Urinary digoxin-like immunoreactive substance in pregnancy. Relation to urinary electrolytes.

High concentrations of digoxin-like immunoreactive substance (DLIS) have been identified in amniotic fluid and in blood during pregnancy. In this study, urine from healthy women was analyzed for DLIS during pregnancy and following delivery, and levels were related to various clinical and urinary findings. Urinary DLIS increased progressively during pregnancy, having a linear relation to gestational week (DLIS = 0.032 week + 0.46, Syx = 0.52, r = 0.46, p less than 0.01), and fell to nonpregnant values during the first postpartum day. The urinary DLIS level correlated with urinary creatinine (r = 0.50, p less than 0.01) and urinary calcium (r = 0.56, p less than 0.01) levels. When adjusted for the gestational week, the urinary DLIS level also correlated with urinary potassium (r = 0.48, p less than 0.01), creatinine (r = 0.55, p less than 0.01), and magnesium (r = 0.55, p less than 0.01) levels. After adjustment for the urinary creatinine level, only the relation of urinary DLIS and urinary calcium levels remained significant (r = 0.44, p less than 0.05). The urinary DLIS level was not found to be related to systemic blood pressure. The ratios of sodium to potassium (r = -0.43, p less than 0.05) and calcium to magnesium (r = 0.37, p less than 0.05) were also related to gestational week but were independent of the urinary DLIS level. Thus, urinary DLIS increases progressively during pregnancy and falls to nonpregnant values on the first postpartum day, the urinary DLIS level can be related to urinary creatinine, urinary potassium, and urinary magnesium levels, and when adjusted for the urinary creatinine level, the urinary calcium level relates independently to the urinary DLIS level.

Effect of aspirin on bleeding time during elective abortion.

The template bleeding time, indicative of a predictable measure of potential blood loss due to altered platelet function, is unaffected by pregnancy or by the first stage of labor. Two tablets of aspirin (650 mg), but not sodium salicylate or acetaminophen, significantly prolongs the template bleeding time for at least 26 hours after consumption in patients undergoing first or second trimester induced abortion. Patients anticipating induced pregnancy interruption should refrain from any aspirin consumption for at least 26 hours prior to abortion.

Antenatal diagnosis of sickle cell disease: amniotic fluid cell DNA analysis.

Using recombinant DNA methods and amniocentesis, the antenatal diagnosis of sickle cell disorders can be accomplished. This article presents the authors' experiences with 21 pregnancies at risk using HpaI and Hind III restriction enzyme digestions of adult leukocytic and fetal amniotic fluid cell DNA. The authors were able to establish direct beta A- and beta S-globin gene linkages to the restricted fragments in 9 families. In 8 families no direct linkages could be determined and estimates of exclusion of fetal beta S homozygosity were used. These estimates were made on the basis of the frequencies of association of the HpaI fragments with the beta S and beta A genes in the Afro-American population. In 4 families, no estimates or linkages could be established, and the patients were counseled in reference to fetoscopy. The data also indicated the frequencies of association of the HpaI fragments with the beta A and beta S gene in the New Jersey-New York population. These studies did not seem to indicate any exclusive preferential segregation of the HpaI and Hind III polymorphisms.

Pregnancy associated with renal glucosuria.

On reviewing 17,647 pregnancies over a 6-year period, 291 of 17,229 singleton pregnancies were noted to be associated with renal glucosuria. On analyzing these 291 pregnancies in 277 women, renal glucosuria was more frequently observed in those women with blood group types A and B and less in those with blood group type O. The incidence of renal glucosuria in nulliparous women, 2.8%, was significantly higher than that in parous women, 1.1%. A significantly high incidence of prematurity, 25.0%, was noted in women who persistently spilled a large amount of glucose.

Letter to the editor: Non steroid anti-inflammatory drugs and pregnancy.

PIP: A review of relevant clinical research literature leads to the conclusion that any known nonsteroid anti-inflammatory drug (NSAID) should be contraindicated for use during pregnancy. This conclusion is reached as a result of the potentially profound effects of NSAIDs noted on platelet functions and their inhibition of specific tissue prostaglandin(PG) synthetases. Study results have shown that administration of Naproxen to midtrimester abortion patients prolonged the instillation-abortion interval from 33.4 hours +or- 2.9 hours (in a placebo treated group) to 64.7 hours +or- 6.4 hours. Treatment with aspirin prolonged induction-abortion time by about 9 hours and treatment with indomethacin by 30 hours. 2 recent clinical papers have shown that use of acetylsalicylic acid, a relatively weak inhibitor of PG synthetase when compared to Naproxen, by pregnant women at or near term increased their length of gestation, their mean duration of labor, the frequency of postmaturity among them, and the incidence of pre- and postpartum hemorrhage. A small dose of aspirin given to mothers at or near term results in platelet dysfunction in both the mother and the newborn infant. NSAID most frequently disrupts normal hemostatic homeostasis mechanisms. In addition, studies have shown that use of NSAIDs increases the incidence of chromosomal abnormalities in spontaneous abortuses. Such drugs should not be used to prevent threatened abortions.^ieng

Prolongation of rat gestation time by unsaturated fatty acids.

Arachidonic, linoleic, linolenic, and oleic acids, administered to Sprague-Dawley rats on Days 20 and 21 of gestation prolonged the gestation time; neither the duration parturition, parturitional bleeding, nor the perinatal mortality rate was affected. Since arachidonic acid is the obligatory precursor of prostaglandins E2 and F2 alpha, currently believed to be associated with the initiation of labor, and polyunsaturated fatty acids inhibit the cell-mediated immune response in vivo, the precise role of prostaglandins and their precursors in the initiation of parturition must be critically examined.