bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of anticoagulants on the measurement of pregnancy‐associated plasma protein‐A (PAPP‐A)
Authors: TOOP K. M. , KLOPPER A.
Published: August 2005

Summary. The level of pregnancy‐associated plasma protein‐A (PAPP‐A) in blood measured by rocket immunoelectrophoresis is affected by the addition of anticoagulants. When compared with levels in serum, those in heparin and sequestrene plasmas were higher, while those in sodium citrate, acid citrate dextrose and fluoride oxalate plasmas were lower. Similar results were obtained when the anticoagulants were added to serum and the effect on the measured level was dose‐dependent within limits. Addition of anticoagulants to serum affected the mobility of PAPP‐A in crossed immunoelectrophoresis, but this was not necessarily in keeping with the effect on rocket height. Addition of sodium chloride to serum did not influence the measured levels of PAPP‐A.
Prenatal diagnosis of fetal brain ventricle dilatation
Authors: JÖRGENSEN CONNIE , INGEMARSSON INGEMAR , SVENNINGSEN NILS W.
Published: August 2005

Summary. In a 13 month prospective screening programme 3120 pregnant women were examined with diagnostic ultrasound at 17 and 32 weeks gestation; five fetuses (0–16%) were found with dilatation of brain ventricles. Early diagnosis was made in one patient resulting in legal termination of the pregnancy. The four other patients were diagnosed at the second ultrasound examination.
Cervical and serum IgA and serum IgG antibodies to Chlamydia trachomatis and herpes simplex virus in threatened abortion: a prospective study
Authors: GRÖNROOS M. , HONKONEN E. , TERHO P. , PUNNONEN R.
Published: August 2005

Summary. The aetiological role of Chlamydia trachomatis (CT) and herpes simplex virus (HSV) was investigated in 189 patients with threatened abortion. Assessment of infection was based on isolation, and on determination of serum immunoglobulin (Ig)G and IgA antibodies as well as cervical IgA antibody levels with new sensitive radioimmunoassay (RIA) techniques. One third of the women were delivered of a healthy infant and two thirds aborted, but the two groups were otherwise clinically similar. By isolation, only 2.7% of the patients were CT‐positive, but increased cervical IgA antibody level to CT was detected in 41.3%. The mean level of these local antibodies was similar in both study groups, but the mean levels of serum IgA and IgG antibodies were somewhat higher in the patients who aborted although the difference was not significant. None of the cervical specimens was positive for HSV by isolation but the cervical IgA antibody level to HSV was raised in 47.1% of the patients. Both cervical and serum IgA antibody levels to HSV were significantly raised among the patients who aborted, but there were no differences between the patients with spontaneous abortion and those with a blighted ovum. There was no clear association between CT and abortion, but an association between HSV and abortion is possible. The incidence of raised levels of both CT and HSV IgA antibodies in the cervix was surprisingly high in both groups and the significance of this finding remains to be investigated.
Lipids and lipoproteins in women after oophorectomy and the response to oestrogen therapy
Authors: NOTELOVITZ MORRIS , GUDAT JOHN C. , WARE MARSHA D. , DOUGHERTY MOLLY C.
Published: August 2005

Summary. The short‐term effects of different types and doses of oestrogen on serum lipids and lipoproteins were studied in 35 oophorectomized women. After 3 months treatment, serum cholesterol levels were unaffected by 1 and 2mg of micronized l7bT‐oestradiol or 0.625 and l.25mg of conjugated equine oestrogens. Triglyceride levels were significantly elevated after treatment with l.25mg of conjugated oestrogens. A trend towards a higher relative proportion of high‐density lipoproteins and a lower relative proportion of low‐density lipoproteins was observed for all four oestrogen regimens, however, statistical significance was not achieved. The proportion of very‐low‐density lipoprotein was unaffected by oestrogen treatment. The age of the oophorectomized women was found to have no effect on either the direction or magnitude of the lipid or lipoprotein responses to oestrogen. Using FSH depression as an index, 1 .25 mg of conjugated oestrogens was found to be the most potent of the four oestrogen regimens tested. Therefore, with respect to lipid balance, little additional clinical benefit is achieved by using a more potent regimen and the risk of adverse side effects may be increased.
High birthweight in an ethnic group of low socioeconomic status
Authors: YUDKIN P. L. , HARLAP S. , BARAS M.
Published: August 2005

Summary. Analysis of 14 219 births in West Jerusalem showed that infants of North African origin had a higher birthweight than infants of other ethnic groups. The group of mothers of North African origin included a relatively high proportion from the lowest social classes. The observed excess birthweight was apparent after allowing for the effects of gestation, maternal body size, baby's sex, parity and smoking. Maternal age and season of birth also had a significant effect on birthweight. Birthweight was higher if the mother had immigrated to Israel after the age of 10 years than if she had immigrated at a younger age, or had been born in Israel.
Schwangerschaftsprotein 1 (SP1) in serum and cerebrospinal fluid of patients with gestational trophoblastic disease
Authors: HO P. C. , MA H. K.
Published: August 2005

