Showing papers on "Pregnancy published in 1970"

Undernutrition and child development.

Abstract: When 19 children who had been hospitalized with undernutrition in the first year of life were compared with a control group three to four years later, the test group was found to be lower in height, weight, head circumference and developmental quotient. Impairment of physical and mental development appeared to correlate with the duration of undernutrition in the first year of life. Nine children admitted to the hospital with undernutrition but treated in the first four months of life now have a mean developmental quotient of 95, which is similar to the mean of 99 for the control children. In 10 with undernutrition after four months of age low indexes for height, weight and head circumference were more frequent, and the mean developmental quotient was 70. Social factors associated with undernutrition included paternal separation, alcohol-related problems, inadequate money and many young siblings.

Standards for Birthweight at Gestation Periods from 32 to 42 weeks, Allowing for Maternal Height and Weight

Abstract: Standard charts are given for assessing the normality of birthweight for length of gestation from 32 to 42 weeks; first-born and later-born infants are shown separately, and allowance is made for maternal height and mid-pregnancy weight.

Role of amniocentesis in the intrauterine detection of genetic disorders.

Abstract: One hundred and sixty-two transabdominal amniocenteses were performed between the thirteenth and eighteenth weeks of fetal gestation as part of the management of 155 "high-risk" pregnancies. Successful cultivation of amniotic-fluid cells led to the intrauterine detection of Down's syndrome (10 cases), Pompe's disease (one case), lysosomal acid phosphatase deficiency (one case) and metachromatic leukodystrophy (one case). The risk of this procedure is low since neither fetal nor maternal complications were demonstrated in this series of patients. Cultivation of amniotic-fluid cells obtained by transabdominal amniocentesis early in the second trimester of pregnancy provides a method that enables parents at "high risk" for having offspring with certain serious genetic disorders to have children without risk of such a defect.

Hemolytic Anemia in Wilson's Disease

Abstract: Penicillamine therapy was discontinued for a period of 200 days in a patient with Wilson's disease. Copper reaccumulated in the body at the rate of about 0.43 mg/day. Urinary copper remain...

Reduction of incidence of prematurity by folic acid supplementation in pregnancy.

Abstract: Folic acid administered to pregnant Bantu, whose diet is low in folate, was associated with a significant reduction in the incidence of prematurity. No such effect could be demonstrated in White patients subsisting on an average Western diet. This suggests that folate deficiency may contribute to the “pregnancy wastage” in populations whose dietary folate intake is low, and is a further indication for folic acid supplementation during pregnancy in these groups.

Trimethadione and human teratogenesis

Abstract: A family is described in which four malformed children were born to a mother while she was taking trimethadione, an antiepileptic drug infrequently prescribed for adults. Following discontinuation of the drug, she had two normal children. This family led to a survey of all 278 epileptic women admitted to one hospital during the 23 years following the introduction of trimethadione for treatment of petit mal. Only eight women had ever taken it or its close congener paramethadione, and only three had taken it early in a pregnancy. Thus the outcomes of 14 pregnancies, during which the mothers took trimethadione or paramethadione early, have become known to the authors, those in the index family and those in three additional families ascertained through the survey. These pregnancies showed a high frequency of abnormality: eight children with developmental defects of various types, only three of whom have survived early infancy; one child with multiple hernias and juvenile, nonfamilial diabetes; and three spontaneous abortions. The survey suggests that neither epileptic women as a group nor those taking antiepileptic drugs usually prescribed for adults have an obviously increased frequency of malformed children but that epileptic women taking trimethadione or paramethadione may constitute a special subgroup whose children do have an increased frequency of birth defects. The small number of observations possible at a single institution, although suggestive, precludes a firm opinion as to the possible role as human teratogens of the oxazolidine-2,4-diones.

Progesterone, pregnancy and the augmented plasma insulin response.

Abstract: Intramuscular progesterone, 300–400 mg, was given daily to 5 normal men and to 2 hysterectomized women for 6 days to assess the role of this steroid in the development of hyperinsulinemia observed during pregnancy. Twentyfour hr urinary pregnanediol excretion increased to levels that were within the range of late gestation. On days 5 and 6 plasma glucose concentrations during oral glucose and intravenous tolbutamide tolerance tests were unchanged, but plasma insulin responses including fasting levels were significantly increased above control values. Patterns of insulin response were similar to those measured during studies of 10 normal women in late pregnancy. Progesterone effects were independent of any changes in fasting plasma glucose, free fatty acids, serum cortisol or immunoreactive growth hormone. These results suggest that progesterone, like pregnancy, evokes an enhanced plasma insulin response to insulinogenic stimuli as pancreatic islet adjustment to peripheral insulin antagonism evolv...

Hormonal control of gestation in the intact rat.

Abstract: Administration of specific and wellcharacterized rabbit antisera to ovine luteinizing hormone (LH) to pregnant rats, before day 12 of gestation, resulted in vaginal bleeding followed by resorption of fetuses. This effect of the antiserum could not be reversed by the administration of either ovine prolactin or extracts of day 12 rat placentae. Homotransplantation of 2 pituitaries under the kidney capsule also did not reverse this effect. Whereas 0.25–5 μg estradiol-17β was ineffective, 4 mg of progesterone could overcome the effects of the antiserum. Deprivation of LH even for 2–8 hr was injurious to fetal growth. These effects of the antiserum could be reversed by the simultaneous administration of LH. Thus, evidence has been presented to show that LH maintains pregnancy up to day 12 by stimulating steroidogenesis. Of the 3 gonadotropins (LH, prolactin and FSH) tried, administration of LH during the second half of pregnancy resulted in postponement of parturition. Similar results were obtained with the ad...

Thyroid function in the preterm fetus.

Abstract: Measurements of serum total thyroxine (T4), free thyroxine (FT4), and/or immunoreactive thyrotropin (TSH) were conducted on 14 pairs of maternal and cord blood specimens obtained at the time of elective therapeutic abortion of 11- to 18-week pregnancies and on 21 paired maternal and fetal cord blood specimens collected at the time of spontaneous, premature delivery of 22- to 34-week pregnancies. T4 concentrations were elevated in all maternal samples to levels characteristic of pregnancy; mean values were similar at 11 to 18 and at 22 to 34 weeks and did not differ from the mean level reported previously at term. Mean maternal TSH concentrations also were similar at 11 to 18 weeks, 22 to 34 weeks, and at term. The mean FT4 concentration in maternal serum between 11 and 18 weeks was significantly higher than the level reported previously at term. Fetal serum T4 and FT4 concentrations were low between 11 and 18 weeks and increased progressively between 22 weeks and term. Fetal serum TSH concentrations were low between 11 and 18 weeks of pregnancy but seemed to increase abruptly between 18 and 22 weeks to levels characteristic of term infants. These data suggest that the maternal concentration of FT4 is higher early in pregnancy than at term, perhaps because of the higher blood levels of human chorionic thyrotropin in early pregnancy. They also indicate autonomous function of the fetal hypothalamic-pituitary control system as early as 12 weeks9 gestation. The abrupt increase in fetal serum TSH between 18 and 22 weeks suggests rapid maturation of the fetal hypothalamic-pituitary unit during this period. The subsequent progressive increase in fetal FT4 concentration indicates an increasing thyroidal response to the TSH stimulus.

Fallacy of the Fundal Height

Abstract: The method of estimating gestational age from the height of the fundus uteri during pregnancy has been investigated. Such wide variations occur in the length of the maternal abdomen and umbilical position and in the level of the uterine fundus at each gestational age that the method is not reliable. Assessment of uterine size by pelvic examination in the first trimester of pregnancy correlates more closely with gestational age than assessments made by abdominal palpation of the uterus at a later time.

A genetic study of febrile convulsions.

Abstract: SUMMARYThe incidence of febrile convulsions was the same in parents and in sibs of 208 children with febrile convulsions–9% or three times the prevalence in the population. The findings and the rate in second- and third-degree relatives were compatible with transmission by a single dominant gene with incomplete penetrance. Half the affected relatives with epilepsy were distant. Rate of epilepsy in parents and sibs, uncles, aunts, and cousins was not higher than the prevalence in the population. 3We found no evidence that some families might differ from others in the mode of transmission nor that some cases were nongenetic. 4] There was clinical and EEG evidence of a different degree of expressivity in some families. Probands with parents, uncles, aunts, or cousins with febrile convulsions had twice as high a rate of recurrence as children with no relatives with febrile convulsions. Probands with a relative with convulsions developed 3-per-second spike-and-wave paroxysms in the EEG twice as often as probands with a negative family history. More than half the probands with solely epilepsy in the family had severe or multiple natal or neonatal complications. When a relative had febrile convulsions, one-fifth of the probands had natal or neonatal complications. 6] Recurrent spontaneous convulsions persisted in 3 children (1.4%), all severely brain damaged. One was a congenital idiot, I had an intercurrent encephalitis, and I was mentally retarded.

Increased exposure of tissues to cortisol in late pregnancy.

