J.S. Scott

Influence of previous blood-transfusion on incidence of pre-eclampsia.

The incidence of pre-eclampsia in 125 primigravidas who had previously received blood-transfusions was significantly less than in a matched series of controls--i.e., 12.8% compared with 23.2%. This suggests that immunological factors may be involved in the aetiology of pre-eclampsia.

Immunology of pre-eclampsia.

Abstract Immunological tests (lymphocyte response to phytohaemagglutinin, HLA antibody production, mixed lymphocyte reaction, HLA types and degree of matching) in women with severe pre-eclampsia show that their immunological activity is reduced or suggest that there is a high degree of immunological compatibility between mother and child. This hypoimmune response state is consistent with the epidemiological features of pre-eclampsia; and a relation might exist between the hypoimmune response and disorders of other systems in pre-eclampsia.

OVULATION STIMULATION PROBLEMS OF PREDICTION OF RESPONSE TO GONADOTROPHINS

Abstract A regimen of incremental gonadotrophin dosage controlled by concurrent daily œstrogen monitoring was used in the treatment of anovulation. A linear relationship was observed between the log of the 24-hour urinary œstrone excretion and time. If confirmed, this could be used as a basis for predicting oestrone levels on subsequent days. The steepness of the slope was significantly greater in cycles resulting in multiple conceptions, and this would distinguish hyperstimulation from a normal response. Proximity of the administration of the luteinising-hormone preparation to the time of the initial œstrogen excretion peak seems to be important in securing ovulation. Ovulation occurred only when luteinising hormone was administered within 48 hours of the peak. Predicting the time of the peak is difficult when an incremental dose regimen is used. In this series, the intercept of the log oestrone regression line with the 10 μg. level was followed by the peak in 5±2 days. Day 5 from the time of this intercept is therefore taken as the optimum time for the luteinising injection.

PRACTICABILITY AND COST OF ŒSTRIOL ASSAYS FOR SAVING BABIES IN A MATERNITY HOSPITAL

Abstract After scrutiny of the relevant records for a three-year period, it was concluded that 15 out of 244 stillborn babies would have survived if the maternal œstriol excretion had been known. The requisite daily assays by a simple and rapid method (1100 per annum) would have cost £800 per annum, or £160 per baby saved. Since larger numbers could be handled with the same resources in a central service, the cost could be reduced to £50 per baby saved. It was concluded that even when the resources for chemical pathology are limited a service for the determination of œstriol of the type described should have high priority.