bluuebunny/crossref_metadata_2025 huggingface dataset:
Granular Cell Myoblastoma of the Vulva
Authors: Fliegner John R. H.
Published: February 2008

A case of multiple granular cell myoblas‐tomata of the vulva in a 26‐year‐old woman is described.

The pathology and possible histogenesis of the condition is discussed. Evidence in favour of a neural origin is increasing.

An outline is given of the treatment and prognosis of granular cell myoblastoma.
Vaginal Infections by Torulopsis Glabrata
Authors: Wilkey I. S.
Published: February 2008

Torulopsis glabrata can be recovered from the vagina almost as frequently as Candida albicans. It can be identified readily by usual mycological procedures.

Though apparently less virulent than C. albicans, T. glabrata is probably a vaginal pathogen causing a clinical syndrome resembling that of C. albicans. The treatment of infection by these two organisms appears to be the same.
The Use of Amnioscopy in the Detection of Meconium*
Authors: Barham K. A.
Published: February 2008

Transcervical amnioscopy has been used to view the amniotic fluid of 540 patients where there was an increased risk of meconium appearing.

The technique, indications, contraindications and difficulties have been outlined.

Using the criteria described, amnioscopy detected nearly a half of those who developed meconium in the amniotic fluid.

Three types of meconium could be distinguished — light green, dark green and yellow. Some aspects of the type and duration of meconium in the amniotic fluid were considered in relationship to the foetal outcome.

When a marked reduction of liquor was detected in the otherwise clear forewaters 1 in 3 were later found to have meconium.

There were 4 perinatal deaths, 2 during labour and 2 within 24 hours of delivery. In 3 of these meconium had been detected by amnioscopy. Clear liquor throughout carried a good foetal prognosis.

The procedure provides the clinician with worthwhile information at little risk to mother or foetus.
The Value of Single Urinary Specimens for Oestrogen Estimation During Pregnancy
Authors: Mackay E. V. , Macafee C. A. J. , Anderson Caroline
Published: February 2008

A consecutive series of 46 patients (110 tests) was studied to determine the relationship between the oestriol/creatinine ratios of 24‐hour and single urine specimens.

A satisfactory correlation was found between the 2 ratios (correlation coefficient 0.86, P < 0.001).

The single specimen urinary oestriol/creatinine ratio may have a place in the prediction of placental function, particularly at the onset of labour.
A Case of Dicephalic Monster
Authors: Leeton John
Published: February 2008

A case is presented of a 9,500 g. (19lb. 14oz.) dicephalic monster causing obstruction to delivery after birth of the first head. It is considered that the delivery of a double monster either before or during labour, if it is judged to be greater than 2500 g. (5lb. 8oz.), is best done by Caesarean section because of the high risk of maternal morbidity associated with vaginal delivery.
The Obstetrical Performance of Urban Aborigines
Authors: Morrison John
Published: February 2008

A consecutive series of 100 aboriginal patients, delivered at the King Edward Memorial Hospital, Perth, has been studied and compared with a Caucasian social class 4 group attending the same hospital.

It is evident from the study that the detribalised aborigine constitutes a high risk patient in relation to reproduction.
The Arias‐Stella Reaction: Its value to the Clinician
Authors: Johnson Douglas G.
Published: February 2008

1. A study of 79 patients with extrauterine pregnancy and 51 patients found to have the Arias‐Stella reaction in curettings is presented.

2. The value of this endometrial reaction in clinical practice is discussed.

3. It is concluded that, in the diagnosis of extrauterine pregnancy, the Arias‐Stella reaction is of little value to the clinician unless the possibility of pregnancy has not been considered.
The Role of Peritoneal Mononuclear Cells in the Regeneration of the Uterine Epithelium of the Rat
Authors: Singer Albert , Reid Bevan
Published: February 2008

The question of the origin of regenerating epithelial cells in the process of metaplasia in the human female genital tract was investigated by setting up a model system in the rat. The uterine lining was injured by the injection of trichloroacetic acid into the uterus following laparotomy. At different intervals the resulting repair process was monitored by histological and autoradiographic study. To test a previous hypothesis that the progenitor cell of the regenerate epithelium was a migratory monocytic cell, autogenous peritoneal cells were removed from the rat peritoneal cavity and labelled in vitro with sodium 51chromate. They were then replaced and their subsequent fate followed by autoradiographic procedures. Within 5 hours labelled monocyte peritoneal cells were found migrating through the necrosed layers of the uterine lining. By day 5, similarly labelled cells were found as components of the new epithelium. The epithelial type when differentiated could be varied experimentally toward a stratified (keratin‐producing) or simple (mucin‐pro‐ducing) type depending on the prevailing pH in the uterine lumen.
A Review of 350 Cases of Paracervical Nerve Block
Authors: Boden Donald C.
Published: February 2008

Three hundred and fifty cases of para‐cervical block are reviewed showing the procedure to be safe, technically simple, and giving considerable relief of pain in the first stage of labour.
The Application of the Kleihauer Technique to Fetal Blood
Authors: Jones W. R.
Published: February 2008

An acid elution technique, when applied to fetal blood, demonstrated completely eluted or “adult” erythrocytes as early as the twelfth week of gestation. In the third trimester the proportion of completely eluted cells varied from approximately 1% at 32 weeks to 2% at term. These results form a baseline for the use of the method as an accurate and rapid means of assessing the donor erythrocyte content of cord blood in babies born after intrauterine transfusion.
Ultrasonic Scanning in Obstetrics
Authors: Morrison J. , Blackwell R. J.
Published: February 2008

Summary

The principles of diagnostic ultrasound, their application in obstetrics and some characteristic echogram patterns in pregnancy are presented.
Utero‐vaginal Prolapse during Pregnancy
Authors: Fliegner John R. H.
Published: February 2008

Summary

Twenty‐three patients with severe degrees of utero‐vaginal prolapse complicating pregnancy and labour have been studied.

