Epidemiology of hydatidiform mole during early gestation

Citations from the Literature

rt long period if time. Our patientswith essential hypertension clperienccd no changes in left ventricular performance because of the early stage of their hypertensive disease. Adjunctive erythromycin treatment for idiopathic preterm labor: Results of a randomized, double-blinded, placebocontrolled trial McGregor JA; I-rench JI: Rellcr LB; et al. Department of Obstetrics and G_vnecology, University of Colorado Health Sciences Center, Denver, CO 80262. USA AM. J. OBSTET. GYNECOL.: 154/l (98-103) 1986 Pathogencsis and optimal treatment and prevention of prctcrm labor remain incomplctcly understood. F.ntry of ccrvital/vaginal microorganisms into low,er uterine tissues has been implicated in pretcrrn labor and may bc amenable to specific therapy. IFiftyeight women with <34 completed v+ecks of gestation and without other obstetriccomplications, who were receiving intravenous tocolytics because of uterine contractmns and who had cervical alteration (<5 cm dilated), \l cm at the beginning of treatment, mean time until delivery was 32.5 days with erythromycin and 22.4 dayswith placebo treatment @ = 0.027). Ot the erythromycin-treated women, seven ot eight were delivered at >37 weeks and only three of nine placebo-treated women were delivered at >37 weeks (p = 0.035). Orally administered cnteric-coated erythromycin as adjunctive treatment of pregnant women in labor <34 weeks is well tolerated. Adjunctive erythromycin given to women treated for preterm labor ~34 weeks is associated with prolongation of pregnancy and delivery at 37 weeks only in momen with cervical dilatation at the beginning of treatment. Epidemiology of hydatidiform mole during early gestation Atrash HK; Hague CJR; Grimes DA Division of Reproductive Health, Center for Health Promotion and Education, Centers for Disease Control, United States Public Health Service, Atlanta, GA USA AM. J:OBSTET. GYNECOL.; 154/4 (906-909) 1986 Different mcthodologic approaches have resulted in a wide variability in the reported incidence of hydatidiform molt in the United States. WC studied the epidemiology of hydatidiform mole among 84,318 women obtaining legal abortIon< in the United States during the period 1975 to 1978. Our estimated rate of 7.5 hydatidiform moles per 10,000 pregnancies was similar to most reported rates for the United States. The rate was significantly higher for women 14 ycar5 or younger and those 45 years or older. Race, number of previous pregnancies, and number of previous spontaneous abortions w’cre not found to significantly affect the risk of having the disease. The incidence was slightly (but not significantly) higher for women obtaining abortions during the first trimester than for those obtaining abortions during

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later gestation. This study minimizes the errors encountered in estimating the total number of pregnancies and the number of hydatidiform moles at later stages of gestation. Hydatidiform mole, although relatively uncommon, represents a complication of pregnancy that is of public health importance. Intrauterine infection with varicella-zostervirus after maternal varicella Paryani SC;: Arvin AM Department of Pediatrics, infectious Disease Division, Stanford University School of Medicine, Stanford, CA, USA N. ENCL. J. MED.; 314/24 (1542-1546) 1986 We investigated the consequences of maternal infection with varicella-zoster virus in a prospective study of 43 pregnancies complicated by varicella and 14 pregnancies complicated by herpes zoster. Nine of 43 pregnant women H ith varicella had associated morbidity ~ pneumonia (4 women), death (l), premature labour (4 of 42), premature delivery (2 of 42), and herpes zoster (1). Intrauterine varicella infection was identified on the basis of clinical evidence (anomalies characteristic of the congenital varicella syndrome, acute varicella at birth, or herpes zoster in infancy) or immunologic cvidencc (IgM antibody to varicella-zoster in the neonatal period, persistent IgG antibody to varicclla-zostcr at one to two years of age, or in vitro lymphocyte proliferation in response to varicella-zoster virus antigen). The congenital varicella syndrome occurred in 1 of 11 infants of women with first-trimester varicella. Immunologic evidence uf intrauterine varicella infection was present in 7 of 33 infants tested; 4 of these infants were asymptomatic. According to clinical or immunologic criteria, 8 of 33 infants had evidence of intrauterine varicella infection. These observations show that varicella during pregnancy was associated with maternal morbidity and evidence of fetal infection. but that herpes zoster was not.

FERTILITY

AND STERILITY

The predictive value of hCG beta subunit levels in pregnancies achieved by in vitro fertilization and embryo transfer: An international collaborative study Confino E; Demir RH : Friberg J; Gleicher N Department of Obstetrics and Gynecology, Mount Sinai Hospital Medical Center, Chicago, IL 60608, USA FERTIL. STERIL.; 45/4 (526-531) 1986 Serial human chorionic gonadotropin (hCG) beta subunit measurements of 300 pregnancies achieved by in vitro fertilization (IVF) were obtained by 15 IVF centers worldwide. Hormonal curves were established for 164 normal singleton pregnancies, 25 normal multiple gestations, 60 chemical pregnancies, 41 first-trimester spontaneous abortions, and 10 ectopic pregnancies. In comparison to the normal singleton pregnancy curve, chemical pregnancies and spontaneous abortions showed statistically lower hCG levels. hCG levels of ectopic pregnancies, compared with normal singleton gestations, were lower from days 7 to 14. It is concluded that beta-hCG determinations of in vitro fertilized pregnancies allow pregnancy diagnosis as early as 7 to 9 days after embryo Int J Gynaecol Obstet 24