bluuebunny/crossref_metadata_2025 huggingface dataset:
HAEMOGLOBIN AIc (GLYCOHAEMOGLOBIN) IN DIABETIC PREGNANCY: AN INDICATOR OF GLUCOSE CONTROL AND FETAL SIZE
Authors: Widness J. A. , Schwartz H. C. , Thompson Diana , Kahn C. B. , Oh W. , Schwatrz R.
Published: August 2005

Haemoglobin AI, (Hb AIc), a glycohaemoglobin present in normal human blood, is elevated in glucose intolerant individuals. In non‐pregnant diabetic subjects, a direct relationship has been established between per cent Hb AIc and blood and urinary glucose levels over weeks and months. In this study, Hb AI, level and mean random blood glucose concentration in the third trimester of pregnancy were found to correlate directly in 12 diabetic women without vascular disease (Pt0.001). In this same group of women, third trimester Hb AIc levels also correlated significantly with infant birth weight (P<O ·05) and birth weight adjusted for gestational age (P<O·Ol). Finally, third trimester mean blood glucose concentrations also correlated directly with birth weight (P t O ·05) and adjusted birth weight (P <0·001). In pregnancies complicated by diabetes, rigid glucose control has been recommended to achieve optimal fetal and maternaloutcomes. Hb AI, is a new tool with which to assess blood glucose control during diabetic pregnancy.
THE ROLE OF THYROID STIMULATING IMMUNOGLOBULINS OF GRAVES'S DISEASE IN NEONATAL THYROTOXICOSIS
Authors: Munro D. S. , Dirmikis S. M. , Humphries H. , Smith T. , Broadhead G. D.
Published: August 2005

Graves's disease is characterized by hyperthyroidism, a diffuse, uniform enlargement of the thyroid gland and marked eye signs. It is now widely believed that the thyroid overactivity of Graves's disease is a result of the presence in the circulation of abnormal thyroid stimulating immunoglobulins (TSIg). TSIg are transferred from mother to fetus and cause neonatal thyrotoxicosis in around 1 per cent of babies born to mothers who have a history of Graves's disease. Because TSIg may persist in the maternal circulation after successful treatment of Graves's disease by partial thyroidectomy, neonatal thyrotoxicosis may occur in babies born to mothers who have been euthyroid throughout pregnancy. In our study, 9 of 12 examples of neonatal thyrotoxicosis encountered in 96 pregnancies occurred in babies born to mothers who were thought to be thyrotoxic at some stage during the pregnancy. Two main categories of TSIg are recognized: the long‐acting thyroid stimulator (LATS) and LATS‐protector (LATS‐P) both of which were assayed in maternal serum samples withdrawn during the third trimester. Levels in maternal and cord blood were similar. The critical level of TSIg causing neonatal thyrotoxicosis appeared to be 10 units/ml and above 20 units/ml the babies were always thyrotoxic at birth.
NFUROFIBROMATOSIS AND PREGNANCY
Authors: Jarvis G. J. , Crompton A. C.
Published: August 2005

Ten patients with neurofibromatosis were studied in 27 pregnancies. Two of the patients had evidence of pre‐eclampsia in their first pregnancy but not in subsequent ones. In all other pregnancies, no adverse features were noted. It would seem that neurofibromatosis is not specifically associated with any obstetric complications. The need for further reporting of cases is stressed.
URINARY OESTROGEN AND PREGNANEDIOL EXCRETION, ENDOMETRIAL AND OVARIAN PATHOLOGY AND BODY WEIGHT IN WOMEN WITH POSTMENOPAUSAL BLEEDING
Authors: Reti L. L. , Rome R. M. , Brown J. B. , Fortune D. W.
Published: August 2005

Urinary oestrogen and pregnanediol excretion in 102 women who had a curettage for postmenopausal bleeding was correlated with the histological appearance of the endometrium, with age and with weight, and were compared with the values obtained in 42 normal postmenopausal women. The 36 patients with proliferative and hyperplastic endometrium and the 16 patients with endometrial carcinoma had significantly higher oestrogen excretion than the controls. The 27 patients with atrophic endometrium had only slightly higher mean oestrogen values than the controls. Twenty‐three patients had taken hormones and the 20 patients who bled during treatment had the same urinary hormone values as the controls (excluding three patients with ovarian and/or endometrial carcinoma). The ovaries were examined in 37 patients who had a total hysterectomy and bilateral salpingo‐oophorectomy. Significantly higher oestrogen values were found in those patients with ovarian tumours in which the stroma showed hyperplasia. When an ovarian tumour was associated with normal stroma or when the ovary showed cortical stromal hyperplasia without a tumour, urinary hormone values were normal. Oestrogen excretion and age were not related, but a correlation was found between oestrogen excretion and body weight.
REMOVAL OF INTRA‐ABDOMINAL INTRAUTERINE CONTRACEPTIVE DEVICES
Authors: Osborne J. L. , Bennett M. J.
Published: August 2005

Thirteen cases of misplaced intrauterine contraceptive devices removed from the abdominal cavity over a two year period at the Chelsea Hospital for Women, are reviewed. Five of the six plastic devices were removable laparoscopically but all the copper containing devices required a laparotomy for removal because of an omental or peritoneal reaction.
MIXED MESODERMAL TUMOUR OF THE CERVIX UTERI
Authors: Das C. K. , Nirodi N. S.
Published: August 2005

A 44‐year‐old African female with a mixed mesodermal tumour of the cervix is described and the literature briefly reviewed.
MATERNAL SERUM ALPHA‐FETOPROTEIN SCREENING IN A PROVINCIAL HEALTH DISTRICT
Authors: Woolfson J. , Holt E. M. , Whyman A. E. , Mabbs D. V.
Published: August 2005

