bluuebunny/crossref_metadata_2025 huggingface dataset:
THE RELATION BETWEEN PLASMA OESTROGEN, PROGESTERONE AND PROLACTIN CONCENTRATIONS AND THE EFFICACY OF VAGINAL PROSTAGLANDIN E2 GEL IN INITIATING LABOUR
Authors: MacKenzie I. Z , Jenkin G. , Bradley Susan
Published: August 2005

In an attempt to relate the efficacy of treatment to endogenous hormone levels, plasma oestrogen, progesterone and prolactin levels were analysed in women at term following the vaginal administration of prostaglandin E2 gel to induce labour. Patients who went, into labour after treatment had significantly higher oestradiol‐17β levels before treatment compared with those requiring formal surgical in‐duction the following day. No difference could be demonstrated in levels of progesterone or prolactin in the two groups of patients. The significance of these results is discussed.
INHIBITION OF PROSTAGLANDIN‐INDUCED UTERINE ACTIVITY BY NIFEDIPINE
Authors: Anderson K.‐E. , Ingemarsson I. , Ulmsten U. , Wingerup L.
Published: August 2005

The effects of the calcium antagonist, nifedipine, on uterine activity induced by prostaglandins F2α (PGFZ2α) and E2 (PGE2) were studied in women undergoingtherapeutic midtrimester abortion, and in patients with a missed abortion in the 16th to 27th week of pregnancy. In the five subjects receiving intra‐amniotic PGF2α (25 to 40 mg) for midtrimester abortion, nifedipine (30 mg orally) decreased uterine activity from a mean of 372 to 203 Montevideo Units. The effect on the intensity of the contractions was pronounced; frequency and basal tone were little affected. In patients with missed abortion, uterine contractions were induced by extra‐amniotic application of PGE2 (0.5 to 1.5 mg) in a viscous gel. The activity was often more irregular than that in the women receiving intra‐amniotic PGF2α. However, nifedipine (30 mg orally) had a marked inhibitory effect on the uterine contractions. It is concluded that nifedipine can be used for treatment of uterine hyperactivity induced by prostaglandins. Combined treatment with β2‐adrenoceptor stimulants might be considered.
THE RELATION BETWEEN PLASMA UNCONJUGATED OESTRIOLAND CYSTlNE AMINOPEPTIDASE CONCENTRATIONS ANDUTERINE CONTRACTIONS
Authors: Hull M. G. R. , Monro P. P. , Ellis B. W.
Published: August 2005

The relation between maternal plasma unconjugated oestriol (E3) concentrations and uterine activity was investigated by very frequent, carefully timed determinations of E, during synchronously recorded uterine contractions in six normal subjects. There was an initial rise (10 to 50 per cent above the mean) in E3 levels reaching a peak coincident with the contraction peak (range 20 seconds before to 15 seconds after) followed by a fall of similar magnitude below the mean reaching a nadir about 80 seconds (range 60 to 105 seconds) after the contraction peak. Although the pattern of E3 fluctuation was most marked in labour the overall degree of variation was no greater than at other times. Cystine aminopeptidase (CAP) concentrations in the same serum samples showed no significant correlation with uterine contractions. The reasons for, and practical applications of, the E3 results are discussed.
HAEMODYNAMICS OF MILD HYPERTENSION IN PREGNANCY
Authors: Lim Y. L. , Walters W. A. W.
Published: August 2005

One hundred and sixty‐three haemodynamic studies were done serially in 23 normotensive and 25 mildly hypertensive women during pregnancy. With all subjects resting in the left lateral position, heart rate, cardiac output, stroke volume, left ventricular work index, total peripheral vascular resistance and haematocrit were all significantly higher while plasma volume per unit body weight was significantly lower in the hypertensive than in the normotensive pregnant women. It is postulated that this hyperkinetic circulatory state is due to hyper‐activity of the sympathetic adrenergic component of the autonomic nervous system in hypertensive pregnancy.
EFFECT OF NORMAL PREGNANCY UPON THE GLYCOSYLATED HAEMOGLOBINS
Authors: Lind T. , Cheyne G. A.
Published: August 2005

In this cross‐sectional study total glycosylated haemoglobin (Hb AmtmannIa+b+c) has been measured in 20 healthy non‐pregnant women and in five groups of 20 healthy women at various times during pregnancy. A statistically significant decrease occurs in these minor haemoglobin fractions by about 20 weeks gestation and this reduced level is maintained throughout the rest of pregnancy. If diabetic patients are to have their control assessed during pregnancy by determination of these fractions this fact might be relevant.
THE SIGNIFICANCE OF ABNORMAL GLUCOSE TOLERANCE (HYPERGLYCAEMIA AND HYPOGLYCAEMIA) IN PREGNANCY*
Authors: Abell D. A.
Published: August 2005

Maternal hypoglycaemia (plasma glucose below 5th centile) had a highly significant association with fetal growth retardation, and perinatal mortality was significantly increased in the presence of both hypoglycaemia and hyperglycaemia (plasmaglucose above 95th centile) when pregnancy outcome was analyzed in 5000 consecutive patients who had a glucose tolerance test performed during the third trimester of pregnancy. This study confirms the significance of abnormal glucose tolerance as a causative factor of feto‐placental dysfunction. The flat glucose tolerance test pattern had no significance beyond the presence of associated hypoglycaemia, but reactive hypoglycaemia, and persistent abnormalities of plasma glucose levels during the test, were associated with higher incidences of complicated outcome. Hypertonic dextrose therapy administered to the patient with persistently subnormal urinary oestriol excretion was less likely to cause a favourable response in oestriol excretion if glucose tolerance was abnormal, perhaps because the adverse influences of abnormal glucose tolerance were not reversible by the third trimester of pregnancy. Hypoglycaemia and hyperglycaemia, additional to diabetes mellitus, are significant factors in the aetiology and diagnosis of abnormal pregnancy, and point to the need to investigate therapeutic measures.
SCANNING ELECTRON MICROSCOPIC APPEARANCES IN THE AMNION IN POLYHYDRAMNIOS AND OLIGOHYDRAMNIOS.
Authors: Pollard Stella M. , Symonds E. M. , Aye N. N.
Published: August 2005

