To understand the mechanisms those are involved in the appearance of foetal heart rate decelerations (FHR) after the combined epidural analgesia in labour. Observational study done at University Hospital for 86-term singleton pregnant... more
To understand the mechanisms those are involved in the appearance of foetal heart rate decelerations (FHR) after the combined epidural analgesia in labour. Observational study done at University Hospital for 86-term singleton pregnant women with spontaneous labour. Serial bedside measurement of the main cardiac maternal parameters with USCOM technique; stroke volume (SV), heart rate (HR), cardiac output (CO) and total vascular resistances (TVR) inputting systolic and diastolic blood pressure before combined epidural analgesia and after 5', 10', 15' and 20 min. FHR was continuously recorded though cardiotocography before and after the procedure. Correlation between the appearance of foetal heart rate decelerations and the modification of maternal haemodynamic parameters. Fourteen out of 86 foetuses showed decelerations after the combined spino epidural procedure. No decelerations occurred in the women with low TVR (<1000 dyne/s/cm(-5)) at the basal evaluation. FHR abno...
To evaluate the differences and similarities in diastolic function and left ventricular geometry in gestational and essential hypertension. Thirty-nine consecutive gestational hypertensive pregnant women in the third trimester of... more
To evaluate the differences and similarities in diastolic function and left ventricular geometry in gestational and essential hypertension. Thirty-nine consecutive gestational hypertensive pregnant women in the third trimester of gestation (GH), 40 nonpregnant essential hypertensive women (EH), and 38 normotensive nonpregnant women (N) matched for age were enrolled into the study and underwent echocardiographic and Doppler evaluations. The GH and EH patients were evaluated prior to the administration of any drug treatment. Left atrial function was similar in GH and N subjects and lower than that in EH patients. Both GH and EH patients had early left ventricular diastolic filling pattern significantly different as compared to N subjects (longer isovolumetric relaxation time, deceleration time of the E wave, and lower E wave velocity in GH and EH vs. N), whereas the late filling properties were similar in GH and N subjects with a lower A velocity, and velocity-time integral vs. EH (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Systolic fraction of the pulmonary vein flow was similar in GH and EH patients and lower in N subjects. Altered left ventricular geometry was more common in GH than in EH, whereas normotensive subjects did not show any alteration of the geometric pattern. Gestational and essential hypertension induce similar early altered diastolic filling of the left ventricle. Essential hypertension is characterized by a compensatory late filling mechanism due to an enhancement of left atrial function. Gestational hypertension is characterized by altered left ventricular geometry, which is far less common during essential hypertension.
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The objective of the present study is to compare the effectiveness of transdermal glyceryl-trinitrate versus oral nifedipine in lowering blood pressure in patients affected by pregnancy-induced hypertension (PIH). Thirty-six consecutive... more
The objective of the present study is to compare the effectiveness of transdermal glyceryl-trinitrate versus oral nifedipine in lowering blood pressure in patients affected by pregnancy-induced hypertension (PIH). Thirty-six consecutive pregnant women have been evaluated at different gestational ages after the diagnosis of PIH or preeclampsia (PE). After a 24-h ambulatory blood pressure monitoring, patients were allocated to three groups: those receiving oral nifedipine and those receiving transdermal glyceryl-trinitrate in a continuous (24 h/day) or intermittent (16 h/day) administration. A second blood pressure monitoring was performed after 2 weeks of treatment. Systolic and diastolic blood pressure were compared by using the Cosinor method looking at mesor, amplitude, and acrophase. Baseline systolic and diastolic blood pressure was similar among the three groups. Neither the transdermal glyceryl-trinitrate administered for 24 or 16 h nor oral nifedipine affected systolic and diastolic blood pressure. Analysis of variance showed that the posttreatment values were similar among the groups. Further studies are needed to verify the possible use of transdermal glyceryl-trinitrate as an antihypertensive drug during pregnancy.
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... 7 Khong TY, DeWolf F, Robertson WB, Brosens I. Inadequate maternal vascular response to placentation in pregnancies complicated by pre-eclampsia and by small for gestational age infants. Br. ... 19 Duvekot JJ, Cheriex EC, Pieters FAA,... more
... 7 Khong TY, DeWolf F, Robertson WB, Brosens I. Inadequate maternal vascular response to placentation in pregnancies complicated by pre-eclampsia and by small for gestational age infants. Br. ... 19 Duvekot JJ, Cheriex EC, Pieters FAA, Menheere PPCA, Peeters LLH. ...
