bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intrauterine Growth Retardation*
Authors: Beischer N. A. , Abell D. A. , Drew J.H. 
Published: February 2008

SummaryFetal growth retardation ranks third after prematurity and malformations as a cause of perinatal deaths. Antenatal fetal monitoring (biochemical testing of fetoplacental function plus cardiotocography) has emerged as the most important means of reduction in the number of stillbirths and improvement in the quality of survival of infants who are born alive. Clinical acumen combined with biochemical and/or ultrasonographic testing will identify no more than 70% of growth retarded fetuses. However, not all small for dates fetuses are at risk, and many doomed to die in utero are not by definition, growth retarded.It should be the obstetrician's aim to identify the fetus at risk of death from hypoxia whether growth retarded or not. Biochemical and ultrasonographic methods of testing are not truly comparable, since some aim to identify the growth retarded fetus, irrespective of his state of health, whereas others aim to detect fetoplacental dysfunction, irrespective of whether or not the fetus is growth retarded.With present methods of antenatal diagnosis and treatment and timing of delivery determined by nonstressed cardiotocography, the physical and intellectual prognosis of growth retarded infants is most satisfactory; follow‐up studies have shown that only about 2% of these infants are severely handicapped.
Bivariate Analyses Of Attitudes Towards Breast‐Feeding
Authors: Counsilman J. J. , Mackay E. V. , Copeland R. M. 
Published: February 2008

Summary1,790 postpartum women were asked about their breast‐feeding attitude, physical and other attitudinal variables. Bivariate analyses were conducted between attitude and each of 38 other variables. Of the causally independent variables, education and occupation were the most strongly related to attitude, and along with doctor's preference were perhaps the most important influences on a mother's baby‐feeding attitude. No physical or health measure was strongly related to attitude towards breast‐feeding, although there were consistent associations between favourable attitudes and optimal categories of the physical and health variables. A hypothesized model of the influences on breast‐feeding attitude and behaviour is presented.
Ritodrine In The Management Of A Case Of Acute Fetal Distress
Authors: Zentner Rodney 
Published: February 2008

SummaryAcute fetal distress occurred during the first stage of labour in a multipara. Since Caesarean section was unavoidably delayed an intravenous bolus dose of ritodrine was given resulting in abolition of uterine contractions and return of the fetal heart tracing to normal. Subsequently a healthy infant was born by Caesarean section.
The Dilemma of Mild Hyperprolactinaemia
Authors: Pepperell Roger J. , Martinez Cecilia , Dickinson Ann 
Published: February 2008

Summary: Ninety‐eight women with mild hyperprolactinaemia (<4N) were followed for a mean duration of 5.5 years. Where pregnancy was desired treatment with bromocriptine (pM clomiphene) was effective in 87%. Following cessation of bromocriptine therapy almost one‐third had a ‘spontaneous' resolution of hyperprolactinaemia and resumed cyclical menstrual activity and fertility.Pituitary tumours were identified on coned‐view assessment in 9% of patients at the time of presentation and a further 10% during follow‐up. Although some of these latter tumours may have been diagnosed earlier had CAT scans been performed routinely in all hyperprolactinaemic patients, such a policy would be hard to justify for those with mild hyperprolactinaemia as the tumours were small, produced no harmful effects, and would almost certainly have responded to bromocriptine should this have been administered.All patients found to have pituitary tumours and given bromocriptine, showed no evidence of tumour progression subsequently, even where pregnancy occurred and the bromocriptine therapy was ceased. In addition, patients without pituitary tumours who were given bromocriptine to achieve pregnancy, were less likely to develop tumours during follow‐up even when pregnancy had occurred.Bromocriptine therapy can thus be justified in mildly hyperprolactinaemic patients to reduce troublesome galactorrhoea, achieve pregnancy, improve the chance of ‘spontaneous' resolution of the menstrual problem and infertility, control or reduce tumour growth where a pituitary tumour has been identified, and reduce the risk of tumour development in patients with normal radiographs at the time of presentation.
Outcome of Extremely Low Birth‐weight Infants in Relation to the Hospital of Birth
Authors: Kitchen William , Ford Geoffrey , Orgill Anna , Rickards Anne , Astbury Jill , Lissenden Jean , Bajuk Barbara , Yu Victor , Drew John , Campbell Neil , Roy R. Neil D. 
Published: February 2008

