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PubMed1992

Electrical injury from Tasering and miscarriage.

A case report is presented of a woman who was "Tasered" by law enforcement personnel while 12 weeks pregnant. The Taser (Thomas A. Swift's Electric Rifle) is an electronic immobilization and defense weapon that has been commercially available since 1974. The Taser was developed as an alternative to the .38 special handgun. The patient was hit with Taser probes in the abdomen and the leg. She began to spontaneously miscarry 7 days later and received a dilatation and currettage procedure 14 days later for incomplete abortion. The world's literature on electrical and lightning injury to pregnant women is reviewed, and the mechanism of action of Taser injury is discussed. As use of the Taser becomes more common, obstetrical clinicians may encounter complications from the Taser more often.

Abortion, Spontaneous↗
PubMed1993

Deep obstetrical and gynecological infections caused by non-typeable Haemophilus influenzae.

Six patients with deep obstetrical and gynecological infections due to non-typeable Haemophilus influenzae are presented. 3 patients had tubo-ovarian abscesses, 2 septic abortions and 1 postpartum sepsis. All our patients with tubo-ovarian abscesses had used intra-uterine contraceptive devices until admission and all had a protracted course of illness. Both patients with septic abortion had a severe course, one of them with disseminated intravascular coagulation demanding treatment in the intensive care unit. The patient with postpartum infection had a milder course. The possibility of infection with H. influenzae and the emergence of beta-lactamase producing strains warrant adequate culture procedures in women with obstetrical and gynecological infections in order to ensure proper treatment.

Abortion, Incomplete↗
PubMed2006

Right ectopic gestation following in vitro fertilisation: case report.

The management of ectopic gestation has in recent years transformed from the normally accepted laparotomy to the laparoscopic approach. The objective of this case report is to describe a rare occurrence of an ectopic gestation following in vitro fertilisation procedure. A 35-year-old para 0 + 0, presented with lower abdominal pain and per vaginal bleeding six weeks after an in vitro fertilisation was done in South Africa. The patient was admitted with severe lower abdominal pain and per vaginal bleeding at six weeks gestation following an in vitro fertilisation procedure. She had undergone an "evacuation" one-week prior to this episode due to an initial diagnosis of an incomplete abortion. No chorionic villi were reported on histology. The repeat serum BhCG was 777 mimicro/l and at laparoscopy a right unruptured ampullary ectopic gestation (4 cms in size) was evident. A right linear salpingostomy was subsequently performed laparoscopically. Histology confirmed the presence of tubal chorionic villi. The laparoscopic management of ectopic pregnancies is now regarded as the gold standard in many centres in the world. In this patient the ectopic pregnancy resulted following an intra-uterine zygote transfer, and was managed successfully.

Abdominal Pain↗
PubMed1991

Observations of vaginal calculi in dolphins.

Vaginal calculi have been described from the common (Delphinus delphis), Pacific white-sided (Lagenorhynchus obliquidens) and spotted (Stenella attenuata) dolphins. We describe additional calculi found in six sexually mature D. delphis from southern California. Three calculi were large (ca. 7 x 5 cm), exhibited concentric layer crystallization, and were unique from previously published descriptions. One calculus described previously and one in our sample appeared to be a fetal skeleton and skull respectively. Using CAT scans of a first trimester northern right whale dolphin (Lissodelphis borealis) and of a near term Delphinus delphis, we discuss the potential origin and development of vaginal calculi through analysis of ossification in embryonic delphinids. We hypothesize that the calculi represented spontaneous incomplete abortion with retention of part or all of the fetus in the distal reproductive tract. The form of the calculus relates to the degree of skeletal development at the time of fetal death. Calculi from a pregnant dolphin provided one measure of residence time.

Abortion, Veterinary↗
PubMed1991

Detection of retained products of conception following spontaneous abortion in the first trimester.

A retrospective analysis was performed to determine whether ultrasound could reliably rule in or out retained products of conception (POC) in women after first-trimester spontaneous abortions (miscarriages). Ninety-seven first-trimester pregnancies with pathologically proven results from dilatation and curettage (D&C) were studied within 7 days of ultrasound examination (60% within 2 days), either by the abdominal or a combination of abdominal and vaginal approaches. Cases were eliminated if there was clinical evidence of a spontaneous evacuation of POC during the interval between the ultrasound and the D&C. POC were diagnosed only if chorionic villi were evident pathologically. The pertinent ultrasound findings were related to the endometrium (thickness, echogenicity, a gestational saclike structure or a space-occupying collection). The results indicated that ultrasound could correctly diagnose POC in all of the cases by detecting a gestational sac or collection (77 cases), or a thickened endometrium of greater than 5 mm (6 cases). Ultrasound was less reliable in ruling out retained POC. When only a thin endometrial stripe of less than 2 mm was present, there was little likelihood of having POC (1 of 7 cases) with a moderately thick endometrium of 2 to 5 mm not diagnostic. Vaginal ultrasound added little new information and failed to change the ultrasound interpretation.

