bluuebunny/crossref_metadata_2025 huggingface dataset:
PLASMA UNCONJUGATED OESTRIOL IN LATE PREGNANCY : CIRCADIAN VARIATION AND THE EFFECT OF MEALS AND A GLUCOSE LOAD
Authors: Hull M. G. R. , Monro P. P. , Gillmer M. D. G.
Published: August 2005

Plasma unconjugated oestriol (E3) concentrations were determined by radio‐immunoassay in 10 normal subjects in late pregnancy, throughout a normal day and night, and after a 50 g oral glucose load. There was a circadian pattern in E2 concentration characterized by an abrupt increase of 15 per cent at night. There was no significant rhythm during the day or night, taken separately. However there was a 10 to 11 per cent reduction in E3 concentrations soon after some meals and after a glucose load, possibly due to expansion of the plasma volume. Excluding the effect of meals, the fluctuation of E3 concentrations in individuals (median of the coefficients of variation) was 11 5 per cent in the day. Overall, it was 13·2 per cent in the day, 12·1 per cent at night and 15·9 per cent over the whole period studied. Since the variation in plasma unconjugated E3 concentrations through 24 hours was no greater than random fluctuations or day‐to‐day variation there is no need to restrict the time of blood sampling in clinical practice.
THE POSSIBLE ADVERSE EFFECT OF PROPRANOLOL ON THE FETUS IN PREGNANCIES COMPLICATED BY SEVERE HYPERTENSION
Authors: Lieberman B. A. , Stirrat G. M. , Cohen S. L. , Beard R. W. , Pinker G. D. , Belsey Elizabeth
Published: August 2005

A retrospective study is presented of the effect of propranolol on fetal outcome in pregnancies complicated by maternal hypertension. In nine pregnancies in which propranolol was given to markedly hypertensive women (diastolic blood pressure over 105 mm Hg) the fetal outcome was worse than in 15 patients using other hypotensive agents. The probability of fetal or neonatal death was related to the amount of proteinuria and the presence of parenchymal renal disease but was also significantly higher when the mother had been treated with propranolol. Experimental evidence suggests that beta‐adrenergic blockade is harmful to the hypoxic fetus, for these reasons the use of propranolol in hypertensive pregnancies complicated by placental insufficiency may be contraindicated unless there is no satisfactory alternative.
PREGNANCY AND NELSON'S SYNDROME TWO CASE REPORTS
Authors: Feeney J. G. , Craig G. A. , Hancock K. W.
Published: August 2005

We describe two patients with Nelson's syndrome in whom pregnancy progressed normally to spontaneous delivery of normal infants. One patient, who subsequently was found to have a basophil adenoma of the pituitary, developed diabetes insipidus in late pregnancy and the diabetes insipidus regressed spontaneously after delivery.
VAGINAL BLEEDING IN CHILDHOOD: A REVIEW OF 51 PATIENTS
Authors: Heller M. E. , Savage M. O. , Dewhurst John
Published: August 2005

A search of the medical records at the Hospital for Sick Children, Great Ormond Street and Chelsea Hospital for Women, London, revealed 51 cases of vaginal bleeding in children under the age of 10 occurring in the years 1962 through 1977. The bleeding was caused by some form of precocious puberty in 37 patients (73 per cent). Eight of these patients had cyclical vaginal bleeding in the absence of secondary sexual development or advanced bone age. Fourteen patients (27 per cent) bled because of a local lesion and six of these had a malignant neoplasm of the genital tract.
THE ACUTE EFFECT OF SMOKING ON INTERVILLOUS BLOOD FLOW OF THE PLACENTA
Authors: Lehtovirta P. , Forss M.
Published: August 2005

Smoking a standard cigarette caused an acute decrease in intervillous placental blood flow. This change normalized within 15 minutes. At the time intervillous blood flow was depressed, heart rate and blood pressure were elevated and remained so throughout the study period. Repeated decreases in the intervillous blood flow could explain growth retardation of the fetus and some other complications of pregnancy in women who smoke.
PLASMA PROLACTIN IN PREGNANCY INDUCED HYPERTENSION
Authors: Jenkins D. M. , Perry L. A.
Published: August 2005

In a prospective study, plasma prolactin concentration at 37 to 41 weeks gestation in 45 primigravidae showed a significant correlation with maximal rise in diastolic blood pressure between levels at 7 to 16 weeks and those measured between 28 weeks and delivery.
A COMPARISON OF SALBUTAMOL AND ETHANOL IN THE TREATMENT OF PRETERM LABOUR
Authors: Sims C. D. , Chamberlain G. V. P. , Boyd I. E. , Lewis P. J.
Published: August 2005

Intravenous salbutamol and ethanol were compared as treatments for preterm labour, 42 patients being assigned randomly to salbutamol and 46 to ethanol. There was no statistically significant difference in outcome between patients in the two groups, the mean delay in delivery achieved being 15 days with salbutamol and 20 days with ethanol. Neither treatment was very effective since only 10 patients given salbutamol and 14 given ethanol had their delivery postponed to 37 weeks or later. Salbutamol was more rapidly acting than ethanol but produced more cardiovascular side effects.
GROUP B BETA HAEMOLYTIC STREPTOCOCCI IN THE FEMALE GENITAL TRACT: A STUDY OF FOUR CLINIC POPULATIONS
Authors: Embil J. A. , Martin T. R. , Hansen N. H. , Macdonald S. W. , Manuel F. R.
Published: August 2005

The carrier rate of group B beta‐haemolytic streptococci (GBS) was assessed in pregnant and non‐pregnant women attending four clinics. Multiple sites were sampled and standard methods were used to isolate GBS. Colonization rates were highest in patients attending a venereal disease clinic but were not associated with other sexually transmitted diseases. Higher colonization rates were detected when multiple sites were sampled. Serotypes II and III occurred most frequently.
CONGENITAL HYPOFIBRINOGENAEMIA AND RECURRENT ABORTION
Authors: Hahn L. , Lundberg P. A. , Teger‐Nilsson A. C.
Published: August 2005