The underlying pathology, symptomatology and methods of treatment are considered.

It is emphasized that the symptoms of utero‐vaginal prolapse are aggravated in the latter half of pregnancy and the traditional remission of symptoms in the middle and third trimesters occurs exceptionally.

Labour is usually uninfluenced by severe degrees of utero‐vaginal prolapse, and is usually of shorter duration than normal.
Further Assessment of the Single Parameter Approach to the Diagnosis of a Positive Cervical Smear
Authors: Diamond R. A.
Published: February 2008

Large nuclei were present in all of a series of 256 confirmed positive smears. In 1,300 routine smears there were 345 (25.7%) which contained large nuclei and of these only 11 were positive. None of the smears rejected as negative by the 12 μ criterion was suspicious. By the use of the 12 μ criterion, 75% of routine smears can confidently be rejected as negative. The majority of negative smears containing large nuclei were either from postmenopausal or postnatal patients. Using the Vickers cytology screening apparatus, cervical cells can be spread and stained on a continuous tape, and attempts are now being made to perfect this instrument to identify large nuclei. Using this machine, or a similar device, only 25% of cervical smears need to be examined by the human eye.
An Appraisal of an Anatomically and Physiologically Correct Method of Breech Delivery: The Bracht Manoeuvre
Authors: Jotkowitz Max W. , Picton F. C. R.
Published: February 2008

The spontaneous delivery of the fetus presenting by the breech is compared with the classical “Liverpool” technique.

Manoeuvres of the classical type enforce a mechanism almost diametrically opposite to that which is anatomically and physiologically correct.

The Bracht manoeuvre, which is based on the latter principle, is described and the results obtained in 101 deliveries are presented and are compared with the overall results in 457 breech deliveries.
An Evaluation of Monitor Tests for the Induction of Ovulation*
Authors: Grant Alan , Robertson Struan
Published: February 2008

The total urinary oestrogen output has been compared with the indirect signs of oestrogen production using cervical mucus and vaginal smears.

Two tests were carried out on cervical mucus (fern test and spinnbarkeit or thread length), and the karyopyknotic index was estimated in the vaginal smear.

The indirect indices failed to exhibit any constantly increasing change when the output of oestrogens exceeded 50 μg./day. Reference to the tables will indicate that although these indices rose up to a level of 50 μg. and thence forward to 80 μg., they did not give any sign that such a 30 fig. rise had taken place.
Haemodialysis in the Management of Chronic Renal Failure During Pregnancy
Authors: Pepperell R. J. , Adam R. , Dawborn J. K.
Published: February 2008

A 20‐year‐old woman with severe renal failure (serum creatinine 7 mg./100 ml.; blood urea 250 mg./100 ml.) was subjected to haemodialysis from the 24th to the 30th week of pregnancy in order to increase the chance of fetal survival. She had previously had 2 abortions at 16‐20 weeks.

The blood urea level during dialysis varied between 25 and 98 mg./100 mi., and the serum creatinine between 2.4 mg. and 7.2 mg./100 ml. The patient developed marked polyhydramnios during the 27th week of gestation which ultimately led to premature delivery of a 1,020 g. female child who survived only 12 hours. Hyperparathyroidism also developed during the pregnancy. For the 14 months after delivery the patient's renal function has remained stable with conservative management.

Haemodialysis should be considered during pregnancy if there is a sudden deterioration of renal function or development of hypertension which threatens the fetus before viability. Careful attention to anaemia, calcium malabsorption and other effects of chronic renaI failure which are less responsive to dialysis is also essential.
Du21220–A New β–Mimetic Drug: A Pilot Trial to Determine its Use as a Uterine Relaxant in Conjunction with the β–Blocking Drug Practolol
Authors: Beveridge Helen , Wood Carl
Published: February 2008

The results of a pilot trial of the effects of the β‐mimetic drug Du21220 on uterine activity in 6 patients is reported. Du21220 was found to be an effective uterine relaxant. The only cardiovascular side‐effect was a rise in maternal heart‐rate. Practolol did not reverse the uterine inhibitory effect of Du21220, and in the one patient where tachycardia was marked, it produced a significant lowering of the heart‐rate, which suggests that practolol may be a useful adjunct to Du21220 to counteract the tachycardia which may occur. Neither drug caused hypotension.
Education in Gynaecology and Obstetrics The Challenge
Authors: Bonham D. G.
Published: February 2008

On March 24th, 1970 Her Majesty the Queen, Honorary Fellow of the College of Obstetricians and Gynaecologists, opened the first building of the Auckland School of Medicine which is now in its third year. Our Postgraduate School was established in 1948, the same year as the establishment of the New Zealand Regional Council. The growing school of medicine has come latterly under the influence of pre‐clinical forces but with the advent of the clinical course in 1971 the clinical advisers are hard at work preparing a curriculum that must suit practitioners who will be still working in 2013, if the retiring age remains the same. “Upon the education of the people of this country the fate of this country depends” these words, spoken by Disraeli in the House of Commons in June 1874, are no less true in this or any other country today.
Multiple Pregnancy and Cervical Ligation With a Case Report of Triplets
Authors: Dennerstein Graeme J.
Published: February 2008