Abortion, Incomplete↗
PubMed1991

Ultrasound of the postpartum uterus. Prediction of retained placental tissue.

We reviewed ultrasound images an 53 postpartum patients referred for possible retained products of conception and correlated specific ultrasound patterns with clinical and pathologic follow-up. The most common finding in patients with retained placental tissue was an echogenic mass in the uterine cavity, seen in 9 of 11 patients with pathologically proven retained placental tissue. In the remaining 2 patients with pathologically confirmed retained placenta, a heterogeneous mass was seen in the uterine cavity at some point during the course of serial sonography. Retained placental tissue was unlikely when ultrasound demonstrated a normal uterine stripe (n = 18), endometrial fluid (n = 6), or hyperechoic foci in the uterine cavity without an associated mass (n = 17). The latter finding was often associated with recent uterine instrumentation. The sonographic appearance of retained placental tissue is variable, but detection of an echogenic mass in the uterus strongly supports the diagnosis. A heterogeneous mass is sometimes caused by retained placenta, but can also be secondary to blood clots or infected or necrotic material in the absence of placental tissue. Sonographic evaluation for retained products of conception is best done before uterine instrumentation to avoid confusion with iatrogenically introduced air.

Abortion, Incomplete↗
PubMed2004

Accuracy of diagnosis of retained products of conception after dilation and evacuation.

OBJECTIVE: Uterine re-evacuation samples taken in cases of suspected residua after curettage are occasionally negative for gestational tissue. We aimed at evaluating the occurrence of such postcurettage re-evacuation-negative samples and at exploring factors that may influence their occurrence. METHODS: This was a cross-sectional comparative retrospective study of 69 consecutive women who underwent uterine re-evacuation for suspected postcurettage gestational remnants. Pathologic reports of samples drawn during re-evacuations were reviewed to determine whether the extracted tissue contained gestational tissue. The presence of factors that may influence the rate of a positive or negative sample (eg, sonographic findings, gestational age at initial procedure, and presenting symptom) was noted and compared between women with and without histologically verified remnants. RESULTS: Twenty-eight (41%) of the re-evacuation samples were histopathologically positive for gestational remnants. Residual tissue was more commonly found when the initial evacuation was performed at a more advanced gestational age (> 15 weeks). Women referred by emergency department attendants had significantly fewer positive samples. Normal expert sonographic examination practically excluded yielding samples. Conversely, no negative samples were preceded by sonographic reports mentioning residua. CONCLUSIONS: Most re-evacuation samples taken during a re-evacuation procedure for suspected residua are negative for gestational tissue. Parameters that are likely related to histologically confirmed gestational residual tissue are advanced gestational age at initial evacuation, level of the sonographer's skill, persistent bleeding as the presenting symptom, and a sonographic report specifically mentioning retained gestational tissue.

Abortion, Incomplete↗
PubMed1999

Magnitude of abortion-related complications in Ethiopian health facilities: a national assessment.

OBJECTIVE: To describe the occurrence of abortion-related complications, available treatment and referral arrangements at various level of the Ethiopian health system, including those in remote areas. DESIGN: A cross sectional descriptive study. SETTING: The study was carried out in all but two of the regions in Ethiopia. SUBJECTS AND PARTICIPANTS: From the respective regions, health facilities were randomly selected. Health workers and traditional birth attendants were interviewed and operations registers were reviewed. RESULTS: In hospitals, the interviewees estimated that an average of 17 patients with post-abortion complications were seen per month, in lower level health facilities providing post-abortion care the estimate was one patient per month. In lower level units not providing post-abortion care, 84% of the interviewees responded that they saw patients with complications due to abortion. The study shows that abortion complications occur in both urban and rural areas and are seen not only in hospitals, but also in health centres and at health stations, many of which are ill equipped to handle the patients. CONCLUSION: The results indicate a need to address services to improve treatment of abortion complications and other reproductive health services, as well as the provision of education to prevent unsafe abortions with both communities and lower level health facilities that serve them.

Abortion, Illegal↗
PubMed2000

Medical abortion in China.

This paper reviews the literature on early medical abortion in China. Mifepristone was approved for termination of pregnancy up to 49 days' gestation in China in 1986. The commonly accepted regimens are 150 mg mifepristone administered in several small doses or a single 200 mg dose followed by 0.6 mg oral misoprostol. Complete abortion rates are 90% to 97%. Ultrasound is strongly recommended to rule out ectopic pregnancy. Patients remain in the clinic for four to six hours after misoprostol. If the fetal sac is not expelled during the four-hour observation, the second dose of 0.4 mg misoprostol is given in many of the clinics. Rates of emergency curettage ranged from less than 1% to 4%, and rates of blood transfusion were less than 1%. The major complication of concern is undiagnosed ectopic pregnancy. The Chinese experience has shown that medical abortion is well accepted as an alternative to surgical intervention when provided under medical supervision and administrative monitoring.

