Kenneth R. Niswander

SEX DIFFERENCES IN THE INCIDENCE OF NEONATAL ABNORMALITIES AND ABNORMAL PERFORMANCE IN EARLY CHILDHOOD.

Data from the Collaborative Study of Cerebral Palsy were analyzed for sex differences in physical, psychological, and neurological development from birth to 4 years of age. Significant sex differences, showing the male to be at a disadvantage, were found in performance on all scales. The possibility that these differences in performance were related to neonatal experience was supported by the finding of significant sex differences in neonatal condition. Males, although they have the advantage of higher birthweight, do less well than females from birth through 4 years of age. Although these sex differences must have a basic genetic origin, it was suggested that such factors as obstetrical problems, neonatal distress, and maternal attitudes may have a mediating effect. Possible etiologic mechanisms were discussed.

Fetal morbidity following potentially anoxigenic obstetric conditions: I. Abrupito placentae☆☆☆

Abstract 1. 1. The incidence of abruptio placentae among 17,265 parturients and its relationship to race, parity, maternal age, duration of pregnancy, and toxemia are presented. 2. 2. The correlations with prematurity and with toxemia of pregnancy are reconfirmed. 3. 3. The perinatal mortality associated with this disorder and the neurologic status of the infants who survive is evaluated. The risks inherent in this potentially anoxigenic condition and the chances for the surviving infant to be neurologically intact are discussed.

Progestational agents and blood coagulation. V. Changes induced by sequential oral contraceptive therapy.

Blood coagulation changes induced by sequential oral contraceptive (OC) therapy were studied. 112 healthy women volunteers were monitored over a 2-year period while on a regimen of sequential OC therapy (50 mcg ethinyl estradiol daily from Day 5 through 14 and 50 mcg ethinyl estradiol plus 1 mg morethindrone acetate on Day 15 through 25). The treated group showed marked increases toward hypercoagulability in the Hicks and Pitney thromboplastin generation time screening test at 3 and 9 months, Factor 5 at 9 months, Factor 8 at 3 and 9 months, and fibrinogen at 3 months. Decreases from base lines were seen in antiplasmins at 24 months and in alkaline phosphatase at all intervals (3, 9, and 24 months). It was suggested that the decrease in serum antiplasmin indicates a compensatory tesponse in the fibrinolytic system to the hyperactivity of the coagulation system.

Treatment of fibrinolytic hemorrhage with proteinase inhibitors: a preliminary report.

TABLE 1 shows the antifibrinolytic agents studied and the distribution of patients treated. In early experiments,2 we have investigated antiplasmin preparations isolated from human and bovine blood and the lima bean inhibitor. When epsilon-aminocaproic acid (EACA) and TrasylolB became available for clinical investigation, we concentrated our efforts on these agents. Of 151 patients treated, 80 received EACA and 57 Trasylol. In the series where conventionally treated controls were included in the study, 75 patients were entered. EACA was obtained from the Lederle C0.t and Trasylol from the Metachem C0.S Methods employed to estimate members of the fibrinolysin system have been reported previou~ly.~.~

Changes in the fibrinolysin system during experimental pulmonary hyaline membrane formation in guinea pigs.

Summary Pulmonary hyaline membranes developed in guinea pigs exposed for several days to 95% oxygen at atmospheric pressures. This process was accompanied by increased antiplasmin activity in plasma and decreased pulmonary plasminogen activator activity. The latter phenomena may promote the formation of alveolar hyaline membranes by interfering with enzymatic removal of fibrin derived from pulmonary exudation. We wish to acknowledge the devoted assistance of G. Hauser, H. B. Lassman, I. B. Mink, and V. Zaniewski.

Dysfunctional labor. IX. Delivery outcome.

Abstract A series of 1,194 patients were studied in labor by means of clinical observations and separately by cervical dilatation time and descent time function curves. Clinical diagnostic criteria of abnormalities were found to be discrepant from the more objective graphic criteria. Delivery outcome was determined on the basis of clinical and graphic diagnoses of abnormality, respectively. From the prognostic point of view, the diagnosis arrived at by cervimetric means was shown to be more likely to be correct, and therefore more useful, than the diagnosis made clinically.