Summary: A case is presented of a triplet pregnancy with a successful outcome in a woman in whom a Shirodkar operation was performed for probable cervical incompetence. Literature relevant to cervical incompetence, multiple pregnancy and premature labour is used as a basis for discussion.
Placental Localization with Radionuclides
Authors: Buttfield I. H. , Biggs J. S. G.
Published: February 2008

Summary: The results in 70 patients studied by indium‐113m for placental localization using a scanner or gamma camera are presented. This method is reliable, safe, and convenient. The radiation exposure to the mother and fetus is very much less than with radiological methods.

The diverging collimator provides a valuable addition to the gamma camera methods previously described.

Difficulties in the diagnosis of minor degrees of placenta praevia are often due to problems in defining the position of the lower segment and possibly to changes which occur in the lower segment in late pregnancy:
A Comparison of Hypotensive Drugs in Patients with Hypertensive Disorders in Late Pregnancy
Authors: Ratnam S. S. , Lean T. H. , Sivasamboo R.
Published: February 2008

Summary: Four hundred patients with severe toxaemia of pregnancy were treated with 1,4‐dihydrazinophthalazine (Nepresol), protoveratrine (Puroverine) and guanethedine (Ismelin). In the first half of the study, all 3 drugs were used; in the latter half, only Nepresol was used. Of the 357 patients who were still undelivered after 6 hours, 167 received Nepresol, 96 Puroverine and 94 Ismelin. The response was good in 87% of the patients receiving Nepresol, 60% of those receiving Puroverine and 22% of those receiving Ismelin. In addition to its superiority in effectiveness, Nepresol had minimal side effects, whereas Puroverine with doses adequate to lower the blood pressure often caused severe vomiting and bradycardia. Nepresol lowered the blood pressure rapidly to optimum levels and it is felt that more patients would have died from the sequelae of hypertension if this effect had not been achieved. Three of the 5 maternal deaths were a result of hypertension, 2 being due to cerebral haemorhage and 1 as a result of acute pulmonary oedema.
Pudendal Block: An Assessment of Efficacy and of the Area of Analgesia
Authors: Schokman F. C. M. , Correy J. F.
Published: February 2008

Summary: It is still widely taught that adequate local analgesia to the vulval area is only achieved by a combination of pudendal nerve block and local infiltration of the vulva.

Pudendal block performed on a series of patients demonstrates the fallacy of this teaching. The frequent involvement of the posterior femoral cutaneous nerve during pudendal block explains the more extensive area of analgesia obtained than would be expected by blocking the pudendal nerve alone.
Modern Intra‐uterine Contraceptive Devices
Authors: Baeyertz J.
Published: February 2008

Summary: Comparative results are presented with the use of the Margulie's spiral (“Gynekoil”) and Lippe's loop in 500 women in private practice over a period of 5 years. In this series there were no pregnancies due to undetected expulsion, but the pregnancy rate with the device in situ was 1.7 per 100 women years with the spiral and 0.9 for the loop. However, owing to a miscarriage rate of 70%, the term pregnancy rate was 0.42. The only major problem experienced was menorrhagia; 20% of patients with the spiral compared with 3.3% of those with the loop required removal of the device for this reason. The initial expulsion rate was 10% for the spiral and 4.6% for the loop, but since two‐thirds of the patients were able to retain the device on re‐insertion, only 3% of the total discontinued for this reason. The infection rate was 1% and there were no known perforations. The loop was found to be superior to the spiral in every way and it is not surprising that manufacture of the spiral has since been discontinued.

It thus appears that the modern I.U.C.D. has a reasonable acceptability rate and meets an increasing demand for some alternative to oral contraceptives. However, its use ideally requires a certain degree of selection, skill, and supervision and although possessing some advantages over other methods, it cannot be regarded as the perfect contraceptive.
Robert Barnes and His Obstetric Forceps
Authors: M. C. Forster Frank
Published: February 2008

Robert Barnes’ (1817‐1907) position in British obstetrics and gynaecology and his association with Australia are surveyed. The introduction of his obstetrical forceps into this country is traced. The reasons for the common, widespread use of this century‐old instrument are given. Strong criticism is made of the suitability of this design for modern clinical practice. A study made of 15 different makes of Barnes’ forceps used in Melbourne labour‐wards showed great variation in their measurements. It was concluded that (1) Barnes’ forceps should be relegated to the museum (2) a forceps designed for the type of delivery now being undertaken is required and (3) there should be standards for the manufacture of forceps.
Does Lifting Cause Prolapse?
Authors: Smibert James
Published: February 2008

: It is often stated that lifting heavy weights results in an increase in intra‐abdominal pressure and is a cause of uterine prolapse.

An experiment was designed to test this theory. No evidence was found that lifting weights alters intra‐abdominal pressure.

If lifting weights does play a part in the causation of prolapse, it is not through elevation of intra‐abdominal pressure.
Contraception with a Six‐Monthly Injection of Progestogen Part 3. Effects on the Endometrium
Authors: Khoo S. K. , Mackay E. V. , Adam R. R.
Published: February 2008

Endometrial histology was studied at 2‐monthly intervals in a group of 57 patients who were administered 6‐monthly injections of medroxyprogesterone acetate as a method of contraception.

