Chromosome examination of 20,222 newborn children: results from a 7.5-year study in Arhus, Denmark.
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Biomedical subjects
Publications and source records attributed to K B Hansen.
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A total of 146 twin pregnancies were studied to evaluate the importance of bed rest. A significantly reduced frequency of preterm delivery was found after bed rest in hospital as compared to bed rest at home or no bed rest at all. An increase in gestational age and in birth weight was seen after bed rest. No effect was found on the intrauterine increase of fetal weight per time. Early routine ultrasound is recommended, so that effective bed rest may be instituted in due time.
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In a current investigation of children born in the Arhus area (Denmark) chromosome examinations were made in 6,691 newborns. Of these children, 170 boys had a large Y chromosome (2.6%). The present material was examined using a bi-variate stratified analysis to eliminate social and simple biological factors that could act as confounders. No increased frequency of malformations was found, and birth weight and length was nearly equal in the probands and the controls. A significantly increased frequency of prostaglandin stimulation of labour was found for the mothers of the Yq+ boys. Differences in the frequency of mechanical disproportion or abnormal presentation could not explain this. The Yq+ boys suffered more frequently from intrauterine asphyxia leading to acute Caesarean section. This finding cannot be explained by long-standing placenta problems alone. A possible mechanism which could link these findings together is suggested, and it is concluded that the boys with Yq+ most probably should be regarded as being at a certain risk at the time of birth.
A total of 116 women were referred for hysterosalpingography because of primary or secondary infertility. Chlamydia trachomatis was isolated from the cervix of four (3.4%) of the patients whereas Mycoplasma hominis was isolated from 39 (33.6%) of them. Four patients developed acute pelvic inflammatory disease after hysterosalpingography; two of them were chlamydia culture-positive and developed a significant chlamydial antibody response during the course of the disease. One of the other two patients, who developed upper genital-tract infection, was culture positive for M. hominis and developed a significant antibody response to this micro-organism. The results indicate that C. trachomatis should be sought in patients before hysterosalpingography and, if detected, appropriate antibiotic cover should be instituted before the procedure.
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In order to study the value of leukocyte counts and quantitative microbiologic cultivation of milk in the diagnosis of puerperal mastitis, 491 milk samples from nursing women were examined. In milk samples from mammary glands without inflammatory symptoms, leukocyte counts were less than 10(6)/ml of milk, and the milk was sterile or harbored less than 10(3) bacteria/ml. Samples from mammary glands with inflammatory symptoms could be divided into three groups. In one group, leukocyte counts were less than 10(6)/ml of milk, and cultivation results were similar to those of mammary glands without symptoms. The symptoms persisted for an average of 2.1 days. These cases were considered as milk stasis. In another group, the leukocyte counts were greater than 10(6)/ml of milk, but the milk was sterile or contaminated by skin flora bacteria. Average duration of symptoms was 5.3 days. These cases were considered as noninfectious inflammation of the breast. In the third group, leukocyte counts were greater than 10(6)/ml of milk and bacteria occurred in numbers of greater than 10(3)/ml, which suggests the presence of infectious mastitis. In these cases only antibiotic treatment should be recommended.
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The protective effect of splenic implantation or hemisplenectomy on the survival rate was studied in 34 Wistar rats inoculated intravenously with 8.5 x 10(6) CFU Streptococcus pneumoniae type 25, 4 months prior to the bacterial challenge, different surgical procedures were performed, dividing the animals into 5 equally large groups: (1) sham operation, (2) hemisplenectomy, (3) splenectomy with a 100% reimplantation, (4) splenectomy with a 50% reimplantation, and (5) splenectomy without reimplantation. The observation period after the bacterial inoculation was 13 d. Differences in mean survival rates were found: (1) 13 d, (2) 10.6 d, (3) 7.1 d, (4) 5.6 d, and (5) 3.1 d. The increasing survival rates correlated with increasing weights of the residual splenic tissue. This animal study indicates that residual splenic tissue may account for a lesser tendency to infection.
A description is given of acute fatty liver of pregnancy in a 26-year-old primigravida who survived. Complicating disseminated intravascular coagulation was diagnosed at parturition, and the importance of early diagnosis of this is emphasized. A suggestion for treatment is given as a possible means of improving the prognosis in this mostly fatal disease.
As part of an ongoing study of the influence of environmental factors on pregnancy, childbirth, and fetuses, comparisons have been made between incidences in 1969-1974 and in 1980-1982 of chromosome aberrations in liveborn children in the same area of Denmark. The incidence of chromosome aberrations in the first period was 2.6 per 1000, compared with 41. per 1000 during the latter period. However, the difference was mainly due to an increase in inversions, and this in turn was due to a difference in chromosome staining methods between the two periods. It is concluded that the Danish study and similar studies in the United States, Canada, and Scotland indicate that early detection of chromosome aberrations by chromosome examination at birth is indicated in order to be able to inform and counsel parents of children with chromosome aberrations. Chromosome examination at birth is also of importance in the diagnosis of structural inheritable chromosome aberrations and consequent family investigation and genetic counseling.
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