANTS
Authors: Kendall A. C. , Hommers Marion
Published: August 2005

An estimate of the probability of long term neurological sequelae in breech delivered low birth weight infants is an important factor in deciding on the method of delivery in breech presentation. From the hospital records we have identified those infants who during the years 1973 and 1974 were live born of low birth weight (under 2500 g) and who were delivered by the breech. Of 51 infants, 36 survived the neonatal period. Two have died, one of multiple congenital abnormalities and one of accidental injuries, two left the country during their second year of life at which time they were known to be developing normally. Two remained untraced. The remaining 30 are all living locally, they are all neurologically normal and are attending ordinary schools. In the absence of intensive methods of neonatal care the risk to the breech delivered low birth weight baby is of neonatal death rather than of long term neurological sequelae.
CHROMOSOMAL ANALYSIS OF COUPLES WITH REPEATED SPONTANEOUS ABORTIONS
Authors: Sant‐Cassia L. J. , Cooke Patricia
Published: August 2005

Chromosome banding studies were carried out on both partners of 182 consecutive couples with a history of two or more spontaneous abortions. Seventeen abnormal karyotypes were detected. This represents a frequency of 4.67 per cent, which is higher than hitherto reported. The pregnancy outcome in 105 couples with normal and abnormal karyotope was compared and no significant difference was found.
RED CELL ANTIBODIES DETECTED IN ANTENATAL TESTS ON RHESUS POSITIVE WOMEN IN SOUTH AND MID WALES, 1948–1978
Authors: Hardy Joan , Napier J. A. F.
Published: August 2005

A total of 733 rhesus positive women with antibodies were found during antenatal screening of 380 790 pregnancies in South and Mid Wales over a 30‐year‐period. A steady increase was observed in the frequency of antibodies, particularly non‐rhesus antibodies and the mothers concerned had a significantly increased history of previous blood transfusion. In 50 per cent of those with non‐rhesus antibodies, transfusion was the only stimulus. Conversely, for the majority (61 per cent) of women with rhesus antibodies feto‐maternal incompatibility was the sole apparent stimulus. No identifiable stimulus could be found in 25 per cent of women with anti‐E and 13 per cent of those with anti‐Kell. Compared to rhesus negative mothers with anti‐D severe clinical haemolytic disease of the newborn was uncommon, but in 75 per cent of rhesus positive mothers with infants carrying the homologous antigen, there was some evidence of haemolytic disease. Anti‐c̄ was much the worst in this respect with 19.4 per cent of infants needing transfusion. The probability of having an incompatible infant was much less for the mothers with non‐rhesus antibodies (27.3 per cent) and of these infants only 5.7 per cent needed transfusion.
SERUM GASTRIN I CONCENTRATIONS OF MOTHER AND NEWBORN IMMEDIATELY AFTER BIRTH
Authors: Dokumov St. , Tarkolev N. , Shterev At , Istatkov M.
Published: August 2005

Serum gastrin I concentrations were investigated by radioimmunoassay in 50 mothers and their newborn infants immediately after birth. The mean serum gastrin concentration in maternal blood was 52.80 ± 13.37 (SD) pg/ml, and in cord blood 84.12±42.90 (SD) pg/ml. Both values were significantly higher than serum gastrin levels found in normal, healthy, nonpregnant women (Mean±D = 32.34±18.35 pg/ml). There were no statistically significant differences in the cord serum gastrin concentrations with respect to sex, weight and length of the infant and age and parity of the mother.
HAEMATOLOGICAL VALUES IN CORD BLOOD IN RELATION TO FETAL HYPOXIA
Authors: D'Souza S. W. , Black Patricia , MacFarlane T. , Jennison R. F. , Richards B.
Published: August 2005

Haematological values in cord venous blood were studied in 458 newborn infants born at term. The severity of hypoxia in these babies was determined by measuring the pH in cord venous blood, and in cord arterial blood. Hypoxia was associated with increases in haemoglobin, in the red cell count, in the white cell count and in the haematocrit. Furthermore, the increase in the mean corpuscular volume, and decrease in mean corpuscular haemoglobin concentration could have been due to a net influx of less mature red cells into the circulation. It is suggested that fetal erythropoiesis is stimulated by intrapartum hypoxia.
IMMUNOPATHOLOGICAL AND CLINICAL STUDIES IN HERPES GESTATIONIS
Authors: Foidart J. M. , Yaar M. , Hall R. , Gaspard U. , Katz S. I.
Published: August 2005

Herpes gestationis is a recurring pruritic, vesiculobullous disease of pregnancy and puerperium. Recently, Lawley et al (1979) reported a high frequency (38 per cent) of fetal morbidity and mortality in 40 cases of immunologically proven herpes gestationis. This study was undertaken to determine whether the antibody to skin basement membrane (found in most patients with herpes gestationis) is able to bind to the placenta basement membranes and thereby to threaten the pregnancy. We were unable to detect this antibody in the placental basement membranes of a patient with herpes gestationis, nor could we demonstrate that the anti‐basement membrane antibody, found in the sera of herpes gestationis patients, binds to homologous or autologous placentas and fetal membranes. The importance of an accurate diagnosis and appropriate treatment of this condition is discussed.
CLOTTING AND FIBRINOLYTIC ACTIVITIES IN PERITONEAL FLUID
Authors: Pattinson H. A. , Koninckx P. R. , Brosens I. A. , Vermylen J.
Published: August 2005

