Peter Paterson

MATERNAL AND FŒTAL KETONE CONCENTRATIONS IN PLASMA AND URINE

Abstract The plasma and urinary ketone concentrations of twenty-two pregnant women were measured under standard conditions. The findings suggest that pregnancy is associated with an increased susceptibility to develop ketosis. The maternal and foetal plasma-ketone concentrations were closely related, at the time of delivery, with a gradient from mother to foetus which produces a transfer of ketones in that direction. Both levels were elevated when labour was prolonged, but no relation with acid-base status or with blood-glucose was found. Foetal levels were relatively elevated when preeclampsia was present, suggesting that fœtal-fat catabolism may take place in circumstances where placental function is disturbed. The intravenous infusion of 50 g. of dextrose reduced elevated maternal plasma-ketone levels.

Oxygen transfer from mother to fetus during labor

The present study was aimed at determining the effect of maternal inhalation of 10, 50, and 100 per cent oxygen upon fetal blood PO 2 and acid-base status during labor. As maternal capillary blood PO 2 increases or decreases, fetal scalp capillary blood PO 2 changes in the same manner. In both normal and abnormal patients inhalation of oxygen enriched mixtures increased fetal blood PO 2 . The most effective way of increasing fetal blood PO 2 was by administering 100 per cent oxygen by mask. The increase in fetal blood PO 2 was usually rapid. Fetal base deficit sometimes increased during the experiments. This change was associated with a decrease of fetal capillary blood PCO 2 .

A Review of 600 Laparoscopic Sterilizations

Summary: A personal series of 600 laparoscopic sterilizations is presented. The English language literature on laparoscopy is reviewed with emphasis on the complication rate associated with the procedure. Based on these analyses, a number of recommendations are put forward which should minimize the incidence of complications.

Hysteroscopy — An Evaluation

Summary: An assessment has been made of the technique of hysteroscopy. Five per cent dextrose and 32% dextran are the most satisfactory intrauterine media to employ. The procedure is a most valuable diagnostic aid in gynaecology and promises to have a place as a method for achieving female sterilization.