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Objective: To evaluate the significance of clinical signs and blood indices for the diagnosis of appendicitis during pregnancy., Sample: Of the 40,112 women delivering at our institution (January 1995 to June 2002), 38 women (0.094%) were operated due to the suspicion of appendicitis during pregnancy., Methods: Body temperature, clinical examination, white blood cell counts and lag time from arrival to operation were obtained for each patient. All women were operated with the clinical diagnosis of appendicitis, and their appendices were removed and examined by a pathologist., Results: Inflammatory appendix was discovered in 19 (0.047%) of the pregnancies with subsequent deliveries while a normal appendix was found in 19 of the 38 (50%) appendices removed. The group with normal appendix did not significantly differ from women with inflamed appendix with regard to gestational age at presentation, signs of peritoneal irritation, body temperature, leukocyte count, time elapsed between arrival and surgery, gestational age at delivery and birth weight., Conclusions: The accurate diagnosis of appendicitis during pregnancy is a difficult task requiring a very high level of suspicion and clinical skills and not merely relying upon laboratory and classic signs., (Copyright 2003 S. Karger AG, Basel)

A prospective, blind study was carried out on 44 patients to evaluate the most suitable time to perform transvaginal sonohysterography. On the day of arrival at our unit, regardless of their cycle day, the women underwent sonohysterographic evaluation, which was repeated during the first 10 days of the next cycle. Patients with sonohysterographic findings underwent hysteroscopy. According to the timing of the first examination, they were divided into two groups, i.e. group 1 for the first 10 days of the cycle, and group 2 for days 16 through 28. At the end of the study the groups were compared. The results showed a false-positive rate of 27% in group 2, while no false-positive was found in group 1. We concluded that the best time for sonohysterography in patients who still have their menstrual period is during the first 10 days of the cycle., (Copyright 1999 S. Karger AG, Basel)

Our objective was to evaluate the efficacy and safety of labor induction in women with a breech presentation, and an unripe cervix. We conducted a retrospective, matched-paired study on patients with breech presentation and an unripe cervix (n = 23), who underwent induction of labor using extra-amniotic saline instillation. The women were compared to three matched control groups: 46 women with vertex presentation and an unripe cervix, whose labor was induced by the same method, 23 with breech presentation who underwent a vaginal trial of labor, and 23 women with breech presentation who underwent a cesarean section without a trial of labor. In the study group, 12 women (52.2%) delivered vaginally. Rates of Apgar score, birth trauma, and maternal morbidity were similar in all groups. Induction of labor in patients with a breech presentation and an unripe cervix may be attempted in selected cases as it seems to be efficacious (vaginal delivery rate of 52.2%) and safe for both fetus and mother.