Fine needle aspiration in gynaecologic oncology

One hundred and ten fine needle aspirations were performed on 73 patients with primary and recurrent gynaecological cancers. The sampling sites included superficial and retroperitoneal lymph nodes, soft tissue masses, liver, lungs, abdominal and pelvic masses, parametrium, thyroid and breast nodules. This relatively simple, safe and yet reliable technique can obviate the need for biopsies in most situations, and a more liberal use of aspiration cytology in gynaecological malignancies is advocated.

Ultrasonic detection of maternal ascites in patients with severe pre-eclampsia

Ultrasonography is a reliable method in the detection of free fluid in the abdomen. In 2 patients with severe pre-eclampsia, maternal ascites was diagnosed by ultrasound. Both babies were delivered prematurely by Caesarean section, indicated by deteriorating maternal condition. One of the babies died in the early neonatal period. The sonologist should be aware of the possible presence of peritoneal free fluid in patients with severe pre-eclampsia, and be able to demonstrate this accordingly in the ultrasonogram.

Prognostic significance of raised serum alpha-fetoprotein levels in twin pregnancies

Maternal serum alpha-fetoprotein (AFP) was measured during the second trimester in 219 twin pregnancies uncomplicated by neural-tube defects (NTD) and in 11 twin pregnancies discordant for NTD. Serum AFP levels were recorded in multiples of the median value (MOM) calculated from normal singleton pregnancies. Of the twin pregnancies uncomplicated by NTD 49% had AFP levels less than 2.5 MOM, 7.8% had levels greater than 5 MOM and 59% of these were associated with either abortion, stillbirth or fetus papyraceous. In twin pregnancies with serum AFP levels less than 5 MOM and unsuccessful outcome was noted in only 4% (chi 2, P less than 0.05). There was a significant negative correlation between serum AFP levels and combined birthweights (r = 0.954). All 11 pregnancies discordant for NTD had serum AFP values greater than 5 MOM and this level appears to be a suitable cut-off point above which there should be further diagnostic investigations and monitoring of fetal well-being.