bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relaxin – A Review
Authors: MacLennan Alastair H. 
Published: February 2008

Summary:: Relaxin is a polypeptide hormone, similar in structure to insulin and has been found in the female of all species studied. The corpus Iuteum of pregnancy is the main source of relaxin in many species but in others the decidua is apparently of greater importance. It has also been found in other tissues; e.g. prostatic fluid, testis and ovary. First discovered and extracted from the corpora lutea of pregnant sows in an impure form in 1926, it was found to relax the pubic ligament of the oestrogen primed guinea‐pig. It was named after this action, but has since been found to have many other possible roles, including preparation of the endometrium for implantation, inhibition of uterine activity in early pregnancy, remodelling of the uterine stroma during pregnancy, cervical ripening and the initiation of parturition. Relaxin's main cellular action in pregnancy may be to drive collagen biosynthesis in its target organs, thus facilitating the remodelling of the connective tissue. Due to the impurity of relaxin preparations used in clinical trials until the mid‐1970's, the role of relaxin in the human has been in doubt. Porcine and rat relaxins have now been highly purified and their detailed structure is known. Human relaxin awaits adequate isolation, purification and characterization, and is not yet available for laboratory and clinical trials. However, the recent preparation of purified porcine relaxin for clinical trials and the availability of specific radioimmunoassays for this relaxin together with the identification of relaxin receptor sites, are rapidly helping to establish the concept that relaxin is indeed an important hormone both in human reproduction and in other physiological processes.
The Cost of Routine Antenatal Screening for Syphilis
Authors: Bryce Robert L. , Pritchard Robert C. 
Published: February 2008

Summary:The incidence of new cases of syphilis diagnosed after routine antenatal screening at a Sydney teaching hospital between 1975 and 1979 was 2 in 12,222. Both patients were treated and no infants were born with congenital syphilis. The cost of the screening programme for this period was estimated at $9,778.
Endodermal Sinus Tumour of the Ovary: The Place of Alphafetoprotein Detection, Surgery and Chemotherapy
Authors: Khoo S. K. , Buntine D. W. , Massey P. F. , Jones I. S. C. 
Published: February 2008

Summary:New developments in the management of the rare endodermal sinus tumour of the ovary, together with the reporting of 2 additional patients, are presented. There is a need for accurate clinical and pathological evaluation of the disease. As shown in the present study, histochemical staining for alphafetoprotein (AFP) provides an additional factor in diagnosis, and monitoring of AFP levels in serum is a useful guide to treatment. The prognosis, previously uniformly poor, appears to be improved with the use of multidrug chemotherapy. In a collated series of 98 patients, the 24‐month survival rate was 65% in Stage I disease and 67% in Stage II disease. However, the choice of effective drugs remains uncertain. The improved survival of young patients with aggressive chemotherapy has now raised the question of preservation of fertility at the time of surgery. In a small collated series of 26 patients with Stage I disease, survival to 36 months was not jeopardized by the conservative removal of one tube and ovary.
The Pattern of Hydatidiform Moles in Singapore
Authors: Lee Y. S. , Cheah E. , Szulman A. E. 
Published: February 2008

Summary:Hydatidiform mole is common in Singapore, and the incidence of malignant trophoblastic neoplasia is significantly higher than in Western countries. Within a 10‐year period (1968–1977), 538 cases of hydatidiform mole were diagnosed. On retrospective study, 498 (92.6%) were considered to be complete and 40 (7.4%) partial. The ratios of complete to partial moles were similar for the major population groups.In the present study, only complete moles were found to give rise to persistent trophoblastic disease. The lack of such association in partial hydatidiform moles is in keeping with their known low malignant potential. Occasional abnormal post‐evacuation hCG curves, however, are being described from other centres, and while the underlying pathology remains largely undocumented, partial moles have to be dealt with on an empirical basis in the light of the hCG follow‐up levels.
Two Cases of Placental Sulphatase Deficiency with Unusual Endocrine Features
Authors: Knox David J. , Fraser Ian S. , Shutt Donald A. 
Published: February 2008

