bluuebunny/crossref_metadata_2025_split huggingface dataset:
Contraception with a Six‐Monthly Injection of Progestogen Part 3. Effects on the Endometrium
Authors: Khoo S. K. , Mackay E. V. , Adam R. R. 
Published: February 2008

SummaryEndometrial histology was studied at 2‐monthly intervals in a group of 57 patients who were administered 6‐monthly injections of medroxyprogesterone acetate as a method of contraception.Features indicative of glandular proliferation, such as mitotic activity and pseudostratification of the epithelium, were promptly and frequently lost after commencement of treatment; to a lesser extent, epithelial vacuolation, secretion, and stromal oedema were also affected. Decidual reaction was a consistent feature during treatment; it was particularly marked 2 months after each injection. The effects persisted throughout the 2‐year period of study, although a slight recovery was evident 6 months after each injection. These endometrial changes are discussed with reference to previous reports in the literature, to the duration of action of the drug, and to its mode of action as a contraceptive agent. It is suggested that the “quiescence” of the endometrium is reversible.
A Successful Pregnancy Associated with Sex Chromosomal Mosaicism of the XO/XX Type
Authors: Mackay E. V. , Adam G. S. , Khoo S. K. , Cockburn K. G. 
Published: February 2008

SummaryA case report of a woman suffering from secondary amenorrhoea of 11 years' duration and primary infertility of 3 years' duration is presented. Clinical and laboratory findings indicated ovarian failure and anovulation associated with XO/XX chromosomal mosaicism. A successful pregnancy was achieved following clomiphene treatment.The wide variation of phenotypic expression and the association of varying degrees of ovarian dysgenesis in sex chromosomal abnormalities of the XO/XX type are briefly discussed.The rare occurrence of pregnancy under such circumstances is pointed out and the value of complete investigation and assessment of ovarian status, especially in those patients who eventually marry, should be considered.
Experience With Gynaecological Laparoscopy
Authors: Condos P. 
Published: February 2008

Summary: The findings at 100 gynaecological laparoscopics, performed at Hammersmith Hospital, are presented. The procedure was found to present few difficulties, and for the most part permitted accurate diagnosis without exploratory laparotomy. Only 17 of 76 patients investigated for infertility, amenorrhoea, hirsutism, chronic pelvic pain, pelvic mass or suspected ectopic pregnancy were found to require operative treatment. The exclusion of ectopic pregnancy in 10 of 13 suspected cases was particularly rewarding.Laparoscopic sterilization by electro‐coagulation and division of Fallopian tubes in 20 patients was found to be simple and efficient. Fistulous tracks were observed on follow‐up hystero‐salpingography in 5 patients, but on examination at open operation the Fallopian tubes were found to have been adequately divided and sealed.Complications of laparoscopy were in general infrequent and minor in nature: in 1 patient CO2 was insufflated into the colon; failure to visualise the pelvis adequately was the reason for abandoning the operation in 3 patients.
Herpes Simplex of the Lower Genital Tract in the Female
Authors: McIndoe W. A. , Churchouse M. J. 
Published: February 2008

Summary: An “epidemic” of vaginal herpes simplex in 18 gynaecological patients in the 3‐year period, January 1968 to February 1971, is presented. The basis of diagnosis has been in most cases an acute illness (13 of 18 patients), a positive cytology report (13 of 17 patients) and a positive herpes simplex virus culture report (13 of 15 patients).Early in the series the clinical picture was of a significant illness in which the cervix was primarily involved. The clinical picture then changed, the patients more commonly presenting with acute vulvitis and either marked dysuria or retention of urine.The implication of this infection to the fetus in the last weeks of pregnancy and its relationship to invasive carcinoma of the cervix is discussed.
The Value of Lower Limb Ossification Centres in the Radiological Estimation of Fetal Maturity
Authors: Chan W. F. , Ang A. H. , Soo Y. S. 
Published: February 2008

