[Grand multiparity--is it still an obstetrical problem?].
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Chronic ingestion of methanol extract of the above-ground part of motherwort (Leonurus sibiricus L) in drinking water at the concentration of 0.5% enhanced the development of both pregnancy-dependent mammary tumours (PDMT) and mammary cancers originated from PDMT. By contrast, the treatment markedly suppressed the development of mammary cancers that originated from hyperplastic alveolar nodules (HAN) associated with the decreased formation of HAN. The incidence of uterine adenomyosis was also inhibited in mice given motherwort. The urinary excretion of allantoin, creatine and creatinine and glucose tolerance were stimulated by motherwort. The cause of discrepancy of the effects of motherwort on mammary cancers due to their origins is not clear at present. However, the stimulation by the agent of the excretion of any carcinogenic factors may at least partly contribute to its inhibition of mammary cancers originating from HAN.
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The maternal death rate is high in grand multiparas giving birth in remote villages in Milne Bay Province, Papua New Guinea. Such women are often reluctant to go to hospital for delivery. However, many of them have accepted the idea of going to hospital to await delivery and postpartum tubal ligation. We discuss the results and benefits of this program. 43% of grand multiparas suffered one or more complications during their hospitalization; 77% were sterilized. Considerable morbidity and mortality can be prevented by an active program for hospital management of grand multiparas. Costs of such early referral are at least partially offset by decreasing costs for late emergency transfer of obstetric disasters. 47% of emergency air charters for obstetric complications were for grand multiparas. Numbers of such emergency transfers have decreased as increasing numbers of grand multiparas have been referred early for delivery and tubal ligation.
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