bluuebunny/crossref_metadata_2025 huggingface dataset:
EPIDURAL ANALGESIA, FETAL MONITORING AND THE CONDITION OF THE BABY AT BIRTH WITH BREECH PRESENTATION
Authors: Donnai P. , Nicholas A. D. G.
Published: August 2005

Between December 1970 and March 1973, 138 patients with a singleton fetus presenting by the breech after 36 weeks of pregnancy were deemed suitable for vaginal delivery under epidural analgesia; 130 were delivered vaginally, 10 of them by breech extraction. There was one stillbirth and no neonatal deaths. Epidural analgesia for vaginal breech delivery seemed beneficial. In 65 cases it was possible to compare the umbilical vein pH with the Apgar score at one minute. In 35 patients a continuous recording of the fetal heart rate was used to predict the Apgar score at one minute and the results are discussed.
THE EFFECT OF PREGNANCY ON THE RENAL HANDLING OF GLUCOSE
Authors: Davison J. M. , Hytten F. E.
Published: August 2005

Tubular reabsorption of glucose has been measured during glucose infusion in 29 healthy women during and after pregnancy. All the women had normal glucose tolerance to an oral load, and normal glucose excretion when not pregnant, but exhibited a wide range of daily glucose excretion in pregnancy. Throughout pregnancy the renal reabsorption of glucose is less effective than in the non‐pregnant state and, in general, the greater the amount of glycosuria which develops in pregnancy, the less effective is the reabsorption during infusion. Post partum, women with minor degrees of glycosuria during the preceding pregnancy return to a normal highly efficient reabsorption performance during infusion, but women who exhibit greater degrees of glycosuria have a reduced capacity to reabsorb even though they are no longer glycosuric after the pregnancy. It is concluded that pregnancy imposes some specific change in the glucose reabsorptive capacity of the proximal tubule and that women with more than usual degrees of glycosuria in pregnancy may, in addition, have an element of tubular damage. This is discussed in relation to other renal function changes in pregnancy in an attempt to explain the characteristic intermittency of clinical glycosuria in pregnancy.
FETAL DEATH IN ECLAMPSIA: I ITS RELATION TO LOW GESTATIONAL AGE, RETARDED FETAL GROWTH AND LOW BIRTHWEIGHT
Authors: Neutra Raymond
Published: August 2005

Of 173 eclamptics admitted to the only public maternity hospital in Cali, Colombia 44 had stillbirths making a rate of 25.4 per cent. Fetuses delivered before 32 weeks had nearly four times the stillbirth rate of those delivered at term. Those weighing less than 1600 g. had stillbirth rates about six times higher than those weighing above 2500 g. An attempt was made to divide the risk conveyed by low birthweight into two components; that which was due to low gestational age, and that which was due to an abnormally low rate of growth during the gestational time available. Deviation of birthweight below that expected for age (retarded fetal growth, RFG) was used as a measure of the latter component. RFG became more common as gestation progressed and was associated with fetal death only in the latter part of gestation and with marginal statistical significance. After 35 weeks, fetuses at or below two standard deviations from Gruenwald's mean weight for gestational age (Gruenwald, 1966) had a fetal death rate five times higher than those at the mean. The risk of fetal (intrauterine) death conveyed by low gestational age has not been definitively explained. Alternative pathophysiological mechanisms are discussed.
ENDOMETRIOID TUMOURS OF THE OVARY
Authors: Curling O. M. , Hudson C. N.
Published: August 2005

From 291 cases of malignant disease of the ovary in the North East Metropolitan Region of London, 250 have been classified as of epithelial origin. Of these, 44 have been designated as endometrioid carcinoma. The recognition and features of endometrioid ovarian carcinoma are discussed.
THE UTERINE AND CARDIOVASCULAR EFFECTS OF SALBUTAMOL AND PRACTOLOL DURING LABOUR
Authors: McDevitt D. G. , Wallace R. J. , Roberts A. , Whitfield C. R.
Published: August 2005

Intravenous salbutamol, a β‐adrenoceptor stimulant, given to nine patients in normal labour, with continuous monitoring of uterine activity and of the maternal and fetal cardiovascular systems, was shown to decrease uterine activity significantly; maternal and fetal heart rates were significantly increased, and maternal systolic and diastolic arterial pressures were significantly decreased during the infusion, although no treatment had to be discontinued because of these effects. Apart from worsening of low back pain during the infusion in one patient, subjective sideeffects were trivial. With the salbutamol infusion continued at an effective maintenance rate, the cardioselective β‐adrenoceptor blocking drug, practolol, given intravenously, reduced the maternal heart rate (although not significantly) but it did not alter the fetal heart rate; it also appeared to interfere transiently with the inhibiting action of salbutamol on uterine activity, but cervical dilatation was arrested until the salbutamol infusion was discontinued. At least in five patients, labour remained suppressed until oxytocin was infused intravenously.
THE EFFECTS ON PLATELET AGGREGATION OF ORAL PROSTAGLANDIN E2 USED FOR THE INDUCTION OF LABOUR
Authors: Myatt L. , Elder M. G.
Published: August 2005

Secondary ADP induced platelet aggregation was inhibited in 17 patients after the administration of oral prostaglandin E2 tablets for the induction of labour. Primary ADP induced aggregation was shown to be inhibited by oral prostaglandin E2when the platelets responded to the lower concentration of 0.5 μg/ml of ADP.This inhibition was not detectable when the higher concentration of 1 0 μg/ml ADP was necessary. There would appear to be a decreased risk of thrombosis initiated by platelet aggregation as a result of using oral PGE2 tablets for inducing labour.
THE RELATION BETWEEN MATERNAL AND CORD SERUM IRON LEVELS AND ITS EFFECT ON FETAL GROWTH IN IRON DEFIClENT MOTHERS WITHOUT MALARIAL INFECTION
Authors: Nhonoli A. M. , Kihama F. E. , Ramji B. D.
Published: August 2005