Abortifacient Agents, Nonsteroidal↗
PubMedDate not supplied

[Herpes simplex virus and malignancies of female genital organs].

INTRODUCTION: Primary herpes simplex virus (HSV) infections of female genital tract usually end with remission, while the virus remains in the organism--almost in the sacral ganglion in a latent form, protected from humoral and cellular immunity. Stress induces the virus and the result is recurrent genital infection. Frequent exacerbations damage some parts of vital cellular structures without cytolysis, but stimulate malignant transformations. MATERIAL AND METHODS: Vulvar (portio vaginalis uteri) and endometrial tumor tissue samples were analyzed for HSV by direct and indirect fluorescent antibody technique (FAT). Pre and postoperative sera samples were analyzed for presence of anti-HSV antibodies--IgM and IgG by Elisa-Enzygnost method. Acellular filtrates obtained by ultrasonic destruction of malignant tissues were used as inoculum for rabbit corneal scarification. RESULTS AND DISCUSSION: Out of 63 tissue samples, 42 were positive for HSV antigen i.e. 67.3%. According to location 50% of vulvar, 76% PVU and 65% of endometrial tissues were positive. This antigen induces production of virus specific antibodies. Two types of antigens are known: the so-called T-antigen persisting in the cell nucleus and cell-surface antigen--product of the viral genome and can be evidenced by immunofluorescence method. Anti HSV antibodies were present in 63 preoperative serum samples and belonged to IgG group, but not one to IgM, implying a long and chronic course of infection excluding acute primary. Out of 38 postoperative serums the titer of antibodies decreased in 36 evidently, but in two samples remained unchanged. Two samples of endometrial and one from PVU origin contained HSV antigen type one. In the remaining 16 samples HSV 2 antigen was present. Rabbit corneal scarification was the proof of complete infectious virus in malignant tissues. Acellular filtrate of malignant tissues served as inoculum. Corneas of examined rabbits showed a mild inflammation after 24 hours which disappeared in the next 24 hours. We could not isolate the infectious virus by rabbit corneal scarification. Instead of herpetic changes, mild inflammation was evident. This abortive, incomplete symptomatology was probably caused by nonstructural early protein, which is a product of viral genome incorporated in malignant cells. CONCLUSION: On the basis of our results, we can conclude that HSV can have, beside other factors, a very important, maybe an initial role in development of malignant changes of female genital tract, not only on vulva and PVU, but on endometrium as well. HSV I can cause genital infections and have some role in malignant changes as well as HSV 2. However, complete infective virion couldn't be isolated from malignant tissues.

Adult↗
PubMed1975

[Behavior of serum magnesium level during abortion].

Double determinations of whole blood- and serum magnesium levels were according to a complexometric method as described by Schwarzenbach (Hôlasek and Flaschka's procedure) in 134 females (66 healthy pregnant women, 68 abortions). Further, hematocrit was determined in these women. By aid of these values we were able to calculate Mg-concentrations/100 ml erythrocytes in all cases. Serum magnesium levels were depressed in the same relation in abortions and normal gravidae. Therefore, we do not confirm the results of other authors (22) asserting a typical significant decrease of serum-Mg in abortions. We warn against excessive differential-diagnostic interpretation of depressed serum magnesium in abortions. Magnesium concentrations in 100 ml erythrocytes were found significant increased over in abortions against women going through a successfully pregnancy. The cause of this magnesium increase is believed in reactive increased pouring out young partly immature erythrocytes containing high magnesium concentrations caused by losses of blood.

Abortion, Incomplete↗
PubMed1985

A randomized comparative trial of the Lippes Loop D, Gravigard and TCu 220C IUDs.

This randomized prospective trial compared the use-effectiveness and pregnancy rates in 3 IUDs following immediate postabortal insertion in 199 women over 3107 months of use. At 24 months the Gravgard (Cu 7) was not significantly different from either of the other 2 devices. However, the Lippes Loop D when compared with the TCu 220C had a higher expulsion rate (P less than 0.05) and a higher use-related termination rate (P less than 0.001). Further details of accidental pregnancies, removal for incomplete abortion or pelvic inflammatory disease and within 48 hours after insertion are presented.

Birth Rate↗
PubMed1976

Postabortal and postpartum tetanus. A review of 19 cases.

The occurrence of postabortal and postpartum tetanus over a 7 1/2-year period at Groote Schuur Hospital, Cape Town, is reviewed. Of all the women between the ages of 15 years and 50 years who were admitted with tetanus, 34,7% were admitted after abortions. The mortality rate was 15,8%, which appears to be the lowest thus far reported. Possible methods of preventing postabortal tetanus are discussed.

Abortion, Incomplete↗