[A case of allergy to a copper-medicated IUD. Etiopathogenetic and clinical aspects]. / Su di un caso di allergia a I.U.D. medicato al rame. Considerazioni etiopatogenetiche e cliniche.

PIP: The use of copper medicated IUDs has replaced the use of inert IUDs, thanks to their increased effectiveness, a Pearl index of 1% as compared to 2.5%. There are very few reported cases of copper allergy due to IUDs; this article presents 1 such case. A 22 year old healthy woman was inserted with a Cu 250 IUD; 1 week after insertion she presented widespread erythematous patches all over her body, excluding her face. Cortisone and antihistamine treatment were ineffective; the IUD was removed, and all symptoms disappeared in less than 20 days; subsequent tests revealed the patient to be allergic to copper sulphate.^ieng

[Analysis of the results and considerations on the organizational aspects of the implementation of the Law 194/78 in a provincial hospital]. / Analisi dei risultati, considerazioni di ordine organizzativo circa la legge 194/78 applicata in un Ente Ospedaliero di provincia.

PIP: Law number 94 legalizing abortion passed in Italy in May 1978. This article reports on the situation of induced abortion in the small provincial hospital of Avigliana, Torino, 1 year after the implementation of the law. The paramedical personnel were supportive of the medical and obstetrical personnel who, not being conscientious objectors, accepted to perform abortions. Every woman was thoroughly checked and counseled prior to the operation by the same doctor who was going to perform the abortion; the procedure was always done under general anesthesia and by vacuum aspiration. There were 66 abortions between June-December 1978, and 115 between January-July 1979. Contrary to expectations the number of deliveries also increased, from 66 during the 1st half to 145 during the 2nd half of operations. More than half the number of patients were referred from the ambulatory clinic within the same hospital, as compared to only 25% during the 1st half; only 7.8% were referred by private physicians, as compared to 30% during the 1st half. Almost 50% of patients were housewives both during the 1st and during the 2nd half; age of patients was, for the great majority, between 24-35; parity was 2 in 43.8% of cases for the 1st half, and in 40% of cases in the 2nd half. The majority of operations was performed within the 1st 8 weeks of pregnancy, and many women came from districts outside that of Avigliana. 34.8% of requests for abortion were because of failure of contraception, and almost 40% for socioeconomic reasons; only 8.2% of requests were motivated by reasons of health. Misinformation about contraceptive practices was widespread among the patients.^ieng

[Neonatal malformations and hormone therapy during pregnancy]. / Malformazioni neonatali e terapia ormonale in gravidanza.

PIP: The use of pharmacological treatment during pregnancy has always been extremely controversial, especially if the drugs involved are sex hormones, such as diethylstilbestrol. The percentage of congenital malformations attributable to hormonal therapy during pregnancy is 3%; the period of maximum susceptibility to teratogenic agents is between the 3rd-10th week of gestation, or the period of organogenesis. The 1st reported case of congenital malformation due to hormonal therapy during pregnancy goes back to 1957; since then the literature has published more on this subject. One of the most important studies was done in 1977 by Heinonen on a group of 50,282 pregnant women; 1042 had been treated with sex hormones. 19 infants, or 18.2/1000, had cardiovascular defects. Among the remaining 49,240 patients there were 385 cardiovascular malformations, or 7.8/1000. The problem is still far from being resolved; it is up to the individual physician to give the best possible advice, after careful consideration of the clinical situation of every pregnant patient.^ieng

[Special obstetrico-gynecologic hospital structure and local service units. Considerations on the availability and need for ULS 35 and 36]. / Struttura specialistica ospedaliera ostetrico-ginecologica e unità locale dei servizi. Considerazioni sulle disponibilità e necessità delle U.L.S. 35 e 36.

The underlying principles of the national health reform measures and those approved by the Piedmont Region's programmes with regard to social and health reorganisation are recalled. Reference is made to anomalies with respect to local health services No. 35 and No. 36 in the case of obstetrics and gynaecology, there being three maternity departments for 97,251 inhabitants in the area concerned. The main aspects of the division are examined. It is shown that implementation will only be possible if there is a usership capable of feeding every branch of the structure set up. It is suggested that the specialist activities of obstetrics and gynaecology be concentrated at Susa and Avigliana, though oven this division will not ensure a proper flow of users. The position could be improved by better employment of the basic structures, i.e. the consulting surgeries and SAUB out-patient departments.