bluuebunny/crossref_metadata_2025 huggingface dataset:
Concealed Placental Abruption in Cholestasis of Pregnancy
Authors: Brinsmead M. W.
Published: February 2008

A case report of a patient with recurring jaundice in 2 successive pregnancies is presented to illustrate the problems encountered with this condition. The condition is reviewed with reference to its effect on both mother and fetus.
On Modern Forceps Delivery and Laufe's Divergent Forceps
Authors: Forster Frank M. C.
Published: February 2008

Summary: Some aspects of modern forceps delivery and design are reviewed. The history of the divergent forceps is traced and a 6‐year clinical experience of Laufe's divergent forceps reported.
Laufe's Divergent Forceps The Canberra Experience
Authors: Cutter Bryan
Published: February 2008

Summary: The nature and function of the Laufe's divergent forceps is briefly described. This instrument has now been in use in Canberra for 2 1/2 years. It has been found easy to apply and safe to use, and has found general acceptance. It has become the instrument of choice for outlet forceps delivery. Its acceptance and further study in other obstetrical units is recommended.
Superfetation in Man
Authors: Walter A. , Hasenohr G. , Kerin J. F. P.
Published: February 2008

Summary: A probable case of superfetation is recorded. An attempt is made to establish the differential development of the 2 fetuses by a histological comparison. Evidence for a second and later ovulation and fertilization as the basis for superfetation is presented and discussed.
Solitary Ovarian Bands and Adhesions
Authors: Karimi Rokhsareh , Chapman Kenneth
Published: February 2008

Summary: Two allegedly neurotic patients with right iliac fossa pain were investigated with the laparoscope. The findings are described and implications discussed.
Sterilization — Tubal Approach or Hysterectomy?*
Authors: Paterson Peter J.
Published: February 2008

Summary: A comparison is made of the advantages and disadvantages of tubal surgery or hysterectomy for female sterilization purposes. The former is usually the more desirable but, because 15–20% of women ultimately require hysterectomy, criteria are described whereby this group can be identified and the operation carried out as a first choice.
Severe Menorrhagia in a Patient with Hereditary Haemorrhagic Telangiectasia
Authors: O'Neill James P. , Hill Hilary
Published: February 2008

Summary: Synthetic progestin‐oestrogen therapy (Enavid) successfully controlled both menorrhagia and epistaxis over a span of 12 years in a patient with hereditary haemorrhagic telangiectasia. Severe menorrhagia ultimately developed, for which an emergency hysterectomy became necessary. In reviewing the literature, only 1 case of menorrhagia due to this condition has been found.
Haemodialysis in Acute Renal Failure Following Hyperemesis Gravidarum
Authors: Rosenthal Talma , Insler Vaclav , Iaine Adrian
Published: February 2008

Summary: Acute renal failure due to hyperemesis gravidarum in a 27‐year‐old woman is described. Prompt haemodialysis led eventually to full recovery of the mother and vaginal delivery of a viable infant. Immediate intensive care with haemodialysis is mandatory if pregnancy is complicated by acute renal failure, in order to protect the fetus from the uraemic environment.
Antenatal Fetal Heart Rate Monitoring
Authors: Sill Helen , Wilson E. W.
Published: February 2008

Summary: The value of antenatal fetal heart rate monitoring has been studied in 110 patients. When the fetal heart rate pattern was normal, the fetal outcome was satisfactory. When abnormalities of the fetal heart rate were present there was an increased incidence of fetal distress in labour, and reduced Apgar scores at 1 and 5 minutes. The place of fetal heart rate monitoring in antenatal care is discussed.
A Critical Assessment of the Induction and Maintenance of Labour Using the Cardiff Infusion System, Mark II
Authors: Correy J. F. , Tait T. G. , Fullerton R.
Published: February 2008

Summary: A series of patients in whom labour was induced by amniotomy and Syntocinon administration by the Cardiff Infusion System (C.I.S.) is presented. The problems of this equipment, both mechanical and technical, are discussed. Induction is more effective in terms of the reduced amniotomy‐established labour and ammotomy‐delivery intervals, but experienced supervision is required once labour is established. There is some evidence that the duration of labour may be increased by the use of oxytocin, this probably being related to the type of contraction induced by oxytocin administration.
Difficulties in Diagnosis and Management of Cervical Squamous Papillary Tumours*
Authors: Leong Anthony S. Y. , Chan Wing Fook
Published: February 2008

Summary: Ten cases of squamous papillary tumours were found in a review of over 1,200 cervical biopsies. Two of these lesions proved to be malignant, 1 fulfilling the description of verrucous carcinoma. The clinical and pathological features of these 10 cases are presented and discussed. The difficulties encountered in separating malignant from benign papillary growths in the uterine cervix are demonstrated, and the necessity for adequate biopsies is emphasized.
Efficacy of the Dalkon Shield in Contraception
Authors: Ng Allan Y. H. , Chan T. , Cheng M. C. E. , Hangchi D. , Ratnam S. S.
Published: February 2008

Summary: The Dalkon Shield was inserted in 180 multiparous women. Altogether 162 women‐years were available for study. In contrast to earlier studies, it was found that the pregnancy rate of 3.7 per 100 women‐years was higher than that of the Lippes Loop and the Double Coil while the expulsion and medical removal rates were similar. The Dalkon Shield did not appear to have any significant advantage over the Lippes Loop.
Stromal Sarcoma of the Endometrium Complicated by Pregnancy
Authors: Picker Richard H. , Pfanner David W. , Payne W. , Coupland G. E.
Published: February 2008

