Nutrients and infertility: an alternative perspective.

BACKGROUND: Different gonadotrophin preparations or different protocols of ovulation induction are powerless to determine a significantly increase in oocyte quality in the majority of aged patients or in patients with repeated failed in vitro fertilization-embryo transfer (IVF-ET) cycles. INFORMATION SOURCES: Papers published on journal focused on nutraceutical and human reproduction. EVIDENCES: It is questionable if various molecules that are positively associated with higher oocyte competence, higher fertilization rate and embryo development could be supplemented to infertile patients with the aim to partly reduce the frequency of unsuccessful IVF. PERSPECTIVES: Aim of this short review is mainly to focus the attention on potentially positive effects in female fertility of few, well established substances, that could be suggested as a dietary supplement.

Risk factors for placenta praevia.

Risk factors for placenta praevia have been analysed in a case control study conducted in Milan, Italy. A total of 140 cases of placenta praevia and the two women who delivered healthy babies consecutively after each index case (280 controls) were identified reviewing clinical records of 49,765 registered deliveries at the Clinica Mangiagalli in Milan from 1979 to 1991. An increased relative risk (RR) of per cent confidence interval, CI, 2.3-6.7) and among those with previous abortions (RR = 1.8, 95 per cent CI, 1.2-2.8) or with more than one previous pregnancy (RR = 1.9, 95 per cent CI, 1.1-3.3). A non-significant trend in risk was observed with parity (RR = 1.2 for one and 1.5 for two previous deliveries versus nulliparas) and for caesarean section (RR = 1.2 for one and 2.1 for two previous caesarean deliveries versus no previous caesarean section). No relation emerged with sex of the newborn and multiple pregnancy and risk of placenta praevia. Our study shows that older age and previous abortions are associated with an increased frequency of placenta praevia.

[Clinical effectiveness and safety of Seaprose S in the treatment of complications of puerperal surgical wounds]. / Efficacia clinica e tollerabilità del Seaprose S nel trattamento delle complicanze delle ferite chirurgiche in puerperio.

The aim of the study was the assessment of the efficacy and safety of Seaprose S in women out patients from the maternity ward with infiltrated surgical wounds subsequent to vaginal birth or caesarean section. The semialkaline proteolithic enzyme Seaprose S, available in 30 mg tablets was administered at a dosage of 3 tablets a day for a period of 8 days. Thirty-two puerpera with a mean age of 31 years +/- 0.9 SE were admitted to the study with an episiotomic wound in 13 cases and a laparotomic wound consequent on caesarean section in the remaining 19 cases. The clinical situation deriving from the surgical wound resolved on average on the 4th day, in particular the swelling and the congestion of the wound had already diminished in the first days of treatment (p less than 0.01). Safety of Seaprose S was good considering that in no cases were side effects attributable to the treatment observed. In conclusion, from the data obtained in this study one may confirm the validity of Seaprose S in the treatment of laparotomic and episiotomic wounds.

[Ablative cesarean section and post-partum hysterectomy: review of 11 years of obstetric practice]. / Taglio cesareo demolitore ed isterectomia post-partum: rassegna di 11 anni di attività ostetrica.

Obstetric hysterectomy is often performed as an emergency life-saving procedure. This retrospective report reviews the 11 years experience (1-1 1980 through 31-12-1990) at Mangiagalli Hospital, Milan. During this time 50 obstetric hysterectomies (incidence rate = 0.12%) were performed; cesarean hysterectomies were 30 (60%), hysterectomies after cesarean section 14 (28%) and after vaginal delivery 6 (12%). Its rate during or after cesarean section was 0.44% and after vaginal delivery was 0.02%. Thirty-six per cent of patients were nulliparous. Main indications were placental disorders, uterine atony with uncontrollable bleeding, disseminated intravascular coagulation (DIC). In 7 cases was performed an elective operation, in 4 cases for neoplasia and in 3 cases for myomata uteri. Maternal mortality rate was 2.04%, five patients (10%) developed hematomas and required further interventions.