bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ovulation Induction for the Treatment of Infertility
Authors: Black Tania L. , Cox R. I. , Cox L. W. 
Published: February 2008

SummaryOf 100 patients who were not ovulating, 88 have been treated for infertility using clomiphene citrate, or follicle stimulating hormone, or combinations of these, together with human chorionic gonadotrophin.All patients have ovulated at least twice, excepting those who conceived during the first ovulatory cycle. 66 pregnancies have occurred in 60 patients and there were 5 multiple pregnancies.Three types of response to an ovarian function test using HMG are reported, and their significance with respect to menstrual abnormality and response to clomiphene and FSH treatment is discussed.Mention is made of the likelihood of return normal function after ovulation‐induced pregnancy or ovulation induction.Daily monitoring and individualization of treatment has kept the incidence of complications much lower than in most other reported series.
The Spontaneous Cure Rate of Various Infertility Factors or Post Hoc and Propter Hoc
Authors: Grant Alan 
Published: February 2008

SummaryA prospective study has been made on 2,581 patients suffering from primary and secondary infertility.secondary infertility. Thirty‐five per cent of these patients became pregnant during the course of investigation and before any treatment could be given.Half of the pregnancies followed the performance of tuba1 patency tests. Salpingograms were twice as effective in producing a pregnancy as were Rubin's tests (11% versus 5%).Fifteen per cent of 1,177 patients became pregnant after the cause of the sterility was known and before any treatment was given.Anovulation underwent a spontaneous cure in 25% of patients and 20% became pregnant.The spontaneous cure rate amongst patients with tubo‐ovarian adhesions was about 15%.Tubal patency tests frequently have a curative effect where the post‐coital test isOnly about 1 in every 7 patients with known infertility factors will become pregnant without treatment. Definitive attempts to cure specific infertility factors were successful in 47% of such patients.If we give the reproductive tract of an infertility patient a good “spring cleaning” by plodding through the various tests for this condition, we can expect a third of the patients to become pregnant without our ever knowing what infertility factors were present.Patients with infertility come to us because they want to be pregnant soon and not sometime. The way to achieve this is by early active investigation and treatment, and not by platitudes, placebos or procrastination.
Prolonged Labour in Multigravidae
Authors: Giles P. F. H. 
Published: February 2008

SummaryAn analysis is presented of labours lasting 36 hours or longer in 155 multigravidae delivered at the Royal Women's Hospital, Melbourne, from 1958 to 1965. The method of delivery was Caesarean section in 24%, forceps delivery in 21%, and unaided vaginal delivery in 49%.In booked patients the corrected perinatal mortality was 40/1000 and in non‐booked patients it was 100/1000; the overall perinatal mortality was 111/1000. The perinatal mortality was highest in those delivered by Caesarean section and in those who had a difficult vaginal delivery; it was not raised in those who had an unaided vaginal delivery. Cephalopelvic disproportion was common; 48% of the babies delivered weighed over 4000g.Friedman's curves showing dilatation of the cervix against elapsed time were found to be invaluable in predicting the outcome of prolonged labours. Prolongation of the latent phase of labour carried a low perinatal mortality (33/1000, corrected to 0/1000) and a 70% normal vaginal delivery rate; a protracted active phase or secondary arrest in the active phase of labour carried perinatal mortality rates of 180/1000 (corrected 109/1000) and 200/1000, and a very high Caesarean section rate.Analysis of the prolonged labours showed that favourable prognostic signs for the vaginal delivery of a healthy baby were (in order of importance) a favourable fetal lie and position, good placental function, membranes remaining intact until late in labour, and lack of maternal distress.Signs of maternal distress (such as the need for intravenous fluids, frequent analgesics, or a rising maternal pulse) or the need for oxytocin infusion because of delay in the active phase pointed to the need for careful evaluation and possible early Caesarean section.
The Place for Anti‐D Gamma Globulin in Abortion
Authors: Edwards R. F. 
Published: February 2008

