The effects of Betamethasone on white blood cells during pregnancy with PPROM.

OBJECTIVE: To determine the effects of Betamethasone injections on maternal white blood cell counts. STUDY DESIGN: Thirteen pregnant women without fever or clinical infection and with premature rupture of the membranes at less than 34 weeks gestation were studied. No subject had labor during the week of study. Daily complete blood counts were done before and on days one and two after two 12 mg intramuscular injections of Betamethasone given 24 hours apart. RESULTS: The steroid injections produced a significant increase in total white counts from 9.8 +/- 5.0 to 14.2 +/- 0.7 x 10(3) cells/cc. There was a significant increase in polymorphonucleocytes and a decrease in lymphocytes and monocytes. CONCLUSION: The use of Betamethasone injections to mature fetal lungs results in a leukocytosis, but total white cell counts remain less than 20 x 10(3) cells/cc.

Chlamydia trachomatis. A trojan horse.

Chlamydia trachomatis is a prevalent and virulent pathogen in the genital tract of sexually active women. The sequelae are diverse and represent a significant source of morbidity. The Centers for Disease Control estimates 4 million new cases annually, making it the most prevalent sexually transmitted disease in the United States. Several risk factors are well-defined and the pathophysiology has become better understood, helping to improve the body of data concerning sequelae. Newer diagnostic methods, such as gene probes, ELISA, and PCR, are now available to aid in detection. Novel treatment regimens have been developed to improve eradication of the infection and compliance. There are still questions regarding this pathogen and its interaction with other lower genital tract pathogens. Improved detection, reporting and appropriate treatment can reduce the effect of Chlamydial infections on reproductive capacity.

The effect of antenatal dexamethasone administration on the prevention of respiratory distress syndrome in preterm gestations with premature rupture of membranes.

A prospective blinded randomized study was carried out to determine the effect of antepartum administration of dexamethasone on the incidence of respiratory distress syndrome in 250 patients with gestations between 28 and 33 weeks complicated by premature rupture of membranes. The incidence of respiratory distress syndrome was not lowered by the length of rupture of membranes in the 124 untreated patients. The overall incidence of respiratory distress syndrome was reduced from 51% to 25% by the administration of corticosteroids. Further, the dexamethasone-treated group had a statistical significant reduction in the incidence of intraventricular hemorrhage, total time of hospitalization, and average cost per patient. No statistical difference was encountered in the incidence of maternal or neonatal sepsis.

Analysis of luteinizing hormone and follicle-stimulating hormone release kinetics during a dynamic secretory event, the postpartum preovulatory surge in the rat, based on quantitative changes in stored and circulating luteinizing hormone and follicle-stimulating hormone and metabolic clearance data for these hormones.

The original objective of this study was to use available distribution volume (V) and deca constant (k) estimates for rat LH and FSH to determine the amounts of these hormones synthesized and released during a dynamic secretory event, the postpartum preovulatory surge. The problem was approached by 1) determining the approximate rates and durations of pituitary LH and FSH depletion during the surge, and 2) comparing observed plasma LH and FSH patterns with patterns calculated on the assumptions a) that the rates and durations of LH and FSH release would have to equal or exceed the rates and durations of LH and FSH depletion, and b) that the V and k estimates reported by Bogdanove and Gay (Endocrinology 84: 1118, 1969) would be applicable in this situation. The observed surges proved to be 3- to 10-fold smaller than the calculated patterns, suggesting either that depletion exceded release or that inappropriate values of V and/or k had been used in the calculations. Subsequent reexaminations of LH clearance kinetics (Campbell et al., accompanying reports) provided larger estimates for both VLH and kLH. Recalculation of the data, using these new parameters, eliminated the apparent discrepancy between depletion and release. On the basis of these direct comparisons of stored and circulating LH, it seems that a "half-life" shorter than 30 min and a distribution volume greater than 3 ml/100 g must be used to model the effects of variations in LH release on circulating LH in the rat.