Objective To describe the prevalence and causes of postnatal maternal morbidity. Design Questionnaire survey of postnatal patients. Further data extracted from SMRl returns, case records and the Aberdeen Maternity and Neonatal Databank. Setting Postnatal care in a teaching maternity hospital, midwife delivery hospital, general practitioner maternity units and in the community. Subjects Twenty percent random sample of deliveries (1249 women) surveyed one week, eight weeks and 12 to 18 months after delivery. Main outcome measures Incidence of self reported maternal morbidity, treatment received, readmission rates and causes for readmission. Results Of mothers in the sample 85% (99% CI 82‐88%) reported at least one health problem in hospital, rising to 87% (84‐90%) of those at home; 76% (71‐81%) reported at least one health problem after eight weeks post‐delivery. Conclusions Maternal morbiditv is extensive and under‐recognised after delivery. Measures to reduce and alleviate it must be sought.

The high prevalence of smoking among women in their reproductive years continues to be a matter of concern. The negative effects of smoking on general health are well known, but smoking may also affect fertility. The objective of the present study was to perform a systematic review of the literature to determine whether there is an association between smoking and risk of infertility in women of reproductive age, and to assess the size of this effect. In the 12 studies used for this meta-analysis, the overall value of the odds ratio (OR) for risk of infertility in women smokers versus non-smokers was 1.60 [95% confidence interval (CI) 1.34-1.91]. Studies of subfertile women undergoing in-vitro fertilization (IVF) treatment also show a reduction in fecundity among women smokers. A meta-analysis of nine studies found an OR of 0.66 (95% CI 0.49-0.88) for pregnancies per number of IVF-treated cycles in smokers versus non-smokers. Despite the potential limitations of meta-analyses of observational studies, the evidence presented in this review is compelling because of the consistency of effect across different study designs, sample size and types of outcome. However, continued reassurance is needed that the calculated overall effect is not in fact due to confounding variables.

Objective To describe the prevalence of, and degree of distress caused by, 15 symptoms commonly attributed to the menopause among a random sample of women aged 45 to 54, selected from the total population of a geographically defined area. Design Postal questionnaire survey. Setting Grampiane Health Board area. Participants Eight thousand women, aged 45 to 54, randomly selected from the Grampian Community Health Index. Main outcome measures Self‐reported symptoms, including depression, and use of hormone replacement therapy (HRT) among women of differing menopausal status. Results The response rate was 78%; 57% of respondents had experienced one or more of the 15 symptoms listed, but only 22% had found such symptoms a problem. Women's experience of classic vasomotor and atrophic symptoms varied according to menopausal status but experience of general somatic and psychological symptoms did not. Users of HRT and women whose menopause was iatrogenic found more symptoms a problem. Conclusions Symptoms attributed to the menopause are common among women in the age group studied but often are not perceived as a problem. Among nonusers of HRT, only vasomotor and atrophic symptoms vary with menopausal status. Other somatic and psychological symptoms experienced by middle‐aged women cannot be regarded as part of the same ‘menopausal syndrome’.

The response of the pituitary to exogenous LHRH was investigated in 9 normally ovulating women during the late follicular phase of a spontaneous (control) cycle, a cycle during treatment with clomiphene and a cycle during treatment with 'pure' FSH. During clomiphene treatment, basal FSH concentrations increased significantly up to Day 6 of the cycle and then decreased progressively while basal LH values showed a continuous rise. During treatment with FSH, basal LH concentrations decreased significantly. The response of both FSH and LH to LHRH showed a significant and quantitatively similar decrease during clomiphene or FSH administration as compared to the spontaneous cycles. It is suggested that basal secretion of FSH and LH is regulated by two separate mechanisms, and that an ovarian inhibitory factor(s) attenuates the response of both FSH and LH to exogenous LHRH and possibly the endogenous LH surge in superovulated cycles.

The PG concentrations in the semen of 23 fertile men were 73 microgram PGE/ml, 267 microgram 19-OH PGE/ml, 2.1 microgram PGF/ml and 18.3 microgram 19-OH PGF/ml. The wide ranges of concentrations found for the PGEs (2-272 microgram/ml) and for the 19-OH PGEs (53-1094 microgram/ml) throw some doubt on the previously established correlation between infertility and low prostaglandin concentrations.