bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tamoxifen and Aminoglutethimide in the Management of Patients With Advanced Endometrial Carcinoma Not Responsive to Medroxyprogesterone
Authors: Quinn M. A. , Campbell J. J. , Murray R. , Pepperell R. J. 
Published: February 2008

Summary:Eleven patients with advanced endometrial carcinoma not responsive to medroxyprogesterone were entered into a trial of therapy with tamoxifen, aminoglutethimide or both in combination. Two patients had a complete response, 1 to aminoglutethimide and 1 to tamoxifen. One patient who initially had a partial response to tamoxifen but then relapsed, had a partial response to aminoglutethimide. Two patients had stable disease for 8 and 6 months on aminoglutethimide, and 1 patient who initially showed no response to tamoxifen has had stable disease for 14 months since addition of aminoglutethimide to therapy. The relative lack of toxicity of these drugs make their use attractive in the management of such patients.
Maternal Alcohol, Tobacco and Cannabis Consumption and the Outcome of Pregnancy
Authors: Gibson G. T. , Baghurst P. A. , Colley D. P. 
Published: February 2008

Summary:In a prospective study of 7,301 births, associations were sought between maternal alcohol, tobacco and cannabis use and several adverse outcomes of pregnancy. Apparent effects of alcohol use on prematurity, intrauterine growth retardation, congenital abnormalities and low Apgar score were consistent with previously reported work, but were not statistically significant. Infants born to smokers had lower birthweights and were more prone to intrauterine growth retardation, but they did not appear to have an increased risk of prematurity or perinatal death. Only 36 women reported using cannabis 2 or more times a week, not merely as smokers of marijuana but also as users of the more potent resin forms of cannabis. Subsequently 25% of these women gave birth to premature infants.
Term Breech Delivery – Is a High Caesarean Section Rate Justified?
Authors: Woo J. S. K. , Chan P. H. , Ghosh A. , Wong V. , Ma H. K. 
Published: February 2008

Summary:The Caesarean section rate for breech presentation has fallen from 60% in 1978 to 38% in 1980 at the University teaching hospital in Hong Kong. The number of Caesarean sections carried out for the indication of ‘unfavourable pelvis’ in 1980 was approximately half that in 1978. No significant difference in perinatal outcome was noted in the group delivered vaginally in these 2 years. It was concluded that a high Caesarean section rate in term breech presentation may not be justified in modern obstetric practice because of the associated increase in maternal morbidity. Many patients labelled as having an 'unfavourable pelvis' can in fact have a safe vaginal breech delivery.
Maternal Exposure to Environmental Chemicals and the Aetiology of Teratogenesis
Authors: Gibson G. T. , Colley D. P. , Baghurst P. A. 
Published: February 2008

Summary: Data on exposure of 10,879 pregnant women to various household and agricultural chemicals were obtained by interview; 6,267 of these women were seen both antenatally and postnatally, enabling a genuine prospective study of the association between chemical exposure and congenital abnormalities in the infant. The remaining 4,612 women were privately booked and were first seen postnatally.Statistical analysis of the 2 groups revealed a strong association of malformations with chemical exposure in both groups, even after other known risk factors were taken into account.
The Effect Of Prenatal Diagnosis On The Incidence Of Down Syndrome In Western Australia
Authors: Mulcahy Marie T. 
Published: February 2008

SummaryThis paper compares the incidence rates of Down syndrome livebirths in Western Australia during two 5‐year periods before and after the advent of prenatal cytogenetic diagnosis. A statistically significant fall in the incidence of liveborn Down syndrome is demonstrated and the relevance of amniocentesis screening is discussed in the light of possible future demographic change.
Understanding Preterm Labour: The Use Of Path Analysis
Authors: Chenoweth J. N. , Esler E. J. , Chang A. , Keeping J. D. , Morrison J. 
Published: February 2008

SummaryA retrospective study was performed on 465 spontaneous preterm and 13,949 term births, in order to analyze the sequence of events that culminate in preterm labour. Twenty‐one variables were investigated by the mathematical technique of Path Analysis. Nine direct and independent precursors of preterm labour were identified. These were antepartum haemorrhage, poor antenatal attendance, previous delivery of a small baby, multiple pregnancy, proteinuria, grand multiparity, cervical suture, low maternal weight, and a history of bleeding before 20 weeks.
The Effect Of Ampicillin and Colistin On Post‐Caesarean Section Endometritis With Identification Of Possible Risk Factors
Authors: Birkenfeld Arie , Anteby Shaoul O. 
Published: February 2008

