bluuebunny/crossref_metadata_2025_split huggingface dataset:
SPONTANEOUS BACTERIAL PERITONITIS DURING PREGNANCY
Authors: Browne M. K. , Cassie R. 
Published: August 2005

SummaryA patient is described with spontaneous bacterial peritonitis occurring at 27 weeks gestation. The causative organism was a Group B haemolytic Streptococcus which was also found in blood culture and in the vagina. The possible mechanisms of this rare infection are described.
MORPHOLOGICAL CHANGES OF THE SPIRAL ARTERIES IN THE PLACENTAE BED IN RELATION TO PRE‐ECLAMPSIA AND FETAL GROWTH RETARDATION
Authors: Gerretsen G. , Huisjes H. J. , Elema J. D. 
Published: August 2005

SummaryThe spiral arteries at the level of the decidual‐myometrial junction in the placental bed were examined histologically in 93 biopsies. Of these, 23 originated from normal uncomplicated pregnancies, 30 from pre‐eclamptic and 40 from otherwise complicated pregnancies. The association of the‘physiological changes’ of the spiral artery with uncomplicated pregnancy and their absence in pre‐eclampsia, as noted by Brosens and others, has been confirmed. In addition, in pregnancies without pre‐eclampsia, these changes were significantly more often absent with fetal growth retardation. The hypothesis is put forward that hypertension of pregnancy is a compensatory mechanism to ensure an adequate blood supply to the placenta when the‘physiological changes’ fail to occur.
THE RELATION OF CIRCULATING PROGESTERONE AND OESTRADIOL CONCENTRATIONS TO THE ONSET OF MENSTRUATION
Authors: Godfrey K. A. , Aspillaga M. O. , Taylor A. , Lind T. 
Published: August 2005

SummaryForty patients have been studied over 96 menstrual cycles during which a blood sample was obtained within five days of the next menstrual period. Two features emerged: circulating concentrations of progesterone and oestradiol could be elevated on the day bleeding began and conversely the levels of these hormones could be low for some days without menstruation occurring. These data suggest there may not be any direct relation between circulating ovarian hormone levels and the onset of menstrual bleeding.
OESTRADIOL: THE PREDOMINANT INTRANUCLEAR OESTROGEN IN THE ENDOMETRIUM OF OESTROGEN‐TREATED POSTMENOPAUSAL WOMEN
Authors: Whitehead M. I. , Lane G. , Dyer G. , Townsend P. T. , Collins W. P. , King R. J. B. 
Published: August 2005

SummaryIntracellular oestrogen metabolism has been investigated in endometrial tissue from postmenopausal women receiving oestrogen therapy either alone or in combination with a progestogen. During oestrogen therapy alone, there was a 3·2 fold predominance of oestradiol over oestrone within the endometrial cell nucleus and the mean nuclear oestrogen receptor content was 1·40 pmol/mg DNA. The addition of norethisterone decreased the nuclear oestradiol/oestrone ratio to 1–4:1 by lowering the oestradiol mass. A concurrent reduction in the mean level of the nuclear oestrogen receptor to 0·58 pmol/mg DNA indicated a decrease in oestro‐genic stimulation. The activity of oestradiol‐17β dehydrogenase was significantly increased. There was a plasma excess of oestrone over oestradiol during oestrogen therapy alone and the oestrone/oestradiol ratio was not significantly altered following norethisterone administration. The ability of the endometrium to incorporate oestradiol selectively into the nucleus is discussed in relation to the risk of endometrial hyperplasia with unopposed oestrogen therapy. The profound biochemical changes induced by norethisterone help elucidate mechanisms whereby progestogens lower oestrogenic potency and thereby protect the endometrium against excessive stimulation.
A comparison of low‐risk pregnant women booked for delivery in two systems of care: shared‐care (consultant) and integrated general practice unit. I. Obstetrical procedures and neonatal outcome
Authors: KLEIN MICHAEL , LLOYD IVOR , REDMAN CHRISTOPHER , BULL MICHAEL , TURNBULL A. C. 
Published: August 2005

