Carriage of beta haemolytic streptococci (BHS) in pregnant women and acquisition by neonates.

Beta Haemolytic Streptococci(BHS) carriage rate in pregnant women during labour and its acquisition by their newborns just after birth was investigated in 60 mother baby pairs. The carriage rate of group B Streptococci (GBS) was 11.6%, acquisition rate by newborns of carrier and non-carrier mothers was 85.7% and 1.8% respectively. A total of 28.5% newborns were carrying GBS on all the skin sites and were heavily colonized and therefore, at higher risk of developing early onset of Streptococcal infections. Penicillin G and Ampicillin were most effective antibiotics against GBS.

Rupture of the uterus in full-term pregnancy.

Of 48,519 deliveries conducted at Jinnah Postgraduate Medical Centre (JPMC) over 7 years (January, 1986 to December, 1992), 257 were of ruptured uterus, giving a rate of one in 189 deliveries. Main cause of rupture was obstructed labour. Maternal mortality was 3.9% and foetal mortality 88% in cases admitted with uterine rupture and 17.6% in rupture occurring within the hospital (JPMA 43: 172, 1993).

Dietary and serum calcium in pregnant women.

Dietary and serum calcium were estimated in 200 normal pregnant women between 37-41 weeks of gestation and in cord blood of their new born. Calcium intake per person per day was low, 11.8mmol/L, as compared with the daily recommended allowance of 30 mmol/L. Mean maternal serum calcium level was also low (1.9 mmol/L) and only 20% of mothers had serum calcium within normal range. Mean calcium value in cord blood was at lower limit of normal range, being 2.3 mmol/L; 38.5% of cord samples (77) were below the normal range.

Maternal morbidity in the Department of Obstetric and Gynaecology, Jinnah Postgraduate Medical Centre Karachi.

Maternal morbidity was observed in 377 obstetric cases at Jinnah Postgraduate Medical Centre (JPMC) during a period of one year. Morbidity rate was 4.4% of total deliveries. Three hundred and twenty-four (86%) mothers had no proper antenatal supervision. Infection was more common after abdominal delivery and injury to genital tract after vaginal delivery. The most serious injury was rupture of gravid uterus. Thirty-seven cases of ruptured uterus were admitted in one year and 5 cases occurred within the hospital (1 in 1225 deliveries).

Serum calcium, urea and uric acid levels in pre-eclampsia.

Serum calcium, urea and uric acid levels were determined in 100 normal pregnant women and 50 patients with pre-eclampsia. Serum calcium levels were significantly lower and urea and uric acid levels higher in pre-eclampsia. Low levels of calcium were found as early as 28 weeks and can therefore be used for early diagnosis of pre-eclampsia.

Maternal factors affecting birthweight of uncomplicated pregnancy.

Two hundred full-term pregnant mothers with no complication of pregnancy and no associated disease selected from Jinnah Postgraduate Medical Centre were studied for their nutritional status and other characteristics. The effect of these factors on birthweight of their new-born was determined. Total calorie intake per capita per day was low being 1913. The mean birthweight was 2.9kg, 26% weighed 2.5kg or less. No significant sex difference was observed in the birthweight. Variables having a significant positive influence on birthweight were maternal age at first delivery, up to 25 years, beyond which correlation was not significant; maternal weight and maternal total calorie intake (irrespective of source) up to an intake of 2500 calorie per day, beyond which correlation was not significant. Combined effect of these three maternal factors on birthweight was highly significant. Coefficient of correlation, R being 0.81.

Plasma vitamin A and carotene in maternal and cord blood.

Mean plasma vitamin A and carotene levels in 200 pregnant women at term were 30.3 mcg% and 43.6 mcg%. Sixty-four percent of women had vitamin A in lower limit of normal (less than 33 mcg%) and 26% had deficient and low levels of carotene. Mean values of plasma vitamin A and carotene in cord blood was 13.7 mcg% and 16.5 mcg%, respectively, and lower than that of maternal blood at term. Women who had adequate levels of vitamin A (greater than 33 mcg%) in blood had significantly higher intake of vitamin A. Similarly the newborn babies of those mothers who had adequate levels of vitamin A had significantly higher levels of vitamin A than those of mothers who had inadequate levels (less than 33 mcg%).

Carriage of group B streptococci in rectum and urogenital tract of pregnant women.

One hundred pregnant women in third trimester were screened for the carriage of group B streptococci (GBS) in a prospective study. Rectal and urogenital samples were collected, 25% women were positive for non group B beta haemolytic streptococci. Twelve (48%) were positive at single site and 13 (52%) at more than one site. Beta haemolytic streptococci isolated were non-groupables in 19 (76%) and groupables in 6 (24%). Among groupables, Group D streptococci (GDS) were the commonest 3 (12%) followed by Group G2 (8%) and Group F1 (4%). Group B streptococci were not isolated in our study population.

Excessive physical work during pregnancy and birth weight.

The effect of excessive physical work during pregnancy on birth weight was studied in 329 full term pregnant mothers with no complication of pregnancy and no associated disease delivering at Jinnah Postgraduate Medical Centre, Karachi. Birth weight was influenced by excessive physical work amongst mothers on diet deficient in calories according to calorie allowance recommended by WHO but not in mothers on recommended calories.

Carcinoma of gall bladder.

A study of 118 newly diagnosed patients with gallbladder disease during a two year period showed that the frequency of gallbladder cancer was 8.4% and cholelithiasis played a significant role in its etiology. No remarkable differences were observed in the clinical and biochemical findings between the benign and malignant disease of gallbladder.

Composition of gall stones-microchemical analysis.

The composition of gall stones removed surgically from 31 patients was determined by microchemical analysis. Twenty six had mixed infective, 2 cholesterol and 3 pigment stones. All the stones consisted of combination of various constituents in varying amount. Bilirubin was detected in the centre and peripheral layers of all, protein was found in the centre of 84.6% and cholesterol in the centre of 54% and the peripheral layers of all the gall stones. The findings in this study suggest that infection is the most likely cause of biliary lithogenesis.