Summary. The β subunit of human chorionic gonadotrophin (β‐hCG) and Schwangerschaftsprotein 1 (SP1) were measured by radioimmunoassay in the serum and cerebrospinal fluid (CSF) of 46 postmolar and postpartum patients who developed gestational trophoblastic disease. There was a significant correlation between β‐hCG and SP1 serum levels. The mean serum SP1 level in high‐risk patients was significantly higher than that in low‐risk patients. There was a significant correlation between serum and CSF β‐hCG levels. The ratio of serum to CSF β‐hCG levels was low in the three patients with clinical evidence of intracranial metastasis. SP1 was present in the CSF of only one of these three patients, but it could be detected in the CSF of another four patients without clinical evidence of metastases in the central nervous system. The two low‐risk patients with SP1 present in the CSF showed poor response to intramuscular methotrexate.
Involvement of prostaglandins in vasopressin stimulation of the human uterus
Authors: STRÖMBERG P. , ÅKERLUND M. , FORSLING M. L. , KINDAHL H.
Published: August 2005

The involvement of prostaglandins (PG) in the vasopressin (VP) action on the human uterus was investigated in healthy women during three menstruations. Intrauterine pressure was recorded and total pressure area measured. Repeated plasma samples were taken for estimations of arginine(A)‐ and lysine(L)‐VP, 15‐keto‐13,14‐dihydro‐PGF2α and 11‐ ketotetranor PGF metabolites. During the first menstruation LVP was infused in a dose of 0.08 μg/min. During the second menstruation the infusion of LVP was repeated with the same dose, but 70 min before infusion the women received an oral dose of 500 mg of naproxen. During the third menstruation PGF2α was administered intravenously in a dose of 25 μg/min. LVP infusion per se caused a significant increase in uterine activity and plasma levels of LVP and PG metabolites. When the women were pretreated with naproxen practically the same uterine activity was induced and closely similar plasma levels of LVP were obtained, but the levels of PG metabolites decreased significantly in comparison with the first series of experiments. Infusion of PGF2α caused an increase in uterine activity but no change in the plasma levels of AVP. The results indicate that uterine stimulation with VP is possible without an obligatory last step of PG synthesis and release. The results also support the concept that an elevated VP level in primary dysmenorrhoea may be of aetiological importance and is not just released as a 'stress'‐hormone because of the dysmenorrhoeic pain.
Transfer before delivery on Mersey side: an analysis of the first 140 patients
Authors: LOBB M. O. , MORGAN M. E. I. , BOND A. P. , COOKE R. W. I.
Published: August 2005

Summary. Pregnant women (140) were transferred to the Regional Unit between May 1979 and December 1981 for delivery of preterm infants considered to be at risk. The 144 live infants and seven stillbirths that were delivered had a mean birthweight of 1.37 kg and a mean gestation of 29 weeks; there were nine abortions. In 1980 the uncorrected neonatal survival for very low birthweight infants was significantly better for those transferred before delivery (81%) than for infants born in the Region and not transferred (52%). The survival of very low birthweight infants transferred after delivery was 53%.
Fetal urinary tract obstruction: is active intervention before delivery indicated?
Authors: McFADYEN I. R. , WIGGLESWORTH J. S. , DILLON M. J.
Published: August 2005

Summary. Obstruction of the urinary tract was diagnosed by ultrasound in four fetuses at 16—30 weeks: three of these diagnoses were confirmed after delivery; the fourth fetus had multicystic kidneys with hydroureter and hydronephrosis but no obstruction. The fetus with obstruction diagnosed at 16 weeks was terminated: it had lung hypoplasia with the prune‐belly syndrome. The other two fetuses with obstruction were diagnosed at 25 and 34 weeks; the urinary tracts of both were drained for 5–14 days with reduction of distension. Both were born alive but that diagnosed at 25 weeks died of lung hypoplasia, the other survived, required nephrectomy and at the age of 3 is small but developing normally. Fetal urinary tract obstruction may prevent normal development of the lungs, be associated with other anomalies which cannot be diagnosed before delivery and retard infant development in survivors. Drainage of the dilated urinary tract does not harm the fetus or mother but has not been shown to improve neonatal survival or infant development.
Feedback mechanism in sulpiride‐induced hyperprolactinaemia
Authors: NAKANO R. , YAGI S.
Published: August 2005

Summary. Feedback of oestrogen on gonadotrophin release was studied in five normally cycling normoprolactinaemic women who were rendered moderately hyperprolactinaemic by oral administration of sulpiride (150mg daily) for 11 consecutive days. Five patients with peptic ulcer, who had been given 150 mg of sulpiride for 3–18 months and had chronic marked hyperprolactinaemia were also studied. Ethinyl oestradiol (200μg) was administered by mouth daily for 4 consecutive days and serum concentration of prolactin, luteinizing hormone (LH), follicle‐ stimulating hormone (FSH) and oestradiol were measured by a doubleantibody radioimmunoassay for 11 days. Oral administration of ethinyl oestradiol caused an initial decrease followed by a rebound of LH with a peak in all the women tested. The serum FSH levels showed only the initial decrease, followed by a slight rebound. Serum oestradiol levels decreased during oral administration of ethinyl oestradiol in all the women. The results of the present investigation suggest that oestrogen feedback effect on LH release is maintained in sulpiride‐induced hyperprolactinaemic women as well as in women with normal cycles.
Hormonal treatments of sexual unresponsiveness in postmenopausal women: a comparative study
Authors: DOW M. G. T. , HART D. M. , FORREST C. A.
Published: August 2005

