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Background: DR Congo has adopted universal salt iodization to reduce disorders due to iodine deficiency. Since 1994, only iodized salt can be imported, but there is currently no routine monitoring of the iodine content of distributed salt. It is therefore unclear if iodine deficiency remains a health problem, particularly in pregnant women.Objective: To evaluate the iodine content of salt in households of pregnant women in Lubumbashi.Methods: We conducted a survey of the iodine content of salt consumed by 375 women presenting at prenatal consultations in three socially different areas of Lubumbashi: urban, semiurban, and rural. The women were questioned about where they purchased salt, how it was packaged, and how they stored the salt, and each woman provided a sample of salt for determination of its iodine content by the iodometric method.Results: Most women (84.3%) bought salt in the public markets, mainly in bulk (93.6%); 80.0% stored salt in plastic boxes. The median iodine content was 27.5 ppm (IQR, 16.0-38.1) in urban areas, 19.0 ppm (IQR, 7.4-31.7) in semiurban areas, and 20.1 ppm (IQR, 5.3-31.7) in rural areas. The iodine content was less than 15 ppm (minimum threshold) in 36.3% of samples, including 13.9% without any detectable iodine. The iodine content was above 40 ppm (maximum limit) in 18.9% of samples. Only 44.8% of salt samples had adequate iodine content.Conclusions: The population of Lubumbashi remain at risk for hypothyroidism and hyperthyroidism. A effective and regular system for the control of iodin content in distributed salt is needed in DR Congo. [ABSTRACT FROM AUTHOR]

Background: Despite notable progress in the fight against iodine deficiency disorders in the Democratic Republic of Congo, a recent study has shown that pregnant women in Lubumbashi were still iodine deficient. Our objective was to assess thyroid function in this population., Methods: In a cross-sectional study conducted in maternity units from three different socioeconomic areas in Lubumbashi, serum thyrotropin, free thyroxine, thyroglobulin, and thyroperoxidase antibodies were measured in 225 pregnant women attending antenatal visits, in 75 women who recently delivered, and in 75 nonpregnant controls. The outcome was the prevalence of thyroid dysfunction., Results: Median values in pregnant women, women who recently delivered, and nonpregnant women were 1.80, 2.80, and 1.54 mIU/L for thyrotropin (p<0.001); 0.85, 1.11, and 1.16 ng/dL for free thyroxine (p<0.001); and 13.3, 9.5, and 10.4 ng/mL for thyroglobulin (p=0.01), respectively. The prevalence of thyroid dysfunction in pregnant women, in women who recently delivered, and in nonpregnant women was 31%, 8%, and 20% for isolated hypothyroxinemia (p<0.001); 12%, 24%, and 5% for subclinical hypothyroidism (p=0.002); 8%, 3%, and 3%, for overt hypothyroidism (p=0.09); and 5%, 13%, and 4%, for positive thyroperoxidase antibodies (p=0.03), respectively. In multiple logistic regression, women who were pregnant or who recently delivered, who lived in a poor socioeconomic area, and who had low urinary iodine concentration were more likely to have an increased serum thyrotropin: odds ratio (OR)=3.43 (95% confidence interval [CI] 1.23-9.53) for pregnancy, OR=4.49 [CI 1.66-15.01] for postpartum period, OR=3.68 [CI 1.85-7.35] for semiurban area, and OR=0.44 [CI 0.19-0.96] for urinary iodine concentration ≥ 250 μg/L., Conclusions: Our results show that there is a high prevalence of thyroid dysfunction in pregnant women of Lubumbashi, and this high prevalence is associated with iodine deficiency. To prevent obstetrical adverse outcomes and neurological damage in children, iodine supplementation is needed before conception or in early pregnancy in Lubumbashi.

