bluuebunny/crossref_metadata_2025_split huggingface dataset:
Placenta Accreta A Report of Six Cases
Authors: Beavis E. L. G. 
Published: February 2008

Summary

Placenta accreta is a very rare condition, although minor degrees probably occur more frequently than can be recognized. The abnormal relationship between the chorionic tissue and the decidua may involve part or all of the placental surface. The depth of involvement also varies … the chorionic villi may abut directly on to the surface of the myometrium, or pass into its substance, or progress through it to the serous surface of the uterus.
Six cases are described and are compared with 34 cases collected from the recent literature.
Placenta accreta may be suspected if there is a history of manual removal or curettage after delivery, or if the existing pregnancy is complicated by placenta praevia.
The complications of placenta accreta are considered, and it is emphasized that methods of management which are usually adequate may not suffice when this condition is present.
Occasionally hysterectomy may be necessary, and if so the subtotal operation with preservation of the ovaries is the procedure of choice.
It is important to conduct obstetrics in hospitals with readily available facilities for blood transfusion, and for surgical treatment if necessary, if maternal death due to this abnormality is to be prevented.
Symphysiotomy in a Primitive Community
Authors: Ryan B P K. 
Published: February 2008

Summary:A brief description of the indications, technique and complications of symphysiotomy has been given.The details of its use in 8 patients have been described; the immediate results in 7 of these patients were considered to be satisfactory. Because of the peculiar conditions in New Guinea, it seems that there is a greater place there for symphysiotomy than in more advanced countries.
Combined Actinomycotic and Tuberculous Salpingitis.
Authors: Churches Kelvin , Barter R. A. 
Published: February 2008

Summary:The clinical features, pathological findings, and treatment of a patient with combined actinomycotic and tuberculous infection of the fallopian tubes is described.Although the illness was characterized by marked toxicity and prolonged morbidity, eventual recovery was complete.The literature concerning actinomycosis of the female genital tract is briefly reviewed.
Primary Carcinoma of Bartholin's Gland
Authors: O'Neill James P. 
Published: February 2008

Summary:1. Primary carcinoma of Bartholin's gland is a rare condition. Including the 2 cases above, there have now been 125 reports in the literature.2. Because initial symptoms are mild, there may be a considerable “patient delay”.3. Clinical diagnosis and histological confirmation are usually simple.4. No one person sees enough cases to evaluate different forms of treatment. Because of the doubtful radiosensitivity of the tumour, radical vulvectomy with bilateral radical groin dissection appears to be indicated in patients with operable lesions. The role of post‐operative deep X‐ray therapy is debatable.5. Case 1 illustrates most of the clinical features of the disease in its early stages. Case 2, with a very unusual mode of presentation, reflects the poor outlook when the disease is advanced.
Report of Three Cases of Vesicocervical Fistula
Authors: Macknight Ella 
Published: February 2008

Summary:Three cases of vesicocervical fistula are presented.In each case, the abnormality followed a lower uterine segment Caesarean section.The initial presentation usually consists of a leakage of urine from the cervix and vagina, and the appearance of periodic haematuria.A satisfactory technique for the repair of this defect is described.
Tubal Pregnancy: A Report on Sixty‐three Cases
Authors: Hammouda A. A. 
Published: February 2008

Summary:An analysis of 63 patients with tubal pregnancy is presented.The incidence in this series was 1:198 viable pregnancies. A review of the clinical features of ectopic pregnancy is given.The importance of early and adequate resuscitation in cases of rupture is stressed. Conservative surgery should be employed in a selected group of patients with tubal pregnancy.Eighteen patients who were followed became pregnant (40%), and 12 of these carried the pregnancy to term.
The Clinical Implications of the Reflux Theory with Reference to Reproductive Abnormalities
Authors: Iffy L. 
Published: February 2008