Summary. Forty postmenopausal women, referred for hormone replacement therapy and all of whom reported a significant concern about a decline in their sexual interest, were randomly allocated to one of two hormone implant treatment groups: either oestradiol (50 mg) alone, or oestradiol (50 mg) and testosterone (l00mg). Comparison between the two groups as a whole revealed no significant differences on any measure, both treatments being associated with a significant reduction in the severity of psychological, somatic and vasomotor symptoms, and with a significant improvement in sexual interest and responsiveness. Similar effects were also observed in patients who denied, pretreatment, any concurrent dyspareunia. Although it is not possible to identify the reasons for change, the results indicate no advantages of supplementary testosterone administration over oestradiol alone for sexually unresponsive postmenopausal women.
Epidemiological determinants of vesicovaginal fistulas
Authors: TAHZIB FARHANG
Published: August 2005

Summary. Between 1969 and 1980 1443 patients with vesicovaginal fistulas were operated on in Ahmadu Bello University Hospital in Northern Nigeria. They have been studied in relation to their obstetric, social and environmental background. The preventable nature of the lesion was explored particularly with respect to age, parity and obstructed labour, and to traditional practices including‘gishiri cutting', which alone accounts for 13% of all the fistulas. Vesicovaginal fistulas are still a major cause for concern in many developing countries; measures for prevention include universal education and improved status of women in society as well as improved and accessible medical services.
Langerhans’cells in human cervical epithelium: effects of wart virus infection and intraepithelial neoplasia
Authors: MORRIS H. H. B. , GATTER K. C. , SYKES G. , CASEMORE VALERIE , MASON D. Y.
Published: August 2005

Summary. The distribution of Langerhans’cells and T and B lymphocytes in cervical epithelium affected by wart virus infection (WVI) and intraepithelial neoplasia (CIN) has been studied by immunohistological techniques with a panel of monoclonal antibodies. In comparison with normal tissue epithelium infected by wart virus consistently showed a partial depletion or absence of both Langerhans’cells and T lymphocytes. The few Langerhans’cells which remained showed loss of their normal dendritic processes and were confined to the vicinity of the basement membrane. In contrast, epithelium from patients with CIN showed an increase in spindle‐shaped Langerhans’cells associated with increased numbers of stromal and intraepithelial lymphoid cells. These findings suggest that there is a marked difference in host immune responses in these two conditions and may explain why WVI tends to persist in the epithelium while CIN is often associated with a lymphoid reaction.
Effect of lumbar epidural analgesia on lower urinary tract function in the immediate postpartum period
Authors: WEIL ANTOINE , REYES HERNAN , ROTTENBERG RENÉ D. , BEGUIN FRANÇOIS , HERRMANN WALTER L.
Published: August 2005

Summary. Urodynamic investigations including cystometry and electronic simultaneous urethro‐cystometry were made in 27 primiparae between 2 and 5 days after delivery to assess possible effects of lumbar epidural analgesia on the function of the lower urinary tract. Three groups of patients were studied: 11 patients had vaginal delivery without epidural analgesia, 11 patients with similar obstetrical characteristics were delivered vaginally with epidural analgesia, and five others were delivered by caesarean section under epidural analgesia. The group of patients who were delivered vaginally under epidural analgesia had a significantly higher incidence (n= 4) of hypotonic bladders as determined by cystometry than the group without epidural analgesia (n= 0), (P < 0 05). The maximum cystometric capacity was significantly greater (P < 0.05) in the group who delivered vaginally with epidural analgesia than in the group without epidural analgesia, as well as the caesarean section group (with epidural analgesia), (P < 0.01). Possible side effects of epidural analgesia implied by these results are discussed and a method for surveillance of urethro‐vesical function both during labour and after parturition is proposed.
Plasma copper and zinc concentrations and infertility
Authors: SOLTAN M. H. , JENKINS D. M.
Published: August 2005

Summary. Plasma copper concentration was significantly lower in 48 infertile women than in 35 control subjects and somewhat lower in women with secondary rather than primary infertility. Plasma zinc concentration was not appreciably different in infertile and fertile women. Low plasma copper concentration may influence normal human female fertility.
Lamicel: a new technique for cervical dilatation before first trimester abortion
Authors: NICOLAIDES KYPROS H. , WELCH CHRISTOPHER C. , PHERSON MARION B. A. MAC , JOHNSON IAN R. , FILSHIE G. MARCUS
Published: August 2005

Summary. Mechanical dilatation of the cervix can be both difficult and dangerous and has potentially serious complications. Lamicel, a synthetic hydrophilic polymer, was inserted into the cervix between 2 and 24 h before termination by vacuum aspiration in the first trimester in 48 nulliparae. A control group of 12 nulliparae were not treated with Lamicel. The force needed to dilate the cervix, accurately measured with a specifically designed force‐measuring instrument, was found to be significantly reduced in all treated groups. The greatest rate of dilatation occurred within the first 2 h after insertion.
Antenatal fetal heart‐rate variability in relation to fetal acid‐base status at caesarean section
Authors: HENSON G. L. , DAWES G. S. , REDMAN C. W. G.
Published: August 2005

Summary. A quantitative comparison was made of fetal heart‐rate (FHR) traces obtained shortly before delivery, and of umbilical artery blood gas values, in 49 women delivered by caesarean section for reasons other than fetal compromise and in 23 women delivered by section for antenatal fetal compromise judged from visual inspection of conventional FHR recordings. The FHR traces in the compromised group of fetuses were abnormal, with low variability and a high incidence of decelerations, but there was no significant difference from the normal group in metabolic acidaemia, as judged by the base excess of umbilical artery blood. The compromised group consisted almost exclusively of infants small‐for‐gestational age. These results suggest that the FHR pattern of the compromised fetuses is not the direct result of intrauterine asphyxia but of some other factor associated with growth retardation.
Plasma lipids in women using progestogen‐only oral contraceptives
Authors: BRIGGS MICHAEL , BRIGGS MAXINE
Published: August 2005

