Lupus anticoagulants, anticardiolipin antibodies, and fetal loss: a case-control study

Article Abstract:

Lupus anticoagulants and anticardiolipin antibodies are two forms of autoantibodies, or antibodies which react with the body's own tissues. Both lupus anticoagulants and anticardiolipin antibodies react with phospholipids, molecules which are common constituents of cell membranes. Such autoantibodies are often found in association with pathological conditions, including thrombosis, thrombocytopenia (a reduction in the number of platelets), and fetal loss. However, since such antibodies also found in some individuals with no apparent ill effects, the role of these antibodies in disease remains unclear. While numerous studies have indicated that lupus anticoagulants and anticardiolipin may be associated with fetal loss, not all studies have confirmed these findings. Furthermore, many of the studies focused on women who had recurrent fetal loss. There are no data which indicate that the presence of these antibodies might be an indicator of increased risk of fetal loss. To examine this question further, a case-control study was conducted of 331 women who suffered spontaneous abortion or fetal death. The clinical findings in these patients were compared with those of 993 women who were pregnant during the same period but who did not have a fetal loss. It was found that 5.1 percent of the patients who suffered fetal loss had the autoantibodies, as did 3.8 percent of the women who were unaffected by fetal loss. This difference is not significant, and the results of this study provide no reason to consider lupus anticoagulants or anticardiolipin antibodies as a risk factor for fetal loss. It should be emphasized, however, that the women in this study lost one fetus and did not have a history of recurrent fetal loss. The present study did not address the question of whether these antibodies may serve as prognostic indicators among women who have lost more than one fetus. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Miscarriage, Antiphospholipid antibodies, Anticardiolipin antibodies

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Why can't a woman be more like a man?

Article Abstract:

The role of women in medicine has rapidly expanded. Thirty-four percent of current medical school students are women, and the percentage of female medical residents now totals 28. Many of these women combine family life with medical training. Residency is, at best, a period of arduous, exhausting work. While the work shifts that resident physicians could be required to perform in the past were essentially uncontrolled, recent legislative changes (as in in New York) have led many areas to restrict residents' hours on duty. An article in the October 11, 1990 issue of The New England Journal of Medicine reports that the long hours, physically exhausting work, and high levels of stress have little effect on the pregnancies of medical residents, compared with a control group of wives of residents. However, the needs of pregnant residents are evidenced by the frequent lack of maternity leave policy at training hospitals. A recent survey of 342 hospital-members of the the Council of Teaching Hospitals revealed that 57 percent do not grant maternity leave to residents. One hundred and twenty-six institutions reported that postpartum leave is granted, but 62 percent limit the period to 6 to 8 weeks. In addition to the issue of hospital policy, women physicians who do take maternity leave come under fire from their peers, both males and females, and often by their program directors. The mother-physician may also be handicapped by missing a significant period of training. Although her knowledge about pregnancy and children may be increased by her childbearing and maternal experience, postpartum leave is viewed only as a gap in her medical education. The value of a mother's time at home during her baby's first months is a question that remains unaddressed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Statistics, Family, Vocational guidance, Women physicians, Work rules, Maternity benefits, editorial

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Outcome of pregnancy in women with moderate or severe renal insufficiency

Article Abstract:

Women with moderate to severe kidney disease will probably have a higher incidence of pregnancy complications but the probability that their infants will survive is very high. This was demonstrated in 82 pregnancies in 67 women with moderate to severe kidney disease. Twenty-eight percent had high blood pressure before pregnancy but that figure rose to 48% by the third trimester. Forty-three percent experienced a rapid decline in kidney function directly related to the pregnancy and eight of these pregnancies led to end-stage kidney disease. However, 93% of the infants survived.

Complications and side effects, Pregnant women, Kidney diseases

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