SummaryA study was made of the incidence and volume of feto‐maternal haemorrhage in 129 patients with threatened or incomplete abortion, and in a control group of 110 healthy pregnant women. The incidence of feto‐maternal haemorrhage was 15.5% in the abortion group and 3.6% in the control group. The incidence of significant feto‐maternal haemorrhage was 14.3% in patients with incomplete abortion. The significant of these findings is discussed and it is concluuded that prophylactic anti‐D gamma globulin should be given to all non‐immunised rhesus negative women having any type of abortion.
The Management of Eclampsia with Intravenous Diazepam and Protoveratrine
Authors: Elliott Peter M. 
Published: February 2008

SummaryEclampsia is uncommon in Australia but remains an important cause of maternal mortality. The present paper reports the efficacy of diazepam (“Valium”) and protoveratrine (“Puroverine”) in the management of 3 patients with eclampsia. Convulsions were controlled initially by direct intravenous injection of diazepam and sedation was maintained by repeated intramuscular administration of this drug. After immediate control of convulsions, the blood pressure was lowered by intravenous and thereafter intramuscular protoveratrine. No further convulsions occurred after the commencement of treatment.
Endocrinology of the Conceptus
Authors: France John T. 
Published: February 2008

SummarySteroid metabolism in pregnancy involves complex inter‐relationships between fetus, placenta and mother.Evidence indicates that the placenta lacks certain enzymes that are necessary for the biosynthesis of steroid hormones. The fetus possesses these enzymes, but on the other hand lacks those enzymes which are present in the placenta. The placenta and fetus are then themselves not complete endocrine organs, but together complement each other, forming a functional unit for the production of steroids. Thus, progesterone is produced in the placenta mainly from maternal cholesterol. Oestrogen production takes place in the fetal‐placental unit. The placenta converts dehydroepiandrosterone sulphate and 16α‐hydroxydehydro‐epiandrosterone sulphate of fetal origin into oestrone/oestradiol and oestriol respectively.Dehydroepiandrosterone sulphate secreted by the maternal adrenal can also be utilised by the placenta for oestrogen biosynthesis. About 50% of the oestrone and oestradiol produced arises from this source.
Labour and Delivery after Caesarean Section
Authors: Kuah K. B. 
Published: February 2008

SummaryThree hundred and sixty‐six patients with a history of previous Caesarean section or hysterotomy have been studied with reference to subsequent labour and mode of delivery in 454 pregnancies.Elective Caesarean section was performed in 132 (29%); vaginal delivery, which was attempted in 322 cases, was successful in 78%. The vaginal delivery rate for the whole series was 55%.The type of uterine scar and state of scar at subsequent delivery are recorded. The incidence of scar dehiscence was found to be 1.1%. There was no maternal mortality in the series but an increase was noted in maternal morbidity.
Pelvic Lymph Node Metastases in Carcinoma of the Cervix
Authors: Kneale Barry 
Published: February 2008

SummaryDuring 1951‐1959 inclusive 391 patients with invasive cervical cancer were subjected to pelvic lymphadenectomy, usually in association with radical hysterectomy. Twenty‐nine per cent, had nodal metastases, the incidence being 20% in Stage 1 and 26% in Stage 2. Of the patients with involved nodes only 32% survived 5 years or more, compared with 76% in those without involved nodes. Patients in the latter group with Stage 1 lesions had a much better prognosis than those with Stage 2 lesions.External irradiation of lymph nodes prior to surgery markedly reduced the incidence of metastases. The serious effects of megavoltage therapy prior to radical surgery were noted. The significance of the site and number of nodal metastases was examined. The importance of survival for 3 years in the patient with positive nodes is emphasised.
Genital Tract Sources of Renin
Authors: Symonds E. M. , Skinner S. L. , Stanley M. A. , Kirkland J. A. , Ellis R. C. 
Published: February 2008

SummaryMyometrium from a non‐pregnant subject has been shown to produce renin in tissue culture. The pattern of renin productionin vitroby myometrium from a non‐pregnant subject was similar to that demonstrated in tissue culture of myometrium from pregnant subjects.Bowie‐positive cells have been demonstrated in a scattered distribution throughout the myometrium and chorion. It is suggested that these cells are the site of synthesis of renin in these tissues. These cells occur much more frequently in chorion than in myometrium, a finding which relates well to the renin content of these tissues.
A Review of 50 Cases of Primary Amenorrhoea
Authors: Evans James H. 
Published: February 2008