Summary: A rare case of stromal cell sarcoma of the uterus complicated by pregnancy is described. The nomenclature of uterine mesenchymal sarcomata is discussed.
An Unusual Complication of Intrapartum Fetal Heart Monitoring
Authors: Charters D. W. , Abdulla U.
Published: February 2008

Summary: A case is presented in which a scalp clip electrode was found in the rectovaginal septum 18 days after Caesarean section.
The Value of Fetal Radiography When Maternal Oestriol Excretion is Subnormal
Authors: Acton Christine M. , Targett C. S. , Abell D. A. , Beischer N. A.
Published: February 2008

Summary: Two hundred and fifty consecutive patients with subnormal urinary oestriol excretion were studied. Radiological assessment of fetal bone age showed a delay of at least 4 weeks in 22 of 61 (36%) with intrauterine growth retardation and in 7 of the remaining 189 (4%) without this complication. Variance between radiological and clinical assessments of gestational age should be initially interpreted as an indication of growth retardation rather than prematurity or wrong dates.
The Active Management of Pre‐term Labour and Its Effects on Fetal Outcome
Authors: Baillie P. , Malan A. F. , Saunders M. C. , Davey D. A.
Published: February 2008

Summary: The results of a controlled trial using β‐adrenergic drugs and betamethasone in the management of pre‐term labour are described. In an 11‐month period, 514 patients were admitted in pre‐term labour and 146 of these were included in the study. The reasons for non‐treatment of the remainder were chiefly the pressure of maternal contraindications, the diagnosis of “stress” in the fetus, and delay in the commencement of active treatment.

In patients treated before 37 weeks, there were significantly fewer perinatal deaths than in control patients. There was no difference, however, between patients given β‐adrenergic therapy plus betamethasone and those given β‐adrenergic therapy alone. In patients in whom labour had been delayed for more than 72 hours, there were no deaths due to apnoea or hyaline membrane disease.
The Panorama of Laparoscopic Technology in Female Sterilization
Authors: Lean T. H.
Published: February 2008

Summary: Developments in laparoscopic sterilization are described. Laparoscopic tubal cautery is associated with a failure rate ranging from 0.2 to 2.0 per 100 operations. The morbidity rate averages about 5% with an average of 1% requiring emergency surgery. Mortality ranges from 20 to 30 per 100,000 operations, compared with a non‐laparoscopic sterilization rate of 25 per 100,000 operations.

Current developments in the field of laparoscopic sterilization are described, incorporating experiences with the use of the haemoclip, the Hulka‐Clemens clip, the Falope ring or Yoon band, and also the beginnings of the miniature laparo‐scope or so‐called “needlescope”.
Gonadotrophin Stimulation for Oocyte Recovery and in Vitro Fertilization in Infertile Women
Authors: Talbot J. M. , Dooley M. , Leeton J. , Lopata A. , McMaster R. , Wood C. , Brown J. B. , Evans J. H.
Published: February 2008

Summary: The effects of gonadotrophin stimulation were investigated by urinary oestrogen and pregnanediol analyses and by timed laparoscopic examination in 14 infertile ovulatory women with total tubal destruction who were candidates for in vitro oocyte fertilisation.

An unpredictable ovarian response was obtained in 6 patients when a fixed regimen of 4 doses of FSH followed by HCG was used as described by Steptoe and Edwards (1970).

Therapy was then changed in 8 patients to larger daily doses of FSH which were monitored by urinary oestrogen excretion and HCG was given according to the response. This regimen resulted in hormone excretion patterns which resembled those found during the normal ovulatory cycle except that oestrogen peak values were higher. The laparoscopic findings were consistent with the hormone values and information was obtained relating the timing of ovulation to the patterns of oestrogen and pregnanediol excretion. It is hoped that these findings can be applied to the improved collection of follicular oocytes of optimum maturity for in vitro fertilisation.
Mixed Mullerian Tumour of the Fallopian Tube Presenting as a Hydrosalpinx
Authors: Weiss David B. , Aboulafia Yeshaya , Rosenmann Eliezer
Published: February 2008

Summary: Primary tumours of the Fallopian tube are rare and this is particularly true of the mixed Müllerian variety. Such a tumour developing in association with chronic follicular salpingitis and hydrosalpinx is reported.
Heart Function in Normotensive and Hypertensive Pregnancy — A Preliminary Communication
Authors: Walters W. A. W. , Lim Y. L.
Published: February 2008

Summary: Heart function in 19 normotensive and 27 hypertensive pregnant women was studied by a new technique for measuring systolic time intervals and by standard methods for measuring haemodynamic variables. In the hypertensive pregnant women, although heart rate and blood volume were not altered significantly, cardiac output, stroke volume, left ventricular work and total peripheral resistance were all increased and were accompanied by slightly less efficient cardiac contractility compared with findings in normotensive pregnant women.
Plasma Fibrinolytic Activity in Early Pregnancy
Authors: Condie Roy G.
Published: February 2008

Summary: In an attempt to elucidate changes in the fibrinolytic mechanism in early pregnancy, a prospective study was carried out on six nulliparous women from the time of stopping oral contraception until 16 weeks of gestation. A venous stasis stress test was applied at each sampling, and plasminogen activator levels were assayed in peripheral venous plasma.

