Biomedical subjects
Publications and source records attributed to M Fejgin.
We conducted a detailed literature search for the rare combination of scleroderma and pregnancy. Ninety-four patients were reported, 14 of whom died during the course of the pregnancy, mainly due to secondary renal and cardiopulmonary involvement. Out of the 95 fetuses, 19 were lost. Thus, when complications arise, the option of prompt termination of the pregnancy should be considered.
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A case-control study was undertaken to examine the possible morbidity associated with Chlamydia trachomatis in 28 pregnant women having idiopathic premature contractions, in 35 healthy preterm pregnant women, and in 43 healthy pregnant women at term. Serum C. trachomatis IgG- and IgA-specific antibodies were determined by the single serovar inclusion immunoperoxidase assay. There were no significant differences in the prevalence rate of elevated C. trachomatis IgG-specific antibodies (titer greater than or equal to 1:128) between pregnant women suffering from idiopathic premature contractions as compared with healthy preterm and term pregnant women (11%, 28%, and 26%, respectively). The known prevalence rate in a normal healthy population is 23%. The prevalence rate of elevated C. trachomatis IgA-specific antibodies (titer greater than or equal to 1:16) was significantly lower in the pregnant women with idiopathic premature contractions as compared with the healthy preterm and term pregnant women (0%, 20%, and 17%, respectively; p less than 0.002 and p less than 0.012). These findings do not support the assumption that C. trachomatis has a role in premature contractions.
An unusual complication of spontaneous second trimester abortion which was unaided by external agents is presented. We found no similar case in the literature.
A rare case of transperitoneal ovum migration resulting in an intra-uterine pregnancy is presented. A woman with left congenital ovarian absence and a surgically removed right oviduct, conceived following microsurgical repair of left tubal occlusion.
Polycystic ovarian disease is characterized by menstrual disorders, infertility, obesity, and large ovaries. Large ovaries with multiple cysts are the direct cause of the high incidence of ovarian hyperstimulation during ovulation induction. Lately, gonadotropin-releasing hormone (GnRH) analogues have been employed to decrease ovarian steroidogenesis and thus reduce the incidence of ovarian hyperstimulation. In this study the ovarian size was ultrasonographically assessed during chronic GnRH analogue treatment, revealing a significant reduction in ovarian volume. This decrease in volume results in a reduced incidence of hyperstimulation, and we think the ultrasonic scanning can be effectively used to assess the success of GnRH treatment.
A case of nodular malignant lymphoma, small cleaved cell in both ovaries, tubes and peritubal tissue is reported in a 55-year-old nulliparous woman with primary clinical symptoms of dyspnea and chest pain. The disease was first diagnosed at laparotomy. The patient was treated by bilateral adnexectomy and chemotherapy. This is the third case of adnexal small cleaved cell nodular lymphoma reported in the literature. Clinical and pathological aspects of this relatively rare pathological entity are reviewed.
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Complete heart block in pregnancy is not a common encounter. The first case was reported in 1914 by Nanta and today some 100 cases are documented. Heart block may be congenital or acquired secondary to cardiac surgery, rheumatic heart disease, or infective disorders. Heart block, whether congenital or acquired, rarely creates any special obstetric problems. Today there is an increasing use of cardiac pacemakers in younger people and the first reported obstetric experience with a cardiac pacemaker implanted before pregnancy was by Shouse and Acker. This review will document the course and outcome of all reported pregnancies in women conceiving with an artificial pacemaker, and discuss complications and principles of management. We will also report our experience with a woman suffering from a complete heart block in whom an internal cardiac pacemaker was inserted before pregnancy.
A case of acute rupture of an ovarian pregnancy in which Beta Subunit of human chorionic gonadotropin was negative is presented. This is the first case known in the literature. Clinical and laboratory aspects of ovarian pregnancy are reviewed.
The incongruity between oestrogen elevation and immature follicles is one of the problems encountered during the induction of ovulation with gonadotrophins. This phenomenon is particularly pertinent in women with polycystic ovarian disease. Our work presents a regimen of treatment that was found helpful in overcoming this problem. It is based on a close ultrasonic assessment of the follicular growth, which also serves as the sole means for the decision of human chorionic gonadotrophin (HCG) administration (mature follicle range is 19-25 mm). Accordingly, the human menopausal gonadotrophin doses were individually adjusted and, if necessary, omitted in an effort to avoid excessive oestrogen elevation at the time of HCG administration. The resultant plateau or decline of oestrogen levels in our series do not interfere with ovulation. Seventeen conceptions occurred after 53 treatment cycles in 19 women.
Electric shock injuries in pregnant women are rare events. The uterus and amniotic fluid are thought to be excellent conductors of electric current which reaches the fetus causing cardiac arrest and fetal death. All cases except one reported in the literature occurred in the third trimester, and ended with the death of the fetus. We report a case of a woman struck by a high voltage electric current in the 13th week of her pregnancy, causing fetal death and abortion.
A case of diffuse chorioangiomatosis leading to fetal hydrops, disseminated intravascular coagulopathy with massive umbilical vein thrombosis and fetal death is described. Although rare, this benign mesenchymatous malformation of the placenta should be kept in mind as a possible cause of neonatal morbidity. Prenatal diagnosis could prevent fetal death.
The efficacy of a preoperative single-dose of co-trimoxazole in reducing postoperative urinary tract infection and febrile morbidity after abdominal hysterectomy was evaluated in a randomized placebo-controlled study of 90 patients undergoing surgery. Among the co-trimoxazole patients, 6.2% developed urinary tract infection compared to 31% in the placebo group (p less than 0.001) and 12.5% febrile morbidity compared to 38% in the placebo patients (p less than 0.025). No adverse side effects of co-trimoxazole were observed and this regimen seems both safe and effective.
The acid-base balances of 63 neonates delivered either spontaneously or by the vacuum extractor or low forceps were compared. The outcome was similar in neonates delivered by vacuum extractor or forceps. However, significant differences were noted in the pH and base deficit of infants born by instrumental versus spontaneous delivery. These differences were no longer present when groups with similar duration in the second stage of labor were compared. We conclude that the use of instruments for outlet vaginal delivery carries no additional risk for the fetus.
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