bluuebunny/crossref_metadata_2025 huggingface dataset:
TERBUTALINE INHIBITION OF MIDTRIMESTER UTERINE ACTIVITY INDUCED BY PROSTAGLANDIN F2αAND HYPERTONIC SALINE
Authors: Anderson K.‐E. , Bengtsson L. Ph. , Ingemarsson I.
Published: August 2005

The effect of the beta receptor stimulator, terbutaline, on uterine activity induced by intra‐amniotic injection of prostaglandin F2αor hypertonic saline was investigated in 20 patients undergoing therapeutic abortion in the second trimester. Intrauterine pressure was recorded, and the basal tone, intensity and frequency of contractions and “total” activity (expressed in Montevideo Units or MU), were measured. Uterine activity was higher in the prostaglandin group (mean value 393 MU) than in the hypertonic saline group (mean value 238 MU). However, terbutaline, infused at a rate of 5 to 20 μg/minute, decreased the activity by approximately the same absolute amount in the two groups to a mean value of 214 MU in the prostaglandin group and to 68 MU in the saline group. In some patients of the saline group, terbutaline completely inhibited uterine contractions. Basal tone, which was high in the prostaglandin group (mean value 28 mm Hg) decreased to a mean value of 17 mm Hg during terbutaline infusion. In the saline group the mean value for basal tone decreased from 10.5 to 7.5 mm Hg. It is concluded that uterine activity, induced by intra‐amniotic injection of prostaglandin F2αor hypertonic saline, can be inhibited by terbutaline. The mechanisms of action for prostaglandins and hypertonic saline are discussed.
A STUDY OF THE EFFECT OF BROMOCRIPTINE ON SERUM OESTRADIOL, PROLACTIN, AND FOLLICLE STIMULATING HORMONE LEVELS IN PUERPERAL WOMEN
Authors: Nader S. , Kjeld J. M. , Blair C. M. , Tooley M. , Gordon H. , Fraser T. R.
Published: August 2005

Nine normal women were examined in the first 11 days of the puerperium. Serum prolactin, oestradiol and follicle simulating hormone (FSH) levels were measured and the FSH response to 100μg of intravenously administered follicle stimulating hormone/lutenizing hormone‐releasing hormone (LH/FSH‐RH) was assessed on day 1 post partum in five subjects and on days 4 (two subjects), 6 and 7 post partum in the other four subjects. Bromocriptine therapy was given to six of these women and four to seven days after the start of such therapy, when prolactin levels had faIlen to normal non‐pregnant levels, these women were retested. Before bromo criptine treatment, the basal FSH levels were unmeasurable in six and low in one other of the nine subjects. After bromocriptine treatment, the basal FSH levels were measurable in four out of six patients and were higher than in the untreated patients (P<0.0l). The FSH response to LH/FSH‐RH was unmeasurable in eight out of nine before treatment, which is less than the response seen in 26 normal men and women (P<0.01), There was also no discernible FSH response to LH/FSH‐RH after treatment with bromocriptine. Before treatment with bromocriptine, the serum prolactin levels were elevated in all nine women but were within the normal range for non‐pregnant women after three days of bromo criptine therapy. Thus postpartum gonadotrophin suppression seemed to depend on high prolactin levels and at least part of the antigonadotrophic action of prolactin seemed to be at pituitary level.
ULTRASONIC “B” SCANNING AS A PREGNANCY TEST AFTER LESS THAN SIX WEEKS AMENORRHOEA
Authors: Blackwell R. J. , Shirley I. , Farman D. J. , Micheal C. A.
Published: August 2005

Sixty patients with less than six weeks amenorrhoea were examined by ultrasonic “B” scanning for the detection of pregnancy. The results were compared with those obtained by histological examination of the aspirate after the patient had undergone menstrual regulation by vacuum aspiration of the uterine contents. The overall accuracy was 79 per cent with 15 per cent false positives. The accuracy after 39 days amenorrhoea was 95 per cent. The technique was compared with an immunological pregnancy test.
CONTINUOUS PETHIDINE/DIAZEPAM INFUSION DURING LABOUR AND ITS EFFECTS ON THE NEWBORN
Authors: Eliot B. W. , Hill J. G. , Cole A. P. , Hailey D. M.
Published: August 2005

This paper presents a study comparing the effects on the mother and baby of a continuous intravenous infusion of pethidine and diazepam and of intramuscular pethidine and promazine. It is concluded that the administration of intravenous pethidine and diazepam is safe in labour provided that diazepam has not been given during the previous week.
METABOLISM OF PROSTAGLANDIN F2α WITHIN THE HUMAN UTERUS IN EARLY PREGNANCY
Authors: Keires M. J. N. C. , Williamson J. G. , Turnbul A. C.
Published: August 2005

The potential for intra‐uterine metabolism of prostaglandins in early pregnancy was studied by incubation of prostaglandin F2α (PGF2α) with tissues obtained by termination hysterectomy at 7 and 16 weeks gestation. Enzymes regulating the degradation of prostaglandins were demonstrated in placenta and membranes and to a lesser extent, in myometrium and decidua. It is believed that these enzymes may have a physiological rôle in maintaining the continuity of pregnancy, and that the high degradation of PGF2α in placenta and membranes may be one of the reasons that, for termination of pregnancy, far higher doses are required intra‐amniotically than extra‐amniotically.
THE RELATIONSHIP OF A “SHORT PERIOD” TO CONCEPTION
Authors: McCarthy T. G.
Published: August 2005

The case records were examined of 918 patients delivered in 1963 at a London hospital. Comparisons were made between 52 patients who had a “short period” following the presumed date of conception and 155 randomly selected control patients. Patients who had a “short period” showed a significantly higher rate for the induction of labour (p<0.025) and a lower infant birthweight (0.1<p<0.2). Calculation of the menstruation‐delivery interval using the “short period” rather than the last full period, gave a closer approximation to the duration of pregnancy found in the random control series of 155 patients.
PNEUMOTHORAX AND SURGICAL EMPHYSEMA IN A NEWBORN BABY CAUSED BY AMNIOCENTESIS
Authors: Hanid Tessy K.
Published: August 2005

