bluuebunny/crossref_metadata_2025 huggingface dataset:
Vitamin D metabolism in normal and hypoparathyroid pregnancy and lactation
Authors: MARKESTAD TROND , ULSTEIN MAGNAR , BASSOE HANS H. , AKSNES LAGE , AARSKOG DAGFINN
Published: August 2005

Summary. Plasma concentrations of vitamin D metabolites in −17 non‐pregnant women, 22 pregnant women at delivery, and in eight lactating women 3 and 16 days after delivery, were compared with those in a postpartum hypoparathyroid patient treated with 1α‐hydroxyvitamin D (1α‐OHD). The mean concentration of 1,25‐dihydroxy vitamin D [1,25–(OH)2D] was 203 (SD 61) pmol/1 in the pregnant, and 86 (SD 27) pmol/1 in the non‐pregnant women (P<0.0005). The levels 3. and 16 days after delivery were similar [57 (11) compared with 62 (19) pmol/1], and lower than the non‐pregnant value (P<0.01). The 25‐hydroxyvitamin D (25‐OHD) concentration remained unchanged between the 3rd and 16th days after delivery, whereas the 24,25‐dihydroxyvitamin D [24,25‐(OH)2D] level increased from 2.7 (SD 1.8) to 3.7 (SD 2.3)nmol/l (P<0.025). The patient temporarily required an increased supplement of 1α‐OHD during pregnancy, but a dose which was appropriate before pregnancy resulted in marked hypercalcaemia and a rise of 1,25‐(OH)2D concentration within 16 days of delivery despite lactation. The results suggest that the metabolic need for the active vitamin D metabolite 1,25‐(OH)2D is increased during pregnancy and rapidly reduced during early lactation in healthy and hypoparathyroid women.
Assessment of a transcervical aspiration technique for chorionic villus biopsy in the first trimester of pregnancy.
Authors: HORWELL DAVID H. , LOEFFLER FRANK E. , COLEMAN DULCIE V.
Published: August 2005

Summary. A cannula attached to a syringe was passed through the cervical canal into the uterine cavity in an attempt to aspirate chorionic villi just before termination of a first trimester pregnancy in 82 patients. Chorionic villi were obtained from 40% of these patients. In view of the value of this technique for the first trimester diagnosis of genetic disorder, development of the technique and further trials of transcervical aspiration of chorionic villi would seem warranted.
An ultrastructural study of menstrual blood in normal menstruation and dysfunctional uterine bleeding
Authors: SHEPPARD B. L. , DOCKERAY C. J. , BONNAR J.
Published: August 2005

Summary. Menstrual fluid was obtained from the uterine cavity and vagina in 20 women within the first 48 h of menstruation. Ten of the women had normal menstrual cycles and blood loss and ten were patients with dysfunctional uterine bleeding. The menstrual samples were examined by electron microscopy for the presence of fibrin and platelets and nearly all were found to contain both fibrin and aggregating platelets. By a simple quantitative system no differences in fibrin and platelet content were found between samples collected from the uterine cavity or the vagina. Likewise no difference was found in the morphology of fibrin and platelets between women with normal menstrual loss and patients with dysfunctional uterine bleeding.
Endoscann, a new endometrial cell sampler
Authors: SEGADAL ELSA , IVERSEN OLE. E.
Published: August 2005

Summary. The cytological diagnoses made on material obtained with a mechanical sampler, the‘Endoscann', were compared with those from conventional histology after uterine curettage in a group of 200 patients (74% were postmenopausal). There was diagnostic agreement in 21 of 23 women with cancer and 2 of 5 with premalignant disease. A negative cytological result was only acceptable when the clinical assessment was also negative. With this proviso the instrument may be used for the screening of high‐risk groups for endometrial cancer, and to investigate postmenopausal bleeding. As this is an outpatient procedure it can achieve considerable savings. Cell blocks suitable for staging of the endometrial cycle can be obtained from women with infertility.
Pregnancy in women with sickle cell trait
Authors: TUCK SUSAN M. , STUDD J. W. W. , WHITE J. M.
Published: August 2005

Summary. The complications and outcome of 334 pregnancies in women with sickle cell trait beween 1975 and 1981 are reviewed. The perinatal mortality rate was 6 per 1000. The main maternal complications were recurrent urinary tract infections (6%) and haematuria (16.5%). Fetal distress in labour was seen in 17% and 11.5% were delivered by emergency caesarean section. Compared with a comparable group of women without sickle cell trait, the mean birthweight of the babies (3202 g) was not reduced. The mean age of the mothers (25 years), their mean parity (1.46) and the percentage who were para 4 or more (13%) were all significantly increased, with important implications for the continuing transmission of the sickle cell gene.
A comparison of low‐risk pregnant women booked for delivery in two systems of care: shared‐care (consultant) and integrated general practice unit. I. Obstetrical procedures and neonatal outcome
Authors: KLEIN MICHAEL , LLOYD IVOR , REDMAN CHRISTOPHER , BULL MICHAEL , TURNBULL A. C.
Published: August 2005

Summary. Samples of records of comparable low‐risk pregnant women booked for delivery in an integrated general practice unit (GPU) and a consultant (or shared‐care) system were derived from a computer tape of all 5005 births which occurred at the John Radcliffe Hospital in 1978.