A 26‐year‐old patient, who had had six consecutive spontaneous early abortions, is presented. The patient had hypofibrinogenaemia. The importance of a normal fibrin network in early pregnancy is discussed.
BIRTH WEIGHT STANDARDSINA COMMUNITY OF MIXED RACIAL ORIGIN
Authors: Grundy M. F. B. , Hood J. , Newman G. B.
Published: August 2005

A prospective study of approximately 2000 consecutive deliveries at a north London hospital, with a mixed population distribution of Caucasian, British and Irish, Indian and West Indian mothers was made between May 1975 and August 1976. Most of the results are based on 1322 births of known gestational age. Babies of Indian mothers were found to be approximately 300 g lighter than their Caucasian equivalents at term, and by United Kingdom birth weight standards, 15 per cent of the babies of Indian mothers were below the fifth centile. Birth weights of babies of West Indian mothers ranged between those of the Indian and the Caucasians
USE OF A PORTABLE REAL‐TIME ULTRASOUND SCANNER IN DISTRICT ANTENATAL CLINICS
Authors: Balfour R. P.
Published: August 2005

A portable real‐time ultrasound scanner was transported to nine district antenatal clinics up to 35 miles from the base hospital. A total of 100 patients was scanned. During a scanning time of five to ten minutes, measurements of biparietal diameters were obtained easily, and in most cases details of placental location, fetal movement and the fetal spine were obtained.
TRIPLET PREGNANCY
Authors: Daw E.
Published: August 2005

A series of 14 triplet pregnancies has been analyzed. The older triplet mother had a better chance of fetal survival than the younger mother. Parity did not appear to have much effect on fetal survival but the maturity of the infants at birth had more influence than did birth weight, on their survival. The interval between the delivery of the second and third infants did not correlate with the poor prognosis for the last infant. Spontaneous breech delivery appeared to have a worse prognosis than assisted breech delivery. There was a high incidence of girls and they appeared to do better than the boys. There was a high incidence of monozygotic twin pairs in these triplet pregnancies.
AMNIOTIC FLUID ALPHA‐FETOPROTEIN LEVELS AND THE PRENATAL DIAGNOSIS OF NEURAL TUBE DEFECTS: A COLLABORATIVE STUDY OF 2180 PREGNANCIES IN THE NETHERLANDS
Authors: Kleijer W. J. , De Bruijn H. W. A. , Leschot N. J.
Published: August 2005

Amniotic fluid alpha‐fetoprotein (AFP) concentrations were measured in 2180 patients at risk of fetal abnormality because of previous history, family history, advanced maternal age, suspected fetal growth retardation and hydramnios. In 12 patients investigated before 20 weeks gestation, pregnancy was terminated because of a raised amniotic fluid AFP‐level: 11 fetuses had neural tube defects (NTDs) and one had a congenital nephrosis. There were no false negative results in the 1927 patients tested before 20 weeks and with a pregnancy of known outcome. In patients tested after 20 weeks, the amniotic fluid AFP concentration was raised in 20 cases of anencephaly, in 9 fetuses with severe congenital malformations without NTD and in one apparently normal fetus. Of 428 patients with a previous offspring who had a NTD, only 8 (1.9 per cent) again had a fetus with a NTD.
PULMONARY VENTILATION IN PREGNANCY*
Authors: Alaily A. B. , Carr K. B.
Published: August 2005

Serial tests of ventilatory function were made in 38 normal primigravidae during and after pregnancy. During pregnancy all patients showed major changes in tidal volume, functional residual capacity and residual volume. Minor changes were found in many other measurements, all of which occurred at an early stage of pregnancy. Most of the obvious alterations cannot be accounted for adequately by mechanical disturbance from the gravid uterus.
MYOMETRIAL RESPONSE TO A LONG‐ACTING VASOPRESSIN ANALOGUE IN EARLY PREGNANCY
Authors: ÅKerlund M. , Laudańaski T.
Published: August 2005

Intrauterine pressure was recorded for 4 to 6 hours in 21 healthy women having a therapeutic abortion at 6 to 9 weeks gestation. Fourteen of the women received an intravenous injection of 300 pg of N‐a‐triglycyl‐(8‐lysine)‐vasopressin (TGLVP) and seven were used as controls. Uterine tone and the amplitude and duration of uterine contractions increased in all women receiving the drug, uterine tone usually rising first, with a change in contractions as a secondary effect which lasted for the rest of the observation period. Uterine activity did not change in the controls. These results suggest that TGLVP might be used for the induction of abortion during the first trimester of pregnancy.
PATTERNS OF FETAL HEART RATE DURING NORMAL PREGNANCY
Authors: Wheeler T. , Murrills A.
Published: August 2005

Ninety‐seven recordings of the fetal heart rate, lasting for one hour, were made from 59 normal patients between 21 and 41 weeks of gestation. The heart rate was measured from beat to beat using the R‐wave of the fetal electrocardiogram (ECG) as the indicator of each heart cycle. The recordings showed a significant decrease in the baseline heart rate as gestation advanced. Significant departures from the baseline took the form of short episodes of bradycardia in the earlier recordings and short episodes of tachycardia in the later recordings. The undulatory pattern of variability was most common (46 per cent of the recording time); the proportion of narrowed undulatory variability decreased significantly and the proportion of saltatory variability increased significantly as gestation advanced. From 34 weeks of gestation, long‐term changes in the pattern of the fetal heart rate, related to periods of fetal rest and activity, were observed in the recordings. The periods of rest lasted for an average of 15 minutes and were characterized by a reduction in heart rate variability to the narrowed undulatory and silent types. Analysis of the cardiac beat‐to‐beat variation showed an arrhythmia, not previously described in the human fetus, that may be related to fetal breathing.
PLATELET LIFESPAN IN NORMAL PREGNANCY AS DETERMINED BY A NONRADIOISOTOPIC TECHNIQUE
Authors: Wallenburg H. C. S. , Van Kessel P. H.
Published: August 2005

A nonradioisotopic technique for determination of platelet lifespan was applied to 19 healthy women whose gestational ages were between 32 and 40 weeks. Nine non‐pregnant women and five men were also studied. Platelet counts were performed in all subjects. No significant difference was demonstrated between platelet lifespan in pregnant women (9·2 days), in non‐pregnant women (9·7 days) and in men (9·2 days). There was no significant difference between platelet counts in men and in non‐pregnant women, but the mean number of platelets in pregnant women was significantly lower. It is concluded that no significant changes in platelet behaviour appear to occur in normal pregnancy.