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ABSTRACT Fetal behavioural state determination allows the evaluation of fetal spontaneous CNS activity. The term fetuses in normal pregnancies show a well defined behavioural pattern with a stable percentage of 1F, 2F, 3F, 4F, and values... more
ABSTRACT Fetal behavioural state determination allows the evaluation of fetal spontaneous CNS activity. The term fetuses in normal pregnancies show a well defined behavioural pattern with a stable percentage of 1F, 2F, 3F, 4F, and values of coincident epochs over 80–85%. In hypertensive pregnancies the determination of behavioural states has been conducted after the cardiovascular impairment of the fetuses, defined by means of Doppler flow evaluation, had been estabilished. In these fetuses an increase in non coincidence of behavioural state variables and a decrease in 3F and 4F states have been found. A slight decrease is showed in 2F, while state IF is increased in earlier gestational ages, and lowers to normal values in term pregnancies.
ABSTRACT The Pregnancy Induced Hypertension (PIH) was associated to alterations of ion transport, which may be due to abnormalities of membrane composition and function.We studied the syncytiotrophoblast plasma membranes of PIH mothers... more
ABSTRACT The Pregnancy Induced Hypertension (PIH) was associated to alterations of ion transport, which may be due to abnormalities of membrane composition and function.We studied the syncytiotrophoblast plasma membranes of PIH mothers compared with normal ones.We observed a decreased microviscosity and an alteration of cholesterol to phospholipid ratio, together with an increased percentage of unsaturated fatty acid respect to the controls. We therefore hypothesized an involvment of the chemical-physical properties of the syncytiotrophoblast plasma membranes in the modified functional properties observed in the PIH.
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Research Interests: Cardiology, Kinetics, Calcium, Pregnancy, Humans, and 5 moreHypertension, Female, Adult, Sodium, and Proteinuria
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The authors describe their experience in telephonic transmission of cardiographic recordings. With a Corometrics 116 and 410 unit installed in a remote facility, 61 CTG recordings were tele transmitted and received by a Toshiba personal... more
The authors describe their experience in telephonic transmission of cardiographic recordings. With a Corometrics 116 and 410 unit installed in a remote facility, 61 CTG recordings were tele transmitted and received by a Toshiba personal computer. The comparison between original and transmitted CTG record was excellent and a very low percentage of signal loss during transmission (3.2%). The advantages of telephone transmission of CTG in peripheral areas are stressed.
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Delay in fetal maturation in diabetic and accelerated fetal maturation in hypertensive pregnancies have been reported in the past. The spontaneous activity of fetal nervous system during pregnancy was followed longitudinally in a group of... more
Delay in fetal maturation in diabetic and accelerated fetal maturation in hypertensive pregnancies have been reported in the past. The spontaneous activity of fetal nervous system during pregnancy was followed longitudinally in a group of 29 normal pregnancies from 28 x th to 40 x th week of gestation by means of fetal behavioural states determination. 1 F state (quiet sleep) progressively increases from median values of 5.0% to values of 22.5-25% at term of pregnancy. This state represents the positive activity of inhibitory centers has been related to a positive evolutionary process of brain maturation according to preceding experiences conducted on experimental models and preterm babies followed with EEG and direct observation in the early neonatal period. The method of behavioural states determination has been applied to a group of 33 gestational diabetes (GDM) pregnant women followed longitudinally, and a clear reduction of development of 1 F state has been evidentiated, with significant differences (p less than 0.001) at 35-36 weeks of gestation versus the control group. The normal values are reached in concomitance with L/S value of maturity. In 30 pregnant women affected by gestational hypertension (GH) different result are obtained: 1 F state seems to develop earlier, and is increased (p less than 0.001) around 30-32 weeks versus the control group if a fetal growth reduction is present. The value of 1 F behavioural state in the evaluation of fetal condition of pathological pregnancies is discussed.