Summary:Two cases of placental sulphatase deficiency are described both of which showed typical clinical features, associated with very low urinary and serum oestrogens. In the one case that reached term there was a spontaneous rise in serum oestradiol levels (from 16 to 44 nmol/1) after 38 weeks, although no oestradiol rise occurred after DHEAS loading. She later achieved a vaginal delivery. Although no steroid sulphatase activity could be detected in the placenta of case 2, there was a small transient rise in serum oestradiol (from 15.4 to 32.7 nmol/I) after maternal DHEAS loading. However, the absolute levels reached were very low compared to the response seen in normal pregnancies. The spontaneous rise in basal oestradiol levels between 38 and 41 weeks and the transient rise following DHEAS loading have not been previously reported for patients with placental sulphatase deficiency. Umbilical cord blood levels of several steroids in case 2 showed some similarities to previous case reports. Levels of DHEA, 16αOH DHEA, 170H pregnenolone and Cortisol were significantly lower than control values. DHEAS, 16αOH DHEAS, 170H progesterone and andros‐tenedione were within the normal range.
Bilateral Retinal Detachment in Association with Preeclampsia
Authors: McEvoy M. , Runciman J. , Edmonds D. K. , Kerin J. F. P. 
Published: February 2008

Summary:Bilateral, serous, non‐rhegmatogenous retinal detachment is a rare complication of preeclampsia. Duke‐Elder and Dobree (1967) stated than Van Graefe reported the first case in 1855. Since then 24 further cases have been reported – Wagener (1933), Wahrsinger (1943), Singh (1953), Bosco (1961), Gitter (1968), Klein (1968), Kenny (1972), Mabie (1980) and Oliver (1980). The incidence over the past 40 years appears to be decreasing and probably reflects the lower incidence of severe preeclampsia as a result of better antenatal care. These detachments are bilateral, serous and non‐rhegmatogenous i.e. atraumatic. They often only involve the posterior pole. Bosco (1961) arrived at an incidence of 1 in 18,524 pregnancies. Previous case reports have suggested a higher incidence in primigravidas and all previous cases have occurred antenatally. In all but 1 previous case (Mabie, 1980), the detachment occurred concomitantly with hypertensive retinopathy. We report a multigravida with preeclampsia who, in the absence of any hypertensive retinopathy, developed bilateral, bullous retinal detachments in the puerperium.
Staphylococcal Toxic Shock Syndrome
Authors: Sorrell T. C. , Packham D. R. , Helprin G. , Munro R. , Gibson J. S. 
Published: February 2008

Summary:A case of postpartum fever due to staphylococcal toxic shock syndrome, and a case of menstruation‐associated disease are described. Features pertinent to early diagnosis and management, particularly in patients with postpartum fever, are emphasized. Epidemiological data are discussed with reference to current theories of pathogenesis.
Multiple Pregnancy and Fetal Abnormalities in Association With Oral Contraceptive Usage
Authors: Macourt D. C. , Stewart P. , Zaki M. 
Published: February 2008

Summary: 1,000 multiple births were examined in relation to maternal exposure to an oral contraceptive before conception. There was a significantly higher rate of monozygotic twinning among pregnancies which took place within 6 months of cessation of the contraceptive.In the monozygotic group there was a significant increase in the incidence of congenital abnormalities (P < 0.01) when conception occurred within 3 months of cessation of the contraceptive.
A Randomised Trial and a Comparative Study of the Copper 7 200 and the Multiload Copper 250 Intrauterine Devices
Authors: Wilson Jennifer 
Published: February 2008

Summary: A randomized trial of the Copper 7 200 (Cu 7 200) and the Multiload Copper 250 (ML Cu 250) intrauterine devices (IUD) was carried out for 13 months. On life table analysis at 12 months, net cumulative closure rates for use‐related terminations (net rates) for the Cu 7 200 were higher than for the ML Cu 250 for accidental pregnancy (NS), expulsions (P<0.02) and medical removals for pain and/or bleeding (P<0.01). The continuation rate was lower for the Cu 7 200 (P<0.001). In a larger comparative study, at 12 months there was a highly significant difference (P<0.001) in favour of the ML Cu 250 in accidental pregnancy, expulsions and removals for pain and/or bleeding and continuation of use.Since the ultimate purpose of the use of an IUD is pregnancy protection with a minimum of side effects, the continued use of the Cu 7 200 is not recommended.
Problems in the Diagnosis of Ectopic Pregnancy: The Pseudogestational Sac
Authors: O'Neil A. G. B. , Hammond I. G. , Reid S. E. 
Published: February 2008