A significant reduction in fibrinolytic activity from the prepregnant level did not occur until 16 weeks of gestation in the unstressed situation, and until 12 weeks in the stressed situation. In both the prepregnant and pregnant states the stress of venous stasis effected a significant release of activator on each occasion of testing.
Alphafetoprotein by Radioimmunoassay in Maternal Serum and Amniotic Fluid
Authors: Khoo S. K. , Tillack Sandra , Mackay E. V.
Published: February 2008

Summary: The use of a competitive inhibition radioimmunoassay allows the measurement of alphafetoprotein (AFP), a specific a‐globulin produced by fetal and malignant liver cells, in serum and amniotic fluid at low concentrations of ng/ml. In normal pregnancy, mean AFP levels in maternal serum showed a slow rise, from undetectable levels (less than 20 ng/ml) before 12 weeks of gestation, to a maximum at 30 weeks. After that, there was a comparable decline in levels for the remainder of pregnancy, up to 42 weeks. From 14 weeks there was a wide variation in individual AFP values at all stages of gestation, but most of them fell within 2 standard deviations above the mean.

A correlation was found between AFP levels in samples of maternal serum and amniotic fluid taken simultaneously, with levels in amniotic fluid reading at least 50% higher. AFP levels in amniotic fluid in late pregnancy corresponded to the lecithin/sphingomyelin ratio in an inverse relationship.
Emotional Adjustment Following Tubal Sterilization by Laparoscopy and Laparotomy in 1,052 Women
Authors: Wise D. J. , Perkin G. J. , Correy J. F.
Published: February 2008

Summary: A questionnaire assessing emotional adjustment after tubal sterilization was completed by 1,052 women. Age, parity, religion, and prior emotional stability were found not to predict dissatisfaction. However, there was a significant relationship between medical indications for sterilization and an unsatisfactory outcome. Approximately 30% of the sample reported improvement in emotional and sexual adjustment; the number showing deterioration was low. Patients sterilized by laparotomy found the procedure significantly more trying than those sterilized by laparoscopy.
Small Bowel Perforation by a Shield Type Intrauterine Contraceptive Device
Authors: Aitken G. W. E. , Verco C. J.
Published: February 2008

Summary: A case of asymptomatic perforation of the small intestine by an intrauterine contraceptive device (a Dalkon shield) is presented. This is believed to be the first reported case of such an occurrence.
Spontaneous Rupture of a Massive Pyometra
Authors: Chew P. C. T. , Ratnam S. S.
Published: February 2008

Summary: A 66‐year‐old patient presented with acute peritonitis from a ruptured pyometra associated with an extensive cervical carcinoma. The relevant literature is reviewed.
Induction of Ovulation Resulting in Nonuplet Pregnancy
Authors: Carey H. M.
Published: February 2008

Summary: Fertilisation and development of 9 ova to the stage of theoretical viability (28 weeks), followed the induction of ovulation with 3 injections of human pituitary gonadotrophin and 1 injection of human chorionic gonadotrophin. The total urinary oestrogen level prior to ovulation reached a peak of 235 μg per 24 hours, the day prior to the injection of 6,000 I.U. HCG. High plasma prolactin levels due to a small pituitary tumour may have accounted for variability in response to HPG.
Fetal Cephalometry During Normal Pregnancy in a New Zealand Population
Authors: Aickin D. R. , Chatfield W. R. , Rippon P. E.
Published: February 2008

Summary: Fetal biparietal diameters were measured by sonar during normal pregnancies on 1,018 occasions. The range of measurements was determined for each week of pregnancy from 19 weeks to 41 weeks.
The Definition of an Ideal Teacher by Fifth Year Medical Students Studying Obstetrics and Gynaecology
Authors: Wood Carl , Walters William A. W. , Paget Neil
Published: February 2008

Summary: Seventy‐four of 101 fifth year medical students doing obstetrics and gynaecology completed a questionnaire concerning the characteristics of an ‘ideal teacher’. The results of the survey show that these students ranked teacher characteristics related to the gathering of information more highly than other characteristics. Concepts of student preparation for classes and feedback on progress with a subject were regarded by students as being much less important, while reference to latest developments in the subject was regarded as being of least importance.
Bowen's Disease of the Vulva — Its Possible Relationship to Exposure to Arsenic
Authors: Cope Ian , Osborn Robert
Published: February 2008

Summary: A case of Bowen's disease of the vulva with microinvasion is described. The association with other gynaecological malignancies and possible arsenic exposure is discussed.
Endocervical Glial Polyp
Authors: Leong Anthony S. Y.
Published: February 2008

Summary: A polyp composed of astrocytic glial tissue was found in the endocervix of a young woman with intermenstrual and postcoital bleeding. The histogenesis and clinical significance of this lesion is discussed.
The Relationship Between Maternal Glucose Tolerance and Fetal Size at Birth
Authors: Abell David A. , Beischer Norman A.
Published: February 2008

Summary: Two thousand consecutive patients have been studied to investigate the association between maternal glucose tolerance during pregnancy and fetal size at birth. It was shown that the incidences of small for dates (SFD) and low birth weight (LBW) babies were significantly increased when there was maternal hypoglycaemia (P<0.001), particularly when this occurred at the 3‐hour reading of the test. This finding has therapeutic implications. The incidences of large for dates (LFD) and high birth weight (HBW) babies were not related to the degree of maternal hyperglycaemia. Glucose is essential for fetal growth, but does not appear to be the cause of excessive fetal size.
Acute Pancreatitis in Pregnancy
Authors: Sivanesaratnam V. , Ong T. H.
Published: February 2008

Summary: Two patients with acute pancreatitis in pregnancy are described and some pertinent features in these and other reported series are discussed.
Placental Weight and Amniotic Fluid Volume in the First Half of Pregnancy
Authors: Birkbeck J. A.
Published: February 2008

