Behavior of alkaline phosphatase in serum during pregnancy. I. Normal pregnancy]

On 120 patients, during normal pregnancy, from the 17th to the 42nd week of pregnancy, 372 heat labile alkaline phosphatase estimations were carried out by means of the 4-nitrophenol method. In addition to that, after incubation of sera at 65 degrees C for 30 minutes, the activity of the heat stable placental isoenzyme was checked. With progressing pregnancy, the heat stable fraction rises significantly and the heat labile fraction of total alkaline phosphatase increases slightly. There is a correlation between the readings of the two fractions. In 169 cases, the total urinary oestrogen output correlates also with the heat stable alkaline phosphatase.     

The lung profile. I. Normal pregnancy.

The lung profile run by two-dimensional thin-layer chromatography is described, including the L/S ratio and the percentages of disaturated acetone precipitated lecithin, PI, and PG. Results show that the accuracy of this profile increases that of the mature L/S ratio value even further, while decreasing the missed predictions with low L/S ratios to only about 7%.     

Serum amylase changes during pregnancy.

Study of the behavior of serum amylase activity in 200 preganant women in various stages of pregnancy indicated that: (1) serum amylase rises gradually during pregnancy until the twenty-fifth week and thereafter falls slightly; (2) serum amylase values may be found in normal pregnant women during the second and third trimesters that exceed those in normal men and nonpregnant women; (3) during the second trimester of pregnancy there may be an alteration in the relative distribution of the pancreatic and salivary-type isoamylases with the salivary type tending to dominate. Knowledge of these changes is of importance in the clinical assessment of serum amylase values in pregnant women complaining of abdominal pain and other symptoms suggestive of complicating acute pancreatitis. An explanation for the observed changes is not readily available and further study is required.     

Normal amniotic fluid volume changes throughout pregnancy

The purpose of this study was to provide a quantitative characterization of the changes in amniotic fluid volume that occur throughout gestation. From 705 published amniotic volumes for normal pregnancies, we found that after log transformation, amniotic fluid volume had a uniform variability over 8 to 43 weeks' gestation. Thus the 95% confidence interval covered the range of 1/2.57 to 2.57 times the mean volume at any given gestational age. Contrary to expected trends, mean amniotic fluid volume did not change significantly between 22 and 39 weeks and averaged 777 ml, with the 95% confidence interval ranging from 302 to 1997 ml. The data are summarized in nomograms covering 8 to 43 weeks' gestation.     

Normal pregnancy and oxygenation during sleep

Pregnancy is associated with significant alterations in respiratory function. Changes during pregnancy include reduced functional residual capacity (FRC) and residual volume (RV), increased alveolar-arterial difference for oxygen (A-alphaPO2) and in the supine position, reduced cardiac output. In conjunction with sleep-related apneas or hypopneas, these could lead to maternal oxygen desaturation during sleep. Because of the conflicting data from sleep studies in late pregnancy, we performed complete polysomnography on 11 pregnant women at 36 weeks of gestation and again postpartum. We also measured the PaO2, every 2h. The frequency of apneas and hypopneas was significantly lower during pregnancy compared with that on the postpartum control night. PaO2 levels in the supine position, during sleep, were also significantly lower during pregnancy compared to the postpartum period. No correlation was observed between PaO2 levels and apneas or hypopneas or percent of REM sleep.     

Ocular changes during pregnancy

Pregnancy is often associated with ocular changes. Most of them are specifically associated with the pregnancy itself, rare disturb the normal visual function and are transient in nature. The ocular effects of pregnancy may be divided into physiologic changes, pathologic conditions or modifications of pre-existing conditions. Pregnancy is associated with changes in corneal sensitivity and thickness, decreased tolerance to contact lenses, decreased intraocular pressure, can affect refractive error. Pathologic conditions reported to develop during pregnancy include hypertensive and vascular disorders, central serous chorioretinopathy, uveal melanoma and others. The most significant modified pre-existing condition is diabetes mellitus. Pregnant women are at increased risk for the progression of preexisting proliferative diabetic retinopathy, and diabetic women should see an ophthalmologist before pregnancy or early in the first trimester. This review describes various ocular changes that occur during pregnancy and summarizes the ocular disturbances in these three categories.     

Mitral valve prolapse. Echocardiographic changes during pregnancy

Mitral valve prolapse (MVP) has been reported to be the most common cardiac disorder in reproductive-age women. The purposes of this prospective investigation were to determine the effect of pregnancy on cardiac function in women thought to have MVP and to determine whether any such changes would adversely affect pregnancy outcome. During a recent three-year period, 43 (1.2%) of 3,582 pregnant women followed in our clinic had a prior diagnosis of MVP without any other cardiac disorder. On closer evaluation, only 21 women (0.6%) had a previous echocardiogram suggestive of MVP. Serial echocardiograms in these women revealed that pregnancy caused either no change or an improvement in the valve prolapse. No cardiac complications were present, and perinatal outcomes were favorable. MVP may be less pronounced during pregnancy, and an echocardiogram late in gestation seems worthwhile to confirm the diagnosis before delivery.     

Physiologic changes during normal pregnancy

Investigators in the past year have turned their efforts to several age-old obstetric questions. Using modern experimental tools, questions were raised about the validity of N?gele's rule of 280 days as a mean gestational length. One large study agreed with the 280-day mean length, while two other studies disputed it. Current guidelines for appropriate weight gain in pregnancy range from 9 to 14 kg. Several studies found that mean weight gain in healthy pregnant women was greater than these guidelines, with a mean of 15 kg and a normal range from 8 to 25 kg. Women who exercise strenuously throughout gestation were found to have smaller babies than control subjects, with a very mild asymmetric growth retardation. Their labors came on earlier, were shorter in duration, and involved less obstetric and surgical intervention. In an interesting study of maternal hemodynamics, standing was found to be associated with a decrease of more than 15% in cardiac output compared with output in the lateral supine position in the third trimester. Investigators studied exercise in the water and found it to have less effect on fetal cardiovascular parameters than exercise of similar intensity on land.     

Physiological skin changes during pregnancy

Associated with pregnancy skin changes appear at approximately 90% pregnant. For the necessity of proper and complex care of the pregnant woman. The actualization of this knowledge among the family doctors and the obstetricians is crucial. The ability of precise diagnosis of physiological skin changes allows specifying the suspected cases of pathologic etiology and referring them to the dermatological referral centers for in-depth diagnosis and eventual treatment. The physiologic changes of skin appendies were discussed in the presented paper, vascular alterations color, as well as the generative alterations and the changes in the skin.     

Lung function changes during pregnancy]

The lung functions in different pregnant stages were measured in 41 women with pregnancy and 12 normal women without pregnant. Forced Vital Capacity (FVC) was found gradually decreasing as pregnancy advanced (P less than 0.05). After 28 weeks of gestation, the Vital Capacity (VC), Forced Expired Volume in 1 second (FEV 1) significantly decreased as compared with the normal values (P less than 0.01 or P less than 0.05). These results suggested that the lung function changed gradually during pregnancy, especially after the 28th week, significantly in VC, FVC and FEV 1. Maybe there are slight obstructions in the bronchial tubes. After the 28th week of gestation and it may be the reason for occurrence of breathshort and the lung infection.