Validation of traction force indicator in ventouse devices.

OBJECTIVE: To evaluate whether the traction force indicator in a ventouse device gave an accurate estimation of the force applied. METHODS: The study was carried out at the Derby City Hospital. An estimate of measurement errors was made by analyzing the standard deviation of the residuals for 30 Kiwi OmniCup devices (Clinical Innovations, Abingdon, Oxfordshire, England) and a standard industrial spring balance. RESULTS: The measurement errors for the traction forces were very small and acceptable for the OmniCup. The overall estimate of measurement errors was 0.45 kg (1.35 lb). CONCLUSION: The overall measurement error for the traction force indicator of the OmniCup was found to be very small. Injuries associated the ventouse, such as cephalohematomas and subgaleal hemorrhages, may be minimized if the recommended limits for a safe traction force are not exceeded.

Transcervical sampling as a means of detection of fetal cells during the first trimester of pregnancy.

OBJECTIVE: Our aim was to evaluate the detection of fetal cells from transcervical samples by means of fluorescence in situ hybridization analysis. STUDY DESIGN: Forty-seven women undergoing first-trimester termination of pregnancy were recruited for transcervical sampling and 16 were recruited for endocervical mucus aspiration. Subjects were asked to assess the discomfort of the procedure. Fluorescence in situ hybridization analyses were performed with X and Y chromosome-specific probes. Results were compared with those of conventional chromosomal analysis. RESULTS: Male signals (XY) were observed in 19 of 25 male fetuses (76%), and female signals (XX) were observed in 21 of 22 female fetuses. There was a significant variation between operators in cell retrieval. With mucus aspiration only 37.5% of male fetuses were correctly identified. The subjects did not find the procedure uncomfortable and reported that it was comparable to having a cervical smear taken. CONCLUSIONS: Transcervical irrigation correctly identified the sex of 76% of male fetuses, but it still has considerable operator variability. This variability might be reduced by improved catheter design.

Detection of cells of fetal origin from transcervical irrigations.

Twenty-one women (age range 17-38 years) undergoing termination for social reasons in the first trimester were selected. Ultrasound determined the gestation and placental site. A commercially available flexible, sterile plastic tube was advanced to the level of the internal os. Five to eight millilitres of normal saline was injected and then gently aspirated into the tube. Chorionic villus sampling (CVS) or amniocentesis was subsequently performed for back-up sexing. Commercial X and Y probes were used simultaneously for fluorescence in situ hybridization (FISH) study of the cervical washing and back-up samples, XY signals were observed in 10 out of 12 male fetuses and 1 out of 4 female fetuses (false positive), indicating 81.3 per cent correct prediction. Four cervical washing samples did not provide enough cells for FISH. The frequency of cells showing XY signals varied from 3.6 to 47.8 per cent in male-predicted pregnancies. Placental-location, gestational age, or maternal age did not affect the successful retrieval of fetal cells. Trophoblast cells were obtained in a significant number (83 per cent) of pregnant women with male pregnancies by transcervical irrigation in the first trimester. This preliminary part of the study shows the presence of fetal cells in the transcervical samplings and the feasibility of FISH in detecting them; however, further studies are needed to isolate and purify fetal cells.

Small intestinal perforation following minor trauma.

Small intestinal perforation occurred in two patients aged 70 years and 88 years who had experienced minor trauma by tripping or falling on the pavement. They both developed signs of generalized peritonitis and at laparotomy were found to have perforated the mid ileum. There was no sign of direct abdominal trauma but they had suffered minor facial trauma as a result of the fall.

Cervical epithelial abnormalities among women with vulval warts-no more common than among controls.

Eighty-four women with vulval warts and 46 controls were examined for cervical epithelial abnormalities by cytology and colposcopy. The prevalence of colposcopically detected abnormalities was the same in the two groups. Minor cytologic abnormalities (less than moderate dyskaryosis) were more common among women with warts than among controls. It is concluded that women with vulval warts are no more likely than controls to have evidence of cervical epithelial abnormalities. These findings are discussed in the light of apparently contradictory findings by other workers.

Ectopic beta-human chorionic gonadotropin production by a dermoid cyst.

Benign cystic teratomas of the ovary (dermoid cysts) are common in women in the 20- to 40-year-old age group; 10% of these teratomas are bilateral. There have been reports of hormone production by dermoid cysts, particularly thyroid-stimulating hormone. We report the first case to our knowledge, of ectopic human chorionic gonadotropin production by a dermoid cyst.