The MML technique is faster to perform and similar in terms of febrile morbidity, time to bowel restitution, or need for postoperative medications. It is likely to be more cost-effective.

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The gamma chain compositions of the fetal hemoglobins of 2453 newborn babies from East Asian countries (1350 babies), from Italy, Yugoslavia, Bulgaria, and Georgia (417 Caucasian babies), and 686 black babies from Georgia were determined by high pressure liquid chromatography. Unusual results for a limited number of babies were confirmed by chemical analyses, and were evaluated further by family studies. Statistical analyses indicated high gene frequencies for the A gamma T chain in Italian (f = 0.237), Yugoslavian and Bulgarian (f = 0.238), and white Georgia babies (f = 0.224), a lower frequency in Japan (f = 0.178), and India (f = 0.173), and particularly in mainland China (f = 0.079). The A gamma T gene frequency in normal (AA) Black babies was 0.102. When a beta S or beta C mutation was also present this frequency was greatly decreased, particularly in babies with the AC condition (f = 0.036). These results suggest the near absence of the A gamma T mutation on the chromosome also carrying the beta C determinant. Most babies had the expected G gamma values which vary between 60 and 80%, but several (mainly black) babies had higher values (between 80 and 90%), while one normal black baby had a G gamma value of (nearly) 100%. This condition may be a form of A gamma +1-thalassemia and has been discussed in detail elsewhere (Blood 58:491-500, 1981). Thirty-five clinically normal (mainly Chinese, Indian, and Japanese) babies had G gamma values of about 40%. Twenty-six babies had A gamma I values of about 60%, while the remaining nine babies had A gamma T and A gamma I chains in a ratio of either 1 to 2 or 1 to 1. Two additional newborns did not produce any G gamma chains, but had only A gamma I chains or A gamma T chains. Family studies failed to indicate a specific hematological abnormality. These unusual ratios between the G gamma and A gamma (either A gamma I or A gamma T) chains have led to speculations regarding possible genetic abnormalities present in these infants.

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Background. Modifications to the classic cesarean section technique described by Pfannenstiel and Kerr have been proposed in the last few years. The objective of this trial was to compare intraoperative and short-term postoperative outcomes between the Pfannenstiel-Kerr and the modified Misgav-Ladach (MML) techniques for cesarean section.Methods. This prospective randomized trial involved 162 patients undergoing transverse lower uterine segment cesarean section. Patients were allocated to one of the two arms: 88 to the MML technique and 74 to the Pfannenstiel-Kerr technique. Main outcome measures were defined as the duration of surgery, analgesic requirements, and bowel restitution by the second postoperative day. Additional outcomes evaluated were febrile morbidity, postoperative antibiotic use, postpartum endometritis, and wound complications. Student's t, Mann-Whitney, and Chi-square tests were used for statistical analysis of the results, and a p < 0.05 was considered as the probability level reflecting significant differences. Results. No differences between groups were noted in the incidence of analgesic requirements, bowel restitution by the second postoperative day, febrile morbidity, antibiotic requirements, endometritis, or wound complications. The MML technique took on average 12 min less to complete (p ¼ 0.001). Conclusion. The MML technique is faster to perform and similar in terms of febrile morbidity, time to bowel restitution, or need for postoperative medications. It is likely to be more cost-effective.

Intra-partum haemoperitoneum resulting from rupture of the utero-ovarian vessels is a rare obstetrical emergency that needs rapid resuscitation with fluid and/or blood replacement and prompt surgical intervention.

Through adverse effects on the developing brain, maternal nutritional deficiency may increase the risk of schizophrenia apart from any genetic predisposition. After the Dutch Hunger Winter in 1944-1945, in which there was a major but time-limited decrease in food intake, the most exposed offspring had a twofold increase in the risk of becoming schizophrenic. The present investigators sought a similar association in the Wuhu region of Anhui, one of the Chinese provinces most affected during an extreme famine in the years [1959][1960][1961]. Rates of schizophrenia were obtained from psychiatric case records for the period 1971 through 2001. Researchers were unaware of exposure status. The Wuhu area has a population of 62 million. Up to the last decease, there has been little migration in or out of the region. The records review also took note of a family history of major mental illness.Birth rates declined by approximately 80% in [1960][1961]. Mortality began to increase in 1959 and peaked in 1960. Overall mortality for Anhui was 12%, and for Wuhu and surrounding counties, 15%. The absolute number of cases of schizophrenia in children born during the famine years decreased but, as a proportion of total births in each year, the cumulative risk increased in the years 1960-1961 compared with the preceding and following years. The sexes were equally affected, and no difference in age at onset of schizophrenia was noted. Cumulative mortality rates were 35% to 40% in children conceived or born during the famine years. The figures for those born in the years just before the famine were 20% to 30%. The mortality-adjusted relative risk of schizophrenia was 2.3 (95% confidence interval [CI], 1.99-2.65) for children born in 1960 and 1.93 (95% CI, 1.68-2.23) for those born in 1961. There was no change in the proportion of familial cases in the years under study.These findings indicate strongly that prenatal exposure to famine conditions increases the risk of schizophrenia later in life. The increase in risk is nearly the same as in the Dutch studies, from an ethnically and culturally distinctive population, but it is based on a much larger sample and on clear evidence of exposure. EDITORIAL COMMENT(This is a fascinating and unique study in which the authors took advantage of a particularly fortuitous convergence of research circumstances to draw conclusions about one aspect of the consequences of the horrific Chinese fam-ine of 1959-1961. Those circumstances included a stable population with minimal immigration or emigration, a single psychiatric hospital serving the entire region, and remarkably complete and continuous inpatient and outpatient psychiatric OBSTETRICS Volume 61, Number 1 OBSTETRICAL AND GYNECOLOGICAL SURVEY ABSTRACT Pregnancy-related stroke is rare, but it can be a devastating event. Apart from mortality estimates of 8% to 15%, survivors may have marked and permanent disability. The authors reviewed data from the Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality for the y...