Objective To determine the likely factors that contribute to RhD sensitisation. Design Retrospective study of all new cases of RhD sensitisation occurring between 1988 and 1991.Setting Leeds Blood Centre, National Blood Service, Yorkshire. Population One hundred and forty-seven cases of RhD sensitisation from 15 obstetric units within the Yorkshire region, of which 129 (312 pregnancies) could be assessed. after delivery, RhD immunisation occurred in approximately 1% of RhD negative women. There are a number of explanations for the continued development of RhD sensitisation, including failure of administration of anti-D immunoglobulin, failure of protection despite administration of anti-D immunoglobulin, and unrecognised sensitising events, such as occult fetomaternal haemorrhage during the third trimester of pregnancy. We conducted a retrospective study to determine the likely factors that contributed to RhD sensitisation in a consecutive series of 147 cases that occurred during the period 1988 to 1991. Ethics committee approval was obtained before undertaking this study.
METHODSAt the outset the criteria to be measured were identified, including: 1. the identification of potential immunising events outlined in local and National 0
Summary. Seven pregnancies complicated by partial placenta membranacea occurring over a 2‐year period are described. The condition is encountered more frequently than the total or near‐total form, but is similarly associated with recurrent antepartum haemorrhage, miscarriage or preterm delivery. Diagnosis by ultrasound scan may prove difficult. Five pregnancies had histological evidence of chorioamnionitis, which may have helped to precipitate labour; three fetuses showed pulmonary inflammatory changes of at least 2 days' duration. No maternal predisposing factors could be elicited.
SummaryA panel of haemostatic tests was perfomed on 400 primiparous women at 28 weeks to test whether one or more could predict the development of pregnancy complications. Fifteen women subsequently developed pre-eclampsia with significant proteinuria and 13 delivered growth retarded infants. There were no significant differences between mothers in the pre-eclampsia group and 22 randomly selected controls. A stepwise logistic discriminant analysis of the data did not produce a significant model. In the growth retarded group only beta thromboglobulin levels were significantly lower than in the controls (p <0.05), although in the logistic discriminant analysis the inclusion of both beta thromboglobulin and fibrin degradation products led to a borderline significant improvement in fit of the model. We conclude that the haemostatic variables studied are not significantly changed at 28 weeks nor clinically useful predictors of either pre-eclampsia or fetal growth retardation.
Summary
A patient with co‐existent carcinoma and tuberculosis of the Fallopian tube is described. Tuberculosis was diagnosed by the finding of numerous typical granulomata throughout the uterus, tubes and ovaries, and by exclusion of other possible causes of these; and carcinoma by the finding of solid tumour, with a marked anisocytic appearance, invading submucosa. Despite the well recognised epithelial hyperplasia seen in tuberculous salpingitis, there remains no evidence that the occurrence of carcinoma in such cases is other than fortuitous.
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