Use of Mueller matrix colposcopy in the characterization of cervical collagen anisotropy.

Annually, about 15 million preterm infants are born in the world. Of these, due to complications resulting from their premature birth, about 1 million would die before the age of five. Since the high incidence of preterm birth (PTB) is partially due to the lack of effective diagnostic modalities, methodologies are needed to determine risk of PTB. We propose a noninvasive tool based on polarized light imaging aimed at measuring the organization of collagen in the cervix. Cervical collagen has been shown to remodel with the approach of parturition. We used a full-field Mueller matrix polarimetric colposcope to assess and compare cervical collagen content and structure in nonpregnant and pregnant women in vivo. Local collagen directional azimuth was used and a total of eight cervices were imaged.

Placenta percreta masquerading as an acute abdomen.

BACKGROUND: The incidence of placenta percreta has been on the rise during the past decades, coincident with the increase in cesarean deliveries. The diagnosis of this potentially life-threatening complication is difficult, especially when it masquerades as other severe complications of pregnancy. CASE: A woman with one previous cesarean delivery presented at 28 weeks of gestation with right upper quadrant pain. Laparotomy revealed an intraperitoneal hemorrhage from a protrusion of the placenta at the previous uterine incision remote from the site of pain presentation. The fetus was delivered, and a hysterectomy was performed with subsequent good recovery. Pathology confirmed placenta percreta. CONCLUSION: The presentation of an acute abdomen with symptoms remote from the site of pathology in the third trimester masked the diagnosis of placenta accreta. When a clear diagnosis cannot be established, operative exploration must be considered.

Periarteritis nodosa and pregnancy

Pregnant patients with periarteritis resulted in maaternal death in 7 of 8 cases that have been reported. In the present case, periarteritis was in remission throughout the pregnancy; the patient was thus the second known maternal survivor. The infant also did well. It is suggested that pregnancy probably does not have as direct an effect on the course of the disorder as appears from the outcome of the previous case. Extreme caution must prevail, especially as diagnosis is often difficult and experience so limited (AU)

Psychosexual attitudes in the female following sterilization

This study represents a three year follow-up summarizing the psychosexual attitudes of 120 patients who were sterilized with tubal occlusion by one of three methods: culdoscopy, laparoscopy or postpartum laparotomy. The results indicate that most patients had a favorable impression of the procedure with little significant change in their sexual habits. Eight per cent of patients expressed regret at not being able to have more children. The frequency of coitus remained largely unchanged.(AU)

Acute myasthenia gravis in pregnancy

Two cases of acute myasthensia gravis associated with pregnancy are presented. The first developed in the puerperium following normal labour, and the second was precipitated by Curare used in delivery by Caesarean section. Both were young females who had normal ante-natal courses. The association between pregnancy and myasthenia gravis is reviewed, and also the drugs which may precipate the disease. A plea is made for careful monitoriong of patients receiving these drugs, until their reaction is established (AU)

Single dose treatment of Trichomonas vaginalis with tinidazole (Fasigyn)

Trichomonas vaginalis was treated by using a single dose of 2 gms. Trinidazole in 72 non-pregnant females and their husbands/consorts. Sixty-seven were followed for six weeks and 64 (94.2 per cent) were cured, while three were considered failures-two method failures-and one patient failure. Second doses of Tinidazole in these three patients were successful. Five patients were lost to follow-up and of these, three believed cured. Side effects were minimal gastro-intestinal disturbances in four patients. These results suggest that the single dose treatment is highly acceptable to both patient, husband/consort as well as to the doctor prescribing against trichomonas vaginalis (AU)

A case of primary carcinoma of the fallopian tube: with a review of the literature

Primary adenocarcinoma of the right Fallopian tube is reported in a 53-year-old Negro woman. The diagnosis was established by histopathological examination of the surgically resected specimen, there being no suspicion of the tumour pre-operatively. Metastates occurred to the iliac lymph nodes. The patient was treated by hyterectomy and bilateral salpingo-oophorectomy followed by high voltage irradiation of the pelvis. This is the first example of primary tubal carcinoma encountered at the University Hospital of the West Indies. The relevant literature is reviewed and discussed (AU)

The use of steroids in pregnancy

Recent reports in the literature have stated that there is an increase risk to the foetus in the mothers who have been receiving steroids for diseases associated with pregnancy. Thirty seven cases of pregnancy associtated with diseases treatable by steroids were studied. The outcome of each pregnancy was related to the phase of activity fo the disease as well as the treatment with steroids. Of the 37 pregnancies - 22 were treated with steroids and 15 were not. In the group who had steroids there was a lower foetal loss than in the untreated group. Of the foetal loss due to abortion, stillbirths and neo-natal causes - the majority were in cases who were not receiving treatment and in whom the disease was active. The incidence of prematurity was higher when the disease process was active or further exacerbated regardless of treatment. No foetal abnormality was found. Steroids have very little adverse effect in pregnancy and should not be withheld as it is the exacerbations of the disease processes which may be detrimental to the pregnancy (AU)

Malabsorption and protein-losing enteropathy following small gut ischemia

This is a case reported of a 41-year-old male who was first seen at the University College Hospital with an incarcerated inguinal hernia. At herniorraphy, the suspiciously gangrenous segment of gut was not resected. Six weeks later the patient returned to hospital with severe weight loss, and symptoms and signs of intestinal obstruction. There was radiological, biochemical and haematological evidence of malabsorption and severe protein losing enteropathy. The patient made a complete recovery after surgical resection of the affected segment of gut (AU)