bluuebunny/crossref_metadata_2025 huggingface dataset:
NUMERICAL ANALYSIS OF THE NORMAL HUMAN ANTENATAL FETAL HEART RATE
Authors: Visser G. H. A. , Dawes G. S. , Redman C. W. G.
Published: August 2005

A numerical method for separation of the frequency components of the fetal heart rate, and for identifying episodes of high or low variation, was applied to 196 64‐minute ultrasound records in normal pregnancies during the last half of gestation. Most variables of heart period variation increased with gestation, as did the incidence of accelerations. Before 35 weeks, accelerations of ≥14 beats/minute did not occur in all records. Cyclic episodes of low and high variation (‘unreactive’ and‘reactive’ episodes), associated with rest‐activity cycles, could be identified from 27 weeks onwards. After 36 weeks gestation the length of low variation episodes increased and the variation during these episodes fell. Near term, low variation episodes lasted up to 40 minutes. It is concluded that on scrutiny of fetal heart rate records for evidence of normality, or otherwise, due account should be taken of gestational age.
MEASUREMENT OF THE LECITHIN/SPHINGOMYELIN RATIO AND PHOSPHATIDYLGLYCEROL IN AMNIOTIC FLUID: AN ACCURATE METHOD FOR THE ASSESSMENT OF FETAL LUNG MATURITY
Authors: Hallman Mikko , Teramo Kari
Published: August 2005

A total of 506 amniotic fluid samples from 337 pregnancies was analysed for lecithin/sphingomyelin (L/S) ratio and phosphatidylglycerol. Two‐dimensional chromatography on either laboratory‐made or commercial thin‐layer silica gel plates was required for proper resolution of the phospholipids. The predictive accuracy of the L/S ratio and the phosphatidylglycerol analysis was assessed in 225 patients, 187 of whom had an L/S ratio of 2 or more. In addition to predicting respiratory distress syndrome of the newborn, the phospholipid results predicted the risk of transient tachypnoea, symptomatic pneumothorax and the persistence of fetal circulation. The phosphatidylglycerol results improved the predictive value of both the mature L/S ratio (2 or more) and the non‐mature L/S ratio (below 2).
AN ANALYSIS OF PRETERM SINGLETON DELIVERIES AND ASSOCIATED PERINATAL DEATHS IN A TOTAL POPULATION
Authors: Chng P. K.
Published: August 2005

Preterm singleton perinatal deaths were due mainly to antepartum intrauterine deaths or severe obstetric complications resulting in elective deliveries, and asphyxiating conditions complicating very preterm fetuses in spontaneous labour. None of these deaths was salvagable by delaying delivery or suppressing labour. In uncomplicated preterm labour, there were no perinatal deaths.
HAEMOSTASIS IN MENSTRUAL ENDOMETRIUM IN THE PRESENCE OF AN INTRAUTERINE DEVICE
Authors: Christiaens G. C. M. L. , Sixma J. J. , Haspels A. A.
Published: August 2005

The histology and ultrastructure of the haemostatic response in the endometrium have been studied in 12 uteri containing an inert or copper wound intrauterine contraceptive device (IUCD). The uteri were removed during the premenstrual phase or during the first 96 hours of menstruation. The results have been compared to earlier observations in non‐IUCD influenced endometrium. In all uteri the tissue shedding proceeded more slowly in the presence of an IUCD and considerably fewer haemostatic plugs were found. The platelets in these plugs were more loosely packed and less degranulated, and the plugs contained less fibrin than in the absence of an IUCD. Haemostatic plugs were still observed at times when no such plugs were seen in uteri without an IUCD. Unoccluded vessel lesions were regularly seen and vessels open to the shedding surface were occasionally encountered. These observations suggest that IUCD‐induced menorrhagia is caused by the combination of delayed shedding and a decreased haemostatic reaction in the endometrium.
ORAL CONTRACEPTION AND MYOCARDIAL INFARCTION REVISITED: THE EFFECTS OF NEW PREPARATIONS AND PRESCRIBING PATTERNS
Authors: Adam S. A. , Thorogood M. , Mann J. I.
Published: August 2005

All deaths from myocardial infarction occurring during 1978 in women aged 15–44 years in England and Wales have been investigated. Using a case‐control approach, oral contraceptives were found to be associated with an approximately two‐fold increase in risk of this condition, but the effect was apparent only in women with no known risk factors for ischaemic heart disease. Preparations containing 30 μg or less oestrogen were associated with the same risk as those containing 50 μg oestrogen, but this could be due to the fact that preparations containing less oestrogen tend to contain higher doses of progestogens. Oral contraceptives appear no longer to be prescribed for women with recognised coronary risk factors and this improved prescribing practice has probably resulted in a substantial decrease in mortality attributable to oral contraceptive use.
THE EFFECT OF MENOPAUSAL STATUS AND SEQUENTIAL MESTRANOL AND NORETHISTERONE ON SERUM BIOCHEMICAL PROFILES
Authors: Moore B. , Paterson M. E. L. , Sturdee D. W. , Whitehead T. P.
Published: August 2005

Serum biochemical profiles were compared in matched groups of premenopausal and postmenopausal women. Significantly higher concentrations of sodium, urea, calcium, albumin and alkaline phosphatase were found in the postmenopausal group. In the postmenopausal group, following treatment with sequential mestranol and norethisterone, significant reductions were recorded in the concentrations of sodium, urea, calcium, albumin, alkaline phosphatase and glucose and significant increases were recorded in the concentration of globulin and in body weight. The findings suggest that haemoconcentration may take place after the menopause and that this effect may be modified by hormone treatment. No adverse effect on liver function was noted following the hormone treatment.
MATERNAL PLASMA PROSTACYCLIN CONCENTRATION IN PRE‐ECLAMPSIA AND OTHER PREGNANCY COMPLICATIONS
Authors: Ylikorkala O. , Kirkinen P. , Viinikka L.
Published: August 2005

To study the involvement of antiaggregatory and vasodilatory prostacyclin (PGI2) in various pregnancy complications, we measured the concentrations of 6‐keto‐prostaglandin F1α, a stable hydration product of PGI2, using a specific radio‐immunoassay, in plasma samples from 123 women between 22 and 41 weeks of complicated or normal pregnancy. The levels of 6‐keto‐PGF1α (mean±SE) in pre‐eclampsia (267.0 ± 26.6 pg/ml, n = 22), diabetic pregnancy (266.6 ± 19.2 pg/ml, n = 21), twin pregnancy (310.7 ± 28.2 pg/ml, n = 10), threatened premature labour (285.9 ± 23.2 pg/ml, n = 26), placenta praevia or placental abruption (248.9 ± 24.5 pg/ml, n = 6), hepatosis gravidarum (249.3±15.0 pg/ml, n = 3) or in pregnancies complicated by intrauterine fetal growth retardation (296.9 ± 34.2 pg/ml, n = 14) or fetal death (267.5±20.9 pg/ml, n = 6) did not differ from each other or from the 6‐keto‐PGF1α levels in normal pregnancy (266.4 ±15.0 pg/ml, n =22). Furthermore, the 6‐keto‐PGF1α levels bore no relation to the gestational age, maternal drug use (insulin, glucocorticoids, antihypertensive drugs) or to the sex, birth weight or condition of the newborn infant, or to the placental weight.
PREGNANCY‐ASSOCIATED PLASMA PROTEIN‐A (PAPP‐A) AND hCG IN EARLY PREGNANCY
Authors: Bischof P. , DuBerg S. , Herrmann W. , Sizonenko P. C.
Published: August 2005

Pregnancy‐associated plasma protein‐A (PAPP‐A) is a recently described glycoprotein of unknown biological function. The development of a radioimmunoassay enabled us to measure plasma levels of PAPP‐A and human chorionic gonadotrophin (hCG) in 12 non‐pregnant volunteers and in 159 women in early pregnancy attending the outpatient clinic for legal abortion. PAPP‐A but not hCG was measurable in all non‐pregnant women. In pregnant patients (with 36 to 86 days of amenorrhea) hCG reached a peak value (163.1–197.6 ng/ml) between the 9th and the 13th week whereas PAPP‐A steadily increased throughout this period of pregnancy. Between the 6th and the 13th week after the last menstrual period, levels of PAPP‐A increased proportionally more than hCG. This work provides the first evidence of a PAPP‐A production in non‐pregnant subjects and the very early marked increase of PAPP‐A secretion during pregnancy.
FETAL ELECTROENCEPHALOGRAPHY USING A NEW, FLEXIBLE ELECTRODE
Authors: Weller C. , Dyson R. J. , McFadyen I. R. , Green H. L. , Arias E.
Published: August 2005

A single flexible active electrode for monitoring the fetal electroencephalogram (FEEG), has been designed specifically for use in routine obstetrics. It does not require penetration of or adherence to the fetal scalp, and it is reusable. The equipment's performance has been tested in 20 normal labours. The recordings obtained were not contaminated by the fetal electrocardiogram and were relatively free from artefact so that minimal filtering of the signal was required. No FEEG signal was obtained if the electrode was applied to breech presentations. The trace obtained from a healthy fetus was comparable with that recorded after delivery.
VITAMIN D SUPPLEMENTS ENHANCE WEIGHT GAIN AND NUTRITIONAL STATUS IN PREGNANT ASIANS
Authors: Maxwell J. D. , Ang Liza , Brooke O. G. , Brown I. R. F.
Published: August 2005

In a double blind trial of supplementary vitamin D (1000 iu daily) administered in the last trimester of pregnancy to Asian women living in London, supplemented mothers gained weight faster (63.3 g/day) than those in the control group (46.4 g/day), and at term had significantly higher plasma levels of retinol binding protein and thyroid binding prealbumin indicating better protein‐calorie nutrition. Maternal weight gain correlated with postpartum levels of both retinol binding protein and thyroid binding prealbumin. Almost twice as many infants in the unsupplemented group weighed under 2500 g at birth, and had significantly lower retinol binding protein levels than infants of supplemented mothers. The nutritional benefits of supplementation provide further support for the routine administration of vitamin D to all British Asians during pregnancy.
THE ROLE OF SALIVARY PROGESTERONE IN STUDIES OF INFERTILE WOMEN
Authors: Walker S. , Mustafa A. , Walker R. F. , Riad‐Fahmy D.
Published: August 2005

Fifteen women with normal menstrual cycles, dated by accepted criteria, had salivary progesterone concentrations during' the luteal phase of the cycle which were significantly higher than those in the follicular phase. Progesterone concentrations in matched samples of plasma and saliva showed excellent correlation in both normal and infertile women. Salivary progesterone profiles derived from daily sampling of 20 infertile patients not only allowed accurate assessment of ovarian dysfunction but also indicated more effectively than conventional techniques the change in hormonal status following ovulation induction therapy with clomi‐phene citrate or bromocriptine.
CHOICE OF ECBOLIC AND THE MORBIDITY OF DAY‐CASE TERMINATIONS OF PREGNANCY
Authors: Garrioch David B. , Gilbert Josephine R. , Plantevin Odille M.
Published: August 2005

In 103 women admitted for out‐patient vaginal terminations of pregnancy, the relation was investigated between the use of ecbolics and blood loss, vomiting and other side effects. Patient self‐rating was incorporated in the study for comparative purposes. Use of a combined preparation of oxytocin and ergometrine resulted in the lowest blood losses. Ergometrine administered alone was associated with immediate nausea and vomiting but no delayed effects. Seven days after abortion, 35% of the women were still complaining of vaginal bleeding, although in most the volume was low.
PROSTAGLANDIN E2 PESSARIES TO FACILITATE FIRST TRIMESTER ASPIRATION TERMINATION
Authors: MacKenzie I. Z. , Fry Anna
Published: August 2005