Objective: Adequate iodine and Fe intakes are imperative during pregnancy to prevent fetal defects, but such data are not available in the Democratic Republic of Congo. We aimed to assess iodine and Fe status in pregnant women from Lubumbashi., Design: Cross-sectional study. We measured urinary iodine concentration (UIC) in random urine samples using a modified Sandell–Kolthoff digestion method; the WHO reference medians were used to classify iodine intake as deficient, adequate, more than adequate or excessive. Serum ferritin concentrations were measured by immunoenzymatic assay and considered insufficient when ,12 ng/ml., Setting: Maternity units from rural, semi-urban and urban areas of Lubumbashi, Democratic Republic of Congo., Subjects: Two hundred and twenty-five randomly selected pregnant women attending prenatal consultation, seventy-five postpartum women and seventy-five non-pregnant women as controls., Results: Overall median UIC in pregnant women was 138 (interquartile range: 105–172) mg/l, indicating iodine deficiency, whereas postpartum and nonpregnant women had adequate iodine intake: median UIC5144mg/l and 204mg/l,respectively. Median UIC values were lower in late pregnancy than in early pregnancy: in the first, second and third trimester respectively 255mg/l, 70mg/l and 88mg/l in the rural area; 306mg/l, 166mg/l and 68mg/l in the semi-urban area; and 203mg/l, 174mg/l and 99mg/l in the urban area. Fe was insufficient in 39% of pregnant women compared with 21% of non-pregnant and postpartum women. In the third trimester, deficiencies in both iodine and Fe were high: 40%, 12% and 18% in the rural, semi-urban and urban areas, respectively., Conclusions: Our data suggest that pregnant women are at risk of iodine and Fe deficiencies in Lubumbashi. Country policies fighting against iodine and Fe deficiencies during pregnancy should be reinforced.

Background: Although HIV testing is offered during antenatal care, the proportion of women giving birth without knowing their HIV status is still important in DR Congo. The objective of this study was to determine the acceptability of rapid HIV testing among parturients in labor room, and to identify factors that are associated with the acceptability of HIV testing., Methods: Intervention including rapid HIV testing among pregnant women in labor rooms in Lubumbashi for 5 months, from September 2010 to February 2011. Pregnant women who tested HIV positive were attended by prevention of mother-to-child transmission service. Descriptive statistical analysis and logistic regression were performed., Results: Among 474 pregnant women who enter the labor room, 433 (91.4%; confidence interval [CI]: 95%: 88.4-93.7%) had voluntary testing for HIV in the labor room after counseling. The acceptance of rapid testing for HIV was significantly higher when the duration of counseling was less or equal to 5 minutes (adjusted Odds ratio [aOR]=5.8; [CI] 95%: 2.6-13); among those who did not report having this screening test during antenatal care (aOR=3.8; [CI] 95%: 2-7.8), among those who were in early labor (aOR=2.3; [CI] 95%: 1.2-4.7) and lower in adolescents than in adults (aOR=0.1; [CI] 95%: 0.0-0.7)., Conclusion: Counseling and voluntary HIV testing are accepted in our labor rooms. Consistently offering this service in the labor room could be a catch-up strategy to be combined with antenatal care testing., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

The purpose of this study is to evaluate and determine the prevalence of anemia and associated factors (malaria and intestinal helminthiasis) in some high risk groups, especially in pregnant and breast-feeding women and in children aged 1-2 years old from within a deprived semi-urban population of Lubumbashi (Bongonga and Sendwe). These results were compared to those obtained from an urban population having a more satisfying socio-economic situation (University Clinics). The overall frequency of anemia in the subjects studied from the three centres varies from 50-80%. The proportion of anemic cases is clearly higher in the Bongonga and Sendwe populations (70-80%) than in that of the urban group (50%) (P < 0.05). Among all of the subjects examined, pregnant women are found to be the group with the highest proportion of anemic patients (P < 0.05). All things considered, anemia is associated with malaria in 40% of the cases and with intestinal parasitism (Ascaris and/or Ankylostome infestation) in 9%. Faced with such a situation, the strategy to fight against anemia and associated parasitosis demands and requires multi-disciplinary actions centred on health education, collective screening and specific anti-parasite treatment.

