The attitudes of fertile and infertile women to Oocyte donation in a Muslim and Secular population.

OBJECTIVE: To determine general attitudes of fertile and infertile women to oocyte donation in a Muslim and secular population. METHODS: The participants consisted of fertile women (n=133) who had at least one healthy living child spontaneously conceived without any fertility treatment and infertile women (n=133) who were diagnosed with primary infertility. Both groups were evaluated with charts comprised of 34 questions addressing demographic characteristics and the social aspects of oocyte and sperm donation. RESULTS: Although the age of fertile women was significantly greater than infertile women, there was no significant difference in terms of duration of marriage, education level, or employment status between the two groups. Most of the women in each group reported that they did not have enough knowledge about oocyte donation to make a decision. Only 12% of fertile women and 18% of infertile women declared that they would have oocytes from another woman if they did not have or could not have a child (p=0.004). Only 9.0% of fertile women and 18.8% of infertile women declared that they would donate oocytes to anyone who is infertile (p=0.021). CONCLUSION: Despite improvement in health care, most fertile and infertile women are still against oocyte donation. This situation may be related to the conservative leanings of Turkish society in recent decades.

Antioxidant and antiapoptotic effects of erdosteine in a rat model of ovarian ischemia-reperfusion injury.

OBJECTIVES: To evaluate the protective effect of erdosteine, an antiapoptotic and antioxidant agent, on torsion-detorsion evoked histopathological changes in experimental ovarian ischemia-reperfusion (IR) injury. MATERIALS AND METHODS: Eighteen female Wistar albino rats were used in control, IR, and IR+Edosteine (IR-E) groups, (n=6 in each). The IR-E group received the erdosteine for seven days before the induction of torsion/retorsion, (10 mg/kg/days). The IR and IR-E groups were exposed to right unilateral adnexal torsion for 3 hr. Three hours later, re-laparotomy was performed, and the right ovaries were surgically excised. Oxidant and antioxidants levels were determined in serum. The ovarian tissue samples were received and fixed with 10% neutral buffered formalin. The sections were stained with H&E, anti-PCNA, and TUNEL. RESULTS: The IR group were showed severe acute inflammation, polynuclear leukocytes and macrophages, stromal oedema and haemorrhage. Treatment with erdosteine in rats significantly retained degenerative changes in the ovary PCNA (+) cell numbers were significantly decreased in the IR and IR-E groups unlike the control group. However, its numbers were significantly increased in the IR-E group unlike the IR group. TUNEL (+) cell numbers were significantly increased in the IR group unlike the control and the IR-E groups. In erdosteine treated group, TUNEL (+) cells were detected significantly less than the IR group (P<0.05). CONCLUSION: In conclusion, erdosteine maybe a protective agent for ovarian damage and decreasing lipid peroxidation products and leukocytes aggregation after adnexal torsion in animals.

A rare case of rectovaginal fistula following consensual vaginal intercourse.

INTRODUCTION: Postcoital nonobstetric vaginal lacerations due to consensual sexual act are generally minute mucosal tears. In some cases, the vaginal mucosa is lacerated deeper and the bleeding may require suturing of opened vessel ends or even transfusion. AIM: The aim of this case report is to present a rare case of acute fistula formation by penile penetration through the full thickness of the rectovaginal wall after consensual vaginal intercourse and to its management in emergency settings. METHODS: We report a rare case of isolated rectovaginal laceration sparing anal sphincters and perineumin a 24-year-old woman following her second consensual vaginal intercourse with her new partner. Speculum examination demonstrated a 4 cm laceration on the left posterior vaginal wall forming a fistula between the rectum and vagina, 2 cm above the hymenal ring and not extending to the posterior fornix or perineum. Three layer suturing of rectal, vaginal mucosa, and rectovaginal septum was enough to treat the acute fistula in this case. RESULTS: After 2 months follow-up, we observed the complete healing of the rectovaginal laceration with no fistula formation and the patient resumed her sexual activity. Long term follow-up of patients is necessary to observe complete healing and to ensure the absence of a chronic fistula formation. CONCLUSION: Simple suturing of rectal and vaginal mucosa, appropriate antiseptic precautions, and antibiotic coverage are enough to treat acutely formed low rectovaginal fistulas resulting from coitus. Decision to form colostomy and diversion of feces in the repair of such injuries should be taken cautiously.