Maternal serum alpha‐fetoprotein (AFP) estimation as a routine screening test for neural tube defect (NTD) was introduced into the West Berkshire Health District, where 17 per cent of all deliveries and most of the antenatal care is under‐taken by the general practitioners. In the first year, 4458 patients were screened and 43 of those (0.96 per cent) had raised serum AFP levels. Amniocentesis was performed on 31 patients (0.69 per cent). Ten fetuses with severe NTDs and one with exomphalos were detected and the pregnancies terminated. In six patients, raised serum AFP levels were due to fetal death. No normal pregnancy was terminated. Acceptability by patients was high. Provided that a good diagnostic ultrasound facility is available locally, maternal serum AFP estimation seemed to be a valuable screening test.
THE COMPARTMENTAL DISTRIBUTION OF OESTROGENS AND PREGNANCY SPECIFIC β1 GLYCOPROTEIN.
Authors: Smith R. , Klopper A. , Hughes G. , Wilson G.
Published: August 2005

Pregnancy specific β1 glycoprotein (PSβ1, G), unconjugated oestriol, total oestriol and oestradiol were measured in the peripheral venous blood of 25 pregnant women. The results were compared with similar measurements in maternal tissue fluid, cerebrospinal fluid, and uterine vein blood; or with retroplacental blood, umbilical cord blood, and amniotic fluid. The highest mean concentration of PSβ1G occurred in maternal venous blood and was 17.37 (SD 7.07) mg/dl. The mean peritoneal value was 21 per cent of the mean peripheral vein value. Two tissue fluid values were 32 per cent and 5 per cent of the corresponding peripheral vein values. No measurable amount of PSβ1G was found in maternal cerebrospinal fluid and cord artery. Unconjugated oestriol was found in highest concentration in retroplacental blood. The concentration fell from here to contiguous compartments. An exchange between these compartments was suggested by significant correlations in their oestriol content. Conjugated forms of oestriol, as represented by the measurement of total oestriol, were present in highest concentration on the fetal side in cord arterial blood, but could be found in all other compartments. Oestradiol appeared in highest concentrations in retroplacental blood. Low values of oestradiol were found in the fetal compartment. Correlations between maternal compartments were few and this was considered evidence of impeded transmission between these compartments.
METABOLISM OF DIPHENYLHYDANTOIN (PHENYTOIN) DURING PREGNANCY
Authors: Landon M. J. , Kirkley Maureen
Published: August 2005

Plasma levels of diphenylhydantoin (DPH) and the 24 hour urinary excretion of both DPH and its major metabolite 5‐(p‐hydroxyphenyl)‐phenylhydantoin (HPPH) were measured serially during pregnancy in a group of five unselected epileptic patients. Plasma DPH levels fell and on average were some 40 per cent lower at term than they had been in early pregnancy. With one exception, the patients were well controlled during pregnancy but two patients who regularly had plasma DPH levels below 10 μ/ml both suffered seizures in the puerperium. There was no convincing change in the excretion of either DPH or HPPH which together accounted for less than half the administered dose. Gestational length exceeded 41 weeks in 4 of the 5 patients studied but all were delivered of normal healthy infants, of average birthweight, with no congenital defects or clotting disorders.
GIANT CELL ARTERITIS OF THE FEMALE GENITAL TRACT
Authors: Petrides M. , Robertson I. G. , Fox H.
Published: August 2005

summary

In a patient who had a hysterectomy and bilateral salpingo‐oophorectomy for endometrial adenocarcinoma, a giant cell arteritis was found in many of the myometrial and tuba1 vessels and in a few of the small arteries of the cervix and ovaries. On subsequent questioning, a history of treatment for polymyalgia rheumatica during the preceding 12 months was elicited. Of the three previously reported patients with giant cell arteritis of the uterus, two were suffering from polymyalgia rheumatica whilst one possibIy had disseminated visceral giant cell arteritis.
PROTEASE INHIBITORS IN SERUM AND AMNIOTIC FLUID DURING PREGNANCY
Authors: Ramesh Bhat A. , Isaac Vimala , Pattabiraman T. N.
Published: August 2005

Antitryptic and antichymotryptic activities in amniotic fluid and maternal serum were measured at various stages of pregnancy using the caseinolytic assay method for proteases. The inhibitory activities increased up to 20 weeks in amniotic fluid and remained in the same range up to 30 weeks; a sharp fall was observed at term. In serum, there was a gradual rise of activities with peak values around 30 weeks. The decrease with further advance of pregnancy was not as sharp as in amniotic fluid. The ratios of antitryptic to antichymotryptic activities remained fairly constant (1 54±0.07) in amniotic fluid throughout pregnancy. In maternal serum the ratio varied over a range of 1.28 to 2.67 and the increase in antichymotryptic activity was relatively greater between 16 and 30 weeks resulting in a lower ratio between the two activities. Amniotic fluid was found to contain a higher proportion of a heat stable inhibitor compared to serum and its contribution to total antitryptic activity variedfrom8.7 to 15.6 percent.
AN EXTRAPERITONEAL OPERATION FOR VAGINAL VAULT SUSPENSION TO THE ANTERIOR ABDOMINAL WALL
Authors: Javey H.
Published: August 2005

A completely extraperitoneal abdomino‐vaginal operation for vaginal inversion, using Mersilene mesh, is described. There were no major postoperative complications and at follow‐up of the 13 patients at 10 to 26 months after operation the results were satisfactory.
MIXED MESENCHYMAL SARCOMA OF THE BROAD LIGAMENT CASE REPORT
Authors: Sworn M. J. , Hammond G. T. , Buchanan Rose
Published: August 2005

A 55‐year‐old patient who presented with a pelvic mass was found to have a mixed mesenchymal sarcoma of the broad ligament. The histogenesis and diagnostic criteria of this rare tumour are discussed.
IDIOPATHIC RETROPERITONEAL FIBROSIS INVOLVING THE VAGINA: CASE REPORT.
Authors: Heah J. T. C.
Published: August 2005