Features indicative of glandular proliferation, such as mitotic activity and pseudostratification of the epithelium, were promptly and frequently lost after commencement of treatment; to a lesser extent, epithelial vacuolation, secretion, and stromal oedema were also affected. Decidual reaction was a consistent feature during treatment; it was particularly marked 2 months after each injection. The effects persisted throughout the 2‐year period of study, although a slight recovery was evident 6 months after each injection. These endometrial changes are discussed with reference to previous reports in the literature, to the duration of action of the drug, and to its mode of action as a contraceptive agent. It is suggested that the “quiescence” of the endometrium is reversible.
A Successful Pregnancy Associated with Sex Chromosomal Mosaicism of the XO/XX Type
Authors: Mackay E. V. , Adam G. S. , Khoo S. K. , Cockburn K. G.
Published: February 2008

A case report of a woman suffering from secondary amenorrhoea of 11 years' duration and primary infertility of 3 years' duration is presented. Clinical and laboratory findings indicated ovarian failure and anovulation associated with XO/XX chromosomal mosaicism. A successful pregnancy was achieved following clomiphene treatment.

The wide variation of phenotypic expression and the association of varying degrees of ovarian dysgenesis in sex chromosomal abnormalities of the XO/XX type are briefly discussed.

The rare occurrence of pregnancy under such circumstances is pointed out and the value of complete investigation and assessment of ovarian status, especially in those patients who eventually marry, should be considered.
Reproductive Pattern After Completion of Ovulation Stimulation Treatment
Authors: Cox L. W.
Published: February 2008

Summary: Patients were followed up after concluding stimulating treatment for anovulation to see whether ovulatory function improved. This occurred in 33 of the 87 patients from whom information was obtained, and in some other patients, whose menstrual pattern was unchanged, spontaneous ovulation with pregnancy occurred. Reversion to their previous state occurred in 46 patients and 8 became worse.
Experience With Gynaecological Laparoscopy
Authors: Condos P.
Published: February 2008

Summary: The findings at 100 gynaecological laparoscopics, performed at Hammersmith Hospital, are presented. The procedure was found to present few difficulties, and for the most part permitted accurate diagnosis without exploratory laparotomy. Only 17 of 76 patients investigated for infertility, amenorrhoea, hirsutism, chronic pelvic pain, pelvic mass or suspected ectopic pregnancy were found to require operative treatment. The exclusion of ectopic pregnancy in 10 of 13 suspected cases was particularly rewarding.

Laparoscopic sterilization by electro‐coagulation and division of Fallopian tubes in 20 patients was found to be simple and efficient. Fistulous tracks were observed on follow‐up hystero‐salpingography in 5 patients, but on examination at open operation the Fallopian tubes were found to have been adequately divided and sealed.

Complications of laparoscopy were in general infrequent and minor in nature: in 1 patient CO2 was insufflated into the colon; failure to visualise the pelvis adequately was the reason for abandoning the operation in 3 patients.
Resumption of Ovulation After Incomplete Abortion
Authors: Ratten G. J.
Published: February 2008

Summary: A series of 50 patients whose pregnancy was complicated by incomplete abortion is reported. The average time which elapsed before the return of ovulation, as diagnosed by the demonstration of secretory endometrium histologically, was 50 days (range 10 to 104 days), and there was no difference between patients who aborted in the first and second trimesters. Twenty per cent of first menstruations were anovular and 6% of patients had 2 anovular menstruations prior to the return of ovulation.
Experiences with Gonavislide, A New Slide Test For Pregnancy
Authors: Killip M.
Published: February 2008

Summary: Gonavislide is a new latex direct agglutination pregnancy test. A study on 100 patients comparing its use with an existing method (Planotest) has confirmed the ease and accuracy of the test.
Herpes Simplex of the Lower Genital Tract in the Female
Authors: McIndoe W. A. , Churchouse M. J.
Published: February 2008

Summary: An “epidemic” of vaginal herpes simplex in 18 gynaecological patients in the 3‐year period, January 1968 to February 1971, is presented. The basis of diagnosis has been in most cases an acute illness (13 of 18 patients), a positive cytology report (13 of 17 patients) and a positive herpes simplex virus culture report (13 of 15 patients).

Early in the series the clinical picture was of a significant illness in which the cervix was primarily involved. The clinical picture then changed, the patients more commonly presenting with acute vulvitis and either marked dysuria or retention of urine.

The implication of this infection to the fetus in the last weeks of pregnancy and its relationship to invasive carcinoma of the cervix is discussed.
Chemotherapy in Malignant Trophoblastic Disease
Authors: Long A. R.
Published: February 2008

Summary: A brief outline of the use of methotrexate and actinomycin‐D in the treatment of malignant trophoblastic disease is given.

Twelve cases are presented, 1 being treated by hysterectomy alone and 11 by chemotherapy.
The Value of Lower Limb Ossification Centres in the Radiological Estimation of Fetal Maturity
Authors: Chan W. F. , Ang A. H. , Soo Y. S.
Published: February 2008

Summary: A radiological study was made of the lower limb ossification centres in a group of 153 normal newborn infants. Their gestational ages ranged from 37 to 44 weeks.

