Classical versus low-segment transverse incision for preterm caesarean section: maternal complications and outcome of subsequent pregnancies

Summary. In a retrospective, controlled, follow-up study of 326 women who had a primary preterm caesarean section, the risks of postoperative maternal morbidity and uterine rupture or dehiscence in subsequent pregnancies were investigated in relation to the mode of incision (classical compared with low-segment transverse incision). The classical incision was associated with a higher frequency of postpartum fever in the immediate postoperative period (16% compared with 6%, P<0·01). Of the 326 patients reviewed 286 (88%) were contacted for information about subsequent pregnancies. Information was obtained for 70 pregnancies subsequent to a classical caesarean section, and 71 pregnancies subsequent to a low-segment transverse caesarean section, which had continued for more than 20 weeks gestation. Of the pregnancies after the classical operation 13% had abnormal scars compared with none of those after the low-segment transverse operation ( P =0·0014). The frequency of scar dehiscence was 6% after a classical scar compared with none after a low-segment transverse scar (P=0·0581).     

Factors affecting birthweights in Hindus, Moslems and Europeans

Summary. The birthweights of 664 Hindu and 132 Moslem babies were compared with those of 486 European babies born at the same hospital. The mean birthweight of the Europeans was 3362 g, compared with 3146 g for the Moslems and 2960 g for the Hindus. The Asian women were smaller than the European and tended to have a shorter length of gestation. Forty-four per cent of the Asians and 46% of the European mothers were of social classes I and II; 28% of the Europeans and 2% of the Asians smoked. There were no significant differences between Asians and Europeans in the effects of maternal size, parity, gestational age and fetal sex on birthweight. After adjustment for these variables and for cigarette smoking there was no significant difference in birthweight between the Moslems and the Europeans, but the mean birthweight of the Hindus was about 190 g lighter than that of the Europeans. Hindus from East Africa had lighter babies than those from India.     

AMBLYOPIA IN THE FOUR TO NINE YEAR AGE GROUP. A FOUR-YEAR SURVEY

A guide to the ophthalmologist in the choice of the older child with amblyopia most likely to respond to active intensive visual stimulation in short bursts is presented. A series of 99 children treated on a CAM vision-stimulator is described. Visual improvement of at least two rows of letters on the Snellen chart was maintained for at least three years after treatment in 62% of these patients aged between five and nine years with visual fixation within 3^° of the fovea. Amblyopia following minor trauma or minor pathology also responded well. Children maintaining the visual improvement were those with esophoria up to 13^°. those with hypermetropia up to 11.0 D and those with astigmatism of 1.5 D. Also responding well were children with anisometropia with up to 3.0 D of either hypermetropia or astigmatism     

Lipoid Proteinosis; a clinical, pathological and genetic study

The clinical, pathological, and genetic findings in two closelyrelated families in which a number of cases of lipoid proteinosisoccurred are described. The necropsy findings, particularlythe neuropathological aspects, in a patient who died from acoincidental pancreatic carcinoma are detailed. The geneticaspects are reviewed.     

Bacteriuria in pregnancy treated with a single dose of cephalexin

Summary. Of 87 women in whom bacteriuria was diagnosed on dip slides at between 9 and 22 weeks gestation only 51 (59%) had true bacteriuria in urine obtained by suprapubic aspiration. A single oral dose of cephalexin (3 g) was given to 37 of these patients, 10 were Indian and none of them had recurrence of infection after treatment, whereas 11 of the 27 (41%) 'indigenous' women again had bacteriuria within 2 weeks of treatment. None of the other 26 patients had recurrent bacteriuria in the pregnancy studied. Success of treatment was not related to renal concentrating ability nor, apart from ethnic group, were there other significant differences between successes and failures. Although single-dose treatment seems to be less effective in pregnancy than in the non-pregnant patients, it is an acceptable method of treatment provided that all treated patients are followed closely to detect those who do not respond and require further therapy.     

FIXATIVE-SOLUBLE TRITIUM POOL SIZE AFTER TRITIATED THYMIDINE INJECTION INTO MICE WITH SKIN STIMULATED BY PLUCKING

Summary.— The size of the fixative-soluble tritium pool in skin has been studied in the hair growth cycle induced by plucking. The size of the pool appears to increase dramatically immediately after plucking and remains fairly high during the early phase of the growth cycle. In the middle of the cycle there is a second increase in size. Part of this radioactive pool is thought to be ³HTdR, or a substance capable of labelling S phase cells. The pool persists for several days. The thymidine incorporation quotient (T.I.Q.) shows much less scatter than the fresh or fixed tissue values or their difference. The T.I.Q. also changes during hair growth. The implications of these findings for cell kinetic studies using tritiated thyminine and autoradiography are discussed.     

Hemoglobin Hope: A Beta Chain Variant

A new hemoglobin, hemoglobin Hope, with a beta chain abnormality hasbeen found in three generations of a St. Louis Negro family. The abnormalhemoglobin in the heterozygous state caused neither clinical stigmata norabnormality in the red blood cells. Hemoglobin Hope was detected by agargel electrophoresis at pH 6.2, but could not be differentiated from hemoglobinA by starch block electrophoresis at pH 8.6. Also, it could not be separatedfrom hemoglobin A by paper, or starch gel electrophoresis employing a rangeof buffers from pH 6.2 to 8.6. Amino acid analysis showed that aspartic acidwas substituted for glycine at position 136 of the beta chain. HemoglobinHope may be formulated as ₂^A₂^{136 gly-asp}.

Submitted on March 30, 1964 Accepted on September 30, 1964