Summary: A radiological study was made of the lower limb ossification centres in a group of 153 normal newborn infants. Their gestational ages ranged from 37 to 44 weeks.The lower femoral centre was present in 98% of all cases. The upper tibial centre was found in 73.1% of cases over 38 weeks of gestation. The cuboid centre was shown in 37.6% of those over 40 weeks.No correlation between sex and the ossification of the lower limb centres was found.No significant differences in the incidence of the lower femoral and cuboid centres in the 3 ethnic groups were noted. However, the upper tibial centre was present significantly more often in Indian infants than in Chinese or Malay infants. The higher the birth‐weight, the more likely were the upper tibial and cuboid centres to be seen radiologically.
The Problem of the Large Enterocele
Authors: Zacharin Robert F. , Hamilton N. T. 
Published: February 2008

Summary: Dissatisfaction with available methods of treating large enterocele prompted a re‐examination of the problem.The present technique, applicable to large pulsion enterocele, consists essentially of excision of the pouch of Douglas and partial closure of the levator hiatus.Fourteen patients have been subjected to this procedure since 1968 with very encouraging results.
Schistosomiasis in Gynaecology ‐ Two Cases in Immigrants in Western Australia
Authors: Joyce P. R. , Blackwell J. B. , Charters A. D. 
Published: February 2008

Summary: Two patients with gynaecological schistosomiasis have been recorded in Western Australia; both were immigrants from Tanzania (then Tanganyika). One patient exhibited ova and adult worms of S. mansoni in a leiomyoma of the body of the uterus. This is believed to be the first recorded finding of an adult Schistosoma mansoni worm in a leiomyoma, and suggests that the presence of ova results, at least partly, from direct invasion of the veins of the uterus and oviposition by the adult worm, and not entirely by embolisation of eggs.The other patient showed S. haematobium associated with a tubal gestation.A life span of at least 20 years is evident in the case of the S. mansoni infestation.
Acceptability of an Injectable Contraceptive in a Rural Population of Thail
Authors: McDaniel Edwin B. , Pardthaisong Tieng 
Published: February 2008

SUMMARYInitial acceptability of contraception by hormone injection was high in the rural population studied. 2,967 rural women accepted contraception by a once‐in‐three months injection of Depo‐Provera in a mobile family planning clinic program offering pills and injections. Injection patients represented 46.9% of all new acceptors; the continuation rate was 48.4% at the end of 18 months and the continuation of rural injection users was slightly higher than that of urban users of the same method in the first 15 months.In a study of 252 cases with known reasons for discontinuation of the injection method, it was found that almost 80% discontinued for medical reasons, and that of these, 64% stopped because of various bleeding problems.61% of all discontinuations for bleeding problems were due to amenorrhoea. Advantages and disadvantages of the injection and pill methods of contraception are outlined from the standpoints of users and medical personnel.The importance of a high‐appeal method of contraception, such as the injections, even as an introduction to the concept and practice of family‐planning, cannot be discounted.
The Effects of Injectable Contraceptives on Lactation
Authors: Koetsawang Suporn , Chiemprasert Thiemchandra , Kochananda Premploem 
Published: February 2008

SUMMARYA study of the effects of DMPA injectable contraceptive on lactation is presented. Thirty DMPA treated mothers were compared to 25 control cases. The study showed that DMPA does not adversely affect the milk production, milk composition or breast fed babies themselves. On the contrary, this method tends to promote lactation.DMPA injectable contraceptive is therefore an appropriate method for use in lactating mothers.
“Micro‐dose” Chlormadinone Acetate
Authors: Seddon R. J. , Black E. R. 
Published: February 2008

SUMMARYChlormadinone acetate 0.5 mg. was administered daily for a total of 6,036 weeks to 209 women attending the Auckland clinics of the Family Planning Association.Seventy‐five women discontinued the trial for reasons which included accidental pregnancy (2), planning pregnancy (6), increased frequency of bleeding (11) and cases lost to follow‐up (1).One of the two accidental pregnancies occurred during a cycle in which some tablets were omitted.The distribution of the intervals between bleeding episodes followed a bimodal pattern during the first 12 weeks of treatment. After the 13th week the interbleeding interval was maximal between 25 and 33 days.Headache was the commonest symptom during the trial but accounted for only one patient withdrawal.
The Control and Surveillance of Systemic Contraceptives in Australia
Authors: Robertson T. I. 
Published: February 2008