A patient with idiopathic retroperitoneal fibrosis involving the vagina and causing urinary symptoms is described. The condition responded satisfactorily to immunosuppressive drugs and steroid.
AMNIOCENTESIS WITH AND WITHOUT ULTRASOUND GUIDANCE
Authors: Crandon A. J. , Peel K. R.
Published: August 2005

The increasing use of amniocentesis requires that the technique be made as safe as possible. The results of 284 amniocenteses done under ultrasound control are presented and compared with the results of 140 amniocenteses performed without ultrasound control. The use of ultrasound guidance increased the success rate from 80 to 99.6 per cent and decreased the incidence of feto‐maternal haemorrhage from 8.5 to 2.8 per cent. The incidence of blood‐stained amniotic fluid was reduced from 43.5 to 17.6 per cent. The clinical significance of these findings is discussed and the results interpreted as indicating that amniocentesis done with ultrasound guidance is a safer and less traumatic procedure.
THE INCIDENCE OF DIFFERENT TYPES OF FETAL MOVEMENTS DURING PREGNANCY
Authors: Sadovsky E. , Laufer N. , Allen J. W.
Published: August 2005

In high risk pregnancies with severe fetal distress, a reduction of fetal movements may take place before fetal death occurs. This decrease is accompanied by a weakening of the fetal movements. One hundred and twenty pregnant women (310 recordings) between 20 and 41 weeks gestation recorded fetal movements and classified them into weak, strong, and rolling. The movements noted by the woman were correlated to those recorded by a fetal movements recorder. The rate of weak movements gradually decreased until the 36 to 37th week, while the strong and rolling movements increased. From the 36 to 37th week till term weak movements increased again with a decline in strong and rolling movements. Before fetal death, or in severe fetal distress with decreased total movements, the relative rate of weak movements increased. Reduction in daily total movements without a change in the distribution of the type of movement may not indicate fetal distress.
PROSTAGLANDIN E2 TABLETS USED INTRAVAGINALLY FOR THE INDUCTION OF LABOUR
Authors: Gordon‐Wright A. P. , Elder M. G.
Published: August 2005

Prostaglandin E2 tablets were administered intravaginally to 505 patients for the induction of labour, without amniotomy, using doses ranging from 1 to 5 mg as a single insertion. The advantages and limitations of this method of induction of labour are discussed.
THE EFFECT OF DANAZOL ON MENORRHAGIA, COAGULATION MECHANISMS, HAEMATOLOGICAL INDICES AND BODY WEIGHT
Authors: Chimbira T. H. , Cope E. , Anderson Anne B. M. , Bolton F. G.
Published: August 2005

Eighteen patients with objective evidence of menorrhagia (more than 80 ml menstrual blood loss) were treated with danazol for twelve weeks. Danazol significantly reduced the menstrual blood loss from 231±39 ml (mean±SEM) to 135±33 ml in the first treatment month and the mean loss thereafter was only 21 ml and 3 ml for the second and third months respectively. A rapid increase in haemoglobin level and a reduction in the number of days of bleeding were also observed on danazol treatment. No important effect on the coagulation profile was observed during the period of study. Three months after stopping danazol, menstrual blood loss (103±27 ml) was still significantly less than the pre‐treatment loss.
PLASMA FERRITIN LEVELS AS AN INDEX OF IRON DEFICIENCY IN WOMEN USING INTRAUTERINE DEVICES
Authors: Guillebaud J. , Barnett Myra D. , Gordon Y. B.
Published: August 2005

Forty‐seven women were studied before and for one year after insertion of an intrauterine contraceptive device (IUCD). The menstrual blood loss increased in 44 subjects (94 per cent), and this was related to the surface area of the IUCD. Plasma ferritin levels in the iron deficient range (below 16 ug/l) were present in 9 subjects (19 per cent) before insertion of the IUCD, whereas by the end of one year, 21 subjects (45 per cent) had reached these levels. The incidence of depressed ferritin levels was highest in subjects with a monthly blood loss exceeding 80 ml. The haemoglobin, mean corpuscular haemoglobin and mean corpuscular volume measurements declined progressively, but were less sensitive predictors of iron deficiency. These findings indicate the need to monitor iron status and administer oral iron replacement therapy in subjects with an IUCD.
INTRAPARTUM FETAL MONITORING PRACTICE IN THE UNITED KINGDOM
Authors: Gillmer M. D. G. , Combe D.
Published: August 2005

In September 1978 a postal survey was made to establish the influence of continuous fetal heart rate monitoring on clinical practice in 264 Consultant Obstetric Units in the United Kingdom. Replies were received from 244 units (92·4 per cent) and only one of these did not possess any fetal heart monitors. The approximate percentage of patients monitored during labour in these units displayed a bimodal distribution with peaks at 20 to 30 and 80 to 90 per cent, reflecting a division of opinion about the need to monitor all or only ‘high risk’ patients. For each hospital the ratio of the numbers of patients delivered during 1977 to the number of monitors was calculated and the values ranged from 172 to 2708. In nearly 25 per cent of the hospitals it was not possible to monitor all high risk patients. Fetal blood pH estimation was used in conjunction with fetal heart rate measurement in 98 hospitals (40·2 per cent) but 38 (15·6 per cent) had a pH meter in or adjacent to the labour ward although this was not used for pH estimation. Midwives were taught to apply fetal scalp electrodes in half of the units but were taught to collect fetal blood samples in only two. It is suggested that there is a need (i) to improve the monitoring facilities in many units, (ii) to encourage midwives to become more involved in practical monitoring techniques and (iii) to develop improved methods for fetal pH determination during labour.
THE EFFECTS OF ERGOMETRINE ON THE LOWER OESOPHAGEAL SPHINCTER TONE AT CAESAREAN SECTION
Authors: Dimopoulos G. E. , Brock‐Utne J. G. , Downing J. W. , Edwards H. , Moshal M. G.
Published: August 2005