Summary. Using a strict protocol, in an attempt to avoid confounding factors, healthy women were assigned at random to a continuous daily dose of either 30 μg levonorgestrel or 350 μg norethisterone. Volunteers were either aged 40–45 years, or were >30 years and 8–12 weeks post partum. Blood plasma lipids and lipoproteins were measured on specimens collected in the fasting state before treatment, then every month during progestogen treatment. After 6 months there was a small increase in plasma triglycerides, especially in older women, and also in a non‐lactating younger group. Changes in lipoprotein‐cholesterol fractions were insignificant, though there were significant pretreatment differences between the various groups.
The treatment of cervical intraepithelial neoplasia using the carbon dioxide laser
Authors: EVANS A. S. , MONAGHAN J.M.
Published: August 2005

Summary. A total of 423 patients with cervical intraepithelial neoplasia (CIN) have been treated with a carbon dioxide laser in the out‐patient colposcopy clinic. Thirty patients required two or more treatments. Outcome has been assessed in 408 patients followed for more than 1 year. Sixteen patients (4%) have had a recurrence of CIN. Failures were not related to age, parity or size of lesion.
Multicentric carcinoma of the female lower genital tract
Authors: HAMMOND I. G. , MONAGHAN J. M.
Published: August 2005

Summary. The clinical history and treatment of 17 patients with multi‐centric primary carcinomas of the cervix and vulva is presented. There is a significant association between vulval intraepithelial neoplasia and cervical neoplasia. The concept of multicentricity in relation to invasive and intraepithelial neoplasia of the cervix and vulva is critically reviewed.
Effect of cervical application of prostaglandin (PG) E2 on plasma 13,14‐dihydro‐15‐keto‐PGF2α and oxytocin in pregnant women at term
Authors: FUCHS A.‐R. , HUSSLEIN P. , KOFLER E. , GRÜNBERGER W. , RASMUSSEN A. , REHNSTRÖM J.
Published: August 2005

Summary. The concentrations of 13,14‐dihydro‐15‐keto‐prostaglandin F2α (PGFM) and oxytocin were measured by radioimmunoassay in the peripheral plasma of 21 women with low Bishop scores in whom cervical ripening and labour were induced with a cervical cap containing 1.5 mg of prostaglandin (PG) E2, left in place for 6 h. Blood samples were taken before and at 3, 6, 9 and 24 h after the cap was applied. Four women (control group) had a cap without PGE2. Labour began in 13 women receiving PGE2, 12 of whom were delivered within 24 h. In these women plasma PGFM rose progressively to levels seen during spontaneous labour, paralleling the changes in cervical dilatation. The increase became significant at 6 h, when cervical dilatation was 4.5 cm (SEM 0.5). Plasma oxytocin also increased significantly while the cap was in place and then decreased. Plasma PGFM and oxytocin did not change in the control subjects, and in the eight women needing further induction of labour the initial rises were transient and not statistically significant.
Differences in the reported frequencies of some obstetrical interventions in Europe
Authors: BERGSJØ PER , SCHMIDT EBERHARD , PUSCH DETLEV
Published: August 2005

Summary. Answers to a questionnaire on perinatal practices in countries of the WHO European region revealed rates of operative delivery ranging from about 6 to 24%. When the caesarean section rates were compared with the rates of forceps and vacuum extraction for each country, no systematic trend was found. There was a slight negative correlation between the frequencies of operative delivery and national perinatal mortality rates, but this accounts for only a small amount of the inter‐country variation in perinatal mortality rates. The frequencies of induction of labour ranged from 12 to 36% in four countries with reliable national data. Relatively few European countries have population‐based statistical data on the frequencies of caesarean section, forceps delivery and vacuum extractions. The national recording of induction of labour is unusual. Considering the medical and psycho‐social impact of these procedures, we suggest national or regional monitoring.
The effect of intrapartum chemoprophylaxis on the vertical transmission of group B streptococci
Authors: EASMON C. S. F. , HASTINGS M. J. G. , DEELEY JANE , BLOXHAM BARBARA , RIVERS R. P. A. , MARWOOD R.
Published: August 2005

Summary. Intrapartum chemoprophylaxis with benzylpenicillin or erythromycin significantly reduced the rate of transmission of group B streptococci (GBS) from mothers colonized during pregnancy to their babies from 45% to 3% (P<0.001). None of the babies born to women who were given prophylaxis was colonized with GBS in the first 24 h of life. Six weeks after leaving hospital, however, 23% of the babies in the antibiotic group had become colonized with GBS compared with 44% in the control group. GBS strains resistant and tolerant to both benzylpenicillin and erythromycin were found in this study. Intrapartum chemoprophylaxis breaks the cycle of GBS transmission at birth and may be useful in preventing early onset GBS disease, but is unlikely to affect late onset infections.
Umbilical vein blood flow in rhesus‐isoimmunization
Authors: KIRKINEN P. , JOUPPILA P. , EIK‐NES S.
Published: August 2005

Summary. In 18 pregnancies complicated by rhesus‐isoimmunization, blood flow in the fetal umbilical vein was measured by a noninvasive technique combining real‐time and pulsed Doppler ultrasound. Blood flow was found to be elevated in severely affected fetuses and immediately after intrauterine blood transfusion. Blood flow in the fetal umbilical vein was inversely correlated with cord haemoglobin concentration at birth (r=−0.68). The technique used can be used for noninvasive assessment of fetal condition in rhesus‐isoimmunization.
Polyglycolic acid and catgut sutures, with and without oral proteolytic enzymes, in the healing of episiotomies
Authors: ROBERTS A. D. G. , HART D. McKAY
Published: August 2005

