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1.
J Assist Reprod Genet ; 40(8): 1897-1903, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-37351803

RESUMEN

PURPOSE: To predict ovulation in subfertile women using serial follicular growth (FG) and serum hormone measures (estradiol (E2), luteinizing hormone (LH), and progesterone (P) levels) in mathematical models. METHODS: This was a prospective observational study of 116 subfertile women aged between 18 and 40 years. FG was assessed by serial transvaginal ultrasonography starting from cycle days 8-12, depending on cycle length. Once the dominant follicle reached 15-16 mm, hormone levels were assessed daily. The primary outcome measure was ovulation (Ov), with a serum LH level ≥15 IU/l defining the start of the LH surge (the day prior to ovulation) and a serum P level >1 µg/ml concurrent with a drop in serum E2 levels indicating Ov. To determine Ov, mathematical models were generated using FG, LH, E2, and P measurements. RESULTS: A mathematical model was constructed using exponential regression to relate days until and after ovulation with P levels. The Ov(P) model was found to be superior to the Ov(LH) model in the prediction of Ov, with high R2 and low RMSE values of 0.9983 and 0.2454, respectively. In the range of [-2, 2] days, the net accuracy of the Ov(P) model was 63.0%, while with an allowed one-day error, the accuracy was 99.6%. CONCLUSION: Serum P levels display a highly predictable linear curve in natural cycles, which enables the prediction of ovulation. The Ov(P) model can be independently used to schedule embryo transfer in natural frozen-thaw cycles and could therefore replace the Ov(LH) model in clinical practice.


Asunto(s)
Hormona Folículo Estimulante , Progesterona , Femenino , Humanos , Adolescente , Adulto Joven , Adulto , Estudios Prospectivos , Hormona Luteinizante , Ovulación , Estradiol
2.
Gynecol Endocrinol ; 38(12): 1073-1078, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36220075

RESUMEN

Objective: The aim of the present study is to compare the effects of Natural Cycle and modified Natural Cycle protocols for frozen-thawed embryo transfer on clinical pregnancy rate and live birth rate. Methods: This prospective randomized controlled trial comprised 145 patients scheduled for frozen-thawed embryo transfer and was conducted at a university hospital between 2019 and 2021. The Natural Cycle protocol was administered to 73 patients and the modified Natural Cycle protocol to 72 patients and the clinical outcome was compared between the groups. The main outcome measure was live birth rate. Results: Baseline characteristics and cycle parameters were similar in both groups. There was no difference in clinical pregnancy rate (58.9% and 54.2%, respectively; p = .565) and live birth rate between the Natural Cycle and modified Natural Cycle groups (49.3% and 48.6% respectively; p = .932). Conclusion: This study established that clinical pregnancy and live birth rates were not affected by natural cycle ovulation being spontaneous or hCG-triggered among patients undergoing frozen-thawed embryo transfer. Thus, the protocol for natural cycle frozen-thawed embryo transfers should be chosen according to the priorities of the patient and the physician.


Asunto(s)
Criopreservación , Transferencia de Embrión , Embarazo , Femenino , Humanos , Estudios Prospectivos , Criopreservación/métodos , Transferencia de Embrión/métodos , Índice de Embarazo , Tasa de Natalidad , Nacimiento Vivo , Estudios Retrospectivos , Ensayos Clínicos Controlados Aleatorios como Asunto
3.
Br J Neurosurg ; 32(5): 577-578, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-28637111

RESUMEN

Pure epidural cavernous hemangiomas are quite rare. In this paper, a case of lumbar epidural cavernous hemangioma presenting as a lumbar radiculopathy is presented. The magnetic resonance imaging findings, differential diagnosis and therapy options of this rare case are discussed.


