Treatment of pelvic endometriosis with etonogestrel subdermal implant (Implanon).

Background: Endometriosis is one of the commonest benign gynaecological disorders and has a peak incidence between 30 and 45 years of age. Treatment options are medical or surgical, depending on the location and extent of the disease and the woman's childbearing aspirations or need for contraception. Over the past five decades several formulations of progestogen have been used to treat endometriosis.

Migration of sterilisation clips: case report and review.

A case is reported of a sterilisation clip which was discovered, three years after operation, to have migrated to the subcutaneous tissue. A review of current techniques of female sterilisation is given together with a discussion of other relevant accounts of clip migration. It is shown to be a rare event with no reported serious sequelae.

A study of pethidine kinetics and analgesia in women in labour following intravenous, intramuscular and epidural administration.

1 Epidural administration of opiates for analgesia has recently generated widespread interest and would theoretically be advantageous as a method for relief of pain in labour. 2 Plasma pethidine concentrations were measured after intravenous, intramuscular and epidural administration of pethidine to women in labour and after epidural administration to non-pregnant female surgical patients. 3 Kinetic parameters were derived from the plasma concentration data in each group of subjects and the relationship between plasma kinetics and analgesia in labour were examined.

Carcinofibroma--a variant of the mixed Mullerian tumour. Case report.

An endometrial neoplasm composed of both stromal and epithelial elements, in which only the epithelial element appeared malignant, is reported. Only two similar cases have previously been described. In view of the rarity of these neoplasms, little is known about their behaviour and this presents problems of management particularly in a young patient.

Comparison of epidural and intramuscular pethidine for analgesia in labour.

Analgesia mediated by a direct spinal action of narcotic drugs administered via the epidural route may have considerable advantages over conventional(conduction block) epidural analgesia in labour. The efficacy, mode of action and placental transfer of epidurally administered narcotics in labour has not yet been established. We have compared the systemic absorption, analgesia and other effects on the mothers and transfer of drug to the fetus in primigravidae who received epidural or intramuscular pethidine 100 mg in labour.

Prophylaxis for Mendelson's syndrome before elective caesarean section. A comparison of cimetidine and magnesium trisilicate mixture regimens.

A clinical trial was conducted in which patients undergoing elective Caesarean section received eitherrr oral cimetidine 400 mg or magnesium trisilicate mixture BPC 20 ml before anaesthesia. The pH values of gastric fluid were significantly higher and the incidence of pH less than 2.5 was significantly lower in patients who received magnesium trisilicate mixture BPC.

Failure of epidural morphine to relieve pain in labour.

Lumbar epidural injections of 2 mg preservative-free morphine were given to 10 subjects in established labour. Assessment of pain using a visual analogue scoring system revealed no appreciable relief of pain 30 min after morphine infection. Analgesia was subsequently provided by epidural injection of 8 ml bupivacaine 0.

Topography of the lumbar epidural space. A study in cadavers using injected polyester resin.

Polyester resin was injected into the epidural space of fresh-adult cadavers to study the shape of the lumbar epidural space and the spatial relationship between the dura mater and vertebral canal. In most of the anatomical preparations the shape of the lumbar dural sac was distinctly triangular and in some cases a dorso-median fold of the dura was apparent. These observations support the explanation suggested by others to account for the midline translucency seen in contrast radiological examination of the lumbar epidural space.

Lumbar extradural injection pressures in pregnant women. An investigation of relationships between rate of infection, injection pressures and extent of analgesia.

Before the induction of labour in 34 pregnant women 1.5% lignocaine 10 ml was injected into the lumbar extradural space at constant rates between 0.143 and 0.

Placental intervillous blood flow measured by inhaled 133Xe clearance in relation to induction of epidural analgesia.

A method of determining placental intervillous blood flow (IBF) using an inhaled 133Xe technique is described. The method was used to investigate the effect on IBF of epidural analgesia with an initial dose of 37.5 mg bupivacaine.

Cimetidine as a single oral dose for prophylaxis against Mendelson's syndrome.

Cimetidine, a histamine H2-receptor antagonist which inhibits gastric acid secretion, was administered as a single 400 mg oral dose before anaesthesia to forty-six patients undergoing elective gynaecological surgery. The incidence of gastric residue pH above 2.5 was significantly greater (P less than 0.

Intracranial birth trauma in vaginal breech delivery: the continued importance of injury to the occipital bone.

Between 1966 and 1976, postmortem examinations revealed significant intracranial birth trauma in 17 infants delivered breech first and in ten infants delivered head first; separation of the squamous and lateral parts of the occipital bone (occipital osteodiastasis) was found in five of the infants who died after breech delivery. The finding of the lesions in these infants is attributed to the adoption, since 1971, of a postmortem technique involving dissection of the suboccipital region before opening the skull. Review of earlier necropsy reports suggests that the lesion was sometimes missed.

Postmenopausal tuberculosis of the cervix. Case report and review.

A patient with tuberculosis of the cervix who presented with postmenopausal bleeding is reported and the related literature is reviewed.