Management strategies to meet nurses' values and increase their satisfaction and retention are presented.

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Objective-Serum sialic acid has recently gained interest as a possible cardiovascular risk factor as well as a potential tumour marker. The effect of pregnancy on serum sialic acid is unclear particularly in the post-partum period. Design-Longitudinal cohort. Setting-Teaching hospital antenatal clinic. Population-29 pregnant women, 27 age matched non-pregnant women. Methods-Specific enzymatic assay for sialic acid. The first serum sample was taken between 37 and 42 weeks of gestation; in 22 women this was followed by a second serum sample at 12 weeks postpartum. Serum sialic acid concentration was also measured in the 27 controls. Results-Mean (SD) serum sialic acid concentration was higher during pregnancy than post-partum: 91.1 (11.1) v 77.5 (11.1) mgldl (p < 0.001); or in the control group: 66.0 (9.7) mgldl (p < 0.001).Conclusions-Serum sialic acid is elevated during pregnancy and postpartum. (7 Clin Pathol 1997;50:494-495)

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