an individual pattern of development in the perinatal period. Glutathione peroxidase activity increased by 135% ( p < 0.001) during the last 3 days before birth, catalase activity by 105% ( p < 0.01) during the first 2 postnatal days, and the activity of superoxide dismutase by 52% (p < 0.05) from gestational day 19 to 2 days after birth.Contamination by superoxide dismutase from blood in the lung samples accounted for less than 2% of the activity. In contrast, not less than 10-30% of glutathione peroxidase

SummaryAmniotic fluid cells provide important information about the fetus. Studies of the surface ultrastructure of such cells identified four cell populations in midgestational fluids. A parallel study of tissue surfaces in contact with or communicating with the amniotic fluid showed that some tissues made no contribution to the cell populations, while others contributed extensively. Two principal cell shedding mechanisms were found in mid‐trimester—exfoliation of whole cells and detachment of cellular fragments. The latter mechanism was observed from skin and umbilical cords during a limited period in mid‐pregnancy. The majority of cells were derived from exfoliation of squamous epithelia.

The value of ultrasound and 131-Hippuran renography for diagnosing hydronephrosis during pregnancy was investigated. In a control series of 31 symptom-free pregnant women the ultrasonographically measured renal pelvic diameters in the three trimesters were 5, 10 and 12 mm on the right side and 3, 4 and 5 on the left, respectively. In ten healthy non-pregnant women the pelvic diameter varied from 3 to 9 mm on the right side and from 2 to 6 mm on the left side when measured during antidiuresis and water diuresis. Out of 35 pregnant women complaining of flank pain, 31 showed an increased renal pelvic diameter. These 35 women also underwent renography on the same day as the ultrasound examination. In 6 of 27 pregnant women with right-sided pain and in 3 of 8 with left-sided pain, diuresis renography indicated acute ureteral obstruction and in 6 of these 9 patients impairment of renal parenchymal function was also evident. In some cases the impaired renal function was fully reversed after surgical intervention. It is concluded that ultrasound investigation of the kidney is a valuable method for screening prior to renography. Since the negative prediction value of using 17 mm as the upper limit of the pelvic diameter was 100%, patients with a smaller pelvic diameter may not need to be referred further for renography or urography, and radiation will thus be minimized. On the other hand, renography is indicated when the pelvic diameter is more than 17 mm in patients complaining of flank pain.(ABSTRACT TRUNCATED AT 250 WORDS)

The value of four amniotic fluid tests – the lecithin/sphingomyelin ratio, the presence of phosphatidylglycerol, amniotic fluid cytology and the creatinine concentration – in the prediction of fetal lung maturity was investigated. The sensitivity was high for all tests except for amniotic fluid cytology, which had a higher specificity. The overall outcome, particularly the value for predicting immaturity, was improved by various combinations of tests. The combination of amniotic fluid cytology and creatinine proved useful in predicting the gestational age. A diagram for estimation of gestational age is presented.

Abstract. The increased incidence of the idiopathic respiratory distress syndrome (IRDS) in infants of diabetic mothers may be explained by preterm delivery and asphyxia but the metabolic derangement per se may also be responsible for the inadequate production of surfactant. Experimental studies of the underlying mechanisms in the lungs of fetuses of pregnant diabetic rats have shown a decreased formation of the two major surfactant phospholipids disaturated phosphatidyl choline and phosphatidyl glycerol. In addition, the activities of key enzymes responsible for the production of these phospholipids are decreased in the fetal lung tissue. Inadequate utilization of pulmonary glycogen for surfactant biosynthesis has also been observed. Furthermore, experimental studies support that other changes than fetal hyperinsulinaemia are needed to produce a state of disturbed surfactant production. In human diabetic pregnancy strict metabolic control allows the fetal lungs to mature in a near-normal fashion. The presence of phosphatidyl glycerol in the amniotic fluid seems to be the best available predictor of lung maturity in diabetic pregnancy, in which both the lecithin/sphingomyelin ratio and amniotic fluid cytology may result in false-positive and false-negative values. The trend towards extension of delivery to term will undoubtedly diminish the need for estimation of fetal lung maturity by amniocentesis. Avoiding preterm delivery and adhering to strict metabolic control of the maternal diabetes would be expected to decrease the neonatal respiratory problems in diabetic pregnancy.