Biomedical subjects
Publications and source records attributed to M H Hall.
A total of 123 twin pregnancies were studied, 68 by records analysis only, and 55 by serial haematological assessment in detail. The incidence of low haemoglobin levels is found to be greater than in singleton pregnancy; evidence of iron and folic acid deficiency is common in sternal marrow aspirates but not in peripheral blood films. Routine haematinic prophylaxis in twin pregnancy is not advocated.
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An obstetric-neonatal-gynecological data bank has been developed for the Aberdeen District in Scotland and is now fully computerized. Within it, a twin register including over 550 pairs of known placentation and zygosity has developed.
Different mammographic parenchymal patterns have been found to be associated with significantly different rates for the development of breast cancer in a screening program of self-referred women. These differences are qualitatively similar but of lesser magnitude than those in previous reports by Wolfe which were based on symptomatic women who had had a previous negative mammogram. In addition, this report indicates a small difference in the rate of breast cancer at first mammographic examination, using the same parenchymal classifications. These findings, coupled with other risk factors, may permit the concentration of mammographic screening on a smaller segment of the population at risk, thus improving the benefit to risk ratio.
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Study of a complete antenatal population, a group of normal primigravid singleton pregnancies, and a group of normal twin pregnancies, suggests that the fall in the serum folate concentration which occurs in normal pregnancy is due principally to plasma volume expansion and should therefore be regarded as physiological.
The literature on psychosocial aspects of abortion is confusing. Individual publications must be interpreted in the context of cultural, religious, and legal constraints obtaining in a particular society at a given time, with due attention to the status and availability of alternatives to abortion that might be chosen by a woman with an "unwanted" pregnancy. A review of the literature shows that, where careful pre- and post-abortion assessments are made, the evidence is that psychological benefit commonly results, and serious adverse emotional sequelae are rare. The outcome of refused abortion seems less satisfactory, with regrets and distress frequently occurring. Research on the administration of abortion services suggests that counselling is often of value, that distress is frequently caused by delays in deciding upon and in carrying out abortions, and by unsympathetic attitudes of service providers. The phenomenon of repeated abortion seeking should be seen in the context of the availability and cost of contraception and sterilization. The place of sterilization with abortion requires careful study. A recommendation is made for observational descriptive research on populations of women with potentially unwanted pregnancies in different cultures, with comparisons of management systems and an evaluation of their impact on service users.
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Over the three years period 1980-1982, 18 256 pregnancies in the Grampian Region of N-E Scotland including the islands of Orkney and Shetland were screened for raised levels of maternal serum alpha fetoprotein (MSAFP) in the second trimester. Thirty six cases of fetal open neural tube defect in singletons were detected (18 anencephaly and 18 spina bifida). Four additional cases of open spina bifida were associated with normal MSAFP levels although two of these were detected by amniotic fluid AFP measurement when amniocentesis was carried out because of previous NTD history. A further three cases of open spina bifida and two of anencephaly occurred in unscreened pregnancies. The MSAFP screening programme alone was thus instrumental in reducing the birth incidence of open neural tube defects by 36 out of 45 cases (80 per cent) in singletons.