We are grateful to Mrs P. Rotmans and Mr E. Haddeman for their advice and technical help.
COMPONENTS OF THE HAEMOSTATIC MECHANISM IN TWIN PREGNANCY
Authors: Condie R. , Campbell Doris
Published: August 2005

Components of the haemostatic mechanism were measured at intervals throughout pregnancy in 11 patients with twins and compared with a group of 21 patients with singleton pregnancies. Mean plasma fibrinogen levels were consistently (but not significantly) elevated in the mothers of twins while other parameters showed no differences.
SERUM LACTATE DEHYDROGENASE IN DETECTING LIVER DAMAGE ASSOCIATED WITH PRE‐ECLAMPSIA
Authors: Shukla P. K. , Sharma D. , Mandal R. K.
Published: August 2005

Assessment of liver damage by estimation of serum enzymes including lactate dehydrogenase (LDH) and its hepatic fraction, LDH5, was made in 60 normal pregnant women, 20 patients with pre‐eclampsia and 10 with eclampsia. Definite evidence of damage was found in patients with pre‐eclampsia and eclampsia and was related to the severity of the disease.
WATER RELATIONS OF THE OVARIAN CYCLE
Authors: Good W.
Published: August 2005

This study reports the likely pattern of change in serum osmolality during the normal ovarian cycle, together with that which occurs during ovulation‐induction by gonadotrophin. The variation in serum osmolality is attributed to the action of oestrogen on venous distensibility, and the effect of that response on the osmotic equilibrium between intra‐ and extravascular fluid. Although the action of gonadotrophin is mediated by the products of follicular theca and granulosa cells, the physiological response is ultimately affected by water. Both ovulation and menstruation may therefore depend on achieving a critical water content of follicular fluid and endometrial tissue.
THE EFFECT OF PRETERM DELIVERY ON PERINATAL MORTALITY
Authors: Rush R. W. , Davey D. A. , Segall M. L.
Published: August 2005

A detailed retrospective analysis was made of 2329 preterm infants who accounted for 11 per cent of all births during 1974 and 1975 in the Peninsula Maternity Services, Cape Town. Whereas preterm delivery did not contribute to perinatal mortality in terms of stillbirth (more than 90 per cent occurred before labour), it exceeded all other causes in terms of early neonatal death. Preterm birth was responsible for 81 per cent of early neonatal mortality not attributable to lethal deformities. Early neonatal mortality rates were closely linked to both gestational age and birth weight and to the reason for preterm birth. The rate was high (109.8 per 1000) when preterm labour was spontaneous and without obvious maternal or fetal disease, but relatively low (56.5 per 1000) when preterm delivery was elective. Growth retardation, particularly, was associated with a relatively low neonatal mortality. It is suggested that more emphasis should be placed on the assessment of surface active phospholipids in amniotic fluid in the management of preterm labour. And since most early neonatal deaths were linked to spontaneous preterm delivery of uncertain aetiology, the pathophysiology of premature labour is in urgent need of further investigation.
A MORPHOLOGICAL STUDY OF THE ENDOCRINE PANCREAS IN HUMAN PREGNANCY
Authors: Van Assche F. A. , Aerts L. , Prins F. De
Published: August 2005

During human pregnancy an enlargement of the islets of Langerhans and hyper‐plasia of the β cells is present. These morphological changes indicate that the endocrine pancreas is able to adapt to the metabolic changes of pregnancy.
EFFECT OF INTRAVENOUS INFUSION OF BETASYMPATHOMIMETIC AGENTS ON PLASMA RENIN ACTIVITY DURING PREGNANCY
Authors: Lammintausta R. , Erkkola R. , Katainen P.
Published: August 2005

The plasma renin activity (PRA) was measured in 26 pregnant patients before and during ritodrine infusion (10 patients), during isoxsuprine infusion (12 patients), and during glucose infusion (4 control patients). All patients were in the third trimester of pregnancy, not in labour and not hypertensive. A low dose of ritodrine, a beta, adrenergic agent, caused a rise of PRA but no simultaneous rise in heart rate; this suggests that beta, activity is involved in renin release. Normal doses of ritodrine and isoxsuprine increased the maternal heart rate to 110 to 120 beats/minute and also doubled the PRA level. Two hours after the end of the ritodrine infusion the PRA level was still above that before the infusion. The results suggest high reserves of renin during pregnancy.
PLASMA PREGNANCY‐SPECIFIC β‐GLYCOPROTEIN IN COMPLICATIONS OF EARLY PREGNANCY
Authors: Jandial V. , Towler C. M. , Horne C. H. W. , Abramovich D. R.
Published: August 2005

The prognostic value of a single plasma pregnancy‐specific β1‐glycoprotein estimation was assessed in 64 patients admitted with a history of vaginal bleeding between 7 and 19 weeks gestation. A correct prognosis was obtained in a high percentage of cases with either continuing pregnancies or with non‐viable pregnancies. In very early pregnancy with a gestation less than 10 weeks, a correct prognosis was obtained in about 75 per cent of cases but serial estimations in this group might improve the prognostic value of the test. The assay proved to be infallible where there was doubt as to whether the subject was pregnant. In the present study, single HPL estimations proved to be less useful in evaluating the outcome of complications of early pregnancy.
MENOPAUSAL HOT FLUSHES : A DOUBLE BLIND COMPARISON OF PLACEBO, ETHINYL OESTRADIOL AND NORGESTREL
Authors: Dennerstein Lorraine , Burrows G. D. , Hyman G. , Wood C.
Published: August 2005

