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Sixty-nine cases of febrile pyuria gravidarum
the condition must be accepted as pain, and if the urinary findings are negzttive, the physiologic accompaniment of pregnancy. Such a dilatation may be considered pathologic only when there are abnormal urinary and kidney Gndings associated wit,11 pain, provided the pain disappears temporarily following mechanical or pharmacologic: emptying of the ureter. WILLI.~V / A
Schumacher: Pregnancy.
X-ray Studies of the Changes in Renal Arch. f. GynPlr. 143: 38, 1936.
Pelvis
P.
MEFU'GERT.
and Ureter
Due to
Schumacher studied the changes produced in the renal pelvis aud ureter by pregnancy by means of intravenous pyelography. He states that all of the mfdiods previously used were not physiologic and resulted therefore in erroneous conclusions. Intravenous pyelography produces no pathologic or abnormal changes and the reOne hundred women sults of these studies are therefore accurate and precise. were studied at various intervals throughout pregnancy. No changes were found in the normal course of the ureters, during the first five months of pregnancy. IIow ever, the abdominal portions of the ureters appeared hypotonie and dilated in ma1r.v instances even early in pregnancy. From the fifth to sixth month, 50 per cent of thu ureters and 80 per cent after the seventh month were pushed laterally and posteriorly After the fifth month, ureteral dilatation is throughout their abdominal course. present in 100 per cent and is bilateral in X3 per cent, In 1.5 per cent only the right ureter was involved and in 2 per cent only the left one showed dilatation. This dilatation amounts to at least 2 cm. and is present in multipnrae as well as in primiparae. By contrast, the pelvic portions of the ureters were found to be dilated in only 2 per cent. The remaining 95 per cent showed normal tonus and peristalsis in this area. The dilatation is due to pressure of the pregnant uterus which pnshes the ureter against t,he belly of the psoas muscle. The right ureter is more frrquently dilated and to a greater degree as result of greater pressure due to nteriut: torsion to the right. Type of pelvis, and fetal position and presentation have no effect upon the amount of pressure rxerted. The asthenie type sl~ows more cornpression than does the normal type. RAWK
Albeck, V.: Scanclinav.
Sixty-nine 9:
Among 10,000 69 patients had labor and in 6 cases, pregnancy cases pregnancy one mother died patients still had medical treatment.
Cases of Febrile
Pyuria
Gravidarum.
A.
Anta Cbst,.
REX.
et Gyncc.
30, 1930. partnrient women the author found 226 cases of pyuria. Of t,hese, Only 15 patients had premature fever during pregnancy or labor. instances, toxemia of pregnancy was most likely the cause. In 6 was interrupted therapeutically, hence in about, one-third of the did not go to term. The fetal mortality was 11.6 per rent. Only but one had a nephrectomy heforc she left the hospital. All the a bacteriuria at the time t,hcy left the hospital in spite 01’ intcnairc .J. P. GRF,ENAILL.
Popoff and Spauswick: escens. J. Lab. & Clin.
Pyelonephritis Med.
16:
437,
of Pregnancy
due to Eberthella
Alkal-
1931.
A primigravida, aged twenty-three years, three months pregnant was admitted to the hospital with a diagnosis of pyelitis complicated by vomitiug of pregnancy. Cystographic examination revealed a generalized cystitis with both ureters in normal position and with no dilatation or angulation. The urine obtained directly from both
Schumacher: Pregnancy.
X-ray Studies of the Changes in Renal Arch. f. GynPlr. 143: 38, 1936.
Pelvis
P.
MEFU'GERT.
and Ureter
Due to
Schumacher studied the changes produced in the renal pelvis aud ureter by pregnancy by means of intravenous pyelography. He states that all of the mfdiods previously used were not physiologic and resulted therefore in erroneous conclusions. Intravenous pyelography produces no pathologic or abnormal changes and the reOne hundred women sults of these studies are therefore accurate and precise. were studied at various intervals throughout pregnancy. No changes were found in the normal course of the ureters, during the first five months of pregnancy. IIow ever, the abdominal portions of the ureters appeared hypotonie and dilated in ma1r.v instances even early in pregnancy. From the fifth to sixth month, 50 per cent of thu ureters and 80 per cent after the seventh month were pushed laterally and posteriorly After the fifth month, ureteral dilatation is throughout their abdominal course. present in 100 per cent and is bilateral in X3 per cent, In 1.5 per cent only the right ureter was involved and in 2 per cent only the left one showed dilatation. This dilatation amounts to at least 2 cm. and is present in multipnrae as well as in primiparae. By contrast, the pelvic portions of the ureters were found to be dilated in only 2 per cent. The remaining 95 per cent showed normal tonus and peristalsis in this area. The dilatation is due to pressure of the pregnant uterus which pnshes the ureter against t,he belly of the psoas muscle. The right ureter is more frrquently dilated and to a greater degree as result of greater pressure due to nteriut: torsion to the right. Type of pelvis, and fetal position and presentation have no effect upon the amount of pressure rxerted. The asthenie type sl~ows more cornpression than does the normal type. RAWK
Albeck, V.: Scanclinav.
Sixty-nine 9:
Among 10,000 69 patients had labor and in 6 cases, pregnancy cases pregnancy one mother died patients still had medical treatment.
Cases of Febrile
Pyuria
Gravidarum.
A.
Anta Cbst,.
REX.
et Gyncc.
30, 1930. partnrient women the author found 226 cases of pyuria. Of t,hese, Only 15 patients had premature fever during pregnancy or labor. instances, toxemia of pregnancy was most likely the cause. In 6 was interrupted therapeutically, hence in about, one-third of the did not go to term. The fetal mortality was 11.6 per rent. Only but one had a nephrectomy heforc she left the hospital. All the a bacteriuria at the time t,hcy left the hospital in spite 01’ intcnairc .J. P. GRF,ENAILL.
Popoff and Spauswick: escens. J. Lab. & Clin.
Pyelonephritis Med.
16:
437,
of Pregnancy
due to Eberthella
Alkal-
1931.
A primigravida, aged twenty-three years, three months pregnant was admitted to the hospital with a diagnosis of pyelitis complicated by vomitiug of pregnancy. Cystographic examination revealed a generalized cystitis with both ureters in normal position and with no dilatation or angulation. The urine obtained directly from both