In this relatively iron deficient population both multiparous and primiparous pregnant women had similar serum iron levels. The mothers' levels had a linear correlation with the cord serum levels, but the lowest mean cord levels were above 100 μg./dl. Maternal and cord blood haemoglobin levels, birthweights and placental weights showed no constant relation to the serum iron levels, and even in anaemic mothers the fetus was relatively non‐anaemic with a haemoglobin level around 13 g./dl. In non‐anaemic mothers the cord blood haemoglobin rose rapidly and progressively.
CARBOHYDRATE‐INDUCED LIPOGENESIS IN THE HUMANPLACENTA OF NORMAL AND DIABETIC PREGNANCIES
Authors: Coltart T. M. , Bateman Cynthia
Published: August 2005

Usingin vitroincubation, human placental slices have been shown to synthesize lipid from14C fructose, but to a lesser extent than from14C glucose. Diabetic placentae did not incorporate more of either sugar into lipid than did placentae from normal pregnancies; nor did insulin in the incubation medium enhance lipogenesis. There was a correlation between the extent of incorporation of 14C fructose and14C glucose into triglyceride, suggesting a linked enzyme system for phosphorylation of the two hexoses.
EFFECT OF PROTEIN HORMONES AND STEROIDS ON TISSUE CULTURES OF ENDOMETRIAL CARCINOMA
Authors: Hustin Jean
Published: August 2005

Neoplastic tissue was obtained from 30 patients with endometrial carcinoma and the response of this tissue to various hormones was studied in vitro by histological methods and by measuring the incorporation of 3H thymidine into DNA. Progesterone and synthetic progestogens had a consistently adverse effect on tissue survival in vitro while pregnenolone had a beneficial effect.
THE CYTOLOGICAL DIFFERENCE BETWEEN AMNIOTIC FLUIDS OF MALE AND FEMALE FETUSES
Authors: Hudson Elizabeth A.
Published: August 2005

Counts of cyanophilic squamous cells in 48 specimens of amniotic fluid obtained during the last three months of pregnancy gave the correct diagnosis of the sex of the fetus in every case. It is confirmed that the fetal genital tract is the source of a considerable exfoliation of cyanophilic squamous cells. Counts of total cells per mm3 on 38 specimens showed that amniotic fluid from female fetuses contains on average significantly more cells than amniotic fluid from male fetuses at any one week of gestation. The cytological sex difference should be taken into consideration in the interpretation of differential cell count estimations of fetal maturity.
THE KARYOPYKNOTIC INDEX OF AMNIOTIC FLUID CELLS AND ITS RELATIONSHIP TO OESTROGEN CONCENTRATION
Authors: Hudson Elizabeth A.
Published: August 2005

Estimations of karyopyknotic index and amniotic fluid oestrogen concentration were made on 107 specimens of amniotic fluid obtained between the 25th and 42nd weeks of pregnancy. The karyopyknotic index was shown to fall with advancing gestation as the amniotic fluid oestrogen concentration increased. The negative correlation between karyopyknotic index and amniotic fluid oestrogen concentration was highly significant when the fetus was female but was not significant when the fetus was male. Intermediate cells from the genital tract of the female fetus can account for the cytological difference between amniotic fluid from male and female fetuses. The fall in amniotic fluid karyopyknotic index when the fetus is female is comparable with the fall in maternal vaginal karyopyknotic index towards term which suggests that the fetal vagina responds in the same way as the maternal vaginal epithelium to the circulating hormones and not to the oeslrogens in the amniotic fluid.
PLASMA CONCENTRATION OF GONADOTROPHINS, OESTROGEN AND PROGESTERONE IN THYROTOXIC WOMEN
Authors: Akande E. O. , Hockaday T. D. R.
Published: August 2005

Plasma levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), oestrogen and progesterone were measured daily in 15 thyrotoxic women in the reproductive age for 28 to 30 consecutive days before commencement of therapy and for a similar period following restoration of the euthyroid state. Five of these patients had secondary amenorrhoea whilst the other 10 had hypomenorrhoea. Twelve healthy volunteer euthyroid women of similar age and parity, with no history of menstrual abnormality, served as controls. The levels of both gonadotrophins (LH and FSH) and oestrogen were found to be significantly raised in all thyrotoxic patients in comparison with levels in the euthyroid female controls (P<0.001). “Mid‐cycle” LH and FSH peaks were present in thyrotoxic patients who were still menstruating whilst they were absent in those who had developed amenorrhoea. Plasma oestrogen concentration rose to a peak on the day before the surge of LH (and FSH) in all euthyroid female controls as well as in thyrotoxic patients who were still menstruating. In contrast, oestrogen peaks occurred without ensuing LH (and FSH) peaks in thyrotoxic patients who had developed amenorrhoea, suggesting a failure of the positive feed‐back mechanism. The levels and patterns of plasma progesterone in thyrotoxic subjects who were still menstruating were similar to those of euthyroid controls. However, no significant circulating plasma progesterone was detected in thyrotoxic subjects who were amenorrhoeic. The levels and patterns of all these hormones (gonadotrophins, oestrogen and progesterone) became normal after restoration of euthyroid state and normal menstruation.
PLASMA CONCENTRATION OF GONADOTROPHINS, OESTROGEN AND PROGESTERONE IN HYPOTHYROID WOMEN
Authors: Akande E. O.
Published: August 2005