Summary. Polyglycolic acid (PGA) sutures and traditional catgut were compared in 190 patients undergoing episiotomy. Each group was also randomly allocated to a double blind comparison of therapy with oral proteolytic enzymes (Chymoral) and placebo. The combination of Chymoral and polyglycolic acid sutures was shown to reduce the level of pain, assessed subjectively, and there was a significant reduction in analgesic requirements in the Chymoral/PGA group.
Vascular pedicle transposition of an ovary to enhance fertility—a new operative technique
Authors: O'BRIEN BERNARD McC. , JOLLY HILARY F.
Published: August 2005

Summary. The concept of vascular pedicle transposition of an ovary and the case history of a patient upon whom such an operation was performed is presented.
Malignancy arising in cystic ovarian teratomas.
Authors: STAMP G. W. H. , McCONNELL E. M.
Published: August 2005

Summary. Twenty‐four cases with a malignant change involving one of the elements of an ovarian dermoid cyst are reported. The patients were older than those with benign ovarian dermoid cysts. Squamous carcinoma was most frequent with adenocarcinoma, undifferentiated carcinoma and a fibrosarcoma also occurring. Survival time after diagnosis was less than 1 year in 75% of the cases.
Causes of stillbirth: a clinicopathological study of 243 patients
Authors: HOVATTA OUTI , LIPASTI ARJA , RAPOLA JUHANI , KARJALAINEN OLAVI
Published: August 2005

Summary. The clinical and autopsy findings in all stillbirths during the years 1974—1979 at the Helsinki University Central Hospital were analysed. There were 243 stillborn infants of whom 200 died before labour. According to the autopsy findings asphyxia accounted for 38% and major malformations for 17% of the deaths, but because of fetal maceration no diagnosis could be made at autopsy in 43%. The cause of death suggested by the clinical findings was placental failure in 57%, cord complication in 12% and major malformations in 17%. The cause of death remained unsolved in 9%. The importance of routine ultrasound and a‐ fetoprotein screening for the detection of unrecognized risk patients is emphasized.
Short term variability of fetal heart rate during pregnancies complicated by hypertension
Authors: ÄMMÄLÄ PIRKKO , KARINIEMI VEIKKO
Published: August 2005

Summary. The clinical significance of the differential index (DI), which describes the short term variability of fetal heart rate (FHR), in fetal surveillance was assessed in 202 hypertensive pregnancies. The analyses of FHR variability were made by a microprocessor‐based on‐line method using the abdominal fetal electrocardiogram as a triggering signal. The analysis was successful in 258 out of 323 trials (80%). Five perinatal deaths (2.5%) occurred in the whole series. Fetal distress developed in 47 out of 137 patients who had a successful FHR analysis within 1 week of delivery. The sensitivity of the antepartum DI in predicting fetal distress in labour was 46%, predictive value was 88% and specificity 97%. The risk of intrapartum fetal distress after a pathological DI was 4 times that after a normal DI (relative risk), which is highly significant.
Inhibition of lactation by cyclofenil and bromocriptine
Authors: THORBERT GUNNAR , ÅKERLUND MATS
Published: August 2005

Summary. In a double blind controlled study of the inhibition of lactation 13 women received 300 mg of cyclofenil and 11 women 2.5 mg of bromocriptine twice daily for 14 days. Lactation was effectively inhibited by both drugs, but with bromocriptine there was a significantly higher frequency of relapse. The plasma concentration of prolactin, which decreased rapidly with bromocriptine, returned to the pretreatment level the day after drug treatment stopped, but with cyclofenil it remained low. Plasma oestradiol followed a similar pattern. Plasma FSH increased more rapidly with bromocriptine than with cyclofenil. There was no significant difference between the treatment groups at any stage for haematology, coagulation or liver function tests. The more sustained effect of cyclofenil on prolactin secretion with a reduced frequency of relapse, and the lower oestradiol level, which might indicate a reduced risk of thromboembolism, suggest that this drug has some advantage over bromocriptine in the inhibition of postpartum lactation.
Binding of [3H] monohydroxytamoxifen in ovarian carcinoma
Authors: HOLT JOHN A. , JORDAN V. CRAIG , TATE ANNA C. , LORINCZ MARGARET A.
Published: August 2005

Summary. A monoclonal antibody (D‐547) against human breast cancer oestrogen receptor was used to demonstrate that the oestrogen receptor in ovarian epithelial carcinomata binds [3H]monohydroxytamoxifen. This binding was observed in sedimentation velocity analyses of both cytosol and nuclear compartments. Binding of [3H]monohydroxytamoxifen to the antibody‐recognized moiety could be inhibited by diethylstilboestrol or oestradiol, but not by androgen, progestin or corticoid, indicating oestrogen specificity for the binding site. The sedimentation coefficient of the antibody‐recognized [3H]monohydroxytamoxifen binding moiety was similar to that when 16α‐[125I]iodo‐oestradiol was used as the ligand.
The effect of low‐dose heparin on blood loss at abdominal hysterectomy
Authors: DOCHERTY P. W. , GOODMAN J. D. S. , HILL J. G. , PICKLES B. G. , BOARDMAN J. , TAYLOR C. G. , BUSH P. V. , SKINNER L. E. M. , SLATER R. C.
Published: August 2005

