A histochemical study was performed on 46 placentas showing so-called hydropic degeneration of villi. The 46 cases included early abortuses (35 cases), incomplete moles (four cases), and complete hydatidiform moles (seven cases). All the specimens showed diffuse, positive staining of the distended villous stroma with alcian blue at pH 1.2 ...

Primary vaginal adenocarcinoma unrelated to intrauterine hormone exposure is very uncommon. We report a case of a 52-year-old woman who presented with primary vaginal adenocarcinoma that showed intestinal differentiation with prominent papillary formations and numerous papillary and villous features with prominent goblet cells. There was vaginal adenosis in the immediate ...

In a retrospective study of 130 out of 141 consecutive cases of antepartum haemorrhage admitted to the Obstetrics Unit of the Port Moresby General Hospital in the three years 1987 to 1989, 33% had abruptio placentae, 48% had placenta praevia and in 19% the cause of the APH could not ...

A case of May-Hegglin anomaly, a rare autosomal dominant thrombocytopenia, is reported. This disorder is characterized by giant platelets, basophilic inclusion bodies within the cytoplasm of granulocytes and an occasional bleeding tendency. This bleeding tendency depends on the platelet count. The fetuses of such patients run the risk of intracranial ...

This article is the first segment of what we hope will become a regular feature in the Journal of Clinical Monitoring. The Monitoring Dilemmas series is designed for clinicians who are struggling with the information presented by new monitoring. The past decade has seen an explosion in the number and ...

A case report of breech delivery complicated by entrapment of the aftercoming head is presented. McRoberts maneuver was applied to facilitate the release of the head. It is suggested that the same theoretical basis that stands behind the use of McRoberts maneuver in shoulder dystocia might make it applicable as ...

A transverse vaginal septum is the most common congenital anomaly of the vagina. Vaginal atresia is seen less frequently. There have been some variations in cases of transverse vaginal septum and vaginal atresia. This is the first report of a patient with retrohymenal vaginal atresia and perforate transverse vaginal septum.

All cases (70) of failed instrumental deliveries which occurred between 1980 and 1988 at Ramathibodi Hospital, Bangkok, Thailand were critically reviewed. The incidence of failure was 0.5%, and failure occurred more often in primigravidae. Failure to appreciate the true level of the fetal head and too early intervention accounted for ...

A 30-year-old woman with bilateral, recurrent, borderline papillary serous cystadenocarcinoma of the ovary was treated with bilateral oophorocystectomy and omentectomy with uterine preservation. Ten years later, through induction of an artificial endometrial cycle and ovum donation, she conceived twins and delivered two healthy infants. Staging exploratory laparotomy at the time ...

Maternal morbidity was observed in 377 obstetric cases at Jinnah Postgraduate Medical Centre (JPMC) during a period of one year. Morbidity rate was 4.4% of total deliveries. Three hundred and twenty-four (86%) mothers had no proper antenatal supervision. Infection was more common after abdominal delivery and injury to genital tract ...

A retrospective study was performed to compare elective versus emergency cesarean hysterectomy in a residency program. We noted the following statistically significant differences between emergency and elective cases: (1) Estimated blood loss (mean +/- SD) for emergency and elective cases was significantly different at 1495 +/- 772 and 875 +/- ...

Accumulation of fluid in the uterine cavity was recorded in three cases during vaginal ultrasound (US) monitoring for in vitro fertilization (IVF) cycles. The three patients had hydrosalpinges and tuboovarian cystic masses. They all had a common complaint of intermittent vaginal discharge. Attempts at aspirating the fluid to empty the ...

In one study two cases of premature expulsion of the placenta were recorded among 60 supervised calvings (3.3 per cent); both calves died. In a second study, 47 cases were recorded among 332 cases of perinatal mortality (14.2 per cent). The condition was associated with fetal malpresentation and malposture, and ...

Four cases of incarceration of the retroverted gravid uterus are described. Typical observations were: a rather low fundal height at vaginal examination, no detectable uterine cervix, and the fetal presenting part deeply impacted in the pelvic cavity. One spontaneous correction in the third trimester is described. In general a cesarean ...

ABH typing by immunocytochemical method has been carried out on 163 selected vaginal swabs. 127 cases (78%) were determined correctly, 11 cases (7%) incorrectly and 25 cases (15%) could not be classified. Often, not all of the vaginal cells showed the expected positive staining, which was not counted as a ...

There is a high association between anterior placenta previa, placenta accreta and previous cesarean section. We report three cases which illustrate the particular danger of massive hemorrhage posed by placenta previa/accreta in a scarred uterus. As the incidence of cesarean section continues to rise worldwide, the problem of placenta previa/accreta ...