Summary: The term pseudogestational sac was first suggested by Mueller in 1979. It was applied to the echo pattern which he noted on ultrasonic examination of 2 patients with ectopic pregnancy. He suggested that the echo pattern, which can easily be misinterpreted as a gestational sac, is produced by the decidual cast with blood contained in its centre.During the past 3 years, 6 cases of pseudogestational sacs have been recorded at K.E.M.H. In 3 of these the possibility of ectopic pregnancy was suggested by the ultrasonologist because of suspicious extra‐uterine echo patterns associated with the pseudogestational sac.In the remaining 3 patients the ultrasonologist reported that there was an intrauterine pregnancy, an error which influenced clinical management. These 3 cases are summarized below.
Positive Peritoneal Cytology in Corpus Carcinoma Report of a Fatal Outcome
Authors: Hacker Neville F. , Castaldok Thomas W. , Morrow C. Paul , Ballon Samuel C. 
Published: February 2008

Summary: A 64‐year‐old patient underwent total abdominal hysterectomy and bilateral salpingo‐oophorectomy in October, 1978 for a Stage IA, grade 2 papillary adenocarcinoma of the endometrium. Peritoneal washings contained numerous malignant cells, although the tumor invaded the myometrium only superficially.Two weeks after operation, 12 mCi of P32 were instilled into the peritoneal cavity. In May, 1979, laparotomy was performed for clinical obstruction of the small intestine and revealed diffuse peritoneal, omental, and hepatic metastases. Radiation changes involved the terminal ileum, ascending and sigmoid colon; an ileorectal fistula was also identified.The factors that might cause malignant cells to be present in the peritoneal cavity and the ideal treatment of such patients have yet to be determined. The risk of intraperitoneal P32 might outweigh its benefits.
Fetal Distress Due to Intravenous Administration of Pethidine (Meperidine) with Promethazine During Labour
Authors: Bergman Arieh , Eckstein Nachman , Yedwab Gideon , David Menahem P. 
Published: February 2008

Summary: Fetal bradycardia due to uterine hypertonia was observed after the intravenous administration of pethidine (meperidine) 75 mg with promethazine 25 mg during active labour. These analgesic drugs are known to affect uterine contractions by enhancing both amplitude and frequency, but are thought to affect uterine tone minimally.Twenty cases of uterine hypertonia resulting in fetal bradycardia were monitored in a period of 6 months in women receiving these drugs during labour. In all cases, the uterine hypertonia appeared shortly after the drug administration. The uterine hypertonus as well as the fetal bradycardia were self limited and no intervention was undertaken.Recognition of this phenomenon is important in order to prevent unnecessary anxiety on the part of medical attendants.
Book Reviews
Authors: Wilson L. Hardy 
Published: February 2008

Book reviewed in this article:Atlas of Pelvic SurgeryThe Fetus and Independent LifeAbortion and Sterilisation … Medical and Social AspectsThe Infertility Resources Handbook.Developmental Effects of Diethylstilbestrol (DES) in Preg‐nancyMalignant Disease of the VulvaPrinciples and Practice of Obstetrics and PerinatologyNovak's Textbook of GynaecologyGynaecology
Acute Appendicitis Complicating Pregnancy and the Puerperium A Study of 5 Cases
Authors: Humphrey M. D. , Ayton R. A. 
Published: February 2008

Summary:This series of 5 cases of appendicitis complicating all stages of pregnancy and the puerperium illustrates particularly the potentially rapid course of the disease and the need to perform laparotomy on suspicion. Diagnosis may be aided, in later pregnancy, by the finding of pain increments when the fetus moves, as well as by the use of Alders test. Though a muscle‐splitting incision over the point of maximal tenderness is usually suggested, we recommend a right paramedian incision when the fetus is viable as it gives greater flexibility.
Ptyalism and Partial Hydatidiform Mole Associated with a Normal Term Male Fetus
Authors: Hartfield V. J. 
Published: February 2008

Summary:The case is described of a subfertile woman whose only successful pregnancy was complicated by the unusual combination of ptyalism and a partial hydatidiform mole. Review after delivery of an ultrasonic scan taken at 17 weeks showed the mole to be present at that time. A normal male child was delivered at term. It is concluded that there was no causal relationship between these 2 conditions.Excessive salivation in pregnancy is a rare condition. Cooper (1956) found only 1 true case in 60,520 admissions to the University of Cape Town maternity hospitals. Likewise a hydatidiform mole with a co‐existent fetus is uncommon. Beischer (1966) gave an incidence of 1 in 20,000 pregnancies at the Royal Women's Hospital in Melbourne. However, in 12 of the 15 cases reported by him in 1961, the pregnancy ended before the third trimester. Jones and Lauersen (1975) reported 1 case with a live baby at term amongst the 8 studied; the incidence at the New York Hospital was 1 in 22,000 pregnancies. I have not been able to find any report of a case where a hydatidiform mole has been associated with ptyalism. The present case, as well as being apparently unique, provides some interesting insights into the 2 conditions.
Chromosome 1 C‐band Heteromorphisms in Patients with Carcinoma in Situ and Invasive Carcinoma of the Cervix Uteri
Authors: Atkin N. B. , Brito‐Babapulle V. 
Published: February 2008