SUMMARYThe general control and surveillance of therapeutic drugs in Australia is discussed. Problems concerned with the systemic contraceptives, in particular the assessment of carcinogenicity arc detailed. It is suggested that monitoring and surveillance systems need to be extended and that the participation of Government in the field of hospital records, coding, morbidity statistics and research into drugrelated problems should be increased. Close international co‐operation in this area is suggested. The systemic contraceptives must be seen in correct perspective in the vast and expanding field of therapeutics. A plea is made for all parties concerned to develop a greater awareness of the many associated problems.
Cancer of the Endometrium, An Improved Epidemiological Assessment
Authors: Bonham D. G. , Bonham R. J. G. 
Published: February 2008

Summary: Five hundred and thirty‐five patients with endometrial carcinoma have been followed up using a computerised life‐table technique.The age at diagnosis exerted a profound influence on mortality. Older patients had a higher cancer specific mortality and yet were able to live in near‐equilibrium with the disease for a longer period than younger women. In the younger women, surgery alone was superior to radiotherapy followed by surgery.
Fetal Assessment in Late Pregnancy: A Current Review*
Authors: Biggs J. S. G. 
Published: February 2008

Summary: A review of papers in 4 selected obstetrical journals showed that oestrogen assays held a dominant place amongst methods of fetal assessment during 1971 and 1972. Plasma oestriol assays appear likely to increase in clinical importance.Ultrasonic studies have maintained their place in fetal assessment. Human placental lactogen assays appear to have been accepted as an adjunct to other tests.The phospholipid assay of fetal lung maturity showed the greatest rise in interest and activity amongst methods of fetal assessment in the past 2 years.
Stromal Decidual Change in the Pregnant Cervix: Colposcopic, Cytological and Histological Considerations
Authors: Laverty Colin R. , Fortune Denys W. , Davoren Ruth , Butterfield Louis J. , Hollyock Vernon E. 
Published: February 2008

Summary: Forty‐two pregnant patients with cytology smears suggesting cervical intra‐epithelial neoplasia were examined in a special clinic by colposcopy, cytology and biopsy. This study was concerned with the recognition of decidual change in the cervical stroma in these patients, establishing its incidence and deterrnining whether its presence influenced interpretation of the colposcopic and cytological findings.Intense decidual change was seen in die biopsy from 6 patients (14.3%); in 4 of these the change was colposcopically apparent, and in 1 decidual cells were present in the cytology smear. Colposcopically, decidual alteration can be distinguished from atypical transformation zone changes suggestive of cervical intra‐epithelial neoplasia. Similarly, in cytology smears, die well preserved decidual cells of cervical origin are not difficult to distinguish from atypical squamous cells.
Blood Oestrogen Values during Labour when the Fetus is in Jeopardy
Authors: Aickin D. R. , Smith Margery A. , Brown J. B. 
Published: February 2008

Summary:A fluorimetric method has been applied to the measurement of total oestrogens in finger‐prick and peripheral blood collected during labour in 120 pregnancies (283 estimations). Signs of fetal jeopardy were present in 36 of these labours. The lower limits of normal for the second half of pregnancy were defined as the 10th percentile for a normal population of pregnant women. Near term this figure was 4.6 μg/100 ml blood.Serial blood oestrogen values obtained during the labours in which fetal jeopardy was not evident showed no consistent trends and the average coefficient of variation was 20%. Serial blood oestrogen values obtained during labours in which evidence of fetal jeopardy developed showed twice as many falling trends as rising trends and the average coefficient of variation was 27%. Seven pregnancies were identified in which the blood oestrogen values more than halved or more than doubled as labour progressed; 5 of these were associated with fetal jeopardy and one provided a unique example of blood oestrogen values which fell steadily over a period of 28 hours to less than a third of the commencing value during a labour in which acute fetal distress developed. Another showed the reverse effect of blood oestrogen values which steadily increased to 3 times the commencing level during a labour in which acute fetal distress developed.Twenty‐one per cent, of patients showed at least 1 low blood oestrogen value during labour compared with 26% before labour. The incidence of all features indicating fetal jeopardy was increased (P= 0.01) when the blood oestrogen values were low during labour and all of the 4 stillbirths were associated with low values before fetal death. Blood oestrogen values during labour correlated with the plasma and/or urine values found before labour in the majority (79%) of pregnancies.It was concluded that the main application of blood oestrogen assays in labour is in the pregnancies where values have not been obtained recently before labour. However, markedly falling or rising oestrogen values were found during labour in a small number of pregnancies and the incidence of fetal jeopardy in these was high. Therefore, when suitably rapid oestrogen assay methods become available they might be of use in monitoring fetal welfare during labour, particularly when labour is prolonged.
Twin Pregnancies. Influence of Antenatal Complications, Hospital Bed Rest, and Misdiagnosis on Prematurity and Perinatal Mortality
Authors: Khoo S. K. , Green K. 
Published: February 2008