The carriage of Group B Streptococcus was investigated in 500 females in the third trimester of their pregnancy by culturing vaginal and rectal swabs and urine collected from each patient. A high rate of colonization was noted since 152 cases (30.4%) were found to harbor the organism, and 219 specimens ...

It has been hypothesized that vaginitis emphysematosa is a manifestation of trichomonal or Gardnerella infection. In support of this etiologic concept, four cases of the disorder are described showing the apparent curative effect of treating the associated infection. The linkage of these and other reported cases with conditions of impaired ...

The aim of this work is to suggest a new diagnostic approach to the "female varicocele syndrome" which utilizes transvaginal ultrasonography. The presence of circular or linear anechogenic structures with a diameter greater than 5 mm, which were found in transverse and oblique sections of the lateral fornices, was indicative ...

Desquamative inflammatory vaginitis is an uncommon cause of an intractable vaginitis often accompanied by serious dyspareunia, which can occur at any stage of reproductive life and after the menopause. The cytological changes are identical with those seen in atrophic vaginitis yet the disorder often occurs in the presence of apparently ...

Since 1975 the crisis in professional liability has been the most important problem affecting the future of obstetrics and gynecology. Increasing numbers of physicians have stopped delivering babies and most obstetricians have decreased their high-risk obstetrics. Most of the attention in the specialty has been directed toward the liability problem ...

The placenta accurately reflects many important prenatal events. It is therefore important that it be examined. This is especially useful in cases of possible future litigation, the "bad-baby cases." There is much experience now that pathologic findings in the placenta often have a decisive role in the accurate disposition of ...

Placenta accreta is defined as a condition involving an abnormal adherence of the placenta to the myometrium. It is rare for placenta accreta to present before 20 weeks' gestation; only eight cases have been previously reported. This case report describes a first-trimester placenta accreta which presented during suction curettage for ...

A review of eclampsia in Kelantan was undertaken from 1983-1988. There were 146 documented cases in the state (66 per 100,000 deliveries). Eight maternal deaths occurred. Sixty seven (45.9%) were primigravida. Six of the 79 multiparous women developed eclampsia for the first time following remarriages to new partners. The multisystem ...

The most dreaded complication of vaginal breech delivery is entrapment of the aftercoming head. When this is due to disproportion, persistent attempts at vaginal extraction are likely to result in a dead or damaged baby. A largely unknown solution in this desperate predicament is to surgically enlarge the pelvis by ...

In this article, we report a case of a newborn who was delivered by cesarean section for breech presentation and who sustained a fracture of the femur. Nine-month follow-up revealed good healing of the fracture. We also present a short review and discussion of only six other similarly reported cases. ...

In many cases of breech presentation, a trial of labor is practical and safe among carefully selected parturients. Anesthesia and full neonatal support should be available. Described is the protocol in use at several large institutions that maintain a Cesarean rate for breech presentation in the 60 to 70 per ...

Hysteroscopy performed on 126 infertile patients and on 73 fertile patients revealed a significant association between abnormal uterine cornual ostia and infertility (p less than 0.002). Ostial abnormalities included absence of cupping with uterine cavity distension, diminution of ostial diameter and complete ostial occlusion. High intrauterine pressures from dye perturbation ...

Chorioangioma (CA) is found in about 1% of all placentas. Here we report cases of CA: one associated with intra-uterine fetal death, and the other with feto-maternal transfusion resulting in severe anaemia of the child. Feto-maternal transfusion through a CA could, in suspected cases, be diagnosed by s-AFP, one-minute alkali-denaturation ...

An 18-year-old single female presented with primary amenorrhea and cyclic lower abdominal pain. Pelvic examination revealed normal appearing external genitalia but absent vagina. Pelvic sonogram was compatible with cervical and vaginal agenesis, which was confirmed at operation. Hysterectomy and construction of a new vagina by the McIndoe's technique were performed. ...

The placenta, normally confined to the decidual lining of the uterine cavity, can in some circumstances invade the muscular wall of the uterus, a condition known as placenta accreta. Less common is placenta increta, in which placental cotyledons become intertwined with the muscular stroma of the uterus. Placenta percreta, in ...

A retrospective analysis of eight cases of third-trimester fetal demise managed with prostaglandin E2 vaginal suppositories (PGE2) is presented. Management included laminaria insertion prior to induction and an initial lower dosage of PGE2. No cases of uterine rupture or cervicovaginal lacerations were encountered. A summary of the literature as it ...

Three cases of asymptomatic pelvic endometriosis during pregnancy were reported. All cases denied abnormal vaginal bleeding, dyspareunia or dysmenorrhea; but only one case was noted to have a problem of infertility. Conservative operations were performed at the second trimester and during cesarean section with an uneventful postoperative course. Cyclic menses ...