Asunto(s)
Hemangioma Cavernoso del Sistema Nervioso Central/cirugía , Enfermedades de la Columna Vertebral/cirugía , Espacio Epidural , Femenino , Hemangioma Cavernoso del Sistema Nervioso Central/diagnóstico por imagen , Hematoma Espinal Epidural/diagnóstico por imagen , Hematoma Espinal Epidural/cirugía , Humanos , Vértebras Lumbares/diagnóstico por imagen , Vértebras Lumbares/cirugía , Imagen por Resonancia Magnética , Persona de Mediana Edad , Enfermedades de la Columna Vertebral/diagnóstico por imagen , Resultado del Tratamiento
4.
Cutan Ocul Toxicol ; 36(2): 132-134, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-27292185

RESUMEN

BACKGROUND/OBJECTIVE: Acne vulgaris is one of the most common diseases of the youth. Systemic isotretinoin is the only drug which acts on all of the etiopathogenic mechanisms of acne. Isotretinoin has some well-known side effects. Besides these, there is a suspicion whether it affects fertility or not. Previously, we conducted a study about isotretinoin's effect on ovarian reserve which showed deteriorative reserve. In this study, we aimed to evaluate the long-term effects of systemic isotretinoin on female fertility. MATERIALS AND METHODS: Of the 82 female patients who were enrolled in the first study, 79 patients were included in this study. Twelve months after the end of systemic isotretinoin treatment, patients were reevaluated by using the same parameters which include anti-Mullerian hormone (AMH), ovarian volume (OV), antral follicle count (AFC), follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, free testosterone and total testosterone. RESULTS: The changes in the mean AMH, OV and AFC were statistically significant between the sixth and eighteenth months (the end of systemic isotretinoin treatment and 12 months treatment free). The mean AMH, OV and AFC values at the beginning and at the 18th month were statistically similar. CONCLUSION: The deteriorative effects of systemic isotretinoin treatment on ovarian reserve, which can be accepted as an indicator of female fertility, diminish in time.


Asunto(s)
Acné Vulgar/tratamiento farmacológico , Fármacos Dermatológicos/efectos adversos , Isotretinoína/efectos adversos , Reserva Ovárica/efectos de los fármacos , Ovario/efectos de los fármacos , Administración Oral , Adolescente , Adulto , Hormona Antimülleriana/sangre , Fármacos Dermatológicos/administración & dosificación , Fármacos Dermatológicos/uso terapéutico , Estradiol/sangre , Femenino , Hormona Folículo Estimulante/sangre , Humanos , Isotretinoína/administración & dosificación , Isotretinoína/uso terapéutico , Hormona Luteinizante/sangre , Estudios Prospectivos , Testosterona/sangre , Factores de Tiempo , Adulto Joven
5.
J Reprod Med ; 61(11-12): 581-4, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-30226717

RESUMEN

Objective: To investigate the effect of azoospermia type on fertilization and clinical pregnancy rates when microdissection testicular sperm extraction (TESE) is performed for sperm retrieval in nonobstructive azoospermia (NOA). Study Design: STUDY DESIGN: Patients who underwent microdissection TESE for NOA and conventional TESE for obstructive azoospermia (OA) were included in the study. Intracytoplasmic sperm injection (ICSI) results were compared between groups. Results: The mean ages in the 2 groups were similar. FSH and LH levels in the NOA group were significantly higher than those of the OA group. Between groups there was no statistically significant difference in testosterone levels. The sperm retrieval rate was 58.56% in NOA. Fertilization and clinical pregnancy rates were similar for patients with NOA and OA. Conclusion: In patients with NOA, microdissection TESE accurately determines active spermatogenesis areas via the high identification power of the operative microscope. From these areas surgeons can collect healthier spermatozoa, which can result in better ICSI outcomes, the results of which are similar to those with OA.


Asunto(s)
Azoospermia/patología , Microdisección/métodos , Recuperación de la Esperma , Adulto , Femenino , Humanos , Masculino , Embarazo , Índice de Embarazo , Estudios Retrospectivos , Inyecciones de Esperma Intracitoplasmáticas/métodos , Motilidad Espermática
6.
Cutan Ocul Toxicol ; 35(4): 296-9, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-26653640

RESUMEN

BACKGROUND/OBJECTIVE: Acne vulgaris is one of the most common diseases of the youth. Systemic isotretinoin is the only drug which acts on all of the etiopathogenic mechanisms of acne. Isotretinoin has some well-known side effects. Besides these, there is a suspicion whether it causes infertility or not. In this study, we aimed to evaluate the effects of systemic isotretinoin on male fertility. METHODS: Eighty one male patients, who were older than 18 years of age, and had severe or refractory acne vulgaris were included in the study. They were given a total dose of 120 mg/kg of systemic isotretinoin over a period of six months. Before and after the study, the spermiogram parameters of the patients were evaluated to show any possible effect on male fertility. The patients' total testosterone, follicle stimulating hormone and luteinizing hormone levels were also evaluated. RESULTS: All of the spermiogram parameters changed positively (p < 0.05). There was no significant change in the hormone levels. CONCLUSION: Systemic isotretinoin has a positive effect on male fertility. Since the hormone levels did not change significantly, this positive effect of isotretinoin is not via the hypothalamic-pituitary-gonadal axis but can be due to its regenerative and proliferative effects on the testes.