The lower femoral centre was present in 98% of all cases. The upper tibial centre was found in 73.1% of cases over 38 weeks of gestation. The cuboid centre was shown in 37.6% of those over 40 weeks.

No correlation between sex and the ossification of the lower limb centres was found.

No significant differences in the incidence of the lower femoral and cuboid centres in the 3 ethnic groups were noted. However, the upper tibial centre was present significantly more often in Indian infants than in Chinese or Malay infants. The higher the birth‐weight, the more likely were the upper tibial and cuboid centres to be seen radiologically.
Inhibition of Postpartum Lactation With Single‐Dose Drugs
Authors: Ng K. H. , Lee K. H.
Published: February 2008

Summary: A trial was undertaken with 2 single‐dose drugs for the inhibition of postpartum lactation. Two hundred patients were studied, of whom one half were given a single oral tablet of quinestrol (Estrovis) 4 mg. and the other half were given a single intramuscular injection of Ablacton. The results showed that both preparations were equally effective in the initial inhibition of lactation and were rarely associated with rebound breast engorgement or withdrawal bleeding.
The Problem of the Large Enterocele
Authors: Zacharin Robert F. , Hamilton N. T.
Published: February 2008

Summary: Dissatisfaction with available methods of treating large enterocele prompted a re‐examination of the problem.

The present technique, applicable to large pulsion enterocele, consists essentially of excision of the pouch of Douglas and partial closure of the levator hiatus.

Fourteen patients have been subjected to this procedure since 1968 with very encouraging results.
Schistosomiasis in Gynaecology ‐ Two Cases in Immigrants in Western Australia
Authors: Joyce P. R. , Blackwell J. B. , Charters A. D.
Published: February 2008

Summary: Two patients with gynaecological schistosomiasis have been recorded in Western Australia; both were immigrants from Tanzania (then Tanganyika). One patient exhibited ova and adult worms of S. mansoni in a leiomyoma of the body of the uterus. This is believed to be the first recorded finding of an adult Schistosoma mansoni worm in a leiomyoma, and suggests that the presence of ova results, at least partly, from direct invasion of the veins of the uterus and oviposition by the adult worm, and not entirely by embolisation of eggs.

The other patient showed S. haematobium associated with a tubal gestation.

A life span of at least 20 years is evident in the case of the S. mansoni infestation.
Acceptability of an Injectable Contraceptive in a Rural Population of Thail
Authors: McDaniel Edwin B. , Pardthaisong Tieng
Published: February 2008

Initial acceptability of contraception by hormone injection was high in the rural population studied. 2,967 rural women accepted contraception by a once‐in‐three months injection of Depo‐Provera in a mobile family planning clinic program offering pills and injections. Injection patients represented 46.9% of all new acceptors; the continuation rate was 48.4% at the end of 18 months and the continuation of rural injection users was slightly higher than that of urban users of the same method in the first 15 months.

In a study of 252 cases with known reasons for discontinuation of the injection method, it was found that almost 80% discontinued for medical reasons, and that of these, 64% stopped because of various bleeding problems.

61% of all discontinuations for bleeding problems were due to amenorrhoea. Advantages and disadvantages of the injection and pill methods of contraception are outlined from the standpoints of users and medical personnel.

The importance of a high‐appeal method of contraception, such as the injections, even as an introduction to the concept and practice of family‐planning, cannot be discounted.
The Effects of Injectable Contraceptives on Lactation
Authors: Koetsawang Suporn , Chiemprasert Thiemchandra , Kochananda Premploem
Published: February 2008

A study of the effects of DMPA injectable contraceptive on lactation is presented. Thirty DMPA treated mothers were compared to 25 control cases. The study showed that DMPA does not adversely affect the milk production, milk composition or breast fed babies themselves. On the contrary, this method tends to promote lactation.

DMPA injectable contraceptive is therefore an appropriate method for use in lactating mothers.
“Micro‐dose” Chlormadinone Acetate
Authors: Seddon R. J. , Black E. R.
Published: February 2008

Chlormadinone acetate 0.5 mg. was administered daily for a total of 6,036 weeks to 209 women attending the Auckland clinics of the Family Planning Association.

Seventy‐five women discontinued the trial for reasons which included accidental pregnancy (2), planning pregnancy (6), increased frequency of bleeding (11) and cases lost to follow‐up (1).

One of the two accidental pregnancies occurred during a cycle in which some tablets were omitted.

The distribution of the intervals between bleeding episodes followed a bimodal pattern during the first 12 weeks of treatment. After the 13th week the interbleeding interval was maximal between 25 and 33 days.

Headache was the commonest symptom during the trial but accounted for only one patient withdrawal.
The Control and Surveillance of Systemic Contraceptives in Australia
Authors: Robertson T. I.
Published: February 2008

The general control and surveillance of therapeutic drugs in Australia is discussed. Problems concerned with the systemic contraceptives, in particular the assessment of carcinogenicity arc detailed. It is suggested that monitoring and surveillance systems need to be extended and that the participation of Government in the field of hospital records, coding, morbidity statistics and research into drugrelated problems should be increased. Close international co‐operation in this area is suggested. The systemic contraceptives must be seen in correct perspective in the vast and expanding field of therapeutics. A plea is made for all parties concerned to develop a greater awareness of the many associated problems.
Reproductive Failure after Oomiphene Induced Ovulation
Authors: Correy J. F. , Schokman F. C. M.
Published: February 2008

Summary: In a group of infertile patients with oligo‐ovulatory and anovu‐latory menstruation, pregnancy is frequently achieved by the use of placebo or cyclic hormone treatment. In those not responding to such treatment, clomiphene citrate appears to be relatively ineffective in achieving pregnancy. The possible causes of the low pregnancy yield and suggestions as to how this may be improved are discussed.
Experience with the Suction Curette in Termination of Pregnancy at a Sydney Teaching Hospital
Authors: Picker Richard H. , Pfanner David W.
Published: February 2008

Summary: Experience with the suction curette for termination of pregnancy in 385 consecutive cases has revealed a number of complications, including a hysterectomy rate of 1.5%. It is suggested that termination of pregnancy by this technique should not be undertaken lightly and that case selection should be strictly controlled.
Familial Mediterranean Fever, Amyloidosis and Pregnancy
Authors: Pennington John C. , Pfanner David W.
Published: February 2008

Summary: A case of pregnancy in an Armenian with pre‐existing familial Mediterranean fever and amyloidosis is presented and discussed.

The patient's renal function showed marked permanent deterioration in association with the pregnancy, and the infant, although premature, was “small for dates”.
Traumatic Amenorrhoea and Cervical Stenosis Report of a Case With Successful Pregnancy
Authors: Sydney A. M. Macintosh
Published: February 2008

Summary: A case is reported of traumatic amenorrhoea and secondary infertility. A successful pregnancy followed dilatation of the cervix; Caesarean section was required for failure of cervical dilatation and fetal distress.
Primary Carcinoma of the Fallopian Tube: Case Report
Authors: Hathout H. M. , Hassan Salonas
Published: February 2008

Summary: A case of primary carcinoma of the left Fallopian tube is reported. The patient presented with postmenopausal bleeding which persisted after curet‐tage and removal of a benign endometrial polyp. Total hysterectomy and bilateral salpingo‐oophorectomy was performed, and the diagnosis of tubal carcinoma was made only on histopathological examination of the specimen.
Pregnancy Complicated by Accidental Rubella Vaccination
Authors: Allan Beverley C. , Hamilton Susan M. , Wiemers Margaret A. , Winsor Heather , Gust I. D.
Published: February 2008

Summary: The case histories of 65 women whose pregnancies were complicated by the inadvertent administration of rubella vaccine are described. In 36 the pregnancy was terminated. Spontaneous abortion occurred in 3. Nineteen women were delivered of normal infants and in 7 the birth is still awaited. No virological or clinical evidence of fetal infection or abnormality was found. The pre‐vaccination immune status of most of the women was unknown. Adequate assessment of the effect of rubella vaccination on pregnancy will only be possible when many more such cases are studied.
The Phospholipid Test of Fetal Respiratory Maturity: Its Value in Clinical Obstetrics
Authors: Biggs J. S. G. , Gaffney T. J. , McGeary Heather M. , McMahon M. J.
Published: February 2008

Summary: The lecithin‐sphingomyelin ratio has been studied in amniotic fluid samples from 122 patients. The respiratory distress syndrome developed in 11 of the babies. The importance of a transitional zone in which respiratory function in the newborn cannot be predicted with certainty is stressed. We have found the test to be of much value in deciding the timing of elective Caesarean section or induction of labour.
Cancer of the Endometrium, An Improved Epidemiological Assessment
Authors: Bonham D. G. , Bonham R. J. G.
Published: February 2008

Summary: Five hundred and thirty‐five patients with endometrial carcinoma have been followed up using a computerised life‐table technique.

The age at diagnosis exerted a profound influence on mortality. Older patients had a higher cancer specific mortality and yet were able to live in near‐equilibrium with the disease for a longer period than younger women. In the younger women, surgery alone was superior to radiotherapy followed by surgery.
True Hermaphroditism with Oogenesis and Spermatogenesis
Authors: Shannon R. , Nicolaides N. J.
Published: February 2008

True hermaphroditism exists when both ovarian and testicular tissues are present in the same person. This condition is quite rare and it is particularly rare for the subject to exhibit oogenesis and effective spermatogenesis.
Fetal Assessment in Late Pregnancy: A Current Review*
Authors: Biggs J. S. G.
Published: February 2008

Summary: A review of papers in 4 selected obstetrical journals showed that oestrogen assays held a dominant place amongst methods of fetal assessment during 1971 and 1972. Plasma oestriol assays appear likely to increase in clinical importance.

Ultrasonic studies have maintained their place in fetal assessment. Human placental lactogen assays appear to have been accepted as an adjunct to other tests.

