Evaluation of the feasibility of a new method for performing chorion villus sampling.

OBJECTIVE: This study aimed to evaluate the usefulness and safety of a new method for taking a placental biopsy. METHODS: The procedures were performed using the traditional single needle technique (group 1) or the new method (group 2). In group 2, the piston was fixed in a simple metallic clip and the negative pressure was maintained in a continuous manner which was controlled with a three-way stopcock. RESULTS: Multiple uterine insertion was necessary in 14 cases (32.6%) in group 1 and five (11.9%) in group 2 (p < 0.05). The amount of chorionic tissue obtained was significantly higher in group 2 (19.1 +/- 15.0 mg vs. 33.9 +/- 17.4 mg p < 0.05). The abortion rates did not differ in either group. CONCLUSION: While using this technique, the operator is capable of performing the procedure without any assistance and of applying constant negative pressure only in the placenta. The advantageous outcomes are probably related to the size as well as the incessant fashion of the vacuum force.

The effect of amniocentesis on preterm delivery rate in women with uterine myoma.

OBJECTIVES: To evaluate the effect of genetic amniocentesis on the preterm delivery rate in women with uterine myoma. METHODS: The volume of each fibroid and the relation to the placenta, myometrium and uterine corpus were recorded. Amniocentesis was performed by an experienced operator, if indicated. RESULTS: During the study 14,579 pregnant women were examined and 234 had complications of uterine myomas (1.61%). Forty-three women delivered prematurely (19.46%). The results revealed that multifocal fibroids in relation to the myometrium, uterine myoma subjacent to the placenta, total myoma volume greater than 150 cm3 are statistically significant independent risk factors for preterm delivery, while amniocentesis was not found to be an independent risk factor for preterm delivery. CONCLUSIONS: Although having uterine myoma is a fairly known cause of preterm delivery, second trimester genetic amniocentesis does not seem to have any additional adverse effect on the preterm delivery rate in women with uterine myomas.

Laparoscopic microsurgical tubal reanastomosis: a preliminary study.

OBJECTIVE: To determine the effect of laparoscopic reversal of tubal sterilization on pregnancy rate. METHODS: Eight patients who underwent laparoscopic tubal reversal between March 1999 and 31 December 2001 were evaluated. RESULTS: Four of eight patients who had had laparoscopic tubal reversal became pregnant. Three have delivered; pregnancy in the fourth woman is ongoing. To date, the other four patients are still not pregnant. Two ofthese four cases have tubal patency but have not achieved pregnancy; in the other two cases, the operation was unsuccessful and tubal patency did not occur. CONCLUSION: In our preliminary study, the pregnancy rate was 50%.

Removal of intra-abdominal intrauterine device by laparoscopy.

OBJECTIVE: In this study, we aimed to evaluate the cases in which intra-abdominal intrauterine devices (IUDs) were removed by laparoscopy. METHODS: A retrospective study, from 1994 to 2000 was carried out with eight patients who underwent laparoscopy for the removal of an IUD. The patients admitted to our clinic with 'lost IUD' were examined by pelvic ultrasonography, X-ray and hysteroscopy. IUDs were found to be extrauterine but within the abdominal cavity. The IUDs were removed by operative laparoscopy. RESULTS: The mean age of the patients was 31.5 years. The mean duration of usage of IUD was 5.5 years. The IUD was located in the cavity of Douglas in four cases, in the posterior wall of the uterus (perimetrium) in one case and in the conglomerated mass bordered by the intestines in three cases. The types of the IUDs were Cu-T 380A (n = 5), Multiload (n = 1) and Lippes-Loop (n = 2). The mean laparoscopic operation time was 25 min. No major complications (intestinal or vessel injuries) or minor problems occurred. Laparotomy was not necessary in any of the eight cases. All cases were treated as out-patients and discharged on the same day. After counselling, three women requested sterilization, which was performed at the same laparoscopy session by the administration of bilateral Yoon rings, and other family planning methods were chosen by five women. There were no problems when cases were followed at the 10th and 30th postoperative days. DISCUSSION: Our results support the idea that, in cases of extrauterine but intra-abdominal IUD, laparoscopic removal of the IUD must be the first choice of therapy.

Results of cytogenetic investigation in adolescent patients with primary or secondary amenorrhea.

A cytogenetic study of 77 adolescent girls with primary or secondary amenorrhea was performed. A pathologic or male karyotype was found in 18 (26.4%) of 68 patients with primary amenorrhea. In 1 (11.1%) of 9 patients with secondary amenorrhea, 46,XX/47,XXX mosaicism was recovered. The importance of the cytogenetic investigations in patients with primary or secondary amenorrhea was discussed.

Labial fusion in a pubertal girl: a case report.

An 18-year-old virgin, pubertal girl was treated for abnormal menses and dysmenorrhea. She had no history of trauma, sexual infection, or abuse. Occlusion of the introitus of the vagina had been first diagnosed 10 years earlier. The patient presented with fusion of the labia minora in the midline, posteriorly. Her physical examination, ultrasonographic laboratory examination, and intravenous pyelogram were all normal. Following surgical treatment, she had no problems at the time of postoperative follow-up.

Fraser syndrome.

In a consanguineous marriage, a woman at 32 weeks' pregnancy presented with intrauterine growth retardation and bilateral renal agenesis. Fraser syndrome (cryptophthalmus syndactyly syndrome) was diagnosed based on cryptophthalmos, atresia of meatus acusticus externus in auricula, syndactyly, hypoplastic larynx, hypoplastic left lung, agenesis of urinary system and aberrant pancreas in duodenum. The syndrome is inherited as a recessive trait and the risk of recurrence is 25%.

Endogenous digoxin-immunoreactive substance in normal and preeclamptic pregnancies.

AIMS: To determine the potential use of a digoxin-immunoreactive substance in the prediction of preeclampsia, to study the relationship between serum levels of this substance and gestational age, and to evaluate the correlation between this substance and blood pressure findings in preeclamptic pregnancies. METHODS: Serum digoxin-immunoreactive substance concentrations were measured by RIA (double antibody radioimmunoassay) in normotensive (n = 14) and preeclamptic (n = 17) pregnant women in their third trimesters. Statistical evaluation was performed with the Mann-Whitney U-test and correlation-regression analysis. RESULTS: The mean (+/- S.E.) digoxin-immunoreactive substance levels in the normal and preeclamptic patients were 0.29 +/- 0.06 and 0.31 +/- 0.05 ng/ml, respectively, the slightly higher level in the hypertensive group being statistically non-significant. Serum digoxin-immunoreactive substance levels did not demonstrate good correlation with gestational age and systolic blood pressure in preeclamptic pregnancies. CONCLUSIONS: An endogenous digoxin-immunoreactive substance is present in the sera of third trimester pregnant women, but it does not contribute to the pathogenesis or prediction of preeclampsia.

An unusual cervical adenosis.

A 57-year-old woman with a mass on the uterine cervix was presented. Her complaint was persistent leukorrhea and treated by hysterectomy because of cervical mass. The histologic diagnosis was adenosis of the cervix. It is believed that this is the first report of benign adenosis of cervix in this size in woman who was not exposed to Diethylstilbestrol in utero.

Giant cervical polyp due to a foreign body in a 'virgin'.

A 17-year-old virgin who had a giant cervical polyp which had developed through a foreign body and protruded out of the hymen was evaluated; the aetiological significance of the foreign body in the formation of the cervical polyp is discussed.