In the Randers area of Denmark urinary iodine excretion (which reflects iodine intake) was found to be much lower than recommended intake levels, both in women in late pregnancy [52(23-118) micrograms iodine/g creatinine, median, range, n = 20] and in non-pregnant controls [42(23-71), n = 20]. Serum thyroglobulin which is high in iodine deficiency was 32.5 micrograms/l (median) (range 10.5-78.0) in the control women and considerably higher in the pregnant women [67.0 micrograms/l (9.0-385)]. This increase was probably due to the extra iodine requirement of pregnancy which was not satisfied with an adequate increase in iodine intake. The results may suggest that pregnant women in this area should receive iodine supplementation and that a general program of iodine supplementation should be considered.

Iodine requirements are increased during pregnancy and lactation and adequate iodine intake is important for normal brain development of the fetus/newborn child. The aim of the present study was to evaluate the extent to which this increase in iodine requirement is met in pregnant women living in various regions of Denmark. One hundred and fifty-two healthy pregnant women admitted to five different Danish departments of obstetrics participated in the study. Iodine status was evaluated by measurement of iodine in spot urine at day five after delivery and by careful history of the intake of iodine containing vitamin/mineral tablets. Approximately one third of the women had received tablets containing iodine. In women who had not received iodine supplementation urinary iodine was low with a median value of 39.7 micrograms/g creatinine (Aalborg 28, Randers 33, Ringkøbing 34, Arhus 43 and Copenhagen 62 micrograms/g creatinine). These values are far below internationally recommended levels. The consequences remain to be evaluated and no firm recommendations can be given. It seems reasonable, however, to recommend a high intake of food containing iodine (e.g. milk products) during pregnancy and lactation. Since nearly all the women took some kind of vitamin/mineral supplementation it could be considered to advocate intake of vitamin/mineral tablets containing iodine.

A. Iodine status of neonates in Denmark: regional variations and dependency on maternal iodine supplementation. Acta Prediatr 1994;83:578-82. Stockholm. ISSN 0803-5253Iodine status of 147 neonates born in five different regions of Denmark was evaluated in relation to the iodine content of breast milk and iodine supplementation taken by the mother. Approximatcly twothirds of the women had not received iodine supplementation. They had low iodine concentrations in breast milk and urinary iodine concentrations of the neonates at day 5 were low. The median values (milk/urine) were 33.6/31.7 &I (Randers 22/26, Ringknrbing 29/16, Aalborg 36/31, Wrhus 54/41 and Copenhagen 55/59 pg/l). Higher values were found in the group where tablets containing iodine had been taken (milk/urine: 57.0/61 . O &I). In general, the values are low compared with internationally recommended levels. We suggest that mothers without autoimmune thyroid disease should receive iodine supplementation in the form of vitamin/mineral tablets containing iodine (1 50 p g per tablet). 0 Breast milk, iodine deficiency. iodine supplementation, neonates S B Nohr, Lindenborgwj 53, 9200 Aalborg S V , Denmark

Abdominal pregnancies are a small fraction of ectopic pregnancies. They usually implant on the peritoneal surface after partial disruption of the initial implantation site in the tubes. The pelvic cavity is the preferential site, but they have been reported from all over the peritoneal cavity. In the present case the pregnancy was situated on the surface of the right liver lobe. Abdominal pregnancies usually present with acute hemoperitoneum and the pre-operative diagnosis is extremely difficult. The possible role of IUDs as an etiological factor is briefly discussed.

To evaluate whether long-term human fetal exposure to beta 2-adrenergic receptor agonists elicit alterations in the human fetal heart, a fetal echocardiographic examination was performed in 9 fetuses between the 24th and 35th week of gestation (median 28 weeks) and 9 age-matched controls. Examinations were performed during long-term tocolytic terbutalin treatment. Drug dosages varied between 7.5 and 20.0 mg/day (median 10.0 mg/day) and treatment durations prior to examination varied between 14 and 60 days (median 25 days). No significant differences were noted between the exposed fetuses and their controls as regards FHR, left ventricular dimensions, interventricular septal thickness, left ventricular contractility (fractional shortening) and the derived left ventricular stroke volume. Despite the limited number of subjects it is believed that long-term terbutalin exposure does not have any untoward major fetal left ventricular consequences.

M-mode echocardiography was used to evaluate fetal heart function following maternal smoking in 21 healthy smoking pregnant women between 24 and 39 weeks of uneventful gestation. Prior to smoking one cigarette (nicotine content 1.7 mg), a fetal M-mode echocardiographic examination was performed and repeated 5 and 10 min after maternal smoking. Maternal heart rate and systolic blood pressure increased 8.7% and 15.0%, respectively, immediately after smoking, while diastolic blood pressure remained unchanged. Fetal heart rate increased 4.3% and left ventricular diastolic and systolic diameters decreased 4.5% and 15.0%, respectively. No changes in right ventricular dimensions, ventricular ejection times, ventricular wall thickness or septal thickness were observed. Fractional shortening, mean velocity of fractional shortening, stroke volume and cardiac output of the left ventricle also remained unchanged subsequent to smoking. Thus, maternal smoking of one cigarette seems to elicit only a transitory acceleration in fetal heart rate without concomitant significant changes in fetal heart function.

No abstract

Trisomy 20 mosaicism in cultured amniotic fluid cells has in only a few cases been confirmed in fetal tissue. This may lead to the assumption that the trisomic cells are of extra‐fetal origin and interruption of the pregnancy is not advisable. Chromosome analysis of numerous fetal tissues indicated in two cases the presence of one or more trisomy 20 cell clones in rectum and esophagus, respectively. The clinical significance of trisomy 20 mosaicism in single organs remains to be elucidated. Besides the karyotype, genetic counselling should take into account all accessible information of the pregnancy, e.g. ultra‐sound, serum alpha‐fetoprotein values and obstetrical history.