摘要:

Amniotic fluid spectrophotometric analysis for bilirubin (delta optical density [ΔOD450], at 450 nm) is used to assess the severity of fetal involvement in isoimmunized pregnancies. Two patients presented with sickle cell anemia and hyperbilirubinemia who also were isoimmunized. The first patient had anti-kell and anti-e antibodies, whereas the second patient had anti-Lewisaand anti-Coltonbantibodies. Delta OD450was elevated in both patients. The difficulty in interpretation of high ΔOD450in the presence of maternal hyperbilirubinemia is stressed. Sickle cell diseased patients are particularly prone to present with this problem. These patients always have hyperbilirubinemia and a relatively high incidence of irregular antibodies because of the numerous blood transfusions they receive. The management of these two patients is presented with suggestions for the use of alternative modalities of monitoring isoimmunized pregnancies in patients with hyperbilirubinemia.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

An unusual case of multifocused postpartum thrombotic microangiopathy was encountered in a woman with pregnancy-induced hypertension, which presented clinical features different from those generally seen in postpartum hemolytic uremic syndrome or thrombotic thrombocytopenic purpura. These changes included acute disseminated intravascular coagulation, severe elevations of liver enzymes, severe renal dysfunction, and hemolytic anemia. The patient was treated successfully with heparin, gabexate mesilate, furosemide, fresh whole blood, and large doses of corticosteroid with antibiotics, and she recovered completely without sequelae. The hypothetical pathogenesis of the complex symptoms of this catastrophic clinical condition is proposed.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Perineal hernias have been a significant complication of pelvic exenteration since the inception of this procedure. A variety of natural and artificial materials have been used to support the small bowel to prevent its descent into the lower pelvis with subsequent hernia and fistula formation. More recently, neovagina construction using gracilis myocutaneous flaps has provided both sexual function and support for the small bowel. A patient is presented who had prolapse of her neovagina and a perineal hernia 12 months after exenterative surgery. A technique to repair this complication is described, and a possible method of preventing it is discussed.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Pelvic fibromatoses are only unusually encountered in gynecologic practice, but then consistently create a diagnostic and therapeutic challenge. The reported patient typifies the difficulties encountered in surgical excision. A discussion of theories of etiology and management options follows.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID