bluuebunny/crossref_metadata_2025 huggingface dataset:
SINUSOIDAL FETAL HEART RATE PATTERN WITH SEVERE FETAL ANAEMIA
Authors: Blrkenfeld A. , Yaffe H. , Sadovsky E.
Published: August 2005

A sinusoidal fetal heart rate pattern, associated with Kell incompatibility, severe fetal anaemia, maternal hypertension and intrauterine fetal growth retardation, is described. The mechanism and management are discussed.
A NEW REGIMEN FOR THE TREATMENT OF VAGINAL CARCINOMA IN SITU USING 5‐FLUOROURACIL
Authors: Stokes I. M. , Sworn M. J. , Hawthorne J. H. R.
Published: August 2005

A patient with vaginal carcinoma in situ was treated with 5‐fluorouracil in a less intensive regimen than previously recorded. This appeared to be effective and did not cause serious vaginal discomfort or dyspareunia.
DIAGNOSIS OF THE LUTEINIZED UNRUPTURED FOLLICLE SYNDROME BY STEROID HORMONE ASSAYS ON PERITONEAL FLUID
Authors: Koninckx P. R. , Moor P. De , Brosens I. A.
Published: August 2005

The luteinized unruptured follicle syndrome is a frequent phenomenon, occurring in half of our women with regular cycles and infertility. Progesterone concentrations and 17p‐oestradiol concentrations were assayed in peritoneal fluid of women during the luteal phase. Up to day 20 of the cycle, the concentrations were significantly higher in women with an ovulation stigma than in women without an ovulation stigma on their corpus luteum. The range of concentrations was sufficiently different in the early luteal phase to be used diagnostically, the only limitation being the presence of a cystic corpus luteum. We suggest that the assay of progesterone and 17β‐oestradiol in peritoneal fluid should be done in all women with infertility and biphasic basal body temperature charts in order to diagnose the luteinized unruptured follicle syndrome.
CORD ENTANGLEMENT CAUSING PREMATURE PLACENTAL SEPARATION AND AMNIOTIC FLUID EMBOLISM
Authors: Corridan M. , Kendall E. D. , Begg J. D.
Published: August 2005

A woman died undelivered of amniotic fluid embolism. Postmortem examination showed that cord entanglement had caused premature placental separation with a marginal tear of the membranes and so opened a route of entry for amniotic fluid into the subplacental maternal venous sinuses. It is suggested that premature separation of the normally implanted placenta, associated with macro‐or microscopic tears of or damage to the fetal membranes, provides a route of entry for amniotic fluid through the placental site in approximately one half of the fatal cases of amniotic fluid embolism.
THE INTRAVENTRICULAR CONDUCTION TIME OF FETAL HEART IN UNCOMPLICATED PREGNANCIES
Authors: Brambati B. , Pardi G.
Published: August 2005

By means of a new averaging system, fetal electrocardiograms (ECGs) were obtained simultaneously from three orthogonal leads on the maternal abdomen. The duration of the QRS complex was measured in 421 pregnant women with uncomplicated pregnancies chosen at random between 17 and 41 weeks gestation. Normal standards were established and a close relation was found between QRS duration and the maturity of the fetus. A highly significant relation was observed in 78 patients between the birth weight and the QRS duration. Estimates of birth weight from QRS interval have a standard deviation of 302 g and this may allow the prediction of birth weight with reasonable accuracy. Information on the properties of the fetal ventricular conduction system can be derived from the data presented.
RITODRINE IN THE TREATMENT OF PRETERM
Authors: Larsen J. Falck , Hansen M. Kern , Hesseldahl H. , Kristoffersen K. , Larsen P. K. , Osler M. , Weber J. , Eldon K. , Lange A.
Published: August 2005

In a randomized trial, three alternative schemes of treatment of preterm labour with ritodrine (long infusion, short infusion, and intramuscular injection) were compared with standard treatment by bed rest and sedatives. None of the ritodrine treatments were found to be better in postponing delivery than the standard treatment. However, the Bishop scores of the patients in the standard treatment group tended to be lower than of the patients treated with ritodrine. Moreover, all cases of congenital malformation and polyhydramnios occurred in the patients treated with ritodrine. The incidence of respiratory insufficiency was significantly higher in infants of mothers treated with ritodrine. The mean birth weight was highest in the standard treatment group.
TRANSMISSION OF HEPATITIS B ANTIGENS FROM SYMPTOM FREE CARRIER MOTHERS TO THE FETUS AND THE INFANT
Authors: Wong Vivian C. W. , Lee A. K. Y. , Ip Henrietta M. H.
Published: August 2005

Materno‐fetal transmission of hepatitis B was studied in 97 healthy carriers of hepatitis B surface antigen (HBsAg). Antepartum transmission occurred in at least 10 per cent. Intrapartum transmission may have occurred in about 40 per cent as a result of swallowing of the infective fluid by the baby during delivery, and materno‐fetal transfusion during labour. Person to person transmission after delivery played a minor role. The presence of hepatitis B associated e antigen (HBeAg) in 48 per cent of maternal serum correlated strongly with the subsequent presence of antigen in the infants. There was a linear association between the incidence of antigens in cord blood and the duration of the first stage of labour, with a significant association when labour exceeded nine hours. Caesarean section is recommended if mothers have HBeAg; likewise amniocentesis and breast feeding should be discouraged if mothers have HBeAg.
HYPERTHYROIDISM COMPLICATING PREGNANCY: RESULTS OF TREATMENT BY ANTITHYROID DRUGS IN 77 PREGNANCIES
Authors: Sugrue D. , Drury M. I.
Published: August 2005

