SUMMARY The progress in pregnancy of a female with myophosphorylase deficiency (McArdle's disease) is described. In spite of the increased muscular effort expended, both pregnancy and labour were normal and the muscle symptoms unchanged, suggesting that compensatory mechanisms might have operated. These possible mechanisms are discussed. Women suffering from the myopathy need not expect any deterioration during pregnancy.
Summary
A prospective study of 1353 labours and the relevant newborn failed to reveal any significant difference between the incidence of neonatal hyperbilirubinaemia (defined as a level of 12 mg. or more per 100 ml.) following spontaneous labour, and after labour induced or accelerated by oxytocin. The incidence of unexplained neonatal hyperbilirubinaemia after spontaneous labour was 6.3 per cent. Following induced labour however there was a highly significant (P<0 00l) association between the mean total dose of oxytocin used for induction and the incidence of neonatal hyperbilirubinaemia. The proportion of babies who developed hyperbilirubinaemia increased in direct relation to the total dose of oxytocin used for the induction. In this series the incidence of hyperbilirubinaemia increased sharply when the total dose of oxytocin exceeded 20 units as it did in 12 per cent of induced labours. No association was demonstrated between neonatal hyperbilirubinaemia and birthweight, or duration of spontaneous labour. When labour was induced, however, the proportion of newborn babies with hyperbilirubinaemia increased with the duration of labour. The significance of these findings is discussed.
Summary
A case of acardius amorphus is reported. The rarity of foetal monsters without a functioning heart is emphasized and the method of classification reviewed. The theories of teratogenesis are discussed. Evidence is presented in support of the theory that there is a primary failure of the organ to develop. The possibility of anoxia and nutritional deficiency of the foetus being solely responsible for the malformation seems unlikely.
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