RESUMO
A preliminary report is given on a new laparoscopic sterilization procedure. By a double-puncture method, a loop of tube is brought out of the abdomen through the suprapubic incision. The loop is then resected by a modified Pomeroy method. Between Octorber 1976 and June 1978, 75 sterilizations were performed without any major problem. Sterilization failed in one case when one tube could not be seen. All recoveries were uneventful. Safety, effectiveness, simplicity, and potential reversibility seem to be the qualities of this method.
Assuntos
Laparoscopia , Esterilização Tubária/métodos , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Gravidez , Esterilização Tubária/efeitos adversosRESUMO
Insulin resistance appears to be responsible of approximately half of the cases of polycystic ovaries, the other half being probably provoked by an anomaly of the stimulation of ovaries by an excess of LH. Nevertheless, it is likely that in most cases the two factors conjugate. The excess of androgen production by the ovarian stroma is one of the major symptoms of this disease. Today, however, the diagnosis is carried mainly with the assistance of ultra-sounds which, besides the increased ovarian volume, have permitted to discover an increased ovarian stromal vascularity. Two essential datas derive from the whole works: the increased frequency of ovarian hyperstimulation syndrome and the great number of metabolic complications which requires an endocrinological supervision. But the most recent works focus on the extension to all ages of this form of pathology: from the intra-uterine life to the post menopause; and on the hereditary character of this disease. The mystery remains concerning the mechanism of the favourable effect in clomifene resistant PCOS, of surgical and laparoscopic methods of ovulation induction to which it may be useful to resort after mature consideration. More recently the benefit at the administration of metformine has been confirmed by several works.
Assuntos
Resistência à Insulina , Doenças Ovarianas , Adolescente , Androgênios/metabolismo , Feminino , Humanos , Infertilidade/etiologia , Infertilidade/terapia , Doenças Ovarianas/diagnóstico por imagem , Doenças Ovarianas/etiologia , Doenças Ovarianas/fisiopatologia , Ovário/metabolismo , Síndrome do Ovário Policístico/diagnóstico por imagem , Síndrome do Ovário Policístico/etiologia , Síndrome do Ovário Policístico/fisiopatologia , Síndrome do Ovário Policístico/terapia , UltrassonografiaRESUMO
The author reports a case of abdominal pregnancy in a woman with a malformed uterus after 30 weeks of amenorrhoes. The several different clinical abnormal features are detailed: threatened early labour, death in utero, inability to induce labour by several different methods, sub-acute obstruction and "rupture" of the membranes. Diagnosis was made only on laparotomy. Rupture of the uterine cornu had occurred in a bicornuate uterus with single cervix with secondary implantation of the oocyte in the abdominal cavity. The ruptured cornu was removed.
Assuntos
Gravidez Abdominal/diagnóstico , Útero/anormalidades , Adulto , Feminino , Morte Fetal/etiologia , Humanos , Trabalho de Parto Induzido , Gravidez , Gravidez Abdominal/etiologia , Gravidez Abdominal/fisiopatologiaRESUMO
Systematic ultrasound examination made it possible to discover a placental angioma measuring 50 mm in diameter and situated in contact with the feral plaque. This angioma had reached 78 mm in size across its largest diameter by the 23rd week and appeared to become stable thereafter, getting in size towards the 35th week. This state of involution was confirmed when the placenta was examined and it was found there was a second angioma present, and that is was functional, and that there were several microangiomata. The pregnancy, clinically and biologically, was normal throughout and ended with the birth of a healthy girl, who in particular had no enlargement of her heart.
Assuntos
Hemangioma/diagnóstico , Doenças Placentárias/patologia , Complicações Neoplásicas na Gravidez/diagnóstico , Ultrassonografia , Adulto , Feminino , Hemangioma/patologia , Humanos , Gravidez , Complicações Neoplásicas na Gravidez/patologia , Segundo Trimestre da GravidezRESUMO
40 tubal sterilisations have been carried out in 5 years. The indications most often are for grand parity. The anatomical criteria for effective sterilisation by the vaginal route should be sought by gynaecological examination under general anaesthetic. The date for the operation, the technique and its difficulties have been described. The operation lasted on an average 30 minutes. The average stay in hospital was 8.2 days. Only one local complication using this techinque was noted. On one occasion the authors had to abandon the vaginal route to reach the tubes. This simple procedure without any aesthetic inconvenience seems to them to be the ideal route for tubal sterilisation.
