Predictive value of amniotic fluid volume measurements on perinatal outcome

Amniotic fluid volumes were measured in 1,659 pregnant women to determine the predictive value of these measurements on perinatal outcome. All cases were evaluated by other tests of fetal well-being. 128 cases were oligohydramniotic, and 1,531 cases were normal. In all cases, several parameters were assayed, e.g. fetal distress, way of delivery, meconium in amniotic fluid, Apgar score, transfer to pediatric clinics and early-late neonatal complications. The results of the perinatal evaluation of oligohydramnios were as follows: assessing fetal distress: specificity 94.2%, sensitivity 18.4%, positive predictive value 35.9%, negative predictive value 86.7% and accuracy 82.8%, and assessing low Apgar score the values were 93.0, 21.3, 95.9 and 89.5%, respectively. As a result, measurement of the amniotic fluid volume is an important parameter predicting perinatal outcome, and its predictive value increases if it is combined with other fetal well-being tests with different end points.

Yolk sac size and shape as predictors of poor pregnancy outcome

Two hundred and fifty women, underwent endovaginal sonography in the first trimester to establish the normal size and shape of the secondary yolk sac and to assess the value of yolk sac evaluation in predicting poor pregnancy outcome. We calculated the correlation coefficients between yolk sac and menstrual age, yolk sac and crown-rump length and between yolk sac and mean gestational yolk sac diameter as r: 0.9581 (p < 0.001), r: 0.9427 (p < 0.0001) and r: 0.8855 (p < 0.0001), respectively. Of 250 cases, 219 had a normal pregnancy course through the end of the first trimester (Group I) while 31 had a poor prognosis such as abortion or embryonic demise (Group II). Eight of 219 in Group I and 20 of 31 in Group II had an abnormal yolk sac size. A yolk sac diameter out of two standard deviations of the mean for the menstrual age allowed prediction of an abnormal pregnancy outcome with a sensitivity of 65%, a specificity of 97%, a positive predictive value of 71%, and a negative predictive value of 95%. Ten of 219 and 9 of 31 had abnormal yolk sac shape. An abnormal yolk sac shape allowed prediction of an abnormal pregnancy outcome with a sensitivity of 29%, a specificity of 95%, a positive predictive value of 47% and a negative predictive value of 90.5%. We concluded that secondary yolk sac evaluation is a valuable tool to predict pregnancy outcome.

Microsurgical transposition of the human fallopian tube

Reports of tubal microsurgical transposition techniques to restore fertility are quite rare. In this article, an interesting microsurgical procedure, in a woman with congenital uterine and tubal abnormality is presented. Under certain circumstances, microsurgical transposition of the human fallopian tube has the potential of being a useful therapeutic alternative.

Unexpected nature of a pelvic mass in pregnancy: Castleman's disease

The obstetrician is rarely confronted with a pregnant patient who presents with a large suspicious pelvic mass. Diagnostic tools are not always of value and laparotomy may be performed for obstetric and histopathologic reasons. In this article we present an interesting case of an unusual pelvic mass in pregnancy secondary to benign lymphoepithelial disease (Castleman's disease). We could not find a case similar to the one reported in the medical literature.