Intracervical administration of prostaglandin E2-gel prior to therapeutic abortion: a prospective randomized double-blind study.

Forty primigravid women due to undergo first trimester termination of pregnancy were randomly selected for intracervical application of 1 mg prostaglandin E2 in gel or gel only as placebo. In the PGE2-gel group, a marked dilatation of the cervical canal was obtained, with post-gel treatment mean Hegar dilatation of 11.18 mm in that group, compared to 4.

Ultrasonically controlled retrieval of an intrauterine contraceptive device (IUCD) in early pregnancy.

Removal of an intrauterine contraceptive device (IUCD) in nonpregnant patients under ultrasonic guidance has previously been reported, but results of the method in pregnancy are controversial. In the present study removal of the IUCD was performed in 16 women who conceived with the device in place. Four women were scheduled for pregnancy termination and 12 women wished to continue their pregnancy.

Serum ovarian steroids, prolactin and prostaglandin metabolites in women using the inert intrauterine device.

Serum levels of 17 beta estradiol, progesterone, prolactin and metabolites of prostaglandins E2 and F2a were investigated in 18 healthy women before and after the insertion of a Saf-T-Coil intrauterine device. The results suggest that the presence of an intrauterine device may cause hormonal changes affecting the luteal phase of the menstrual cycle.

Midtrimester diagnosis of endocardial fibroelastosis and atrial septal defect: a case report.

We present a case report of endocardial fibroelastosis combined with atrial septal defect in which the diagnosis was strongly suspected at 25 weeks of gestation. To our knowledge the only previous report of prenatal diagnosis of endocardial fibroelastosis was of one made at 36 weeks of gestation.

Obstructive renal failure and pleural effusion caused by the gravid uterus.

Acute renal failure due to ureteral obstruction by the gravid uterus is considered to be a rare complication of late pregnancy. Pleural effusion caused by urinary tract obstruction is also extremely uncommon. This presentation reports what is believed to be the first case in which both these complications appeared at the same time in a pregnant patient.

Prenatal sonographic appearance of persistent cloaca.

A case of fetal persistent cloaca is presented. The intra-uterine sonographic appearance at 30 weeks' gestation is described. The clinical and ultrasonic differential diagnosis is discussed.

Microphthalmia--prenatal ultrasonic diagnosis: a case report.

Prenatal real-time ultrasonographic diagnosis of microphthalmia is presented. Diagnosis was made at 18 weeks' gestation in a fetus of a patient with a previous infant affected with the syndrome of cryptophthalmia with absence of septum nasi and ambiguous genitalia (Fraser syndrome). Recognition of microphthalmia as a part of Fraser syndrome and the easy visualization of fetal facial bones and orbits in the second trimester made the diagnosis possible.

Psychogenic stress in women during fetal monitoring (hormonal profile).

The influence of fetal heart rate monitoring on endocrinological parameters (growth hormone, insulin, cortisol, dopamine, epinephrine and norepinephrine) for stress was tested in women during pregnancy and in labor. Significant increases in the levels of all hormones except dopamine were found during monitoring in women with the non-stress test in comparison with the control group. Increases of more than 50% in the level of all hormones were found during labor with or without monitoring, reflecting stress during labor.

Assessment of gestational age by ultrasonic measurement of the femur length.

The effectiveness of ultrasonic femur length measurement from 12 to 40 week's gestation, as a means of assessing fetal age, was tested and compared with that of biparietal cephalometry. The femur length and biparietal diameter (BPD) were obtained from 471 measurements, from pregnant women with confirmed datings, using real-time scanning with a 3,5 mHz transducer frequency. Using a freeze frame and electronic calipers, the mean value of three consecutive measurements of the femur, when visualized with its characteristic appearance, was recorded.

Estrogen-producing Sertoli cell tumor of the ovary--a case report.

Estrogen-secreting Sertoli cell tumor of the ovary is rare. The few cases reported were characterized by metrorrhagia suggesting the hyperestrogenic state. An additional case of Sertoli cell tumor is reported in which the clinical picture is of secondary amenorrhea followed by metrorrhagia.

Prenatal diagnosis of placental hemangioma--clinical implication: a case report.

Placental hemangioma is considered to be associated with a high rate of maternal and fetal complications. We report a case where ultrasonography revealed the placental tumor at 28 weeks gestation. The patient was kept under strict surveillance which permitted diagnosis of pre-eclampsia at 34 weeks gestation with successful termination of pregnancy at 37 weeks.

External bladder--amniotic fluid shunt for fetal urinary tract obstruction.

Ultrasound diagnosis of bilateral hydronephrosis, hydroureters, and megacystis together with oligohydramnios secondary to urethral stenosis was made in a male fetus at 29 weeks' gestation. In utero decompression of the obstructed urinary tract and expansion of the amniotic fluid was achieved by placing an external bladder-amniotic fluid shunt using two catheters, one inserted into the fetal bladder and the other placed in the amniotic sac. The infant was delivered by cesarean section at 35 weeks' gestation and had a favorable outcome.

Further study of the inhibition of premature labor by indomethacin. Part I.

Prematurity still remains one of the unsolved problems in obstetrics and is responsible for a majority of cases of perinatal morbidity and mortality. The use of indomethacin to stop uterine contractions and prevent premature delivery is based on the observation that indomethacin inhibits the release of prostaglandin which is assumed to play a role in the induction and continuation of labor. The effect of indomethacin as an antagonist to prostaglandin was evaluated in a series of 297 women in premature labor.

Further study of the inhibition of premature labor by indomethacin. Part II double-blind study.

In the etiology of premature labor prostaglandins fulfill a significant role. It is known that indomethacin is a strong inhibitor of prostaglandin synthesis. The effect of indomethacin on premature labor was studied in a prospective randomized double-blind study in 36 patients.

Micrognathia-prenatal ultrasonographic diagnosis.

The first case of prenatal real-time ultrasonographic diagnosis of micrognathia is presented. Diagnosis was made at 17 weeks' gestation in the fetus of a patient with previous infant affected with the syndrome of thrombocytopenia with absent radii (TAR). Recognition of micrognathia as a part of TAR syndrome and the easy visualization of fetal facial bones in the second trimester made diagnosis possible.