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The construction of referral curves for the computerized ctg parameters may increase the clinical efficacy of the examinations in tracings of unfavourable interpretation. With the help of &quot;System 8000&quot; software, the... more
The construction of referral curves for the computerized ctg parameters may increase the clinical efficacy of the examinations in tracings of unfavourable interpretation. With the help of &quot;System 8000&quot; software, the longitudinal variation of computerized parameters fetal movements/hour, fetal movements in high and low variability, accelerations, length of high and low variability periods, mean range and value of short variability have been analyzed in a group of 12 low risk patients followed biweekly from the 24-26th week of gestation through term. While accelerations, minutes of low and high variability showed an absence of significative variation during pregnancy (F = 1.78; F = 9.3, F = 4.5 P = n.s.), significant (p less than 0.001) variation showed the other parameters. Number of movements/h and movements in high variability had an increase from 24-26 weeks to 32-34 weeks and a progressive further decrease till term; movements in low variability disappear after 32-34 weeks of gestation; mean range and short variability increase until 34 weeks and remained stable till end. Therefore the results obtained are in use for the high risk fetuses that perform a computerized ctg registration: nevertheless, the longitudinal evaluation reveals the maturation of fetal central nervous control on heart rate and fetal movements after the 34-36th weeks of gestation as a shown from behavioural states evaluation.
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Behavioral state instability in growth-retarded fetuses might be related to a decrease in serotonine production. Tryptophan maternal and cord blood values after elective cesarean section have been investigated by means of high performance... more
Behavioral state instability in growth-retarded fetuses might be related to a decrease in serotonine production. Tryptophan maternal and cord blood values after elective cesarean section have been investigated by means of high performance liquid chromatography in 20 growth-retarded fetuses due to pregnancy-induced hypertension (PIH) and 20 normal pregnancies as control group. The feto-maternal ratio of tryptophan is significantly higher in normal fetuses than in PIH growth-retarded fetuses (p less than 0.001). Behavioral states have been determined 1 week and just before cesarean section. Values of 1F, 2F, 3F and 4F differ in the 2 groups (p less than 0.001). A higher percentage of non-coincidences (p less than 0.001) and state interruptions (p less than 0.001) is found in PIH fetuses. A significant correlation is demonstrated between the increase of non-coincidences and decrease in the feto-maternal Trp ratio (p less than 0.001).
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Intraerythrocyte potassium was determined on samples from 198 physiologic, 88 hypertensive and 92 diabetic pregnant women. An increasing trend was observed during puerperium after the day 3, but a significant difference among the groups... more
Intraerythrocyte potassium was determined on samples from 198 physiologic, 88 hypertensive and 92 diabetic pregnant women. An increasing trend was observed during puerperium after the day 3, but a significant difference among the groups was not detected. These results may be due to a wider involvement of other cations (sodium, calcium) in the pathophysiology of pregnancy.
Research Interests: Pregnancy, Humans, Hypertension, Female, Potassium, and 4 moreErythrocytes, Cations, Body Fluids, and Pre Eclampsia
Amiodarone treatment in pregnancy might be difficult to handle because of the long half-life of the drug (14-28 days up to 2 months) and because it reduces maternal and neonatal thyroid activity. Although short-term use in pregnancy has... more
Amiodarone treatment in pregnancy might be difficult to handle because of the long half-life of the drug (14-28 days up to 2 months) and because it reduces maternal and neonatal thyroid activity. Although short-term use in pregnancy has been described in cases of fetal supraventricular tachycardia, there are few reports on the chronic use of the drug. In this paper we describe our experience with amiodarone treatment in two pregnant sisters with familial dilatative cardiomyopathy and ventricular malignant extrasystole. Prolonged administration of amiodarone (400-200 mg/die) since the beginning of pregnancy did not have any adverse effects; maternal and neonatal thyroid function was normal, as was the neurological and motor development of the neonates.
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The imbalance of cation transport is considered to play an important role in the development of hypertension, and this also applies to hypertension during pregnancy. Magnesium (Mg) is one of the factors that regulate cation transport... more
The imbalance of cation transport is considered to play an important role in the development of hypertension, and this also applies to hypertension during pregnancy. Magnesium (Mg) is one of the factors that regulate cation transport across the cell membrane. We therefore studied the effect of a magnesium-deficient diet on the activity of erythrocyte Na/K-ATPase and Mg-ATPase from six pregnant rabbits and compared the results to those obtained from six controls on a normal diet. None of the rabbits on the deficient diet developed hypertension or intrauterine growth retardation; nevertheless the activity of both enzymes was significantly reduced compared to the group on the normal diet. Since the reduced activity of these enzymes can determine sodium or calcium retention in the cell, Mg deficiency could be the basis of the onset of some forms of hypertension in pregnancy.
