bluuebunny/crossref_metadata_2025 huggingface dataset:
ALPHA‐FETOPROTEIN LEVELS IN PREGNANCIES COMPLICATEED BY GASTROINTESTINAL ABNORMALITIES OF THE FETUS
Authors: Clarke P. C. , Gordon Y. B. , Kitau M. J. , Chard T. , McNeal A. D.
Published: August 2005

Alpha‐fetoprotein (AFP) levels have been measured in maternal serum and amniotic fluid in a variety of gastrointestinal abnormalities of the fetus. Maternal serum AFP levels were consistently elevated in abdominal wall defects of the fetus after 15 weeks gestation and the amniotic fluid levels were raised in 3 of the 4 patients measured. In atresia of the gastrointestinal tract and diaphragmatic hernia, serum AFP levels were usually normal unless there was an associated neural tube defect or multiple pregnancy, although the majority were not measured between 15 and 26 weeks gestation. If elevated amniotic fluid levels of AFP are used in the decision to terminate pregnancy on the assumption of a probable neural tube defect of the fetus, a proportion of terminations will be performed because of abdominal wall defects of the fetus.
ARTERIAL BLOOD GASES IN PRE‐ECLAMPSIA
Authors: Templeton A. A. , Kelman G. R.
Published: August 2005

Arterial blood gases, physiological dead space and percentage pulmonary venous admixture (physiological shunt) were measured in 31 patients with proteinuric pre‐eclampsia. There was no difference in pulmonary function in 22 patients with moderate pre‐eclampsia when compared with normal pregnancy, but in 9 patients with severe pre‐eclampsia, there was a significant increase in alveolar‐to‐arterial Po2 difference and physiological shunt, indicating a degree of pulmonary ventilation/perfusion imbalance. There was no accompanying hypoxaemia, suggesting that the impairment was of no clinical importance.
EXCRETION UROGRAPHY BEFORE AND AFTER SURGICAL TREATMENT OF PROCIDENTIA
Authors: Jones J. B. , Evison G.
Published: August 2005

Excretion urography in 18 patients with procidentia confirmed the presence of a significant incidence of urinary tract obstruction and its relief following corrective surgery.
TREATMENT OF RECURRENT PREGNANCY HYPERTENSION BY PROPHYLACTIC ANTICOAGULATION
Authors: Valentine B. H. , Baker J. L.
Published: August 2005

A patient is described who had two pregnancies complicated by severe preeclampsia in the second trimester which resulted in intrauterine death. During the third pregnancy anticoagulant therapy with warfarin was instituted at 14 weeks gestation and a healthy female infant was delivered at 38 weeks gestation.
EPIDURAL ANALGESIA DURING LABOUR IN TWIN PREGNANCY
Authors: Jaschevatzky O. E. , Shalit A. , Levy Y. , Günstein S.
Published: August 2005

We report on the use of epidural analgesia during labour in 58 out of a total of 234 twin deliveries performed over a five‐year period. A comparable control group consisted of 44 twin pregnancies delivered consecutively during the year preceding the introduction of epidural analgesia into our department. Epidural analgesia shortened the mean time of labour and made possible the performance of all necessary instrumental and obstetrical manoeuvres, without additional anaesthesia or adverse effects on the second twin. The epidural group required oxytocin more often due to an increased incidence of hypotonic uterine dysfunction. There was also a considerable increase of instrumental deliveries in the epidural group. The condition of the newborn infants of both groups, evaluated by Apgar score at one minute, was similar, but there was a higher perinatal mortality among pre‐term infants delivered under epidural analgesia. Epidural analgesia was found to be an acceptable method of relieving pain in twin labour, but because of the increased necessity to use oxytocin and the relatively high perinatal mortality observed among pre‐term infants, further experience is necessary before it can be claimed that this is the method of choice for relief of pain in twin labour.
CORRELATION BETWEEN THROMBOPLASTIC ACTIVITY AND LECITHIN/SPHINGOMYELIN RATIO IN AMNIOTIC FLUID PRELIMINARY REPORT
Authors: Yaffe H. , Bar‐On H. , Eldor A. , Ron M. , Sadovsky E.
Published: August 2005

The thromboplastic activity of amniotic fluid was correlated with the lecithin sphingomyelin (L/S) ratio in 59 pregnancies. It was shown that the thromboplastic activity and the L/S ratio in amniotic fluid had a coefficient of correlation of r =−0.73 (P<0.004). The thromboplastic activity was estimated by a modified method for prothrombin time, and a time of 113 seconds appeared to correspond to an L/S ratio of 2, in that it was the borderline between maturity and immaturity of the fetal lungs. Thirty women were delivered within 24 hours of a sample of amniotic fluid being obtained. In the three patients whose babies developed the respiratory distress syndrome, the thromboplastic activity was estimated as being slower than 113 seconds.
PREGNANCY FOLLOWING METERGOLINE TREATMENT IN A PATIENT WITH HYPERPROLACTINAEMIA
Authors: Crosignani P. G. , Reschini E. , Peracchi M. , D'Alberton A. , Lombroso G. C.
Published: August 2005

A 33‐year‐old woman who had had amenorrhoea and galactorrhoea for ten years and had hyperprolactinaemia was treated with metergoline, a serotonin antagonist. There was a marked decrease in plasma prolactin levels. After two months, ovulation and pregnancy occurred. This is the first such report.
HOME AND HOSPITAL CONFINEMENT IN NEWCASTLE UPON TYNE, 1960 TO 1969
Authors: Barron S. L. , Thomson A. M. , Philips P. R.
Published: August 2005

During the decade 1960 to 1969, perinatal mortality rates in Newcastle upon Tyne fell in parallel with national trends, in association with a marked reduction of domiciliary midwifery. Analysis of the records of women booked for confinement at home or in specialist hospitals showed that the reduction of mortality occurred with unexpected uniformity in both categories, in low risk as well as high risk patients, and in all causes of mortality except congenital malformations. It could not be attributed to improvements in maternal characteristics nor to increased size of babies at birth. The most probable explanation seems to be a combination of many improvements in the quality of care, with increased awareness of risks, better selection of high‐risk groups, and improved supervision and management throughout. There is no indication that any single factor in obstetric management, such as more intervention during labour, had a dominant effect.
A MULTIFACTORIAL SURVEY OF NEONATAL JAUNDICE
Authors: Jeffares M. J.
Published: August 2005

