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Biomedical subjects

I D Cooke

Publications and source records attributed to I D Cooke.

At least 217 records · Page 12Linked to original sources
PubMed1982

Feto-maternal consequences of high-dose glucose infusion during labour.

The effects on the fetus of high doses of glucose given to the mother in labour to correct maternal ketonuria were investigated. Three groups of patients were compared: one group received 1 litre of 10% (w/v) glucose intravenously over 1 h, the second group received 1 litre of 0.9% sodium chloride solution intravenously over 1 h and the final group had no supplementary infusion. It was observed that whereas glucose administration rapidly corrected maternal ketonaemia, there was a significant fall in pH and a rise in lactate in fetal blood. These effects were not observed in the other two groups. It was concluded that the use of high doses of intravenous glucose in labour should be avoided.

Adult↗
PubMed1982

The value of antenatal cardiotocography in the management of high-risk pregnancy: a randomized controlled trial.

The value of routine regular antenatal cardiotocography (CTG) in the management of high-risk pregnancy was assessed in a prospective randomized controlled study of 353 patients. All patients had a weekly CTG trace during the last 6 weeks of pregnancy and according to the random allocation the tracings were concealed from, or available to, the clinicians. Other methods of assessing fetal welfare were available to both groups. There was no significant difference between the concealed and revealed groups in the timing and mode of delivery, birthweights, Apgar score and neonatal morbidity. No apparent effect from the routine use of antenatal CTG in high-risk pregnancy was shown.

Adolescent↗
PubMed1982

Plasma prolactin concentrations during conception and the first ten weeks of human pregnancy.

Plasma prolactin concentrations were measured daily throughout 20 cycles in which conception occurred and for several weeks during early pregnancy. Thirteen of the pregnancies were 'spontaneous' (i.e. without exogenous pharmacological stimulation) and 7 occurred during either clomiphene or bromocriptine treatment. Prolactin concentrations were fairly stable throughout the conception cycles until shortly after the time of the first missed menses. From this time concentrations rose gradually to reach a mean concentration of 1250 mU/l 60 days after ovulation. However, there were marked fluctuations from day to day within individuals and considerable variation in the magnitude of the prolactin rise between subjects. Three subjects were mildly hyperprolactinaemic and although prolactin levels remained slightly elevated throughout the study period, this did not affect the outcome of pregnancies.

Bromocriptine↗
PubMed1982

The human menstrual cycle: plasma concentrations of prolactin, LH, FSH, oestradiol and progesterone in conceiving and non-conceiving women.

Hormonal profiles were obtained throughout 26 conception cycles and 27 non-conception control cycles. The pregnancies followed treatment (clomiphene or bromocriptine) in 12 women but were spontaneous in the remaining 14. No sustained significant difference between the various types of conception cycle was found for LH, FSH, oestradiol or progesterone concentrations. Prolactin concentrations varied widely, suggesting that mean cycle prolactin concentrations ranging from 45 to 760 mi.u./l are compatible with conception. Although there were no significant differences in progesterone secretion within the conception cycles, there were highly significant differences between the conception cycles and the non-pregnant control cycles. Mean progesterone concentrations in the conception group were higher (P less than 0.005) than those in the control women over Days 3-8 following the LH peak. This difference could only be partly accounted for by heterogeneity within the control group (15-20% of the control cycles had low progesterone concentrations and were probably subfertile. It is suggested that the higher conception cycle progesterone concentrations during the early part of the luteal phase may constitute a preimplantation component of the maternal recognition of pregnancy in women.

Bromocriptine↗
PubMed1981

Chorionic gonadotropin concentration in early human pregnancy: comparison of specific and nonspecific assays.

Daily blood samples were collected during 10 menstrual cycles in which conception had occurred, and changes in circulating concentrations of human chorionic gonadotropin (hCG) were measured simultaneously in specific and nonspecific radioimmunoassays. The hCG concentration profiles were not identical, and the fundamental differences could not be related to differences in technique. Both specific and nonspecific parameters of hCG concentration rose exponentially for the first 2 to 3 weeks following first detection and were thus amenable to linear regression analysis. Doubling times were significantly different at 2.3 and 1.8 days, respectively. Extrapolation of the regression data gave a (theoretical) plasma concentration of 3 IU/liter at 9.5 days after the luteinizing hormone peak using the specific assay but at only 5.5 days using the nonspecific assay. This difference is sufficiently large to suggest the presence of other forms of hCG or its subunits about the time of implantation and during early pregnancy.