Summary: Fifty cases of primary amenorrhoea are reviewed with reference to the aetiology. In all patients the buccal smear chromatin complement was measured and chromosomal study proceeded to if this revealed less than 25% of cells to be chromatin positive. Total urinary gonadotrophin and oestrogen assays were performed in all patients and the spectrum of values seen is presented.The most common cause was chromosomal abnormality (24%). Although investigation to the extent performed is often not necessary to establish a precise diagnosis, such study is indicated to assess gonadal potential and subsequent fertility potential. In the present series, 31 (62%) patients were potentially fertile. With rational and physiological therapy all patients should be capable of leading normal, sexually active lives. To the present time, pregnancy has resulted from gonadotrophin therapy in the 5 patients in whom it has been indicated.
Urinary Gonadotropins — General, F.S.H. and L.H. and Urinary Oestrogens in Dysfunctional Amenorrhoea
Authors: Taft H. P. , Ekkel I. , Brown J. B. , Evans J. H. 
Published: February 2008

Summary: Urinary gonadotrophins—general, F.S.H. and L.H.—and urinary oestrogens were measured in 10 patients, two with primary and eight with secondary dysfunctional amenorrhoea.Gonadotrophin levels were within the normal range whether or not urine oestrogen excretion was at postmenopausal levels. No pattern of relationship between the F.S.H.: L.H. ratio and urine oestrogen emerged, these ratios being similar to those found in other “non‐cycling” situations.The absence of an inverse relationship between gonadotrophin and oestrogen with gonadotrophin levels being inappropriately low relative to oestrogen levels, considered together with the clinical history and outcome of treatment, support the thesis of hypothalmic‐pituitary failure as the cause of the defect in these patients.
Contraception with a Six‐Monthly Injection of Progestogen: Part 1. Effects on Blood Pressure, Body Weight and Uterine Bleeding Pattern, Side‐Effects, Efficacy, and Acceptability
Authors: V. Mackay E. , K. Khoo S. , R. Adam R. 
Published: February 2008

Summary: A clinical study of the use of medroxyprogesterone acetate as a method of contraception, administered as 6‐monthly intramuscular injections of 300 mg., was carried out in 61 women. A total of 989 months of study were completed and 14 women received 4 injections or more.There were no significant changes in the systolic and diastolic pressure or in the body weight during 18 months of observation as compared with the pre‐treatment levels.Disorganisation of the uterine bleeding pattern was encountered, particularly during the first 6 months. However, there was a progressive decrease in the duration of bleeding per month and increase in the proportion of women who had amenorrhoea with time.Side‐effects were varied but mild; depression and diminution in libido were comparatively common.No pregnancy occurred during the period of study. Twenty of the 61 women discontinued treatment for reasons related to the drug, the important factor in 75% of the drop‐outs was unacceptable bleeding.
Contraception with a Six‐Monthly Injection of Progestogen: Part 2. Effects on Cervical Mucus Secretion and Endocrine Function
Authors: V. Mackay E. , K. Khoo S. , R. Adam R. 
Published: February 2008

SummaryThe cervical mucus and the endocrine function were studied in 61 women who received 6‐monthly intramuscular injections of 300 mg. medroxyprogesterone acetate as a method of contraception.Changes in cervical mucus were immediate and marked; its ferning and spinnbarkeit properties were absent, and its volume was greatly reduced. The karyopycnotic index of the vaginal smear remained relatively low during treatmentUrinary oestrogen excretion was only temporarily affected; depression in mean levels occurred only in the first 1 to 2 months after each injection. Urinary total gonadotrophins were depressed and an increasing proportion of women showed subnormal activity after each subsequent injection. The majority of urinary pregnanediol levels obtained were not consistent with corpus luteum activity.There were no significant changes in urinary excretion of ketosteroids and 17 hydroxycorticosteroids.No obvious differences in the hormonal indices of women with different patterns of uterine bleeding were noted.The mechanism of action of medroxyprogesterone is discussed with reference to the literature. Contraceptive efficacy is probably provided by changes in cervical mucus as well as inhibition of ovulation, without severe disturbance of endogenous oestrogen production.
Post‐haemorrhagic Shock in the Newborn
Authors: L. Tan K. 
Published: February 2008

