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Monday, March 06, 2006

Today's searches

Somebody was searching for abortion and kidneys. The following women are among those who died of kidney failure, or with kidney problems as a contributing factor, after abortions: Ingar Weber, Rhonda Rollinson, Yvonne Mesteth, "Molly" Roe, Rosie Jiminez, Christella Forte, Marla Cardamone, and "Rosa" Roe.

It doesn't seem to be so much that the abortion damages the kidneys directly. In a saline abortion, if saline gets into the mother's bloodstream it will damage all of her organs, including her kidneys which will be struggling to rid her body of excess salt. In other abortions, either sepsis or coagulation problems can damage the kidneys.

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Another search was for partial mole viable pregnancy irregular sac. I look at the issue of molar pregnancies in When the POC Really is Just Tissue. I did a search online and found some additional information.

Twin Pregnancy Consisting of a Complete Hydatidiform Mole and a Fetus:
The management of twin pregnancy with a normal fetus and coexistent complete mole remains controversial. Without giving reasons, some authors have recommended immediate termination, while others have suggested allowing such pregnancies to progress until the baby is mature enough to survive outside the uterus.

However, review of the literature shows that pregnancies that had progressed to an advanced stage were either partial molar pregnancies or twin pregnancies in which the complete mole had died. When the mole had remained active, most twin pregnancies had ended between 14 and 26 weeks either spontaneously or as a result of termination because of severe bleeding or toxemia.


Are fertility drugs a risk factor for persistent trophoblastic tumour?:
Data on features of pregnancy with a gestational age of 24 weeks are summarized in Tables III and IV. Among these women (n = 10), six women delivered live infants without any anomalies (five Caesarean section and one vaginal delivery). One subsequently developed PTT with lung metastasis. In patients who delivered <24 weeks, the information about delivery was available in 12/16 cases. This included: uterine evacuation before fetal viability due to spontaneous vaginal abortion (n = 4), vaginal bleeding (n = 4), pre-eclampsia (n = 3), and hyperemesis gravidarum with abdominal pain (n = 1). None of the patients with a triplet (n = 6) or quadruplet (n = 2) pregnancy delivered a live infant.

....

At present, it is possible to distinguish between a prenatal diagnosis of a triploid non-viable fetus and a chromosomally-normal and viable infant. The latter condition presents the patient and the physician with a critical dilemma between a therapeutic abortion or an expectant management until fetal viability. The conservative approach is supported by the fact that there have now been several reported cases of HM-and-CF after natural conception that have been carried to viability and delivery of a live infant. In a review of the literature, Bristow et al. have found 26 cases of HM-and-CF with seven cases of surviving infants (Bristow et al., 1996).


Hydatidiform Mole With Coexisting Twin After In-Vitro Fertilization:


Hydatidiform Mole With Coexisting Twin After In-Vitro Fertilization:
Hydatidiform mole with coexsisting fetus (HMCF) is a rare entity occuring in 0.005-0.01% of all pregnancies. ....

Ultrasonographic evaluation revealed a live fetus consistent with 16 weeks of gestation. There was no evidence of growth retardation or fetal anomaly. However, a well-defined and separate multiple cystic mass was found in the low uterine segment and HMCF was suspected. ....

During the following 10 weeks patient experienced multiple episodes of antenatal hemorrhage which resolved spontaneously. At 28 weeks of gestation she had a Cesarean section delivery for a reduction in fetal growth velocity and fetal heart rate deceleration. A live male infant (760g) and normal placenta (180g) were delivered. 1050 g of cystic, vesicular mass was removed manually. Histological examination confirmed the clinical impression of one normal placenta and also a complete hydatidiform mole. During the immediate postpartum period, the patient had an uneventful course. Unfortunately, the baby developed ‘wet lung' and died at postpartum 7 th day. ....

Generally, partial mole is mostly associated with triploid fetuses that tend to die before the end of the first trimester and surviving fetuses after mid pregnancy are rarely encountered. On the other hand the fetus coexisting with complete mole is usually associated with normal karyotype and has a chance of survival. It was reported that before 28 week of gestation, the chances of survival are minimal and the chance for continuation of pregnancy beyond this point is 60 %. Of pregnancies which continue beyond the 28 th week, a surviving child may be expected in 70% of pregnancies.


Click here for a graphic photo of a mole with attached fetus. The source does not indicate how the fetus died, but does indicate that it had no abnormalities. The following article is the source for the photo:

Gestational Trophoblastic Disease: A Comprehensive Review:
Co-existence of a fetus with molar changes of the placenta is relatively rare, occurring in 1 in 22,000 -100,000 pregnancies. A variety of criteria have been used to evaluate these pregnancies. Compared with singleton hydatidiform moles, twin pregnancies with a fetus and a mole carry an increased risk for post-molar gestational trophoblastic disease, with higher proportion of patients having metastatic disease and requiring multi-agent chemotherapy. Among patients with co-existent moles and fetuses who continue pregnancy, a subset develops early complications leading to termination of the pregnancy before fetal viability, with a markedly increased risk of post-molar gestational trophoblastic disease, when compared with patients whose pregnancies continue into the third trimester. Major congenital abnormalities have not been reported in surviving infants.