A report is presented of a newborn baby who developed a pneumothorax and extensive surgical emphysema after being delivered by Caesarean section for fetal distress soon after the mother had an amniocentesis.
A NEW METHOD FOR ESTIMATION OF FETAL WEIGHT IN LATE PREGNANCY BY ULTRASONIC SCANNING
Authors: Lunt R. , Chard T.
Published: August 2005

The biparietal diameter and area of the fetal skull, and the area of the fetal thorax, were measured by ultrasonic scanning in 68 patients in the seven days prior to delivery. These parameters and various expressions based on the skull and thoracic areas were related to birth weight. It was concluded that the skull and thoracic areas multiple (STAM) index was a more efficient predictor of birth weight than the biparietal diameter.
DATE OF CONFINEMENT PREDICTION FROM SERUM DIAMINE OXIDASE DETERMINATION IN EARLY PREGNANCY
Authors: Elmfors B. , Tryding N.
Published: August 2005

A reliable assessment of the date of confinement is often important in early pregnancy. In many pregnancies the menstrual history is in doubt or the size of the uterus does not correspond to the last menstrual period. During early pregnancy the rise of serum diamine oxidase (DAO) is confined within narrow limits to certain weeks of gestation. In a series of 189 patients from the 6th to 16th week of pregnancy, the date of confinement was estimated by enzyme determination, and was also calculated by Naegele's formula. Dating by serum DAO was found to be more accurate than the menstrual history, and this technique is recommended for use in routine clinical practice.
ELEVATED LEVELS OF MATERNAL PLASMA ALPHA‐FETOPROTEIN AFTER AMNIOCENTESIS
Authors: Chard T. , Kitau M. J. , Ledward R. , Coltart T. , Embury S. , Seller M. J.
Published: August 2005

An elevation of maternal AFP levels was observed in 11 of 65 cases (17 per cent) after amniocentesis. It is suggested that blood samples in which AFP levels are to be measured should always be collected before and not after amniocentesis.
THE EFFECTS OF NARCOTICS ON FETAL ACID BASE STATUS
Authors: Chang A. , Wood C. , Humphrey M. , Gilbert M. , Wagstaff C.
Published: August 2005

This paper reports two randomized control trials on the effects of nalorphine, pethidine, morphine and heroin on fetal and maternal acid base status. The drugs decreased pH and increased pCO2 in the mother, and decreased pH and base excess in the fetus. The changes in the fetus were independent of the changes in the mother. In equivalent dosages, nalorphine increased maternal pCO2 more than pethidine and morphine. The effects of heroin were found to be greater than that of other drugs, and we suggest that heroin should be avoided where the fetus is already at risk.
PLASMA GONADOTROPHIN LEVELS IN OVULATORY AND ANOVULATORY PATIENTS
Authors: Pepperell R. J. , Burger H. G. , DeKretser D. M. , Rennie G. C.
Published: August 2005

Although episodes of FSH and LH secretion in four normal, fourteen anovulatory and one postmenopausal woman were confirmed by samples taken every 15 minutes for three hours, single plasma samples invariably provided a valid estimate of the current mean plasma FSH level, and of the current mean plasma LH level during the follicular phase of the ovulatory menstrual cycle and in anovulatory women with a mean plasma LH value of less than 0.8 mlU/ml. If the mean plasma LH value in anovulatory women exceeded 0.8 mlU/ml, the maximum difference between single and mean values was 28.3±4.7 per cent for four patients with oligomenorrhoea and 43.4±5.2 per cent for five patients with secondary amenorrhoea. Single plasma samples were collected from 26 patients with primary amenorrhoea, 95 patients with secondary amenorrhoea, 51 patients with oligomenorrhoea and 33 postmenopausal patients not on replacement therapy. In each group there were subjects with plasma FSH values in the postmenopausal range and they were unlikely to respond to ovulation induction. Those patients aside, plasma FSH values were similar in subjects with secondary amenorrhoea and oligomenorrhoea, but patients with oligomenorrhoea had significantly higher plasma LH values (p<0.001); mean levels of neither FSH nor LH showed a significant correlation with response to treatment with clomiphene but in patients with secondary amenorrhoea an ovulatory response to clomiphene did not occur unless the individual's plasma FSH value was in excess of 1.4 mlU/ml. In patients with oligomenorrhoea, plasma LH levels below 0.8 mlU/ml precluded successful treatment with clomiphene.
DYDROGESTERONE AND ENDOMETRIOSIS
Authors: Johnston W. I. H.
Published: August 2005

The results are reported of the administration of dydrogesterone, 5 mg twice daily, to 49 patients with endometriosis. All but five patients were symptom‐free after nine months of therapy. Most subjective symptoms had disappeared within four to eight weeks; dyspareunia usually took longer. In 30 out of 32 patients who had a culdoscopy after one or two treatment courses, a ‘cure’ of endometriosis was confirmed. Ten out of nineteen infertile patients became pregnant following treatment. The only side‐effects were transient mastalgia and dizziness in two patients. No amenorrhoea or other disturbances of the menstrual cycle were reported.
NEW PRIMARY CANCERS IN PATIENTS ORIGINALLY PRESENTING WITH CARCINOMA OF THE CERVIX
Authors: Mould R. F. , Barrett Ann
Published: August 2005

A total of 4502 patients with carcinoma of the cervix was studied: in 113 patients 116 other primary neoplasms were found and tumours of lung, breast, colon and rectum occurred most frequently. Most of the patients in our series died with the other primary present. Treatment of the cancer of the cervix by radiotherapy seemed to play no role in the induction of another primary cancer.
HYDATIDIFORM MOLE AND THYROTOXICOSIS A CASE REPORT
Authors: Itzkowic David
Published: August 2005

