Australian and New Zealand Journal of Obstetrics and Gynaecology

Chew, Franklin T. K.; Abell, David A.; Beischer, Norman A.

doi: 10.1111/j.1479-828X.1977.tb02663.xpmid: 267476

Summary: Antenatal cardiotoccgraphy was performed in 137 consecutive patients with persistently subnormal urinary oestriol excretion in spite of rest in hospital. Abnormal fetal heart rate (FHR) patterns were detected in 25 patients (18.2%). Late deceleration FHR patterns associated with Braxton Hicks contractions were recorded in 8 patients, and were associated with intrauterine death in 2 patients when delivery was delayed. The late deceleration FHR pattern occurring with Braxton Hicks contractions is a manifestation of acute on chronic fetal distress. The appropriate management is delivery within 24 hours, preferably by Caesarean section, especially if there is loss of beat‐to‐beat variation, and absence of sporadic FHR accelerations.

Chew, Peter; Salmon, J. A.; Ratnam, S. S.

doi: 10.1111/j.1479-828X.1977.tb02664.xpmid: 267477

Summary: Serial estimations of plasma oestradiol‐17(E2) and human placental lactogen (HPL) were made in 58 high‐risk pregnancies. In pregnancies complicated by marked hypertension, intrauterine growth retardation, and intra‐uterine death, plasma E2 did not reflect fetal well‐being accurately, unlike HPL which was accurate in predicting fetal outcome. In diabetic pregnancy, plasma E2 and HPL levels were similar to those found in normal pregnancy.

Yeung, K. K.; Pang, J. C. K.

doi: 10.1111/j.1479-828X.1977.tb02665.xpmid: 267478

Summary: Oral prostaglandins E2 and F2a were used to augment amniotomy in the induction of labour in 173 patients. The success rate was significantly higher with prostaglandin E2 than with prostaglandin F2a (89% and 75%, respectively). This was achieved despite a significantly lower incidence of gastrointestinal side effects. No serious maternal or fetal complications occurred with either drug. It is concluded that oral prostaglandin E2 is more efficient than oral prostaglandin F2a in the induction of labour.

Fahmy, Kamal; Ghali, Atef

doi: 10.1111/j.1479-828X.1977.tb02666.xpmid: N/A

Summary: Sixty‐three consecutive cases of prolapsed pulsating cord managed by vacuum extraction and 52 others managed by Caesarean section are reviewed. Statistical comparison showed that there was no significant difference between both groups as regards the number of depressed babies at birth, fetal complications or fetal loss (P > 0.05). Postoperative maternal complications were more significant with Caesarean sections (P < 0.001). The vacuum extractor appears to offer an alternative to Caesarean section in selected cases of prolapsed pulsating cord. Satisfactory maternal and fetal results depend on adequate funic decompression, proper selection of cases, rapid interference and skill in vacuum extraction. When speed is observed, the instrument can be applied within 5 minutes of diagnosis and in most cases delivery achieved with 10 minutes traction.

Chynoweth, R.; Abrahams, M. J.

doi: 10.1111/j.1479-828X.1977.tb02667.xpmid: N/A

Summary: One hundred and forty‐seven women were assessed before undergoing hysterectomy. Information was obtained about their physical condition, social background, and psychological status. After operation an assessment was made concerning their attitude to the operation, physical health, mental health, sexual relationships, and their partner's attitude to the sexual relationship. Factors were identified which correlated with a poor outcome. The significance of these findings is discussed with particular reference to the possible use of more active intervention in the ‘at risk’ patient.

Skipper, John S.

doi: 10.1111/j.1479-828X.1977.tb02668.xpmid: N/A

Summary: Severe and recurrent stress incontinence of urine in women presents many problems in management, especially in the elderly and the obese. The use of Mersilene gauze mesh as a modified Aldridge sling is presented as an alternative means of treatment in difficult cases where there are poor tissues to work with. A series of 30 patients is presented with an 86% cure rate; the use of Mersilene as a broad sling beneath the bladder neck and urethra overcomes one of the main problems in the use of synthetic materials.

Laufer, N.; Freund, H.

doi: 10.1111/j.1479-828X.1977.tb02669.xpmid: N/A

Summary: Although achalasia of the oesophagus is a rare condition in pregnancy it is frequently associated with serious maternal complications and a poor fetal prognosis. We add 2 such cases to the 8 others reported, and review the literature. It is our opinion that oesophagomyotomy is the treatment of choice for this condition; it should be employed early in the course of the disease before it has reached an advanced state when there is danger to mother and child.

Durham, John A.

doi: 10.1111/j.1479-828X.1977.tb02670.xpmid: N/A

Summary: A case of noradrenaline secreting phaeochromocytoma, arising from the para‐aortic chain is described. It presented in the last trimester of pregnancy with attacks of severe headache, hypertension, and marked sinus brady‐cardia. The tumour was removed after the completion of a successful Caesarean section.