The feasibility of early second trimester pregnancy (12 to 14 weeks) termination with single intra-amniotic injection of 15-methyl PGF2 alpha.

Prostaglandin analogues have proven to be safe and effective for second trimester pregnancy terminations when given by various routes. Of these, the intra-amniotic (IA) route has proven to be safer, especially in women with medical disorders, as it causes the least occurrence of systemic side-effects. Previously, blind transabdominal IA instillation of the analogue 15-methyl PGF2 alpha was routinely possible only after 16 weeks' gestation.

Intracytoplasmic sperm injection of mouse oocytes with 5 mM Ca2+ at different intervals.

The objective of this investigation was to determine whether intracytoplasmic sperm injection (ICSI) can be performed in the mouse. Metaphase II oocytes were obtained from F1 hybrid mice (C57BL x CBA) by i.p.

Evaluation of new catheter systems for intrauterine pressure measurement.

To verify the reliability of intrauterine pressure recordings by a newly available intrauterine catheter. In five women in labor the tips of the two newly available catheters (Hewlett Packard HP 13975 A) were tied together and placed in the same amniotic fluid pocket. In three other women the tip of the new catheter (HP) and tip of an established catheter system (Intran II) were tied and placed in the uterine cavity above the fetal head.

Automated 24-hour ambulatory blood pressure monitoring in preeclampsia.

A prospective controlled study was designed to compare automated 24-hour ambulatory blood pressure monitoring with intermittent blood pressure recordings obtained using a sphymomanometer. Blood pressure was measured in 20 hospitalized preeclamptic women in the third trimester. Data obtained using the Spacelabs automated blood pressure monitor was recorded over a period of 24 hours, and thereafter stored and processed in a computer.

The impact of long-term testosterone replacement therapy on lipid and lipoprotein profiles in women.

The lipid and lipoprotein profiles of 39 female transsexuals, exposed to testosterone esters (250 mg monthly) for an average duration of 33 months after their sex reassignment operation (group 2), were compared to those of 29 normal menstruating female transsexuals prior to starting androgen therapy (group 1). A third group, comprising 17 post-operative female transsexuals were studied while on, and after stopping their androgen therapy for 6-12 months (group 3). The average concentration of testosterone in androgenized women was comparable to those found in normal males and levels of SHBG were significantly lower than those in the control group.

Endocrine effects in Asian postmenopausal women, treated with SH D 461 M and Prempak-C.

We reported the results of a randomized cross-over study comparing SH D 461 M (Climen) and Prempak-C in 38 postmenopausal women who were established users of hormone replacement therapy (HRT). Climen contains 11 tablets of 2 mg estradiol valerate (EV), and 10 tablets with 2 mg EV plus 1 mg of cyproterone acetate. Prempak-C, on the other hand, is a regimen consisting of 28 tablets of 0.

Pregnancy outcome and mitral valve prolapse.

Mitral valve prolapse (MVP) comprises a large proportion of obstetric cardiac problems and has a general prevalence of 4%. We examined the obstetric outcome of patients with MVP delivered between 1988-1991 at the National University Hospital, Singapore. During this interval, deliveries totalled 16,755 of which 85 (0.

Endocrine effects in Asian postmenopausal women treated with SH D 461 M and Prempak-C.

We reported the results of a randomized cross-over study comparing SH D 461 M (Climen) and Prempak-C in 38 postmenopausal women who were established users of hormone replacement therapy (HRT). Climen contains 11 tablets of 2 mg estradiol valerate (EV), and 10 tablets with 2 mg EV plus 1 mg of cyproterone acetate. Prempak-C, on the other hand, is a regime consisting of 28 tablets of 0.

Isolation and culture of inner cell mass cells from human blastocysts.

Totipotent non-committed inner cell mass (ICM) cells from human blastocyts, if demonstrated to be capable of proliferating in vitro without differentiation, will have several beneficial uses, not only in the treatment of neurodegenerative and genetic disorders, but also as a model in studying the events involved in embryogenesis and genomic manipulation. Nine patients admitted to an in-vitro fertilization programme donated 21 spare embryos for this study. All 21 embryos were grown from the 2-pronuclear until blastocyst stages on a human tubal epithelial monolayer in commercial Earle's medium (Medicult, Denmark) supplemented with 10% human serum.

Influence of circulating D-dimer levels on assays of fibrinogen.