Summary: There were 351 nveborn infants of birth‐weight 500–999 g born in the State of Victoria in the years 1979 and 1980; 89/351 (25.4%) survived to the age of 2 years: 42 (47.2%) survivors were of gestational ages of 24 to 26 weeks and 47 (52.8%) were born at 27 to 32 weeks' gestation. Survival of these extremely low birth‐weight infants was significantly better (71/245, 29%) for births in tertiary centres compared with those born elsewhere (18/106, 17%). Of the 351 livebirths, 69.8% occurred in 1 of the 3 tertiary centres.All 89 survivors were traced; 84 (94.4%) were assessed at the age of at least 2 years by a multidisciplinary team. Three children had been fully assessed at 1 year of age and paediatric reports were available for 2 children. The quality of survival of children born in tertiary centres was significantly better than those transferred to a tertiary centre after birth; the prevalence of serious functional handicap was 72.2% (13/18) for outborn children compared with 22.5% (16/71) for those born in tertiary centres. The prevalence of serious functional handicap in the inborn survivors was lowest (9/55, 16.4%) in singleton births who had been of appropriate birth‐weight for gestation.A review of the 18 surviving outborn infants' records indicated that 6 (33.3%) could have been transferred to a tertiary centre in utero and for the 12 infants where birth in a tertiary centre was not feasible, improvements in the early neonatal care were possible in another 7 infants.
Complications of Beta‐Mimetic Therapy in Preterm Labour
Authors: Ingemarsson I. , Arulkumaran S. , Kottegoda S. R. 
Published: February 2008

EDITORIAL COMMENT: This careful review of the reported complications of beta‐mimetic drugs may properly cause obstetricians to have ‘second thoughts on stopping labour’ (Anderson, 1981: 53), in many patients, especially when there is premature rupture of the membranes and the possibility of intrauterine infection.Summary: Selective beta‐mimetic drugs are the most frequently used agents for arresting preterm labour. For this purpose these drugs have to be given in high doses for several hours and since they act on several organ systems, side‐effects, some of which are potentially dangerous, appear. These hazards, which involve chiefly the cardiovascular and metabolic areas, have been examined in the light of available experience with these drugs. This review considers the possible mechanisms for the side‐effects and offers suggestions on how the dangers in the use of beta‐mimetic drugs in preterm labour might be avoided.
Failed Induction of Labour
Authors: Arulkumaran S. , Gibb D. M. F. , TambyRaja R. L. , Heng S. H. , Ratnam S. S. 
Published: February 2008

Editorial Comment: There is an important take away message in this paper–namely that 65% of nulliparas with an unfavourable cervix who had induction of labour performed by amniotomy and simultaneous oxytocic infusion came to Caesarean section, two‐thirds because of failed induction.Summary: Over a 15‐month period 1,057 consecutive inductions of labour were performed representing a 10% induction rate; 174 (16.5%) of these patients were delivered by Caesarean section of which 74 (7.0%) were for failed induction of labour, 58 (5.5%) for fetal distress, 19 (1.8%) for cephalopelvic disproportion, 6 for malposition and 17 for other reasons. The mean cervical score at induction of labour was 5.7 and 5.5 for cephalopelvic disproportion (CPD) and malposition respectively but was 4.0 for failed induction. The mean cervical dilatation at the time of Caesarean section was 5.7 cm and 6.6 cm for CPD and malposition respectively whereas it was 3.5 cm for failed induction. Mean maximum dose of oxytocin was 19.2 milliunits per minute (mu/min) and 22.5 mu/min for CPD and malposition respectively whereas it was 24.7 mu/min for cases of failed induction. Nulliparas with a cervical score of 3 or less had a 65.4% Caesarean section rate of which more than two‐thirds were for failed induction of labour. Analysis of indications for induction of labour revealed that a fair number of inductions had debatable obstetric indications. Tailoring induction of labour to the cervical score and indication might reduce the Caesarean section rate for failed induction of labour. Rational management to ensure an adequate dose of oxytocin and sufficient time in the first stage of labour is important. Failed induction of labour may be differentiated from failure of labour progress due to CPD or malposition.
Thiamine Deficiency – A Neglected Problem of Infants and Mothers – Possible Relationships to Sudden Infant Death Syndrome
Authors: Jeffrey Heather E. , McCleary Barry V. , Hensley William J. , Read D. J. C. 
Published: February 2008

