Water metabolism in pregnancy.

Date:
1979
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Credit

Water metabolism in pregnancy. Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Source: Wellcome Collection.

About this work

Description

Professor Frank Hytten, in discussion with Mr Geoffrey Chamberlain, talks about the metabolism of water during pregnancy. Two aspects of water metabolism are considered. The first centres on the fact that in early pregnancy plasma osmolality falls, a fact which is largely due to the effect of overbreathing - the mother avoids a state of diabetes insipidus by 'resetting' her osmo-receptors. The second is the phenomenon of water storage in pregnancy - an average of 2 1/2 litres in excess of that usually stored in known sites of tissue growth which, in some individuals, can rise to as much as 8 litres. They argue, however, that oedema is universal in healthy pregnant women and attempts to change it using drug therapy is dangerous to both mother and child. 5 segments.

Publication/Creation

UK : University of London Audio-Visual Centre, 1979.

Physical description

1 encoded moving image (27.56 min.) : sound, black and white.

Duration

00:27:56

Copyright note

University of London

Terms of use

Unrestricted
CC-BY-NC
Creative Commons Attribution-Non-Commercial 2.0 UK: England & Wales

Language note

In English

Creator/production credits

Discussed by Mr Geoffrey Chamberlain and Professor Frank Hytten, Northwick Park Hospital. Produced by Jennie Smith. Medical editor: Mr Geoffrey Chamberlain, Institute of Obstetrics and Gynaecology, London. Made for British Postgraduate Medical Foundation in association with the Blair Bell Research Society. Made by University of London Audio-Visual Centre.

Notes

This video is one of around 310 titles, originally broadcast on Channel 7 of the ILEA closed-circuit television network, given to Wellcome Trust from the University of London Audio-Visual Centre shortly after it closed in the late 1980s. Although some of these programmes might now seem rather out-dated, they probably represent the largest and most diversified body of medical video produced in any British university at this time, and give a comprehensive and fascinating view of the state of medical and surgical research and practice in the 1970s and 1980s, thus constituting a contemporary medical-historical archive of great interest. The lectures mostly take place in a small and intimate studio setting and are often face-to-face. The lecturers use a wide variety of resources to illustrate their points, including film clips, slides, graphs, animated diagrams, charts and tables as well as 3-dimensional models and display boards with movable pieces. Some of the lecturers are telegenic while some are clearly less comfortable about being recorded; all are experts in their field and show great enthusiasm to share both the latest research and the historical context of their specialist areas.

Contents

Segment 1 Geoffrey Chamberlain introduces Professor Frank Hytten. Hytten, referring to various graphs and charts to illustrate his points, discusses the reasons for the abrupt fall in plasma osmolality during the first six weeks of pregnancy. He shows how drinking a glass of water in pregnancy has a totally different effect on osmolality levels than in a non-pregnant person - he makes it clear that this is something very unusual to pregnancy. Time start: 00:00:00:00 Time end: 00:06:34:10 Length: 00:06:34:10
Segment 2 Hytten goes on to explain the reasons for the low osmolality levels of pregnancy and discusses water retention. Chamberlain discusses with Hytten why it is that pregnant women are so thirsty when they have such low osmolality. Time start: 00:06:34:10 Time end: 00:10:06:20 Length: 00:03:32:10
Segment 3 Hytten talks about the storage of water by pregnant women which is, on average around six litres. Oedema, or an excess of water, is normal in pregnancy, particularly during the last trimester. However, generalised oedema occurs much earlier in pregnancy and can reach eight litres in excess of expected levels. Hytten argues that although this may be uncomfortable for the mother, it causes no health risks or damage to the unborn child. He talks in detail about his research in Aberdeen in this area. Time start: 00:10:26:20 Time end: 00:17:20:20 Length: 00:06:54:00
Segment 4 Here Hytten moves on to discuss the sites in the body where excess fluid is stored. He shows, using graphs and electron microscopies, how it is distributed generally all over, probably in the connective tissue ground substance. He stresses again that although the swelling which occurs due to fluid retention has been frequently thought of as something to be treated medically, it is a normal phenomenon of pregnancy and therefore not a medical concern. Time start: 00:17:20:20 Time end: 00:21:50:20 Length: 00:04:30:00
Segment 5 Hytten is shown seated with Chamberlain, they discuss the difficulty in assessing how much fluid retention a patient may have as it can change from day to day or depending on environment and weather. They discuss the relationship between oedema and pre-eclampsia and the futility of giving diuretic drugs to pregnant women to reduce water retention. They end their discussion with a humorous chat about the virtues of research in Aberdeen. Time start: 00:21:50:20 Time end: 00:27:56:02 Length: 00:06:05:07

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