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One hundred cases of threatened abortion were randomly allocated to four lines of treatment namely, long acting progesterone, antispasmodic, indomethacin and placebo. The lowest success rate was encountered in the indomethacin treated group; symptoms of intolerance were common and three cases out of sixteen turned into missed abortion. Indomethacin does not offer any advantage over other lines of treatment in threatened abortion.

This report documents the outcome of two pregnancies is a woman with phenylketonuria (PKU) who was treated with a low phenylalanine diet before conception and during pregnancy. Her first pregnancy resulted in an abortion at 17 wk. During the second pregnancy the patient was unable to maintain the right diet consistently, and her blood phenylalanine levels in the first and second trimester were elevated. This pregnancy ended in the birth of a growth retarded microcephalic infant after an amenorrhea of 42 wk. The infant has maintained a normal growth velocity below the tenth percentile, and has not shown signs of mental retardation.

To study the significance of maternal prolactin (PRL) secretion in early pregnancy failures, intravenous thyrotropin-releasing hormone (TRH) stimulation tests were carried out in 39 women with normal or doomed early pregnancy, as verified by ultrasound examination, before the onset of clinical symptoms of abortion. The basal PRL levels did not differ between the women with normal early pregnancy (N = 15), blighted ovum (N = 13), or with missed abortion (N = 11). Thyrotropin-releasing hormone injection stimulated PRL secretion in all cases, but the response was smaller (P less than .01) in women with early pregnancy failure. It is concluded that PRL is not significant in the etiology or course of early pregnancy wastage and that its basal or stimulated measurement is of limited value in the prediction of pregnancy outcome.

The role of the fibrinogen molecule in the maintenance of normal pregnancy is not yet well understood; however, several cases have been previously reported in which failure to complete normal pregnancy was associated with either hypofibrinogenemia, dysfibrinogenemia, or deficiency in factor XIII (fibrin-stabilizing factor) which is important for the crosslinking of the fibrin. A case of congenital afibrinogenemia is described. The patient, a 22-yr-old woman, who suffered from a moderate hemorrhagic tendency associated with very low (less than 10 mg/dl) plasma fibrinogen levels, had three consecutive spontaneous abortions. In view of the previous cases reported, the question is raised whether patients with low or abnormal fibrinogen should be treated with plasma transfusions in order to maintain a normal pregnancy.

Clinical studies on the natural history of early spontaneous abortion included ultrasonic examination of the conceptus, determination of serum human chorionic gonadotropin beta (H), evaluation of trophoblast viability (V), chromosomal analysis of chorionic tissue and assessment of the mixed lymphocyte reaction-blocking effect (BE) of serum in 22 cases with missed abortion and 4 with incomplete abortion. TV was evaluated by simultaneous staining with fluorescein diacetate-propidium iodide (FDA-PI). The data obtained were as follows: 1) Chromosomal abnormalities were observed in 13 of 21 patients analyzed. 2) V was 78.6 +/- 5.6 (n = 7) in induced abortion, 42.3 +/- 16.2 (n = 22) in missed abortion and 8.8 +/- 4.8 (n = 4) in incomplete abortion. 3) There was a significant linear correlation between the maximum diameter of the gestational sac (D) and the weight of the chorionic tissue (W) (W = 1.30 + 0.08D, r = 0.44, p less than 0.05), and between the titer of H and the weight of the viable chorionic tissue (Wv = W x V) (Wv = 0.66 + 0.01H, r = 0.77, p less than 0.01). Consequently, the following formula was devised: V = (H + 66)/(0.08D + 1.30). 4) Results obtained from the formula indicated that V stays at an elevated level for some time and then falls gradually or rapidly after fetal death in spontaneous abortion. 5) Spontaneous expulsion of the conceptus occurred when V declined to about 10% in 4 cases. 6) There was a significant linear correlation between BE and V (V = 34.58 + 0.31BE, r = 0.45, p less than 0.05). It was thus concluded that the intrauterine retention period of the conceptus after fetal death is dependent on V, which can be estimated by D, H and BE in spontaneous abortion.