Summary: i) An unexpectedly high incidence of biochemical thiamine deficiency (erythrocyte transketolase) was found in groups of mothers and infants, selected for apparent health from a westernized Caucasian community in Australia.Deficiency was common in mothers at term but not their infants, and in apparently healthy older infants but not their mothers. These findings can be explained by preferential delivery of thiamine to the fetus, at the expense of the pregnant mother; after delivery the mother recovers, and the infant becomes depleted.ii) The incidence of thiamine deficiency was high in ‘near‐miss' sudden infant death syndrome (SIDS) infants and their mothers, and in siblings of SIDS. The thiamine deficient infants had a high familial incidence of SIDS deaths. These ‘high risk families' might reflect poor nutrition or genetic defects of thiamine uptake and metabolism.Since apparently thriving infants with thiamine deficiency can sometimes die unexpectedly, thiamine status deserves more attention in clinical practice and research.
Gynaecological Tuberculosis: Analysis of a Personal Series of 710 Cases
Authors: Sutherland A. M. 
Published: February 2008

Summary: A study has been made of 710 patients with proved gynaecological tuberculosis investigated between January 1, 1951 and March 31, 1985. The main presenting symptoms in order of frequency were infertility, pelvic pain, excessive menstrual loss and amenorrhoea. The average age was 31 years at first attendance, only 16% of married women had been pregnant and palpable adnexal masses were found in 47%.Seven drug programmes have been used, the best results being obtained with the current regimen employing rifampicin, ethambutol and isoniazid. Where drug treatment failed, surgery under further drug cover was successfully employed. Toxic drug reactions occurred in 114 patients.
Changes in Obstetric Practice in Our Time
Authors: Ratten Graeme J. 
Published: February 2008

Summary: In the years since 1939 there has been a marked change in the nature and results of obstetric practice at the Royal Women's Hospital, Melbourne.The noteworthy changes have been a reduction in the number of maternal deaths (from 12.2 per 1,000 in the 1940's to 0.2 per 1,000 in the 1980's), especially those due to septic abortion, and an increase in the Caesarean section rate (from 2% to 14%).The increase in the operative delivery rate has been matched by a decrease in mortality in patients thus delivered, the maternal and perinatal mortality rates changing from 5.5 and 88.9 per 1,000 to 0 and 7.6 per 1,000 respectively in the case of forceps delivery and from 24.7 and 162.5 per 1,000 to 0.15 and 10.6 per 1,000 respectively in the case of Caesarean delivery.
Study of Vaginal Delivery in Patients with One Previous Lower Segment Caesarean Section
Authors: Singh T. Kishor C. , Barman S. D. , Gupta A. N. 
Published: February 2008