A double blind crossover study was planned in order to compare the effects of oestrogen, progestogen and placebo on hot flushes. The 49 women studied had previously undergone hysterectomy and bilateral oophorectomy. The drug regimen consisted of three months each of ethinyl oestradiol 50 μg/day, d norgestrel 250 μg/day, a combination of these two substances (‘ordiol’) and a placebo. The predominant reason for requesting a change of medication was intolerable hot flushes associated with placebo use. All hormonal preparations were found to be significantly more effective than placebo in reducing hot flush frequency and intensity. Oestrogen containing medications were more effective than the progestogen (norgestrel).
MATERNAL SERUM ALPHA‐FETOPROTEIN AND DIABETES MELLITUS
Authors: Wald N. J. , Cuckle H. , Boreham Jillian , Stirrat G. M. , Turnbull A. C.
Published: August 2005

Maternal Serum Alpha‐Fetoprotein (Afp) Levels Were Measured From 12 To 24 Weeks Gestation In 27 Singleton Pregnancies In Women With Insulin‐Dependent Diabetes Mellitus And 90 Controls Without Diabetes Who Were Matched For Gestational Age. The Geometric Mean Afp Level Among The Diabetic Pregnancies Was 60 Per Cent Of That In The Controls, A Difference Which Was Statistically Significant (P <0.01). The Difference In Afp Level Between Diabetic Patients And Controls Was Most Marked In Sera Taken Before 21 Weeks Gestation.
UNSTRESSED ANTEPARTUM CARDIOTOCOGRAPHY IN THE MANAGEMENT OF THE FETUS SUSPECTED OF GROWTH RETARDATION
Authors: Flynn Anna M. , Kelly J. , O'Conor M.
Published: August 2005

A detailed analysis of the antenatal cardiotocographs (ctgs) in 57 patients with suspected fetal growth retardation is presented. four traces were normal and 53 were ‘non‐reactive. non‐reactive’ traces can be sub‐divided into three categories, which, in order of severity are, ‘;suspect’, ‘flat’ and ‘ominous’. when compared with the ‘suspect’ group, perinatal mortality was significantly increased and the apgar scores at one and five minutes significantly decreased in the‘flat’ and‘ominous’ groups. the presence of fetal distress in labour was significantly higher in the‘flat’ group as compared with the 'suspect’ group. intrauterine deaths occurred only in the‘ominous’ group. with experience, ten patients later in the series with‘ominous’ patterns were delivered within 24 hours of the detection of such and nine infants survived. at follow‐up between 6 and 34 months after birth, psychomotor development was normal in 47 of the 49 surviving infants.
A STUDY OF BIRTH WEIGHT, PLACENTAL WEIGHT AND MORTALITY OF TWINS AS COMPARED TO SINGLETONS
Authors: Bleker O. P. , Breur W. , Huidekoper B. L.
Published: August 2005

A study was made of 1655 sets of twins born between 1931 and 1975 in two clinical centres. Compared to singletons, twins were born three weeks earlier, weighed less at birth from 33 weeks to term and had smaller placentae from 21 to 22 weeks to term. The influence on birth weight of sex was smaller in twins, the influence of parity greater. Because, compared to singletons, lower placental indices were found in twins up to 37 to 38 weeks, the conclusion is drawn that the retardation of growth in twins is to some extent due to the placenta itself. When singletons and twins of the same gestational age were compared, the mortality was found to be similar, somewhat lower in twins up to 37 to 38 weeks and higher afterwards. Monochorial twins were found to be born earlier, weigh less at birth and have a higher mortality than dichorial twins. Placental weights were not different and the conclusion is drawn that the retardation of growth in monochorial twins is to some extent due to the higher incidence of marginal and velamentous insertions of the umbilical cord associated with lower birth weights.
THE EFFECT OF OXYTOCIN IN INDUCED LABOUR ON NEONATAL JAUNDICE
Authors: D'Souza S. W. , Black Patricia , Macfarlane T. , Rrichards B.
Published: August 2005

A prospective study in 180 mothers and babies examined the effects of oxytocin in induced labour on plasma bilirubin levels in cord blood, as well as on the incidence of neonatal jaundice. Raised plasma bilirubin levels in cord blood, probably enhanced by breakdown of fetal red cells, appeared to be a dose dependent effect of oxytocin. Commensurate with this was the finding that a larger proportion of babies in the induced group manifested a greater severity of jaundice.
FURTHER CLINICAL EXPERIENCEIN THE TREATMENT OF HIRSUTISM WITH CYPROTERONE ACETATE
Authors: Underhill Rosemary , Dewhurst John
Published: August 2005

Further experience in the treatment of female hirsutism with the anti‐androgen cyproterone acetate is reported. Two‐thirds of treated patients have shown improvement but relapse occurred within two or three months of stopping treatment. Acne also healed in two patients.
CLINICAL DILEMMAS ARISING FROM THE ANTENATAL DIAGNOSIS OF NEURAL TUBE DEFECTS
Authors: Stirrat G. M. , Turnbull A.C. , Bennett M. J. , Wald N. J. , Bobrow M. , Lindenbaum R.H. , Cuckle H.S
Published: August 2005

Eight case histories are presented which demonstrate clinical problems associated with the antenatal screening for and diagnosis of neural tube defects. It is suggested how some of these problems might be avoided in future.
COMPUTER ANALYSIS OF FETAL HEART RATE VARIATION DURING NORMAL PREGNANCY
Authors: Wheeler T. , Cooke E. , Murrills A.
Published: August 2005