Asunto(s)
Acné Vulgar/tratamiento farmacológico , Fármacos Dermatológicos/uso terapéutico , Fertilidad/efectos de los fármacos , Isotretinoína/uso terapéutico , Adolescente , Adulto , Hormona Folículo Estimulante/sangre , Humanos , Hormona Luteinizante/sangre , Masculino , Recuento de Espermatozoides , Motilidad Espermática/efectos de los fármacos , Espermatozoides/efectos de los fármacos , Espermatozoides/fisiología , Testosterona/sangre , Adulto Joven
7.
J Obstet Gynaecol ; 36(5): 649-53, 2016 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-26926158

RESUMEN

Surgical abortion is one of the most frequently performed gynaecological procedures and its associated pain has always been a problem in gynaecology. Here we studied the analgesic efficacy of lidocaine spray and paracervical block (PCB) in patients undergoing first-trimester surgical abortion. A randomised double-blind placebo-controlled study was conducted on 108 women requesting pregnancy termination. The subjects were randomly assigned into four groups: Group 1 (PCB plus lidocaine spray) (n=27), Group 2 (PCB) (n=27), Group 3 (lidocaine spray) (n=27) and Group 4 (placebo) (n=27). Intra-procedural and post-procedural pain scores were measured with a standard visual analogue scale (VAS). The median VAS scores during procedure in placebo, lidocaine spray, PCB plus lidocaine spray and PCB groups were 8 (7-9), 5 (4-8), 4 (3-4) and 5 (3-5), respectively. The most effective method of pain relief during first-trimester abortion can be achieved through a combined use of PCB plus lidocaine spray. Therefore, lidocaine spray is a non-invasive complementary anaesthetic method versus traditional PCB for first-trimester surgical abortion.


Asunto(s)
Aborto Inducido/efectos adversos , Anestesia Obstétrica/métodos , Anestésicos Locales/administración & dosificación , Complicaciones Intraoperatorias/tratamiento farmacológico , Lidocaína/administración & dosificación , Dolor/tratamiento farmacológico , Aborto Inducido/métodos , Adulto , Terapia Combinada , Método Doble Ciego , Femenino , Humanos , Dolor/etiología , Dimensión del Dolor , Embarazo , Primer Trimestre del Embarazo , Resultado del Tratamiento
8.
Gynecol Obstet Invest ; 79(2): 78-82, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25660129

RESUMEN

UNLABELLED: BACKGROUD/AIMS: Widely prescribed in routine practice, isotretinoin has an unknown impact on ovarian reserve. With a long history in acne treatment and numerous potential side effects, it is surprising that very few prospective studies have investigated its effect on ovarian reserve. Therefore, we aimed to evaluate the impact of oral isotretinoin on ovarian reserve based on hormonal parameters, anti-Müllerian hormone (AMH), ovarian volume (OV), and antral follicle count (AFC) in women of reproductive age with acne. METHODS: Our study group consisted of 82 women of reproductive age with acne who were treated with oral isotretinoin. The patients were evaluated for ovarian reserve prior to therapy and reevaluated 6 months after isotretinoin treatment with regard to hormonal parameters, AMH, OV, and AFC. RESULTS: Significant differences were found between the pre- and posttreatment period for AMH [2.20 ng/ml (25th-75th percentile 1.14-4.07) vs. 1.31 ng/ml (0.32-2.28)], total AFC [16 (14-18.25) vs. 12.5 (10-15)], and total OV [23 ml (18-29) vs. 15 ml (13-18); p < 0.001]. CONCLUSION: Our study is the first to analyze the levels of serum AMH, AFC, and OV together in patients treated with oral isotretinoin for acne. The results of our study demonstrated that oral isotretinoin had a significant negative effect on ovarian reserve.


Asunto(s)
Acné Vulgar/tratamiento farmacológico , Hormona Antimülleriana/sangre , Fármacos Dermatológicos/efectos adversos , Isotretinoína/efectos adversos , Reserva Ovárica/efectos de los fármacos , Ovario/efectos de los fármacos , Adolescente , Adulto , Femenino , Estudios de Seguimiento , Humanos , Folículo Ovárico/efectos de los fármacos , Adulto Joven
9.
J Obstet Gynaecol Res ; 41(10): 1556-61, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-26171763

RESUMEN

AIM: To investigate the possible effect of maternal obesity on the accuracy of sonographically estimated fetal weight in the third-trimester shortly before induction of labor and to compare the accuracy of the estimation between normal weight, overweight, and class I, class II and class III obese groups. METHODS: This was a prospective study of singleton pregnancies with sonographic fetal weight estimation prior to scheduled delivery. Women were classified according to current body mass index (BMI) into five categories: normal (BMI 18.5-24.9 kg/m(2), n = 41), overweight (BMI 25.0-29.9 kg/m(2), n = 44), obese class I (BMI 30.0-34.9 kg/m(2), n = 40), obese class II (BMI, 35.0-39.9 kg/m(2), n = 38) and obese class III (BMI ≥ 40.0 kg/m(2), n = 35). The estimated fetal weight was compared with the actual birthweight, and the difference between them was recorded as the error. RESULTS: Mean absolute error of sonographic fetal weight estimation was 106.97 ± 80.83 g, 198.88 ± 124.32 g, 248.82 ± 122.75 g, 308.31 ± 138.97 g and 446.00 ± 151.46 g in the normal, overweight, obese class I, obese class II, and obese class III groups, respectively (P < 0.001). The corresponding mean absolute percentage errors were 3.51 ± 2.76, 6.37 ± 3.91, 7.93 ± 4.81, 9.87 ± 4.32 and 14.06 ± 5.83 (P < 0.001). CONCLUSIONS: Maternal obesity decreases the accuracy of sonographic fetal weight estimation. Clinicians should be aware of the limitations of sonographic fetal weight estimation, especially in obese patients.


Asunto(s)
Peso al Nacer , Obesidad , Ultrasonografía Prenatal , Adulto , Femenino , Humanos , Embarazo , Tercer Trimestre del Embarazo , Estudios Prospectivos , Adulto Joven
10.
Asian J Androl ; 2024 Jun 11.
Artículo en Inglés | MEDLINE | ID: mdl-38856308

RESUMEN

ABSTRACT: This observational cohort study investigated the potential of a novel sperm-washing medium (SWM) enriched with serotonin (5-HT), L-carnitine (L-C), and coenzyme Q10 (CoQ10) to enhance sperm motility and reduce DNA damage. It compared this innovative medium (5-HT/L-C/CoQ10 SWM) with two widely used commercial media (SWM 1 and SWM 2). Ninety-eight volunteers from an infertility clinic provided semen samples, which were divided into three aliquots for analysis in different SWMs: group 1, SWM was composed of hydroxyethyl piperazineethanesulfonic acid (HEPES), sodium bicarbonate, human serum albumin (HSA), taurine, and gentamicin sulfate (SWM 1); group 2, SWM was composed of HEPES, sodium bicarbonate, and HSA (SWM 2); and group 3, SWM was composed of HEPES-buffered human tubal fluid supplemented with 5-HT, L-C, and CoQ10 (5-HT/L-C/CoQ10 SWM). Sperm motility was categorized as progressive, nonprogressive, or immotile. Apoptosis, reactive oxygen species (ROS) production, and DNA fragmentation were also assessed. There were no significant differences in total or progressive sperm motility among the groups. Spermatozoa in group 3 exhibited reduced apoptosis, necrosis, and ROS levels and increased viability. No significant differences were observed in the DNA fragmentation index among groups. The 5-HT/L-C/CoQ10 SWM reduced sperm oxidative stress and apoptosis compared with those of the two commercially available SWMs, suggesting that 5-HT/L-C/CoQ10 SWM could be useful for enhancing in vitro fertilization success rates.