Concern about a neonatal jaundice rate of 8·6 per cent prompted a retrospective survey of 981 full term infants. There was a highly significant association between increased oxytocin dosage and neonatal jaundice in induced labours. A significant association was also demonstrated between neonatal jaundice and both breastfeeding and minor infections. No association was demonstrated between neonatal jaundice and the method of delivery or birth weight. The results of the survey suggest that while oxytocin in high doses should be used with caution, the benefits obtained from the drug outweigh the risk of hyperbilirubinaemia which it may cause.
INTERCELLULAR SPACES AND CELL JUNCTIONS IN ENDOMETRIAL GLANDS: THEIR POSSIBLE ROLE IN MENSTRUATION
Authors: Davie R. , Hopwood D. , Levison D. A.
Published: August 2005

summary

Intercellular spaces and cell junctions in human endometrial glands were studied by electron microscopy following different methods of fixation. The size of the spaces, known to alter during the cycle, was found to depend also on the method of fixation. Various intrusive cells and different types of cell debris were seen in these spaces. The three most widely recognized cell junctions (desmosomes, tight junctions and gap junctions), were all most abundant near the cell apices. The possible significance of these findings in elucidating the cellular mechanism of menstruation is discussed.
FETAL HEART RATE RESPONSES TO FETAL MOVEMENTS
Authors: Aladjem S. , Feria A. , Rest J. , Stojanovic J.
Published: August 2005

A classification of fetal heart rate (FHR) responses to fetal movements is based on the study of 210 hours of antepartum cardiotocographic tracings in clinically normal pregnant patients between 30 and 42 weeks gestation. The physiological mechanisms underlying the FHR responses to fetal movement are discussed.
FETAL ARRHYTHMIA DURING PREGNANCY AND LABOUR
Authors: Komáromy B. , Gaál J. , Lampé L.
Published: August 2005

The significance of fetal arrhythmia presenting during pregnancy and labour has been examined in 68 patients. The different types of rhythm disorders diagnosed included 61 extrasystoles, 6 atrioventricular blocks and 1 auricular fibrillation. Extrasystoles were not associated with acidosis or organic cardiac disease. Atrioventricular block, though not associated with fetal hypoxia, was occasionally associated with congenital cardiac failure.
METABOLIC EFFECTS OF SALBUTAMOL INFUSION DURING PREMATURE LABOUR
Authors: Thomas D. J. B. , Dove A. F. , Alberti K. G. M. M.
Published: August 2005

Plasma electrolytes, glucose and insulin concentrations were measured and serial electrocardiograms performed during the intravenous infusion of salbutamol to five women in premature labour. The plasma potassium (mean±standard error) fell from 3·5±0·l to 2·7±0·l mmol/l, and the glucose and insulin rose by 4·2±0·7 mmol/l (72·13 mg/100 ml) and 26·5 mU/l respectively. The maximum fall in potassium, and the rise in glucose and insulin occurred two hours after starting the infusion. No changes in other electrolytes were found. Electrocardiograms showed no signs of hypokalaemia. Highest pulse rates (148·4 beats per minute) occurred at two hours but no arrhythmias were observed.
OUTPATIENT TERMINATION OF PREGNANCY
Authors: Fllshie G. M. , Sanders R. R.
Published: August 2005

Termination of pregnancy was performed under local anaesthesia as an outpatient procedure on 251 patients. The gestational ages ranged from 5 to 12 weeks. Either the portable Karman curette equipment or the syringe kits were used. The incidence of complications was low. Only 6 per cent of patients would have preferred general anaesthesia. The optimal gestational age at which to terminate pregnancies appeared to be between 6 and 10 weeks. Ninety‐one per cent of patients used effective contraception after the termination.
EVACUATION OF RETAINED PRODUCTS OF CONCEPTION IN A TREATMENT ROOM AND WITHOUT GENERAL ANAESTHESIA
Authors: Fllshie G. M. , Sanders R. R. , O'Brien P. M. S. , Overton J. , Khattab T. , Oats J. J. N.
Published: August 2005

One hundred patients with an incomplete abortion, 14 patients with retained products of conception after a second trimester termination, 5 patients with missed abortion and 2 patients with secondary postpartum haemorrhages (making a total of 121 patients) had a uterine evacuation in a treatment room using the portable Karman curette equipment. No general anaesthesia was used but patients were given intravenous pethidine or papavaretum (Omnopon) and diazepam. Four patients found the procedure painful but only two of them would have preferred general anaesthesia. There were no immediate complications but three patients required re‐evacuation of the uterus.
MATERNAL PLASMA TESTOSTERONE LEVELS IN MOLAR PREGNANCY
Authors: Chew P. C. T. , Goh H. H. , Ratnam S. S.
Published: August 2005

Plasma testosterone levels in 14 patients with intact molar pregnancy were found to be elevated compared to patients with normal pregnancies of corresponding gestation. The plasma testosterone concentration ranged from 2·0 to 8·4 ng/ml with a mean±SE of 5·2±0·5 ng/ml. After evacuation of the uterus, there was a significant fall in plasma testosterone levels which ranged from 1·6 to 5·9 ng/ml with a mean±SE of 3·2±0·3 ng/ml. The trophoblast might have been the source of extra testosterone in molar pregnancy.
EFFECT OF OVARIAN WEDGE RESECTION FOR THE STEIN‐LEVENTHAL SYNDROME ON PLASMA FSH, LH, OESTRADIOL AND TESTOSTERONE LEVELS AND ON THE RESPONSES OF THE PITUITARY TO INTRAVEN US LHRH
Authors: Valkov I. M. , Dokumov S. I.
Published: August 2005