Summary:A significantly higher incidence of heteromorphism for the size of the C‐band regions of the chromosome 1 homologues was found in the lymphocytes of patients with carcinoma in situ and invasive carcinoma of the cervix uteri than in controls (15 out of 19 and 12 out of 18 patients, respectively, as compared with 13 out of 38 controls). There was also a higher incidence of partial inversions of this region in patients with carcinoma in situ and invasive carcinoma although the differences from that found in the controls were not statistically significant. C‐band variants of chromosome 1 may play a part in the cytogenetic events that determine the early stages of some forms of malignancy.
Acute Fatty Liver of Pregnancy – Survival Despite Associated Severe Preeclampsia, Coma and Coagulopathy
Authors: Cheng Chee Yam 
Published: February 2008

Summary:Acute fatty liver of pregnancy is the least common and most serious cause of jaundice of pregnancy. It is rare, fewer than 100 cases having been reported (Koff, 1981). There is a high probability that it is frequently misdiagnosed and categorized vaguely as some form of variant of ‘toxaemia of pregnancy’ which is not surprising because of its late‐pregnancy onset and the production of multi‐system manifestations (Holzback, 1976). In the case reported here, there was associated severe preeclampsia with fetal intrauterine death but maternal survival.
Editorial Comment: Is a Basement Membrane Necessary for the Histological Diagnosis of Intraepithelial neoplasia?: Glandular Intraepithelial Neoplasia (GIN) – A Unifying Concept Of The Precursors Of Endometrial Adenocarcinoma
Authors: Ruffol Eugene H. , Cavanagh Denis , Marsden Donald E. 
Published: February 2008

SummaryThere is considerable variation and a good deal of confusion surrounding definitions and nomenclature for premalignant lesions of the endometrium. A unifying concept, based on the model of cervical intraepithelial neoplasia, is proposed to provide a uniform, practical basis for the diagnosis and management of the precursors of endometrial cancer. Lesions would be classified as glandular epithelial neoplasia (GIN) Grades, 1, 2 and 3. Illustrated examples, and comparisons with other classifications are provided.
An Evaluation Of Teaching Cervical Mucus Symptoms To Ovulating Infertile Women
Authors: Graham Frederick M. , Gosling Leonie , France John T. 
Published: February 2008

SummaryWomen (n=l 13) with ovulatory menstrual cycles but complaining of infertility were instructed in the observation and charting of cervical mucus symptoms. At the completion of 3 teaching cycles, 80 subjects (70.8%) had successfully charted at least one cycle with an ovulatory mucus pattern (10 subjects became pregnant). Sixty‐two (54.9%) of the women continued for a further 3 cycles of investigation during which, around the time of ovulation, an assessment was made of the mucus at the cervix. On the basis of this assessment subjects were classified as either Group I: charting ovulatory mucus symptoms with ‘fertile type’ mucus observed at the cervix – 48 subjects (10 became pregnant); Group 2A: charting uninterpretable mucus symptoms but 'fertile type’ mucus observed at the cervix – 8 subjects; or, Group 2B: charting uninterpretable mucus symptoms and mucus of poor quality observed at the cervix – 6 subjects. The study shows that infertile ovulating women can be taught to observe and chart their mucus symptoms. Such charting is useful in identifying the fertile period of the cycle for timing of intercourse and for timing of postcoital tests and cervical assessment. It is also useful in identifying the small number of women (5.3%) with an apparent deficiency in mucus production. Whether the 20 subjects (17.7%) who became pregnant were assisted in this objective by their charting of symptoms is unclear.
A Review of Primary Caesarean Sections in Tasmania
Authors: Murray‐Arthur F. , Correy J. F. 
Published: February 2008