The phospholipid assay of fetal lung maturity showed the greatest rise in interest and activity amongst methods of fetal assessment in the past 2 years.
Intra‐Amniotic Catheter for Pressure Measurement in Fetal Heart Rate Monitoring
Authors: Anderson Ian , Renou Peter
Published: February 2008

This report describes a new type of nylon catheter for intra‐amniotic pressure measuring. We have monitored the fetal heart rate for some years and on occasions have experienced problems with insertion and blockage of open ended catheters used to measure intra‐uterine pressure which is essential for the interpretation of the significance of fetal heart rate changes. Blockage occurs at the distal end of the catheter, due either to the design or to leakage at the point of attachment to the pressure transducer, thus allowing debris to enter and obstruct the distal orifice. The new catheter is designed to overcome these difficulties. The pressure transducer is a device mounted on or near the monitor which converts the pressure in the catheter to an electrical signal. It usually has a Luer fitting for attachment of the catheter.
Stromal Decidual Change in the Pregnant Cervix: Colposcopic, Cytological and Histological Considerations
Authors: Laverty Colin R. , Fortune Denys W. , Davoren Ruth , Butterfield Louis J. , Hollyock Vernon E.
Published: February 2008

Summary: Forty‐two pregnant patients with cytology smears suggesting cervical intra‐epithelial neoplasia were examined in a special clinic by colposcopy, cytology and biopsy. This study was concerned with the recognition of decidual change in the cervical stroma in these patients, establishing its incidence and deterrnining whether its presence influenced interpretation of the colposcopic and cytological findings.

Intense decidual change was seen in die biopsy from 6 patients (14.3%); in 4 of these the change was colposcopically apparent, and in 1 decidual cells were present in the cytology smear. Colposcopically, decidual alteration can be distinguished from atypical transformation zone changes suggestive of cervical intra‐epithelial neoplasia. Similarly, in cytology smears, die well preserved decidual cells of cervical origin are not difficult to distinguish from atypical squamous cells.
Pregnancy Associated With the Homozygous Condition of Haemoglobin E Report of 5 Cases
Authors: Ong H. C.
Published: February 2008

Summary: Pregnancy in association with the homozygous condition of haemoglobin E runs a benign course. In 5 cases there was no significant haematological abnormality and anaemia was not a feature. No significant maternal complications occurred in pregnancy or during the puerperium. There were no premature deliveries or fetal deaths.
A Case of Peutz‐Jeghers' Syndrome in Early Pregnancy Mimicking Hyperemesis Gravidarum
Authors: Banks A. W.
Published: February 2008

Summary: An initial misdiagnosis of hyperemesis gravidarum was made in a patient with Peutz‐Jeghers' syndrome, the patient presenting with vomiting due to jejunal intussusception.
Blood Oestrogen Values during Labour when the Fetus is in Jeopardy
Authors: Aickin D. R. , Smith Margery A. , Brown J. B.
Published: February 2008

A fluorimetric method has been applied to the measurement of total oestrogens in finger‐prick and peripheral blood collected during labour in 120 pregnancies (283 estimations). Signs of fetal jeopardy were present in 36 of these labours. The lower limits of normal for the second half of pregnancy were defined as the 10th percentile for a normal population of pregnant women. Near term this figure was 4.6 μg/100 ml blood.

Serial blood oestrogen values obtained during the labours in which fetal jeopardy was not evident showed no consistent trends and the average coefficient of variation was 20%. Serial blood oestrogen values obtained during labours in which evidence of fetal jeopardy developed showed twice as many falling trends as rising trends and the average coefficient of variation was 27%. Seven pregnancies were identified in which the blood oestrogen values more than halved or more than doubled as labour progressed; 5 of these were associated with fetal jeopardy and one provided a unique example of blood oestrogen values which fell steadily over a period of 28 hours to less than a third of the commencing value during a labour in which acute fetal distress developed. Another showed the reverse effect of blood oestrogen values which steadily increased to 3 times the commencing level during a labour in which acute fetal distress developed.

Twenty‐one per cent, of patients showed at least 1 low blood oestrogen value during labour compared with 26% before labour. The incidence of all features indicating fetal jeopardy was increased (P= 0.01) when the blood oestrogen values were low during labour and all of the 4 stillbirths were associated with low values before fetal death. Blood oestrogen values during labour correlated with the plasma and/or urine values found before labour in the majority (79%) of pregnancies.

It was concluded that the main application of blood oestrogen assays in labour is in the pregnancies where values have not been obtained recently before labour. However, markedly falling or rising oestrogen values were found during labour in a small number of pregnancies and the incidence of fetal jeopardy in these was high. Therefore, when suitably rapid oestrogen assay methods become available they might be of use in monitoring fetal welfare during labour, particularly when labour is prolonged.
Twin Pregnancies. Influence of Antenatal Complications, Hospital Bed Rest, and Misdiagnosis on Prematurity and Perinatal Mortality
Authors: Khoo S. K. , Green K.
Published: February 2008

A study of 881 twin pregnancies in Brisbane was made to examine the value of hospital bed rest and assess the influence of parity, antenatal complications, and failure of antenatal diagnosis of twins on the rate of prematurity and perinatal mortality. The overall prematurity rate (30–36 weeks) was 30.1% and the perinatal mortality rate 12.2%. There was a marked increase in prematurity and perinatal fetal deaths in 2 groups of patients — those with antenatal complications and fetal abnormalities, and those with a misdiagnosis. Hospital bed rest between 30 and 36 weeks of gestation for the uncomplicated pregnancy provides only a marginal improvement in perinatal mortality; the differences between the rested and non‐rested groups, 4.0% against 6.1%, were not significant. Surprisingly, the rate of prematurity was higher in the rested group (31.9%) than in the non‐rested group (20.1%). The rates of prematurity and perinatal mortality were increased in primigravidae.
Twin Pregnancy in Singapore
Authors: Dawood M. Yusoff , Ratnam S. S. , Lim Y. C.
Published: February 2008