Seventy‐seven pregnancies (79 infants) complicated by hyperthyroidism were seen at three Dublin Maternity Hospitals during a 25 year period. Hyperthyroidism was diagnosed following conception in 14 pregnancies. Treatment was with carbimazole alone in 73 pregnancies, in a usual dose of 5 to 10 mg daily. The total fetal loss was 15.2 per cent with a perinatal loss of 5.1 per cent. The perinatal loss in patients treated with carbimazole alone was 4.1 per cent (excluding one death due to congenital malformation). Four infants (5.1 per cent) had goitre and 57 (85.1 per cent) of the surviving infants were above the 25th centile for gestational age. Spontaneous premature labour occurred in 7 pregnancies (9.1 per cent). There was a relative excess of infants with a birth weight less than the 25th centile, of neonatal goitre and premature labour after pregnancy in which treatment was started following conception. Hyperthyroidism complicating pregnancy can be treated effectively with antithyroid drugs given alone and in the minimal effective dose.
THE EFFECT OF MALARIAL CHEMOPROPHYLAXIS ON IMMUNOGLOBULIN LEVELS OF PREGNANT NIGERIAN WOMEN AND THE NEWBORN
Authors: Ibeziako Pat. A. , Williams A. I. O.
Published: August 2005

Immunoglobulins G, M and A were estimated at various stages of gestation in a group of 60 Nigerian primigravidae who were given malarial chemoprophylaxis throughout pregnancy. Immunoglobulin levels were also determined in paired maternal and cord sera of the same women at the time of delivery. Corresponding values for the malarial fluorescent antibody titres were also obtained. There was a fall in both the IgG levels and the fluorescent antibody titres with increasing gestalion. The mean IgG and malarial fluorescenl anlibody litres were generally lower than those previously reported in Nigerian women not on malarial chemoprophylaxis. The mean cord IgG in this sludy was lower than the mean paired maternal IgG value. This agrees with reported studies in the African population but differs from those reported in Caucasians. The cord IgG values were correlated to the paired maternal IgG levels and those were found to be correlated with the corresponding malarial antibody titres. The factors that influence the fetomaternal IgG gradient are discussed. It is concluded that the newborn of mothers on prolonged malarial chemoprophylaxis may have a lowered acquired immunity to malaria.
IRON STUDIES IN PREGNANT AND NON‐PREGNANT WOMEN WITH HAEMOGLOBIN SS OR SC DISEASE
Authors: Oluboyede O. A.
Published: August 2005

Iron studies were performed in 22 pregnant and 18 non‐pregnant women with haemoglobinopathies. Mean packed cell volume and mean haemoglobin concentration were significantly lower (p <0.001) in haemoglobin SS patients than in haemoglobin SC patients, in both the pregnant and non‐pregnant groups. Transferrin saturation was significantly lower in pregnant patients (haemoglobin SS and SC) than in the non‐pregnant group (p <0.001). Serum ferritin values in the haemoglobin SS and SC pregnant patients were not significantly different (p >0.05). There was a strong correlation between serum ferritin levels and transferrin saturation in the pregnant group (r = 0.71; p <0.001). Fourteen of the 22 pregnant women (63 per cent) and 9 of the 18 non‐pregnant women (50 per cent) had scanty or no iron in the bone marrow; the serum ferritin levels increased progressively with greater amount of haemosiderin in the bone marrow. There was evidence of iron deficiency in both the pregnant and non‐pregnant women with haemoglobinopathies and this suggests the need for further study on the routine administration of iron in the management of patients with sickle cell disease.
THE EFFECT OF LUMBAR EPIDURAL ANALGESIA ON THE RATE OF CERVICAL DILATATION AND THE OUTCOME OF LABOUR OF SPONTANEOUS ONSET
Authors: Studd J. W. W. , Crawford J. Selwyn , Duignan N. M. , Rowbotham C. J. F. , Hughes A. O.
Published: August 2005

A study of 1955 spontaneous labours is presented relating progress and outcome to the presence of a lumbar epidural block in 282 of these patients and to the need for oxytocin augmentation in 427. Graphs for cervical dilatation starting at admission to hospital were constructed for normal and dysfunctional labours of spontaneous onset. Patients requiring augmentation of labour had a lesser cervical dilatation on admission to hospital, a longer first stage, more instrumental deliveries, more Caesarean sections and a greater number of babies with a low Apgar score. An epidural block had no effect on either the duration of first stage or the rate of cervical dilatation but was associated with a 20‐fold increase in rotational forceps delivery and no increase in Caesarean section rate. With an epidural block there was no increase in the number of babies with cerebral irritation or low Apgar scores and there was a statistically significant improvement in the Apgar scores of babies of mothers in augmented dysfunctional labour who had an epidural block. The incidence of rotational forceps delivery in patients with an epidural block could be reduced with safety by allowing such patients to have a longer second stage before considering interference purely for delay.
MOTHERS'VIEWS OF CARE IN LABOUR
Authors: Kirke P. N.
Published: August 2005

The management of labour was the main focus of interest in this study of mothers' views of their obstetric care. Most of the mothers, 63 per cent, were satisfied with their care by both the doctors and midwives during labour and delivery. Those who were not satisfied rarely questioned the technical competence of the staff but were more concerned with the manner in which care was provided. Thirteen per cent stated that they were not attended by a doctor at any stage during labour or delivery and 43 per cent said they were left alone for at least five minutes; both groups of mothers were more anxious during labour and delivery and were less satisfied with their overall care than those who did not have such experiences. The mothers' feelings about the various procedures which they had during labour and delivery, including induction, were generally favourable. Although overall satisfaction with care was expressed by 77 per cent of the mothers, the findings suggest that obstetricians and midwives need to give greater consideration to the social and psychological aspects of patient care.
ENVIRONMENT AND REPRODUCTION
Authors: Baird Dugald
Published: August 2005

