Postpartum hemolytic uremic syndrome following placental abruption.

Hemolytic uremic syndrome associated with pregnancy is a rare condition. Authors report a patient treated with corticosteroids for bronchial asthma who was afflicted by placental abruption at 24 weeks' gestation. The abruption was preceded by developing herpes zoster and by deteriorating respiratory symptoms. The induced labor was followed by anuria, acute renal failure, microangiopathic hemolytic anemia, thrombocytopenia then fever and hypertension. The patient was treated early with plasma infusion, transfusion and hemodialysis. She recovered completely after 7 weeks. This case seems to be unique inasmuch as the hemolytic uremic syndrome was preceded by prodromal illness during pregnancy and was associated with placental abruption.

Effect of enzaprost F on the dilatation of cervical canal following intracervical and extra-ovular application in the first trimester of pregnancy.

PIP: Primigravidas ranging in age from 14-24 years who presented themselves for lawful abortion in the 7th-12th week of pregnancy were distributed into 2 groups to examine whether Enzaprost F (Chinoin) may be used in form of intracervical tablet and extraovular solution for preoperative cervix dilatation in the 1st trimester of pregnancy. In 1 group (n = 210), 10 cervical tablets were introduced into the cervical canal under aseptic circumstances following vaginal exposure by using the ascending tube of Szontagh's IUD. The tablets contained in 200 cases 2.5 mg prostaglandin F2alpha (Pgf2alpha) each (Enzaprost F cervical tablet, Chinoin) and in 10 cases only carrier substance (placebo). The dilatation of cervical canal was measured by means of Hegar's dilators prior to the introduction of the PGF2alpha containing tablets in 80 cases, 2 hours subsequently in 111 cases, and 3-4 hours subsequently in 89 cases, directly before emptying the uterus. If the dilatation of cervical canal failed to reach 11 mm after the preoperative treatment this was dilated further with Hegar's dilators directly before emptying the uterus. In the placebo group the dilatation of cervical canal was measured by the same method before and 2 and 4 hours after the application of tablets. In the other group (n = 45), pregnant women were ranged who had 2nd grade purity of vagina due to previous local vaginal treatment. In the 7th-12th week of pregnancy, the effect of 10 Enzaprost F cervical tablets was observed to be a function of time. The average dilatation of cervical orifice was 5.0 mm before treatments. 2 hours after the application of PGF2alpha, the cervical canal was dilated to 6.9 and 3-4 hours later to 8.5 mm. In response to 1.0 Enzparost F solution containing 1.0 mg active substance injected into the uterus through Foley catheter the cervical canal dilated within 3 hours to in average 8.1 mm, within 18 hours to in average 10.9 mm. The dilatation of the cervical canal measured after 18 hours did not differ significantly from the value obtained after 3 hours. The dilatation of cervical canal measured before treatment in the group of placebo-treated primigravidas was in average 4.6 mm and in hours 2 and 4 of treatment 4.8 and 4.9 mm, respectively. The difference was statistically nonsignificant. Temporary mild systemic unwanted effect occurred in 35% of patients treated with Enzaprost F cervical tablets and in 88% of women subjected to extraovular treatment.^ieng

[Obstetrical experiences with adolescents]. / Unsere Erfahrungen über die Geburtshilfe bei Jugendlichen.

Course and results of pregnancies of 661 adolescent girls below 18 years are compared with those of 18 037 controls. Perinatal mortality is twice in the adolescent group than in controls. Toxemias of pregnancy, insufficient labor and intrauterine hypoxia are represented more frequently in adolescent girls.

Episodic secretion of hormones and the diagnostic value of single blood estimates. III. Testosterone, androstenedione, dehydroepiandrosterone, dehydroepiandrosterone sulphate, cortisol.

The episodic fluctuation of serum testosterone, androstenedione, dehydroepiandrosterone (DHA), dehydroepiandrosterone sulphate (DHAS) and cortisol levels was analysed to determine the reliability of a single blood estimate in characterizing the mean value of a 4 h period. Radioimmunoassay of the steroids was performed in sera of 8 apparently healthy women in various phases of the menstrual cycle in 10 min intervals between 08 and 12 h a.m. Reliability criteria of the methods used were comparable to those in common use. The within-person fluctuation of individual values was determined by the coefficient of variation of single estimates, and the methodological error of the single estimates was characterized with the maximum increment from the mean at 95% confidential limits. A maximum deviation of 30.8, 28.6, 37.0, 25.0 and 61.2%, respectively, found in the above order of steroids, suggests several hormone estimations to be necessary for judging hormone availability in a subject.

Episodic secretion of hormones and the diagnostic value of single blood estimates. II. Progesterone, oestradiol and oestrone.

The episodic fluctuation of serum progesterone, oestradiol and oestrone levels was studied. Progesterone was determined in the luteal phase, oestradiol and oestrone concentrations were measured in the proliferative and luteal phases in 8 subjects in 10 min intervals between 08 and 12 h a.m. Reliability criteria proved the radioimmunological methods used to be comparable to those employed routinely. The within-person fluctuation of hormone levels characterized by the coefficient of variation of single estimates averaged 20.16, 23.0 and 11.6% for progesterone, oestradiol and oestrone, respectively. The considerable fluctuation of hormone concentrations suggest the importance of hormone measurements to control luteal function and folliculogenesis during the menstrual cycle.