The appearances of the amnion from two patients with polyhydramnios and two patients with oligohydramnios are described. In polyhydramnios the amnion showed a normal incidence of all the four patterns found in normal amnion at term and no abnormal features were noted. In oligohydramnios, two of four normal patterns predominated and intercellular canals were sparse.
THROMBOPLASTIC AND FIBRINOLYTIC ACTIVITY OF HYDATIDIFORM MOLAR TISSUE AND VESICULAR FLUID
Authors: Maurine Tsakok F. H. , Ratnam S. S. , Chew S. C. , Chua Siok Eng
Published: August 2005

We found similar levels of thromboplastic activity in molar tissue, vesicular fluid and normal placental tissue from pregnancies matched for gestational age. The fibrinolytic activity of molar tissue and vesicular fluid was, however, increased and vaginal haemorrhage tended to be heavier when fibrinolytic activity was high (p = 0.06). Subsequent choriocarcinoma occurred more frequently in patients with molar tissue which had low fibrinolytic activity (p = 0.08).
ANTENATAL SEARCH FOR β‐THALASSAEMIA IN A TWIN PREGNANCY.
Authors: Ward H. , Matsakis M. , Mouzouras Mary , Shirley Isabel , Modell Bernadette
Published: August 2005

summary

The antenatal search for fetal β‐thalassaemia in a twin pregnancy is described. Thalassaemia major was correctly excluded in both fetuses, and some of the problems of identifying patients at risk are outlined as well as those of obtaining fetal blood in the second trimester of pregnancy.
CASE NOTE DESCRIPTIONS OF THE PLACENTA: ARE THEY WORTHWHILE?
Authors: Penfold P. , Drury Linda , Lewis Leila , Royston J. P. , Hytten F. E.
Published: August 2005

In 429 placentae, measurements were made of weight, diameter, shape, eccentricity of the cord and weight and length of the cord, and the results were compared with Apgar score of the infant at birth and its standardized birth weight. There was no evidence that cord eccentricity, placental shape or ‘thickness’, or the dimensions of the cord had any significant relation to the growth of the fetus or its condition at birth. The value of routine recording of crude measurements and qualitative assessments of the placenta in case notes is questioned.
INDUCTION OF LABOUR‐A SIX YEAR REVIEW
Authors: Clinch J.
Published: August 2005

A retrospective survey of surgical induction of labour has shown that induced patients had a lower perinatal mortality rate and a lower Caesarean section rate than non‐induced women.
CONCENTRATIONS OF THE PROSTACYCLIN METABOLITE, 6–KETO–PROSTAGLANDIN F1α, IN AMNIOTIC FLUID DURING LATE PREGNANCY AND LABOUR.
Authors: Mitchell M. D. , Keirse M. J. N. C. , Brunt Jane D. , Anderson Anne B. M. , Turnbull A. C.
Published: August 2005

Concentrations of 6–keto–prostaglandin F1α (6–keto–PGF1α, the stable metabolite of prostacyclin, PGI2) have been measured in amniotic fluid obtained during late pregnancy and labour. Samples taken at amniotomy during spontaneous labour contained a significantly greater concentration of 6–keto–PGF1α than samples taken at amniotomy before the onset of labour (p <0.01). There was no correlation between the level of 6–keto–PGF1α, in amniotic fluid before labour and gestational age (p > 0 1). It is suggested that prostacyclin may have a functional role in the mechanism of parturition in man.
RED CELL MASS DURING AND AFTER NORMAL PREGNANCY
Authors: Taylor D. J. , Lind T.
Published: August 2005

Red cell mass, derived from plasma volume and haematocrit, was calculated serially in 45 healthy women during pregnancy and 4 to 6 months after delivery. Compared to the non‐pregnant, postpartum value there was a reduction of approximately 100 ml at 12 weeks gestation. An increase in red cell mass occurred thereafter: at 36 weeks gestation values 180 ml greater than the non‐pregnant were found. Iron and folic acid supplements almost doubled this increment to 349 ml of red cells.
SPONTANEOUS PREGNANCY IN A PATIENT WITH. HYPERGONADOTROPHIC OVARIAN FAILURE.
Authors: Wright C. S. W. , Jacobs H. S.
Published: August 2005

A 27‐year‐old woman was referred to the gynaecological endocrine clinic because of infertility and secondary amenorrhoea. Serum luteinizing hormone and follicle stimulating hormone levels were raised and oestradiol concentrations were sub‐normal. In spite of these findings, spontaneous resumption of menstrual cycles associated with a fall of gonadotrophin concentrations was followed by a normal pregnancy.
MALIGNANT CHANGE IN BENIGN CYSTIC TERATOMA OF THE OVARY
Authors: Curling O. M. , Potsides P. N. , Hudson C. N.
Published: August 2005

In a clinico‐pathological study of malignant disease of the ovary in the former North East Metropolitan Region, malignant transformation of benign cystic teratoma has emerged as the commonest malignancy of‘germ cell’origin. The clinical and pathological details of 12 patients are reported.
PSEUDO‐OBSTRUCTION OF THE BOWEL IN PREGNANCY CASE REPORTS
Authors: Shaxted E. J. , Jukes R.
Published: August 2005

Two patients with intestinal obstruction in pregnancy are presented and discussed. In neither case was there any obvious cause for the intestinal obstruction. Pseudo‐ obstruction of the bowel has not previously been described as a complication of pregnancy.
THE RECURRENCE RATE AND SIGNIFICANCE OF LOW OESTRIOL EXCRETION IN SUCCESSIVE PREGNANCIES
Authors: Oats J. J. N. , Beischer N. A.
Published: August 2005