Using national perinatal death statistics extending back to the 19th century and more recent and detailed data from Scotland, it can be shown that death rates from central nervous system deformities and from other causes, generally associated with the mother's socio‐economic circumstances, are related to the period at which the mother herself was born and reared. For example, the increased death rate from anencephaly which occurred throughout the late 1940s and the 1950s can be attributed to cohorts of women who were all born during the great economic depression of 1926 to 1937. While advances in obstetric care will probably continue to reduce the perinatal mortality rate, it is unlikely that rates similar to those in Sweden can be achieved until a generation of women has been reared in an environment comparable to that in Sweden where social class differences in stature have disappeared.
CHANGES IN THE FETAL HEART RATE ASSOCIATED WITH FETAL BREATHING AND FETAL MOVEMENT†
Authors: Wheeler T. , Gennser G. , Lindvall R. , Murrills A. J
Published: August 2005

Thirty‐eight recordings of fetal heart rate and fetal activity were made from 21 normal patients between 36 and 41 weeks gestation. Each recording lasted for an average of 39 minutes. The heart rate was measured from beat to beat using the R‐wave of the fetal electrocardiogram as the indicator of each heart‐beat. Fetal breathing movements and fetal body movements were detected using either A‐mode or B‐mode ultrasound systems. The relation of fetal breathing and fetal movement to the fetal heart rate was studied both by cardiotachography and computer analysis of the R‐R intervals. Fetal body movements (kicking and rolling) were usually associated with a brief tachycardia, the latter typically occurring every two to three minutes. In 14 recordings, the periods of fetal activity were interrupted by periods of fetal rest with an average duration of 12.5 minutes. Fetal breathing was seen in 26 of the 34 recordings analysed and occurred principally during the periods of fetal activity. Fetal breathing was associated with a significant increase in heart rate variation measured as the standard deviation of the R‐R intervals and the mean absolute R‐R interval difference. Sometimes a pattern of respiratory sinus arrhythmia was seen.
THE EFFECT OF INTRAVENOUS GLUCOSE ON HUMAN FETAL BREATHING MEASURED BY DOPPLER ULTRASOUND
Authors: Goodman J. D. S.
Published: August 2005

Fetal breathing movements were recorded from 24 normal fetuses using the continuous Doppler ultrasound method. This system has been improved by the addition of a microprocessor which facilitates the accurate determination of breath to breath intervals. A control group of twelve patients in late pregnancy received 2 ml sterile water. By comparison the administration of 25 g intravenous glucose to a similar group of 12 patients caused an increase in the proportion of time during which fetal breathing was present from 18.2±5.8 per cent (mean±SE) to 67.0±6.3 per cent after 25 minutes (p±0.001). There was no significant change in the rate or variability of breathing.
FETAL BREATHING MOVEMENTS AND MATERNAL HYPEROXIA
Authors: Ritchie J. W. K. , Lakhani K.
Published: August 2005

The effect of maternal inhalation of 50 per cent oxygen upon fetal breathing movements was investigated. No significant effect was noted in patients with normal pregnancies or in those complicated by insulin dependent diabetes or mild preeclampsia. A significant increase in fetal breathing movements was observed in those pregnancies complicated by either severe preeclampsia or fetal growth retardation.
THE CAUSES OF LOW OESTROGEN EXCRETION IN PREGNANCY: ASSESSMENT OF THE FETAL CONTRIBUTION BY STEROID MEASUREMENTS POST PARTUM
Authors: Taylor N. F. , Philip Ruby S. , Shackleton C. H. L.
Published: August 2005

Oestrogen levels in urine from 21 normotensive and 13 hypertensive pregnant women were moderately correlated (r=0.48) with levels of 3β‐hydroxy‐5‐ene steroids (oestrogen precursors) in urine from their infants. In five infants from otherwise normal pregnancies in which oestrogen excretion was very low, levels of 3β‐hydroxy‐5‐ene steroids were significantly lower than normal while there was no difference between hypertensives and normals. Levels of urinary cortisol metabolites in the infants were moderately correlated with 3β‐hydroxy‐5‐ene steroids (r=0.55) and were especially low in 2 out of 5 infants in the series suffering from distress during delivery. We conclude that subnormal fetal steroidogenesis rather than reduced placental metabolism is the most common cause of low oestrogen excretion of unknown aetiology. A factor in the increased perinatal risk in this group may be an associated insufficient cortisol synthesis by the fetus.
LAPAROSCOPIC SPERM RECOVERY IN INFERTILE WOMEN
Authors: Templeton A. A. , Mortimer D.
Published: August 2005

Sperm recovery from the peritoneal fluid was attempted in a group of infertile women in whom it was anticipated that all routine investigations would be normal (commonly referred to as ‘normal infertiles’). Forty‐four couples were recruited into the study but in retrospect only 24 met the study criteria of normal semen, normal pelvis and appropriate timing. In 15 of these 24 patients, spermatozoa were covered from the peritoneal fluid, and so far seven have become pregnant. In the nine patients where spermatozoa were not recovered, none have so far become pregnant. There was no correlation between sperm recovery and the quality of the post‐insemination cervical mucus examination. This test allows more accurate assessment of the ability of spermatozoa to reach the site of fertilization.
LAPAROSCOPIC FOLLOW‐UP OF PATIENTS WITH OVARIAN CARCINOMA
Authors: Quinn M. A. , Bishop G. J. , Campbell J. J. , Rodgerson J. , Pepperell R. J
Published: August 2005

Laparoscopy with cytology of ascitic fluid or peritoneal washings was performed on 110 occasions in 62 patients with ovarian cancer to assess response to chemotherapy. Damage to bowel occurred on three occasions and complete visualisation of the peritoneal cavity was not possible in 14 patients. When tumour was seen and/or cytology was positive, the prognosis was poor; absence of macroscopic tumour with negative cytology did not preclude continuing disease. A group of patients was identified in whom a change of therapy based on laparoscopic findings after six months of treatment, might have proven beneficial. Laparoscopy has a limited place as a second‐look procedure in patients undergoing treatment for carcinoma of the ovary.
REDUCTION OF MENSTRUAL BLOOD LOSS BY DANAZOL IN UNEXPLAINED MENORRHAGIA: LACK OF EFFECT OF PLACEBO
Authors: Chimbira T. H. , Anderson Anne B. M. , Naish C. , Cope E. , Turnbull A. C.
Published: August 2005

