Platelet dysfunction in cardiopulmonary bypass: an experimental comparative study between a centrifugal and a new pulsatile pump.

The aim of this investigation was to study the effect of a new pulsatile pump for extracorporeal circulation (ECC) on platelet count and platelet function with respect to a Biomedicus centrifugal pump. Thirteen pigs, 8 in the pulsatile group (PG) and 5 in the centrifugal group (CG), underwent a partial extracorporeal circulation lasting 3 h. The animals were sacrificed 3 h post-ECC. The platelet study was both quantitative (platelet count) and qualitative (platelet function analysis) by assessing the closure time (CT) with a PFA-100 system. The decrease in platelet number from basal to 3 h post ECC was only significant in CG (p = 0.009). The platelet function was impaired in both groups, but the value of CT with col/ADP increased significantly only in CG (p < 0.001). The increase of CT with col/EPI was greater in CG (p = 0.07) than in PG (p = 0.2). The results indicated that the new pulsatile pump preserves platelets quantitatively and qualitatively well compared to a Biomedicus pump.

[Uterine inversion]. / Inversio uteri.

Inversion of the uterus is a rare complication of childbirth. A primigravida aged 21 and a multigravida aged 32, hospitalized as emergency cases because of inversion of the uterus with major blood loss, were treated with infusion of liquids (to combat shock), repositioning of the uterus under anaesthesia and prevention of reinversion by uterine tonics. Inversion of the uterus should be part of the differential diagnosis in every case of fluxus post partum.

A dominant-hereditary variation of the Pena-Shokeir syndrome; a case report.

Four children with the Pena-Shokeir syndrome are described. Apart from the classical manifestations of the syndrome: camptodactyly, ankyloses, facial anomalies, pulmonary hypoplasia, all four children had an extremely rigid skin. Possibly this rigidness of unknown origin led in these cases to fetal akinesia, which seems to be the explanation of the clinical manifestations of the syndrome. All children were born to one man, three in his first marriage, one in his second. Therefore this case report almost certainly presents a dominant-hereditary variation of the syndrome.

Abortion risk and pregnancy interval.

In a group of 187 women, the result of the next pregnancy following a spontaneous first-trimester abortion was studied, in relation to the interval between the two pregnancies. Conception within 3 months of the abortion gave no greater risk for another abortion than did conception after a longer interval (9/56 = 16% vs. 24/131 = 18%).

Prognosis of subsequent pregnancies after recurrent spontaneous abortion in first trimester.

The outcome of subsequent pregnancies was studied in 24 women with a history of three or more consecutive spontaneous abortions in the first trimester. Twenty one of the women agreed to forgo active treatment during the study period and three received progestogens or surgical intervention. As the outcome of their first pregnancy after recurrent abortion 18 of the 24 women delivered a liveborn infant after 28 weeks or more. Of all 49 pregnancies in the untreated group during the study, 10 ended in abortion. Only one woman in the study failed to achieve a live birth. Except in exceptional cases encouraging women with recurrent abortion to keep trying for a successful outcome is just as effective as currently recommended treatments.

[Development of pregnancy following sterilization of the woman]. / Het verloop van de zqangerschap na sterilisatie van de vrouw.

PIP: A written inquiry was conducted among women who had become pregnant following sterilization. 103 responses elicited the following information. 17 extrauterine pregnancies were discovered and 14 of these women had been subjected to laparoscopic tubal coagulation; the other 86 pregnancies were intrauterine. Answers concerning the supply of information in writing prior to the intervention as well as the period between sterilization and pregnancy, and the evolution of the 86 intrauterine pregnancies are analyzed in some detail. Of the 42 women who underwent abortion, 24 were against abortion in principle. Assistance by the family doctor and the specialist in coping with the undesired pregnancy was classified as inadequate. Emotional disorders necessitating expert care occurred in 10%. Better information and more honesty in patient relations are advocated. (author's)^ieng

[Pregnancy following laparoscopic sterilization]. / Zwangerschap na laparoscopische sterilisatie.

PIP: In a group of 1342 women sterilized laparoscopically, 8 pregnancies occurred, 3 intrauterine and 5 extrauterine. Extrauterine pregnancy in such cases is particularly dangerous in that often neither the patient nor her physician consider the possibility of pregnancy. Every woman subjected to laparoscopic sterilization should be informed of this risk. (Author's modified)^ieng