EDITORIAL COMMENT: The incidence of scar disruption in this series of trial of Caesarean section scars was 3.5% (5 of 144) when pitocin was used for induction or augmentation of labour, and 1.3% (7 of541) when pitocin was not used. This series sounds a warning that concern with today's high Caesarean section rate must not encourage us to overreact and to use oxytocin to improve prospects for vaginal delivery when a patient elects to have a trial of Caesarean section scar.Summary: This retrospective study evaluated the prospects of having a vaginal delivery following a lower segment Caesarean section in Nehru Hospital; 685 (52%) of 1,315 patients with a previous Caesarean section were given a trial of vaginal delivery with a success rate of 69%. Vaginal breech delivery was allowed in 14 patients without affecting the outcome of term babies and without maternal morbidity or mortality. There were 12 cases (1.7% incidence) of scar disruption of which 4 were of scar rupture. There was no maternal or fetal death as a result of these disruptions even though 3 mothers had subtotal hysterectomy. Pitocin was used in 144 (21%) patients. Of the 12 cases of scar disruption 5 patients had received pitocin. There was no favourable influence of prior vaginal delivery on the success of the trial, and 3 patients with scar disruption had already had a vaginal delivery in addition to a lower segment Caesarean section.
Failure of Chloroquine Malaria Prophylaxis in Pregnancy
Authors: Mola Glen L. , Wanganapi Alex 
Published: February 2008

EDITORIAL COMMENT: Failure of chloroquine for malaria prophylaxis is important, if not alarming, for residents and visitors, especially pregnant women, in these areas.Summary: Women in a hyperendemic malarious area of Papua New Guinea are supplied with weekly chloroquine chemoprophylaxis at antenatal clinics. A study of 180 women in late pregnancy failed to show any difference in Plasmodium falciparum parasite rates between regular and irregular clinic attenders. Nor was anaemia in late pregnancy associated with parasitaemia; however, grandmultiparas exhibited significantly more prevalent parasitaemia and anaemia in late pregnancy. This study reveals a need for a more detailed investigation of the effects and usefulness of chemoprophylaxis with chloroquine in areas where P. falciparum chloroquine resistance is present.
The Management of Severe Preeclampsia with Intravenous Magnesium Sulphate, Hydralazine and Central Venous Catheterization
Authors: Red Leslie L. , Ross Andrew , Kloss Michael , Paull John , Markman Leslie 
Published: February 2008

EDITORIAL COMMENT; This paper reports satisfactory results in the management of severe preeclampsia in 46 patients using magnesium sulphate and hydralazine by intravenous infusion, and central venous catheterization for monitoring fluid balance. The reader may wonder what proportion of patients with preeclampsia warrant this type of intensive care. These patients were managed over a 3‐year interval and represent about 3% of patients with preeclampsia. In other words in 1,000 pregnancies about 100 patients will develop the signs of preeclampsia before or during labour, and in about 3 of the 100 the disease wilt be sufficiently severe to warrant the careful intensive management described in this paper.Summary: A prospective study of patients with severe preeclampsia managed by magnesium sulphate infusion for eclampsia prophylaxis, hydralazine infusion for vasodilatation and central venous catheterization for fluid monitoring is reported. In this preliminary report of 46 patients, there was no episode of eclampsia following treatment, no maternal death, and hypertension was well controlled in all patients. Of the 51 babies born, there were 7 stillbirths, and 4 neonatal deaths; 6 of the 7 stillbirths were less than 30 weeks' gestation, and 23 of the 46 patients were delivered by Caesarean section.
Pregnancy Outcome in Women with Reflux Nephropathy — A Review of Experience at the Royal Women's Hospital Brisbane, 1977–1986
Authors: Weaver Edward , Craswell Peter 
Published: February 2008

Summary: The outcome of pregnancy was examined, retrospectively, in women with a diagnosis of reflux nephropathy attending The Royal Women's Hospital from January, 1977 to August, 1986. Of 15 women, 10 were known to have had the disease antepartum and 5 were diagnosed postpartum. On the basis of plasma creatinine concentration prior to pregnancy, 10 patients had 22 pregnancies with normal renal function and 5 patients had 7 pregnancies with plasma creatinine concentrations ranging from 0.12 to 0.17 mmol/1.The pregnancies of the women with normal renal function were complicated by urinary tract infections, while those with impaired renal function were associated with preeclampsia. The perinatal mortality for both groups were zero. A relatively low incidence of vesicoureteric reflux was found in 12 of the offspring who were subjected to micturating cystourethrography (mild reflux in 1 of 24 ureters).
Chlamydia Trachomatis Isolation in Women Attending a VD Clinic in Auckland, New Zealand
Authors: Willmott F. E. , Say P. Janet , Hookham A. B. 
Published: February 2008