A total of 440 women who had low oestriol excretion in a previous pregnancy was investigated by urinary oestriol assays in one or more subsequent pregnancies. The incidence of low oestriol excretion in the subsequent pregnancy was 29.1 per cent, or more than double that in the total obstetric population (13.4 per cent; p <0.001). Patients with persistently low oestriol excretion had a 40.8 per cent recurrence rate in subsequent pregnancies. When oestriol excretion was low in successive pregnancies it retained a significant association with increased incidences of stillbirths, neonatal deaths and fetal growth retardation. It was concluded that low oestriol excretion in a previous pregnancy is a definite indication to test fetoplacental function in subsequent pregnancies even when the clinical findings are normal.
MELATONIN IN THE MATERNAL AND UMBILICAL CIRCULATIONS DURING HUMAN PARTURITION
Authors: Mitchell M. D. , Bibby J. G. , Sayers Linda , Anderson Anne B. M. , Turnbull A. C.
Published: August 2005

The concentration of melatonin in maternal peripheral plasma was measured during late pregnancy, term and pre‐term labour. There was a small increase in the mean concentration of melatonin during labour which was significant in term labour. Umbilical arterial and venous plasma, whether obtained at term, after spontaneous vaginal delivery or at Caesarean section, contained significantly greater concentrations of melatonin than maternal plasma. A significant arterio‐venous difference was demonstrated for both groups of umbilical samples with raised venous levels after spontaneous vaginal delivery but higher arterial levels at Caesarean section.
DIFFERENTIAL RESPONSE TO LHRH FOLLOWING OESTROGEN THERAPY IN WOMEN WITH AMENORRHOEA
Authors: Shaw R. W.
Published: August 2005

The effect of administering 2.5 mg oestradiol benzoate upon subsequent response to 100 ug synthetic luteinizing hormone releasing hormone (LHRH) was investigated in 24 women with amenorrhoea but with no demonstrable pituitary or ovarian cause and in whom serum prolactin levels were within the normal range. Differential responsiveness to LHRH was observed when re‐testing the subjects 44 hours following the oestrogen administration. Twelve out of 24 subjects showed an augmentated LH response, the post‐treatment response similar to that observed in normal regularly menstruating females when tested in the follicular phase of their cycles. In 11 of these 12 patients ovulation could be induced by clomiphene. The remaining 12 patiens failed to show an augmentation of LH response and indeed had a suppressed post‐treatment response. In this group of subjects a significantly lower basal serum oestradiol‐17β level was found (p <0·01) and none of these patients ovulated following clomiphene administration. This differential responsiveness to LHRH following oestrogen therapy in patients with amenorrhoea of‘hypothalamic’ origin further subdivides this heterogeneous group into two sub‐groups who respond to clomiphene administration in a different manner and sheds further light upon the pathogenic mechanism of gonadotrophin release in such patients.
DYNAMIC FETAL CEPHALOMETRY
Authors: Davies P. , Richardson R. E.
Published: August 2005

An iterative method of fetal cephalometry for use with real time scanners is described using a flow chart. The method is shown to be capable of yielding measurements having a standard deviation of less than 1 mm and we have found it to be superior to the combined A and B scan technique from which it is derived.
AMNIOTIC FLUID OPTICAL DENSITY DETERMINATION AS A RAPID TEST FOR ASSESSMENT OF FETAL LUNG MATURITY
Authors: Hill C. M. , Harkes A. , Donnai P. , Ferguson A. , Tindall V. R.
Published: August 2005

The lecithin/sphingomyelin (L/S) ratios and optical densities at 650 nm were determined for 158 samples of amniotic fluid obtained by amniocentesis. A further 24 samples collected by vaginal aspiration from patients with spontaneous rupture of the membranes were also analysed. The relation between the L/S ratio and the optical density suggests that the more rapidly obtainable optical density measurement could be used as a screening procedure for fetal pulmonary maturity. A valid estimate of maturity by optical density is not possible in amniotic fluid aspirated from the vagina.
THE PRACTICAL VALUE OF THE PROGESTOGEN CHALLENGE TEST, SERUM OESTRADIOL ESTIMATION OR CLINICAL EXAMINATION IN ASSESSMENT OF THE OESTROGEN STATE AND RESPONSE TO CLOMIPHENE IN AMENORRHOEA
Authors: Hull M. G. R. , Knuth U. A. , Murray M. A. F. , Jacobs H. S.
Published: August 2005

In 246 women with amenorrhoea we compared the result of the progestogen challenge test (menstrual response to oral medroxyprogesterone acetate 5 mg daily for 5 days) (225 patients) with the serum oestradiol‐17β (E2) concentration (154 patients) and with clinical assessment of the oestrogen state of the lower genital tract (183 patients) and related them to the response to clomiphene (188 patients). Ovulation in response to clomiphene was defined essentially by a mid‐luteal serum progesterone concentration of at least 25 nmol/l. E2 values were only useful when they fell below 150 pmol/l; they then indicated that ovulation was very unlikely to occur after clomiphene (2 per cent). Clinical assessment was also only useful in predicting failure to ovulate with clomiphene. However, the progestogen challenge test gave good prediction of ovulatory as well as anovulatory responses to clomiphene. After absent or scanty bleeding following progestogen, only 4 per cent of our patients ovulated, and repeated treatment with clomiphene did not increase the ovulatory rate. After a normal menstrual response to progestogen, 39 per cent ovulated in their first cycle with clomiphene using only 50 mg daily, this proportion rising to 55 per cent if 100 mg was used, and to 75 per cent after treatment for three cycles.
THE EFFECT OF MENOPAUSAL STATUS AND SEQUENTIAL MESTRANOL AND NORETHISTERONE ON SERUM CHOLESTEROL, TRIGLYCERIDE AND ELECTROPHORETIC LIPOPROTEIN PATTERNS
Authors: Paterson M. E. L. , Sturdee D. W. , Moore B. , Whitehead T. P.
Published: August 2005

