摘要:

A histologic study was conducted of sagittal sections of the genital tracts of 281 autopsied female stillborns and neonates. The prevalence of vaginal adenosis among 43 offspring exposed in utero to diethylstilbestrol (DES) was 70%, a frequency 18 times greater than the 4% prevalence among 159 unexposed offspring. The relationship of the prevalence of vaginal adenosis to the gestational age at initial exposure was highly significant: 81% of those first exposed during the period of vaginogenesis had adenosis, whereas none exposed after 21 weeks' gestation had adenosis (P1= 1 ± 10−4). The relationship of the prevalence of vaginal adenosis to the total dose of DES prior to 22 weeks' gestation also was significant (P1= 0.02), and this relationship was independent of gestational age at first exposure (P1= 0.01). In contrast, the prevalence of adenosis among 23 offspring exposed to steroidal estrogens and progestins was about the same as that among the unexposed offspring. Vaginal adenosis was unrelated to the complications of pregnancy for which the hormones were given, the calendar year of birth, and the gestational age at delivery.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

A study was undertaken to evaluate the accuracy of colposcopic examination when performed without the use of endocervical curettage. It included 763 cases of suspected cervical-vaginal pathology. An additional evaluation of colposcopic accuracy was made for special-case categories of 1) stromal invasion, 2) pregnancy, 3) menopause, and 4) diethylstilbestrol (DES) exposure. Colposcopic accuracy was determined by cytologic and histologic material obtained either at the initial colposcopic evaluation or during follow-up surgery. With the literature as a standard for accuracy, it was concluded that the omission of endocervical curettage from the colposcopic examination did not reduce accuracy. In addition, the diagnostic conization rate was lower than in most reported series. Finally, the rate of missed invasive lesions was not increased by the omission of endocervical curettage.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

It is now widely accepted that debulking operative resections can provide effective palliation for some patients with advanced pelvic malignancy, particularly with those malignancies originating in the ovary. Some of these radical operations require the resection of long segments of the ureter and portions of the bladder. Although there is a variety of techniques that can be used in this situation to restore the continuity of the urinary tract, in some instances a simple ureteral ligation may represent the best method of managing the “short ureter.” In our experience with 23 patients who underwent intentional ureteral ligation, the procedure was found to be safe, expeditious, and beneficial in managing some of the complex problems associated with advanced pelvic malignant disease.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

The clinical and pathologic features of 60 smooth muscle tumors of the vagina were studied to determine the pathologic characteristics which best relate to clinical behavior and to define criteria for the diagnosis of leiomyosarcoma. Cellular atypism, mitotic activity, and tumor size and contour were examined, and their relationship to recurrence was evaluated. Only 5 neoplasms recurred, and these were all ≥3 cm, with ≥5 mitotic figures per 10 high-power fields (HPF) and various degrees of atypia. The only patient whose tumor had an infiltrating margin died with metastatic tumor in the lungs. With the exception of this 1 neoplasm, all other smooth muscle tumors of the vagina were either benign or only locally aggressive. Local excision is the treatment of choice when the tumor is well circumscribed. A neoplasm with moderate to marked atypism and ≥5 mitotic figures per 10 HPF merits the designation of leiomyosarcoma.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

A study was designed to determine the effect of a low-estrogen-dosage oral contraceptive on the serum concentration of testosterone-binding globulin (TBG) and total and unbound testosterone in patients with polycystic ovary disease (PCOD). Treatment with norethindrone 0.5 mg and ethinyl estradiol 0.035 mg (Modicon, Ortho) increased the TBG concentration and reduced the unbound serum testosterone concentration.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Laparoscopic tubal sterilization, using a Silastic band to occlude the tubal lumen, was performed on 224 patients. The incidence of complications was low and only 2 pregnancies occurred. Further evaluation by hysterosalpingography on 97 patients revealed 2 distinct images. The site of tubal occlusion was seen on laparoscopy performed on 7 patients. The radiographic and laparoscopic findings are discussed.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Of 356 women undergoing sonography to diagnose or rule out an ectopic gustation, data sufficient to assign a final diagnosis were available on 260 of them. Ectopic gestation was diagnosed in 25 cases in this group and intrauterine pregnancy in 99, while the remaining 136 patients were found not to be pregnant. During sonography, ectopic gestations were suspected or diagnosed in 27 instances: In 17 cases this was in agreement with the final diagnosis, but neither an intrauterine nor an extrauterine gestation existed in 10 cases, although neoplastic or inflammatory masses were present. Of the 25 patients with the final diagnosis “ectopic pregnancy,” this was not detected with sonography in 8 instances. Intrauterine pregnancies were diagnosed by sonar in 94 of the 99 cases. Although reliable sonar identification of ectopic gestation is not always possible, sonography is helpful in diagnosing intrauterine pregnancy so that surgical intervention can be avoided.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Twenty-four conservative surgical procedures for unruptured tubal pregnancies were performed on 23 patients with poor past obstetric performance. All cases were diagnosed preoperatively by laparoscopy. Salpingotomy was performed in 20 cases and fimbrial expression of the ectopic pregnancy was performed in 4 cases. In the group of conservatively treated patients there were 15 live births in 11 women and 28 intrauterine pregnancies in 14 women. No ectopic pregnancies occurred in the operated tube. Early diagnosis and conservative surgical treatment of unruptured tubal pregnancy is appropriate for patients with poor reproductive histories.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

A prospective trial is presented of the benefits and risks of external cephalic version in breech presentation. From January through October 1977, attempts at external version were performed in 53 cases with a success rate of 70%. The version technique is described. Mode of delivery after the maneuver in mothers with breech presentation who for different reasons were not included in the series is reported as well. Both the incidence of breech presentation and the incidence of cesarean section in breech presentation were reduced during the period of study. No serious complications in association with attempts at external version were observed.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Over a 3-year period at the Long Beach Women's Hospital, where electronic FHR (fetal heart rate) monitoring was routine, there were 8622 live births, including 41 infants born with major congenital malformations. The neonatal death rate in these malformed infants was 44%; 17 were delivered by cesarean section, 11 of which were performed because of fetal distress. There were no characteristic FHR patterns that would specifically identify major congenital malformations. There was a significantly increased incidence of prematurity, breech presentation, and cesarean section delivery in the congenital malformation group as compared to the overall population delivering at the Women's Hospital. The clinical implications of these observations are discussed.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID