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We have investigated the relationship between erythropoietin (Epo) and pH, PaO₂ and haematocrit in 100 cord blood samples obtained at Caesarean section prior to labour. Of 82 term ( > 37 weeks) infants, 64 were appropriately grown (10^th–90th centiles), and their mean cord serum Epo and cord blood Epo was 23 ± 8 mU/ml (mean ± SD). Strong inverse correlations were found between cord serum Epo and cord blood pH (r = ––0.74; p < 0.0001), and between cord serum Epo and cord blood PaO₂ ( r = ––0.55; p < 0.0001), but not between cord serum Epo and cord haematocrit (r = 0.02; p < 0.9). For the 18 preterm babies (gestation 32.4 ± 4.1 weeks, birth weight 1,820 ± 476 g), the Epo level was 36 ± 8 mU/ml, which was not significantly greater than for the term babies. Strong inverse correlations were again found between Epo and pH (r= ––0.87; p < 0.0001) and Epo and PaO₂ (r = ––0.69; p < 0.002). Babies from complicated pregnancies (intra-uterine growth retardation, pre-eclampsia, antepartum haemorrhage, diabetes mellitus and fetal distress) tended to have higher Epo levels. Thirteen babies had Epo levels > 40 mU/ml, and 11 (85%) of these required neonatal intensive care. Cord serum Epo correlates better with oxygen tension and pH at birth than with fetal growth and haematocrit, which are measures of chronic stress to the fetus.

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The objective was to assess the feasibility of nonsurgical evacuation of first trimester pregnancy wastage. A randomized control trial involving three groups: (1) dilatation and curettage (D&C) only, (2) intramuscular prostaglandin methyl-F2a, 500 ixg in a single injection (PGmF2(ï, 500 pug IM), (3) oral Trilostane, 120 mg every 6 hours on four occasions, together with PGmF2o, 500 \xg IM administered with the third trilostane dosage. Sixteen patients were referred to the Coombe Hospital and diagnosed ultrasonographically as having an incomplete miscarriage or missed abortion of < 12 weeks gestation. Treatment failures were subjected to D&C. The main outcome measures included the number of complete evacuations diagnosed ultrasonographically, analgesic requirements, side effects, and symptoms at 6 weeks after treatment. Using a reduction in uterine cavity surface area to < 6 cm2 as success following treatment, complete evacuation occurred in 100% of women treated with Trilostane and prostaglandin, 50% of women treated with prostaglandin only, and 40% of women treated by D&C only. The combination of Trilostane and prostaglandin is very effective in evacuating first trimester incomplete miscarriage or missed abortion. However, further dosage refinements are necessary to minimize prostaglandin side effects. (J GYNE-COLSURG 8:159, 1992) Address reprint requests to: Eftis Paraskevaides Lecturer for the RCSI Coombe Lying In Hospital Dublin 8Ireland