Congenital infection with Schistosoma japonicum but not with Schistosoma bovis in sheep.

The present study investigated whether Schistosoma japonicum or Schistosoma bois could establish prenatally in lambs. Three ewes were exposed to S. japonicum by intramuscular injection of cercariae, and 3 ewes were exposed to S. bovis cercariae using the leg-emerging technique approximately 2 mo before delivery, and 1 age-matched pregnant ewe served as an uninfected control. The study lasted 18-20 wk after infection, which was 8-9 wk after delivery. All 6 exposed ewes became infected with either S. bovis or S. japonicum. Eight lambs were borne by the 7 ewes, of which 1 (S. bovis exposed) was dead and 1 (S. japonicum exposed) died at delivery. Of the 3 S. japonicum-exposed lambs, 2 were found infected. Four lambs born of S. bovis-exposed ewes were negative. Despite having no worms, these 4 S. bovis-exposed lambs as well as the 1 negative S. japonicum-exposed lamb had, in contrast to the nonexposed control lamb, few, but distinct, liver granulomas dominated by eosinophils and giant cells with large central necrotic areas but with no remnants of eggs or worms. Hence, congenital infection was demonstrated in S. japonicum-infected lambs, but not in S. bovis-infected ones.

Reproductive performance following conservative microsurgical management of tubal pregnancy.

Between 1981 and 1986, 58 women underwent conservative surgery for ectopic pregnancy; 30 had both tubes present, and 28 had the operation on their single tube. Twenty-five of the 30 women with both tubes present desired pregnancy; 17 (68%) conceived again, 14 (56%) had at least one intrauterine pregnancy and 3 (12%) had a repeat extrauterine pregnancy. Twenty-six of the women with a solitary tube desired pregnancy, 12 (46%) of them had at least one intrauterine pregnancy, and 10 (38.5%) had a repeat extrauterine pregnancy. It was concluded that the incidence of intrauterine pregnancy after conservative surgery in patients with both tubes present is not lower than after radical surgery, and that the incidence of extrauterine pregnancy is not higher. The intrauterine pregnancy rate in patients with a solitary tube is high and still higher than the best results available with in-vitro fertilization and embryo transfer. Therefore conservative surgery is indicated in these patients despite the high incidence of repeat extrauterine pregnancy. Since most of the patients who conceived did so during the first year following the operation, we recommend that patients try to conceive immediately.

Reproductive outcome after microsurgical treatment of tubal pregnancy in women with a single fallopian tube.

Whether restoration of tubal function following conservative surgery for ectopic pregnancy was achieved can only be estimated in patients with a single tube. Between 1978 and 1983, 22 women with a tubal pregnancy in their single tube underwent conservative microsurgical treatment. In 18 women dorsal salpingotomy was performed, in 3 the tube was gently milked (squeezing the products of conception through the fimbria), and in 1 the segment containing the products of conception was excised and the tube anastomosed. Twenty-one patients desired pregnancy. The mean follow-up period was 21.4 months. Of the patients desiring pregnancy, 76% conceived. The intrauterine pregnancy rate was 47.6%, and the repeat ectopic pregnancy rate was 42.8%. This ectopic pregnancy rate was significantly higher than those quoted in recent literature. Although the study group was a very-high-risk group, restoration of tubal function was achieved in a high proportion of cases. The intrauterine pregnancy rate was high and higher than the best results available with in vitro fertilization and embryo transfer, which is the only treatment available after bilateral salpingectomy. Therefore, conservative surgery is definitely indicated in such patients despite the high incidence of repeat ectopic pregnancy.