Microbiological and histological findings in the fallopian tubes of women using various contraceptive methods.

The oviducts of seventy-three women undergoing sterilization by partial salpingectomy were submitted for microbiological and histologic studies. Twenty women were intrauterine device users, twenty-five women were oral contraceptive pill users and twenty-eight women used natural or barrier methods of contraception. Among intrauterine device users, there was an excess of mild and severe acute inflammatory histologic changes involving both the lumen and the tubal mucosa. Five of the eight intrauterine device users with acute inflammatory change had sterile tubal cultures.

PIP: The oviducts of 7o women undergoing sterilization by partial salpingectomy were subjected to microbiologic and histologic study. The objective was to determine whether there is a link between the histologic evidence of salpingitis and microbiological findings in the fallopian tubes of IUD users. Of the 73 subjects, 20 had been IUD users, 25 used oral contraceptives (OCs), and 28 were natural or barrier mehtod users. Microscopic examination revealed no significant differences between user groups with respect to edema, fibrosis, chronic inflammation, or granulomatous inflammation. However, acute inflammatory cells were found in the lumen and the mucosa of the right or left tube in an excess of IUD users. 5 of the 8 IUD users with acute inflammatory change had sterile tubal cultures. There were no differences between user groups with respect to the microbiologic organisms found in cervical or oviductal cultures, supporting the concept that inflammatory changes do not necessarily reflect the presence of infection. Further studies of the links between IUD use, sterile acute inflammation, and pelvic infection are recommended.

Prostaglandins and therapeutic abortion.

PIP: Clinical findings indicate that prostaglandins are potent oxytoics agents and that they may play a physiological role in labor and abortion. A number of clinical trials have demonstrated the successful induction of abortion in the 1st and 2nd trimesters of pregnancy using intravenous PGF2 alpha. A recent clinical trial by the authors using intravenous PGF2 alpha on 10 women 10-15 weeks pregnant resulted in 9 complete abortions and 1 incomplete abortion requiring surgical intervention. Induction-abortion interval ranged from 7 hours 55 minutes to 31 hours 39 minutes with a mean of 24 hours 41 minutes. Total amount of PGF2 alpha in the 9 successful cases had a mean value of 93.53 mg. There were side effects in all patients but no serious complications. A high incidence of side effects was observed at the 50 mcg/minute level; all regressed rapidly upon termination of infusion. The study suggests that PGF2 alpha is an effective abortifacient in both the 1st and 2nd trimesters. When compared with suction termination in the first trimester, prostaglandin use was more time consuming, more demanding of supervisory personnel, less successful, and thus more expensive. Further research must be done to determine how prostaglandins work, their efficacy, and optimum methods of administration and safety.^ieng

The application of prostaglandins in gynecology.

This article describes the history of prostaglandins and the current status of research into their applications in gynecology. Studies of their use in inducing menstruation, labor and abortion are described.

Recurrent hemorrhage from corpus luteum during anticoagulant therapy.

A 43-year old woman had recurrent massive intraperitoneal hemorrhage from rupture of a hemorrhagic corpus luteum in two successive menstrual cycles while receiving anticoagulant therapy. Left oophorectomy was performed on the first occasion and right salpingo-oophorectomy with left salpingectomy on the second. While the precise incidence cannot be determined, rupture from a hemorrhagic corpus luteum appears to be a rare but potentially catastrophic complication of anticoagulant therapy. Hence possible ovarian hemorrhage should be considered in women of reproductive age receiving heparin or sodium warfarin therapy.

Therapeutic abortion with concurrent sterilization: comparison of methods.

Among patients seeking abortion are a group who request concurrent sterilization. This study compared three combinations of abortion and sterilization techniques. Suction termination with laparoscopic tubal ligation appears to be the combination of choice, for the mean hospital stay of patients undergoing this procedure was two days and the operative morbidity was 3.1%. For suction termination with tubal ligation at laparotomy, and hysterotomy with tubal ligation the mean hospital stays were 6 and 5.7 days respectively and the operative morbidity was four to five times greater.

Maternal plasma HbF levels in pregnancy.

Serial maternal serum hemoglobin F (HbF) levels were measured by radioimmunoassay in 23 normal pregnancies. The maternal HbF fraction remains within the normal range during the first trimester (mean + 2 S.D. = 0.15 + 0.13). After 15 weeks gestation, maternal HbF levels rise in some, but not all, pregnancies. In about 30% of the cases the HbF fraction remains within the range seen in adult men and non-pregnant women. Irregular rises in HbF were found in other pregnancies studied serially. The maternal HbF fraction may be an indicator of transplacental hemorrhage.