Summary:1. The author's research originating from his reflux theory of the aetiology of ectopic pregnancy has been reviewed and the main conclusions of his investigations summarized. It has been concluded that there is overwhelming evidence suggesting that a wide range of pregnancy disorders are related to one main pathogenetic factor: post‐mid‐cycle ovulation and conception.2. It has been suggested that pre‐ and particularly post‐mid‐cycle contraceptive measures, together with adequate hormone therapy, could prevent, to a certain degree, the repetition of various pathological conditions of pregnancy.3. Some technical questions concerning the management of various pregnancy anomalies have been discussed.
Culdoscopy — A Study of 402 Cases
Authors: Grant Alan , Robertson Struan 
Published: February 2008

Summary

The indications, contra‐indications and technique of culdoscopy are recorded.
The results of 402 culdoscopies, with particular reference to diagnostic accuracy and complications, are described.
Culdoscopy saved a “blind” laparotomy in 35% of patients examined prior to proposed plastic operations on the fallopian tubes.
Culdoscopy enabled a diagnosis to be made in 66% of gynaecological problems.
Culdoscopy explained “unexplained” sterility in 75% of patients.
Culdoscopy frequently demonstrated pelvic disease where none could be felt on pelvic examination.
The diagnostic accuracy was 92% overall, and 96% in a personal series.
The major difficulties are those encountered by the anaesthetist.
Culdoscopy is safer, quicker, cheaper and less damaging than an abdominal operation done for exploratory purposes.
Hypertensive Congenital Adrenal Hyperplasia:Observations of the Urinary Excretion of Oestrogens and Pregnanediol during Pregnancy
Authors: Shearman Rodney P. 
Published: February 2008

SummaryDetails are presented of a thirty‐two‐year‐old patient with hypertensive congenital adrenal hyperplasia. Born with abnormal external genitals, the patient menstruated regularly from the age of 9 years despite progressive virilization. The external genitals were corrected surgically. Treatment with prednisone controlled both hypertension and virilization. Conception occurred 9 months after the initiation of treatment but terminated in spontaneous abortion.A second pregnancy resulted in delivery of a living male infant near term. Urinary oestrogens were extremely low throughout pregnancy; urinary pregnanediol, initially normal, reached the low limits of normal with the development of hypertension in the last trimester.
The Use of Radiation Response (RR) in Selecting the Method of Treatment of Carcinoma Cervicis Uteri
Authors: Chesterman John N. 
Published: February 2008

Summary:The Grahams' method of determining prognosis by vaginal cytology has been employed in a small series of cases, not yet large enough to be statistically significant. However, the trends of our results all point in the one direction, towards confirmation of the findings of the Grahams and of Kjellgren and others.

After radiation, women with good RR have a greater survival rate than those with poor RR.
Good RR is more often found in older women, after the menopause.
Women with poor RR have a higher survival rate when treated by surgery instead of radiation.

At the Women's Hospital, Crown Street, we have found that good SR is closely correlated to good RR, but that poor SR is not a significant indication of subsequent RR.For this reason, we consider that SR alone is not useful as a guide to the method of treatment.
Cytological Prediction of Radiosensitivity in Carcinoma of the Cervix*
Authors: Chanen William 
Published: February 2008

Summary:1. A study of sensitization response (SR) and radiation reaction (RR) values in carcinoma of the cervix has been conducted with special reference to the use of these indices to select those patients most likely to benefit from post‐irradiational surgery.2. SR studies did not prove to be a reliable prognostic index. In particular, no valid association could be demonstrated between SR value and the incidence of local residual growth or pelvic lymph node metastasis.3. RR studies revealed a significant correlation between RR value and the presence of local residual growth after previous radiotherapy. This finding can be used as an aid in selecting those patients who would best benefit from subsequent radical surgery.4. The drawbacks involved in RR evaluation lie chiefly in the technical difficulties of reading, in its limited use with small and superficial Stage I growths, and its failure to help detect the presence of nodal metastasis.5. Determination of the correct treatment of carcinoma of the cervix is a complex and highly individual problem. Before a decision is made, every available facet of prognostic aid should be considered.
Recent Modifications to the International Clinical Staging of Cancer of the Cervix, Corpus Uteri and a New Staging in Vaginal Carcinoma
Authors: McGarrity K. A. 
Published: February 2008

