Carl P. Huber

Heart rate response of the human fetus to induced maternal hypoxia.

Abstract Induced maternal hypoxia, using 15 per cent oxygen in nitrogen as a stimulus, causes a predictable pattern of response of the fetal heart rate. In clinically normal pregnancy, the fetal heart rate changes little, if at all, during the stimulation or poststimulation periods. In abnormal pregnancy, the stimulus is augmented by impaired placental function and causes a severe fetal response, clearly reflecting the secondary hypoxic status of the fetal environment. The theoretical basis for the stimulus-effect relationship is discussed. The correlation between test results and subsequent development of fetal distress is presented with the proposal for using this test in the prospective management or investigation of abnormal pregnancies.

Lesions of the circulatory system of the placenta

Summary Lesions of the circula tory sys tems of the plac nta have been studied in a series of placentas delivered during the third trimester of pregnancy or at term. Fiv types of lesions were recognized in the 100 placentas used for sta tistical frequency: 1. Intervillous fibrin deposition was encountered in varying degrees in all of the placentas studied. The lesion is found in areas of the in tervillous space where the circulation wou ld tend to be slow. 2. Thirty-seven infarcts resuiting from obstruction of a maternal artery in the decidual plate were seen. There was usually only one in a placenta, but occasionally several such lesions were present. 3. Ninety-two intervillous thrombi were found. Sometimes multiple lesions of this type were present, but usually less than 3 were present in a placenta. The lesion is probably du to slowed eddying currents in the intervillous space as a result of obstruction of maternal veins in the decidual plate. 4. A lesion following partial premature separation of the placental site was found in two of the placentas. This lesion is due to separation of both maternal arterioles and veins in the decidual plate. 5. Fetal vessel thrombosis involving a major villous stalk was encountered in six of the placentas. A diffuse lesion of the same type is seen in the placenta fo lowing intrauterine death. The lesions demonstra ted and the points of obstruction of the circulation are consistent with current concepts of placental circulation.

Carcinoma of the endometrium in premenopausal women

Abstract Twenty to 25 per cent of endometrial carcinomas occur in premenopausal women. Insufficient emphasis has been given this in the past. Therefore, delays of many months frequently occur before the origin of abnormal bleeding is clarified among women in their fourth and fifth decades. All cases of premenopausal endometrial carcinoma seen at the Indiana University Medical Center from 1945 through 1966 were reviewed. Diabetes, nulliparity, and obesity were noted to occur with almost the same frequency as among postmenopausal patients with endometrial cancer. Hypertension appeared to be less common in the younger patient but the incidence of thyroid disease seemed to be abnormally high. The absolute 5 year survival rate, among those patients eligible for such an assessment, was 90.2 per cent.

Blood prothrombin levels in the newborn.

Abstract A study of the clinical records combined with laboratory data concerning the clotting activity of the blood of 530 newborn infants confirms the previously reported observation that there is a physiologic decrease in prothrombin activity during the early days of the neonatal period. The prevention of this decrease by the administration of a vitamin K substance has been investigated. A simple clinically applicable test for the rapid assay of the clotting activity of the blood has been presented.