Objective: To determine the prevalence of anemia and associated factors (malaria and intestinal helminthiasis) in high risk groups of Lubumbashi, Congo, particularly in pregnant and breast-feeding women and children aged 1-2 years., Material and Methods: From March to May 2002, 632 pregnant women, 570 breast-feeding women, and 570 infants (1-2 years) were examined in three medical centers in Lubumbashi, Congo. Some of the subjects lived in deprived semi-urban areas (Bongonga and Sendwe), others in urban areas with a satisfactory socio-economic situation (University Clinic)., Results: Overall frequency of anemia was estimated between 50 and 80% in the study populations. The proportion of anemic cases was clearly higher in the Sendwe and Bongonga populations (70-80%) than in the other urban populations (50%) (P<0.01). For the three categories of examined subjects, anemia was found to be most prevalent among pregnant women (P<0.05). Anemia was found to be associated with malaria in 40% of the patients and with intestinal parasitism (ascaris / ankylostoma) in 9%., Conclusion: Considering these results, systematic screening and treatment of anemia and associated factors such as malaria and intestinal helminthiasis is needed for the Lubumbashi population.

Objective: Pregnancy induced hypertension has been shown to be associated with a normal or low activity of the maternal circulating renin-angiotensin system (RAS) but little is known of the local RAS in placenta and fetal membranes. The present study attempts to determine, at full term of human preeclamptic pregnancies, the activity of the chorioplacental renin-angiotensin system., Patients and Measurements: We analysed the concentrations of active renin, prorenin, angiotensin converting enzyme (ACE) and angiotensin II in homogenates of human placenta and fetal membranes from preeclamptic patients at full term pregnancy. The values of renin, ACE and angiotensin II found in the patients with moderate preeclampsia (gestosis index 0-1) (n = 10) were compared with those of normal pregnant women (n = 8)., Results: Our experiments showed that in preeclamptic pregnancies, the chorion membrane contained the highest concentrations of active renin (2905 +/- 152 pg/g, mean +/- SD), prorenin (21,315 +/- 2849 pg/g) and ACE (1258 +/- 302 U/g) whereas the placenta had more angiotensin II than the chorion and amnion (741 +/- 45 vs 456 +/- 40 and 428 +/- 64 pg/g, respectively). In the placenta, as in the fetal membranes, no significant difference was found in the levels of active renin, ACE or angiotensin II between hypertensive patients and normal subjects but a slightly lower level of chorionic prorenin (P < 0.05) was observed in pregnancy induced hypertension., Conclusion: These findings indicate that in moderate preeclampsia (gestosis index 0-1), the activity of the renin-angiotensin system in term human placenta and fetal membranes remains essentially normal.

The recent discovery of a local renin-angiotensin system in trophoblastic tissues has raised many questions regarding its role in the physiology of normal gestation and its implications in the pathophysiology of hypertension during pregnancy. In this article, the authors first review the most interesting aspects of the chorioplacental renin-angiotensin system, dwelling on the tissue distribution of angiotensin II and its receptor subtypes in the placenta and fetal membranes of different species. The relationship between angiotensin II and other locally synthesized chorioplacental substances is also analysed and the therapeutic implications of phenomena observed in pregnancy-associated hypertension are discussed.

Regulation of the angiotensin AT1 receptor in human placenta is poorly understood. In this study, we analyzed the time course of angiotensin AT1 receptor expression, internalization, and recycling by human trophoblast cells. We also studied the effects of estradiol, progesterone, and chloroquine on regulation of the angiotensin AT1 receptor in 48-h cell culture. The angiotensin II receptor expression increased with the time of incubation, reaching a level at 48 h of culture that was about 120% above the initial value. A large majority of angiotensin II receptors was of the AT1 subtype, as it was completely inhibited by losartan (1 mumol/L). The internalization of [125]angiotensin II binding and the angiotensin AT1 receptor recycling were also time dependent, with t1/2 values of 12 and 21 min, respectively. In human trophoblast cells exposed to progesterone (10 mumol/L) for 48 h, angiotensin AT1 receptor density was decreased by 49%, whereas estradiol (10 mumol/L) or chloroquine (100 mumol/L) treatment was ineffective. In the freshly isolated trophoblast cells initially treated with unlabeled angiotensin II (200 nmol/L) for 30 min, chloroquine was shown to decrease angiotensin AT1 receptor recycling by 73%, whereas estradiol and progesterone had no effect. These findings indicate that progesterone induces a down-regulation of the angiotensin AT1 receptor in human placenta and that the recycling of this receptor can be delayed by chloroquine.

