bluuebunny/crossref_metadata_2025 huggingface dataset:
Transabdominal Cervico‐uterine Suture
Authors: Watkins R. A.
Published: February 2008

Summary: Two cases of cervical incompetence resulting from high amputation of the cervix are presented. In the absence of any significant descent of the cervix it is not technically possible to insert a cervical suture from the vaginal approach. A successful technique for inserting a cervical suture via the abdominal approach is described.
Fetoplacental Function and Antenatal Complications When the Fetus is Malformed
Authors: Macafee C. A. J. , Beischer N. A. , Brown J. B. , Fortune D. W.
Published: February 2008

Summary: The patterns of maternal urinary oestriol excretion in 115 pregnancies in which the fetuses were malformed are presented. The incidences of antenatal complications, fetal distress in labour and Caesarean section are analysed and compared with those in a control series of 693 pregnancies in which the fetuses had similar malformations.

Major fetal malformations were associated with high incidences of low oestriol excretion (61%) and intra‐uterine growth retardation (46%). Hydrocephaly was characterized by low oestriol excretion but not to the extent found with anencephaly. The fetus will have a major abnormality in approximately 1 in 30 pregnancies in which maternal oestriol excretion is subnormal. X‐ray of the fetus should precede Caesarean section for a fetal indication when maternal oestriol values are low.
Urinary Oestriol Excretion in Pregnancies Complicated by Rhesus Immunization
Authors: Aickin D. R. , Beischer N.A , Brown J. B.
Published: February 2008

Summary: Urinary oestriol measurements were performed in 239 rhesus immunized patients with rhesus positive infants. Oestriol excretion was low in 31 of the 55 pregnancies (56%) resulting in perinatal deaths, including 17 of the 26 in which the fetus was hydropic at birth. When oestriol excretion was low the perinatal mortality rate was 65% (31 of 48). When the fetus had severe erythroblastosis, oestriol assays sometimes provided useful extra information when amniotic fluid bilirubin was unexpectedly low.

The important conclusion from this study was that low oestriol excretion was an accurate index for selection of the fetus in jeopardy in rhesus immunized patients, although normal oestriol values did not guarantee that the fetus was in good condition.
Oestriol Excretion in the Pregnancy Complicated by Diabetes Mellitus
Authors: Evans J. H. , Taft H. P. , Rome R. M. , Brown J. B.
Published: February 2008

Summary: Urinary oestriol excretion was studied throughout 93 diabetic pregnancies. Low levels of excretion (38%) were common to all clinical categories of diabetes and were not influenced by either the duration or severity of the disease.

The overall perinatal loss was 13%; the incidence was 7% in patients with normal excretion values and 23% in those with low values. Six of the 8 deaths associated with low oestriol excretion occurred after birth and all were due to the respiratory distress syndrome. Low assays may warn of impending intra‐uterine death, but intervention may not be possible. A normal excretion level should not, however, permit a complacent attitude.
Urinary Oestrogen Excretion in Women With Intra‐uterine Fetal Growth Retardation
Authors: Martin J. D. , Hähnel R. , Kean B. P. , Troy V. G.
Published: February 2008

Summary: The urinary oestrogen excretion of 50 mothers with confirmed intra‐uterine growth retardation of the fetus was normal in 37, low normal in 4 and low in 9. Although no fetal distress occurred in the women with low oestrogen excretion, 3 required Caesarean section for fetal distress during labour. One fetus died from an obstetric complication when the oestrogen excretion was normal and 2 when the oestrogen excretion was low. Greater care in the timing of delivery in patients with reduced urinary oestrogen excretion should further reduce perinatal mortality.
Simple Vulvectomy—A 10‐Year Review
Authors: Abell David A.
Published: February 2008

Summary: A review of 16 cases of simple vulvectomy performed at The Royal Women's Hospital in the 10‐year period from 1959 to 1968 is presented. This operation finds its place in gynaecology following accurate and thorough diagnostic techniques, and close liaison between gynaecologist and pathologist. In some patients, simple vulvectomy affords the prime method of treatment, although in the majority it falls second to conservative attempts at management which have failed, particularly in the condition of lichen sclerosis et atrophicus.

The reported high incidence of recurrence of pathology after simple vulvectomy was not confirmed.
The Ultrastructure of Molar Trophoblast
Authors: Sen D. K. , Sinnathuray T. A. , Lau K. S.
Published: February 2008

Trophcblastic tumours have a high incidence in South East Asia (Acosta‐Sison, 1959; Chun et al., 1964). Most of the reports on the ultrastructural appearances of hydatidi‐form mole have come from Japan (Mori et al., 1960; Kosaka, 1964) and the United States of America (Wynn and Davies, 1964; Gonzales‐Angulo et al., 1966). There is as yet no complete agreement regarding the ultra‐structural appearances of trophoblastic tumours; important points of difference include the appearance of microvilli on the surface of the syncytiotrophoblast (Gonzales‐Angulo et al., 1966; Fox and Kharkongor, 1971); the presence of intermediate cells (Okudaira and Strauss, 1967; Fox and Kharkongor, 1971); and whether the appearances are those of degeneration, hyperplasia, or neoplasia (Wynn and Davies, 1964; Okudaira and Strauss, 1967).
TALKING POINT: Laparoscopy and Loss of Clinical Acumen
Authors: Correy J. F.
Published: February 2008

It all began in Australia after the F.I.G.O. Congress in Sydney in 1967. Never has a gynaecological procedure or any other procedure requiring a general anaesthetic become so popular by so many in such a short time.
Rubella and the Obstetrician—A Review of Recent Advances
Authors: Giles P. F. H.
Published: February 2008