Peritoneal fluid does not clot spontaneously on collection, due to a lack of prothrombin activation, consequent upon a virtual absence of factors V and VIII. Factor VIII related antigen is present in peritoneal fluid in only very small amounts, suggesting that this factor is excluded from the peritoneal cavity, probably by virtue of its size. Slight thrombin activity is demonstrated by the presence of fibrin monomers in the fluid. That peritoneal fluid also contains fibrinolytic activity is shown by high levels of plasminogen and plasmin‐antiplasmin complexes, though no plasminogen activator could be detected. No differences were found in clotting and fibrinolytic activities between fluid taken from these patients with, and those without, laparoscopic evidence of pelvic endometriosis.
RAISED MATERNAL SERUM AFP, OLIGOHYDRAMNIOS AND POOR FETAL OUTCOME
Authors: Stirrat G. M. , Gough J. D. , Bullock Stephanie , Wald N. J. , Cuckle H. S.
Published: August 2005

Six women who had an ultrasound scan examination in early pregnancy on account of a high serum alpha‐fetoprotein level were noted to have little or no amniotic fluid. This paper gives details of the six pregnancies, two of which were extrauterine; only one of the six infants survived.
FACTOR VIII COMPLEX IN NORMAL PREGNANCY, PRE‐ECLAMPSIA AND FETAL GROWTH RETARDATION
Authors: Fournie A. , Monrozies M. , Pontonnier G. , Boneu B. , Blerme R.
Published: August 2005

The levels of the three components of factor VIII complex (VIII R:AG, VIII R:WF, VIII :C) were measured during normal late pregnancy, in pre‐eclampsia and in pregnancies complicated by fetal growth retardation. In late normal pregnancy, there was a steady increase in factor VIII complex and the highest level was reached at delivery; in primary fetal growth retardation, the values were similar. In pregnancies complicated by pre‐eclampsia, with or without fetal growth retardation, there was a significant increase of VIII R: AG VIII R: WF; the more severe the course of the disease, the greater the increase. The level of VIII R: AG—VIII R: WF appears to be an indicator of vascular pathology and it is suggested that this assessment may be of value in monitoring high risk pregnancies.
ULTRASOUND DEMONSTRATION OF AN UNUSUAL FETAL GROWTH PATTERN IN INDIANS
Authors: Meire H. B. , Farrant Pat
Published: August 2005

An ultrasound study of fetal growth patterns in women of Indian origin showed that the mean abdominal circumference measurements throughout pregnancy were significantly smaller than measurements obtained in white European patients. The mean birth weight of the Indian, babies was 340 g less than that of the controls and Indian patients also exhibited a significantly shorter duration of gestation. There was no significant difference between the biparietal diameter measurements of European and Indian women throughout pregnancy.
THE PREDICTION OF FETAL GROWTH RETARDATION IN TWIN PREGNANCY
Authors: Houlton M. C. C. , Marivate M. , Philpott R. H.
Published: August 2005

A total of 132 twin pregnancies first seen at less than 36 weeks gestation were studied prospectively to determine the epidemiological, and anthropomorphic factors associated with single or dual fetal growth retardation; the clinical, biochemical and ultrasound serial measurements that are predictive of single or dual fetal growth retardation, and to design scoring systems for the prediction of fetal growth retardation. A number of factors were associated with an increased risk of fetal growth retardation, but the highest risk was present when there was an abnormality in both plasma oestriol and placental lactogen, and the biparietal diameter growth rates were divergent. Scoring systems were derived using multivariant discriminant analysis for three clinical situations: the patient seen for the first or second time; where only clinical facilities exist and the patient was seen on three or more occasions; and where facilities exist for the biochemical tests of placental function and ultrasonic measurement of the biparietal diameters. The scoring system for the last situation had the highest predictive rate and the lowest false positive rate.
PROSTAGLANDIN E AND F CONCENTRATIONS IN PLACENTAE OF NORMAL, HYPERTENSIVE AND PRE‐ECLAMPTIC PATIENTS
Authors: Hillier K. , Smith M. D.
Published: August 2005

The prostaglandins E and F were measured by radioimmunoassay in placentae from 23 normotensive, 25 hypertensive and 13 pre‐eclamptic patients. The prostaglandin E levels were respectively (pg/mg±SEM) 16.34±2.06, 16±75.2±52 and 12±10.3±63. The prostaglandin F levels were 2.43±0.41, 2.70±0–42 and 2.06±0.31. These prostaglandin concentrations did not differ significantly. Local ischaemia may, therefore, be explained by altered responsiveness to these prostaglandins or to changes in other prostaglandins (such as the vasodilator PGI2) or other vasoactive agents.
THE EFFECT OF PRE‐OPERATIVE POVIDONE IODINE VAGINAL PESSARIES ON VAULT INFECTIONSAFTER HYSTERECTOMY
Authors: Blackmore Meryl A. , Turner Gillian M. , Adams M. R. , Speller D. C. E.
Published: August 2005