Summary:1. A short history has been given of the development of the Annual Report on the Results of Treatment in Carcinoma of the Uterus, since its formation.2. A short history of the development of stage‐grouping in relation to carcinoma of the cervix has been traced since its development in 1929.3. Stage‐grouping adopted by the General Assembly of National Societies of the International Federation of Gynaecology and Obstetrics in Vienna in 1961 is given.4. General rules relating to classification and staging are described.
The Gynaecological Sequelae of Blood in the Peritoneal Cavity
Authors: Brake Ian T. 
Published: February 2008

Summary:

A histopathological study of the material from 229 patients with ectopic pregnancy is presented, with particular emphasis on changes in the blood clot (organization) in relation to the fallopian tube and other pelvic viscera.
Distinct differences in the rate and degree of organization were noted, according to whether the blood clot was intra‐ or extra‐luminal.
There is evidence to suggest that previous inflammation has little or no effect on the rate of organization of the clot.
By analogy with changes observed in this series it is postulated that intra‐luminal spread of infection from the uterus may be commoner than is generally supposed.
After reviewing the evidence concerning the fate of blood in the peritoneal cavity, it is recommended that a thorough but gentle evacuation of blood and clot is in the best interests of the patient.
Phonocardiography as a Foetal Heart Monitor
Authors: Maxwell Ian 
Published: February 2008

Summary:

The normal phonocardiogram of the foetus in utero is described. The commonly observed variants are indicated.
Phonocardiography is a simple and practical method of activating an instantaneous ratemeter for continuous foetal heart monitoring. Successful recordings were obtained in 84% of cases.
Examples of normal and abnormal tracings are illustrated. Variations in rate and rhythm may be detected early by monitoring.
The value of continuous monitoring of the foetal heart is outlined.
Amniotic Embolism and Uterine Rupture
Authors: Attwood H. D. , Rome R. M. 
Published: February 2008

Summary:Three cases of amniotic embolism associated with uterine rupture are reported. In one, the embolism was an incidental finding; in the second, the embolism clinically and pathologically was an associated cause of death and in the third, the amniotic fluid embolism was the only cause of death.An assessment of the incidence of amniotic embolism requires examination of blocks from all pulmonary lobes. The significance placed on the finding of emboli in such material should be assessed in the light of the clinical history and the anatomical findings.In the case where amniotic embolism was the only cause of death the right ventricle was collapsed — a finding against pulmonary vascular obstruction. The effects of experimental amniotic embolism can be counteracted by the pulmonary vasodilator, isoproterenol.
The Use of Radioactive Isotopes in Determining Placental Function
Authors: Cox L. W. , Munday R. N. , Sauer H. H. A. 
Published: February 2008

Summary:

Using Na24, 79 uterine muscle clearance tests were performed.
Of these, successful calculation was possible in 54 cases.
Prolonged clearance times are not more common in hypertension and pre‐eclampsia.
Prolonged clearance times are not more common in postmaturity.
Prediction of “placental insufficiency” by prolonged clearance times is not reliable enough to use this test clinically.
The Non‐Surgical Treatment of Vulval Condylomata Acuminata
Authors: Quinlan Desmond K. 
Published: February 2008

Summary:

Vulval condylomata acuminata occur most commonly during the child‐bearing period of life. Pregnancy causes a marked exacerbation in the rate of growth.
The growths may be pre‐malignant in Africans.
A plea is made for conservative treatment, using podophyllin, as opposed to surgery.
The method of podophyllin treatment is described.
Experience with Medroxy‐progesterone Acetate in the Control of Threatened Late Abortion and Premature Labour
Authors: Wurm Roger 
Published: February 2008

Summary:

A new progestational agent, medroxyprogesterone acetate (Provera), has been used in the second and third trimesters of pregnancy in an attempt to prolong gestation and thereby increase foetal salvage.
Experience in 89 pregnancies has been recorded. In 21 pregnancies, cervical suture has provided supportive therapy.
Sixty‐one surviving infants have resulted from 65 pregnancies in which prolongation was achieved for a significant period of time.
The intravenous injection of an aqueous suspension of crystalline Provera has been used in 12 patients. On 6 occasions, where cervical dilatation was less than 3 cm., parturition was postponed.
No significant side‐effect, in either mother or infant, has resulted from the use of this synthetic progestational agent.
An Evaluation of the Conservative Treatment of Endometriosis
Authors: Grant Alan 
Published: February 2008

