K. W. Hancock

Early discharge following vaginal hysterectomy

Objective To assess the feasibility of discharging selected patients home within 72 h of vaginal hysterectomy.

METEOROLOGICAL RELATIONS OF ECLAMPSIA IN LAGOS, NIGERIA

A retrospective study of the meteorological relations of eclampsia in Lagos, Nigeria supports other observations that the incidence of this disease varies significantly with the weather. Protective action by arid conditions is consistent with the known effect of dehydration on convulsions of differing aetiologies and is attributable to increased pulmonary transpirational water loss. Exacerbation of eclampsia by cool, humid conditions may therefore reflect excessive water retention, due partly to suppressed pulmonary transpiration and partly to kidney malfunction in those women.

VIABILITY OF HUMAN TROPHOBLAST IN VITRO

Human placental monolayer cultures contain three main cell types: epithelioid, giant multinucleated and fibroblastic cells. Only epithelioid and giant multinucleated cells are of trophoblastic origin. The viability and relative abundance of the three cell types were investigated using four methods of assessment: trypan blue exclusion, phase‐contrast microscopy, mitotic indices and synthesis of human chorionic gonadotrophin. Between days 1 and 8, epithelioid and giant multinucleated cells were dominant. The mitotic index gradually declined during this period but cell viability as assessed by dye exclusion and phase‐contrast microscopy was high and active synthesis of chorionic gonadotrophin occurred. Fibroblastic cells dominated the culture from approximately day 9. Experiments with trophoblast in vitro should therefore be performed during the first eight days of culture.

WATER INTOXICATION AND OXYTOCIN INFUSION

The case reports are presented of two patients who developed water intoxication after high‐dose oxytocin infusions. Plasma sodium and urine flow were studied in two further patients given high‐dose oxytocin infusions. The findings are related to previously published observations.

CONSERVATIVE MANAGEMENT OF PITUITARY PROLACTINOMAS; EVIDENCE FOR BROMOCRIPTINE-INDUCED REGRESSION

Thirty‐six women with sustained hyperprolactinaemia, 29 showing radiological abnormality of the pituitary fossa, were managed conservatively; 28 accepted bromocriptine treatment which controlled hyperprolactinaemia in all and was associated with improvement in the radiological appearance of the pituitary in 4 cases. Two of the 8 patients who did not accept bromocriptine showed radiological extension of the pituitary lesion; one showed radiological improvement. Bromocriptine should be regarded as a drug to control the pituitary tumour, not merely one which inhibits the endocrine effects.

Blood pressure, plasma osmolarity and oedema in pregnancy

Summary. Relations of mean arterial pressure to age, parity, plasma osmolarity, sodium and albumin were examined in normal non‐pregnant, normal pregnant and pre‐eclamptic Nigerian women. Mean arterial pressure showed a positive correlation with age in non‐pregnant subjects, but not in normal pregnant or pre‐eclamptic women. There was no siginficant correlation of mean arterial pressure with parity, plasma sodium or albumin in any of the three groups. A weak positive correlation was found between mean arterial pressure and plasma osmolarity in non‐pregnant women and, although this was absent in normal pregnancy, it reappeared as a significant negative correlation in pre‐eclampsia. These observations were considered, with special reference to osmotic aspects of the changes involved, and biophysical aspects of oedema are discussed. It is suggested that the osmotic properties of interstitial fluid albumin play a key role in the development of both physiological and pathological oedema in pregnancy.

Autoantibodies to soluble cellular antigens in unexplained recurrent abortion and infertility

In 36 women with unexplained primary recurrent abortion, 13 with secondary unexpained recurrent abortion, 25 with primary unexplained infertility, 7 with secondary unexplained infertility and two groups of control women, autoantibodies to soluble cellular antigens were measured by Western blotting to a disaggregated HeLa cell antigen preparation, by counter immunoelectrophoresis and by indirect immunofluorescence. Using Western blotting the women with primary infertility and those with secondary recurrent abortion had a significantly higher prevalence of autoantibodies (P less than 0.01 in each case). This was not shown using the other methods. It is possible that these antibodies could be causally related to the pathology of the conditions studied.

BIOCHEMICAL CHANGES OF NORMAL PREGNANCY AND PUERPERIUM IN LAGOS, NIGERIA

A cross‐sectional study is presented of biochemical changes in the third trimester of normal pregnancy and puerperium during the wet season in the tropical climate of Lagos, Nigeria. These changes are less marked in first than in subsequent pregnancies, and although qualitatively similar, in some respects they differ from those observed in the temperate climatic zone. The indications are that quantitative differences may exist which could be relevant to the management of pregnancy in the tropics.

A STUDY OF GONADOTROPHIN RELEASE IN A WOMAN WITH HYPOGONADOTROPHIC HYPOGONADISM AND ANOSMIA

A patient with hypogonadotrophic hypogonadism with anosmia is presented. The patients response to repeated gonadotrophin releasing hormone administration indicated a significant priming effect of such therapy on the anterior pituitary.