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A non proteinaceous extract of Bromelia pinguin fruit was examined for activity on the rat uterus in vivo and in vitro. The in vivo experiments involved pregnant rats given the extract intraperitoneally. These rats did not abort nor were any foetal deformities observed. The extract inhibited spontaneous activity of the pregnant rat uterus in vitro. The extract of Bromelia pinguin fruit may have some utero-active compound which inhibits uterine motility.(AU)

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The objective was to compare the pregnancy outcome of teenage girls and mature women. The design was a retrospective study of births from January to December 1990, based on the antenatal clinic and labour ward, University Hospital of the West Indies, Jamaica. Teenage mothers, 13 to 19 years old, and a control group of mothers, 22 to 23 years old, were selected from the records of 2,394 live, singleton births between 200 and 305 days' gestation. The main outcome measures were birth weight, crown heel length, head circumference: length ratio, ponderal index and placental weight. The results showed that in the teenage group, weight body mass index at booking, haemoglobin concentration in each trimester, and minimum haemoglobin level during pregnancy were lower than in the control group. Systolic blood pressure in the first and the second trimesters was lower than in controls, but there was no significant difference in the third trimester nor in the delivery systolic blood pressure. Babies of teenage mothers had lower birth weights and smaller head circumferences than the babies of the control group, but there was no significant difference between the groups in crown heel length, ponderal index, head circumference: length ratio, and placental weight. These data support the hypothesis that teenaged girls are not physically mature and, as a consequence, their offspring have lower birth weights and smaller head circumferences (AU)

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In this retrospective study of birth outcome, 214 pregnant girls between the ages of 13 and 19 years and a matched control group of 297 older pregnant women (22-23 years) were selected from the records of 2394 live, singleton births between 200 and 305 days gestation, who attended antenatal clinics at the University Hospital of the West Indies, January - December 1990. Birth weight, crown heel length, head circumference, head circumference:length ratio, ponderal index, placental weight were measured. Weight and BMI at booking in the teenagers were less that those in the controls. Their haemoglobin levels in each trimester and their minimum haemoglbin levels were lower than those in their controls, but there was no significant difference in the third trimester or the delivery systole blood pressure. Babies of teenagers had lower birth weights and smaller head circumferences, but there was no significant difference between their crown heel length, ponderal index, head circumference:length ratio, and placental weight. These data support the hypothesis that teenage girls are not physically mature as demonstrated by their booking weight and BMIs and that as a consequence, their offspring are compromised as is evident by their lower birth weights and head circumference. (AU)

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Although endometrioid carcinoma constitutes the second most common type of primary ovarian adenocarcinoma, the sertoliform variant is rarely encountered. We describe a case of this rare ovarian carcinoma which mimics a Sertoli cell tumour in its pathological appearance (AU)

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Although endometrioid carcinoma constitutes the second most common type of primary ovarian adenocarcinoma, the sertoliform variant is rarely encountered. We describe a case of this rare ovarian carcinoma which mimics a Sertoli cell tumour in its pathological appearance

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A ten-year review was carried out on all patients seen at UHWI who were coded as having "pre-eclampsia". Two hundred and thrity-four patients were identified. The true pre-eclamptics (proteinuric hypertensives) were found to have significantly poorer pregnancy outcome with earlier delivery, lower foetal weight, apgar scores and placental weight than controls and non-proteinuric hypertensives. The outcome for these two latter groups was not significantly different. Non-proteinuric hypertensives are at less risk than proteinuric hypertensives, and we might consider a more measured response to this group (AU)

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Thirteen triplet gestations delivered at the University Hospital of the West Indies, Mona, from 1968-1987 are reviewed. The incidence was 1 per 4,491 births. The perinatal mortality rate was 28.2 percent. Prematurity and congenital malformations were the main causes of death. Malpresentations were present in 64 percent of cases. Earlier diagnosis with close surveillance of the pregnancy and liberal use of delivery by Caesarean section should improve the outcome for the babies (AU)

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The optimum management of prolonged pregnancy is controversial. Eighty-two patients with this problem were managed prospectively. If the cervix was favourable for induction of labour, this was done. If the cervix was unfavourable, pregnancy was allowed to continue but the foetus was monitored with twice weekly non-stressed cardiotocography. A control group of 115 patients who were all induced at 42-weeks gestation was used to compare pregnancy outcome. Selective intervention resulted in reducing the induction rate by half. Pregnancies managed conservatively resulted in fewer (6.6 percent as opposed to 30 percent) Caesarean births in the induced pregnancies. More babies with higher Apgar scores at birth were born to the conservatively managed patients (AU)

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One hundred and thirty-eight patients suspected to have utero-placental insuffiency and hence at "high-risk" had 420 tests performed, representing a preliminary experience with non-stressed cardiotocography in antepartum foetal surveillance. A ten-point scoring system based on base-line foetal heart rate, foetal movements, base-line variability and foetal heart rare response to foetal movements and Braxton-Hicks contractions was used to analyse the test results. Perinatal morbidity as evidenced by foetal distress in labour, number of operative deliveries, babies with low Apgar scores of six or less. The perinatal mortality rate was 9/1000 with a score of 7-10 as against arate of 120/1000 with a test score seven. The results compare favourably with other studies, and confirm the usefulness of this technique in monitoring foetal welfare. (AU)

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Thirteen pregnancies in ten patients with homograft cardiac valves resulted in 11 healthy infants, one spontaneous abortion, one elective termination of pregnancy, and the stillbirth of one member of a twin pregnancy. Two forceps deliveries and three cesarean section were performed and routine antibiotic prophylaxis at the time of delivery was utilized to prevent infective endocarditis in all patients. No hemorrhagic or teratogenic complications were observed, and this was considered directly related to the fact that anticoagulant therapy was rendered unnecessary with the homograft valve - a distinct advantage. A more permissive policy of allowing pregnancy in young women with homograft cardiac valves is suggested by the satisfactory outcome of the pregnancies reported here (AU)

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Thirty-eight pregnancies in 27 patients who had previous open heart surgery resulted in 32 healthy babies, 4 spontaneous abortions and 2 elective abortions. Seven forceps deliveries and 5 Caesarean sections were performed. Detailed information was available for 22 infants all of whom were healthy and were born at term without evidence of haemorrhagic or teratogenic complications (no anticoagulant therapy was used in the mothers). The gratifying outcome of the majority of these pregnancies suggests that a more liberal policy in allowing pregnancy in patients who have had successful open heart surgery shoud be pursued (AU)

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