Vault prolapse: a new approach.
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Biomedical subjects
Publications and source records attributed to D T Jenkins.
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Gas chromatographic profiles of neutral lipids in amniotic fluid pellets were analysed for 51 specimens collected from patients in the last two months of pregnancy. The most noticeable change was a large increase in squalene relative to other components in samples at term. By expressing data as a ratio of squalene to cholesterol (S/C), it was possible to accurately predict which amniotic fluid specimens came from patients whose pregnancies were of a gestation of 40 weeks or later. Highest values for S/C and for squalene were obtained for pregnancies which were several weeks overdue.
Measurement of diamine oxidase (DAO) activity in vaginal fluid as an aid to diagnosis of premature rupture of the fetal membranes was studied. In 76 patients following artificial rupture of the membranes and in 70 patients with known intact membranes, the accuracy was 100%. One hundred and forty-nine patients were admitted to hospital with suspected ruptured membranes; using the criteria outlined in this paper, 51 had ruptured membranes and in 98 the membranes were intact. The overall accuracy was 96%.
Creatinine levels were measured in 546 specimens of amniotic fluid with a lecithin/sphingomyelin ratio of 2.5 or more. With amniotic fluid creatinine levels below the normal range, 3 of 6 infants had major congenital abnormalities and two had severe rhesus isoimmunization; 3 of the infants died. Of 514 cases with amniotic fluid creatinine levels within the normal range (mean +/- 2 SD), 13 babies (2.5%) had major congenital abnormalities but only one of the babies died, giving a perinatal mortality rate of 0.2%. The significance of these findings is discussed.
Serum ferritin levels were measured in 200 consecutive pregnant women at their first antenatal visit; 64 (32%) were found to have levels below the normal range. The results were correlated with haemoglobin concentration, serum iron levels, gestation, parity, and social class. The results indicate that low iron stores occur with increasing frequency as gestation advances, that ferritin assay is a better indicator of iron status than serum iron and haemoglobin levels, and that all patients should be given iron supplements in pregnancy, irrespective of social class or parity.