A series of five cases of prolonged labour in African multiparae is presented. The diagnosis of asynclitism, i.e. anterior parietal presentation, and its correction with a ventouse resulted in vaginal deliveries, thus avoiding primary caesarean sections. The mechanisms of asynclitism and its implications as a common cause of prolonged labour ...

The spiked Lippes loop was inserted in 53 women and the standard loop in 55 women immediately following the delivery of the placenta after normal vaginal delivery. A group of 50 recently delivered women with no IUD was studied as a control. The cases were followed up for 1 year. ...

With meticulous surgical technique, bleeding following vaginal hysterectomy and colporrhaphy is an unusual complication. With exteriorization of the stumps, any such haemorrhage is revealed in the form of vaginal bleeding. Two unusual cases of perivesical and broad ligament hematoma are presented and the possible role of vaginal packing in the ...

We have reported a case of unintentional, roentgenographically proven cannulation of the lumbar subdural space. Injection of 13 ml of local anesthetic provided satisfactory anesthesia for cesarean section, and administration of 1 mg of morphine resulted in postcesarean analgesia for 22 hours. Subdural catheterization is a possible explanation for the ...

It is a sobering fact that mishaps during the administration of anesthesia sometimes have a way of initiating problems which escalate step by step to a situation of total disaster for the patient. Inexperience and poor judgment often lie behind such tragedies and the following case report is presented not ...

Studies were undertaken to detect a possible reporting or diagnostic bias that might have affected the results of previous epidemiologic investigations of toxic shock syndrome (TSS). The methods used in this reassessment of initial findings regarding TSS epidemiology (which were obtained through passive- and active-surveillance systems) included record review and ...

We report the case of a 38-year-old eclamptic patient undergoing emergency Caesarean section who required awake nasotracheal intubation because of her massively swollen and lacerated tongue. Vasoconstriction, in addition to topical anaesthesia, was required due to thrombocytopaenia. The use of three per cent lidocaine with 0.125 per cent phenylephrine for ...

We report a case of an adolescent female with apparent agenesis of the uterus with chromosomally competent ovarian dysgenesis. In our case, the apparent absence of the uterus on the laparoscopy constituted a severe hypoplasia of the organ prior to estrogen stimulation, rather than aplasia. Following a year of estrogen/progesterone ...

Eight hematopathologists independently reviewed 56 consecutive cases of benign and malignant lymphoproliferative disorders (LPD) to determine: (1) the degree of interobserver agreement on the interpretation of immunologic findings on fresh-frozen sections alone and on that of the immunologic findings in conjunction with corresponding hematoxylin and eosin (H & E)-stained histologic ...

Intrauterine resolution of a case of nonimmune hydrops fetalis associated with cytomegalovirus infection occurred during conservative antenatal management. Although the etiology for a case of nonimmune hydrops diagnosed antenatally is often obscure, a systematic investigation provided an antenatal diagnosis of cytomegalovirus infection, permitting expectant management and eventual vaginal delivery at ...

In recent years numerous articles have reported on the inaccuracies of the dilatation and curettage procedure, citing a false-negative rate of up to 10% to 15%. Indeed, several articles have reported that, in this era of simplified endoscopy, the blind dilatation and curettage should no longer play a significant role ...

When sought by light microscopy in formalin-fixed tissue, fusobacteria are apparent in 7-18% of chorioamnionitis cases. Brown and Hopps bacterial staining characteristically visualizes their long, slender and filamentous forms. Fusobacteria-like organisms in placentae have previously been associated with prematurity. Our findings indicate that perinatal infection with fusobacteria may cause neonatal ...

The authors present a very infrequent case of invasive placenta in a 33-year-old caucasian primigravida, admitted in our Department because of labor. In the course of a cesarean section performed for failure of progress, the presence of a highly adherent placenta located in the anterior part of the lower uterine ...

Fetomaternal hemorrhage and abruptio placentae may occur concurrently. A prospective study was done to determine the incidence of fetomaternal hemorrhage in noncatastrophic cases of abruptio placentae consistent with sonographic findings. Significant fetomaternal hemorrhage was found in 75% of noncatastrophic cases. Implications of conservative management of abruptio placentae with fetomaternal hemorrhage ...

A case of repeatedly recurrent massive vaginal vault prolapse is presented. Representative articles on various ingenious modalities for the repair of this condition are reviewed. An additional safe and simple procedure is described. Criteria for the ideal prosthetic material are listed. Marlex mesh prosthesis, which appears to fulfil all the ...

Hydrohematometrocolpos anomalies denote the different types of accumulation of fluid and menstrual products in the vagina and the uterus. They are rare conditions due to an intact hymen, vaginal membrane, or vaginal atresia. They may present at different times during development. The method of presentation is variable, and the presence ...