The effect of intravenous ergometrine 0.5 mg during general anaesthesia for Caesarean section on lower oesophageal sphincter (LOS) function was investigated in eight patients. Ergometrine increased the LOS pressure markedly (p <0.005).
CHLORMETHIAZOLE TREATMENT AND BREAST FEEDING
Authors: Tunstall M. E. , Campbell Doris M. , Dawson Blanche M. , Jostell K.‐G.
Published: August 2005

Four mothers receiving chlormethiazole for pre‐eclampsia and their babies were the subjects of the investigation. Blood samples at delivery and blood and breast milk samples in the postpartum period were analysed for chlormethiazole. Concentrations ranged from 1·340 to 1·640 ug/g of sample in umbilical artery blood at birth, and fell to 0·010 to 0·153 ug/g in capillary blood 20 to 26 hours later. After the start of breast feeding, chlormethiazole in the babies was detectable in only 3 out of 27 serial blood samples and was 0·018, 0·009 and 0·006 μg/g. The highest calculated amount of chlormethiazole ingested at a breast feed was 37.2 ug. It is suggested that breast feeding should not be delayed solely on account of chlormethiazole therapy.
DIAGNOSTIC ACCURACY OF THE MIMARK ENDOMETRIAL CELL SAMPLER IN 101 PATIENTS WITH POSTMENOPAUSAL BLEEDING
Authors: Swingler G. R. , Cave D. G. , Mitchard P.
Published: August 2005

The efficacy of the MiMark endometrial cell sampler in the cytological assessment of endometrium was evaluated in 101 patients with postmenopausal bleeding. The apparatus was successful in diagnosing all but one of the endometrial carcinomas in the series. Reports of its accuracy in diagnosing endometrial hyperplasia and other endometrial pathology cannot be substantiated.
ACUTE PROLIFERATIVE GLOMERULONEPHRITIS WITH CRESCENTS AND RENAL FAILURE IN PREGNANCY SUCCESSFULLY MANAGED BY INTERMITTENT HAEMODIALYSIS
Authors: Naik R. B. , Clark A. D. , Warren D. J.
Published: August 2005

A 26‐year‐old patient with no previous history of renal disease developed acute non‐streptococcal crescentic glomerulonephritis with severe renal failure in the 17th week of her second pregnancy. It became necessary to treat her with haemodialysis to maintain the blood urea around 25 mmol/l. The haemoglobin was maintained above 9 g/dl with regular blood transfusions and the blood pressure was controlled with hypotensive drugs. Measurement of fetal biparietal diameter and human placental lactogen indicated normal fetal growth and placental function. The patient spontaneously delivered a healthy infant at 32 weeks. Haemodialysis requirements decreased post partum and the patient even managed without dialysis for 12 weeks. Renal function, however, remained severely impaired and maintenance haemodialysis was again necessary a t nine months post partum. Glomerulonephritis complicating pregnancy is reviewed and the management of acute and chronic renal failure in pregnancy is discussed.
SUBJECTIVE RECORDING OF FETAL MOVEMENT
Authors: Wood C. , Gilbert M. , O'Connor A. , Walters W. A. W.
Published: August 2005

A group of 137 patients, 113 of whom had obstetric complications, recorded fetal movements by a subjective method. Low fetal movement counts were associated with maternal cigarette smoking and prolongation of pregnancy and high counts with maternal ingestion of sedatives or tranquillizers, abnormal fetal heart rate in labour and a true knot in the umbilical cord. The absence of fetal movement during four consecutive 20‐minute counting‐sessions was not associated with poor fetal outcome. Further investigations to assess the usefulness of fetal movement counting are recommended. Such investigations should take into account the limitations imposed by the methods and the obstetric population for study.
EFFECT OF AMNIOTOMY ON FETAL BREATHING MOVEMENTS
Authors: Wladimiroff J. W. , Roodenburg P. J. , Bovenlander J.
Published: August 2005

Fetal breathing movements were recorded by real‐time ultrasound before and after artificial rupture of the membranes. Fifteen normal pregnancies between 39 and 41 weeks gestation were studied. A significant increase in breathing incidence and maximum breathing rate was observed in the first 10 minutes after amniotomy.
THE DISTRIBUTION OF POLYAMINE OXIDASE ACTIVITY IN THE FETOMATERNAL COMPARTMENTS
Authors: Illei G. , Morgan D. M. L.
Published: August 2005

Polyamine oxidase activity was measured in different compartments of the feto‐maternal unit by a radiochemical method. The activity in the retroplacental serum (mainly of intervillous origin) was 20 to 30 times higher than in maternal uterine or peripheral venous blood sera. No activity was found in the fetal cord blood sera. The enzyme level in the maternal peripheral sera fell to undetectable levels within 72 hours post partum. Preliminary data indicate that the enzyme might be produced by the decidua rather than by the placenta. It is suggested that the enzyme may constitute an important part of a supposed local immunological barrier formed at the placental bed to help to protect the fetal allograft from maternal immune rejection through a local suppressive effect on maternal cellular immunity.
POLYAMINE OXIDASE ACTIVITY IN HUMAN PREGNANCY SERUM
Authors: Illei G. , Morgan D. M. L.
Published: August 2005

The existence of a spermine oxidizing enzyme was established in human pregnancy serum by a radiochemical method, and a cross‐sectional study of its quantitative profile between 10 and 40 weeks gestation was undertaken. Though there was a wide scatter of values, the rise in the average activity was continuous and highly significant. The flavoprotein inhibitor, quinacrin, inhibited the enzyme activity, while the pyridoxal phosphate inhibitor, isoniazid, had no significant inhibitory effect suggesting that the enzyme is of tissue origin. The possible role of polyamines and their oxidation in physiological immunoregulation is discussed.
CIRCULATING LEVELS OF PREGNANCY PROTEINS IN EARLY AND LATE PREGNANCY IN RELATION TO PLACENTAL TISSUE CONCENTRATION
Authors: Lee J. N. , Grudzinskas J. G. , Chard T.
Published: August 2005