In women with menorrhagia of unknown cause, the efficacy of the drug danazol in reducing heavy menstrual blood loss was investigated making objective measurements of menstrual blood loss. Drug regimens tested were daily administration of 200 or 100 mg danazol for 12 weeks and daily danazol given in the luteal phase or during menstruation. The results suggest that 200 mg danazol daily is the most acceptable regimen clinically since it significantly reduced menstrual blood loss and was associated with a relatively low incidence of side effects. In 16 women on this dose menstrual blood loss was suppressed from a mean pre‐treatment loss of 183±25ml to 38±11 ml (p<0.01) in the second, and 26±9 ml (p<0.01)in the third treatment months. The majority of women had regular episodes of bleeding with no alteration in cycle length and a reduction in the number of days of bleeding. Although 100 mg daily suppressed menstrual blood loss, particularly by the third month of treatment, it increased the number of episodes of bleeding in some women which they found unacceptable. Both 200 mg and 100 mg relieved dysmenorrhoea in the majority of women presenting with the symptoms. Danazol taken daily in the early follicular or luteal phase of the menstrual cycle did not significantly alter menstrual blood loss. There was no effect of placebo therapy on measured menstrual blood loss in a single blind trial in eight women with menorrhagia.
MALE PSEUDOHERMAPHRODITISM WITH 17α‐HYDROXYLASE DEFICIENCY
Authors: Abad L. , Parrilla J. J. , Marcos J. , Gimeno F. , Bernal A. Loapez
Published: August 2005

A case of male pseudohermaphroditism with 17α‐hydroxylase deficiency is reported in a 23‐year‐old woman presenting with primary amenorrhoea and a history of bilateral inguinal hernia repair. She was tall, had hypoplastic external genitalia with a blood pressure of 220/140 mm Hg. Her karyotype was XY. Acute adrenal failure occurred following exploratory laparotomy. After treatment with gluco‐corticoids and oestrogens, the hormone and electrolyte profiles returned to normal and the blood pressure fell. The biochemical implications of this enzyme deficiency are discussed.
24‐HOUR CREATININE CLEARANCE DURING THE THIRD TRIMESTER OF NORMAL PREGNANCY
Authors: Davison J. M. , Dunlop W. , Ezimokhai M.
Published: August 2005

Serial changes in 24‐hour creatinine clearance were determined in 10 healthy women during late pregnancy and after the puerperium. A decrease occurred in all subjects during the six weeks preceding delivery, so that mean values for the last three weeks of pregnancy did not differ from the non‐pregnant mean. Possible reasons for this phenomenon and its clinical implications are discussed.
UTERINE ACTIVITY PLOTTED ON AN INDUCTOGRAPH AS AN AID TO MANAGEMENT OF LABOUR
Authors: Gee H. , Beazley J. M
Published: August 2005

By combining uterine activity data with an ‘inductograph’ it is possible to distinguish between normal progress and at least three different types of delayed progress during the early stage of stimulated labour. Delayed progress may be associated with optimal, insufficient or, sometimes, excessive uterine activity. The patterns described facilitate early recognition and management of clinical problems such as cephalopelvic disproportion, undue cervical resistance, inadequate myometrial activity, and impending fetal distress.
SALBUTAMOL AND KETONURIA IN PREGNANCY CASE REPORT
Authors: Scarpello J. H. B. , Phillips P. J , Connor H. , Woods H. F , Ward J. D.
Published: August 2005

A patient is described who had heavy ketonuria without associated glycosuria during treatment with salbutamol in pregnancy. Blood glucose and ketone concentrations were normal while urine secretion of ketone bodies was increased. This suggests that ketonuria resulted from an altered renal threshold rather than a change in intermediary metabolism. Plasma ketone concentration should be measured before stopping salbutamol on the basis of ketonuria alone.
TRANSCUTANEOUS FETAL OXYGEN TENSION AND FETAL HEAR RATE PATTERN PRECEDING FETAL DEATH CASE REPORT
Authors: Weber T. , Secher N. J.
Published: August 2005

Simultaneous cardiotocography (CTG) and transcutaneous PO2 (tcPO2) measurements were made in a pregnancy complicated by membrane rupture and cord prolapse at 27 weeks gestation. A Caesarean section was not done because the fetus was judged to have little chance of survival and to be at very high risk of severe brain damage if it did. The fetus weighed 830 g and the CTG changes preceding fetal death were similar to those described by others. The tcPO2 was zero for periods of a few seconds to 20 minutes at 1 to 2 hours before fetal death, and the tcPO2 was constantly zero during the last 50 minutes of fetal life. Tracings showing the tcPO2/CTG changes preceding fetal death are reproduced.
ORIGIN OF PERITONEAL FLUID IN WOMEN: AN OVARIAN EXUDATION PRODUCT
Authors: Koninckx P. R. , Renaer M. , Brosens I. A.
Published: August 2005

