J Reprod Med
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Fifty-five anovulatory women undergoing hMG-hCG treatment in order to become pregnant had daily first morning urine specimens and blood samples drawn, starting from the 11th postovulatory day. The urine was tested with Neocept and the blood with a radioreceptor assay or a radioimmunoassay for beta-subunits of hCG. Twenty-two of the women became pregnant. ⋯ Of 8 women with a positive urine test on day 15 or sooner, only 1 aborted, whereas 7 of the 14 women who were found thereafter to be positive aborted. None of the treated women who ovulated but did not conceive had a positive urine test. Of these women there were nine with a prolonged luteal phase (18 to 22 days).
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Serial urinary beta human chorionic gonadotropin (beta-hCG) immunoassay was performed on 60 patients during early pregnancy. Results were expressed as tube dilutions positive and were compared with quantitative serum beta human chorionic gonadotropin radioimmunoassay (beta-hCG-RIA) values. The parallel rise of human chorionic gonadotropin (hCG) measured by serum beta-hCG-RIA and a macroflocculation beta-specific urinary immunoassay in early pregnancy was confirmed. ⋯ Results were expressed for each method according to standard regression lines or doubling time for individuals. Utilizing either statistical method, urinary testing was as accurate as serum testing for the prediction of normal pregnancy (about 90% for each). Serum testing was 78% correct in predicting abortion; urinary testing was 63% accurate.
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Treatment of the underlying cause and supportive care constitute the basic principles of management of disseminated intravascular coagulation. The role of anticoagulation with heparin is controversial in the absence of any controlled studies. This case report describes two patients with acute obstetric disseminated intravascular coagulation in whom the use of heparin resulted in marked clinical improvement. Treatment with heparin may be of help in situations where there is a delay in elimination of the underlying cause.
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Case Reports
Maternal-fetal pneumomediastinum complicating labor: report of a case and review of the literature.
Maternal pneumomediastinum and subcutaneous emphysema is a rare, alarming but relatively benign complication of labor. It usually manifests itself during the second stage. ⋯ In this case pneumomediastinum and pneumothorax occurred in the newborn, also. To our knowledge, this is the first reported case of simultaneous pneumomediastinum in mother and neonate.