We studied basal plasma FSH, LH, testosterone and oestradiol levels and post‐LHRH plasma FSH and LH levels in ten patients both before and after a wedge resection of the ovaries for Stein‐Leventhal syndrome. We compared the results with those obtained in 15 healthy patients between the third and seventh day of a normal menstrual cycle. Before operation, patients with the Stein‐Leventhal syndrome had raised basal and post‐LHRH LH levels and raised plasma testosterone levels. All these abnormalities disappeared after wedge resection of the ovaries. Both before and after operation patients with the Stein‐Leventhal syndrome had low plasma oestradiol levels. These results are used to formulate a hypothesis about the aetiology of the Stein‐Leventhal syndrome.
PREGNANCY COMPLICATED BY INSULINOMA
Authors: Rubens R. , Carlier A. , Thiery M. , Vermeulen A.
Published: August 2005

An insulinoma was excised during pregnancy. The tumor was located by radiography and severe hypoglycaemia made it necessary to administer diazoxide to the mother. The out come of the pregnancy was satisfactory. The rationale and risks of giving diazoxide in pregnancy are discussed.
PERFORATION OF THE SIGMOID COLON DURING PREGNANCY: A RARE COMPLICATION OF ENDOMETRIOSIS
Authors: Clement P. B.
Published: August 2005

Perforation of the sigmoid colon in a 28‐year‐old woman during the 37th week of pregnancy is reported. There was almost complete replacement of the bowel wall by endometriotic tissue showing extensive decidualization of its stroma. This appears to be a very rare complication of endometriosis and the effects of pregnancy upon endometriosis are briefly reviewed.
PREGNANCY FOLLOWING BILATERAL UTERINE ARTERY LIGATION
Authors: Mitchell G. G. , Mellor S. , Burslem R. W.
Published: August 2005

A successful pregnancy following bilateral uterine artery ligation performed in an attempt to relieve dysfunctional menorrhagia is reported. Serial biparietal diameters showed a normal growth curve and the newborn infant weighed 2640 g. The patient was normotensive throughout the pregnancy. Prior to uterine artery ligation, she had had four pregnancies but there were no surviving children. It is suggested that uterine artery ligation may have a limited place in the management of patients with dysfunctional menorrhagia.
OMPHALOCOELE AND RAISED ALPHA‐FETOPROTEIN IN MATERNAL SERUM
Authors: Young J. L. , Crawford J. W.
Published: August 2005

We describe a pregnant patient with raised serum AFP levels. The infant had multiple congenital abnormalities which included an omphalocoele.
A SIMPLE AND SENSITIVE RADIOIMMUNOASSAY FOR PREGNANCY‐SPECIFIC β1‐GLYCOPROTEIN
Authors: Towler C. M. , Horne C. H. W. , Jandial V. , Chesworth J. M.
Published: August 2005

A simple, sensitive and relatively rapid radioimmunoassay for pregnancy‐specific β1‐glycoprotein (PSβG) is described. The concentrations of PSβG in plasma from cord blood and in amniotic fluid were approximately 0·1 per cent and 1·0 per cent respectively of the maternal plasma levels. The amniotic fluid PS(3G levels in pregnancies associated with an anencephalic fetus were not significantly different from normal levels.
BLOOD COAGULATION STUDIES IN PREGNANT PATIENTS WITH INFECTIVE HEPATITIS
Authors: Dube B. , Bhattacharya Sulekha , Sinha V. N. , Pandey L. K. , Dube R. K.
Published: August 2005

Coagulation studies were made on 22 pregnant women with acute infective hepatitis and on 15 normal control pregnant women in third trimester. Fourteen hapatitis patients had clinical evidence of liver failure and all of them had a haemorrhagic diathesis; none of the patients without liver failure showed clinical evidence of haemostatic defects. Coagulopathy was present in most patients, its severity being greater in those with hepatic failure. Significant alterations were observed in bleeding time, whole blood clotting time, prothrombin time, thrombin time, plasma fibrinogen and serum levels of fibrinogen degradation products. The last three disturbances were most frequent in patients with liver failure. Increased fibrinolysis and disseminated intravascular coagulation also appeared to play a contributory role, particularly in patients with hepatic failure.
CHARACTERISTICS OF NORMAL LABOUR AMONG DIFFERENT RACIAL GROUPS IN MALAYSIA
Authors: Lim M. A. , Wong W. P. , Sinnathuray T. A.
Published: August 2005

The characteristics of normal labour in 977 Malay, Chinese and Indian parturients were established from a retrospective study. Indian babies were found to be significantly smaller than Malay babies which were significantly smaller than Chinese babies (P≤0·05, P≤0·05). The mean duration of the first stage of labour taken from the time of admission to the labour ward was 3·4 hours in primiparae and 2·7 hours in multiparae. The mean durations of the second stage of labour were 23·7 minutes and 13·1 minutes respectively. Curves of mean dilatation of cervix and probit analysis at 80 per cent revealed significant differences in the progress of normal labour in primiparae among the three racial groups. The Indian primiparae not only had a slower rate of cervical dilatation but seemed to reach the accelerated phase of dilatation later. No significant differences were noticed in the labours of multiparae.
THE RELATION BETWEEN UMBILICAL CORD TISSUE PROSTAGLANDIN E2 LEVELS, MODE OF ONSET OF LABOUR, FETAL DISTRESS AND METHOD OF DELIVERY
Authors: Willman Eve A. , Rodeck C. H. , Collins W. P. , Clayton S. G.
Published: August 2005

The tissue concentrations of prostaglandin E2 (PGE2) were measured by radioimmunoassay in components of the umbilical cord. The levels were significantly higher in the walls of arteries than in non‐vascular tissue from the umbilical cord. The highest values were found after emergency Caesarean sections and the lowest after induced labour ending in normal delivery. The use of forceps and the presence of fetal distress were both associated with significantly raised tissue concentrations of PGE2.
PLASMA OESTROGENS IN A PREGNANCY ASSOCIATED WITH CHRONIC HAEMODIALYSIS
Authors: Marwood R. P. , Ogg C. S. , Coltart T. M. , Klopper A. I.
Published: August 2005

