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Four used intrauterine contraceptive devices and two new control devices were studied by scanning electron microscopy. All intrauterine contraceptive devices were found to have surface deposits that differed not only from site to site on a given device but between devices. A finding of this study not previously described in the literature was the observation of a euhedral crystal rosette of an apatite mineral group [Ca5(PO4)3(F,Cl,OH)] on the Lippes Loop that had been in situ for 15 years.

The relationship of endometrial cavity length to intrauterine contraceptive device (IUD) performance was evaluated in 319 patients wearing three types of devices. The rate of events, defined as pregnancy, expulsion, or medical removal, increased significantly when the length of the IUD was equal to, exceeded, or was shorter by two or more centimeters than the length of the endometrial cavity. Total uterine length was found to be a less accurate prognostic indicator of IUD performance than endometrial cavity length alone.

Among 4,069 healthy gravidas undergoing saline abortion, patients administered intravenous oxytocin had a significantly shorter instillation-to-abortion time (median, 25.5 hours) than did patients not administered oxytocin (median 33.3 hours). The instillation-to-abortion time was independent of the rate of oxytocin administration, which ranged from 1 to 4 U. per hour (17 to 67 mU. per minute), but was associated with the time at which oxytocin infusion was begun. When oxytocin infusion was started within eight hours after instillation, a shortened time from instillation to abortion was observed. Although oxytocin augmentation may result in a lower proportion of patients being exposed to the risk of infection associated with prolonged intervals from instillation to abortion, this potential advantage appears counterbalanced by an increased incidence of clinical consumptive coagulopathy associated with instillation-to-abortion intervals of less than 24 hours.

A survey, conducted in the summer of 1974, to determine the extent of regionalized perinatal care in the United States revealed 28 states to have programs in operation. Evaluation was a common concern of these programs. A model for the evaluation of Regionalized Perinatal Care Programs is presented here with the North Carolina program used as an example. Evaluation was mandated as an integral component of the program in North Carolina, and this model has been developed in response to that mandate.

A study was undertaken to assess the effects of the study design (frequency and method of inquiry about the side effects) on the reporting of oral contraceptive (OC)-associated side effects. The study found that the one-contact-per-cycle schedule yielded consistently lower rates of side effects than the two-contact-per-cycle schedule. Also, asking subjects about the occurrence of specific symptoms led to the reporting of higher rates of side effects than those obtained by general inquiry. The study suggests that differences in the reported rates of side effects may be due in part to the manner in which the data were collected.

This study examines the relationships between fetal size (biparietal diameter and crown-rump length) and gestational age among subjects aborted by hypertonic saline in the second trimester of pregnancy. With a confidence of 90 per cent, biparietal diameter can be used to predict gestational age within plus or minus 2 weeks, and crown-rump length can be used to predict gestational age within plus or minus 3 weeks.

Five hundred eighty-eight women who were delivered of twins at 13 hospitals affiliated with the Northwestern University Medical School or its outreach institutions between 1971 and 1975 were studied. Eighty-six of the infants did not survive the pregnancy, delivery, or the first week post partum. Maternal demographic and obstetric characteristics are outlined. Infants are categorized by birth order and by birth weight. The mean weight (and standard deviation) of first twins was 2,388 gm (+/- 742 gm) and that of second twins was 2.314 gm (+/- 766 gm). The rate of pregnancy wastage was highest in mothers who were under 20 years of age, who were of low parity, and who were delivered prior to the physiologic maturation of the fetus. The crude mortality rate of twin 1 was 6.1/100 versus 8.5/100 for twin 2. The causes of death in all infants over 2,000 gm are listed. All pregnancy losses are categorized into unavoidable deaths (26.6%), probably not avoidable deaths (59.4%), and possibly avoidable deaths (13.9%).

The incidence of occurrence of transfusion of Rh-positive blood into Rh-negative individuals is unknown at the present time. A survey was designed to ascertain this information for the 12 month period ending March 31, 1974. Replies were obtained from 2,286 transfusion facilities in the United States. A total of 203 patients were reported to have received Rh-incompatible transfusions during the interval studied. Of these, 44 were women 49 years of age or under. Slightly more than half the women who received Rh-positive blood were treated with Rho (D) immune globulin. Those who received an adequate dose did not develop antibodies when appropriately tested. Twenty-five per cent of those who received an inadequate dose of Rh-immune globulin developed antibodies. Forty-two per cent of those receiving no Rh-immune globulin prophylaxis were noted to have antibodies.

This report provides specific information on the prevalence rates of the most common side effects during the first 3 cycles of use of 3 combination oral contraceptives (OCs) containing 50 mcg estrogen. The probabilities of a symptom occurring for the first time, or persisting once present, during the initial cycles of OC use are given for each of the 3 combined OCs.

Among 2,019 women screened by triplicate culture technique, 191 (9.5 per cent) had one or more positive cultures of specimens for Neisseria gonorrhoeae. The prevalence rates by site of infection were as follows: cervix-8.1 per cent; rectum-2.4 per cent, and oropharynx-0.9 per cent. Of the 191 patients with gonorrhea, 163 (85 per cent) had a positive culture of the cervical specimen. Addition of routine cultures of rectal and oropharyngeal specimens detected only 15 per cent of positive cases, while tripling the cost of the screening program. Based on a cost-benefit anallysis, a culture of the cervical specimen is most appropriate for routine screening, and cultures of rectal and/or oropharyngeal specimens should be obtained on a selected basic only.

The hospital and operative records of 318 women with a discharge diagnosis of tuboovarian abscess (TOA) were reviewed to evaluate the possible relationship between contraceptive usage and the occurrence of TOA. A significantly higher (p < 0.10) proportion of the intrauterine contraceptive device (IUD) users had acute pelvic inflammatory disease and a significantly lower proportion (p < 0.10) compared to users of other contraceptive methods were surgically treated. The proportions of women with unilateral and bilateral TOAs were similar, regardless of the contraceptive method used. This was true whether diagnosis was based on physical examination alone or confirmed at operation.