Using a double blind administration protocol, the effect on the cervix of prostaglandin E2 (PGE2) vaginal pessaries inserted one to six hours before aspiration termination of pregnancy has been assessed. Pessaries containing 10 mg of PGE2 produced significant cervical softening and dilatation compared with those containing only 5 mg of PGE2 or placebo, the effect was almost as good as 15 mg of PGE2 but the lower dose caused fewer gastro‐intestinal side‐effects and uterine cramps. Blood loss at abortion and in the early post‐abortal recovery period was significantly reduced following PGE2 treatment compared with placebo. The method described is simple and effective in reducing difficult cervical dilatation and is appropriate for day‐care abortion management.
LONG‐TERM SYMPTOMATIC AND CYSTOMETRIC CURE OF THE URGE INCONTINENCE SYNDROME USING A TECHNIQUE OF BLADDER RE‐EDUCATION
Authors: Mahady Ian W. , Begg Barbara M.
Published: August 2005

In a group of 48 patients with the urge incontinence syndrome, 43 were cured of symptoms using a technique of bladder re‐education. This consisted of supportive psychotherapy, initial drug therapy and bladder re‐training. Thirty‐seven of these patients also showed cystometric evidence of improvement in detrusor control.
PELVIC ACTINOMYCOSIS CAUSING URETERIC OBSTRUCTION
Authors: Fulton I. C. , Paterson W. G. , Crucioli V.
Published: August 2005

Two patients are described who had used intrauterine contraceptive devices and developed pelvic actinomycosis with ureteric obstruction.
ELECTRON MICROSCOPIC STUDY OF INTERCELLULAR CANALICULAR SYSTEMS IN THE PARIETAL FETAL MEMBRANES
Authors: Minh Hoang‐Ngoc , Smadja A. , de St Maur P. P. , Orcel L.
Published: August 2005

An electron microscopic study of the amnion and the chorionic cytotrophoblast has demonstrated the existence of intercellular channels running between the lateral sides of the cells with typical junctional complexes sealing their proximal ends. In the amnion these channels open through the basal lamina into the connective tissue, and in the chorionic cytotrophoblast they open in the direction of the decidua. This situation seems to indicate that fluid emerges from the open mouth of the amniotic intercellular channels and then continues to flow into the channels of the cytotrophoblast, across its podocytic processes, to be discharged into the decidua, and finally drained by maternal decidual vessels. This morphological study suggests that parietal fetal membranes might be an important route for transport of solute and fluid from the amniotic fluid to the maternal circulation.
TREATMENT OF PREINVASIVE DISEASE OF THE CERVIX BY CONE BIOPSY
Authors: Bevan J. R. , Attwood M. E. , Jordan J. A. , Lucas A. , Newton J. R.
Published: August 2005

During the years 1952–1977, 646 patients with abnormal cervical cytology underwent cone biopsy (595) or ring biopsy of the cervix. The histological diagnoses were invasive carcinoma 20 (3%) microinvasive carcinoma 16 (2%), carcinoma in situ and severe dysplasia 418 (65 %), other dysplasias 149 (23 %). The remainder, 43 (7%) had no demonstrable abnormality. Following biopsy 41 (7%) patients with non‐invasive disease had abnormal cytology within a year of biopsy. A further 12 (2%) developed abnormal cytology after one year. These recurrences occurred up to 12 years after the initial treatment, and in one patient invasive squamous carcinoma has developed.
CARCINOFIBROMA—A VARIANT OF THE MIXED MULLERIAN TUMOUR
Authors: Thompson Mary , Husemeyer R.
Published: August 2005

An endometrial neoplasm composed of both stromal and epithelial elements, in which only the epithelial element appeared malignant, is reported. Only two similar cases have previously been described. In view of the rarity of these neoplasms, little is known about their behaviour and this presents problems of management particularly in a young patient.
ULTRASONIC ASSESSMENT OF CARDIOVASCULAR GEOMETRY AND FUNCTION IN THE HUMAN FETUS
Authors: Wadimiroff J. W. , McGnie J.
Published: August 2005

A new technique of studying fetal cardiac geometry and function from two‐dimensional real‐time images is presented. A significant increase in left ventricular size with advancing gestational age was observed. Left ventricular cardiac output (LVCO) was 210±48 ml/min (Mean±1 SD) between 27 and 33 weeks and 336±35 ml/min between 34 and 41 weeks gestation. Blood flow (mean flow) in the descending aorta during these two periods was 365±80 and 490±65 ml/min. In four fetuses, the LVCO per kg birth weight ranged between 114 and 123 ml/kg/min and the blood flow in the descending aorta between 168 and 179 ml/kg/min. If total cardiac output is considered to be twice the LVCO, the proportion of total cardiac output being distributed through the descending aorta and placenta is about 75% and 45% respectively.
“LUPUS” ANTICOAGULANT AND INHIBITION OF PROSTACYCLIN FORMATION IN PATIENTS WITH REPEATED ABORTION, INTRAUTERINE GROWTH RETARDATION AND INTRAUTERINE DEATH
Authors: Carreras Luis O. , Vermylen Jos , Spitz Bernard , Van Assche Andre
Published: August 2005

