H19 is an imprinted maternally expressed gene, which is not translated to protein and functions as an RNA molecule. It is closely related to the oppositely imprinted paternally expressed insulin-like growth factor 2 (IGF-2). While the biological function of H19 is not understood, IGF-2 is a growth factor that plays a role in human follicular and endometrial differentiation. We examined the expression of H19 in the endometrium and ovary during the menstrual cycle by in situ hybridization applied to paraffin sections of human endometrium and ovaries at different stages of differentiation. In the endometrium, H19 expression was confined to the stroma and fluctuated with endometrial dating to reach its peak in the late secretory stage. IGF-2 was also prominently expressed in late secretory endometrium, but its expression was evident both in the stroma and glandular epithelium. Expression of H19 was not found in primordial, primary, and preantral follicles of the ovary, but prominent expression was evident in the theca of antral and cystic atretic follicles, and focal expression was noted in the granulosa of corpora lutea. An association between H19 expression during the menstrual cycle and the differentiation state of the human female reproductive tract, which is under hormonal control, is suggested.

Isolated cytotrophoblast cells from term human placenta were separated into eleven fractions according to cell size, by centrifugal elutriation. Each fraction isolated was examined by electron microscopy to elucidate ultrastructural features consistent with differences in stages of cellular differentiation. As a rule, increasing cell size correlated with evidence of progressive intracellular differentiation. This was represented by the appearance of specialization structures in later fractions, and by changes in the density of organelles and other cellular constituents. Progressive development and maturation of the rough endoplasmic reticulum was also evident. These data are the first to demonstrate successful subfractionation of the heterogeneous cytotrophoblast cell population into distinct groups, each representing different levels of cellular differentiation. These morphologic features of differentiation correlate closely with established biochemical parameters associated with various stages of intermediate cytotrophoblast cell differentiation.

An attempt was made to postpone term in 59 pregnant rats by s.c. injections of indomethacin or cyproheptadine, or a combination of both. The cyproheptadine group gave birth to their litters on days 20-22, yet indomethacin postponed labour to the 23rd day, both when given alone or in combination with cyproheptadine. As the fourth saline group went into labour on the 20--23rd day the indomethacin postponement cannot be considered significant. Indomethacin being a prostaglandin antagonist and cyproheptadine a serotinin antagonist, it may be concluded that neither prostaglandin nor serotonin are decisive for the intricate process which triggers parturition. Other factors, such as decrease of progesterone, increase of oestrogen and perhaps foetal oxytocin, as well as placental ACTH, seem to concur in inducing labour, their effect being fortified by serotonin and prostaglandins during parturition.

In three of 1,094 cases of cord complications the mothers experienced reduction of fetal movments until cessation. In these three instances the fetal heart beat was audible but changes appeared on the fetal heart rate monitor. The course of loss of fetal movements resembled that seen in cases of placental insufficiency. It is suggested that the reduced fetal movements and the changes in fetal heart rate were due to a diminished blood flow in the cord vessels as a result of gradual cord compression.

Serum prolactin values in normal pregnant women showed a progressive increase from a mean value of 50 ng/ml in the 12th week to 270 ng/ml at term, with the range at term being 100-600 ng/ml. There was a fairly good correlation (r = 0.7) between the values of 24-hour urine estriol in 138 determinations and in the serum prolactin in 133 pregnant women. The regression lines of serum hPRL values with time of gestation in cases of intrauterine growth retardation (IUGR) and diabetes mellitus were less steep than those seen in normal pregnancy. The serum hPRL value of patients with preeclamptic toxemia, latent diabetes, premature rupture of membranes, or multiple pregnancies were found not to differ significantly from the values observed in normal pregnancy. The results indicate that prolactin determinations in pathologic pregnancies are not useful as an aid in their evaluation.

SummaryBaromocriptine (2 bromo‐α‐ergocryptine), stilboestrol, clomiphene citrate, testosterone propionate and a placebo were given to 75 postpartum women for the suppression of puerperal lactation. An additional 15 women who breast‐fed their babies served as a control group. Blood samples were taken for the determination of serum prolactin levels by a specific homologous double antibody radioimmuno‐assay. Concurrently, the clinical effectiveness of the various treatments was assessed. High levels of prolactin were found at the time of delivery. Bromocriptine effectively reduced serum prolactin and prevented lactation; stilboestrol increased serum prolactin and partially suppressed lactation; clomiphene citrate and testosterone propionate both lowered serum prolactin levels and partially suppressed lactation. The placebo showed almost no effect on serum prolactin. It appeared that bromocriptine was the drug of choice in the suppression of puerperal lactation.

Thirty-three women with preeclamptic toxemia were retrospectively divided into three groups, according to clinical data, urinary estriol excretion, fetal growth, fetal movements and fetal heart recordings. In group 1 (six patients) there was no fetal growth retardation, and fetal motor function and heart rate were normal. In group 2 (17 patients) there was fetal growth retardation, estriol values were usually low, and fetal movements and heart rate were normal. In group 3 (10 patients) fetal movements decreased markedly almost until complete cessation for 12 to 24 h, and pathological changes were present in fetal heart recordings. A classification of preeclamptic toxemia according to these criteria is suggested. Patients who manifest placental metabolic failure, such as the women in group 2, should be hospitalized for observation only, as no immediate danger to the fetus is apparent. If there are signs of severe fetal distress and cardiomotor failure, such as in group 3, prompt delivery is essential to prevent fetal death in utero.