[Gestosis in the third trimester. Past and present experiences. Results].
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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.
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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.
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.
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The maternal Serum concentrations of beta 1 SP 1, IgM and alpha 2-macroglobulin were determined in relation to the gestation age, using the simple radial immunodiffusion method in 102 non-pathologic pregnancies and 35 pregnancies involving risk factors. To assess the clinical relevance of these determinations, we examined to what extent the changes in concentration of beta 1 SP 1 IgM and alpha 2-macroglobulin would permit a prognostically useful conclusion on the placenta function and foetal condition. All patients with lowered beta 1 SP 1-serum concentrations were examined for their antepartua CTG-evaluation, as well as the type of termination of parturition. The normal distribution for beta 1 SP 1 showed a continuous rise in serum concentration up to the 37th pregnancy week. During the last 3 weeks, beta 1 SP 1 remained almost constant. For the cases with EPH-gestosis and placenta insufficiency, a beta 1 SP 1-concentration below the normal distribution level was found in the large majority of all cases. In diabetes mellitus during gravidity, twin gravidity and MHN, the determination of beta 1 SP 1 is not of any decisive prognostic significance. The maternal serum levels of IgM showed no significant differences when comparing normal pregnancy and risk pregnancy. The serum concentration of alpha 2-macroglobulin increased in both groups of patients with increasing gestation age. Of the three examined protein bodies, we consider beta 1 SP 1 to be a good, additional parameter for the assessment of the trophoblast function.
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