Induction of labour, epidural analgesia and forceps delivery were all less frequently carried out in women booked for delivery in the GPU. Infants of multiparous women were more often intubated in the shared‐care system (3%) than in the GPU (0%); rates in infants of nulliparous women were similar (approx. 7%) in the two systems. These data suggest that short‐term outcomes are as good for GPU‐booked low‐risk women and their infants as for comparable women booked in consultant or shared‐care.
Antenatal biochemical screening to predict low birthweight infants
Authors: AICKIN D. R. , DUFF G. B. , EVANS J. J. , LEGGE M.
Published: August 2005

Summary. Urine and plasma oestriol, plasma progesterone, human placental lactogen, α‐glycoprotein and serum cystyl aminopeptidase were measured at intervals during 608 pregnancies. The predictive accuracy of low values for identification of pregnancies with low birthweight outcomes was assessed for each test at various gestations. Data were analysed to obtain 10th–90th centile values for each test from 28 weeks to delivery.

Groups with values under different centile levels were compared: those under the lower centiles had higher proportions but smaller absolute numbers of low birthweight infants than those under higher centiles. No test was superior to the others at all centiles and gestations. Biochemical screening of pregnant populations to identify high‐risk groups for intensive fetal monitoring has limited potential. If screening is used, the definition of high‐risk groups is best achieved by practical rather than statistical criteria. If monitoring facilities are available and well accepted by patients then higher centile‘cut‐offs’to define fetal risk may be used than when they are not. Combining any pair of tests with values below the 10th centile did not reduce false positive and negative predictions any more than could be achieved by movement of centiles up or down for a single test.
Birthweight and paternal height
Authors: PRITCHARD COLIN W. , SUTHERLAND HAMISH W. , CARR‐HILL ROY A.
Published: August 2005

Summary. The distributions of standardized birthweights of babies born to women of given heights married to short and tall husbands were compared. The standardized birthweights were consistently greater for babies born to women with tall husbands. It is concluded that tall parental stature relates to favourable environmental and genetic components among those influencing birthweight.
A comparative analysis of birthweight for gestational age standards
Authors: FORBES J. F. , SMALLS M. J.
Published: August 2005

Summary. The possible consequences of the use of various birthweight for‐gestational age standards in a local population were investigated. Birthweight‐for‐gestational age standards based on the analysis of 55 387 births occurring to women resident in the area of the Greater Glasgow Health Board (GGHB) between 1975 and 1979 were estimated. The Glasgow based standard was then compared with a number of growth standards reported for other populations, including the widely adopted standards of Thomson et al. (1968). The relative performance of each standard when applied to the Glasgow population was assessed by calculating the sensitivity, specificity and predictive value of the various standards vis‐å‐vis the distribution of light‐for‐dates infants defined according to the Glasgow standard. The results suggest that both the accurate assessment of fetal growth at birth and the evaluation of screening procedures for antenatal detection of growth retardation require growth standards reflecting the pattern of fetal growth and development in the population at risk.
Lymphocyte subsets in normal and pre‐eclamptic pregnancies
Authors: MOORE M. P. , CARTER N. P. , REDMAN W. G.
Published: August 2005

Summary. Peripheral blood lymphocyte subsets in normal and preeclamptic pregnancies have been studied by using the monoclonal antibodies OKT3 (T cells), OKT4 (helper/inducer T cells) and OKT8 (suppressor/cytotoxic T cells). In addition the numbers of mononuclear cells bearing la and monocyte antigens have been assessed by using the monoclonal antibodies OKIal and OKM1. No significant differences were found between 10 normal pregnant and 10 non‐pregnant subjects. Ten preeclamptic patients were studied and showed an increase in OKT4‐positive helper cells. This was significant in terms of percentage of mononuclear cells but not the absolute numbers or the helper/suppressor (OKT4/OKT8) ratio.
Effect of external cephalic version in late pregnancy on breech presentation and caesarean section rate: a controlled trial
Authors: HOFMEYR G. J.
Published: August 2005

Summary. A prospective randomized controlled trial of external cephalic version (ECV) in late pregnancy is reported. AH pregnancies were assessed with ultrasound and cardiotocography. ECV was successful in 29 out of 30 patients (97%). Breech presentation at delivery occurred in 67% of the control group and in 3% of the ECV group. The caesarean section rates were 43 and 20% respectively. Tocolysis was used in seven patients. A new technique of ECV with the steep lateral position is described. Complications were limited to cardiotocographic changes and one patient with unexplained vaginal spotting. The procedure is recommended provided appropriate patient selection and surveillance is practised.
Antenatal screening for congenital nephrosis in Finland by maternal serum α‐fetoprotein
Authors: RYYNÄNEN M. , SEPPÄLÄ M. , KUUSELA P. , RAPOLA J. , AULA P. , SEPPÄ A. , JOKELA V. , CASTREN O.
Published: August 2005

Summary. In the Kuopio and North‐Karelia districts of Finland 10 724 pregnancies were screened for congenital nephrosis by maternal serum AL‐fetoprotein (AFP) measurement. Outcome was known for 10 504 (98%) pregnancies, of which 509 (4.8%) had a serum AFP level ≤ 2.5 multiples of the normal median (MoM) at 15–18 weeks gestation. After exclusion of those women who had a normal serum AFP level (< 2.5 MoM) in a second sample,‘wrong dates’or multiple pregnancy, 267 (2.5%) remained with a high serum AFP level. Amniocentesis was carried out in 225 (2.1%) and 16 women had an amniotic fluid AFP level > 10 SD above the normal mean. In this group there were six fetuses with congenital nephrosis (four confirmed and two suspected), six other serious malformations (including an intrauterine death) and four without obvious abnormality. In the 98% pregnancies followed up there were no infants with congenital nephrosis that had been missed. Babies with congenital nephrosis require permanent hospitalization and have a mean survival of 8 months. In Finland, within certain areas, the birth prevalence is as high as 1 in 2600 per year. In such areas maternal serum AFP measurement appears to be a useful method of screening for congenital nephrosis. The service was also well accepted since 94% of the women with raised serum AFP levels wished to be screened again in a future pregnancy.
Ratio of the concentration of hypoxanthine to creatinine in urine from newborn infants: a possible indicator for the metabolic damage due to hypoxia
Authors: HARKNESS R. A. , SIMMONDS R. J. , COADE S. B. , LAWRENCE C. R.
Published: August 2005

Summary. The ratio of the urinary concentrations of the ATP metabolite, hypoxanthine, to that of creatinine was determined in normal newborn infants. An increase in this ratio reflects high hypoxanthine excretion and thus ATP breakdown. The ratio can be determined on random urine samples, thus simplifying sampling. Urinary changes are persistent; abnormalities are detectable on the second day of life after intrapartum hypoxia. Preliminary results suggest that this ratio on a sample during the second day of life could‘diagnose’intrapartum hypoxia and might therefore quantitatively assess those obstetric‘risk factors’believed to operate through hypoxia.
Ultrasonic assessment of subsequent unexplained infertility after ovulation induction
Authors: COULAM CAROLYN B. , HILL LYNDON M. , BRECKLE ROBERT
Published: August 2005

Summary. The development of ovarian follicles was studied ultra‐sonographically in 21 cycles in eight infertile patients with the diagnosis of ovulatory dysfunction in whom conception did not occur after the defect had apparently been corrected. Pelvic ultrasound demonstrated three patterns in 20 of the 21 cycles studied: ovarian hyperstimulation in seven cycles; follicular atresia before ovulation in three cycles; persistent unruptured follicular cysts in 10 cycles. Recognition of these patterns has been helpful in modifying therapy in infertile patients.
Inferior epigastric haemorrhage, an avoidable complication of laparoscopic clip sterilization
Authors: PRING D. W.
Published: August 2005

Summary. Forty laparoscopists were questioned as to their preferred site for introducing a Samaritan clip applicator during sterilization procedures. The introduction sites were compared with the location recommended by Lieberman (1976) and with the surface anatomy of the inferior epigastric vessels. Of those gynaecologists questioned, only 12% used a site within 1 cm of that recommended by Lieberman; 25% used a site within 1 cm of the epigastric vessels as suggested by surface anatomy. It is proposed that a second puncture site in the midline or at the lateral border of the rectus muscle should be used to avoid the complication of inferior epigastric vessel trauma at laparoscopic sterilization procedures.
A comparative assessment of an automated blood microprocessor for fetal blood pH measurements in the labour ward
Authors: STEWART P. , HILLAN E. , CALDER A. A. , NICOL S. M.
Published: August 2005

Summary. A new fully automated, self‐calibrating, blood pH analyser was compared with a standard reference instrument for the measurement of pH of fetal scalp and umbilical cord blood samples. The new instrument is reliable and simple to operate, the volume of blood needed for analysis is small and it does not require the availability of trained laboratory technicians for its use.
Neurofibromatosis and severe hypertension in pregnancy
Authors: EDWARDS J. N. T. , FOOKS M. , DAVEY D. A.
Published: August 2005

Summary. Four pregnant patients with neurofibromatosis (Von Recklinghausen's disease) either developed hypertension during pregnancy or had an exacerbation of a pre‐existing chronic hypertension. Two patients required early termination of pregnancy for severe hypertension; a third had severe intrauterine growth retardation resulting in intrauterine fetal death; and one had an otherwise uneventful pregnancy and a live healthy infant. Because of the association between neurofibromatosis and hypertension, patients with neurofibromatosis require special antenatal care and management.
Interpretation of in‐vitro thyroid function tests during pregnancy
Authors: SMITH STEPHEN C. H. , BOLD ALAN M.
Published: August 2005

Summary. In‐vitro thyroid function tests are difficult to interpret in pregnancy because of, among other things, the effect of oestrogens on thyroid binding globulin (TBG) concentrations. In an attempt to clarify the position, serum concentrations of total thyroxine (T4), free T4, TBG, T4/TBG ratio, tri‐iodothyronine (T3) and thyroid stimulating hormone (TSH) were measured. Total T4 and TBG concentrations rose to above the non‐pregnant reference range by 20 weeks. The T4/TBG ratio fell to hypo‐thyroid values by 20 weeks but although the free T4 level was lower in the third trimester compared with values in the first and second trimesters, only a few subjects had hypothyroid values. The TSH values remained unchanged throughout pregnancy. The significance of these changes is discussed and reference ranges for these hormones at each trimester are provided.
Circulating levels of placental proteins, placental protein 5 (PP5), placental lactogen and Schwangerschafts‐protein 1 (SP1), in antepartum eclampsia
Authors: SALEM H. T. , SHAABAN M. M. , GHANEIMAH S. A. , SEPPÄLÄ M. , CHARE T.
Published: August 2005

Summary. Placental protein 5 (PP5), Schwangerschaftsprotein 1 (SP1) and human placental lactogen (hPL) were measured in 36 serum samples from seven women with antepartum eclampsia. PP5 levels were generally elevated, hPL levels were reduced and SP1 levels were within the usual ranges.
Maternal hypertension with superimposed pre‐eclampsia: effects on child development at 7½ years
Authors: OUNSTED M. , COCKBURN J. , MOAR V. A. , REDMAN C. W. G.
Published: August 2005