EDITORIAL COMMENT: Changes in practice should be evaluated. Rising rates of Caesarean section should be questioned in terms of fetal results and risks to the mother. Perinatal mortality rates are easily calculated but the justification of an increased Caesarean section rate is likely to be an improved quality of survival of the infant — this information is not readily available but must not be overlooked in the Caesarean section argument. Finally, the perinatal mortality rate associated with Caesarean section cannot be expected to fall when the increased rate takes in more of the fetuses at greatest risk (prematurity ±breech presentation, severe preeclampsia, premature rupture of the membranes, antepartum haemorrhage).Summary: In the years 1975–1982 inclusive there were 55,095 deliveries in Tasmania and of these 2,738 patients (4.9%) were delivered by primary Caesarean section. The primary Caesarean section rate increased from 4.3% in 1975 to 6.6% in 1982. This increase has been due to the increased incidence of primary Caesarean section associated with breech presentation and to a lesser extent fetal distress. Although the overall perinatal mortality rate fell from 19.5 per 1,000 births in 1975 to 10.8 per 1,000 births in 1982, there has been no corresponding fall in the perinatal mortality rate associated with primary Caesarean section. As an increase in Caesarean section will lead to an increase in maternal mortality and morbidity it is considered that an active review of the reasons for the rise in Caesarean section should be undertaken by those hospitals where the rate is unusually high.
Unexplained Intracranial Haemorrhage in Utero: The Battered Fetus?
Authors: Gunn Tania R. , Becroft David M. O. 
Published: February 2008

Summary: Twenty stillborn infants with unexplained intracranial haemorrhages were identified in a review of approximately 3,500 perinatal postmortems performed between 1966 and 1982. After apparently uneventful pregnancies, fetal death occurred before the onset of labour and was recognized at a mean of 10 days before delivery; 80% had subdural haemorrhages, others had intraventricular and/or intracerebral haemorrhages, and many had haemorrhages at more than one of these sites. These haemorrhages were of sufficient size to have caused death and no other causes were found at postmortem examinations.All 20 mothers were immigrants to New Zealand from the Pacific Islands and almost all were older, married, multi‐gravidas with uneventful medical histories and in stable socio‐economic circumstances. In the period studied the incidence of stillbirths with unexplained intracranial haemorrhages was 1.15 per 1,000 Pacific Islander births and, at one hospital, these haemorrhages were found in 14.6% of Pacific Islander stillbirths. There were no unexplained intracranial haemorrhages in other racial groups.Prenatal subdural haemorrhage without a history of maternal trauma is extremely rare. In the absence of supporting maternal histories and other fetal or maternal injuries the possibility that these are ‘battered’ fetuses remains circumstantial.
Preoperative Cervical Dilatation: A Trial of Laminaria Tents and Prostaglandin Fα2 Gel
Authors: Morris N. D. , McCallum G. I. , Hammond L. 
Published: February 2008

Summary: Surgical damage to the cervix in patients undergoing termination of pregnancy may be responsible for serious complications in subsequent pregnancies.Sixty nulliparous women undergoing first trimester termination of pregnancy were randomly allocated to 3 treatment groups, one using laminaria tents preop‐eratively, one using intracervical PGF2α gel preoperatively and one using no pre‐treatment.Results showed clear benefits in the laminaria group, in terms of achieving preoperative cervical dilatation and ease of further operative dilatation. Laminaria tents were superior to PGF2α gel which was, in turn, superior to no pretreatment. There were no differences in blood loss or postoperative complications among the 3 groups.Laminaria tents provide a cheap, effective and safe method of reducing the risk of cervical damage in women undergoing surgical termination of pregnancy.
Intrauterine Growth Standards for Hong Kong Chinese
Authors: Woo Joseph S. K. , Li Dominic F. H. , Ma Ho‐Kei 
Published: February 2008

Summary: Intrauterine growth standards for Hong Kong Chinese were derived from birth‐weight data between 28 and 42 weeks' gestation in 15,815 livebirths delivered in 1982 to 1984 at 2 maternity teaching hospitals in Hong Kong. Normal distribution of birth‐weights was noted in each of the gestational weeks studied. The mean birth‐weight was 3,237g at 40 weeks which was similar to the mean weights reported in other populations for this gestation. The trend of the median weight curve was also similar to that in other Caucasian and Asian reports. The growth pattern for males and females were similar and males were on the whole heavier than females throughout the gestational period studied. At 40 weeks, the 10th percentile weight also showed wide variations between reports, which would have important bearing on the studying of intrauterine growth retardation.When the mean weight at term as derived from the present study was compared to a previous report on birth‐weight data in 1970–1972 in the same hospital, a significant increase in birth‐weight was observed over the 12‐year period. The importance of having up‐to‐date intrauterine weight standards for a specific population is discussed.