We discovered a‘lupus’ anticoagulant in 2 out of 24 women with a history of repeated abortions, intrauterine growth retardation and intrauterine death of unknown origin. The‘lupus’ anticoagulant was detected by an abnormal dilute tissue thromboplastin assay (prothrombin time performed with dilute thromboplastin). The production of prostacyclin by fresh or exhausted rings of rat aorta was decreased by the plasma of one of these two patients with a‘lupus’ anticoagulant. In view of the increasing evidence for a physiological role of prostacyclin in pregnancy and fetal life, we suggest that an inhibition of prostacyclin production could compromise fetal outcome.
CLIMACTERIC FLUSHING: CLINICAL AND ENDOCRINE RESPONSE TO INFUSION OF NALOXONE
Authors: Lightman S. L. , Jacobs H. S. , Maguire A. K. , McGarrick G. , Jeffcoate S. L.
Published: August 2005

Six postmenopausal women with frequent attacks of flushing were studied by measuring plasma luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin and noradrenaline concentrations at regular and frequent intervals and at the time of each of 82 flushes. The hormone measurements were made on a control day and on the second day during infusion of either naloxone (22 μg/min) or saline. The perception of a flush was associated with a significant increase of plasma LH concentrations. There were no significant changes in plasma FSH, prolactin or noradrenaline concentrations. Naloxone infusion resulted in a highly significant reduction in the frequency of flushes and in the number of LH pulses. We conclude that flushing and its neuro‐endocrine correlates are related to activation of opiate receptors. Naloxone may provide the basis for a non‐steroidal treatment of climacteric flushing attacks.
AN INTERACTION BETWEEN DANAZOL AND WARFARIN
Authors: Goulbourne I. A. , Macleod D. A. D.
Published: August 2005

A 40‐year‐old patient is described who was taking warfarin because she had a prosthetic mitral valve. When she was treated with danazol for endometriosis, her prothrombin time increased and she had a haematemesis.
Categorization of terminal fetal heart‐rate patterns in antepartum cardiotocography
Authors: LANGER O. , SONNENDECKER E. W. W. , JACOBSON M. J.
Published: August 2005

Summary. Seven patients with terminal fetal heart‐rate patterns in antepartum cardiotocographs (non‐stress testing) are present. The characteristics of an early and late pattern, not hitherto described, are illustrated and defined, and the association between these patterns and fetal movements is emphasized. Treatment by urgent caesarean section is shown to be the only appropriate treatment.
Serum polyamine oxidase activity in spontaneous abortion
Authors: ILLEI G. , MORGAN D. M. L.
Published: August 2005

Summary. Serum polyamine oxidase activity was determined in 38 women admitted to the Maternity Department of Szombathely, Hungary, with clinical signs of threatened abortion between 11 and 22 weeks gestation and who aborted spontaneously with 48 h of admission. Serum polyamine oxidase activity was found to be significantly lower in these women compared with that in women having normal pregnancies of the same gestational age. The higher polyamine oxidase levels which were found in five women who aborted during oxytocin infusion probably resulted from increased contractions expelling enzyme‐rich blood from the intervillous space into the maternal circulation. Present evidence is insufficient to explain the full clinical significance of these findings.
Maternal serum diamine oxidase in fetal death and low‐birth‐weight infants
Authors: GAHL WILLIAM A. , RAUBERTAS RICHARD F. , VALE ANN M. , GOLUBJATNIKOV RJURIK
Published: August 2005

Summary. Serum diamine oxidase was measured at different gestational ages in 681 pregnancies resulting in live births and 102 pregnancies resulting in fetal deaths. Statistical analysis revealed that gestational age‐adjusted diamine oxidase levels in the fetal‐death group were significantly lower (P < 0.001) than those in the live‐birth group. Moreover, the relative risk associated with a low diamine oxidase level, compared with a normal level, increased from 3.7 at 8 weeks to 16.6 at 12 weeks. Pregnancies resulting in low‐birth‐weight infants exhibited normal serum diamine oxidase levels. The association between low diamine oxidase and subsequent fetal death is discussed in view of the hypothesis that polyamines and polyamine‐degrading enzymes interact to protect the fetoplacental unit from immune rejection.
Lipid metabolism in pregnancy
Authors: DARMADY JUDITHM , POSTLE ANTHONYD
Published: August 2005

Summary. Serum cholesterol and triglyceride concentrations in 34 normal women were monitored before, during and after pregnancy. All women displayed an initial fall in both substances during the first trimester. The concentrations increased to maximum values during the third trimester. There was a considerable variation in the time required for this hyperlipidaemia to decline after delivery. Lactation appeared to be an important factor in this variation; women who bottle‐fed their infants maintained an elevated serum triglyceride level for three times longer than those who breast‐fed their infants.
Maternal serum α‐fetoprotein and low birth weight in relation to gestational age
Authors: WALD NICHOLAS J. , CUCKLE HOWARD S. , BOREHAMICRF JILLIAN , STIRRAT GORDON M. , TURNBULL A. C.
Published: August 2005

Summary. To determine when in the first and second trimester a raised serum α‐fetoprotein (AFP) level best predicts low birth weight a case‐control study was performed on 157 singleton low birth‐weight (2.5 kg) and 314 singleton control pregnancies (birth weight >2.5 kg). The association between raised maternal serum AFP and low birth weight was confirmed, but there was no special time in pregnancy before 29 weeks gestation when a raised AFP level predicted low birth weight materially better than at any other time.
Screening for neural‐tube defects and maternal anxiety
Authors: FEARN JO , HIBBARD B. M. , LAURENCE K. M. , ROBERTS A. , ROBINSON J. O.
Published: August 2005

Summary. Anxiety levels were studied in 176 women with raised serum α‐fetoprotein levels at 16–18 weeks gestation, at the time they attended a central assessment clinic, and again 2–3 weeks later in those not found to have a fetus with a neural‐tube defect. Methods of imparting information about the serum screening tests and the manner in which a normal amniotic fluid result was conveyed to the patient were also studied. Overall, women attending the clinic for further assessment were extremely anxious, irrespective of the source of their information. Anxiety scores 2–3 weeks after testing were greatly influenced by whether the patient had been given a definite normal result or whether she was told to assume that the result was normal if she did not hear from the clinic. Patients who, after reassessment, did not require amniocentesis had some residual anxiety in spite of verbal reassurance.
Antibody activity against herpes simplex virus in human amniotic fluid
Authors: COX D. , HAWKINS S. L. , HARTLEY C. E. , MYLOTTE M. J. , SKINNER G. R. B.
Published: August 2005

