1/13. A case of twin pregnancy with complete hydatidiform mole and coexisting fetus following IVF-ET. Twin pregnancy consisting of complete hydatidiform mole (H-mole) and a coexisting fetus occurs with an estimated incidence of 1 per 22,000-100,000 pregnancies. The incidence of this unusual twin pregnancy with complete H-mole and a coexisting fetus after in vitro fertilization and embryo transfer (IVF-ET) is not thought to be greater than that of general population. We present an unusual twin pregnancy with complete H-mole and a coexisting fetus that occurred following IVF-ET, which was terminated at 21 weeks of gestation and developed into nonmetastatic gestational trophoblastic tumor. ( info) |
2/13. sex-determining region Y levels in maternal plasma: Evaluation in abnormal pregnancy. AIM: A number of studies for the measurement of cell-free fetal dna in maternal blood have been reported; however, their clinical significance has remained unclear. We proposed to clarify the relationship between fetal dna levels and obstetrical disorders. methods: One hundred and eighty-five cases of normal pregnancy, ranging from 8 to 40 weeks' gestation, and 70 cases of abnormal pregnancy were included. SRY levels in maternal plasma were quantified with a real-time quantitative polymerase chain reaction. RESULTS: sex-determining region Y (SRY) levels and the number of patients with positive levels peaked at 33-36 weeks in normal pregnancy. The SRY levels in threatened abortion (11.6 /- 4.8 copies/mL to 0 /- 0, P < 0.05) and threatened preterm labor (44.6 /- 16.1 copies/mL to 15.9 /- 6.2, P < 0.01) were significantly higher than those of the normal group. In pre-eclamptic patients, SRY levels were markedly higher than those of the normal group (173.2 /- 94.8 copies/mL to 22.4 /- 8.9, P < 0.05). patients with premature separation of the placenta (266.8 /- 137.1 copies/mL to 4.9 /- 3.7, P < 0.05) and placenta previa (167.7 /- 32.4 copies/mL to 37.0 /- 17.3, p <0.01) also showed elevated SRY levels. CONCLUSION: sex-determining region Y levels in maternal plasma were elevated in patients with an abnormal pregnancy, particularly those with placental injury of damage. These results suggested that increased SRY levels are consistently caused by the leak of fetal components, and thus the measurement of SRY levels in maternal plasma is useful for the evaluation of placental injuries. ( info) |
3/13. Transient parkinsonism: induced by progesterone or pregnancy? We report on the development of transient parkinsonism after progesterone injection in a pregnant patient with a risk of abortion. Etiological possibilities are discussed, including pregnancy itself, possible toxic effects of the dead fetus, and progesterone injection. progesterone-induced parkinsonism seems the most likely diagnosis in this case. ( info) |
4/13. Treating threatened abortion with Chinese herbs: a case report. In the report a patient who suffered from threatened abortion was successfully cured with Chinese herbs. After treatment, vaginal bleeding stopped and the aching sensation in the loins and prolapsing sensation in the abdomen disappeared. The gestational ring changed from a crescent moon shape to a normal shape. ( info) |
5/13. Ruptured interstitial pregnancy presenting as an intrauterine pregnancy by ultrasound. Interstitial pregnancy is an uncommon subset of ectopic pregnancy in which the conceptum implants in the intrauterine portion of the fallopian tube. These pregnancies tend to progress further before rupture than do other tubal pregnancies and subsequently have greater propensity for massive intra-abdominal bleeding and maternal demise. Abdominal ultrasound can be deceptive in evaluating interstitial ectopic pregnancies. Transvaginal ultrasonography is more sensitive in the diagnosis of early ectopic pregnancy. knowledge of the application and limitations of both transabdominal and transvaginal ultrasound will assist the emergency physician in the timely evaluation of this potentially lethal condition. ( info) |
6/13. A case of rh isoimmunization: should threatened first-trimester abortion be an indication for Rh immune globulin prophylaxis? Despite the recommended 28 weeks' gestation antenatal, postnatal, and postabortion prophylaxis with Rh immune globulin, residual Rh immunization still occurs in Rh-negative women. We describe a patient whose history suggests development of an anti-D antibody after first-trimester bleeding. To our knowledge, this is the first such case reported in the English literature. ( info) |
7/13. Ectopic pregnancy: 'classic' vs common presentation. Ectopic pregnancies are common, are increasing in incidence, and are preventable causes of reproductive morbidity and death. They are also frequently misdiagnosed, and are one of the most common causes for malpractice claims made against primary care physicians. The classic description of the presenting signs and symptoms of ectopic pregnancy was derived from a series of ruptured ectopic pregnancies. To decrease the complications and preserve fertility, ectopic pregnancies must be detected before they cause tubal rupture. A family medicine center experience with the diagnosis of ectopic pregnancy over a six-month period is presented. The study confirmed the expected frequency of this condition in this population but findings disclosed that the classic presentation was, in fact, uncommon. Implications for decision making derived from these case reports are discussed. A high level of clinical suspicion for this problem must be maintained. ( info) |
| We report 31 cases with velamentous insertion of the umbilical cord of whom two had coexistent vasa previa. The prevalence of the former was 0.22% and of the latter 0.014%. perinatal mortality was low, 3.2%, but there was a high rate of complications during pregnancy, such as threatened abortion, antepartum and intrapartum bleeding, premature delivery and fetal distress. Fifteen patients underwent caesarean section. Four of the term infants were small for gestational age. One infant had congenital malformations. The two cases with vasa previa are described in detail. We conclude that velamentous insertion of the umbilical cord should be kept in mind in the differential diagnosis of fetal distress accompanied with antepartum or intrapartum vaginal bleeding. ( info) |
9/13. Spontaneous abortion and ectopic pregnancy. ( info) |
10/13. Prevention of fetal growth retardation by buffy-coat transfusions--a case report. A case is described with two previous unsuccessful pregnancies (one missed abortion and one severe fetal intrauterine growth retardation ending in fetal death). Examination showed that the patient and her husband each share one antigen of the HLA-A and -B series. In spite of two previous pregnancies the patient had no lymphocytotoxic antibodies. The patient then received 5 buffy-coat-pool transfusions and the sera reacted with an increasing number of panel cells (Fig. 1). A mature healthy infant was born at term. We consider that the cytotoxic antibodies achieved, took over a protective function for the later undisturbed progress of the pregnancy. This may be a possible way of preventing intrauterine growth retardation caused by immunologic factors. ( info) |