Summary. Children born to women participating in a prospective study of hypertension during pregnancy were followed up from birth. Data on growth and development at the age of 7½ years of 56 children whose mothers had superimposed pre‐eclampsia are compared with results of 176 children whose mothers had only hypertension. Perinatal mortality in the hypertension‐only group was similar to that for the hospital population in general at the time of their birth; but in the group who developed pre‐eclampsia it was significantly higher. At the age of 7½ years no differences were found in the frequency of health, handicap, sight and hearing problems, weight, height, head circumference, and standing and supine blood pressures. For six aspects of intellectual development children in the pre‐eclampsia group had slightly higher mean scores; and in one of these, ‘perceptual matching’ the difference was significant after adjustment had been made for confounding variables. Pre‐eclampsia superimposed on hypertension does not increase the likelihood of impaired growth and development among children who survive the perinatal period.
Urethrocliesis—a simple cure for stress incontinence
Authors: PAYNE P. R.
Published: August 2005

Summary. Urethrocliesis is a vaginal operation for stress incontinence in which the whole length of the urethra is narrowed by two rows of nonabsorbable sutures. A 2‐year follow‐up of the first 62 patients shows that 60 patients were satisfied with the results of their operation: a result that compares favourably with any of the other surgical procedures used for stress incontinence. The simplicity of the operation, and the fact that it can be applied to the old and young with an equal degree of success, commends it as an initial line of treatment in the management of stress incontinence.
Antepartum non‐stress cardiotocography in ‘high risk’ pregnancies
Authors: McCUNE G. S. , DOIG J. , RIDLEY W.
Published: August 2005

Summary. Non‐stress antepartum fetal cardiotocographic tracings were obtained on 2268 occasions from 1084 ‘at risk’ pregnancies, and the findings are assessed in 834 of these that were recorded within 7 days of delivery or fetal death. The baseline fetal heart rate, reactivity, baseline variability and the response to spontaneous uterine contractions have been related to the perinatal outcome. Poor or absent reactivity, reduced baseline variability and variable or late decelerations, in response to contractions, were useful indicators of fetal compromise, but baseline heart rate was less helpful. These abnormalities can occur individually, or in combination, and the different patterns so produced have been related to perinatal outcome.
Controlled study comparing vaginal prostaglandin E2pessaries with intravenous oxytocin for the stimulation of labour after spontaneous rupture of the membranes
Authors: MAGOS A. L. , NOBLE M. C. B. , WONG TEN YUEN A. , RODECK C. H.
Published: August 2005

Summary.In a prospective randomized study, 36 patients with spontaneous rupture of the membranes of ≥4 h duration were stimulated with 3 mg vaginal prostaglandin E2pessaries or intravenous oxytocin. Oxytocin stimulation was associated with shorter labours and a lower incidence of abnormal cervimetric progress. Of the patients given prostaglandin pessaries, 40% required a second dose after 4 h for slow progress; 45% of the primigravidae subsequently developed abnormal labour which was corrected by augmentation with oxytocin in all cases. One caesarean section was carried out for disproportion, and the remaining 35 patients were delivered vaginally. Prostaglandin pessaries were not associated with an increased incidence of hyperstimulation or sepsis. In conclusion, although PGE2pessaries are safe in spontaneous rupture of the membranes, intravenous oxytocin is more efficient in stimulating labour.
Vasopressin effects on isolated non‐pregnant myometrium and uterine arteries and their inhibition by deamino‐ethyl‐lysine‐vasopressin and deamino‐ethyl‐oxytocin
Authors: ÅKERLUND M. , KOSTRZEWSKA A. , LAUDÁNSKI T. , MELIN P. , VILHARDT H.
Published: August 2005

Summary. The contractile effects of lysine‐ (L) and arginine‐ (A) vasopressin (VP) on isolated non‐pregnant myometrium and uterine arteries and the inhibition of these actions by two analogues of posterior pituitary hormones, deamino‐ethyl‐LVP (dE‐LVP) and deamino‐ethyl‐oxytocin (dE‐OXY) were investigated. Both AVP and LVP effectively stimulated the smooth muscle preparations. The threshold dose for both agonists was about 2 ng/ml of bath fluid and a maximal response was obtained with approximately 75 ng/ml. No distinguishable effect was produced by dE‐LVP and dE‐OXY alone, but when given before the agonists in concentrations of 150 or 300 ng/ml, dose‐dependent inhibition of the contractions was seen. The inhibition of the uterine artery responses was always greater than the inhibition of the effects on myometrial activity and dE‐LVP appeared to have stronger antagonistic effects than dE‐OXY on the myometrial responses to the agonists. The inhibition of the myometrial and uterine artery responses to AVP could explain the therapeutic effect of dE‐OXY recently found in primary dysmenorrhoea, where increased VP secretion seems to be of aetiological importance.
Erythropoietin and cord blood haemoglobin in the regulation of human fetal erythropoiesis
Authors: THOMAS ROSLYN M. , CANNING CELIA E. , COTES P. MARY , LINCH DAVID C. , RODECK C. H. , ROSSITER C. E. , HUEHNS E. R.
Published: August 2005

Summary. Erythropoietin was estimated by radioimmunoassay in serum from 78 cord blood samples, collected in the second and third trimesters in 72 pregnancies. In 43 samples obtained during or after normal pregnancy (from 19 to 42 weeks gestation) erythropoietin levels increased with gestation. Cord blood haemoglobin also increased with gestation, but the rate of increase was less during the last weeks of pregnancy. Erythropoietin levels were similar in the cord blood of infants of the same gestation, whether born vaginally or by caesarean section. The fetus can respond to severe anaemia or hypoxia with increased erythropoietin levels as early as 24 weeks gestation. Elevated erythropoietin levels were found in two out of eight infants born after labour in which there was ‘acute’ fetal distress, suggesting the presence of unrecognized chronic fetal hypoxia in these pregnancies.
Maternal mortality in Riyadh, Saudi Arabia
Authors: CHATTOPADHYAY SISIR K. , SENGUPTA BUOY SREE , CHATTOPADHYAY CHHAYA , ZAIDI ZARINA , SHOWAIL HUSSEIN
Published: August 2005

