Summary. The T/QRS ratio of the fetal ECG was obtained during labour from 25 women with normal pregnancies. The poor signal‐to‐noise ratio of the unprocessed signals, chiefly due to baseline wander, led to a wide variation between individual measurements. This problem was overcome by data averaging, the ratio being expressed as a mean over 1‐min epochs. The average T/QRS ratio of each labour record ranged from 4% to 23% with a mean of 10% (for all 25). The average range (between 5th and 95th centile) of the 1‐min T/QRS ratios was 13% and there were no significant changes as labour progressed. The effect of contractions on the T/QRS ratio was measured from eight subjects and found to be inconsistent.

Pregnancy outcomes in patients with end-stage renal disease (ESRD) on dialysis are improving. Recent literature supports intensive hemodialysis (HD) as the modality of choice during pregnancy in ESRD. We report the successful delivery of a healthy infant at full term in a patient with ESRD by supplementing peritoneal dialysis (PD) with intermittent HD to achieve adequate dialysis intensity.

Summary. The T/QRS ratio of the fetal electrocardiogram (ECG) was recorded to within 30 min of delivery from 105 women in labour. There were no significant differences in the mean T/QRS ratio in the last hour of record between those with normal and intermediate, or abnormal fetal heart rate (FHR) patterns. In 66 labours the mean T/QRS ratio in the first hour of record was compared with that of the last hour; the only significant change was a small decrease in the mean ratio from 11% to 7% in a group of 11 fetuses with an abnormal FHR pattern throughout the recording time. Eight babies were born with evidence of acidosis (umbilical artery pH<7.16), and another four were born in poor condition (1 min Apgar score <4) without evidence of acidosis; none had a mean last hour T/QRS ratio significantly different from the previously established normal range.

The aim of this study was to establish whether the T/QRS ratio of the fetal electrocardiogram (ECG) was influenced by uterine contractions. Data was collected from 55 women during labour using a purpose built computer which also measured background noise. The T/QRS ratio was measured on individual complexes and the measurements averaged. Measurements made during periods of excessive noise were excluded. The average T/QRS ratio during contractions showed a small but significant increase of 1.02% (principally in the second half of the contraction). The significance of this small increase is uncertain and for most fetuses the ratio would remain in the normal range during contractions. The higher T/QRS ratios, recorded in the noisy records, draw attention to the importance of accounting for this problem when fetal ECG data are reported.

There are various indications for screening pregnant women for gestational diabetes. Screening is then often carried out by performing a timed random blood sugar (t-RBS). In this unit a raised t-RBS is an indication to perform a glucose tolerance test (GTT), and if this is abnormal, the patient is managed with dietary modification or insulin therapy. A t-RBS is considered abnormal if the fasting value (> 2 hours since last meal) is > 5.7 mmol/l, or the non-fasting value (<2 hours since last metal) is > 6.3 mmol/l. However, higher t-RBS values have been recommended by the Diabetic Pregnancy Study Group. This group considers a t-RBS abnormal if the fasting value is > 6.1 mmol/l, or the non-fasting value is > 7.0 mmol/l. A retrospective audit was carried out to determine if cases of gestational diabetes would have been missed if the new guidelines were adopted. There were 112 patients with a fasting t-RBS of 5.8 to 6.1 mmol/l, inclusive, and 196 patients with a non-fasting t-RBS of 6.4 to 7.0 mmol/l, inclusive; 45 patients did not have a GTT result. Therefore 263 patients were included in the study. The number of patients with a normal GTT result was 257 (97.7%), and 6 (2.30%) patients had an abnormal GTT result. Only 4 (1.52%) were labelled as gestational diabetics, and all these cases were managed with diet alone with no adverse obstetric outcome. A large number of GTTs are performed unnecessarily in our unit, and the values recommended by the Diabetic Pregnancy Study Group should be adopted.