EDITORIAL COMMENT: Chlamydial infection is an important cause of chronic pelvic inflammation and sterility. Isolation rates are 20–60% in women attending VD Clinics and 2–6% in those attending Family Planning Clinics. It is less certain how important this infection is in other gynaecological patients. All practitioners should consult their bacteriologist so that they can arrange the appropriate test for identification of this small, Gram‐negative intracellular bacterium (that escapes detection on routine study) in patients with persistent vaginal discharge or pelvic pain.Summary: Chlamydia trachomatis was isolated from 120 of 504 women (24%) attending a VD clinic at Auckland Hospital. Epidemiological correlates indicated a sexual mode of transmission. The only symptom of significance was lower abdominal pain. Cervicitis was more common in women with chlamydia, especially if they were on hormonal contraceptives. Chlamydia was isolated more commonly in women with gonorrhoea (52%) and genital warts (37%). The high incidence of asymptomatic and unsuspected infection emphasizes the need for routine chlamydial culture in VD clinics.
Human Papilloma Virus Infection and Associated Intraepithelial Neoplasia of the Cervix, Vagina and Vulva
Authors: Planner R. S. , Hobbs J. B. 
Published: February 2008

EDITORIAL COMMENT: This issue contains reports of 3 studies indicating that a cervical smear indicative of wart virus disease or of cellular abnormalities short of dysplasia may be associated with intraepithelial neoplasia of any degree (CINICIN3). The following statement on cervical smear reporting procedures endorsed by the Royal Australian College of Obstetricians and Gynaecologists could be regarded as unduly conservative in the light of this recent information.CERVICAL SMEAR REPORTING PROCEDUREThe problem of doctors repeating smear tests month after month on patients who have abnormal tests because of no firm recommendation by the pathologist involved, prompted the endorsement of the following recommendations by the Victorian Cytology Service:i That when a cytological prediction is made of established dysplasia, of any degree, with or without papilloma or wart virus infection, and whether or not the patient is pregnant, the recommendation should read ‘Colposcopic evaluation is recommended’.ii When a cytological prediction of papilloma or wart virus infection is made, without evidence of established dysplasia, in the first instance the recommendation should be ‘Please repeat smear in 6 months’.iii If evidence of papilloma or wart virus infection persists, a second 6‐monthly smear may be recommended. If the changes are present in the third smear, indicating persistence of a lesion for 12 months, the recommendation should be ‘In view of the persistence of the changes, colposcopic evaluation should be considered’.Summary: A prospective colposcopic and histological study was performed on 333 patients with cytologically detected human papilloma virus infection (HPV) without cytological evidence of associated intraepithelial neoplasia. The colposcopic changes seen in the cervix, vagina and vulva were documented and target biopsies were taken from abnormal areas in these 3 sites. Colposcopic and histological evidence of HPV infection was found in the cervix of 314 patients (94%), vagina in 274 patients (82%) and vulva in 146 patients (44%). Histologically proven cervical intraepithelial neoplasia was found in 94 of 333 patients biopsied (28%), vaginal intraepithelial neoplasia in 3 of 333 patients biopsied (0.9%) and vulval intraepithelial neoplasia in 9 of 146 patients biopsied (6.2%). This study identified the colposcopic changes of HPV infection to be widespread throughout the lower female genital tract. The diagnosis of intraepithelial neopiasia undetected by cytology in 28% of patients with HPV infection indicates that such patients require colposcopy and target biopsy according to the colposcopic findings.