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Natural History of Streptococcus Faecalis Endocarditis

1960; BMJ; Volume: 2; Issue: 5199 Linguagem: Inglês

10.1136/bmj.2.5199.640

0959-8138

Charng Chee Toh, K. P. Bali,

Otolaryngology and Infectious Diseases

ANAEMIA IN PREGNANCY MBAJORNsAThe present investigation has confirmed that a deficiency of folic acid is very common in late pregnancy, and can readily be prevented by prophylactic admini- stration of this vitamin.The risk of inducing neuro- logical changes in an unrecognized case of Addisonian anaemia, in this age-group and with such a short course of treatment, is exceedingly slight.We therefore have not thought it necessary to add vitamin B12 to our prophylactic regimen.Over the age of 30, however, patients with megaloblastic anaemia of pregnancy should be investigated with Addisonian anaemia in mind.In the two hospitals concerned no case has been found in association with pregnancy during the last three years.Francis and Scott (1959) appear to have reached similar conclusions. SummaryIn order to study the routine administration of folic acid during the last trimester of pregnancy, the haemo- globin levels at term of 758 women treated with folic acid and iron have been compared with 721 controls treated with iron alone.The mean haemoglobin in the group treated with folic acid was 82.2%, as against 79.82% in the controls.The difference of 2.38% is statistically significant (P<0.01).Folic acid appeared to raise the haemoglobin not only of anaemic patients but also of normal women, resulting in a higher haemoglobin value at all levels.A comparison of the 721 controls with 983 pregnant women who attended the antenatal clinic before routine iron prophylaxis in hospital was begun has shown a rise in the haemoglobin at term from 73.4 to 79.82%.66% of women had haemoglobins of less than 80% when they first attended hospital, but in the majority the anaemia responded to treatment even in the control group.In at least 20% of patients who remained anaemic despite treatment there was a sharp rise in the haemoglobin after delivery.A further 66 cases of megaloblastic anaemia of pregnancy have been reported, 45 of which were diagnosed during the period of the folic-acid trial.There were no cases of the disease in the group treated with folic acid, but the incidence in the control group was also somewhat lower than in the past.The overall inicidence was 1.2% of all hospital confinements.In 14 out of 41 cases of megaloblastic anaemia there was evidence of diminished fat-absorption.Our thanks are due to Mr. L. M. Edwards for his co-operation throughout this investigation, and to Mr. A. C. Key, F.LM.L.T., for the biochemical findings; to Miss Kathleen Weaver, A.I.M.L