Summary. Serum ferritin concentration has been measured during the course of pregnancy in 154 women. There was a rapid decrease in iron stores during early pregnancy irrespective of any iron therapy. Oral iron did, however, prevent the stores reaching iron deficient levels during the second half of pregnancy. The results suggest that maternal erythroid activity starts early in pregnancy and may exhaust the iron stores before the fetal demands for iron can be met.
suMMARY The platelet count was measured at approximately monthly intervals during the course of 44 normal pregnancies. There was no evidence of any fall in the platelet count during pregnancy. Any significant change in the platelet count in pregnant women is unlikely to be the result of a normal pregnancy.It has recently been suggested that the platelet count decreases during the course of pregnancy and that this is particularly marked during the last trimester (Sejeny et al., 1975 27 May 1976 cell-poor suspension. In our laboratory the coefficient of variation for this apparatus is 3 0% and the mean carryover is 1'6y. Quality control was maintained throughout the study by the cusum analysis of control samples of a stable latex particle suspension inserted after every 20 patient samples. ResultsThe mean platelet counts of the 44 women on their first visits and at each of their subsequent visits to the clinic are shown in the Table. There was no consistent change in the mean platelet count during the course of pregnancy and this was confirmed by an analysis of variance (F = 0-2; p > 0-1). Within the sequence of results for each woman there was, however, considerable variation. The mean coefficient of variation for each woman was 20%. In seven of the women the coefficient of variation exceeded 25 % and in three it exceeded 30%. DiscussionThe results presented here indicate that during 44 normal pregnancies the mothers' platelet counts showed no significant change. Moreover, at no
cord was located by performing a series of longitudinal scans, and the above-mentioned procedure was performed. A 5-MHz probe, attached to a Doppler velocity flowmeter (Model 806 C; Parks Electronics), was placed to one side of the pulsed-echo probe, and the continuous beam of ultrasound was directed in the same plane as the pulsed beam, with an angle of approximately 30' between it and the umbilical vessel. The Doppler probe, which was hand-held, required slight angular manipulation to obtain optimum Doppler-shift signals, which were monitored through headphones. The position of the probe was held, and the signals recorded on a tape recorder. The recorded signals were then processed through an audiofrequency analyser (Kay Sonagraph 6061) to produce a display (sonagram) of red-cell velocity in real time. The density of the signal in the sonagram is proportional to the number of red cells travelling at a particular velocity at a particular time.The angle of the Doppler probe is held at approximately 30 to the vessels, and positioning is made possible by using the B-scan to place the pulsed-echo probe at right angles to the vessels. This serves as a guide to position the Doppler probe. Experience in collecting Doppler signals also helps in obtaining the optimum angle of the probe to the vessel.' The audiofrequency analyser displays the signals in terms of frequency against time, and there is a linear relation between frequency and velocity at these levels.-These signals are records of blood velocity, however, and do not represent volume flow. ResultsTwenty patients, whose pregnancies ranged from 12 to 40 weeks' gestational age, were referred for ultrasonic examination either to confirm gestational age or to locate the placenta before amniocentesis. DiscussionThis technique is safe and non-invasive, and allows fetal umbilical blood-flow patterns to be observed from as early as 12 weeks' gestation. It required no elaborate preparation, and was thus suitable for use as an outpatient procedure. The technique is basically simple and easy to learn, and can be used throughout pregnancy. The shape of the blood-velocity waveform will change with conditions affecting the efficiency of blood supply,6 and the method should be useful in assessing such conditions as pre-eclampsia and intrauterine growth retardation. ReferencesComline, R S, and Silver, M, British Medical Bulletin, 1975, 31, 25. Clavero, J A, et al, Amnerican J7ournal of Obstetrics and Gyntecology, 1973, 116, 340. 3McCallum, W D, Amierican _ournal of Obstetrics and Gynecology, 1977, 127, 491. Campbell, S, and Wilkin, D, Britishl Journal of Obstetrics and Gyniaecology, 1975, 82, 689. B3ti'ish Mcdfical _7ournal, 1977B3ti'ish Mcdfical _7ournal, , 2, 1451 Summary A prospective study of 1000 consecutive primigravidae was conducted to assess the relevance of the colour of the liquor to the welfare of the child. The results showed that clear liquor early in labour virtually ensures the birth of a healthy infant, provided the duration of labour is limit...
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