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[Monitoring of high-risk pregnancies (author's transl)].

The AA. have monitored 202 patients affected by several pathological conditions and at different stages of their pregnancies. Among them, 173 were pregnancies without complications. Monitoring was performed on the basis of the following 3 indices: HCS radioimmunological assay, total plasmatic estriol, and vaginal cytology. Results show, as demonstrated in the graphs and the final discussion, that already within the first weeks of gestation the pathological cases under observation presented marked modifications of the indices studied when compared to controls.

Abortion, Missed↗

Nephrotic syndrome due to preeclamptic nephropathy in a hydatidiform mole and coexistent fetus.

A case study and review of the literature of 2 uncommon obstetric events associated with each other is presented. The diagnosis, treatment, and evaluation of a case of nephrotic syndrome due to preeclamptic nephropathy in a hydatidiform mole and coexistent fetus is presented. Cytogenic studies and appropriate follow-up therapy are discussed. The complete remission of renal and hypertensive complications with evacuation of the pregnancy and lack of malignant transformation is stressed and is found to be characteristic of "partial" mole.

Adult↗

[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↗

Coagulation and renal disease.

The role of coagulation in relation to the aetiology, pathogenesis and progression of renal diseases is discussed. The intimate interdependence between the coagulation process and platelet function, fibrinolysis, complement activation and kinin release is emphasized; these processes are usually involved in most types of immunological inflammation. Coagulation abnormalities occurring in distinct renal diseases are reviewed and the benefits derived from therapy aimed at correcting these abnormalities are compared with the known natural histories of these diseases.

Animals↗

Tracheobronchial epithelial multinucleation in preeclampsia.

Smears were made from the tracheobronchial washings from 40 parturient women undergoing operative delivery while under general anesthesia administered via an endotracheal tube. There was a significantly greater incidence of epithelial multinucleation in the smears from 12 patients who had had preeclampsia for more than 24 hours than in those from 13 healthy pregnant women, from eight women with preeclampsia of less than 24 hours' duration, and from seven women with associated diseases other than preeclampsia. Although we are unable to explain this phenomenon, we have reviewed its possible causation in the face of existing theories on the cause of preeclampsia.

Bronchi↗

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↗

Toxemia of pregnancy. Part II. Immunofluorescent studies with placental connective tissue antisera: the possibility of characteristic lesions.

Seventeen placentas from term gestation complicated by toxemia of pregnancy and 17 normal controls were tested by the fluorescent antibody technic. Antisera to normal placental connective tissue and toxemic placental connective tissue were used. The antisera were obtained by the injection into rabbits of placental extracts rich in connective tissue elements from normal and toxemic placentas. The antitoxemic antisera, after absorption with soluble sonic fraction of normal placentas, stained the following elements exclusively in 14 of the 17 placentas: part of the syncytial knots, fibrillar elements in the adventitia of blood vessels, and amorphous deposition of connective tissue. In each of the remaining three placentas at least two of the lesions were observed. The observation of bright fluorescence in part of the syncytiotrophoblasts and the syncytial knots in toxemic placentas led to the suggestion that they arise late in pregnancy during the disease. The thin fibrillar elements and the amorphous deposition of connective tissue were documented in the various developmental stages in toxemic and normal placentas as well. These findings established possible characteristic lesions in the placenta of pregnancies complicated by toxemia.

Adolescent↗

Production of experimental toxemia in the pregnant dog.

The aortas of 14 pregnant bitches were treated 1 to 3 weeks before term, producing a stricture that reduced the lumen from an average normal of 7-11 mm to 2.1 mm in diameter. Nine animals developed hypertension, 3 had significant proteinuria, and 1 had fluid retention. Light microscopy revealed moderate or severe glomerular lesions in 9 animals characterized by endotlial cell swelling, mesangial cell proliferation, and focal basement membrane thickening; electron microscopy revealed mesangial enlargement and electron-dense deposits. Immunofluorescence with rabbit anti-dog fibrinogen showed glomerular deposition of fibrinogen or its breakdown products in 11 of 12 cases so studied. Focal necrosis was seen in the liver in 5 cases, and diffuse hemorrhagic infarction of the placenta was present in all animals. None of these changes was found in nonpregnant or in sham-operated controls.

Animals↗