A farmer's wife who had helped with lambing aborted spontaneously in March after a short febrile illness in the 28th week of her pregnancy. She developed disseminated intravascular coagulation post partum with acute renal failure and pulmonary oedema. Recovery was complete after two weeks of hospital care. A strain of Chlamydia psittaci, probably of ovine origin, was isolated from the placenta and fetus. The patient's serum showed rising titres of antibody against chlamydia group antigen; the placental and fetal isolates; and a known ovine abortion, but not a known avian, strain of C psittaci. IgG against both ovine abortion and enteric strains of C psittaci was detected, but IgM against only an abortion strain was detected. Histological examination showed pronounced intervillus placentitis with chlamydial inclusions in the trophoblast but no evidence of fetal infection or amnionitis. Laboratory evidence of chlamydial infection was found in an aborting ewe on the farm in January and in remaining sheep and lambs in July.Doctors should recognise the possible risk to pregnant women in rural areas where chlamydial infections in farm animals are widespread.
Summary Maternal plasma levels of the trophoblast product, pregnancy‐specific β1‐glycoprotein (PSβG), have been measured both in normal pregnancies and in pregnancies complicated by pre‐eclampsia and/or fetal growth retardation. PSβG levels correlate significantly with placental and fetal weight and fall below the normal range in about 60 per cent of all patients with fetal growth retardation. PSβG measurements appear to give a considerably better indication of fetal size than measurements of either human placental lactogen (HPL) or plasma oestriol.
Summary Pregnancy‐specific β1–glycoprotein (PSβG) is a major product of the trophoblast which has only recently been identified. Like human placental lactogen, the concentration of PSβG in maternal blood rises throughout pregnancy until about 34 weeks, thereafter tending to remain constant until term, with only a small day‐to‐day variation in individuals. The circulating maternal levels of PSβG between 34 weeks and term are about 200 μg/ml, 20 to 30 times greater than the levels of placental lactogen, thus allowing detection and measurement of PSβG by relatively simple techniques. The levels of PSβG are above the normal range in the majority of twin pregnancies. It is suggested that PSβG measurements may be useful in assessing placental function and may help in the detection of multiple pregnancies at an early stage of gestation.
An intravenous injection of 50 mg dehydroepiandrosterone was given to 19 women at the 38th week of pregnancy. The concentration of androstenedione, testosterone, oestradiol and oestrone in plasma was measured at intervals following the injection. The concentration of androstenedione and testosterone rose rapidly, reaching a peak after 10 minutes and returning to near baseline level by 30 minutes. Oestradiol rose more slowly, reaching a peak after 45 minutes and being sustained at high levels for 3; hours before returning slowly to baseline. Oestrone rose yet more slowly and did not reach a peak until 24 hours after the injection. It is concluded that the steroid responses are too variable from one individual to another for this test to be useful in the clinical assessment of fetal wellbeing but that it was likely to be a powerful tool in the investigation of placental steroid biogenesis.
Summary The plasma concentrations of four ‘pregnancy proteins' and three steroid hormones have been measured throughout pregnancy in 15 primigravidae. Two of the proteins, human placental lactogen (HPL) and pregnancy‐specific β1‐glycoprotein (PS βG), are specific for pregnancy and correlate well with the stage of gestation. It is suggested that measurement of PSβG may be useful in assessing feto‐placental wellbeing. Neither of the pregnancy‐associated proteins, steroid‐binding β‐globulin (SB βG) and pregnancy‐associated α2‐glycoprotein (α2‐PAG), correlated with the length of gestation although, near term, plasma α2‐PAG levels appeared to be related to fetal weight. In addition, no correlation has been demonstrated between placental or fetal weight and any of the pregnancy‐specific proteins or steroid hormones studied.
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