Benjamin Eckerling

PHEOCHROMOCYTOMA AND PREGNANCY: SIMULTANEOUS DELIVERY BY CESAREAN SECTION AND RESECTION OF TUMOR.

Abstract A case of pheochromocytoma which was diagnosed during pregnancy is described. A normal baby was delivered by cesarean section and the tumor removed at the same time. The poor prognosis of cases in which the diagnosis of pheochromocytoma is not made ante partum has been discussed. Determinations of norepinephrine levels in maternal venous blood and cord blood suggest the presence of a placental barrier, presumably enzymatic in nature, to norepinephrine transfer.

Blood glucose levels and glucose tolerance in women with subclinical diabetes receiving an oral contraceptive

This study evaluated the effect of an ovulatory suppressive drug norethynodrel (2.5 mg) and mestranol (.1 mg enovid) used as an oral contraceptive on carbohydrate metabolism and in particular on the fasting blood sugar and intravenous glucose tolerance of young women with subclinical diabetes. 3 groups were studied 1) 12 nonobese women having subclinical diabetes mellitus not receiving insulin 2) 22 healthy nonobese women starting oral contraceptives and 3) 26 healthy nonobese women receiving no medication which was the control group. The mean value of the plasma glucose disappearance rate for Groups 1 and 2 had decreased significantly after 3 months therapy. No significant change in glucose tolerance had occurred with time in Group 3 (controls). It was suggested that glucose tolerance should be investigated and in those subjects who exhibit definite carbohydrate metabolic derangement oral contraceptive therapy should be avoided.

PLACENTAL HORMONE ACTIVITY AFTER REMOVAL OF THE FETUS IN A CASE OF ADVANCED ABDOMINAL PREGNANCY

THE removal of a living fetus while the placenta remained in place in a case of advanced abdominal pregnancy has permitted us to study some of the endocrinological aspects of placental function. The problems under consideration were whether the presence of a living fetus is essential for the secretion of oestrogens, progesterone and chorionic gonadotrophin, and what are the relative roles of the fetus and the placenta in their production; even more important, is the level of excreted hormones a reliable index of fetal viability.

Spontaneous rupture of the splenic vein in pregnancy with massive retro- and intraperitoneal hemorrhage

Abstract A patient who had a spontaneous massive retro- and intraperitoneal hemorrhage, caused by a spontaneous rupture of the splenic vein which was a complication in late pregnancy, is described. Because of early intervention the mother survived. The literature is reviewed, and the limited number of case reports is mentioned, and the following measures are recommended: (1) ample and rapid blood replacement; (2) immediate exploratory laparotomy; (3) evacuation of the uterus; (4) ligation of the bleeding vessel or resection of organ.

An unusual case of rupture of a pregnant rudimentary horn of a bicornuate uterus

Abstract Relatively few comprehensive studies 1–4 comprising a significant number of cases of congenital malformations of the female reproductive tract associated with pregnancy have appeared in the obstetrical literature. Among congenital uterine malformations the most frequently encountered is the bicornuate uterus. The report presented is a case of rupture of a pregnant rudimentary horn of a bicornuate uterus.

Fetal electrocardiogram obtained with subcutaneous maternal electrodes: A new method

Abstract The low voltage of the fetal heart signals and the usual background interference are the main obstacles in obtaining clear fetal electrocardiographic tracings with a high signal-to-noise ratio. By the use of subcutaneous needle electrodes, impulses from the maternal abdominal wall can be short-circuited. Fetal heart potentials with higher amplitude and less background noise are thus recorded. Fetal viability, presentation, multiple pregnancy, and congenital arrhythmias were diagnosed antenatally by means of the fetal ECG with subcutaneous electrodes and were later correlated with the outcome of the pregnancy. More than two hundred tracings were performed with 98 per cent accuracy.

Fatal Candida septicemia developing after hysterectomy and transfusion

.A #-year-old woman was admitted because of severe menorrhagia. On admission, physical examination as well as laboratory examinations werr normal, and gynecologic examination revealed multiple uterine fibromyomas. The patient, who was Rh negative, reported to have received in her youth several intramuscular injections of her hushand’s blood for an illness of a nature unknown to her. Obstetric history revealed three unsuccessful pregnancies, two of which ended in the delivery of dead infants, considered to be due to Rh incompatibility; a third pregnancy terminated in the sixth month with delivery of a dead erythroblastotic baby. On the day following admission total hystercctomy and bilateral salpingo-oophorectomy were performed. During the intervention, blood loss was not excessive and the patient received one whole blood transfusion. She left the operating table in satisfactory condition. Several hours later. COMMUNICATIONS IN BRIEF

A CASE OF ECTOPIC GESTATION WITH TRANSMIGRATION OF OVUM

LARGE series of ectopic pregnancies continue to be reviewed, and many instances of individual variations have been reported. These reports are interesting, bath for the clinical lessons to be learned from them and the new light they shed on the theories of ectopic gestation. The case reported herewith demonstrated the role of transmigration of the ovum in ectopic gestation, and several interesting and unusual clinical features.