Chorionic Gonadotropin↗
PubMed1981

Endocrine profiles and fertility status of human menstrual cycles of varying follicular phase length.

Assessment of the relationship between ovarian endocrine function and follicular phase length was made in 48 patients (51 cycles) with spontaneous ovular cycles of varying length. On the basis of follicular phase length when measured from the first day of menstruation to, and including, the day of the luteinizing hormone (LH) peak, cycles were grouped into short (less than 21 days), medium (12 to 16 days), and long (more than 6 days). Daily serum LH, androstenedione, 17 beta-estradiol, progesterone, and 17 alpha-hydroxyprogesterone concentrations were determined in the periovular period. The overall pattern of serum steroid concentrations in medium and long cycles was similar to that previously described for normal women. However, cycles with a short follicular phase had lower mean concentrations of androstenedione and estradiol. In order to assess the fertility potential of cycles with follicular phases of varying length, the prior 265 cycles of 92 consecutive patients who conceived with artificial insemination by donor (AID) were studied. In all cases, insemination occurred on day 0 and day + 1 with respect to the LH peak, and all cycles were assumed to have equal fertility potential. Statistical analysis revealed no significant difference in fertility potential among cycles with follicular phases of differing length.

Adult↗
PubMed1981

The cervical factor in patients with ovulatory infertility.

Thirty patients with ovulatory infertility had two consecutive postcoital tests. Couples with inconclusive or abnormal results had in vitro sperm penetration tests, using donor mucus and donor sperm. The quality of the cervical mucus, the concentration of plasma oestradiol and luteinising hormone and the result of the post-coital test were assessed each day. After two consecutive cycles, the postcoital test was normal in 84 per cent, inconclusive in 12 per cent and abnormal in 4 per cent of the women. The in vitro cross reaction test showed that two couples had definite abnormality in the sperm-cervical mucus interaction and one couple were having inadequate coitus. Normal post coital tests should not be expected with an Insler cervical mucus score of less than 8. Normal postcoital tests were found between days -2 and +1 with respect to the luteinising hormone peak. There is a direct relation between the plasma oestradiol concentration and the individual cervical score but the predictability of plasma oestradiol values for a given cervical score is very poor. The plasma oestradiol concentration was significantly different between groups having cervical scores less than 7 and 8-10 or 11-12 (p less than 0.01).

Adult↗
PubMed1981

Pregnancy specific beta 1 glycoprotein and chorionic gonadotrophin in early human pregnancy.

Venous blood samples were collected prospectively in ten menstrual cycles where conception occurred, and for several weeks thereafter, and the circulating concentrations of pregnancy specific beta 1 glycoprotein (SP1) and human chorionic gonadotrophin (HCG) determined using specific radioimmunoassays. The data were converted to logarithms and pooled and pooled using the day of the LH peak as zero time. The concentration profiles so obtained were remarkable similar and showed a rapid exponential increase in concentration during the very early stage of pregnancy. The doubling times were 2.4 days and 2.3 days for SP1 and HCG respectively and both proteins were initially secreted in approximately equivalent concentrations. However, some 30 days following the LH peak, the concentration profiles began to diverge, with SP1 levels continuing to rise whilst HCG concentrations showed the characteristic plateau at 8 and 10 weeks of gestation.

Chorionic Gonadotropin↗
PubMed1979

Prolactin concentrations in normal menstrual cycles and conception cycles.

Plasma prolactin concentrations were measured daily throughout twenty-three menstrual cycles from regularly ovulating women. In five of the cycles conception occurred spontaneously. The frequency distribution of prolactin concentrations was calculated and an appropriate linear transform obtained. Means and 95% confidence limits were determined by inspection of the logarithmic probability plots and these gave mean concentrations (and ranges) of 302 (106-871) mU/1 for the nonconception cycles and 178 (58-550) mU/1 for the conception cycles. Distribution of prolactin concentrations was log-normal in all cases, although the population containing the conception cycles was distinct from the population of non-conception cycles. It is suggested that the normal range found in ovulating women is 80-800 mU/1 but that for conception to occur levels should be slightly lower and approximate to the range 60-600 mU/1. Thus the lower limit of normal is about 60 mU/1 and the upper limit about 800 mU/1. Any concentration over 800 mU/1 should be designated as hyperprolactinaemia.