Summary. Samples of records of comparable low‐risk pregnant women booked for delivery in an integrated general practice unit (GPU) and a consultant (or shared‐care) system were derived from a computer tape of all 5005 births which occurred at the John Radcliffe Hospital in 1978.Induction of labour, epidural analgesia and forceps delivery were all less frequently carried out in women booked for delivery in the GPU. Infants of multiparous women were more often intubated in the shared‐care system (3%) than in the GPU (0%); rates in infants of nulliparous women were similar (approx. 7%) in the two systems. These data suggest that short‐term outcomes are as good for GPU‐booked low‐risk women and their infants as for comparable women booked in consultant or shared‐care.
Antenatal biochemical screening to predict low birthweight infants
Authors: AICKIN D. R. , DUFF G. B. , EVANS J. J. , LEGGE M. 
Published: August 2005

Summary. Urine and plasma oestriol, plasma progesterone, human placental lactogen, α‐glycoprotein and serum cystyl aminopeptidase were measured at intervals during 608 pregnancies. The predictive accuracy of low values for identification of pregnancies with low birthweight outcomes was assessed for each test at various gestations. Data were analysed to obtain 10th–90th centile values for each test from 28 weeks to delivery.Groups with values under different centile levels were compared: those under the lower centiles had higher proportions but smaller absolute numbers of low birthweight infants than those under higher centiles. No test was superior to the others at all centiles and gestations. Biochemical screening of pregnant populations to identify high‐risk groups for intensive fetal monitoring has limited potential. If screening is used, the definition of high‐risk groups is best achieved by practical rather than statistical criteria. If monitoring facilities are available and well accepted by patients then higher centile‘cut‐offs’to define fetal risk may be used than when they are not. Combining any pair of tests with values below the 10th centile did not reduce false positive and negative predictions any more than could be achieved by movement of centiles up or down for a single test.
Pelvic node dissection in the treatment of vulval carcinoma—is it necessary?
Authors: MONAGHAN J. M. , HAMMOND I. G. 
Published: August 2005

summaryA report is given of 160 patients with vulval carcinoma who were managed by one Oncologist (J.M.M.) in a regional gynaecological oncology department. Prognosis was closely related to nodal mtastases which were in turn related to tumour size and degree of differentiation. These factors may be a guide to the need to carry out pelvic node dissection during radical surgical treatment. The place of radical surgery is emphasized and the need for postoperative staging suggested.
Pathological mechanisms in polycystic ovary syndrome: modulation of LH pulsatility by progesterone
Authors: MOLLOY B. G. , EL SHEIKH M. A. A. , CHAPMAN C. , OAKEY R. E. , HANCOCK K. W. , GLASS M. R. 
Published: August 2005

summaryThe pulsatile discharge of luteinizing hormone (LH) in nine patients with polycystic ovary syndrome (PCO) and nine patients with amenorrhoea but without PCO, who exhibited LH discharge in response to oestrogen provocation, were studied by 4‐h measurement of gonadotrophin pulsatility before and after a course of progesterone injections. No significant differences were found in the gonadotrophin pulsatility patterns of the two groups, although the LH/FSH ratio rose significantly in the patients without PCO after progesterone but not in the patients with PCO, suggesting an abnormality of FSH storage. The ability to discharge gonadotrophins in response to oestrogen provocation has been reported to be present in patients with 3 LH pulses in a 4‐h study period. This, however, was not demonstrated in five of the nine PCO patients despite the presence of ‘normal’ gonadotrophin pulsatility patterns.
Circadian hormone secretory profiles in women with severe premenstrual tension syndrome.
Authors: STEINER M. , HASKETT R. F. , CARROLL B. J. , HAYS S. E. , RUBIN R. T. 
Published: August 2005

summaryThe circadian secretory profiles of serum prolactin, growth hormone and cortisol were measured in two women suffering from severe premenstrual tension syndrome and in two asymptomatic control subjects. Subjects and controls were screened and included after a rigorous selection process. Blood samples were obtained every 30 min over a period of 24 h in each woman both on day 9 (follicular phase) and day 26 (luteal phase) of the menstrual cycle. There was no relationship between the hormonal secretory profiles and the premenstrual tension syndrome.
Mid‐trimester pregnancy—a time of tranquility or activity?
Authors: MORGAN D. M. L. , HYTTEN F. E. 
Published: August 2005

Summarynumber of compounds in pregnancy blood reach a maximum or minimum concentration at around 20–24 weeks of pregnancy, a period of conspicuous clinical tranquility. The compounds mostly derive from either fetal tissue or decidua and it is suggested that they may be part of an elaborate mechanism which controls invasion of the uterine wall by trophoblast.
A microcomputer system in the delivery suite
Authors: HOULTON MICHAEL , AUSTIN JOAN , JENKINS DAVID , TURNER GILLIAN M. , WILKINS DAVID G. 
Published: August 2005