Summary: Relationships between placental weight and amniotic fluid volume, and fetal age, weight and crown‐heel length, have been examined in a series of pregnancies terminated at between 8 and 20 weeks' postmenstrual age. The most significant relationship of each is with fetal weight, supporting the views of some previous authors. Placental index has been recalculated using the new data.
Hysteroscopy — An Evaluation
Authors: Paterson Peter J.
Published: February 2008

Summary: An assessment has been made of the technique of hysteroscopy. Five per cent dextrose and 32% dextran are the most satisfactory intrauterine media to employ. The procedure is a most valuable diagnostic aid in gynaecology and promises to have a place as a method for achieving female sterilization.
Fetal Distress in the First Stage of Labour Associated with Early Fetal Heart Rate Decelerations and a Short Umbilical Cord
Authors: Bain C. , Eliot B. W.
Published: February 2008

Summary: Five cases of fetal distress early in the first stage of labour associated with a primary short umbilical cord (less than 35 cm) are described. These are used to illustrate the difficulty of correlating changes in fetal heart rate patterns with fetal distress in labour. The importance of fetal blood sampling as the final arbiter in the diagnosis of fetal hypoxia is emphasised.
Testing for Pregnancy
Authors: Douglas A.
Published: February 2008

Summary: Some of the social and philosophical concepts and medicolegal aspects of pregnancy tests in general, and do it yourself tests in particular, are presented.
A Survey of Congenital Abnormalities and Drugs in a Private Practice
Authors: Newman N. M. , Correy J. F. , Dudgeon G. I.
Published: February 2008

Summary: A retrospective analysis of drugs ingested in the first trimester of pregnancy in 7,933 consecutive deliveries in patients in a private practice was made. No particular congenital abnormality was found to be associated with any particular drug or group of drugs. However, there was a twofold increase in congenital abnormalities in the group with a positive history of drug intake in the first trimester of pregnancy.
Idiopathic Thrombocytopenic Purpura Complicating Pregnancy
Authors: Chang A. , Morrison J. , Teoh G.
Published: February 2008

Summary: A patient with idiopathic thrombocytopenic purpura complicating pregnancy is presented, followed by a review of the literature and discussion of the problems of this complication.

The need for close monitoring of fetal welfare in late pregnancy and the advantages of Caesarean section are emphasized.
Pregnancy in Rudimentary Horn of Uterus
Authors: Khanum Wazira , Kachroo Sheela
Published: February 2008

Summary: A case of ruptured rudimentary uterine horn at 16 weeks of gestation is described.
Some Problems of the “Empty‐Handed” Mother
Authors: Harris Michael J.
Published: February 2008

Summary: The mother who is discharged from an obstetric unit after confinement and leaves her baby behind faces a number of psychological problems. These can be related to the emotional crises initiated when the baby is admitted to a special care ward and to the absence of normal mother‐infant bonding. The child faces increased risks on going home.

Group discussion is one technique to support these mothers. Anxieties and fears, as expressed in such groups, are discussed in this paper.
Obstetrical Sequelae of Fetal Hypotonia and Paresis
Authors: Pearn John
Published: February 2008

Summary: Neuromuscular diseases which affect the fetus form a useful and perhaps exclusive model by which the role of normal fetal muscle tonicity in pregnancy and delivery can be examined. In this context, the pregnancies, deliveries, and neonatal sequelae of 76 patients with infantile spinal muscular atrophy have been reviewed. It has been found that normal fetal tone is important in the prevention of traction injuries during delivery. Reduced fetal movements do not influence the duration either of pregnancy or of labour. Weak fetal swallowing, provided even minimum deglutition is present, is sufficient to prevent polyhydramnios at least in the third trimester. Other obstetric and neurological overtones of perinatal hypotonia are discussed.
The Results of Tuboplasty With Fimbrial Conservation and Intra‐Abdominal Hydrotubation
Authors: Foy Bryan N.
Published: February 2008

Summary: A technique of tuboplasty associated with intra‐abdominal hydrotubation is described. The procedure was performed on 20 patients, 95% of whom had subsequent tubal patency, while 55% became pregnant. It is concluded that, although high patency rates may be obtained by using hydrocortisone and prosthetic adjuncts, further improvement in terms of successful pregnancy are more likely to be gained by improvement in surgical techniques.
Thanatophoric Dwarfism ‐ A Delivery Dilemma
Authors: Teoh G. , Morrison J. , Chang A.
Published: February 2008

Summary: A case of thanatophoric dwarfism, a fatal form of achondroplasia, is presented.
Successful Pregnancy After Renal Transplantation
Authors: MacLean A. B. , Abbott G. D. , Aickin D. R. , Bailey R. R. , Bashford D. H. , Little P. J.
Published: February 2008

Summary: A successful pregnancy outcome in 2 patients with cadaveric renal transplants is described. Changes in renal function, fetal monitoring, and delivery by Caesarean section are discussed. The occurrence of viral infections during pregnancies in these immunosuppressed women is a potential fetal hazard.
Haemolytic Disease of the Newborn Due to Anti‐S
Authors: Harrison K. L. , McLarty P. C.
Published: February 2008

Summary: A case of mild haemolytic disease of the newborn due to anti‐S is presented. Anti‐S is not a common antibody and there have been very few reported cases in which it has caused haemolytic disease of the newborn.
Postmenopausal Endometrial Tuberculosis
Authors: Hutchins C. J.
Published: February 2008

