[Amniocentesis and chorionic villi biopsy. A 10-year material]. / Amniocentese og chorion villus biopsi. Et 10-års materiale.

PURPOSE: The aim of the study was to evaluate the prenatal diagnosis at a secondary referral hospital. METHOD: A retrospective study was carried out on 1752 women examined by amniocentesis (AC) (n = 1037) or chorion villus sampling (CVS) (n = 715) at Randers Centralsygehus from 1 April 1987 to 31 December 1996. RESULTS: A cytogenetic diagnosis was made in 99.8% of the AC group and 99.4% of the CVS group. Complications, recorded as either spontaneous abortion, bleeding/threatening abortion, pain/contractions or amniotic fluid leakage, were seen in 1.9%, 3.3%, 2.9%, and 2.3% after AC and 1.8%, 7.3%, 3.4%, and 0% after CVS. There were significantly more re-examinations after CVS when the procedure was carried out by less experienced operators (p < 0.003), whereas experience did not influence the number of re-examinations after AC (p = 0.8). CONCLUSION: The frequency of complications during prenatal procedures performed over a period of ten years was comparable with that reported in other studies. It is expedient and safe to perform prenatal examinations at a secondary referral hospital where currently 200 procedures are performed each year.

Cytobrush and endocervical curettage in the diagnosis of dysplasia and malignancy of the uterine cervix.

BACKGROUND: The validity of cytobrush and endocervical curettage combined with colposcopically directed biopsies in the diagnosis of cervical dysplasia and malignancy has not been evaluated in randomized trials. We aimed to elucidate the diagnostic validity of the two methods. METHODS: A prospective, randomized study of 180 consecutive patients. All patients were examined without anesthesia by colposcopically directed biopsies of the ectocervix and randomly assigned to either cytobrush or endocervical curettage. Patients with < or = CIN 1 were investigated with the alternative method three months later. Patients with > or = CIN 2 had a cone biopsy. RESULTS: One hundred and thirty-one patients were evaluable. The sensitivity of cytobrush and endocervical curettage combined with colposcopically directed biopsies of the ectocervix was 96% and 84% (p = 0.08), respectively. The specificities of the two investigations were 95% and 88%, respectively (p = 0.78). All cytobrush specimens were evaluable but because of a low recovery of endocervical material a diagnosis could not be made in 12% of the patients examined by endocervical curettage. CONCLUSION: The sensitivity of the combined use of cytobrush and biopsies of the ectocervix was equal to or higher than the sensitivity of endocervical curettage and ectocervical biopsies. The specificities of the two investigations were much alike. All cytobrush specimens were evaluable but a diagnosis could not be performed in 12% of the endocervical curettage specimens because of too little endocervical material. Furthermore, cytobrush is less inconvenient to the patient. Therefore, in the follow-up of patients with cervical dysplasia endocervical curettage may be replaced with cytobrush.

[Granulosa cell tumor. A 30-year material from a central hospital]. / Granulosacelletumor. Et 30-års materiale fra et centralsygehus.

During a 30-years period seventeen women were correctly diagnosed as having a granulosa cell tumour. Two died of the tumour, while six women died of other causes. No pathological features correlated to prognosis. A conservative surgical approach to preserve fertility is not recommended; of the three fertile women in our group one died of the disease and another one had two relapses within three years. Eleven tumours showed evidence of increased oestradiol production, and this proved useful as a tumour marker. Follow up is rarely performed unless relapse occurs.

[Strategy for delivery in breech presentations. A retrospective study]. / Strategi for forløsning af underkropsfødsler. En retrospektiv undersøgelse.

A six-year material of 236 singleton breech deliveries at term was evaluated retrospectively. Infants who were small for the gestational ages at birth were excluded. Vaginal delivery proved successful in 41.1% of the material. The vaginal success rate was 61.8. Low parity and age and high birth weight reduced the vaginal success rate. The route of delivery did not affect the outcome in terms of infantile morbidity or mortality. Nevertheless, an increased number of neonates with congenital disorders was observed. It is concluded that trial of vaginal delivery may be employed in a selected group of pregnant women with breech presentations without increasing the risk of adverse effects of the neonate.

[Chorionic villi biopsy as an alternative to amniocentesis]. / Chorion villus biopsi som alternativ til amniocentese.

The results of a retrospective assessment of the first 112 chorion villus biopsies carried out in the Department of Obstetrics and Gynaecology in the Central Hospital in Randers are presented. Karyotype determination was obtained in 98.2% and in 83.9% already by means of direct microscopic examination after incubation for 24 hours. No complications which could be attributed to the biopsies were registered. The present authors consider that the method should be employed more extensively for prenatal cytogenetic diagnosis.

[Serum estradiol as a marker in recurrent granulosa-theca-cell tumor]. / Serumøstradiol som markør ved recidiverende granulosa-thecacelltumor.

A case of a granulosa-theca-cell tumour of the ovary in a 39-year-old woman is reported. Despite benign histology and apparently radical operation, tumor growth relapsed twice before apparent cure. Oestradiol in serum proves valuable as a tumour marker and correlates well with tumour relapse.

Isolated torsion of the normal fallopian tube.

Isolated torsion of the fallopian tube is a rare disease of unknown etiology. Pathological conditions often pre-dispose to torsion. The correct diagnosis is usually not established until the operation and it is almost always necessary to remove the tube. Awareness of this condition and early laparoscopy in case of unexplained acute low abdominal pain may result in early diagnosis and possible preservation of the affected tube.