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The Authors describe their experience in telephonic transmission of cardiotocographic recordings. With a Corometrics 116 and 410 unit installed in a remote facility, 61 CTG recordings were tele-transmitted and received by a Toshiba... more
The Authors describe their experience in telephonic transmission of cardiotocographic recordings. With a Corometrics 116 and 410 unit installed in a remote facility, 61 CTG recordings were tele-transmitted and received by a Toshiba personal computer. The concordance between original and transmitted CTG record was excellent and a very low percentage of signal loss during transmission (3.2%) was found. The advantages of telephone transmission of CTG in peripheral areas are stressed.
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Magnesium (Mg) is an activator of many cellular processes, among which is cation transport. An imbalance of cation transport may be involved in several diseases, as well as during pregnancy. Since the action of Mg in vivo in preventing... more
Magnesium (Mg) is an activator of many cellular processes, among which is cation transport. An imbalance of cation transport may be involved in several diseases, as well as during pregnancy. Since the action of Mg in vivo in preventing gestational diseases is known, as well as its role in vitro on some cation transport activities, we studied the action of increasing concentrations of Mg on the activity of the enzyme Na/K-ATPase isolated from placental tissue of six normotensive women, at term. Incubation in a medium with increasing concentrations of Mg resulted in a significant activation of the enzyme, which was related to Mg concentration. The study demonstrates the action of Mg in vitro on isolated enzymes, and suggests the use of enzyme purification as a model for the study of cation transport in pregnancy.
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Four patients with vulvar Paget&#39;s disease were analysed retrospectively. In all cases the clinical manifestation was typical, with pruritus and visible lesion. None of the cases had a palpable cutaneous or subcutaneous mass but at... more
Four patients with vulvar Paget&#39;s disease were analysed retrospectively. In all cases the clinical manifestation was typical, with pruritus and visible lesion. None of the cases had a palpable cutaneous or subcutaneous mass but at the histologic exam a minimally invasive Paget&#39;s disease was detected. Treatment consisted of total vulvectomy and subsequent new reconstructive time; only one patient with clinically localized disease was treated with simple vulvectomy. Postoperative complications were minimal, thanks to the reconstructive time that assured a rapid recovery of the surgical injury and reconstruction of the urethral and vaginal meatuses. In all cases we obtained the complete removal of the lesion (negativity of resection margins), except in one case that was also the only one to have a recurrence after 40 months. The patients have been followed for an average of 58 months. Considering the results, we suggest demolitive surgery with subsequent reconstructive time in the treatment of vulvar Paget&#39;s disease.
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The outcome of HPV infection and its progression to neoplastic disease may be conditioned by the immune status of patients. In the present study we observed the systemic lymphocyte subset, with particular regard to NK cells and NK... more
The outcome of HPV infection and its progression to neoplastic disease may be conditioned by the immune status of patients. In the present study we observed the systemic lymphocyte subset, with particular regard to NK cells and NK activity in 7 patients with HPV infection. The lymphocyte phenotypes in peripheral blood were studied using a panel of monoclonal antibodies, while NK activity was evaluated as percentage of lysis of K 562 target cells. We noticed a significant decrease of basal NK activity especially in patients with HPV 16-18 infection (p less than 0.001), without any difference in the absolute number of these cells.
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The &quot;in vitro&quot; cell growth of 14 ovarian carcinomas was evaluated and related with the clinical-pathologic stage (FIGO) and grade of histologic differentiation of disease, with the patients&#39; immunological pattern... more
The &quot;in vitro&quot; cell growth of 14 ovarian carcinomas was evaluated and related with the clinical-pathologic stage (FIGO) and grade of histologic differentiation of disease, with the patients&#39; immunological pattern and with the relapse and survival rates. We identified 4 different patterns of &quot;in vitro&quot; cell growth (P1, P2, P3 and P4). Their correlation with the clinical-pathologic stages of disease as well as with the recurrence and survival rates was strong: 75% of recurrences in pattern P3 and 100% in pattern P4, while tumours with patterns P1 and P2 did not relapse. Similar results were obtained for survival, in fact 2 of the 3 patients who died from disease had cell growth pattern P4, and the other a P3. A significant correlation was found with basal natural killer cell activity of peripheral blood lymphocytes too: in patients with P1 neoplasia the basal NK cell activity was significantly higher (p &lt; 0.05) while it was significantly lower (p &lt; 0.05) in patients with P4 neoplasia in comparison with the others. We conclude that the &quot;in vitro&quot; biological behaviour of ovarian neoplasia can be regarded as prognostic factors even if patients&#39; basal NK activity represents the most significant prognostic element, directly related to the recurrence rate (p = 0.002).
