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A case of primary hepatic pregnancy in which the presenting features were suggestive of ruptured ectopic pregnancy is described. The bleeding area on the liver was oversewn and the patient recovered uneventfully. Primary hepatic pregnancy is briefly discussed.

A case of primary hepatocellular carcinoma (HCC) in a 17-year-old pregnant primigravida diagnosed during the 32nd week of pregnancy is presented. A live infant was delivered after induction of labour during the 33rd week. The mother, although still alive 3 months postpartum, had ongoing spread of the malignancy. Only 7 cases of primary liver cancer in pregnancy have been reported to date, with 100% maternal mortality and only 3 live infants. The literature and the diagnosis and management are discussed.

Endometrial biopsy (EB) specimens obtained from infertile women at Natalspruit Hospital are routinely subjected to histological examination, culture for tubercle bacilli and guinea-pig inoculation (GPI). A retrospective analysis of 103 EB specimens from Natalspruit Hospital and 255 specimens from private patients (in the Greater Johannesburg area) examined during January 1981 - August 1983 revealed a 1,96% overall incidence of endometrial tuberculosis (TB). The incidence of endometrial TB in infertile Black women attending Natalspruit Hospital during this period was 4,85%. Confirmed cases of endometrial TB yielded positive cultures in 57% of cases; GPIs were positive in 71% of cases and histological findings were positive in 42% of cases. Statistical comparison of culture and GPI was difficult because of the small number of cases involved. Cost analysis of culture and GPI suggested that culture of EB specimens as a routine screening procedure for infertile patients is more cost-effective and that GPI tests should be reserved for cases in which TB is highly probable. The literature on symptoms, pathology and diagnostic investigation of pelvic TB is briefly reviewed.

Serum alpha-fetoprotein estimations were performed in 38 cases of ruptured or leaking ectopic pregnancy and 7 cases of ruptured, haemorrhagic corpus luteum cyst. A wide range of values was obtained, but in ectopic pregnancies, 65% of values were above the median range for each respective week of pregnancy. In 11 patients (29%), serum alpha-fetoprotein values were 2.5 times the median. In 13 patients values were within or below the normal range. The study demonstrated that in most cases of ruptured or leaking ectopic pregnancies serum alpha-fetoprotein values were significantly raised. A smaller subgroup of patients may show very low alpha-fetoprotein values in maternal serum.