Showing papers on "Pregnancy published in 1969"

Medical Complications During Pregnancy

Abstract: Chapter 1: Obstetric Management of the High-Risk Patient Chapter 2: Diabetes in Pregnancy Chapter 3: Hypertensive Disorders in Pregnancy Chapter 4: Hematologic Aspects of Pregnancy Chapter 5: Venous Thromboembolism During Pregnancy Chapter 6: Pregnancy and Cardiovascular Disease Chapter 7: Thyroid Diseases Chapter 8: Pituitary and Adrenal Disorders of Pregnancy Chapter 9: Calcium Homeostasis and Disorders of Calcium Metabolism During Pregnancy and Lactation Chapter 10: Clinical Genetics Chapter 11: Ethical Issues in Obstetrics Chapter 12: Emergency Management of the Obstetric Patient Chapter 13: Renal Diseases Chapter 14: Gastrointestinal Complications Chapter 15: Liver Diseases Chapter 16: Bacterial, Fungal, and Parasitic Disease Chapter 17: Viral Infections Chapter 18: Pulmonary Diseases Chapter 19: Neurologic Complications Chapter 20: Rheumatic Disease in Pregnancy Chapter 21: Immunology of Pregnancy Chapter 22: The Skin in Pregnancy Chapter 23: Neoplastic Diseases Chapter 24 : Psychiatric Complications Chapter 25: Substance Abuse

Malaria, anaemia and pregnancy.

Abstract: Physicians at University College Hospital in Ibadan Nigeria selected 250 initially unmarried 17-25 year old women employed at the hospital as subjects of a prospective study of the relationship between malaria anemia and 1st pregnancy. 60 women later became pregnant. Physicians gave full physical examination to each of the 250 women which included urine analysis determination of liver and spleen size and a variety of hematologic tests such as packed cell volume (PCV) and blood film for malaria parasites. The frequency of malaria parasitemia and the density of infection were higher in pregnant women (4-12 times more frequent and 1775 parasites/cubic mm respectively) than the same women prior to pregnancy or in the nonpregnant women. Plasmodium falciparum caused infection in almost all cases with P. malariae being responsible for only 4 cases. The incidence of splenomegaly was much higher in the group of pregnant women (42%) than found in the same women before pregnancy. 38 women did not take antimalaria chemoprophylaxis until that point in pregnancy when treatment was necessary and 24 (63%) of them developed hemolytic anemia (PCV <28%). On the other hand none of the 19 women who received antimalarial drugs developed hemolytic anemia but 1 did develop megaloblastic anemia in the 18th week. The hemolytic anemia occurred between weeks 16-24. In some cases PCV fell before the appearance of detectable parasite densities and hemolysis continued for 2 weeks after chloroquine therapy effectively eliminated parasites. In a country where malaria is endemic administering antimalarial drugs prophylactically throughout pregnancy is the most important antenatal treatment.

Transcortin: a corticosteroid-binding protein of plasma. X. Cortisol and progesterone interplay and unbound levels of these steroids in pregnancy.

Abstract: The concentrations of total cortisol, progesterone and transcortin rise during pregnancy. Unbound cortisol shows a gradual increase during pregnancy, its level rising to about 3 times the concentration in normal plasma and in proportion to the rise of the total cortisol concentration. The level of unbound progesterone rises in the course of pregnancy, approximately in proportion to the total progesterone concentration. Progesterone replaces transcortin-bound cortisol increasingly during pregnancy until, in its later stage, the ratio of transcortin-bound progesterone to transcortinbound cortisol becomes about 0.3. The computed value for the association constant of the cortisol-transcortin complex in pregnancy plasma is about 12 μm−1 and that of the progesteronetranscortin complex is about twice this value.