SummaryTwo hundred and seventy eight women undergoing Caesarean section were evaluated retrospectively to determine the value of prophylactic antibiotic treatment. The patients were divided into 2 groups: 180 women who received no prophylactic treatment and 98 who were treated prophylactically with ampicillin and colistin (Colymycin). Significantly lower rates of infection with prophylactic treatment were found in all groups studied (P < 0.001) (P < 0.05 in the group with premature rupture of membranes). Premature rupture of membranes was found to be the only risk factor significantly altering the rate of infection in the untreated group. Patients with premature rupture of membranes or with prolonged stay in the labour room prior to surgery had a significantly higher rate of infection even after the introduction of prophylactic treatment with ampicillin and colistin (P < 0.001).
Persistent Chest Opacity in Trophoblastic Disease: Is Thoracotomy Justified?
Authors: Wong L. C. , Ma H. K. 
Published: February 2008

SummaryFrom 1972 to June 1980, 138 patients were admitted into the University Gynaecological Unit, Queen Mary Hospital for persistent gestational trophoblastic tumours. Forty had pulmonary metastases, all were treated by chemotherapy and 5 died shortly after commencement of treatment. The remaining 35 patients went into biochemical remission. Five of these patients had persistent chest shadows and 2 had evidence of active disease. Thoracotomy is of doubtful value both in therapy and in predicting prognosis. These patients have an increased risk of relapse. Close and long‐term follow‐up HCG assay is advocated.
Indications for the Treatment of Tubal Infertility Patients by Microsurgery or In Vitro Fertilization
Authors: Paterson Peter J. 
Published: February 2008

Summary: Pregnancy rates following the treatment of tubal infertility patients by microsurgery or in vitro fertilization (IVF) have been analysed.The results indicate that microsurgery should be the primary treatment for the following: (a) Sterilization reversal (except fimbriectomies or tubes of less than 3cm length); (b) Incomplete lateral tubal occlusion; (c) Medial tubal occlusion; (d) Peritubal or periovarian adhesions.IVF is indicated as the primary treatment for tubal infertility patients when investigation demonstrates (a) Total lateral tubal occlusion; (b) Previous fimbriec‐tomy sterilizations; (c) Reconstructable tubal length of less than 3cm.
Return to Theatre –Experience at the Mercy Maternity Hospital, Melbourne 1971–1982
Authors: Ashton Peter , Beischer Norman , Cullen John , Ratten Graeme 
Published: February 2008

Summary: This paper summarizes the problems which necessitated return to theatre at the Mercy Maternity Hospital, 1971–1982. There were 154 of 29,488 patients (0.5%) having obstetrical or gynaecological treatment in theatre who made this journey. They all survived, some after heroic resuscitative measures.Haemorrhage necessitated the patient's return to theatre following 0.2% of Caesarean sections and 0.2% of gynaecological operations.Many obstetric patients who return to theatre are potential maternal deaths. The assistance of an experienced colleague is essential in their management. When massive or continuing haemorrhage occurs at Caesarean section, hysterectomy should be considered, especially if the placenta appears to be morbidly adherent, these being the very patients at risk of a return to theatre if hysterectomy is not performed. With the increasing Caesarean section rate, placenta praevia accreta has become more common, to the extent that ultrasonographic localization of the placenta is recommended in all patients who have had a previous Caesarean section.Curettage is not indicated in the treatment of primary postpartum haemorrhage after Caesarean section; moreover, its performance in the management of secondary postpartum haemorrhage when the patient was delivered by Caesarean section should be regarded as a formidable procedure. When a patient who was delivered vaginally returns to theatre because of continuing haemorrhage after curettage performed for secondary postpartum haemorrhage hysterectomy is likely to be required.Safe methods of suturing the lower uterine segment incision at Caesarean section, and the lateral angles of the vaginal vault after abdominal hysterectomy are described.
Second Trimester Maternal Serum Alpha‐fetoprotein as an Indicator of Fetal Risk
Authors: Legge M. , Duff G. B. , Pike L. , Aickin D. R. 
Published: February 2008