The concentrations of human chorionic gonadotrophin (hCG), human placental lactogen (hPL), pregnancy specific β1 glycoprotein (SP1), ferritin (PP2) and placental protein 5 (PP5) were examined in maternal serum and placental tissue in early and late pregnancy. The circulating concentration of hPL, SP1, and PP5 were higher during late pregnancy than early pregnancy, that of hCG lower, and ferritin (PP2) levels showed no difference. Placental tissue levels of hPL and SP1 were higher in late pregnancy, hCG levels lower, and ferritin (PP2) and PP5 showed no change. The ratio of the concentration in maternal serum to that in placental tissue increased during pregnancy for all proteins with the exception of ferritin. It is proposed that the mechanism of secretion of trophoblast specific proteins varies widely and that this should be taken into account in the clinical interpretation of circulating levels in the mother.
THE RELATION BETWEEN THE CONCENTRATION OF PLACENTAL SPECIFIC PROTEINS IN RETROPLACENTAL AND PERIPHERAL BLOOD
Authors: Grudzinskas J. G. , Menabawey M. , Wiley B. A. , Teisner B. , Chard T.
Published: August 2005

Concentrations of four placental proteins: human placental lactogen (hPL), placental protein 5 (PP5), pregnancy specific β1 glycoprotein (SP1) and human chorionic gonadotrophin (hCG), and a normal serum component, α2 macroglobulin, were measured in the peripheral circulation and in blood obtained from the retroplacental space in 20 women at term delivery. Levels of hPL and PP5 were higher in the retroplacental blood than in the peripheral circulation in all patients. By contrast, levels of SP1 and hCG were consistently lower in retroplacental blood than in the peripheral circulation. Similarly, levels of α2 macroglobulin were lower in the retroplacental blood. It is suggested that this ‘reverse’ gradient is a technical artefact. These findings are discussed in relation to synthesis of placental proteins in a site distal to the retroplacental space, and the introduction of a technical artefact in the collection of samples.
PITUITARY GONADOTROPHINS AND PROLACTIN IN PATIENTS WITH ENDOMETRIAL CANCER, FIBROIDS OR OVARIAN TUMOURS
Authors: Ylikorkala O. , Kauppila A. , Rajala T.
Published: August 2005

The serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH) and, prolactin (PRL) were measured before and after gonadotrophin releasing hormone (GnRH) and thyrotrophin releasing hormone (TRH) stimulation in 17 patients with endometrial cancer, in 15 patients with uterine fibroids, in 11 patients with ovarian cystadenomas or cancer and in 14 age‐matched controls. The women with fibroids had a low FSH level and a diminished FSH response to GnRH but an excessive PRL response to TRH while the other patient groups did not differ from the controls. The results indicate no relation between pituitary function and endometrial or ovarian tumour.
BIRTH WEIGHT: ANALYSIS OF VARIANCE AND THE LINEAR ADDITIVE MODEL
Authors: Keeping J. D. , Chang A. , Morrison J. , Esler E. J.
Published: August 2005

The normal distribution of birth weight in a Queensland population has been surveyed. A method of analysis is presented which allows for the influence of a number of factors that affect birth weight.
BIRTH WEIGHT OF HAUSA INFANTS IN NORTHERN NIGERIA
Authors: Rehan N. E. , Tafida D. S.
Published: August 2005

The birth weight of 1460 Hausa singleton infants was recorded and analysed. The birth weight of Hausa infants (Mean ± SD) was 3.03±0.45 kg, being higher in males (3.08±0.47 kg) than females (2.97±0.48 kg). The difference was significant (P <0.001). The mean birth weight of first born children was significantly lower than the subsequent born, and increasing birth order was associated with higher birth weight irrespective of maternal age. The birth weight was influenced more by the parity as compared to maternal age. The incidence of low birth weight was 15.8 per cent, being lower in males (13.6 per cent) as compared to females (18.1 per cent). Comparison were made with studies from other parts of the country as well as from other countries.
DISCREPANCIES IN THE HISTOLOGICAL DIAGNOSIS OF HYDATIDIFORM MOLE
Authors: Javey H. , Borazjani G. , Behmard Shahla , Langley F. A.
Published: August 2005

Sections of tissue from 256 patients on which a histological diagnosis of hydatidiform mole had been made were reviewed by a visiting pathologist. There was agreement between the reporting pathologists and the visiting pathologist in only 55.1 per cent of cases, a less severe diagnosis was made by the visiting pathologist in 42.2 per cent of cases. The disagreement was as high as 66.6 per cent with pathologists who rarely worked in the gynaecological field. This study casts serious doubt on the consistency of the histological diagnosis of hydatidiform mole made in any one laboratory and between different laboratories. It is suggested that in epidemiological studies the diagnosis should be made by a panel of pathologists using strict histological criteria and in an individual laboratory diagnosis should be made or confirmed by a pathologist experienced in gynaecological pathology.
HORMONAL PROFILES IN LACTATING AND NON‐LACTATING WOMEN IMMEDIATELY AFTER DELIVERY AND THEIR RELATIONSHIP TO BREAST ENGORGEMENT
Authors: West Christine P. , McNeilly A. S.
Published: August 2005

Prolactin, human placental lactogen (HPL), oestrone, oestradiol and progesterone levels in plasma were measured before and during the first seven days after delivery in women who did not breast feed. The results confirmed the rapid clearance of placental steroids from the circulation after delivery. Plasma prolactin levels remained elevated during the early puerperium and the range of values were the same in non breast‐feeding women and a group of breast feeding women. Of the 25 women studied, six developed breast engorgement. No difference in hormonal profiles were found leading to the conclusion that there is no endocrine basis for breast engorgement in non‐breast feeding women.
THE RELATION BETWEEN MATERNAL SERUM ALPHA‐FETOPROTEIN LEVELS AND FETOMATERNAL HAEMORRHAGE
Authors: Hay D. L. , Barrie J. U. , Davison G. B. , Buttery B. W. , Horacek I. , Pepperell R. J. , Fliegner J. R. H.
Published: August 2005

Spontaneous fetomaternal haemorrhage at 14 to 20 weeks gestation resulted in raised serum alpha‐fetoprotein (AFP) levels in 13 of 150 patients attending a genetic counselling clinic. In all 13 patients, the placenta was anterior or fundal in position. By allowing for a rise in serum AFP levels of 4 μg/l for each fetal cell seen in 30 high power fields (Kleihauer test), a 62·5 per cent reduction in the number of patients selected for amniocentesis because of raised serum AFP levels would have been achieved. The occurrence of fetomaternal haemorrhages at the time of amniocentesis can be detected by either the Kleihauer technique or the measurement of maternal serum AFP levels.
NORMAL AND ABNORMAL ANTENATAL ULTRASONIC CARDIOGRAPHIC PATTERNS
Authors: Merkur H.
Published: August 2005

Data is presented from 1019 antenatal ultrasonic cardiographs performed on 391 patients; uterine contractions were not monitored concurrently with the fetal heart rate (FHR). No fetal deaths in utero or preterminal FHR patterns were seen within 24 hours of a normal trace. A comprehensive classification of FHR patterns is presented.
OUTCOME OF PREGNANCY IN WOMEN USING DIFFERENT METHODS OF CONTRACEPTION
Authors: Vessey M. , Meisler Laura , Flavel Rosemary , Yeates D.
Published: August 2005

During the years 1968‐74, 17 032 women were recruited to the Oxford Family Planning Association prospective study of the effects of different methods of contraception. The present analysis, which concerns 5700 pregnancies experienced by the participants in the investigation, adds to the evidence that ex‐users of oral contraceptives and intrauterine devices suffer no deleterious effects on the outcome of pregnancy in terms of miscarriage, ectopic gestation, stillbirth, congenital malformation, alteration in the sex ratio or reduction in birth weight. Accidental pregnancies in women taking oral contraceptives were few in the present study (66 in all), but it seems likely that harmful effects of exposure of the fetus to the pill in utero, if any, occur infrequently. Women experiencing an accidental pregnancy with an intrauterine device in situ are at a markedly increased risk of miscarriage and ectopic gestation and are more likely to give birth to an underweight infant than other women.
ACUTE LEUKAEMIA RELAPSE PRESENTING AS OVARIAN TUMOUR
Authors: Obeid D. , Cotter P. , Sturdee D. W.
Published: August 2005

Relapse of acute lymphoblastic leukaemia is described in a woman with a leukaemic ovarian tumour from which reseeding of the bone marrow had occurred. It is proposed that irradiation of the ovaries with the initial leukaemic therapy may prevent this form of relapse.
MATURITY OF FETAL LUNGS TESTED BY PRODUCTION OF STABLE MICROBUBBLES IN AMNIOTIC FLUID
Authors: Pattle R. E. , Kratzing C. C. , Parkinson C. E. , Graves L. , Robertson R. D. , Robards G. J. , Currie J. O. , Parsons J. H. , Sutherland P. D.
Published: August 2005

Lung surfactant in amniotic fluid, and hence the maturity of the fetal lungs, can be assessed by observation of stable microbubbles (less than 15 m diameter). Bubbles are formed by agitation with a Pasteur pipette and examined in hanging drops under the 10 power of a microscope. Either after a count of bubbles, or after a general survey of hanging drops, the fluid is given a stable microbubble rating. A 'strong’rating indicates that the idiopathic respiratory distress syndrome will not occur after delivery, and that the lecithin/sphingomyelin ratio will indicate maturity. Complete absence of stable microbubbles suggests a high risk of respiratory trouble for the newborn infant, as does a weak or lower rating in the 30 to 37 week gestational age group. The test takes 5 to 10 minutes to perform, is cheap and easy, is not affected by blood, but may be affected by meconium. If a 'strong’rating is found, measurement of the L/S ratio can safely be omitted.
ULTRASOUND ASSESSMENT OF FETAL GROWTH
Authors: Varma Thankam R. , Taylor H. , Ridges C.
Published: August 2005

Consecutive ultrasonic measurements of the fetal head area, thorax area, abdomen area, head/thorax (H/T) area ratio and head/abdomen (H/A) area ratio were obtained from 100 patients with a normal pregnancy and from 186 patients with suspected intrauterine fetal growth retardation. Of all the measurements used, H/A area ratio was found to be most accurate in identifying intrauterine fetal growth retardation predicting 82.9 per cent at 33 weeks and 85.7 per cent at 36 to 38 weeks of gestation. This technique was also found to be useful in distinguishing between the two types of growth retardation. The H/A area ratio was helpful in identifying the growth acceleration pattern of a large baby.
THE COMPOSITION OF AMNIOTIC FLUID IN PREGNANCIES COMPLICATED BY FETAL ANENCEPHALY OR SPINA BIFIDA
Authors: Pettit B. R. , Baker S. P. , King G. S.
Published: August 2005

The concentration of amniotic fluid glucose, total protein, sodium, potassium, calcium, magnesium and phosphate as well as amniotic fluid osmolality were measured in normal second trimester pregnancies and in second trimester pregnancies complicated by fetal anencephaly or spina bifida. Amniotic fluid glucose concentration was low in anencephaly, while phosphate and total protein were high; calcium concentration and osmolality were slightly elevated with spina bifida. The application of these findings to antenatal diagnosis are discussed.
SERUM GONADOTROPHINS, PROLACTIN AND OVARIAN STEROIDS IN PRIMARY DYSMENORRHOEA
Authors: Ylikorkala O. , Puolakka J. , Kauppila A.
Published: August 2005

