The impact of endometriosis on fertility

Although the prevalence of endometriosis in infertile women seemed to be nearly 50%, all women with endometriosis are not infertile..

The impact of sweeping the membranes on cervical length and labor: a randomized clinical trial

Objectives: The aim of the study was to investigate to what extent sweeping of the membranes contributes to cervical shortening and if cervical shortening is related to the time to onset of labor and duration of the active phase of labor. Methods: This prospective randomized clinical trial was performed at Baskent University between February and March 2011. Women were randomly assigned to receive membrane sweeping (Sweeping Group) (n=69) or no membrane sweeping (Control Group) (n=71). Cervical length was measured (cervix1) in both groups by examiner 1 and the Bishop Score was determined in the control group and sweeping was performed in the sweeping group by examiner 2. Two days later the patients had another cervical length measurement (cervix 2) by examiner 1, blinded to the group and results of the examiner 2. t test, Mann-Whitney U test and Chi-square test were used for statistical analyses. Results: Cervix 1 was 27.4}8.4 mm and 29.6}8.9 mm (p= 0.14), cervix 2 was 23.3}8.8 mm and 23.8}8.5mm (p= 0.28) and cervical shortening was 5}4 mm and 5}4mm (p= 0.446), time to onset of labor was 6.3}4.6 and 5.7}4.1 (p= 0.38) and duration of labor was 5.8} 2.89 and 5.7} 2.4 (p= 0.82) for the sweeping and the control groups, respectively. Conclusions: Sweeping of the membranes does not reduce cervical length and does not shorten time to onset of labor and duration of the active phase of labor. NCT01309308: Sweeping the Membranes, Cervical Length and Duration of Labor

Giant vulvar hematoma during pregnancy after sexual intercourse: A case report

Lower genital tract hematomas are rarely seen in clinical practice. Although one can frequently see vulvar hematomas when delivering a baby, there are few reports on vulvar hematomas in pregnant patients. Here the authors present a case on a giant vulvar hematoma in a pregnant patient that developed after usual sexual intercourse. Due to the enlarging hematoma and unbearable pain, an operation was offered to the patient. Under general anesthesia, a 5-cm vertical incision was made on the thinnest portion of the vaginal mucosa, and the hematoma was evacuated. As the case reported here is very uncommon, the usual recommendations about sexual intercourse during pregnancy should not change

Przegląd chorób układu krążenia w ciąży

Abstract With recent advances in prenatal care, the incidence of direct causes of maternal death has declined and indirect causes have gained significant importance. Thromboembolism, hypertension and cardiovascular diseases are the most common indirect causes of maternal death. Acute myocardial infarction, stroke, venous thromboembolism, peripartum cardiomyopathy, aortic dissection and amniotic fluid emboli are responsible for the majority of the maternal deaths from cardiovascular causes. The issue of pregnancy of heart transplant – and Turner syndrome – patients requires extensive research. Obstetricians should possess good knowledge of cardiovascular complications of pregnancy because a high index of suspicion and early diagnosis, together with timely and appropriate interventions may save the life of the fetus and the mother.Streszczenie W związku z rozwojem medycyny, częstość występowania bezpośrednich przyczyn zgonów matek, np. krwotoków, znacząco się zmniejszyła. Jednak obserwuje się wzrost śmiertelności matek spowodowanych innymi, niebezpośrednimi przyczynami takimi jak: choroba zakrzepowo-zatorowa, nadciśnienie indukowane ciążą oraz choroby układu sercowo-naczyniowego. Zawał mięśnia sercowego, udar mózgu, zakrzepica żylna, kardiomiopatia okołoporodowa, tętniak rozwarstwiający aorty oraz zator płynem owodniowym są odpowiedzialne za większość przypadków śmiertelności matczynej wywołanej chorobami układu sercowo-naczyniowego. Na szczególną uwagę zasługują coraz częściej pojawiające się pacjentki po transplantacji serca oraz ciężarne z zespołem Turnera. Położnicy powinni posiadać rozległą wiedzę dotyczącą chorób układu krążenia i możliwych ich powikłań podczas ciąży, ponieważ wczesna diagnoza oraz właściwa interwencja mogą uratować życie płodu i matki

A novel approach using a minimal number of injections during the IVF/ICSI cycle: Luteal half-dose depot GnRH agonist following corifollitropin alfa versus the corifollitropin alfa with a GnRH-antagonist cycle

Objective: Corifollitropin alfa is a good choice for assisted reproductive technology (ART) cycles because fewer injections are needed than with other agents. In this retrospective cohort, we analyzed luteal injected half-dose depot gonadotropin hormone-releasing hormone (GnRH) agonist cycles in women who received corifollitropin alfa and those who underwent a conventional corifollitropin alfa cycle with a GnRH antagonist. Material and Methods: In this retrospective cohort, we analyzed luteal injected half-dose depot GnRH agonist cycles in women who received corifollitropin alfa and those who underwent a conventional corifollitropin alfa cycle with a GnRH antagonist at the Division of Reproductive Endocrinology and IVF Unit, Obstetrics and Gynecology Department, Baskent University School of Medicine, Adana, Turkey, from March 2014 to August 2015. The patient's baseline characteristics were similar between the two groups. Forty-five patients underwent the long protocol, in which a half-dose of depot GnRH agonist was administered on day 21 of the preceding cycle. Forty-nine patients underwent the GnRH-antagonist protocol. Corifollitropin alfa was administered on the menstrual cycle day 3. Results: The mean ages of the two groups were similar (32.77+/-5.55 vs. 34.2+/-4.51 years ["for the long-and antagonist-protocol groups, respectively"]). The total number of retrieved oocytes, the fertilization rate, and the number of transferred embryos were similar between the two groups. The only significant difference between the two protocols was the number of injections during the controlled ovarian stimulation (COH) cycle, which included the depot-agonist injection in the long-protocol group (4.46+/-1.64 vs. 5.71+/-2.51, p=0.006). The clinical pregnancy and implantation rates were similar in the two protocols (16/45 [35.6%] vs. 16/49 [32.7%] for the intention to treat and 32.5+/-6.82% vs. 36.25+/-8.58%, respectively). Conclusion: Our results show that ART cycles could be performed with fewer injections using corifollitropin alfa and a half-dose of depot GnRH agonist

Pasireotide: A new option for treatment of acromegaly

Acromegaly is characterized by excess production of growth hormone (GH) and insulin-like growth factor-1 (IGF-1). Although surgery is the first treatment option, somatostatin receptor analogs (SSRAs) can be used in selected cases which surgery is contraindicated. A patient who has been diagnosed as acromegaly was admitted to our hospital. Hypophyseal adenomectomy had been performed one year ago. The patient was taking lanreotide for 6 months and disease was not under control. She had loss of vision. Although she had a residual tumor, second surgery couldnt be performed due to the location of tumor. The patient was followed for 6 years. Radiotherapy and other medical treatment options were tried but none of them were successful. At the end of six years, pasireotide was started. At the third month of treatment, biochemical control was achieved. Pasireotide may be a treatment option for some patients with acromegaly that are inadequately controlled by first generation SSRAs. [Med-Science 2020; 9(2.000): 518-21