In an effort to determine the influence of hypothyroidism on the hypothalamo‐pituitary‐ovarian axis plasma levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), oestrogen and progesterone were measured daily for 10 to 14 consecutive days in five women with hypothyroidism. In all subjects investigated the levels of all the hormones measured were low in comparison with the values in euthyroid women. FSH/LH ratios were, however, higher in hypothyroid women than in both phases of the menstrual cycle in euthyroid controls. It is postulated that changes in the FSH/LH ratio may be related to the low levels of oestrogen and probably to failure of ovulation in hypothyroid women.
ROLE OF SEX‐HORMONE‐BINDING GLOBULIN IN HORMONAL CHANGES AND AMENORRHOEA IN THYROTOXIC WOMEN
Authors: Akande E. O. , Anderson D. C.
Published: August 2005

Plasma levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), oestrogen, testosterone and sex‐hormone‐binding globulin (SHBG) were determined in 15 thyrotoxic women in the reproductive age before and after treatment with carbimazole. The levels of these hormones and SHBG were compared with those of 12 euthyroid healthy female volunteers of comparable age and parity. Plasma gonadotrophins (LH and FSH), oestrogen, testosterone and SHBG were all markedly elevated in thyrotoxic subjects but became normal when the euthyroid state and normal menstruation were restored after treatment. From the results a hypothesis is suggested which relates the hormonal disturbance primarily to a thyroid hormone‐induced rise in SHBG levels.
CORD PLASMA GLUCOSE AND INSULIN CONCENTRATIONS AND MATERNAL‐FETAL RELATIONS
Authors: Lind T. , Gilmore Elizabeth A. , McClarence Maureen
Published: August 2005

The concentration of glucose and insulin was estimated in 854 samples of umbilical cord blood plasma and 503 concurrently collected maternal blood samples. The mean cord insulin concentration, excluding all infants born to known diabetic mothers, was 7 μU./ml., but the distribution was skewed with 10 per cent of infants having a value of 12 μU./ml. or more. The giving of intravenous sugar‐coating fluids to the mother during labour tended to exaggerate the skewness rather than move the whole distribution to the right. Babies born by the vaginal route, whatever the presentation or method of delivery, had slightly lower mean insulin values than those born by Caesarean section. It thus seems unlikely that “stress” is a factor causing high cord insulin values at birth. Other data concerning maternal‐fetal glucose and insulin relations are discussed.
SERUM CALCIUM, PHOSPHORUS AND MAGNESIUM LEVELS IN PREGNANT AND NON‐PREGNANT NIGERIANS
Authors: Olatunbosun D. A. , Adeniyi F. A. , Adadevoh B. K.
Published: August 2005

Serum calcium, inorganic phosphorus and magnesium were determined in 282 Nigerian women comprising 213 pregnant women, 37 non‐pregnant controls, and 32 postpartum women. There was very little change in the serum calcium levels throughout pregnancy; the slight reduction which occurred during the 8th and 9th months was not statistically significant. There was a significant reduction in the serum concentrations of inorganic phosphorus and magnesium during the 8th and 9th months of gestation; the levels of both minerals rose to non‐pregnant levels at term.
THE EFFECT OF A LOW CALORIE DIET OR A THIAZIDE DIURETIC ON THE INCIDENCE OF PRE‐ECLAMPSIA AND ON BIRTH WEIGHT
Authors: Campbell Doris M. , Macgillivray Tan
Published: August 2005

A 1200 calorie diet or cyclopenthiazide with potassium was given to two groups of 51 high weight gain primigravidae and baby weight and the incidence of pre‐eclampsia were compared with those in a matched control group. There was no difference in the development of pre‐eclampsia, but the weight of babies in the control group was higher than in the treated groups. The body fat was reduced in the diet group and the total body water in the diuretic group.
FETAL AXILLARY LYMPHANGIOMA COMPLICATING BREECH DELIVERY
Authors: Burke M. F. , Curry Elizabeth M. , King J. M.
Published: August 2005

A case of massive lymphangioma arising from the axilla and complicating a breech delivery is described. From research of the literature it is believed that this is the only such case recorded.
THE ANALYSIS OF CONTINUOUS FETAL HEART RATE TRACES IN THE FIRST AND SECOND STAGES OF LABOUR
Authors: Thomas Gareth , Blackwell R. J.
Published: August 2005

In the search for a simplified method of fetal heart rate trace assessment 50 traces recorded during the first stage of labour and those recorded in the last hour of each of a further 50 labours have been analysed intensively. The importance of baseline variability in predicting possible fetal distress in both the first stage and the last hour of labour is shown and the possible use of an objective measurement of baseline variability in the further screening for fetal acidosis is described. The importance of lag time measurement in the first stage of labour is demonstrated and the relationships between fetal scalp blood pH and other heart rate parameters is discussed Significant inverse correlations between one‐minute Apgar score and maximum amplitude of deceleration and total deceleration area in the last hour of labour are also shown. Temporal relationships between intrauterine pressure rises and transient changes of fetal heart rate failed to give significant correlations in the last hour. These findings in the last hour of labour are compared with those obtained in the first stage of labour and the differences are discussed.
USE OF PROPRANOLOL IN DYSFUNCTIONAL LABOUR
Authors: Mitrani A. , Oettinger M. , Abinader E. G. , Sharf M. , Klein A.
Published: August 2005

Labour pains associated with fear and anxiety increase the blood level of catecholamines. This in turn causes dysfunctional labour due to the weak uterine contractions which follow stimulation of uterine adrenergic beta receptors. Intravenous propranolol was administered to ten primigravidae with typical dysfunctional labour. This was shortly followed by normal uterine activity and delivery without any significant maternal or fetal complications. To the best of our knowledge this is the first attempt to treat dysfunctional labour by the intravenous administration of a beta‐blocking agent, and our preliminary results are encouraging.
THE BENEFITS AND RISKS OF AMNIOCENTESIS FOR THE ASSESSMENT OF FETAL LUNG MATURITY
Authors: Rome R. M. , Glover Jenifer I. , Simmons S. C.
Published: August 2005