An Examination of the Quantitative Relationship Between Progesterone and the Maintenance of Pregnancy

Abstract: Peripheral plasma, placental and uterine progesterone concentrations were determined in pregnant rats and were related to the effects of ovariectomy and placental dislocation on the maintenance of pregnancy. Pregnancy maintenance correlated more closely with uterine than plasma progesterone levels, a distinction readily made following ovariectomy. During late pregnancy a uterine progesterone concentration of 2 μg/lOOg seemed sufficient to prohibit the development of parturient activity, although at midpregnancy higher uterine levels appeared necessary for the protection of fetal life. Fetal survival was critically dependent upon the gestational age at the time of ovariectomy and was linked either to a compensatory placental hypertrophy or to retention of the placentae of prematurely discharged fetuses. Under conditions in which pregnancy was maintained in ovariectomized rats, plasma, but not placental or uterine, progesterone dropped below normal preparturient levels. Adequate progesterone substitution th...

Fibrinolytic enzyme system and pregnancy.

Abstract: The effect of pregnancy on the components of the fibrinolytic enzyme system was determined by serial observations on 10 healthy women during normal pregnancy, labour, and the puerperium. The plasminogen level was substantially increased in the third trimester; the increase occurred pari passu with a pronounced increase in fibrinogen concentration. After allowing for the expansion of plasma volume in pregnancy a twofold increase in the absolute amounts of circulating fibrinogen and plasminogen was found. In late pregnancy and during labour the level of plasminogen activator was greatly decreased, whereas a normal or increased level was present in the first week of the puerperium. No alteration in the levels of inhibitors of plasminogen activation by urokinase was found during normal pregnancy. The thrombin time and platelet count remained unchanged during pregnancy and labour but the platelet count rose significantly during the first week of the puerperium.The haemostatic mechanism in pregnancy appears to be altered towards an enhanced capacity to form fibrin and a diminished ability to lyse fibrin. These changes may be a physiological development to ensure the integrity of the foetal and maternal circulations and provide rapid and effective haemostasis in the uterus during and after placental separation. Nevertheless, the changes may also establish a vulnerable state for intravascular fibrin deposition.

The development of maternal responsiveness in the rat

Abstract: Maternal responsiveness in the rat develops gradually during pregnancy and parturition, and in the postpartum period of maternal care. Virgins can be shown to have a basic level of maternal responsiveness, which is raised during pregnancy and again at parturition. After parturition the young maintain the mother's maternal responsiveness, but there are indications that as they grow older they cause a decline in her responsiveness. Maternal responsiveness is shown to be based upon substance(s) carried in the blood of the postparturient mother. Transferring blood plasma from a new mother to a virgin causes the latter to become maternal towards young within 48 hours, where normally it requires two to three times this period of exposure to young.

Some Implications of the Sleep Patterns of Pregnancy for Postpartum Emotional Disturbances

Abstract: All-night EEG and EOG recordings were obtained from thirteen female subjects. Ten were studied during later pregnancy and the postpartum period. Three were studied during the entire pregnancy as well as postpartum. Data obtained within the first week after the menses was re-established served as a control baseline. In addition, data were obtained from thirteen age-matched non-pregnant subjects for comparison with the controls. Among all pregnant subjects the amount of sleep latency, the number of awakenings, and the amount of stage 0 were greater in the prepartum and postpartum periods than in the control period or in the non-pregnant subjects. Stage 1-REM was lower in the prepartum and postpartum periods than in the non-pregnant subjects. The amount of stage 4 was lower in the prepartum periods than in all the other periods. It increased during the postpartum period, and was even greater in the control period than in the non-pregnant group. Among the three subjects studied from early pregnancy there was more total sleep time and more naps in early pregnancy than in the other periods. In the third trimester, sleep time decreased below control and non-pregnant levels. These findings are discussed.

Pregnancy and Open-Heart Surgery

Abstract: During pregnancy, when surgically reparable heart disease can no longer be medically manged, open- or closed-heart surgery is the procedure of choice without prior therapeutic abortion. Cyanotic congenital heart disease in a pregnant patient when completely correctable surgically may be an indication for surgery in itself. Available data suggest that pregnancy per se does not increase the maternal risk of heart surgery with use of extracorporeal circulation. Fetal mortality in our series was 33%.

Fibrin degradation products in normal and abnormal pregnancy and parturition.

