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Effect of German measles during pregnancy
American Federation for Clinical Research
776
six hours after administration in aqueous solution. When injected in a wax and oil medium the rise in urinary levels was delayed about eighteen hours. Consistently positive AschheimZondek tests were not obtained with threeminute urine volumes later than thirty hours after an aqueous solution was given, whereas the tests were positive forty-eight hours after the wax preparation was injected. When the hormone was given as an emulsion, the urinary excretion findings indicated only a slight delay in initial absorption and persistence through the forty-eight-hour test period. When given orally in plain or salol-coated capsules in doses as high as 200,000 I.U., the hormone was not excreted in detectable amounts. When a Miller-Abbott tube was passed into the ileum and 300,000 I.U. of hormone was introduced, even a three-hour urine volume did not contain any trace of hormone, and increasing the dose to 1,050,OOO I. U. resulted in only a trace of hormone in a three-hour urine volume. Similarly, 123,000 I. U. introduced as a retention enema was followed by the appearance of only a small amount in the urine. From these experiments it is obvious that enteral administration is not feasible due to the destruction of the hormone in the gastrointestinal tract.
EFFECTON FETAL RESPIRATIONOF METHIDONADMINISTERED DURINGLABOR. A. C.
Barnes, M.D. Hapke, M.D.,
and (by invitation) F. B. Columbus, Ohio. (From the
Ohio State University Medical-School.) The present study
is concerned with the respiratory depressant effects on the fetus of methidon administered to the mother during labor. Ninety patients have been delivered under low spinal or caudal anesthesia. No drugs other than the ones under study were administered systemically. The times of the first fetal respiration and of the first lusty cry were clocked for each delivery. Thirty patients served as a control group and received no systemic medications. Thirty patients received methidon at varying intervals prior to delivery. Thirty patients received demerol to serve as additional controls. On the basis of these studies we believe that: (1) The experimental method used here offers the most valid approach to the study of neonatal narcosis available to date. (2) Regardless of time intervals prior to delivery, 10 mg. of methidon
is without significant effect on fetal respiration. (3) A 15 mg. dose of methidon, if administered three hours or less before delivery, produces a significant delay in the first respiration and first lusty cry. If the time interval is greater than three hours, little depressant effect could be noted. (4) Methidon administered under these circumstances is a more marked respiratory depressant than demerol.
EFFECTOF GERMANMEASLESDURINGPREGNANCY. Stuart Abel, M.D. (by invitation) and T. R. Van Dellen, M.D., Chicago,
Illinois. A request for letters from mothers who had had German measles during pregnancy was included in a syndicated health column. They were asked to state the exact month of gestation that the illness occurred and the effect on the offspring. Over ninety replies were obtained and of these, eighty-two were considered acceptable. The series includes two sets of twins, making a total of eighty-four children. Three stillbirths were recorded from mothers having German measles during the first trimester of pregnancy. Twenty-five of the children were normal at birth. In seven of these the mother contracted the disease during the first trimester, eleven during the second and seven in the last. Fifty-six of the infants were abnormal at birth, thirty-six with a single defect and twenty with more than one defect. In fortyfour (76 per cent) of these, the mother told of having German measles during the first trimester of pregnancy, eight in the second, one in the third and unknown in three. Nineteen of the infants had congenital heart disease, seventeen had cataracts, fourteen were deaf, and seven were mentally deficient. Gastrointestinal, eye, spinal and skeletal abnormalities also occurred in lesser numbers. The most serious defects or combination of defects occur in women having German measles during the first trimester; defects are less serious and more infrequent in the second. Only one abnormal child was born in the third trimester group. The diagnosis was cerebral palsy and was not considered to be related to the mother’s illness. Statistics obtained reveal that 87 per cent of the babies born of mothers having German measles during the first trimester were abnormal. No abnormalities developed in the third trimester. AMERICAN
JOURNAI.
OF
MEDICINE
776
six hours after administration in aqueous solution. When injected in a wax and oil medium the rise in urinary levels was delayed about eighteen hours. Consistently positive AschheimZondek tests were not obtained with threeminute urine volumes later than thirty hours after an aqueous solution was given, whereas the tests were positive forty-eight hours after the wax preparation was injected. When the hormone was given as an emulsion, the urinary excretion findings indicated only a slight delay in initial absorption and persistence through the forty-eight-hour test period. When given orally in plain or salol-coated capsules in doses as high as 200,000 I.U., the hormone was not excreted in detectable amounts. When a Miller-Abbott tube was passed into the ileum and 300,000 I.U. of hormone was introduced, even a three-hour urine volume did not contain any trace of hormone, and increasing the dose to 1,050,OOO I. U. resulted in only a trace of hormone in a three-hour urine volume. Similarly, 123,000 I. U. introduced as a retention enema was followed by the appearance of only a small amount in the urine. From these experiments it is obvious that enteral administration is not feasible due to the destruction of the hormone in the gastrointestinal tract.
EFFECTON FETAL RESPIRATIONOF METHIDONADMINISTERED DURINGLABOR. A. C.
Barnes, M.D. Hapke, M.D.,
and (by invitation) F. B. Columbus, Ohio. (From the
Ohio State University Medical-School.) The present study
is concerned with the respiratory depressant effects on the fetus of methidon administered to the mother during labor. Ninety patients have been delivered under low spinal or caudal anesthesia. No drugs other than the ones under study were administered systemically. The times of the first fetal respiration and of the first lusty cry were clocked for each delivery. Thirty patients served as a control group and received no systemic medications. Thirty patients received methidon at varying intervals prior to delivery. Thirty patients received demerol to serve as additional controls. On the basis of these studies we believe that: (1) The experimental method used here offers the most valid approach to the study of neonatal narcosis available to date. (2) Regardless of time intervals prior to delivery, 10 mg. of methidon
is without significant effect on fetal respiration. (3) A 15 mg. dose of methidon, if administered three hours or less before delivery, produces a significant delay in the first respiration and first lusty cry. If the time interval is greater than three hours, little depressant effect could be noted. (4) Methidon administered under these circumstances is a more marked respiratory depressant than demerol.
EFFECTOF GERMANMEASLESDURINGPREGNANCY. Stuart Abel, M.D. (by invitation) and T. R. Van Dellen, M.D., Chicago,
Illinois. A request for letters from mothers who had had German measles during pregnancy was included in a syndicated health column. They were asked to state the exact month of gestation that the illness occurred and the effect on the offspring. Over ninety replies were obtained and of these, eighty-two were considered acceptable. The series includes two sets of twins, making a total of eighty-four children. Three stillbirths were recorded from mothers having German measles during the first trimester of pregnancy. Twenty-five of the children were normal at birth. In seven of these the mother contracted the disease during the first trimester, eleven during the second and seven in the last. Fifty-six of the infants were abnormal at birth, thirty-six with a single defect and twenty with more than one defect. In fortyfour (76 per cent) of these, the mother told of having German measles during the first trimester of pregnancy, eight in the second, one in the third and unknown in three. Nineteen of the infants had congenital heart disease, seventeen had cataracts, fourteen were deaf, and seven were mentally deficient. Gastrointestinal, eye, spinal and skeletal abnormalities also occurred in lesser numbers. The most serious defects or combination of defects occur in women having German measles during the first trimester; defects are less serious and more infrequent in the second. Only one abnormal child was born in the third trimester group. The diagnosis was cerebral palsy and was not considered to be related to the mother’s illness. Statistics obtained reveal that 87 per cent of the babies born of mothers having German measles during the first trimester were abnormal. No abnormalities developed in the third trimester. AMERICAN
JOURNAI.
OF
MEDICINE