Summary. The maternal mortality in the Maternity and Children Hospital, Riyadh, during the years 1978–1980 was 52 per 100 000 births, when the total births were 55 428. This is higher than the rate reported from the hospitals in developed countries but lower than rates reported by the university hospitals of developing countries such as India, Thailand and Nigeria. Haemorrhage, associated disease, pulmonary embolism and infection, in that order, were the main causes of maternal deaths. The main avoidable factor was failure by the patient to seek the medical care. Much could be done in reducing deaths due to haemorrhage by improving blood transfusion facilities in the peripheral hospitals. Adequate health education, especially of rural women and their midwives, is a crucial factor in improving the maternal death rate for the country as a whole.
Fetal scalp blood lactate as an indicator of intrapartum hypoxia
Authors: SMITH N. C. , SOUTTER W. P. , SHARP F. , McCOLL J. , FORD I.
Published: August 2005

Summary. Fetal scalp blood lactate was measured during labour by a simple, rapid method and its value as an indicator of fetal intrauterine hypoxia was assessed and compared with that of pH measurement. The normal ranges of lactate concentration and of pH values were calculated. Significantly higher concentrations of lactate and lower pH values were found in samples of scalp blood taken close to delivery from babies with Apgar scores of ≤6 at 1 min compared with those from healthy babies with Apgar scores of ≥7 at 1 min. A similarly significant difference was observed between the cord blood lactate and pH values of these two groups of babies. Ominous fetal heart rate patterns were associated with higher lactate concentrations and lower pH values in fetal scalp blood than were normal fetal heart rate patterns. The measurement of fetal scalp blood lactate or pH, or continuous electronic fetal heart rate monitoring were equally good at predicting the condition of the infant at birth.
Plasma dopamine β‐hydroxylase activity in pregnancyinduced hypertension
Authors: MURTHY P. S. V. RAMANA , PREMA K.
Published: August 2005

Summary. Plasma dopamine p‐hydroxylase (DBH) activity was estimated in non‐pregnant women, normotensive pregnant women during the third trimester and women with pregnancy‐induced hypertension (PIH). Nonpregnant women from a high income group had significantly higher DBH activity than their low income counterparts. DBH activity was significantly elevated in women with PIH when compared with non‐pregnant and normal pregnant women from a low income group, but was lower than the level in well‐nourished, non‐pregnant normotensive women.
The frequency, causes and prevention of severe urinary dysfunction after radical hysterectomy
Authors: KADAR NICHOLAS , SALIBA NICHOLAS , NELSON JAMES H.
Published: August 2005

Summary. Urinary dysfunction that developed in 58 patients treated by radical hysterectomy, with or without total vaginectomy and whole pelvic irradiation over a 10‐year period, was studied retrospectively by case record review and telephone enquiry. Seven of the 58 (12%) were found to be severely handicapped, six by incontinence and enuresis, and one by the complete inability to void. Twenty‐one (36%) patients had absent bladder sensation or urine loss that caused only minor inconvenience. Advancing age, the menopause, whole pelvic irradiation, and total vaginectomy did not increase the likelihood of developing long‐term urinary problems. The determining factor was whether the most lateral portions of the cardinal and uterosacral ligaments had been resected or spared at the time of surgery. It is concluded that serious disability may be avoided by conserving the lateral portions of the pelvic ligaments while obtaining adequate surgical margins during radical hysterectomy.
Endocrinology of human parturition: a review
Authors: FUCHS ANNA‐RIITTA , FUCHS FRITZ
Published: August 2005

Summary. The existing data on the hormonal factors involved in human parturition indicate that the steroid hormones, progesterone and the oestrogens, play only a facilitatory role in the initiation of labour. A definite role for fetal adrenal steroids in this process has yet to be established, and they too may serve only a facilitating function. The stimulation of the uterine muscle during labour results from an interaction of oxytocin and prostaglandin (PG) F2α. Recent evidence suggests that oxytocin is most important for the initial phase of labour, whereas increased synthesis of PGF2α is essential for the progression of labour. The role of PGE2 remains unclear, but this PG may play an important role in the ripening of the cervix which in turn is essential for successful parturition. The finding of maximal oxytocin receptor concentrations in the myometrium in labour adds strong support to the notion that oxytocin is the trigger for uterine contractions. The factors which control oxytocin receptor formation are therefore important; this may be one of the processes where the steroids play a crucial role. Oxytocin is also one of the stimuli that increase uterine PG synthesis; the coupling of oxytocin receptor occupancy and PG synthetase activity in uterine tissues may be another crucial factor in the mechanism of labour. The formation of gap junctions between the myometrial cells also seems essential for the synchronization and progression of myometrial activity. We propose, therefore, that the co‐ordinating of oxytocin receptor formation, PG synthesis and gap junction formation is a key to the initiation and maintenance of human labour. The fetus may fulfil such a co‐ordinating role through its influence on placental oestrogen production, through mechanical distention of the uterus, and through its secretion of neurohypophysial hormones and other stimulators of PG synthesis.
Factors affecting birthweights in Hindus, Moslems and Europeans
Authors: McFADYEN I. R. , CAMPBELL‐BROWN MARY , ABRAHAM RACHEL , NORTH W. R. S. , HAINES A. P.
Published: August 2005