The frequency of clinical infection of the vaginal vault after hysterectomy was compared in two groups of patients, a study group treated with povidone‐iodine vaginal pessaries for 36 hours pre‐operatively and prepared with povidone‐iodine preparations at the time of operation, and a control group given no preliminary treatment and prepared with chlorhexidine preparations at the time of operation. No significant difference was demonstrated between the two groups. Vault infection occurred in 32 per cent of the entire series of patients (severe infection 14 per cent) and infection correlated with the presence of pathogenic bacteria in the vagina. No significant differences in bacterial colonisation of the vagina between the two groups were demonstrated at any stage of the investigation. Preliminary preparation of the vagina with povidone‐iodine pessaries is not recommended.
REVERSAL OF FEMALE STERILIZATION
Authors: Pill C. F. , Noble A. D. , Letchworth A. T.
Published: August 2005

Reversal of sterilization was attempted in 22 women without the use of an operating microscope. Fifty per cent became pregnant. Success was influenced by the site and extent of the tubal damage resulting from the sterilization procedure, mechanical occlusive sterilization techniques offering the best change of a successful reversal.
VAGINAL BLEEDING DISTURBANCES ASSOCIATED bWITH THE DISCONTINUATION OF LONG‐ACTING INJECTABLE CONTRACEPTIVES
Authors: Gray R. H. , Parker R. A. , Dlethelm P.
Published: August 2005

A randomized comparative trial of 832 women receiving norethisterone oenanthate (NET‐OEN) and 846 women receiving depot medroxyprogesterone acetate (DMPA) injections at 12 week intervals was conducted in 10 centres. The pregnancy rate with NET‐OEN was significantly higher than with DMPA. The termination rate for amenorrhoea was substantially lower with NET‐OEN than DMPA, whereas the discontinuation rates for bleeding problems were similar with the two drugs. Analysis of bleeding patterns among continuing and discontinuing users suggests that women tolerated frequent bleeding episodes, but found prolonged bleeding or prolonged bleeding‐free intervals unacceptable. Bleeding for more than 30 days during an injection interval and complete amenorrhoea for a whole injection interval were jointly associated with 43.7 per cent of all terminations among NET‐OEN users and 64.5 per cent of all terminations among DMPA users. In future efforts to improve the acceptability of long‐acting injectable contraceptives, more attention should be given to the control of prolonged amenorrhoea and prolonged bleeding.
A CASE OF CLEAR CELL ADENOCARCINOMA OF THE VAGINA IN PREGNANCY
Authors: Davis J. A. , Wadehra V. , McIntosh A. S. , Monaghan J. M.
Published: August 2005

The case is described of a 20 year old pregnant woman with clear cell adenocarcinoma of the vagina who had been exposed to diethyl stilboestrol in utero. This is the second of three cases known to have occurred in Britain. The importance of radical treatment is discussed. Neither cervical nor vaginal intra‐epithelial neoplasia were seen histologically, although squamous metaplasia was widespread, and in some areas was immature and showed atypical features which could be misinterpreted as intra‐epithelial neoplasia. An area of atypical adenosis was noticed, a hitherto rarely observed feature.
HEPATOBLASTOMA AS A CAUSE OF INTRAUTERINE FETAL DEATH
Authors: Benjamin Elizabeth , Lendon M. , Marsden H. B.
Published: August 2005

A hepatoblastoma was found in a 36 week stillborn infant. The tumour compressed the inferior vena cava and was the cause of hydrops foetalis. There was also agenesis of the gall bladder. Amniotic fluid alpha‐fetoprotein levels at 15 weeks were normal and did not indicate the presence of the tumour.
METABOLIC AND CIRCULATORY EFFECTS OF ORAL SALBUTAMOL IN THE THIRD TRIMESTER OF PREGNANCY IN DIABETIC AND NON‐DIABETIC WOMEN
Authors: Wager J. , Fredholm B. B. , Lunell N.‐O. , Persson B.
Published: August 2005