A case is reported of coexistent hydatidiform mole and thyrotoxicosis. The latter was treated medically prior to evacuation of the mole, thereafter thyroid function returned to normal.
ADVANCED ABDOMINAL PREGNANCY WITH SEVERE PRE‐ECLAMPSIA
Authors: Anderton K. J. , Duncan Sheila L. B. , Lunt R. L.
Published: August 2005

Severe pre‐eclampsia leading to fetal death in advanced abdominal pregnancy is reported. Attention is drawn to the low reported incidence of pre‐eclampsia in this condition and possible explanations are put forward.
CARCINOEMBRYONIC ANTIGEN (CEA) IN OVARIAN CANCER: FACTORS INFLUENCING ITS INCIDENCE AND CHANGES WHICH OCCUR IN RESPONSE TO CYTOTOXIC DRUGS
Authors: Khoo S. K. , Mackay E. V.
Published: August 2005

We report the serum levels of carcinoembryonic antigen (CEA) in 109 patients with ovarian cancer. Histology, degree of differentiation, and clinical stage influenced the incidence of positive CEA. Although CEA was significantly raised in patients with a variety of tumours, the highest incidence (77 per cent) was found in those with serous cystadenocarcinoma. Nearly all (94 per cent) of the poorly differentiated tumours were associated with a positive CEA result. Serial CEA levels provided a useful guide to management during cytotoxic chemotherapy, rapidly falling levels indicating a favourable tumour response which was reflected clinically. However, only two‐thirds of tumours were associated with detectable CEA levels in serum, day‐to‐day variations in individual serum levels occurred, and CEA levels tended to fall paradoxically during terminal illness. The significance of persistently low levels in the apparent absence of disease was uncertain.
AMNIOTIC FLUID LEVELS OF FIBRIN(OGEN) DEGRADATION FRAGMENT E AND ALPHA–FETOPROTEIN IN NORMAL PREGNANCY AND WITH FETAL NEURAL TUBE DEFECT
Authors: Gordon Y. B. , Ratky S. M. , Leighton P. C. , Kitau M. J. , Chard T.
Published: August 2005

Amniotic fluid levels of alpha‐fetoprotein (AFP) and fibrin(ogen) degradation fragment E (FgE) were measured in 214 normal subjects and 27 pregnancies associated with an abnormal fetus (open neural tube defect or exomphalos). AFP levels showed no overlap between the normal and abnormal groups, thus confirming the reliability of the AFP assay in the detection of these abnormalities. FgE levels however showed considerable overlap and could not be used as a diagnostic parameter. Agarose gel chromatography of the amniotic fluid revealed the presence of large molecular weight FgE related antigen in open neural tube defect suggesting that leakage of proteins from exposed capillaries is responsible for the elevation of amniotic fluid protein levels.
PLASMA LEVELS OF PREGNANCY–SPECIFIC β1–GLYCOPROTEIN IN NORMAL PREGNANCY
Authors: Towler C. M. , Horne C. H. W. , Jandial V. , Campbell Doris M. , MacGillivray I.
Published: August 2005

Pregnancy‐specific β1–glycoprotein (PSβG) is a major product of the trophoblast which has only recently been identified. Like human placental lactogen, the concentration of PSβG in maternal blood rises throughout pregnancy until about 34 weeks, thereafter tending to remain constant until term, with only a small day‐to‐day variation in individuals. The circulating maternal levels of PSβG between 34 weeks and term are about 200 μg/ml, 20 to 30 times greater than the levels of placental lactogen, thus allowing detection and measurement of PSβG by relatively simple techniques. The levels of PSβG are above the normal range in the majority of twin pregnancies. It is suggested that PSβG measurements may be useful in assessing placental function and may help in the detection of multiple pregnancies at an early stage of gestation.
THE CONCENTRATIONS OF PROSTAGLANDIN E2 AND PROSTAGLANDIN F2α IN TISSUES WITHIN THE FETOPLACENTAL UNIT AFTER SPONTANEOUS OR INDUCED LABOUR
Authors: Willman Eve A. , Collins W. P.
Published: August 2005

The concentrations of prostaglandin E2 (PGE2) and prostaglandin F2α(PGF2α) were measured by radioimmunoassay in portions of umbilical cord, placenta, amnion, chorion and decidua. The samples were obtained during 12 confinements immediately after the delivery of a healthy baby. Labour had either occurred spontaneously (6 subjects) or had been induced approximately two weeks after the estimated date of delivery. The results showed that the concentration of PGE2 was significantly higher (Student's ‘t’ test) in samples of placenta (P<0.05), decidua (P<0.025), umbilical cord (P<0.0125) and amnion (P<0.0025) from those patients who had started labour spontaneously. In contrast, the concentration of PGF2α was only raised to a significant extent (P<0.025) in the amnion. The findings are discussed.
DIAGNOSTIC ULTRASOUND IN THE MANAGEMENT OF PATIENTS USING INTRAUTERINE CONTRACEPTIVE DEVICES
Authors: Wittmann B. K. , Chow Therese T. S.
Published: August 2005

A group of 80 patients was scanned by ultrasound within 24 hours of insertion of an intrauterine contraceptive device (IUCD) and re‐examined clinically and/or by ultrasound after the next menstrual period. An attempt was made to identify factors such as uterine size, uterine flexion and the position of the IUCD which might be related to its expulsion or removal when, on initial scanning, the device was not located in the fundal area; removal was necessary in 5 out of 6 patients. In patients with an endometrial cavity of less that 40 mm length and/or acute uterine flexion, the overall figure for expulsion and removal was 54 per cent (13 out of 24). It is hoped that a consideration of these factors will lead to a reduction of the failure rate of the IUCD.
INFERTILITY AND BILHARZIASIS OF THE FEMALE GENITAL TRACT
Authors: Bullough C. H. W.
Published: August 2005

