A survey of pregnant women with tuberculosis at the Port Moresby General Hospital.

From March 1995 to February 1998, 110 patients diagnosed with tuberculosis (TB) in pregnancy or the puerperium at the Port Moresby General Hospital (PMGH) were surveyed. 96% were diagnosed as a result of the symptoms of tuberculosis, 4% through contact tracing. 11 of 40 patients who first attended antenatal clinic in the second trimester were not diagnosed until after delivery. The mean birthweight of term infants of TB patients was significantly less than term infants in a previous survey at PMGH. 45% of babies were growth restricted. With increasing duration of treatment, both increasing maternal weight gain in pregnancy and higher mean birthweight were found. Maternal and perinatal mortality were high in the study patients. There were 6 maternal deaths and a perinatal mortality rate of 137/1000. The majority of maternal and fetal losses occurred in patients who had pulmonary, miliary and meningeal TB. Improvement in the detection of tuberculosis in antenatal patients and the introduction of adequate treatment before delivery should prevent maternal deaths and perinatal morbidity and mortality.

Reporting of lactation and normal menstrual information by Papua New Guinean women.

As part of a survey of 600 women enrolled in a study of postpartum progesterone-only contraception (400 women who opted to use progesterone-only contraception and 200 controls) participants were asked about menstrual history and lactation experience. The mean longest menstrual cycle duration was found to be 29.5+/-SD3.5 days and the mean shortest cycle duration was 26.6+/-SD2.8 days. The mean duration of menstrual bleeding was 3.75+/-SD1.16 days. Few women reported menstrual period problems such as dysmenorrhoea (6.5%) and menorrhagia with clots (0.7%). However, 3% of the women reported irregular cycles with intervals of longer than 1 month. Overall the women reported breastfeeding their previous baby for a mean duration of 14 months. The group of women electing to use hormonal contraception reported that they had breastfed their last baby for 13.5+/-SD7.5 months while control women had done so for 14.1+/-SD9.4 months. The longest mean duration that women reported to have breastfed a previous infant was 19.5+/-SD9.6 months in the hormonal contraception group and 19.1+/-SD8.6 months in the control group.

Failure of chloroquine malaria prophylaxis in pregnancy.

Women in a hyperendemic malarious area of Papua New Guinea are supplied with weekly chloroquine chemoprophylaxis at antenatal clinics. A study of 180 women in late pregnancy failed to show any difference in Plasmodium falciparum parasite rates between regular and irregular clinic attenders. Nor was anaemia in late pregnancy associated with parasitaemia; however, grandmultiparas exhibited significantly more prevalent parasitaemia and anaemia in late pregnancy. This study reveals a need for a more detailed investigation of the effects and usefulness of chemoprophylaxis with chloroquine in areas where P. falciparum chloroquine resistance is present.