Amniocentesis for estimation of the lecithin: sphingomyelin (L/S) ratio was performed on 483 patients on 552 occasions. The introduction of this test has been associated with a highly significant (p < 0.001) decrease of 59 per cent in the incidence of respiratory distress syndrome. The finding of a low L/S ratio (< 2.0) enabled delivery to be deferred until lung maturity had been reached in 43 (10.3 per cent) of the 419 patients who had successful amniocentesis. Fetal death occurred after amniocentesis in two patients (0.41 per cent). One fetus died after haemorrhage occurred behind an anterior placenta and the other died of exsanguination. Failed amniocentesis occurred in 64 patients (13.2 per cent), and was more common when the placenta was anterior or was not located before the procedure and when fetal growth was retarded. Fetal distress in labour occurred more commonly after failed amniocentesis. Spontaneous labour followed amniocentesis in 47 patients (9.7 per cent) and was significantly more prone to occur after 38 weeks gestation. Rhesus isoimmunization did not occur in any of the rhesus‐negative patients who delivered rhesus‐positive babies and who were screened six or more months after amniocentesis, although anti‐D immunoglobulin was not given routinely after amniocentesis. Suggestions are made as to how the success rate of this valuable procedure can be improved and how some of the serious fetal and maternal sequelae can be avoided.
UTERINE ACTION AFTER INDUCTION OF LABOUR WITH ORAL PROSTAGLANDIN E2 TABLETS COMPARED WITH INTRAVENOUS OXYTOCIN
Authors: Elder M. G.
Published: August 2005

Uterine action throughout the whole of labour induced by low amniotomy and either oral prostaglandin E2 tablets or intravenous oxytocin was studied in 10 randomly matched pairs of patients. Oral prostaglandin E2 tablets induced fewer contractions per hour, and these contractions were longer and more variable in length than those induced by intravenous oxytocin. There was no difference in basal uterine tone or in the amplitude of contractions. A comparison was made between the outcome of labour induced by low amniotomy and either oral prostaglandin E2 tablets 0.5 mg. hourly in 65 patients, or intravenous oxytocin in 41 patients. This dose of prostaglandin E2 tablets was an inadequate adjunct to low amniotomy in nulliparous patients. Despite this, the induction‐delivery interval for the whole prostaglandin group was not significantly greater than that for the oxytocin group. There were no significant differences in fetal heart rate pattern, or in the incidence of gastro‐intestinal side‐effects between the two groups.
A CRITICAL EVALUATION OF SONAR “CROWN‐RUMP LENGTH” MEASUREMENTS
Authors: Robinson H. P. , Fleming J. E. E.
Published: August 2005

In a study to evaluate the reproducibility and accuracy of the sonar technique of measurement of the in vivo fetal crown‐rump length (Robinson, 1973), a series of in vivo and in vitro experiments was performed in which the random and systematic errors inherent in the technique were assessed. The potential sources of random error were those of operator judgement, movement of the fetus and mother, machine sensitivity settings and measurement from the photograph; while the sources of systematic error were those of oscilloscope scale factor, and velocity calibration inaccuracies, and the effect of beam width. The overall effect of the random errors, that is, the reproducibility of the technique, was assessed in an in vivo blind trial in which three independent measurements were made of the fetus. In a series of 30 experiments the average standard deviation of the three readings was found to be 1.2 mm. Evaluation of the systematic errors by in vivo experimentation, on the other hand, showed that the basic sonar measurements were in error by an overestimate of 1 mm for the beam width effect and 3.7 per cent for the scale factor and velocity calibration errors. A weighted non‐linear regression analysis of 334 measurements was performed in order to obtain a “curve of best fit” for the period covering 6 to 14 weeks of menstrual age. The values obtained were corrected for the systematic errors and compared with widely quoted anatomical figures. In the second part of this investigation the original data was further analyzed to determine on a statistical basis the accuracy of the technique as a method of estimating maturity. It was shown that such an estimate could be made to within 4.7 days with a 95 per cent probability on the basis of a single measurement, and to within 2.7 days if three independent measurements were made.
A SEMI‐AUTOMATED SERUM ALPHAFETOPROTEIN RADIOIMMUNOASSAY FOR PRENATAL SPINA BIFIDA SCREENING
Authors: Vince J. D. , Mcmanus T. J. , Ferguson‐Smith M. A. , Ratcliffe J. G.
Published: August 2005

A simple, reliable, semi‐automated and inexpensive radioimmunoassay for serum alphafetoprotein (AFP) is described which fulfils the requirements for a screening test for open neural tube defects. The normal range for serum AFP throughout pregnancy has been determined in 1534 samples. In a retrospective study of 15 samples of maternal serum taken from nine pregnant women carrying a fetus affected with a neural tube defect, the serum AFP level was found to be above the 95th centile in four of the five cases of open defect sampled between 15 and 20 weeks gestation. Preliminary results of a prospective study are reported in which two cases of enencephaly were detected among 671 unselected pregnancies sampled between 15 and 20 weeks gestation.
THE MANAGEMENT OF ANTICOAGULANT THERAPY DURING AND AFTER PREGNANCY
Authors: Pridmore B. R. , Murray K. H. , Mcallen P. M.
Published: August 2005

Fifteen patients were treated with oral anticoagulants during pregnancy. At 37 weeks they were changed to heparin and were given 5 mg of Vitamin K1 by intravenous injection. Labour was induced seven to ten days later. All infants were normal and healthy and in the 12 tested the cord prothrombin times were within the normal range.
EFFECT OF BROMOCRIPTINE AND CHLOROTRIANISENE ON TNHIBITION OF LACTATION AND SERUM PROLACTIN A COMPARATIVE DOUBLE‐BLIND STUDY
Authors: Utian W. H. , Begg G. , Vinik A. I. , Paul M. , Shuman L.
Published: August 2005

