In patients who are hypotensive after blunt abdominal trauma and not hemodynamically stable enough to undergo diagnostic CT, negative US findings virtually exclude surgical injury, while positive US findings indicate surgical injury in 64% of cases.
Sonography is an effective screening examination that can obviate more hazardous tests such as CT, cystography, and peritoneal lavage in most pregnant patients with trauma requiring objective evaluation of the abdomen.
Maternal thrombophilia is an accepted risk factor for perinatal death, having been associated with pregnancy-related thrombosis and preeclampsia, intrauterine growth restriction, placental abruption, recurrent miscarriage, and late fetal loss. Up to two thirds of these vascular complications can be related to some form of inherited or acquired thrombophilia. It is not clear whether paternal factors contribute to thrombophilia-related perinatal mortality. The investigators examined data from a prospective registry of perinatal mortality in The Netherlands. Seventy-four women with a previous perinatal death and 54 of their male partners were assessed, along with 71 women having uneventful pregnancies and 66 of their partners.Cases and control subjects did not differ with respect to age or oral contraceptive use. Compared with control women, case women had significant higher rates of antithrombin deficiency (12% vs. 0%), elevated factor VIII activity (43% vs. 17%), and increased activated protein C (APC) resistance (32% vs. 6%). Total protein S antigen also was increased in case women. There were no significant group differences in the prevalence of deficient protein C activity, hyperhomocysteinemia, factor V G1691A (F V Leiden) mutation, prothrombin mutation, or the MTHFR C677T mutation. The overall prevalence of one or more thrombophilic factors was 70% in case women and 30% in control women. Male cases had significantly increased APC resistance compared with the male control group (22% vs. 0%). Of 54 couples with past perinatal mortality, 30 (55%) had more than one thrombophilic abnormality compared with 10 (17%) of control couples.The prevalence of thrombophilia is about doubled not only in mothers, but also in fathers having a history of perinatal mortality, suggesting that it is a risk factor. ABSTRACTTobacco contains many mutagenic compounds, and tobacco-specific metabolites have recently been found in fetal blood and cell-free amniotic fluid. This study examined possible genotoxic effects of maternal smoking on amniotic fluid cells. Chromosomal instability in the form of chromosomal gaps and breaks was sought along with structural chromosomal abnormalities. Amniocytes were obtained by amniocentesis in a prospective series of 25 women who had smoked 10 or more cigarettes a day for at least 10 years and in 25 nonsmokers. Two independent observers assessed 494Obstetrical and Gynecological Survey ABSTRACTThe authors retrospectively analyzed pregnancies after uterine artery embolization in the course of an ongoing prospective observational study. Twenty-nine pregnancies occurred in 671 women who underwent this procedure-all done by the same interventional radiologist. Detailed information was available for 24 of the 26 completed pregnancies (three pregnancies at less than 8 weeks gestation at the time of analysis were excluded).Seven pregnancies, 27% of those analyzed, ended in miscarriage. In addition, there were two terminations and one ectopic pregnancy. First-trimester bleeding occurred in 40% of 16 pregnanci...
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