The serum cholesterol, trigylcerides and electrophoretic lipoprotein patterns of 35 postmenopausal women, who subsequently received sequential mestranol and norethisterone, were compared with those of 35 premenopausal women of the same age and weight. The postmenopausal women had a significantly higher level of serum cholesterol (p <0.01) than the premenopausal women, and a significant reduction (p <0.001) occurred in this group after two months of therapy. There was no significant difference in level of serum cholesterol between the premenopausal group and the postmenopausal group receiving sequential mestranol and norethisterone for two months. The serum triglycerides were not significantly higher in the postmenopausal group but there was a significant increase (p <0.001) after two months of therapy. The marked alteration in lipid levels at the menopause may in part account for the great increase in coronary artery disease in postmenopausal women but whether these changes are reversible by giving hormone therapy remains speculative.
ACUTE POLYHYDRAMNIOS—A COMPLlCATION OF MONOZYGOUS TWIN PREGNANCY
Authors: Weir P. E. , Ratten G. J. , Beischer N. A.
Published: August 2005

Eight patients with acute polyhydramnios were encountered in 31 103 pregnancies, an incidence of 1 in 3888. All patients with acute polyhydramnios had monozygous twin pregnancies and 14 of the 16 infants were normal. The condition occurred in the second trimester and usually ended in premature delivery within a few days. The perinatal mortality was 100 per cent and accounted for 14.9 per cent of the perinatal mortality in twins.
MATERNAL HORMONE PROFILE IN OXYTOCIN INDUCED LABOUR
Authors: Buchan P. C.
Published: August 2005

Serial blood samples were collected from ten patients at between 40 and 42 weeks gestation, who were having labour induced by amniotomy and intravenous oxytocin. The plasma levels of human placental lactogen and pregnancy‐specific β1 glycoprotein showed no more than their normal late pregnancy variability during labour; oestradiol‐17β showed a small rise in early labour followed by a fall in the second stage of labour; unconjugated oestriol and 11‐hydroxycorticosteroids showed a progressive rise throughout labour and progesterone a progressive fall. The ratio of progesterone to oestradiol‐17β fell throughout labour. The significance of these changes in our understanding of the control of placental hormone secretion and of the hormone profile of spontaneous labour is discussed.
POLY‐PLETHYSMOGRAPHIC STUDY ON THE EFFECTS OF RITODRINE ON THE CARDIOVASCULAR SYSTEM OF PATIENTS IN LABOUR
Authors: Ragni N. , Pinto P. F. , Bentivoglio G. , Repetti F. , Pelucco D. , Di Muzio M.
Published: August 2005

The effects of ritodrine infusion on the cardiovascular system of six women in threatened or premature labour are reported. In contrast to other betamimetics, ritodrine caused a moderate rise in systolic blood pressure, the corresponding fall in diastolic pressure leading to a widened pulse pressure but no riskg of hypotension. Ritodrine caused a rise in cardiac output, and was well tolerated by the patients. Special care should be taken in treating patients with known heart disease.
STUDIES ON PREGNANCY‐ASSOCIATED PLASMA PROTEIN A IN THE THIRD TRIMESTER OF PREGNANCY
Authors: Smith R. , Bischof P. , Hughes G. , Klopper A.
Published: August 2005

The plasma concentration of pregnancy‐associated plasma protein A (PAPP‐A) was measured in 34 women during the last 10 weeks of pregnancy. From 30 to 36 weeks the concentration of this protein increased steadily. Thereafter the concentration of PAPP‐A rose more steeply, the highest amounts being found in early labour. The concentration of PAPP‐A in peripheral venous blood and in the uterine vein was much the same. It was less in the retroplacental blood and a great deal less in the peritoneal fluid. The day‐to‐day variation was small; the coefficient of variation at 38 weeks was only 7.3 per cent. After delivery, the concentration of PAPP‐A fell more slowly than other placental proteins and steroids, the average half‐life being 51 hours. Although there is no doubt that PAPP‐A is a product of the syncytiotrophoblast, our findings suggest that it is not simply secreted by the chorionic villi directly into the intervillous space but makes its way into the maternal circulation by a more circuitous route.
DISAPPEARANCE OF PREGNANCY‐SPECIFIC β1 GLYCOPROTEIN FROM THE MATERNAL CIRCULATION AFTER DELIVERY
Authors: Menabawey M. , Grudzinskas J. G. , Chard T.
Published: August 2005

It is likely that there are systematic differences between circulating pregnancy‐specific β1 glycoprotein (SP1) levels measured by radioimmunoassay and immunoprecipitation systems. We have re‐investigated the decline in circulating levels of SP1 following delivery of the placenta. Serial blood samples were collected for 120 hours from 10 women following Caesarean section or vaginal delivery at term. The apparent half‐life of SP1 after delivery ranged between 17 and 45 hours.
THE VARIATION OF MATERNAL BLOOD LEVELS OF PLACENTAL PROTEIN 5 IN LATE PREGNANCY
Authors: Obiekwe B. C. , Grudzinskas J. G. , Gordon Y. B. , Chard T.
Published: August 2005

Serum placental protein 5 levels measured in the third trimester of pregnancy showed nyctohemeral and day‐to‐day variation, but this variation did not follow any recognisable pattern.
EFFECT OF LISURIDE ON INHIBITION OF LACTATION AND SERUM PROLACTIN
Authors: De Cecco L. , Venturini P. L. , Ragni N. , Rossato P. , Maganza C. , Gaggero G. , Horowski R.
Published: August 2005

