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Septic pelvic thrombophlebitis is a major complication of endometritis. The thrombi commonly occur in the uterine and/or ovarian veins and may extend into the inferior vena cava.Following vaginal delivery, a 19-year-old woman, gravida 2, developed postpartum septic pelvic thrombophlebitis extending from the right ovarian vein up to the diaphragm and down to the femoral vein. The patient was treated successfully with heparin and antibiotics, and eventually was discharged on oral anticoagulants for an extended period. Follow-up revealed complete resolution of the thrombus.Septic pelvic thrombophlebitis is not limited to the pelvis and lower abdominal vessels.

To determine the carriage rate of enterococcus in the lower genital tract of women having a cesarean delivery and to determine whether a single 2-g intraoperative dose of ampicillin eradicates enterococcus from the lower genital tract.Lower genital tract cultures were taken in 84 women who were in labor or had ruptured membranes and who were about to have an indicated cesarean delivery. The subjects were randomized to receive either a single 2-g dose of ampicillin or a cephalosporin as prophylaxis. Cultures were repeated 24 hours postpartum.Enterococcus was isolated preoperatively in 33 subjects (39.3%) and postoperatively in 36 (42.9%). The enterococcus was eradicated in five of 17 women (29.5%) who received ampicillin.These results suggest that a single 2-g dose of ampicillin does not eradicate enterococcus from the lower genital tract.

Roseola infantum (exanthem subitum) was first described as a specific syndrome by Zahorsky in 1913. It is a benign disease that occurs almost exclusively in infants and young children (six months to three years of age). We report a case of roseola in a pregnant woman. We were unable to find any prior reports of roseola in pregnancy. The classic presentation of roseola is characterized by high temperatures (103-105 degrees F) that last 3-5 days and resolve by crisis followed by the appearance of a morbilliform rash that lasts a few hours to a few days. The infectious agent is human herpesvirus-6. We recommend the addition of roseola to the differential diagnosis of rashes that occur in pregnancy. The potential danger to the fetus from this virus is unknown.

From February 1988 to April 1990, we collected blood for hepatitis B surface antigen (HBsAg) from all women coming to the Texas Tech University Health Science Center in Lubbock for prenatal care. These patients were from rural western Texas and eastern New Mexico. They were also screened for hepatitis B risk factors, as outlined by the Centers for Disease Control. We reviewed the prenatal records of all HBsAg-positive women. Six of 4452 women (0.13%) had a positive HBsAg test. Four of the six women had identifiable risk factors and two did not; two were non-Hispanic caucasian (Anglo), two were Hispanic, and two were black. Anglos comprised 49.5% of the rural population, Hispanics 34.9%, blacks 12.8%, and Asians 2.8%. No Asian women were positive for HBsAg. The prevalence of HBsAg positivity was lower in this rural population than in previously reported urban populations. While the prevalence in the studied blacks and Hispanics was similar to that in previous reports, the prevalence in the rural Anglos was lower.

Some obstetricians recommend the Zavanelli maneuver to resolve shoulder dystocia. Descriptions in the literature report an almost automatic ease in performance of the maneuver. We report a case of severe shoulder dystocia in which management with the Zavanelli maneuver and immediate cesarean was extremely difficult. The procedure involved exact reversal of all the cardinal movements of labor, and the delivery required terbutaline, general anesthesia, and added personnel to ensure successful extraction of the fetus. A delivery requiring the Zavanelli maneuver can be difficult to perform and may be worsened by insufficient personnel and inexact reversal of all the cardinal movements of labor.

Substantial amounts of iron and magnesium were observed to be released from ash from Mt St. Helens' and US Geological Survey Silicate Rock Standards by the siderophore rhodotorulic acid.

Mt. St. Helens' ash or U.S. Geological Survey silicate rock standards would replace FeCl3 as the limiting nutrient and repress the synthesis of rhodotorulic acid inRhodotorulia pilimanae cultures.