The volume of peritoneal fluid was measured after laparoscopic aspiration in 303 women. Contamination with blood was estimated at 4.2 per cent by haemoglobin assay. In 120 women with regular menstrual cycles, the volume of peritoneal fluid increased progressively during the follicular phase, was highest during the early luteal phase (20.0±6.3 ml) and declined thereafter. In 89 women with moderate and mild endometriosis the amounts of peritoneal fluid were similar, but 9 women with severe endometriosis had lower (P<0.05) volumes during the luteal phase. Women with inactive ovaries had uniformly low amounts of peritoneal fluid: 4.2±2.3 ml in 31 women taking combined oral contraceptive pills; 4.7±5.8 ml in 17 women taking 5 mg of lynoestrenol daily and 1.2±1.9 ml in 20 postmenopausal women with an inactive endometrium. In contrast, two postmenopausal women with proliferative endometrium had 7 and 10 ml of peritoneal fluid. Women with active ovaries, 5 with absent or distally occluded Fallopian tubes and 7 without a uterus had normal amounts of peritoneal fluid. The volume of peritoneal fluid was not affected by pelvic varicose veins, a visible corpus luteum or an ovulation stigma. Peritoneal fluid appears to be predominantly an ovarian exudate, neither an exudate from the pelvic peritoneum nor a tubal secretion.
FETAL MOVEMENT PATTERNS IN THE FIRST TRIMESTER OF PREGNANCY
Authors: Van Dongen L. G. R. , Goudie Elizabeth G.
Published: August 2005

Fetal movements were examined at various ages during the first trimester of pregnancy in 46 patients. Characteristic types and patterns of movement were found to relate to the age of the fetus. By 10 to 12 weeks, a full range of movements had developed and the movement patterns then closely resembled those normally found in the second and third trimesters of normal pregnancy.
A STUDY OF INVESTIGATIONS USED TO PREDICT OUTCOME OF PREGNANCY AFTER THREATENED ABORTION
Authors: Duff G. B , Evans J. J. , Legge M.
Published: August 2005

Sixty‐nine patients who presented with threatened abortion had a number of investigations aimed at providing information with which to predict pregnancy outcome. Ultrasound examination, and measurement of plasma oestradiol and progesterone levels were all significantly more accurate in predicting the pregnancy outcome than clinical examination. Measurements of plasma levels of β1‐glycoprotein, alpha fetoprotein (AFP), beta subunit human chorionic gonadotrophin (hCG), cystyl aminopeptidase, and human placental lactogen (hPL) also appeared better than clinical examination but the differences did not reach statistical significance while measurement of hCG levels in early morning urine were less accurate than clinical examination.
BURSTING PRESSURE AND COLLAGEN CONTENT OF FETAL MEMBRANES AND THEIR RELATION TO PREMATURE RUPTURE OF THE MEMBRANES
Authors: Al‐Zaid N. S , Bou‐Resli M. N , Goldspink G.
Published: August 2005

The collagen content and the bursting pressure of human fetal membranes was measured for full term spontaneously ruptured, full term artificially ruptured and prematurely ruptured membranes. The bursting pressure of the prematurely ruptured membranes was significantly higher than the membranes which ruptured spontaneously at term. No significant difference was found in the collagen contents.
ULTRASTRUCTURE OF THE VILLI AND FETAL CAPILLARIES IN PLACENTAS FROM SMOKING AND NONSMOKING MOTHERS
Authors: Asmussen I.
Published: August 2005

The ultrastructure of placental villi from 10 heavy smokers (10≥cigarettes per day) was compared with that of 16 nonsmokers (never smoked). Thickening of the basement membrane and increase in collagen content of the villous stroma was found. The fetal capillaries were fewer in number and with decreased lumen either due to oedema or contraction of the endothelial cells. All cells, both in the fetal capillaries as well as syncytiotrophoblast and cytotrophoblast contained large amounts of filaments and fibrillae possibly capable of cell contraction. Thus a result of these findings might be a decreased placental flow in smokers.
THE ABDOMINAL COCOON CASE REPORT
Authors: Marinho A. , Adelusi B.
Published: August 2005

A girl of 17 is described who presented, six weeks after the end of her first pregnancy, with intermittent abdominal pain and an abdominal mass due to encasement of the terminal ileum in a ‘cocoon’ of fibrous tissue. The cocoon was excised and the patient did well. The aetiology and management of this condition are briefly discussed.
THE USE OF FOLEY'S CATHETER IN RIPENING THE UNFAVOURABLE CERVIX PRIOR TO INDUCTION OF LABOUR
Authors: Ezimokhai M. , Nwabineli J. N.
Published: August 2005

Foley's catheter was used to ripen the cervix prior to induction of labour in 21 primigravidae and the results compared with those obtained using 5 mg of prostaglandin E2 in vaginal gel in another group of 14 primigravidae. The improvement in cervical score and outcome of induction of labour was similar in both groups. There were no complications attributable to the use of these agents. Foley's catheter is easy to use, cheap and readily available.
THE USE OF PROSTAGLANDIN E1 ANALOGUE PESSARIES IN PATIENTS HAVING FIRST TRIMESTER INDUCED ABORTIONS
Authors: Nakano R. , Hata H. , Sasaki K. , Yamoto M.
Published: August 2005

A new prostaglandin analogue, 16, 16‐dimethyl‐trans‐Δ2‐PGE1 methyl ester (16 me E1) was used for preoperative cervical dilatation in 23 pregnant women who had abortion induced for socio‐economical reasons in the first trimester of pregnancy. A single vaginal pessary containing 1 mg 16 me E1was inserted into the posterior fornix at 3‐hour intervals. Thirteen (56.5 per cent) of the 23 patients had complete abortions and two patients (8.7 per cent) had incomplete abortions. In six patients (26.1 per cent) the cervix was dilated to at least 10 mm and the remaining two patients (8.7 per cent) required mechanical dilatation at the time of vacuum evacuation. Apart from mild gastrointestinal symptoms, no serious side effects were noted. It is concluded that the new prostaglandin analogue, 16 me E1, could be used safely and effectively for preoperative dilatation of the cervix before surgical abortion in early pregnancy.
PRELIMINARY EXPERIENCE OF THE USE OF MEPTAZINOL AS AN OBSTETRIC ANALGESIC
Authors: Jackson M. B. A. , Robson P. J
Published: August 2005