A double‐blind study to compare the effect of 2‐Br‐alpha‐ergocryptine (bronio‐criptine, CB 154, Sandoz) an ergot alkaloid with chlorotrianisene (Tace, Mer‐National) on the inhibition of postpartum lactation was carried out in 38 women. At the dosages selected bromocriptine was more effective than chlorotrianisene in inhibiting lactation. Furthermore, bromocriptine significantly reduced serum prolactin levels to low normal values by the seventh day of treatment, whereas chlorotrianisene did not alter the normal progressive reduction in prolactin postpartum. Neither drug had significant toxic effects.
“GESTATION SAC” VOLUMES AS DETERMINED BY SONAR IN THE FIRST TRIMESTER OF PREGNANCY
Authors: Robinson Hugh P.
Published: August 2005

Sonar estimates of “gestation sac” volumes in the first trimester of pregnancy were made from a series of 319 measurements; the volumes estimated included the amniotic fluid, the extraembryonic coelom and the fetus. The technique employed involved the use of parallel section scans taken in series from one end of the gestation sac to the other, followed by planimetric measurements of the sac areas so produced. The potential errors which may be incurred in these measurements are discussed, and it is considered that the technique carries an overall possible error in the order of ±10 per cent. Growth curves produced from the measurements in this series show that the sac increases in volume from a mean of 1 ml. at 6 weeks to a mean of 100 ml. at 13 weeks, initially in an exponential fashion but latterly in a more linear manner. The mean values of the sonar gestation sac fluid volumes (after subtraction of the estimated fetal volume) in the 10 to 13 week range, show good correlation with those amniotic fluid values reported in the literature where direct measurements were made at the time of hysterotomy. As a method of assessing the maturity of a pregnancy this technique is of lesser value than the sonar measurement of fetal crown‐rump length because of the relatively wider scatter of results. It has, however, found a useful place in clinical practice in the early sonar diagnosis of blighted ova or anembryonic pregnancies.
THE DIAGNOSIS OF FETAL HYDRONEPHROSIS, MEGAURETER AND URETHRAL OBSTRUCTION BY ULTRASONIC ECHOGRAPHY
Authors: Garrett Williams J. , Kossoff George , Osborn Robertt A.
Published: August 2005

Two cases of fetal urethral obstruction, one with megaureter and obvious hydro‐nephrosis, were diagnosed by two‐dimensional ultrasonic echography. With good quality echograms it should be possible to make the diagnosis early in pregnancy.
THE AETIOLOGY, CHARACTERISTICS AND DIAGNOSTIC OBSTETRIC RELEVANCE OF LATE DECELERATION PATTERNS IN ROUTINE PRACTICE
Authors: Thomas Gareth
Published: August 2005

A retrospective study is described in which all the late deceleration patterns seen in one obstetric unit over the course of 34 months have been reviewed with regard to their apparent aetiology, their characteristics and associated abnormal fetal heart rate patterns and the incidence of fetal distress. The results show that, regardless of the aetiology and the characteristics, the incidence of fetal distress (defined as a pH of less than 7.25 or an Apgar score of less than 7 at one minute) lies between 40 and 50 per cent. The implications of this degree of diagnostic inaccuracy are discussed and the importance of fetal blood sampling as the final arbiter in the diagnosis is emphasized. During the course of the study a significant relationship was demonstrated between the use of epidural analgesia and the incidence of late deceleration patterns. This finding is discussed.
THE RENAL CLEARANCE OF OESTRIOL IN LATE HUMAN PREGNANCY
Authors: Swapp Garden H. , Masson Gorden M. , Klopper Arnold I.
Published: August 2005

The renal clearance of unconjugated oestriol, oestriol glucosiduronate and oestriol sulphate by the kidney in late human pregnancy has been compared with simultaneous measurements of inulin clearance. The results for the fractions not bound to protein indicate that after glomerular filtration, unconjugated oestriol is completely reabsorbed, oestriol glucosiduronate is both filtered and excreted actively by the tubules, and that oestriol sulphate is filtered but not excreted or absorbed by the tubules; the administration of probenecid confirms these observations on tubular handling. The possibility of using endogenous oestriol sulphate as a means of measuring the glomerular filtration rate in pregnancy is suggested.
ASSESSMENT OF THYROID FUNCTION DURING PREGNANCY
Authors: Chan Vivian , Paraskevaides C. A. , Hale J. F.
Published: August 2005

Serum levels of thyroid stimulating hormone and of the two thyroid hormones were compared in pregnant women and in non‐pregnant control subjects. Circulating levels of thyroid stimulating hormone did not alter significantly throughout pregnancy. Total thyroxine and triiodothyronine concentrations increased markedly during the first and second trimesters, associated with a progressive increase in the thyroid binding capacity of serum proteins. Urinary triiodothyronine and thyroxine excretion during the third trimester of pregnancy was comparable to that found in non‐pregnant euthyroid females and, it is concluded, provides the simplest method of assessing thyroid function during pregnancy.
MORPHOLOGICAL CHANGES IN MATERNAL LYMPHOCYTES IN PREGNANCY
Authors: Knobloch Viktor , Jouja Vladimir , Svobodová Marie
Published: August 2005

