[BREECH DELIVERY OF PRIMIPARAE].
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Myoglobin levels were measured in 70 maternal and 74 cord sera drawn immediately after delivery. The mean cord myoglobin was 28 ng/ml. Myoglobin levels increased with birthweight, and black infants tended to have slightly higher levels than white babies. Myoglobin levels were not elevated in babies with fetal distress (evidenced by abnormal monitor tracings or meconium staining) compared to babies with no distress. Maternal myoglobin (18 +/- 15.3 ng/ml) was about 10 ng/ml lower than cord levels and there was little correlation between the two. Mothers differed among themselves only with respect to complications of labor and delivery. Those with complications had significantly higher myoglobin levels (29 +/- 24.1 ng/ml) than mothers without difficulties (15 +/- 10.0 ng/ml, P less than 0.05). The fetal myoglobin level was relatively independent of the mother's. While high or potentially toxic myoglobin levels were not observed in this study, it appears that the fetus may be protected by the placental barrier.
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This Editorial chronicles the current experience in ultrasound usage during pathologic events occurring in the third stage of labor. Further improvement in the technology for carrying out clinical research will improve our knowledge so that more information can be gleaned from this modality to bestow optimal management for such potentially dangerous conditions. Awareness of the capabilities of sonography may provide the motivation for its use, and obstetricians are encouraged to scan the third stage of normal deliveries for better recognition of normal findings and improved assessment of abnormal ones. Although final decisions should be based mainly upon sound clinical judgement, we contend that complicated third stage of labor warrants turning on the scanner.
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The purpose of this retrospective study was to determine the risk factors for the morbidity of the mothers and their fetus in patients with diabetic retinopathy and/or nephropathy with an open family planning. We compared the course of pregnancies, complications as well as the maternal and neonatal morbidity in 76 patients with diabetic retinopathy or nephropathy (White R F) with 85 patients without severe microangiopathy (White C D). We found a correlation between retinopathy progression and hyperglycaemia during the first trimester (p < 0.05). There was an increase in the deterioration of visual acuity up to blindness due to the progression of this microangiopathy in cases of proliferative retinopathy. There was a significant increase of the mean diastolic blood pressure (mdp) and preeclamptic symptoms occurred in 71% of the cases with severe microangiopathy (p < 0.05). Deterioration of the diabetic nephropathy with excessive proteinuria (> 10 g/d) and unmanageable hypertension or a progression of the retinopathy led to an earlier delivery in 80% of the patients (p < 0.05). A high rate of preterm deliveries (39%) and a frequent occurrence of intrauterine growth retardation's (9%) characterised the fetal outcome. The following examinations for a patient with an open family planning, if diabetes is diagnosed during childhood or the course of the disease is between 10 and 15 years, should be done: Ophthalmological evaluation, control of the renal function, contraceptive advice and an improvement of the metabolic situation. In case of a diabetic nephropathy in combination with hypertonus the patients shoud be warned against pregnancy.(ABSTRACT TRUNCATED AT 250 WORDS)
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