Ninety‐seven one‐hour recordings of the abdominal fetal electrocardiogram (ECG) were made from 59 normal patients between 21 and 41 weeks of gestation. The heart intervals, measured between successive R‐waves, were analysed by computer. The signal‐to‐noise ratio of the fetal ECG limited the precision of the interval measurements to approximately one millisecond. The characteristics of the baseline heart rate changed significantly as gestation advanced, the mean R‐R interval, the standard deviation of the intervals and the standard deviation of the interval differences all increasing with gestation (p <0.001). In later gestation the baseline heart rate during periods of fetal rest differed significantly from that during periods of fetal activity; during rest the mean R‐R interval was greater (p <0.001) and the standard deviations of the intervals and interval differences were smaller (p <0.001). Examination of the coefficient of variation of the heart intervals gave a result which contradicted the significance of this measurement as an index of fetal welfare as proposed by Curran and MacGregor (1970).
THE POSSIBLE ROLE OF PROSTAGLANDINS IN THE SYSTEM IN THE NEWBORN HYPERFUNCTION OF THE RENIN‐ANGIOTENSIN‐ALDOSTERONE
Authors: Sulyok E. , Németh M. , Tényi I. , Csaba I. F. , Thurzó V. , Hadnagy J.
Published: August 2005

Plasma renin activity and plasma aldosterone concentration were measured by radioimmunoassay in eight newborn infants born vaginally to mothers on indomethacin treatment. Measurements were made in venous cord blood at birth and on the sixth day of life. The results were compared to those obtained in eight healthy control newborn infants of similar gestational age and birth weight. Maternal treatment with indomethacin was associated with a decrease of plasma renin activity (mean±SD) from 16.71±2.76 ng/ml/hour in the control group to 9.60±3.84 ng/ml/hour in the treated group. Plasma aldosterone concentration was lower in the cord blood of the treated group and a similar trend was demonstrated in the sixth day samples. It is suggested that the increased endogenous prostaglandin production during labour may be one of the factors responsible for the development of hyperactivity of renin‐angiotensin‐aldosterone system in the newborn.
ACUTE MENOPAUSAL TRANSITION ASSOCIATED WITH CLOMIPHENE THERAPY: TWO CASE REPORTS
Authors: Lenton Elizabeth A. , Burton R. M. , Cooke I. D.
Published: August 2005

Two patients presenting with anovulation and secondary infertility were treated with clomiphene citrate. Intermittent blood samples were obtained for the first three months of therapy in each case. One patient failed either to ovulate or menstruate in response to clomiphene and the other patient had only two episodes of cyclical bleeding before she too became amenorrhoeic. Hormonal analyses revealed that both women had undergone a rapid and precocious menopausal transition which has persisted throughout the subsequent three years.
PLASMA HCG LEVELS IN PATIENTS WITH BLEEDING IN THE FIRST AND SECOND TRIMESTERS OF PREGNANCY
Authors: Jouppila P. , Tapanainen J. , Huhtaniemi I.
Published: August 2005

The prognostic value of maternal plasma human chorionic gonadotrophin (hCG) determinations, measured by a specific β‐subunit radioimmunoassay, was studied in 188 patients with bleeding between 6 and 20 weeks gestation. The patients were arranged into different subgroups according to ultrasound findings as well as clinical and histopathological evidence. In threatened abortion with successful outcome (50 per cent of all patients studied), the weekly mean hCG values were normal or even slightly elevated. In patients with a blighted ovum, the first hCG level measured was in the normal range in 34 per cent of the patients. In patients who aborted embryo with former life signs, hCG values were generally normal before the abortion. The hCG levels were usually low in patients with incomplete abortion and ectopic pregnancy. An initially subnormal level of hCG was associated with a poor outcome of pregnancy in 92 per cent of patients. If the first hCG level was within the normal range the outcome of pregnancy was favourable in 79 percent of patients.
SERUM FOLLICLE STIMULATING HORMONE LEVELS IN HUMAN PREGNANCY
Authors: Khattab T. Y. , Jequier Anne M.
Published: August 2005

We describe a specific radioimmunoassay for follicle stimulating hormone (FSH) and the finding of immunoreactive FSH in human pregnancy sera. A total of 394 serum samples was taken from 204 normal pregnant women at different stages of gestation. The FSH levels remained constant throughout pregnancy and no rise was associated with the late first trimester elevation of human chorionic gonadotrophin (hCG).
TREATMENT OF PRURITUS VULVAE BY MULTIPLE INTRADERMAL INJECTIONS OF ALCOHOL. A DOUBLE‐BLIND STUDY
Authors: Sutherst J. R.
Published: August 2005

A double blind study is described in which 17 patients with intractable pruritus vulvae were treated by multiple intradermal injections of absolute alcohol. In each patient half the vulva was treated with alcohol whilst the other half was injected with water. Treatment with alcohol was significantly better than treatment with water (p < 0.001).
IN VITRO STUDY OF THE POSSIBLE ROLE OF THE INTRAUTERINE CONTRACEPTIVE DEVICE TAIL IN ASCENDING INFECTION OF THE GENITAL TRACT
Authors: Purrier B. G. A. , Sparks R. A. , Watt P. J. , Elstein M.
Published: August 2005

Potentially pathogenic bacteria colonized the mucus coating the tails of both monofilamentous and multifilamentous intrauterine contraceptive devices (IUCD) in 72 (55 per cent) out of 132 in vitro tests. This suggests that the IUCD tail may be responsible for the passage of vaginal bacteria into the uterus.
A DOUBLE‐BLJND CROSS‐OVER STUDY OF THE EFFECT OF DOXYCYCLINE ON MYCOPLASMA INFECTION AND INFERTILITY
Authors: Inton R. A. , Egdell L. M. , Andrews B. E. , Clarke S. K. R. , Richmond S. J.
Published: August 2005

