Oesophageal stricture due to reflux oesophagitis in pregnancy. Case report.

A patient with persistent vomiting in pregnancy due to oesophageal stricture secondary to reflux oesophagitis is reported. Reflux oesophagitis is common during pregnancy but usually responds to small frequent meals, the avoidance of certain positions and simple antacid therapy. Where symptoms are persistent and become worse in late pregnancy we suggest that more energetic therapy in the form of cimetidine or alginate antacid mixture (Gaviscon) should be considered to prevent oesophageal stricture formation.

Vaginal stenosis due to bullous erythema multiforme (Stevens-Johnson syndrome). Case report.

Bullous erythema multiforme is a disorder in which oral and genital erosions, ocular inflammation and cutaneous bullae may follow a viral or bacterial infection or the ingestion of certain drugs, such as sulphonamides. Unpleasant sequelae have been reported including residual scarring, and death may occasionally result from infection or renal failure; severe scarring can cause blindness and infrequently the genital tract is involved. We report a patient who developed complete vaginal stenosis following bullous erythema multiforme in pregnancy.

Blood loss and side effects in day case abortion.

Suction termination of pregnancy was performed in 276 patients as an out-patient procedure under general anaesthesia. Ergometrine, oxytocin, or sterile water were given with the induction of anaesthesia. There was no significant difference in blood loss in the three treatment groups, although blood loss in termination of pregnancy performed after eight weeks was increased in all three groups. Nausea, vomiting and abdominal pain occurred significantly more often after ergometrine compared to oxytocin or water.

Combined estrogen and progestogen for the menopause.

A single-blind pilot study using combined estrogen and progestogen therapy was undertaken in 25 patients for a period of six months in an attempt to evaluate symptomatic control, the acceptability or otherwise of bleeding patterns, and the effect on endometrial pathology. Two different progestogens were employed, i.e. norgestrel and norethisterone acetate, and each was given in combination with estradiol valerate in a cyclical and a continuous regime. Symptomatic control was good in all groups, but there was a mild recrudescence of some symptoms during the tablet-free interval in the cyclical groups. Regular withdrawal bleeding was reported in almost all cases receiving cyclical therapy, and unscheduled bleeding was noted in those on continuous regimes. Endometrial hyperplasia did not occur following treatment in any of the groups, and there was a return to the normal histology in two patients in whom hyperplasia existed prior to treatment. These results support the view that endometrial hyperplasia is least likely to occur if progestogens are administered in combination with estrogen. There were no obvious differences between the effects of the two progestogens.

Body weight in parous women: is there any alteration between successive pregnancies?

In 50 women who had five successive pregnancies the difference was studied between the mean maternal weight at the 20th week of gestation and six weeks post partum. The difference changed from a weight loss to a weight gain in the fourth and fifth pregnancies. The maximum weight increment occurred between the end of the first pregnancy and the 20th week of the second, especially in obese multiparae.