Relation between the luteinizing hormone peak, the nadir of the basal body temperature and the cervical mucus score

Summary. The results of a cervical mucus scoring system and of basal body temperature (BBT) chart interpretation were compared with those of a short-incubation radioimmunoassay for luteinizing hormone (LH) in 198 ovulatory menstrual cycles. The timing of the maximal cervical mucus score was similar to that of the LH peak in all but 7% of assessable cycles. In contrast, the timing of the nadir of the BBT differed widely from that of the LH peak in 45% of cycles with interpretable charts. These findings suggest that cervical mucus scoring might be useful for identifying the time of ovulation where LH assays are unavailable or where speed and economy are at a premium.     

Cytoplasmic steroid receptors in ovarian tumours

Summary. Cytoplasmic oestrogen receptors were measured in 40 primary and four secondary ovarian tumours; of these, 43 tumours were also analysed for cytoplasmic progesterone receptors and 34 tumours for cytoplasmic androgen receptors. Serous tumours were significantly more likely to be oestrogen-receptor positive than mucinous tumours, but the incidence of positive progesterone and androgen receptors was similar in serous, mucinous and endometrioid tumours. The mean oestrogen receptor content of serous tumours was significantly higher than that of endometrioid tumours. Well-differentiated epithelial tumours were significantly more likely to be oestrogen-receptor and progesterone-receptor positive than less differentiated epithelial tumours. Two granulosa cell tumours were oestrogen-receptor positive and one of these was also progesteronereceptor and androgen-receptor positive. Four normal óvaries were also analysed for receptor content and two were found to be androgen-receptor positive. The presence of cytoplasmic receptors in ovarian tumours may explain their reported response to endocrine therapy.     

Prostaglandin E production by amniotic cells in relation to term and preterm labour

Summary. The rate of prostaglandin E (PGE) production was measured in collagenase-dispersed amniotic cells obtained from 14 women after spontaneous labour at term—seven after spontaneous preterm labour, nine after delivery by elective caesarean section at term and six after induction of labour at term. Cells were incubated with and without arachidonic acid and PGE was estimated by specific radioimmunoassay. Basal PGE output (pmol/10⁶ cells per 3 h) was highest in the spontaneous labour group, 27·5 (SEM 5·5) and lowest in the preterm labour group, 4 (SEM 1·2) ( P <0·001). Values in the elective section and induction groups were 13·6 (SEM 2·7) and 10 (SEM 3·1), respectively; these values were significantly higher than in the preterm labour group and the values after induction were significantly lower than after spontaneous labour. Addition of arachidonic acid resulted in a significant increase in PGE output in all groups, but the values after preterm labour remained significantly lower than those of any group at term. These data indicate that towards term there is a maturation in the PG synthetase activity of the amnion and that PGE output in this tissue is increased in spontaneous labour.     

广西5个民族女性生理骨盆的对比研究

本文对广西壮、汉、仫佬、侗、瑶5个民族的500名妇女的生理骨盆进行了调查。调查内容包括临床、X线测量等47个项目。各项测量数据均在5个民族间进行两两比较。发现壮、汉两民族X线测量除入口前后径壮族略小于汉族外,其余各项指标无显著区别。而仫佬、侗、瑶3个民族又有其共同特点,如骨盆由入口→出口三个平面的横径、中部前后径、骨盆前部高度,3个民族间无明显区别,但此5条径线均明显大于壮、汉两民族。此外,仫佬、侗、瑶3民族的骶骨明显弯曲。骨盆入口形态后段呈扁形者5个民族的出现率均高,而仫佬、侗、瑶3民族骨盆入口前段呈猿形者又高于壮、汉两民族。     

药物流产后胎盘残留问题的研究

为减少药物流产后出血,缩短出血时间,将200例孕10～16周药物流产者按不同给药剂量采用不同给药途径终止妊娠,探讨其流产效果及流产后影响胎盘绒毛残留的因素。200例对象中192例流产成功,成功率96％。米索前列醇阴道用药效果明显优于口服(P<0.01)。24小时后清宫者绒毛胎盘残留明显低于即刻清宫(P<0.01)。残留与以往电吸人流次数及米非司酮剂量有关。提示做过二次或二次以上电吸人流手术者,药物流产后宜即刻行清宫术。     

阴道镜下定位活检诊断宫颈病变375例分析

目的:探讨阴道镜在宫颈病变诊断中的临床应用价值。方法:选择375例高危病例,经阴道镜检查诊断,行宫颈多点活检,以组织病理学为诊断金标准。结果:阴道镜诊断宫颈病变的符合率分别为:宫颈炎84.2%,CINI~II级83.3%,CINⅢ级93.1%和浸润癌100%。结论:通过阴道镜对宫颈细微结构的观察,镜下定位使活检目标更具准确性,提高了活检的阳性率。     

Is centralized hospital care necessary for all insulin-dependent pregnant diabetics?

Summary. A retrospective population study in Northern Ireland examined the benefits of centralized care in insulin-dependent diabetic pregnancies. In the 5 years 1979–1983, there were 139 250 deliveries in Northern Ireland and of these 221 pregnancies occurred in 187 insulin-dependent diabetic patients; 100 were managed entirely in peripheral maternity units, 61 were referred from a peripheral unit to the Royal Maternity Hospital, Belfast and 60 were managed entirely in this central referral hospital. The patients referred from the periphery had the worst past obstetric history with a combined perinatal mortality rate of 200 per 1000. During the study period the perinatal mortality rate was 107 for the referred pregnancies, 33 for those managed entirely in the peripheral units and 18 for those managed at the Royal Maternity Hospital. If those pregnancies terminated for fetal abnormality, and deaths beyond the perinatal period are included, the figures for total fetal loss were 15.5%, 5.5% and 7.1% respectively. Overall the major congenital malformation rate was 7.5%, and for the respective groups 6.5%, 3.0% and 13.0%. For the general population during the same period the perinatal mortality rate was 1.4% and the major congenital malformation rate was 2.5%. Thus it is suggested that only peripheral hospitals which can offer combined antenatal/endocrine care and with a neonatal intensive care unit should undertake the management of the pregnant diabetic.