Pregnancy in a patient undergoing regular haemodialysis at home is described. The pregnancy was complicated by antepartum haemorrhage due to a Type I placenta praevia, and premature labour occurred at 32 weeks, resulting in spontaneous vaginal delivery of a live infant which survived. Plasma progesterone, oestrone, unconjugated oestradiol and oestriol levels were normal during the last two weeks of pregnancy, but failed to show a characteristic fall in the puerperium. The conjugated oestriol fraction was 20 to 30 times the normal mean level and did not fall after delivery. These findings are discussed.
PRIMARY SPLENIC PREGNANCY
Authors: Mankodi R. C. , Sankari K. , Bhatt S. M.
Published: August 2005

A patient with a primary splenic pregnancy is described.
NON‐PREGNANT MATERNAL PLASMA VOLUME AND FETAL GROWTH RETARDATION BY
Authors: Croall J. , Sherrif Susan , Matthews Jennifer
Published: August 2005

The hypothesis that low maternal blood volume is an aetiological factor in fetal growth retardation was considered. It was found that a high proportion of women who had repeatedly given birth to small‐for‐dates babies had a low non‐pregnant plasma volume.
PULSED OXYTOCIN INFUSION IN THE INDUCTION OF LABOUR
Authors: Pavlou C. , Barker G. H. , Roberts A. , Chamberlain G. V. P.
Published: August 2005

A randomized controlled trial was mounted in which induction of labour at term was successfully accomplished in 12 patients by amniotomy and intermittent (or pulsed) oxytocin, compared with 16 patients receiving continuous oxytocin. In the pulsed group, oxytocin was infused for one minute in every ten using a modified Cardiff Infusion System Mark III in the automatic setting. Compared with the control group the induction‐delivery and induction‐to‐full‐dilatation intervals were similar but the total dose of oxytocin required was significantly lower in the pulsed group than in the control group.
INDUCTION OF LABOUR BY PHARMACOLOGICAL AND PHYSIOLOGICAL DOSES OF INTRAVENOUS OXYTOCIN
Authors: Toaff M. E. , Hezroni J. , Toaff R.
Published: August 2005

In addition to membrane rupture, pharmacological doses of oxytocin (2·6 mU/ minute rising stepwise to 422·4 mU/minute) were used in 134 patients and the results compared to those obtained in 144 patients given only physiological doses of oxytocin (2·6 to 13·2 mU/minute). Pharmacological doses of oxytocin gave better results in terms of induction‐delivery intervals, incidence of failed inductions and puerperal morbidity. The incidence of hypertonus was similar in both groups and unrelated to oxytocin doses. A uterine activity of 276 Montevideo units, modified to 200 to 220 Montevideo units for grande multiparae, is defined as the goal of oxytocin treatment in induction of labour. A sign of imminent uterine tetany in the intrauterine pressure curve (the ‘damping sign’) is described.
A RANDOMIZED CONTROLLED TRIAL OF SELECTIVE PLANNED DELIVERY
Authors: Martrn D. H. , Thompson W. , Pinkerton J. H. M. , Watson J. D.
Published: August 2005

A prospective randomized controlled trial designed to investigate selective planned delivery is reported: 264 obstetrically normal women in the 38th week of pregnancy were admitted to this trial and 184 completed it. The infants of mothers in the planned delivery group had higher serum bilirubin levels on the fifth day post partum than control infants but no baby required treatment for hyperbilirubinaemia. Mothers in the planned delivery group required significantly greater amounts of pethidine while control mothers had a significantly higher incidence of meconium staining of the amniotic fluid. However, the infants in the two groups had similar Apgar scores at birth. There was one stillbirth in the control group; this was due to unrecognized fetal hypoxia during labour induced at 42 weeks for postmaturity.
MATERNAL SERUM ALPHA‐FETOPROTEIN LEVELS IN TRIPLET AND QUADRUPLET PREGNANCY
Authors: Wald N. , Cuckle H. , Stirrat G.
Published: August 2005

Maternal serum alpha‐fetoprotein (AFP) levels were higher in six triplet pregnancies and three quadruplet pregnancies than in control singleton pregnancies matched for maternal age, parity and time of gestation at which the serum sample was taken. Between 12 and 23 weeks of pregnancy, the average AFP levels among the triplet pregnancies was three times that found in the singleton pregnancies, and the level in the quadruplet pregnancies was even higher. Maternal serum AFP levels appear to be associated with the number of fetuses in utero.
FETAL ELECTROMECHANICAL INTERVALS IN LABOUR
Authors: Robinson H. P. , Adam A. H. , Fleming J. E. E. , Houston Anne , Clark D. M.
Published: August 2005

Measurements of fetal cardiac electromechanical intervals were obtained in two groups of patients before and during labour. This was achieved by means of a system, developed in our Department, which allows the simultaneous recording of the fetal electrocardiogram and filtered Doppler signals from the fetal heart. The intervals studied were the pre‐ejection period (PEP), the phase of isovolumetric contraction (IVC) and the left ventricular ejection time (LVET). Mean and SD values prior to the onset of labour were established and found to be 73.6±4.7 mseconds, 38.9±5.8 mseconds, and 155.2±9.6 mseconds respectively. While LVET varied inversely with heart rate, PEP and IVC showed no such correlation. In the second part of the study, serial measurements were made throughout labour in 22 patients. Eighteen of these fetuses had normal pH values at or near delivery, and in 16 of them PEP measurements varied by less than 10 mseconds from the pre‐labour value, the remaining two fetuses exhibiting an unexplained shortening of this interval. All four fetuses with evidence of acidosis at delivery had PEP measurements which lengthened by more than 10 mseconds during labour. It is suggested that, with further development and experience, this technique may prove to be a useful adjunct to current methods for intrapartum fetal monitoring.
A CERVIMETER FOR CONTINUOUS MEASUREMENT OF CERVICAL DILATATION IN LABOUR—PRELIMINARY RESULTS
Authors: Richardson J. A. , Sutherland I. A. , Allen D. W.
Published: August 2005