Summary. Neutralizing and radioimmunobinding antibody against type 1 herpes simplex virus was detected in about 50% of amniotic fluid samples. The occurrence and levels of antibody activity correlated with neutralizing and immunoprecipitating antibody activity in the sera of these subjects.
Fetal habituation in high‐risk pregnancies
Authors: LEADER LEO R. , BAILLIE PETER , MARTIN BAHIA , VERMEULEN ELSEBETH
Published: August 2005

Summary. Habituation is a basic form of learning and probably requires an intact central nervous system. Habituation in the behavioural response to vibration in 40 normal human fetuses was compared with that in a group of high‐risk pregnancies with an increased risk of fetal neurological damage. Highly significant differences in habituation patterns between the high‐risk groups and normal control subjects were found. This test may offer a method of assessing the integrity of the fetal central nervous system.
Measurement of fundal height as a screening test for fetal growth retardation
Authors: ROSENBERG KATHRYN , GRANT JOHN M. , TWEEDIE IRENE , AITCHISON TOM , GALLAGHER FRAN
Published: August 2005

Summary. Fundal heights were measured on 761 women in the course of their routine antenatal care. This information was assessed, alone and in combination with other variables such as previous obstetric history and smoking, for its utility in predicting growth retardation. The results were disappointing. By most criteria used for classification, approximately half of the growth retarded babies were classified as such while half were missed. False positive rates were unacceptably high. It is concluded that fundal height measurement is of little use as a screening test for growth retardation.
Dopamine influence on human uterine activity at term pregnancy
Authors: URBAN J. , RADWAN J. , LAUDANSKI T. , AKERLUND M.
Published: August 2005

Summary. The influence of dopamine on uterine activity was studied by external tocography in women at the end of a normal pregnancy. In those who were not in labour dopamine infusion (4 μg min‐1 kg‐1 body weight) induced regular uterine contractions and with higher doses the response increased. For women in spontaneous labour, dopamine at a dose of 4 SmUg min‐1 kg‐1 caused a significant increase in the frequency of contraction, but in women receiving an oxytocin infusion, no further stimulation was seen. Dopamine did not have any noticeable effect on fetal heart rate, maternal pulse rate or blood pressure and no other general effects were observed.
Effect of dexamethasone on amniotic fluid absorbance in Rh‐sensitized pregnancy
Authors: NAVOT D. , ROZEN E. , SADOVSKY E.
Published: August 2005

Summary. Five Rh‐sensitized pregnant women between 23 and 30 weeks gestation, with a poor obstetric history and initially high ΔA450 values, were treated with weekly doses of 24 mg of dexamethasone over a period of 2–7 weeks to enhance fetal lung maturation. Four women showed a gradual decline in ΔA450 during the treatment. All five deliveries were delayed until fetal lung maturity was confirmed by amniotic fluid lecithin/sphingomyelin (L/S) ratio and all five fetuses survived. It is possible that high doses of dexamethasone delayed the anticipated intrauterine deterioration of the fetuses and may have prevented the need for intrauterine transfusions.
Clinical and urodynamic effects of anterior colporrhaphy and vaginal hysterectomy for prolapse with and without incontinence
Authors: STANTON STUART L. , HILTON PAUL , NORTON CHRISTINE , CARDOZO LINDA
Published: August 2005

Summary. The clinical and urodynamic effects of anterior colporrhaphy and vaginal hysterectomy were studied in 73 patients, of whom 29 had incontinence due to urethral sphincter incompetence. Pre‐ and post‐operative urodynamic assessment was made and follow‐up continued for 2 years. Symptoms of urge incontinence, stress incontinence and prolapse were significantly reduced following surgery. Urodynamic data showed no significant change. The incidence of detrusor instability and voiding difficulties was not increased.
Thrombotic thrombocytopenic purpura in pregnancy
Authors: ATLAS M. , BARKAI G. , MENCZER J. , HOULU N. , LIEBERMAN P.
Published: August 2005

Summary. A 20 week primigravida with intrauterine fetal death and the rare occurrence of thrombotic thrombocytopenic purpura (TTP) in pregnancy is presented. Aprotinin has been used to overcome uterine inertia non‐responsive to oxytocin stimulation. TTP was successfully treated with repeated plasmaphereses. The literature is briefly reviewed and the complexity and importance of the differential diagnosis specific to the pregnant patient is discussed.
Oxytocin‐stressed and unstressed cardiotocograms for the prediction of fetal compromise
Authors: HOMBURG R. , BEN‐DAVID M. , ZAKU H.
Published: August 2005

Summary. The results of unstressed and oxytocin‐stressed cardiotocograms recorded in 222 high‐risk pregnancies within 48 h of delivery were compared with signs of fetal distress in labour and Apgar scores. Thirtynine (18%) developed a late deceleration pattern in labour and 18 newborn (8%) had Apgar scores of <7 at 1 min. A direct comparison of the predictive value of unstressed and stressed cardiotocograms, using Fisher's exact test, showed a very significant difference in favour of the stressed cardiotocogram for the prediction of both fetal compromise and fetal well‐ being. The exclusion, or very selective use, of the oxytocin‐stressed cardiotocogram and reliance on the unstressed cardiotocogram for the anlepartum investigation of high‐risk pregnancies sacrifices accuracy for convenience.
A scoring system for antenatal identification of fetal growth retardation
Authors: WENNERGREN MARGARETA , KARLSSON KIRSTEN , OLSSON T.
Published: August 2005