Summary: Post‐haemorrhagic shock in the newborn is a relatively rare condition. If evidence of fetal bleeding during labour was not available, a baby in this condition would often be misdiagnosed as having shock due to asphyxia. Three cases of post‐haemorrhagic shock are presented. The routine examination of vaginal blood shed during the first stage of labour for the presence of fetal haemoglobin is recommended. This would enable prompt obstetric action and perhaps avert fetal disaster. Careful examination of the placenta is also important and may permit the diagnosis of fetal haemorrhage soon after birth of the infant.
Laparoscopic Removal of an Intra‐uterine Divice
Authors: W. Page S. , L. Monks P. 
Published: February 2008

Summary: A case is reported wherein a plastic contraceptive device was removed by means of the laparoscope and biopsy forceps from an extra‐uterine site in the pelvis. The removal under direct laparoscopic vision was both rapid and simple.
Growth and Malignancy of Ovarian Tumours in Pregnancy
Authors: Beischer N. A. , Buttery B. W. , Fortune D. W. , Macafee C. A. J. 
Published: February 2008

SummaryA series of 164 ovarian tumours diagnosed during pregnancy or the puerperium is presented. The commonest were the benign cystic teratoma (45 cases) and the mucinous cystadenoma (40 cases). Rapid growth of the tumour during pregnancy was observed in 5 of the 41 patients (12%) in whom assessment was possible; in none of these was the lesion malignant. The incidence of malignancy was 2.4% (4 of 164 cases) or 10 times less than that of ovarian tumours in non‐pregnant patients. This difference was accounted for by the variation in age distribution in pregnant and non‐pregnant patients with ovarian tumours.There were 21 patients with tumours 15 cm. or more in diameter. In this group the incidence of malignancy was 5% and the commonest complications were torsion (5 patients) and infection during the puerperium (4 patients).
A Comparison of the Long‐Acting Contraceptive Agents Norethisterone Oenanthate and Medroxyprogesterone Acetate
Authors: Chinnatamby Siva 
Published: February 2008

SummaryTwo intramuscular contraceptive agents, norethisterone oenanthate, 200 mg. given each 84 days, and medroxyprogesterone acetate, 150 mg. given each 90 days, have been studied in 1035 women for 10,161 cycles. Continuation of medication is about 85% at the end of 15 months; this rate is much higher than that of any other method in use in Ceylon. Of the side‐effects the most important is the disruption of the menstrual cycle leading to either long periods of amenorrhoea or continued bleeding. In spite of this, only 26 patients abandoned therapy for this reason. Oestrogen was given only to selected patients to arrest bleeding or to cause withdrawal bleeding in cases with long periods of amenorrhoea. The pregnancy rates were 2.3 per 100 women years for the norethisterone oenanthate, and 0.4 for the medroxyprogesterone; these could have been minimised if the drug was administered early in the cycle and on the 84th day as planned.There is no doubt that the long‐acting injectable is a very acceptable form of control of conception to the woman of low socio‐economic group provided the side effects (especially the disruption of the menstrual cycle) can be minimised.
An Investigation of Trophoblast Iso‐Immunization in Normal Pregnancy
Authors: Jones W. R. , Kaye M. D. , Ing R. M. Y. 
Published: February 2008

Summary: There has been widespread interest in the survival of the mammalian placenta as an allograft and in the possibility that humoral isoimmunization against placental antigens might occur in normal pregnancy.In this study, an indirect immunofluorescent test for circulating antitrophoblast antibodies failed to confirm previous reports of their presence in the serum of pregnant and postpartum women. An incidental, but common and non‐specific immunofluorescent staining characteristic of extra‐cellular fibrinoid material was demonstrated in sections of early placenta and to a lesser degree in late placenta.
Menstrual Disorders in Patients With Thyrotoxicosis
Authors: Saunders D. M. , Stiel J. N. , Hales I. B. 
Published: February 2008

Summary: A retrospective study of the menstrual pattern of 137 thyrotoxic patients attending the thyroid clinic of the Royal North Shore Hospital of Sydney was undertaken and comparison with a euthyroid control group was made.The study showed that there was no significant difference in menstrual function between the 2 groups.
The Control of Hypertension in Labour
Authors: Michael C. A. 
Published: February 2008