Metabolic and cardiovascular effects of 4 mg oral salbutamol were studied in ten non‐diabetic, ten chemical diabetic and five juvenile diabetic women in late pregnancy. None of the women had been treated with beta‐sympathomimetic drugs earlier in their pregnancy. Heart rate and blood pressure were recorded and blood samples for measurement of plasma cyclic AMP, insulin, C‐peptide, glucose, lactate, glycerol, non‐esterified fatty acids (NEFA) and 3‐hydroxybutyrate (3‐HB) were collected every 30 minutes for 120 minutes after salbutamol. All women underwent the same procedure at random without salbutamol. There were significant cardiovascular effects of salbutamol in all the groups but no differences in these effects between the groups. Salbutamol caused significant increases of glycogenolysis and lipolysis in all the groups, significantly larger in the juvenile diabetic than the non‐diabetic and chemical diabetic women. This observation could be explained by the inability of the juvenile diabetics to secrete insulin, shown by their non‐measurable plasma C‐peptide levels. The metabolic responses following salbutamol in the chemical diabetics were intermediate between the non‐diabetic and juvenile diabetic groups. The results show that diabetes does not alter the sensitivity of beta‐receptors involved in cardiovascular regulation, while the metabolic responses to oral salbutamol are enhanced, especially in juvenile diabetics. We suggest that during treatment with beta‐sympathomimetic drugs, blood glucose should be monitored in all patients showing criteria of potential diabetes.
RELIABILITY OF ULTRASOUND AS COMPARED TO DIRECT FETAL ELECTROCARDIOGRAPHY FOR ANTEPARTUM CARDIOTOCOGRAPHY
Authors: Keirse M. J. N. C. , Trimbos J. B. , Mallens T. E. J. M. , van der Heemst M.
Published: August 2005

Eighty‐five pairs of simultaneously recorded external and internal cardiotocograms (CTGs) were coded and evaluated with a ten‐point scoring system routinely used for the assessment of antepartum CTG. The highest consistency in interpretation between the external ultrasound and the internal fetal scalp CTG was found for basal heart rate followed by decelerations. Oscillatory amplitude and frequency were interpreted differently in 14 per cent of CTGs and accelerations in 16 per cent. When differences in interpretation arose, there was certainly no tendency for the external CTG to present an optimistic image of the fetal heart rate variables. With the exception of oscillatory amplitude all variables, including oscillatory frequency and the total CTG score, were more frequently underestimated than overestimated on external CTGs. When accelerations were present on only one recording, there was an 85 per cent chance for these to be absent on the external CTG. The study abolishes fears that the routine clinical assessment of antepartum CTGs of adequate technical quality provides overrated and more optimistic data than would be achieved by direct fetal scalp monitoring.
COLPOSCOPY IN PREGNANCY A TWELVE YEAR REVIEW
Authors: Mcdonnell J. M. , Mylotte M. J. , Gustafson R. C. , Jordan J. A.
Published: August 2005

In a 12‐year period, 195 patients with abnormal cervical cytology in pregnancy had colposcopy, of whom 73 had Grade IV cytology. Colposcopic findings in pregnancy correlated closely with the postpartum colposcopic assessment and this in turn predicted the ultimate histological diagnosis. Wedge biopsies were taken in two women in whom invasive disease could not be excluded colposcopically. Cone biopsy was avoided in all patients. No frank or occult invasive disease was missed but one patient was ultimately found to have a small focus of microinvasive disease six months post partum. Postpartum cytology gave a reasonable guide to the ultimate histology, although postpartum colposcopy was found to be of value even where cytology had by then reverted to normal.
HORMONAL PROFILES IN POSTMENOPAUSAL WOMEN AFTER THERAPY WITH SUBCUTANEOUS IMPLANTS
Authors: Thom Margaret H. , Collins W. P. , Studd J. W. W.
Published: August 2005

Plasma hormones were estimated in 24 postmenopausal patients who had been castrated. Each was given a sub‐cutaneous implant of either 100 mg or 50 mg of oestradiol, or 50 mg of oestradiol with 100 mg of testosterone, or 200 mg of testosterone. Plasma hormone estimations were repeated at two weeks, one month and then monthly for up to 12 months. Plasma follicle stimulating hormone (FSH) and luteinizing hormone (LH) concentrations were seen to fall at two weeks after all implants containing oestradiol. Plasma testosterone concentrations rose from a mean concentration of 1.0 nmol/1 to 5.0 nmol/1 and 6.7 nmol/1 after implants of 100 mg and 200 mg of testosterone respectively. Implants containing oestradiol caused the pretreatment ratio of the concentrations of oestrone to oestradiol to change from 2:1 to 1:2. The implant of 100 mg of oestradiol caused the plasma oestradiol concentration to rise to a mean value of 602.3 pmol/1 and those of oestrone to rise to 356.7 pmol/1. The more commonly used implants contain 50 mg of oestradiol and these caused the mean concentration of plasma oestradiol to rise to 346.7 pmol/1 and oestrone to rise to 233.9 pmol/1. These values compare favourably with those attained after oral oestrogen therapy.
ABDOMINAL ACTINOMYCOSIS COMPLICATION OF LAPAROSCOPY?
Authors: House M. J.
Published: August 2005

A 26 year old woman who had had an intrauterine contraceptive device had an abdominal mass due to actinomycosis excised three months after routine laparoscopy. The aetiology and possible association with laparoscopy is discussed.
NON‐POSTURAL SERIAL CHANGES IN RENAL FUNCTION DURING THE THIRD TRIMESTER OF NORMAL HUMAN PREGNANCY
Authors: Ezimokhai M. , Davison J. M. , Philips P. R. , Dunlop W.
Published: August 2005