Serum samples were collected from 27 women with incapacitating primary dysmenorrhoea and from 16 normal women in the early part of the cycle (between days 3 to 6), at midcycle (between days 13 to 16) and in the late part of the cycle (between days 23 to 26) for determination of FSH, LH, prolactin (PRL), 17‐ oestradiol (E2) and progesterone (P). The gonadotrophin and P levels showed normal and similar ovulatory patterns in both groups. The PRL concentrations (mean±SD) in dysmenorrhoeic women were lower than normal in the early part (9.2±4.0 ng/ml vs 14.5±7.3 ng/ml, p <0.01) and in late part of the cycle (11.7±5.2 ng/ml vs 16.5±10.2 ng/ml, p 0.05), but not so at midcycle (9.1±2.8 ng/ml vs 10.4±4.4 ng/ml, p> 0.05). The E2 level was higher than normal in dysmenorrhoeic women in the late cycle (163.0±76.7 pg/ml vs 93.3±64.3 pg/ml, p < 0.01), but apart from this the ratio of E2/P did not differ between the groups. These hormonal changes may be related to an excessive production of endometrial prostaglandins in primary dysmenorrhoea.
REAL‐TIME ULTRASOUND OBSERVATION OF FETAL ACTIVITY IN LABOUR
Authors: Wittmann B. K. , Davison B. M. , Lyons E. , Frohlich J. , Towell M. E.
Published: August 2005

Fetal activity was observed by realtime ultrasound for one hour in 25 patients in labour. Fetal respiratory movement, although reduced compared to the antenatal period, was observed in 13 patients. In three patients, hiccough‐like movements were noted. Fetal body and/or extremity movements were observed in all patients (mean 41/hour) and frequently occurred in episodes. These bursts of movements were significantly correlated with contractions and fetal heart rate (FHR) accelerations. There was a significant association between absent or reduced number of fetal respiratory movements and/or hiccoughs (10 or less/hour) and an abnormal FHR. Absence of any type of fetal activity was also significantly associated with an abnormal FHR. The correlation between fetal activity and conventional methods of fetal assessment is discussed.
TRANSFER OF GLUTAMIC ACID ACROSS THE HUMAN PLACENTA PERFUSED IN VITRO
Authors: Schneider H. , Möhlen K.‐H. , Challier J.‐C. , Dancis J.
Published: August 2005

Transfer of amino acids was studied with an in vitro perfusion technique of human placenta in which independant maternal and fetal circulations were established. When the fetal perfusate was recirculated, a concentration gradient was established with fetal concentrations of alanine, glycine and lysine about 1.5 times higher than maternal. In this system, the placenta could actively transfer 4.1 mM per day of each of these amino acids. Glutamic acid and aspartic acid were progressively removed from the fetal circulation so that fetal concentrations fell below maternal. The exchange rates of L‐ and D‐glutamic acid were compared, the latter providing a measure of simple diffusion. The ratio of L:D exchange rates was 0.64 from the maternal to the fetal circulation and 0.41 in the reverse direction, indicating a more rapid bidirectional exchange of the D‐isomer. Simultaneously measured exchange rates of leucine gave a L:D ratio of 1.73 and 1 00 respectively, indicating active transfer of L‐leucine towards the fetus. While for L‐glutamic acid, transfer across the placenta was even lower than expected on the basis of simple diffusion, uptake into the tissue was high. Of the amount presented to the placenta, 49 percent was taken up, of which only 10 per cent passed to the other side. The rest was retained and presumably metabolized. For L‐leucine, the uptake was only 16 percent of which 75 per cent was transferred. The placenta serves as an effective barrier to the transfer of glutamic acid by rapidly metabolizing this amino acid. It is postulated that maternal glutamine, which is efficiently transferred across the placenta, contributes its amid‐N2 to the fetal synthesis of purines and pyrimidines and that the resulting surplus of glutamic acid is returned to the placenta which removes it from the circulation and metabolizes it.
A RANDOMIZED DOUBLE‐BLIND TRIAL OF TWO LOW DOSE COMBINED ORAL CONTRACEPTIVES
Authors: Bounds Walli , Vessey M. , Wiggins P.
Published: August 2005

Fifty‐five women using Loestrin‐20 (20 μg ethinyl oestradiol and 1 mg norethisterone acetate) as an oral contraceptive have been compared with a like number using Microgynon‐30 (30 μg ethinyl oestradiol and 150 μg levonorgestrel) in a randomized, double‐blind trial. Despite the small sample size, the main finding in the trial is clear‐cut; Loestrin‐20 provides poor cycle control and is thus less acceptable as an oral contraceptive than Microgynon‐30. Although there is also a suggestion that Loestrin‐20 may be less effective than Microgynon‐30, the difference in the accidental pregnancy rates is not statistically significant.
THE RELATION BETWEEN MATERNAL PLASMA ALPHA‐FETOPROTEIN AND BIRTH WEIGHT IN TWIN PREGNANCIES
Authors: Brock D. J. H. , Barron Lilias , Watt Muriel , Scrimgeour J. B.
Published: August 2005

In the course of routine screening for neural tube defects, maternal plasma alpha‐fetoprotein (AFP) was measured between 15 and 23 weeks of gestation in 64 twin pregnancies. Women with AFP levels more than twice the median for singleton pregnancies gave birth to infants with significantly decreased birth weights. Women with AFP less than the median also tended to produce twins with decreased birth weights. The distribution of gestations at delivery suggested that in twin pregnancies low AFP values gave an early warning of growth retardation while high values signal possible premature delivery.
THE EFFECT OF MATERNAL POSTURE, MEALS AND TIME OF DAY ON FETAL MOVEMENTS
Authors: Minors D. S. , Waterhouse J. M.
Published: August 2005

During the last 3 to 4 months of their pregnancies, six healthy mothers provided a daily record of their own activity together with the amount of fetal movement. Fetal movement increased throughout most of the daytime to reach a peak in the evening. The mothers detected most movement when they were lying, less when they were sitting and least when they were standing. Later in the day the mothers were less likely to be standing and more likely to be sitting; when fetal movement was measured with the mother in the sitting posture, more movement occurred as the day progressed. Mealtimes did not have any effect upon movement. Some implications of these findings, both for the assessment of fetal well‐being and for theories of the development of circadian rhythms in the infant, are discussed.
NORMAL VALUES FOR FETAL SCALP TISSUE pH DURING LABOUR
Authors: Weber T. , Hahn‐Pedersen Suzanne
Published: August 2005