Summary: Serum alpha‐fetoprotein levels were raised to 2.0 or more times the median for gestation in 30 of 507 singleton pregnancies after excluding pregnancies complicated by fetal neural tube defects.The serum alpha‐fetoprotein levels were significantly more often elevated in pregnancies complicated by prematurity, fetal heart rate abnormalities, delivery of a small for dates infant, a perinatal death and admission of the baby to the neonatal unit. While the predictive value of an elevated serum alpha‐fetoprotein was 76% for abnormal outcomes in general it ranged between only 16% and 46% for specific abnormalities. The usefulness of this assay relates only to its ability to predict an abnormal outcome when performed during the second trimester.
Preparation for Induction of Labour of the Unfavourable Cervix with Foley Catheter Compared with Vaginal Prostaglandin
Authors: Thomas I. L. , Chenoweth J. N. , Tronc G. N. , Johnson I. R. 
Published: February 2008

EDITORIAL COMMENT: It is salutary to note that many workers now advocate mechanical methods of cervical dilatation condemned in the past for very good reasons (maternal infection, cervical trauma). It is also noteworthy that this paper reports impressive results of Foley catheter with traction (spontaneous vaginal delivery 66%, Caesarean section rate 22%) in patients with an unfavourable cervix who required induction of labour (see Arulkumanan et al Aust. NZJ Obstet. Gynaecal. 1985; 25: 190–193).Summary: Ripening of the unfavourable cervix prior to induction of labour using traction on a Foley catheter (32 patients) was compared with 40 mg of prostaglandin F2α in Tylose gel applied to the external cervical os and held in place for 12 hours with a vaginal diaphragm (25 patients). Each patient in the above groups had a modified Bishop score of 0–3 and was randomly allocated to one or other group. Comparison was made with a further 25 patients in whom the cervical score was 4–6.Timing of amniotomy and commencement of Syntocinon infusion were equivalent for all patients.Prostaglandins conferred no advantage over Foley catheter in terms of am‐niotomy‐delivery interval, operative delivery rate, and condition of the baby one minute after birth.The disadvantages of prostaglandins for cervical ripening are a longer preparation‐delivery interval, and cost ($77 versus $4.75 for the Foley catheter). Currently, prostaglandins are not officially approved for use in Australia for induction of labour. It is suggested, therefore, that the Foley catheter is preferable for ripening the unfavourable cervix as a prelude to amniotomy.
Racial Variations in Obstetric Practice
Authors: Cauchi Maurice N. 
Published: February 2008

Summary: This study involves a retrospective analysis of 453 pregnant persons, with the aim of comparing certain disorders of pregnancy as well as infant and placental parameters in various racial groups within the same community. Significant variations were seen in the mean age of the patients, age at first pregnancy, frequency distribution of first pregnancy, infant weight as well as gravida: parity ratio. There was a 3‐fold increase in incidence of preeclampsia in the Australian‐born population compared to other racial groups. Mild anaemias (haemoglobin < 11.5 g/dl) were found in up to 61% of the Australian‐born population compared to 32% of the other racial groups; however, more significant degrees of anaemia were more commonly found in certain ethnic groups (e.g. Greek 16%, Italian 15%, Australian‐born 6%).These studies emphasize that overall incidence studies in a polyglot population can have very limited meaning, and that greater attention must be paid to the actual racial variations within a population.
Computed Tomography Prior to Surgery for Ovarian Carcinoma
Authors: Simon Alex , Fields Scott , Schenker Joseph G. , Anteby Shaoul O. 
Published: February 2008

Summary: The value of investigation of patients with ovarian carcinoma by preoperative computed tomography scan was evaluated in all the patients operated on during the last 2 years; 22 patients were included in this study and evaluated. In 11 patients the scan was performed prior to the primary surgery and in the other 11 patients before second look following chemotherapy.CT scan was found to be highly sensitive in detecting ascites, pelvic wall extension and spread or involvement of the uterus. Peritoneal and omental spread was detected in only half of the patients before primary surgery. Prior to second look operation CT scan was effective in excluding liver metastasis, ascites, paraaortic lymph node enlargement, pelvic wall extension and pelvic residual tumour. Generally, CT scan failed to detect peritoneal and omental spread. It is an important tool for preoperative evaluation of the extension of the disease and planning of surgery, but still, the final staging deserves explorative laparotomy.
Infant Development Following the Use of Intravenous Nutrition to Women with Persistently Low Urinary Oestriol Excretion
Authors: Carne Raymond J. , Drew John H. 
Published: February 2008

