Archives of gynecology and obstetrics
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Arch. Gynecol. Obstet. · Jan 1993
Case ReportsThe "forgotten" intrauterine device: a cause of infertility.
We present a case of infertility due to a "forgotten" IUD. Users of intrauterine devices are reported to have an increased risk of frank or subclinical genital infections which later may be the cause of infertility. ⋯ During the last two years we have seen three infertile patients with an IUD in situ. Two had ovulation, and one got pregnant immediately after the IUD was removed.
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Arch. Gynecol. Obstet. · Jan 1991
Case ReportsPrimary mixed neuroendocrine and mucinous carcinoma of the ovary.
A rare case of mixed carcinoma of ovary with a predominant malignant neuroendocrine and a lesser mucinous tumor component is described. Extensive areas of enteric-type epithelium containing endocrine cells were present in both the mucinous borderline tumor element and in the small foci of mucinous adenocarcinoma. Transition from the mucinous tumor to the malignant neuroendocrine component provides evidence for the derivation of some neuroendocrine or carcinoid tumors direct from mucinous tumors without necessarily being a component of a teratoma. Contrary to reported examples of mucinous carcinoid, the overgrowth and spread of the neuroendocrine component characterised the aggressive and lethal nature of this tumor.
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A maternal mortality audit was introduced in the Midlands Province (Zimbabwe) in order to identify which avoidable factors were involved most frequently. During the two-year study period, the maternal mortality rate was 137 per 100,000 total births. ⋯ An avoidable factor was identified among 87% of these deaths involving the health system in 57% of the cases and the patient in 33%. Access to the health facilities and transport problems only played a minor role.
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All types of circulatory shock result in a severe hypotensive state at some stage in their development and virtually all involve an early splanchnic vascular hypoperfusion and a later impairment of cardiac function. One important and consistent feature of circulatory shock is a fundamental insufficiency of microcirculatory flow leading to inadequate perfusion of the somatic cells of many of the important organs of the body. If the cellular hypoxic insult can be limited by fluid therapy with colloids and crystalloids, then the incidence of systemic complications in the post-shock period will also be reduced.