By use of staining with toluidine blue, the changes in the nucleoli of lymphocytes in 150 healthy women were studied. The patients were divided into five groups: non‐pregnant women; women in the first, second and third trimesters of pregnancy; and women who were five days post parturn. A progressive and statistically significant rise in the number of lymphocytes with micronucleoli was found during pregnancy and there was a fall after delivery. This increase was associated with a decrease in the incidence of ring‐shaped nucleoli. There were no significant changes in the absolute number of lymphocytes and in “active” lymphocytes during pregnancy.
MATERNAL CARDIOMYOPATHY OF PREGNANCY CAUSING STILLBIRTH
Authors: Rand R. J. , Jenkins D. M. , Scott D. G.
Published: August 2005

Cardiomyopathy of pregnancy developed in a healthy primigravida at 34 weeks gestation and was followed two weeks later by the spontaneous delivery of a fresh stillbirth. An immunological basis underlying both the mother's condition and the fetal death was suggested by the presence of myocardial antibodies in maternal and cord blood. Reference is made to two other cases in which a similar pathological process may have occurred.
THE FUNCTION OF THE ANTERIOR PITUITARY‐ADRENAL CORTEX AXIS IN HYPEREMESIS GRAVIDARUM
Authors: Kauppila A. , Ylikorkala O. , Järvinen P. A. , Haapalahti J.
Published: August 2005

In order to study the function of the pituitary‐adrenal axis, serum ACTH and cortisol levels were estimated before and after insulin induced hypoglycaemia in nine women with hyperemesis gravidarum, seven women in normal early pregnancy and in eight non‐pregnant controls. Before hypoglycaemia, the basal ACTH level in the hyperemesis group (102.4±62.9 pg/ml) was higher than in normal early pregnancy (67.5±19.2 pg/ml; p<0.05) or in non‐pregnant controls (54.8±25.2 pg/ml; p<0.01). Correspondingly, the mean cortisol value in hyperemesis (0.47±0.16 μmol/1) was higher than in normal early pregnancy (0.39±0.10 μmol/1; p>0.05) or in non‐pregnant controls (0.32±0.13 μmol/1; p<0.01). After insulin the elevation of ACTH (p>0.05) and cortisol (p<0.01) was observed in every group. The level of ACTH and cortisol was highest in hyperemesis group. Our results do not support the idea that hypofunction of the pituitary‐adrenal axis contributes to the aetiology or pathogenesis of hyperemesis gravidarum. The high ACTH level might be evidence of the psychic instability of hyperemesis gravidarum patients.
MATERNAL PLASMA ALPHA‐FETOPROTEIN IN NORMAL AND COMPLICATED PREGNANCIES
Authors: Rodeck C. H. , Campbell S. , Biswas S.
Published: August 2005

Plasma alpha‐fetoprotein (AFP) has been estimated by radioimmunoassay in healthy non‐pregnant adults, some of whom were taking oral contraceptives, and in women with normal and complicated pregnancies. A curve with the 90 per cent range in normal pregnancy was established. The proportion of values below the 5th centile in complicated pregnancies was significantly greater than in uncomplicated pregnancies. However, three‐quarters of the estimations in the complicated groups lay within the 90 per cent range. No correlation was found between maternal plasma AFP values and the incidence of fetal distress, small‐for‐dates babies or perinatal mortality. It is concluded that the measurement of maternal plasma AFP is not a reliable test for predicting fetal well‐being.
EXTRADURAL ANALGESIA IN LABOUR WHEN THE BREECH PRESENTS
Authors: Darby S. , Thornton C. A. , Hunter D. J.
Published: August 2005

A retrospective study was made of the course and outcome of labour in 226 patients in whom a singleton fetus presented by the breech. Patients with macerated stillbirths or who were delivered before the 28th week of gestation had been excluded. Of the 226 patients, 101 received extradural analgesia, 79 received parenteral analgesia and 46 underwent elective Caesarean section. There was no difference in the incidence of breech extraction or emergency Caesarean section in the first two groups of patients. The length of both first and second stages of labour in multiparae was prolonged in the extradural group, but not markedly so. The Apgar scores of the infants delivered vaginally were not significantly different at one minute in both groups but the five minute Apgar score in the infants of primiparae was significantly higher in the extradural group. The Apgar score at one minute in the group delivered by emergency Caesarean section was significantly lower after extradural block but the difference was not significant at five minutes. This study suggests that the management and outcome of labour when the breech presents is not adversely affected by the provision of extradural analgesia.
THE EFFECT OF PARTURITION ON AMNIOTIC FLUID LECITHIN CONCENTRATION
Authors: Craven D. J. , Khattab T. Y. , Symonds E. M.
Published: August 2005

Amniotic fluid lecithin has been measured during the antenatal period and at comparable periods of gestation at the onset of spontaneous labour. Lecithin values were higher in labour, the difference being statistically significant in two of the three groups studied. Lecithin values were also measured serially during induced labour in 14 normal women at term. A significant fall was observed throughout labour. Creatinine levels were measured in the amniotic fluid in five of these patients and showed no significant change.
LAPAROSCOPIC STERILIZATION WITH AN ELASTICATED SILICONS RING
Authors: Lee W. K. , Baggish M. S.
Published: August 2005

A method of laparoscopic sterilization using an elasticated silicons ring is described. It was used in 155 patients over a period of 13 months by 12 gynaecologists. There were 12 complications specifically related to the method and only one of them required laparotomy. One tubal patency was discovered, but no pregnancy occurred in a total follow‐up period of 81.25 yeais. Many patients had pain in the first 24 hours after operation but only 3 per cent had pain after three months.
A NEW METHOD FOR ASSESSMENT OF FETAL LUNG MATURITY
Authors: Shinitzky M. , Goldfisher A. , Bruck A. , Goldman B. , Stern E. , Barkai G. , Mashiach S. , Serr D. M.
Published: August 2005

