John F. J. Clark

Amniotic fluid and umbilical artery levels of sex hormones and prostaglandins in human cocaine users

Biochemical evaluation of amniotic fluid contents is often used to monitor fetal secretory and excretory functions. To determine whether cocaine use during pregnancy affects fetal endocrine secretions, amniotic fluid and umbilical artery samples were collected at term, and selected gonadal hormones and prostaglandins were assayed. Gestational age, birth weights, and placental weights were recorded. The data showed that birth weights were significantly decreased (P less than 0.001) in cocaine users, but gestational age and placental weights were unaffected. Amniotic fluid levels of androstenedione and testosterone were decreased (P less than 0.05) in males born to cocaine users; females were not affected. Prostaglandins (PGF2 alpha and PGE2) were significantly increased (P less than 0.01) in cocaine users. In the umbilical artery, follicle-stimulating hormone was increased (P less than 0.01) in males and females, while luteinizing hormone was increased (P less than 0.01) only in males. We conclude that cocaine passes through the placenta and affects the fetal testes-hypophyseal endocrine system.

Advanced ectopic pregnancy

Abstract 1. 1. A study of advanced ectopic pregnancies, as herein defined, occurring at Freedmens Hospital during the 10 year period 1948 through 1957, is presented. 2. 2. This series comprises 17 abdominal, 2 intraligamentous, and 11 tubal pregnancies. 3. 3. The incidence of ectopic pregnancies in our hospital is very high, 1 in 84 pregnancies; as is the incidence of abdominal pregnancies, 1 in 1,746 pregnancies. 4. 4. An attempt is made to correlate pathogenesis of the abdominal pregnancies to difficulty of diagnosis and surgical management. 5. 5. Those clinical findings which we felt to be most helpful are discussed.

Studies into maternal influences on the well-being of the fetus and newborn: I. The distribution of abnormal hemoglobins among pregnant Negro women

Abstract Electrophoretic patterns of the hemoglobin from 524 consecutive pregnant Negro women revealed a 4.77 per cent incidence of sickle cell trait and an incidence of 3.62 per cent among 304 nonpregnant Negro controls. Possible implications of the low incidence of sickle cell trait in both the study group and controls are discussed. Among 36 women with abnormal hemoglobin traits, 25.2 per cent of 139 pregnancies ended in spontaneous abortions. Among normal controls, 239 pregnancies resulted in only 6.7 per cent spontaneous abortions. Further studies are needed to clarify the role of sickle cell trait and possibly hemoglobin C trait in the total picture of spontaneous abortions.

Potassium permanganate as an abortifacient, A 5-year review.

Abstract Sixty cases of genital bleeding from the use of potassium permanganate, occurring during the 5 year period 1954 to 1959, have been reported. The medical profession should be kept aware of this entity, for it may be the cause of serious genital hemorrhage and late sequelae. Some of the complications and clinical vagaries of chemical burns of the vagina and cervix are presented, as well as an outline of principles of treatment.

Superimposed toxemia, abruptio placentae, hypofibrinogenemia, acute renal shutdown, and paralytic ileus complicating a case of prepregnancy hypertension

Abstract This case exemplifies the numerous problems that can occur in a pregnant woman with prepregnancy hypertension on which is suddenly superimposed toxemia of pregnancy. An alteration in the clotting mechanism was constantly watched for. Acute renal shutdown was one of the complications we were concerned with after the episode of bleeding and the period of shock which might cause damage to the pituitary, brain, and kidney. Paralytic ileus that developed after the anuria possibly could be explained by bleeding into the peritoneal cavity. It is not an uncommon factor. Ruling out whether or not the patient had a volvulus of the sigmoid was another problem.