11.
Arch Gynecol Obstet ; 288(6): 1413-6, 2013 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-23708392

RESUMEN

PURPOSE: To measure the estradiol (E2) and progesterone levels on day of human chorionic gonadotropin (hCG) and to assess follicular development, pregnancy rates and IVF-ICSI outcomes comparing gonadotropin releasing hormone (GnRH) agonist and antagonist protocols. METHODS: A total 195 women were included in the study. The patients were treated with agonist or antagonist protocol according to the clinician's and patient's preference. GnRH agonist and antagonists were administered to 77 and 118 patients, respectively. RESULTS: Retrieved oocyte number (RON), metaphase two oocyte number (MON), E2 and progesteron levels on day of hCG, and fertilization rate were significantly higher in agonist group than antagonist group (p < 0.05). Implantation rate (IR), clinical pregnancy rate (CPR), and ongoing pregnancy rate (OPR) were significantly higher in antagonist group than agonist group (p < 0.05). However, there was no significant difference between both groups in relation with total follicle stimulating hormone (FSH). CONCLUSION: GnRH agonist treatment seems to be associated with higher serum E2 and progesterone levels and resulted in lower pregnancy rates than antagonist treatment.


Asunto(s)
Estradiol/sangre , Estrógenos/sangre , Hormona Liberadora de Gonadotropina/agonistas , Hormona Liberadora de Gonadotropina/antagonistas & inhibidores , Infertilidad Femenina/terapia , Inyecciones de Esperma Intracitoplasmáticas , Adulto , Gonadotropina Coriónica , Protocolos Clínicos , Esquema de Medicación , Femenino , Fertilización In Vitro/métodos , Hormona Folículo Estimulante/sangre , Humanos , Infertilidad Femenina/sangre , Oocitos/crecimiento & desarrollo , Embarazo , Índice de Embarazo , Resultado del Tratamiento
12.
Turk J Obstet Gynecol ; 20(1): 59-63, 2023 Mar 10.
Artículo en Inglés | MEDLINE | ID: mdl-36908095

RESUMEN

The aim of this review is to present information related to oocyte cryopreservation, and particularly oocyte vitrification, performed to preserve fertility in oncologic and social indications. The success rates of oocyte cryopreservation have increased with the widespread use of the vitrification technique and are currently similar to those of in vitro fertilization performed with fresh oocytes. Vitrification is the most successful technique for oocyte cryopreservation. The most important factors that influence the success rate are the patient's age at the time of vitrification and the number of mature oocytes frozen. Thus, live birth rates differ for each age depending on the number of oocytes thawed and the freezing method. The American Society of Reproductive Medicine and the American Society of Clinical Oncology recommend presenting the option of oocyte cryopreservation for fertility preservation in cancer patients. Besides cancer patients, use of oocyte vitrification is increasing in women who wish to postpone pregnancy age and to have reproductive freedom with the development of the cryopreservation technique and the achievement of pregnancy rates similar to the use of fresh oocytes. Patients are provided consultancy service in terms of indication, the success rates by age, and the total number of oocytes frozen. It should be emphasized that this procedure is not a type of insurance policy for fertility, especially in elective oocyte cryopreservation.

13.
Eur J Obstet Gynecol Reprod Biol X ; 20: 100264, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38058588

RESUMEN

Objective: To determine pre-delivery fibrinogen levels in predicting adverse maternal or neonatal outcomes in patients with placental abruption. Materials and method: We conducted a retrospective study of all women admitted for placental abruption between January 2012 and May 2018. Postpartum hemorrhage (PPH), disseminated intravascular coagulation (DIC), massive blood transfusion and hospitalization in intensive care unit parameters were evaluated for maternal outcomes. For the neonatal outcomes, the 5th minute APGAR score, umbilical artery pH and stillbirth were evaluated. Results: The mean predelivery fibrinogen levels were 221.3 ± 111.6 mg/dL. In multivariate logistic regression analysis, fibrinogen level was determined as an independent indicator for PPH, red cell concentrate (RCC) and fresh frozen plasma (FFP) transfusion. When fibrinogen levels decreased below 130 mg/dL, the risk of PPH increased and when fibrinogen levels decreased below 100 mg/dL, the risk of overt DIC and also the risk of red cell concentrate and fresh frozen plasma transfusion increased. In terms of the fetal results, there may be adverse neonatal outcomes when fibrinogen levels are below 250 mg/dL. Conclusion: Predelivery fibrinogen levels are good indicators for predicting adverse maternal outcomes in placental abruption cases. In addition, fibrinogen levels might be a guide for management of placental abruption cases.