In a prospective study, 138 African patients with infertility and 42 patients with incomplete abortion were examined for evidence of bilharziasis. There appeared to be a significant association between primary infertility and bilharziasis due to Schistosoma haematobium.
THE THEORY, FEASIBILITY AND ACCURACY OF AN ULTRASONIC METHOD OF ESTIMATING FETAL WEIGHT*
Authors: Morrison J. , McLennan M. J.
Published: August 2005

We present the theory, method, feasibility and accuracy of estimating fetal weight by measuring the fetal volume using compound ultrasonic scanning. The two parameters had a very high coefficient of correlation (0.9794), and the standard error in one series of 20 patients was only ±106 g. The correlation coefficient achieved by one of us who was new to ultrasound techniques was 0.82, which compared favourably with correlations between fetal weight and biparietal diameter measurements (r = 0.26). A discussion as to the correction factors required to allow for the unknown value of the velocity of ultrasound in fetal tissues, the clinical use of this method, and the possible means by which the accuracy of estimating fetal weight may be further improved is included.
THE EFFECTS OF THE FENOTEROL HY DROBROMIDE (PARTUSISTEN) AEROSOL ON UTERINE ACTIVITY AND THE CARDIOVASCULAR SYSTEM
Authors: Lipshitz J. , Baillie P.
Published: August 2005

Fenoterol hydrobromide (Partusisten) aerosol was used in a placebo‐controlled, double‐blind, double crossover trial to study its effects on oxytocin‐induced uterine contractions and the maternal cardiovascular system. The active and placebo aerosols were each administered a total of ten times or twice each in five patients who were in established oxytocin‐induced labour with intact membranes. Five puffs, of 200 μg each, of the active aerosol reduced uterine activity by more than half; the effect on the cardiovascular system was to cause a mild tachycardia and to widen the pulse pressure.
UMBILICAL VEIN CORTISOL AFTER SPONTANEOUS AND INDUCED LABOUR AND AT ELECTIVE CAESAREAN SECTION
Authors: Weekes A. R. L. , Wade A. P. , West C. R.
Published: August 2005

Umbilical vein (W) plasma cortisol levels were assayed at delivery after spontaneous labour, oxytocin‐induced labour, prostaglandin E,‐induced labour and after delivery by elective Caesarean section. Higher mean UV cortisol levels were observed after vaginal delivery than after delivery by elective Caesarean section. The highest mean UV cortisol level was observed in the PGEa group which accords with the known ability of prostaglandins to increase steroid production. The significance of these findings is discussed.
RELATION OF UMBILICAL VEIN CORTISOL TO NEONATAL BILIRUBIN CONCENTRATIONS
Authors: Weekes A. R. L. , Wade A. P. , West C. R.
Published: August 2005

Umbilical vein cortisol levels were assayed following spontaneous labour in 30 patients. Serum bilirubin was measured in the infants born at three days after delivery. No correlation was demonstrated between third day bilirubin concentration and the cord blood cortisol. The implications of this finding are discussed.
PLACENTAL TRANSFER AND FETAL UPTAKE OF 3H‐DIGOXIN IN HUMANS
Authors: Saarikoski S.
Published: August 2005

Placental transmission and fetal distribution of 3H‐digoxin were studied in seven pregnant women undergoing legal termination of pregnancy during the first half of gestation. The radioactivity in fetal and maternal plasma and in fetal tissues was estimated using the oxidation method, and the integrity of the labelled drug by thin layer chromatography. The 3H‐digoxin activity was clearly demonstrated in the umbilical cord blood five minutes after injection of the drug into the maternal blood, and the fetal plasma concentrations of 3H‐digoxin approximated to the maternal value 30 minutes after drug administration. The distribution of 3H‐digoxin in the fetal tissues was relatively even, with the highest 3H concentrations found in the heart and placenta, the lowest in the brain. The results suggest that the capacity of human fetal heart to bind digoxin during the first half of gestation is limited.
TERMINATION OF ABNORMAL INTRAUTERINE PREGNANCIES WITH INTRAMUSCULAR ADMINISTRATION OF DIHOMO 15 METHYL PROSTAGLANDIN F2α
Authors: Karim S. M. M. , Ratnam S. S.
Published: August 2005

A synthetic compound, 2a, 2b dihomo 15 (S) 15 methyl prostaglandin F2α methyl ester given 8 hourly by intramuscular injection was used to terminate pregnancies in 72 patients with a missed abortion, intrauterine fetal death, molar or anencephalic pregnancies. Treatment was successful in all cases. A 4 mgdose of loperamide given orally at 15 to 30 minutes before the injection of prostaglandin analogue prevented diarrhoea as a side effect.
ADENOCARCINOMA OF THE UTERINE CERVIX: CYTOLOGICAL EVIDENCE OF A LONG PRECLINICAL EVOLUTION
Authors: Boddington M. M. , Spriggs A. I. , Cowdell R. H.
Published: August 2005

Adenocarcinoma of the cervix occurred in 13 women who had previously had ‘negative’ cervical smears. These smears were reviewed, and abnormalities were found in six cases, the intervals ranging from two to eight years. It is concluded that adenocarcinoma, like squamous carcinoma of the cervix, can have a prolonged evolution during which it is cytologically detectable.
THE EFFECT OF PROLACTIN ON THE RESPONSE OF HUMAN LYMPHOCYTES TO PHYTOHAEMAGGLUTININ
Authors: Karmali R. A. , Horrobin D. F.
Published: August 2005

Lymphocytes were collected from ten normal human males and incubated with or without phytohaemagglutinin (PHA) in the absence or presence of ovine prolactin in concentrations found in normal individuals and in human pregnancy. Prolactin consistently inhibited lymphocyte transformations. The degree of inhibition became progressively less as PHA concentrations were increased.
ANENCEPHALIC CONJOINED TWINS
Authors: O'Toole V. E. J.
Published: August 2005

A case of anencephaly in female thoracophagus conjoined twins is presented and discussed.
RELATIONSHIP OF ORAL CONTRACEPTION TO DEVELOPMENT OF TROPHOBLASTIC TUMOUR AFTER EVACUATION OF A HYDATIDIFORM MOLE
Authors: Stone M. , Dent J. , Kardana A. , Bagshawe K. D.
Published: August 2005

