Search

The study was carried out in a group of 280 women (46 non-pregnant women, 24 pregnant women in I trimester, 50 pregnant women in II trimester, 108--in III trimester and 52 women on 3rd day of puerperium). All the women were healthy, the course of pregnancy normal, puerperium without complications. The women had the activity of alpha-amylase determined, by the Caravay method in the blood serum, blood taken in the morning on an empty stomach, from the cubital vein. The results were calculated statistically. It was found that the activity of alpha-amylase in the blood serum of healthy women decreases as normal pregnancy progresses. The activity of alpha-amylase in the blood serum of women on 3rd day of puerperium maintains the level as in III trimester of pregnancy.

Glucose metabolism was evaluated in pregnant women with clinically and biochemically demonstrated intrahepatic cholestasis. Laboratory investigations included measurements of serum glucose concentrations on fasting and 2 hours after breakfast, the glucose tolerance test (100 gm oral glucose load), and 24-hour glycemia profile. All patients were admitted to the II Department of Obstetrics and Gynecology, Institute of Obstetrics and Gynecology of the Medical School in Warsaw, Poland. None of the patients exhibited manifest diabetes mellitus or had any clinical history suggestive of previous diabetes. The serum samples collected 2 hours after breakfast demonstrated higher glucose concentrations in women with intrahepatic cholestasis when compared with healthy control subjects. The glucose tolerance tests demonstrated consistently higher concentrations of glucose in blood serum samples after loading in the study group. The 24-hour glycemia profile showed greater glucose concentrations in serum samples collected 2 hours after breakfast and after supper. These results suggest that in the course of cholestasis in pregnancy, visible changes occur in the carbohydrate metabolism of the pregnant woman.

The study was carried out in a group of 176 women (39 non-pregnant women, 30 women in I trimester of pregnancy, 37--in II trimester, 35--in III trimester and 35 women on 3rd day of puerperium). All the women were healthy, had no renal diseases and did not report the history of urinary tract diseases. They did not have hypertension either. In all the women the authors determined the activity of alpha-amylase in the urine by the Caravay method. The urine collection was done according to Kokot. The results were determined in enzymes/h, and were calculated statistically. It was found that the activity of alpha-amylase increases as pregnancy progresses. In the women on 3rd day of puerperium the activity of the enzyme examined in the urine comes back to the values found in non-pregnant women.

Twenty-five samples obtained by amniocentesis were studied in 25 pregnant women between 35 and 40 weeks of pregnancy with hypertension. The following biochemical investigations were done in the samples: total protein, beta-lipoproteins, cholesterol, uric acid, urea, creatinine, AlAT and AspAT, total alkaline phosphatase and its thermostable isoenzyme, ceruloplasmin and alpha-amylase. The results were analysed in relation to the development of the respiratory distress syndrome in the newborn and were subjected to statistical analysis. In the amniotic fluid of hypertensive mothers in whose children the respiratory distress syndrome developed, reduction was found in the concentrations of beta-lipoproteins and cholesterol. This may have a prognostic significance in the prediction of respiratory distress in early neonatal period.

The studied material comprised 36 newborns and their mothers, among them 12 newborns had meconium in the amniotic fluid (study group) and 24 newborns with clear amniotic fluid served as controls. The fluids were studied biochemically. In both compared groups the analysed factors were: 1) week of labour, 2) body weight and length, 3) clinical condition of the newborn by the Apgar score, 4) type of labour, 5) type of pregnancy complications in mothers. The results were subjected to statistical analysis. It was found that meconium presence in the amniotic fluid correlated with the presence of clinical symptoms suggesting intrauterine asphyxia of the fetus, and the number of caesarean sections was greater in this group. A correlation was noted between the presence of meconium in the amniotic fluid and worse clinical condition of the newborn.

The study was carried out in 45 samples of amniotic fluid taken by amniocentesis from 21 hypertensive mothers (study group) and 24 healthy mothers (control group). In these samples the concentrations were determined of total oestrogens and human placental lactogen. In the evaluation of the state of the newborns the following was considered: 1) length and body weight, 2) status in the 1st minute of life (Apgar score). The results were subjected to statistical analysis. In hypertensive mothers during pregnancy HPL and total oestrogen concentrations were decreased. In the study group reduction of body weight and length was found. The general condition of the newborns in the 1st minute was similar in both groups.

The authors examined 74 women in III trimester (29-40 week), among them 44 women with hypertension induced by pregnancy (group examined) and 30 healthy women (control group). The blood serum of these women was studied for: creatinine, urea, uric acid, electrolytes K+ and Na+. Besides, the blood was studied for acid-base equilibrium (apparatus Corning type 128). The 24-hour urine of the two groups was studied for the concentrations of ions: 1) ammonium (NH4+), 2) hydrogen (H+) and 3) potassium and sodium (K+ and Na+). The authors also made the endogenic creatinine clearance (Ckr). The results were calculated statistically. The women with hypertension induced by pregnancy had in their blood serum an increase in the concentration of creatinine, urea and uric acid. As to the parameters of acid-base equilibrium, the authors found an increase in pCO2. Besides, the women with this kind of hypertension had: a decrease in the excretion of ions NH4+ and H+ in the urine, a decrease of Ckr with electrolytes K+ and Na+ being within the normal range.

