The course of pregnancy in 97 women with ulcerative colitis was studied over a 12-year period. During this period they had 173 pregnancies and delivered 136 children. There were two gemellary deliveries. Nine women had a spontaneous and 16 an induced abortion, of which 4 were performed on therapeutic indication. For a woman with ulcerative colitis the risk of an exacerbation of the bowel disease was 32% per year in her fertile years, whereas it was 34% per year during pregnancy. This difference is not statistically significant. As compared with women with an inactive bowel disease, women in whom the disease was active at the start of pregnancy had a small but significantly greater risk of spontaneous abortion and premature delivery. The frequency of malformations, prematurity, and neonatal hyperbilirubinaemia was not higher in the children of ulcerative colitis mothers than in those of healthy mothers. Treatment with sulphasalazine, salazosulphadimidine, and corticosteroids had no influence on the course and outcome of pregnancy. Birth length and weight of the children of mothers with ulcerative colitis equalled those for children of healthy mothers. In conclusion, pregnancy does not necessitate any change in the usual medical treatment of ulcerative colitis. Women with ulcerative colitis should be advised preferably to conceive at a time when their bowel disease is inactive. Generally, ulcerative colitis constitutes no indication for induced abortion.
The rectal temperature of normal healthy camels at rest may vary from about 34°C to more than 40°C. Diurnal variations in the winter are usually in the order of 2°C. In summer the diurnal variations in the camel deprived of drinking water may exceed 6°C, but in animals with free access to water the variations are similar to those found in the winter. The variations in temperature are of great significance in water conservation in two ways. a) The increase in body temperature means that heat is stored in the body instead of being dissipated by evaporation of water. At night the excess heat can be given off without expenditure of water. b) The high body temperature means that heat gain from the hot environment is reduced because the temperature gradient is reduced. The effect of the increased body temperature on heat gain from the environment has been calculated from data on water expenditure. These calculations show that under the given conditions the variations in body temperature effect a considerable economy of water expenditure. The evaporative heat regulation in the camel seems to rest exclusively on evaporation from the skin surface (sweating), and there is no apparent increase in respiratory rate or panting connected with heat regulation. The evaporation from isolated skin areas increases linearly with increased heat load. The critical temperature at which the increase sets in is around 35°C. The fur of the camel is an efficient barrier against heat gain from the environment. Water expenditure is increased in camels that have been shorn.
Over a 13-year period, the course of 109 pregnancies in 68 women with Crohn's disease was studied. A total of 76 children were delivered. There were no gemellary deliveries, and none of the children had congenital malformations. Pregnancy entailed no increased risk of an exacerbation of the bowel disease. As compared with the reference population and with women with ulcerative colitis, the total material showed an increased risk of premature delivery and spontaneous abortion, but a further analysis showed that this was due only to an increased risk in women with active disease at the time of conception and in women who had undergone bowel resection during pregnancy. Birth weight and birth length corresponded to those in the reference population. The frequency of neonatal hyperbilirubinaemia was not higher in children of mothers with Crohn's disease than in children of healthy mothers. Treatment with sulphasalazine, salazosulphadimidine, and corticosteroids did not influence the course of pregnancy or the frequency of neonatal jaundice or malformations. Consequently, in Crohn's disease a pregnant woman should be given the same medical treatment as when not pregnant. Generally, the women should be advised preferably to conceive at a time when their bowel disease is inactive. The risk groups should be followed up with frequent obstetrical examinations throughout pregnancy.
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