Following an open pilot trial, meptazinol [m(3‐ethyl‐l‐methyl‐hexahydro‐l‐H‐azepin‐3‐yl) phenol hydrochloride] was compared to pethidine in a single‐blind study in women requiring analgesia during labour. Meptazinol provided significantly better analgesia than pethidine with similar but possibly less distressing maternal side effects. There were no obvious adverse effects in the newborn.
CIRCULATING LEVELS OF PLACENTAL PROTEIN 5 IN THE MOTHER: RELATION TO BIRTH WEIGHT
Authors: Obiekwe B. C , Grudzinskas J. G , Chard T.
Published: August 2005

A total of 914 blood samples was obtained from an unselected population of 400 women between 36 and 40 weeks gestation. Serum PP5 levels were measured by a sensitive radioimmunoassay. After ranking of PP5 levels and birth weight the value of serum PP5 in the diagnosis of intrauterine growth retardation was examined. The sensitivity, predictive value, and specificity of the test were 17.07, 16.66, and 90.25 per cent respectively; these results suggest that serum PP5 levels are less accurate than other biochemical parameters in the identification of fetal growth retardation in late pregnancy.
LONG TERM RESULTS OF TREATMENT OF CARCINOMA OF CERVIX
Authors: Jolles B.
Published: August 2005

In this survey of 602 patients treated for carcinoma of the uterine cervix during the period 1944–1968 (with a 100 per cent follow‐up) survival rates at 5, 10, 15 and 20 years after radiotherapy were 41, 28, 18 and 11 per cent. The crude five‐year cure rate of over 70 per cent for Stage I and 58 per cent for Stage II cases and an overall five‐year survival rate of 42 per cent for all stages compares favourably with results published from other institutions in the United Kingdom.
COLPOSCOPY IN THE MANAGEMENT OF THE PREGNANT PATIENT WITH ABNORMAL CERVICAL CYTOLOGY
Authors: Kirkup W. , Singer A.
Published: August 2005

Thirty patients with abnormal cervical cytology had a colposcopy during pregnancy. Their management during and after pregnancy is described and supports the contention that the introduction of a colposcopy service safely permits a greater selectivity in management without recourse to operative intervention during pregnancy. In one patient a preclinical invasive squamous carcinoma of the cervix was diagnosed by colposcopy, and in another three, in whom colposcopy could not exclude the presence of invasion, a wedge biopsy under anaesthesia and two punch biopsies without anaesthesia had to be performed. In the remaining 26 patients, the possibility of invasion could be excluded by colposcopy and further treatment deferred until after pregnancy.
SUCCESSFUL PREGNANCY INDUCED BY HUMAN MENOPAUSAL GONADOTROPHIN IN A PATIENT WITH GROWTH HORMONE DEFICIENCY AND PRIMARY AMENORRHOEA: CASE REPORT
Authors: Cassar J. , Verco C. J , Joplin G. F
Published: August 2005

A patient with growth hormone deficiency and primary amenorrhoea became pregnant with the help of human menopausal gonadotrophin. Pregnancy was complicated only by abdominal discomfort due to her very small stature and by moderate oedema. She was delivered of healthy female twins by lower segment Caesarean section at the 37th week.
VESICO‐UTERINE FISTULA TREATED BY AMENORRHOEA INDUCED WITH CONTRACEPTIVE STEROIDS. TWO CASE REPORTS
Authors: Rubino S. M
Published: August 2005

Two women with vesico‐uterine fistulae causing amenorrhoea and cyclic hematuria were successfully treated by the continuous administration of an oestrogen‐progestogen combination for six months.
MATERNAL PLASMA AND URINARY HORMONE LEVELS DURING AND AFTER A SUCCESSFUL ABDOMINAL PREGNANCY
Authors: France J. T. , Jackson P.
Published: August 2005

In a successful abdominal pregnancy, urinary oestriol levels were about the fifth centile, but other hormone concentrations suggested that placental function was normal until 32 weeks gestation. After that, plasma oestrogen concentrations levelled off and plasma placental lactogen concentrations declined. Pre‐eclampsia developed at 34 weeks and necessitated the delivery at 36 weeks and 2 days of a live normal female infant by laparotomy. The placenta was not removed. All hormone levels fell rapidly during the first weeks of the puerperium and then more slowly during the next six weeks to non‐pregnancy levels. Plasma progesterone, urinary pregnanediol, and plasma oestradiol were the slowest to return to non‐pregnant levels.
EARLY ECTOPIC PREGNANCY AFTER VAGINAL HYSTERECTOMY TWO CASE REPORTS
Authors: Cocks P. S.
Published: August 2005

Two patients with ectopic pregnancy following vaginal hysterectomy are described. In each patient conception occurred prior to hysterectomy. A review of the literature reveals 23 similar cases with 13 presenting as early postoperative complications and 10 as late postoperative complications.
LACK OF EFFECT OF INTERVIEW AND GYNAECOLOGICAL EXAMINATION ON PLASMA LEVELS OF PROLACTIN AND CORTISOL
Authors: Pearce J. M. , McGarrick Gail , Chamberlain G. V. P. , Jeffcoate S. L.
Published: August 2005

Levels of prolactin and cortisol were measured in plasma from 18 non‐pregnant patients attending a general gynaecological outpatient clinic for the first time. Each patient was seen by one of two clinicians and blood samples were taken at six different stages of the clinical interview and examination. No significant changes in the levels of prolactin or cortisol were observed suggesting that pulsatile secretion and the response to the stress of an outpatient gynaecological visit are not important factors in the interpretation of plasma prolactin levels.
COMPARISON OF PREGNANCY OUTCOME AFTER AMNIOCENTESIS FOR PREVIOUS NEURAL TUBE DEFECT OR RAISED MATERNAL SERUM ALPHAFETOPROTEIN
Authors: Read A. P. , Donnai D. , Harris R. , Donnai P.
Published: August 2005

