[Inflammation of the pelvis minor]. / A kismedencei gyulladás.

Pelvic inflammatory disease (PID) is the must important gynecologic infectious disease. It causes not only serious clinical symptoms, life threatening complications, but also severe damage to the female upper reproductive tract. Among its important sequale are infertility due to tubal occlusion, ectopic pregnancy, dyspareunia, and chronic pelvic pain. The must important causative organisms are Neisseria gonorrhoeae, Chlamydia trachomatis, as well as anaerobic and facultative bacteria found in the vaginal flora of women with bacterial vaginosis. The author reviews the latest developments regarding the epidemiology, etiology diagnostics, medical and surgical therapy of the disease. The importance and possibilities of prevention are discussed.

[Bacterial vaginosis]. / Bacterialis vaginosis.

Bacterial vaginosis being the most frequent vaginal infection is the leading cause of genital fluor. The author reviews the latest developments regarding the etiology, diagnostics and therapy of disease. Per os metronidazol and intravaginal clindamycin play the main role in treatment. The most often occurring complications of bacterial vaginosis are premature rupture of membrane and premature labour, postpartum endometritis, pelvic inflammatory disease and gynecological postoperative infections.

[Causes, diagnosis and therapy of habitual abortions]. / A habituális vetélések okai, kivizsgálása és terápiája.

Recent knowledge concerning the etiology of habitual abortions is reviewed by the author. The anatomic, genetic, endocrine and immunologic causes furthermore the assumed role of maternal diseases and infections are summarised. Besides diagnostic procedures and therapeutic possibilities are discussed.

[Fetal chromosome abnormalities diagnosed by chorionic villi sampling]. / Chorionbolyhokból diagnosztizált magzati kromoszóma-rendellenességek.

Chorionic villus sampling was performed for chromosome analysis in 387 cases during a 4-year-period. In 115 cases transcervical while in 272 cases transabdominal sampling was carried out. Chromosomal abnormalities were found in 25 cases (6.4%). Autosomal trisomies occurred in 17 cases, structural anomalies in 2 cases and sex chromosomal aberrations in 6 cases. The pregnancy was terminated in 19 cases because of chromosome abnormality, in 5 further cases because of X-linked disease and male fetus. After transcervical sampling spontaneous abortion occurred in 7 cases (5.8%), while after transabdominal sampling in 8 cases (2.8%). The authors prefer in their practice the early transabdominal CVS, which can be performed safety already at the end of the first trimester.

"Premature anaphase" in a couple with recurrent miscarriages.

An increased frequency of mitoses with centromere separation affecting all chromosomes was found in lymphocyte cultures from a couple with recurrent spontaneous abortions. The phenomenon was observed in both the wife and husband. The abnormal behaviour of centromeres may predispose the individual to cell division errors, the consequence of which may be a spontaneous abortion.

[Spontaneous abortion and genetic natural selection]. / Spontán vetélések és a természetes genetikai szelekció.

Author reviews the recent researches related to the genetic causes of spontaneous abortions as well as the results of the cytogenetic examinations of gametes, early embryos and clinical miscarriages. In the background of more than half of first trimester spontaneous pregnancy losses severe chromosomal aberration of the fetus can be found. About 60% of abnormal karyotypes is formed by autosomal trisomies, the rest is divided among polyploidies, X-monosomy and different structural anomalies. The incidence of fetal trisomies correlates with maternal age, besides balanced translocations of parents and delayed fertilisation can also play a role in the etiology of fetal chromosomal abnormalities. Regarding that most of these abnormalities accidentally develop because of meiotic or mitotic error there is no great risk of recurrence. Women who have had one spontaneous abortion will soon get pregnant again and give birth to a healthy child. The abortion of fetuses with abnormal karyotype is the appearance of natural genetic selection.

Cytogenetic analysis of spontaneous abortions with direct analysis of chorionic villi.

A total of 224 cases of spontaneous abortions were studied by analysing chromosomes directly from chorionic villi. Abnormal karyotypes were found in 51.3% of the investigated cases. Among the chromosome abnormalities the most frequent were the trisomies (55.7%), followed by polyploidy (23.5%), monosomy X (15.6%) and structural anomalies (5.2%). The rapid and relatively simple method is suitable for studying the causes of spontaneous abortions, and this information may be helpful also for genetic counselling.

