Hjördis Robbe

Mucoviscidosis and Intestinal Atresia.: A Study of Four Cases in the Same Family

Observations made during recent years have again directed attention t o such prenatal mechanical factors as volvulus, intussusception and strangulation as the cause of intestinal atresia and the recanalization theory of Tandler [21] and Forssner [lo] has been refuted [15,16,17, 191. The combination of mucoviscidosis and congenital intestinal atresia has further contributed to these etiological discussions [4, 5, 14, 241. The purpose of this paper is t o describe the pathological findings in a family in which four of five siblings suffered from mucoviscidosis and two of them also had intestinal atresia. This familial concentration and the pathological findings support the theory that intestinal atresia in mucoviscidosis is probably secondary t o meconium ileus as suggested by Bernstein e t al. [4] and they furthermore t o a certain extent make i t possible t o date the development of atresia.

Physical Working Capacity, Blood Volume and Heart Volume in Cardiac Patients During and After Pregnancy

The overall-incidence of heart disease in women of child-bearing age is low, being a few per cent only, but on the other hand, heart disease is usually found to be from the first to the fourth most frequent cause of death during pregnancy, delivery and the puerperium (for references, see the recent reviews by G u t t m a c h e r , 1955; M e n d e l s o n , 1957; B u r w e l l and M e t c a l f e ,

Prematurity and small heart volume.

A total of 2070 Finnish children with congenital heart disease are included in the material. A little over 12% were premature, while the incidence of prematurity in the general population is about 4.5%. The children with congenital heart disease were more often the firstborn or one of the first of a large family than children in the general population. Moreover, the children with congenital heart disease were relatively more often born during the summer or early autumn. In order to elucidate in more detail the causes of this difference from the normal distribution of deliveries at different times of the year, the birth curve of the children concerned was assessed against the epidemiological situation in Finland. A positive correlation was found between the incidence of acute infectious diseases and the incidence of infants with congenital heart disease born 8-9 months after these infections. The investigations indicate that variations in the epidemiological situation, primarly the incidence of acute infectious diseases and factors relating thereto, appear to be followed by corresponding fluctuations in the incidence of congenital heart disease. The finding that the infants with congenital heart disease were relatively often firstborn or one of the first of a family might perhaps indicate that the mothers and foetuses are more sensitive to the action of exogenous teratogenous factors during the first pregnancy than during later pregnancies.