Research Interests: Adolescent, Humans, Natural Killer cells, Female, Aged, and 3 moreMiddle Aged, Adult, and Survival Rate
In 156 patients with gynecologic neoplasia the sieric levels of tumor markers (CA 125, CA 15-3, CA 72.4, SCC and 90 K) before the primary treatment and during the follow-up have been evaluated. In the patients with ovarian cancer elevated... more
In 156 patients with gynecologic neoplasia the sieric levels of tumor markers (CA 125, CA 15-3, CA 72.4, SCC and 90 K) before the primary treatment and during the follow-up have been evaluated. In the patients with ovarian cancer elevated levels of CA 125 (80%), CA 72.4 (62%), 90 K (49%) and CA 15-3 (16.6) were found. The integrated evaluation of CA 125 and 90 K sieric levels was positive in the 86% of cases. The evaluation of CA 125 in combination with 90 K seems to facilitate the earlier detection of ovarian cancer recurrences. Elevated levels of SCC (89%) were found in the patients with cervical cancer. In the patients with endometrial or vulvar cancer the evaluation of these tumor markers was not significant.
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An increase in total body water is common in normal pregnancy. It is thought to be an important mechanism of maternal adaptation to pregnancy. The aim of the present study was to assess longitudinal changes in body water compartments in... more
An increase in total body water is common in normal pregnancy. It is thought to be an important mechanism of maternal adaptation to pregnancy. The aim of the present study was to assess longitudinal changes in body water compartments in pregnant women and to correlate these measurements with the course of pregnancy. One hundred seventy-three pregnant women with apparently normal, single pregnancies participated in this longitudinal study. Anthropometric measurements and multifrequency bioelectrical impedance were performed during the first, second, and third trimesters of pregnancy. One hundred three of the women completed all of the measurements; 50 of the women had a normal pregnancy and 13 had gestational hypertension. Total body water, extracellular water, and intracellular water values in normal pregnancies showed a significant, progressive increase throughout pregnancy. In women with gestational hypertension, total body water, extracellular water, and intracellular water values showed an opposite trend, suggesting a lack of plasma volume expansion through fluid-retention mechanisms. Our results show that multifrequency bioelectrical impedance analysis can be used to monitor variations in body water compartments in normal pregnancy and detect gestational hypertension.
Research Interests: Engineering, Nutrition and Dietetics, Treatment, Adipose tissue, Malnutrition, and 26 moreClinical Nutrition, Stroke, Pregnancy, Humans, Clinical research, Hypertension, Female, Body Composition, Cell, Male, Exploration, Bioelectrical Impedance Analysis, American, Impedance, Aged, Middle Aged, Longitudinal Studies, Body water, Adult, Spectrometry, Food Sciences, Gastric Bypass, Reference Values, Electric Impedance, Extracellular Space, and The American
Research Interests: Clinical Practice, Pregnancy, Humans, Hypertension, Doppler Ultrasound, and 12 moreBlood Pressure, Female, Obstetrics Gynecology, Risk factors, Adult, Fetal Growth Restriction, Internal medicine Doppler ultrasonography, Risk Factors, Clinical Protocols, Predictive value of tests, Positive predictive value, and Pre Eclampsia
ABSTRACT
The tension-free vaginal tape (TVT) technique is now commonly used in the management of female genuine stress incontinence. Short operation time, small amount of local anesthetic, fast postoperative mobilization, brief hospital stay,... more
The tension-free vaginal tape (TVT) technique is now commonly used in the management of female genuine stress incontinence. Short operation time, small amount of local anesthetic, fast postoperative mobilization, brief hospital stay, little residual urinary volume and little need for sick leave make TVT a simple and well-accepted minimal invasive surgery for the treatment of stress incontinence. We became suspicious of the procedure due to the very expensive cost of the instrumentation. Moreover we think that this &quot;blind&quot; procedure may be less dangerous by using a more familiar instrument than a large and gross steel needle. We propose the use of an unmodified procedure with a new, cheaper and easy-to-use steel clamp-like-instrument.