Summary: Recent advances in the diagnosis and prevention of rubella are reviewed. The following are considered: rubella infection in pregnancy and the expanded rubella syndrome; serological diagnosis in the mother and newborn; the place of gamma globulin; the development and side‐effects of rubella vaccines; immunization programmes and their limitations; whether live, attenuated rubella virus given just before or during pregnancy is teratogenic; how to investigate such patients and avoid such mishaps; problems with vaccination in the puer‐perium; and the place of routine tests for rubella in pregnancy.
Extensive Vulval Condylomata Acuminata Necessitating Caesarean Section
Authors: Wilson Jennifer
Published: February 2008

Summary: A case is reported in which elective Caesarean section was necessitated by extensive vulval and vaginal condylomata acuminata. The problems of treatment in pregnancy, particularly during the latter part of the third trimester, are discussed.
Intravenous Chlormethiazole in the Management of Severe Pre‐Eclampsia
Authors: Tischler E.
Published: February 2008

Summary: Intravenous chlormethiazole in combination with hydralazine and epidural analgesia was used in the management of 25 patients with severe pre‐eclampsia in the last 8 weeks of pregnancy. Chlormethiazole is a potent anti‐convulsant and no eclamptic fits occurred. Phlebitis at the site of infusion and maternal and neonatal hypothermia were the most common side effects observed. Accidental overdosage was not followed by respiratory depression. Comparison with a similar group of patients treated with the lytic cocktail showed no significant difference in the condition of babies at birth. Fetal salvage, however, was better in the chlormethiazole‐treated group. Chlormethiazole crosses the placenta. It is rapidly cleared from the maternal bloodstream, but persists in the neonatal circulation in considerable concentration during the first 24 hours of life.
Intravenous Diazoxide in the Treatment of Severe Pre‐Eclamptic Toxaemia and Eclampsia
Authors: Michael C. A.
Published: February 2008

Summary: Forty‐nine patients with severe pre‐eclampsia and 4 patients with eclampsia were treated with the hypotensive drug diazoxide combined with diaze‐pam. In all patients a satisfactory reduction and subsequent control of the blood pressure occurred. There was no maternal mortality and the perinatal mortality was 13%. After administration of the above drugs no eclamptic convulsion occurred or recurred. It is felt that the combination of diazoxide with diazepam is more effective in controlling an elevated blood pressure in labour than the previous conventional administration of heavy sedatives with their associated maternal and fetal hazards.
Feto‐placental Function and Antenatal Complications when the Fetus has Hydrocephalus
Authors: Macafee C. A. J. , Beischer N. A. , Fortune D. W.
Published: February 2008

Summary: Urinary oestriol values were below normal on 1 or more occasions in 7 of 14 patients whose fetuses had hydrocephalus. The obstetric records of 132 patients delivered of such infants showed that the incidence of intra‐uterine growth retardation was doubled, and 4 fetuses had adrenal hypoplasia. Mothers of hydrocephalic fetuses had an increased incidence of prenatal complications which tend to be associated with low oestriol excretion. Hydrocephalus intrinsically is not associated with poor feto‐placental function.
Radioactive Indium is Not Readily Transferred to the Amniotic Fluid
Authors: Biggs J. S. G. , Buttfield I. H.
Published: February 2008

Summary: Studies performed within one hour of indium‐113m placental localization in 8 patients showed that only about 0.01% of radioactivity had passed from maternal blood to amniotic fluid.
A Review of 600 Laparoscopic Sterilizations
Authors: Paterson Peter J. , Grimwade James C.
Published: February 2008

Summary: A personal series of 600 laparoscopic sterilizations is presented. The English language literature on laparoscopy is reviewed with emphasis on the complication rate associated with the procedure. Based on these analyses, a number of recommendations are put forward which should minimize the incidence of complications.
Hair Growth in a Patient with Hirsutism: Poor Response to Ovarian Suppression
Authors: Biggs J. S. G.
Published: February 2008

Summary: Hair growth was studied in a young woman with hirsutism and irregular menstruation by weighing weekly shavings from the thighs for a year. The apparent response to combined oestrogen and progestogen therapy appeared likely to be due to seasonal variations in hair growth. The value of objective measurement of hirsutism is demonstrated.
Biochemical Assessment of Fetal Lung Maturity
Authors: Wysocki S. J. , Dix R. D. , Hähnel R.
Published: February 2008

Summary: Three tests currently used in assessing fetal pulmonary maturity were carried out on 86 specimens of amniotic fluid. These were the foam test and determinations of lecithin concentration and lecithin/sphingomyelin (L/S) ratio. An excellent correlation was found between the foam test and both lecithin concentration and L/S ratio. Twenty amniotic fluid samples collected within a week of delivery were analysed, and results demonstrated that a negative foam test result was associated with fetal pulmonary immaturity. This foam test corresponded to a lecithin concentration of less than 2.5 mg./100 ml. of amniotic fluid and an L/S ratio of less than 6.
Prediction of Fetal Weight by Ultrasound Cephalometry
Authors: Varma Thankam R.
Published: February 2008

Summary: Two hundred patients who had infants of normal weight and 100 patients who had small‐for‐dates infants had ultrasonic cephalometry performed within a week of delivery. Fetal weight was estimated using Hellman's formula. Fetal weight estimations were determined with an absolute mean error of 278 g. in the normal weight group and 302 g. in the small‐for‐dates group. However, the wide variations in neonatal weight with a given value of estimated biparietal diameter in both groups makes the method rather unsatisfactory.
The Correlation of Fetal, Placental and Maternal Weight with Glucose Tolerance
Authors: Macafee C. A. J. , Beischer N. A. , Willis M. M. , Wood C.
Published: February 2008

Summary: A 50 g. oral glucose tolerance test was performed at 32 weeks of gestation in 1,000 consecutive antenatal patients, 10 (1%) of whom were found to have gestational diabetes.