The need for chemotherapy for trophoblastic tumour after evacuation of a hydatidiform mole was found to be significantly increased in patients taking oral contraceptives before normal human chorionic gonadotrophin (HCG) values were obtained. Oral contraception was also found to delay the fall in HCG excretion in patients not requiring treatment with cytotoxic drugs.
THE ESTABLISHMENT OF A PROGRAMME OF ARTIFICIAL INSEMINATION BY DONOR SEMEN WITHIN THE NATIONAL HEALTH SERVICE
Authors: Ledward R. S. , Crich Joan , Sharp Patricia , Cotton R. E. , Symonds E. M.
Published: August 2005

A human semen bank has been established in Nottingham for artificial insemination using donor semen (AID). Frozen semen has been used for all inseminations. The introduction and organization of such a programme within the National Health Service is described. Six pregnancies have so far been confirmed and two normal infants have been delivered.
EVALUATION OF DIFFERENT APPROACHES TO OBSTETRIC CARE: PART I
Authors: Chalmers I. , Lawson J. G. , Turnbull A. C.
Published: August 2005

The obstetric management and results obtained by two obstetric teams working in the Cardiff Maternity Hospital over a five‐year period are compared. One team had a more active approach to induction of labour and antepartum monitoring with urinary oestrogen assay and serial ultrasound cephalometry than the other. After controlling for differences in the attributes of the two groups of patients treated, it was not possible to show any striking advantage or disadvantage of the more active approach.
PERINATAL INFECTIONS BY GROUP B β‐HAEMOLYTIC STREPTOCOCCI
Authors: Becroft D. M. O. , Farmer Keitha , Mason G. H. , Morris M. C. , Stewart J. H.
Published: August 2005

Since 1970 there has been an increase in isolations of Group B β‐haemolytic streptococci from infants and mothers at the National Women's Hospital and the organism has become the major cause of fatal perinatal infection. Forty‐three of 60 stillborn and liveborn infants with postmortem isolations of Group B streptococci had pneumonia and of these a minority also had meningitis and/or septicaemia. Amnionitis was found in 15 of 20 placentae examined from these patients and an ascending infection from the maternal genital tract, often through intact membranes, was considered likely in the majority. However, a review of the prenatal histories of 33 infants showed that only a minority had premonitory features such as prolonged rupture of membranes, prolonged labour or maternal fever. Thirteen of 26 liveborn infants had a birth weight less than 2500 g. The majority presented within one hour of birth with respiratory distress or apnoea and died within 48 hours of birth. Early diagnosis of Group B infection is possible if bacteriological and radiological evidence is sought in infants of low birth weight, with low Apgar scores and with early onset of respiratory distress syndrome or apnoea in addition to those having the more usual indications of intrauterine infection. Group B streptococci were carried vaginally in 9 per cent of women attending an antenatal clinic and this high carrier rate is considered to preclude prophylactic treatment.
THE OUTCOME OF PREGNANCY AFTER GONADOTROPHIN THERAPY
Authors: Caspi E. , Ronen J. , Schreyer P. , Goldberg M. D.
Published: August 2005

One hundred and ten women conceived 143 times following induction of ovulation by gonadotrophins. The abortion rate was 21 per cent. Some bleeding occurred in 38.7 per cent of pregnancies and 54 per cent of them ended in abortion. For the 112 pregnancies reaching 20 weeks, the multiple pregnancy rate was 26.8 per cent (21 twins, 5 triplets, 3 quadruplets and 1 sextuplet). Hypertension was present in 8.9 per cent of patients and in 3.3 per cent of those with multiple pregnancy. The length of gestation was related to the number of fetuses at birth and postmaturity did not occur. The Caesarean section rate was 32.1 per cent. The birth weight of the infants was normal and the male to female sex ratio was 0.64 for singleton births and 0.78 for twins. The fetal loss was 15.9 per cent (7.1 per cent for pregnancies of over 28 weeks). Growth and development of the children were apparently normal. The incidence of all congenital malformations was 7 per cent.
BLOOD COAGULATION, FIBRINOLYSIS AND PLASMA PROTEINS IN WOMEN WITH NORMAL AND WITH EXCESSIVE MENSTRUAL BLOOD LOSS
Authors: Hahn L. , Cederblad G. , Rybo G. , Pehrsson N‐G. , Korsan‐Bengtsen K.
Published: August 2005

A group of women with excessive menstrual blood loss (menorrhagia) without any known local or general underlying disease was studied and compared to a group of women with normal menstrual blood loss. Blood coagulation, platelet function and fibrinolysis as well as a variety of plasma proteins were analyzed on six occasions during one menstrual cycle. Womenwith menorrhagia were found to have a slightly higher concentration of fibrinogen–fibrin degradation products, a higher factor V and VIII activity, higher antithrombin III, alpha1‐antitrypsin concentrations and higher antifibrinolytic activity than the normal women. The concentration of albumin, betaIE‐globulin, orosomucoid, ceruloplasmin and IgG were lower in women with menorrhagia than in normals. The capillary fragility did not differ significantly between the groups. The observed differences in clotting factors between the groups could not have caused the differences in blood losses.
PLASMA SOLUTE CONCENTRATIONS DURING GONADOTROPHIN‐INDUCED OVULATION
Authors: Macdonald H. N. , Good W. , Hancock K. W.
Published: August 2005

The effects of ovulation induction on some plasma solute concentrations were investigated serially in eleven women, nine of whom conceived in that cycle. Increasing oestrogen output during the follicular phase was associated with decreasing levels of osmolality, urea, total protein and the albumin free protein fraction. Smaller decreases in the concentrations of sodium, potassium, chloride, carbon dioxide combining power (CO2CP) and albumin were not statistically significant. The luteal phase was marked by a rise in osmolality and a fall in CO2CP but no other significant changes. Levels of osmolality, sodium and potassium fell in early pregnancy when oestrogen output was further increased. These results appear consistent with an oestrogen induced expansion of the extracellular fluid compartment by retention of water in excess of solute, which might also account for the similar changes in pregnancy.
HAEMATOLOGICAL CHANGES DURING OVULATION‐INDUCTION BY GONADOTROPHINS
Authors: Good W. , Hancock K. W. , Macdonald H. N.
Published: August 2005