Summary. In a double blind trial, the effect of prophylactic low‐dose subcutaneous heparin or saline on peri‐operative blood loss was studied in 100 women undergoing abdominal hysterectomy. Mean blood loss was 401 (SEM 75) ml and 246 (SEM 15) ml in the women who received heparin or saline, respectively. Coagulation studies were carried out during the pre‐and post‐operative phases in order to assess the contribution of any coagulation abnormalities to operative blood loss. In identifying patients at risk, platelet function tests were of some value.
The epithelium of human hydrosalpinges: a light optical and scanning electron microscopic study
Authors: VASQUEZ G. , WINSTON R. M. L. , BOECKX W. , GORDTS S. , BROSENS I. A.
Published: August 2005

Summary. Multiple tubal biopsies from 21 patients with thin‐walled dilated hydrosalpinges and from 12 patients with thick‐walled fibrous hydrosalpinges were studied. All the biopsies were examined by light microscopy and scanning electron microscopy and the ciliated surface area at multiple locations measured by planimetry. These biopsies were compared with control biopsies taken from 13 normal women at varying stages of the menstrual cycle.
Clinical significance of sinusoidal fetal heart rate pattern
Authors: KATZ MIRIAM , MEIZNER ISRAEL , SHANI NAFTALY , INSLER VACLAV
Published: August 2005

Summary. Sinusoidal fetal heart rate pattern has been regarded as a sign of fetal jeopardy and 92 instances of this pattern were analysed. The morphologically different major and minor sinusoidal patterns were assessed with regard to their clinical significance as predictors of fetal compromise. There were 83 instances of minor sinusoidal pattern (amplitude of oscillation <25 beats/min) with only one antepartum fetal death. Major sinusoidal pattern (amplitude of oscillation >25 beats/min) was diagnosed in nine patients and in six of them the fetus died before, during or after delivery. It is concluded that patients with minor sinusoidal heart rate patterns may be managed expectantly, whereas on the rare occasion when a major sinusoidal pattern is seen expeditious delivery is justified.
Degenerative changes and detection of plasminogen in fetal membranes that rupture prematurely
Authors: JENKINS DAVID M. , O'NEILL M. , MATTAR M. , FRANCE VENIETIA M. , HSI BAE‐LI , PAGE FAULK W.
Published: August 2005

Summary. Amniocnonon ootainea at caesarean section ana vaginal delivery, at 34–36 weeks gestation and at term, have been studied by electron microscopy and immunofluorescence for evidence of amniotic epithelial degenerative changes and the presence of plasminogen. When delivery was by caesarean section between 34–36 weeks, electron microscopy revealed no degenerative changes in four cases, but in two cases they were widespread. All but one membrane obtained at term showed only minimal amniotic epithelial cell degenerative changes, but extensive change was seen when delivery was premature after premature membrane rupture. Plasminogen was seen in amniotic epithelium proportional to the degree of cell degeneration; it was absent from healthy membranes. These findings demonstrate that degenerative changes are extensively present in membranes that rupture prematurely, particularly before the onset of premature labour, and suggest a role for plasminogen in membrane rupture.
Changes in plasma steroid hormones during treatment of preterm labour with ritodrine‐HC1
Authors: HANSSENS M. C. A. J. A. , SELBY C. , FILSHIE G. M. , GILBERT B. J. , SYMONDS E. M.
Published: August 2005

Summary. Peripheral plasma concentrations of unconjugated oestradiol 17‐β, progesterone and total oestriol were measured in 21 patients presenting with ‘uncomplicated’ preterm labour. Serial measurements were made during intravenous treatment with ritodrine over a period of 24 h. Mean levels of unconjugated oestradiol 17‐β fell significantly during infusion with ritodrine. Changes in progesterone levels remained within the range of diurnal fluctuations normally found in uncomplicated late pregnancy. Mean total oestriol levels fell significantly, but the changes did not exceed normal variations. No correlation was found between the magnitude, the rate or the timing of changes in any of the hormones measured and the short or long term effects of ritodrine on uterine activity. Although alterations in the peripheral oestrogen concentrations may be a direct effect of β‐mimetics, it is unlikely that this mechanism is important in the inhibition of uterine activity.
Effect of intravenous clonidine on menopausal flushing and luteinizing hormone secretion
Authors: TULANDI TOGAS , LAL SAMARTHJI , KINCH ROBERT A.
Published: August 2005

Summary. The effect of clonidine (0.075 mg given intravenously) on subjectively experienced menopausal flushes, skin temperature and luteinizing hormone (LH) secretion was investigated in eight women in a double‐blind, saline‐controlled cross over study. Subjects were monitored over a 5‐hour period. The number and magnitude of temperature peaks (increment >1°C) was unaffected by clonidine. Clonidine significantly decreased the number of subjectively experienced flushes as well as the intensity of the flushes. Clonidine had no effect on the number of LH secretory pulses or on total LH secretion. These results indicate that the therapeutic effect of clonidine is independent of factors responsible for episodic skin temperature changes or factors regulating LH secretion.
The assessment of gastric acidity and antacid effect in pregnant women by a non‐invasive radiotelemetry technique
Authors: O'SULLIVAN G. M. , BULLINGHAM R. E. S.
Published: August 2005

