A 75 g oral glucose tolerance test was carried out on 953 pregnant women who were identified on the basis of clinical risk factors. The tests were analysed by the WHO criteria: 826 were normal, 120 showed impaired glucose tolerance, and 7 identified diabetes. A number of obstetric and perinatal outcome measures were compared between the groups with normal and impaired glucose tolerance, and also with 135 women who had pre-existing Type 1 diabetes and delivered during the study period. There was no significant difference in the incidence of antenatal complications between mothers with normal and impaired glucose tolerance. There was a higher rate of induced labour ( p < 0.05) and caesarean section ( p < 0.01) in the impaired glucose tolerance group compared to the normal group, but no difference in fetal outcome or neonatal morbidity. All of these outcome measures were increased in the Type 1 diabetic pregnancies. KEY WORDS Pregnancy Impaired glucose tolerance Fetal outcomeA further 16 patients had an antenatal glucose tolerance test but were excluded from the analysis (10 tests were incomplete due to vomiting after the glucose load, 3 patients delivered at other hospitals, and the case records of a further 3 patients could not be traced). A standard

Laparoscopic surgery in gynaecology is mainstream and widely practised. While this brings many benefits to the patient, injury to the surgeon is often under-reported. Careful theatre layout and correct instruments minimise the risk to the surgeon. There is a lack of gynaecology-specific guidelines/training in optimal theatre layout and surgeon positioning. This article examines the current available evidence and suggests changes that clinicians can make in order to optimise their working environment. Learning objectivesTo appreciate the many ways the operating theatre can be changed to facilitate optimal ergonomics. To be aware of the different equipment available to facilitate comfort when operating. To recognise the short-term and long-term repercussions of poor ergonomics. Ethical issuesShould this form part of every surgeon's training? Despite obvious benefits for patients, should employers pay closer attention to the health of their staff?

Pentoxifylline improves some motility characteristics of human spermatozoa, but the variability of response to this drug has not been clearly defined. We used computer-assisted sperm motion analysis to examine the in-vitro response of spermatozoa to pentoxifylline. Individuals (n = 31) with normal sperm counts were randomly selected and their spermatozoa exposed to different concentrations of pentoxifylline. Further tests on a subgroup of individuals examined the longevity of spermatozoa in response to this agent. Straight line velocity (VSL) was only improved at 0.1 mM and the major effect of the drug was on curvilinear velocity (VCL) and lateral head displacement (ALH). Prolonged exposure to pentoxifylline enhanced sperm motion only at 0.1 mM. Higher concentrations produced dose-dependent detrimental effects on all the motion characteristics. There was considerable inter-individual variability in both VCL and ALH response ranging from little or no detectable response to a 40% increase above control value. The maximum response was most commonly seen at a concentration of 2 mM pentoxifylline.