- Email: [email protected]
Our experience of neonatal blennorrhea prevention
Selected
turnover was markedly reduced at the time of postpartum follow-up examination. At the time of abortion the concentration of organic I131 in fetal serum was approximately one fifth that in maternal serum. J. Edward Hall
Parker
Twenty-two
and Beierwaltes: During Pregnancy p. 792. women
found
Thyroid Antibodies and in the Newborn, to
have
circulating
antithyroid antibody (AB) either before or during pregnancy were observed during 23 pregnancies. The maternal AAB titers began to fall as early as the first trimester, tended to strike a plateau at a low level in the third trimester, and rose again during the first few months after the termination of pregnancy. These antibodies were demonstrated in the cord blood of 8 newborn infants of 9 mothers who had demonstrable circulating AAB at the time of delivery but which could not be demonstrated in the cord blood of 7 newborn infants of mothers whose AAB titers had fallen to zero by the time of delivery. AAB disappeared from the blood of all infants during the first 3 months of life. No clinical evidence of hypothyroidism was found in the living at birth, or at the time of follow-up examination for as long as 2 years after birth. The levels of serum protein-bound iodine at birth in 6 newborn infants with proved transplacental transfer of AAB, and later in 4 of these offspring, were within the subjects and 2 other normal range for It is concluded the maternal and of cretinism.
the ages concerned. that the presence of AAB in fetal circulation is not a cause
J. Edward Albert:
Hall
Studies on the Biological Characterization of Human Gonadotropins, p. 839.
Human pituitary gonadotropins (HPG) were prepared by the kaolin-acetone method from large quantities of urine of normal men, postmenopausal women, and eunuchs. These three preparations of HPG were studied by a general gonadotropin assay, by assays for FSH and LH, and hy a fingerprint system for identification of gonadotropins. The ratio of gonadotropic potcncy of the HPG preparations from men and postmenopausal women was the same regardless of the method of assay used, indicating that the proportions of FSH and LH in the HPG from these two sources were the same. However, the
abstracts
557
HPG from the urine of eunuchs contained more FSH than LH as compared with HPG from the urine of men and postmenopausal women. The FSH/LH ratio in HPG from eunuchs was about twice that of HPG from men or postmenopausal women. This work is suggestive but not absolute evidence that HPG is a mixture of two gonadotropins.
J. Edward New
York
State
Journal
Hall
of Medicine
Vol. 61, No. 15, Aug. 1, 1961. Sands,
Richard X.: A Method
Obstetrics
and
Trigonitis During Pregnancy, of Treatment, p. 2598.
Gynecology
No. I, January-February, “Chervakova,
“Sapir,
of the
USSR
1961.
T. V.: Phonocardiographic Changes in the Fetus With Asphyxia Development During Labor, p. 25. I. M.: Our Experience of Neonatal Blennorrhea Prevention, p. 39.
Chervakova: Phonocardiographic Changes in the Fetus With Asphyxia Development During Labor, p. 25. The main cause of stillbirths is fetal asphyxia. For many years obstetricians tried to find early signs of impending asphyxia. Fetal movements, appearance of meconium in vertex presentation, and changes in fetal heart beats were considered such indications. Newer methods of research to determine the condition of the fetus in the form of a phonocardiograph and electrocardiogram were used in this study and the author arrived at the following conclusion: Recording of a phonographic curve showing the rate of heartbeats in a fetus during asphyxia enables it to detect early, acoustically indeterminable, variations in the heartbeat of the fetus and to assess the severity of asphyxia. An analysis of phonographic curves is illustrative of the fact that derangements in the cardiac acti\Tity of the fetus during asphyxia are due to the disturbed basic functions of the heart, viz., its automatism, excitability, conductivity, and contractibility.
Jacob Soloms S apir: Our Experience of Neonatal Prevention, p. 39.
Blennorrhea
A sulfa preparation, Albucid, used for many diseases of the eyes, was employed in this study for the prevention of blennorrhea in the newborn. At
the
time
of this
writing,
Albucid
was
used
in
558
February 15, 1962 Am. J. Obst. & Gynec.
