No abstract

SUMMARY1. In foetal lambs from 40 days gestation (0.27 of term) onwards delivered into a warm saline bath, apparently spontaneous breathing movements were present intermittently. They became deeper and more rapid with increasing age.2. In foetal lambs (from 0-66 of term) in which observations were made for many days after chronic implantation of tracheal, carotid and amniotic catheters, rapid irregular respiratory movements were present up to 40 % of the time, and brief gasps also were seen.3. The presence of these movements was unrelated to the foetal carotid blood gas values over a wide range of spontaneous variation.4. These foetal breathing movements were accompanied by comparatively small alterations of pulmonary volume recorded from a tracheal flowmeter, insufficient to clear the tracheal dead space. Occasionally a more prolonged expiration led to the outward flow of fluid.5. A description is given of sleep and wakefulness in foetal lambs from 0-78 of term.6. Rapid irregular breathing was associated with rapid eye movement sleep as seen in a warm saline bath or, in utero, as inferred from records of eye movements and electrocortical activity.7. Respiratory movements were often associated with relatively large variations in foetal heart rate, blood pressure and descending aortic blood flow.8. Rapid irregular foetal breathing was unaffected by section or blockade of the cervical vagi, but was abolished by general anaesthesia.

Ninety‐two cases of granulosa cell tumor of the ovary have been studied. The clinical and pathologic data from this group were similar to that obtained in previous series. Because of the long natural history of many granulosa cell tumors, crude death rates over a relatively short period give little indication of the true malignant potential of these neoplasms and hence corrected survival rates were calculated; these show that, if no patient died from any other disease, approximately half of the women with this neoplasm would die, as a result of the tumor, within 20 years. Factors indicating a relatively poor survival rate were: age over 40 at the time of diagnosis, a presentation with abdominal symptoms, a palpable mass, a solid large tumor, bilateral tumors, extraovarian spread, and numerous mitotic figures in the tumor. It is suggested that all granulosa cell tumors should be considered as malignant and that the factors pointing to a poor prognosis are those indicating that a particular tumor has been diagnosed at a late stage in its natural history, either because it has been present for a long time or because it is highly malignant. There are no definite criteria for defining the prognosis in a case in which the tumor has been removed at any early stage in its natural life history.

The risk of transmission of HIV-1 from mother to infant increases when the fetal membranes rupture more than four hours before delivery.