Twenty-five samples of amniotic fluid obtained by amniocentesis from 25 pregnant women with hypertension in the 35 to 40 weeks of pregnancy were studied. The following biochemical determinations were done in the samples: acid-base equilibrium (pH, pO2, pCO2, base deficit, standard HCO3- and total CO2), concentrations of potassium and sodium ions, total and ionised calcium and inorganic phosphorus. The results were analysed depending on the presence of the respiratory distress syndrome in the newborn, and were subjected to statistical analysis. It was found that determination of acid-base equilibrium and concentrations of K+, Na+, total and ionised Ca++ and inorganic phosphorus in the amniotic fluid of hypertensive women are probably without prognostic significance with respect to the development of the respiratory distress syndrome in newborns.

The studied group comprised 47 women in the 3rd trimester of pregnancy (29-40 weeks), including 17 with type I diabetes (study group) and 30 healthy women (control group). In the study group in one case diabetes was diagnosed during pregnancy and treated with diet only, in the remaining 16 pregnant women the mean diabetes duration was 6.2 years and the mean daily insulin dose was 70 u. According to White's classification one patient was in class A, 10 in class B and 6 in class C. In all cases renal function was normal, with normal blood values of creatinine, urea, electrolytes, uric acid, protein and acid-base equilibrium. Endogenous creatinine clearance was also normal. The studied biochemical parameters of renal tubular function included: 1) deamination of amino acids--with measurement of ammonium ion (NH4+) excretion with urine, 2) carbonic acid metabolism--with determination of urinary excretion of hydrogen ions (H+), 3) urinary excretion of sodium (Na+) and potassium (K+) ions. Besides that 24-hour urine was always measured. The studied women were similarly hydrated (standard diet, fluid balance control). The results were subjected to statistical analysis. In women with type I diabetes the volume of 24-hour urine was increased, although it fell within the normal range, urinary excretion of Na+ and K+ was raised. No change was found in amino-acid deamination an carbonic acid metabolism since the excretion of NH4+ and H+ was normal.

The study was carried out in 194 healthy women, including 50 non-pregnant, 31 pregnant in the 1st trimester, 32 in the 2nd and 30 in the 3rd trimester, and 51 in the 3rd day of puerperium. Their age was 19-43 years, they gave no history of renal disease nor urinary tract disease. The biochemical tests evaluating the function of renal tubules and glomeruli were done in 24-hour urine: 1) 24-hour urine volume, 2) NH4+, 3) H+, 4) K+ and 5) Na+ ions. Endogenous creatinine clearance was determined as well in all cases. The results were subjected to statistical analysis. Increased tumular metabolism of carbonic acid begins in the 16th week of pregnancy, increases further till the end of pregnancy and is still high on the 3rd day of puerperium. Amino acid metabolism increase in the tubules was noted only in the 3rd trimester of pregnancy, and it was normal again on the 3rd day of the puerperium. K+ and Na+ excretion was raised in the 3rd trimester, and on the 3rd day postpartum potassium excretion was still high while that of sodium was normal. Endogenous creatinine clearance rose in the 2nd and 3rd trimesters and failed to return to the value before pregnancy on the 3rd day postpartum. The observed changes in the biochemical functions of renal tubules and glomeruli in physiological pregnancy may be responsible for the typical changes of blood acid-base equilibrium in pregnancy (compensated metabolic acidosis with respiratory alkalosis).

In order to obtain the sera for determining the histocompatibility antigens, 290 samples of blood collected from 278 women were examined for anti-HLA lymphocytotoxic antibodies. These were found in sera of 55 women (20%) and their specificity was identified in 15 samples. No effect of antepartum hemorrhage, premature births and abortions on the production of antibodies was found. The presence of cytotoxic antibodies had no effect on the course of pregnancy and timing of delivery.

Blood glucose levels were measured in fasting state and 2 hours after breakfast, together with glucose tolerance tests (after a load of 100 g of glucose) and 24-hour glycaemia profile in pregnant women with intrahepatic cholestasis of pregnancy in the third trimester of pregnancy. In all these tests abnormalities were found indicating a considerable impairment of carbohydrate metabolism during this complication of pregnancy. The changes manifested themselves as increased blood glucose level 2 hours after breakfast, increased glucose level in 24-hour glucose profile, and raised blood glucose levels in glucose tolerance tests in all studied time intervals besides the first and last determinations.

The study was carried out on 23 samples of amniotic fluid taken between 35th and 39th week of pregnancy from 23 pregnant women with arterial hypertension (13 cases of hypertension induced by pregnancy, 5 cases of primary hypertension and 5 cases of hypertension accompanying renal diseases). Seven women undergoing the study gave birth to newborns with symptoms of delayed intrauterine growth below 10 centile (group examined), 16 mothers gave birth to eutrophic babies (control group). In the amniotic fluid of the group examined, bilirubin revealed a significantly higher level. The authors found no changes in the concentrations of ammonia, ions H+ and HPL between the group examined and the control group whereas they were able to observe a significantly lower level of glucose and oestrogens in the amniotic fluid in case of delayed intrauterine foetal growth.