Assuntos
Doenças Fetais/diagnóstico por imagem , Imageamento Tridimensional , Neoplasias do Mediastino/diagnóstico por imagem , Teratoma/diagnóstico por imagem , Ultrassonografia Pré-Natal , Adulto , Feminino , Doenças Fetais/cirurgia , Humanos , Neoplasias do Mediastino/complicações , Neoplasias do Mediastino/cirurgia , Poli-Hidrâmnios/etiologia , Gravidez , Teratoma/complicações , Teratoma/cirurgiaRESUMO
117 women with severe pelvic organ prolapse (POP; stage > 2) were enrolled to elucidate a 24-month outcome of POP surgery, using conventional or mesh repair with 3 techniques. 59 patients underwent conventional repair and 58 underwent mesh repair. Two types of mesh were used: a trocar-guided transobturator polypropylene (Avaulta, Bard Inc.) and a porcine dermis mesh (Pelvisoft, Bard Inc.). Women with recurrences, who underwent previous unsuccessful conventional repair, were randomised. Primary outcome was the evaluation of anatomic failures (prolapse stage > 1) in treated and untreated compartments. Anatomic failure was observed in 11 of 58 patients (19%; CI 8.9-29) in the mesh group and in 16 of 59 patients (27.1%; p value = 0.3) in the conventional group. 9 of 11 failures in the mesh group (15.5%; CI 6.2-24.8) were observed in the untreated compartment (de novo recurrences), 14.3% in Pelvisoft and 16.7% in Avaulta arm, while only 1 recurrence in the untreated compartment (1.7%) was observed in the conventional group (odds ratio 10.6, p = 0.03).
Assuntos
Procedimentos Cirúrgicos em Ginecologia/instrumentação , Prolapso de Órgão Pélvico/cirurgia , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Recidiva , Telas CirúrgicasRESUMO
AIM: The aim of this paper was to evaluate the hypothesis that pretreatment with dehydroepiandrosterone (DEHA) may improve the result on in vitro fertilization (IVF) and the pregnancy outcome among infertile women with normal ovarian reserve. METHODS: Double-blind, randomized, placebo-controlled study; 52 infertile patients received the long protocol IVF. Patients in Group 1, received 75 mg of DHEA once a day, 8 weeks before starting the IVF cycle and during treatment; control group (Group 2) received placebo. The primary endpoint was pregnancy, live birth and miscarriage rates, secondary endpoint was standard IVF parameters such us stimulation duration (hCG day), E2 on HCG-day, endometrial thickness, number of retrieved oocytes, metaphase II oocytes, embryos transferred and score of leading embryos transferred. RESULTS: Patients in the DHEA group had a significantly higher live birth rate compared with controls (P<0.05). Miscarriage rate was higher in control group (P<0.05). CONCLUSION: DHEA supplementation could have a beneficial effect on IVF outcome in infertile women with normal ovarian reserve.
Assuntos
Desidroepiandrosterona/administração & dosagem , Fertilização in vitro/métodos , Infertilidade Feminina , Resultado da Gravidez , Aborto Espontâneo/epidemiologia , Adulto , Gonadotropina Coriônica/sangue , Método Duplo-Cego , Feminino , Humanos , Oócitos/metabolismo , Reserva Ovariana/fisiologia , Gravidez , Taxa de Gravidez , Estudos Prospectivos , Resultado do TratamentoAssuntos
Hemangioma/diagnóstico , Complicações Neoplásicas na Gravidez/diagnóstico , Compressão da Medula Espinal/diagnóstico , Neoplasias da Medula Espinal/diagnóstico , Doença Aguda , Adulto , Feminino , Hemangioma/patologia , Humanos , Imageamento por Ressonância Magnética , Gravidez , Complicações Neoplásicas na Gravidez/patologia , Terceiro Trimestre da Gravidez , Compressão da Medula Espinal/patologia , Neoplasias da Medula Espinal/patologiaAssuntos
Abortivos não Esteroides/efeitos adversos , Apendicite/induzido quimicamente , Cesárea/efeitos adversos , Metotrexato/efeitos adversos , Gravidez Ectópica/etiologia , Adulto , Cicatriz/complicações , Feminino , Humanos , Doença Iatrogênica , Placenta Acreta/etiologia , Gravidez , Gravidez Ectópica/tratamento farmacológico , Falha de TratamentoRESUMO
We report the efficacy of a minimally invasive approach of the multidose protocol with methotrexate (MTX) in the management of three cases of interstitial pregnancy (IP), with elevated serum ß-hCG in two cases. New considerations and management strategies are discussed. Successful termination of IP and in one case, a subsequent successful pregnancy, was achieved. The process led to the development of an enhanced understanding of diagnostic modalities and their limitations, with regard to the particular entities under discussion. We also focused attention on pivotal points and anatomical features in the management of this dangerous occurrence. Long-term results with careful follow-up were analysed by instrumental procedure. This hazardous type of ectopic pregnancy can be managed with systemic administration of MTX, also in patients with elevated ß-hCG values. The present report underlines that an integrated approach in early diagnosis, multidose treatment and close follow-up, are essential forms of medical management.