AND SummaryA comparison between data derived from changes in fetal heart rate and p H of fetal blood in 279 high-risk patients is described. 'The incidence of fetal acidosis was low when the continuous record of FHR showed good beat-to-beat variation in rhythm and no slowing during uterine contractions. The incidence of fetal acidosis accompanying fetal tachycardia or bradycardia was low if the rate remained unaltered during contractions. Decelerations of fetal heart rate accompanied by baseline tachycardia and/or loss of beat-to-beat variation were the changes most commonly associated with fetal acidosis and hence, by inference, with fetal asphyxia. Deep and/or delayed decelerations were also suggestive of fetal asphyxia. Late decelerations, although at first sight innocuous, were frequently found to be a sign of severe fetal asphyxia.

AND SummaryA comparison between data derived from changes in fetal heart rate and p H of fetal blood in 279 high-risk patients is described. 'The incidence of fetal acidosis was low when the continuous record of FHR showed good beat-to-beat variation in rhythm and no slowing during uterine contractions. The incidence of fetal acidosis accompanying fetal tachycardia or bradycardia was low if the rate remained unaltered during contractions. Decelerations of fetal heart rate accompanied by baseline tachycardia and/or loss of beat-to-beat variation were the changes most commonly associated with fetal acidosis and hence, by inference, with fetal asphyxia. Deep and/or delayed decelerations were also suggestive of fetal asphyxia. Late decelerations, although at first sight innocuous, were frequently found to be a sign of severe fetal asphyxia.

No abstract

A composite titanium/silicone rubber clip has been developed for female sterilization. The 12.7 mm long metal clip is lined with silicone rubber and is bent round the Fallopian tube by means of an applicator that can be used laparoscopically. As tubal necrosis occurs, the rubber expands to keep the lumen blocked. The tube eventually divides and the stumps heal, closed. Since the Mark 3 version of the clip was introduced, over 5700 women in several countries have been sterilized. The first 540 British women who were followed-up for five to 17 months experienced one method failure (ectopic) and two operator failures, a total failure rate of 5 . 5 / 1000. Clip-related complications were minimal and long-term sequelae were comparable to tubal ligation. The clip causes minimal destruction but still seems effective for tubal occlusion and it can accommodate thick tubes.

Summary: Termination of pregnancy was attempted with intravenous infusion of prostaglandin E2 (5 ug./minute) in 52 consecutive cases. Abortion was successful in 50 of these and complete in 43. There were no serious side-effects. IntroductionThe stimulant action of different prostaglandins on the intact pregnant human uterus has been shown by several investigators (Bygdeman et al., 1968;Embrey, 1969). Prostaglandins E2 and F2a have been successfully used for the induction of labour in women at or near term (Karim, 1969a(Karim, , 1969bKarim et al., 1969Karim et al., , 1970a. Prostaglandin F2a in higher concentrations (50 ,ug./minute) has also been used to stimulate the uterus in the first and second trimesters of pregnancy to induce therapeutic abortion (Karim and Filshie, 1970). In this paper we describe the effects of an intravenous infusion of 5 ,ug. of prostaglandin E2 per minute on the early and midpregnant uterus in 52 women and its usefulness for therapeutic termination of pregnancy in the first and second trimesters.