Factors associated with high-risk pregnancies in Canadian Inuit.

Antenatal risk factors and management problems during labour and delivery were examined for 141 consecutive deliveries in Canadian Inuit of the eastern Arctic. The applicability of three risk scoring systems for antenatal use was evaluated. Pregnancies were categorized as being at high, moderate or low risk according to the authors' published criteria. Only two of the systems gave statistically valid predictions of the outcome of pregnancy in terms of risk categorization. Sensitivity and uniformity of the systems were lacking: the risk scores were low in 32% to 58% of the pregnancies in which the mother or the infant or both had problems during labour or delivery or both, and in 27% to 36% of the pregnancies in which the infant alone had problems. Antepartum factors that indicated a significantly increased risk of problems during labour or delivery or both were maternal age less than 16 or more than 35 years, prevous stillbirth or neonatal death, previous birth weight of less than 2501 g, previous pastpartum hemorrhage or other problem in the third stage of labour, antituberculosis therapy in the mother, and any of antepartum hemorrhage, multiple pregnancy, breech delivery, malpresentation or long period between rupture of the membranes and delivery in the current pregnancy. The data indicate that scoring systems should take into account regional or population variations if they are to have reasonable sensitivity.

Serial measurements of plasma half-lives and urinary excretion of antipyrine in low-birth-weight infants.

Antipyrine has been used previously to estimate total body water in infants. In the present study, antipyrine spaces were determined early on the first day of life and again at the end of the fourth day in 22 early mild-fed low-birth-weight babies as part of a study of serial measurements of water balance. This report deals with findings arising from analysis of disappearance rates of antipyrine in plasma used for the determination of antipyrine space (total body water estimation). Urine excretion of antipyrine was measured from 24-hour urine outputs in 9 of these babies. The data showed that: (1) wide individual variants of plasma antipyrine half-life times occurred on both the first and fourth days of life; (2) plasma half-life times in the low-birth-weight infants were usually much longer than those of adults; (3) half-life times on the first day of life were significantly longer than on the fourth day of life; (4) urine excretion of unchanged antipyrine was a significant factor in the disappearance rate of antipyrine from the body with between 7 and 36% of the dose appearing in the urine (average 21%) within 96 h of the initial injection.

A comparison of hexachlorophene and lactacyd on growth of skin flora in healthy term newborn infants.

Reports of toxicity from the routine bathing of newborn infants with hexachlorophene resulted in discontinuing its use in the newborn nurseries of the Ottawa Civic Hospital, only to be followed by an outbreak of skin infections. As a result, a controlled trial of bathing newborn babies with either Lactacyd or pHisoHex was begun. The efficacy of the soaps was evaluated by comparing the colonization of the nose and umbilical cords of 158 pHisoHex-washed babies and 156 Lactacyd-washed babies on the day of discharge from hospital. The gram-negative and gram-positive bacterial flora of nose and cord of infants washed with pHisoHex and Lactacyd were identical in frequency and distribution.