ABSTRACT
Heterotopic pregnancy is increasingly being diagnosed since the advent of assisted reproductive technology involving the use of superovulatory drugs and/or in-vitro fertilization and the availability of high-resolution ultrasound scans. There are reports of Heterotopic tubal pregnancies following clomiphene use. Heterotopic ovarian pregnancies are however rare. Clomiphene citrate, which is widely used in the primary care setting to treat anovulatory infertility, is felt safe. We present a case of heterotopic ovarian pregnancy following treatment with clomiphene citrate. The diagnosis and management of heterotopic ovarian pregnancy are also discussed.
Subject(s)
Clomiphene/adverse effects , Fertility Agents, Female/adverse effects , Pregnancy Complications/diagnosis , Pregnancy, Ectopic/diagnosis , Adult , Choristoma , Diagnosis, Differential , Female , Humans , Infant, Newborn , Ovary , Pregnancy , Pregnancy Complications/chemically induced , Pregnancy Complications/diagnostic imaging , Pregnancy Complications/surgery , Pregnancy, Ectopic/chemically induced , Pregnancy, Ectopic/diagnostic imaging , Pregnancy, Ectopic/surgery , Ultrasonography, PrenatalSubject(s)
Blood Cells , Prenatal Diagnosis , Trophoblasts/cytology , Cells, Cultured , Cytodiagnosis , Female , Humans , PregnancyABSTRACT
The effect of epidural analgesia on oxytocin release during the second stage of normal labour was studied by comparing 10 primigravidae who had epidurals with 10 control subjects who did not have epidurals. A significant increment in oxytocin between paired peripheral blood samples taken at the onset of full cervical dilatation and crowning of the fetal head was found in the control subjects but not in those with epidurals. Forceps delivery was required more often in the group with epidural analgesia and was associated with lower oxytocin levels at crowning. Since distension of the lower birth canal and stimulation of pelvic autonomic nerves leads to oxytocin release, and the need for forceps associated with epidurals can be reduced by oxytocin, these differences are attributed to the lumbar epidural block.
Subject(s)
Anesthesia, Epidural/adverse effects , Anesthesia, Obstetrical/adverse effects , Labor Stage, Second , Labor, Obstetric , Oxytocin/blood , Adolescent , Adult , Female , Humans , Obstetrical Forceps , PregnancyABSTRACT
The role of the haemostatic system in relation to menstrual bleeding is poorly understood. Platelet retention to glass beads and plasma concentrations of 6-oxo-PGF1 alpha and thromboxane B2 were measured in uterine and peripheral venous blood obtained from 18 women undergoing abdominal hysterectomy. Concentrations of 6-oxo-PGF1 alpha were significantly (p less than 0.01) higher in uterine (1.4 +/- 0.3 ng/ml, mean +/- SEM) than in peripheral vein blood (0.2 +/- 0.1 ng/ml) as was the level of thromboxane B2 (0.5 +/- 0.1 and 0.2 +/- 0.1 ng/ml, respectively). Platelet retention in uterine vein blood (11 +/- 4%) was significantly lower than in peripheral blood (42 +/- 4%; p less than 0.01) and the degree of platelet retention correlated inversely with the plasma concentration of 6-oxo-PGF1 alpha (r -0.43; p less than 0.01). There was a significant rank correlation between time since menstruation and concentrations of 6-oxo-PGF1 alpha in uterine (tau + 0.69; p less than 0.001) and peripheral (tau + 0.56; p less than 0.05) vein blood. The results indicate that an increased local production of prostacyclin (PGI2) relative to thromboxane A2 at the time of menstruation could contribute to the mechanism of uterine bleeding.
Subject(s)
Menstruation , Prostaglandins F/blood , Thromboxane B2/blood , Thromboxanes/blood , Uterus/blood supply , Adult , Aged , Female , Humans , Menorrhagia/blood , Menorrhagia/physiopathology , Middle Aged , Platelet Adhesiveness , Veins/physiologyABSTRACT
The effect of placental microvillus preparations (MVP) on lymphocytes in whole blood cultures obtained from mothers in the early stages of their first pregnancies was studied. Variable dilutions and variable harvesting were used to construct kinetic curves of [6-3H]-thymidine uptake per day. Significant responses (P less than 0.02 to 0.05) were observed in autologous plasma and heterologous serum with and without phytohemagglutinin. The responses showed a variability which may be explained by chance combination of similar MVP and in vivo trophoblast antigens, some with stimulatory and others with suppressor actions. The presence of a blocking antibody to a suppressor antigen in autologous plasma could also contribute.
Subject(s)
Antigens/analysis , Lymphocytes/immunology , Pregnancy , Trophoblasts/immunology , Adolescent , Adult , Cells, Cultured , Female , Humans , Kinetics , Microvilli/immunology , Pregnancy Trimester, First , Trophoblasts/ultrastructureSubject(s)
Immunity, Maternally-Acquired , Lymphocytes/immunology , Microvilli/immunology , Placenta/cytology , Trophoblasts/ultrastructure , Antigens, Surface/analysis , Culture Techniques , Female , Humans , Lymphocyte Activation , Placenta/immunology , Pregnancy , Pregnancy Trimester, First , Pregnancy Trimester, Third , Trophoblasts/immunologyABSTRACT
Trophoblast cells circulating in peripheral venous blood during pregnancy were extracted by differential centrifugation and identified by indirect immunofluorescence with antitrophoblast microvillus antibody. In a study where trophoblast identification was checked by blind comparison with non-pregnant control subjects' trophoblast cells were detected in six out of 10 pregnant women studied.