Summary: Three cases of postmenopausal tuberculosis endometritis are presented. The pathogenesis and treatment of the condition are discussed. Tuberculosis is a continuing problem, especially in older patients, and cannot be discounted as a cause of postmenopausal bleeding.
Review: Human Prolactin ‐ Recent Advances in Physiology and Therapy
Authors: Healy D. L. , Burger H. G.
Published: February 2008

Summary:Human prolactin has been proven to exist as a unique hormone of the anterior pituitary gland. Use of sensitive bioassay and radioimmunoassay techniques has enabled it to be measured in serum and amniotic fluid. Serum prolactin values increase in some women during the luteal phase of the menstrual cycle, in all women during pregnancy and during postpartum suckling. High concentrations of this hormone are also found in amniotic fluid and in neonates for the first few weeks of life. Unlike most other pituitary hormones, prolactin is normally under inhibitory control from the hypothalamus and various stimulatory and inhibitory tests have been used to test the integrity of this hypo‐thalamic‐pituitary axis. Such tests have been used in clinical conditions where abnormally high serum prolactin levels, or hyperprolactinaemia, have been found in an attempt to localize the disorder and explain its pathogenesis. Hyperprolactinaemia is common in secondary amenorrhoea and galactorrhoea, or inappropriate lactation, and should be excluded in all patients presenting with these problems. It also occurs frequently in patients with pituitary tumours and may cause the reduced libido and impotence in some men complaining of infertility. Drug therapy is now available to suppress serum prolactin concentrations and has been used successfully to prevent or suppress puerperal lactation. Pathological states, such as hyperprolactinaemic secondary amenorrhoea and galactorrhoea have also been treated with these drugs with lowering of serum prolactin values to the normal range and subsequent restoration of ovulation and fertility, or cessation of lactation. A policy for the diagnosis, investigation and clinical management of such patients is presented.
A Review of Obstetric Practice in Hobart Over 25 Years
Authors: Correy J. F.
Published: February 2008

Summary: A study is presented of broad trends in obstetric practice in Hobart during the past 25 years. It is anticipated that the information presented may be useful for reference purposes in other epidemiological studies involving any or all of the parameters assessed.
Miconazole in the Treatment of Vulvovaginal Candidiasis
Authors: Teoh S. K. , Asari A. R. , Yusof K.
Published: February 2008

Summary: The effectiveness of miconazole cream 2% in the treatment of vulvovaginal candidiasis was studied in 46 patients who had positive cultures of Candida spp. in Nickerson's media; 35 of 39 patients who received treatment and returned for follow‐up were completely relieved of symptoms within 6 days. Cultures of Candida spp. for these women were negative. Treatment for the male partner was also successful.
Cervical Pregnancy ‐ Case Report
Authors: Shearman Rodney P. , Parkin G. M.
Published: February 2008

Summary: A case of cervical pregnancy is described. The diagnosis was made pre‐operatively. Management included digital evacuation of the pregnancy, bilateral ligation of the internal iliac arteries and repeated packing of the implantation site in the cervical canal. The patient has since had one unsuccessful and 2 successful intra‐uterine pregnancies.
Granular Cell Myoblastoma of the Vulva
Authors: Hutchins C. J.
Published: February 2008

Summary: Although granular cell myoblastoma has been reported many times since its first description by Weber in 1854 and can no longer be regarded as a rarity, only a small number of these tumours have been described in gynaecological situations. Such a tumour arising in the labium majus is reported, and its pathogenesis, differential diagnosis, and treatment discussed.
Oral Prostaglandins E2 and F2a in the Induction of Labour
Authors: Yeung K. K. , Pang J. C. K.
Published: February 2008

Summary: Oral prostaglandins E2 and F2a were used to augment amniotomy in the induction of labour in 173 patients. The success rate was significantly higher with prostaglandin E2 than with prostaglandin F2a (89% and 75%, respectively). This was achieved despite a significantly lower incidence of gastrointestinal side effects. No serious maternal or fetal complications occurred with either drug. It is concluded that oral prostaglandin E2 is more efficient than oral prostaglandin F2a in the induction of labour.
The Place of Vacuum Extraction in Prolapsed Pulsating Cord
Authors: Fahmy Kamal , Ghali Atef
Published: February 2008

Summary: Sixty‐three consecutive cases of prolapsed pulsating cord managed by vacuum extraction and 52 others managed by Caesarean section are reviewed. Statistical comparison showed that there was no significant difference between both groups as regards the number of depressed babies at birth, fetal complications or fetal loss (P > 0.05). Postoperative maternal complications were more significant with Caesarean sections (P < 0.001). The vacuum extractor appears to offer an alternative to Caesarean section in selected cases of prolapsed pulsating cord. Satisfactory maternal and fetal results depend on adequate funic decompression, proper selection of cases, rapid interference and skill in vacuum extraction. When speed is observed, the instrument can be applied within 5 minutes of diagnosis and in most cases delivery achieved with 10 minutes traction.
Severe and Recurrent Stress Incontinence of Urine Treated by the Mersilene Gauze Hammock Operation
Authors: Skipper John S.
Published: February 2008

Summary: Severe and recurrent stress incontinence of urine in women presents many problems in management, especially in the elderly and the obese. The use of Mersilene gauze mesh as a modified Aldridge sling is presented as an alternative means of treatment in difficult cases where there are poor tissues to work with.

