Calcium metabolism in African primigravids.

Serum calcium inorganic phosphorus, protein and alkaline phosphatase as well as urine calcium were studied in fifty-five primigravid Nigerian women during pregnancy and postnatal period. Each patient was seen at the various stages of pregnancy and thus acted as her own control. Serum calcium levels fell with progressing pregnancy. Urine calcium showed a highly significant decrease throughout pregnancy and in the puerperium. Alkaline phosphatase showed a continuous rise with advancing gestation which was statistically highly significant, with a return towards normal values in the postnatal period. Serum inorganic phosphorus showed no significant alteration right through the pregnancy period. The normoproteinaemia seen in the group studied suggests that albumin did not make any contribution to the fall in the serum calcium levels seen during the study.

Serum and urine electrolytes in primigravid Africans during pregnancy and postnatal period.

Serum and urine electrolyte changes were studied in 55 primigravid African women during pregnancy and the postnatal period. The findings suggest that there is a fall in the serum sodium in the first trimester, which is followed by a gradual and steady rise throughout pregnancy. The serum potassium did not show any consistent pattern, while the serum chloride generally followed that of the serum sodium. These findings are similar to those reported for the Caucasian, although the African subject displays a lower serum sodium level and a much higher chloride level throughout pregnancy and the postnatal period. It is suggested that the reduction in sodium excretion noted in the third trimester is a reflection of the increasing sodium concentration in the blood with advancing pregnancy. The few patients who developed oedema and pre-eclampsia excreted relatively larger amounts of sodium in the puerperium.

Insulin-reaction test for diagnosis of low renal threshold for glucose in African diabetics.

Ten randomly selected Nigerian diabetic patients who were given an intramuscular insulin-reaction test (I.M.I.R.T.) to determine their renal threshold for glucose were found to have a very low mean renal threshold. This finding could be of great significance in the clinical management of Nigerian diabetics in whom relatively high urine-sugar levels may be found despite low blood-glucose levels. It is suggested that the I.M.I.R.T. be routinely carried out, where possible, for more accurate management of the Nigerian diabetic patient.