Summary:A study of 881 twin pregnancies in Brisbane was made to examine the value of hospital bed rest and assess the influence of parity, antenatal complications, and failure of antenatal diagnosis of twins on the rate of prematurity and perinatal mortality. The overall prematurity rate (30–36 weeks) was 30.1% and the perinatal mortality rate 12.2%. There was a marked increase in prematurity and perinatal fetal deaths in 2 groups of patients — those with antenatal complications and fetal abnormalities, and those with a misdiagnosis. Hospital bed rest between 30 and 36 weeks of gestation for the uncomplicated pregnancy provides only a marginal improvement in perinatal mortality; the differences between the rested and non‐rested groups, 4.0% against 6.1%, were not significant. Surprisingly, the rate of prematurity was higher in the rested group (31.9%) than in the non‐rested group (20.1%). The rates of prematurity and perinatal mortality were increased in primigravidae.
Twin Pregnancy in Singapore
Authors: Dawood M. Yusoff , Ratnam S. S. , Lim Y. C. 
Published: February 2008

Summary:Two hundred and thirty‐four cases of twin pregnancy seen between January, 1970 and December, 1972 were analysed. The incidence of twin pregnancy was 1 in 133 pregnancies and occurred proportionately in Chinese, Malays, and Indians according to population numbers. Parity did not significantly affect the incidence of twin pregnancy. Common antenatal complications included anaemia, hypertensive disorders of pregnancy, and haemorrhage. Hospitalised bed rest did not significantly alter the perinatal mortality. Premature labour occurred in 20% of patients and only 10.8% went beyond 40 weeks of gestation. The incidence of depressed second twin increased slightly after a time‐interval of more than 10 minutes between the delivery of the first twin and the second twin, but increased significantly when the time‐interval was more than 30 minutes. The first twin tended to be larger than the second twin. The sex ratio was 100 females to 134.5 males. The overall perinatal mortality was 76.4 per 1,000, with a perinatal mortality of 64.4 per 1,000 for the first twin and 93.6 per 1,000 for the second twin.
The Variability of Fetal Lie, Presentation and Position During “Normal” Pregnancy
Authors: Morrison John , Orr Christopher J. B. , Teoh Gloria G. C. 
Published: February 2008

Summary: The fetal lie, presentation, and position was recorded serially from the 16th week of gestation until delivery in 100 pregnant women.The incidence of these characteristics varied with gestation and parity, with stabilization of fetal lie occurring at the 22nd week in nulliparous patients, and at the 30th week in parous patients; the frequency of longitudinal lie rose from 63% at 16 weeks of gestation to 99% at 32 weeks of gestation.Only 1 persistent breech presentation and 1 persistent transverse lie occurred in the 100 patients. The predominant position in the cephalic presentations was left occipital with a significantly higher incidence in the nullipara.Considerable variability of lie, presentation, and position occurred in serial examinations, and late spontaneous version from breech to vertex occurred in 4 multiparous patients.
An Appraisal of Clomiphene in the Induction of Ovulation
Authors: Correy J. F. , Schokman F. C. M. 
Published: February 2008

Summary: From a total of 252 patients with presumed anovulation referred by specialist gynaecologists to the gynaecological endocrine clinic of the Royal Hobart Hospital, 93 were regarded as suitable for treatment with clomiphene citrate. Thirty‐four patients (37%) have become pregnant either with clomiphene (28) or spontaneously in the month following the clomiphene being discontinued (6). The low pregnancy rate is attributed to the method of selection of patients for treatment with clomiphene.An analysis has been made of the 321 courses of clomiphene given to the 93 patients to determine the incidence of ovulation and pregnancy, the time of ovulation in relation to the completion of each course of clomiphene, and the length of the secretory phase.
Experience With an Antenatal Diagnostic Genetic Clinic
Authors: Harkins J. L. , Doran T. A. , Benzie R. J. , Pirani B. B. K. 
Published: February 2008

