Pregnancy In Association Research Articles

Ovarian Pregnancy in Association with a “Copper 7” Intrauterine Device

Summary: This report concerns a case of ovarian gestation with a “Copper 7” intrauterine contraceptive device in situ. The clinical picture was that of a leaking ectopic pregnancy; diagnosis was suspected at laparotomy and confirmed by histological examination.

Idiopathic acute fatty liver of pregnancy. Death from extrahepatic manifestations.

A 23-year-old woman developed acute fatty liver of pregnancy in association with acute pancreatitis, renal hypoperfusion and protein-losing enteropathy. Even though hepatic function improved, the patient succumbed to extrahepatic manifestations of the condition. This case demonstrated the multisystem involvement of this entity and suggests the possibility that manifestations are related to the presence of a vasoconstrictor substance.

Ovarian Pregnancy and Intrauterine Device

THE MECHANISM of action of intrauterine contraceptive devices (IUCDs) is still unknown. The reported tubal pregnancies in association with IUCDs make it evident that, in these cases, the device did not interfere with fertilization of the ovum in the fallopian tube. The purpose of this report is to record the first case of ovarian pregnancy, to our knowledge, in association with an IUCD. Report of a Case In June 1966, a 29-year-old, white, gravida 6 para 5 had a Lippes loop inserted. She did well until Jan 3, 1967, when her menses lasted for ten days. Bleeding began again on Jan 15 and persisted for ten days, and for eight more days beginning Jan 30. She continued to bleed almost daily until the time of her admission on Feb 23. Four weeks prior to admission, pain developed in the right lower quadrant of the abdomen, and continued until surgery. Examination

Metastasizing hydatidiform mole

The hydatidiform changes in this case only partially involved the placenta, therefore, not fulfilling the usually reported criteria for single ovum pregnancy in association with hydatid mole. :\[ucller and Lapp~ presented as evidence in fa\or of single ovum pregnancy the fact that 75 prr rrnt of the single placenta was entirely ITplaced by vesicles 1 mm. to 1 em. in diameter with involvement surrounding the umbilical cord. BO\d(·s ''1 case report described severed umhiliral cord emerging from typical molar tissue and ,·inually no normal placental tissue present. It is true that hydatiform changes in single ovum pregnancies more frequently completf'ly in,-.,]vP the placenta or nearly so. Partial placental involvcnwnt may also occur, however, and ac··nrding tn Novak,1 it is in this type of limited involvem<'nt that fetus may be associated and inde<'d may he compatible with the birth of li ing child. Tlwre is dinrse opinion among authorities as to whctlwr hydatid mole is degenerative or neoplastic The endocrine activity is 'if'wrd as an argument in favor of the neoplastic nature of hydatid mole by Patterson.5 Morris ~~~~d Hon'· state that a rapid drop to subnormal 1<·\·rls in chorionic gonadotrophin titers indicates degt'IH'ration of molar tissue,'' thereby indicating din•ct rdationship in trophoblastic activity with 1lw microscopic picture and indirectly supporting tlw point of view that hydatid mole is not primaril:; degenerative lesion. The biologic acti,·ity as reflerted in the chorionic gonadotrophin titers then suggest~ that hydatid mole is primarily neoplastic with the capability of degenerati\T <'hangPs. . case is reported which is exemplary of hydatid molar changf's in smaller per cent (partial) of placenta than usually considered in the puhli;;hrd criteria for single ovum pregnancy. The mark('d hiologic activity pr('sent in this ca:-;e we fpp] underlin<s the neoplastic nature of this dise<~sc t'ntitv.

THE YOLK‐SAC OF THE MOLE TALPA EUROPAEA

SUMMARY The distribution of RNA, fats, iron, glycogen and alkaline phosphatase in the endometrium, yolk‐sac placenta and decidua of Talpa europaea is described. The areolae which are formed are associated, at first, with the vitelline circulation and are probably important sites for the uptake of iron—derived from maternal erythrocytes, protein and saliva insoluble carbohydrate material derived from the secretions of the adjacent uterine glands. The aerolae persist into late pregnancy in association with the allantoic circulation. A vascular yolk‐sac placenta is formed in early pregnancy but it is probably not of any real significance in embryonic nutrition—with the exception of the areolae mentioned above. It is evident that the structural changes which occur in the uterine wall during the formation of this placenta are essentially preparatory to the subsequent establishment of the allantochorionic placenta. Stainable glycogen is absent from the decidual tissue and little lipoidal material is present except in the symplasma which invests the trophoblastic villi. The avascular yolk‐sac placenta, the progressive establishment of which is described, is concerned with the absorption of protein, saliva insoluble carbohydrate material and other substances contained in the secretions of the uterine glands of the mesometrial wall of the uterus. The uterine secretions are of considerable importance in embryonic nutrition and probably continue to be of some significance even in late pregnancy. The yolk‐sac increases in volume up to about the 11·5 mm. stage and the concentration of protein in its fluid at this stage is about 60 per cent of that in the maternal serum. In late stages the concentration of protein in the fluid is greater than that in the maternal serum. Fibrinogen is absent from the fluid in Talpa. The yolk‐sac fluid could serve as an important source of absorbable material and it is probable that the yolk‐sac splanchnopleur, the histochemical and histological properties of which are described, is of some significance EM a placental structure in this species. Reichert's membrane is formed in the avascular wall of the yolk‐sac in early pregnancy and it attains a thickness of about 3 μ in late stages. Its histochemical and tinctorial properties resemble those which have been described for the membrane in the rat and hedgehog and; EM in these species, it is formed of collagenous material. In Talpa the membrane is probably of endodermal origin.

Pregnancy in association with diabetes mellitus.

Pregnancy in association with diabetes mellitus.

Hyperplastic corpus luteum of pregnancy, associated with carcinoma of the breast

1.1. A case of marked hyperplasia of the corpus luteum of pregnancy in association with carcinoma of the breast is presented. It is suggested that the marked hyperplasia was initiated and maintained by the hyperestrinemia associated with pregnancy, the hyperestrinemia also stimulating the growth of an incipient breast carcinoma.2.2. A search of the literature has revealed no other reported instances of hyperplasia of the corpus luteum of pregnancy.

Pregnancy in Association with Cardiospasm.

Pregnancy in Association with Cardiospasm.