Quantitation of proteinuria in pregnancy by the use of single voided urine samples.

The most commonly used method to measure urinary protein involves a 24-hour urine collection. In a study of 54 specimens, we found excellent correlation between the protein content of a 24-hour urine collection and the protein/creatinine ratio of a single urine sample (r = 0.9936; P less than .0001). We conclude that the protein/creatinine ratio of a single urine specimen represents a highly accurate method to assess renal function in the pregnant patient, and seems clearly more practical than the 24-hour urine collection.

Acute salpingitis in sterilized women.

Previously sterilized women are generally considered protected against salpingitis. However, when we diagnosed salpingitis by laparoscopy in 48 patients during a 16-month period, we found four (8%) who had been previously sterilized. Therefore, contrary to generally stated belief, salpingitis may occur after interruption of tubal continuity.

Hypertensive diseases of pregnancy and parity.

Chesley's classic long-term follow up study of eclamptic women clearly demonstrated the prognostic significance of parity in the differential diagnosis of various hypertensive diseases of pregnancy. Multiparous patients with eclampsia were different on long-term follow-up from primiparous eclamptic women. A logical conclusion from this observation is that multiparous and primiparous patient groups should be analyzed separately whenever hypertensive diseases of pregnancy are evaluated. This study is therefore an attempt to define the clinical profile of hypertension during pregnancy on the basis of parity alone. The prenatal and hospital records of 99 successive pregnant patients identified as hypertensive during a 1-year period at Mount Sinai Hospital Medical Center served as the study population. A group of 25 primiparous and 25 multiparous patients, all with uncomplicated pregnancies and normal deliveries in sequence during a 1-month period, served as normal nonhypertensive control groups. Various pregnancy parameters were statistically evaluated for study and control groups. Significant differences were found between hypertensive primiparous and multiparous patients in mean weight increase (p less than 0.05), gestational age at first increase in blood pressure (p less than 0.007), and time from first increase in blood pressure until delivery (p less than 0.008). The difference in birth weight was not significant between hypertensive groups. In contrast, among the control groups, multiparous patients had significantly larger offspring than primiparous patients (p less than 0.01). Weights of normal primiparous control women were almost identical to those of primiparous hypertensive women (3252.8 +/- 511.8 versus 3203.26 +/- 679.5 gm). Birth weights of offspring from multiparous hypertensive women, while not significantly different from those of primiparous hypertensive women, were significantly lower than those of multiparous control subjects (3093.94 +/- 898.7 versus 3593 +/- 305.6; p less than 0.01). No significant differences in a variety of laboratory findings, reflexes, edema, or mode of delivery were observed between the various groups. The clinical and laboratory presentation of hypertension in pregnancy may be similar between primiparous and multiparous patients. Nevertheless, clear differences do exist in both maternal presentation and impact of maternal disease on fetal growth and development. These differences strongly suggest a different pathophysiology as the underlying cause of hypertensive disease in primiparous and multiparous pregnant women.(ABSTRACT TRUNCATED AT 400 WORDS)

The visibly fluorescent phospholipids of serum lipoproteins.

The blusih-white fluorescence exhibited by lipoproteins from human serum has been investigated. It appears that high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very low density lipoprotein (VLDL) all exhibit this fluorescence with excitation maximum at about 360 nm and fluorescence maximum at about 450 nm. The fluorescence resides in the phospholipid fraction of the lipoproteins and is not located in the fatty acids, since the water-soluble deacylated phospholipid fraction exhibited the same fluorescence. Upon electrophoresis of this fraction at pH 6.5 the fluorescent material carried a negative charge and moved a distance similar to glycerophosphoserine and glycerophosphoinositol, which both carry one negative charge. This negatively charged fluorescent product is ninhydrine negative, and gives a positive reaction for phosphate esters and 1,2-glycols. The detailed structure of the fluorescent product is not yet known. It is suggested that reactive aldehydes are involved in its formation from the aminophosphatides. Its possible relationship to tissue peroxidation is discussed.