Summary: Twenty‐five patients with severe pre‐eclamptic toxaemia in labour were treated with one of the hypotensive drugs bethanidine or diazoxide combined with diazepam. In all patients a satisfactory reduction and subsequent control of the blood pressure occurred. There was no maternal mortality or morbidity and there was one neonatal death from prematurity. Diazoxide has a more rapid and predictable action than bethanidine, but it may cause hyperglycaemia in the fetus and therefore should probably be avoided in diabetic patients.It is contended that the combination of a hypotensive agent with an anticonvulsant drug such as diazepam is more effective in controlling an elevated blood pressure in labour than the conventional administration of heavy sedatives with their associated maternal and fetal hazards.
Physiological Weight Changes in Pregnancy in Malaysian Women*
Authors: Sinnathuray T. A. , Wong W. P. 
Published: February 2008

Summary: A study was made of the changes in weight during pregnancy and puerperium of 600 Malaysian women of 3 ethnic groups.The average total weight gain throughout pregnancy was about 11 kg. (24 lb.), the figure being higher for primigravidae (about 11.7 kg.) and lower for multigravidae (10.7 kg.).The average total weight gain throughout pregnancy was about 1–2 kg. (2–4 lb.) less than that for European and American women, but about 5–6 kg. (11–13 lb.) more than that reported for Indian and Nigerian women.The net weight gain of 4.5 kg. (10 lb.) at the end of the puerperium in Malaysian women is higher than that reported in Western studies. This is probably a reflection of the cultural, dietary, and physical habits of Malaysian women in the puerperium.
Abortifacient Action of Prostaglandins with Particular Reference to the Use of PGF2α Administered into the Amniotic Sac in the Second Trimester of Pregnancy
Authors: Shearman Rodney , Korda Andrew , Smith Ian 
Published: February 2008

SUMMARYThe results of the intra‐amniotic administration of prostaglandin F2a to 117 patients for the termination of second trimester pregnancy are recorded.The mean induction‐abortion interval was 23.7 hours, with a range of 5 to 61 hours in 111 successful cases. The induction‐abortion interval was influenced by parity and time of administration of the PGF2a, but not by the gestational age of the pregnancy.There were 6 failures (5.1 % of cases treated) and of these, only one patient required hysterotomy. Abortion was complete in 74 patients and obviously incomplete in 37 patients.There was a high incidence of systemic sideeffects, however they were transient. The most common side‐effects were nausea, vomiting and diarrhoea, dyspnoea, sweating and skin flushing.There were two cases of cervical damage; one involved bilateral lacerations and the other a bucket handle rupture of the cervix.
Serum Heat Stable Alkaline Phosphatase Compared with Urinary Oestriol in Abnormal Pregnancy
Authors: Ward Humphry , Whyley G. A. , Fricker E. S. A. , Stolen A. E. 
Published: February 2008

Summary: Three hundred and one estimations of serum heat stable alkaline phosphatase were made in 46 normal pregnancies to obtain mean values and a range between 22 weeks and term.One hundred and twelve patients with complications of pregnancies had 674 serial serum HSAP assays and 586 urinary oestriol estimations performed.Serum HSAP levels alone or those expressed as a percentage of the total alkaline phosphatase were found to be of little or no value in monitoring the fetal welfare in high risk pregnancies or in predicting stillbirth or neonatal death.Serial urinary oestriol estimations were abnormal in 83% of pregnancies complicated by intra‐uterine fetal growth retardation and in 88% of these pregnancies if fetal distress had occurred.
Rubella Antibody Titres, Rubella Vaccination, and the Obstetrician
Authors: Giles P. F. H. , Mackay‐Scollay E. M. , Christiansen K. 
Published: February 2008

Summary: The performance of a rubella haemagglutination‐inhibition antibody test at the first antenatal visit of 1,765 women was found to have several advantages; the 81% of patients found to be immune were reassured, the 19% at risk were identified, told what to do if they should be exposed to rubella or developed a rash, and were subsequently offered rubella vaccination in the puerperium.Rubella antibody titres of maternal and cord blood are compared and any significant differences are discussed.One case of rubella in pregnancy, and another of rubella vaccination just before conception, are presented. Of 20 mothers vaccinated in the puerperium, 5 reported side effects, and 2 did not develop antibodies.The place of tests on cord bloods for rubella haemagglutination‐inhibiting antibodies is discussed.