A new method for evaluation of fetal lung maturity in utero is described. The method is based on the fluorescence polarization (P) of the lipids in the amniotic fluid after labelling with a special dye. Tests performed with 49 amniotic fluid samples drawn from 33 pregnancies clearly demonstrated a decrease in P during gestation which correlated with the increase in the lecithin/sphingomyelin ratio (L/S) in the fluid. During gestation the P value at 24°C decreased steadily from about 0.4 to 0.2 and the value of P (24°C)= 0.310 has been tentatively chosen as the threshold above which respiratory distress syndrome may develop. The described method, which requires a specially designed instrument, offers a series of important advantages over the presently available methods. It is simple, rapid, highly accurate and reproducible, and independent of amniotic fluid volume. The P value reflects the microviscosity in the whole lipid assembly of amniotic fluid and is not confined specifically to lecithin.
ACTH LEVELS IN AMNIOTIC FLUID DURING PREGNANCY
Authors: Tuimala R. , Kauppila A. , Haapalahti J.
Published: August 2005

The fetal pituitary‐adrenal axis plays an important role in the regulation of fetal development. In order to obtain information about fetal ACTH secretion at different gestational ages, a total of 109 amniotic fluid ACTH determinations was performed by ra.dioimmunoassay. There was a significantly higher level of ACTH during 26 to 30 weeks of pregnancy (429 ±180–4 pg/ml) than in early (208–7±90–6 pg/ml) and in late (172–7±97–4 pg/ml) pregnancy; fetal sex, uterine contractions and maternal complications in pregnancy did not affect levels. The ACTH level in the first urine of six newborn infants (160‐Oib40‐6 pg/ml) approximated to that in the amniotic fluid in late pregnancy. Our results support the assumption of a fetal origin for ACTH in amniotic fluid. The high secretion of ACTH at the beginning of the last trimester of pregnancy may stimulate the development of the adrenal cortex and result in the increased cortisol secretion necessary for fetal lung maturation.
CARCINOMA OF THE CERVICAL STUMP
Authors: Oats J. J. N.
Published: August 2005

A study was made of 56 patients with carcinoma of the cervical stump after subtotal hysterectomy who were seen between 1946 and 1972 at the National Women's Hospital, Auckland, New Zealand. The duration of symptoms before diagnosis, stage distribution and five‐year survival rates were examined and compared with those in 1459 patients with carcinoma of the cervix, and no previous subtotal hysterectomy, who presented over the same period.
EVALUATION OF DIFFERENT APPROACHES TO OBSTETRIC CARE: PART II
Authors: Chalmers Iain , Lawson J. G. , Turnbull A. C.
Published: August 2005

The obstetric management and outcome of normal patients presenting to two obstetric teams working in the Cardiff Maternity Hospital are compared over a five‐year period. One team induced labour with amniotomy and oxytocin infusion three times more frequently than the other. No advantage or disadvantage of this practice was demonstrated using various measures of perinatal morbidity and mortality. The implications of these findings are discussed together with those of two previously reported observational studies. The need for experimental research in perinatal medicine is stressed.
SEQUENTIAL STUDIES ON COMPONENTS OF THE HAEMOSTATIC MECHANISM IN PREGNANCY WITH PARTICULAR REFERENCE TO THE DEVELOPMENT OF PRE‐ECLAMPSIA
Authors: Condie R. G. , Ogston D.
Published: August 2005

Components of the haemostatic mechanism were studied at intervals in 60 primigravidae over the course of pregnancy and the puerperium; 12 of these developed pre‐eclampsia. During pregnancy there was a fall in fibrinolytic activity and fibrinolytic capacity and a rise in fibrinogen, FR‐antigen, α1‐antitrypsin and α2‐macroglobulin. The women who subsequently developed pre‐eclampsia could not be identified on the basis of these measurements. Following delivery there was a more rapid return of fibrinolytic activity and capacity towards normal in the women who had not had pre‐eclampsia. The urinary FR‐antigen level was higher in the women with pre‐eclampsia.
THE USE OF A COMPUTER IN AN OBSTETRIC DEPARTMENT
Authors: Tuck Christine S. , Cundy A. , Wagman H. , Usherwood M. McD. , Thomas M.
Published: August 2005

Experience with a computer in an obstetric department is presented. A regular statistical analysis of the work of the department was readily available and computer printed summaries were produced for 86 per cent of the patients within one week of their discharge home. Solutions to problems encountered are discussed. It is concluded that a computer can be used economically and advantageously in this way even in hospitals without a computer on site. Future developments in the use of the computer are outlined.
CARBOHYDRATE METABOLISM IN PRE‐ECLAMPSIA
Authors: Singh M. M.
Published: August 2005

Intravenous glucose tolerance tests were performed on 30 primigravidae with pre‐eclampsia and 15 normal primigravidae in late pregnancy. The groups were matched for age, height and weight and had no stigmata of potential diabetes. Plasma glucose, plasma immunoreactive insulin and plasma placental lactogen (HPL) levels were measured before (fasting) and at timed intervals after the glucose challenge; the glucose response was expressed as the increment index. The patients with severe pre‐eclampsia had significantly lower fasting plasma glucose levels than those with mild pre‐eclampsia and normal pregnancies. The mean increment index, in both the severe and mild pre‐eclamptic groups was significantly lower than that of the normal pregnant group. Fasting HPL levels were significantly lower in patients with severe pre‐eclampsia than in those who had mild preeclampsia or a normal pregnancy. Both the fasting plasma insulin and insulin response following glucose injection were lower in patients with severe preeclampsia than in those with mild pre‐eclampsia or a normal pregnancy. The differences however were not statistically significant. The results of this study suggest that carbohydrate metabolism in severe pre‐eclampsia is altered to an extent similar to that in patients with chemical gestational diabetes, and this alteration may be due to maternal p‐cell anoxia caused by the vascular changes in pre‐eclampsia.
THE FETAL MEMBRANES AS A POSSIBLE SOURCE OF AMNIOTIC FLUID PROSTAGLANDINS
Authors: Keirse M. J. N. C. , Turnbull A. C.
Published: August 2005

