bluuebunny/crossref_metadata_2025 huggingface dataset:
EFFECT OF LABOUR ON THE LECITHIN/SPHINGOMYELIN RATIO IN SERIAL SAMPLES OF AMNIOTIC FLUID
Authors: Whittle M. J. , Hill C. M. , Harkes A.
Published: August 2005

Serial samples of amniotic fluid were taken from 48 patients during labour. The lecithin/sphingomyelin (L/S) ratio was estimated and found to rise in 52 per cent, remain almost unchanged in 33 per cent and fall in 15 per cent. The rate of rise in the L/S ratio seemed inversely related to the length of labour.
THE PHYSIOLOGICAL MACROCYTOSIS OF PREGNANCY
Authors: Chanarin I. , McFadyen I. R. , Kyle R.
Published: August 2005

Sixty‐four healthy women were followed during normal pregnancies in which they took supplements of iron or iron+folate or an inactive placebo. The red cell size increased in those patients receiving iron alone or iron+folate. The group on the inactive placebo who received no supplemental iron had red cells of constant size and a falling serum iron. Nineteen women not included in the trial developed macrocytosis during pregnancy: marrow samples from these showed normoblastic erythropoiesis in 18 and minor megaloblastic changes in one. Macrocytosis developing during pregnancy is a physiological change in the majority of cases.
COLPOSCOPIC EVALUATION OF PREGNANT PATIENTS WITH ABNORMAL CERVICAL SMEARS
Authors: Benedet J. L. , Boyes D. A. , Nichols T. M. , Mlllner A.
Published: August 2005

Colposcopic examination and biopsy were used to assess 123 pregnant patients presenting with abnormal cervical smears. Eighty‐seven per cent were 30 years of age or less and 95 (77 per cent) had had one or no previous children. Two patients were found to have microinvasive carcinoma and, in an additional 95 patients, either severe dysplasia or carcinoma in situ was present. Fifty‐five patients (45 per cent) had subsequent conization or hysterectomy and in no instance was the histological diagnosis more serious than that anticipated from the colposcopic evaluation. Only three patients (1·6 per cent) had a cone biopsy during pregnancy; only one minor complication occurred. Colposcopic examination is the choice method of evaluating patients with abnormal cervical smears in pregnancy.
THE EXCRETION OF γ‐GLUTAMYL TRANSFERASE IN PREGNANCY
Authors: Noble M. C. B. , Landon M. J. , Davison J. M.
Published: August 2005

A cross‐sectional study of γ‐glutamyl transferase (γ‐GT) excretion in 316 healthy pregnant women showed the enzyme excretion (mU per mmol creatinine) was significantly higher than that of a non‐pregnant control group. The increase was apparent before the end of the first trimester and continued thereafter. These changes may be indicative of hypertrophy and/or hyperplasia of the nephron and be part of the overall renal adaptation to normal pregnancy. Even higher levels were recorded in three obstetric patients in whom renal complications were to be expected and this may indicate a specific type of renal damage.
CARBOHYDRATE TOLERANCE IN THE PUERPERIUM DURING SUPPRESSION OF LACTATION WITH BROMOCRIPTINE AND OESTROGENS
Authors: Peters F. D. , Roemer V. M.
Published: August 2005

The influence of bromocriptine on carbohydrate tolerance in the puerperium was examined and its effects compared with those of an oestrogenic compound. Sixteen patients were studied in each group. The controls consisted of 16 women who were breast‐feeding. Compared with the controls, no significant difference was found in the oral glucose tolerance test in patients who had oestrogen, but blood glucose values in women receiving bromocriptine were significantly lower. Inhibition of lactation with bromocriptine may obscure abnormal glucose tolerance.
A STUDY OF PLASMA DIAZEPAM LEVELS IN MOTHER AND INFANT
Authors: Gamble J. A. S. , Moore J. , Lamki H. , Howard P. J.
Published: August 2005

A 10 mg dose of diazepam was given intravenously to mothers at 15 to 205 minutes before delivery, and plasma diazepam concentrations were measured by gas‐liquid chromatography in mothers and infants at delivery and again 24 hours later. The plasma levels in the infants were always significantly higher than in the mothers but there was no evidence to suggest that the newborn were unable to metabolize the drug. All infants had a good Apgar score at birth.
THE EFFECTS OF INTRAMUSCULAR NORETHISTERONE OENANTHATE USED AS A CONTRACEPTIVE ON INTRAVENOUS GLUCOSE TOLERANCE AND ON BLOOD COAGULATION FACTORS VII AND X
Authors: Howard Geraldine , Myatt L. , Elder M. G.
Published: August 2005

Intravenous glucose tolerance tests, and estimations of prothrombin time, and plasma coagulation factors VII and X, were made on 12 women receiving 200 mg norethisterone oenanthate intramuscularly as a contraceptive. These estimations were made before, and at 2 and 12 weeks after, a single injection of norethisterone oenanthate. There was no significant effect on the intravenous glucose tolerance, prothrombin time, or on plasma coagulation factors VII and X, further confirming the safety of norethisterone oenanthate when used as a short‐term injectable contraceptive.
TROPHOBLASTIC TUMOUR, ORAL CONTRACEPTIVE THERAPY AND PREGNANCY ASSOCIATED ALPHA2‐GLYCOPROTEIN (PAAG), CASE REPORT
Authors: Teisner B. , Mogensen B. , Folkersen J. , Svehag S‐E.
Published: August 2005

Pregnancy associated alpha2‐glycoprotein (PAAG) and human chorionic gonadotrophin (HCG) levels were studied in a patient with an invasive mole who was being treated with cytotoxic drugs and oral contraceptives. Both the PAAG and HCG levels fell during cytotoxic drug treatment while oral contraceptives caused a rise in PAAG concentrations. A relation between oestrogen‐induced PAAG and prolonged survival of trophoblastic tumour is proposed.
PRIMARY ECHINOCOCCAL INFECTION OF THE OVARY
Authors: Azhar H.
Published: August 2005

An Iranian Moslem patient with primary echinococcal infection of the ovary is described. Echinococcal infection is extremely rare in practising Moslems.
RISK OF PRE‐TERM DELIVERY IN PATIENTS WITH PREVIOUS PRE‐TERM DELIVERY AND/OR ABORTION
Authors: Keirse M. J. N. C. , Rush R. W. , Anderson A. B. M. , Turnbull A. C.
Published: August 2005

Patients with a history of two or more pregnancies which ended spontaneously before 37 weeks gestation had an increased risk of spontaneous pre‐term labour and delivery in future pregnancies. This increased risk related mainly to previous second trimester abortions and not to previous first trimester abortions. Patients with one previous spontaneous pre‐term labour and delivery had a 37 per cent risk, and those with two or more pre‐term deliveries a 70 per cent risk of again delivering pre‐term. There appeared to be no beneficial effect of cervical suture on the incidence of pre‐term delivery in these patients.
PROSTAGLANDINS IN THE HUMAN UMBILICAL CIRCULATION AT BIRTH
Authors: Mitchell M. D. , Brunt J. , Bibby J. , Flint A. P. F. , Anderson A. B. M. , Turnbull A. C.
Published: August 2005

Prostaglandin E (PGE), prostaglandin F (PGF) and 13, 14‐dihydro‐15‐keto‐prostaglandin F (PGFM) have been measured in umbilical cord plasma obtained immediately after delivery of the baby before clamping of the cord. In general the prostaglandin levels followed the pattern PGFM>PGE>PGF. A significant arterio‐venous difference was demonstrated only for PGE with raised venous levels (P<0.01). In cord blood samples obtained from infants whose mothers had received epidural anaesthesia, no arterio‐venous difference for PGE could be demonstrated although the mean levels were not significantly different from controls. The concentrations of prostaglandins in Umbilical cord plasma proximal to the placenta were found to rise continuously from the time of delivery of the baby with no significant changes after cord clamping or placental delivery. The possible physiological significance of these findings is discussed.
THE DISTRIBUTION OF ARACHIDONIC ACID IN PLASMA AND TISSUES OF PATIENTS NEAR TERM UNDERGOING ELECTIVE OR EMERGENCY CAESAREAN SECTION
Authors: Filshie G. M. , Anstey M. D.
Published: August 2005

The distribution of arachidonic acid in both the free and the bound state was measured in the maternal circulation, the fetal circulation and tissues within the pregnant uterus in 16 patients undergoing Caesarean section. Half of the patients had an elective Caesarean section and half had a Caesarean section during labour. No differences in arachidonic acid concentrations were found between the maternal or fetal circulations in women having elective Caesarean section and those having a Caesarean section in labour. The total and bound values of arachidonic acid in myometrium were higher in patients undergoing Caesarean section in labour. There was also an increased amount of arachidonic acid when expressed as an arachidonic acid/palmitic acid ratio between the fetal circulation and the maternal circulation, suggesting an active transport mechanism for arachidonic acid across the placenta. Levels of free arachidonic acid were in microgram quantities in both plasma and tissues, suggesting that the availability of free arachidonic acid was not the limiting factor in prostaglandin production.
EFFECTS OF NIFEDIPINE ON MYOMETRIAL ACTIVITY AND LOWER ABDOMINAL PAIN IN WOMEN WITH PRIMARY DYSMENORRHOEA
Authors: Anderson K‐E. , Ulmsten U.
Published: August 2005

The effects of the calcium antagonist nifedipine on uterine activity and lower abdominal pain were studied during the first menstrual day in 10 women with severe primary dysmenorrhoea. Intrauterine pressure was recorded at three different levels by means of microtransducers. Nifedipine, 20 to 40 mg given orally, within 10 to 30 minutes effectively reduced the myometrial activity and relieved the pain. A moderate increase in heart rate, and a transient facial flushing were noted. In some patients receiving 30 or 40 mg this was associated with a slight headache. Otherwise no side effects were observed. It is suggested that calcium antagonists can be used to treat primary dysmenorrhoea and other conditions in which an inhibition of uterine activity is desirable.
AXILLARY AND VULVAL BREASTS ASSOCIATED WITH PREGNANCY
Authors: Patnaik P.
Published: August 2005

A patient with accessory breasts in the vulval and axillary regions is presented. There was very little change in accessory breasts during and after pregnancy.
CHARACTERISTICS OF PATIENTS REQUESTING REVERSAL OF STERILIZATION
Authors: Thomson P. , Templeton A.
Published: August 2005

With the increased number of female patients seeking sterilization and the good chance of successful reversal using modern microsurgical techniques, it can be anticipated there will be a rise in the number of patients requesting reversal of sterilization. We have studied the characteristics of 36 patients who requested reversal of sterilization at the Royal Infirmary, Edinburgh, in the last five years. The majority of patients requested reversal on the basis of a new relationship. Other reasons included sexual problems and child death. Eighteen of the patients had clear evidence of marital disharmony at the time of sterilization. Seven of the patients had been admitted to hospital with a drug overdose since being sterilized.
RENAL TUBULAR FUNCTION IN NORMAL PREGNANCY
Authors: Kelly Anne M. , McNay Margaret B. , McEwan Helen P.
Published: August 2005

Maternal plasma and urine concentrationsof β2‐ microglobulin and γ‐glutamyl transpeptidase (EC:2.3.2.2) were measured serially in normal pregnancy. These parameters remained constant throughout and can therefore be used to evaluate tubular function in pregnancies complicated by renal disorders.
COPPER INTRAUTERINE CONTRACEPTIVE DEVICES IN ADOLESCENT NULLIPARAE
Authors: Weiner E. , Berg A. Å. , Johansson Ines
Published: August 2005