A complete renin-angiotensin system has been shown to be present in human placenta, but its physiological role is poorly known. To investigate the implication of this system in the regulation of steroid hormone secretion, we studied the effect of angiotensin-II on the release of estradiol and progesterone from human placental explants. Our experiments showed that angiotensin-II stimulated estradiol secretion from term placental explants in a dose- and time-dependent fashion, although progesterone release was unaffected. Estradiol release induced by angiotensin-II (0.2 mumol/L) was blocked by angiotensin AT1 receptor antagonist losartan in a dose-dependent manner, suggesting the involvement of the AT1 receptor subtype in the process. On the contrary, the angiotensin AT2 receptor antagonist PD123319 (1 mumol/L) or the angiotensin AT2 receptor agonist CGP42112A (1 mumol/L) had no effect. Analysis of the amount of steroid hormones in the placental tissues incubated for 12 h showed that angiotensin-II increased estradiol production by 34% compared with the unstimulated explants, whereas the total levels of the estrogen precursor androstenedione and testosterone were decreased by 30-45% in the presence of the peptide, suggesting a stimulatory effect on the aromatization step. This hypothesis was reinforced by the absence of effect of angiotensin-II on both estradiol and testosterone concentrations in the placental explants pretreated with the aromatase inhibitor 4-hydroxyandrostenedione (25 mumol/L). Progesterone synthesis was not affected by angiotensin-II. The present study indicates that angiotensin-II induces the secretion of estradiol from human placenta through the angiotensin AT1 receptor subtype activation, and this effect seems to be linked to the stimulation of local androgen aromatization.

Samples of human myometrium have been collected during pregnancy and from non-pregnant women. Binding studies revealed the presence of a 50-fold higher density of angiotensin II AT2 receptor in the non-pregnant state than during gestation. Low levels of the AT1 receptor subtype (approx. 20 fmol/mg protein) were detected in both pregnant and non-pregnant myometrium. Outside pregnancy, the AT2 receptor accounted for greater than 95% of all angiotensin receptors, whereas during pregnancy the value dropped to about 40%. The down regulation of the human myometrial AT2 receptor during pregnancy may be related to the high hormonal content of the environment induced by gestation. The mechanism by which the AT2 receptor is regulated appears to be different to that of the AT1 receptor.

The purpose of this work was to determine which subtype of angiotensin II receptors was involved in angiotensin II-induced human placental lactogen (hPL) and pregnancy-specific beta 1-glycoprotein (SP1) secretion from human placenta. The experiments were performed using placental explants and isolated trophoblast cells. They were pretreated with Dup753 (antagonist of angiotensin AT1 receptor), PD123319 (antagonist of AT2 subtype) or with CGP42112A (agonist of angiotensin AT2 receptor) before the addition of angiotensin II. The octapeptide angiotensin II significantly increased the hPL and SP1 release from both placental explants and isolated trophoblast cells. The angiotensin AT1 receptor antagonist Dup753 inhibited the angiotensin II-stimulated hPL and SP1 secretion in a dose-dependent manner but the AT2 specific ligands PD123319 and CGP42112A had no effect. This study indicates that the angiotensin AT1 receptor is the main mediator of angiotensin II in the stimulation of hPL and SP1 secretion from human placenta.