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Meconium staining of the fetus and placenta is associated with increased neonatal mortality and asphyxia. Very often it is unclear whether the discharge of meconium is a cause or an effect of fetal distress. In the available literature... more
Meconium staining of the fetus and placenta is associated with increased neonatal mortality and asphyxia. Very often it is unclear whether the discharge of meconium is a cause or an effect of fetal distress. In the available literature there are no large epidemiological studies of pregnancy outcome with meconium-related lesions, even though this could be useful to improve our state of knowledge on this topic. A case of umbilical cord vascular necrosis is described. A severely asphyxiated infant was delivered at 39 weeks&amp;amp;amp;amp;amp;amp;amp;amp;#39; gestation by cesarean section due to alarming results of fetal heart rate monitoring and rupture of membranes with meconium-stained amniotic fluid. There was no meconium aspiration. We report a review of 15 similar cases. In the whole series, a linkage between umbilical cord vascular necrosis and evidence of remote meconium discharge always seems to be detectable. The pathophysiological mechanism is unknown. It is still not clear why only a tiny percentage of cases with meconium-stained amniotic fluid develops umbilical cord lesions and poor pregnancy outcome. Further investigations are needed to explain why some meconium-stained newborns suffer severe neurological and other damage even without meconium aspiration.
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A case of spontaneous heterotopic pregnancy (simultaneous intra- and extrauterine) with living embryos is described. A 26 year old primigravida, affected by threatened abortion at 7 weeks gestation with right pelvic pain underwent a... more
A case of spontaneous heterotopic pregnancy (simultaneous intra- and extrauterine) with living embryos is described. A 26 year old primigravida, affected by threatened abortion at 7 weeks gestation with right pelvic pain underwent a transvaginal sonography which allowed a certain diagnosis. A minilaparotomy with right salpingectomy was performed at the 8th week of gestation. Intrauterine pregnancy was uneventful and a healthy female infant was delivered at term weighting 3200 g. The international literature concerning heterotopic pregnancy is reviewed. Diagnostic and therapeutic aspects are discussed in the light of this case. Heterotopic pregnancy is an insidious pathology with a constant increase of incidence that should be considered as a diagnostic possibility in all cases at risk. Minilaparotomic salpingectomy in general anesthesia is probably the safest treatment for the patient and the least traumatic for a good outcome of her intrauterine pregnancy.
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This investigation shows that a general anesthetic produces similar effects in vivo and in vitro. Anesthesia with a barbituric drug, Thiopental, induces an increase in membrane fluidity and a decrease in the activity of... more
This investigation shows that a general anesthetic produces similar effects in vivo and in vitro. Anesthesia with a barbituric drug, Thiopental, induces an increase in membrane fluidity and a decrease in the activity of acetylcholinesterase in syncytiotrophoblast plasma membranes (SPM) obtained from placentas after caesarean section. The same effects can be reproduced in vitro after anesthetic addition to the isolated plasma membranes. Morphological and freeze-fracturing studies also suggest that membrane protein components are affected by anesthetics.
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The importance of establishing correlations between cardiac function (cardiac output and stroke volume) and total body water (TBW) content in normal and hypertensive pregnancy focuses primarily on their potential relevance in treatment.... more
The importance of establishing correlations between cardiac function (cardiac output and stroke volume) and total body water (TBW) content in normal and hypertensive pregnancy focuses primarily on their potential relevance in treatment. Total body water content and cardiac function were evaluated in 25 normotensive (N) and 22 gestational hypertensive (GH) pregnant women matched for age, gestational age, and pre-pregnancy body mass index (BMI) during the third trimester of gestation. Patients underwent maternal echocardiography, bioelectrical impedance analysis (BIA), and hematocrit (Hct) evaluation, and the water balance index (WBI), i.e. the ratio of total body water to hematocrit, was computed. Hematocrit showed significantly lower values in normal than in GH women (31.9+/-2.2% vs. 36.2+/-2.5%; p<0.001). There was no difference in TBW between the two groups. The WBI was higher in normal than in GH women (1.35+/-0.20 l.kg-1.m-2 vs. 1.19+/-0.18 l.kg-1.m-2; p<0.001). Normal sub...