Fetal heart rate (FHR) monitoring forms the basis of routine fetal assessment, particularly short-term variability in the interbeat interval which can be difficult to interpret. Respiratory sinus arrhythmia (RSA), the change in heart rate in response to breathing, contributes to short-term variability, and the presence of RSA in utero may reflect the functional integrity of the central nervous system. This paper describes the use of Doppler ultrasound to derive the required measures of fetal heart rate and fetal breathing movements and spectral analysis to identify RSA. Cases are presented to illustrate the results obtained both in the presence and absence of RSA.

SummarySerial ultrasound tracking was employed to study the incidence of dysfunctional ovulation patterns in 92 regularly menstruating infertile women for a total of 331 spontaneous cycles. The incidence of abnormal cycles in 42 women undergoing artificial insemination with husbands' semen (36·2 per cent of 149 cycles) was higher (P < 0·005) than in the 50 control women who were apparently normal and receiving donor insemination because of clearly infertile partners (20·3 per cent of 182 cycles). Fourteen of 42 women undergoing A.I.H. had cervical mucus disorders and the incidence of abnormal cycles was 33·9 per cent of 71 cycles which was also higher (P < 0·05) than in the control group. Our findings suggest that dysfunctional ovulation is a significant factor in the infertile women with cervical factor disorders and correction of such ovulatory defects may improve the outcome of A.I.H.

The nature and incidence of normal and abnormal spontaneous ovarian cycles, identified with ultrasound and endocrine tracking, were examined in 45 regularly cycling infertile women with no definitive cause and 15 women who were apparently normal and were receiving donor insemination because of clearly infertile partners. In 136 cycles, four apparently distinct abnormal patterns were detected. The total incidence in the infertile group was 58% compared with 23% in the donor insemination group (P less than 0.005). Twelve of 26 subjects who had at least three cycles tracked showed two different abnormalities, and 1 subject had three different abnormalities in five abnormal cycles. These results suggest that abnormal cycles are a significant factor in unexplained infertility and that diagnosis and treatment cannot be based on the study of a single cycle.

Twenty conception cycles were tracked with ultrasound ovarian scanning from the midfollicular to midluteal phase, and simultaneous hormone profiles were obtained in 18 of the cycles. Twelve cycles were spontaneous and 8 were induced with a variety of regimens. Two of the spontaneous cycles did not have endocrine data, and in one other no follicular growth was observed, despite repeated scanning. The induced cycles did not differ significantly from the spontaneous ones in any respect except the number of follicles and the consequent estradiol (E2) levels. E2 levels per unit total follicular surface area, however, were similar in both groups and remained relatively constant throughout the late follicular phase.

Summary. Data gathered during a longitudinal study of cardiac output throughout pregnancy, measured by application of impedance cardiography, have been reassessed in respect to individual items of measurement. Examination of the pattern of change in these values did not reveal any flaw in the proposition that impedance cardiography, with the invocation of the Kubicek equation, can confidently be applied in such a study.

The intraobserver and interobserver variation of ultrasound measurement of Graafian follicles was assessed. Fourteen follicles from 10 to 30 mm in diameter were each measured three times in three orthogonal planes by three observers. The intraobserver standard deviation (SD) was 0.6 mm and interobserver SD, 1.2 mm, irrespective of follicle diameter. The pooled SD for both variables was 1.2 mm, giving 95% confidence limits of +/- 2.4 mm for any measurement.

SummaryComparison of the reproducibility of fetal crown rump length measurements (CRL) obtained in a resting state by sonar with a phase focused linear array real time scanner, a real time mechanical sector Scanner, and a static B‐scanner did not show any significant differences between machines. Maternal movement was found to produce a change in fetal intrauterine position and to induce fetal movement. Examination following maternal movement was feit to be more representative of clinical conditions and produced greater variability of CRL measurement, shown by all machines to a differing extent, although the differences between machines were not substantial. There is some evidence that the discernment of fetal movement and the quality of fetal echoes obtained with different machines affects the reproducibility of CRL measurement. Thus variability of CRL measurement with every machine is small in terms of gestational age and justifies the use of real time machines to establish gestational age.

Investigations of two patients have Summary shown that when routine blood-volume studies, using serum-albumin labelled with iodine-125 are done on a mother at the time of delivery, a considerable amount of radioactive iodine may be transmitted to the infant in the breast-milk. This is likely to increase by a factor of 10 the risk that the child will subsequently develop cancer of the thyroid.