A series of 30 patients is presented with an 86% cure rate; the use of Mersilene as a broad sling beneath the bladder neck and urethra overcomes one of the main problems in the use of synthetic materials.
A Noradrenaline Secreting Phaeochromocytoma Complicating Pregnancy
Authors: Durham John A.
Published: February 2008

Summary: A case of noradrenaline secreting phaeochromocytoma, arising from the para‐aortic chain is described. It presented in the last trimester of pregnancy with attacks of severe headache, hypertension, and marked sinus brady‐cardia. The tumour was removed after the completion of a successful Caesarean section.
A Review of the Significance of Gestational Diabetes
Authors: Elliott Peter
Published: February 2008

Summary: One hundred and ninety‐six pregnancies complicated by gestational diabetes in a referred private practice over an 18‐year period have been reviewed. Initially they were managed as true diabetics and the pregnancies terminated before the 38th week. More recently, pregnancies have been managed on an outpatient basis and allowed to proceed to term, with a higher percentage of vaginal deliveries and no increase in perinatal mortality or morbidity.

A high incidence of neonatal jaundice was noted, but no explanation emerged. Differences between true diabetes and gestational diabetes, with particular reference to perinatal mortality are discussed and the good prognosis for the gestational form emphasised. Follow‐up suggests that a continuation of the rapport established between physician, obstetrician and patient during pregnancy may be important in delaying or preventing the subsequent onset of diabetes.
Incompetence of the Cervix
Authors: McDonald Ian A.
Published: February 2008

Summary: The author reviews a personal series of 248 cases of incompetence of the uterine cervix. Careful selection of patients and variation of the operative techniques to suit the abnormality have led to a substantial improvement in the success rate.

In the past 10 years, 94% of patients have been delivered of living babies. The history of the condition is briefly described.
Vaginal Transposition of the Ovary in Primates (Papio Cynocephalus and Macaca Arctoides)
Authors: Iffy Leslie , Caterini Herik R. , Arrata W. S. Michael , Beluhan Frank Z. , Lyons Michael , Apuzzio Joseph , Chatterton Robert T.
Published: February 2008

Summary: Experimental data indicate that the time and mechanism of ovulation play a significant role in some cases of infertility and in a broad range of reproductive abnormalities. In order to establish a new experimental model for the study of these phenomena in primates, transposition of the ovary from the pelvis into the vaginal fornix was attempted in 2 species of monkeys: (a) Macaca Arctoides and (b) Papio Cynocephalus.

Particularly in the latter species, ovarian relocation into the anterior and the posterior vaginal fornices proved feasible. Most ovaries continued functioning in their new location during the 2–5 months of the follow‐up, despite macroscopic and microscopic evidence of infection. Post mortem examination of one of the experimental animals several years after the surgical procedure revealed the presence of an intact functioning ovary still in close contact with the vaginal fornix.
Endocrinology of Twin Pregnancy
Authors: TambyRaja R. L. , Ratnam S. S.
Published: February 2008

Summary: Plasma oestradiol 17β, plasma oestriol and plasma progesterone were estimated in 10 twin pregnancies from 30 to 40 weeks. Plasma oestradiol and plasma oestriol rose gradually, reaching their highest levels around 36 weeks. Plasma progesterone levels were very high and showed little variation in the last 10 weeks of gestation. Plasma seroids were twice levels described for singleton pregnancies.
A Comparison of Salbutamol and Ethanol in the Treatment of Premature Labour
Authors: Reynolds J. W.
Published: February 2008

Summary: Eighty‐four patients in premature labour were treated either with ethanol or salbutamol. No difference could be demonstrated between the 2 drugs in preventing premature labour, but side effects were less marked with salbutamol.
Effect of Ampicillin Administration of Plasma Levels of Oestradiol‐17β, Oestriol and Placental Lactogen
Authors: Chew Peter C. T. , Wong Y. M. , Mok Helen , Ratnam S. S.
Published: February 2008

Summary: Ampicillin was given to 21 noninfected patients in the last trimester of pregnancy. There was no significant alteration in plasma unconjugated oestradiol‐17β and placental lactogen levels during treatment. Total plasma oestriol, on the other hand, showed a significant reduction of 30% to 40% during and after treatment.
Intense Antenatal Plasmapheresis in Severe Rhesus Isoimmunization
Authors: Pepperell R. J. , Cooper I. A.
Published: February 2008

Summary: Plasmapheresis using the continuous flow cell separator has been employed to reduce Rh (D) antibody titres in 3 subjects with severe rhesus isoimmunization. Each of these subjects, and another whose infant was subsequently shown to be Rh negative, is reported in detail to emphasize the importance of commencing therapy early in the second trimester of pregnancy and the difficulties encountered in determining the Rh status of the fetus when the husband is heterozygous for the Rh (D) antigen. Only 1 of the 3 infants survived. In both instances where plasmapheresis was commenced after 20 weeks of gestation, the fetus succumbed in utero. Commencement of plasmapheresis at 17 weeks of gestation resulted in infant survival, although the infant was still severely affected by the immunization process and required exchange transfusion immediately after birth. The technique offers hope for the patient who is severely immunized and where intrauterine transfusion is necessary before 26 weeks of gestation or has previously been associated with intrauterine death, but it should probably be commenced very early in the second trimester of pregnancy.
Evaluation of a Sensitive Beta Subunit H.C.G. Haemagglutination Assay as a Pregnancy Test
Authors: Killip M.
Published: February 2008