Low levels of protein Z are associated with HELLP syndrome and its severity.

Protein Z (PZ) was found to be associated with pregnancy complications. There are no data implying an association between hemolysis (H), elevated liver enzymes (EL), and low platelet counts (LP) (HELLP) syndrome and changes in plasma levels of PZ. The aim of this study is to investigate whether HELLP syndrome is associated with plasma concentrations of PZ. Protein Z levels in 29 women with HELLP syndrome were compared with 29 healthy, nulliparous and 25 normal pregnant women. The median PZ levels in patients with HELLP syndrome were found to be significantly lower than those of pregnant women. No significant difference was found between HELLP and healthy groups. Protein Z levels correlated with platelet counts, lactate dehydrogenase (LDH), and aspartate aminotransferase (AST) levels in patients with HELLP syndrome. Median PZ level was higher in partial HELLP than in complete HELLP. We calculated 1330 ng/mL as a cutoff value for PZ level to discriminate HELLP syndrome from normal pregnancy. Low PZ levels are associated with the pathobiology of HELLP syndrome.

Comparison of oral nonsteroidal analgesic and intrauterine local anesthetic for pain relief in uterine fractional curettage: a randomized, double-blind, placebo-controlled trial.

OBJECTIVE: We sought to investigate the analgesic efficacy of oral dexketoprofen trometamol and intrauterine lidocaine in patients undergoing fractional curettage. STUDY DESIGN: A randomized, double-blind, placebo-controlled trial was conducted on 111 women. Subjects were randomly assigned into 4 groups to receive either 25 mg of dexketoprofen or similar-appearing placebo tablets and either 5 mL intrauterine 2% lidocaine or saline. The main outcome measure was the intensity of pain measured by a 10-cm visual analog scale. Pain scoring was performed prior to, during, and 30 minutes after the procedure. RESULTS: No statistically significant difference was found among the mean pain scores of women during the procedure in the dexketoprofen and saline, placebo and lidocaine, and dexketoprofen and lidocaine groups. The mean pain scores in all 3 groups revealed significant reduction when compared with placebo and saline combination (P = .001). CONCLUSION: Administration of intrauterine lidocaine or oral dexketoprofen appears to be effective in relieving fractional curettage associated pain. However, a combination of them does not work better in further reduction of pain.

The effect of uterine fundal pressure on the duration of the second stage of labor: a randomized controlled trial.

OBJECTIVE: To determine the effect of uterine fundal pressure on shortening the second stage of labor and on the fetal outcome. DESIGN: Randomized controlled trial. SETTING: Teaching and research hospital. SAMPLE: One hundred ninety-seven women between 37 and 42 gestational weeks with singleton cephalic presentation admitted to the delivery unit. METHODS: Random allocation into groups with or without manual fundal pressure during the second stage of labor. MAIN OUTCOME MEASURES: The primary outcome measure was the duration of the second stage of labor. Secondary outcome measures were umbilical artery pH, HCO3-, base excess, pO2, pCO2 values and the rate of instrumental delivery, severe maternal morbidity/mortality, neonatal trauma, admission to neonatal intensive care unit, and neonatal death. RESULTS: There were no significant differences in the mean duration of the second stage of labor and secondary outcome measures except for mean pO2 which was lower and mean pCO2 which was higher in the fundal pressure group. Nevertheless, the values still remained within normal ranges and there were no neonates with an Apgar score <7 in either of the groups. CONCLUSION: Application of fundal pressure on a delivering woman was ineffective in shortening the second stage of labor.