[Etiology, pathophysiology and clinical aspect of endometriosis]. / Az endometriosis etiológiája, patofiziológiája és klinikuma.

Endometriosis is one of the most frequent gynecological diseases. In its development take a part genetical, mechanical and immunological factors. Main symptoms are cycle-dependent pelvic pain, infertility and characteristic morphological alterations ("pelvic mass"). For the diagnosis the laparoscopy plays the leading role. Therapy is based either on the hormonal inhibition of ovarian function (danazol, GnRH agonists), or surgical interventions (operative laparoscopy), as well as the combination of both methods.

[Chromosome analysis in spontaneous abortion using direct preparation of chorionic villi]. / Spontán abortumok kromoszóma-vizsgálata chorionbolyhokból direkt preparálás útján.

Two hundred cases of spontaneous abortions were studied by analysing chromosomes directly from chorionic villi. Abnormal karyotypes were found in 52% of the investigated cases. Among the chromosome abnormalities the most frequent were the trisomies (56.7%) followed by polyploidy (23.1%), monosomy X (15.4%) and structural anomalies (4.8%). The rapid and relatively simple method is suitable for studying the causes of spontaneous abortions, and these information may be helpful also for genetic counselling.

Familial extra bisatellited microchromosome and Down syndrome.

Authors report on a Down infant, whose chromosome complement includes an extra small bisatellited marker chromosome. This marker was also found in four healthy members of the family.

Induction of second trimester abortion by intraamniotic instillation of Rivanol (ethacridine) combined with oxytocin infusion.

We report our experience of 0.1% intraamniotic Rivanol in the interruption of 100 midtrimester pregnancies (15-24 gestation weeks). The mean injection to abortion interval was 37.2h and there were no complications. Intraamniotic Rivanol injection combined with oxytocin infusion seemed an effective and safe method for terminating second trimester pregnancies.

Transvaginal operation of the Stein-Leventhal syndrome: description of a new operative technique.

The vaginal operation of the Stein-Leventhal syndrome is presented. The procedure is described. In comparison to the abdominal operation, the new technique has the following advantages: shorter duration of the operation, no scar due to laparotomy, smaller peritoneal wound, and less severe trauma.

[Intra-amniotic Rivanol injection for the mid-term interruption of pregnancy]. / Intraamniális Rivanol feltöltés középidös terhességek megszakítására.

Authors report their experiences about the use of intraamniotic Rivanol injection in the interruption of midtrimester pregnancies. Instillation was made between 15-24 gestation weeks with the use of 0.1% Rivanol solution in 108 cases. The abortion occurred averagely 36.9 hours after induction without remarkable complications in all cases. According to their experiences the intraamniotic Rivanol injection is an effective and safe method for the interruption of second-trimester pregnancies.

[Rapid karyotyping from cord blood]. / Gyors karyotypizálás köldökzsinórvérböl.

A rapid method of chromosomal analysis of the newbornbabies is described. The karyotype of the newborn can be detected with the use of direct preparation from the cord blood within a few hours. This can be helpful in the cases of suspected chromosomal aberration, and in that of ambigous genitalia to decide the further activities or to choose the right legal sex.

[Relation between the body weight of the pregnant patient and her serum alpha fetoprotein levels]. / Zusammenhang zwischen Gewicht der Schwangeren und ihrem Serum-Alphafetoprotein-Niveau.

In 1000 singleton pregnancies between 16 and 18 weeks maternal serum alpha-fetoprotein (AFP) levels were related to maternal weight. The heavier women had lower mean levels apparently as a result of the diluting effect of larger blood volume. Lighter women had higher AFP levels, perhaps on account of the greater concentration of AFP in their relatively smaller volume of blood. A policy of evaluating the maternal serum AFP level according to maternal weight among women with borderline positive results could reduce both the number of patients having a diagnostic amniocentesis, and the rate of false negative cases.