Nine year survey of 138 ectopic pregnancies.
Aboud E. Chaliha C.
Department of Obstetrics and Gynaecology, Northwick Park Hospital, Harrow, Middlesex, UK.
During the nine years (1986-1994), 138 women underwent surgery for ectopic pregnancies (One for every 213 deliveries). The commonest presenting symptom was abdominal pain (96%) followed by vaginal bleeding (83%). Four patients were asymptomatic and were diagnosed at a routine antenatal ultrasound scan. The most frequent physical findings were abdominal tenderness (87%) and followed by adnexal tenderness (57%). Histories of infertility in 17%, use of intrauterine contraceptive device (13%), and previous ectopic pregnancy in 11% were elicited. Eleven patients (8%) had a false negative urinary pregnancy test and subsequently required surgery. The ectopic pregnancies were tubal in 97% of the cases. There were 3 ovarian ectopics and one cervical ectopic.
Preeclampsia with fetal death in a patient with schistosomiasis japonica.
Obata NH. Kurauchi O. Kikkawa F. Yamada M. Fukuda Y. Itakura A.
Department of Obstetrics and Gynecology, Nagoya University School of Medicine, Japan.
A case of preeclampsia with fetal death at 32 weeks' gestation is reported. Liver examination of the patient revealed network patterns on ultrasonography and linear calcifications on unenhanced CT scans in the liver. These findings are typical of those of chronic schistosomal infection. Indeed, liver biopsy specimens showed eggs of schistosoma japonicum. We diagnosed her case as preeclampsia with liver cirrhosis due to chronic schistosomiasis japonica. Schistosomal placentitis may have been present and may have contributed to preeclampsia and fetal death.
Persistent mullerian duct syndrome.
Rizk DE. Ezimokhai M. Hussein AS. Gerami S. Deb P.
Department of Obstetrics and Gynecology, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates.
We report an 18-month old male presenting with a right-sided inguinal hernia and undescended testes. At herniotomy, a uterus and two fallopian tubes were found in the pelvic peritoneum adjacent to the two gonads which received their blood supply partly along the mullerian duct remnants. The gonads were testes by histological examination. Bilateral orchiopexy was performed without removal of the mullerian structures for fear of jeopardizing the testicular blood supply. The diagnosis of persistent mullerian duct syndrome was confirmed postoperatively by genetic and hormonal investigations.