Summary. Non‐invasive radiotelemetry techniques were used for the in‐vivo assessment of gastric acidity and the effect of antacids in non‐pregnant women and women in the third trimester of pregnancy. A particulate (magnesium trisilicate mixture) and a non‐particulate (sodium citrate) antacid were studied. There was no significant difference in basal gastric acidity and gut transit time between the pregnant and non‐pregnant subjects. The median and range of values for the efficacy (defined as the integrated area under the pH/time curves) of sodium citrate was 138.3 pH.min (29.8–520.7) in the non‐pregnant and 103.0 pH.min (54.3–375.6) in the pregnant subjects. The median and range of values for the duration of action of sodium citrate were 38.6 (18.1–147.4) min in the non‐pregnant and 30.5 (20.0–119.1) min in the pregnant women. Magnesium trisilicate mixture resulted in a greater intragastric pH change and had a greater efficacy than sodium citrate, but the duration of action of the two antacids was similar.
The identification of false‐positive amniotic fluid acetylcholinesterase results due to fetal calf serum contamination
Authors: BARLOW R. D. , CUCKLE H. S. , WALD N. J.
Published: August 2005

Summary. All 103 amniotic fluids with positive gel‐acetylcholinesterase (AChE) test results, obtained in Oxford between July 1980 and March 1983, were tested for the presence of fetal calf serum using a counter‐immunoelectrophoresis test for bovine serum albumin. None of the samples from pregnancies associated with neural‐tube defect (85), exomphalos (nine) and intrauterine death (four) had a positive fetal calf serum test, suggesting little or no immunological cross‐reaction between the antiserum used in the test and amniotic fluid proteins. Among the remaining five samples, from unaffected pregnancies (two bloodstained and three clear), two had positive fetal calf serum test results (both were clear samples). The fetal calf serum test is therefore a useful technique capable of identifying false‐positive AChE test results, without mis‐classifying true‐positive results as false‐positive.
Estimation of fertility and fecundity in women receiving artificial insemination by donor semen and in normal fertile women
Authors: PEEK JOHN C. , GODFREY BARBARA , MATTHEWS COLIN D.
Published: August 2005

Summary. The pregnancy rates after artificial insemination by donor semen (AID) have been compared with pregnancy rates in normal fertile women to assess the efficiency of AID. To do this, the curve y=a(1−(1−b)x) was fitted to life‐tabled cumulative pregnancy rates. The equation describes a model in which the parameter a is the proportion of women who are potentially fertile under the conditions of treatment, and in which the parameter b is the pregnancy rate per cycle (or fecundity) of these fertile women. For 259 AID patients with no previous pregnancy a was 65% while for 57 AID patients with a previous pregnancy after AID ‘a’ was 99.9%. The values of b were similar for the two groups of patients, being 20% and 22% respectively. Women without fertility problems who had become pregnant after discontinuing oral contraception provided the reference group. Since only pregnant women were selected, a was 100% by definition. The values of b for the reference group were 22% for 100 primigravid women and 20% for 100 multigravid women. Only 65% of the AID patients were potentially fertile with AID, but those that were fertile became pregnant at the same rate as normal women who discontinued oral contraception.
The value of immunohistochemical markers in the diagnosis of cervical neoplasia
Authors: FRAY R. E. , HUSAIN O. A. N. , TO A. C. W. , WATTS K. C. , LADER S. , ROGERS G. T. , TAYLOR‐PAPADIMITRIOU J. , MORRIS N. F.
Published: August 2005

Summary. This study was designed to determine whether immunohistochemical stains for tumour‐associated markers may be useful in the detection and differential diagnosis of premalignant and malignant lesions of the cervix. The expression of four markers detected by monoclonal antibodies, human milk fat globule 1 and 2 (HMFG‐1 and 2), Cal and anti‐carcinoembryonic antigen (anti‐CEA) on conventional histological sections of various cervical lesions has been investigated. None of these markers was specific for neoplastic lesions of the cervix and all four markers were expressed by metaplastic as well as neoplastic cells, and it was concluded that their application in the histopathological examination of the cervix is limited.
The expression of Ca antigen in normal, hyperplastic and neoplastic endometrium
Authors: FERGUSON A. M. , FOX H.
Published: August 2005

Summary. The expression of Ca antigen in normal, hyperplastic and neoplastic endometria has been studied by an immunoperoxidase technique. Ca antigen was frequently detectable in normal secretory endometrium, was found only rarely in cystic glandular hyperplasia or hyperplasia with architectural atypia, was expressed with moderate frequency in hyperplasia with cytological atypia and was invariably present in endometrial adenocarcinoma. It is concluded that the Ca antigen is of no discriminatory value in differentiating between hyperplastic and neoplastic conditions of the endometrium.
The effect of amniocentesis and drainage of amniotic fluid on lung development in Macacafascicularis
Authors: HISLOP ALISON , FAIRWEATHER D. V. I. , BLACKWELL R. J. , HOWARD SUSAN
Published: August 2005

Summary. Amniocentesis and withdrawal of amniotic fluid was performed on pregnant monkeys (Macaco fascicularis) at two stages in development, either between 47 and 64, or between 85 and 95 days gestation. After birth the lungs of each infant monkey were studied using precise morphometric techniques, and compared with those in a control group of animals. The lungs after amniocentesis had alveoli of normal maturity but reduced in number and increased in size, features which both reduce the relative area for gas exchange. There was also a reduction in the number of respiratory airways. These changes occurred regardless of the time of amniocentesis, the amount of fluid removed and even if the membranes were simply punctured with no fluid removal. There is some evidence to suggest that similar sublethal effects may be present in human infants after maternal amniocentesis.
Increased vascular resistance in the descending aorta of the human fetus in hypoxia
Authors: JOUPPILA PENTTI , KIRKINEN PERTTI
Published: August 2005

