Viral hepatitis serological markers among pregnant women in Caracas, Venezuela: implication for perinatal transmission of hepatitis B and C.

Viral hepatitis serological markers were analyzed in two groups of pregnant women residing in Caracas from: 1) a maternity unit at the moment of delivery (106 sera, low income population), and 2) a private clinic during the third trimester of pregnancy (105 sera, medium-high economic class population). A higher percent positivity was observed in the maternity unit compared to the private clinic for hepatitis A virus (HAV) as measured by anti-HAV activity (96% vs 48%; p < 0.01%), for hepatitis B virus (HBV) as measured by anti-HBc activity (13% vs 2%; p < 0.01%), but not for HBV carriage, as measured by HBsAg (3.8% vs 0%; p = 0.06 %). These differences appear to correlate with the socio-economic level. All the HBsAg positive sera were HBeAg negative and negative for the presence of DNA by PCR, confirming the low rate of perinatal transmission observed in Venezuela. Two out of 106 sera (1.9%) were positive for HCV antibodies in the maternity unit and 0/105 in the private clinic, although these differences were non significant (N.S.). Two out of 106 sera (1.9%) were positive for HEV antibodies in the maternity unit and 1/80 (1.3%) in the private clinic (N.S.). The anti-HEV seropositivity probably reflects a past infection. The importance of testing these viral markers during pregnancy is discussed.

Decreased plasma motilin concentrations in pregnancy.

Plasma motilin concentrations were measured in 37 women during the second and third trimester of pregnancy and one week after delivery. The mean plasma motilin concentrations, both fasting and after a glucose load and a mixed meal, were significantly (p less than 0.001) reduced during pregnancy, returning to the normal range one week post partum. Pregnancy appears to have a profound inhibitory effect on plasma motilin, and this may in part be responsible for the gastrointestinal hypomotility associated with pregnancy.

Estimacion de la edad gestacional por cefalometria ecosonografica. / Evaluation of the gestacional age using echosonographic cephalometry

En un periodo de dos anos se practicaron 2184 ecosonogramas obstetricos y ginecologicos a 1600 pacientes. Se analiza el diametro biparietal (DBP) en un grupo de pacientes (890) con edad gestacional conocida, ciclos menstruales regulares y embarazo simple. Un total de 1240 mediciones de DBP llenaron el criterio para ser incluidos en el estudio. Se elaboran dos tablas, una primera tabla (Tabla 2) donde se calculam los percentiles del DBP para una edad gestacional conocida; y una segunda tabla (Tabla 3) donde se calculam los percentiles de la edad gestacional para un DBP conocido. Se explica brevemente el metodo de como calcular la edad gestacional ecografica ajustada al crecimiento (GASA)y los factores que pueden ser fuente de confusion al interpretar la medicion del DBP

Metabolic effects of beta-sympathomimetic drugs and dexamethasone in normal and diabetic pregnancy.

Marked hyperglycaemia and hyperinsulinaemia were observed in two normal women in premature labour treated with an intravenous infusion of a beta-sympathomimetic drug and intramuscular dexamethasone injections. Similar therapy in a chemical diabetic patient caused diabetic ketoacidosis, while treatment of an insulin dependent diabetic with dexamethasone alone resulted in a major increase in her insulin requirements. It is suggested that the diabetogenic effects of beta-sympathomimetic drugs and dexamethasone may be additive and that regular plasma glucose estimations should be made when they are used, especially in patients with impaired glucose tolerance.