Seventeen healthy women were investigated near the beginning and again near the end of the third trimester of their normal pregnancies. Infusion studies were performed in the left lateral position. There was a highly significant decrease in effective renal plasma flow but not in glomerular filtration rate, measured as inulin clearance. Plasma creatinine concentration increased significantly, but the renal handling of creatinine was unchanged; simultaneous 24‐hour creatinine clearance showed a tendency to decrease. Serum urate concentration also increased significantly, apparently due to an increase in net tubular reabsorption of urate.
THE EFFECT OF INTRAVENOUS THERAPY DURING LABOUR ON MATERNAL AND CORD SERUM SODIUM LEVELS
Authors: Spencer S. A. , Mann N. P. , Smith M. L. , Woolfson A. M. J. , Benson S.
Published: August 2005

A total of 113 women in labour were studied prospectively to determine the relation between maternal and cord serum sodium levels and the effect of intravenous infusions of glucose solutions and oxytocin during labour on the mother and infant. Maternal and cord sodium levels were correlated, with no systematic difference between the two, which is consistent with passive diffusion of sodium across the placenta. Glucose infusions and oxytocin caused statistically significant depression of maternal and cord serum sodium levels, but with the quantities used this did not adversely affect the mothers or infants. It is recommended that caution should be exercised in prescribing intravenous therapy during labour and, if more than 500 ml of fluid is required, sodium should be included.
PLACENTAL PROTEIN 5 (PP5) IN PLACENTAL ABRUPTION
Authors: Salem H. T. , Westergaard J. G. , Hindersson P. , Seppälä M. , Chard T.
Published: August 2005

The circulating levels of serum placental protein 5 (PP5) were measured in serial samples from 10 subjects who later had placental abruption. PP5 levels were elevated in five immediately prior to the clinical diagnosis of abruption.
ACUTE‐PHASE C56‐FORMING ABILITY AND CONCENTRATIONS OF COMPLEMENT COMPONENTS IN NORMOTENSIVE AND HYPERTENSIVE PREGNANCIES
Authors: Johansen K. A. , Williams J. H. , Stark J. M.
Published: August 2005

A prospective study of 61 women who were normotensive at booking revealed an increased incidence of C56‐forming ability in those who later developed hypertension. Similar changes were found before delivery in a separate group of women admitted with latent hypertension and in each of 11 women with severe pre‐eclampsia and a surviving fetus. The C56‐forming ability, an acute phase feature, often preceded the hypertension and the findings suggest an indirect relation between complement changes and the mechanism causing hypertension in pregnancy. Concentrations of complement components in hypertension and normotensive pregnancies were also compared with each other and with those of normal healthy non‐pregnant women. The hypertension patients had increased total alternative pathway function and higher factor B concentrations. The C56‐negative sera from hypertension patients tended to have C7 concentrations higher than normal whereas C56‐positive patients had higher C5 concentrations. The aetiological and pathological implications are discussed.
PERSISTENCE OF SYMPTOMS OF PREMENSTRUAL TENSION IN HYSTERECTOMIZED WOMEN
Authors: Bäckströum C. T. , Boyle H. , Baird D. T.
Published: August 2005

Daily symptom ratings were recorded in seven women with premenstrual tension syndrome for one month before and for up to two months after hysterectomy. Ovarian activity was monitored after operation by twice weekly measurements of total oestrogen and pregnanediol in 12‐hour urine samples. Cyclical changes in mood persisted following hysterectomy with the greatest mental and physical symptoms occurring during the late luteal phase of the cycle. In contrast there was a marked decrease in activity and vigour ratings during the late luteal phase of the cycle and during menstruation. There was a small but significant improvement in symptoms in most women following hysterectomy. These results demonstrate that neither the presence of the uterus nor the occurrence of menstruation are necessary for the manifestation of the premenstrual tension syndrome and support the view that it has a hormonal basis.
THE CERVICAL FACTOR IN PATIENTS WITH OVULATORY INFERTILITY
Authors: Zegers Fernando , Lenton Elizabeth A. , Sulaiman Rafida , Cooke Ian D.
Published: August 2005

Thirty patients with ovulatory infertility had two consecutive postcoital tests. Couples with inconclusive or abnormal results had in vitro sperm penetration tests, using donor mucus and donor sperm. The quality of the cervical mucus, the concentration of plasma oestradiol and luteinising hormone and the result of the post‐coital test were assessed each day. After two consecutive cycles, the postcoital test was normal in 84 per cent, inconclusive in 12 per cent and abnormal in 4 per cent of the women. The in vitro cross reaction test showed that two couples had definite abnormality in the sperm‐cervical mucus interaction and one couple were having inadequate coitus. Normal post coital tests should not be expected with an Insler cervical mucus score of less than 8. Normal postcoital tests were found between days −2 and +1 with respect to the luteinising hormone peak. There is a direct relation between the plasma oestradiol concentration and the individual cervical score but the predictability of plasma oestradiol values for a given cervical score is very poor. The plasma oestradiol concentration was significantly different between groups having cervical scores <7 and 8–10 or 11–12 (p <0.01).
PROGNOSTIC SIGNIFICANCE OF NEGATIVE HYSTERECTOMY SPECIMEN FOLLOWING INTRACAVITARY IRRADIATION IN STAGE I ENDOMETRIAL CARCINOMA
Authors: Cheung A. Y. C.
Published: August 2005

