Pseudotumour cerebri in pregnancy: a case report

Pseudotumour Cerebri is a rare disorder, which occurs in the reproductive age group. It is relatively rare in pregnancy. We report one case of Pseudotumour Cerebri which was diagnosed preconceptially and was initially treated with corticosteroids. When pregnancy was diagnosed, the corticosteroid was discontinued and treatment was changed to repeated lumbar punctures. Symptomatic relief was achieved and the patient had an unremarkable antenatal course. A 3050 g full term female was delivered vaginally with apgar scores of 9 and 10 at 1 and 5 minutes respectively. Seven similar cases were reviewed which also diagnosed preconceptially. Clinical presentation, modalities of treatment and outcome of pregnancy are discussed

Comparison between postpartum lactate concentration in the umbilical artery and apgar score

Postpartum lactate concentration in the umbilical arteries was measured in 237 patients by means of the enzymatic method, using the lactic acid [LA] pack in the Du Pont Automatic Clinical Analyzer. Blood samples were taken immediately postpartum and Apgar scores were determined at one and five minutes, whereby the lactate level in the umbilical artery was found to be higher than the normal adult level [0.6-2.2 mmol/l]. The lowest level was 1.1 mmol/l and the highest was 7.7 mmol/l, with a mean of 3.26 mmol/l, and a standard deviation of 1.36. It was also found that in 184 patients the lactate concentration was less than the mean and only one newborn had an Apgar score of less than 7 at five minutes. In 53 patients, the lactate concentration was more than the mean and 13 newborns had an Apgar score of less than 7 at five minutes. When comparing the frequency of low Apgar scores [less than 7] at five minutes in the two groups [above and below the mean], using the Z-score, there was a statistically significant difference [P < 0.01]. Using the lactate level as a method of assessing the newborn in comparison with the Apgar score, the sensitivity was 92.86% and the specificity was 82.06%

Palliative cytoreductive surgery in advanced ovarian carcinoma

Seventeen patients with advanced epithelial ovarian carcinoma underwent aggressive cytoreductive surgery ["Debulking"] at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Thirteen patients [76.5%] had large bowel surgery, 5 [29.4%] had colostomy, and 2[11.8%] had urinary tract segmental resection performed. All patients received postoperative chemotherapy in the form of cis-platinum and cyclophosphamide. The patients were divided into two groups: group 1 [N = 9] consisted of those patients who died within 12 months of undergoing surgery, and group 2 [N = 8] comprised of those who survived for more than 12 months following surgery. Data from these patients was analysed and eight factors including nationality, age, parity, menopausal status, ascitic fluid volume, stage and grade of the carcinoma, as well as its histological type were studied. However, except for the stage of the disease, none of these factors was found to be significant in predicting survival of more than 12 months following surgery. We conclude that cytoreductive surgery has a role in palliation, however, the variables presented cannot be utilised to predict survival in females with advanced carcinoma of the ovaries

Female genito-urinary fistulae

During the period from 1987 until 1989, twenty-eight female patients with genito-urinary fistulae were seen at King Abdulaziz University Hospital, 78.6% of which were of obstetrical etiology. Thirteen patients had small fistulae [< 2cm] and fifteen patients had large fistulae [> 2cm], nine of which were considered to be giant fistulae [> 5cm]. The patients' age, parity, nationality and duration of their fistulae are presented. Our experience of repairing twenty-four fistulae showed that the cure rate was higher in small fistulae [90.9%] compared to large fistulae [69.2%]. The cure rate was also found to be higher in patients who underwent the abdomino-vaginal approach [71.4-100%], compared to those who underwent the vaginal approach [66.7-83.3%]

Non-Hodgkin's lymphoma in pregnancy

Non-Hodgkin's lymphoma is rarely reported during pregnancy. Only 32 cases have been reported in the English literature over the past 50 years, in which well-documented cases of non-Hodgkin's lymphoma were diagnosed and treated during pregnancy. In this paper, we report another three patients with non-Hodgkin's lymphoma which were diagnosed and managed during pregnancy. The first patient was treated with multiagent chemotherapy [cyclophosphamide, vincristine, bleomycin and prednisone], during pregnancy the outcome of which resulted in a healthy infant. The second patient had an ovarian lymphoma which was treated surgically by Caesarean hysterectomy, bilateral salpingo-oophorectomy and staging. The outcome was a healthy male infant. The third patient died immediately after diagnosis