Copper intrauterine contraceptive devices (IUCDs) were used in 243 young nulligravidae attending a gynaecological clinic for schoolgirls in Uppsala between March 1973 and June 1975; 226 of these girls (93 per cent) were seen again during December 1975 making a total of 3138 months of observation. At the time of follow up, 126 patients (55.8 per cent) still had the IUCD in situ; 20 per cent had expelled the IUCD and in another 24.2 per cent the IUCD had been removed because of bleeding and/or pain or because of suspected pelvic inflammatory disease (7 patients). Twelve of the girls conceived during the period of observation making the Pearl index 4. 6; nine of the conceptions occurred within nine months of the insertion of the IUCD. Unlike others we do not advocate the use of the IUCD for young nulligravidae.
UNUSUAL PRESACRAL TUMOURS OBSTRUCTING DELIVERY
Authors: Forchan B. , Jennings P. J.
Published: August 2005

Two patients who had obstructed labour due to a presacral tumour are reported. Both tumours were diagnosed in the second stage of labour. In one patient delivery was accomplished with Barton's forceps. The other patient required a Caesarean section. The tumours were excised at a later date. One was an epidermoid cyst and the other was thought to be a malignant haemangioendothelioma.
A STUDY OF PLASMA PROGESTERONE, OESTRADIOL‐l7β, PROLACTIN AND LH LEVELS, AND OF THE LUTEAL PHASE APPEARANCE OF THE OVARIES IN PATIENTS WITH ENDOMETRIOSIS AND INFERTILITY
Authors: Brosens I. A. , Koninckx P. R. , Corveleyn P. A.
Published: August 2005

Thirty‐four infertile patients with regular cycles and endometriosis were studied and compared to a control group of 28 women. The endometriosis was classified as mild (n = 16), moderate (n = 9) and severe (n = 9) according to Acosta et a1 (1973). The interval between the LH peak and the onset of subsequent menstruation was shorter (P = 0.024) in patients with endometriosis than in the control group. In mild endometriosis, oestradiol‐17β levels fell on the day after the LH peak, but this was not the case in moderate and severe endometriosis. In mild, moderate and severe endometriosis the plasma progesterone concentration did not rise on the first day following the LH peak, and at laparoscopy significantly (P<0.005) less ovulation stigmata were present. We conclude that endometriosis is associated with luteinization in situ and that this may explain the associated infertility.
THE TREATMENT OF MILD ADRENAL HYPERPLASIA AND ASSOCIATED INFERTILITY WITH PREDNISONE
Authors: Sarris S. , Swyer G. I. M. , Ward R. H. T. , Lawrence Daphne M. , McGarrigle H. H. , Little Valerie
Published: August 2005

Thirty patients with mild post‐pubertal adrenal hyperplasia, characterized by raised urinary 17‐oxosteroid levels and variable combinations of irregular menses, hirsuties, infertility, and spontaneous abortion, were treated with 2.5 to 10 mg of prednisone per day and all conceived (55 pregnancies). With this treatment, regular, ovulatory cycles occurred immediately in 25 patients, and after two to six months, in the rest. Treatment reduced raised 17‐oxosteroid levels to normal and brought about some improvement in hirsuties and acne. Forty‐seven pregnancies ended in the birth of liveborn infants; one of these died of prematurity and another had congenital emphysema. One pregnancy was terminated, two were of unknown outcome and five (9.4 per cent) ended in abortion. Before treatment, 20 out of 22 pregnancies (91 per cent) had ended in abortion.
AMOEBIASIS IN PREGNANCY AND THE PUERPERIUM
Authors: Armon P. J.
Published: August 2005

The overall incidence and mortality of amoebiasis in the Kilimanjaro Region of Tanzania is briefly reviewed and seven patients with fatal amoebic colitis occurring during pregnancy and the puerperium are described. The possible causes of the fulminating course of the disease in pregnancy are considered and the management is discussed.
MATERNAL AND ENVIRONMENTAL FACTORS AFFECTING TWIN BIRTHS IN CANADIAN CITIES
Authors: Elwood J. M.
Published: August 2005

Details of 4972 pairs of twins born to mothers resident in 14 large Canadian cities in the years 1952, 1957, 1962, and 1967 were compared to those of a random sample of 4969 single births. Both dizygotic and monozygotic twinning rates, derived by Weinberg's formula, showed increases with both maternal age and with the number of previous livebirths. Dizygotic twinning rates also showed a seasonal variation with an October maximum. Twinning rates were lower in Oriental women, but did not vary between other ethnic groups, or by city of residence, legitimacy, paternal age or maternal history of stillbirths.

The data were kindly supplied by Mr N. Tompkins and the staff of Statistics Canada, and computer programming was performed by Mr K. Johnson.
THE COMPARATIVE EFFECTS OF A SYNTHETIC AND A‘NATURAL’ OESTROGEN ON THE HAEMOSTATIC MECHANISM IN PATIENTS WITH PRIMARY AMENORRHOEA
Authors: Toy J. L. , Davies J. A. , Hancock K. W. , Mcnicol G. P.
Published: August 2005

A synthetic and a natural oestrogen were administered alternately for three months to nine women with primary amenorrhoea using a randomized cross‐over schedule. Measurements of haemostatic function were performed before and at the end of each treatment period. No significant change in haemostatic function was observed after treatment with the‘natural’ oestrogen, oestriol succinate. In contrast, treatment with a synthetic oestrogen, ethinyloestradiol, caused shortening of the prothrombin time and an increase in plasma concentration of factor VII and plasminogen. These data support other observations in suggesting that natural oestrogens may have fewer potentially adverse effects on haemostatic function than synthetic oestrogen.

We thank the Special Trustees of Leeds General Infirmary for financial support towards the technical costs of this project. Organon Laboratories Limited provided generous financial assistance and the oestriol succinate tablets used in the study. We are grateful to Mrs B. Griffin, Mrs A. Spencer, Mrs G. Levell and Mr J. Leek for technical help.
SERUM FSH, LH AND OESTRONE LEVELS IN POSTMENOPAUSAL PATIENTS ON OESTROGEN THERAPY
Authors: Larsson‐Cohn U. , Johansson E. D. B. , Kågedal B. , Wallentin L.
Published: August 2005

Serum FSH, LH and oestrone levels were determined in postmenopausal women before and at 1, 3 and 6 months after the onset of cyclical treatment with 0·05 mg of ethinyl oestradiol (n = 19) or 2 mg of oestradiol valerianate (n = 20). Most samples from the women taking oestradiol valerianate were also analyzed for oestradiol. Vaginal smears were obtained from all patients. Although all women were relieved of vasomotor symptoms, the FSH levels usually exceeded the fertile range. Ethinyl oestradiol reduced FSH by 70 to 75 per cent and LH by 30 to 40 per cent while oestrone was increased by 20 to 40 per cent. In the women taking oestradiol valerianate, FSH and LH levels were both reduced by 20 to 25 per cent whereas serum oestradiol increased by 200 to 300 per cent and oestrone increased by 600 to 700 per cent. The mean vaginal maturation value rose equally in the two groups but 40 per cent of the patients in both groups showed no change in the value. There was no correlation between the appearance of vaginal endocrine smears and hormone levels.
MENSTRUAL PATTERNS AFTER LAPAROSCOPIC STERILIZATION USING A SPRING‐LOADED CLIP
Authors: Lieberman B. A. , Belsey Elizabeth , Gordon A. G. , Wright C. S. W. , Letchworth A. T. , Noble A. D. , Neven P. A. R.
Published: August 2005

Details of the menstrual cycles in 504 women were recorded before laparoscopic sterilization with a spring‐loaded clip and at six months and one year after the procedure. The operation did not affect the length of the menstrual cycle or duration of menstrual flow, nor the patient's assessment of the amount of blood loss or the incidence of dysmenorrhoea. The previous method of contraception was significantly related to subsequent menstrual patterns.

We are indebted to Ms Margaret Hughes, Ms Sylvia Keilor, Ms Ann Robinson and Ms Sharon Lindop for their invaluable help with data collection and patient follow‐up. Ms Hughes kindly typed the manuscript. Data collection was funded by the International Fertility Research Program, Research Triangle, North Carolina, USA.
A RANDOMIZED CONTROLLED TRIAL OF A SHORT COURSE OF CEPHALORIDINE IN THE PREVENTION OF INFECTION AFTER ABDOMINAL HYSTERECTOMY
Authors: Mathews D. D. , Agarwal Visanta , Ross Helen
Published: August 2005

One hundred patients took part in a randomized controlled trial to test the efficacy of three 1 g doses of cephaloridine in preventing infection after abdominal hysterectomy. The first dose was given as an intravenous bolus at the commencement of surgery and the second and third as intramuscular injections 6 and 12 hours later. Given in this way, cephaloridine was found to be very effective in preventing febrile morbidity, abdominal wound infection and urinary tract infection. It was less effective in preventing pelvic wound infection and postoperative colonization of the vagina with Escherichia coli.

Our thanks are due to Dr Clive Dash of Glaxo Laboratories Limited for supplying us with so much information about cephaloridine and for his help and encouragement throughout the trial. We are also grateful to all the hospital staff who helped with the trial.
THE VALUE OF A SCORING SYSTEM IN PREDICTING OUTCOME OF PRE‐TERM LABOUR AND COMPARING THE EFFICACY OF TREATMENT WITH AMINOPHYLLINE AND SALBUTAMOL
Authors: Liu D. T. Y. , Blackwell R. J.
Published: August 2005

A simple score, derived by allocating points to a selection of factors which influence the outcome of pre‐term labour, was found to relate to the success of treatment. Used as a measure of the situation before therapy, this score can define a baseline allowing a realistic comparison of therapeutic methods. In this series, despite treatment, a large number of patients still were delivered before term and within a few days of admission to hospital. Thus it would seem that although drugs suppress uterine activity, they cannot neutralize the adverse effects of other factors associated with pre‐term labour.
PROPRANOLOL FOR THE TREATMENT OF HYPERTENSION IN PREGNANCY
Authors: Eliahou H. E. , Silverberg D. S. , Reisin E. , Romem I. , Mashiach S. , Serr D. M.
Published: August 2005

Twenty‐five women were treated with propranolol during 26 pregnancies complicated by hypertension. The fetal wastage, which had been 48 per cent before treatment with propranolol was reduced to 15·4 per cent, with one missed abortion and three stillbirths. Of the 22 livebornGG infants 2 were small‐for‐dates but all 22 had Apgar scores of 9 or 10 at five minutes. There were no congenital anomalies in 25 viable infants and none of the 22 liveborn infants had clinical or laboratory evidence of hypoglycaemia. The blood pressure was controlled in 17 of 19 patients taking propranolol alone (40 to 160 mg/day) and in 6 of 7 taking propranolol with diuretics.
AN INTERNATIONAL COLLABORATIVE STUDY OF THE ASSAY OF HUMAN PLACENTAL LACTOGEN: ESTABLISHMENT OF WHO INTERNATIONAL REFERENCE PREPARATION OF HUMAN PLACENTAL LACTOGEN
Authors: Cotes P. Mary , Das R. E. Gaines
Published: August 2005

A reference preparation of human placental lactogen (HPL) for use in immunoassays is described. In an international collaborative study it was found to be stable and suitable for use as a standard for HPL in plasma. Estimates of HPL in plasma made in different laboratories agreed more closely when expressed in terms of this reference preparation than in terms of individual laboratory standards. The reference preparation is available in ampoules (coded 73/545) which each contain an identical amount of HPL, found in the study to be approximately 850 μg. The preparation has been established as the International Reference Preparation for HPL for immunoassay and, based on the results of the study, the content of each ampoule is defined as 850 micro International Units.
A SURVEY OF 100 PATIENTS WHO HAD LAPAROSCOPIC VENTROSUSPENSIONS
Authors: Paterson M. E. L. , Jordan J. A. , Logan‐Edwards R.
Published: August 2005

The technique for and results of 100 laparoscopic ventrosuspensions are described; patients were followed for an average of 40 months and in all but 11 the uterus was anteverted at the end of the follow‐up period. The presenting symptoms of dyspareunia, dysmenorrhoea or sacral backache were almost always improved as a result of the operation.

The authors thank Professor H. C. McLaren, Mr J. Kelly, Mr W. G. Mills, Mr H. O. Nicholson and Mr H. Roberts for allowing their patients to be studied.
PLASMA TESTOSTERONE IN MOLAR PREGNANCY: CORRELATION WITH GESTATIONAL AGE, UTERINE SIZE, THECA‐LUTEIN CYST AND SERUM HCG
Authors: Chew P. C. T. , Ratnam S. S. , Goh H. H.
Published: August 2005

Plasma testosterone and serum HCG were measured by radioimmunoassay in 46 patients with intact molar pregnancy. There was no significant difference in plasma testosterone between patients with theca‐lutein cyst and those without the cyst. This suggests that ovarian contribution to the elevated testosterone in molar pregnancy is probably a minor one. No correlation was found between plasma testosterone and uterine size. However, a positive correlation (r =+O·3567, P<0·00l) was found between plasma testosterone and HCG and a rising trend in plasma testosterone was observed with increasing gestation. These results suggest that molar trophoblast is probably the major source of elevated testosterone in the maternal circulation.
THE INFLUENCE OF PRE‐INDUCTION VAGINAL PROSTAGLANDIN E2 GEL UPON SUBSEQUENT LABOUR
Authors: Mackenzie I. Z. , Embrey M. P.
Published: August 2005

Eight hundred and three patients with singleton viable pregnancies and fetal cephalic presentation were given prostaglandin E, in viscous gel by intravaginal instillation the evening before planned surgical induction. When the cervix was ‘ripe’, surgical induction was avoided in 65·9 per cent of primigravidae and 87 5 per cent of multigravidae; the administration of epidural analgesia was less frequent, the rate of spontaneous vaginal delivery greater, the Caesarean section rate lower, and the state of the newborn at delivery better than in those patients who required surgical induction. Side effects attributable to the prostaglandin gel were rare as were complications.
FETAL BREATHING MOVEMENTS IN HIGH RISK PREGNANCY
Authors: Trudinger B. J. , Lewis P. J. , Mangez Jean , O'Connor Evelyn
Published: August 2005

In 12 normal and 50 high risk pregnancies fetal breathing and fetal trunk movements were measured by real time ultrasound after the mothers had been given oral glucose. Fetal breathing was significantly reduced in the two fetuses which subsequently died and in five of six fetuses developing fetal distress in labour. Two patterns of breathing were noted in 23 fetuses with cessation of Intrauterine growth: either reduced fetal breathing or almost continuous breathing. Fetal trunk movements were more variable than breathing movements and a reduction in trunk movements had less predictive value.
CONTINUOUS MEASUREMENT OF TISSUE pH IN THE HUMAN FETAL SCALP
Authors: Wood C. , Anderson I. , Reddy S. , Shekleton P.
Published: August 2005

A method for continuous measurement of scalp tissue pH is described. The tissue pH probe was found to be robust and values for tissue pH were close to those for scalp blood pH. Combining the pH and fetal heart rate (FHR) electrodes in the one mechanical assembly facilitated application to the fetal scalp in early labour but the combined assembly electrode was found to have some disadvantages and manufacture of a separate tissue pH electrode is recommended. Continuous monitoring of scalp tissue pH enables closer study of the physiological basis of changes in fetal acid base status and should prove useful to the obstetrician in management of high risk pregnancies during labour.
THE EFFECTS OF QUINESTROL AND BROMOCRIPTINE ON BLOOD COAGULATION, SERUM PROLACTIN AND SERUM FSH LEVELS IN PUERPERAL WOMEN
Authors: Osbourne G. K. , Whigham K. A. E. , Howie P. W. , England P. , Kelly A. , Prentice C. R. M.
Published: August 2005

The effects of bromocriptine and quinestrol upon coagulation and fibrinolysis during the puerperium were studied. Quinestrol therapy was associated with increased levels of factors VII and IX and decreased antithrombin activity on the sixth postpartum day, and increased factor IX and plasminogen levels on the fourteenth postpartum day. Six weeks after delivery elevated levels of factors II and VII and of plasminogen were recorded in women given quinestrol. Bromocriptine therapy only caused an increase in the level of factor IX at six weeks after delivery. Compared to controls, patients given bromocriptine had lower prolactin and higher FSH levels during the puerperium whereas the patients given quinestrol had increased prolactin levels and a late fall in FSH levels.
MECONIUM‐LIKE STAINING OF AMNIOTIC FLUID DUE TO HIGH FETAL INTESTINAL OBSTRUCTION CASE REPORT
Authors: Williams J. , Zakut H. , Cohen D. , Nissan S.
Published: August 2005

A baby with congenital jejunal and ileal atresia is described. There was meconium‐like staining of the amniotic fluid which was probably due to fetal regurgitation or vomiting.
TOBACCO CHEWING IN PREGNANCY
Authors: Krisshna Kewal
Published: August 2005

The effects of tobacco chewing by pregnant women were investigated. When compared with those who did not do so, tobacco‐chewing mothers had a greatly increased stillbirth rate, a low male: female infant sex ratio and a major reduction in birth weight which was due in large part to early delivery.
EFFECTS OF MATERNAL CIGARETTE SMOKING ON THE FETUS AND PLACENTA
Authors: Naeye R. L.
Published: August 2005

In a large, prospective study, mothers who smoked during one pregnancy but not another had smaller infants in the pregnancy in which they smoked, irrespective of birth order and many other factors that affect fetal growth. Light cigarette smokers gained an average 90 g less at term than non‐smokers, entirely due to the smaller size of the light smokers' newborn infants. Heavy smokers gained 533 g less than non‐smokers, only one‐third of which was due to the smaller size of the heavy smokers' newborn infants. As smoking increased, placentas enlarged and developed microscopic lesions characteristic of underperfusion from the uterus. This underperfusion was probably periodic rather than continuous because the smokers' decidua had few of the arterial lesions that are characteristic of chronic low blood flow. Pregnancies were a mean 1.5 days shorter in smokers than in non‐smokers, due to more frequent amniotic fluid infections in the smokers.
THE EFFECT OF ORAL SALBUTAMOL ON SERUM POTASSIUMAND BLOOD SUGAR
Authors: Hastwell G. , Lambert B. E.
Published: August 2005

Serum potassium and blood sugar concentrations were measured in six patients treated with oral salbutamol to inhibit premature labour. The fall in serum potassium and rise in blood sugar were variable and not present in every patient. The values returned to the normal range usually within 72 hours of continuous usage of the drug.
CONTINUOUS FETAL TISSUE pH RECORDINGS DURING LABOUR A PRELIMINARY REPORT
Authors: Weber T. , Hahn‐Pedersen Suzanne , Bock J. E.
Published: August 2005

We made continuous fetal pH‐measurement in 50 patients and showed a good correlation between tissue pH and umbilical artery, umbilical vein and the fetal scalp blood pH. There were practical problems in the use of the glass pH electrode.
COMPARISON OF PLACEBO AND BROMOCRIPTINE IN THE TREATMENT OF PATIENTS WITH NORMOPROLACTINAEMIC AMENORRHOEA
Authors: Crosignani P. G. , Reschini E. , Lombroso G. C. , Arosio M. , Peracchi M.
Published: August 2005

Fourteen women with normoprolactinaemic amenorrhoea were treated with bromocriptine (2.5 mg twice daily) for a period ranging from 4 to 17 weeks, while a matched group of 19 amenorrhoeic women were treated with a placebo (one tablet twice daily) for 4 to 12 weeks. About half of the patients in both groups had at least one episode of vaginal bleeding during treatment. There was no clear difference in the menstrual and ovulatory pattern between placebo and bromocriptine groups.
EFFECT OF SMOKING DURING PREGNANCY UPON THE HAEMATOLOGICAL VALUES OF CORD BLOOD
Authors: D'Ssouza S. W. , Black Patricia M. , Williams Norma , Jennison R. F.
Published: August 2005

Haematological indices in cord blood, measured by a Coulter Counter, in 50 mothers who smoked 10 or more cigarettes a day were compared with those in 75 control mothers who were non‐smokers, but of similar age and parity. Smoking during pregnancy was associated with higher levels of haemoglobin, and the haematocrit, as well as with higher red cell counts and a higher mean corpuscular haemoglobin. The percentage of fetal haemoglobin in cord blood was not affected by smoking. There was no correlation between social class and cord blood haemoglobin; but within social class groups, higher cord blood haemoglobin levels were associated with smoking. It is suggested that smoking during pregnancy stimulates fetal erythropoeisis.
VISCOSITY, HAEMATOCRIT, FlBRINOGEN AND PLASMA PROTEINS IN MATERNAL AND CORD BLOOD
Authors: Foley M. E. , Isherwood D. M. , McNicol G. P.
Published: August 2005

The viscosity at low shear rate of whole blood, plasma and serum, the haematocrit, plasma fibrinogen, plasma proteins, and IgM were measured in maternal and cord blood immediately following delivery. The whole blood viscosity in maternal blood (mean 19.96±3.74 centipoise or c/p) was similar to cord blood viscosity (mean 19.44±4.28 c/p). The mean haematocrit in maternal blood (0.385±0.026) was significantly lower than the cord haematocrit (0.488±0.039). Mean plasma viscosity (1.86±0.47 c/p) and plasma fibrinogen (4.25±0.75 g/litre) in maternal blood were significantly higher than cord plasma viscosity (1.12±0.19 c/p) and cord plasma fibrinogen (1.81±0.61 g/l). Mean serum viscosity (1.22±0.28 c/p) and mean IgM levels (2.38±0.36 g/l) in maternal blood were significantly higher than cord serum viscosity (0.92±0.15 c/p) and cord IgM (0.48±0.06 g/l). The low levels of IgM and fibrinogen may protect the fetus from the increased viscosity that could be expected in association with a high haematocrit.
THE SIGNIFICANCE OF RAISED MATERNAL PLASMA ALPHA‐FETOPROTEIN IN TWIN PREGNANCY
Authors: Keilani Z. , Clarke P. C. , Kitau M. J. , Char T.
Published: August 2005

A hundred twin pregnancies were examined before 27 weeks gestation. The level of maternal plasma alpha‐fetoprotein (AFP) was correlated with outcome of the pregnancy. Forty per cent of all women had elevated plasma AFP levels. At birth the combined infant weights were greater in the women with elevated AFP; the gestational age at delivery was unrelated to the level of AFP in early pregnancy.
FACTORS ASSOCIATED WITH LOW BIRTH WEIGHT OF INFANTS DELIVERED AT TERM
Authors: Fedrick Jean , Adelstein Philippa
Published: August 2005

The singleton births in the 1958 British Perinatal Mortality Survey (Butler and Bonham, 1963; Butler and Alberman, 1969) were used to study the aetiology of low birth weight of infants delivered at term. After exclusion of macerated stillbirths and infants with lethal congenital defects, 468 infants of 259 days or more gestation and a birth weight which was less than 2500 g were identified. The mothers and their pregnancies were compared with those of the population of 16 994 singleton births. Delivery at term of a low birth weight infant was significantly associated with maternal prepregnant weight, maternal height, maternal smoking, primiparity, maternal employment, low social class, a previous infant of low birth weight, threatened abortion and severe toxaemia. No significant associations were found with illegitimacy, area of residence, previous spontaneous abortion, essential hypertension, mild toxaemia, chronic or acute infections or other conditions. There were significant negative associations with a history of previous large infants and with maternal blood group AB.
ANTENATAL IDENTIFICATION OF WOMEN AT INCREASED RISK OF BEING DELIVERED OF A LOW BIRTH WEIGHT INFANT AT TERM
Authors: Adelstein Philippa , Fedrick Jean
Published: August 2005

A method is described by which the risk of being delivered of a low birth weight infant at term can be predicted during the third trimester. A composite score is obtained by multiplying together relevant relative risks. The effectiveness of the method is discussed.
MEASUREMENT OF THE FETAL HEART RATE DURING PREGNANCY BY A NEW ELECTROCARDIOGRAPHIC TECHNIQUE
Authors: Wheeler T. , Murrilis A. , Shelley T.
Published: August 2005

An external technique for recording the fetal heart rate (FHR) during pregnancy is described. The system is based upon the detection of the fetal electrocardiogram (ECG) from the maternal abdomen and elimination of the maternal QRS complexes by a new system of subtraction. Fetal QRS complexes with an amplitude of 10 microvolts or more were processed to produce heart rate recordings of much higher quality than previously obtained with the phonocardiographic and ultrasonic systems. The proportion of successful recordings was reduced between 27 and 34 weeks of gestation due to the decrease in size of the fetal QRS complex which occurred at this time; this was a major drawback of the ECG system.
ABNORMAL PLATELET FUNCTION IN PRE‐ECLAMPSIA
Authors: Whigham Kathryn A. E. , Howie P. W. , Drummond A. H. , Prentice C. R. M.
Published: August 2005

Platelet behaviour was studied in groups of women suffering from mild and severe pre‐eclampsia, and compared with normal pregnant and non‐pregnant controls. Platelets from women with severe pre‐eclampsia were less responsive than normal to a variety of aggregating agents, and this impairment was significant in response to collagen and vasopressin. Women with severe pre‐eclampsia had raised plasma adenine nucleotide levels and lowered platelet 5‐hydroxytryptamine levels compared with the controls. Platelets from women with mild pre‐eclampsia showed only a slight difference from normal. These findings may be the result of platelets having undergone aggregation and disaggregation within the circulation, and suggest that platelets may be involved in the pathogenesis of pre‐eclampsia.
THE EFFECT OF INDOMETHACIN ON SPONTANEOUS ACTIVITY IN THE ISOLATED HUMAN MYOMETRIUM AND ON THE RESPONSE TO OXYTOCIN AND PROSTAGLANDIN
Authors: Garrioch, D. B.
Published: August 2005

The spontaneous activity of human myometrial strips obtained during the proliferative and secretory phases of the menstrual cycle and during the early and late stages of pregnancy was studied. Both prostaglandin F2α (PGF2α) and oxytocin caused contractions which were superimposed on a low level of spontaneous activity but only PGF2α was seen to affect high levels of activity. Spontaneous contiactions were ultimately abolished by the addition of indomethacin. The strips remained responsive to PGF2α but not to oxytocin.
REDUCTION BY MEFENAMIC ACID OF INCREASED MENSTRUAL BLOOD LOSS ASSOCIATED WITH TNTRAUTERINE CONTRACEPTION
Authors: Guillebaud J. , Anderson Anne B. M. , Turnbull A. C.
Published: August 2005

Twenty‐five healthy parous women using intrauterine contraceptive devices (IUCD's) received mefenamic acid, 500 mg 8‐hourly, during two menstrual periods. Two pre‐ and two post‐treatment menses were similarly studied, by the collection of used sanitary pads and/or tampons and measurement of daily blood loss. A highly significant reduction in mean total blood loss during the treatment periods was observed, unaffected by whether therapy began on the first day of bleeding or in the late luteal phase. The reduction was observed among both inert and copper‐containing IUCD‐users. Expressed as a percentage of the mean pre‐treatment volume, the reduction in loss was not significantly different for those IUCD‐users who were light losers (less than 80 ml) compared with heavy losers (80 ml or more), but it was greater in volume terms among the latter. The amounts lost during the post‐treatment periods, whether or not placebo tablets were given, were not significantly different from pre‐treatment. Reports of side effects were infrequent. By contrast with the reduction in volume lost, no effect of mefenamic acid on the total duration of bleeding and non‐collectable 'spotting’could be demonstrated.
VERRUCOUS CARCINOMA OF THE VULVA
Authors: Zaaijman J. du T. , Slabber C. F.
Published: August 2005

A patient with verrucous carcinoma of the vulva is presented. A radical vulvectomy and superficial inguinal lymphadenectomy was done. The short‐term result was satisfactory.
THE TREATMENT OF UTERINE BLEEDING WITH VASOPRESSIN HORMONOGEN (GLYPRESS1N)—A PILOT STUDY
Authors: Pavlin V. , Flynn M. J. , Mulder J. L. , Cort J. H.
Published: August 2005

In a pilot study 12 women with severe uterine bleeding received an intravenous injection of 0 ‐ 2 mg of a vasopressin hormonogen, glypressin. In 11 of the patients a rapid reduction or cessation of blood loss were observed. Two patients had facial pallor following the injection but no other side effects occurred. Five of the older women with long histories of menorrhagia were placed on a regime of one injection of glypressin on the first day of menstruation for six months; in all of them the duration of bleeding was reduced to three days and the monthly blood loss became very slight. On the basis of these results more extensive clinical trials in menorrhagia and metrorrhagia are recommended.
SEQUENTIAL CHANGES IN THE HUMAN RENIN‐ANGIOTENSIN SYSTEM FOLLOWING DELIVERY
Authors: Pipkin F. Broughton , Oats J. J. N. , Symonds E. M.
Published: August 2005

