Diabetes mellitus and pregnancy

Diabetes mellitus and pregnancy

KLEMPNER : 129 TJRETEROHYDRONEPHROSIS markedly improved, as evidenced by the ability of the kidney to concentrate up to 1.018 in comparison with t...

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KLEMPNER

:

129

TJRETEROHYDRONEPHROSIS

markedly improved, as evidenced by the ability of the kidney to concentrate up to 1.018 in comparison with the previous level of 1.010. A normal-sized uterus with bilateral adnexal ma.sses can now be felt. The pelvic mass has diminished in size though the infiltration of the rectovaginal septum still persists. The pelvic mass is now somewhat movable i-n comparison with its previous dense adherence to the pelvic walls (Fig. 4). Intravenous pyelogram (Feb. 10, 1937) shows a definite decrease in the ureterohydronephrosis particularly on the left side (Fig. 5). It has been interesting to follow this unusual complication in a common disease and to note the improvement under a conservative regime. 69 EAST

90TH

STREET

Courtois, J., Longuet, A., and Bacillus Infections of Pregnancy,

Lecoq,

R.:

The

Gynecologie

R6le (Paris)

of 35:

Avitaminosis in Coli 216,

1936.

According to the authors disturbances in the female sex hormones predispose to acidosis. The presenceof vitamins in general and vitamins A and B in particular plays a very important role in pregnancy. Lack of vitamin A increases the tendency to acidosis. The absence of vitamin A diminishes the defense of the villus epithelium and favors infection, particularly infection due to the colon bacillus. E:xogenous and endogenous factors may also result in colon bacillus infections during pregnancy. The exogenous factors usually arise in the alimentary hlkalosis like acidosis may favor the development of a colon bacillus but alkalosis is extremely rare in a pregnant woman whereas acidosis is common. With this knowledge it is easy to overcome colon bacillus during pregnancy. The means consist of overcoming alkalosis or more acidosis by the administration of phosphoric acid or sodium bicarbonate. there must be an abundant supply of vitamins A and B. In some instances injections are necessary and in others a serum or vaccine may help. J.

Kraus, J.: Diabetes Mellitus and Pregnancy,

Med.

Klin.

32:

375,

P.

tract. infection, unusually infections commonly Likewise, saline

GREENHILL.

1936.

Before the advent of insulin a pregnancy in patients with diabetes mellitus was rare, because of severely regressive changes in the follicle apparatus of the ovaries which led to amenorrhea and sterility. The probable cause for this is diminished function of the hypophysis. In most cases the diabetes antedates the pregnancy. First appearance of Before the introduction of diabetes during pregnancy is rather uncommon. insulin, pregnancy was a serious complication of diabetes. During the latter part of pregnancy, there is less danger from diabetes but there is an aggravation again after labor and during the puerperium. Since the use of insulin the maternal mortality has dropped from limit8 between One danger of insulin is hypoglycemic coma. In 27 and 55 per cent to 17 per cent. Furthermore, a spite of insulin the fetal death rate still is about 43 per cent. large proportion of these children die during the first few weeks of life. Many ohildren born of diabetic mothers are overweight which is due to the hyperglycemia of the mother. When insulin is used most of the babies have a normal weight. J. P. GREENHILL.