P. Buck

Hydatidiform mole following in-vitro fertilization. Case report

A 40-year-old woman with bilateral tubal block underwent a fourth treament cycle for in-vitro fertilization and embryo transfer (IVF-ET). The patient was admitted with vaginal bleeding at 9.5 weeks gestation. A hydatidiform mole was suspected. Pathological examination of the products of conception, confirmed a diagnosis of a complete hydatidiform mole

The recruitment of oocyte donors

exceed 46% resulting in a detection rate of 1%. During the study year, 32% of amniocenteses in the higher risk group were in women less than 35 years old. In the year before serum screening was introduced, 154 amniocenteses were performed against 150 in the study year, Summary data for Wales, however, suggested an increase in amniocenteses due to serum screening. In our study, the overall prevalence of Down’s syndrome in screened women was 1 in 600. For those with a higher risk result, it was 1 in 42 and for those with a low risk result, 1 in 1160: a 28-fold difference. This study was not designed to test the statistical hypotheses of screening, but we were interested to note that our detection rate using two analytes was similar to contemporary studies using the triple test (Haddow etal. 1992; Wald etal. 1992). Before serum screening became available, concerns about Down’s syndrome were not raised with women below the age of 35. At UHW an extra 10 min for the midwife and clinic doctor were required to discuss the test before screening, and for those women with a higher risk result, at least another 30 min were necessary. We were particularly concerned about potential psychological effects in the women with false positive and negative results; our experience emphasised the need for sound primary counselling. One case demonstrated multiple benefits for a woman who did not want a termination. Our impression is that at present evaluation of the serum screen for Down’s syndrome is incomplete. The participants believe that amniocentesis or other diagnostic tests should remain available for women aged 35 and over. This is especially so for women aged 38 and over where age is the dominant risk factor and serum screening often only introduces a time delay before amniocentesis is carried out (Reynolds er al. 1993).

Pelvic lymphocysts occurring after Wertheim's operation: a review of 11 years' experience

SummaryIn an analysis of 100 cases of radical hysterectomy with extraperitoneal lymphadenectomy performed for carcinoma of the cervix, postoperative pelvic lymphocysts were detected in 11 patients (11 per cent). Eight of these (73 per cent) were asymptomatic. Although potentially serious complications are known to occur with lymphocysts, only minor ones were encountered. This paper outlines the clinical features and management in this group of patients. A system of management dependent on the size and symptoms of the cyst is proposed.