Selected abstracts
15,000 newborn infants with no instance of blennorrhea, although in 51 mothers gonorrhea was definitely established. The author recommends a 30 per cent Albucid solution to be applied two times, immediately following the birth of the child and 2 hours later. Nonspecific conjunctivitis, mild form, was noted in 0.9 per cent of cases.
Jacob Solome No. 2, March-April,
1961.
“Sozansky,
A. M.: The Features Peculiar to the Biochemical Composition of the Amniotic Fluid in Late Toxemia of Pregnancy, p. 27.
Sozausky:
Features Peculiar to the Biochemical Composition of the Amniotic Fluid in Late Toxemia of Pregnancy, p. 27.
In late toxemia of pregnancy certain biochemical changes take place in the blood, like hypoproteinemia, hyperchloremia, and increased residual nitrogen. It was also shown in late toxemia that definite morphologic, histochemical, and biochemical changes take place in the placenta and amnion, the organs participating in producing the amniotic fluid. The above led the author to believe that changes in the content of the amniotic fluid should also take place. Investigations were made in 32 women suffering of late toxemia of pregnancy and 98 women in the second half of pregnancy without this pathology, and the conclusions are as follows: In late toxemia the content of chlorides, urea, and residual nitrogen in the blood serum of the mother, the fetus, and in the amniotic fluid is increased. The albumin in the amniotic fluid is also increased despite the hypoproteinemia in mother and fetus. The amount of sugar in the amniotic fluid in late toxemia is slightly decreased, and in the fetus it is increased.
blood
of
the
mother Jacob
No. 3, May-June, *Zhmakin, “Filimonov,
Zhmakin:
and Solome
1961.
K.
N.: Vacuum-Extraction tive Obstetrics, p. 4. N. N.: The Employment Extractor, p. 16.
Vacuum-Extraction stetrics, p. 4.
in Operaof Vacuum-
in Operative
Ob-
The author summarizes the history and experience in various clinics with the use of the vacuum extractor and comes to these conclusions: The operation of vacuum extraction is indi-
cated in the first stage of labor (dilatation of the OS by 2% to 3 transverse digits and absence of fetal membranes), in persistent uterine inertia and absence of effect from previous pharmacologic stimulation. The duration of vacuum stimulation should not exceed 20 to 30 minutes. Vacuum extraction is indicated in the second stage of labor in persistent uterine inertia and absence of effect from previous pharmacologic stimulation, in beginning fetal asphyxia, in endometritis complicating labor, after reposition of prolapse of the umbilical cord, in partial detachment of the placenta. The duration of vacuum extraction should not exceed 20 minutes. When symptoms of fetal asphyxia are pronounced it is necessary to extract the fetus with the aid of obstetric forceps and not with the vacuum extractor. Vacuum extraction is contraindicated when there is a discrepancy between the size of the fetus and the maternal pelvis, in face, brow, and pelvic presentation, in incorrect reposition of the head, in transverse presentation, in premature and dead fetus, in severe forms of toxemia of pregnancy, and in diseases of the cardiovascular system in the mother. Vacuum stimulation and vacuum extraction are not traumatic for the mother and fetus. The operation should be conducted without general anesthesia, inasmuch as it enables the avoidance of an excessive force of traction. The problem of remote sequelae of the above operations for the child requires further studies. The operations of vacuum extraction and application of obstetric forceps should not be viewed as competitivc-each of these operative procedures has its specific indications and conditions.
,Jacob Solome Filimonov:
Employment
of Vacuum-Extractor,
p. 16. In the period of 1958 to 1959, the vacuum extractor was used in Maternity Hospital No. 19 in Moscow in 220 births, which is 2.3 per cent of the total number of labors. For purposes of the following statistics were given: comparison, From 1937 to 1957, excepting the war years, out of 53,397 births forceps were used 720 times ( I .5 per cent). The frequency of forceps application during the 1958 to 1959 period dropped to 0.9 per cent. most frequently uterine inertia. curred in 27.3 9.3 per cent of
The vacuum extractor was used when labor was complicated by Laceration of the perineum ocper cent, puerperal diseases in cases. There were 5 stillbirths.