Summary: A regionalized, multi‐disciplined approach to antenatal diagnosis of genetic disease is a significant and positive contribution to modern obstetrical care. The indications, pick‐up rate, pregnancy outcome, and complications in such a programme are described.Rather than providing but another reason for abortion, our Unit has carried out only 37 abortions in 1,016 patients. The vast majority of our patients have been reassured and have carried their pregnancies, with less stress, successfully to term.Detailed cost‐benefit studies of the programme have not yet been carried out; however, a 4% incidence of significant abnormalities in any screening programme is considered to be acceptable. With respect to Down's syndrome, we feel that the screening of all women 35 years of age or older, or those with translocation problems yields personal and financial relief to the parents and to the State where affected pregnancies are identified and terminated.Ideally, this service should be made available to all patients at risk of genetic disease.Experience with the Canadian Registry indicates that by the end of 1976, only 2% of Canadian women at risk had availed themselves of the service. This situation is, however, rapidly changing.As increased utilization of antenatal genetic services occurs, new problems of personnel, equipment, techniques and space (to say nothing of money) will continue to occur. Careful attention to technological developments will be an essential feature of future progress.
A Survey of Women With Unplanned Exnuptial Pregnancies in Brisbane
Authors: Chang Allan , Rosevear Wendell , Mylonas Kris , Keeping Douglas , Morrison John 
Published: February 2008

Summary: : The social circumstances of women with exnuptiai unplanned pregnancies were surveyed, and the differences between those continuing with their pregnancy and those who decided to terminate their pregnancy were compared.Women who continued their pregnancies were younger, poorer, less educated, and more likely to be employed in unskilled jobs when compared with those who decided to have their pregnancy terminated.
Shoulder Dystocia: A Study of 47 Cases
Authors: Johnstone Neil R. 
Published: February 2008

Summary: : Shoulder dystocia at vaginal delivery occurred in 0.2% of cases. Antenatal prediction of this complication was very difficult. In primigravidae in labour, delay late in the first stage was a warning sign; induction of labour, the use of regional analgesia, and forceps delivery for delay in the second stage of labour were associated with subsequent shoulder dystocia, although a cause‐effect relationship was not established.The immediate maternal and fetal morbidity were high, nearly 30% of the babies suffering from a severe neural or bony injury. Forty‐four per cent of the babies were beyond 41 weeks of gestation, and 70% weighed over 4,000 g. The avoidance of postmaturity by elective induction of labour at 41 weeks of gestation would significantly reduce the incidence of shoulder impaction at delivery.
Sterilization: A Comparative Review
Authors: Keeping J. D. , Chang A. , Morrison J. 
Published: February 2008

Summary: Publications relating to surgical procedures for sterilization have been reviewed, and the incidences of complications and subsequent pregnancies compared.Laparoscopic sterilization has the lowest incidence of complication, the morbidity rate being lower than that of laparotomy sterilization or hysterectomy, and the mortality rate lower than that of a single pregnancy or taking oral contraceptives for 1 year.
Antenatal Diagnosis of Homozygous β Thalassaemia in Mediterraneans in Australia
Authors: Smith M. B. , Betheras F. R. , Davison G. , Batchelder E. , Barton J. , Cauchi M. N. 
Published: February 2008

Summary:Facilities for the antenatal diagnosis of homozygous β thalassaemia have recently become available in Australia and in this paper, data from a series of 18 pregnancies examined at The Royal Women's Hospital, Melbourne, are analysed.Fetal blood was collected by fetoscopy and adequate samples were obtained in 16 cases (89%). In 5 pregnancies, fetal blood was shown to have a marked reduction in β globin production (β/α synthesis < 0.030) and these pregnancies were terminated. Two pregnancies (11%) were lost in the immediate post‐fetoscopy period and in a third pregnancy, neonatal death followed premature labour at 26 weeks' gestation. Seven babies were delivered normally at 36–40 weeks' gestation and cord blood studies excluded homozygous thalassaemia in all cases. The remaining pregnancy has yet to be delivered.