The oestrogen response to ovulation‐induction by gonadotrophins initiates a preovulation rise in total leucocytes and promotes fluid retention. In consequence of the latter, cyclic changes occur in blood haemoglobin and the haematocrit. The level of oestrone excretion in the follicular phase of induced cycles indicates that multiple follicular development probably occurs, and this also appears to affect the luteal phase. It seems likely, therefore, that the data present a rather exaggerated picture of the situation which obtains in normal menstrual cycles.
FIBRINOLYTIC ACTIVITY IN UTERO AND BLEEDING COMPLICATIONS WITH INTRAUTERINE CONTRACEPTIVE DEVICES
Authors: Bonnar J. , Kasonde K. , Haddon M. , Hassanein M. K. , Allington M. J.
Published: August 2005

Increased menstrual loss and irregular uterine bleeding are major drawbacks to acceptibility of intrauterine contraceptive devices (IUCDs). Fibrinolytic activity around IUCDs removed from 80 women was measured by embedding the device immediately after removal in a plasminogen‐rich fibrin plate. In fifteen of the women an endometrial biopsy was also taken at the time of removal of the IUCD. In women who had the IUCDs removed because of bleeding a much higher fibrinolytic activity was found than in women not complaining of excessive bleeding. The fibrinolytic activity was shown to be due to plasminogen activator and not plasmin. The findings suggest that the excessive menstrual bleeding which occurs with the IUCD may be due to enhancement of fibrinolytic activity in the endometrium which can be modified by fibrinolytic inhibitors such as epsilon aminocaproic acid.
THE EFFECT OF DAILY NORETHISTERONE (0.35 mg) ON CERVICAL MUCUS AND ON URINARY LH, PREGNANEDIOL AND OESTROGEN LEVELS
Authors: Elstein M. , Briston P. G. , Hewitt K. J. , Kirk D. , Miller H.
Published: August 2005

The effect of 0.35 mg of norethisterone daily on cervical mucus and on urinary LH, pregnanediol and oestrogen levels was studied during two treatment cycles in five subjects who had been observed during a control cycle. Variable changes in hormone excretion patterns were found and are discussed.
PRECISION OF ULTRASONIC FETAL CEPHALOMETRY
Authors: Poll V.
Published: August 2005

Ultrasonic measurement of the biparietal diameter is a frequently used technique in the assessment of fetal maturity. The popularity of this technique is based partly upon the claim that it can be performed with considerable precision, but recently published work has not supported this claim. This paper describes a blind clinical trial in which the precision of a single biparietal measurement was determined under normal clinical conditions. The results show that this measurement can be determined with a precision better than ±1.6 mm (±2 standard deviations). The clinical significance of this result is discussed.
EFFECT OF INSULIN ON ADIPOSE TISSUE LIPOLYSIS IN HUMAN PREGNANCY
Authors: Coltart T. M. , Williams Christine
Published: August 2005

Adipose tissue has been shown to retain its sensitivity to the antilipolytic effects of insulin during late pregnancy. This suggests that during late pregnancy, increased adipose tissue lipolysis is due to a lipolytic factor rather than insulin resistance.
CIGARETTE SMOKING AND FETAL BREATHING MOVEMENTS
Authors: Manning F. A. , Feyerabend C.
Published: August 2005

Cigarette smoking caused a reduction in the incidence of fetal breathing movements in normal and abnormal pregnancies. The size of the reduction varied, being greatest in small‐for‐dates pregnancies and pregnancies complicated by fetal distress in labour and least in pre‐eclamptic pregnancies. The fall in the amount of fetal breathing movements was significantly related to the rise in maternal plasma nicotine after smoking but was unrelated to the rise in carboxyhaemoglobin. Smoking non‐nicotine (herbal) cigarettes produced increases in carboxyhaemoglobin concentrations similar to those observed after smoking tobacco cigarettes, and was not associated with a fall in the incidence of fetal breathing movements. Chewing gum containing nicotine produced rises in plasma nicotine concentration similar to those observed after smoking tobacco cigarettes and was associated with a significant reduction in the incidence of fetal breathing movements. Hence nicotine appeared to be the factor in cigarette smoke responsible for the reduction in the incidence of fetal breathing movements. Nicotine was present in the cord blood of infants whose mothers smoked. The possible mechanism by which nicotine caused a reduction in the incidence of fetal breathing movements and its possible relevance to the detrimental effects of smoking on the fetus are considered.
STUDIES ON THE EFFECT OF MATERNAL PRE‐ECLAMPTIC TOXAEMIA ON PLACENTAL WEIGHT AND ON HEAD SIZE AND BIRTH WEIGHT OF THE NEWBORN
Authors: De Souza S. W. , John R. W. , Richards B.
Published: August 2005

The influence of pre‐eclamptic toxaemia (PET) on head size and birth weight of newborn infants and placental weight was studied in single live births after 35 to 42 weeks gestation from mothers with or without toxaemia. There were no significant differences in the distribution of mean birth weight, head size, placental weight, head size/birth weight ratio or placental weight/birth weight ratio between the toxaemic and non‐toxaemic groups. There were significant differences between toxaemic and non‐toxaemic mothers as regards parity, height and smoking habits. Since such maternal characteristics influence birth weights a correction was applied for them. The influence of maternal mid‐term weight and sex of the infants was also taken into account. No significant differences in corrected birth weights, between toxaemic and non‐toxaemic groups were detected on further analysis. It is suggested that the present obstetric management has prevented the retarding effect of pre‐eclamptic toxaemia on fetal and placental growth by reducing the severity and duration of the illness.
ALPHA‐FETOPROTEIN LEVELS IN MATERNAL PLASMA AND AMNIOTIC FLUID DURING PROSTAGLANDIN‐INDUCED MID‐TRIMESTER ABORTIONS: THE RELATION TO FETAL DISTRESS AND DEATH
Authors: Ward R. H. T. , Whyley G. A. , Fairweather D. V. I. , Thomas G. , Chard T.
Published: August 2005