Summary: A new test for the detection of the beta subunit of human chorionic gonadotrophin (HCG) was used to test urine samples from 80 patients in whom pregnancy was suspected and who had given a negative result with a routine slide pregnancy test. The samples were also tested with Higonavis, a haemagglutination test for HCG, at a level of 500 iu/l. The beta subunit test was correctly positive in 18/21 patients (86%) and correctly negative in 57/59 (97%). The respective figures for the Higonavis test were 15/21 (71%) and 59/59. The sensitivity of the beta subunit test (100 iu/l) and cross‐reaction with LH (10%), as indicated by the manufacturer, were confirmed.
The Use of the Prostaglandin Synthetase Inhibitor Mefenamic Acid in the Treatment of Menorrhagia
Authors: Jakubowicz Diana L. , Wood Carl
Published: February 2008

Summary: A randomized, controlled, double‐blind clinical trial was conducted to compare the effect of the prostaglandin synthetase inhibitor mefenamic acid (Ponstan) given during menstruation to that of a placebo in the treatment of menorrhagia. A statistically significant reduction in menstrual blood loss was recorded by 14 of 15 patients in the mefenamic acid group. The incidence of side effects was minimal. Placebo therapy was significantly more effective than no therapy. Further exploration of the use of mefenamic acid in patients with excessive menstrual loss is recommended.
Hormone Replacement Therapy at the Menopause A Double Blind Controlled Study of Women's Preferences
Authors: Dennerstein Lorraine , Burrows Graham D. , Senior Jean , Wood Carl
Published: February 2008

Summary: Forty‐nine women who had previously undergone hysterectomy and bilateral oöphorectomy took part in a double blind cross‐over trial of hormone replacement therapies. This consisted of 3 months each of ethinyl oestradiol 50 μg per day, d norgestrel 250 μg per day, a combination of these 2 substances (‘Nordiol’), and a placebo. All drugs were administered in a randomized sequence as identical tablets. The 36 women who completed the study concorded in their preference of the drug received. The order of preference was ethinyl oestradiol, the combination of ethinyl oestradiol and d norgestrel, d norgestrel and placebo. From a symptomatic viewpoint, this suggests the use of oestrogen alone as the preferred hormone replacement therapy in menopausal women. The combination of oestrogen and progestogen may provide a satisfactory alternative where the use of unopposed oestrogens is undesirable.
Second Ectopic Pregnancy Following Laparoscopic Sterilization
Authors: Sullivan P. J.
Published: February 2008

Summary: An unusual case of a second ectopic pregnancy occurring after a technically correct laparoscopic sterilization is presented. The incidences of second ectopic pregnancy and failed sterilization are discussed. The unusual means of fertilization occurring here is postulated, and the safest management of ectopic pregnancy occurring after laparoscopic sterilization is proposed.
Obstetrics: Education and Practice in Sydney, 1870–1939: Part 1
Authors: Lewis Milton J.
Published: February 2008

Summary: The development of obstetric education in Sydney, 1870–1939, is presented in two parts: part 1 looks at the education of nurses and part 2 looks at the education of doctors and their practice of midwifery. Maternal mortality remained stubbornly high until the late 1930's. Reformers urged better education as the solution to the “problem” of maternal mortality. It is suggested that the established maternity care system very probably limited such benefits as came from better education.
Pregnancy‐Specific β‐1 Glycoprotein (SP‐1) in Normal and Abnormal Pregnancy
Authors: Chapman M. G. , Jones W. R.
Published: February 2008

Summary:Maternal serum levels of a pregnancy specific β‐1 glycoprotein (SP‐1) were measured by radial‐immunodiffusion in 369 normal pregnancies. Mean levels rose progressively to approximately 200 mg/l at 36 weeks of gestation followed by a plateau and a fall at term. The 95% confidence limits were established for SP‐1 by logarithmic correction of the positively skewed raw data and certain theoretical and practical advantages were demonstrated in the use of SP‐1 compared with human placental lactogen (HPL) measurement in the assessment of fetal‐placental growth and function. In a preliminary study of abnormal pregnancy states it was found that maternal serum SP‐1 assay may aid in the early detection of retarded intrauterine growth, and that it provides a better monitoring system than HPL in this condition. SP‐1 levels were normal in pregnancies complicated by hypertension without retarded intrauterine growth.
Fetal‐Maternal Macrotransfusion — A Study of 400 Postpartum Women
Authors: Harrison K. L. , Baker J. W.
Published: February 2008

Summary: The results of postpartum fetal cell counting in 400 Rh‐negative patients delivering Rh‐positive infants are presented and correlated with the mode of delivery and the ABO blood group relationship of baby and mother. Manipulative procedures, especially Caesarean section, are shown to increase the incidence of macrotransfusion. To make the most economical use of the new 125 μg doses of anti‐D gamma globulin, quantitation of fetal‐maternal transfusions is shown to be vital if the existing level of protection from rhesus sensitization is to be maintained or increased.
An Assessment of Vulval Lichen Sclerosus
Authors: Jones I. S. C.
Published: February 2008

Summary: Vulval lichen sclerosus (L.S.) has been assessed clinically, colposcopically, and histologically to ascertain the suitability of including this condition in the nomenclature proposed by the International Society for the Study of Vulval Disease (I.S.S.V.D.).

In many cases the macroscopic appearance of lichen sclerosus is characteristic, but this is not always the case. Histologically, the appearances of the dermal hyaline change, the reduction in the length and the number of rete pegs, to a lesser extent thinning of the dermis and sometimes thinning of the epidermis are characteristic. The presence of dermal inflammatory cells and changes in the thickness of the keratin layer are, however, much more variable. Exact measurements of the various layers of the vulval skin are not necessary in the routine assessment of lichen sclerosus.