Normal values for fetal scalp tissue pH during labour were determined by using a glass electrode (Kontron‐Roche®). A total of 132 recordings was obtained and 84 (64 per cent) were of good quality. After a good quality recording had been obtained, there were 64 infants with an Apgar score of 9 or 10 at one and five minutes after delivery. The 64 recordings showed pH values (Mean ± 2SEM) of 7.38±0.12 six hours before delivery and 7.28±0.12 at the time of delivery. Between the 5th and 55th minutes of the second stage of labour the pH (Mean ± 2SEM) fell from 7.30±0.14 to 7.20±0.13.
RELEASE OF PROSTAGLANDINS AFTER AMNIOTOMY IS NOT MEDIATED OXYTOCIN
Authors: Sellers S. M. , Hodgson H. T. , Mitchell M. D. , Anderson A. B. M. , Turnbull A. C.
Published: August 2005

The rise in peripheral plasma levels of 13,14‐dihydro‐15‐keto‐prostaglandin F (PGFM) following amniotomy has now been shown to be maximal within five minutes of the procedure, and levels remain elevated for at least 30 minutes. There was no change in plasma oxytocin levels with amniotomy and therefore a local mechanism for prostaglandin release has been postulated.
PANCREATITIS, PREGNANCY AND GALLSTONES
Authors: McKay A. J. , O'Neill J. , Imrie C. W.
Published: August 2005

In an 18 year hospital experience of over 500 patients with primary acute pancreatitis, 20 developed the disease either while pregnant (7 patients) or within five months of pregnancy (13 patients). Eighteen of the 20 patients had gallstones and adequate biliary surgery abolished further attacks of pancreatitis. Only two patients had surgery during the acute phase of their illness. The single fetal death was associated with early surgical intervention and there were no maternal deaths. We found no evidence of a specific link between pregnancy and pancreatitis but there is a marked association between pancreatitis and gallstones.
NATIONAL TRENDS IN THE CERTIFIED CAUSES OF PERINATAL MORTALITY, 1968 to 1978
Authors: Edouard L. , Alberman Eva
Published: August 2005

Certified causes of perinatal mortality have been regrouped into 14 categories of clinical significance. Using data from official publications, trends over the years 1968 to 1978 in England and Wales have been described. Sharp falls from certain years are observed for some categories whereas others show a sustained fall.
MATERNAL SERUM ALPHA‐FETOPROTEIN AND BIRTH WEIGHT
Authors: Wald N. J. , Cuckel H. S. , Boreham Jillian , Turnbull A. C.
Published: August 2005

Maternal serum alpha‐fetoprotein (AFP) levels between 16 and 18 weeks of pregnancy were studied in relation to birth weight among 4198 singleton pregnancies resulting in a liveborn or stillborn infant without a neural tube defect. The highest mean birth weight (3365 g) was found among infants born to women with AFP values in the range 0.50 to 0.74 times the normal median for the relevant week of gestation. As the AFP decreased from this level to less than 0.25 times the median, the birth weight decreased by 193 g and the proportion of infants weighing 2500 g or less increased from 4 per cent to 11 per cent. As the AFP level increased from 0.50 to 0.74 times the median to 3.0 times the median or greater, the birth weight decreased by 371 g and the proportion of infants weighing 2500 g or less increased from 4 per cent to 22 per cent. The negative association was the more important of the two since the magnitude was greater and it affected 92 per cent of pregnancies. The positive association among women with low AFP levels was substantially reduced when the analysis was restricted to women who had spontaneous labours. It seems that this minor positive association arises mainly because women in whom gestation is over‐estimated tend to have both a low AFP and, later, an apparently prolonged pregnancy leading to the elective delivery of an infant who is, in fact, born early.
UMBILICAL CORD PLASMA PROGESTERONE AT TERM IN RELATION TO MODE OF DELIVERY
Authors: Maynard P. V. , Stein Penelope E. , Symonds E. M.
Published: August 2005

The progesterone concentration in the umbilical venous and arterial plasma has been measured by radioimmunoassay. In 35 normal spontaneous vaginal deliveries the concentration in the umbilical venous plasma was highly correlated with the difference between venous and arterial plasma concentrations. There was no correlation of progesterone levels with infant birth weight or placental weight, but slightly higher amounts were found in samples taken from women with female fetuses than those with male fetuses. There was also a significant correlation of venous progesterone concentration with duration of labour. In 14 subjects where forceps were used to assist delivery because of prolonged second stage labour, progesterone levels were found to be elevated, whereas in nine cases of elective Caesarean section they were reduced. It is suggested that the fetus may stimulate progesterone secretion by the placenta in response to stress and that there may also be a fetal sex‐related response.
THE INCIDENCE OF UROLOGICAL SYMPTOMS IN NORMAL PREGNANCY
Authors: Stanton S. L. , Kerr‐Wilson R. , Harris V. Grant
Published: August 2005

We questioned 181 healthy pregnant women about their urological symptoms during pregnancy; frequency and stress incontinence were commonest. The incidences of stress incontinence and urge incontinence were increased and that of hesitancy was decreased by pregnancy. Descent of the presenting part did not affect any of these symptoms.
PLASMA TOCOPHEROL AND LIPID LEVELS IN MOTHER AND UMBILICAL CORD; INFLUENCE ON BIRTH WEIGHT
Authors: Jagadeesan V. , Prema K.
Published: August 2005

Levels of tocopherol, cholesterol and triglycerides were estimated in paired maternal and umbilical cord plasma samples. All three constituents were significantly lower in cord plasma than in maternal plasma. Since tocopherol and lipids share a common lipoprotein carrier system, the present data suggests that the reduction observed in cord circulation could be due to the inability of the fetus to synthesise these carrier proteins. There was no relation between maternal vitamin E concentrations and infant birth weights.