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Thrombocytopenia has been reported in patients with type IIB von Willebrand's disease (vWd) during pregnancy. In the present work we report the behaviour of platelet count and von Willebrand factor (vWf) multimers in a pregnant type IIB vWd patient who presented with mild thrombocytopenia in the steady state. The evolution of pregnancy was associated with a progressive decrease of platelet count which showed its lowest value two days before delivery (20 x 10(9)/l). The tendency of the platelet count to decrease was suddenly reversed a few days later (77 x 10(9)/l). At the same time, the vWf multimeric pattern showed a strict but inverse correlation with the platelet count. In fact, a progressive increase in low and intermediate sized vWf multimers, which proceeded until platelets reached their minimum level, was noted. A few days after delivery, concomitant with the prompt platelet increase, low and intermediate multimers became decreased. During pregnancy, the patient's platelet showed additional increased responsiveness to ristocetin but did not demonstrate spontaneous platelet aggregation (SPA). On the contrary, the patient's plasma, collected both during and after pregnancy, caused normal platelets to aggregate spontaneously. SPA appeared completely blocked by an anti-GPIIb-IIIa monoclonal antibody (MAb), which recognized the binding site for fibrinogen, vWf and fibronectin. In contrast, a MAb against ristocetin-induced vWf binding site on GPIb did not affect SPA. These findings suggest that the common stimulus or stimuli, responsible for the pregnancy-induced decrease of platelet count and improvement of vWf multimeric pattern in type IIB vWd is strictly related to pregnancy.(ABSTRACT TRUNCATED AT 250 WORDS)

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The authors have studied 152 patients aged between 15 and 20 year old who underwent colposcopy and colpocytology. They have compared the incidence of white colposcopic lesions with the results of the cytology. According to literature the results have pointed out that the very young patients are "at risk-patients" for serious cervical lesions and that depistage of gynecologic tumors must be done in all the other women.

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The Authors evaluate the variation of Sex Hormone Binding Globulin during the menstrual cycle in 17 normal menstruating healthy women. The resulting data seem to show not significant modification in the protein serum level, in agreement with most of the reports in literature. A possible explanation might be the insufficient length of estrogen stimulation in the prolipherative phase. This might lead to hypothesize that in presence of marked impairments of sex steroid metabolism SHBG levels may vary significantly.

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Nowadays pregnancy is considered a psychosomatic experience during which personal and existential factors interact with cultural and environmental ones. This very important event causes conflictual conditions. In fact as regards to become a mother a different psychological attitude corresponds to a social-cultural change (historical environment, contraception, geographical area, etc.) that has shifted the objectives and the duties giving the woman the "theoretical" possibility to decide of her nature autonomally. This problem issues from two desires: the pregnancy and the maternity ones. Taking into account this attitude in 1200 women attending the Obstetric Psychoprophylaxis classes in 1982 at the Obstetric and Gynecological Department of Padua University, the Authors have pointed out interesting aspects concerning the way the woman today considers the conception and the pregnancy.

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The Author reports 45 cases of vulvovaginitis in children. In agreement with the literature the reported data show a fairly high prevalence of concomitant urinary infections. Timely and correct treatment of genital and urinary inflammations can prevent relapses, new infections and reduce the incidence of more serious urinary phlogosis to a minimum.

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In the practice of obstetric psychoprophylaxis every method employed considered always the group both from a psychological and a pedagogic point of view. Today the group of pregnant women (or couples) is considered under various aspects: - psychological: the group as a support for members with regard to maternal and parental emotional feelings; - anthropological: the group fills up an empty vital space and becomes a "rite de passage" from a state of social identity to another one; - social: the group is a significative cultural intermediary between health services and the women-patient. The knowledge of these aspects becomes an important methodological support for group conductors. We present an analysis of our experience with groups and how this has affected the Psychoprophylaxis in the last years.

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The AA. considered 58 pregnant women affected by asymptomatic bacteriuria of pregnancy and 20 pregnant women with sterile urine during the first trimester of pregnancy as control group. Despite a constant treatment suggested by antibiogram the incidence of infective relapses was high but no patients were affected by important infections as acute haemorrhagic cystitis and acute pyelonephritis. In control group only 15% of patients had an asymptomatic urinary infection. These patients received the same treatment of the first group. In AA. opinion, a constant and careful screening of asymptomatic urinary infections is necessary in all pregnant women to prevent acute pyelonephritis.

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The Author reports 40 cases of patients affected by asymptomatic bacteriuria at the 1st trimester of pregnancy, assessing changes in their hemoglobin values, and compared them to 20 control patients with sterile urine at the 1st trimester. No major difference is found in hemoglobin changes between the two groups, probably owing to the repeated parameter controls throughout pregnancy and the continuing treatment undergone by all the affected patients.

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Usually the term "obstetric psychoprophylaxis" refers to a specific method or technique. We prefer to consider it as a procedure that involves on one side the woman, the child and its family, and on the other the services entitled to give pre- and post-natal assistance. In order to realize this, a reformation of our methodological parameters and a critical analysis of the results obtained are required. In the courses of obstetric psychoprophylaxis that are held in the Department of Obstetrics and Gynaecology of the University of Padua we take into consideration the following themes: - Methodological approach - Professional training of the staff - Significance of psychosocial culture in the management of the pregnancy by the health services.

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The Author examines 93 patients between 45 and 65 years of age. Their sexual activity at the time of the interview is analysed and compared with the reported activity in youth and adulthood. The results show that good many patients reporting unsatisfactory sexual activity at the time of the study had experienced a deficient sexual life when younger too. This problem must be tackled through a medico-psychologic interdisciplinary intervention.

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