The incidence of plasma glucose levels above the ninetieth percentile at any time during a glucose tolerance test was not increased in patients who were delivered of infants weighing 4,000 g. or more at birth.

When the maternal weight was above the ninetieth percentile there was a significant increase in the incidence of high fasting plasma glucose levels (P<0.01) but the values were not increased at 1, 2 or 3 hours.

There was no correlation between elevated plasma glucose levels and increased placental weight. The association between placental insufficiency (weight below the tenth percentile) and hypoglycaemia (plasma glucose below the tenth percentile) requires further investigation.
Comparison of Plasma and Urinary Oestrogens in Pregnancy
Authors: Hähnel Roland , Reichman Coral , Martin John D.
Published: February 2008

Summary: Prior to the introduction into the hospital of plasma oestrogen estimations as a routine test in pregnancy, oestrogens were estimated simultaneously in urine and plasma in all inpatients and in a random selection of outpatients for a trial period. A total of 524 estimations were performed on 382 patients. The urine and plasma results were correlated with each other and with length of gestation, clinical disorders and birth weight in order to evaluate the suitability of plasma oestrogen estimations as a routine feto‐placental function test to replace 24‐hour urinary oestrogen excretion.
A Method of Vaginal Sterilization
Authors: Ashton Peter W.
Published: February 2008

Summary: A simple method of vaginal tubal ligation utilizing a Magill laryngoscope is described. The advantages of this over the laparoscopic and abdominal approaches are outlined, and the difficulties and complications which were encountered in 70 patients are discussed.
Conjoined Twins ‐ Antenatal Diagnosis
Authors: Morrison J. , Cary J. E. , Devenish‐Meares P.
Published: February 2008

Summary: A case of conjoined twins is presented, the definitive antenatal diagnosis being established by compound ultrasonic scanning. The value of this method as an adjunct to radiology is discussed.
Placenta Membranacea
Authors: Mathews John
Published: February 2008

Summary: A case of placenta membranacea is described. This illustrates features of the condition which is associated with a significant increase in maternal morbidity and fetal mortality. In this complication, a relatively thin placenta is formed over the entire surface of the chorion, and the pregnancy is frequently complicated by abortion, or intractable antepartum haemorrhage necessitating premature interruption of the pregnancy.
Ovarian Pregnancy in Association with a “Copper 7” Intrauterine Device
Authors: Robertson Struan
Published: February 2008

Summary: This report concerns a case of ovarian gestation with a “Copper 7” intrauterine contraceptive device in situ. The clinical picture was that of a leaking ectopic pregnancy; diagnosis was suspected at laparotomy and confirmed by histological examination.
Virus Infections Simulating Acute Surgical Abdominal Emergencies in Pregnancy
Authors: Lee Alan D. , Allan Beverley C.
Published: February 2008

Summary: Case histories are presented of 13 women admitted to hospital with acute abdominal pain occurring between the twelfth and thirty‐eighth weeks of pregnancy. In the 8 patients in whom laparotomy was performed a mild peritonitis, without obvious cause, was found; virus was cultured from each of these patients — from peritoneal fluid in 3 and from the faeces in 10. The antigenically related echoviruses types 1 and 8 were prominent amongst the strains isolated. Controls, pregnant women without acute abdominal pain, though not well matched in time, showed a very much lower incidence of viral infection. it is suggested that these 13 cases are examples of mild peritonitis in pregnancy caused by viral infection.
Studies on Scrum OestradioI‐17‐β in Normal and Hypertensive Pregnancies — Preliminary Results
Authors: Dawood M. Yusoff , Chan Tanny , Ratnam S. S.
Published: February 2008

Summary: Serum oestradiol‐17‐β was measured by a radioimmunoassay method as described by Hotchkiss et al. (1971), using antiserum against 6‐oxo‐oestradiol succinyl bovine serum albumin conjugate raised in sheep. One hundred and fifty‐eight determinations of serum oestradiol were performed on normal pregnancy cases between the 30th and 42nd weeks of gestation. Serial serum oestradiols were assayed in 5 cases of hypertensive disorder of pregnancy in the third trimester. Serum oestradiol‐17‐β rose from a mean value of 12.01 ± 3.80ng./ml. (± 1 S.D.) at 30 weeks of gestation to a peak of 66.72 ± 31.39 ng./ml. (±1 S.D.) at 40 weeks. Thereafter serum oestradiol fell to 66.02 ± 26.48 ng./ml. (± 1 S.D.) at 41 weeks and 42.77 ± 18.53 ng./ml. (± 1 S.D.) at 42 weeks of gestation.

