Aspiration and tetracycline sclerotherapy for management of simple ovarian cysts.

OBJECTIVE: To evaluate the procedure of aspiration and tetracycline sclerotherapy in the management of simple ovarian cysts. METHODS: Twenty-five cases of simple ovarian cysts were subjected to cyst fluid aspiration and 5% tetracycline injection under ultrasound guidance. Cytological examination of the aspirated fluid was carried out in 24 cases and the patients were followed for 6-36 months. RESULTS: Cytology revealed a cellular sediment in 18 cases (simple cysts), follicular cells in four cases (follicular cysts), and blood and hemosiderin-laden macrophages in two cases (endometriosis); subsequent surgery was required in only one case (endometriosis). CONCLUSIONS: The procedure of aspiration and tetracycline sclerotherapy was easy, safe and acceptable, with no recurrences. It appears to be a valid alternative to cyst aspiration in the management of simple ovarian cysts.

Toxoplasmosis as a cause of repeated abortion.

The extent to which toxoplasmosis causes habitual abortion is still controversial. The present study was carried out on 100 cases of repeated abortions, and 40 multiparous pregnant women at 20th week gestation as a control. Tests for the presence of toxoplasma IgG and/or IgM antibodies were done for both groups. It was found that 19% of the selected cases, and 7.5% of the control were seropositive for IgM. The difference was statistically insignificant, therefore acute toxoplasmosis, most probably, is not related to habitual abortions, whereas 37% of the selected cases and only 10% of the control group were seropositive at high dilution for IgG antibody, this statistical significant difference indicates that chronic toxoplasmosis, most probably is a significant cause of repeated abortion. Also it has been found that toxoplasmosis has a significant relation to abortion at first trimester.

Stepwise uterine devascularization: a novel technique for management of uncontrolled postpartum hemorrhage with preservation of the uterus.

OBJECTIVE: The objective of this study was to test the efficacy of a novel stepwise technique of uterine devascularization for management of uncontrollable postpartum hemorrhage. STUDY DESIGN: Stepwise uterine devascularization was performed for 103 patients to control intractable postpartum hemorrhage not responding to classic management. This technique entails five successive steps, so if bleeding is not controlled by one step the next step is taken until bleeding stops. The steps were (1) unilateral uterine vessel ligation, (2) bilateral uterine vessel ligation, (3) low uterine vessel ligation, (4) unilateral ovarian vessel ligation and (5) bilateral ovarian vessel ligation. RESULTS: The procedure was effective in all cases (100%), and hysterectomy was not needed in any case. No complications occurred, and the survival rate was 100%. Among the patients followed up normal menstruation and pregnancy occurred. CONCLUSION: Stepwise uterine devascularization is an effective and safe alternative to hysterectomy for management of uncontrollable postpartum hemorrhage.

Termination of pregnancy with fetal death in the second and third trimesters--the double balloon versus extra-amniotic prostaglandin.

OBJECTIVES: To evaluate the use of a double balloon catheter in the termination of pregnancy with fetal death in the second and third trimesters, in comparison with the administration of extra-amniotic PGF2-alpha. METHODS: Twenty cases with IUFD at > 20 weeks of gestation were divided into two groups. Group I was subjected to the double balloon alone, while in Group II extra-amniotic instillation of PGF2-alpha via a Foley's catheter was used. RESULTS: There were no significant differences between the two groups with regard to induction-expulsion time, induction-delivery time and failure rate. CONCLUSIONS: The double balloon catheter proved to be an effective non-pharmacological method. The technique was simple and well tolerated by the patients. The side-effects of the prostaglandin and the cost of the medication were avoided.