Biosynthesis and metabolism of prostaglandins was studied in human amniotic and chorionic membranes obtained at term. Using specific in vitro methods it was demonstrated that the fetal membranes contain an organization of enzymes regulating both synthesis and degradation of prostaglandins. Differentiation between amnion and chorion showed that virtually all of the biosynthesis and metabolism occurred in the chorion, whereas enzymatic activities in the amnion were negligible or low. The results suggest a high turnover of prostaglandins in the chorion, and its importance as a source of prostaglandins found in amniotic fluid is discussed.
PLACENTAL PATHOLOGY IN MIDTRIMESTER PREGNANCIES INTERRUPTED BY INTRA‐AMNIOTIC INJECTION OF HYPERTONIC UREA
Authors: Segal S. , Ornoy A. , Bercovici B. , Antebi S. O. , Polishuk W. Z.
Published: August 2005

The histological appearances of 52 placentae from patients who had a urea‐induced second trimester abortion were studied. Extensive subchorionic intervillous fibrin deposition and swollen degenerated stromal cells (probably Hofbauer cells), were found both in the placenta and membranes. Between urea injection and abortion, serial vaginal smears showed signs of progesterone deficiency. The urea‐induced placental and fetal damage was similar to that seen with hypertonic saline.
BURKITT'S LYMPHOMA OF THE OVARY IN ASSOCIATION WITH PREGNANCY TWO CASE REPORTS
Authors: Armon P. J.
Published: August 2005

Burkitt's lymphoma of the ovary, occurring in association with pregnancy, is rare, only one case having been previously reported. Two cases are reported here and the possible effect of pregnancy discussed.
COLPOSCOPIC EVALUATION OF PATIENTS WITH ABNORMAL CERVICAL CYTOLOGY
Authors: Benedet J. L. , Boyes D. A. , Nichols T. M. , Millner A.
Published: August 2005

Because of suspicious or abnormal smears, 620 patients were referred to the Colposcopy Clinic of the British Columbia Cancer Institute between 1st March 1973 and 31st December 1974; it was possible to make a colposcopic examination in 549 of these patients (88–5 per cent). The colposcopic impression was within one histological grade of a colposcopically‐directed biopsy in 476 patients (86 per cent). There were 221 patients who had a cone biopsy after a colposcopicallydirected biopsy and in 192 of these (87 per cent) the two biopsies were within one histological grade of each other; but there were two patients with occult invasive carcinoma in a cone biopsy and only carcinoma in situ in a directed biopsy. In the same group of 221 patients the colposcopic evaluation and final diagnosis (the most advanced histological lesion seen in biopsy) agreed in all but seven patients.
THE COMBINED EFFECT OF NONSTEROIDAL ANTI‐OESTROGENS AND SEX STEROIDS ON THE GROWTH OF RAT UTERINE ADENOCARCINOMA CELLS IN TISSUE CULTURE
Authors: Sekiya S. , Takamizawa H.
Published: August 2005

Nonsteroidal anti‐oestrogenic drugs, tamoxifen and clomiphene citrate, at concentrations higher than 0.001 μg/ml reduced the colony forming ability of cells derived from a rat uterine adenocarcinoma in vitro. The 50 per cent inhibitory dose of these drugs was about one‐hundredth of that of sex steroids. When the cells were treated with combinations of these nonsteroidal anti‐oestrogenic drugs and the 50 per cent inhibitory dose (8 μg/ml) of progesterone, a synergistic effect on the inhibition of colony formation was observed. In contrast to progesterone, oestradiol‐17β (the 50 per cent inhibitory dose of which was about 16 μg/ml) suppressed additively the colony formation only in combination with low doses of anti‐oestrogenic drugs.
A STUDY OF THE ELASTICITY AND TENSION OF FETAL MEMBRANES AND OF THE RELATION OF THE AREA OF THE GESTATIONAL SAC TO THE AREA OF THE UTERINE CAVITY
Authors: Parry‐Jones E. , Priya S.
Published: August 2005

The surface area of the uterine cavity before delivery was compared with that ot the gestational sac after delivery and experiments were carred out to test the elasticity of membranes and the tension on them during labour. The results indicated that after 28 weeks of pregnancy the intact fetal membranes were under tension and were not a passive lining to the uterine cavity and that there was a significant decrease in the elasticity of those membranes which ruptured before labour irrespective of the maturity of the pregnancy. The results failed to support the suggestion that there was a deficiency in the area of the gestational sac in those cases where the membranes ruptured before labour.
EXPERIMENTS IN THE MEASUREMENT OF INTRAUTERINE PRESSURE
Authors: Odendaal H. J. , Neves Dos Santos L. M. , Henry M. J. , Crawford J. W.
Published: August 2005

A series of experiments investigating the quality of the signals obtained from intrauterine catheters was conducted in the labour rooms and laboratories. Clear evidence of signal attenuation due to partial blockage of catheters was obtained. Some methods which might help to overcome these problems are described.
INVESTIGATION OF SOME PROBLEMS ASSOCIATED WITH THE CARDIFF INFUSION PUMP
Authors: Neves Dos Santos L. M. , Odendaal H. J. , Crawford J. W. , Henry M. J.
Published: August 2005

Since there is some concern about the use of the Cardiff infusion pump in the automatic mode, experiments were devised to simulate some possible problems. The possibility of misleading information allowing overstimulation to occur was demonstrated. Even when the input signal was accurate there could, at least theoretically, be excessive stimulation. Some suggestions about future design and ways of correcting the problems are discussed.