EDITORIAL COMMENT: This study concludes that dextrose infusions to mothers with high‐risk pregnancies does not compromise the intellectual quality of survival, although it appears to improve perinatal mortality rates. This finding has relevance to the time‐honoured practice of giving 5% dextrose to patients in labour when progress is suboptimal and operative delivery likely — for prevention and/or treatment of maternal ketosis and distress — the assumption being that prevention of maternal dehydration improves fetal and maternal condition and reduces the need for Caesarean section. Recent publications (1,2) suggest that dextrose infusions to the mother in labour could harm the fetus with hypoxia, resulting in anaerobic glycolysis of the dextrose load, which could increase the tendency to fetal acidosis. This objection to the use of dextrose in labour is theoretical and defies clinical experience. Carne and Drew's paper suggests that dextrose infusions to a group of mothers with a high proportion of growth retarded infants is certain& nor harmful and indeed appears to be beneficial, as one would expect to be the case since the fetus lives on glucose. Even Christianity has its critics; the practice of giving 5% dextrose intravenous& to the mother with prolonged or difficult labour to prevent or ameliorate maternal and/or fetal distress has not been discredited.Summary: During the 6‐year period 1971 to 1976, 10,545 patients had urinary oestriol determinations during pregnancy and 333 (3.2%) had persistently low values. Of the 335 resultant infants 206 were from patients treated with intravenous dextrose and/or amino‐acids (treated group) and 129 from nontreated patients (nontreated group). The stillbirth rate was 2.4% in the treated group and 11.6% in the untreated group (p > 0.001), and the neonatal death rates were 2.9% and 4.7% respectively (p = NS). Assessment of the surviving infants to 7 years of age revealed no significant differences in growth between treated and nontreated groups. There was no increase in the incidence of major neurological abnormalities in the treated infants (2.9%) when compared to those from nontreated pregnancies (1.3%) (p = NS), nor was there a significant difference in the incidence of minor neurological abnormality or findings on psychological assessments. We conclude that dextrose and/or amino‐acid infusions given to pregnant women with low oestriol excretion reduced the perinatal mortality rate without significant compromise to subsequent development of surviving infants.
The Vertical Birthing Position of the Trobrianders, Papua New Guinea
Authors: Pöschl Ulrike 
Published: February 2008

EDITORIAL COMMENT: It is considered that this review of birthing positions will interest many readers. Figure 6* provided by Dr Michel Odent, Pithiviers, France, shows remarkable similarities to figure 5, and illustrates that modern Western obstetric practice has not completely abandoned the vertical birthing position!Summary: During an ethnomedical field study the author succeeded in participating and photographing 4 traditional birthgivings among the Trobrianders/Papua New Guinea. Their various vertical postures are described with special reference to specific Trobriand practices and discussed by literature review. The results suggest that vertical birthing positions are advantageous to horizontal ones and should be reconsidered by modern Western obstetrics.
The Treatment of Advanced Recurrent Carcinoma of the Uterine Cervix with Platinum Based Cytotoxic Chemotherapy
Authors: Hardy J. R. , Maclean G. D. , Foote G. A. , Harvey V. J. 
Published: February 2008

