This article describes a study designed to test a method for assessing the cost to the health services of illegally induced abortion and the feasibility of estimating the incidence of induced abortion by a field interviewing approach. The participating centers included three hospitals in Ankara, Turkey; three hospitals in Ibadan, Nigeria; one hospital in Caracas and one in Valencia, Venezuela; and two hospitals in Kuala Lumpur, Malaysia. Hospitalized abortion cases were classified as induced or spontaneous or as "probably induced," "possibly induced," or "unknown" according to a classification scheme comprising certain medical criteria. The sociodemographic characteristics of induced and spontaneous abortion cases were subjected to discriminant function analysis and the discriminating variables best characterizing the induced versus the spontaneous abortion groups were identified for each center. On the basis of this analysis, the "probably" and "possibly" induced and "unknown" categories were further classified as induced or spontaneous abortion, with stated probabilities. Thus an overall estimate is made of the proportion of all hospitalized abortions that can be considered illegally induced outside the hospital. Selected results on costs of induced and spontaneous abortion are shown. The method further tested the feasibility of obtaining valid survey data on abortion from the communities studied by re-interviewing the women hospitalized for induced and spontaneous abortion six months later in their homes. This exercise showed a degree of under-reporting of abortion that varied widely among centers, even among women who had admitted illegal induction at the time of hospitalization. The feasibility of estimating the incidence of illegal abortion by field studies is discussed in the light of these findings.

A hysteroscopy technique is described which enables intrauterine and transcervical operative procedures to be carried out with ease and accuracy. The uterine cavity is expanded by a viscous solution of dextran which provides several advantages over other media. Techniques for resection of intrauterine adhesions and uterine septa are described and case reports are given. The apparent anti-adhesive properties of dextran would be considered an advantage in most operative procedures, possibly with the exception of transcervical electrocautery for tubal sterilization.

A modified endoscopic technique for the inspection of the uterine cavity is described. The modification consists in the injection of a clear, water‐soluble and viscous dextran solution into the uterine cavity, through which a clear view of the latter is obtained. Thirty cases were examined by this method following hysterography. Comparative studies of the observations made at hysteroscopy and the hysterographic findings in these cases showed that hysteroscopy is of greater diagnostic value than hysterography because the nature and extent of any intrauterine lesion present can be assessed directly.

A decreased insulin response to glucose administration has been suggested to be a prerequisite for the development of diabetes mellitus. Factors that increase the demand for insulin in the organism may precipitate diabetes in subjects with a low insulin response to a glucose infusion test (GIT). Since it is well-known that pregnancy is a diabetogenic factor, its effect on the carbohydrate metabolism of subjects with a low insulin response was studied. During pregnancy, the insulin response of the low responders was enhanced as in the controls, but at all stages the insulin response was significantly less than in the controls. None of the subjects developed glucose intolerance during pregnancy. The fasting blood glucose and plasma insulin levels and the k-value in intravenous glucose tolerance tests (IVGTT) were modified according to similar patterns in both groups. The sensitivity to endogenous insulin was significantly greater in the low insulin responders but was reduced to a greater extent than in the controls towards the end of pregnancy. In four of the 11 low insulin responders the initial insulin response to glucose in the last trimester was lower than in mid-pregnancy. This occurred only in one out of 14 high insulin responders. It is suggested that gestational diabetes occurs in those low insulin responders who demonstrate either a dramatic decrease in insulin sensitivity, or limitations in the enhancement of insulin release, or, more likely both conditions.

Twenty-eight healthy women, 17 with high and 11 with low insulin response to glucose but with normal glucose tolerance, were followed throughout pregnancy. Plasma FFA, glycerol and D-beta-hydroxybutyrate as well as plasma insulin and glucose in blood were determined before and during a glucose infusion test (GIT) in each trimester and after pregnancy. In 13 infants of high insulin responders (IHR) and 10 infants of low responders (ILR) an intravenous glucose tolerance test (IVGTT) was performed, and the above lipid parameters were studied at birth and during the IVGTT. The low responder group was postulated to consist mainly of prediabetic individuals (8). Their infants have previously been shown to have an increased glucose assimilation rate at IVGTT (12, 13), as has been shown for infants of diabetic mothers. There was little difference between the two groups of mothers except for the insulin levels during the GIT in non-pregnant and early pregnant subjects, which were considerably lower in the low responders. They all had decreased fasting levels of FFA, glycerol, and D-beta-hydroxybutyrate in mid-pregnancy and normal values in late pregnancy. The ILR showed the same changes in FFA and glycerol as the IHR, but their D-beta-hydroxybutyrate levels were higher at birth than those of the IHR and lower after birth. Another difference found, was the correlation between birth weight and fasting insulin (and to some extent the insulin level at birth) in the ILR group, which was not found in the IHR. Apart from those differences the ILR and the IHR seemed to handle their fat metabolism in a similar way in the early neonatal perinatal period.