産科領域における血中アンモニアに関する研究
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Studies on blood ammonia in the obstetrical field hade been described since 1930, when Bock first reported on this subject. However, the number of reports on this subject are few and the results of the studies are varying.<BR>To examine above varying results closely, this author, conducted measurements of blood ammonia, and blood urea nitrogen, which is closely connected to the first substance, of women who were pregnant, parturient or puerperal. Further, in cases of toxemia of late pregnancy, drugs which are closely related to ammonia disposition in vivo and urea cycle, were administered to examine the relation between their clinical effect and blood ammonia and urea nitrogen. Again, in order to observe the passage of ammonia through the placenta, the ammonia in the cord blood was determined.<BR>In measuring blood ammonia, Seligson's method was employed, and in measuring urea nitrogen, Diacetyl-Monoxime method was used.<BR>The result obtained were as follows :<BR>1. The quantities of blood ammonia in normally pregnant women and in parturient or puerperal women were found to be higher in values compared with those in non-pregnant healthy women. In normally pregnant women, the values were found to rise higher and higher as the time of parturition approached, and, at the first stage of labor, to reach the highest values, but when they entered into puerperal period, they began to fall gradually, and one month after parturition, they recovered the values approximating to those of healthy non-prgnant women.<BR>2. The quantity of blood ammonia in the case of hyperemesis gravidarum or of toxemia of late pregnancy was found to be higher in value than in a normally pregnant woman at the same stage.<BR>3. As the result of a continued investigation of the quantities of blood ammonia, urea nitrogen and the coefficient of hyperemesis gravidarum in patients with hyperemesis gravidarum, it was found that, when the patients received treatment, the values of blood ammonia and urea nitrogen gradually decresed, and the coefficient of hyperemesis gravidarum rapidly decreased.<BR>4. After the patients with hyperemesis gravidarum were given aspartate or ornitine aspartate, the quantities of blood ammonia was found reduced compared with those before treatment. Again, when patients with toxemia of late pregnancy was given aspartate, the quantity of blood ammonia was found to be reduced, showing clinically effective.<BR>5. The quantity of blood ammonia in toxemia of late pregnancy was found the highest in value when this case was serious with the three indicants. The value was the second highest when the case had an indicant of high blood pressure, the third highest when the case had an indicant of albuminurea, and the fourth highest in the case with an indicant of edema.<BR>6. In the case of toxemia of pregnancy, the quantity of blood ammonia at each stage of labor was higher in value than that at each stage in normal parturition, and continued to be high from the first stage of labor till the stage of after-birth, though in normal parturition it falls during the same period. The quantity of urea nitrogen showed no change through all the stages.<BR>7. The quantities of blood ammonia and urea nitrogen at each stage of suction parturition showed higher values as compared with their quantities at each stage of normal parturition.<BR>8. As regards the relation between the length of time needed for parturition and the quantities of blood ammonia and urea nitrogen, no significant change was noticed in the quantities of blood ammonia and urea nitrogen even when the time for the first stage of labor or the expulsion period was prolonged. At the the stage of after-birth, when the period needed for it was prolonged, the value of blood ammonia tended to rise.<BR>9. In the venous blood of the navel cord, approximately the same quantity of blood ammonia as that in the maternal blood was noticed.
- 学校法人 昭和大学・昭和医学会の論文