EDITORIAL COMMENT: The pessimism expressed in this paper with regard to chemotherapy of recurrent or advanced cervical cancer is shared by all who treat this disease. However, the demonstration of response rates of 30% or greater offers some encouragement and supports a reevaluation of the role of chemotherapy in this disease. Chemotherapy is usually reserved for recurrences after treatment by radiotherapy and surgery with the consequent problems of reduced tumour vascularity and renal impairment. These problems may be overcome by the early institution of cytotoxic therapy in high risk patients; studies are underway in patients with positive pelvic lymph nodes and locally advanced disease using chemotherapy in an adjunctive or primary role.Summary: Nineteen patients with advanced recurrent carcinoma of the uterine cervix received platinum based chemotherapy between February 1982 and April 1984. All patients had received prior pelvic irradiation. Eleven patients received combination chemotherapy with platinum, vinblastine and bleomycin (PVB), and 8 patients received a regimen of platinum and 5‐fluorouracil (PF).Two patients achieved a complete response and 4 patients achieved a partial response, a total response rate of 33%. Five out of 6 responders received PVB. The median survival (MS) was 8 months (1–38) months from the first treatment with cytotoxic chemotherapy. In those patients achieving a response, MS was 13.5 months (6–38 + months) with 1 patient alive at 38 months, compared to an MS of 5 months (1–15 months) in those patients without response. Toxicity was significant with nausea and vomiting in the majority of patients. Two patients refused treatment after the first course because of toxicity. The morbidity of treatment was such that despite an encouraging response rate, particularly to PVB (45%), the routine use of such treatment must be questioned.
Pregnancy Outcome in Gestational Diabetes with Preconceptional Diabetes Counselling
Authors: Dicker Dov , Feldberg Dov , Yeshaya Arie , Karp Moshe , Samuel Nurith , Goldman Jack A. 
Published: February 2008

Summary: One hundred and thirty‐six women with known previous gestational diabetes and normal glucose tolerance between pregnancies attended a preconceptional clinic at least 2 months before conception, and were regularly consulted by a diabetological team. Evaluation consisted of oral glucose tolerance test (OGTT), mean blood glucose, glycosylated haemoglobin and management by self‐blood‐glucose monitoring (SBGM) and nutritional counselling. When these patients were compared to a group of 154 patients with gestational diabetes who attended our clinic at different stages of pregnancy, the former had improved glucose homeostasis whereas the latter had more frequent elevations of fasting and postprandial glucose levels throughout pregnancy. This group had also more maternal complications and higher Caesarean section rates. Congenital anomalies were 0.65% among offspring of nonattenders, while none occurred in those with preconceptional counselling. Macrosomia and hypoglycaemia were significant neonatal complications in infants of nonattending mothers.We concur with the recommendation that preconceptional counselling in gestational diabetics is required to improve glucose homeostasis throughout pregnancy, and that appropriate evaluation of glucose intolerance should be included as part of prospective family planning.
Mode Of Delivery Of Preterm Twins
Authors: Doyle L. W. , Hughes C. D. , Guaran R.L. , Quinn M. A. , Kitchen W. H. 
Published: February 2008

EDITORIAL COMMENT: This paper concludes that the vaginal route is appropriate, in terms of perinatal mortality and immediate morbidity, for the delivery of approximately 80% of twins born before 33 weeks' gestation. The trend towards Caesarean section in multiple pregnancy should be scrutinized as for singleton pregnancies. Falling perinatal mortality rates associated with increased Caesarean section rates do not prove a cause and effect relationship. The following statistics for multiple pregnancy at a State and Hospital level are quoted for perspective (tables 1A and IB). At the Mercy Maternity Hospital the Caesarean section rate for multiple pregnancy (triplets and quadruplets included) has quadrupled to 32% in 16 years, during which time the overall Caesarean section rate increased from 9 to 16%; this was associated with a modest (25%) improvement in the perinatal mortality rate. Comparable figures for the State of Victoria are not available, but from 1976 ‐ 1985, the total perinatal mortality rate has fallen approximately 30%, and multiple pregnancy continues to account for about 10% of perinatal deaths. In 1985, in Victoria, 2.3% of all infants (1,422 of 61,176) were bom from multiple pregnancies and they accounted for 8.2% (61 of 741) of all perinatal deaths in infants born with birth‐weight of 500g or above.Summary: At one high‐risk perinatal centre over a 9‐year period, 83.1% (103/124) sets of liveborn twins with gestational ages less than 33 weeks were delivered vaginally. Mortality in vaginal births was 26.7% (55/206), almost double that of Caesarean births of 14.3% (6/42), a non‐significant difference. When gestational age discrepancies were corrected, however, the trend favouring survival of Caesarean births disappeared. Furthermore, there were no significant associations between mode of delivery and the condition of the infants at birth, or the presence of respiratory distress in the nursery. Because Caesarean section carries substantial risks for the mother our practice of predominantly vaginal deliveries for preterm twins should continue.