turnover was markedly reduced at the time of postpartum follow-up examination. At the time of abortion the concentration of organic I131 in fetal serum was approximately one fifth that in maternal serum. J. Edward Hall
Parker
Twenty-two
and Beierwaltes: During Pregnancy p. 792. women
found
Thyroid Antibodies and in the Newborn, to
have
circulating
antithyroid antibody (AB) either before or during pregnancy were observed during 23 pregnancies. The maternal AAB titers began to fall as early as the first trimester, tended to strike a plateau at a low level in the third trimester, and rose again during the first few months after the termination of pregnancy. These antibodies were demonstrated in the cord blood of 8 newborn infants of 9 mothers who had demonstrable circulating AAB at the time of delivery but which could not be demonstrated in the cord blood of 7 newborn infants of mothers whose AAB titers had fallen to zero by the time of delivery. AAB disappeared from the blood of all infants during the first 3 months of life. No clinical evidence of hypothyroidism was found in the living at birth, or at the time of follow-up examination for as long as 2 years after birth. The levels of serum protein-bound iodine at birth in 6 newborn infants with proved transplacental transfer of AAB, and later in 4 of these offspring, were within the subjects and 2 other normal range for It is concluded the maternal and of cretinism.
the ages concerned. that the presence of AAB in fetal circulation is not a cause
J. Edward Albert:
Hall
Studies on the Biological Characterization of Human Gonadotropins, p. 839.
Human pituitary gonadotropins (HPG) were prepared by the kaolin-acetone method from large quantities of urine of normal men, postmenopausal women, and eunuchs. These three preparations of HPG were studied by a general gonadotropin assay, by assays for FSH and LH, and hy a fingerprint system for identification of gonadotropins. The ratio of gonadotropic potcncy of the HPG preparations from men and postmenopausal women was the same regardless of the method of assay used, indicating that the proportions of FSH and LH in the HPG from these two sources were the same. However, the
abstracts
557
HPG from the urine of eunuchs contained more FSH than LH as compared with HPG from the urine of men and postmenopausal women. The FSH/LH ratio in HPG from eunuchs was about twice that of HPG from men or postmenopausal women. This work is suggestive but not absolute evidence that HPG is a mixture of two gonadotropins.
J. Edward New
York
State
Journal
Hall
of Medicine
Vol. 61, No. 15, Aug. 1, 1961. Sands,
Richard X.: A Method
Obstetrics
and
Trigonitis During Pregnancy, of Treatment, p. 2598.
Gynecology
No. I, January-February, “Chervakova,
“Sapir,
of the
USSR
1961.
T. V.: Phonocardiographic Changes in the Fetus With Asphyxia Development During Labor, p. 25. I. M.: Our Experience of Neonatal Blennorrhea Prevention, p. 39.
Chervakova: Phonocardiographic Changes in the Fetus With Asphyxia Development During Labor, p. 25. The main cause of stillbirths is fetal asphyxia. For many years obstetricians tried to find early signs of impending asphyxia. Fetal movements, appearance of meconium in vertex presentation, and changes in fetal heart beats were considered such indications. Newer methods of research to determine the condition of the fetus in the form of a phonocardiograph and electrocardiogram were used in this study and the author arrived at the following conclusion: Recording of a phonographic curve showing the rate of heartbeats in a fetus during asphyxia enables it to detect early, acoustically indeterminable, variations in the heartbeat of the fetus and to assess the severity of asphyxia. An analysis of phonographic curves is illustrative of the fact that derangements in the cardiac acti\Tity of the fetus during asphyxia are due to the disturbed basic functions of the heart, viz., its automatism, excitability, conductivity, and contractibility.
Jacob Soloms S apir: Our Experience of Neonatal Prevention, p. 39.
Blennorrhea
A sulfa preparation, Albucid, used for many diseases of the eyes, was employed in this study for the prevention of blennorrhea in the newborn. At
the
time
of this
writing,
Albucid
was
used
in
558
February 15, 1962 Am. J. Obst. & Gynec.