Forty‐two couples in an infertility clinic were examined for genital infection with Mycoplasma hominis or Ureaplasma urealyticum (T strains). In 21 couples one or other partner was found to be infected; no chlamydiae, trichomonads, or gonococci were isolated from any of these couples. All patients were then included in a double‐blind crossover doxycycline/placebo study lasting 8 months. Pregnancy was achieved in one of the 21 couples who were free of infection. Of the 21 couples who were infected, one achieved a pregnancy while still infected, and 19 lost their infection on doxycycline, of whom four achieved a pregnancy. These four pregnancies all occurred among the 10 couples who received doxycycline first. One further pregnancy occurred after the trial was over. Since 5 of the 7 pregnancies occurred in the first 4 months of the trial, they were probably due to the psychological effect of treatment rather than the effect of the drug on infection.
ARTIFICIAL INSEMINATION IN DENMARK BY FROZEN DONOR SEMEN SUPPLIED FROM A CENTRAL BANK
Authors: Hansen K. Brogaard , Nielsen N. C. , Rebbe H.
Published: August 2005

A central semen bank in Denmark supplied deep‐frozen semen. Selection of donors, freezing technique, and practical details about transport of specimens are described. In one of the gynaecological departments supplied with frozen semen, 22 out of 30 patients who had artificial insemination became pregnant. The advantages and disadvantages of using frozen semen are discussed.
SEXUAL DYSFUNCTION AND URINARY INCONTINENCE
Authors: Sutherst J. R.
Published: August 2005

One hundred and three female patients attending an incontinence clinic gave information about their marital lives and sexual habits. Forty‐eight women (46 percent) maintained that their urinary disorder had adversely affected sexual relations. Women with bladder instability had a significantly higher incidence of sexual dysfunction than women with genuine stress incontinence.
ISOLATED ARTERITIS OF THE CERVIX UTERI
Authors: Crow Julie , McWhinney N.
Published: August 2005

Four patients with arteritis apparently isolated to the cervix uteri are presented and the clinical and pathological significance of this condition is discussed.
NORMAL PATTERNS OF FETAL ACTIVITY IN THE THIRD TRIMESTER
Authors: Roberts A. B. , Little D. , Cooper D. , Campbell S.
Published: August 2005

The incidence and frequency of fetal respiratory movements (FRM) and fetal trunk movements (FTM) were measured in 21 normal pregnancies between 28 and 39 weeks gestation. Fetal activity was assessed with a real‐time ultrasound scanner and all observed movements were punched directly onto computer tape. Recordings were made for one hour in three over a 24 hour period, providing a total of 168 hours for analysis. The overall mean percentage incidence of FRM was 31 per cent at a mean breathing rate of 43 breaths/minute. The mean percentage incidence of FRM during the day (0800–1759 hours) was 37 per cent. The overall mean percentage incidence of FTM was 18 per cent with a mean of 29 moves per 30 minute observation period. The mean percentage incidence of FTM during the day (0800–1759 hours) was 16 per cent. There was a well‐defined circadian variation in fetal activity with FRM peaking between 1900 and 2200 hours, and FTM between 2200 and 0100 hours. There was considerable variation in the amount of FRM and FTM recorded from hour to hour. Total fetal activity rarely fell below 10 per cent in any one recording period and this measurement may be a more useful clinical test of fetal well‐being than FRM or FTM alone.
THE EFFECT OF CERVICAL ENCERCLAGE ON PLASMA PROSTAGLANDIN CONCENTRATIONS DURING EARLY HUMAN PREGNANCY
Authors: Bibby J. G. , Brunt Jane , Mitchell M. D. , Anderson Anne B. M. , Turnbull A. C.
Published: August 2005

In women having either cervical encerclage under general anaesthesia or a vaginal examination in the early second trimester of pregnancy, peripheral plasma levels of 13,14‐dihydro‐l5‐keto prostaglandin F (PGFM) were measured before and after each procedure. A significant rise in circulating levels of PGFM was found within minutes of completing cervical encerclage but not after vaginal examination or induction of general anaesthesia.
A SURVEY OF 59 TRIPLET PREGNANCIES
Authors: Itzkowic D.
Published: August 2005

The outcome of 59 triplet pregnancies from four hospitals was analyzed. The combined stillbirth and neonatal mortality rate was 232/1000. Preterm labour and birth order were the most important identifiable factors in relation to neonatal death. Birth weight within a triplet set and malpresentation were not related to neonatal death. Elective cervical suture appeared to be of no value in prolonging gestation.
TESTOSTERONE PRODUCTION WITH HYDATIDIFORM MOLES IN VITRO AND IN VIVO STUDIES
Authors: Chew P. C. T. , Goh H. H. , Ratnam S. S.
Published: August 2005

Fresh molar tissues obtained from seven patients were incubated in vitro with dehydroepiandrosterone and androstenedione. The testosterone concentration in molar tissue ranged from 5.4 ng/g wet weight to 43.8 ng/g wet weight. Both precursors were readily converted to testosterone indicating that 17‐hydroxysteroid dehydrogenase and 3β‐hydroxysteroid dehydrogenase are present in molar trophoblast. A 50 mg dose of dehydroepiandrosterone was infused into patients with hydatidiform mole before and after uterine evacuation. There was a testosterone peak preceding an oestrogen rise which disappeared after uterine evacuation. It is suggested that the elevated testosterone level in molar pregnancy is mainly due to the conversion of dehydroepiandrosterone in the molar trophoblast.
STUDIES ON THE MATERNAL IMMUNE RESPONSE TO PLACENTAL ANTIGENS: ABSENCE OF A BLOCKING FACTOR FROM THE BLOOD OF ABORTION‐PRONE WOMEN
Authors: Stimson W. H. , Strachan A. F. , Shepherd A.
Published: August 2005

The leucocyte migration‐inhibition assay was employed to assess the reactivity of cells from postpartum women to placental antigen preparations. Leucocytes from normal primigravidae responded to their own placental antigens and displayed a limited degree of cross‐reactivity with allogeneic preparations. Autologous plasma suppressed this antigen recognition and the factor responsible was shown to be an IgG antibody. Leucocytes from five women with spontaneous abortions also responded to autologous placental preparations but no immunosuppressive factor could be detected in their blood. It is suggested that target antigens for maternal lymphocytes are present on the placenta, a structure critical to the continuance of pregnancy, and that the presence of the blocking antibody is necessary for fetal well‐being.
PLASMA LEVELS OF OESTRONE AND OESTRADIOL‐17β IN POSTMENOPAUSAL WOMEN
Authors: Badawy S.Z A. , Elliott L. J. , Elbadawi A. , Marshall L. D.
Published: August 2005

