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OBSTETRICS AND GYNÆCOLOGY
Author(s) -
Andrew A. McCarthy,
Bill Hunter,
Peter Timothy Cox
Publication year - 1964
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1964.tb110374.x
Subject(s) - medicine , family medicine , otorhinolaryngology , psychiatry
THEl authors present a further study of the use of endocrine cytology in late pregnancy on 204 patients. Seventy patients had weekly or monthly vaginal smears taken throughout pregnancy, and the remainder had this investigation in the last trimester. Smears have been classified as follows: (a) "normal pregnancy pattern"-the clumped pregnancy smear; (b) "prior to term smear"-the partly discrete pregnancy smear; (0) "at term smear"-discrete pregnancy smear. Apart from these fairly standard types of smears in late pregnancy, other abnormal features have been noted and are thought to indicate a threat to the life of the feet us. One hundred and thirty patients had smears taken within 8 days of the spontaneous onset of labour. Of these 58% showed discrete changes, 34% had partly discrete changes and 8% were clumped. When the discrete smear occurred late in pregnancy, labour usually followed within 7 days, whilst the partly discrete smear ("prior to term") usually persisted for 4 to 5 weeks. Smears taken within 7 days of surgical induction of labour showed a longer induction-onset of labour interval In patients with a "normal pregnancy pattern" than In those with an "at term" or discrete pattern. The authors found no smear which Is pathognomlc of postmaturity or prolonged pregnancy. A high perinatal death rate was noted among a group of 17 patients who had discrete smears and came into spontaneous labour before the thirty-sixth week. Sixty patients with abnormal smears after the thirty-sixth week of pregnancy had 7 perinatal deaths, and no perinatal deaths occurred in 120 cases with normal smears. The persistence of a discrete smear before the thirty-sixth week could be used as a warning to the obstetrician of the possible onset of premature labour. The authors conclude that the value of endocrine cytology In pregnancy has not yet been fully established. but that It may be useful in the selection of patients who are likely to have a premature labour. and In determining when Induction of labour Is necessary because of feetal hazard and whether Induction Is likely to be successful.