Assuntos
Esterilização Tubária/métodos , Vagina/cirurgia , Estudos de Avaliação como Assunto , Feminino , Humanos , Tempo de Internação , Complicações Pós-Operatórias , Gravidez , Fatores de TempoRESUMO
The statement of the definitive character of the menopause is not easy, save in the case of surgical castration. In all other cases one has seen the reappearance of the menstrual periods after several months of amenorrhoea. Although, in principle, amenorrhoea of an entire year's duration corresponds to the menopause, there are exceptions. In the case of women who are undergoing contraceptive treatment, the only means of knowing if they are menopausal consists of interruption of the oestro-progestational contraception and of advising the use of a local contraceptive for a period of several months.
Assuntos
Amenorreia/fisiopatologia , Menopausa , Menstruação , Adulto , Fatores Etários , Amenorreia/induzido quimicamente , Amenorreia/diagnóstico , Anticoncepcionais Orais/farmacologia , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
Despite correct management of HMG and hCG, the margin between effective dose and overdose is narrow. Surveillance must be clinical, biochemical and echographic. Biochemistry and echography give information on follicle maturation. Echography is a particularly valuable means of monitoring the effect of administration of hypophyseal hormones on the development of follicles.
Assuntos
Gonadotropina Coriônica/uso terapêutico , Menotropinas/uso terapêutico , Indução da Ovulação/métodos , Estradiol/urina , Feminino , Humanos , Laparoscopia , Folículo Ovariano/anatomia & histologia , Detecção da Ovulação/métodos , UltrassonografiaRESUMO
The authors consider all the mechanisms through which a genital infection is able to affect fertility and fecundity. They conclude that a strict diagnosis and treatment must complement accurate information of the public by physicians.
Assuntos
Infecções Bacterianas/complicações , Doenças das Tubas Uterinas/complicações , Infertilidade Feminina/etiologia , Doenças do Colo do Útero/complicações , Infecções Bacterianas/prevenção & controle , Doenças das Tubas Uterinas/prevenção & controle , Feminino , Humanos , Doenças do Colo do Útero/prevenção & controleRESUMO
PIP: Contraception with the IUD is definitely on the increase in France where, in January 1978, there were about 850,000 users. According to the authors of this article the IUD is an excellent contraceptive method, except in the case of nulliparous women, who seem more susceptible to complications caused by IUDs. A survey of the published literature shows that uterine perforation is easier in nulliparous women, and that expulsion is more frequent, as is removal for reasons of bleeding and pain, and as unwanted pregnancy resulting from IUD failure. More importantly, frequency of infection is higher among nulliparous IUD wearers; it must be remembered that serious infection often leads to sterility. As a result of such findings nulliparity must be regarded as an absolute contraindication to the use of an IUD unless no other contraceptive choice is possible.^ieng
Assuntos
Anticoncepção , Hemorragia , Infertilidade , Dispositivos Intrauterinos , Dor , Paridade , Doença Inflamatória Pélvica , Perfuração Uterina , Coeficiente de Natalidade , Comportamento Contraceptivo , Demografia , Países Desenvolvidos , Doença , Europa (Continente) , Serviços de Planejamento Familiar , Fertilidade , França , Infecções , População , Dinâmica Populacional , Reprodução , Sinais e SintomasRESUMO
A procedure of total vaginal hysterectomy without vaginectomy with a vaginal vault suspension to the anterior abdominal wall-- without laparotomy--is presented. The patient for whom this operation is indicated is the old sexually active women.
Assuntos
Histerectomia Vaginal/métodos , Histerectomia/métodos , Prolapso Uterino/cirurgia , Idoso , Feminino , Humanos , Sexo , Vagina/anatomia & histologiaRESUMO
PIP: Endometrial biopsies were performed on 21 female volunteers aged 18-40 years to evaluate the inhibitory effects of a new contraceptive formulation and the influence of the steroid on 1 of the major target organs. The formulation contained 30 mcg of ethinyl estradiol and 150 mcg of the new progestin desogestrel. The 21 women had taken the OC for at least 3 months. The aspiration biopsies were performed during 3 different cycle phases in 3 different centers in Nice, Bordeaux, and Paris. 5 biopsies done during days 1-9, 5 during days 10-17, and 7 during days 18-23 were retained. Results from the 17 biopsies were remarkably homogeneous for all cycle dates. The endometrium was constantly hypotrophic, the glandular tubes were of small size, and signs of glandular secretion were present in 16 of 17 cases with intracellular vacuoles and a visible secretion. Mitosis was observed in the glandular cellule in only 1 case. The stroma were edematous in 9 of 17 cases. The results demonstrated a low estrogenic stimulation and a dominant progestagenic action due to the strong antigonadotrophic and progestagenic properties of desogestrel. The advantages of the new generation of progestins such as desogestrel are obvious from the study. The study also demonstrates the need for endometrial biopsies to characterize the overall effects and climate of combined OCs, since some of the most common markers can provide misleading results.^ieng