Alleged forgery of sonography report leads to elective abortion of late 23 week-old fetus.

In this case report, a very obese young woman who claimed to be 17 gestational weeks into pregnancy, sought an elective abortion. Upon dilation and curettage, the doctor assessed the fetal remains to be nearly 26 gestational weeks. After contacting local authorities, who turned the case over to the Office of the Medical Examiner, the doctor determined that the woman had apparently forged her sonography report from the radiology clinic. She was thus able to obtain an abortion at more than 23 gestational weeks. While abortion laws vary from state to state, most doctors are reluctant to perform an abortion on a woman so far into term, since serious medical complications may arise and fetal viability must be considered. This case history may demonstrate the importance of independent confirmation of gestational age prior to such a procedure.

Effects of thermal endometrial ablation. Clinicopathologic correlations.

Electrothermal ablation of endometrium was performed on 207 women for abnormal and sometimes painful uterine bleeding. Recurrence of symptoms or inadequacy of treatment led to hysterectomy in 33 women at intervals of 2 weeks to 60 months. Patterns of uterine tissue destruction, healing and repair, and endometrial regeneration were correlated with the postablation interval. The endometrial thickness was completely destroyed. Necrosis dominated the first month, and a chronic repair-regeneration phase followed. Foreign body giant cells reacted with necrotic eschar, remnants of which were present to 47 months. Intact endometrium regenerated focally in 10 uteri and diffusely in 5. Indications for hysterectomy were attributed directly to ablation failure in 18 of 33 cases. Familiarity with the morphologic effects of ablation will aid in relating ablation failures to direct mechanisms, complications of the procedure, or unrelated events.