Summary. The birthweights of 664 Hindu and 132 Moslem babies were compared with those of 486 European babies born at the same hospital. The mean birthweight of the Europeans was 3362 g, compared with 3146 g for the Moslems and 2960 g for the Hindus. The Asian women were smaller than the European and tended to have a shorter length of gestation. Forty‐four per cent of the Asians and 46% of the European mothers were of social classes I and II; 28% of the Europeans and 2% of the Asians smoked. There were no significant differences between Asians and Europeans in the effects of maternal size, parity, gestational age and fetal sex on birthweight. After adjustment for these variables and for cigarette smoking there was no significant difference in birthweight between the Moslems and the Europeans, but the mean birthweight of the Hindus was about 190 g lighter than that of the Europeans. Hindus from East Africa had lighter babies than those from India.
Effect of delays in collection or analysis on the results of umbilical cord blood measurements
Authors: SYKES GARY S. , MOLLOY PAULA M.
Published: August 2005

Summary. Changes in umbilical cord blood pH, Po2 and Pco2 were measured when blood was stored in preheparìnized polyethylene syringes in the refrigerator for up to 6 h after delivery, and when there was delayed sampling up to 1 h after delivery from umbilical cord segments left at room temperature. Blood stored in the refrigerator usually showed a decrease in pH and increases in Po2 and Pco2, but the mean rates of change were small: ‐ 0.005 units/h for pH; +0.06 kPa/h for Pco2 and +0.03 kPa/h for Po2. Changes in the three variables in blood collected from umbilical cords up to 1 h after delivery were small and not systematic. Much of the variation was within the limits of accuracy of the ABL‐3 (Radiometer) blood‐gas analyser. The results showed that while immediate collection and analysis of umbilical cord blood is advisable for the greatest accuracy, it is not essential. As long as the delay is not excessive, the results can still be used as a useful guide to the biochemical condition of an infant at birth.
Intraventricular haemorrhage—timing of occurrence and relationship to perinatal events
Authors: BEVERLEY DAVID W. , CHANCE GRAHAM W. , COATES CHARLES F.
Published: August 2005

Summary. A total of 150 infants born at or before 34 weeks gestation had serial cranial ultrasound scans at age 8, 16, 24, 36, 48 h and 1 week. The overall incidence of IVH was 26%, but for infants <1500 g it was 51% and 50% of all haemorrhages were first detected in the first 8 h of life. Low‐outlet forceps delivery and caesarean section offered some protection, but umbilical cord blood gas analysis did not support the hypothesis that hypoxia was causal. Respiratory distress and its complications were significantly associated with IVH. The more severe haemorrhages occurred in the less mature infants. The overall mortality in the study was 27% for the IVH group and 1.8% for the non‐IVH group.
Intrapartum infusion of aqueous glucose solution, transplacental hyponatraemia and risk of neonatal jaundice
Authors: SINGHI SUNIT , CHOOKANG E. , HALL J. ST E.
Published: August 2005

Summary. Cord serum sodium levels in three groups of 278 singleton infants, born vaginally at term, were correlated with the incidence of jaundice (serum bilirubin ≥85 μmol/1) in the first 3 days of life. Of the 278 infants, 87 were born to mothers who were given infusions of 5% or 10% glucose in water during labour (group I), 90 were born to mothers who received glucose solution as a vehicle for oxytocin (group II), and 101 to mothers who did not receive any intravenous fluid therapy (control group). Jaundice was seen significantly more frequently in groups I (28/87, 32%) and II infants (30/90, 33%) than in the control group (12/101, 12%) (P<0.01), but when analysed in relation to cord serum sodium levels, the prevalence of jaundice in the normonatraemic infants (serum sodium ≥131 mmol/1) was similar in the three groups. On the other hand, in groups I and II jaundice occurred about 3.5 times more frequently in the hyponatraemic infants [group I (17/32, 53%) and II (20/39, 51%)] than in the normonatraemic infants (P<0.01). The difference was not associated with any other perinatal or neonatal characteristic.
Changes in serum albumin and α1‐acid glycoprotein concentrations during pregnancy: an analysis of fetal‐maternal pairs
Authors: KRAUER BEATRICE , DAYER P. , ANNER R.
Published: August 2005

Summary. The concentration of the two principal drug‐binding proteins, albumin and α1‐acid glycoprotein, were measured in 44 paired fetal and maternal serum samples obtained at between 12 and 41 weeks gestation. Maternal serum albumin concentrations ranged between 25 and 35 g/1 during this period. Fetal serum albumin was much lower in early gestation, ranging from 7.5 to 16 g/1 at 12 ‐ 15 weeks. With advancing age there was a linear increase so that at 30 weeks the fetal and the maternal serum albumin concentrations were in the same range and after 35 weeks the fetal concentrations exceeded the maternal by some 20%. Thus, the mean fetal/maternal serum concentration ratio of albumin increases from early pregnancy to term: 0.38 at 12–15 weeks; 0.66 at 16–25 weeks; 0.97 at 26–35 weeks; and 1.2 at >35 weeks gestation. Maternal serum α1‐acid glycoprotein concentrations were scattered widely between 0.38 and 1.05 g/l. With the technique used fetal serum concentrations were hardly detectable before 16 weeks. Thereafter they increased at a constant rate, but never attained the maternal values. Near term a fetal/maternal serum concentration ratio of 0.37 was reached. These changes in protein concentrations may have important pharmacological implications.
Microbiology of vaginitis associated with the intrauterine contraceptive device
Authors: KIVIJÄRVI A. , JÄRVINEN H. , GRÖNROOS M.
Published: August 2005