Summary. A scoring system for selection of pregnancies at risk of intrauterine growth retardation (IUGR) is presented. It is based on eight weighted items which include information from previous pregnancies and from the current one including the increment of fundal height and of maternal weight. With a risk population of 7% all IUGR infants were included. The IUGR infants constituted 34% of the risk group.
Amniotic fluid volumes and concentrations of C‐peptide in diabetic pregnancies
Authors: STANGENBERG M. , PERSSON B. , VACLAVINKOVA V.
Published: August 2005

Summary.Amniotic fluid (AF) volumes were determined by sodium paminohippurate (PAH) diloution in a consecutive series of 24 diabetic women at 34–35 weeks gestation. AF and maternal venous blood samples were analysed for C‐peptide immunoreactivity (CPR). When the patients were subgrouped according to the presence (n=17) or absence (n=8) of neonatal morbidity, AF volumes (1340±236 ml vs 807±130 ml; mean ±SEM), AF concentrations of CPR (l.38±0.54 nmol/1 vs 0.61±0.14 nmol/1) and maternal blood glucose levels (5.3±0.2 mmol/1 vs 4.8±0.3 mmol/1) during the last trimester of pregnancy were not different. The total content of CPR was significantly (P<0.05) greater in pregnancies with neonatal complications (1.25±0.31 nmol) compared with that in pregnancies without neonatal complications (0.54±0.18 nmol). AF volumes were significantly (P<0.02) larger in pregnancies where feeding problems occurred (1546±307 ml,n=9) compared with that in pregnancies without such problems (957±188 ml,n=16). These findings indicate an impact of fetal hyperinsulinism on the functional maturation of the fetus. When the patients were subgrouped according to the presence or absence of detectable maternal plasma CPR, i.e. >0.05 nmol/1, and to insulin dependent and gestational diabetes no differences of AF volumes, AF concentrations of CPR or total AF contents of CPR were found.
Evidence against oral contraceptives as a cause of neuraltube defects
Authors: CUCKLE HOWARD S. , WALD NICHOLAS J.
Published: August 2005

Summary. Information on oral contraceptive (OC) use, collected at the first antenatal visit, was abstracted from the medical notes in respect of 107 index pregnancies resulting in the delivery of an infant with a neural‐ tube defect (NTD) and 214 unaffected controls. The relative risk of having an NTD infant for women who had at any time used OCs was 0.82 (95% confidence interval 0.52,1.32) compared with that in women who had never used OCs. For women who stopped OC use less than 3 months before becoming pregnant or who continued in early pregnancy, the relative risk was 1.18 (95% confidence interval 0.70, 1.98) compared with women who had used OCs at any other time. An analysis restricted to those women who had at any time used OCs did not suggest an association between NTD risk and the interval between stopping OC use and becoming pregnant. None of our analyses therefore provided any evidence that OCs cause NTDs and if a risk exists it can only be small.
Sperm function in patients with unexplained infertility
Authors: TEMPLETON ALLAN , AITKEN JOHN , MORTIMER DAVID , BEST FIONA
Published: August 2005

Summary. Sperm function was studied in 27 patients with hitherto unexplained infertility. The ability of spermatozoa to reach the site of fertilization was assessed by laparoscopic sperm recovery from the peritoneal fluid and fimbrial rinsings and sperm fertilizing capacity with the zona‐free hamster egg penetration in vitro test. The ability of spermatozoa to reach the site of fertilization correlated significantly with their fertilizing capacity in vitro, but was totally unrelated to any of the conventional criteria of semen quality, including the postcapacitation movement characteristics of the spermatozoa. Among patients with unexplained infertility, there are individuals with defects of sperm function which cannot be identified by conventional clinical techniques.
Progestogen therapy for ovarian carcinoma
Authors: TIMOTHY IRENE
Published: August 2005

Summary. Women with ovarian adenocarcinoma who were treated with high dose progestogens showed subjective and objective improvements during treatment.
Incidence and prevalence of preclinical carcinoma of cervix in a British population
Authors: PARKIN D. M. , HODGSON P. , CLAYDEN A. D.
Published: August 2005

Summary. Quantitative knowledge of the natural history of cancer of the cervix is essential to the design of optimal screening programmes. We have estimated the incidence and prevalence of cervical intraepithelial neoplasia in a population of women receiving cytological examinations, and compared the results with those from other series. Relative risk of disease is reported in relation to easily identified variables (marital status, parity, contraceptive use, symptoms) which are likely to be of practical value in denning selective screening policies.
Effect of single‐dose prophylactic co‐trimoxazole on theincidence of gynaecological postoperative urinary tractinfection
Authors: IRELAND D. , TACCHI D. , BINT A. J.
Published: August 2005

Summary. One hundred patients having abdominal hysterectomy forbenign conditions were randomized into two groups; 50 received cotrimoxazole by intramuscular injection immediately before operation and acontrol group of 50 were given no antibacterial cover. Single‐dosechemoprophylaxis with co‐trimoxazole was effective in reducing theincidence of postoperative urinary tract infection from 35% in the controlgroup to 4% in the treated group.
Antenatal prediction of urinary tract infection in pregnancy
Authors: CHNG P. K. , HALL MARION H.
Published: August 2005

Summary. Prediction of urinary tract infection in pregnancy by bacteriuria testing is unsatisfactory; if resources are short, the taking of a careful history of previous urinary tract infection is almost as effective. Restriction of bacteriuria testing to the women with such a history would be more economical than routine testing and would give better specificity (but not sensitivity) than bacteriuria testing or history taking alone.
Routine real‐time scanning at the first hospital visit
Authors: ANDERSON R. S. , PHILLIPS P. J. , MIDWINTER A.
Published: August 2005

