PubMed · 91795
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I Chalmers. 1979-11-17. The search for indices.. https://doi.org/10.1016/s0140-6736(79)92455-3
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The usefulness of determining hemoglobin A1c (HbA1c) levels during pregnancy was evaluated. In contrast to previous reports, the HbA1c values did not predict abnormal maternal glucose tolerance or infant birth weight. They did, however, correlate with long-term control of the diabetes of pregnant insulin-dependent patients. The slight decrease in HbA1c values observed as pregnancy advanced was secondary to improved control of diabetes.
To determine the maturation of pulmonary surfactant at birth, phospholipid patterns in tracheal or pharyngeal aspirates of 54 newborn infants were analyzed by two-dimensional thin-layer chromatography. The compositions of phospholipids and their surface tension-lowering abilities were assessed after gestations with various complications. Preterm infants with respiratory distress syndrome (RDS) lacked phosphatidylglycerol and had lower lecithin/sphingomyelin ratios than infants without RDS. An acceleration of both phosphatidylcholine (lecithin) and phosphatidylglycerol concentrations was observed in 21 preterm infants born after prolonged rupture of the membranes and treatment with isoxuprine. In these infants, the phospholipid pattern of lung effluent was similar to that of term infants even at gestational ages less than or equal to 30 weeks. Biochemical lung maturation was delayed in aneccephalic infants, infants of diabetic mothers, and one infant of a mother with hypothyroidism.
162 twin pregnancies of the I. Univ.-Clinic of Gynecology and Obstetrics in Vienna between 1969 and 1977 have been analysed (1969--1974 = group I; 1975--1977 = group II). It was found that the main risk factors of twin gravidity are the high rate of babies born before term, the high rate of operative deliveries and the high rate of perinatal mortality. The twin pregnancy should be diagnozed early. This allows the possibility of prophylactic therapy of onset of labour before term. According to our observations the difference in mortality rates between the first and the second group is very high (13,3 in comparison to 5,5%). The management of twin pregnancies as a high risk delivery with continuous fetal monitoring has doubled the number of indications for caesarean section. The essential problem of twin pregnancy seems to be the high rate of premature deliveries. Therefore an adequate increase of the legal antenatal and postnatal maternal protection period is emphasized.