RESUMO
The third published case of human placental lactogen (hPL) deficiency in a normal pregnancy is reported. The results of the 3 cases are discussed. In all cases, estriol levels were normal and hPL levels were either unmeasurable or below 1 microgram/ml. The placenta showed no obvious abnormalities. Growth hormone and prolactin determinations did not contribute to the understanding of the deficiency; neither did the glucose levels in the maternal blood. All 3 infants were male.
Assuntos
Estriol/sangue , Lactogênio Placentário/deficiência , Gravidez , Adulto , Feminino , Hormônio do Crescimento/sangue , Humanos , Recém-NascidoRESUMO
Pelvic pathology due to the parasite Echinococcus is infrequent in industrialized nations. It, however, may involve multiple organs and can mimic virtually any disease process. The parasitology, epidemiology, diagnosis, and treatment of hydatid disease is reviewed with particular emphasis on pelvic hydatid disease.
Assuntos
Equinococose/diagnóstico , Neoplasias Ovarianas/diagnóstico , Adulto , Diagnóstico Diferencial , Equinococose/parasitologia , Equinococose/cirurgia , Equinococose/transmissão , Feminino , Humanos , PelveRESUMO
Nine recent cases of coexisting intra- and extrauterine pregnancy at The Mount Sinai Medical Center are presented. The myriad of clinical presentations is exemplified in the postabortal, endometriosis, posttreatment; ovulation induction, and routine "rule-out ectopic" situations. A brief review of the literature follows detailing historical reports of diagnostic inaccuracy and delayed diagnosis. Several studies are cited supporting the difficulty of correctly diagnosing heterotopic pregnancy as well as factors which may predispose to it. The advantages and pitfalls of ultrasonography are mentioned as well as recommendations for early laparoscopic intervention when clinical history and ultrasound are suggestive. Caution is advised in those infertility patients who may undergo "routine" curettage at laparoscopy for ectopic pregnancy and thus, be at risk for inadvertent termination of an otherwise salvageable intrauterine pregnancy. This report further supports several other reviews in noting that the incidence of combined pregnancy may be much greater than formerly appreciated.
Assuntos
Gravidez Ectópica/diagnóstico , Gravidez , Adulto , Feminino , Humanos , Gravidez Ectópica/patologia , Gravidez Ectópica/cirurgia , Gravidez Tubária/diagnóstico , Gravidez Tubária/cirurgiaAssuntos
Anormalidades Múltiplas , Doenças em Gêmeos , Ictiose/congênito , Gêmeos Dizigóticos , Gêmeos , Feminino , Humanos , Ictiose/genética , Ictiose/patologia , Recém-Nascido , Masculino , Gravidez , Diagnóstico Pré-NatalRESUMO
This retrospective study was undertaken to compare the efficacy, side effects, and complications of prostaglandin E2 (PGE2) given as a vaginal suppository with those of PGE2 administered via the intrauterine extra-amniotic route to induce labor after fetal death. The induction-to-delivery intervals were comparable, with 9.2 +/- 3.94 hours and 8.6 +/-4.49 hours, respectively. However, the mean total amount of PGE2 administered was much less via the intrauterine extra-amniotic route (1.8 milligrams) than by the vaginal suppository (45.2 mg). There was a 100% success rate in the patients treated by the intrauterine extra-amniotic route, but only a 91.3% success rate in those patients treated via the vaginal route. The side effects (vomiting, diarrhea, fever) and the complications (incomplete abortion, uterine rupture, oxytocin augmentation) occurred more frequently with the use of PGE2 as a vaginal suppository. The vaginal route of administration of PGE2 is somewhat more convenient, but the intrauterine extra-amniotic route may offer a higher degree of efficacy and safety with fewer side effects in the management of fetal death in utero.