Alpha‐fetoprotein (AFP) levels were measured in both plasma and amniotic fluid during 43 abortions induced with prostaglandin F2α (PGF2α) and their relationship to the induction‐abortion interval and signs of fetal distress or intrauterine death examined. The mean plasma AFP levels showed a progressive rise after PGF2α administration but abnormally high levels were found infrequently until the time of delivery. Feto‐maternal bleeding could explain the abnormally high plasma AFP levels which occurred early in a few cases. A shorter induction‐abortion interval was found in patients with normal plasma AFP levels. Neither fetal distress nor intrauterine death were associated with abnormally high plasma AFP levels. No change in AFP levels in amniotic fluid was found.
AN EVALUATION OF THE LUTEINIZING HORMONE RELEASING HORMONE (LH‐RH) TEST IN PATIENTS WITH SECONDARY AMENORRHOEA
Authors: Henderson S. R. , Bonnar J. , Souka A R , Bogie W. , MacKinnon Pamela , Mattock Jeannine , Dutton Angela
Published: August 2005

An analysis of the gonadotrophin response to an intravenous injection of LH‐RH (50 μg) has been undertaken in 41 patients with secondary amenorrhoea. Thirtyfive of the patients were free of any recognizable pathology to account for their amenorrhoea and apparently had a dysfunction of the hypothalamic‐pituitary axis. In these patients, the gonadotrophin response to LH‐RH was highly variable. There was in general a correlation between baseline plasma LH or FSH levels and their respective increments. There was no correlation, however, between basal oestrogen levels and gonadotrophin increments except in the case of those patients whose basal levels of plasma FSH were higher than those of LH and in those patients whose body weight was less than the ideal for the population. It appears that the gonadotrophin response to a single injection of LH‐RH in the majority of patients with secondary amenorrhoea of unknown origin is too variable to be of use either as a diagnostic or prognostic tool.
A SERIAL STUDY OF PREGNANCY PROTEINS IN PRIMIGRAVIDAE
Authors: Towler C. M. , Jandial V. , Horne C. H. W. , Bohn H.
Published: August 2005

The plasma concentrations of four ‘pregnancy proteins' and three steroid hormones have been measured throughout pregnancy in 15 primigravidae. Two of the proteins, human placental lactogen (HPL) and pregnancy‐specific β1‐glycoprotein (PS βG), are specific for pregnancy and correlate well with the stage of gestation. It is suggested that measurement of PSβG may be useful in assessing feto‐placental wellbeing. Neither of the pregnancy‐associated proteins, steroid‐binding β‐globulin (SB βG) and pregnancy‐associated α2‐glycoprotein (α2‐PAG), correlated with the length of gestation although, near term, plasma α2‐PAG levels appeared to be related to fetal weight. In addition, no correlation has been demonstrated between placental or fetal weight and any of the pregnancy‐specific proteins or steroid hormones studied.
TISSUE OXYGENATION AND RED CELL 2,3 DIPHOSPHOGLYCERATE IN NORMAL AND ABNORMAL PREGNANCY
Authors: Maclennan A. H. , Emerson Pauline M. , Hunter D. J. S. , Darley J. H.
Published: August 2005

Maternal tissue oxygenation as reflected by the level of red cell, 2,3‐diphosphoglycerate (DPG) was measured before, during and after normal pregnancy. Following an initial fall at the beginning of pregnancy there was a significant rise in the mean level of DPG during pregnancy with an abrupt fal in the puerperium. The mean red cell DPG level in the third trimester of pregnancies complicated by pre‐eclampsia and diabetes was not statistically different from the normal but the mean value of all pregnancies in which the fetus was stillborn or growth retarded was significantly lower (p<0.001). The possible mechanism of the changes in normal and abnormal pregnancy is discussed and it is suggested that the measurement of red cell DPG in the third trimester of pregnancy may prove to be a useful parameter of placental oxygenation.
THE INFLUENCE OF PYRIDOXINE ON PROLACTIN SECRETION AND MILK PRODUCTION IN WOMEN
Authors: Canales E. S. , Soria J. , Zárate A. , Mason M. , Molina M.
Published: August 2005

Pyridoxine treatment did not inhibit milk secretion in 14 puerperal women. In contrast, romocriptine was antilactogenic. Pyridoxine appeared not to suppress prolactin secretion.
LUNG FUNCTION TESTS IN BRONCHIAL ASTHMA DURING AND AFTER PREGNANCY
Authors: Sims C. D. , Chamberlain G. V. P. , de Swiet M.
Published: August 2005

Respiratory function tests (forced vital capacity and forced expiratory volume in one second) were performed serially in pregnancy, the puerperium, and at least six weeks ost partum in 27 patients with a history of asthma and in 12 control subjects. Eleven asthmatic patients with spirometric evidence of respiratory obstruction in pregnancy on at least one occasion were considered to have active disease. This group had significantly impaired respiratory function tests when compared to controls. The remaining 16 asthmatic patients were considered to be in remission. No changes in respiratory function tests attributable to pregnancy could be demonstrated in the asthma or control groups. Patients with active asthma tended to have smaller babies than patients with asthma in remission or the control patients.
THE RESPONSE OF LYMPHOCYTES TO PHYTOHAEMAGGLUTININ IN WOMEN WITH PRE‐ECLAMPSIA
Authors: Need Jillian A. , Jenkins D. M. , Scott J. S.
Published: August 2005

The response of maternal lymphocytes to phytohaemagglutinin was determined during and after pregnancy in patients with severe pre‐eclampsia and in controls. The patients with pre‐eclampsia showed a greater degree of immunosuppression during pregnancy than the normotensive controls. This was apparent in the presence and absence of maternal serum. In pre‐eclampsia there may be an abnormality affecting the T cell subpopulation of lymphocytes and also a decreased immunosuppressive effect of maternal serum.
CHANGES IN THE ORAL GLUCOSE TOLERANCE TEST DURING THE PUERPERIUM
Authors: LlND T. , Harris V. G.
Published: August 2005

Oral glucose tolerance tests were performed during late pregnancy, on the second and fifth days of the puerperium and finally six weeks after delivery in a group of 12 healthy women. The glucose response showed no significant change from the pregnancy values on the second and fifth days of the puerperium but each woman had returned to ‘normal’ by the sixth week post partum. In contrast, the insulin response had returned to the non‐pregnant value by the second day of the puerperium.
BASAL SERUM PROLACTIN VALUES AND RESPONSES TO THE ADMINISTRATION OF THYROTROPHIN RELEASING HORMONE (TRH) IN WOMEN WITH AMENORRHOEA
Authors: Glass M. R. , Williams J. W. , Butt W. R. , Edwards R. Logan , London D. R.
Published: August 2005

Basal prolactin concentrations were measured in 77 patients presenting with amenorrhoea; 17 per cent were found to have hyperprolactinaemia. The release of prolactin in response to a standard dose of thyrotrophin releasing hormone for amenorrhoeic subjects with normal basal levels of prolactin was within the normal range. However, patients with hyperprolactinaemic amenorrhoea and no evidence of pituitary tumour were found to have a blunted response.
SINGLE EXTRA‐AMNIOTIC INJECTION OF PROSTAGLANDINS IN VISCOUS GEL TO INDUCE ABORTION
Authors: Mackenzie I. Z. , Embrey M. P.
Published: August 2005

A single extra‐amniotic injection of prostaglandin (PG) E2 or F2α in a highly viscous gel was administered to 230 patients to induce abortion between 9 and 24 weeks gestation. PGE2 doses of 1·0, 1·5, 2·0 or 3·0 mg induced abortion within 24 hours in 30 per cent, 75 per cent, 76 per cent and 70 per cent of patients respectively. The incidence of gastrointestinal side‐effects was dose dependent, being 20 per cent, 35 per cent, 45 per cent and 70 per cent in the respective groups. A 10·0 mg dose of PGF2α induced abortion within 24 hours in 66 per cent of patients and 45 per cent had gastrointestinal side‐effects. Abortion was more often complete with PGE2 (75 per cent) than with PGF2α (36 per cent). Immediate withdrawal of the catheter following PG administration did not influence induction abortion intervals or 24‐hour abortion success rates. This technique significantly reduced individual patient care and minimized the potential risk of intrauterine sepsis associated with extra‐amniotic techniques requiring repeated or continuous PG administration.
THE ‘INDUCTOGRAPH’–A GRAPH DESCRIBING THE LIMITS OF THE LATENT PHASE OF INDUCED LABOUR IN LOW RISK SITUATIONS
Authors: Beazley J. M. , Alderman B.
Published: August 2005

The construction of an ‘inductograph’ is described which defines the rate of progress of the latent phase of labour in 80 per cent of a group of patients selected from a ‘low risk’ category. A standard induction regime was used, and changes in the uterine cervix were assessed quantitatively by a modified form of the Bishop scoring system.
FOLLICLE STIMULATING HORMONE, THYROTROPHIN, HUMAN GROWTH HORMONE AND PROLACTIN IN HYPEREMESIS GRAVIDARUM
Authors: Ylikorkala O. , Kauppila A. , Haapalahti J.
Published: August 2005

To investigate the functional capacity of the anterior pituitary gland in hyperemesis gravidarum, the serum levels of follicle stimulating hormone (FSH), thyrotrophin (TSH), human growth hormone (HGH) and prolactin were measured before and after the combined administration of gonadotrophin and thyrotrophin releasing hormones (GnRH, TRH), and insulin in seven normal pregnancies, nine with hyperemesis and eight nonpregnant subjects. There was no difference between normal pregnancy and hyperemesis for FSH and TSH, but the basal level of HGH was lower and that of prolactin higher in hyperemesis although their responses following stimulation were similar. Thus there seems to be no hypofunction of the anterior pituitary gland in hyperemesis gravidarum.
POLYCYSTIC OVARIAN DISEASE*
Authors: Duignan N. M.
Published: August 2005

Sex hormone binding globulin (SHBG) capacity was reduced in 9 of 31 patients with polycystic ovarian (PCO) disease and the mean level in PCO patients was significantly less (p<0·001) than normal. Serum testosterone levels were elevated in 21 of 32 PCO patients and the mean level was significantly elevated (p<0·001). Serum androstenedione values were raised in 17 of 31 patients and the mean value was also significantly raised (p<0·001). Serum dehydroepiandrosterone sulphate (DHAS) concentrations were elevated in only 2 of 14 patients. Urinary 17‐oxo and 17‐oxogenic steroids were normal in all patients studied. Basal folliclestimulating hormone (FSH) and luteinizing hormone (LH) levels were normal but LH release following injection of luteinizing hormone‐releasing hormone (LH‐RH) was enhanced. A highly significant negative correlation (r=– 0·449; p<0·01) was found between the logarithm of testosterone and the logarithm of LH levels. Serum prolactin concentrations were elevated in 4 of 21 PCO patients. Thyroid‐stimulating hormone (TSH) values were normal. Eighteen of 20 patients ovulated following treatment with clomiphene and nine became pregnant. Five of 12 of patients treated with oestrogen/progesterone preparations noticed an improvement in their hirsutism. It is suggested that the normal cyclical release of LH is inhibited in PCO disease by a negative feedback by androgens to the hypothalamus or the pituitary, and that wedge resection should be reserved for patients in whom other forms of treatment have failed.