Magnesium free dialysis for uraemic pruritus.

bolic disturbances during the pregnancy, and may therefore be termed "macrosomic." Acker et al' reported that the incidence of shoulder dystocia in the deliveries of diabetic mothers was 50%, 23%, and 9% for infants weighing :4500 g, 4000-4499 g, and 3500-3999 g, respectively, compared with 23%, 10%, and 2% for deliveries of non-diabetic mothers. Thus many more infants of diabetic mothers are too large for their maternal pelvis, even when their birthweight is apparently normal. Control of diabetes in pregnancy should not be described as "good" or "bad" as it forms a continuous range and thus would not be expected to have an all or nothing effect on promoting fetal growth. A substantial percentage of infants of diabetic mothers with birth weights within the normal range will be affected by the metabolic disturbances in the uterus caused by diabetes. In a review of 225 infants of diabetic mothers Lemons et al reported that neonatal hypoglycaemia occurred not only in 36 (47%) of the macrosomic infants, but also in 31 (21%) of the infants with birth weights that were not large for gestational age.4 The extent to which an infant will be affected by maternal diabetes, as measured by birth weight or neonatal hypoglycaemia, will vary, explaining why "good" control in the conventional sense may result in a big baby who becomes hypoglycaemic whereas "bad" control may result in a small baby who does not. Our results suggest that all infants of diabetic mothers, irrespective of birth weight, are growth promoted to some degree by their mothers' disease, and thus every infant should be considered to be at risk from the biochemical and mechanical consequences of macrosomia.