Abstract: The levels of fibrin, fibrinogen degradation products (F.D.P.) in the serum were investigated in normal pregnancy and parturition, after caesarean section, and in patients with abruptio placentae, eclampsia, intrauterine death, and post-partum haemorrhage. No significant change occurred during normal pregnancy, but a highly significant increase was found during labour and again during the first week after normal delivery. After caesarean section the levels of F.D.P. were increased two to four hours after operation, and substantially higher levels were found three to eight days after operation than after normal delivery. High levels of F.D.P. were associated with abruptio placentae and eclampsia, and increased levels after intrauterine death and post-partum haemorrhage. An excess of F.D.P. with diminished or normal systemic fibrinolytic activity suggests that local intravascular fibrin deposition and fibrinolysis occur in normal parturition and in these complications of pregnancy. The very high levels of F.D.P. found in abruptio placentae will be important in the pathogenesis of the defective haemostasis that may accompany this complication.

Studies of serum triiodothyronine concentration in maternal and cord blood: transfer of triiodothyronine across the human placenta.

Abstract: Serum total triiodothyronine (T3) concentrations have been determined in pregnant women and newborn infants. The total serum T3 in pregnant women was similar to that found in nonpregnant control persons, in contradistinction to the marked elevation of serum thyroxine (T4) in pregnancy (due to increased thyroxine binding globulin). Cord blood samples showed the newborn serum T3 values to be similar to the maternal and normal values. The administration of varying doses of T3 (50–300 μg/day) to pregnant subjects for as long as 3 weeks before parturition caused a rise in both maternal and newborn T3 values, indicating the placental transfer of T3. However, newborn T3 values were significantly lower than maternal values, indicating a partial placental block to T3 transfer. The use of T4/T3 ratios and free T3 concentrations also helped to demonstrate placental T3 passage. The observation that the increased TBG of pregnancy does not cause an increase in total serum T3 again confirms the negligible role ...

The relation of measured intelligence to birth weight and duration of gestation

Abstract: There have been two main approaches to investigation of the relation of birth weight to intelligence. In one, birth weights of children of low intelligence are compared with those of children of average or high intelligence. Where the comparison has been between children in ordinary schools, as in Ascher & Roberts’s study (1949) in primary, grammar and secondary schools, birth weight differences have usually been unimpressive or absent ; but among the subnormal, mean birth weight appears to be reduced and the reduction is present even after exclusion of those whose low intelligence is associated with physical abnormalities (Barker, 1966). The more usual approach has been to measure the intelligence of children of different birth weights. Numbers investigated by this procedure are, as a rule, rather small and the methods of analysis sometimes make it difficult to assess the results. However, the general conclusion which has been reached is that when children with physical abnormalities-such as blindness, deafness and cerebral palsy-are excluded, the intelligence of the remaining children of low birth weight is about normal (McDonald, 1964). In children of very low weights, however, intelligence appears to be reduced (Drillien, 1964). The relation of intelligence to duration of gestation is even less well established, but the contemporary viewpoint is probably summarized in Baird’s conclusion (1959) that ‘there is no clear indication that within wide limits premature expulsion from the uterus does the foetus any serious harm ’. The data used in the present investigation were described in a preceding paper (Record, McKeown & Edwards, 1969). Briefly, they are derived from observations on all (86,630) Birmingham live births in the period 1 January 1950 to 1 September 1954. Verbal reasoning scores from the results of the eleven-plus examinations were matched for 50,172 children and birth weight and duration of gestation (estimated to the nearest week from the first day of the last menstrual period) were available from obstetric records for 41,534 single births.

Congenital anomalies and diabetes in the Prima Indians of Arizona.

Abstract: Medical records of 1,207 Pima Indian children were examined for reported congenital anomalies. Anomalies occurred in eight (38.1 per cent) of twenty-one offspring born after the onset of diabetes to mothers whose disease was diagnosed before age twenty-five, but in only 3.7 per cent of the offspring of all other women. Children born after the onset of diabetes to mothers whose disease started at or after age twenty-five, and those born to prediabetic mothers had anomalies no more frequently than the children of nondiabetic mothers. Congenital anomalies were not related to paternal diabetes. Anomalies were more frequent in children from “diabetic” pregnancies during which the mother required hypoglycemic medication than from those during which medication was not required. Although a genetic mechanism cannot be completely excluded, the data better support the hypothesis that diabetes produced fetal anomalies among the Pima Indians by its influence upon the intrauterine environment during early pregnancy.