We briefly review instruments that have been used to measure cervical dilatation and describe the development of a new cervimeter. Curves derived from cervical dilatation and intrauterine pressure traces are presented in a form that clearly records the activity of the uterus and the response of the cervix to individual contractions. Our results suggest a new concept for behaviour of the cervix in labour.
PREGNANCY IN PATIENTS WITH BRONCHIECTASIS
Authors: Howie A. D. , Milne J. A.
Published: August 2005

Pulmonary function was monitored at regular intervals throughout pregnancy in three patients with bronchiectasis. They tolerated pregnancy well, and the underlying lung disease did not appear to have any adverse effect on the outcome of the pregnancy.
OESTRADIOL PRODUCTION BY HUMAN GRAAFIAN FOLLICLES CULTURED IN VITRO
Authors: Biggs J. S. G. , Baker T. G. , Hutchon D.
Published: August 2005

Intact human Graafian follicles recovered during the preovulatory phase of the menstrual cycle and cultured in vitro, gave a mean oestradiol production of 33 ng/hour over periods of 4 to 92 hours. Treatment of follicles with human pituitary gonadotrophin or human chorionic gonadotrophin resulted in an increased production of oestradiol.
HYPOTHYROIDISM IN PREGNANCY
Authors: Kennedy A. L. , Montgomery D. A. D.
Published: August 2005

Two mothers with hypothyroidism gave birth to normal infants. In one patient there was good evidence that maternal hypothyroidism improved during the last trimester due to placental transfer of fetal thyroid hormone. If pregnancy is advanced when the diagnosis of hypothyroidism is made, it would seem that replacement therapy may be withheld without detriment to the fetus.
A COMPARISON OF PLASMA LEVELS OF PROGESTERONE, OESTRADIOL, UNCONJUGATED OESTRIOL AND TOTAL OESTRIOL WITH URINARY TOTAL OESTROGEN LEVELS IN CLINICAL OBSTETRIC PRACTICE
Authors: Allen E. Irene , Lachelin Gillian C. L.
Published: August 2005

Plasma levels of progesterone (P), oestradiol (OE2), unconjugated oestriol (OE3) and total OE3 were measured in blood samples taken from patients with fetal growth retardation, pre‐eclampsia and other complications of pregnancy. The levels were compared with the 24‐hour urinary excretion levels of total oestrogen (OE) in these patients, and with the plasma levels found in 31 normal pregnant patients from whom blood samples were taken serially from 21 weeks gestation onwards. There was good correlation between plasma unconjugated and total OE, levels, and urinary OE levels (r = 0.77). In 12 patients with fetal growth retardation and no other abnormality, levels of all hormones were significantly lower than normal; unconjugated OE3, total OE3, and urinary OE levels were significantly less than 1 SD below the normal mean. In 22 patients with mild or moderate pre‐eclampsia who were delivered of normal birth weight infants none of the hormone levels were significantly different from normal. In 12 patients with mild or moderate pre‐eclampsia in association with fetal growth retardation OE2, unconjugated OE3 and urinary OE levels were significantly lower than normal, and total OE3 levels were significantly less than 1 SD below the normal mean. In 12 patients with severe pre‐eclampsia, OE2, levels were significantly less than 1 SD below the normal mean and unconjugated OE3, total OE3, and urinary OE levels were significantly less than 2 SD below the normal mean. In studies of diurnal and day‐to‐day variation the coefficients of variation for P were respectively 12.7 per cent and 14.2 per cent, for OE2, 11 per cent and 12.7 per cent, for unconjugated OE3, 15.6 per cent and 14.1 per cent, and for total OE3, 15 per cent and 15.8 per cent. It was concluded that measurements of plasma total OE, and urinary OE were probably of comparable value and that the plasma estimation had much to commend it.
PRIMARY HEPATIC PREGNANCY
Authors: Luwuliza‐Kirunda J. M. M.
Published: August 2005

A case of primary hepatic pregnancy presenting as a lithopedion in the right hypochondrium is presented. The lithopedion was removed and the patient recovered uneventfully. The diagnosis of primary hepatic pregnancy is briefly discussed.
PREGNANCY AND CHILDBIRTH IN A TRUE HERMAPHRODITE FOLLOWING RECONSTRUCTIVE SURGERY
Authors: Mayou B. J. , Armon P. , Lindenbaum R. H.
Published: August 2005

An 18‐year‐old Tanzanian true hermaphrodite became pregnant one month after reconstructive vaginal surgery. Chromosomal analysis of the mother showed a 46 XX constitution; a chromosome 21 carried a large short arm which might have contained Y chromosome material.
OBSERVATIONS ON MATERNAL AND FETAL FERRITIN CONCENTRATIONS AT TERM
Authors: Kelly Anne M. , Macdonald D. J. , McDougall A. Neil
Published: August 2005

The concentration of serum ferritin was measured in 115 paired maternal and cord specimens obtained from patients delivering at term. There was a significantly lower concentration of ferritin in cord serum when the maternal value was 10 44g/l or less. The maternal ferritin appeared to be lower in mothers who had three or more previous pregnancies or were socially deprived.
UTERINE CIRSOID ANEURYSM
Authors: McLachlan M. S. F. , Bird C. C. , Naiem E. A. , Scott J. S.
Published: August 2005

Cirsoid (or varicose) aneurysm of the uterine vessels causes severe, life‐threatening uterine bleeding. Previous trophoblastic neoplasia is a common predisposing factor. Diagnosis is by arteriography and may be missed without it.
ROUTINE ADMINISTRATION OF IRON AND VITAMINS DURING PREGNANCY: REVIEW OF CONTROLLED CLINICAL TRIALS
Authors: Hemminki Elina , Starfield Barbara
Published: August 2005