In a retrospective study covering the period from January 1/1980 to December 31/1984, the authors found 1535 stillborn infants in the maternity unit of Gecamines Sendwe. The stillbirth rate was very high (30.80 per 1000). It was found that all the pregnancies in which the outcome was fatal for the fetus had not been adequately supervised: 17.84 per cent of women were never examined during their pregnancy while 82.15 per cent underwent less four prenatal visits. The group of primipara and secondipara was predominant (61.88 per cent) between the mothers which had stillborn infants. Urinary tract infection (23.95 per cent) and malaria (17.55 per cent) were the most frequent diseases found in this series.

Membrane angiotensin II receptors were measured in trophoblastic tissues using a 2-step procedure. The first step consisted of the relative measurement performed at a fixed 125I[Sar1 Ile8]AII concentration of 0.15 nM in order to determine which tissues had a sufficient number of binding sites for studying the competition curves. The second consisted of determining the maximal binding (Bmax) and the dissociation constant (Kd) for [Sar1 Ile8] AII and the receptor subtypes in these tissues. The relative binding measurement revealed a significant number of occupied sites in rabbit fetal placenta and chorion (159 +/- 17 and 51 +/- 10 fmol/mg proteins) and in guinea pig chorion (132 +/- 12). The mean values of the other trophoblastic tissues were 3-10-fold lower in the 2 species. The competition curves obtained from tissues with high angiotensin II binding receptors showed the predominance of the AT2 subtype in rabbit fetal placenta (AT1/AT2 = 25/75) and of the AT1 receptor in guinea pig chorion (97/3) and in rabbit chorion (90/10). The [SAR1 Ile8] AII affinity (Kd) obtained from Scatchard plot analysis was 1.2 +/- 0.2 nM (n = 5) in fetal placenta and 1.2 (n = 1) in rabbit chorion and 0.5 +/- 0.1 (n = 3) in guinea pig chorion. In these tissues, the respective Bmax values were 1,281 +/- 115 (n = 5), 263 (n = 1) and 1,188 +/- 134 fmol/mg proteins (n = 3). These findings indicate that rabbit fetal placenta and chorion and guinea pig chorion are the most important sites of action for the renin-angiotensin system present in trophoblastic tissues.

By analyzing human trophoblastic tissues at the full term of pregnancy, this study shows the highest levels of angiotensin-II (729 +/- 111 and 602 +/- 105 pg/g of tissue), angiotensin-II receptors (295 +/- 30 and 250 +/- 32 fmol/mg proteins), human placental lactogen (973 +/- 154 and 680 +/- 28 micrograms/g) and progesterone (1,501 +/- 193 and 1,070 +/- 151 ng/g) in chorionic villi and in placental basal plate respectively. Tissue values of angiotensin-II, hPL and Progesterone were 4 times superior to those obtained in amniotic fluid and in umbilical and maternal blood. Estradiol values in chorionic villi were similar to those in placental basal plate, in chorionic plate and in chorion, but significantly higher (p less than 0,001) than in amnion, amniotic fluid and in umbilical and maternal blood. The concentrations of prolactin in chorion were 3 times superior than those found in amnion, in placental tissue, in amniotic fluid and in umbilical and maternal blood. A positive correlation was observed between Angiotensin-II and its receptors and also with hPL, P4/hPL ratio and E2/P4 ratio. Thus, angiotensin-II could play an important role in the physiology of pregnancy, due to its vasopressive action and due to its interactions with other peptides and chorio-placental steroids.

The total renin and active renin in human fetal appendices were determined by an immunoradiographic assay. In addition, some samples of maternal plasma were analyzed in order to provide a reference value. The prorenin level was determined by subtracting the level of active renin from that of the total renin. At the end of this study, it was found that the mean total renin concentration was 515 +/- 54 pg/ml in the peripheral blood of the woman who had given birth, 30,385 +/- 2,951 pg/g in the tissue of the chorion and 3,986 +/- 822 pg/g in the amnion. The level within the placenta reached 1,113 +/- 155 pg/g of tissue in the chorionic plate, 256 +/- 53 pg/g in the villosities and 294 +/- 46 pg/g in the basal plate. In these various tissues, prorenin accounted for over 80% of the total renin, except in the chorionic villosities, where it accounted for only 72.44%. In general, this study showed that the highest, concentrations of immunoreactive renin are found in the chorionic membrane. This membrane probably plays a decisive role in regulating the renin-angiotensin system within the fetal appendices.

