The non-communicating rudimentary horn: diagnostic and therapeutic challenges

We describe the case of a 23-year-old nulligravid woman who complained of increasing post-menstrual lower abdominal pain. She used contraceptives permanently for three months and was referred with a sub-mucosal lesion suspicious for a type 2 fibroid to be resected. During hysteroscopy, no fibroid mass could be confirmed. A post-operatively performed ultrasound including hydrosonography demonstrated a lesion highly suspicious for a uterus unicollis with a non-communicating uterine horn and a haematometra. Laparoscopy confirmed a normal outer lining of the uterus with hypoplastic tube on the right side. Referring to pre-operative findings, a broadly based uterine horn including a large haematometra was diagnosed. We performed a laparoscopic resection of the rudimentary horn and a right salpingectomy. The patient could be discharged without any complications three days late

Sonographic measurement of the umbilical cord and fetal anthropometric parameters

Objective: To determine reference ranges for the diameter and the cross-sectional area of the umbilical cord during pregnancy and to determine if umbilical cord morphometry is related to fetal size. Methods: A prospective cross-sectional study was designed to assess the sonographic cross-sectional diameter and area of the umbilical cord. The sonographic umbilical cord measurements were obtained in a plane adjacent to the insertion of the cord into the fetal abdomen. Nomograms for the umbilical cord diameter and area were computed. Fetal biometry included: biparietal diameter, abdominal circumference, and femur length. Polynomial regression analysis was conducted. Results: Five hundred and fifty seven patients were included into the study. The regression equation for the umbilical cord diameter (y) according to gestational age (x) was y=-10.0563+1.4265x+0.0194x2 and for the umbilical cord area (y') was y'=91.6-3.3x+0.03x2-0.00007x3. A significant relationship was found between umbilical cord measurements and fetal anthropometric parameters. Conclusion: Reference ranges for umbilical cord diameter and area have been generated. The sonographic diameter and cross-sectional area of the umbilical cord increase as a function of gestational age and both diameter and area correlate with fetal size. Copyright (C) 1999 Elsevier Science Ireland Ltd

Rapid biotic rebound during the late Griesbachian indicates heterogeneous recovery patterns after the Permian-Triassic mass extinction

New fossil data from two Early Triassic (Griesbachian to Dienerian) sections from South China show unusually high levels of both benthic and nektonic taxonomic richness occurring in the late Griesbachian. In total, 68 species (including 26 newly originated species) representing mollusks, brachiopods, foraminifers, conodonts, ostracods, and echinoderms occur in the late Griesbachian, indicating well-established and relatively complex marine communities. Furthermore, the nekton shows higher origination rates than the benthos. Analyses of the sedimentary facies and size distribution of pyrite framboids show that this high-diversity interval is associated with well-oxygenated environments. In contrast to the previously suggested scenario, which inferred that persistently harsh environmental conditions impeded the biotic recovery during the Early Triassic, our new findings, combined with recent work, indicate a fitful regional recovery pattern after the Permian-Triassic crisis, resulting in three main diversity highs: late Griesbachian–early Dienerian, early–middle Smithian, and Spathian. The transient rebound episodes were therefore influenced by both extrinsic local (e.g., redox condition, temperature) and intrinsic (e.g., biological tolerances, origination rates) parameters

Changes in pre-pregnancy weight and weight gain during pregnancy: retrospective comparison between 1986 and 2004

QUESTIONS UNDER STUDY: To compare the incidence of pre-pregnancy overweight, obesity, and difference in weight gain during pregnancy in the years 1986 and 2004, in women delivered at the maternity unit of our hospital. METHODS: Retrospective study. Maternity records of patients delivered in the years 1986 and 2004 were compared. Data extraction included booking weight, height, weight gain, birth weight as well as information on mode of delivery and gestational age at delivery. RESULTS: During the year 1986 and 2004 a total of 690 and 668 patients respectively were included in the analysis. The pre-pregnancy BMI > or =25 doubled over the 18-year period (from 15.9 to 30.1%). In 1986 only 2.6% of all pregnant women gained more than 20 kg, while in 2004 14.2% (p <0.0001) did so. The caesarean section rate was significantly higher in 2004 than 18 years earlier (28.3 and 9.3%, p <0.0001). CONCLUSIONS: We found a significant increase in all parameters between these two groups. Pregnant women are today heavier at the booking visit, are more overweight, and gain more weight during pregnancy. A similar trend is seen in the newborn babies, who have a higher birth weight than those born 18 years ago

High-resolution biochronology and diversity dynamics of the Early Triassic ammonoid recovery: the Dienerian faunas of the Northern Indian Margin

11 pagesInternational audienceA new high resolution biozonation based on the Unitary Association (UA) method is constructed for the Dienerian ammonoid succession of the Northern Indian Margin. It includes 12 UA-zones and leads to the subdivision of the Dienerian into three parts (early, middle and late). The corresponding diversity analyses, coupled with results previously obtained for the early Smithian ammonoids of the same regions, highlight the four following phases: (1) a first modest peak of diversity in the early Dienerian; (2) a very low diversity persisting throughout the middle Dienerian; (3) a slow increase of diversity during the late Dienerian, and (4) a marked diversification in the early Smithian. Turnover rates are very high during this entire time interval, and the boundaries between early–middle and middle–late Dienerian are emphasised by complete renewals of the ammonoid faunas. The low diversity values in the middle and early late Dienerian are concomitant with an anoxic event on outer continental shelves and coincide with warmer temperatures than those of the early Dienerian and early Smithian. This diversity pattern stands in strong contrast with the credo of a protracted or stepwise recovery following the end-Permian mass extinction. Together with the end-Smithian extinction, the middle and early late Dienerian diversity crises were likely both radical setbacks in the recovery of Early Triassic ammonoids. However, these two diversity crises do not necessarily imply identical environmental triggers that ultimately led to anoxic bottom waters on outer continental platforms in both cases