Summary. All patients presenting at one consultant booking antenatal clinic had a routine realtime ultrasonic scan. The purpose was to study the accuracy of the technique, the additional work involved and the clinical benefit. All scans were performed by one operator. The average time per scan was 6 min compared with 15 min for each B scan. When gestation assessed by scan differed from gestation assessed by menstrual dates or clinical examination, an independent assessment was made after birth. There was a marked decrease in utilization of B‐scanning facilities. Routine real‐time scanning at the first visit was a reliable method of assessing gestation in 94% of patients.
Feto‐maternal consequences of high‐dose glucose infusion during labour
Authors: LAWRENCE G. F. , BROWN V. A. , PARSONS R. J. , COOKE I. D.
Published: August 2005

Summary. The effects on the fetus of high doses of glucose given to the mother in labour to correct maternal ketonuria were investigated. Three groups of patients were compared: one group received 1 litre of 10% (w/v) glucose intravenously over 1 h, the second group received 1 litre of 0.9% sodium chloride solution intravenously over 1 h and the final group had no supplementary infusion. It was observed that whereas glucose administration rapidly corrected maternal ketonaemia, there was a significant fall in pH and a rise in lactate in fetal blood. These effects were not observed in the other two groups. It was concluded that the use of high doses of intravenous glucose in labour should be avoided.
Extraction and identification of trophoblast cells circulating in peripheral blood during pregnancy
Authors: GOODFELLOW C. F. , TAYLOR P. V.
Published: August 2005

Summary. Trophoblast cells circulating in peripheral venous blood during pregnancy were extracted by differential centrifugation and identified by indirect immunofluorescence with antitrophoblast microvillus antibody. In a study where trophoblast identification was checked by blind comparison with non‐pregnant control subjects’ trophoblast cells were detected in six out of 10 pregnant women studied.
Umbilical‐cord plasma progesterone in term infants delivered by caesarean section
Authors: SHAXTED E. J. , HEYES VIVIEN M. , WALKER M. P. R. , MAYNARD P. V.
Published: August 2005

Summary. Plasma progesterone concentration was measured by radioimmunoassay in blood samples taken from 67 patients delivered by lower‐segment caesarean section (LSCS). Blood samples were taken from umbilical‐cord artery and vein and from a peripheral maternal vein. Cord venous progesterone levels were higher (c400 ng/ml) in those patients where the fetus was clinically in jeopardy and this was the principal indication for section. Patients in whom the fetus was not in jeopardy had lower cord venous progesterone concentrations (c 300 ng/ml) regardless of whether or not they were in labour. Maternal levels of progesterone were similar in all patients. The advantage to the fetus of these varying progesterone concentrations is not clear, but the evidence lends support to the hypothesis that the fetus exercises control over placental progesterone production during parturition.
A new systematic treatment for infertile women with abnormal hormone profiles
Authors: FLEMING R. , ADAM A. H. , BARLOW D. H. , BLACK W. P. , MACNAUGHTON M. C. , COUTTS J. R. T.
Published: August 2005

Summary. Five infertile women, with normal menstrual rhythm who had been investigated previously by daily hormone analyses throughout at least one complete menstrual cycle and had shown poor luteal‐phase steroid‐hormone profiles were treated by a new approach. They were rendered hypogonadotrophic with large doses of a luteinizing hormone releasing‐hormone analogue (Hoe 766) and were then treated with exogenous gonadotrophins to induce follicular growth and ovulation. Progesterone production after ovulation in all cases was superior to that observed in the individual patients’ without treatment. One patient conceived in her first conception cycle and another in her fourth. This regimen offers a systematic approach to the treatment of unexplained infertility in women with deficient luteal‐phase steroid‐hormone profiles.
Peripheral venous concentrations of oestrogens in postmenopausal women with ovarian cancer
Authors: HEINONEN P. K. , TUIMALA R. , PYYKKÖ KAIJA , PYSTYNEN P.
Published: August 2005

Summary. Serum concentrations of oestrone, oestradiol and oestriol were measured in 23 postmenopausal women, 12 with ovarian cancer and 11 with genital prolapse. Oestrone (387.6 pmol/1) and oestradiol (72.7 pmol/1) levels were higher in the cancer group than those in the control group (159.8 and 27.5 pmol/1 respectively), while oestriol levels did not differ (434.5–270.8 pmol/1). The results indicate abnormal ovarian function in postmenopausal patients with ovarian cancer.
Detection by ultrasound of abnormality in twin pregnancies during the second trimester
Authors: NEILSON J. P. , HOOD V. D. , CUPPLES W. , GIBSON A. A. M. , FERGUSON‐SMITH M. A.
Published: August 2005

Summary. Five cases of abnormality in twin pregnancies, detected by ultrasound examination during the second trimester, are reported. In four pregnancies there was a fetal malformation: discordant anencephaly, a monozygotic, heterokaryotypic twin pregnancy with coexistant Turner's syndrome and intrauterine death, concordant body stalk syndrome, and a dicephalus monster. In the other pregnancy one fetus dies in utero to become a fetus papyraceous. Four of the pregnancies were associated with raised levels of maternal serum α‐fetoprotein, by singleton standards. Ultrasound examination proved of value in each case. Three pregnancies were terminated.
Development of a rational blood‐ordering policy for obstetrics and gynaecology
Authors: PENNEY GILLIAN C. , MOORES H. M. , BOULTON F. E.
Published: August 2005

Summary. The relation between quantities of blood ordered to cover obstetrical and gynaecological diagnoses and quantities actually used was studied over a period of 3 months in one Scottish hospital. It appeared that the amount of blood ordered as‘cover’ for many operative procedures and for patients under observation was, in many instances, uneconomic. On the basis of this a‘maximum surgical blood‐ordering schedule’ has been proposed which would reduce the amount of blood cross‐matched as‘cover’ by 65 %. Review of the circumstances of all transfusions given over the study period suggested that adoption of the proposed schedule would not be detrimental to patient safety.
Lorazepam premedication for labour
Authors: McAULEY D. M. , O'NEILL M. P. , MOORE J. , DUNDEE J. W.
Published: August 2005