Lisuride, a new semisynthetic ergot derivative, was given to 53 women to inhibit lactation; 26 women had 300 ug daily and 27 had 600 ug daily for seven days. Eight lactating women acted as controls. Lisuride effectively inhibited lactation and also suppressed the serum prolactin levels; the latter effect was dose related. Lisuride produced no untoward side effects.
BIOCHEMICAL CHANGES OF NORMAL PREGNANCY AND PUERPERIUM IN LAGOS, NIGERIA
Authors: Agobe J. T. , Akinkugbe A. , Adewoye H. O. , Boyo A. E. , Good W. , Hancock K. W.
Published: August 2005

A cross‐sectional study is presented of biochemical changes in the third trimester of normal pregnancy and puerperium during the wet season in the tropical climate of Lagos, Nigeria. These changes are less marked in first than in subsequent pregnancies, and although qualitatively similar, in some respects they differ from those observed in the temperate climatic zone. The indications are that quantitative differences may exist which could be relevant to the management of pregnancy in the tropics.
THE POSSIBLE RELATION BETWEEN LATE PREGNANCY HYPERTENSION AND 5‐HYDROXYTRYPTAMINE LEVELS IN MATERNAL BLOOD
Authors: Jelen I. , Fananapazir L. , Crawford T. B. B.
Published: August 2005

The concentrations of the vasoactive substance, 5‐hydroxytryptamine (5‐HT), were estimated in whole blood samples from 12 pregnant women with hypertension in the third trimester. These were compared with a control group of 15 normotensive pregnant women of the same gestation. The hypertensive patients were admitted for observation and the whole blood 5‐HT. estimated again after four days bed rest: in all patients the blood pressure had, by this time, returned to within the normal range. No significant difference was found between the mean blood 5‐HT concentrations of the hypertensive and the normotensive groups. A small, but not statistically significant, rise occurred in the hypertensive group after four days bed rest. Thus this study gave no evidence that 5‐HT is implicated in hypertension in pregnancy.
OSCTLLATION‐FREQUENCY AND BASELINE FETAL HEART. RATE IN THE LAST 30 MINUTES OF LABOUR.
Authors: Roemer V. M. , Heinzl S. , Peters F. D. , Mietzner S. , And G. BrÜhl , Heering P.
Published: August 2005

The last 120 minutes of 394 intraparturn fetal heart rate (FHR) records of high technical quality were evaluated. Baseline FHR was estimated and oscillation frequency (OF) counted for each minute. There was a highly significant association between the baseline FHR and the number of oscillations/minute; an increase in baseline FHR of 10 beats/minute was associated with a fall of about one oscillation/ minute. The highest mean OF (9.64.8 events/minute) was found in fetuses with an umbilical artery pH of between 7.20 and 7.25. The baseline FHR should be taken into account when assessing fetal condition.
PRIMARY DYSMENORRHOEA AND VASOPRESSIN
Authors: ÅKerlund M. , Strömberg P. , Forsling M. L.
Published: August 2005

The circulating concentrations of arginine vasopressin on day 1 and on day 5 to 7 of the menstrual cycle were measured by radioimmunoassay in six women with primary dysmenorrhoea and five controls. All women had ovulated in the previous cycle, as indicated by the mid‐luteal phase plasma progesterone levels and had normal plasma osmolality and sodium concentrations. The plasma concentrations of progesterone and oestradiol on day 1 of the cycle were also measured, and no significant difference between the two groups was seen. In women with dysmenorrhoea the vasopressin concentration on day 1 was 0.400.038 (SE) μU/ml which was significantly higher than the concentration in normal women on the same day of the cycle 0.20±0.063 (SE) μU/ml (p <0.01). The plasma concentration of vasopressin in normal women on day 5 to 7 was 0.68 0.119 (SE) μU/ml which was significantly higher than on day 1 (p <0.01). A significant difference between day 1 and day 5 to 7 was not seen in dysmenorrheic women, possibly because the values were already elevated on day 1. The results suggest that vasopressin could be a factor of aetiological importance in primary dysmenorrhoea, and also indicate that the vasopressin concentration in plasma can vary according to the day of the menstrual cycle.
CHANGES IN COAGULATION FACTORS IN POSTMENOPAUSAL WOMEN ON ETHINYL OESTRADIOL
Authors: Hunter D. J. S. , Anderson Anne B. M. , Haddon M.
Published: August 2005

Coagulation factors II, VII, X, VII X complex and anti‐thrombin III were measured in 10 postmenopausal women before, during and after a four‐month course of 20 μg daily of ethinyl oestradiol, taken three weeks in four. Factors VII, X and VII X complex rose significantly during treatment but only factor X levels were significantly elevated at the end of the four‐month treatment period. There was no change in factor II or anti‐thrombin III levels. These effects on coagulation factors during ethinyl oestradiol therapy are, in general, similar to those found during treatment with conjugated equine oestrogens and oestradiol valerate in a previous study from the same laboratory. It seems likely that equipotent doses of ethinyl oestradiol and‘natural’oestrogens have similar effects on these coagulation factors.
CUT‐OFF LEVELS FOR MATERNAL PLASMA ALPHA‐FETOPROTEIN IN THE DIAGNOSIS OF NEURAL TUBE DEFECTS: VALIDATION OF THE USE OF MULTIPLES OF THE NORMAL MEDIAN
Authors: Tovey K. C. , Gerson Marion
Published: August 2005

