Laparoscopic management of rudimentary horn pregnancy.

A unicornuate uterus with rudimentary horn is a rare Müllerian abnormality. This uterine anomaly may cause many gynaecological and obstetric complications, including infertility, recurrent abortions, preterm deliveries and rupture of the uterus, especially when the pregnancy implants in the rudimentary horn. To date, laparotomy has been the treatment of choice when resection of a rudimentary horn was indicated. We report on the case of a woman who benefited from laparoscopic surgery of a rudimentary horn pregnancy. Laparoscopy, in these exceptional cases, is the most accurate diagnostic tool that carries significant advantages in effective surgical management, thereby avoiding laparotomy.

Sialyl transferase in human semen.

The activity of the enzyme sialyl transferase, which is responsible for the transfer of sialic acid, has been examined in the following human seminal plasma: (1) originating from semen with sperm counts above 30 X 10(6)/ml and exhibiting normal values of other andrological parameters; (2) from semen with sperm counts below 25 X 10(6)/ml and with other andrological parameters of poor quality; (3) from semen devoid of sperm. Additionally, enzyme activity was examined in fractionated (split) semen. The activity in plasma based on measurement of radioactivity incorporated into asialofetuin, following incubation in the presence of 14C sialic acid, was expressed as cpm both per volume and per mg protein. There was a tendency for decreased activity with the decrease in sperm density of semen. The difference, however, lacked statistical significance. Enzyme activity in split semen was significantly lower in the first than in the second fraction.

Malignant cervical teratoma of the fetus.

Cervical teratomas have been defined and one new case is now added to the 116 cases previously reported. We have been able to find only six reports of malignant teratoma in the literature so far. The problem of diagnosis and obstetric management are discussed briefly. The incidence of appearance of the tumor is described and the likelihood of hydramnios or of acute obstructive symptoms of the trachea and esophagus at birth are discussed. The differential diagnosis includes cystic hygroma, congenital goitre, bronchial cyst, lymphangioma, neuroblastoma, parotid tumor and carcinoma of the thyroid. The object of this review is to present a synoptic description of these tumors, their clinical manifestations, management, treatment and prognosis, so that it may afford the attending obstetrician a guideline in understanding this rare entity.

Acute opthalmologic complications during the use of oral contraceptives.

PIP: This is a report of 3 cases of ocular damage which occurred during t he use of oral contraceptives. A 21-year-old woman experienced sudden loss of vision in her right eye after 4 months of combination type oral contraceptive therapy. Ocular tension was normal; the fundus showed occlusion of the central retinal artery. The other eye was normal. Anticoagulant medications were given iv and orally. The next day vision was improved and some restoration of circulation to the retina was noted. After 18 months vision and visual fields were normal in both eyes. In another case a 42-year-old patient experienced sudden loss of vision in her left eye. She had been taking contraceptive pills for 14 months. The right eye was normal. The fundus of the left eye showed evidence of acute occlusion of the central artery of the retina with only the temporal side of the field of vision retained. The oral contraceptive was discontinued and anticoagulation medication given. No improvement occurred. After 6 months total occlusion of the lower temporal artery remained. The third case, 1 21-year-old woman, complained of progressive blurring vision in the right eye for 2 weeks. She had taken oral contraceptives following a normal delivery 7 months previously but had stopped medication 1 month before admission. The affected eye showed a central scotoma and a markedly restricted visual field. Anticoaguland drugs and vitamin-B were given. After 7 days vision was markedly improved and the central scotoma had decreased in size. After another week vision and visual fields were normal. In this case an optic neuritis due to occlusion of a branch of the retinal artery was thought to have been present. Immediate therapy for such cases is important. Since estrogens have been implicated in the etiology of thromboembolic disease, smaller doses of this steroid (50 instead of 80 mcg) are recommended.^ieng