Clinical stage I endometrial carcinoma in 353 women was treated by pre‐operative intracavitary irradiation with radium and total abdominal hysterectomy with bilateral salpingo‐oophorectomy. No residual tumour was found in 36 per cent of uterine specimens obtained from hysterectomies performed within two weeks compared to 59 per cent of those removed later than eight weeks after the intracavitary irradiation. A negative hysterectomy specimen was a favourable prognostic index. Patients with no residual tumour in the hysterectomy specimens had a significantly lower five‐years relapse rate (3.8 per cent) than those with residual tumour (19.2 per cent).
SCLEROSING STROMAL TUMOUR OF THE OVARY CASE REPORT WITH ENDOCRINE STUDIES
Authors: Quinn M. A. , Oster A. O. , Fortune D. , Hudson B.
Published: August 2005

The findings in a patient who was found to have a sclerosing stromal tumour of the ovary associated with a tubal pregnancy are described. Measurement of hormones in blood before and after removal of the tumour suggested the tumour was andro‐gen‐secreting.
MEDICAL RESEARCH COUNCIL STUDY ON CHEMOTHERAPY IN ADVANCED OVARIAN CANCER
Authors:   Medical Research Council's Working Party on Ovarian Cancer
Published: August 2005

A total of 264 eligible patients with advanced ovarian cancer were randomised to single or triple agent cytotoxic therapy; 261 were available for analysis. The treatments were continuous oral cyclophosphamide (arm S), and a combination of oral cyclophosphamide, hexamethylmelamine and methotrexate on a pulsed basis (arm T). Mortality attributed to cancer was slightly lower on arm T (p = 0.06), but this was offset by the greater toxicity of this regimen, and overall survival and activity index were similar on the two arms. There was thus little evidence of greater clinical benefit on the triple agent regimen. Tumour mass removed at operation, extent of remaining tumour and age all showed significant correlation with prognosis. Survival was longer in patients whose disease responded to either therapeutic regimen.
THE RELATION BETWEEN THE RELEASE OF PROSTAGLANDINS AT AMNIOTOMY AND THE SUBSEQUENT ONSET OF LABOUR
Authors: Sellers Susan M. , Mitchell M. D. , Anderson Anne B. M. , Turnbull A. C.
Published: August 2005

Maternal peripheral plasma levels of 13,14‐dihydro‐15‐keto‐prostaglandin F (PGFM) were measured in 16 women following amniotomy performed for the induction of labour at term. After 5½ hours, seven patients were in established labour (Group I) but the remaining nine patients required an intravenous infusion of oxytocin (Group II). An initial rapid rise in PGFM concentrations within five minutes of amniotomy occurred in all women and, therefore, the onset of labour does not appear to be a direct consequence of this initial increase. In Group I there was a significant increase in PGFM concentrations between five and 30 minutes after amniotomy and from 30 minutes to the time at which the last sample was collected; these later rises were associated with the onset and progress of labour in these women. These increases in PGFM concentrations did not occur in patients in Group II. The reason for this difference in response to amniotomy is as yet unclear.
PROSTACYCLIN‐LIKE AND KALLIKREIN ACTIVITY OF AMNIOTIC FLUID IN PRE‐ECLAMPSIA
Authors: Bodzenta A. , Thomson J. M. , Poller L. , Burslem R. W. , Wilcox F. L.
Published: August 2005

Amniotic fluid from patients with pre‐eclampsia was compared with samples obtained from normotensive controls with respect to the inhibiting effect on platelet aggregation (PGI2‐like activity) and activating effect on the plasma kallikrein assay and Russell's viper venom test. After 39 weeks gestation, amniotic fluid from pre‐eclamptic patients showed significantly less PGI2‐like activity (p <0.01) and significantly lower kallikrein levels (p <0.01) than that from normotensive controls. The study suggests that the biosynthesis and release of PGI2‐like activity and kallikrein may be impaired in pre‐eclampsia. In view of the association of pre‐eclampsia with intravascular clotting, the highly significant reduction of PGI2‐like activity seems important and appears to warrant a clinical trial of prostacyclin administration in this disorder.
THE INTRAVENTRICULAR CONDUCTION TIME OF FETAL HEART IN PREGNANCIES COMPLICATED BY RHESUS HAEMOLYTIC DISEASE
Authors: Brambati Bruno , Pardi Giorgio
Published: August 2005

The duration and shape of the fetal QRS complex were studied in 88 pregnancies complicated by rhesus isoimmunization. A clear correlation between ventricular depolarization time and haemoglobin levels at birth was observed. A single QRS value greater than 4 SD above the normal mean value, or a tendency to rapid increase was very suggestive of a bad prognosis, while a QRS duration below ±4 SD or declining in sequential determinations reflects a temporary compensation of fetal conditions. From the QRS complex analysis a clear indication appeared of the constant and early involvement of the heart in terms of myocardial hypertrophy and/or cardiac enlargement. The sensitivity of QRS to anaemia and the feasability of continuous non‐invasive monitoring might allow, with the determination of bilirubin concentration in amniotic fluid, improvement in the management of rhesus haemolytic disease.
PUERPERAL HAEMATOLOGICAL INDICES
Authors: Taylor D. J. , Phillips P. , Lind T.
Published: August 2005

Haematological indices were studied serially in 33 healthy women, at one week before delivery, during the first six days of the puerperium, at six weeks and six months post partum. Red cell count, haemoglobin concentration and haematocrit decreased during the first four days of the puerperium; haemoglobin concentrations up to 3·5 g/dl less than pre‐delivery values were recorded in the absence of clinical postpartum haemorrhage. The second puerperal day haemoglobin concentration correlates most closely with the six week postpartum value. A leucocytosis of greater than 20 × 109/1 was found on the first puerperal day in 15 per cent of the women studied.
PROLACTIN CONCENTRATION IN VAGINAL FLUID: A NEW METHOD FOR DIAGNOSING RUPTURED MEMBRANES
Authors: Koninckx P. R. , Trappeniers H. , Van Assche F. A.
Published: August 2005

Prolactin concentrations were assayed in vaginal fluid, urine and plasma in 20 women between 38 and 41 weeks gestation. Plasma concentrations of 12·3 (7·3–20·8) mU/ml (n = 40) were found whereas urine concentrations were low or undetectable. Vaginal fluid concentrations were generally lower than 0·25 mU/ml but occasionally elevated up to 3 mU/ml in women with unruptured membranes. Half an hour after artificial rupture of the membranes, vaginal fluid prolactin concentrations were always higher than paired maternal plasma concentrations (p < 0·001). In women suspected of premature rupture of the membranes, prolactin concentrations in vaginal fluid were always higher than the plasma concentrations except in those in whom the clinical outcome showed that the membranes had not ruptured. A rapid prolactin radioimmunoassay is therefore recommended as a new clinical tool for the diagnosis or exclusion of prematurely ruptured membranes.
ELEVATION OF MATERNAL SERUM MYOGLOBIN CONCENTRATIONS DURING DELIVERY
Authors: Kosowicz J. , Gryczyńska M. , Drews K.
Published: August 2005

Serum myoglobin was determined by radioimmunoassay in 32 women immediately after delivery, in the umbilical cord blood of 30 newborn infants, in 18 women in the third trimester of pregnancy and in 24 healthy non‐pregnant women. In maternal blood following delivery there was a 3 to 10 fold rise in serum myoglobin concentration (mean ± SD = 117·2 ± 82·5 ng/ml). On the other hand, in umbilical cord blood and in late pregnancy, serum myoglobin concentrations did not differ from those in healthy non‐pregnant women (mean ± SD = 23·6±12·6 ng/ml).
PROLACTIN, FLUID BALANCE AND LACTATION
Authors: Dearlove J. C. , Dearlove B. M.
Published: August 2005

The hypothesis that prolactin may play a part in osmoregulation was investigated by giving a hypotonic fluid load to two groups of normal lactating women. No changes in serum prolactin, milk yield, serum or breast milk osmolality were noted, suggesting that encouraging women to drink excessively has no effect upon lacta‐tion, either in terms of yield or composition of milk.
THE TITANIUM/SILICONE RUBBER CLIP FOR FEMALE STERILIZATION
Authors: Filshie G. M. , Casey D. , Pogmore J. R. , Dutton A. G. B. , Symonds E. M. , Peake A. B. L.
Published: August 2005

A composite titanium/silicone rubber clip has been developed for female sterilization. The 12–7 mm long metal clip is lined with silicone rubber and is bent round the Fallopian tube by means of an applicator that can be used laparoscopically. As tubal necrosis occurs, the rubber expands to keep the lumen blocked. The tube eventually divides and the stumps heal, closed. Since the Mark 3 version of the clip was introduced, over 5700 women in several countries have been sterilized. The first 540 British women who were folio wed‐up for five to 17 months experienced one method failure (ectopic) and two operator failures, a total failure rate of 5·5/ 1000. Clip‐related complications were minimal and long‐term sequelae were comparable to tubal ligation. The clip causes minimal destruction but still seems effective for tubal occlusion and it can accommodate thick tubes.
GALACTORRHEA ASSOCIATED WITH LYMPHOCYTIC ADENOHYPOPHYSITIS CASE REPORT
Authors: Cebelin Marilyn S. , Velasco Manuel E. , De Las Mulas Juana Martin , Druet Robert L.
Published: August 2005

A young woman, 14 months post partum, committed suicide when she noticed milk discharging from her nipples and thought she was pregnant. At autopsy the uterus was found to be non‐gravid and the pituitary gland enlarged. Histological examination revealed lymphocytic adenohypophysitis, a rarely identified condition usually associated with hypopituitarism. Immunoperoxidase studies of the pituitary demonstrated prolactin cell hyperplasia. None of the other known causes of galactorrhea was present suggesting that this may be a new addition to the differential diagnosis of galactorrhea. To this date lymphocytic adenohypophysitis has been reported only in women, the majority within 14 months postpartum, and is usually identified only at autopsy.
Enterobius vermicularis INFESTATION OF THE FEMALE GENITAL TRACT CAUSING GENERALISED PERITONITIS CASE REPORT
Authors: Khan J. S. , Steele R. J. C. , Stewart D.
Published: August 2005

Enterobius (Oxyuris) vermicularis is the only nematode which infests man. It inhabits the large intestine and is of low pathogenicity. The ova are occasionally found in ectopic sites within the peritoneal cavity, usually as an asymptomatic granuloma. We describe the first patient to present with generalised peritonitis caused by rupture of a tubo‐ovarian abscess containing the ova of Enterobius vermicularis.
INVOLVEMENT OF THE CENTRAL NERVOUS SYSTEM IN PATIENTS WITH OVARIAN CARCINOMA
Authors: Barker G. H. , Orledge J. , Wiltshaw E.
Published: August 2005

In a survey of 430 patients with ovarian cancer, 4 developed brain deposits; 2 had received cis platin therapy.
AN ULTRASTRUCTURAL STUDY OF UTERO‐PLACENTAL SPIRAL ARTERIES IN HYPERTENSIVE AND NORMOTENSIVE PREGNANCY AND FETAL GROWTH RETARDATION
Authors: Sheppard B. L. , Bonnar J.
Published: August 2005

Uteroplacental spiral arteries in placental bed biopsies and placentas from 80 pregnancies were studied by light and electron microscopy; of these 30 were complicated by fetal growth retardation (less than 10th centile) and 45 by hypertension during pregnancy. The physiological changes of the spiral arteries and the vascular pathology present in hypertensive pregnancy and fetal growth retardation were investigated. In normotensive pregnancies complicated by fetal growth retardation, the physiological changes of pregnancy frequently did not extend beyond the decidual segments of the utero‐placental arteries. In pregnancies complicated by pre‐eclampsia, the physiological changes of pregnancy were not always restricted to the decidual segments of the utero‐placental arteries. Athero‐matous‐like lesions of similar morphology were found in spiral arteries from both normotensive and hypertensive pregnancies complicated by fetal growth retardation. No arteriopathy was found which was specific for pre‐eclampsia.
METEOROLOGICAL RELATIONS OF ECLAMPSIA IN LAGOS, NIGERIA
Authors: Agobe J. T. , Good W. , Hancock K. W.
Published: August 2005

A retrospective study of the meteorological relations of eclampsia in Lagos, Nigeria supports other observations that the incidence of this disease varies significantly with the weather. Protective action by arid conditions is consistent with the known effect of dehydration on convulsions of differing aetiologies and is attributable to increased pulmonary transpirational water loss. Exacerbation of eclampsia by cool, humid conditions may therefore reflect excessive water retention, due partly to suppressed pulmonary transpiration and partly to kidney malfunction in those women.
EFFECT OF TERBUTALINE ON THE HUMAN FETAL PLACENTAL CIRCULATION
Authors: Scares de Moura R.
Published: August 2005

The effect of terbutaline, a β2‐adrenoceptor stimulator, on the vascular resistance of isolated human placenta was examined. Terbutaline produced no change in basal placental vascular resistance, but when the placental vessels were constricted with angiotensin, terbutaline produced a graded decrease in vascular resistance. The vasodilating effect of a high dose of terbutaline was smaller than the effect of 20 μg of isoprenaline and the effect was significantly blocked by propranolol, a β‐adreno‐ceptor antagonist. The results suggest that the vasodilating effect of terbutaline on the fetal placental circulation can play a role in the improvement of fetal condition during treatment of premature labour and intrapartum fetal distress.
FETAL DEATH IMMEDIATELY FOLLOWING NORMAL ANTENATAL FETAL HEART RATE PATTERN CASE REPORT
Authors: Shaxted E. J. , Jenkins H. M. L.
Published: August 2005

A fetal death occurred during antenatal non‐stressed cardiotocography in a woman with gestational diabetes. The death occurred immediately following 30 minutes of normal fetal heart rate tracing with an active baby and with normal bio‐chemical tests of placental function.
COITUS AND ANTEPARTUM HAEMORRHAGE
Authors: Naeye Richard L.
Published: August 2005

The relationship of coitus to antepartum haemorrhage was explored in a longitudinal study of 56 568 pregnancies. The frequency of the haemorrhages was 19/1000 births when women reported no recent coitus compared with 30/1000 when there had been recent coitus (p <0·001). The frequency of the bleeding increased with the frequency of coitus. The correlation between coitus and bleeding was independent of other factors known to increase the risk of antepartum bleeding including cigarette smoking, hypertension, advancing maternal age and placenta praevia.
GENITAL AND PELVIC ACTINOMYCOSIS
Authors: Drew N. C.
Published: August 2005

A case of unilateral tubovarian actinomycotic abscess associated with a Lippes Loop intrauterine contraceptive is presented.