Recurrence rates of neural tube defects in Dublin maternity hospitals.
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Biomedical subjects
Publications and source records attributed to I J Dalrymple.
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A combined series of 101 twin pregnancies for whom routine hospital rest during the last trimester was replaced by intensified antenatal care in a special twins clinic was studied. Perinatal mortality and morbidity was similar to that found in a comparison group of 137 twin pregnancies under the care of consultants and not referred to the twins clinic. Routine cervical assessments and uterine activity measurements were unhelpful in predicting premature delivery. Urinary oestrogens and ultrasonic measurements of fetal biparietal diameter were of little or no value in predicting weight for gestational age but the ultrasonic measurement of abdominal circumference provided limited information on fetal growth. The contribution of a placebo effect to the results of patients receiving more personalised care cannot be discounted.
In a double blind trial, 25 patients with twin pregnancy were given 40 mg of ritodrine hydrochloride by mouth daily and 24 similar patients received a placebo. The ritodrine group had no significant prolongation of pregnancy nor increase in birth weight, and a high incidence of side effects occurred.
Total plasma cortisol, the 'cortisol resin uptake ratio' (cortisol RUR), and 'free cortisol index' (FCI) were estimated in 23 pregnant women from 12 weeks to term and at six weeks post partum. Total plasma cortisol rose continually throughout pregnancy; the cortisol RUR rose up to 20 to 23 weeks and then fell slowly and the FCI also rose although more slowly than the total cortisol. All parameters fell to non-pregnant levels at six weeks post partum. It is confirmed that a true rise in metabolically active cortisol occurs during pregnancy.