The purpose of this review was to determine whether routine administration of iron and vitamins during pregnancy had beneficial effects on birth weight, length of gestation, infant morbidity and mortality, and maternal morbidity and mortality. We searched for controlled clinical trials done in developed Western countries and reported in English, German, Finnish, and Scandinavian languages. Seventeen trials were found. In one trial, women who received vitamin B6 developed less dental caries. In another trial women receiving several different minerals and vitamins had fewer deliveries before the 40th week and less pre‐eclampsia. In a third study, women receiving polyvitamin concentrate had less pre‐eclampsia. None of the studies reported any benefit for other outcomes.
PREVENTION AND TREATMENT OF PREMATURE LABOUR BY DRUGS: REVIEW OF CONTROLLED CLINICAL TRIALS
Authors: Hemminki Elina , Starfield Barbara
Published: August 2005

This review sought evidence from 18 controlled clinical trials about the benefits of drugs (hormones, ethanol or β‐sympathomimetic agents) used to prevent premature birth. Of the 16 trials comparing drug with placebo, 13 were judged to be methodologically adequate. In eight trials, drugs were given prophylactically and in five they were given therapeutically. Two of the therapeutic trials found the drug more effective than placebo in postponing delivery. However, only one therapeutic trial and one prophylactic trial found the drug to affect favourably the outcome for the infant. The side effects of the drugs were not systematically studied. Additional clinical trials are needed to justify the use of drugs to inhibit labour.
THROMBOXANE B2, IN AMNIOTIC FLUID BEFORE AND DURING LABOUR
Authors: Mitchell M. D. , Keirse M. J. N. C. , M. Anderson Anne B. , Turnbull A. C.
Published: August 2005

Concentrations of thromboxane B2 (TXB2) have been measured in amniotic fluid obtained during late pregnancy and labour. Samples taken at amniocentesis contained significantly lower levels of TXB2 than samples taken by amniotomy for the induction of labour which in turn contained significantly less than when the same procedure was performed during labour. In the latter group there was no correlation between the degree of cervical dilatation and the concentration of TXB2. There was no correlation between gestational age and the concentration of TXB2 in amniotic fluid obtained at amniocentesis whereas there was a significant correlation (P<0·025) between these parameters when fluid was taken by amniotomy before labour. It is suggested that the relative activities of the enzymes responsible for the conversion of prostaglandin endoperoxides to prostaglandins, thromboxane A, and prostacyclin may be of great importance during parturition.
A STUDY OF THE EFFECTIVENESS OF PROPRANOLOL IN MENOPAUSAL HOT FLUSHES
Authors: Coope Jean , Williams Susan , Patterson J. S.
Published: August 2005

A prospective, double‐blind, randomized comparison of propranolol, 40 mg three times daily, and matching placebo showed propranolol to be no more effective than placebo in controlling hot flushes in a group of 25 perimenopausal women. Other menopausal symptoms, such as insomnia and palpitations, were equally unaffected. However, a very close correlation was found between the daily atmospheric temperature and the number of flushes occurring in the group.
THE USE OF CATHETER‐TIP PRESSURE TRANSDUCERS FOR THE MEASUREMENT OF INTRAUTERINE PRESSURE IN LABOUR
Authors: Steer P. J. , Carter M. C. , Gordon A. J. , Beard R. W.
Published: August 2005

The disadvantages of the fluid filled polythene catheter used for measuring intrauterine pressure have been overcome by designing a catheter with a pressure transducer at the tip. The information which it gives is accurate and reliable. The optimum method of use has been determined and clinical trials performed. There is no demonstrable morbidity from its use.
PERFORATION OF A PLACENTAL FETAL VESSEL BY AN INTRAUTERINE PRESSURE CATHETER
Authors: Nuttall I. D.
Published: August 2005

Perforation of a fetal vessel on the placental surface by an intrauterine catheter is reported. The immediate recognition of this unusual complication is important. To minimize the risks of perforation, haemorrhage and infection, several precautions should be observed when inserting the catheter.
SERUM FREE FATTY ACIDS, INSULIN AND BLOOD GLUCOSE IN PREGNANCY
Authors: Taylor G. Oladunni , Modie J. A. , Agbedana E. O. , Akande E. O.
Published: August 2005

Blood glucose, serum insulin and free fatty acid levels were determined in 60 pregnant and 44 non‐pregnant women. The mean blood glucose level was significantly lower in pregnant women than in non‐pregnant women but there were no significant changes during pregnancy. The mean serum insulin and free fatty acid levels were not significantly different from the levels for the nonpregnant women, there was also no significant change in their mean levels throughout pregnancy.
UNCONJUGATED SERUM OESTRIOL LEVELS IN MOTHER AND BABY WITH MECONIUM STAINING OF THE AMNIOTIC FLUID
Authors: Gorwill R. H. , Sarda Inder R.
Published: August 2005

To examine the effect on oestrogen metabolism of the stimulus which causes the passage of meconium, we measured maternal venous and cord artery and vein serum unconjugated oestriol levels in 46 patients with meconium staining of the amniotic fluid and 19 controls. Mean cord vein oestriol levels were significantly lower than in controls in the presence of meconium stained amniotic fluid and no fetal acidosis (cord artery buffer base of 36·2 meq/l or more) (P<0·02). The same tendency was seen with acidotic infants (P<O·O5). There is thus evidence of a change in oestrogen metabolism associated with meconium staining of the amniotic fluid.
TRANSFER OF DIGOXIN ACROSS THE PLACENTA AND INTO BREAST MILK
Authors: Chan Vivian , Tse T. F. , Wong Vivian
Published: August 2005

Eleven mothers given digoxin throughout pregnancy because of rheumatic heart disease were studied. Digoxin was identified in the placenta and, for the first time, in milk. Paired cord and maternal blood samples obtained at parturition showed lower digoxin levels in cord blood than in maternal blood. The total tissue‐bound digoxin level in the placenta correlated closely with maternal digoxin levels. These findings suggest strongly the presence of a placental barrier for digoxin. Similar digoxin concentrations (0·825±0·015 nmol/l) were found in milk samples obtained daily between the third and seventh days postpartum. The half‐life of digoxin in the newborn was 36·2±5·43 hours (Mean±SEM); thus all the digoxin present at birth would be excreted within 10 to 11 days.
NEONATAL SERUM BILIRUBIN LEVELS IN SPONTANEOUS AND INDUCED LABOUR
Authors: Sivasuriya M. , Tan K. L. , Salmon Y. M. , Karim S. M. M.
Published: August 2005

