Intra-uterine hematoma in pregnancy.

In 60 patients with a live fetus and an intra-uterine hematoma (IUH) proven by ultrasonic scanning the outcome of pregnancy was spontaneous abortion in 12% and premature delivery in 10%. No correlation between the outcome of the pregnancy and the maximum size of the hematoma or the week of detection was found. A subplacentar localization of the hematoma was associated with a higher, but not statistically significant, incidence of spontaneous abortion than a subchorionic localization. Spontaneous abortion most often occurred in the first weeks after the formation of the hematoma.

[Induction of labor when a large fetus is suspected]. / Igangsaettelse af fødsel ved mistanke om stort foster.

The courses of 945 deliveries in which the infant weighed greater than or equal to 3,800 g are reviewed retrospectively with comparison between the deliveries which began spontaneously and the induced deliveries. In the deliveries which were induced on account of a suspected large foetus, the frequency of emergency Cesarean section was tripled and the frequency of vacuum extraction was doubled. Significantly more infants had Apgar scores of less than 7 after one minute than in the deliveries which began spontaneously. It is concluded that induction of labour is not indicated in cases where a large foetus is suspected.

[Examination of young women with recurrent symptoms of cystitis]. / Undersøgelse af yngre kvinder med recidiverende cystitsymptomer.

Fifty women with recurrent symptoms of cystitis (urgent onset of painful and frequent voiding) were extensively examined bacteriologically. All were submitted to intravenous urography, cystoscopy, gynaecological and urodynamic examination and the urine was examined cytologically and by culture. A control group of 10 healthy women were submitted to the same bacteriologic examinations. Only in a few cases did the investigations give an explanation of the condition but, generally, the examination programme did not contribute to the etiology. Chlamydia trachomatis was found in 6%, which was comparable to the normal population. Gardnerella vaginalis must be considered as part of the normal flora. The extensive examination programme cannot be recommended as a routine.

Fatal course of malignant melanoma during pregnancy with dissemination to the products of conception.

The first case in Denmark of malignant melanoma metastasizing to the placenta and the fetal circulation is presented. The fact that shortly before becoming pregnant the patient had been treated with wide excision and regional lymph node dissection for a cutaneous melanoma of the right calf, gives further support to suspicions about a possible adverse effect of pregnancy on melanoma. In view of the high mortality in babies during their first year of life in the few similar reports available in the world literature, the authors would recommend the avoidance of pregnancy within 5 years of treatment of melanoma of any stage.

Ultrasonic real time diagnosis of hydrothorax before delivery in an infant with extralobar lung sequestration.

A female infant with extralobar lung sequestration (ELS) combined with bilateral hydrothorax and ascites is presented. A 34-year-old para II, pregnant in the 29th gestation week, was referred to hospital because of acute hydramnios. Ultrasound examination demonstrated marked hydramnios, together with ascites and bilateral pleural effusion in the fetus. In the amniotic fluid, alfafetoprotein was found normal and the karyotype showed a normal chromosome pattern, 46 xx. The hydramnios was so severe and the cervix so unripe, that cesarean section had to be undertaken, and a girl of 1650 g, and 42 cm long was born. Just after delivery the infant had bradycardia, cyanosis and respiratory insufficiency, with Apgar score 2 during the first 15 min. Manual ventilation followed by Servo respirator with 100% oxygen was given, but with poor effect. The infant lived only 6 3/4 hours. At autopsy there was hydrothorax, bilateral collapsed lungs and ascites and ELS as the only congenital malformation.

Pregnancy-associated plasma protein A: a possible marker in the classification and prenatal diagnosis of Cornelia de Lange syndrome.

The concentration of human platelet lactogen (hPL), pregnancy specific beta-1 glycoprotein (SP-1) and pregnancy-associated plasma protein A (PAPP-A) were analysed in consecutive serum samples from a patient who gave birth to a child with Cornelia de Lange syndrome. HPL and SP-1 were present in normal concentrations from week 20 to week 35 of gestation whereas PAPP-A could not be detected in any of the samples examined. Immunohistochemical examination of two placentae from Cornelia de Lange syndrome revealed normal localization of hPL and SP-1 but the absence of PAPP-A from the syncytiotrophoblast. The significance of association between Cornelia de Lange syndrome and compromised synthesis of PAPP-A is discussed.

Relief from pain localized to the lower back in early labour. A double blind trial of ketocaine, a new, highly effective, local, cutaneous analgesic (A 2358, Ane-Pad), and placebo.

Pain localized to the lower back in the first stage of labour in 47 primiparous women was treated by epicutaneous application of ketocaine or placebo compresses. Twenty-three patients were treated with ketocaine compresses (Ane-Ped), and 24 patients with compresses soaked with isotonic saline. The pain relieving effect was almost the same in both treatment groups. Pain localized to the lower back was reduced in about 50% of the patients after one hour's application of ketocaine or placebo compresses. Supplementary analgesics had to be administered in about 60% of the patients in each group. No maternal or foetal systemic side effects related to the treatment were registered. Local erythema on the application area was only reported in the ketocaine group. The frequency of feeling of warmth during the application of compresses of ketocaine were high compared to the placebo group, 78% and 29% respectively.