In 3 out of 5 cases of severe hypertensive disorder of pregnancy, which ended in delivery of normal healthy babies, serial serum oestradiol fell within the range of values for normal pregnancy. In 2 hypertensive cases, where the babies showed evidence of intrauterine growth retardation, serial serum oestradiol values were consistently below the range of serum oestradiol for normal pregnancy. Thus serum oestradiol 17‐β could be a useful indicator of fetal well‐being in pregnancies complicated by hypertension.
The Effect of Maternal Socio‐Economic Status on Fetal and Placental Weight at Birth
Authors: Ratten G. J. , Kenny J. M. , Targett C. S. , Beischer N. A.
Published: February 2008

Summary: A study of public, intermediate and private patients delivered in one hospital indicated that patients of higher socio‐economic status had an advantage in respect of fetal and placental weight at birth. The average weight and the tenth and ninetieth percentiles for fetal and placental weight from 36 to 42 weeks of gestation are documented.
Vaginal Infection Causing Spontaneous Rupture of the Membranes and Premature Delivery
Authors: Grice Alan C.
Published: February 2008

Summary: The incidence of vaginal infection in a group of patients in whom spontaneous rupture of the membranes and subsequent premature delivery occurred was compared with the incidence in a control group of patients. The incidence of vaginal moniliasis was essentially the same in both groups of patients. However, the incidence of vaginal trichomoniasis was 2.2 times higher in patients who had spontaneous rupture of the membranes and subsequent premature delivery than in the control group of patients (P < 0.01).
An Attempt to Measure Intrapartum and Postpartum Anxiety
Authors: Wood Carl , Shields Lyndall , Allison Judy
Published: February 2008

Summary: This study evaluated anxiety of 23 patients both in labour and four days after delivery. Anxiety was assessed by use of three questionnaires, the anxiety state score (Spielberger), the manifest anxiety scale (Taylor) and an obstetric anxiety factor questionnaire. Anxiety state intrapartum was significantly higher than that found postpartum. High and low anxiety trait patients reacted differently to labour and the postpartum period, this difference being interpreted in relation to threat to self‐esteem and physical wellbeing. The high anxiety state in labour was associated with fear concerning factors which obstetricians and midwives considered cause anxiety in labour. A high anxiety state in labour was not associated with an increase in the length of labour or poor condition of the baby at birth.
The Use of Bethanidine in Severe Hypertension in Pregnancy
Authors: Michael Con
Published: February 2008

Seventy‐six patients with severe hypertensive disease of pregnancy were treated with oral bethanidine. Control of the blood pressure resulted in prolongation of the pregnancy. The perinatal mortality was 9.2%. It is emphasised that adequate treatment with a hypotensive agent provides protection to the mother from the dangers and sequelae of hypertensive disease of pregnancy.
Congenital Heart Disease and Pregnancy in the Tropics
Authors: Ong H. C. , Puraviappan A. P.
Published: February 2008

A review of 28 patients with pregnancy associated with congenital heart disease showed the absence of significant adverse influence of the lesions described on maternal and fetal morbidity and mortality. The incidence of 0.2% is comparable to reports from Western Countries. It is suggested that the generally benign nature of this complication in pregnancy was related to the presence of a number of favourable factors in our patients; these factors are discussed.
Anencephaly in One of Twins Diagnosed by Ultrasonic Echography
Authors: Fisher C. C. , Garrett W. J. , Kossoff G.
Published: February 2008

Multiple pregnancy with 1 anencephalic twin is uncommon (De Sa et al., 1964), and its diagnosis by ultrasonic echography has not previously been reported. The present case report illustrates the limitations of radiology in diagnosing this condition in early pregnancy. The advantages of ultrasound in such cases is demonstrated and the reason discussed.
Myasthenia Gravis in Pregnancy and in the Newborn Infant
Authors: Sivanesaratnam V. , Lee E. L.
Published: February 2008

A case of myasthenia gravis in pregnancy and in the newborn infant is presented, together with a review of the literature.
Predictive Oestradiol Surge of Premature Labour and its Suppression by Glucocorticoids
Authors: TambyRaja R. L. , Turnbull A. C. , Ratnam S. S.
Published: February 2008

Summary: Plasma oestradiol‐17β and plasma progesterone levels in premature labour have been compared with those measured serially in 33 primigravidae during normal pregnancy and labour. In 31 of the 38 patients in progressive premature labour, the plasma oestradiol level was 2 S.D. or more above the mean for control patients of similar gestational age and was similar to those patients during labour at term. Levels of plasma progesterone in patients in the premature labour group tended to be below the mean for gestation, although still within the normal range. In 12 patients studied serially, oestradiol levels rose dramatically, high values being detected 9.6 ± 5.2 days preceding parturition; progesterone levels gave no consistent trend. Progressive uterine activity in preterm labour and term labour seems to be associated with a progesterone to oestradiol ratio of 6:1. The steroid profiles of 2 patients in premature labour were studied before and after the administration of betamethasone. Both the premature labour and the elevated plasma oestradiol levels were suppressed by the therapy.
Some Studies with Gonadotrophin Releasing Hormone in Amenorrhoeic and Anovulatory Patients
Authors: Matthews C. D. , Cox L. W. , Symons R. G.
Published: February 2008

Summary: Gonadotrophin releasing hormone (GnRH) has been used to investigate the hypothalamic‐pituitary axis of 25 amenorrhoeic patients with a variety of clinical disorders. The results suggest that studies with GnRH alone do not allow a confident distinction between hypothalamic and pituitary causes for amenorrhoea, because of the close interdependence of the axis.