Summary. Blood velocity waveforms from the fetal thoracic aorta, obtained by a combination of real‐time and Doppler ultrasound and a spectral analyser, detected a total end‐diastolic block in the curve in nine pregnancies with chronic fetal hypoxia. Simultaneous cardiotocographic recordings were normal except in one patient. These findings suggest that hypoxia causes an increase of peripheral vascular resistance in the tissues distal to the thoracic aorta and that this change appears earlier than pathological changes in the cardiotocogram. The potential clinical value of this technique justifies further research.
Origins and significance of the increased plasma alkaline phosphatase during normal pregnancy and pre‐eclampsia
Authors: ADENIYI FRANCIS A. , OLATUNBOSUN DAVID A.
Published: August 2005

Summary. Total alkaline phosphatase (AP) was measured in maternal plasma, cord plasma and placental extracts in normal and in pre‐eclamptic pregnancies. Total plasma AP was significantly elevated during the last two trimesters in normal and pre‐eclamptic pregnancies, but contrary to previous reports, both placental and bone AP isoenzymes contributed to the significant elevation of total AP in both types of pregnancy. There was no placental AP isoenzyme in cord plasma but total cord plasma AP was higher in normotensive pregnancies than in pre‐eclamptic pregnancies. Total AP concentration in placental tissue was higher in normotensive pregnancies than in pre‐eclamptic pregnancies. A correlation was established between placental weights and maternal circulating placental AP.
Pregnancy‐associated plasma protein‐A (PAPP‐A): concentration in uterine fluid and immunohistochemical localization in the endometrium
Authors: BISCHOF P. , SCHINDLER A. M. , URNER F. , MENSI N. , HERRMANN W. L. , SIZONENKO P. C.
Published: August 2005

Summary. Pregnancy‐associated plasma protein‐A (PAPP‐A) was localized immunohistochemically in the endometrium and measured in uterine fluid of non‐pregnant women. The variations of PAPP‐A concentrations in uterine fluid during the menstrual cycle paralleled those found in the endometrium. In patients receiving hormone therapy there was a significant correlation between the uterine fluid PAPP‐A concentration and the progestogen to oestrogen potency ratio of the hormonal treatment. The presence of PAPP‐A in the uterine fluid cannot simply be explained by blood contamination or cell damage. These results are interpreted as indirect evidence for an exocrine as well as an endocrine secretion of PAPP‐A by the endometrium which might be influenced by hormones.
The predictive value of three pregnancy‐associated proteins in the detection of the light‐for‐dates baby
Authors: PLEDGER D. R. , BELFIELD A. , CALDER A. A. , WALLACE A. M.
Published: August 2005

Summary. Three pregnancy‐associated proteins, human placental lactogen, pregnancy‐specific β1glycoprotein and pregnancy‐associated plasma protein‐A have been measured in two groups of pregnant women. One group subsequently gave birth to children of normal birthweight, the other group were all delivered of a child with a birthweight less than the 10th centile. From the results obtained the values of the tests in predicting intrauterine growth retardation have been calculated. Human placental lactogen proved to be the most useful of the tests compared in predicting intrauterine growth retardation in the individual patient.
Ratio of amniotic fluid acetylcholinesterase to pseudocholinesterase as an antenatal diagnostic test for exomphalos and gastroschisis
Authors: WALD NICHOLAS J. , BARLOW ROBERT D. , CUCKLE HOWARD S. , TURNBULL A. C. , GOLDFINE CHRISTINA , HADDOW JAMES E.
Published: August 2005

Summary. Amniotic fluid samples from eight pregnancies associated with exomphalos or gastroschisis and 24 with open spina bifida were used to confirm the hypothesis that when the α‐fetoprotein and gel acetylcholinesterase tests are positive in an amniotic fluid not visibly contaminated with blood, the two defects can be distinguished by scanning densitometry of the electrophoretic gel. The ratio of the density for the acetylcholinesterase band in the gel to that of the pseudocholinesterase band was ≤0.10 for the open abdominal wall defects and 0.27 or more for open spina bifida. Based on this and a previously reported series, a cut‐off level of about 0.15 is suggested.
A continuing use for Kielland's forceps?
Authors: TRAUB A. I. , MORROW R. J. , RITCHIE J. W. K. , DORNAN K. J.
Published: August 2005

Summary. A retrospective study over a 5–year period compared neonatal outcomes after birth by Kielland's forceps with those after caesarean section in the second stage of labour. The 253 babies born by these two modes of delivery showed no difference in Apgar score, the need for active resuscitation, incidence of jaundice or abnormal neurological behaviour. The neonatal outcome was no worse in the small number of patients where Kielland's forceps delivery was attempted but failed. This study offers support for the continuing role of Kielland's forceps in modern obstetrical practice.
Should a paediatrician be present at non‐rotational forceps deliveries?
Authors: GRAY L. C. , GRANT H. W.
Published: August 2005

Summary. In a series of 500 consecutive deliveries there were 35 non‐rotational forceps deliveries for delay in the second stage of labour. There was no statistically significant difference in the frequency of resuscitations in this group compared with that in 329 spontaneous vertex deliveries. It is concluded that a paediatrician need not be called routinely to these forceps deliveries when there is no evidence of fetal distress.