Samuel Levin

Two Rare Complications of Simultaneously Occurring Placenta Praevia and Placenta Percreta

Simultaneously occurring placenta praevia and placenta percreta is a well known yet rare obstetric complication. Cases in which invasion of chorionic villi lead to asymptomatic perforation of the uterus or bladder, rarely occur. This paper describes two such cases.

Advanced papillary adenocarcinoma of unknown origin as tumor previa during late pregnancy

A 41‐year‐old woman with advanced abdominal adenocarcinoma presented at term pregnancy. The tumor was presented as previa and obstructed the delivery. A cesarean section was performed and a healthy child was born. At surgery diffuse metastatic disease was detected throughout the pelvis and abdomen and was partially resected. Combined chemotherapy consisting of cis‐platinum, adriamycin and cytoxan was administered for 5 months. At second‐look laparotomy no residual disease was found. We present an unusual presentation of metastatic abdominal undifferentiated carcinoma treated as ovarian cancer.

The Value of Urinary Pregnanediol Estimation for Monitoring Early Pregnancies

Urine samples from 76 pregnant women were tested for pregnanediol content during the first 6 weeks of pregnancy. Pregnanediol was measured by gas chromatography in 24-hour urine samples obtained once weekly from 76 randomly selected pregnant women 21, 28, 35, and 42 days after the last menstrual period. Pregnancy was ascertained by a positive hemagglutination inhibition test for human chorionic gonadotropin. In patients in whom the urinary pregnanediol content was less than 3 mg/24 hours the abortion rate was 81.5%, and 18.5% had normal pregnancies and births In patients whose pregnanediol content was greater than 3 mg/24 hours the abortion rate was 8.3%, and 91.7% had normal pregnancies and births. The 24-hour urinary pregnanediol excretion rate reflects corpus luteum function and can be considered as a means of monitoring pregnancy in its initial stage.

The Effect of Missed Abortion and Spontaneous Abortion on the Fate of Subsequent Pregnancies

Abstract. Sixtytwo patients with spontaneous abortion and 58 with missed abortion were all promptly treated with curettage. The reproductive performance and the subsequent fertility of both groups during a five year period before and after the abotion were compared. To our surprise, no significant differences were found between the two groups.

False positive ultrasonography diagnosis of molar pregnancy

Ultrasonography has become a major tool in early diagnosis of molar gestation (1). Proponents of this method have stressed its diagnostic superiority over amniography (2), pelvic arteriography (3) and exceedingly elevated human chorionic gonadotrophin (H.C.G.) levels. Furthermore it has been mentioned by Brewer (4) that approximately 38 per cent of molar pregnancies do not produce H.C.G. levels detectable by routine hemoagglutination inhibition tests (Hit). Finally, disproportional uterine enlargement has not been shown to be a constant feature ( 5 ) . A case is presented in which clinical parameters strongly suggested and ultrasonography confirmed the diagnosis of molar gestation, which however, was later proven to be completely erroneous.

Reifenstein's syndrome--a target cell failure.

Das Erscheinungsbild des Reifenstein‐Syndroms beinhaltet Hypospadie, Gynäkomastie, Hodenhypoplasie, Azoospermie und erhöhte Gonadotropinwerte. Die Erkran‐kung wird entweder als autosomal dominant oder an das X‐Chromosom gebundene rezessive Störung vererbt und betrifft nur genetisch männliche Individuen. Es wird über einen derartigen Krankheitsfall berichtet. Die Hypophysenfunktion wurde mittels des GnRH‐Tests beurteilt und erwies sich als normal. Prolaktin‐ und Testosteronwerte lagen innerhalb des Normbereiches. Der Patient war phänotypisch männlich, die Sexualfunktion war zufriedenstellend.

The Effect of Cervical Encerclarge on Uterine Dimensions

Observation of women who underwent cerclage of the uterine cervix in pregnancy indicated that during the first 24 hours after operation a marked increase of the uterine size takes place.

Genital Tumor as a Presenting Symptom of Renal Hypernephroma: A Case Report

A case of hypernephroma is presented in which the initial finding was heavy bleeding from a vaginal tumor. Fewer than 90 cases of genital metastases in males or females have previously been reported.

The Relation Between Apgar Score and Subsequent Developmental Functioning

A randomly selected sample of 252 infants aged 5‐18 months was evaluated through medical and developmental examinations. Developmental achievement scores and factors such as management of delivery and fetal distress were studied in relation to Apgar scores. Low‐Apgar‐score infants aged 5‐8 months achieved consistently lower scores on all developmental fields. High‐Apgar‐score infants at younger and older ages did not differ on their achievement scores. Low Apgar score was much more frequent in infants delivered by vacuum extraction than in those delivered spontaneously, with forceps or by cesarian section. The frequency of low Apgar score was higher when fetal distress occurred.

The peroxidase content and the antibacterial activity of the amniotic fluid.

Abstract. A possible relationship between the antibacterial activity of amniotic fluid and its peroxidase content was examined. Antibacterial activity, assessed by counting colonies of S. aureus following 24 hour incubation, was present in 76 % of the samples studied. It was not related to gestational age. Peroxidase activity, assessed by the O‐dianisidine method, was not found in any of the amniotic fluid samples examined.