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doi: 10.3109/00016347009157257pmid: 4103938
Dialysed, unconcentrated 24 h specimens of urine from 24 normal, non‐pregnant women, 28 normal pregnant women and 12 women with pre‐eclampsia were examined using disc electrophoresis. The normal pregnant group showed minor variations from the non‐pregnant group. In particular a significantly raised transfer‐rinuria was noticed. The pre‐eclamptic group showed albuminuria and transferrinuria which was significantly greater than in the normal pregnant group, and the transferrin excretion was found to be 26 times as great as in the normal non‐pregnant group. U‐LDH was inconstant, but the LDH isoenzyme pattern showed a low LDH‐I and/or raised LDH‐III, IV and V activity. The raised albumin excretion is explained by increased albumin synthesis in pre‐eclampsia. It is suggested that similar conditions hold true for the excretion of transferrin. The characteristic shift of the LDH isoenzymes is considered to be due to renal ischaemia.
doi: 10.3109/00016347009157258pmid: 5534844
A dysplastic girl with a partial C trisomy is described. Signs met with in other chromosome syndromes are also discussed. The partial C trisomy is caused by a familial C/C translocation. The mother of the proposita had five spontaneous abortions.
doi: 10.3109/00016347009157259pmid: 5519615
The incidence of malignant tumours of different types during pregnancy was studied. Special attention was paid to the presence and treatment of preinvasive and invasive carcinoma of the cervix uteri. The series consisted of 100 malignancies of different types in pregnant patients treated at Departments I and II of Obstetrics and Gynaecology, University Central Hospital, Helsinki, during 1950–69. The total number of pregnant patients admitted during this period was 153 424 and the incidence was thus 0.07%. In 65 cases interruption of pregnancy was the sole intervention as the patient had been or was treated elsewhere. Of these cases, 63 were extragenital malignancies and two were carcinoma in situ of the cervix. The material included another 13 cases of carcinoma in situ of the cervix, making an over‐rule incidence of 0.009%. Invasive carcinoma of the cervix was diagnosed in 17 patients. They were all treated at this clinic. The incidence was 0.01%. Over 5 years have elapsed from the treatment of 9 patients. Eight of these 9 patients were alive after 5 years, but one died after 7 years. The patients treated less than 5 years ago are alive and asymptomatic. In addition, four other malignant tumours of the genital tract and one mediastinal neurinoma that had metastasised into the abdominal cavity were diagnosed.
doi: 10.3109/00016347009157260pmid: 4933446
A series of 640 cases of carcinoma of the cervix uteri collected in 1959–63 from the First and Second Departments of Obstetrics and Gynaecology, University Central Hospital, Helsinki, was analysed.
Edström, Karin; Fernström, Ingmar
doi: 10.3109/00016347009157261pmid: 5519616
A modified endoscopic technique for the inspection of the uterine cavity is described. The modification consists in the injection of a clear, water‐soluble and viscous dextran solution into the uterine cavity, through which a clear view of the latter is obtained. Thirty cases were examined by this method following hysterography. Comparative studies of the observations made at hysteroscopy and the hysterographic findings in these cases showed that hysteroscopy is of greater diagnostic value than hysterography because the nature and extent of any intrauterine lesion present can be assessed directly.
doi: 10.3109/00016347009157262pmid: 5519617
172 patients with endometriosis were investigated. 125 were trying to conceive at the time of treatment. The following are the salient points of the investigation. (1) 64% of the patients with a desire for pregnancy at the time of treatment had primary sterility. (2) No correlation between the duration of sterility in years and the development of adhesions was found. (3) The surgical findings were of importance in predicting the chances of a pregnancy. If only simple endometrial cysts were present, the chance of becoming pregnant after the operation was almost 80%, whereas if cysts and adhesions existed, only 40% of patients conceived. (4) The duration of previous sterility was not found to affect the prospects of pregnancy. (5) The frequency of abortion was markedly reduced after the operation.
Westholm, Hans; Magno, Ricardo; Å‐Sonberg, Anders
doi: 10.3109/00016347009157263pmid: 4933447
The authors have studied paracervical blocks with bupivacaine, physiological saline and bupivacaine with adrenalin 1: 200 000 by means of a double‐blind technique.
doi: 10.3109/00016347009157264pmid: 5512754
Between 1959 and 1968 a cervical cerclage operation was performed 163 times in 159 women because of assumed cervical incompetence. The operation was carried out during pregnancy 156 times, and 3 times in a nonpregnant patient. 4 women had two operations during the same pregnancy. The operations represent 1 in 404 deliveries at the hospital during the study period. The diagnosis of cervical incompetence was based on the history of previous pregnancies in 99 cases (79%). The finding of a short and open cervix was made 85 times (68%), and the diagnosis was supported by the hystero‐graphic findings in 11 cases (9%). The average duration of gestation at the time of operation was 14 weeks, and the average total duration of the pregnancies was 35 weeks. The previous foetal salvage rate was 30.8%, and the final success rate 83.2%. The comparable rates for normal deliveries without cervical cerclage at the same clinic were 74.7% and 97.1%, respectively. The abortion rate in the series after treatment was 13.6%. Premature deliveries with loss of the child occurred 4 times, leading to a perinatal mortality rate of 3.2%. Breech presentation was found 10 times (6.3%). Caesarean section was undertaken 23 times (18%) in 21 patients. The ratio of the final success rate and the previous foetal salvage rate (foetal salvage ratio) in the whole series was 2.7, and in the randomly selected cases 1.3. This ratio was the highest (3.8) between 26 and 30 years, and when the operation was performed between the 16th and the 19th weeks of pregnancy (3.3). The minimum benefit rate of the operation was 30% [80.2–30.8 – (97.1–74.7)]%. This rate is little affected by unnecessary operations, while difference between the foetal salvage ratios in the operation and the control materials is greatly affected by them. This difference was 1.4 (2.7–1.3) in this material. The differences in abortion rates, laws and standards of obstetric care lead to differences in the materials. Therefore the following criteria are suggested to be included in the reports concerning cervical cerclage operations:
Nieminen, Usko; Pöllänen, Leo; Saarikoski, Seppo
doi: 10.3109/00016347009157265pmid: 5519618
A total of 173 surgically treated cases of carcinoma of the cervix uteri are presented. Wertheim's radical hysterectomy with lymphadenectomy was performed on 137 patients. 158 patients were also given radiotherapy. The 5 year cure rate for the series as a whole was 82.1%. The operative mortality was 0.6%. Fistulae of various types were encountered in 9.8%. During the same period, 467 patients with carcinoma of the uterine cervix were treated by radiotherapy. The 5 year cure rate was distinctly better for the surgically‐treated patients with Stage I carcinoma and slightly better for those with Stage II carcinoma. The incidence of fistula was the same in both groups. Complications of different degrees were more numerous on the whole in ths casss treated by radiotherapy alone.
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