[Extrahepatic portal hypertension in pregnancy: complications and therapeutic approaches].
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Biomedical subjects
Publications and source records attributed to D Pauzner.
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Ultrasonic measurements of endometrial thickness and recording of the echogenic pattern were performed daily throughout an ovulatory cycle in 20 women, aged 20-30, who had normal ovulatory cycles. There were 10 women in whom the cycle terminated in pregnancy and 10 in whom it ended in menstruation. The echogenic pattern of the endometrium was similar in both groups, but the endometrial growth pattern showed a significantly thicker endometrium (p less than 0.05) 8-13 days after ovulation in those who became pregnant.
Pemphigus gestationis is a rare disease, probably of immunologic origin, that causes the placenta to absorb immunoglobulins and deposit them in its basement membrane. The resulting placental insufficiency leads to increased morbidity and mortality among the offspring of such patients. A case of pemphigus gestationis is presented, and the importance of early diagnosis is discussed.
Extrahepatic portal hypertension usually occurs during childhood, but a substantial number of patients may reach adult life. There is a general agreement that pregnancy may become hazardous to these patients, and some authors even consider this condition as a contraindication to conceiving. A case of endoscopic sclerotherapy in such a patient is herein presented, and the approach to such patients is discussed.
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The observation of a very severe peritoneal reaction to translocated copper-bearing devices in five women necessitated operative removal. Three Copper-T (Ortho Gyne-T, Ortho, Saunderton, High Wycombe, England) and two Copper-7 (Gravigard, Searle, High Wycombe, England) devices were involved. Similarly severe peritoneal reactions were noted in 90% of female rats who had small-sized modified copper devices inserted into their peritoneal cavities. In a control group of rats with the same device but without a copper wire, mild adhesions were observed in the majority (85%), and none had a severe peritoneal reaction. It seems evident that the severe peritoneal reaction is induced by the copper wire in both women and female rats.
A fetal tachyarrhythmia was discovered at the thirty-second week of gestation of a 22-year old woman. Fetal echocardiography revealed atrial fibrillation with rapid ventricular rate, without any other demonstrable cardiac abnormality. In spite of therapeutic maternal blood levels of digoxin, the fetal ventricular rate and cardiac size increased, which prompted us to perform cesarean section at the thirty-fourth week of gestation. A baby with a Wolff-Parkinson-White syndrome but no other cardiac anomaly was delivered. Recurrent episodes of nonsustained atrial fibrillation with conduction over the accessory pathway occurred in the first hours of life. The Wolff-Parkinson-White pattern was not present on subsequent ECG recordings. The use of echocardiography in the diagnosis and management of this rare fetal tachyarrhythmia is emphasized.