Pregnancy in patients with autoimmune thrombocytopenic purpura.

The obstetric and hematologic problems in 21 pregnancies of 18 patients with ATP are analyzed: one maternal and one fetal death occurred. Urinary estriol and oxytocinase were measured. Eighteen infants were born by vaginal delivery and three by cesarean section. None of the 20 liveborn infants died, but they had NIP due to the passage of maternal antibodies to the fetus. These results are compared to those reported in previous publications. The obstetric management of these patients should be individualized and carefully planned; it should not be based on the platelet count.

The course of pregnancy in patients with artificial heart valves.

Twenty-five women with prosthetic heart valves (PHV) became pregnant 28 times. Twenty-six of the pregnancies occurred while the patients were receiving oral anticoagulants and these were continued throughout in 25 pregnancies. Dipyridamole or dipyridamole and acetylsalicyclic acid were used in 22 pregnancies. Eighteen infants were delivered, one with a congenital corneal leukoma; none had hemorrhagic complications; their psychomotor development was normal. Nine women aborted 10 times, including patients with two PHV, pelvic trauma and self-induced abortion. We could not detect excess anticoagulation in eight of the nine who had spontaneous losses; excess anticoagulation occurred five weeks before an abortion. There were no maternal deaths despite numerous complications; in two women, brain embolism was related to short interruptions of anticoagulation. The details of management are mentioned. We lack enough evidence to suggest routine sterilization, routine interruption of coumarin therapy during pregnancy or routine interruption of pregnancy in women with certain types and models of PHV; however, pregnancy under such conditions, plus antithrombotic therapy, carries a high risk for the product and a potential teratogenic effect. Women with one or two PHV can have children if their management is closely supervised and if extreme care is taken with the use of oral anticoagulants.

[Quick radioimmunoassay method for the determination of estrogens]. / método rápido para medir estrógenos por radioinmunoanálisis

The aim of this report is to describe a quick method for measuring plasma estrogens by radio immunoassay in one day. Briefly, 1000 cpm of estradiol-3-H were added to 0.1 to 1.5 ml of plasma or serum to calculate losses during the procedure. After ether extraction and without any purification step, aliquots for tracer recoveries and the radioimmunoassay were taken. The antiserum working dilution was 1:100,000. The incubation of the antiserum at 37degreesC with the tritiated and cold estradiol lasts one hour. The free and bound fractions were separated with charcoal/dextran. With this method, 95% of estradiol, 16% of estrone and 6% of estriol are quantified. Other steroids normally present in plasma produce no interference. The minimal detectable level is 10 pg. Pasma and water blanks are indistinguishable of zero (C.V. 1%). Intra-analysis coefficient of variation is 6.1%. Mass recovery of estradiol (5 ng), estrone (5 ng) and estriol (5ng) are 4.75, 0.83 and 0.31 ng, respectively. Tracer recoveries are 92.6%. When plasma levels of estradiol are determined during menstrual cycle, normal and/or pathological pregnancy, by either the method described herein or measured selectively, the results show no significant differences. Finally, practical usefulness of this method is stressed, inasmuch results are obtained in six hours and one person can easily perform 200 samples in one week.