BJOG : An International Journal of Obstetrics & Gynaecology

Gordon, Y. B.; Grudzinskas, J. G.; Lewis, J. D.; Jeffrey, Diana; Letchworth, A. T.

doi: 10.1111/j.1471-0528.1977.tb12674.xpmid: 911715

Circulating levels of pregnancy‐specific β1‐glycoprotein (SP1) and human placental lactogen (HPL) were measured in 153 normal subjects during the third trimester of pregnancy. The levels of SP1 and HPL showed a skewed distribution and rose progressively to reach a plateau by the 36th week. The normal range was calculated by ranking the data and division into centiles as well as by logarithmic transformation of the values. A low but significant correlation was observed between SP1 and HPL levels, SP1 and birth weight. There was also a correlation between HPL levels and placental weight.

Klopper, A.; Masson, G.; Wilson, G.

doi: 10.1111/j.1471-0528.1977.tb12675.xpmid: 911716

Blood was collected from 53 normal women in the 38th week of pregnancy. The plasma concentration of unconjugated oestriol, total oestriol and oestriol sulphate was measured and also human placental lactogen and pregnancy specific β1 glycoprotein. The normal spread of the two proteins was found to be slightly smaller than that of the oestrogens. The concentrations of unconjugated and of total oestriol were related; otherwise these substances varied independently of one another. The concentration of these substances was not related to other obstetric parameters.

Brosens, I.; Dixon, H. G.; Robertson, W. B.

doi: 10.1111/j.1471-0528.1977.tb12676.xpmid: 911717

The morphology of the placental bed spiral arteries was studied in 68 pregnancies complicated by fetal growth retardation and in 40 pregnancies with a normally grown fetus. When the birth weight was normal the extent and depth of physiological vascular changes were normal except in those pregnancies complicated by preeclampsia. When the birth weight was low and the mothers were normotensive the extent and depth of physiological vascular changes were either normal or restricted, and in all patients with hypertension and a baby with low birth weight the physiological changes were restricted to the decidual segments of the spiral (uteroplacental) arteries. Acute atherosis was only found in pregnancies complicated by hypertension, particularly if there was proteinuria. We do not believe that there exists an arteriopathy which is common to hypertensive and normotensive pregnancies complicated by fetal growth retardation.

Ogborn, A. D. R.; Hunt, Kathleen M.; Gordon, H.

doi: 10.1111/j.1471-0528.1977.tb12677.xpmid: 410430

Intrauterine transfusion of the fetus is described in 165 pregnancies. The overall fetal survival rose from 28 per cent in 1964 to 1969 to 42·5 per cent in 1973 to 1975. Apart from technical complications of the procedure itself, the factors most likely to affect fetal survival were the gestational age and amniotic fluid optical density difference before the first intrauterine transfusion, the birth weight and the cord blood haemoglobin level.

Iddekinge, B.; Hughes, Elizabeth A.

doi: 10.1111/j.1471-0528.1977.tb12678.xpmid: 911718

The apparently low incidence of respiratory distress syndrome in babies born prematurely after irstrauterine transfusion and the simultaneous prophylactic administration of intravenous isoxsuprine (a β‐sympathomimetic agent) was investigated by serial study of amniotic fluid lecithin/sphingomyelin ratios. The ratio rose very significantly after intrauterine transfusions and significantly (but less markedly) after the administration of intravenous isoxsuprine alone.

Waterson, A. P.; Almeida, June D.; Weeple, Patricia M.; Hawkins, D. F.; Cummins, Mary

doi: 10.1111/j.1471-0528.1977.tb12679.xpmid: 911719

In a period of six years (1971–77) 9400 sera taken at booking from antenatal patients were examined for hepatitis B antigen (HBsAg), and 40 patients were positive. These 40 patients had 45 pregnancies and were treated with special precautions so far as venepuncture and the management of delivery were concerned. No member of the hospital staff dealing with the patients developed hepatitis B. All infants born to these mothers were normal, two infants were HBsAg‐positive at 7 months and 2 years, but are clinically well. No obstetric problems attributable to the HBsAg‐positive state were encountered.

Jones, R. W.; Asher, M. Innes; Rutherford, Cynthia J.; Munro, Heather M.

doi: 10.1111/j.1471-0528.1977.tb12680.xpmid: 562177

The effects of autoimmune (or idiopathic) thrombocytopenic purpura (ATP) on 51 pregnancies in 29 women is presented. There is no convincing evidence that the clinical course of ATP is influenced by pregnancy. There was no increased incidence of obstetric complications. No problems were encountered following spontaneous vaginal delivery or low forceps delivery. There were no perinatal deaths. Twenty newborn infants were studied in detail and significant thrombocytopenia was present in half of them. The severity of thrombocytopenia in the newborn correlated closely with the severity of maternal disease; those women in clinical remission following splenectomy but with presumed high levels of antiplatelet antibodies were those most likely to be delivered of affected newborn infants. The cord blood platelet count was the most reliable guide to the potential severity of the neonatal thrombocytopenia. Platelet counts were lowest between the second and fourth days of neonatal life. The management of the severely affected infant is discussed.

Wigglesworth, J. S.; Husemeyer, R. P.

doi: 10.1111/j.1471-0528.1977.tb12681.xpmid: 911720

Between 1966 and 1976, postmortem examinations revealed significant intracranial birth trauma in 17 infants delivered breech first and in ten infants delivered head first; separation of the squamous and lateral parts of the occipital bone (occipital osteodiastasis) was found in five of the infants who died after breech delivery. The finding of the lesions in these infants is attributed to the adoption, since 1971, of a postmortem technique involving dissection of the suboccipital region before opening the skull. Review of earlier necropsy reports suggests that the lesion was sometimes missed. Analysis of the fresh stillbirths and neonatal deaths occurring in the 477 vaginal breech deliveries at the Hammersmith Hospital (1966 to 1976) showed that all neonatal deaths in infants weighing more than 3000 g at birth were associated with intracranial birth trauma: 2 out of 3 had occipital osteodiastasis which seems to be more common than is generally recognized and is only found with careful autopsy technique.

Jackaman, R.; Ghanadian, R.; Ansell, I. D.; McLoughlin, P. V. A.; Chisholm, G. D.

doi: 10.1111/j.1471-0528.1977.tb12682.xpmid: 911721

The measurements of serum follicle stimulating hormone (FSH), luteinizing hormone (LH) and testosterone were related to the sperm concentration and testicular biopsy in 137 subfertile men. The biopsies were classified into four histological groups: normal, focal tubular atrophy, maturation arrest and Sertoli‐cell‐only syndrome. A positive correlation was found between sperm concentration and the histological grade of spermatogenesis. FSH was directly related to the spermatogenesis and the values were significantly raised in maturation arrest and Sertoli‐cell‐only syndrome. This relationship was present, but to a much lesser extent, for LH. Serum testosterone levels remained unchanged and no relationship between testosterone and either sperm concentration or testicular biopsy was observed. These data indicate the value of FSH in the investigation of the subfertile male, but suggest that the routine measurement of testosterone is unnecessary.

Walters, W. A. W.; Shields, Lyndall

doi: 10.1111/j.1471-0528.1977.tb12683.xpmid: 911722

Changes in the distensibility of dorsal hand veins during the menstrual cycle were measured in 19 healthy young women using a new optical method relying upon a pressure‐diameter principle. Significantly greater venous distensibility was found during the first half compared with the second half of the menstrual cycle. The possible causes for this finding, particularly the role of oestrogen, are discussed.