The plasma oestrone and oestradiol levels of 34 postmenopausal women were studied and related to various of their other characteristics. The plasma oestrone and oestradiol‐17β levels (Mean±SE) were, respectively, 32.09±4.6 pg/ml and 13.9±3 1 pg/ml. There was a highly significant negative linear association between the years elapsed since the menopause and oestrone levels (P <0.001) and oestradiol levels (P <0.02). Both plasma oestrone and oestradiol levels were directly related to weight, but the relation was only significant for oestradiol. A significant positive correlation was found between vaginal bleeding and excess weight. The degree of oestrogenicity of the vaginal smear was directly related to the levels of oestrone (P<0.08) and oestradiol (P<0.005) and to the degree of endometrial hyperplasia (P<0.02).
OESTROGEN‐GONADOTROPHIN FEEDBACK ABNORMALITIES IN HYPERPROLACTINAEMIC AMENORRHOEA DEMONSTRATED BY THE RESPONSE TO CLOMIPHENE ADMINISTRATION
Authors: Glass M. R. , Shaw R. W. , Butt W. R. , Logan Edwards R. , London D. R.
Published: August 2005

Clomiphene was administered to 16 patients with elevated serum prolactin levels in doses of 100, 200 and 300 mg/day for five days in succeeding months and total urinary oestrogens estimated on days 0, 5, 8, 12 and 15 following commencement of treatment. The responses were compared with six patients who were amenorrhoeic but had normal serum prolactin levels and absent positive feedback to oestrogen. The increased outputs of oestrogens were similar in the two groups. In the hyper‐ prolactinaemic group 5 out of 16 subjects showed evidence of ovulation whilst the remainder showed a secondary failure of response. Six subjects who failed to ovulate were treated with clomiphene and human chorionic gonadotrophin (HCG) and ovulations were induced in 31 out of 34 treatment cycles but no pregnancies were achieved. The responses to clomiphene therapy in the hyperprolactinaemic subjects were compared to the assessment of positive feedback mechanisms by means of oestrogen provocation and oestrogen amplification tests and good correlation was obtained. Only those with evidence of positive feedback to these tests were likely to ovulate on clomiphene.
DETECTION OF FETAL RISK IN POSTMATURITY
Authors: Homburg R. , Ludomirski A. , Insler V.
Published: August 2005

Ninety‐seven postmature pregnancies were monitored by amnioscopy or amniocentesis (to determine presence or absence of meconium), oxytocin challenge tests (OCT), 24‐hour urinary oestriol estimations and fetal movement counts. The colour of the amniotic fluid and the result of the OCT predicted almost all cases of fetal distress in labour and infants with low Apgar scores. Oestriol estimations and fetal movement counts predicted fetal distress only when combined with other positive tests. Of 50 patients with no abnormal test results, 49 had uneventful labours. The Caesarean section rate was not above average and all babies were Iiveborn.
AN ANALYSIS OF THE INFLUENCES OF MATERNAL AGE, GESTATIONAL AGE, CONTRACEPTIVE METHOD, AND THE MODE OF PRIMARY TREATMENT OF PATIENTS WITH HYDATIDIFORM MOLES ON THE INCIDENCE OF SUBSEQUENT CHEMOTHERAPY
Authors: Stone M. , Bagshawe K. D.
Published: August 2005

In relation to the total number of births in the United Kingdom there was an excess of hydatidiform moles arising in women over 34 years of age and possibly also under 15. The incidence of trophoblastic tumour requiring chemotherapy after hydatidiform mole was greatest in the 30 to 34 year age group and it was also high in the 20 to 24 year age group. This distribution appears to be influenced by the morphology of the moles, the mode of their removal and the use of oestrogens and progestogens in the post‐evacuation period. The need for chemotherapy for trophoblastic tumour after evacuation of a hydatidiform mole was found to be two‐ to three‐fold greater in patients who had undergone a medical induction, hysterectomy or hysterotomy compared with those whose hydatidiform moles had been evacuated by vacuum or surgical curettage, or who had aborted spontaneously. The increased risk of chemotherapy was most marked in the earlier weeks of gestation.
THE EFFECT OF AN lNJECTABLE PROGESTOGEN CONTRACEPTIVE ON BLOOD COAGULATION AND FIBRINOLYSIS
Authors: Whigham Kathryn A. E. , Howie P. W. , Mack Alison , Prentice C. R. M.
Published: August 2005

In 26 women receiving either medroxyprogesterone acetate (Depo‐Provera) injections or combined oestrogen‐progestogen pills for contraception, tests of coagulation and fibrinolysis were performed before treatment, and after 8, 16 and 24 weeks of therapy. In the medroxyprogesterone group no significant changes were induced in fibrinogen, the vitamin K‐dependent factors, or antithrombin III. Plasminogen levels fell during therapy, and were significantly lower than pre‐treatment values after 16 and 24 weeks. By contrast, the 13 women receiving oral contraceptives showed raised levels of fibrinogen and plasminogen after 8 weeks of treatment, and of factors VII and X after 24 weeks. These data suggest that medroxyprogesterone acetate injections induce fewer changes in the blood coagulation system than oral contraceptives.
HAEMANGIOMA OF THE FALLOPIAN TUBE
Authors: Joglekar V. M.
Published: August 2005

I present the sixth report of a patient with a haemangioma of the Fallopian tube and the first from the United Kingdom, The patient presented with an acute abdomen due to haemoperitoneum.
FERTILITY IN WOMEN WITH TURNERS SYNDROME CASE REPORT AND REVIEW OF LITERATURE
Authors: Nielsen J. , Sillesen Ingelise , Hansen K. B.
Published: August 2005