SummaryMicrocomputer systems have been installed in the delivery suites of two obstetric units which cater between them for nearly 10 000 deliveries annually. The midwifery and medical staff enter administrative, antenatal, anaesthetic and delivery details during labour and as soon after delivery as possible. The computer prints out the official Birth Notification, the entry for the Midwives Register and the record of labour and delivery for the patient's notes. Subsequently the postnatal doctor and anaesthetist, where relevant, enter details of puerperium and anaesthetic follow‐up, before the production by the computer of discharge and anaesthetic summaries for the community and records. In the first 6 months of use at the Bristol Maternity Hospital (July to December 1982) 2229 patientswere delivered and have had obstetric details recorded on the computer. A general obstetric audit of these patients is presented.
The consumers’ attitude to obstetric care
Authors: MORGAN BARBARA M. , BULPITT CHRISTOPHER J. , CLIFTON PAMELA , LEWIS PETER J. 
Published: August 2005

Summary.Questionnaires were sent to 1000 mothers, 1 year after childbirth, to elicit opinions about various aspects of obstetric care in labour and effects on child bonding. Questionnaires were returned by 632 women. Some attitudes were in broad agreement with the views of natural childbirth groups but more were in agreement with the established medical view. The majority of women did not consider that medical care was excessive and 63% found fetal monitoring reassuring. Questions on mother and child bonding showed that only few mothers (19%) thought that this was influenced by events during labour and delivery. Having pain in labour was seen as an essential part of the emotional experience of childbirth by 45% of the respondents. This attitude and others were correlated with certain psychological traits, marital status and race. Before changes are made in obstetric practices in response to‘consumer’ pressure, the opinions of recently delivered mothers ought to be taken into account.
Effect of mode of delivery on outcome of very‐low‐birthweight infants
Authors: YU V. Y. H. , BAJUK B. , CUTTING D. , ORGILL A. A. , ASTBURY J. 
Published: August 2005

Summary.The hospital survival rate was 47% in 111 inborn infants who weighed 501–1000 g and 90% in 211 who weighed 1001–1500 g. The survival rate after caesarean birth was significantly higher than that after vaginal delivery in the 1001–1500 g group but not in the 501–1000 g group. At 2 years of age, 73% of survivors born at 501–1000 g and 85% of those born at 1001–1500 g had no neurological or developmental disability; no significant difference was found between caesarean and vaginal births. The mode of delivery did not significantly affect survival or late outcome of the 192 singleton infants with cephalic presentation. Although the survival rate was not significantly different between infants with breech and cephalic presentations, the former had a significantly higher disability rate. Within the group of 72 singleton infants with breech presentation, the survival rate after caesarean birth was significantly higher than after vaginal delivery in the 1001–1500 g group but not in the 501–1000 g group. No significant difference in late outcome was found between caesarean and vaginal births in this subgroup.
A randomized trial of external cephalic version with tocolysis in late pregnancy
Authors: BROCKS V. , PHILIPSEN T. , SECHER N. J. 
Published: August 2005

Summary.The effect of external version under tocolysis with intravenous ritodrine during the 37th week of gestation was studied in a prospective randomized trial comprising 130 consecutive women with a fetus in breech presentation. Version was successful in 41% of the patients, all of whom had a cephalic vaginal delivery. Of the 56 women in the control group in whom version was not attempted; 8 (14%) converted to the vertex presentation spontaneously. Failure of version was significantly correlated with primiparity, location of the placenta on the anterior uterine wall, and maternal weight. The caesarean section rate was significantly lower in the version group (27%) than in the control group (46%) (P<0–05). The overall caesarean section rate for a fetus in breech presentation was 50%. There were no serious complications associated with version and the condition of the infants at birth was better in the version group than in the control group. We advise external version under tocolysis in late pregnancy to reduce the frequency of breech presentation in labour.
Prostaglandins in menstrual fluid in menorrhagia and dysmenorrhoea
Authors: REES MARGARET C. P. , ANDERSON ANNE B. M. , DEMERS LAURENCE M. , TURNBULL A. C. 
Published: August 2005