Selected abstracts
15,000 newborn infants with no instance of blennorrhea, although in 51 mothers gonorrhea was definitely established. The author recommends a 30 per cent Albucid solution to be applied two times, immediately following the birth of the child and 2 hours later. Nonspecific conjunctivitis, mild form, was noted in 0.9 per cent of cases.
Jacob Solome No. 2, March-April,
1961.
“Sozansky,
A. M.: The Features Peculiar to the Biochemical Composition of the Amniotic Fluid in Late Toxemia of Pregnancy, p. 27.
Sozausky:
Features Peculiar to the Biochemical Composition of the Amniotic Fluid in Late Toxemia of Pregnancy, p. 27.
In late toxemia of pregnancy certain biochemical changes take place in the blood, like hypoproteinemia, hyperchloremia, and increased residual nitrogen. It was also shown in late toxemia that definite morphologic, histochemical, and biochemical changes take place in the placenta and amnion, the organs participating in producing the amniotic fluid. The above led the author to believe that changes in the content of the amniotic fluid should also take place. Investigations were made in 32 women suffering of late toxemia of pregnancy and 98 women in the second half of pregnancy without this pathology, and the conclusions are as follows: In late toxemia the content of chlorides, urea, and residual nitrogen in the blood serum of the mother, the fetus, and in the amniotic fluid is increased. The albumin in the amniotic fluid is also increased despite the hypoproteinemia in mother and fetus. The amount of sugar in the amniotic fluid in late toxemia is slightly decreased, and in the fetus it is increased.
blood
of
the
mother Jacob
No. 3, May-June, *Zhmakin, “Filimonov,
Zhmakin:
and Solome
1961.
K.
N.: Vacuum-Extraction tive Obstetrics, p. 4. N. N.: The Employment Extractor, p. 16.
Vacuum-Extraction stetrics, p. 4.
in Operaof Vacuum-
in Operative
Ob-
The author summarizes the history and experience in various clinics with the use of the vacuum extractor and comes to these conclusions: The operation of vacuum extraction is indi-
cated in the first stage of labor (dilatation of the OS by 2% to 3 transverse digits and absence of fetal membranes), in persistent uterine inertia and absence of effect from previous pharmacologic stimulation. The duration of vacuum stimulation should not exceed 20 to 30 minutes. Vacuum extraction is indicated in the second stage of labor in persistent uterine inertia and absence of effect from previous pharmacologic stimulation, in beginning fetal asphyxia, in endometritis complicating labor, after reposition of prolapse of the umbilical cord, in partial detachment of the placenta. The duration of vacuum extraction should not exceed 20 minutes. When symptoms of fetal asphyxia are pronounced it is necessary to extract the fetus with the aid of obstetric forceps and not with the vacuum extractor. Vacuum extraction is contraindicated when there is a discrepancy between the size of the fetus and the maternal pelvis, in face, brow, and pelvic presentation, in incorrect reposition of the head, in transverse presentation, in premature and dead fetus, in severe forms of toxemia of pregnancy, and in diseases of the cardiovascular system in the mother. Vacuum stimulation and vacuum extraction are not traumatic for the mother and fetus. The operation should be conducted without general anesthesia, inasmuch as it enables the avoidance of an excessive force of traction. The problem of remote sequelae of the above operations for the child requires further studies. The operations of vacuum extraction and application of obstetric forceps should not be viewed as competitivc-each of these operative procedures has its specific indications and conditions.
,Jacob Solome Filimonov:
Employment
of Vacuum-Extractor,
p. 16. In the period of 1958 to 1959, the vacuum extractor was used in Maternity Hospital No. 19 in Moscow in 220 births, which is 2.3 per cent of the total number of labors. For purposes of the following statistics were given: comparison, From 1937 to 1957, excepting the war years, out of 53,397 births forceps were used 720 times ( I .5 per cent). The frequency of forceps application during the 1958 to 1959 period dropped to 0.9 per cent. most frequently uterine inertia. curred in 27.3 9.3 per cent of
The vacuum extractor was used when labor was complicated by Laceration of the perineum ocper cent, puerperal diseases in cases. There were 5 stillbirths.