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[Proteinuria in the nephropathy of pregnancy and posttoxicosis renal lesion].

Proteinuria was studied in 110 females - 28 pregnant with nephropathy of pregnancy with primary late toxicosis and 82 with past history of the disease with a residual proteinuria after childbirth. Selective type proteinuria was more often found both in pregnant women and in those with a past history of nephropathy. The relative share of the pregnant with non-selective proteinuria is considerably greater. After childbirth, in parallel with the decrease of proteinuria quantity, the non-selective one turns to selective in the majority of the cases. The quantity of the excreted proteins, in the urine, of patients with confirmed glomerular lesions, shows no tendency to decrease. The absence of dynamics in proteinuria quantity and its non-selectivity provides grounds to suspect a deeper lesion of the renal filter, retaining the involution of the morbid process and a tendency to its chronification.

Female↗

[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↗

Sequential determination of serum human placental lactogen, estriol, and estetrol for assessment of fetal morbidity.

Serial measurements were made of the concentrations of maternal serum human placental lactogen (hPL) (300 determinations), estriol (E3) (460 determinations), and estetrol (E4) (275 determinations) in normal human pregnancy during the third trimester period. Simultaneous determinations of serum hPL, E3, and E4 were also made sequentially on blood samples from 6 diabetic and 5 toxemic pregnant women to ascertain the relative usefulness of these parameters as indicators of fetal welfare. In uncomplicated diabetic patients controlled with insulin, all parameters increased with gestational age. In three pregnancies complicated by severe toxemia in which fetal distress progressed to intrauterine fetal death, both serum E3 and E4 levels decreased progressively, but E4 concentration started to decrease at least 1 day earlier than E3 prior to fetal death. In other women, the E4 levels appeared to drop or decrease significantly whereas the E3 levels remained almost unchanged. Daily hPL levels remained low in chronic fetal distress and, therefore, appeared to be of minimal value for predicting either intrauterine death or acute fetal distress. Therefore, serum E4 measurement seems to provide a more sensitive and reliable indicator of fetal morbidity than the measurement of serum E3 during toxemic pregnancies.

Estetrol↗

The effect of postural changes on plasma renin activity during normal and pathologic pregnancies.

A study of the effect of posture on plasma renin activity (PRA) in the third trimester in 27 gravidas revealed a significantly greater increase in PRA in the supine position, compared to the left lateral. The women were classified into 3 groups: normal pregnancy, preeclampsia, intrauterine fetal death. There was no statistical difference in PRA among the 3 groups. It is assumed that the increase of PRA in the supine position was due mainly to mechanical pressure by the gravid uterus on the great vessels (regardless of whether the fetus was dead or alive) and that effective circulatory volume was thus reduced. However, low PRA in the left lateral position in women with preeclampsia seemed to correlate with more severe disease in these women.

Adult↗