Uterine motility in patients with bicornuate uterus.

This study analyzes uterine motility in 12 women with a bicornuate uterus using the results of the recordings of endo-uterine pressure, obtained with two balloon-closed catheters. Seven patients had symmetric uterine cavities, while the rest (5 patient) had very dissimilar ones. The registration of the uterine motility was carried out during various phases of the cycle and after the administration of two drugs (oxitocin and methylergobasine), with the following results: the bicornuate uterus has a spontaneous activity similar to that of a normal uterus. A similar contractile response was observed in the uteri with two anatomically symmetric horns, whereas a dissimilar response was typical of the uteri with marked anatomic differences between the two horns.

Antibiotic prophylaxis in gynecological surgery.

A randomized prospective study was undertaken at the Obstetrics and Gynecology Clinic of the Catholic University of Rome in order to evaluate the effectiveness of two wide spectrum antibiotics: mezlocillin and cefotetan. Both drugs were administered 2 g i.v. 15 to 20 minutes preoperatively to allow optimal serum and tissue levels of antibiotic at the moment of bacterial innoculation. 184 patients undergoing elective gynecological surgery for nonmalignant disease were considered eligible for the study (124 pts abdominal hysterectomy, 58 pts vaginal hysterectomy). We found no statistically significant differences between the results obtained with the two drugs.

A long-acting cephalosporin in short-term prophylaxis in obstetric and gynecologic surgery.

The efficacy of single-dose (1 g i.v.) ceftriaxone (Rocephin) was evaluated in 175 patients undergoing emergency cesarean section (62 patients) or elective cesarean section (113 patients). The overall rate of postoperative infectious morbidity was 8% (14/175), with 9.6% (6/62) of the group undergoing emergency surgery and 7.0% (8/113) of the patients choosing elective cesarean section.

Antenatal phenobarbital in preventing intraventricular hemorrhage in premature newborns.

In a randomized prospective study, we investigated the effect of antenatal phenobarbital on neonatal intraventricular hemorrhage in 39 women destined to deliver babies of less than 32 weeks of gestation. The treatment group received an intravenous loading dose of 700 mg of phenobarbital, followed by a daily maintenance dose until delivery. The newborns were treated with phenobarbital for the first 96 h. Ultrasound examinations of the infants' heads were performed. Intraventricular hemorrhage was significantly less frequent in the treated group: 2 of 21 (9.5%) versus 9 of 18 (50%; p less than 0.006). Moreover no severe hemorrhage (grade 3-4) occurred in the treated babies: 0 of 21 versus 5 of 18 (27.7%; p less than 0.01).

[Sinusoidal fetal heart rhythm (author's transl)]. / Observations sur le rythme cardiaque foetal sinusoïdal.

The authors describe 6 cases of pregnancy, four of the patients presenting fetomaternal Rhesus incompatibility, and two showing no abnormality. Fetal heart rhythm (FHR) recordings in all patients demonstrated the presence of a sinusoidal rhythm, either alone or associated with deceleration. The physiopathology of the rhythm, according to a very critical analysis of reports in the published literature (very severe fetal anemia, hypoxia), was not typical in three of the cases. The authors conclude that the observation of this sinusoidal rhythm for a period of up to 60 min, but not repeated, does not constitute a danger for the fetus. If the period is longer, however, or if there is a fetomaternal pathological condition, decelerations, or reduced amplitude of FHR oscillations, there is a very severe risk to the fetus and the need for urgent delivery has to be seriously considered.