Eero Vartiainen

The Effects and Side Effects of Diuretics in the Prophylaxis of Toxaemia of Pregnancy

In a series comprising 211 pregnant patients, the prophylactic effect of chlorthalidone on the incidence of gestosis was studied by means of a single‐blind trial. The study continued from the 16th week of pregnancy until term. No beneficial effects were observed. In addition, the maternal serum potassium and sodium levels were found to be significantly lowered in the diuretic group. This made it necessary to administer potassium perorally to most of this group and to two of them even in the form of infusions. No significant differences in the parameters of the newborn infants were observed. On the other hand, the placentae in the diuretic group were definitely larger than in the control group, a fact which may be suggestive or eventual alterations in the glycogen metabolism.

The Effect of Oxygen Ventilation and a Vasodilator on Uterine Perfusion, Foetal Oxygen and Acid-Base Balance: I. A Study in Healthy Gravidae

Abstract. The effect of oxygen and xantinol nicotinate (Complamin®) alone or in conjunction on uterine perfusion and the acid‐base balance and po2 of the fetal blood was studied in gravidae suffering from various diseases. The series consisted of 40 gravidae with hypertension and 32 suffering from other diseases. Oxygen ventilation had an unfavourable effect on uterine perfusion in the latter group, just as was found in normal gravidae in a previous study. A still greater depression of uterine perfusion was observed in the hypertensive patients. The fetal po2 rose slightly and the fetal pH fell during oxygen ventilation. Fetal BE and pco2 showed slight rises. Uterine perfusion was also slightly depressed by Complamin® addition. On the other hand no appreciable changes were noted in the fetal blood chemistry. Oxygen and Complamin® in conjunction caused a depression of perfusion similar to that observed with oxygen alone. The response of the fetal pH was significantly more favourable in the combined group than in the oxygen group, and po2 rose, just as in the oxygen group. The conclusion may be drawn that oxygen ventilation of the mother in the final stage of gestation has an unfavourable effect on the fetal acid‐base balance. It seems possible that this effect is to some extent counteracted by Complamin® administration in conjunction with oxygen ventilation.

Acid-Base Relationship Between Mother and Fetus in Gestosis (Pre-Eclampsia) and in Pregnant Women with a Labile Blood Pressure

Abstract. Simultaneous blood microsamples were taken from the maternal ear and uterine cervix and the fetus of healthy pregnant women, those with labile hypertension, and those with severe gestosis (pre‐eclampsia). The Po2, PH, BE and Pco2 were studied. The fetuses showed no signs of asphyxia. The differences in BE values between the women with gestosis and their fetuses were significantly greater than in the cases of healthy pregnancy. No differences were seen between healthy and gestotic gravida groups in Po2, PH, and Pco2values. This favours the opinion that in gestosis of the mother the fetus has a tendency to metabolic acidosis, which apparently places it in a poorer position than the fetuses of healthy mothers, should acute asphyxia occur. At the time of study the Po2 of the fetuses of gravidas with a labile blood pressure was lower than that of fetuses of healthy gravidas.

Bacterial Cultures from Intrauterine Devices Removed from Patients with Pelvic Inflammatory Disease

Bacterial cultures were obtained from intrauterine devices (IUD) removed from 274 patients admitted to the Department of Obstetrics and Gynecology of the University Central Hospital of Helsinki because of suspected pelvic inflammatory disease (PID). meno‐metrorrhagia, pain or other conditions potentially caused by an IUD. A diagnosis of serious PID was made in 42 patients, mild PID in 119 patients, while 113 were found to have no infection. An association between positive cultures of β‐hemolytic streptococci and Escherichia coli and PID was found. Positive cultures of Neisseria gonorrhoeae were significantly correlated with PID. The risk of developing PID was significantly greater during the first month after insertion of the IUD than when more than 30 days had elapsed from insertion of the IUD. The significance of the microbes cultured from removed IUDs as causal agents of pelvic inflammatory disease is discussed.

The Urine-Plasma Ratio of Some Proteins in Gestosis

Abstract. The urine and plasma content of certain proteins was studied near term in healthy gravidas, in gravidas with essential hypertension, proteinuria, hypertension of pregnancy and gestosis (pre‐eclampsia; toxaemia), besides this the ratio of urine‐plasma concentrations for each protein was calculated. In gestosis only the urine‐plasma ratio of ceruloplasmin differed from those of the other proteins, but in the other diseases studied this ratio showed no difference from that in healthy gravidas. The amounts of different proteins excreted in urine did not correlate with the molecular size of the respective protein.

Post-Operative Wound Complications

Abstract. The wound complications occurring after a total of over 32 000 gynaecological operations from 1955 to 1967 have been analysed. The average rate of infection was 2.9%. Staphylococcus aureus was found in 29% of cases and in 24% of swabs E. coli was observed. Altogether Gram‐negative bacilli were found in 27% of the infected wounds. Clear differences can be noticed in the numbers of complications following different operations, the fewest complications occurring after abortion made by hysterotomy and operations for malignant disease, and the greatest number after total hysterectomies and operations for incontinence. Prophylactic appendicectomies increased the rate of wound infections to 4.3%.