Two hundred and thirty‐four cases of twin pregnancy seen between January, 1970 and December, 1972 were analysed. The incidence of twin pregnancy was 1 in 133 pregnancies and occurred proportionately in Chinese, Malays, and Indians according to population numbers. Parity did not significantly affect the incidence of twin pregnancy. Common antenatal complications included anaemia, hypertensive disorders of pregnancy, and haemorrhage. Hospitalised bed rest did not significantly alter the perinatal mortality. Premature labour occurred in 20% of patients and only 10.8% went beyond 40 weeks of gestation. The incidence of depressed second twin increased slightly after a time‐interval of more than 10 minutes between the delivery of the first twin and the second twin, but increased significantly when the time‐interval was more than 30 minutes. The first twin tended to be larger than the second twin. The sex ratio was 100 females to 134.5 males. The overall perinatal mortality was 76.4 per 1,000, with a perinatal mortality of 64.4 per 1,000 for the first twin and 93.6 per 1,000 for the second twin.
Active Management of Labour and Occipito‐Posterior Position
Authors: O'Driscoll Kieran , Stronge John M.
Published: February 2008

Summary: A reappraisal of the clinical significance of the occipito‐posterior position is needed in the altered circumstances which derive from a policy of active management of labour. In a series of 1,000 consecutive primigravidae, the occiput was posterior at the time of delivery on 38 occasions. This had an adverse effect on the conduct of labour in approximately 3 cases (0.3%). It is concluded that the occipito‐posterior position has been reduced to a low level of clinical significance in current practice.
Comparison between Urinary Oestriol Excretion and Serum Placental Lactogen in Early Detection of Intrauterine Fetal Distress
Authors: Ylikorkala Olavi
Published: February 2008

Summary: The value of urinary oestriol excretion and serum placental lactogen (HPL) in the early diagnosis of fetal distress has been compared in a retrospective study of 174 patients whose pregnancies were complicated by hypertension. Severe fetal‐placental dysfunction was present in 36 pregnancies, and 25 (70%) were predicted by the oestriol test, 32 (89%) by the HPL test, and 34 (95%) by the use of both tests. In the 107 pregnancies where fetal‐placental function was clinically normal, confirmation was obtained in 74 (69%) by the oestriol test and in 68 (64%) by the HPL test. The HPL test warned against fetal distress somewhat earlier than the oestriol test. As a simple and rapid method, the HPL test is as suitable as the oestriol test for the routine monitoring of hypertensive pregnancies.
Long Standing Recto‐Vaginal Injuries
Authors: Keane B.
Published: February 2008

Summary: The surgical management of long‐standing obstetric recto‐vaginal injuries is discussed. Rational treatment is based on present knowledge of anatomy and physiology of ano‐rectal continence. Emphasis is laid on the repair of the superficial portion of the external sphincter, and the relative unimportance of the subcutaneous sphincter in anal continence is noted. Two cases are reported, and attention is directed to a simple scheme of pre‐operative and postoperative management.
Pregnancies in Patients with Prosthetic Heart Valves: A Review and Report of 2 Further Cases
Authors: Chew Peter C. T. , Ratnam S. S.
Published: February 2008

Summary: Improvement of cardiac status following prosthetic valve replacement has made this procedure an accepted method in the treatment of damaged valves. With its wider use, an increasing number of women of reproductive years will present to the obstetrician. We report 2 successful pregnancies in patients with Starr‐Edwards valve prostheses. The risk of pregnancy in such patients is reviewed in the light of reports in the literature.
Hydrocolpos
Authors: Ho Nai‐Kiong
Published: February 2008

Summary: A case of hydrocolpos in a neonate is reported. The importance of early diagnosis and appropriate treatment is stressed in the light of complications reported in the literature.
Acceleration of the First Stage of Labour with the Vacuum Extractor
Authors: Fahmy Kamal
Published: February 2008

Summary: A study of 260 consecutive, mid‐first stage vacuum extractions is presented. In 106 patients the cervix was 9 cm dilated and in 154 patients it was 4 to 8 cm dilated. Extraction was carried out to accelerate the first stage of labour because of arrest or slow progress, fetal distress, cord prolapse or maternal distress. In 66.8% of patients delivery was completed within 10 minutes traction time, and in 24.6% of patients within 11 to 20 minutes. Soft tissue injuries of a minor degree were recorded in 14.2% of patients, including 5% cervical tears. Cephalhaematoma occurred in 6.9% of infants, significant scalp lacerations in 3%, and cerebral damage in 0.6%. The uncorrected perinatal mortality rate was 19.2 per 1,000 total births. Comparison of patients with a 9 cm dilated cervix and those with lesser dilation did not show any statistically significant difference as regards delivery within 20 minutes traction, cup slippage, maternal and fetal injuries, depressed babies at birth, or stillbirths.
Coexistent Viable Fetus With Hydatidiform Mole
Authors: Campbell Gordon , Aitken Iain
Published: February 2008

Summary: This report concerns a patient whose pregnancy was complicated by mild antepartum haemorrhage and who subsequently delivered a viable fetus with coexistent hydatidiform mole.
An Unusual Complication in a Binovular Twin Pregnancy — Umbilical Cord of Twin 2 Around the Neck of Twin 1
Authors: Black Jules S.
Published: February 2008

Summary: A case of cord entanglement involving the cord of twin 2 being around the neck of twin 1 is presented. The unusual feature of this case is that the twins were binovular, being male and female, refuting previous statements that for this complication to occur, the twins must be monoamniotic.