A retrospective study was made of measurement of maternal plasma alpha‐feto‐protein (AFP) by a standard radioimmunoassay technique, as a method of screening for neural tube defects (NTDs) between 15 and 20 weeks gestation. There was a good fit of a log‐normal distribution to the data at each week and multiples of the normal median were equivalent to constant centiles over weeks 15 to 20 and possibly at later weeks also. There were 700 plasma samples from women with normal prenancies and 60 from women with pregnancies complicated by fetal NTDs (30 with anencephaly and 30 with spina bifida). At 15 to 20 weeks of pregnancy, 90 per cent of women with fetuses affected by anencephaly, 70 per cent of those with fetuses affected by open spina bifida and 3 per cent of those with normal pregnancies had plasma AFP levels at or above 24 times the normal median for each gestational week. It was estimated that 2·1, 2·4 and 3·1 times the normal median maternal plasma AFP levels were equivalent to the 95th, 97th and 99th centiles respectively. The interassay coefficients of variation estimated on control sera throughout the entire study were 4 to 6 per cent.
A COMPARISON OF CROWN‐RUMP LENGTH MEASUREMENTS USING A REAL‐TIME SCANNER IN AN ANTENATAL CLINIC AND A CONVENTIONAL B‐SCANNER
Authors: Adam A. H. , Dunlop Catherine
Published: August 2005

In a series of 168 patients in the first trimester of pregnancy, fetal crown‐rump length (CRL) measurements were attempted in the Antenatal Clinic using a linear‐array real‐time ultrasound scanner. The measurements could not be made in 23 of the patients; most of them had a gestational age of less than 10 weeks and the difficulty in obtaining measurements was usually due to an underfilled maternal bladder. When compared with CRL measurements obtained with a conventional B‐scanner, a good correlation was obtained (r = 0·92); 80 per cent of the‘real‐time’values fell within a range of 5 mm of the conventional values. In all patients the estimates of gestational age using the two methods were within one week of each other.
ROUTINE INDUCTION OF LABOUR WITH EXTRA‐AMNIOTIC PROSTAGLANDIN E2 IN A VISCOUS GEL
Authors: Sims C. D. , Mellows H. J. , Spencer P. J. , Craft I. L.
Published: August 2005

Prostaglandin E2, 350 μg dispersed in a viscous gel, tylose, was introduced into the extra‐amniotic space as a single dose in 285 patients to induce labour. With a favourable cervix, 82 per cent of multiparae and 50 per cent of primiparae were successfully induced. With unfavourable induction features, the success rates were 48 per cent and 24 per cent respectively. In the remaining patients, all but four were successfully delivered when intravenous oxytocin was also used. The method was safe, simple and inexpensive and had many advantages for patients and nursing staff.
THE BIOCHEMISTRY OF AMNIOTIC FLUID WITH POOR FETAL GROWTH
Authors: Bissenden J. G. , Scott P. H. , Milner S. , Doughty S. , Ratnapala L. , Harton B. A.
Published: August 2005

Amniotic fluid from 79 European and Asian mothers at term was examined for those biochemical changes which in postnatal life are associated with slow growth, a poor diet or frank malnutrition. Amniotic fluid from normal pregnancies of both races contained proportionally less urea nitrogen, more uric acid nitrogen and α‐amino nitrogen, and more free hydroxyproline than was found in urine from pregnant mothers and the newborn. Some of these differences may reflect a relative reduction in nutrient supply in late pregnancy while others are due to immaturity of various biochemical systems. These explanations do not account for all the differences. Compared to results in normal mothers, the Asian mothers with light‐for‐dates babies showed changes suggesting undernutrition (high amniotic fluid alkaline ribonuclease and ‐amino nitrogen). The European mothers with light‐for‐dates babies had biochemical evidence of reduced growth (low amniotic fluid total hydro‐xyproline) but not evidence of undernutrition. Mothers with light‐for‐dates babies in both races had a high amniotic fluid uric acid nitrogen; the cause of this is uncertain. The biochemical measurements were significantly different in the mothers with light‐for‐dates babies and were a more accurate prediction of poor intrauterine growth than clinical criteria alone. Nevertheless, the overlap with normal pregnancies was so great as to limit the clinical usefulness of these measurements in the management of an individual pregnancy.
MULTIPLE BIRTHS IN FORMER ORAL CONTRACEPTIVE USERS
Authors: Harlap S.
Published: August 2005

Multiple births were studied in a cohort of 2953 former oral contraceptive users and 13 630 controls, all the women were interviewed post partum. There were 238 multiple births, a rate of 14·4/1000 deliveries. Former oral contraceptive users had 13·5/1000 sets of multiple births compared to 14·5/1000 in the controls. When women who had received treatment for anovulation were excluded, these rates were 11·1 and 12·7/1000 respectively, a difference which is not statistically significant. There was, however, a significant deficit of multiple births among the small group of former pill users who were underweight in relation to their height at the time of conception. Multiple births were also increased after stopping sequential pills and preparations containing high doses of oestrogen, and there was an excess of multiple births following breakthrough pregnancies. These findings, although statistically significant, are based on small numbers, and require confirmation from other studies.
SEX HORMONE BINDING GLOBULIN CAPACITY AND POSTMENOPAUSAL HORMONE REPLACEMENT THERAPY
Authors: Pogmore J. R. , Jequier Anne M.
Published: August 2005

The sex hormone binding globulin (SHBG) capacity was measured in 26 normal untreated postmenopausal women and 10 postmenopausal women taking different types of hormone replacement therapy. The patients on hormone replacement therapy had significantly higher levels of SHBG than postmenopausal women (p <0.001) and also significantly higher levels than 52 normal ovulating women studied previously (Pogmore and Jequier, 1979; p <0.02). This suggests that postmenopausal women on hormone therapy are being overtreated.
A COMPARISON BETWEEN THE EFFECTS OF NYSTATIN, CLOTRIMAZOLE AND MICONAZOLE ON VAGINAL CANDIDIASIS
Authors: Eliot B. W. , Howat R. C. L. , Mack A. E.
Published: August 2005