Membrane angiotensin II receptors were measured in human placenta by means of 125I [Sar1 Ile8] All (angiotensin II antagonist) and characterized by using 2 other antagonists of angiotensin II: Dup 753 and CGP 42112A. These are specific and selective ligands which enable identification of AT1 and AT2 receptor subtypes respectively. The [Sar1 Ile8] All affinity is similar (Kd approximately 1 nmol.l-1) in the 3 different placental structures examined. However, the Bmax of villous tissues is approximately 9 times higher than that observed in chorionic plate but remains near that found in basal plate. In the central area of the placenta, mean values of 125I [Sar1 Ile8] All binding observed at a single concentration of 0.15 nmol.l-1 are 242 +/- 31 fmol/mg proteins in basal plate, 300 +/- 35 in villous tissues and 36 +/- 8 in chorionic plate. The umbilical vein and arteries respectively have 8.8 +/- 4.8 and 4.0 +/- 1.7 fmol/mg protein. The subtype analysis shows that only AT1 receptor is present in placental tissues. The Bmax values as well as those obtained by the relative measurement performed at a fixed 125I [Sar1 Ile8] All concentration of 0.15 nmol.l-1 indicate that the highest concentrations of angiotensin II receptors are found in placental villous tissues.

Radio-immuno-assay estimations of urinary hCG were carried out with pharmacia Kit beta hCG Riact on 36 women who had received embryo transfers. The analysis was carried in order to try and find how and at what moment in time it is possible to diagnose very early a developing pregnancy after embryo transfer. In this work we have found that the mean level of urinary hCG was significantly higher (P less than 0.001) in women who became pregnant (group B) than in those who did not become pregnant (group A). The difference in mean hormone levels in these two groups became more marked in the following days. The time doubling of the hCG level varied between 1.21 and 3.24 days in group B. By the eighth day the level of urinary hCG was less in group B than in group A, probably due to rapid renal breakdown of hCG. In summary these results show that the level of urinary hCG estimated from the 11th day onwards after an embryo transfer repeated two or three days later makes it possible to detect early pregnancies.

Radioimmunoassay of progesterone in systemic and placental blood of pregnant rabbits and guinea pigs. 1. The level of progesterone in pregnant rabbits and guinea pigs serum was measured directly (without extraction) using a RadioImmunoAssay (RIA). 2. Hormonal concentrations in systemic blood were shown to increase with gestational age, being at their highest half-way through pregnancy (16.03 +/- 2.63 ng/ml for rabbits; 319.01 +/- 42.10 ng/ml for guinea pigs) and decreasing at the end of the pregnancy. 3. Progesterone was not detectable in rabbit placental blood, whereas a high level of this hormone was found in guinea pig placental blood, which increased with gestational age. From the 28th to the 56th post-coital day, the level increased from 143.22 +/- 13.15 to 283.30 +/- 36.84 ng/ml. 4. The method used enables to measure correctly progesterone concentrations in rabbit and guinea pig serum without extraction.