The present study justifies the inclusion of lichen sclerosus on histological criteria in the I.S.S.V.D.'s nomenclature.
Conjoined Twins
Authors: Doig J. R. , Svensen T. C.
Published: February 2008

Summary: A case of thoracopagus conjoined twins is described in which ultrasonography was helpful in achieving an antenatal diagnosis and in allowing consultative decision on management.
Serum Ferritin in Pregnancy
Authors: Jenkins D. T. , Wishart M. M. , Schenberg C.
Published: February 2008

Summary: Serum ferritin levels were measured in 200 consecutive pregnant women at their first antenatal visit; 64 (32%) were found to have levels below the normal range. The results were correlated with haemoglobin concentration, serum iron levels, gestation, parity, and social class. The results indicate that low iron stores occur with increasing frequency as gestation advances, that ferritin assay is a better indicator of iron status than serum iron and haemoglobin levels, and that all patients should be given iron supplements in pregnancy, irrespective of social class or parity.
Placenta Accreta, Percreta and Praevia Accreta
Authors: Kitchen D. H.
Published: February 2008

Summary: Placenta accreta is a rare complication of pregnancy which contributes significantly to maternal morbidity and mortality. Five cases are presented which illustrate different modes of presentation and problems of management; one of the patients (with placenta praevia accreta) died following Caesarean section and subtotal hysterectomy.
Sexual Counselling — A Dual Counselling Approach
Authors: Wren Barry G.
Published: February 2008

Summary: technique has been described which utilises a dual counselling approach to handle problems of a sexual nature. The methods used to structure counselling sessions are discussed as well as the benefits and the drawbacks of using a male and female counsellor to assist people who have some failure in their sexual lifestyle.
Prognostic Aspects of Endometrial Carcinoma
Authors: Svigos J. M. , Cox L. W. , Kirkland J. A. , Harvey N. D. M.
Published: February 2008

Summary: A retrospective analysis of 91 patients with endometrial carcinoma is presented with emphasis on important factors in relation to survival. Patients with Stage 1 carcinoma were treated with a standardized mode of preoperative radiation and extended abdominal hysterectomy. An 87.1% 5‐year survival rate was obtained for patients with well differentiated lesions, with only 1 patient developing a vault metastasis. The assessment of residual tumour after intracavity radiotherapy proved reliable in predicting prognosis and should prove of benefit in directing additional therapy for endometrial carcinoma.
The Tortuous Tube: Pregnancy Rate Following Laparoscopy and Hydrotubation
Authors: Leeton J. , Selwood T.
Published: February 2008

Summary: 256 infertile women whose ovulatory and related male fertility factors were normal were investigated by diagnostic laparoscopy and dye hydrotubation. The tubes were objectively classed into 4 groups — normal, patent with macroscopic tubal adhesions, patent with one tortuosity, and patent with multiple tortuosities. The latter group had a highly significant response to the above procedures and 66% were pregnant within 1 year and 81% within 2 years. No significant effect was found in the other 3 groups. This multiple tortuosity group represents the type of tube that significantly responds to treatment inherent in all tubal patency tests. Its pathogenesis and management are discussed.
Progression of Vulval Carcinoma‐in‐Situ
Authors: Jones I. , Buntine D.
Published: February 2008

Summary: A case of multicentric vulval carcinoma‐in‐situ which progressed to invasive carcinoma during an 8‐year period is presented. Various aspects of this disease are discussed.
Fallopian Tube Presenting as a Uterine Polyp
Authors: Steigrad S. J. , Margin C. J.
Published: February 2008

Summary: A case is reported of a patient who presented with the clinical diagnosis of a uterine polyp extruded through the cervix. Subsequently, the “polyp” was found to be a Fallopian tube which had been pulled into the uterus through a fundal perforation at curettage performed 10 months previously.
Contraceptive Use in Australia*
Authors: Young Christabel M. , Ware Helen
Published: February 2008

Summary: : The purpose of this paper is to trace the pattern of contraceptive use in Australia during the past 50 years, discussing reasons and circumstances related to the changing preference for specific methods, against the background of demographic trends in childbearing and woman's changing role in society. The analysis is based on unique information regarding married couples and young adults in Australia obtained from large‐scale demographic surveys carried out in Melbourne during 1971 and 1977 by the Department of Demography at the Australian National University.
Review: The Significance and Management of Raised Blood Pressure in Pregnancy*
Authors: Walters William A. W.
Published: February 2008

Summary: : Recent advances in the diagnosis, management and prognosis of hypertension in pregnancy are discussed, with emphasis on antihypertensive drug treatment. The use of diuretics, α‐methyldopa, clonidine, hydralazine, β‐adrenergic blockers, diazoxide, chlormethiazole, diazepam and heparin is given special attention.
Measurement of Diamine Oxidase Activity in Vaginal Fluid – An Aid to Diagnosis of Ruptured Fetal Membranes
Authors: Wishart M. M. , Jenkins D. T. , Knott M. L.
Published: February 2008

Summary: Measurement of diamine oxidase (DAO) activity in vaginal fluid as an aid to diagnosis of premature rupture of the fetal membranes was studied. In 76 patients following artificial rupture of the membranes and in 70 patients with known intact membranes, the accuracy was 100%. One hundred and forty‐nine patients were admitted to hospital with suspected ruptured membranes; using the criteria outlined in this paper, 51 had ruptured membranes and in 98 the membranes were intact. The overall accuracy was 96%.