Abortions in two Philippine hospitals

Findings in this study point clearly to the fact that compared to our findings in 1969 at PGH and Sta. Rosa, an increasing number of Filipino women are desperate enough to terminate unwanted pregnancies in a manner that poses hazards to health and even life. In a survey, conducted in barrios in Cavite, twelve percent of respondents who had induced abortions said that they sought hospitalization." In these barrios, therefore, for every hospital admission for induced abortion, one can expect about seven other cases in the community. Considering that a city like Manila can be expected to have more sophisticated clinics, it is quite possible that for every hospital case, a larger number of pregnancies have been successfully terminated in the communityCompared to women with spontaneous abortion, women who have induced abortions are mostly married: have fewer children, and do not want an additional child or prefer only one. The subtantial increase in contraceptive acceptors after abortion means that contraception has great potential for preventing illegal abortions. More efforts should be taken to inform women of the dangers of induced abortion and the longer and more expensive hospitalization following complications. Education of all post-abortal cases on the wisdom of using contraceptives to prevent unwanted pregnancy should be made a part of routine advice given before obstetric clinic/hospital discharge. Women who express or hint rejection of pregnancy and unwed mothers should get special attention because of their vulnerability to deliberate termination of pregnancy. More social services should be established to help mothers continue unwanted pregnancies to term and to help them place the babies for care. The church should take an active role and positive steps in youth and marriage counselling; in encouraging prevention of irresponsible childbearing; and in providing services for rejected children. It is not enough to talk about the evils of abortion and un-natural methods of contraception; it is everyones responsibility to seek and try strategies for preventing unwanted pregnancies and induced abortion. If we do not act, the problem may become a question of conception control of abortion?(Conclusions)

Changes in birth weight, birth length and head circumference of Hungarian children in the county Baranya between 1968 and 1979-1981.

Possible secular changes of newborn's body measurements were investigated in a cross-sectional growth study in the County Baranya (South Hungary) in 1979-1981. The total sample includes 2,130 children. The results were compared with those obtained by Fekete et al. (1968, 1974) in the same region on 3,567 neonates. During the 12-years interval the birth weight increased slightly. The head circumference did not change in girls, but decreased slightly in boys. The birth length values could not be evaluated because of technical reasons. According to the present results secular changes in the body measurements of the newborns could not be seen during the investigated period. The fetal growth standard values ascertained by Fekete et al. (1968, 1974) are still suitable. A repeated anthropometric investigation of newborns is necessary in the near future.

Intrauterine weight retardation and the concomitant length retardation: a statistical analysis of anthropometric data.

In 237 low birth weight for gestational age term infants (birth weight less than or equal to 10th percentile; gestational age less than or equal to 37 wk) percentage deviations of birth weight and crown-heel length for gestational age were correlated (a) in a series of linear regressions of three subsequent groups formed according to the magnitude of weight retardation (b) in the pooled material by non-liner regression. Linear regressions yielded equivocal results as to the existence of concomitant length retardation (no correlation in group 1, significant correlation in group 2 and 3). The significant non-linear correlation (i = 0.66 ; p less than 0.001) and the exponential type regression curve (Y) % length deficit = 2.45 1.04 X' % weight deficit) gave an explanation of the controversial findings. If mild to moderate weight retardation is included in studies comparing weight and length, a greater variability and, possibly, a conclusion of non-existence of concomitant retardation will result while, if severe or extreme weight retardation are screened out using stricter criteria, (e.g. 5th, 3rd percentiles, -2 SD) one would find more infants with significant length retardation, and the conclusions would be the opposite, i.e. an obligatory length retardation following malnutrition. In anthropometric-statistical studies the results should never be generalized and extrapolated below, or beyond the cut-off points chosen.

Neonatal anthropometry: its value in the assessment of nutritional status and neonatal blood glucose homeostasis.

The use and application of neonatal anthropometry in newborns with different body measurements and nutritional evaluation status is reviewed. The neonatal blood glucose level has been used as a model in testing the predictive value of various indices of body size for the capacity of neonatal blood glucose homeostasis. For example, combining weight and length deficit from the expected means for gestational age and relative body measurements such as weight for length and ponderal index not only convey information about the type and magnitude of growth impairment, but are also good predictors of the risk of hypoglycaemia within the different anthropometric groups of growth retarded infants. Efforts have been made to delineate the diagnostic criteria by somatic measurements for identification of the different degrees and types of intrauterine growth deviation. The anthropometric approach to the heterogeneity of the intrauterine growth pattern seems to be a simple and very useful tool in somatic classification and evaluation of the newborn infant. In addition to the assessment of body proportions and nutritional status, the anthropometric approach can be of great help in exploring the relationship of body size and the physiological adaptation to the extrauterine environment.

Body size and neonatal hypoglycemia in intrauterine growth retardation.

The relationship between blood glucose and body physique of 233 (42 hypo-and 191 normologycemic) intrauterine growth-retarded neonates was analyzed using different body measurements and indices of body proportions. Classification by combination of weight and length deficit for fetal age revealed that the disproportionately retarded infants (deficit in weight for age > 30%; deficit in length for age less than equal to 15%) were particularly prone to hypoglycemia. The lowest incidence of hypoglycemia was observed in the group with severe proportionate retardation (weight deficit for age > 30%; length deficit for age > 15%). Among the indices of body proportions ponderal index (W/L3), and percentage deviation from the expected weight for length turned out to be a sensitive predictor of the risk of hypoglycemia. The majority of hypoglycemia neonates were underweight for length and a considerable number of normoglycemic infants were overweight for length. These findings point to the significance of soft tissue wasting rather than low birth weight for gestational age itself, in the development and diagnosis of neonatal hypoglycemia. The significance of anthropometry in the classification of different types of intrauterine growth impairment, as well as in predicting specific hazards after birth is discussed.

The redistribution of cardiac output on cold exposure in new-born rabbits.

1. In anaesthetized new-born rabbits isotope-labelled microspheres were injected into the left ventricle to investigate the distribution of cardiac output.2. On cold exposure the proportion of radioactivity (and hence of cardiac output) distributed to brown adipose tissue rose from 6 to 19%. Similar results were obtained in ten rabbits in which the distribution of microspheres labelled with two different isotopes was examined both in a neutral thermal and cold environment.3. The perirenal, inguinal, pectoral and axillary adipose tissue deposits showed a trivial increase in the proportion of cardiac output (from 1.2 to 1.9%) on cold exposure as compared with the cervical and interscapular deposits.4. The small intestine of new-born rabbits received 24% of the cardiac output while renal flow was only 8%. There were large changes in the proportions of body weight and in the distribution of cardiac output with age from 1 to 6 days from birth.5. The results support the contention that brown adipose tissue is the principal site of additional thermogenesis in anaesthetized new-born rabbits exposed to cold.