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[Prevention of Rh immunization after delivery and abortion].

Out of 845 Rh-negative parturients with Rh-positive children, 515 (60.64%) accepted the application of IgG-anti D serum. The rest refused it, because they had two or more children. Out of 82 Rh-negative pregnant women who had spontaneous abortion, 30 (36.58%) were covered by the IgG-anti D prophylaxis. Artificial abortion was applied in 3148 Rh-negative women, of whom 178 (5.60%) took IgG-anti D serum. Following spontaneous and artificial abortions IgG-anti D was applied mainly in women with no children or with one child. Parity influenced the application of prophylaxis and in artificial abortions also the fact that in these cases women were to pay for the preparation. The control was carried out in the subsequent pregnancy: after delivery only one Rh immunization (0.19%) has so far been recorded--none, however, after spontaneous and artificial abortions.

Abortion, Incomplete↗
PubMed1984

Predictability of pregnancy outcome in preterm delivery.

Multivariate models have great potential value in enhancing the understanding of why some pregnancies have poor outcomes. Recently, such models have been advocated as a basis for predictive scoring systems that attempt to classify patients into high-risk and low-risk groups. In this report the usefulness of such an approach was assessed by studying the predictability of preterm delivery at The Johns Hopkins Hospital during 1980, using a multiple logistic model. Choosing a cutoff point (or probability of preterm delivery) of 10%, 697 of 2865 patients were placed in the high-risk group. The sensitivity, specificity, and positive predictive value of the model, as applied to this select population, were 62.2, 79.4, and 22.7%, respectively. Thus, only 23% of patients predicted to have preterm deliveries in fact delivered preterm. The predictive value could have been improved by increasing the cutoff point, but only at the expense of markedly reducing the sensitivity of the model. It was concluded that the potential value of multivariate analyses of pregnancy outcome as a predictive, risk-classification technique is limited. Nevertheless, such studies may aid the clinical evaluation of each individual patient by providing a better understanding of the etiologies of poor outcome.

Abortion, Incomplete↗
PubMed1981

Ossification defects and craniofacial morphology in incomplete forms of mandibulofacial dysostosis. A description of two dry skulls.

The morphology of two East Indian dry skulls exhibiting anomalies which were suggested to represent incomplete forms of mandibulofacial dysostosis is described. Obvious although minor ossification anomalies were found localized to the temporal, sphenoid, the zygomatic, the maxillary and the mandibular bones. The observations substantiate the concept of the regional and bilateral nature of the malformation syndrome. Bilateral orbital deviations, hypoplasia of the malar bones, and incomplete zygomatic arches appear to be hard tissue aberrations which may be helpful in examination for subclinical carrier status. Changes in mandibular morphology seem to be less distinguishing features in incomplete or abortive types of mandibulofacial dysostosis.

Adult↗
PubMed1982

[Cerebral mycotic aneurysms after abortion endometritis].

The genesis of abortion endometritis appears to be sufficiently clarified when the aneurysm was successfully demonstrated and the vascular bulgings were located at the typical sites of predilection of Forbus' malformation aneurysms. The demonstrated case shows that this conception is not generally valid and that surprising aspects can be derived from pathological-anatomic findings. A 43-year-old female patient had her third subarachnoid haemorrhage on the second day of admission before a neurosurgical operation could be performed and died of the consequences of this haemorrhage. The histological examination spoke for an embolic-mycotic aneurysm genesis in the presence of abortion endometritis. In the literature, the majority of cerebral mycotic aneurysms are described as a consequence of endometritis, only 20 per cent are due to other inflammatory basic diseases. If cerebral vessels are invaded by bacteria, wall structure, tissue reaction and clinical manifestation are dependent upon the virulence of the pathogens an the defense power of the patient. In case of clinically manifest infectious processes and subarachnoid haemorrhage are coinciding, an inflammatory affection of cerebral vessels should be included in the scope of differential-diagnostic considerations. The establishment of correlations becomes more difficult in case of an apparently inconspicuous interval of several months. That neglected symptoms of an (extracerebral) infection can be in direct connection with cerebral aneurysms haemorrhages is shown by the description of a case with cerebral mycotic aneurysms after endometritis not having been described in the literature until now.

Abortion, Incomplete↗
PubMed1981

Clinical relevance of cytotoxic antibodies occurring in pregnancy.

Cytotoxic antibodies were studied in 809 pregnant women's sera. Two kinds of antibody population: HLA-A, B, C and Ia-like, were detected and a correlation was established between their presence and some clinical conditions, such as preterm delivery, spontaneous abortion, pre-eclampsia, neonatal hyperbilirubinaemia and congenital anomalies. An opposite effect of HLA-A, B, C and Ia-like antibodies was observed as far as the first three parameters are concerned. On the basis of these investigations a protective role of Ia-like antibodies for the newborn can be implied.

Abortion, Incomplete↗
PubMed1982

Pregnancy outcome in 98 women exposed to diethylstilbestrol in utero, their mothers, and unexposed siblings.

The reproductive capability and labor complications of 98 women exposed to diethylstilbestrol (DES) in utero were compared with those of 3 separate control groups. The controls consisted of 167 age-matched, normal women, 20 siblings not exposed to DES who had achieved pregnancy, and their mothers. Spontaneous abortion, ectopic pregnancy, incompetent cervix, and premature labor occurred significantly more often in the DES-exposed population than in the normal controls. The controls also achieved a higher percentage of desired pregnancies overall; this was statistically significant (89.6 versus 75.0%, P less than .001). When compared with their mothers, however, the DES-exposed population achieved a greater percentage of desired, viable pregnancies (75.6 versus 67.0%, P less than .001). The unexposed siblings of the DES women achieved a higher percentage of desired, viable pregnancies than did their exposed sisters (86.9 versus 73.6%, P = .274), but less than the normal population (86.9 versus 89.6%).

Abortion, Incomplete↗
PubMed1982

Symptomatic intrauterine retention of fetal bones.

Four patients with symptomatic intrauterine retention of fetal bones are discussed. Presenting complaints included infertility, irregular vaginal bleeding, vaginitis, and spontaneous passage of fetal bones. Two patients had uterine anomalies; 1 patient had a retained twin pregnancy. Pelvic ultrasound and x-ray films of the pelvic cavity are helpful in making a diagnosis. Hysteroscopy is invaluable both in confirming the diagnosis and in achieving successful removal of fetal bone.

Abortion, Incomplete↗
PubMed1980

Two years of mid-trimester amniocentesis in Johannesburg.

During a 2-year period 438 mid-trimester amniocenteses were performed on women at risk of producing an abnormal infant. The commonest indications were advanced maternal age (61% of cases), neural tube defects (18%) and Down syndrome (11%). A 92,5% follow-up revealed a spontaneous abortion rate of 3% (1,5% if abortions within 8 days of the procedure were considered). Premature birth occurred in 4,4% of cases, neonatal death or stillbirth in 0,7%, and birth defects which were detectable by amniocentesis in 2%. Abnormalities were detected in 4,9% of cases, so that 95,1% of the patients were reasured by the results obtained. No defects diagnosable by amniocentesis were missed.

Abortion, Incomplete↗