The gonadotrophic responses to a combination of clomiphene and GnRH have been assessed in a group of 9 infertile patients who have consistently failed to ovulate with clomiphene alone. It is proposed that with the availability of GnRH and of sensitive assays for follicle stimulating and luteinizing hormones, the clinician is in an improved position to evaluate the correct choice of agent to induce ovulation, and to explain some failures of therapy.
Ruptured Splenic Artery Aneurysm and Pregnancy
Authors: Roxburgh D. R.
Published: February 2008

Summary: Four cases of bleeding from the splenic artery associated with pregnancy are presented. Rupture of a splenic artery aneurysm is a rare and extremely dangerous condition and the premonitory symptoms, if any, are common in pregnancy and easily dismissed. Initial collapse is often transient and may be followed by apparent recovery, giving a false sense of security. Successful treatment depends on recognition, restoration of blood volume, and ligation of the bleeding artery. Exploration of the abdomen is essential in any patient with suspected intra‐abdominal bleeding.
Observations on the Effects of Rapid Labour
Authors: Hughes T. B. J. , Hamlett J. D.
Published: February 2008

Summary: The incidence of rapid labour at Mill Road Maternity Hospital, Liverpool, increased between 1967 and 1971 due to active management of labour and more frequent induction of labour. The results of the present study of 722 patients indicate that provided rapid labour (whether induced or spontaneous) takes place under close supervision, there is no disadvantage to mother or fetus.
Urinary Hydroxyproline in Pregnancy — An Index of Placental Function A Preliminary Report
Authors: Eachempati Uma , Ostapowicz Frank , Lazzara Joseph V.
Published: February 2008

Summary: The range of total urinary hydroxyproline was determined by 71 assays on 36 women with normal pregnancies. In addition, 103 assays were performed on 58 women with complicated pregnancies. There was a gradual increase in values up to 36 weeks in normal pregnancy, with a fall towards term. In patients with placental insufficiency due to such conditions as marked hypertension and diabetes, high values were obtained in those with a successful outcome of the pregnancy, which seemed to be indicative of compensatory increased vascularity of the placenta. A lack of this rise was seen in those in whom intrauterine death occurred. It is suggested that total urinary hydroxyproline assay may be useful as an additional parameter for assessing placental function.
The Relationship of Maternal Anaemia and Folate Deficiency to Uterine Haemorrhage during Pregnancy and Fetal Malformation
Authors: Fleming A. F. , Martin J. D. , Stenhouse N. S.
Published: February 2008

Summary: Haematological observations were made on 381 women at their first attendance at the antenatal clinic: 42 subsequently had uterine haemorrhage (abortion, antepartum or postpartum haemorrhage) and 8 gave birth to congenitally malformed infants. These 42 patients (prospective study) and 166 other patients seen for the first time after uterine haemorrhage (retrospective study) have been compared with 331 pregnant controls.

The incidence of folate deficiency did not differ significantly between the control patients and those whose pregnancies were complicated by haemorrhage or congenital malformations. The serum folate was higher in patients after inevitable abortion than in those in whom the pregnancy was continuing. In patients with inevitable abortion, the mean serum folate was lower when there was associated significant bacteriuria, but, as the red cell folate was not decreased, long‐standing folate deficiency was excluded.

Previous pregnancy anaemia frequently recurred and was associated with a strong tendency for women with threatened abortion to go on to complete abortion. Correlations between the number of previous abortions and hypochromic microcytic red cells in the study pregnancy — especially when complicated by bacteriuria — supported the view that chronic anaemia, with or without renal tract disease, contributed to reproductive inefficiency, in particular through spontaneous abortion.

The mean haemoglobin was significantly higher in those women who later delivered malformed infants, possibly because of blood volume differences in abnormal pregnancies.
An Investigation of the Complications and Outcome of Pregnancy in Heterozygous Beta‐Thalassaemia
Authors: Smith Merran B. , Whiteside M. G. , Garis C. N. De
Published: February 2008

Summary: Obstetrical data were reviewed for 100 women of Mediterranean origin with heterozygous beta‐thalassaemia and a baby delivered at 28 weeks or more of gestation, and the results were compared with similar data from a group of non‐thalassaemic Mediterranean women and a group of women of Anglo‐Saxon origin. No increase in fetal wastage during previous pregnancies was found in the thalassaemic group, and fetal weights, placental weights, and period of gestation at delivery were similar in the thalassaemic and non‐thalassaemic Mediterranean women. There was, however, a significant increase in fetal distress and pre‐eclamptic toxaemia in patients with thalassaemia.
Clear Cell Carcinoma of the Ovary—Clinical and Pathological Features
Authors: Cool B. , Laverty C. R. A. , Fortune D. W.
Published: February 2008

Summary: The clinical and pathological features of 12 patients with clear cell carcinoma of the ovary are presented. These made up of 4.1% of all patients with ovarian malignancy at the Royal Women's Hospital, Melbourne, over a period of 33 years. Six of the patients had clinical Stage I disease and all survived; all those with more advanced stages of disease died of their tumour. Six of the patients had endometriosis, and 4 tumours arose in endometriotic cysts. Histologically, the tumour is characterized by variability from area to area, although extensive clear cell areas, marked mitotic activity, marked nuclear pleomorphism, and marked stromal lymphocytic infiltration were seen only in patients with advanced disease.
Procidentia in the Newborn
Authors: Sivanesaratnam V. , Sinnathuray T. A.
Published: February 2008

Summary: Procidentia in the newborn infant is a very rare occurrence. It may result from prolonged labour in a breech presentation. It is important to recognize the condition early and reduce it digitally so that ureteric obstruction is relieved.
Plasma Oestriol Levels in Normal Pregnancy
Authors: Biggs J. S. G. , Miklosi S. , Morrison J.
Published: February 2008

Summary: Plasma total oestriol levels have been measured in a prospective study of 105 women in normal pregnancy, using a fluorimetric assay. There is seen to be good correlation between all recently published studies of normal levels, obtained by several different methods. The statistically significant rise which occurs in each 4‐week period between 24 and 40 weeks of gestation offers a new approach to the screening of obstetric patients for unexpected failure of fetal–placental function.
Premature Labour — Parameters for Comparison Employing Methylxanthine Therapy
Authors: Liu David T. Y. , Measday Brian , Melville Herbert A. H.
Published: February 2008

Summary: An attempt has been made to standardize the assessment of premature labour by the introduction of 2 parameters — the “premature labour unit” and the “premature labour score.” Their clinical application was assessed in relation to the trial of aminophylline (a methylxanthine) as an alternative drug for the treatment of premature labour. Aminophylline proved to be safe and effective; there was a suggestion that it may have benefited the fetus. The scoring system allowed a more meaningful assessment of premature labour.
Cell‐mediated Immunity: Effect of Female Genital Tract Cancer, Pregnancy and Immunosuppressive Drugs
Authors: Khoo S. K. , Tillack Sandra V. , Mackay E. V.
Published: February 2008

Summary: Cell‐mediated immune response was measured by the uptake of tritiated thymidine by lymphocytes cultured in serum‐free medium. Five groups were studied: healthy young women, age‐matched controls, pregnant patients, women with genital tract cancer, and patients who were receiving long‐term treatment with prednisolone and azathioprine. A quantitative assessment of the thymus‐derived “T” lymphocyte was made by its mitogenic response to different doses of phytohaemagglutinin (PHA). There was no significant change in resting lymphocyte activity in any of the above groups. With PHA stimulation, the 3 test groups gave responses significantly below those of healthy controls and age‐matched hospital patients. In pregnancy, depression of response was noted at 20 μg PHA whilst, in cancer and during immunosuppressive therapy, depression was more marked and occurred at 5 μg, 20 μg and 100 μg PHA. The results indicate a disturbance of the “T” lymphocyte function in the 3 conditions studied.
Rectus Abdominis Haematoma in Pregnancy
Authors: Murray John
Published: February 2008

Summary: Over a 10‐year period, 3 patients with haematoma of the rectus abdominis muscle were seen. The complication occurred in the last trimester in women of high parity and poor nutritional state, who were heavy smokers and had associated chronic cough. In one patient, a misdiagnosis firstly of placental abruption and then uterine rupture was made; this patient subsequently developed anterior pituitary necrosis (Sheehan's syndrome).
Tay‐Sachs Disease: Prenatal Monitoring of a High Risk Pregnancy
Authors: Wysocki S. J. , Smith M. , Michael C. A. , Hockey A. , Hähnel R.
Published: February 2008

Summary: A patient with a high‐risk pregnancy for Tay‐Sachs disease was monitored and the correct diagnosis of a normal heterozygous fetus was made. A false overestimation of the enzyme which is deficient in this disease can result if a heat denaruration method of assay is used. Thus, whilst this method of analysis of hexosaminidase A activity yields useful information, electrophoretic separation of the individual hexosaminidase isozymes is necessary for the accurate diagnosis of this condition.
Ovulation Induction by Human FSH — The Results of the Australian Programme: The Human Pituitary Advisory Committee, Australian Department of Health
Authors: Cox. L. W.
Published: February 2008

Summary: The inauguration and working of the Australian Pituitary Advisory Committee are described briefly and the results of treatment with human pituitary gonadotrophins throughout Australia are presented. Two hundred and two pregnancies occurred in 390 treatment series of 179 women. The incidence of multiple pregnancy was 21.8%. The incidence of pregnancy was lower in women who had previous abortions, hirsutes, and galactorrhoea.
Cellular Immune Status of Patients with Pelvic Cancer
Authors: Yamagata S. , Green G. H.
Published: February 2008

Summary: An improved method of whole blood culture to estimate lymphocyte response to phytohaemoagghrtinin (PHA) was established to demonstrate the immune status of patients with pelvic cancer. Lymphocyte response was much higher than that from isolated lymphocyte cultures, and when related to the peripheral lymphocyte count reflected immune status more faithfully than that from a unit number of cells. Using the technique, 100 healthy controls and 432 cancer patients of pre‐treatment or post‐treatment status were examined. The immune status in the majority of patients with benign tumours and in those with carcinoma in situ (CIS) of the cervix was found to be within normal limits, whereas that of patients with invasive cancer was depressed in many cases. The degree of depression related more to the volume of cancer tissue than to the clinical stage. Surgically treated patients mainly demonstrated normal immune status, whereas most post‐radiation patients showed a depression for long periods. The possible causes of the immunodepression seen in cancer patients are briefly discussed.
A Stress Incontinence Clinic — Review of 5 Years Experience
Authors: Glenning Peter P. , Fliegner John R.
Published: February 2008

Summary: An analysis has been made of the results of treatment of a series of 142 patients seen in a stress incontinence clinic. The problems of accurate diagnosis and appropriate treatment are discussed with particular reference to the differential diagnosis of stress and urge incontinence. Results of treatment have been analysed and show the relatively poor long‐term results for vaginal repair operations.

