Culdocentesis in tubal pregnancy

Culdocentesis was carried out in 92 suspected cases of ectopic pregnancy and was positive in 90%. Laparotomy confirmed the accuracy of culdocentesis in 97.5% of the cases of acute tubal rupture, 87.5% of tubal abortions and 80% of 'intact' tubal pregnancies.

Uterine perforation following medical termination of pregnancy by vacuum aspiration

Out of 9344 first trimester elective abortions performed by vacuum aspiration, 37 uterine perforation cases occurred. The suction cannula was responsible for more than 50% of perforations. All cases were multiparous. In 56.8%, the duration of gestation was 6 weeks or less. One third of the cases had a history of child birth within the previous 6 months. Fundal and anterior wall perforations were most common. Cases with a retroverted uterus had a higher incidence of perforation (59.4%) than those with an anteverted uterus (32.4%). Exact pelvic assessment and proper technique and case management are important for preventing perforation.

Conceptual representation of patient data bases

Design of a computer-based assistant for patient data bases is discussed. A conceptual model for such an assistant, which can represent signs, symptoms, lab data, and radiological and morphological findings is described. The query language, interpretive reports, summary findings, and related issues in providing intelligent consultation are discussed. The role of such assistants in the context of a decision-making environment--human or automated--is emphasized.