Abortion due to infection with Chlamydia psittaci in a sheep farmer's wife.

A farmer''s wife who had helped with lambing aborted spontaneously in March after a short febrile illness in the 28th week of her pregnancy. She developed disseminated intravascular coagulation post partum with acute renal failure and pulmonary oedema. Recovery was complete after two weeks of hospital care. A strain of Chlamydia psittaci, probably of ovine origin, was isolated from the placenta and fetus. The patient''s serum showed rising titres of antibody against chlamydia group antigen; the placental and fetal isolates; and a known ovine abortion, but not a known avian, strain of C psittaci. IgG against both ovine abortion and enteric strains of C psittaci was detected, but IgM against only an abortion strain was detected. Histological examination showed pronounced intervillus placentitis with chlamydial inclusions in the trophoblast but no evidence of fetal infection or amnionitis. Laboratory evidence of chlamydial infection was found in an aborting ewe on the farm in January and in remaining sheep and lambs in July. Doctors should recognise the possible risk to pregnant women in rural areas where chlamydial infections in farm animals are widespread.     

Blood Platelet Behaviour during and after Open-heart Surgery

In view of the high incidence of thromboembolic complications after the insertion of cardiac valve prostheses, platelet adhesiveness and aggregation was measured in whole blood before, during, and for several days after this operation in 10 patients. Cardiopulmonary bypass resulted in a profound decrease in the platelet count, in the number of adhesive platelets, and in platelet aggregation. These changes returned to near preoperative levels by the sixth postoperative day. Thereafter a consistent and sustained increase in platelet count, in the number of adhesive platelets, and in platelet aggregation was observed. The results suggest that the prevalence of thromboembolism after valve replacement may be due partly to changes in platelet behaviour.