PATHOLOGICAL METABOLISM IN PREGNANCY 857 



3. Increase of creatih by the rapid degeneration of muscle tissue, 

 owing to the inanition and also to the convulsions. 



4. Decrease in the amount of circulating carbohydrate from defective 

 glycogenic function, or from the withdrawal of dextrose for the needs of 

 the fetus, leads to a rise in the creatin production which is in turn con- 

 verted to creatinin. 



Increase in the Uric Acid Nitrogen in the Blood 



Uric acid represents the results of purin metabolism and is derived 

 from the breaking down of nuclear material. When meat is excluded and 

 no purin bodies are ingested, the endogenous , uric acid metabolism repre- 

 pents the product of the synthesis of the nitrogen of the broken down cell. 

 Like creatin, it is a special metabolism not directly related to the metabo- 

 lism of the proteins. 



As most observers agree that uric acd is one of the first nitrogenous 

 substances to be retained in the blood in degeneration of the kidney and as 

 there seems to be a definite limitation as to the amount that can be ex- 

 creted at any one time, it is possible the increase in this substance only 

 represents a functional disturbance on the part of the kidney. In eclamp- 

 sia, however, there may be an increase of nucleic acid derived from 

 autolysis of the degenerated cell nuclei in the liver and kidney. 



There is a large amount of uric acid in the tissues of the fetus that 

 is rapidly excreted following birth and it is possible that some of this 

 substance passes through the placenta to the mother. Slemons and Bogart 

 found an increase of the blood uric acid at the end of labor. 



It has been known from studies of gout that the threshold is raised 

 by an increased content in the blood. In the various types of nephritis 

 there is a lessened uric acid excretion in the urine with a consequent 

 increase in the blood. 



In Caldwell and Lyle's eclamptic cases the uric acid content ranged 

 from 3 to 11 mg. per 100 c.c. of blood but the average was 6 to 7 

 mg. In Killian's cases, also, the figures varied from 3 to 11 mg. and the 

 average was 6 mg. 



Other Evidences of Disturbed Metabolism 



Blood and urine examinations offer evidences of disturbed metabolism 

 other than those referable to the nitrogen. Glycosuria has been noted in 

 pregnancy by a number of observers. Geelmuyden(a) states that it occurs 

 in 10 to 12 per cent of all pregnancies. An alimentary glycosuria can 

 readily be produced in the pregnant by administering 100 gm. of glucose. 