Plasma renin activity and concentration and angiotensin II concentration have been measured serially in six normotensive primigravidae and in four mildly hypertensive patients in the four hours immediately following normal delivery. In normotensive patients, both renin and angiotensin II levels fell sharply over the first two hours to levels within the non‐pregnant range, with a subsequent rise to levels similar to those found in late pregnancy. Changes in the mildly hypertensive patients were smaller, and somewhat slower. It is suggested that the initial fall represents clearance of a renin of fetoplacental origin and that the subsequent rise may be a release from feedback suppression of renal renin synthesis.
RELATION BETWEEN TOTAL UTERINE IMPULSE, METHOD OF DELIVERY AND ONE‐MINUTE APGAR SCORE
Authors: Rossavik I. K.
Published: August 2005

The resistance to the passage of the fetus during labour has been estimated indirectly by calculation of the total area below the intrauterine pressure curve (total uterine impulse) in two periods during the first stage of labour. A good correlation was found between the total uterine impulse from a cervical dilatation of 5 to 10 cm, the outcome of the second stage of labour and the Apgar score at one minute.
SEX HORMONE LEVELS AND GONADOTROPHIN RELEASE IN PREMATURE OVARIAN FAILURE
Authors: Duignan N. M. , Shaw R. W. , Glass M. R. , Butt W. R. , Edwards R. Logan
Published: August 2005

Premature ovarian failure was studied in ten women under the age of 30; eight had an ovarian biopsy and five of these showed primordial follicles. Plasma levels of oestradiol and progesterone were similar to the follicular phase of a normal menetrual cycle, but in eight patients cervical smears showed a cornification index of less than one per cent. Levels of both androgens and of sex hormone binding globulin capacity were generally normal. Administration of LH‐RH caused a release of FSH which was similar to post menopausal women and higher than normally menstruating women, and a release of LH which was higher than both. Two patients were treated with exogenous gonadotrophins without effect.
ACTIVITY AND CHARACTERIZATION OF A LOW MOLECULAR FRACTION PRESENT IN HUMAN AMNIOTIC FLUID WITH BROAD SPECTRUM ANTIBACTERIAL ACTIVITY
Authors: Sachs B. P. , Stern C. M.
Published: August 2005

The isolation of a low molecular weight fraction from amniotic fluid with broad spectrum antimicrobial activity is reported. This fraction consists of a family of peptides whose bactericidal activity is zinc dependent and can be inhibited by phosphate. Peptides are present in early gestation in low concentration increasing in amount from about 28 weeks gestation when antimicrobial activity becomes detectable in whole amniotic fluid. A simple bacteriological assay for this material is described. Its relation to the occurrence of perinatal infection is discussed.
ANTENATAL SCREENING IN OXFORD FOR FETAL NEURAL TUBE DEFECTS
Authors: Wald N. J. , Cuckle H. S. , Boreham Jillian , Brett Rosemary , Stirrat G. M. , Bennett M. J. , Turnbull A. C. , Solymar Marianne , Jones Nora , Bobrow M. , Evans C. J.
Published: August 2005

Between May 1975 and the end of 1977, 6443 antenatal patients were screened mainly between 16 and 22 weeks of pregnancy for neural tube defects (NTDs) at the John Radcliffe Hospital, Oxford, by maternal serum alpha‐fetoprotein (AFP) measurement; a take‐up of 72 per cent. Seventeen out of 18 (94 per cent) patients with open NTD pregnancies (9 out of 9 with anencephaly and 8 out of 9 with open spina bifida) had positive screening tests, and all except one were offered and accepted a termination of pregnancy. Two hundred and forty‐five (3.8 per cent) patients with unaffected pregnancies also had positive screening tests, although only 1 4 per cent had an amniocentesis. Following ultrasonography, about 50 per cent of patients with unaffected pregnancies with positive screening tests were not offered an amniocentesis because they had a multiple pregnancy or their gestational age had been underestimated. The odds of having a fetus with an NTD among the women who had an amniocentesis was about 1 to 6 (1 to 11 for open spina bifida alone). Two apparently normal pregnancies were terminated. A survey of the acceptability of the screening programme among a consecutive sample of 73 patients who knew that they had a positive screening test revealed that all except one had no objection to screening in general, and 68 (93 per cent) wanted to be tested again in a future pregnancy. The approximate direct cost of the programme was £2 to £3 per patient screened, or about £l000 per NTD detected (about £2200 per open spina bifida detected).
TREATMENT OF PREMENSTRUAL SYNDROME BY SPIRONOLACTONE
Authors: Shaughn O'Brien P. M. , Craven D. , Selby C. , Symonds E. M.
Published: August 2005

Spironolactone was given to 28 women in a double blind cross over trial during four menstrual cycles. Hormonal profiles were measured during the first two cycles. Plasma aldosterone was elevated in the premenstrual phase of the cycles but there was no significant difference between symptomatic and asymptomatic groups. The rise in serum progesterone was higher in the symptomatic group during the postovulatory phase. The administration of spironolactone reduced weight and relieved psychological symptoms in more than 80 per cent of the symptomatic group.
FAMILIAL CARCINOMA OF THE OVARY CASE REPORT
Authors: Philipp E.E.
Published: August 2005

A patient was successfully treated by surgery, progestogens and chlorambucil for a poorly differentiated cystadenocarcinoma of the ovary. Four of her relatives had died of ovarian cancer; it was ascertained that two of them also had poorly differentiated cystadenocarcinoma.
A COMPARISON OF PGE2 AND PGF2α VAGINAL GEL FOR RIPENING THE CERVIX BEFORE INDUCTION OF LABOUR
Authors: MacKenzie I. Z. , Embrey M. P.
Published: August 2005

The efficacy of a vaginal gel containing either 5 mg prostaglandin E2 (PGE2) or 25 mg prostaglandin F2α (PGF2α) to ripen the unfavourable cervix for labour induction was assessed in a double blind trial. PGF2α, compared with PGE2, had little effect upon the clinical state of the cervix, but the resultant duration of labour in each of the two groups was shorter than in a control group. While the numbers of patients requiring oxytocin stimulation of labour and regional anal‐gesia were reduced in both groups compared with the controls, PGF2α was much less effective than PGE2'. Uterine hypertonus was observed using both prosta‐glandins during an experimental study and the implications are discussed.