Trends in compliance with the national colposcopy guidelines.

This study aims to assess trends in compliance with current colposcopy guidelines in 10 gynaecological units in four English counties since 1996; to identify constraints on compliance and suggest change in practice. All 10 gynaecology units in Oxfordshire, Buckinghamshire, Northamptonshire and Berkshire participated. Data were collected prospectively by colposcopists from 23,500 new referrals across a 55-month period from September 1996 to March 2001.

Dermatomyositis presenting in pregnancy.

We report the onset of dermatomyositis in a woman pregnant 38-weeks who subsequently delivered a healthy infant. The disease improved rapidly following delivery. The association of dermatomyositis with pregnancy is unusual, and fetal outcome may be adversely affected.

Mild cervical dyskaryosis: safety of cytological surveillance.

How best to manage women who are found on cervical screening to have mild dyskaryosis remains controversial. Cytological surveillance misses some lesions picked up by colposcopy, but colposcopy is emotionally traumatic for women, the majority of whom will have a normal result. To determine what proportion of lesions are missed by cytological surveillance, and whether any abnormalities persist after colposcopy, we studied, by means of colposcopy and biopsy, the prevalence of cervical intraepithelial neoplasia (CIN) and subclinical human papillomavirus infection (HPVI) in two groups of patients who had had a first smear showing mild dyskaryosis at least 24 months earlier.

Management of the pregnant woman with spinal cord injuries.

This paper forms part of an ongoing prospective study of pregnancy and labour in women with spinal cord injuries and combines a prospective and retrospective analysis of 17 pregnancies in 15 women with spinal injuries. The management and outcome in those 17 pregnancies is reviewed.

Controlled trial of a new cervical spatula.

A wooden spatula was designed to scrape the varied distribution of epithelial abnormalities of the cervix as seen at colposcopy. The efficiency of the spatula in obtaining dyskaryotic cells and improving the cellular quality of smears was compared with that of the Ayre spatula in a controlled trial. More than 17,000 smears were taken from women aged 14-86 years by more than 200 smear takers from 74 centres.

Abnormal cervical smears: are we in for an epidemic?

A retrospective study was conducted to examine the pattern of a disturbing increase in abnormal cervical smears in one health district. Past records over fifteen years (1965-79) were analysed to produce pick up rates according to age, screening state, severity of lesion, and area of residence. Main findings included an increased pick up rate in unscreened (5.

Female genital actinomycosis.

Four cases of female genital actinomycosis are added to the reported total of about 300. The relationship of the disease to the normal microbial flora, intrauterine contraceptive device usage and pelvic sepsis is explored. It is suggested that the disease may be more frequent than hitherto realized.

Fetal wastage as a result of an alpha-fetoprotein screening programme.

Amniocentesis was performed in 102 pregnancies in which maternal serum-alpha-fetoprotein (A.F.P.

Controlled clinical trial of arginine for infertile men with oligozoospermia.

64 infertile men with oligozoospermia took part in a double blind cross-over trial. Each patient received matching capsules of a placebo and arginine for periods of 12 weeks. There was no difference in the conception rates of the wives or changes in the quality of the semen during each period of treatment.

[Tumors of the hilar cells of the ovary. Apropos of 3 cases].

Three new cases of ovarian hilar cell tumour are presented. The variable types of presentation are discussed as well as the methods of approach to confirmatory diagnosis. A full range of investigations is essential to diagnosis prior to operation.

Artificial insemination (A.I.H.) for sperm antibodies and oligozoospermia.

Artificial insemination using husband's semen (A.I.H.

The use of a computer in an obstetric department.

Experience with a computer in an obstetric department is presented. A regular statistical analysis of the work of the department was readily available and computer printed summaries were produced for 86 per cent of the patients within one week of their discharge home. Solutions to problems encountered are discussed.

Mangement of vaginal carcinoma after hysterectomy.

Vaginal carcinoma after hysterectomy occasionally has developed into an invasive lesion. Three cases, all treated differently, are described. The means of preventing further disease and for differently treating the vaginal lesion are discussed.