Nystatin (100 000 units/day for 14 days) and clotrimazole (100 mg/day for 6 days) were equivalent to miconazole (100 mg/day for 14 days or 100 mg twice daily for 7 days) in curing vaginal candidiasis. However significantly more patients relapsed in the nystatin and clotrimazole groups than in either of the miconazole groups.
PRENATAL ULTRASOUND IN THE DIAGNOSIS AND MANAGEMENT OF FETAL EXOMPHALOS. CASE REPORTS
Authors: Lomas F. , Stafford‐Bell M. , Tymms A.
Published: August 2005

A patient is presented in whom ultrasonic examination at 39 weeks detected fetal exomphalos with an intact sac and no associated gross abnormalities. These findings served as major indications for the safe delivery by Caesarean section of a baby that survived and had successful corrective surgery when 6 months old. The infant might well not have survived vaginal delivery.
CONCURRENT SQUAMOUS CELL CARCINOMA OF THE CERVIX AND PENIS IN A MARRIED COUPLE
Authors: Goldberg H. M. , Pell‐Ilderton R. , Daw E. , Saleh N.
Published: August 2005

A married couple who developed, concurrently, squamous carcinoma of the cervix and the penis is reported.
FETAL BREATHING MOVEMENTS AND FETAL DISTRESS
Authors: Calvert J. P. , Ichards C. J.
Published: August 2005

Twenty‐seven pregnancies were monitored by antenatal cardiotocographs, daily fetal movement counts and an assessment of fetal breathing activity by real time scanning, and the results of these tests were related to the development of fetal distress during the first stage of labour. The proportion of time during which fetal breathing movements were present, determined over only a short period of time, was found to be a useful predictor of fetal behaviour during labour.
BLOOD PRESSURE CHANGES WHEN UTERINE STIMULANTS ARE USED AFTER NORMAL DELIVERY
Authors: Hacker N. F. , Biggs J. S. G.
Published: August 2005

Use of an automatic sphygmomanometer showed that intravenous ergometrine given immediately after delivery caused significant elevation of diastolic blood pressure in all 10 normotensive women studied. Blood pressure was also raised in some patients following the use of intramuscular oxytocin and ergometrine (Syntometrine). Uterine stimulants for use after delivery must be chosen with care.
PLACENTAL PROTEIN 5 IN FETAL AND MATERNAL COMPARTMENTS
Authors: Grudzinskas J. G. , Mharnock M. , Obiekwe B. C. , Gordon Y. B. , Chard T.
Published: August 2005

Placental protein 5 is produced by the syncytiotrophoblast and secreted into the maternal peripheral circulation reaching levels of approximately 30 μg per litre in normal pregnancy at term. In the present study the distribution of PP5 was examined in maternal and fetal compartments in 13 patients at delivery.
IMMEDIATE POSTPARTUM INSERTION OF A COPPER‐WIRED INTRAUTERINE CONTRACEPTIVE DEVICE, THE MLCu250
Authors: Thiery M. , Van Der Pas H. , Ddelbeke L. , Van Kets H.
Published: August 2005

The MLCu250, a copper‐wired intrauterine contraceptive device, was inserted in 600 women immediately after delivery of the placenta. Thirty months after insertion, 9843 woman months of experience were computerized and the data analysed according to the life‐table method. The gross cumulative pregnancy and expulsion rates were 13 and 60 respectively. No serious complications were observed and the puerperium was uncomplicated.
HAEMOPERITONEUM DUE TO CORNUAL ENDOMETRIOSIS AFTER LAPAROSCOPIC STERILISATION
Authors: Uri F. I. , Opaneye A.
Published: August 2005

We present a patient with a haemoperitoneum due to bleeding from an area of endometriosis of the uterine cornu six years after laparoscopic sterilisation.
REAL‐TIME ULTRASOUND B‐SCAN AS AN AID TO ANTEPARTUM FETAL HEART RATE MONITORING IN MULTIPLE PREGNANCY CASE REPORT
Authors: Phillips W. D. Powell , Wittmann B. K. , Davison B. M.
Published: August 2005

Real‐time B‐scan was found useful in locating the fetal hearts before antepartum fetal heart rate monitoring by Doppler ultrasound in a patient with a triplet pregnancy.
A RETROSPECTIVE STUDY OF INDUCTION OF LABOUR
Authors: Yudkin Patricia , Frumar A. M. , Anderson Anne B. M. , Turnbull A. C.
Published: August 2005

The labour, delivery and state of the newborn were compared retrospectively in a group of women who had labour induced and a group who started labour spontaneously. There were 200 women at term in each group, individually matched for age, parity and social class and with no medical or obstetric complications prior to labour. The induced group showed a higher incidence of epidural anaesthesia, fetal monitoring and operative delivery. Sixty had forceps deliveries and five had Caesarean sections compared with two forceps deliveries and no Caesarean sections in the ‘spontaneous onset’ group. The higher incidence of operative deliveries in the induced group was not fully explained by the excess of epidurals and fetal monitoring received. More of the babies born after an induced labour had endotracheal intubation during resuscitation.
ULTRASOUND EVIDENCE OF EARLY PREGNANCY FAILURE IN PATIENTS WITH MULTIPLE CONCEPTIONS
Authors: Varma Thankam R.
Published: August 2005

I report a review of 1500 pregnant patients: 30 of them (or 1 in 50) were thought to have multiple pregnancies when examined by ultrasound in the first trimester. Only 14 of the 30 patients (46.7 per cent) produced live infants: 13 twins and one set of triplets. Twelve (40 per cent) had bleeding in early pregnancy and 11 of these had a spontaneous abortion. Five of seven patients found to have a normal pregnancy and a coexistent blighted ovum, ultimately delivered a single live infant.
THE SYNTHESIS OF IMMUNOREACTIVE PROLACTIN BY DECIDUA‐CHORION
Authors: Healy D. L. , Kimpton W. G. , Muller H. K. , Burger H. G.
Published: August 2005