Summary. Fifty primigravidae were given either lorazepam (2 mg) or identical dummy tablets in early labour, in a randomized double‐blind fashion. Analgesia (standardized at pethidine 100 mg) was given as required, and pain relief was assessed by visual analogue scales. Analgesia was significantly better in those mothers who had received lorazepam. There was a higher incidence of respiratory, depression at birth in the infants in this group, although this was not statistically significant. Patients given lorazepam were all satisfied with their analgesic regimen compared with half of those given an inactive tablet. There was a higher incidence of amnesia for labour in the active group. There is a need for a similar study of the effects of other drugs which arc given to supplement pethidine in labour.
Elevated intravesicular fluid luteinizing hormone concentration in hydatidiform mole
Authors: GUNASEGARAM R. , PEH K. L. , LOGANATH A. , KARIM S. M. M. , RATNAM S. S.
Published: August 2005

Summary. Concentrations of human chorionic gonadotrophin (β‐hCG), follicle‐stimulating hormone (FSH), luteinizing hormone (LH) and prolactin (PRL) were measured by radioimmunoassay in the serous fluid of hydatid vesicles obtained from 27 patients with hydatidiform mole. High amounts of all four hormones were found in every case. The mean concentrations ± SEM were 710.8 ± 100.8 i.u./l×10−3 for β‐hCG, 13.8 ± 0.3 i.u./l for FSH, 302.2 ± 34.5 i.u./l×10−3 for LH and 2610.8 ± 562.1 m‐i.u./l for PRL. It is suggested that aberrations in the mechanisms controlling the synthesis and release of luteinizing hormone‐releasing factor (LH‐RF) could result in chronically elevated LH levels leading to changes characteristic of this disease.
Laparoscopic removal of translocated intrauterine contraceptive devices
Authors: McKENNA P. J. , MYLOTTE M. J.
Published: August 2005

Summary. Over a 6 year period, 67 women had a translocated intrauterine contraceptive device (IUCD) removed from the peritoneal cavity or uterovesical fold under general anaesthesia. In 40 patients removal of the IUCD at laparoscopy succeeded, whereas in 24 laparotomy proved necessary and three IUCD were removed per vaginam. Compared with the inert plastic device a larger proportion of copper‐containing IUCD in the peritoneal cavity required laparotomy for removal, however, 44% could be removed by laparoscopy, the less traumatic procedure.
Enlargement of a prolactin‐secreting pituitary microadenoma during bromocriptine treatment
Authors: CROSIGNANI P.‐G. , MATTEI ANNA , FERRARI C. , GIOVANELLI M. A.
Published: August 2005

Summary. A patient with prolactin‐secreting pituitary microadenoma was treated with bromocriptine, 5 mg daily for 1 year. Despite normalization of prolactin levels throughout the treatment period, partial destruction of the sellar floor with growth of the adenoma into sphenoidal sinus were evident in a control tomography performed at the end of the treatment.
Invasive carcinoma of one cervix in a uterus didelphys
Authors: CORBETT P. J. , CROMPTON A. C.
Published: August 2005

Summary. A patient is described with invasive squamous carcinoma developing in one cervix in a didelphic uterus with double cervix and vagina completely separated by a vaginal septum.
Complete and partial hydatidiform mole in Hawaii: cytogenetics, morphology and epidemiology
Authors: JACOBS PATRICIA A. , HUNT PATRICIA A. , MATSUURA JANICE S. , WILSON CAROLA C. , SZULMAN A. E.
Published: August 2005

Summary. The results of a 5 year prospective cytogenetic and epidemiologic investigation of complete and partial hydatidiform mole are described. A total of 40 complete and 88 partial moles were identified by pathologic criteria in a population of 1602 spontaneous abortions. Cytogenetic observations confirmed the close correlation between chromosome constitution and histopathologic type, virtually all the complete moles were paternal parthenogenones and virtually all the partial moles were triploid. The distributions of maternal age, race, place of birth and socioeconomic status were the same in women with partial moles and in the control population of spontaneous abortions. However, the incidence of complete moles was significantly increased in women aged <20 years and also in Filipino women, these two effects being independent of one another.
Prolactin levels in the premenstrual syndrome
Authors: SHAUGHN O'BRIEN P. M. , SYMONDS E. M.
Published: August 2005

Summary. Serum prolactin was measured in 18 subjects complaining of premenstrual syndrome and results were compared with those in 10 control subjects. No consistent changes were seen during the course of the menstrual cycle in either group. There were no significant differences between the prolactin levels of the two groups. There was no correlation between mood change and levels of prolactin.
False positive gel‐acetylcholinesterase results in blood‐stained amniotic fluids
Authors: BARLOW ROBERT D. , CUCKLE HOWARD S. , WALD NICHOLAS J. , RODECK CHARLES H.
Published: August 2005

Summary. The effect of blood contamination on the gel‐acetylcholinesterase (AChE) test used in the diagnosis of fetal open neural‐tube defects was studied with amniotic fluid samples artificially contaminated with fetal or maternal blood in concentrations covering a range exceeding that usually found in clinical practice. Amniotic fluid samples contaminated with maternal blood gave negative gel‐AChE results at all concentrations. Contamination with fetal blood yielded positive results if the erythrocyte concentration was greater than about 60 × 106 cells/ml. Thus contamination of amniotic fluid with blood is only likely to cause false positive gel‐AChE results if this critical concentration is exceeded. Such samples will occur only rarely in clinical practice but when they do the diagnosis should be made with caution.