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PubMed1978

[Pregnancy anemias].

After introductory remarks on the physiology of blood during pregnancy the authors enter the two most frequent anaemias of pregnancy, which are evoked by iron deficiency and infection, as well as the megaloblastic, which are evoked by deficiency of folic acid--more infrequently also by deficiency of vitamin B12. The diagnostic and therapeutic principles are described in detail. It is only in short referred to the very rare haemolytic and toxic farms of anaemia, it is generally renounced to describe the haemorrhagic anaemia. A prophylaxis of the anaemia of pregnancy is intensely recommended.

Anemia↗
PubMed1978

Maternal and fetal plasma renin and dopamine-beta-hydroxylase activities in toxemic pregnancy.

Toxemic and normotensive pregnant women were compared for plasma renin activity (PRA), aldosterone (PA), and dopamine-beta-hydroxylase (DBH). At term, hypertensive patients exhibited higher levels of PRA and PA, but similar levels of DBH, progesterone, and estradiol. Their elevated blood pressure was significantly correlated to their levels of PRA. During the delivery levels of PRA increased significantly in toxemic patients in spontaneous labor. Venous and arterial cord PRA levels were higher in babies born to hypertensive mothers than in babies born to normotensive mothers. Three days postpartum, maternal PRA level was lower than at term. Seven days postpartum, PRA levels remained higher in toxemic than in normal women. Maternal DBH levels did not change during and after delivery. Levels of DBH were undetectable in cord blood. We conclude that the renin-angiotensin system is involved in the pathogenesis of toxemia.

Adult↗
PubMed1978

[The evaluation of cortisol in amniotic fluid and in maternal blood as parameter for foetal lung maturity (author's transl)].

The lecithin/sphingomyelin-ratio (L/S-ratio) in amniotic fluid has become established in recent years as a valuable laboratory parameter for determining foetal lung maturity and has thus helped to avoid the neonatal respiratory distress syndrome. Since glucocorticosteroids are a decisive factor in stimulating foetal lung development, we were prompted to investigate whether the determination of cortisol in amniotic fluid or maternal blood could also serve as an indicator of foetal lung maturity. The cortisol concentration was measured by radioimmunoassay in amniotic fluid (n = 91) and in maternal venous plasma (n = 70) from normal and complicated pregnancies and was compared with the L/S-ratio. A significant correlation between gestational age and cortisol in amniotic fluid (r = 0.711) and in maternal venous plasma (r = 0.625) was observed. There was also a significant correlation between the L/S-ratio and amniotic fluid cortisol (r = 0.701). However, compared to the L/S-ratio, measurements of cortisol yielded 10% false positive and 11% false negative results. A significant correlation between the L/S-ratio and the maternal plasma cortisol could also be demonstrated (r = 0.631). Here the comparison with the L/S-ratio gave even poorer results: 16% false positive and 6% false negative. The high percentage of false results, especially false positive results yielded by cortisol estimations in both fluids leads to the conclusion that the L/S-ratio remains the superior diagnostic parameter in determining foetal lung maturity.

Amniocentesis↗
PubMed1977

[Alpha-fetoproteins in maternal serum. Radioimmunologic determination in current obstetrical practice. Analysis of 669 determinations].

The analysis of 669 levels of maternal serum alpha-fetoproteins carried out using a radio-immunological technique with double antibodies has enabled a diagram of normal values to be established on the one hand has shown up certain modifications of levels when different pathological conditions arise in pregnancy on the other hand. Raised levels were found in: intra-uterine fetal death. In some cases the rise preceded death, in twin pregnancies. Low levels were found in: severe pre-eclamptic pregnancies, in low intra-uterine fetal growth after the 32nd week, in threatened premature labour. Finally, the levels of AFP in the maternal serum were found to be normal in two cases where there were neural tube malformations. The existence of variations in the levels of AFP in maternal serum in a variety of pathological features suggests that these levels could be used as a new parameter in the biochemical monitoring of the fetus.

Abortion, Spontaneous↗
PubMed1977

Maternal serum alpha-fetoprotein in abnormal pregnancies and during induced abortion.

Serial maternal serum alpha-fetoprotein (AFP) levels were determined by radioimmunoassay in patients with abnormal pregnancies and after saline-induced abortion. Results from patients presenting with mild or severe preeclampsia, fetal growth retardation and severe diabetes did not differ from the normal range. However, in patients with premature labor, the majority of AFP levels were significantly below the normal range, and peak AFP levels were achieved approximately one month earlier than normal. In patients whose pregnancies were terminated by abortion, the AFP levels exhibited a significant rise within a few hours after induction because of resorption of fetal elements into the maternal circulation.

Abortion, Induced↗
PubMed1977

[Alpha fetoprotein in maternal blood during normal and pathological pregnancies].

AFP was assayed in serum of normal pregnant women and in patients with pathological pregnancy. Pathological levels of AFP, defined as increased or decreased concentrations compared with the normal distribution, was detected in 83.5 % of pregnant women who delivered a dysmature child and in 88 % of those whose placenta was macroscopically sclerous. A longitudinal determination of AFP appears to be useful in the follow-up of risk of abortion.

Estriol↗
PubMed1978

[Serum, cord blood and amniotic fluid concentrations of beta2-microglobulin in patients with normal and complicated pregnancies (author's transl)].

Serum, cord blood and amniotic fluid beta2-microglobulin contents were measured from normal pregnancies complicated by EPH gestosis, Rh immunisation and pathological serum levels of HPL and alpha1-fetoprotein. We found no changes in high risk pregnancies from normal serum levels. beta2-microglobulin seems to be no parameter in managing complicated pregnancies and fetal growth retardation.

Amniotic Fluid↗
PubMedDate not supplied

Antenatal assessment of fetal age and maturity using fetal fat staining cells in amniotic fluid.

A cross sectional retrospective study of 400 cases of amniocentesis was performed to evaluate the reliability of using fetal fat staining cells as a method for assessment of fetal age and maturity. A sharp rise in the percentage of these cells in amniotic fluid occurred after 37 weeks of gestation and a level of 20 per cent or more indicated fetal age of 38 weeks or more, corresponding to maturity by our definition. The false positive and negative rates were 3.5 per cent and 14 per cent respectively. The pre-eclamptics, diabetics and Rh sensitized groups fell within the distribution of the normal population. The dysmature group, however, showed an earlier rise (20% at 36 weeks). The origin of the fetal fat staining cells and the reasons for the early rise in dysmaturity are discussed. Estimation of fetal fat staining cells in the amniotic fluids using the 20 per cent level is a reliable test for maturity in normal and some abnormal pregnancies, excluding dysmaturity.

Amniocentesis↗