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The Helene Harris Memorial Trust has become recognized as providing
one of the most important international fora for the presentation
of research in ovarian cancer. Four biennial meetings have taken
place, the most recent of which was held between May 11-14, 1993,
in Toronto, Canada. This forum has grown in stature from its
inception in 1987 and has brought together interdisciplinary
clinical and scientific researchers from around the world who are
endeavouring to perform 'cutting edge' studies in the field. The
assembled group of presti gious investigators met on this occasion
to present their data, to exchange ideas, and to arrange
collaborations with the goal of developing new means of detection,
treatment and cure of ovarian cancer. The incentive for the
establishment of the Trust and its international forum was the
prema ture loss through ovarian cancer of Helene Harris, the wife
of Mr John Harris. Mr Harris and the Trustees looked for a
meaningful way to honour the memory of Helene and to advance the
noble cause of gaining an increase in the scientific knowledge of
the subject. For those of us who spend most of our waking hours
assisting patients and their families who are devastated by this
disease, the Trust's generosity provides inspiration, hope and the
opportunity for their practical application in a unique
professional forum.
AIDS continually presents new questions for the obstetrician and
gynecologist. The effect on pregnancy, the possibility of perinatal
transmission, HIV positive tests, and risk to staff are just a few
of the issues confronting clinicians and practitioners today. These
and other questions were addressed by the 19th Study Group of the
Royal College of Obstetricians and Gynaecologists, whose findings
are reported here.
This book is based on the 20th Study Group of the Royal College of
Obstetricians and Gynaecologists, which concerned the important
topic of fetal growth. Basic scientific and both obstetric and
paediatric aspects of the subject were addressed in contributions
from many different disciplines. The deliberations covered the
broad topics of normal fetal growth, fetal overgrowth and fetal
undergrowth. Clinical implications of these entities, especially
fetal undergrowth, played a large part in the proceedings as
dictated by clinical concerns. Definitions, epidemiology, aetiology
and screening were covered, as were technological developments,
with special reference to blood flow and volume flow measurements,
both fetal and placental. Other aspects of clinical fetal
monitoring, including fetal activity measurements, and biophysical
evaluation were rationalised and placed in context, and the
important newly emerging areas of cordocentesis and therapy in IUGR
addressed. Finally, neonatal management of the SGA baby, mortality
and long-term morbidity were discussed.The formal papers presented
by the members of the Study Group are given together with edited
versions of the ensuing discussions and the Group's conclusions.
The first few months of any pregnancy are of supreme importance to
the success of that pregnancy. This statement is so obvious as to
be almost a platitude, yet it must be said that no aspect of
pregnancy has been more neglected in the human than the first three
months. Little is known of the morphological changes that occur at
that time and our knowledge of the mechanisms that control this
vital stage of pregnancy is almost non-existent. The explanation
for this neglect of what is an obvious area for study is the
difficulty of obtaining normal material. It is rare to have
material to study from a healthy first trimester pregnancy and the
study by Hertig and Rock!l) of early conception found by chance in
hysterectomy speci mens must be unique. The information that we do
have about early pregnancy is mostly gained from animal studies or
single miscarriages in humans. Chromosomal defects are common but
are not an explanation for the majority of recurrent miscarriages.
Obstetricians have hypothesised many causes for this condition and
have deve loped numerous metQods for treating it, but the studies
have been poorly con trolled so that our understanding of the
cause(s) has not advanced. Treatment of women with a history of
recurrent miscarriage by paternal leuco cyte infusion
(immunotherapy) may be yet another form of treatment that is hailed
as a new advance only to be rejected when subject to rigorous
testing.
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