Collection and preservation of human placental blood.

High-risk premature infants require red cell transfusions for anemia. Placental blood for autologous transfusions can be collected sterilely into citrate-phosphate-dextrose and stored at 4 degrees C. During storage for 8 days, the placental red cell content of adenosine triphosphate remained normal. The 2,3,-diphosphoglycerate concentration of cells stored 8 days declined sharply; however, the P50 value of the oxyhemoglobin dissociation curve declined to 24.4 +/- 2.40 torr. During storage, placental blood underwent an exchange of extracellular Na+ and K+, but no change in glutathione content. Hemolysis was less than 1 percent. Bacteriologic and fungal cultures remained sterile. These in vitro studies suggest that human placental blood can be collected safely and preserved effectively for autologous red cell transfusion therapy.

Disseminated pelvic Echinococcosis simulating ovarian carcinomatosis: case report and review of pelvic hydatid disease.

Pelvic pathology due to the parasite Echinococcus is infrequent in industrialized nations. It, however, may involve multiple organs and can mimic virtually any disease process. The parasitology, epidemiology, diagnosis, and treatment of hydatid disease is reviewed with particular emphasis on pelvic hydatid disease.

Use of vaginal prostaglandin-E2 suppositories in septic abortion.

A case report of successful clinical use of prostaglandin-E2 vaginal suppositories to terminate a septic abortion is reported. A new indication for such therapy is suggested.

PIP: Prostaglandin-E2 vaginal suppositories were used to terminate a septic abortion in a 23-year-old multiparous female. The patient, at 18 weeks gestation, complained of 36 hours of ruptured membranes. Past obstetrical history included a Cesarean section at term for cephalo-pelvic disproportion. In an effort to avoid a potentially morbid hysterectomy, a trial of vaginal Prostaglandin-E2 suppositores was undertaken. 70 minutes after insertion of the first 20 milligram suppository, regular uterine contractions were noted. The patient was closely monitored for signs of vascular collapse and uterine rupture. 6 hours later a macerated fetus was expelled. The placenta remained loosely attached to the anterior uterine wall and required uneventful curettage for removal. Broad spectrum antibiotic coverage and supportive measures continued. The patient began apyrexic 10 hours following prostaglandin administration. The rapid and efficient results produced in this case suggest a new indication for vaginal Prostaglandin-E2 therapy for termination of septic mid-trimester abortions as long as close patient monitoring with appropriate antibiotic and supportive therapy are instituted.

A gynecologic presentation of mixed phakomatosis.

The case of a 31-year-old Jamaican woman with mixed phakomatosis is presented whose main complaint, bringing her to medical attention, was intractable vaginal bleeding. A previously undescribed form of uterine pathology, including hypertrophic varicose channels within the endometrium, represented the underlying cause for the patient's bleeding. The histological picture was similar to the vascular pathology in other organ systems. It is suggested that the reproductive organs may be involved in the systemic disease process of phakomatoses in a similar way as other, already recognized, organs. The phakomatoses are a group of poorly understood and underrecognized disorders. As multisystemic processes, myriad signs and symptoms may offer a clue to their diagnosis. The presentation of a mixed phakomatosis as a gynecological disorder, however, has not been reported. The following case illustrates this unusual mode of presentation.