Amniocentesis was performed in 219 pregnancies because a previous pregnancy produced a fetus with neural tube defect (NTD) and in 212 pregnancies in which the indication for amniocentesis was a high maternal serum alphafetoprotein (AFP) level. The proportion of abnormal fetuses, the frequency of low birth weight infants, and the frequency of undesired fetal loss were significantly greater in the group with high maternal serum AFP, in which there was also a significant excess of male births. It is concluded that maternal serum AFP screening defines a group of high risk pregnancies. The greater fetal loss and low birth weight associated with high maternal serum AFP levels were not the result of amniocentesis but were an inherent feature of these pregnancies.
SCREENING FOR FETAL RISK WITH URINARY OESTROGEN: CREATININE RATIO AT 34 WEEKS
Authors: O'Herlihy C. , Martin R. H.
Published: August 2005

The urinary oestrogen :creatinine (O/C) ratio was measured in first morning specimens of 261 women at 34 weeks gestation to assess prospectively its potential in predicting fetal complications. Forty‐two patients (16.1 per cent) had low O/C ratios. All three stillbirths in the series occurred in this group and the incidences of fetal growth retardation and fetal distress in labour were also significantly increased. These complications were unusual when the O/C ratio was high. The O/C ratio at 34 weeks reflected fetal well‐being more accurately than clinical examination or blood pressure measurement. The mean O/C ratios of cigarette smokers and non‐smokers were similar, although smokers were delivered of lighter babies. Measurement of the urinary O/C ratio is simple and inexpensive. Used as a screening test at 34 weeks it appears to provide an early and fairly reliable indication of reduced placental function.
CHANGES IN MATERNAL PERIPHERAL LEUCOCYTES AROUND DELIVERY
Authors: Griffin J. F. T. , Beck I.
Published: August 2005

Changes in leucocyte populations and lymphocyte transformation with PHA were measured serially in 12 pregnant women, before and after delivery. There was a significant increase in the total numbers of leucocytes and neutrophils at delivery and for the 24 hours post partum. Lymphocyte counts increased, but not at significant levels, at or following delivery. Lymphocyte transformation rates were significantly higher before delivery and at 24 hours post partum, than at delivery or 2 hours post partum. Although plasma suppressor factors were found before and after delivery, plasma taken at delivery or 2 hours post partum was significantly more suppressive for nonpregnant lymphocytes. It is recommended that maternal blood samples should be taken before delivery for assays of maternal immunocompetence or maternofetal mixed leucocyte reactions.
BABIES OF MOTHERS WITH LEPROSY HAVE SMALL PLACENTAE, LOW BIRTH WEIGHTS AND GROW SLOWLY
Authors: Duncan M. E.
Published: August 2005

One hundred and sixteen women with leprosy and 31 healthy controls were studied throughout 155 pregnancies, and their babies were observed for a period of up to two years. Babies of mothers with leprosy weighed less than those of healthy mothers; the placental weights and coefficients followed the same trend. The babies of the mothers with leprosy grew more slowly than those of the healthy mothers and these findings were most marked in the babies of mothers with lepromatous leprosy. The cause of the reduced feto‐placental weight is thought to be related to the immune status of the mother.
AMNIOTIC FLUID ACETYLCHOLINESTERASE AND PRENATAL DIAGNOSIS
Authors: Seller Mary J. , Cole Kathleen J. , Fensom A. H. , Polani P. E.
Published: August 2005

Raised specific acetylcholinesterase (AChE) activity in amniotic fluid was consistently found to be associated with fetal intrauterine death and neural tube defects, but in just under half of the samples from pregnancies with spina bifida, the increase was marginal. Elevated AChE levels were occasionally found in fluid samples contaminated by maternal blood, and in nearly half of the samples which were a brown or yellow‐brown colour but where there was a normal fetus. Nine fluids, five of which were contaminated with fetal blood, had a false positive result on alpha‐fetoprotein (AFP) assay (elevated AFP levels and a normal fetus), but showed normal AChE activities. It is suggested that AChE estimation might be useful in prenatal diagnosis as a second test for those fluids which have an elevated AFP level.
INTRAPARTUM AND POSTPARTUM PYREXIA AND INFECTION AFTER INDUCTION WITH EXTRA‐AMNIOTIC PROSTAGLANDIN E2 IN TYLOSE
Authors: Callen P. J. , de Louvois J. , Hurley Rosalinde , Trudinger B. J.
Published: August 2005

One hundred and twenty‐four women, bearing 127 children, in whom labour was induced with extra‐amniotic prostaglandin E2 in tylose were studied. High vaginal swabs taken from 111 patients immediately before insertion of prostaglandin E2were examined, specific identification of microbes being restricted to those present in the amniotic fluid, to haemolytic streptococci, and to other specific microbes. Lancefield group B streptococci were isolated from nine patients, and in eight of these the microbes were isolated from the amniotic fluid. Amniotic fluid was examined from 86 patients and was shown to be contaminated with microbes potentially pathogenic for mother or baby in 11 out of 86 (13 per cent) of the patients examined; in eight patients, the contaminating pathogen was the group B streptococcus. All 127 blood cultures taken during or just after delivery were negative. Six out of nine patients with a group B streptococcus in the vagina developed fever and proven streptococcal endometritis; one child developed fever and another streptococcal septicaemia.
FETAL RESPONSE TO CEPHALOPELVIC DISPROPORTION*
Authors: Stewart K. S. , Philpott R. H.
Published: August 2005

A group of African primigravidae undergoing trial of labour were studied along with a control group to assess the specific fetal responses to the possible excessive head compression encountered in cephalopelvic disproportion (CPD). Depending on the outcome of labour, the patients were placed in one of three groups: major CPD, minor CPD and primary uterine dysfunction with no CPD. Particular attention was directed to the fetal heart pattern evoked and the degree of head moulding produced. In the pbresence of marked CPD, the fetus initially responded with early prolonged fetal heart rate decelerations. These continued and as labour progressed, the late decelerations and falling pH typical of hypoxia developed. The early prolonged dip was a steep deceleration which started early, had no time lag and returned to the base line rate late in relation to the end of the contraction. An objective scoring method described the amount of head moulding present. A score of 6 was considered to represent marked moulding. If the patient was still undelivered after a further two hours of strong contractions with no head descent, then it had become excessive. On its own account, excessive moulding should be regarded as a sign of fetal distress.
TESTS OF FETAL WELLBEING IN THE THIRD TRIMESTER OF PREGNANCY
Authors: Hughes G. , Bischof P. , Wilson G. , Smith R. , Klopper A.
Published: August 2005

Five different products secreted by the fetoplacental unit into the maternal circulation were measured in 272 patients when they were 34 weeks pregnant. The most useful indicator of present pathology or future complications of pregnancy was a placental protein, pregnancy associated plasma protein A which was raised in pre‐eclamptic toxaemia, antepartum haemorrhage and premature labour. The highest values were recorded in pre‐eclampsia before any signs of the disease were evident. Schwangerschafts protein 1 was also raised in pre‐eclampsia and antepartum haemorrhage but only after the disease had presented. Placental lactogen was also raised in pre‐eclampsia and its measurement may have some predictive value. Total oestriol was lowered in fetal growth retardation and the unconjugated steroid raised in pre‐eclampsia and lowered in retarded fetal growth.
THE USE OF 16–16 DIMETHYL TRANS Δ2 PGE1 METHYL ESTER (ONO 802) VAGINAL SUPPOSITORIES FOR THE TERMINATION OF EARLY PREGNANCY. A OMPARATIVE STUDY
Authors: Smith S. K. , Baird D. T.
Published: August 2005

Vaginal suppositories containing the 16–16 dimethyl trans Δ2 PGE1 methyl ester (ONO 802) were used for the induction of abortion in early pregnancy, and this non‐surgical technique was compared with suction termination performed under local anaesthesia or general anaesthesia. Ninety patients were recruited to the study and divided equally between the three groups. Complete abortion was induced in 87 per cent of the patients treated with ONO 802 suppositories, which compared favourably with 87 and 100 per cent for the patients who had suction terminations under local anaesthesia and general anaesthesia respectively. The vaginal suppositories induced uterine bleeding in all patients and the mean time of onset of lower abdominal pain was 2 hours 55 minutes. The average numbers of episodes of vomiting and diarrhoea for patients given ONO 802 suppositories were 0·9 and 0·7 respectively. Menstrual blood loss was measured objectively in all groups and no significant differences between the three methods could be found In selected cases, ONO 802 vaginal suppositories would seem to be safe and reasonably effective for the termination of early pregnancy.
A DOUBLE‐BLIND CROSS‐OVER STUDY OF PIPERAZINE OESTRONE SULPHATE AND PLACEBO WITH COAGULATION STUDIES
Authors: Poller L. , Thomson Jean M. , Coope Jean
Published: August 2005

A double‐blind trial of piperazine oestrone sulphate was performed over a period of 14 months on 55 menopausal women complaining of depression and hot flushes. Depression was not affected but the hot flushes were significantly lessened by the oestrogen treatment. After three months of piperazine oestrone sulphate there were no significant accelerations of prothrombin time or increases in factors VII or X but, after six months, there was an acceleration in the prothrombin time. After 14 months those who received piperazine oestrone sulphate for the first six months showed a significant increase in α1‐antitrypsin and factor VIIR:AG. Oestrone piperazine sulphate appears to produce less marked changes in coagulation than oestrogen‐containing oral contraceptives or conjugated equine oestrogens.
ESTABLISHING FULL‐TERM HUMAN PREGNANCIES USING CLEAVING EMBRYOS GROWN IN VITRO*
Authors: Edwards R. G. , Steptoe P. C. , Purdy J. M.
Published: August 2005

The establishment of human pregnancies by the use of fertilization in vitro and placing cleaving embryos into the uterus is described. Preovulatory oocytes were aspirated at laparoscopy from the ovaries of patients soon after the beginning of the mid‐cycle surge of luteinizing hormone (LH) during the natural cycle. The LH surge was identified by assaying 3‐hourly samples of urine, and measurements of oestrogens in 24‐hour samples were used to assess follicular growth. The surge of LH was identified in 68 patients and it showed a diurnal rhythm. Preovulatory oocytes were aspirated from most of the patients. Fertilization and cleavage occurred in 34 instances, and 32 embryos were put into the mother via the cervical canal. Four patients became pregnant. There were indications that a diurnal rhythm played a role in establishing cleaving embryos, each of the four pregnancies occurring when the embryos were placed in late evening. Each of the pregnancies resulted from oocytes which were aspirated from their follicles 24 hours or longer after the LH surge began. Details are given of three abortive pregnancies in patients given gonadotrophins to stimulate the maturation of oocytes used for fertilization in vitro.
FETAL BLOOD VELOCITY WAVEFORMS IN NORMAL PREGNANCY
Authors: Stuart B. , Drumm J. , FitzGerald D. E. , Duignan N. M.
Published: August 2005

A combination of pulsed echo and continuous wave Doppler ultrasound was used to obtain blood flow velocity signals from the umbilical arteries of 18 normal patients from the 16th until the 40th week of pregnancy. Audio frequency analysis of these signals yielded fetal blood velocity waveforms. Analysis of these waveforms demonstrated that the placenta is an organ of low vascular resistance and that placental resistance to blood flow declines with advancing gestational age in normal pregnancy.