[The microbiological etiology of acute pelvic inflammatory disease in Pelonomi Hospital, Bloemfontein]. / Die mikrobiologiese etiologie van akute bekken- infektiewe siekte in Pelonomi-hospitaal, Bloemfontein.

In 40 women with acute pelvic inflammatory disease (APID) specimens for microbiological study were obtained from the rectum, urethra, vagina, cervix and peritoneal cavity. In most patients (83%) the aetiology of the infection was polymicrobial. Chlamydia trachomatis was the most common invader (73.3%), followed by anaerobic organisms (46.6%), Neisseria gonorrhoeae (40%) and aerobic organisms (26.6%). Only 1 patient had a positive peritoneal culture for N. gonorrhoeae. All the other positive Chlam. trachomatis and N. gonorrhoeae cultures were obtained from rectal, urethral and cervical specimens. The positive anaerobic and aerobic cultures were all from peritoneal cavity specimens.

Gamete intrafallopian transfer: a treatment for long-standing infertility.

Gamete intrafallopian transfer (GIFT) has been described by Asch et al. (1,2) as an alternative technique in the treatment of infertile couples. At the University of the Orange Free State, the GIFT technique was introduced in July 1985, and during phase I, 31 patients were treated by means of GIFT. All patients had had at least six cycles of ovulation induction with human menopausal gonadotropin (hMG) and human chorionic gonadotropin (hCG). Their diagnoses were anovulation (3 patients), mild endometriosis (17 patients), and unexplained infertility (11 patients). All husbands' semen analyses were normal. Of the 31 patients, 3 failed, due to spontaneous ovulation before laparoscopy (1 patient) and unsuccessful follicle aspiration at laparoscopy with no oocytes found (2 patients). Four ongoing pregnancies resulted from the remaining 28 patients. This represents a pregnancy rate of 14.29% per laparoscopy (including the failures). The patients who became pregnant had had infertility treatment for 5, 6, 8, and 8 years, respectively. GIFT therefore appears to be a promising method of treatment for long-standing infertility.

Efficacy of different antibiotics in the treatment of pelvic inflammatory disease.

A total of 40 patients with acute pelvic inflammatory disease (APID) were studied over a period of 7 months; one aim was to evaluate the use of different antibiotics in treatment. The most important findings were: (i) most patients had a polymicrobial aetiology for their APID; (ii) Chlamydia trachomatis and the anaerobic bacteria were the most common organisms encountered; and (iii) tetracycline plus metronidazole is probably the best combination therapy for APID.

The value of laparoscopy in the diagnosis of acute pelvic inflammatory disease.

A total of 40 patients with acute pelvic inflammatory disease (acute PID) were examined over a period of 7 months to determine the diagnostic value of laparoscopic examination in these cases. The most important findings were: the clinical diagnosis of acute PID was confirmed by laparoscopy in 55% of patients; laparoscopy was especially of value in differentiating potentially lethal conditions such as ectopic pregnancy and acute appendicitis from acute PID in 15% of patients; laparoscopically obtained microbiological specimens provide a more accurate means of determining the microbiological aetiology of acute PID than vaginally obtained specimens.

Uterine contraction patterns in abruptio placentae.

Tocographic monitoring of 21 patients with grade III abruptio placentae revealed the following: the tocographic pattern can be of diagnostic aid; the tocograph is of no value in measuring progress, because there is no significant change in uterine tone and contraction frequency and amplitude from the time the membranes are ruptured until the delivery of the fetus; and the tocographic patterns in abruptio placentae are probably of diagnostic value as regards the coagulation defect, but further proof of this is necessary.