Alternative forms of surgery are discussed and abdomino‐urethral suspension is advocated as the treatment for recurrent stress incontinence and also for the primary treatment of stress incontinence where prolapse is minimal or where continued long‐term increased intra‐abdominal strains are present.
Hydatidiform Mole and Coexistent Fetus Associated With Eclampsia
Authors: Jofre M. E. , James S. T.
Published: February 2008

Summary: A case of hydatidiform mole with coexistent single fetus is presented. The pregnancy was complicated by eclampsia at the 16th week.
A Case of Nonuplet Pregnancy
Authors: Garrett W. J. , Carey H. M. , Stevens L. H. , Climie C. R. , Osborn R. A.
Published: February 2008

Summary: The management of nonuplet pregnancy following induction of ovulation is described. From study of the placenta, blood group antigens, and cerebral maturity of the babies, it is thought that the pregnancy developed from 9 separate simultaneous ovulations.
Ultrasonic Examination of a Nonuplet Pregnancy
Authors: Kossoff George , Garrett William J. , Radovanovich George
Published: February 2008

Summary: A method of diagnosis of high multiple pregnancy by ultrasonic echography is described. The example given is a case of nonuplet pregnancy.
Transient Fetal Acidosis at Amniotomy
Authors: Chang Allan , Wood Carl
Published: February 2008

Summary: The lower pH and base excess levels sometimes seen in the scalp blood at the time of amniotomy are likely to be secondary to maternal acid base status, which are subjected to postural and other influences. Amniotomy, itself, probably has no significant deleterious effect on fetal acid base status.
Malignant Brenner Tumour
Authors: McKenna H. , Ansford A.
Published: February 2008

Summary: A case of Brenner tumour is described in which the diagnosis was confirmed by the presence of transitional cell nests with cystic areas and mucoid change in a mature fibrous stroma.

The locally infiltrative nature of the tumour, its recurrence, and histological appearance confirm its malignant nature; the lack of metastasis and reasonably long survival suggest the malignancy was of intermediate degree.

The history of the patient suggests that the biological behaviour of a low grade papillary transitional cell carcinoma within a Brenner tumour may follow that of urothelial tumours of similar grade within the urinary bladder.
Plasma Fibrinolytic Activity in Pregnancy with Particular Reference to Pre‐eclampsia
Authors: Condie Roy G.
Published: February 2008

Summary: In an attempt to define the role of an altered fibrinolytic mechanism in the pathogenesis and pathology of pre‐eclampsia, a prospective study was carried out on 60 primigravidae at intervals throughout pregnancy.

Forty remained normal, 11 were deemed to have excessive weight gain, and 12 developed pre‐eclampsia (including 3 from the high weight gain group).

A venous stasis stress test was applied at each sampling, and plasminogen activator levels were assayed in peripheral venous and cord venous plasma.

The high weight gain group showed no differences from the group whose pregnancies remained normal.

Release of activator from venous endothelium under stress was significantly impaired by the 20th week of gestation in the patients who subsequently developed pre‐eclampsia. Furthermore, there was a delay in return to normal fibrinolytic activity after placental expulsion, and the mean cord activator level was lower in these patients.
The Changing Pattern of Eclampsia
Authors: Fliegner John R. H.
Published: February 2008

Summary: Between 1940 and 1974, 955 patients with eclampsia were treated at the Royal Women's Hospital, Melbourne. The incidence in booked patients has fallen from 1 in 200 to 1 in 2,800 at present. There were 57 maternal deaths, with a progressive decline in the mortality rate from 8% in the 1940–1949 period to 2.7% between 1960 and 1969; no maternal deaths have occurred in the 5 years subsequently. Including previable cases, the perinatal wastage has been reduced from 30% to 14%. The incidence of multiple pregnancy was 6.2%. The Caesarean section rate was 5%. In booked patients, postpartum eclampsia is now the commonest variety and is of milder severity than formerly.
Laparoscopic Ventrosuspension
Authors: Tsakok F. H. M. , Ratnam S. S.
Published: February 2008

Summary: Laparoscopic ventrosuspension using the Wolf's laparoscope and 25 cm Rumel's thoracic artery forceps is described. The procedure was performed on 80 patients where laparoscopic investigation was required for diagnosis of subfertility or intractable backache.

The findings of note were endometriosis and sclerotic ovaries.

The commonest complication of the procedure was sinus formation at the inguinal wounds; this problem resolved after a minor technical modification.

After the procedure pregnancy occurred in 14 of 65 infertile patients; however, in only one patient was this the sole treatment. Retroversion was corrected in all patients to date. Other beneficial effects are discussed, including simplicity in technique and short hospitalization.
Hysteroscopic Sterilization with Quinacrine Sulphate and Electrocoagulation
Authors: Ng Allan Y. H. , Chen C. , Ratnam S. S.
Published: February 2008

Summary: Hysteroscopic sterilization by electrocoagulation of the tubal orifices was performed in 17 patients. Hysterosalpingograms 3 months later showed bilateral tubal occlusion in 7 and unilateral tubal closure in 5. Quinacrine instillation was performed in 3 patients. All 3 had patent tubes at hysterosalpingo‐graphy 3 months later. It is concluded that considerable improvements will have to be made in hysteroscopic sterilization before it can become acceptable as a method of sterilization.
Marsupialization and Drainage of Bartholin's Cyst and Abscess, with the Aid of a Modified Foley Catheter
Authors: Jofre Manuel E.
Published: February 2008

Summary: A method of treating cysts and abscesses of Bartholin's glands utilizing a balloon catheter is presented.
An Unusual Complication in a Twin Pregnancy — Umbilical Cord of Twin 2 Around the Neck of Twin 1
Authors: Ong H. C. , Puvan I. S. , Chan W. F.
Published: February 2008

Summary: A case of uniovular twin pregnancy is described in which the cord of twin 2 around the neck of twin 1 was clamped and cut soon after delivery of the head of twin 1, thereby creating an unusual obstetric emergency.
The Influence of Maternal Weight Loss on the Outcome of Pregnancy
Authors: Ratten Graeme J. , Beischer Norman A.
Published: February 2008

Summary: A study of 1,000 consecutive patients showed that no pattern of maternal weight loss after 30 weeks of gestation reflected fetal‐placental function with accuracy. Maternal weight loss near term should alert the clinician to the need for oestriol assay, amnioscopy or cardiotocography, but does not, of itself, indicate induction of labour.
Inhibition of Puerperal Lactation: Pyridoxine of no Benefit
Authors: Fleming J. Stewart
Published: February 2008

Summary: A double‐blind trial comparing the efficacy of pyridoxine, stilboestrol and a placebo showed stilboestrol to be clearly superior in the inhibition of puerperal lactation, pyridoxine being only marginally more effective than a placebo. By advising patients to restrict their fluid intake and support the breasts, it was possible to employ a relatively low total dose of stilboestrol of 75 mg over 5 days.
Post ‐ Eclamptic Myoglobinurie Renal Failure ‐ A Case Report
Authors: Singhal P. C. , Chugh K. S. , Dutta B. N.
Published: February 2008

Summary: A 33‐year‐old secundigravida developed acute renal failure as a complication of eclampsia. Laboratory data revealed raised serum creatine phospho‐kinase, aldolase, and the presence of myoglobulin in the urine. The myoglobinuria was attributable to the convulsions and coma; other possible contributing factors include the severe hypertension (causing vascular damage and ischaemic necrosis of muscle fibres) and the release of myoglobulin from the dead fetus.
Trophoblastic Disease in Iran
Authors: Parsa Hossein
Published: February 2008

Summary: During the 5 years January, 1970 to December, 1974, 235 cases of hydatidiform mole and 47 of malignant trophoblastic disease were seen at the Jahan S. Saleh Hospital in Tehran. The incidence of trophoblastic disease was 1 per 181 viable pregnancies. Malignant sequelae occurred in 7.6% (18 of 235) of patients with hydatidiform mole.
Laparoscopy and Hysterosalpingography in the Diagnosis of Infertility in Patients with Secondary Amenorrhoea and Ovulatory Disorders
Authors: Correy J. F. , Schokman F. C. M.
Published: February 2008

Summary: A series of patients with infertility associated with secondary amenorrhoea and oligo‐ovulation/anovulatory menstruation has been assessed to determine the value of hysterosalpingography and laparoscopy as initial procedures. The results indicate that neither of these procedures aid significantly in the management of anovulation, and that because of the potential morbidity, particularly of laparoscopy, they should be reserved for those patients in whom pregnancy is not achieved after ovulation induction.
Prostaglandins and Postmaturity
Authors: TambyRaja R. L. , Karim S. M. M. , Salmon J. A. , Ratnam S. S.
Published: February 2008

Summary: Levels of E and F prostaglandins in amniotic fluid of patients with prolonged pregnancy have been compared with levels of patients in the last 4 weeks of normal pregnancy. The mean F prostaglandin levels in patients going past term (1,293.3 ± 332.87 pg/ml) were considerably lower than those going into spontaneous labour at term (4,276.71 ± 1,469.62 pg/ml). In 43 patients who went past term, the F prostaglandin levels bore a positive correlation to the cervical score (correlation coefficient 0.654; P < 0.001).

These studies suggest that prostaglandins play an important role in the spontaneous onset of labour at term and are also responsible for cervical ripening at term.
The Urethral Axis Test in the Evaluation of Stress Incontinence
Authors: Elliott Murray
Published: February 2008

Summary: A simple test in the management of patients with anatomical stress incontinence is described. It is considered that this test is useful in identifying the degree of anatomical deformity about the bladder neck and hence helpful in selecting the appropriate operation for the particular patient.

In the author's experience, this test can replace the more elaborate radio‐graphic investigations, usually described for the pre‐operative assessment of such patients.
Normal Term Intra‐uterine Pregnancy in a Nulliparous Patient After 3 Consecutive Ectopic (Tubal) Pregnancies
Authors: Noel Fernand Espitalier
Published: February 2008

Summary: A case of normal term intra‐uterine pregnancy in a nulliparous patient after 3 consecutive ectopic (tubal) pregnancies is presented.
Review: Trends in Fetal Assessment
Authors: Biggs J. S. G.
Published: February 2008

Summary: Progress in methods of fetal assessment in late pregnancy has been reviewed by analyzing the papers on this subject in 4 obstetrical journals in 1975. Among 107 papers on fetal assessment, the most common subjects were phospho‐lipid assays for fetal lung maturity, antenatal fetal heart rate measurements, ultrasonic studies, and oestrogen assays. The lecitbin/sphingomyelin ratio test has become established as the best currently available measure of functional fetal maturity. Antenatal fetal heart monitoring, with or without oxytocin infusion, is a valuable means of identifying the fetus at risk in late pregnancy.
Psychological Complications of Hysterectomy
Authors: Chynoweth R. , Abrahams M. J.
Published: February 2008

Summary: One hundred and forty‐seven women were assessed before undergoing hysterectomy. Information was obtained about their physical condition, social background, and psychological status. After operation an assessment was made concerning their attitude to the operation, physical health, mental health, sexual relationships, and their partner's attitude to the sexual relationship. Factors were identified which correlated with a poor outcome. The significance of these findings is discussed with particular reference to the possible use of more active intervention in the ‘at risk’ patient.
Achalasia of the Oesophagus Complicating Pregnancy
Authors: Laufer N. , Freund H.
Published: February 2008

Summary: Although achalasia of the oesophagus is a rare condition in pregnancy it is frequently associated with serious maternal complications and a poor fetal prognosis. We add 2 such cases to the 8 others reported, and review the literature. It is our opinion that oesophagomyotomy is the treatment of choice for this condition; it should be employed early in the course of the disease before it has reached an advanced state when there is danger to mother and child.