Abstract: In late normal pregnancy the mean day-night variation of non-protein-bound cortisol in plasma was found to be reduced to 52%, from a mean of 82% in non-pregnant subjects. Levels of unbound cortisol at midnight and at 9 a.m. in late pregnancy were raised above the non-pregnant normal. These levels led to increased urinary free cortisol excretion in pregnancy. This “tissue exposure” in late pregnancy is two to three times normal, as judged by both plasma unbound and urinary free cortisol measurements. The well-known increase in urinary free cortisol excretion in pregnancy is explained by the reduced day-night rhythm.

The role of corticoids in parturition.

Abstract: Labor was initiated within 72 hr in 46 of 54 cattle treated with 20 mg dexamethasone intramuscularly. Parturition was induced in animals injected as early as 246 days postconception although the procedure was more effective later than 255 days of pregnancy. Similarly, 10 or 20mg dexamethasone intramuscularly was effective in initiating labor within 72 hr resulting in parturition in 11 of 23 ewes. Only two of eight ewes injected on days 133-139 lambed within 72 hr postinjection compared to 9 of 15 ewes injected on days 140-142 of pregnancy. Normal gestation length is 148 days for the ewes and 278-288 days for the cattle used in this study. Analysis of peripheral plasma during normal parturition in 10 cows indicated a rise in plasma corticoids on days 4-1 prepartum that was significantly different (� < .001) from levels obtained on days 7-5 prepartum or days 3-7 postpartum. This abrupt elevation in maternal plasma corticoids may result from increased synthesis by the fetal adrenals and provide the signal for termination of the pregnancy.

Low birth weight and prenatal nutrition: an interpretative review

Abstract: Birth weight is considered as a possible crucial intervening variable in a causal sequence that leads from prenatal nutrition to perinatal mortality and retarded child development. Birth weight is shown to have a stronger correlation with perinatal mortality than length of gestation. In New York City, if black infants had the same birth weight distribution as white infants, and the same weight-specific perinatal death rates as they now do, their expected overall perinatal death rate would be the same as for white infants. Three conclusions are germane to the prevention of low birth weight: first, the fetal growth that leads to important variation in birthweight occurs in the last trimester; second, birth weight is influenced by factors in the wider environment as well as in the maternal environment; and third, birth weight is influenced by factors having their origin and effect during gestation. The role of maternal nutrition during gestation is then examined as a factor in birth weight. Observational studies of circumstances of wartime deprivation support a nutritional hypothesis, but observational studies of everyday diets in pregnancy, and quasi-experimental studies that supplement nutrition in pregnancy, have given equivocal results. The hypothesis requires fresh testing. An experimental approach can eliminate or control many extraneous and confounding variables.

Ossification of the rat and mouse skeleton in the perinatal period

Abstract: In the perinatal period the skeletal development of rats and mice showed transient stages of missing to incomplete or largely complete ossification. Alizarin red S staining revealed characteristic morphological patterns of maturation, which differed from one part of the skeleton to another. In the two species examined all the skeletal elements were ossified 2 days after birth. In about 12% of the rats and 90% of the mice an additional sternebra formed in the postnatal period. In a small number of cases abnormal ossification was observed. A few days after term the spontaneous rate of abnormally ossified bones was found to be 0.51% in the rats and 1.40% in the mice. A reduced rate of ossification at a given time of development which is never less within the normal range, may be indicative of a nonspecific retardation of fetal maturation.

The Kidney in Pregnancy

Abstract: PREGNANCY is accompanied by changes in maternal renal function. This article summarizes some of these alterations, with special reference to their clinical application and their pertinence to sodiu...

The haemoglobin constitution of infants with the haemoglobin Bart's hydrops foetalis syndrome.

Abstract: Summary. The haemoglobin constitution of 14 infants with the haemoglobin Bart's hydrops syndrome has been examined. Thirteen of the infants were stillborn or lived only a few minutes after delivery, but in one case an exchange transfusion was performed and the pattern of globin chain synthesis examined by an [H3]leucine incorporation experiment utilizing umbilical cord blood. These studies indicate that the syndrome results from a total deficiency of α-chain production. Furthermore, it has been possible to exclude the presence of fragments of α-chain longer than II residues in the cells of these infants. In each infant a small quantity of haemoglobin was found which consisted of normal γ-chains in association with chains of unique constitution. A similar component was found in trace amounts in normal umbilical cord blood. This haemoglobin may be identical with haemoglobin Portland. It is suggested that the non-γ-chain of this haemoglobin is the product of a normal foetal haemoglobin locus which produces very small amounts of gene product in normal infants but which is capable of increased activity in the presence of a partial or total deficiency of α-chains.