Normal term human decidua‐chorion, amnion and placenta were examined for possible synthesis of prolactin (PRL) by organ culture of tissue fragments in medium M199. Before incubation, higher PRL concentrations were found in decidua‐chorion (27.7±5.7 ng/mg protein; mean±SE) and amnion (19.7±6.9 ng/mg protein) than in placenta (3.1±0.5 ng/mg protein; p <0.005). Incubated deciduachorion released significantly more PRL into culture medium than did amnion or placenta. After 72 hours culture, the PRL concentration of decidua‐chorion remained high (17.9±6.4 ng/mg protein); that in amnion (2.3±1.9 ng/mg protein) fell to approach that of placenta (1.4±1.0 ng/mg protein). In further studies, fragments of decidua‐chorion were incubated in medium RPMI 1640 without or with puromycin (0.04 mM) or cycloheximide (0.1 mM). A decrease in medium PRL concentration was observed within four hours of adding these inhibitors of protein synthesis. At four hours, the PRL content of decidua‐chorion cultured in puromycin (12.4±3 8 ng/mg protein) or cycloheximide (11.9±2.9 ng/mg protein) was lower than tissue incubated in medium alone (25.5±4.1 ng/mg protein; p <0.05). Comparable differences in tissue content and medium concentration were also seen at 24 and 72 hours. We conclude that human decidua‐chorion synthesizes a protein immunologically simjlar to PRL and that this tissue may represent the principal source of amniotic fluid PRL.
HYPERPROLACTINAEMIA IN A PATIENT WITH THE McCUNE‐ALBRIGHT SYNDROME
Authors: Carr D. , Mathie I. K. , Manners A. R. , Colman C.
Published: August 2005

A patient is presented with the syndrome of polyostotic fibrous dysplasia and precocious puberty (McCune‐Albright Syndrome). In adult life she developed hyperprolactinaemia with galactorrhoea and amenorrhoea; there was also evidence of excessive secretion of growth hormone.
ENTEROHEPATIC CIRCULATION OF OESTRIOL: A STUDY OF THE EFFECTS OF AMPICILLIN ON PLASMA OESTRIOL LEVELS
Authors: Buchan P. C. , Klopper A.
Published: August 2005

Plasma total oestriol was measured daily before and during ampicillin therapy in five pregnant patients and in eight patients, four of whom were receiving ampicillin, for four days following delivery. Ampicillin caused a fall in plasma oestriol of 25 per cent during the first three days of treatment, thereafter the level remained stable with a lower day‐to‐day variability than in untreated patients. Ampicillin reduced the plasma half life of total oestriol by 60 per cent. This study illustrates how the re‐entry of oestriol from the gut leads to irregular fluctuations in plasma oestriol levels and helps to keep up the plasma concentration of the steroid when inflow from the fetoplacental unit is cut off.
FETAL MOVEMENTS IN SMALL‐FOR‐DATES BABIES
Authors: Jarvis G. J. , MacDonald H. N.
Published: August 2005

Subjective assessment of daily fetal movement rates is a simple clinical guide to fetal well‐being. Fetal death is unlikely to occur until the rate falls below 10 movements/l2 hours whilst a rate of less than 21 movements/l2 hours is strongly associated with a small‐for‐dates fetus and indicates the necessity for further assessment of placental function.
CLINICAL TRIAL OF A NEW ORAL CONTRACEPTIVE PILL CONTAINING THE NATURAL OESTROGEN 17β‐OESTRADIOL
Authors: ÅTedt B. , Jeppsson S. , Liedholm P. , Rannevik G. , Svanberg L.
Published: August 2005

The natural oestrogen, 17β‐oestradiol, has been shown not to depress fibrinolysis and apparently has less influence on liver function and lipid metabolism than ethinyl oestradiol, the synthetic oestrogen in conventional‘combined’oral contraceptive tablets. A triple‐blind study was therefore made of 215 women during 2051 treatment cycles with oral contraceptives containing either (i) 4 mg of micronized 17‐oestradiol and 3 mg norethisterone (Netagen 403), (ii) 4 mg 17‐oestradiol plus 2 mg of oestriol and 3 mg norethisterone (Netagen 423) or (iii) 50 μg ethinyl oestradiol and 3 mg norethisterone (Netasyn). There were no pregnancies or thrombotic incidents. The numbers discontinuing treatment were about the same in the three groups, the main reasons being intermenstrual spotting in those on Netagen 423, amenorrhoea and weight gain in those on Netagen 403 and nausea and weight gain in those on Netasyn. The natural oestrogen showed promise as a new and safe component of the‘combined’pill.
A DOUBLE‐BLIND TRIAL OF SINGLE‐DOSE CHEMOPROPHYLAXIS WITH CO‐TRIMOXAZOLE DURING VAGINAL HYSTERECTOMY AND REPAIR
Authors: Mathews D. D. , Agarwal Visantika , Gordon A. M. , Cooper J.
Published: August 2005

Twenty‐five patients received 10 ml co‐trimoxazole (800 mg sulphamethoxazole and 160 mg trimethoprim) and 25 a placebo by intravenous infusion during one hour from the commencement of surgery for vaginal hysterectomy with anterior colporrhaphy and posterior colpo‐perineorrhaphy. Single‐dose chemoprophylaxis with co‐trimoxazole was shown to be effective in reducing the incidence of post‐operative febrile morbidity and urinary tract infection, especially that caused by Proteus species.
RECURRENT BOWEL OBSTRUCTION DURING PREGNANCY AFTER ILEO‐JEJUNAL BY‐PASS CASE REPORT
Authors: Cumming D. C. , Wren Frances D.
Published: August 2005

A patient weighing 140 kg had a jejuno‐ileal by‐pass procedure. In two subsequent pregnancies she developed bowel obstruction on a total of three occasions.