Hydatidiform mole coexistent with a twin live fetus: a national collaborative study in Japan:
Hydatidiform mole coexistent with a twin live fetus (HMTF) is a rare entity, occurring in 0.005–0.01% of all pregnancies (Beischer, 1961; Jones and Lausen, 1975). Two different mechanisms of the formation of HMTF are possible; a complete mole (46 chromosomes; all paternal in origin) coexistent with twin live fetus(es) (46 chromosomes; 23 maternal and 23 paternal), and a partial mole with an abnormal triploid fetus(es) (both having 69 chromosomes of maternal and paternal origin). The abnormal triploid fetus coexisting with a partial mole tends to die in the first trimester (Jauniaux et al., 1997), while the fetus coexisting with a complete mole in the dizygotic twin pregnancy has a chance to survive.


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Another search was for Delta Women's Clinic of Baton Rouge. This clinic was one of three independently operated facilities under same ownership. The others were in Gulfport, MS and New Orleans LA. The Baton Rouge facility was gutted by fire in 2001. The fire was ruled accidental, due to an electrical problem. The owner of the building had filed suit alleging that the performance of abortions on the premises resulted in the loss of fire and hazard insurance, threatening the owner's mortgage; Delta and Glidden were informed of such but failed to cease performing abortions, in violation of the lease. (Baton Rouge Parish Case No. 299277)

Ingar Weber died after an abortion at Delta in 1990. Sheila Hebert died after an abortion there in 1984.

News coverage also has been ignoring the fact that Planned Parenthood stopped referring women to Baton Rouge Delta after a teen-ager said the doctor walked out of the room during her abortion, and that the clinic had run out of sterilized gloves and pain medication. The health department also recommended revoking Delta's laboratory license due to the possibility of inadequate testing. (Dallas Morning News 9-5-93; AP 10-4-97 in The Advocate, Baton Rouge)

Michelle P. alleged that she went to Delta for the abortion of her 20 week pregnancy. The abortion was performed by Richardson Glidden at Delta March 28, 1984. Glidden failed to determine the position of the fetus, was unable to retrieve fetal leg, and sent Michelle home with assurance that she would expel the leg. Michelle was bedridden with pain for six days, then returned to Delta. Glidden then informed Michelle of a laceration of her uterine wall in addition to the retained leg. Glidden's attempt to remove the fetal leg was unsuccessful. Michelle was transported to a hospital, where the fetal leg was removed through a surgical incision. (Baton Rouge Parish District Court Case No. 281159)

Kathleen R. alleged that she underwent an abortion of her 6-8 week pregnancy performed by Calvin Jackson at Delta July 16, 1974. Upon arriving home, Kathleen was weak and bleeding. Her neighbor called Delta; Jackson was spoken to and informed of the heavy bleeding, which was a serious situation. Jackson prescribed Methergine. Kathleen's husband filled the prescription, and Kathleen's bleeding abated for 5 days. However, Kathleen had to be hospitalized one week following the abortion. There, she underwent a transfusion. Surgeons found a large hematoma and a perforated uterus. Kathleen had to have a hysterectomy to treat her injury. Her lawsuit also alleged that staff at Delta had failed to inform her of the risks of the abortion. (4th Circuit Louisiana Court of Appeals No. 9083)

WAFB-TV in Baton Rouge broke ranks in the coverage after the fire, delving into some of Delta's unsavory past. A patient, Roxy D., had come forward saying that "a 1998 operation at Delta forced her to wear a colostomy bag for eight months." WAFB-TV investigated the clinic, and clinic workers spoke to WAFB, confirming Roxy's story. This is the story that, according to WAFB, prompted a spring 1999 vote of the Louisiana Legislature to include abortion facilities in outpatient surgical centers' regulations. Abortionists claimed that this was an attack on their practice and that following the regulations would drive up the cost of abortions. The abortionists sued, blocking enforcement of the law. In response, Louisiana legislators drafted a law requiring regulations just for abortion clinics.

WAFB's coverage also noted that state prosecutors have received detailed affidavits from former Delta workers about the conditions and practices at the clinic. WAFB's coverage of the fire concluded with noting that Delta heating up even before the fire -- the Roxy D's suit was about to enter into preliminary hearings, the former employees were stepping forward with allegations about conditions within the clinic, workers indicated that Delta's debts were mounting... and then the place burned to the ground.

Delta's abortionist, James Whitmore III, lost his license to practice medicine in 2002. The board had found Whitmore guilty of disregarding basic santitation, being rude to patients, and failing to provide proper care to a woman whose uterus he had perforated during an abortion. The woman ended up needing a hysterectomy. The board found that Whitmore used improperly sterilized equipment, reused single-use items, and let tissue float in the sterilizing solution. Whitmore had previously been on probation for three years beginning in 1992, after his actions led to the death of one post-term infant and the permanent injury of a pre-term infant.

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