Summary:

An evaluation has been made of the treatment of endometriosis by conservative surgery and by progestogens.
In our series of patients, progestogens were given by the intermittent, discontinuous or cyclic method for 20 days every month for 6 months.
The results of treatment with such a regime have been compared with those obtained by other workers, both in Australia and abroad, using the continuous regime (pseudo‐pregnancy).
The pseudo‐pregnancy technique gave a 15% better result than the cyclic one when the patients were re‐assessed 6 months after cessation of treatment.
The pseudo‐pregnancy regime produced a slightly better incidence of subsequent pregnancy in the hands of most clinicians.
The cyclic treatment is cheaper, available to a larger group of patients, and less psychologically disturbing, since some sort of period usually ensues each month.
When oestrogens were added to the progestogens there was more nausea but less amenorrhoea.
Reasons are given why conservative surgery is preferred to progestogens in the initial treatment plan.
Before conservative surgery is performed, the administration of progestogens for a month softens the endometriotic adhesions so that less oozing occurs and the tissue planes become easier to dissect.
Thirty‐eight per cent, of patients who desired to conceive were successful after conservative surgery.
A radical procedure (operation or X‐ray castration) was necessary after conservative surgery in 5% (lowest) and 15% (highest) of those treated. Another 5% required hormonal treatment after operation.
The apparent cure rate after conservative surgery was therefore not less than 80%.
Endometriosis is present in private patients suffering from infertility and pelvic pathology in one‐third to one‐half of the cases.
Advanced Ovarian Pregnancy
Authors: Aitken Graham 
Published: February 2008

Summary:

A patient with an advanced ovarian pregnancy is described, in whom a living infant was delivered after laparotomy.
Errors in the management of the case are discussed.
The literature of ovarian pregnancy is reviewed.
It is suggested that Iffy's concept of delayed ovulation and fertilization, together with his “reflux theory” in the mechanism of ectopic implantation of the fertilized ovum, should enable the possibility of abdominal pregnancy, as a rare but simple variant, to be kept in mind more easily.
The Control of Ovulation by Oestrogens
Authors: Walker Ruth 
Published: February 2008

Summary:Cyclic administration of oestrogen appears to mimic metropathia haemorrhagica in that the patients had heavy, irregular uterine bleeding, often preceded by amenorrhoea. The possibility that cyclic administration of oestrogens alone might provide a method of oral contraception has been rejected for three reasons. Firstly, there may develop a lack of continued effectiveness during continued use of a drug known to have been initially effective. Secondly, cycle control is not satisfactory; the abnormalities experienced are amenorrhoea and a tendency to heavy withdrawal bleeding during continued cyclic administration. Thirdly, there are theoretical long‐term hazards associated with the endometrial proliferation produced by oestrogens, although experimental evidence suggests that these and other hypothetical problems are related to continuous rather than cyclic administration. It is likely that they can be avoided by using progestins which are known to antagonize the proliferative effects of oestrogen administration.
The Investigation of Glycosuria in Pregnancy
Authors: Breidahl Harald D. 
Published: February 2008

Summary:Glycosuria is common in pregnancy, and because of the possibility of its being due to gestational diabetes, with attendant risk to the foetus, all patients with this finding should be investigated with a glucose tolerance test.The upper limits for the normal values obtained in pregnancy with a 50 g. glucose tolerance test were as follows:Fasting…less than 100 mg.%

hour…less than 170 mg.%
hours…less than 120 mg.%
hours…less than 100 mg.%

The whole curve is more reliable than single figures, one or two of which may be elevated in an otherwise normal curve.
Heart Disease and Pregnancy
Authors: Etheridge M. J. 
Published: February 2008

Summary:A series of 370 consecutive patients with heart disease and pregnancy observed during a 10‐year period at the Royal Women's Hospital, Melbourne, is described. The diagnosis and management of these patients is discussed.Five patients had mitral valvotomy during pregnancy and one of these died 14 days after operation from staphylococcal bronchopneumonia.There were 6 women in all who died during pregnancy or in the post partum period. Two of these deaths were unavoidable and due to the natural history of their disease, one other patient had both mitral and aortic valve lesions, whilst the remaining 3 had mitral stenosis.
Nutrition Studies in Pregnancy
Authors: Hankin M. E. , Burden J. K. , Symonds E. M. 
Published: February 2008

Summary:

The eating habits and nutrient intakes have been related to the outcome of pregnancy in a series of 174 women.
The majority of the women were eating diet3 which appeared to be adequate, if not optimal, in regard to most nutrients.
No relationship was found between maternal diet and the outcome of pregnancy in this series.
No relationship was demonstrated between maternal nutrient intake and the birth‐weight of the baby.
The intake of calcium was below most currently accepted standards.
The Management of Threatened Abortion by Pregnanediol Estimation and Vaginal Cytology
Authors: Cox L. W. , Cox R. I. , Skipper J. 
Published: February 2008

Summary:

Forty‐four patients with threatened abortion have been investigated for progestational activity by pregnanediol excretion and lateral vaginal smears.
The prognostic accuracy of both methods of estimation was similar.
When both pregnanediol and smear reports were normal over 80% of pregnancies reached viability.
When either report indicated severe progesterone deficiency no pregnancy reached viability.
It is suggested that the lateral vaginal smear should be used as an index in most cases of threatened abortion if progestational therapy is considered.
Alterations in Pregnanediol Excretion in Threatened Premature Labour Following Massive Progestogen Therapy
Authors: Cox R. I. , Wurm R. S. 
Published: February 2008

Summary:1. A notable increase in pregnanediol excretion has been found in 9 out of 14 pregnant patients receiving massive Provera therapy, after viability has been reached, to control uterine contractions.2. The increase in pregnanediol excretion is most apparent 2–3 weeks after commencing Provera treatment.3. An hypothesis is submitted as a possible explanation of this phenomenon.
A Case of Imminent Eclampsia Witnessed from the Onset
Authors: Lind T. 
Published: February 2008

Summary:A case of imminent eclampsia is described. It is considered that so long as the word eclampsia is used to describe a syndrome and not a finite clinical entity, cases of ‘fulminating eclampsia’ will occur. Such cases will largely be independent of the amount or degree of antenatal care given. Accepting the work of Hamlin, however, the incidence should be less than 1: 5000 patients.
The Role of Radioactive Phosphorus (P32) in the Localisation of Vulval Lesions*
Authors: Thoms George 
Published: February 2008

Summary:1. A study of the ageing changes in normal vulval skin of 200 patients and of the changes in 50 patients with vulval dermatoses and in a similar number with invasive carcinoma, is presented. It was evident that accurate localization of the; biopsy site was desirable.2. Such localization was obtained by measurement of P32 emission from 30 or more vulval sites, 0.5 mc. of the isotope having been administered by the oral route 24 hours previously.3. Histological findings were related to P32 uptake rates.4. Although benign and malignant conditions could not be strictly categorized, localization of sites for biopsy enabled rational treatment to be instituted.
A Review of Intra‐Epithelial Carcinoma of the Uterine Cervix in New South Wales
Authors: McGarrity K. A. 
Published: February 2008

Summary:

Age specific incidence rates of non‐invasive and invasive cancer for 1963 are reviewed.
Comparative figures for non‐invasive (506 patients) and invasive cancer (1,679 patients) from 1955 to 1964, inclusive, are given.
Results of diagnosis by Papanicolaou smear are analysed, with surprise positive and false negative rates.
Results of colposcopic examinations are given, including false negative rate and pick‐up rate for false negative Papanicolaou smear.
Association of marital status, motherhood, and pregnancy with non‐invasive cancer is given.
Methods of treatment of intra‐epithelial cancer are given and a comparison is drawn between the periods 1955‐60 and 1961‐64.
Follow‐up figures are analysed with a brief review of causes of death.
A histological review of 71 sections according to the definitions of the Vienna Committee on Terminology showed that only 65% were considered to be noninvasive, 28% were thought to be benign dysplasia and 7% were classified as invasive (Stage 1a). A description of treatment and follow‐up of the latter group of patients is given.