Brachial plexus paralysis in the newborn. An analysis of 169 cases

One hundred and sixty-nine cases of brachial palsy in newborn infants among 66,149 deliveries during a 10 year period have been analyzed. The incidence of this injury was 1:391 deliveries or 0.25 per cent. Sixty-four cases of brachial palsy were reported in a total of 54,629 spontaneous deliveries or 0.11 per cent; 34 occurred among the 2,857 breech presentations or 1.19 per cent; 67 were observed in a total of 5,184 forceps deliveries or 1.29 per cent; and finally 4 cases were included among the 1,710 vacuum extractions or 0.23 per cent. © 1968

Immunoglobulin D in amniotic fluid, maternal and fetal serum

Amniotic fluid, maternal and cord serum IgD determinations were performed in 30 healthy pregnant women during labor. Immunoglobulin D was determined by simple radial immunodiffusion by using low concentration immunoplates. Maternal serum IgD mean level amounted to 4.39 mg/100 ml, while in fetal serum and amniotic fluid no immunoglobulin D was detected in any of the cases presented. The absence of IgD in the amniotic fluid supports the view of a special mechanism which exerts selective inhibition of its passage into the amniotic cavity

Hepatitis B antigen and antibody in maternal bloody cord blood, and amniotic fluid

Transplacental transmission of hepatitis B virus from hepatitis B antigen carrier mothers was investigated by studying the presence of the antigen and its antibody in maternal blood, umbilical cord blood, and amniotic fluid. Hepatitis B antigen was shown in the umbilical cord blood of 2 out of 14 newborns whose mothers were permanent hepatitis B antigen carriers. The antigen was eliminated from the blood of these newborns in less than 3 months. It was also detected in the concentrated amniotic fluid of one hepatitis B antigen cord blood-positive case. Antibodies (anti-HBs) crossed the placental barrier easily and were found in the umbilical cord blood and in the amniotic fluid. They were not detected in the umbilical cord blood and amniotic fluid of any of the studied newborns of hepatitis B antigen carrier mothers. These data indicate that the fetuses of carrier mothers are exposed to the hepatitis B virus. However, chronic antigen positivity and anti-HBs production was not shown. Occurrence of in utero infection and subsequent resolution cannot be excluded, but it appears more probable that in utero infection is blocked

Mepivacaine local cervical anesthesia for diagnostic hysteroscopy: A randomized placebo-controlled study

The purpose of this study was to evaluate the efficacy and safety of local cervical application of mepivacaine hydrochloride for reducing pain associated with hysteroscopy. Among the patients who underwent hysteroscopic evaluation over a 6-year period (1994-1999) at the hysteroscopy unit of the First Department of Obstetrics and Gynecology of the University of Athens, in 245 anesthesia was necessary. In 45 patients, general anesthesia was decided on, for various reasons. The remaining 200 patients were randomized into two groups of 100. Patients of the study group were given local anesthesia by local cervical injection of mepivacaine hydrochloride, and patients in the control group received normal saline injection. All patients evaluated their pain, using an 11-point (0-10) analog scale, during the procedure as well as 30 and 60 min afterward. The use of local mepivacaine effectively and safely reduced pain associated with hysteroscopy and endometrial biopsy, as the mean value of pain assessment in the study group was notably inferior to that reported by the control group. Still, when unpaired Student's t test was applied for statistical evaluation, the difference was statistically nonsignificant

OPERATIVE HYSTEROSCOPY

OBJECTIVE: Analysis of the obtained results after operative hysteroscopy for several intrauterine abnormalities. METHOD: Thirty women with uterine problems (7 polyps, 16 endometrial, 5 endocervical adhesions and 2 lost IUDs) were submitted to operative hysteroscopy under general anesthesia by using fine rigid auxiliary instruments at Lito Private Maternity Hospital and the 1st Department of Obstetrics and Gynecology of Athens University during 1991. RESULT: The adhesiolysis was successful in all the 21 cases with 5 subsequent pregnancies to date, the hysteroscopic excision of the 7 polyps was uneventful and the removal of the 2 lost IUDs was done by using a special forceps for foreign bodies. CONCLUSION: Operative hysteroscopy presented excellent results intra-operatively, postoperatively and in the routine follow-up by diagnostic hysteroscopy 3 months after intervention

Endometrial abnormalities in breast cancer patients with tamoxifen therapy

Objective Evaluation of the effect of tamoxifen therapy on endometrium in patients who have previously undergone surgery for breast cancer. Design An analysis of hysteroscopic findings and their correlation with those from previous vaginal ultrasonography and subsequent endometrial sampling. Setting The hysteroscopy unit of a university clinic. Subjects 64 patients referred from the breast clinic, who had previously undergone surgery for breast cancer and who were receiving adjuvant tamoxifen therapy, with either suspicious findings on routine vaginal ultrasonography or abnormal uterine bleeding. Of the patients, 22 were premenopausal (group A) and 42 postmenopausal (group B). Each group was divided in two subgroups, comprising either symptomatic patients (groups A1 and B1) or asymptomatic patients (groups A2 and B2). Intervention Diagnostic hysteroscopy. Results All six patients of group A1 were found to have hyperplastic endometrium on hysteroscopy. Subsequent biopsy after dilation and curettage (D&C) revealed simple endometrial hyperplasia in all samples, plus endometrial polyps in two cases. Despite suspicious appearances on vaginal ultrasonography, all 16 asymptomatic premenopausal patients (group A2) were found on hysteroscopy to have normal endometrium. Among the 29 patients with postmenopausal uterine bleeding (group B1) 22 showed hyperplastic endometrial findings on hysteroscopy. The histopathological results from the subsequent D&C, confirmed the hysteroscopic findings, showing various degrees of endometrial hyperplasia and three adenocarcinomas (4.7% of the total number of patients or 10.3% of those with postmenopausal bleeding). Normal or atrophic endometrium was observed in nine of the 13 patients in group B2; there was one polyp, and three cases of hyperplastic endometrium, which were found to be simple hyperplasia on pathological investigation. Conclusions Monitoring of the uterine cavity in patients receiving tamoxifen therapy is mandatory, especially where there is postmenopausal bleeding. Hysteroscopy findings display a considerably higher degree of correlation with endometrial pathology results, than do vaginal ultrasonography findings

The inhibitory effect of amniotic fluid on the growth of Staphylococcus aureus

In the late 1940s, some researchers found that amniotic fluid had an inhibitory effect on bacterial growth due, they believed, to the presence of lysozymes. Later other authorities asserted that amniotic fluid facilitates bacterial growth. More recently, studies have indicated that liquor amnii has a remarkable antibacterial activity. To further examine this antibacterial action, the present study of the effect of amniotic fluid on Staphylococcus aureus was undertaken