Spontaneous heterotopic pregnancy presenting with tubal abortion.

Heterotopic pregnancies are rarely spontaneous. We present the case of a woman who presented with acute abdominal pain. Emergency laparotomy was performed. Intraoperative finding showed right tubal pregnancy and right salpingectomy was performed. Six weeks post-operation, the patient's symptoms and signs of pregnancy persisted and ultrasound showed an intrauterine single viable fetus. The pregnancy was continued to term and a healthy female baby was delivered.

Effect and safety of 17 beta-estradiol vaginal tablet in postmenopausal women with urogenital symptoms.

OBJECTIVE: To evaluate the effects of a 17 beta-estradiol vaginal tablet on urogenital symptoms, vaginal pH, vaginal cytology, endometrial thickness, and plasma estradiol level in postmenopausal women with urogenital symptoms. METHOD: Twenty-seven postmenopausal women with urogenital symptoms received 25 microg of a 17 beta-estradiol tablet intravaginally daily for the first 2 weeks, followed by 10 weeks of twice a week dosage. The results of urogenital symptoms, vaginal pH, vaginal cytology, endometrial thickness, and plasma estradiol level were analysed. RESULTS: The urogenital symptoms improved significantly in all women. The mean vaginal pH was significantly decreased. The vaginal cytology showed estrogenic effect on the karyopyknotic index and the maturation value. There was no significant difference in endometrial thickness and level of plasma estradiol before and after treatment. There was one case of vaginal bleeding from endometrial proliferation. CONCLUSION: Local vaginal treatment of 17 beta-estradiol (25 microg) had a positive effect on the urogenital symptoms, vaginal pH, and vaginal cytology. No elevation of plasma estradiol level was detected after treatment.

Effect of oral estriol on urogenital symptoms, vaginal cytology, and plasma hormone level in postmenopausal women.

OBJECTIVE: To evaluate the effects of oral estriol on urogenital symptoms, vaginal cytology, and plasma follicle stimulating hormone (FSH) and estradiol level in postmenopausal women with urogenital symptoms. METHOD: Twenty-eight postmenopausal women with urogenital symptoms who volunteered to participate in this study received 2 mg of oral estriol daily for 12 weeks. The urogenital symptoms, vaginal cytology, and plasma hormone level before and after treatment were analysed using paired t-test. RESULTS: The genital and urological symptoms improved (P < 0.05) after treatment in all subjects. The vaginal cytology showed estrogenic effect on the karyopyknotic index and maturation value. There was a significantly (P < 0.05) higher level of plasma estradiol after 12 weeks of treatment. However, the difference of plasma FSH level before and after treatment was not statistically significant. CONCLUSION: The daily oral estriol had a positive effect on the urogenital symptoms and vaginal cytology. The plasma estradiol increased after 12 weeks of treatment but the plasma FSH did not change.