Summary. A malodorous, homogeneous, grey, thin and non‐purulent discharge, which resembles non‐specific vaginitis occurs in 20% of women with an intrauterine contraceptive device (IUCD); four times more common than in non‐users. The aim of this investigation was to study the bacteriological aetiology of this ITJCD‐associated vaginal discharge, and to assess whether the infection was ascendent. No specific microbiological aetiology was found, but the normal, Lactobacillus‐dommated microbial vaginal flora was replaced by Gardnerella vaginalis and certain anaerobic species in IUCD‐users with the discharge. Clue cells, pepper‐salt phenomenon and curved rods and/or fusiform‐shaped rods demonstrated by microscopy, were typical of symptomatic patients. The endometrium and the IUCD were infected with these species in the symptomatic group more often than in IUCD‐users who had no symptoms or in the control women who did not use the IUCD.
Spontaneous abortion‐an infectious aetiology?
Authors: MUNDAY P. E. , PORTER R. , FALDER P. F. , CARDER J. M. , HOLLIMAN R. , LEWIS B. V. , TAYLOR‐ROBINSON D.
Published: August 2005

Summary. The role of Chlamydia trachomatis, genital mycoplasmas, Campylobacter spp. and other aerobic and anaerobic bacteria in the aetiology of spontaneous abortion was investigated prospectively in 241 pregnant women at a community hospital. Sixteen women who had threatened abortions were a little younger, of lower social class and had had more previous spontaneous abortions than the 76 women who aborted or the 149 women whose pregnancies were not complicated in the early stages by haemorrhage. The demographic characteristics of the latter two groups of women were similar. C.trachomatis was isolated from the cervix of only one woman and she had no genital‐tract bleeding at any stage in her pregnancy. Mycoplasma hominis was isolated most often from the women who had threatened abortions but otherwise the prevalence of the other various micro‐organisms was similar in women who had spontaneous abortions, threatened abortions, and in those who had pregnancies uncomplicated by vaginal bleeding. It was clear, therefore, that C.trachomatis played no role in the aetiology of spontaneous abortion in the population studied and there was no suggestion that any of the other micro‐organisms were involved either.
Size at birth of live‐born Saudi infants
Authors: TAHA S. A. , ABDULLAH M. A. , JOWDA MAJDIYA SAEED , AKBAR J. U.
Published: August 2005

Summary. Anthropometric measurements were done on 967 singleton live‐born Saudi infants of gestational age 33 to 42 weeks who belonged to the high and middle social classes and who were born consecutively in Riyadh University Hospital. The 914 infants born at term (≥37 weeks) had a mean birthweight of 3.31 kg (SD 0.45), a mean length of 49.74 cm (SD 2.5) and a mean head circumference of 34.4 cm (SD 1.4). Values were significantly higher in males than females. Effect of sex in this study was not apparent until 40 weeks and later. Difference in body size was significant between the first‐born and second infants but the trend was unimpressive with greater parity. Fifty‐three (5.5%) of the infants were born preterm. Twenty‐one of the preterm babies and 18 of the term infants weighed <2500 g, an overall incidence of low birthweight of 4%. Results were compared with studies from Saudi Arabia and other countries. It is concluded that there was no significant difference between birthweights of upper‐class Saudis and Europeans.
Placental protein measurements in complicated pregnancies. II. Pregnancy‐related hypertension
Authors: WESTERGAARD J. G. , TEISNER B. , HAU J. , GRUDZINSKAS J. G.
Published: August 2005

Summary. Maternal serum levels of pregnancy‐associated plasma protein A (PAPP‐A), human placental lactogen (hPL) and schwangerschafts‐protein 1 (SP1) were measured serially during the second and third trimesters in 753 women with a normal pregnancy when recruited during the second trimester. Thirty‐seven pregnancies were complicated by pregnancy‐related hypertension after 28 weeks gestation. Maternal levels of PAPP‐A and SP1, and trends of levels in individual patients, could generally not be distinguished from those seen in patients with a normal pregnancy, and were unrelated to the time of onset of the disease, its severity or the occurrence of other complications with one exception, in which decreased levels of SP1 and hPL were seen. Mean levels of hPL were significantly lower (P<0.05) at 35 weeks gestation. These data suggest that the measurement of the placental proteins examined here is of no value in the prediction of occurrence of pregnancy‐related hypertension.
The content of placental protein 12 in decidua and fetal membranes is greater than in placenta
Authors: RUTANEN E.‐M. , KOISTINEN R. , WAHLSTRÖM T. , BOHN H. , SEPPÄLÄ M.
Published: August 2005

Summary. Radioimmunoassay, gel filtration and sodium dodecyl sulphate‐polyacrylamide gel electrophoresis were used to study the content and properties of placental protein 12 (PP12) in the placenta, decidua and fetal membranes. The tissues were obtained from early pregnancy in 12 cases, and after normal term delivery in eight cases in seven of which chorion and amnion laeve were also studied. There was more PP12 in decidua and fetal membranes than in placenta. The decidua/placenta ratio of PP12 content ranged from 2 to 1154 (mean 193, SEM 66). These results suggest that PP12 is a decidual rather than placental protein.
The pattern of serum levels of pregnancy‐associated plasma protein A (PAPP‐A) during the ovulatory menstrual cycle
Authors: BERSINGER NIKLAUS , KLOPPER ARNOLD
Published: August 2005

Summary. Pregnancy‐associated plasma protein A (PAPP‐A) was measured throughout the menstrual cycle in eight women at daily intervals. The protein could be detected in all serum samples, and one patient showed consistently high PAPP‐A values during the entire observation period. Twenty‐six more women were tested by measuring a single serum specimen. No further high PAPP‐A levels were discovered in these. There is no significant difference in PAPP‐A concentration between the follicular and the luteal phase of the cycle.
Characteristics of uterine activity in nulliparous labour
Authors: GIBB D. M. F. , ARULKUMARAN S. , LUN K. C. , RATNAM S. S.
Published: August 2005

Summary. Uterine activity was studied in 40 nulliparous Chinese women who were in normal labour and had a normal delivery. A catheter‐tip pressure transducer coupled with a uterine activity integrator was used to observe and quantify uterine activity. Normal labour progress was defined as labour progressing within 2 h to the right of a line drawn at 1 cm/h in the active phase. A wide range of uterine activity was recorded with varying degrees of co‐ordination. The minimum level of uterine activity likely to be associated with labour progress was 650 kPas/15 min at 3 cm cervical dilatation. The median level in the active phase of normal labour was 1440 kPas/15 min. There was a strong correlation between measurements in kPas/15 min and Montevideo units/15 min (r= 0.71, P0.001). No significant increase was found in basal tone.
Pelvic node dissection in the treatment of vulval carcinoma—is it necessary?
Authors: MONAGHAN J. M. , HAMMOND I. G.
Published: August 2005

summary

A report is given of 160 patients with vulval carcinoma who were managed by one Oncologist (J.M.M.) in a regional gynaecological oncology department. Prognosis was closely related to nodal mtastases which were in turn related to tumour size and degree of differentiation. These factors may be a guide to the need to carry out pelvic node dissection during radical surgical treatment. The place of radical surgery is emphasized and the need for postoperative staging suggested.
Immunoreactive trypsin and the prenatal diagnosis of cystic fibrosis
Authors: BROCK DAVID J. H. , HAYWARD CAROLINE , GOSDEN CHRISTINE , RODECK CHARLES
Published: August 2005

Immunoreactive trypsin (IRT) was measured by radio‐immunoassay in a series of amniotic fluids obtained at between 15 and 19 weeks from pregnancies with a 1‐in‐4 risk of fetal cystic fibrosis. IRT concentrations were significantly depressed in nine affected pregnancies, but the degree of overlap with the normal range was too great for this to be useful in early prenatal diagnosis. Furthermore, in one fetus, presumed to have cystic fibrosis, the fetal plasma IRT concentration was within the normal range.
Pathological mechanisms in polycystic ovary syndrome: modulation of LH pulsatility by progesterone
Authors: MOLLOY B. G. , EL SHEIKH M. A. A. , CHAPMAN C. , OAKEY R. E. , HANCOCK K. W. , GLASS M. R.
Published: August 2005

summary

The pulsatile discharge of luteinizing hormone (LH) in nine patients with polycystic ovary syndrome (PCO) and nine patients with amenorrhoea but without PCO, who exhibited LH discharge in response to oestrogen provocation, were studied by 4‐h measurement of gonadotrophin pulsatility before and after a course of progesterone injections. No significant differences were found in the gonadotrophin pulsatility patterns of the two groups, although the LH/FSH ratio rose significantly in the patients without PCO after progesterone but not in the patients with PCO, suggesting an abnormality of FSH storage. The ability to discharge gonadotrophins in response to oestrogen provocation has been reported to be present in patients with 3 LH pulses in a 4‐h study period. This, however, was not demonstrated in five of the nine PCO patients despite the presence of ‘normal’ gonadotrophin pulsatility patterns.
Circadian hormone secretory profiles in women with severe premenstrual tension syndrome.
Authors: STEINER M. , HASKETT R. F. , CARROLL B. J. , HAYS S. E. , RUBIN R. T.
Published: August 2005

summary

The circadian secretory profiles of serum prolactin, growth hormone and cortisol were measured in two women suffering from severe premenstrual tension syndrome and in two asymptomatic control subjects. Subjects and controls were screened and included after a rigorous selection process. Blood samples were obtained every 30 min over a period of 24 h in each woman both on day 9 (follicular phase) and day 26 (luteal phase) of the menstrual cycle. There was no relationship between the hormonal secretory profiles and the premenstrual tension syndrome.
Mid‐trimester pregnancy—a time of tranquility or activity?
Authors: MORGAN D. M. L. , HYTTEN F. E.
Published: August 2005

number of compounds in pregnancy blood reach a maximum or minimum concentration at around 20–24 weeks of pregnancy, a period of conspicuous clinical tranquility. The compounds mostly derive from either fetal tissue or decidua and it is suggested that they may be part of an elaborate mechanism which controls invasion of the uterine wall by trophoblast.
A microcomputer system in the delivery suite
Authors: HOULTON MICHAEL , AUSTIN JOAN , JENKINS DAVID , TURNER GILLIAN M. , WILKINS DAVID G.
Published: August 2005

Microcomputer systems have been installed in the delivery suites of two obstetric units which cater between them for nearly 10 000 deliveries annually. The midwifery and medical staff enter administrative, antenatal, anaesthetic and delivery details during labour and as soon after delivery as possible. The computer prints out the official Birth Notification, the entry for the Midwives Register and the record of labour and delivery for the patient's notes. Subsequently the postnatal doctor and anaesthetist, where relevant, enter details of puerperium and anaesthetic follow‐up, before the production by the computer of discharge and anaesthetic summaries for the community and records. In the first 6 months of use at the Bristol Maternity Hospital (July to December 1982) 2229 patientswere delivered and have had obstetric details recorded on the computer. A general obstetric audit of these patients is presented.
The pelvis as a passageway. II. The modern human pelvis
Authors: STEWART D. B.
Published: August 2005

Following on from part I on evolution and adaptations of the pelvis, this paper suggests that variations in the shape and size of both ancient and modern human pelves may be better explained by nutritional factors than by hormonal influences or race.