Clinical assessment of gestational age: a comparison of two methods

The ratio of fundal height (FH) to maternal abdominal length (MAL) was defined as percentage of maternal abdominal length (PMAL) and compared to FH alone in 100 consecutive uncomplicated pregnancies from the 18th week of gestation to delivery at term. Reference graphs for fetal growth evaluation were developed using these two clinical methods. The predictive value of each technique was assessed by comparing gestational age estimates in 29 additional patients at various gestational ages. The correlation coefficient between the known gestational ages and estimates by the PMAL method was .86, and between known gestational ages and estimates by the FH method, .94. Twenty more patients were evaluated by three obstetricians in a double-blind fashion to determine gestational ages by each technique. The average deviation from the real gestational age varied from 2.07 to 3.14 weeks using the FH method, and from 2.82 to 3.97 weeks using the PMAL graph. It was concluded that FH measurement correlates better with gestational age than its ratio to the MAL.

Chondrosarcoma of the uterus

Chondrosarcoma of the uterus is a rare tumor. The clinical and pathological features of a recent case are presented and the histogenesis, treatment, and prognosis of the heterologous sarcomas are discussed. The authors favor the theory of totipotential endometrial stromal cells for the histogenesis, and suggest that radiotherapy and/or chemotherapy continue to be used in addition to total abdominal hysterectomy with bilateral salpingo-oophorectomy.

Pelvic relaxation as a complication of the radical vulvectomy

Attention is drawn to relaxation of the pelvic viscera, one of the remote complications of the surgical procedure employed for cure in invasive carcinoma of the vulva. Though seldom discussed in the literature, this problem complicated 17% of the 58 radical vulvectomy procedures in this series. Justification is discussed for the performance of reconstructive or preventive surgical procedures during the primary operation.