Summary.Menstrual fluid was collected in vaginal cups inserted for 2 h during the first 2 days of menstruation and menstrual serum concentrations of prostaglandins PGF2α and PGE2 were measured by radio‐immunoassay. In 16 women from whom menstrual fluid was collected on both days, PGF2α and PGE2 concentrations were significantly higher on day 1 than on day 2. The highest concentrations of PGF 2α and PGE2 were found in dysmenorrhoeic women on day 1. In non‐dysmenorrhoeic women, the amount of PGF2α and PGE2 collected in 2 h correlated directly with total menstrual blood loss. There was no statistically significant difference in the amount of prostaglandins collected in 2 h in pain‐free menorrhagic women and dysmenorrhoeic women with normal loss. There was also no significant 9‐ketoreductase or 9‐hydroxydehydro‐genase activity present in menstrual fluid which could suggest PGE2 to PGF2α interconversion.
HLA tissue typing and chronic vulval dystrophy
Authors: LAVERY H. A. , PINKERTON J. H. M. , MIDDLETON D. 
Published: August 2005

Summary.Tissue typing was performed on 25 patients who attended the Royal Victoria Hospital with chronic vulval dystrophy (CVD). Age‐matched control groups who had pernicious anaemia only and achlorhydria only were also tissue typed as these conditions had been found more frequently in our patients with CVD. When these three groups were compared with age‐matched control groups of blood donors and patients with gynaecological disorders other than CVD, no specific tissue type was found in patients with CVD nor in those with pernicious anaemia or achlorhydria only.
The management of vaginal intraepithelial neoplasia after hysterectomy
Authors: WOODMAN C. B. J. , JORDAN J. A. , WADE‐EVANS T. 
Published: August 2005

Summary.Twenty‐three patients with vaginal intraepithelial neoplasia (VaIN) presented between 6 months and 13 years after hysterectomy for cervical intraepithelial neoplasia. All were discovered by cytological follow‐up, were colposcopically assessed and diagnosis confirmed by histological examination before treatment. The CO2 laser was used as the initial treatment in 14, but only six remain free of disease after mean follow‐up of 30 months. The reasons for the disappointing results with this form of therapy are discussed and it is suggested that its use may be inappropriate in the management of VaIN following hysterectomy as atypical epithelium may frequently be inaccessible as a result of being sequestered above the vault suture line or hidden in the recesses of the angles of the vaginal vault.
Quantitative microcolpohysteroscopic assessment of the extent of endocervical involvement by cervical intraepithelial neoplasia
Authors: SOUTTER W. P. , FENTON D. W. , GUDGEON P. , SHARP F. 
Published: August 2005

Summary.The Hamou microcolpohysteroscope was used to measure the extension of cervical intraepithelial neoplasia into the endocervical canal in patients before cone biopsy of the cervix. These measurements showed good correlation with those found on subsequent histological assessment.
The recovery of preovulatory oocytes using a fixed schedule of ovulation induction and follicle aspiration
Authors: TEMPLETON ALLAN , VAN LOOK PAUL , LUMSDEN MARY ANNE , ANGELL ROSLYN , AITKEN JOHN , DUNCAN ANDREW W. , BAIRD DAVID T. 
Published: August 2005

summaryThirty‐two unteer women, scheduled for laparoscopy, were subjected to a fixed regimen of ovulation induction and ovarian follicle aspiration, following manipulation of the previous menstrual cycle with oral contraceptive pills or norethisterone. This allowed the time of oocyte recovery to be planned several weeks in advance. The recovery rate of mature oocytes (loosely dispersed cumulus) in the patients who had their cycles adjusted with norethisterone was comparable to that in a group of women treated in an embryo‐transfer programme who were being individually monitored, although there was evidence from cleavage rates and concentration of sex steroids in follicular fluid that further follicular maturation could have occurred. It is suggested that a modification of this schedule could provide an acceptable recovery rate of pre‐ovulatory oocytes for research purposes, and possibly by simplifying the monitoring technique could be alicable to a wider range of patients seeking embryo transfer.
An assessment of pre‐operative microbial screening on the prevention of post‐abortion pelvic inflammatory disease
Authors: MILLS ANGELA M. 
Published: August 2005