Palynology of the Lower Triassic succession of Tulong, South Tibet — Evidence for early recovery of gymnosperms

The thermally altered but otherwise well preserved Early Triassic palynomorphs from the Tulong area (South Tibet) allowed for qualitative and quantitative analyses and the differentiation of two distinct palynofloras, a Smithian lycopod-dominated flora and a Spathian gymnosperm-dominated flora. This suggests that gymnosperm vegetation recovered about 2 Ma after the end-Permian event on the subtropical North Indian Margin. Together with previously described successions from Pakistan, Australia, and Norway the new palynofloral record suggests an earlier establishment of diverse, gymnosperm-rich plant communities after the end-Permian event than previously proposed. The observed change in the ratio of the two major plant groups (pteridophytes/gymnosperms) in these two assemblages supports the global extent of a major climate change near the Smithian–Spathian boundary. The observed palynofloral patterns are closely related to the changes in the carbon isotope record, which suggests that the floral recovery dynamics were linked to environmental conditions

Perinatal outcome of fetuses with a birth weight greater than 4500 g: an analysis of 3356 cases.

To assess the perinatal outcome in a series of macrosomic fetuses according to the intended mode of delivery, and to estimate the individual risk of shoulder dystocia and brachial plexus injury upon information available either prior the onset of labor or at delivery. STUDY DESIGN: Perinatal and postnatal information of 3356 women who delivered during a 10-year period a macrosomic fetus (&gt;4500 g) in vertex presentation were analyzed. After the exclusion of cases with extraneous factors that may have affected the health of the neonate, patient and neonatal characteristics were compared according to the intended mode of delivery. The contribution of factors known prior labor and at the time of deliver on the occurrence of shoulder dystocia and brachial plexus injury was analyzed using multiple logistic regression analysis. RESULTS: During the study period, 2371 women were admitted to spontaneous labor, 778 underwent an induction of labor, and 207 had an elective cesarean section. All cases of shoulder dystocia (n=310), and brachial plexus injury (n=94) occurred among women who delivered vaginally. The rate of brachial plexus injury was higher in cases who had shoulder dystocia than in those who did not (58/310 versus 36/2329, P&lt;0.001). The incidence of brachial plexus injury increases steadily from 0.8 in fetuses weighing 4500-4599 g to 2.86% in those weighing more than 5000 g (P&lt;0.01) and from 2.1 in women taller than 180 cm to 12.5% in those shorter than 155 cm (P&lt;0.05). After adjustment for confounding variables shoulder dystocia (OR 9.2, 95% C.I. 5.38; 15.59), operative vaginal delivery (OR 1.96, 95% C.I. 1.10; 3.49) and clavicular fracture (OR 2.9, 95% C.I. 1.31; 6.44) remained predictors of brachial plexus injury. CONCLUSION: Since some of these risk factors are known prior to delivery, each woman whose fetus is suspected to weight more than 4500 g should be counseled on her individual risk of severe perinatal morbidity before a decision on the mode of delivery is take

Terrestrial ecosystems on North Gondwana following the end-Permian mass extinction

The impact of the end-Permian mass extinction on terrestrial ecosystems is still highly controversial. Here, new high-resolution palynological data from biostratigraphically well-dated Upper Permian to Middle Triassic successions of the Salt Range and Surghar Range (Pakistan) are presented. Our results reveal seven successive floral phases between the Late Permian and the Middle Triassic. At the onset of the Mesozoic, the flora is characterised by high abundances of lycopods associated with pteridosperms and conifers. This association prevails up to the middle Smithian and is followed by a prominent spore spike similar to the global spore spike reported from the Permian–Triassic boundary. Like that of the end-Permian, the middle Smithian spore spike is associated with a negative isotope excursion and is succeeded by a major marine faunal extinction event in the late Smithian. The recurrent patterns observed at the Permian–Triassic boundary and in the middle–upper Smithian suggest a common cause such as massive ejections of volcanic gases. The increasing abundance of conifers still associated with common lycopods in the Spathian suggests fading volcanically induced environmental perturbations and stabilisation of terrestrial ecosystems ca. 2.1 My after the end-Permian event

Revision of the genus Anasibirites Mojsisovics (Ammonoidea): An iconic and cosmopolitan taxon of the late Smithian (Early Triassic) extinction

34 pagesInternational audienceThe family Prionitidae Hyatt represents a major component of ammonoid faunas during the Smithian (Early Triassic), and the genus Anasibirites Mojsisovics is the most emblematic taxon of this family. Its stratigraphical range is restricted to the beginning of the late Smithian (Wasatchites distractus Zone). The genus is also characterized by an unusual cosmopolitan distribution, thus contrasting with most earlier Smithian ammonoid distributions that were typically restricted by latitude. Because the late Smithian witnessed an extinction of the nekton (e.g. ammonoids, conodonts) whose amplitude is equal to or larger than that of the end-Permian crisis, the number of valid species that should be included in the genus Anasibirites becomes a highly relevant question when addressing this extinction at the highest possible taxonomic resolution. Based on a new extensive collection from Timor, the composition of the genus Anasibirites is herein revised with respect to its intraspecific and ontogenetic variations. Comprehensive morphological and biometric studies (c. 950 measured specimens) indicate that, of the c. 60 available species names, only two are valid, namely A. kingianus (Waagen) and A. multiformis Welter. Continuous ranges of intraspecific variation enable us to synonymize A. nevolini Zakharov, 1968 and A. angulosus (Waagen) with A. kingianus. The contribution of Anasibirites to species diversity during the late Smithian extinction is thus significantly less than previously estimated, therefore accentuating the severity of this event