The influence of circulating D-dimer levels on two different assays for fibrinogen was studied in 31 normal female subjects, 18 late pregnant subjects, 8 male subjects with acute myocardial infarction (AMI) and 9 subjects with unstable angina (UA). Both functional and chemical methods for fibrinogen showed significant correlation (r = 0.8171; P < 0.

Maternal mortality: evolving trends.

Despite improvement in socioeconomic standards, good and accessible health care facilities the maternal mortality rate in Singapore is not declining. The maternal mortality rate in National University Hospital, Singapore, over a 7 year period 1986-1992 was 22.9 per 100,000 when direct and indirect causes were considered (34.

Disorders of platelets in pregnancy.

No significant change in platelet number, function or life-span occurs during pregnancy. However, pregnancy may be complicated by various platelet abnormalities or platelets may be involved in pregnancy pathologies. Thrombocytopenia is the most common platelet disorder to affect pregnancy.

An interesting case of intersex: case report.

Intersex is a rare problem. Ambiguous genitalia, a frequent presentation of intersex, is seldom due to true hermaphroditism. This case report describes the findings in such a rare case.

Human embryonic behavior in a sequential human oviduct-endometrial coculture system.

Embryonic behavior to blastocyst, hatching, and hatched stages were evaluated in 77, four-cell human embryos that were first grown in oviductal cell coculture and then equally allotted at the eight-cell stage to two coculture systems in a serum-free medium (34 continued on oviductal monolayers, 32 on endometrium monolayers). Sixty-three percent and 40% of embryos expanded and hatched in the sequential oviductal-endometrial coculture system when compared with 41% and 9% in the oviductal system alone, respectively. The sequential coculture system appears to be an improved system over the single human oviductal coculture system.

Complete androgen insensitivity due to a splice-site mutation in the androgen receptor gene and genetic screening with single-stranded conformation polymorphism.

Objective: To characterize the genetic defect in a family with complete androgen insensitivity syndrome and to determine whether single-stranded conformation polymorphism (SSCP) can be used to detect subtle mutations in the androgen receptor (AR) gene.

Design: Amplification, subcloning where appropriate, and sequencing of the AR gene in members of the affected family and to use SSCP to differentiate rapidly mutant from normal alleles.

Setting: Reproductive endocrinology clinic and laboratory in a university hospital.

Occurrence of Listeria in hot and cold smoked seafood products.

Over a one-year period, 258 samples of smoked fish products were obtained from retail outlets in Newfoundland and processed for Listeria. Of these, 142 were hot smoked and 116 cold smoked, and the samples comprised of nine species of fish. The Canadian FDA listeria isolation protocol consisted of a two-stage enrichment followed by plating on selective isolation media, Oxford, and LPM.

Differential regulation of cholesterol side-chain cleavage (P450scc) and aromatase (P450arom) enzyme mRNA expression by gonadotrophins and cyclic AMP in human granulosa cells.

The co-ordinated biosynthesis of progesterone and oestradiol in the human ovary is critical for reproductive cyclicity and eventual pregnancy. The crucial regulatory enzymes for progesterone and oestradiol biosynthesis in granulosa cells are the cholesterol side-chain cleavage (P450scc) and aromatase (P450arom) enzymes respectively. We utilized the cDNA sequences encoding P450arom and P450scc to examine the roles of FSH and LH, and their intracellular second messenger, cyclic AMP (cAMP), in regulating steroidogenic gene expression.

Obstetrical outcome with increasing maternal age.

A retrospective study of 21,442 Singaporean women who gave birth at the National University Hospital, Singapore, between January 1986 and November 1991 is used to assess the effects of increasing age on obstetric performance. The results show that reproduction after the age of 35 years in Singapore is associated with a higher incidence of antenatal complications such as hypertension and diabetes and a higher rate of obstetric intervention. However, given the current level of obstetric and neonatal care in Singapore, these adverse features do not prejudice the obstetric and neonatal outcomes.

Intrauterine pressure: comparison of extra vs intra amniotic methods using a transducer tipped catheter.

Fourteen women admitted in early labor, with intact membranes, were studied. In each woman, two catheters were inserted transcervically; one catheter was inserted into the extraamniotic space before rupture of membranes, and the second catheter was inserted, after artificial rupture of membranes into the intraamniotic cavity. The contraction to contraction difference in active pressure (pressure above the baseline) recorded by the two catheters, as well as the cumulative total active pressure generated (calculated by adding the active pressure of all contractions) throughout labor by the two catheters were compared.