An investigation was made into the onset and severity of neonatal jaundice in 114 patients following spontaneous labour and labour induced by (a) amniotomy, (b) amniotomy and simultaneous infusion of oxytocin, (c) amniotomy and simultaneous administration of oral prostaglandin E2, (PGE2,). No significant difference in serum bilirubin levels in the first five days of life was found in the four groups.
ACUTE PANCREATITIS AND VITAMIN K DEFICIENCY IN PREGNANCY
Authors: Hughes R. Osborne , O'Mullane N. M. , Pratt I. T.
Published: August 2005

Two patients with acute pancreatitis in pregnancy are described. In both, bleeding from vitamin K deficiency occurred after the initial attack of pancreatitis and the bleeding tendency was successfully treated with vitamin K.
ARTIFICIAL INSEMINATION WITH FROZEN STORED DONOR SEMEN
Authors: Bromwich P. , Kilpatrick M. , Newton J. R.
Published: August 2005

The results of artificial insemination with donor semen (AID) are reported. The semen samples were stored in liquid nitrogen until needed. Eighty‐two pregnancies occurred in 214 patients treated for 1610 cycles. Life table conception rates were 24·3±2·9 after six months and 32·7±3·3 after 12 months of treatment. Thirty of the 82 patients conceived within three treatment cycles and 53 by the sixth treatment cycle. Of the 82 pregnancies, there were 12 miscarriages, no stillbirths or neonatal deaths and one baby was born with a congenital abnormality.
PREGNANCY‐ASSOCIATED PLASMA PROTEIN B (PAPP‐B) IN NORMAL AND ABNORMAL PREGNANCIES AT TERM
Authors: Lin T‐M. , Halbert S. P. , Spellacy W. N.
Published: August 2005

At term, the pregnancy‐associated plasma protein B (PAPP‐B) level in normal pregnancy was correlated with placental and newborn weights, but not with nine other normal obstetric variables. It was lower in pregnancies complicated by diabetes or severe toxaemia, and higher in twin pregnancies.
MELATONIN IN AMNIOTIC FLUID DURING HUMAN PARTURITION
Authors: MITCHELL M. D. , Sayers Linda , Keirse M. J. N. C. , Anderson Anne B. M. , Turnbull A. C.
Published: August 2005

Concentrations of melatonin have been measured in amniotic fluid obtained during late pregnancy and labour. Samples obtained by amniotomy during labour contained higher concentrations of melatonin than samples taken a t amniotomy for the induction of labour. Amniotic fluid obtained by amniocentesis in late pregnancy contained lower concentrations of melatonin than amniotic fluid obtained by amniotomy. The implications of these findings are discussed in relation to pineal influences on parturition.
INDUCTION OF OVULATION WITH CLOMIPHENE AND HUMAN CHORIONIC GONADOTROPHIN IN WOMEN WITH HYPERPROLACTINAEMIC AMENORRHOEA
Authors: Mcgarrigle H. H. G. , Sarris S. , Little Valerie , Lawrence Daphne , Radwanska Ewa , Swyer G. I. M.
Published: August 2005

Seventeen women complaining of infertility (one with primary amenorrhoea, 14 with secondary amenorrhoea, and two with oligomenorrhoea) all had hyper‐prolactinaemia and were treated with clomiphene citrate and human chorionic onadotrophin (HCG), and plasma oestradiol, FSH and LH levels were measured. Although adequate pre‐ovulatory oestradiol levels were present, the surge of LH was absent until the injection of HCG after which all patients ovulated. There were 12 pregnancies in 9 patients resulting in 10 full‐term livebirths, one premature livebirth and one continuing pregnancy. The relevance of these findings to the possible role of prolactin in amenorrhoea is discussed.
VASCULAR ANATOMY OF THE HUMAN UTERUS AND PREGNANCY WASTAGE
Authors: Burchell R. Clay , Creed Francis , Rasoulpour Mina , Whitcomb M.
Published: August 2005

In uteri removed at hysterectomy the uterine arteries were injected with radio‐opaque media and the vascular configuration was correlated with reproductive histories. Patients whose uteri had two ascending uterine arteries on each side had significantly more abortions and smaller newborn infants than patients with a single ascending branch of the uterine artery.
LONGER THOUGH LIGHTER MENSTRUAL AND INTERMENSTURAL BLEEDING WITH COPPER AS COMPARED TO INERT INTRAUTERINE DEVICES
Authors: Guillebaud J. , Bonnar J.
Published: August 2005

A randomized serial study of uterine blood loss was made of 281 women fitted with one of three intrauterine contraceptive devices (IUCDs): a Lippes loop D, a Dalkon shield or a Copper 7. The increase in the amount of blood loss was greatest with Lippes loop D users and least with Copper 7 users. However, the duration of menstrual and intermenstrual bleeding and of spotting was significantly greater among Copper 7 users than with the two inert devices. Thus the mechanisms whereby IUCDs increase the duration as opposed to the volume of uterine bleeding may be different. Previous users of oral contraceptives were found to have significantly less bleeding before IUCD insertion, but showed a similar pattern of increase of uterine bleeding after IUCD insertion to those who had not used oral contraceptives. For all three IUCDs, the increment in amount and duration of uterine bleeding after insertion decreased between the first and the sixth period, on average by about 15 ml and one to two days. No subsequent improvement was found and after 12 cycles the Copper 7 users had longer but less heavy uterine blood loss than users of the Lippes loop D.
THE PLASMA HALF‐LIFE OF PLACENTAL HORMONES
Authors: Klopper A. , Buchan P. , Wilson G.
Published: August 2005