A successful pregnancy in a woman with Turner's syndrome with a 45, X/46,XX karyotype is described. The literature contains reports of a total of nine pregnancies in seven women with a 45,X karyotype and 56 pregnancies in 23 women with mosaicism and a 45,X cell line, as well as a 46,XX and/or 47,XXX cell line. Fifteen of the latter 56 pregnancies ended in spontaneous abortion (27 per cent), and four ended in the delivery of a stillborn child; 12 of the 37 liveborn infants (32 per cent) had a physical or mental abnormality, and 8 (22 per cent) had a chromosome abnormality. Three had Down's syndrome, and five had a 45,X cell line. Due to the relatively high (8 per cent) incidence of Down's syndrome among liveborn infants of women with Turner's syndrome, amniocentesis for fetal karyotyping should be advised.
SIGNIFICANCE OF THE ULTRASOUND LOCATION OF PLACENTAL SITE IN EARLY PREGNANCY
Authors: Chapman M. G. , Furness E. T. , Jones W. R. , Sheat J. H.
Published: August 2005

The placenta was located by routine ultrasound scanning before 24 weeks gestation in 615 consecutive obstetric patients. A ‘low lying’ placenta was present in 175 (28 per cent) of the total group; the incidence decreasing from 32 per cent at 16 weeks gestation to 18 per cent at 24 weeks. Of 94 women with an initial ‘low lying’ placenta who were selected for rescanning, only five had a placenta praevia persisting beyond the 34th week. Patients with an early ‘low lying’ placenta had a significantly higher incidence of small‐for‐dates babies than those in whom the placenta remained clear of the internal cervical os on ultrasound scanning.
AMNIOTIC FLUID SQUALENE AND FETAL MATURITY
Authors: Wysocki S. J. , Hähnel R. , Millward M. J. , Jenkins D. T.
Published: August 2005

Gas chromatographic profiles of neutral lipids in amniotic fluid pellets were analysed for 51 specimens collected from patients in the last two months of pregnancy. The most noticeable change was a large increase in squalene relative to other components in samples at term. By expressing data as a ratio of squalene to cholesterol (S/C), it was possible to accurately predict which amniotic fluid specimens came from patients whose pregnancies were of a gestation of 40 weeks or later. Highest values for S/C and for squalene were obtained for pregnancies which were several weeks overdue.
ENTAL INTERVILLOUS BLOOD FLOW MEASURED BY INHALED 133Xe CLEARANCE IN RELATION TO INDUCTION OF EPIDURAL ANALGESIA.
Authors: Husemeyer R.P. , Crawley J.C.W.
Published: August 2005

A method of determining placental intervillous blood flow (IBF) using an inhaled 133Xe technique is described. The method was used to investigate the effect on IBF of epidural analgesia with an initial dose of 37.5 mg bupivacaine. There was no statistically significant reduction in IBF following the initial dose of bupivacaine in spite of a small but statistically significant reduction in mean blood pressure. There was no significant correlation between the change in mean blood pressure and the percentage change in IBF following epidural block although the single largest percentage reduction in IBF was associated with the largest fall in mean blood pressure.
FETAL BREATHING PATTERNS IN INTRAUTERINE GROWTH RETARDATION
Authors: Trudinger B. J. , Lewis P. J. , Pettit B.
Published: August 2005

Fetal breathing movements were studied with real time ultrasound in 21 normal fetuses and 30 fetuses born small‐for‐dates (less than the 5th centile). The events of the study period were recorded on punched paper tape which was subjected to computer analysis. In the normal group the percentage time of breathing was 54±12.7 (meanSD). The breath to breath interval was 1.34±O.25 seconds and the coefficient of variation of this interval was 49.6±7.7 per cent. In 17 of the small‐for‐dates group amount of breathing was reduced with short breathing episodes and long apnoea intervals. In the other 13 patients in the small‐for‐dates group the coefficient of variation for the breath to breath interval was significantly reduced (39.6±7.9per cent, p < 0 01).
THE RELATION BETWEEN PREGNANCY SPECIFIC β1 GLYCOPROTEIN (SP1) LEVELS AND ABNORMAL GLUCOSE TOLERANCE IN PREGNANCY
Authors: Singh M. M. , Anthony F. , Wood P. J.
Published: August 2005

Pregnancy specific β1 glycoprotein (SP1) levels were measured in 54 potentially diabetic patients in the third trimester of pregnancy using a laser nephelometric method. All patients were tested by the 50 g oral glucose tolerance test. The results show that a significantly greater number of patients with abnormal glucose tolerance had SP1 levels above the mean compared with patients with normal glucose responses. All patients with a diabetic type response had SP1 levels above the mean. There was no significant difference in SP1 levels in the fasting and two‐hour plasma samples. The study suggests that patients with asymptomatic glucose intolerance in pregnancy have higher SP1 levels than patients with normal glucose tolerance. It is possible that one of the factors controlling the placental output of SP1 is the maternal blood glucose level.
DIFFERENCES IN ALBUMIN DISTRIBUTION AND DYNAMICS BETWEEN TOXAEMIC AND NON‐TOXAEMIC PREGNANT WOMEN
Authors: Henshall W. R.
Published: August 2005

By using least squares curve fitting techniques, double exponential curves were fitted to points representing the decay of plasma 131I‐albumin after blood volume estimation in 48 pregnant women. Data from the fitted curves provided estimates of the distribution of albumin between plasma and extravascular compartments, exchange between the two and rate of albumin catabolism. The lower total extracellular albumin mass of a group of 23 severely toxaemic patients was shown to arise solely from the difference in plasma albumin mass between this group and the remaining 25 patients. Comparison of these results with those in the literature suggests that pregnant women have a higher proportion of their exchangeable albumin mass in the plasma compartment and a higher rate of albumin catabolism than non‐pregnant women.