Summary In 1000 consecutive patients with singleton pregnancies 38.7 per cent were smokers and 13.7 per cent had subnormal oestriol excretion. There was a significant correlation between low oestriol excretion and both intrauterine fetal growth retardation and perinatal mortality (P<0.001). Smoking had a significant correlation with intrauterine growth retardation (P<0.001), but not with perinatal mortality (P<0.05). The incidence of low oestriol excretion in smokers (15.5 per cent) was not significantly different from that in non‐smokers (12.6 per cent) (P<0.25). Further study is required to evaluate the effects of heavy smoking on feto‐placental function. Hypoxia is probably not the important influence causing fetal growth retardation in smokers.

Evaluation in screening of hospitalized patients. Am J Clin Pathol 64: 311-314, 1975. The specificity of the serum gamma-glutamyl transpepidase (GGT) was evaluated by its determination in 1,040 unselected adult inpatients. GGT was elevated in 139 (13.4%) patients, but was only rarely elevated in the absence of elevation of other enzymes in the routine chemistry profile. Of the elevations, 32.4% occurred in patients with primary hepatobiliary disease. An elevated serum GGT is a strong indicator of hepatobiliary dysfunction. However, proper interpretation of a serum GGT elevation requires correlation with clinical data and other tests.

Summary: Subnormal urinary oestriol excretion was present in an apparently normal pregnancy and it is suggested that a rare combination of fetal anomalies including diabetes insipidus, absence of the septum pellucidum and optic nerve hypoplasia was the explanation.

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