Reevaluation of the role of culdocentesis in the management of ectopic pregnancy

Article Abstract:

An ectopic pregnancy is a potentially life-threatening implantation of a fetus outside of the uterus. Culdocentesis is a painful invasive procedure that can be used to diagnose an ectopic pregnancy in which a small needle is inserted into the back of the vaginal wall to remove fluid from the abdomen. When the fluid so obtained has a hematocrit (the ratio of red blood cells to total volume) greater than 15, the test is considered positive. Positive results must be further investigated with exploratory surgery. Newer tests such as sensitive pregnancy tests and ultrasonography can be used to confirm a ectopic pregnancy. In addition, laparoscopy, a tube affixed with a magnifying lens inserted through a small opening in the abdomen, can be used to diagnose and treat ectopic pregnancies. To see whether the older culdocentesis method of diagnosing ectopic pregnancies should continue to be used, 297 women undergoing surgery for ectopic pregnancy were studied. Culdocentesis was positive in 210 (83 percent) and negative in 42 (17 percent) of the surgical patients. A positive culdocentesis accurately predicted only half of the ruptured ectopic pregnancies and 58 percent of the unruptured ectopic pregnancies. Six patients had unnecessary surgery based on positive culdocentesis results. Conversely, 27 patients with negative culdocentesis had ectopic pregnancies. Culdocentesis is not as accurate as other, more sensitive and rapid tests that are currently used to detect ectopic pregnancies. Laparoscopy is a more effective test than culdocentesis for ectopic pregnancy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Diagnosis, Pregnancy, Ectopic, Ectopic pregnancy, Laparoscopy, Pelvis Medical examination

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Gender selection: Pressure from patients and industry should not alter our adherence to ethical guidelines

Article Abstract:

Conventional intervention techniques of gender selection in pregnancy require an invasive procedure that places both the mother and pregnancy at risk. New non-invasive techniques for X- and Y-chromosome-bearing sperm sorting are being marketed as a means for 'family balancing', which is contrary to recommendations that are offered by ethics committees of several professional societies.

United States, Public affairs, HEALTH SERVICES, Ethics, Health care industry, Ethical aspects, Sex preselection, Obstetricians

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Defining the incidence of serious complications experienced by oocyte donors: a review of 1000 cases

Article Abstract:

Among 1,000 women who donated an ovum over a 13-year period, only seven developed a serious complication from the procedure. Three developed ovarian hyperstimulation syndrome, two had an adverse reaction to the anesthesia, one developed abdominal bleeding, and one developed a bladder problem.

Health aspects, Donation of organs, tissues, etc., Tissue donation, Egg donors, Ovum donors, Complications

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