14.
Arch Gynecol Obstet ; 286(4): 1061-4, 2012 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-22714067

RESUMEN

PURPOSE: Oocyte retrieval under transvaginal ultrasonographic guidance has been used for in vitro fertilization-intracytoplasmic sperm injection. Despite considerable advances in the assisted reproductive techniques, the efficacy of follicular flushing during egg collection remains controversial. The aim of this study was to compare the follicular aspiration only and aspiration + flushing methods in terms of retrieved oocyte number and clinical pregnancy rates. MATERIALS AND METHODS: A total of 200 patients were randomly divided into the intervention and control groups. All the patients underwent long protocol. Oocyte retrieval was performed when the dominant follicle reached 17 mm. Aspiration was performed using a single- or double-lumen catheter. Follicular flushing was performed after follicular aspiration in 100 patients of the intervention group. In the control group, only follicular aspiration was performed. RESULTS: There were no detected differences in the retrieved oocyte number. Although the clinical pregnancy rate in the intervention group was higher than the control group (40 vs. 33 %), the difference was not statistically significant. Cycle cancelation rate was lower in follicular flushing group (8 %) than control group (11 %) but, this difference was not statistically significant. Metaphase I (MI), germinal vesicle numbers were higher in group 1 than in group 2 and the differences were not statistically significant, either. Total operation time was longer in aspiration + flushing group (group 2) than aspiration only group (group 1) and the difference was statistically significant (p = 0.02). CONCLUSION: In conclusion, our results indicate that follicular flushing during oocyte retrieval does not improve the retrieved oocyte number or clinical pregnancy rate but, it significantly increases the duration of procedure.


Asunto(s)
Fertilización In Vitro/estadística & datos numéricos , Recuperación del Oocito/métodos , Índice de Embarazo , Adulto , Femenino , Humanos , Embarazo , Estudios Prospectivos , Adulto Joven
16.
Wideochir Inne Tech Maloinwazyjne ; 10(4): 574-9, 2016 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-26865895

RESUMEN

Ovarian pregnancy (OP) after embryo transfer is very rare. Due to the rarity and the asymptomatic nature, there are still difficulties in diagnosis and treatment. The traditional operative treatment for OP has been oophorectomy. However, the desire to maintain reproductive capability and improvements in laparoscopy have more recently led to conservative laparoscopic techniques. This rare complication could be diagnosed early and managed by a conservative laparoscopic approach. Here we present a survey of the literature and a case of successful laparoscopic management of ovarian pregnancy after intracytoplasmic sperm injection and embryo transfer. The current case is the first case in the literature in which ovarian pregnancy occurred after a single embryo transfer. We also summarize the literature about management of ovarian pregnancy after embryo transfer.

17.
J Matern Fetal Neonatal Med ; 29(12): 2028-32, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-26333303

RESUMEN

OBJECTIVE: The aim of the study was to investigate standard biometric measurements, such as biparietal diameter (BPD), femur length (FL), abdominal circumference (AC), estimated fetal weight (EFW) and anterior abdomen wall thickness (AAWT) in fetuses complicated by gestational diabetes mellitus (GDM) at the time of GDM screening, and to compare the results with healthy pregnant controls. METHODS: A total of 124 pregnant women between 26 and 28 weeks' gestation were included in the study. These patients were divided into two groups based on their 75-g oral glucose tolerance test results. The study group consisted of 55 pregnant women with GDM, and 69 healthy pregnant women constituted our control group. RESULTS: The study groups did not differ with respect to the mean BPD, FL, AC and EFW; however, the mean AAWT was significantly higher in the GDM group, 4.07 ± 0.46 mm versus 3.28 ± 0.37 mm in the control group (p < 0.001). CONCLUSIONS: The only fetal sonographic measurement found to significantly differ between the study groups was the AAWT in 26 weeks at the time of gestational diabetes screening, suggesting that measuring the AAWT may have a role in the evaluation of fetal growth in pregnancies complicated by gestational diabetes.