Female↗
PubMed1979

Plasma equilin concentrations in an oophorectomized woman following ingestion of conjugated equine oestrogens (Premarin).

The plasma equilin concentration was 25.2 nmol/l (6.7 ng/ml) 4 h after an oral dose of Premarin (1.25 mg), and a maximum concentration of 20.5 nmol/l (5.5 ng/ml) was recorded 3 h after a smaller dose (0.625 mg) was given. 24 h later, the plasma equilin was still considerable, being 6.1 nmol/l (1.6 ng/ml) and 3.7 nmol/l (1.2 ng/ml) for the larger and smaller dosages respectively. The findings for equilin are considerably higher than physiological oestrogen concentrations and in addition show that daily therapy with Premarin could lead to cumulation of the steroid.

17-Ketosteroids↗
PubMed1979

Acute menopausal transition associated with clomiphene therapy: Two case reports.

Two patients presenting with anovulation and secondary infertility were treated with clomiphene citrate. Intermittent blood samples were obtained for the first three months of therapy in each case. One patient failed either to ovulate or menstruate in response to clomiphene and the other patient had only two episodes of cyclical bleeding before she too became amenorrhoeic. Hormonal analyses revealed that both women had undergone a rapid and precocious menopausal transition which has persisted throughout the subsequent three years.

Adult↗
PubMed1978

An assessment of continuous fetal heart rate monitoring in labor. A randomized trial.

Intrapartum continuous fetal heart rate monitoring has been routinely performed at the Jessop Hospital for Women for some years. However, no controlled trials had ever been performed to show its advantages over intermittent auscultation in low-risk patients. A prospective randomized study of 504 patients compared continuous fetal heart rate monitoring with intermittent auscultation. There was no significant difference between the two groups in neonatal deaths, Apgar scores, maternal and neonatal morbidity, and cord blood gases. The cesarean section rate was significantly increased (p less than 0.05) in the monitored patients but this did not seem attributable to fetal monitoring. No beneficial or deleterious effects of continuous fetal heart rate monitoring in labor were shown.

Adult↗
PubMed1978

Plasma steroid and gonadotrophin profiles in ovulatory but infertile women.

A group of twelve patients with a history of infertility lasting at least 2 years despite evidence of regular ovulatory cycles, were selected from an Infertility Clinic after thorough investigation had revealed no other obvious cause for their infertility. Daily plasma gonadotrophin and steroid concentrations were measured in twenty cycles from these women and the results compared with the hormonal profiles obtained from a group of eleven control 'normal' women. No significant differences were found in the concentrations of LH, FSH or oestradiol although plasma progesterone concentrations were significantly lower in the infertile women, particularly during the first half of the luteal phase. In the absence of any other demonstrable defect, it was assumed that the decreased progesterone secretion was directly or indirectly implicated in the pathogenesis of their infertility, and a number of therapeutic regimes (progesterone supplementation of the luteal phase or additional stimulation by either anti-oestrogens or exogenous gonadotrophins) were assessed for their efficacy in correcting this defect. Although plasma progesterone concentrations after most of these regimes were significantly increased, none of the patients in this series conceived.

Adult↗
PubMed1978

Oestradiol secretion in men and pre-menopausal women.

Blood samples were obtained from a group of regularly-cycling normal women (n = 13) and a group of normal men (n = 5) at 15 min intervals for periods ranging from 9-14 h whilst the subjects remained resting quietly in bed. The concentration of plasma oestradiol was measured in a radioimmunoassay which had been carefully optimised and the mean concentration and coefficient of variation calculated for each subject. Plasma oestradiol concentrations were found to fluctuate rapidly in all subjects. The largest sample-to-sample variation was found in regularly cycling women near mid-cycle, and the least variation occurred in the male subjects. The coefficients of variation were approximately twice the intra-assay variation confirming that the observed pulsatile patterns of secretion were not due to technical errors. An analysis of variance performed on the mean hourly concentrations from each subject showed a significant variation (P less than 0.001) between sampling periods with peaks occurring during the first hour of sampling (08.00-09.00 hours). This result is suggestive of the presence of a circadian rhythm although it is not conslusive.

Adult↗