The origin of increased serum iron in pregnancy-induced hypertension

Citotions from the Literoture usefulness of average mean arterial pressure, maximal mean arterial pressure, and maximal diastolic pressure during the second trimester in predicting the development of eclampsia in 207 mtlliparas and 20 multiparas with eclampsia. In the nulliparas, both the mean arterial pressure and the maximal mean arterial pressure during the second trimester were > or = 90 mm Hg in 22% and 34% of the patients, respectively. For the multiparas. the percentages with > or = 90 mm Hg were 30% and 35%, respectively. Only 8.7% of nulliparas with eclampsia had a maximal diastolic pressure during the second trimester > or = 80 mm Hg and no patient had a diastolic pressure of > or = 90 mm Hg. A review of the literature suggests that the mean arterial pressure observed during the second trimester has poor predictive value for future development of preeclampsiaeclampsia. We conclude that there is no correlation between second-trimester blood pressure recordings and subsequent eclampsia. IncraM bbular enzyme excretion in preecknpsia Goren MP; Sibai BM; El-Nazar A Department of Pathology ond Loborototy Medicine, St. Jude Children’s ReseaKh Hospital, Memphis, TN38101, USA AM. J. OBSTET. GYNECOL.; 157/4 I (906-908)/1987/ The pathophysiology of preeclampsia includes ischemia and microinfarctions of the kidney, which could induce renal tubular cells to release enxymes into urine. We therefore measured the concentrations of two markers of renal tubular damage, Nacetyl-beta-D-glycosamhridase and alanine aminopeptidase. in urine specimens from women with mild or severe preeclampsia and compared the results with those from healthy pregnant and nonpregnant women. The median urinary concentrations of Nacetyl-beta-D-glucosaminidase and alanine aminopeptidase in women without preeclampsia increased progressively through the first, second, and third trimesters and reached maximum values of 1.12 and 0.77 U/mm01 creatinine, respectively. Median concentrations of the two enzymes were significantly higher in women with mild preeclampsia (N-acetyl-beta-D-glucosaminidase = 1.40, alanine aminopeptidase = 1.12 U/ mm01 creatinine) or severe preeclampsia (N-acetyl-beta-D-glu= 1.26 U/ cosaminidase = 2.90, alanine aminopeptidase mm01 creatimne). This increased enzyme excretion indicates subclinical preeclampsia renal tubular damage. The origin of increased serum iron in pregnancy-induced bypertenaion Samuels P; Main EK; Mennuti MT; Gabbe SG Jerrold R. Gelding Division of Fetol Medicine, Department of Obstetrics ond Gynecology, Hcxpitol of the University of Pennsylvonia, Philadelphia, PA 19104, USA AM. J. OBSTET. GYNECOL.; 157/3 (721-725)/1987/ Serum iron was measured in 30 patients with pregnancyinduced hypertension and 24 normal pregnant women. The mean iron concentrations was significantly higher in the group with pregnancy-induced hypertension (111 f 26 mug/ml) than in the controls (69 f 17 mug/ml) (p < 0.9001). Readily available laboratory variables were used to determine whether the increased serum iron was the result of (1) hemolysis, (2)

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hepatocellular injury, or (3) intravascular volume contraction leading to hemoconcentration. It appears that a clinically silent, ongoing hemolytic reaction is responsible for the increase in serum iron seen in patients with pregnancy-induced hypertension. Auorexla nervosa, bulimia, and pregnancy Stewart DE; Raskin J; Garfmkel PE; et al Department of Psychiatry, University of Toronto, St. Michael’s Hospital, Toronto, Ont. MSB I Ws, Canada AM. J. OBSTET. GYNECOL.; 157/5 (1194-1198)/1987/ Of 74 women previously treated for anorexia nervosa or bulimia, 15 had conceived 23 pregnancies when assessed at followup. The status of the eating disorder, course of pregnancy and delivery. infant health, and postpartum adjustment are described. Women in whom eating disorders were in remission at conception had greater maternal weight gain and babies with higher birth weights and 5-minute Apgar scores than women who conceived while they still had symptoms of restricting anorexia nervosa or bulimia. Women who had symptoms of eating disorders at conception also had continuance or worsening of these symptoms during pregnancy and the postpartum year. We recommend delay of pregnancy until the eating disorder is truly in remission. A pregnant woman with a bigb level of naturally occurring 1mmunoglobuUn M antibodies to Toxoplasma gondii Konishi E Department of Medical Zoology, Kobe University School of Medicine, Kobe 650, Japan AM. J. OBSTET. GYNECOL.; 157/4 I (832-833)/1987/ A pregnant woman diagnosed as positive for immunoglobulin M antibodies to Toxoplasma go&ii did not have a subsequent rise of specific immunoglobulin G antibodies until delivery. The antibodies were therefore considered as naturally occurring immunoglobulin M antibodies. The baby was completely normal without any clinical and serologic signs suggestive of congenital toxoplasmosis.

Pregnancy In Heaoch-Sehonleln purpora Geetha J; Holtman JS; Kosfeld RE; et al Division of Hematology, Deportment of Medicine, University of Loukville School of Medicine, Louisville, KY 40292, USA AM. J. OBSTET. GYNECOL.; 157/4 I(91 l-912)/1987/ A ZZyear-old white woman with Henoch-Schonlein purpura was treated with frequent plasmapheresis for increased severity of the disease activity during pregnancy. Hypertension, axotemia, and placental dysfunction werehot observed. A healthy infant was delivered by cesarean section, and evidence of vasculitis was not detected in the placenta. Treatment of nonmetastlc gestational tropboblastlc disease with oral methotrexate Barter JF; Soong SJ; Hatch KD; et al Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Alabama Medical Center, Washington, DCZoW7, USA AM. J. OBSTET. GYNECOL.; 157/5 (1166-l 168)/1987/ Int J Gynecol Obstet 27