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Biomedical subjects

I MacGillivray

Publications and source records attributed to I MacGillivray.

At least 55 records · Page 3Linked to original sources

An audit of antenatal care: the value of the first antenatal visit.

A critical analysis of the events recorded at the first antenatal visits in a city where all pregnant women are seen by specialist obstetricians for booking for antenatal care and confinement showed that many women attended too late for optimal care. The selection of women for their risk of complications was not very effective, partly because of failure to take account of information that was available, but mainly because many obstetric complications cannot be predicted, except by classifying large proportions of pregnant women as high risk. Even with the greatest care, inappropriate bookings are made at the first visit, and reappraisal of booking for continuing care and confinement is necessary during pregnancy.

Body Height↗

Is routine antenatal care worth while?

An analysis of the rate at which asymptomatic problems are diagnosed, missed, and overdiagnosed in a total population of pregnant women attending specialists and general practitioners for antenatal care indicated that detection of some problems is incomplete and that overdiagnosis is common. The productivity of routine antenatal care in respect of prediction and detection of obstetric problems is extremely low, and it is suggested that the number of visits for this purpose could be considerably reduced for women without special problems.

Costs and Cost Analysis↗

The relevance of hypertension and oedema in pregnancy.

The triad of severe pre-eclampsia is often described as a combination of hypertension, oedema and proteinuria. Hypertension alone arising in the second half of pregnancy however is not associated with any greater perinatal mortality or low birthweight than normotensive primigravidae and it is probable that this hypertension may be either physiological or a manifestation of essential hypertension or, in some cases, a mild form of pre-eclampsia. Oedema also does not necessarily signify abnormality. High weight gain, fluid retention or oedema is associated with a lower incidence of small babies, but with a higher incidence of pre-eclampsia. Considerable amounts of water retention can occur in normal pregnancy, either measured as an increase during pregnancy, or as a fall after delivery. The diuretics cyclopenthiazide, spironolactone and clopamide given prophylactically to high weight gain primigravidae did not prevent the onset of proteinuric pre-eclampsia, but caused the babies to be lighter in weight than those of controls. Sodium potassium and water content of leucocytes from primigravidae with proteinuric pre-eclampsia is the same as in mild pre-eclampsia and normal pregnancy. Although salt and water retention are common features of pre-eclampsia, they do not cause the condition and are not an essential part of it.

Birth Weight↗

Glucose tolerance in twin pregnancy.

The hypothesis of a slower rate of glucose disappearance after intravenous glucose injection has been tested and proved in a sample of 54 women with twin pregnancies. Different standards for glucose tolerance being therefore required for these women, care should be taken before labelling them as diabetic.

Blood Glucose↗

Nutrition in twin pregnancy.

The urinary nitrogen output appears to be related to both protein and energy intake, so that women having heavier babies probably eat more, although this may simply mean that they are larger women. Women with twin pregnancies have been found to have a lesser urinary nitrogen output, but it seems unlikely that this be due to lower intakes. They might simply utilize their diet more efficiently--a hypothesis that is now being tested.

Birth Weight↗

The value of measurement of pregnancy-specific proteins in twin pregnancies.

In this study of 53 twin pregnancies, the plasma concentrations of the placental proteins, placental lactogen (hPL), and pregnancy-specific glycoprotein (SP1) were measured. Placental lactogen was found to be of more value than SP1 both in the detection of twins and in assessment of fetal growth. Serial measurement of either protein would seem to be more useful in assessment of fetal growth than single measurements. Preliminary studies of the less well known placental protein, PP5, in a small series of twin pregnancies indicate that it may also prove to be of clinical value in the detection and monitoring of twin pregnancies.

Chorionic Gonadotropin↗

Maternal height and twinning.

Data on maternal height are presented for 307 pairs of newborn twins of known zygosity from Oxford and 267 pairs from Aberdeen and north-east Scotland. The results support the hypothesis that mothers of DZ twins are taller than those of MZ twins. Mothers of MZ twins resemble mothers of singletons in height, whereas mothers of DZ twins are taller.

Body Height↗

Twin pregnancies.

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Cardiovascular Physiological Phenomena↗

Smoking during pregnancy. Its effect on maternal metabolism and fetoplacental function.

The effects of smoking during pregnancy on maternal body composition and the fetoplacental unit were investigated serially in well-matched groups of 29 normal, healthy primigravid smokers and 31 nonsmokers. The babies of smokers were lighter by an average of 138 g, and there was a greater proportion of small-for-dates infants among smokers compared with nonsmokers. There was a failure in expansion of mean plasma volume and total body water in patients who smoked throughout pregnancy compared with nonsmokers. No differences were demonstrated in serum protein, intravascular protein mass, serum albumin, intravascular albumin mass, serum electrolytes, serum osmolality, urinary estriol excretion, fetal biparietal diameter, or weekly growth rate between the 2 groups. The concentration of serum heat-stable alkaline phosphatase at 34 and 38 weeks' gestation, during the second stage of labor, and in the early puerperium was significantly higher in smokers. It is postulated that smoking unfavorably alters maternal body composition which is manifested in poor overall performance with the consequent production of smaller infants. The effects of tobacco smoke on the fetus may possibly be mediated via the placenta.

Adolescent↗