Neonatal outcome of fetuses receiving intrauterine transfusion for severe hydrops complicated by Rhesus hemolytic disease.

OBJECTIVE: To evaluate neonatal outcomes among a homogeneous group of fetuses with severe hydrops treated with intrauterine transfusion (IUT). METHODS: In a prospective study at Dokuz Eylul University School of Medicine, Izmir, Turkey, outcomes were compared for 35 IUTs carried out between 2005 and 2010 in 19 pregnancies that were complicated by Rhesus D hemolytic disease with severely hydropic fetuses. RESULTS: There was no correlation between the number of IUTs and the duration of phototherapy or number of exchange transfusions. After delivery, 36% (7/19) of neonates tested positive in a direct Coombs test and their requirement for exchange transfusion was higher than that of neonates who tested negative. The neonatal survival rate was 73.7%. Admission to the neonatal intensive care unit was 78%, and the median duration of neonatal unit stay was 4 days (range, 1-77 days). Only 1 newborn had hearing impairment. CONCLUSION: IUT is a unique, gold standard treatment for severely hydropic fetuses. When treated optimally with IUT, fetuses with severe hydrops showed no increased risk of neurodevelopmental abnormalities. Factors affecting the survival of hydropic fetuses after IUT, and whether the number of IUTs performed affects the number of exchange transfusions required remain unclear.

A randomized controlled trial of coil removal prior to treatment of pelvic inflammatory disease.

OBJECTIVE: To evaluate the effects of removing coils on the treatment of mild and moderate pelvic inflammatory disease (PID). METHODS: Of 126 women who had mild to moderate PID during coil usage, 60 were treated following coil removal and 66 without. Clinical symptoms, findings of gynecologic examination, erythrocyte sedimentation rates (mm/h), leukocyte counts (mm(-3)) were recorded before and after treatment and recovery rates of symptoms and findings were compared with Chi-square and Fisher's absolute Chi-square tests. Student's t-test was used for the comparison of mean sedimentation rates and leukocyte counts. RESULTS: Recovery rates of pelvic pain, purulent vaginal discharge, dysuria/frequency and dyspareunia and clinical improvements in abdominal and cervical tenderness were significantly higher (P<0.05) in the coil removed group. CONCLUSIONS: Removing the coil before medical therapy, increases the rates of clinical improvement in mild to moderate PID.