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Prenatal indomethacin toxicity in one member of monozygous twins; a case report.

A mother, treated with indomethacin because of premature labour, delivered a pair of monozygous twins at a gestational age of 33 weeks. Because of foetal transfusion syndrome, the first twin was polycythaemic and the second anaemic. The latter was also hydropic, suffered from anuria requiring peritoneal dialysis, and showed signs of severe pulmonary hypertension, probably as a consequence of intra-uterine constriction of the ductus arteriosus. The possible interaction between foetal transfusion syndrome, anuria, premature constriction of the ductus arteriosus and the prenatal administration of indomethacin is discussed. In general, indomethacin should cautiously be used as a tocolytic agent.

Adult↗

PubMedDate not supplied

Prophylactic salpingo-oophorectomy in 51 women with familial breast-ovarian cancer: importance of fallopian tube dysplasia.

We report our findings on 51 patients with a familial breast and/or ovarian cancer risk who underwent prophylactic bilateral salpingo-oophorectomy (pBSO). Patients undergoing a pBSO between January 1, 1997, and December 31, 2003, at the University Hospitals Leuven were reviewed retrospectively. Out of 51 patients, 37 (72.5%) underwent genetic testing, while the 14 others (27.5%) underwent pBSO on the sole basis of a positive family history only. BRCA1 mutation was found in 35% of the tested group, while 30% were BRCA2 carriers. Mean age at intervention was 45.3 years; 33 patients were premenopausal. In 44 patients (86%), the pBSO was performed laparoscopically, and in seven patients we decided laparotomy because of technical reasons. In four patients hysterectomy was performed. Histopathologically, the presence of epithelial dysplasia was observed in two patients (dysplasia of the fallopian tube in a BRCA2 patient; discrete focal atypia of tubal and ovarian epithelium in a patient with a negative BRCA1/BRCA2 mutation analysis). Peritoneal cytology specimens (n= 28) were all negative. Laparoscopic pBSO is well tolerated. Concomitant hysterectomy should be considered, given the observed fallopian tube dysplasia and the possibility of a tubal remnant after pBSO.

Adult↗