Summay

Blood was collected from 12 women following Caesarean section or normal delivery at term. The decline in plasma concentration of total oestriol, oestriol sulphate, oestriol glucosiduronate, unconjugated oestriol, human placental lactogen and pregnancy specific β1 glycoprotein following delivery of the placenta was studied for 120 hours. The steroids and human placental lactogen fell very rapidly but pregnancy specific β1 glycoprotein declined much more slowly. Analysis of the curves of puerperal decline suggests that the oestriol moieties are distributed in many compartments of the mother but that the proteins penetrate only to the plasma and the interstitial fluid.
BLOOD PRESSURE IN THE ARM AND LEG IN LATE PREGNANCY
Authors: Naftalin A. A. , Hart W. G. , Walters W. A. W.
Published: August 2005

Arm and leg blood pressures were measured by an indirect sphygmomanometric method in 12 women in late pregnancy and the results were compared with those in 12 matched non‐pregnant women. In most of the pregnant women the diastolic blood pressure measured in the leg fell significantly with a change in posture from the supine to lateral position. In contrast, no significant change was observed in arm blood pressure with postural change after correcting for hydrostatic pressure difference. The interpretation of these findings is discussed with particular reference to methodology of blood pressure measurement.
THE EFFECT OF LOW HAEMATOCRIT ON SERUM HUMAN PLACENTAL LACTOGEN VALUES
Authors: Agboola A.
Published: August 2005

Serial determinations of serum human placental lactogen (HPL) levels in women with haematocrit values of 28 per cent or less between 18 and 30 weeks gestation have been compared with the controls who had haematocrit values of 35 per cent or more. The women with low haematocrit values were found to have significantly raised HPL levels throughout the period of study. The placenta was significantly heavier in the anaemic group (P < 0.01) but there was no significant difference in birth weights of the infants. It would seem that caution should be exercised in using HPL values as an index of placental function in anaemic women.
CHANGES IN SALIVARY PEROXIDASE AND POLYMORPHONUCLEAR NEUTROPHIL LEUCOCYTE ENZYME ACTIVITIES DURING THE MENSTRUAL CYCLE
Authors: Cockle S. M. , Harkeness R. A.
Published: August 2005

An elevation in salivary peroxidase activity has been found about the time of ovulation in 14 menstrual cycles in a total of six women. This peak coincided with the ovulatory luteinizing hormone (LH) and oestrogen peak in the four cycles in which endocrine studies were performed. Rises in some polymorphonuclear neutrophil leucocyte enzymes were also seen around ovulation. The possible use of changes in salivary peroxidase as a method for detection of ovulation is discussed.
ENDOMETRIAL OSSIFICATION ASSOCIATED WITH SECONDARY INFERTILITY
Authors: Dutt Sabita
Published: August 2005

A patient with secondary infertility and endometrial ossification after a spontaneous abortion is described. The aetiology and pathogenesis of endometrial ossification are discussed.
PRIMARY PERITONEAL PREGNANCY IN ASSOCIATION WITH INTRAUTERINE CONTRACEPTIVE DEVICES:
Authors: Kasby C. , Krins A.
Published: August 2005

Two patients with a primary pelvic peritoneal ectopic pregnancy are reported. Both had been fitted with an intrauterine contraceptive device.
THE VALUE OF CARDIOTOCOGRAPHY IN ABRUPTIO PLACENTAE
Authors: Saunderson P. R. , Steer P. J.
Published: August 2005

The main indication for Caesarean section in cases of placental abruption is fetal distress. We report a patient in whom clinical examination, including auscultation of the fetal heart, suggested a mild haemorrhage, which would normally have been managed conservatively, but continuous fetal heart rate monitoring showed severe asphyxia, necessitating emergency Caesarean section at which a large concealed haemorrhage was found.
A COMPARISON OF BIPARIETAL DIAMETER MEASUREMENTS USING A REAL‐TIME SCANNER AND A CONVENTIONAL SCANNER EQUIPPED WITH A CODED CEPHALOMETRY SYSTEM
Authors: Adam A. H. , Robinson H. P. , Fleming J. E. E. , Hall A. J.
Published: August 2005

In 131 patients a comparison was made between measurements obtained using a real‐time scanner and those obtained using a Conventional ‘B’ scanner with an attached ‘coded cephalometry system’: 69 per cent of the readings agreed within ±2 mm and, when the ‘B’ scan reading was considered ‘good’, 90 per cent fell within this range. Between 14 and 28 weeks, gestational age diagnoses using the two methods were within one week of each other in 88 of 89 patients.
ADIPOSE TISSUE METABOLISM IN PREGNANCY: THE LIPOLYTIC EFFECT OF HUMAN PLACENTAL LACTOGEN
Authors: Williams Christine , Coltart T. M
Published: August 2005

In vitro adipose tissue lipolysis was investigated in pregnant and non‐pregnant women. Basal and hormone‐stimulated rates of lipolysis were significantly higher in the pregnant group. Human placental lactogen (HPL) was shown to be lipolytic on adipose tissue from both pregnant and non‐pregnant women; the response being more marked in the pregnant group. We postulate that HPL is responsible for this increased lipolytic sensitivity in pregnancy, the result of which is the elevation in levels of plasma free fatty acids in the third trimester.
ASSESSMENT OF OVARIAN FUNCTION IN PERIMENOPAUSAL WOMEN AFTER STOPPING ORAL CONTRACEPTIVES
Authors: Donald R. A. , Baker D. A. , Metcalf M. G. , Turner E. D.
Published: August 2005

Ovarian function was assessed by measuring plasma gonadotrophins, urinary oestrogen and urinary pregnanediol levels, every week for four weeks, in 34 women, aged 45 to 57 years, after withdrawal of oral contraceptive therapy. A rise in urinary pregnanediol excretion occurred in 14 patients suggesting that ovulation had occurred and that these patients were‘premenopausal'. Elevated serum gonadotrophin values and persistently low urinary oestrogen and pregnanediol excretion occurred in 13 patients suggesting ovarian failure or a‘postmenopausal’state. However, one apparently‘postmenopausal’patient later showed hormonal evidence of ovulation, indicating fluctuation in ovarian function. There were 7 patients with‘indeterminate’hormone profiles whose ovarian function was difficult to assess. All patients excreting more than 45 nmol of oestrogen a day had a spontaneous period within 45 days of stopping hormone therapy.