Total-, free-, and acylcarnitine concentrations were determined in whole blood, plasma, and red blood cells of 88 women during pregnancy. Already in the 12th week of gestation the mean whole blood carnitine level was significantly (p < 0.01) lower than those of the controls. From the 12th gestational week up to parturition there was a further significant (p < 0.01) decrease. This reduction of total carnitine in whole bloods was mainly caused by a significant (p < 0.01) decrease of free carnitine levels, since no marked changes of short chain acylcarnitine values were found throughout pregnancy. The contribution of red blood cell L-carnitine to whole blood carnitine increased significantly (p < 0.05) to 61% at delivery versus 39% (controls). In umbilical cord blood free and total carnitine levels were significantly (p < 0.05) higher than the corresponding maternal levels. The contribution of red blood cell L-carnitine to whole blood carnitine was higher in cord blood than in maternal blood. The results of the present study demonstrate that during pregnancy whole blood and plasma carnitine levels decrease to those levels found in patients with carnitine deficiency. Also the percentage of acylcarnitine on total carnitine, found in the present study, is characteristic for a secondary carnitine deficiency. Thus L-carnitine substitution in pregnant women, especially in risk pregnancies, may be advantageous.

Cold passover and heated humidifiers are employed for the prevention of side-effects associated with continuous positive airway pressure (CPAP) treatment. However, to date, it has not been possible to separately measure the humidity of inspired and expired air. The aim of this study was to compare the relative humidity of the inspired air and the water loss during respiration between cold passover and heated humidifiers under CPAP.Humidity and temperature were determined separately for the respiratory phases, without humidification, with cold passover and heated humidifiers in 10 healthy subjects. Humidity was measured with a capacitive hygrometer, temperature with a "Type K" thermosensor, and impedance of the total respiratory system with impulse oscillometry.The The use of humidifiers is recommended for the treatment of local side-effects associated with nasal continuous positive airway pressure (nCPAP) therapy to increase the humidity and temperature of the respired air [1][2][3][4]. To date, however, only humidity data averaged over a lengthy period of time have been reported [5,6]. Humidifiers are thought to exert an effect by changing the inspired air. Separate measurement of humidity during inspiration and expiration appears to be particularly useful as, owing to the high expiratory humidity, averaging of humidity figures over lengthy periods cannot completely reveal the effect of humidification on inspired air. Therefore, the present authors studied the influence of humidification under continuous positive airway pressure (CPAP) using sensors with a small dead time, making it possible to determine the rapid changes in humidity in the alternation of inspiration and expiration. The authors aimed to compare the relative humidity (Hrel) of the inspired air between cold passover and heated humidifiers, and to measure the water loss of respiration under CPAP treatment. A secondary aim was to evaluate the impedance (Z) of the total respiratory system under the various humidification systems. Methods SubjectsThe study included 10 healthy subjects (six males and four females, mean¡SD age 28.8¡10 yrs, body mass index (BMI) 23.4¡2.9 kg?m -2 , no airway disease, rhinitis, nasal surgery, upper airways infections over the previous 4 weeks). Before the experiments, lung function (forced vital capacity (FVC) 109.9¡25.8% predicted, forced expiratory volume in one second (FEV1) 117.9¡30.9% pred, total lung capacity (TLC) 108.2¡17.4% pred) and nasal Z were determined (body plethysmography was performed using Master Lab1 and impulse oscillometry using IOS Rhino1, both from Jaeger, Hö chberg, Germany). The total Z of the nose was calculated from separate measurements in both nares (Z 5 Hz 4.7¡2.4 cmH 2 O?L?s -1 , resistance (R) 4.0¡2.0, reactance (X) -2.0¡2.0) [7]. DesignThe subjects were examined in randomised order in the supine position, at a CPAP pressure of 10 cmH 2 O

The C-reactive protein (CRP) concentration was determined in 25 infants whose mothers had presented with prolonged rupture of amniotic membranes (PROM) and/or amnionitis. CRP was positive (i.e. greater than or equal to 6 mg/l) within the first 6 hrs of life in 10 and negative in 15 infants. Clinically, all infants with positive CRP developed symptoms suggesting bacterial infection and both the absolute immature neutrophil counts as well as the ratio immature/total neutrophils were significantly higher in them on day 2 of life than in infants with negative CRP. Blood cultures were only positive in infants with positive CRP. Thus CRP can be regarded as an early marker for neonatal bacterial infection due to PROM and/or amnionitis.

Vaginal application of tablets containing prostaglandin at term in pregnant women with a favorable cervical score is a very efficacious method of induction of labour. Due to the motility of the women they consider this method of induction as almost natural. We, therefore, aimed at discussing the optimal procedure in low-risk pregnancies at due date, by means of a prospective randomised trial. In 345 women with a favourable cervical score, labour was either induced by means of intravaginal application of tablets containing PGE2 according to a precise plan, or spontaneous onset of labour was awaited while CTG-controls were performed on an outpatient basis every second day until the 42nd week of pregnancy was completed. 80 per cent of the nulliparas and 96.3 per cent of the multiparas of the induction group delivered within 24 hours of the first tablet application. All pertinent delivery intervals were significantly shorter in this group compared to those women where spontaneous onset of labour was awaited. The incidence of prolonged labour was low in both groups and not significantly different. Only 4.2 per cent of the women in the group where spontaneous labour was awaited, reached the completed 42nd week of pregnancy. Only one woman had to be induced because of a suspicious CTG. The rate of operative deliveries was lower in the induction group (1.1% versus 3.8% Caesarean sections). With the exception of one foetal death due to a cord complication three days after the due date the foetal outcome was excellent in both groups. The acceptance of the procedure was tested by means of a questionnaire during the post partum period.(ABSTRACT TRUNCATED AT 250 WORDS)

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