Asunto(s)
Pared Abdominal/diagnóstico por imagen , Diabetes Gestacional/diagnóstico por imagen , Ultrasonografía Prenatal , Adulto , Estudios de Casos y Controles , Estudios Transversales , Femenino , Humanos , Embarazo , Adulto Joven
18.
Springerplus ; 5(1): 1766, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27795908

RESUMEN

The present study was aimed to assess the relationship between pain expectation before labour, labour pain and pain perception after the labour. Pregnant women were asked to rate their pain level on a standard continuous visual analogue scale at various time points. Pain expectancy (PE), labour pain (LP) and postpartum pain perception (PPP) scores were calculated. The final study group was composed of 230 pregnant women after exclusions. Mean age of pregnant women was 26.2 ± 5.79. The mean PE, LP, and PPP scores were 70.11 ± 18.82, 75.72 ± 19.2 and 65.84 ± 19.56, respectively. The difference among pain scores was statistically significant (p < 0.001). There was a positive correlation between PE and LP or PE and PPP scores (p = 0.27 and p = 0.21). The correlations were statistically significant (p = 0.01 or p = 0.01). In addition, there was a positive correlation between LP and PPP scores (p = 0.87) and the correlation was statistically significant (p = 0.01). This study showed that, if pregnant women had lower expectations of pain before the labour, they indeed experienced lower amount of pain during the labour.

19.
J Med Case Rep ; 9: 286, 2015 Dec 17.
Artículo en Inglés | MEDLINE | ID: mdl-26674527

RESUMEN

INTRODUCTION: Uterine leiomyomas are the most common benign neoplasms of the female reproductive tract. Myomectomy is the preferred surgical treatment in reproductive-aged women who desire to retain their fertility. The use of a laparoscopic approach for large myomas is still controversial, although there are several compelling reasons for its use. The laparoscopic removal of giant uterine myomas is rare, and only a few cases have been published in the literature. CASE PRESENTATION: We report the case of a 33-year-old white woman who was referred to our clinic with progressive abdominal distension. An ultrasonic examination revealed a markedly enlarged uterus containing a 17 cm uterine myoma. Laparoscopic myomectomy was selected as the treatment option. The laparoscopy confirmed the 17 cm fundal intramural myoma. The myoma was totally enucleated and removed without disturbing her endometrial cavity. The myometrial defect was repaired with a continuous suture using the V-loc suture in two layers. The entire myoma was removed using a tissue morcellator. The total weight of the myoma removed was 2005g, and the operation lasted for 140 minutes. Her postoperative course was unremarkable. CONCLUSIONS: Laparoscopic myomectomy offers many advantages compared with abdominal myomectomy. Although the use of a laparoscopic approach to treat very large myomas is controversial and technically demanding, we successfully performed a laparoscopic myomectomy in a patient with a giant myoma. This case confirms the efficiency, reliability, and safety of a minimally invasive surgical approach to treating a giant uterine myoma. Laparoscopic myomectomy can be performed by experienced surgeons regardless of the size of the myoma.


Asunto(s)
Laparoscopía , Leiomioma/cirugía , Miomectomía Uterina , Neoplasias Uterinas/cirugía , Adulto , Femenino , Humanos , Leiomioma/diagnóstico , Tiempo de Internación , Suturas , Resultado del Tratamiento , Miomectomía Uterina/métodos , Neoplasias Uterinas/diagnóstico
20.
J Turk Ger Gynecol Assoc ; 16(3): 158-63, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26401109

RESUMEN

OBJECTIVE: We aimed to compare the effect of general and spinal anesthesia on maternal blood loss in elective cesarean section (CS). MATERIAL AND METHODS: This was a prospective randomized study and included 418 healthy pregnant women with a term uncomplicated singleton pregnancy between 37 and 41 weeks of gestation. The study participants were randomly divided into two groups: the general anesthesia group and spinal anesthesia group. CSs were all performed using the same surgical technique, and within the groups, the same anesthetic procedures were used (either general or spinal). The primary outcome for this study was operative blood loss. Hemoglobin and hematocrit concentrations were compared between the two groups. RESULTS: The preoperative hemoglobin and hematocrit levels were similar in the both groups (p=0.08 and p=0.239, respectively). Significantly lower operative blood loss was achieved using spinal anesthesia versus general anesthesia during elective CS. The differences between preoperative and postoperative blood values for both the study groups were statistically significant (p<0.001). CONCLUSION: This study demonstrates that spinal anesthesia is associated with a lower risk of operative blood loss than general anesthesia in low risk patients undergoing elective CS.

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