Sarcoidosis is a granulomatous multi-system disease of unknown aetiology affecting many organs. Generally, pregnancy has no adverse effect on sarcoidosis and it seems unlikely that the disease would affect the pregnancy or the fetus. Usually, a woman with sarcoidosis should be reassured to carry on her pregnancy. However, a progression of sarcoidosis and the outcome of pregnancy mostly depends on the type and severity of the extrapulmonary lesions. Some localisations, particularly in the kidney, although less often diagnosed may be life-threatening. Thus, a patient with advanced renal involvement should be followed carefully. We report a rare case of a pregnant woman with sarcoidosis giving rise to renal insufficiency due to nephrocalcinosis. The present case shows that the impairment of renal function prior to conception is of major importance. The use of colour Doppler sonography as an additional method for evaluation of kidney function is described.

Objective: The functional link between vascular resistance and flow velocity pulsatility in the kidney has not been well established. The aim of the study was to apply the Gosling model in studies on renal vascular hemodynamics in normal pregnancy and in pre-eclampsia. Methods: Thirty-one women with normal pregnancy and 42 women with preeclampsia were examined. The renal artery pulsatility index (PI) was obtained by Doppler velocimetry. A back pressure (Pz) was calculated including mean arterial pressure (MAP) in the PI formula. Consequently, MAP-Pz is assumed to represent the pressure left for perfusion. Results: In women with pre-eclampsia PI was significantly lower, whereas Pz and MAP-Pz were significantly higher as compared with the normal pregnant women. There was a significant difference between mild and severe pre-eclampsia in respect to MAP-Pz. Within the pre-eclamptic group an inverse relationship between PI and MAP as well as a linear relationship between PI and pressure pulsatility index (PPI) were observed. There was an inverse non-linear relationship between PI and MAP-Pz. Conclusion: A strong dependence of the renal artery PI on input pressure and Pz property of the vascular bed was demonstrated. Our results emphasize that PI should be used with caution when assessing vascular resistance, and that blood pressure should always be taken into account. The calculation of Pz and MAP-Pz might provide new information on kidney hemodynamics.

In this study Doppler ultrasound was used to measure the blood flow velocity in the main and segmental renal arteries in 16 healthy non-pregnant women. There were no differences in blood flow indices between the right and left kidneys as well as between the main and segmental arteries. The variability of the indices in the main and segmental renal arteries in healthy non-pregnant and in the segmental renal artery in normal pregnant women (32-37 weeks of gestation) was investigated. The within-patient error standard deviations of ten cycles and two, and three to nine averaged cycles were compared. In non-pregnant women, values for the error standard deviation comparable with those obtained from ten cycles for the systolic/diastolic ratio and pulsatility index from both main and segmental arteries were obtained by averaging from five to six consecutive cycles, while the error standard deviation for the resistance index stabilized when averaging only two to four cycles. In pregnant women, the error standard deviations for both the systolic/diastolic ratio and pulsatility index reached quite stable values after three cycle had been averaged as did the error standard deviation for the resistance index. We speculate that this difference between non-pregnant and pregnant women is due to more favorable conditions for renal visualization and consequently higher quality Doppler signals during pregnancy. A knowledge about the number of cardiac cycles required for an accurate calculation of renal blood flow velocity indices may prevent time-consuming calculations and inaccurate conclusions.

This study was performed to evaluate the in vitro effects of a new polypeptide, endothelin-1 (ET-1) on small intramyometrial vessels in comparison with the action of noradrenalin (NA). In connection with cesarean section, myometrial biopsies were obtained and small arteries (100-500 microns in diameter) were excised. Cylindrical segments of these vessels were used for registration of contractile activity after administration of ET-1 and NA. ET produced vasoconstriction and was approximately three times as powerful and 70-fold as potent as NA. It is suggested that ET may be involved in the regulation of human utero-placental blood flow.

To assess the effect of isradipine on blood pressure. and uteroplacental and fetal blood flows in pregnancy-induced hypertension, 41 women with a diastolic blood pressure ≥ 95 mm Hg were included in our study. Of these, 27 received isradipine 5 mg twice daily. Uteroplacental blood flow index was calculated from the activity-time curve of the very low radiation from the placenta after intravenous injection of 18.5 Hq indium-113m. Blood flow velocity was measured in the uterine and umbilical arteries, and fetal aorta, using the pulsed Doppler technique. Investigations were per-formed before and after 1 week of isradipine. A control group of 14 women was examined in the same way. The isradipine group showed a significant reduction in mean arterial pressure (from 117 to 112 mm Hg) whereas there was no change in the controls. Uteroplacental blood flow indices were similar before treatment in both groups and did not change during treatment. Furthermore, the pulsatility indices were the same in both groups at the first examination and also did not change. Isradipine had no adverse effects on the fetus. In conclusion, isradipine lowered blood pressure without altering uteroplacental or fetal blood flows.

International Journal of Gynecology & ObstetricsVolume 7, Issue 3 p. 124-135 Article Gas Chromatographic Estimation of Individual Urinary 11-Deoxy-17-Ketosteroids A Routine Method Suitable for Departments of Obstetrics and Gynecology Kjell Carlström PhD, Kjell Carlström PhD Department of Obstetrics and Gynecology, Sabbatsberg Hospital, Karolinska Institutet, Stockholm, SwedenSearch for more papers by this authorMirjam Furuhjelm MD, Mirjam Furuhjelm MD Department of Obstetrics and Gynecology, Sabbatsberg Hospital, Karolinska Institutet, Stockholm, SwedenSearch for more papers by this authorAxel Ingelman-Sundberg MD, Axel Ingelman-Sundberg MD Department of Obstetrics and Gynecology, Sabbatsberg Hospital, Karolinska Institutet, Stockholm, SwedenSearch for more papers by this authorNils-Olov Lunell MD, Nils-Olov Lunell MD Department of Obstetrics and Gynecology, Sabbatsberg Hospital, Karolinska Institutet, Stockholm, SwedenSearch for more papers by this author Kjell Carlström PhD, Kjell Carlström PhD Department of Obstetrics and Gynecology, Sabbatsberg Hospital, Karolinska Institutet, Stockholm, SwedenSearch for more papers by this authorMirjam Furuhjelm MD, Mirjam Furuhjelm MD Department of Obstetrics and Gynecology, Sabbatsberg Hospital, Karolinska Institutet, Stockholm, SwedenSearch for more papers by this authorAxel Ingelman-Sundberg MD, Axel Ingelman-Sundberg MD Department of Obstetrics and Gynecology, Sabbatsberg Hospital, Karolinska Institutet, Stockholm, SwedenSearch for more papers by this authorNils-Olov Lunell MD, Nils-Olov Lunell MD Department of Obstetrics and Gynecology, Sabbatsberg Hospital, Karolinska Institutet, Stockholm, SwedenSearch for more papers by this author First published: June 1969 https://doi.org/10.1002/j.1879-3479.1969.tb00043.xCitations: 8AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Citing Literature Volume7, Issue3June 1969Pages 124-135 RelatedInformation