1.) Total renin, active renin, prorenin, angiotensin II, estradiol and progesterone were measured in maternal, placental and fetal blood and in trophoblastic and uterine tissues of the guinea pig. Furthermore, membrane angiotensin II receptors were measured in trophoblastic tissues. 2.) Blood and tissue concentrations of total renin, active renin, angiotensin II and steroids are shown to increase with gestational age. At the full term of pregnancy (70th post-coital day), tissue concentrations of total renin in chorion (23,900 +/- 2,752 ng/g of tissue/h), maternal placenta (14,210 +/- 1,131), fetal placenta (12,475 +/- 927) and uterus (7,677 +/- 798) are 100 time higher than those observed in placental, fetal and maternal blood. Distribution of blood and tissue prorenin (inactive renin) is similar to that found for total renin. Active renin/Total renin ratio reaches 1% in uterine, placental and chorion tissues and 9.3 +/- 1.0% in maternal, placental and fetal blood. 3.) Angiotensin II levels in systemic maternal blood (690 +/- 99 pg/ml) and in uterine blood (467 +/- 84) are higher than those found in placental blood (266 +/- 39) and in different trophoblastic tissues (between 200 and 400 pg/g). Angiotensin II receptor concentrations are highest in chorion. 4.) Regarding the steroid hormones, it is noted that placental and maternal blood contain more progesterone than trophoblastic tissues. The highest concentrations of estradiol are found in chorion tissue and uterine blood. 5.) A positive correlation is observed between angiotensin II and estradiol in uterine blood (r = 0.69, P less than 0.01) and in chorion (r = 0.71, P less than 0.01). These findings indicate that angiotensin II and estradiol could, by their interactions, play an important role in the physiology of pregnancy.

1. Plasma renin activity was measured in non pregnant rabbits and guinea pigs under Ketamine-induced general anesthesia after pretreatment either with Propranolol or with a Placebo. Study was performed using a radio-immunoassay for angiotensin I. 2. Twenty minutes after the beginning of the observation period, renin activity in rabbits who had received Placebo alone (11.47 +/- 2.35 ng/ml/h) or associated with Ketamine (11.36 +/- 2.54 ng/ml/h) was similar. However, enzyme activity was significantly lower (P less than 0.001) when Propranolol was associated with Ketamine (3.97 +/- 0.58 ng/ml/h) or with Placebo (4.10 +/- 0.55 ng/ml/h). 3. In the same way, renin activity was significantly higher (P less than 0.001) in guinea pigs without Propranolol than in those who had received this drug. 4. These findings indicate that stress induced by general anesthesia with Ketamine or by simple manipulation of animals (Placebo) was accompanied by an excessive increase in plasma renin activity. Propranolol maintained the level of this enzyme activity within normal limits.

A kit of anti-beta hCG monoclonal antibodies (Pharmacia beta hCG Riact) has been tested in the assay and monitoring of urinary hCG. After several tests, the technique was found to be reproducible and specific for assay of hCG and showed good sensitivity in urine assays. Optimal sensitivity was seen in the urine pH range 5.5 and 10.00. Below 5.5 and above 10.00, its detection capacity dropped off sharply. Dilution of urine with the kit buffer gave hormonal values comparable to those of undiluted urine, but improved them substantially when the urine pH was below 5.5. It is therefore wise to dilute urine to avoid the potential risk of assay interference by urine acidity. In frozen urine, hCG concentrations tend to decrease but are not altered significantly. This recently developed method allows easy and reliable monitoring of urinary hCG for detection of unknown pregnancy in spontaneous cycles, surveillance of the state of embryos transferred during in vitro fertilization cycles, and evaluation of the efficacy of treatment of tumors secreting (beta hCG).

A clinical and biological study was conducted between September 1, 1983 and August 31, 1984, at the Sendwe Maternity Hospital in Lubumbashi, concerning anemia in pregnant women. This prospective study showed that 41.90 p. cent of women in this series are anemic. Per order of frequency, the anemia was normocytic in 291 patients (62.85 p. cent), microcytic in 216 (25.04 p. cent) and macrocytic in 56 (12.10 p. cent). Among the etiological factors, the most important are: poor socioeconomic development, multiple intestinal parasites and malaria. Moreover, it should be pointed out that young primiparous women represent 36 p. cent of the cases, or more than one-third of the population. In anemias occurring during pregnancy, the fetus is more vulnerable than the mother. He is the victim of a number of accidents, the most frequent in this series being intrauterine growth delay.