summaryFive hundred women were examined for lower genital tract infection before vaginal termination of pregnancy. Pre‐operatively, Neisseria gonorrhoeae was isolated from nine women (1–8%); five of eight male partners also had gonorrhoea. All the women with gonorrhoea were treated at least 48 h pre‐operatively with ampicillin and probenicid; three of them had symptoms of pelvic infection pre‐operatively and one had symptoms postoperatively. Of these women, 120 (24%) had a follow‐up examination within 47 days of abortion; 15 (3%) required an evacuation of retained products of conception and only 12 (2%) had mild suspected pelvic infection. Screening for Neisseria gonorrhoeae and treatment pre‐operatively prevented pelvic infection in a further eight patients.
Screening for liver metastases from ovarian cancer with serum carcinoembryonic antigen and radionuclide hepatic scintiphotography
Authors: SONNENDECKER E. W. W. , DE SOUZA J. J. L. , HERMAN A. A. B. 
Published: August 2005

summaryThe association between pre‐operative serum carcinoembryonic antigen (CEA) and liver scanning employing technetium (99mTc)‐tin colloid was investigated in 30 women subsequently proven to have primary epithelial ovarian carcinoma to determine whether these two investigations improve the detection of hepatic mtastases. The uer limit of normal for CEA (≥ 5 ng/ml) did not represent the optimal levels for use in predicting ovarian carcinoma nor the presence of liver metastases. But with CEA levels> 10 ng/ml sensitivity for liver metastases was 57%. Liver scanning alone demonstrated metastases in five out of seven patients (71%) with parenchymal liver metastases. The combination of CEA and liver scan was positive in six out of these seven patients (86%).
Antenatal detection of placental steroid sulphatase deficiency: use of a dehydroepiandrosterone sulphate loading test
Authors: OAKEY R. E. 
Published: August 2005

summaryDehydroepiandrosterone sulphate (50 mg) was given intravenously to 15 women in the third trimester of pregnancy in which urinary oestrogen excretion was subnormal (<32 μmol/24 h) without recognizable clinical or therapeutic cause. In six patients, this procedure was followed by a marked increase in plasma oestradiol concentrations [mean (SD), nmol/1] before treatment: 44 (13) and 30 min after injection: 279 (31). After delivery, the placentas from all these patients showed steroid sulphatase activity in vitro (>450 units). In the other nine patients, all of whom subsequently showed negligible placental steroid sulphatase activity in vitro (< 10 units), mean plasma oestradiol concentrations increased only from 18 (9) to 26 (11) nmol/1. Changes in plasma oestradiol concentrations in late pregnancy after injection of dehydroepiandrosterone sulphate therefore readily permit identification of those patients in whom a placental enzyme deficiency is the cause of the subnormal oestrogen production. The defect was identified as steroid sulphatase deficiency by an in‐vitro test of placental tissue after delivery.
Antibacterial activity in human amniotic fluid: relationship to zinc and phosphate
Authors: SCANE T. M. N. , HAWKINS D. F. 
Published: August 2005

summaryAntibacterial activity, tested with B. subtilis, was present in all 44 human amniotic fluids at between 36 and 42 weeks of pregnancy and was unrelated to gestational age within these limits, or to maternal age or parity. High‐molecular‐weight (β‐lysin) activity, present in all samples, was directly related to concentration of bound zinc, but not to that of free zinc. Low‐molecular‐weight antibacterial activity (<1000 Daltons) was only present in nine specimens, but sub‐threshold concentrations were demonstrable by concentrating the ultrafiltrates in more than half of the remaining specimens. Low‐molecular‐weight activity in the ultrafiltrates was directly related to the concentration of bound zinc in the original amniotic fluid. Neither high‐ nor low‐molecular‐weight antibacterial activities were associated with amniotic fluid phosphate levels.
Maternal plasma inhibition of prostaglandin synthase during human pregnancy, parturition and the puerperium
Authors: BRENNECKE S. P. , HUMPHREYS J. , BRYCE R. L. , TEASDALE W. P. , TURNBULL A. C. , MITCHELL M. D. 
Published: August 2005

summaryTo study the possibility that circulating endogenous inhibitor(s) of prostaglandin synthesis (EIPS) represent a control mechanism for prostaglandin production during human pregnancy and parturition, we have measured maternal plasma EIPS levels serially during pregnancy, labour and the puerperium, and cross‐sectionally during the course of labour. No significant trends were detected in relation to pregnancy or parturition. These results do not suort a role for maternal plasma EIPS in the control of prostaglandin production during human pregnancy or labour.